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EL-17-639 Permit No. EL-3-17-63 Miami Shores Village Permit Type:Electrical-Residential 10050 N.E.2nd Avenue NW ' Work Classification:Alteration Miami Shores,FL 33138-0000 Per Permit Status:APPROVED Phone: (305)795-2204 FcoRrvA tssuomate:515/2017 Expiration: 11/01/2017 Project Address Parcel Number Applicant 101 NW 100 Street 1131010220300 NOMADE REALTY LLC Miami Shores, FL 33150- Block: Lot: Owner Information Address Phone Cell NOM DE REALTY LLC 230 NE 107 Street (786)458-7799 (786)251-0138 MIAMI SHORES FL 33161- Contractor(s) Phone Cell Phone Valuation: $ 7,549.95 DONALD MARESE ELECTRIC INC (954)630-6910 (954)630-6910 _..._. .__, .._W_.. .,......_ m...,_.. ..__ Total Sq Feet: 0 Type of Work:FULL SERVICE CHANGE,KITCHEN AND I Available Inspections: Additional Info:FULL SERVICE CHANGE,KITCHEN AND I Inspection Type: Classification: Residential Review Electrical Scanning: 1 Review Electrical r 7 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF. $4.80 Invoice# EL-3-17-63250 DBPR Fee $3.96 DCA Fee $3.96 03/09/2017 Check#:0011 $ 100.00 $ 187.97 Education Surcharge $1.60 05/05/2017 Check#:0014 $ 187.97 $0.00 Permit Fee-Additions/Alterations $264.25 Scanning Fee $3.00 Technology Fee $6.40 Total: $287.97 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. i OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction an7zon, g. Futhermore, I authorize the above-named contractor to do the work stated. May 05, 2017 , orized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy May 05, 2017 1 Miami Shores Village 7BY- Tel: C VED Building Department zo» 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 (305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 26 14 Sf" BUILDING Master Permit No. VC 1-7—G �s PERMIT APPLICATION Sub Permit NO.Z L 1-7 - b3� ❑BUILDING 0 ELECTRIC ❑ ROOFING ❑ REVISION EXTENSION []RENEWAL F-1 PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 101 North West 100 Street City: Miami Shores County: Miami Dade Zip: Folio/Parcel#:1131010220300 Is the Building Historically Designated:Yes NO Occupancy Type: Res Load: Construction Type: EXst Flood Zone: BFE: FFE )OWNER:Name(Fee Simple Titleholder):Nomade Realty LLC Phone#:7862510138 Address:230 North East 107 Street City: Miami State: Florida Zip: 33150 Tenant/Lessee Name: Hassan Benjelloun Phone#:7862510138 ,Email: hassanb@me.com CONTRACTOR:Company Name: Donald Marese Electric Inc Phone#: 9546306910 Address: 2722 Thomas Street City. Hollywood state: Florida Zip: 33020 Qualifier Name: Donald Marese Phone#: 9546306910 State Certification or Registration#: EC 13002571 Certificate of Competency#: DESIGNER:Architect/Engineer: Juan A Rodriguez/JOmolca Phone#: 7864862029 Address:625 SouthWest 82 Avenue City. Miami State: FL Zip: 33144 Value of Work for this Permit:$7549.95 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Al Repair/Replace ❑ Demolition iDescription of Work: Full Service Change, Kitchen and Interior remodel, Smoke/Carbon Detectors, Pipe Instant Hot Water, Lighting, Switch and Plug, Minor Demo. Specify color of color thru tile: Submittal Fee$ Er r Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ 'Structural Reviews$ Bond$ c, TOTAL FEE NOW DUE$ �J •G (Revised02/24/2014) i r• ♦ r Bonding Company's Name(if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES,BOILERS, HEATERS,TANKS,AIR CONDITIONERS,ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. ` � f Signature Signature LLCLP OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this r r�—day of "Ar V 20 l'4 by day of V .20 ? by who' personally known to �t�ise ,who i �rsonaHy kn n to me or who has produced as me or who has produced as identification and who did take an oath. identification and "hqo d', ce an oath. o �;: JANET ROBERTS-KRIEGER NOTARY PUBLIC: NOTARY PUBLIC: .�;� Notary Public-State of Florida =,• 'or My Comm.Expires Mar 20,2010 . oP'� Commissio # FF 104313 Sign: r S Sig ti Print: A Print: Seal: �'P�~v ;- PAT/Z�CfA FEB Seal: MY COMM►SSIO LES EXPIRES July pg ��15Z ************************ *********** *************************************************************** APPROVED BY �7�i 6/ nh /y' Plans Examiner Zoning i Structural Review Clerk (Revised02/24/2014) STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION EC13002571 ISSUED;.. 07/17/2016 7*' CERTIFIED ELECTRICAL CONTRACTOR MARESE,DONALD SR.' .: DONALD MARESE.ELECTRIG'INC Is CERTIFIED under the provisions of Ch.489 FS. Expiration date:AUG 31,2018 L1607170002081 I f } a 1 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers,from boxers to barbeque restaurants,and they keep Florida's economy strong. Every day we work to improve the way we do business in orderirf:1e aael�la��eWrpuol�Cyy to serve you better. For information about our services,please autu�a.�oi alers pus s�opuan uaanuaq suo11aedXW nl rJ log onto www:myfloridalicense.com. There you can find more aWUJ-1dns stool epuo13 3o a1L1s A-4aq Ino u o l gip,o„ information about our divisions and the regulations that impact p '� .I: you, subscribe to department newsletters and learn more about the Department's initiatives. S 160 L8h 058 11ea so psa/r toru/rr.m :12-up Our mission at the Department is:License Efficiently, Regulate assaulsnq pau,,,o-,c1uoulu,pue-uelajan ueEion% - r Fairly.We constantly strive to serve you better so that you can unosal sappaid tils,an�Q,a11ddnS jo aayfp aq, aj.1 serve your customers. Thank you for doing business in Florida, _oilddns jo aoy jo and congratulations on your new license! >ay}p,saat.�raS 1uauta&euel^jo raautuedaQ aq.L �.. ..�.-.----.___._.._..._.._...-..-DETACFi••f ACRE-.-,_ .-,_-. . RICK SCOTT, GOVERNOR KEN LAWSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD I�E�C13002571 The ELECTRICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2018 MARESE, DONALD SIR DONALD MARESE ELECTRIC'INC 2722 THOMAS STREET ""- w" � T_ TM, -�w HOLLYWOOD - FL 33020 L ISSUED: 07/17/2016 DISPLAY AS REQUIRED BY LAW SEQ:� L1607170002081 a { I a BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT, 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895—954-831-4000 VALID OCTOBER 1,2016 THROUGH SEPTEMBER 30,2017 DBA: 1-3035 DONALD MARESE ELECTRIC INC Receipt#:E8 ELECTRICAL/ALARMS/CONTRACTOR Business Name: Business Type: (ELECTRICAL CONTRACTOR) Owner Name:DONALD MARESE Business Opened:o9/01/2ob4 Business Location:2722 THOMAS ST State/County/Cert/Reg•EC 13002571 HOLLYWOOD Exemption Code: Business Phone:954-205-1361 Rooms Seats Employees Machines Professionals 1 For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 3.00 0.00 5.40 0.00 25.00 60.40 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non-regulatory in nature. You must meet all County'and/or Municipality planning WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location.This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. Mailing Address: DONALD MARESE Receipt #05B-16-00000286 2722 THOMAS ST Paid 12/07/2016 60.40 HOLLYWOOD, FL 33020 4 2016 - 2017 - , ----1DONMA-1 OP ID: PR .4CORIX DATE(MWDD/YYYY) ��. CERTIFICATE OF LIABILITY INSURANCE 02/13/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. if SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Stuart Belofsky Gulfstream Insurance Group Inc PHONE 954-561-2220 aC Nu;954-566-0673 P.O.Box 8908 A No Ext Fort Lauderdale,FL 33310-8908 E-MAIL Stuart Belofsky ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Travelers Property Casualty 25674 INSURED Donald Marese Electric Inc INSURERS:RetailFirst Insurance Co 2722 Thomas Street Hollywood,FL 33020-1826 INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE D POLICY EFF POLICY EXP LIMITS LTR IN POLICY NUMBER MM/DD MM/DD A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS-MADE Fx—]OCCUR 6604D532690 16 08/02/2016 08/02/2017 PREMESISES0Ea ENTEET occurrence $ 100,00 MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 X POLICY❑JE Q LOC PRODUCTS-COMP/OP AGG $ 2,000,00 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) ,$ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA UAB OCCUR EACH OCCURRENCE $ _ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATIONX OTH- AND EMPLOYERS'LIABILITY STATUTE ER B ANY PROPRIETOR/PARTNER/EXECUTIVE YINN/A 520-52475 11/24/2016 11/24/2017 E.L.EACH ACCIDENT $ 100,00 D? OFFICER/MEMBER EXCLUDE (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 100,00 It yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 500,00 J DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more apace Is required) Electrical-within buildings k CERTIFICATE HOLDER CANCELLATION VILLMIS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN The Village of Miami Shores ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd Avenue k Miami Shores,FL 33138 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD 0 woo °4 Bio CITY OF HOLLYWOOD a DIAM0, TREASURY SERVICES DIVISION LOMAS LOCAL BUSINESS TAX N yCO�l'ORATE�~� i DONALD MARESE ELECTRIC INC 2722 THOMAS ST HOLLYWOOD,FL 33020 Please contact us with any changes or corrections to your information. CUSTOMER SERVICE: Our hours of operation are 8 AM to 5 PM, Monday through Friday. Should you have any 'questions regarding Local Business Tax or need to update / correct any information related to your Business Tax Account, please contact us by phone at 9S4-921-3225, by email at businesstax@hollywoodfl.org or in person at City Hall, Room 103, 2600 Hollywood Blvd. Please send all written correspondence to: City of Hollywood, Treasury ,Services Division,Attn:Business Tax,Room-103, PO Box 229045,Hollywood,FL 33022-9045. PURSUANT TO STATE LAW, LOCAL BUSINESS TAX IS LEVIED FOR THE PRIVILEGE OF DOING BUSINESS WITHIN A CITY'S LIMITS, AND IS NON-REGULATORY IN, NATURE, ISSUANCE OF A' LOCAL BUSINESS "TAX RECEIPT BY THE CITY OF ` `HOLLYWOOD DOES NOT MEAN THAT THE CITY HAS DETERMINED THAT THE EXISTING OR PROPOSED USE OF A LOCATION IS LAWFUL. ISSUANCE OF A LOCAL BUSINESS TAX RECEIPT DOES NOT LEGALIZE OR CONDONE THE NATURE OF THE BUSINESS BEING CONDUCTED IF CONTRARY TO ANY LOCAL, STATE OR FEDERAL LAW OR REGULATION. THIS IS NOT A BILL.BELOW IS YOUR LOCAL BUSINESS TAX RECEIPT. PLEASE DETACH AND POST THIS ' LOCAL BUSINESS TAX RECEIPT IN A CONSPICUOUS PLACE AT YOUR PLACE OF BUSINESS. �o °usw000�lo C i t y 0 � LL�W�� ar;�ro (/ o o °F r GOLD COAs F L O R I D A 2016/2017 LOCAL BUSINESS TAX RECEIPT Business Name:DONALD MARESE ELECTRIC INC Account Registration#:89057187-2017 DBA: Expiration Date:9/30/2017 Business Location:2722 THOMAS ST Tax Paid:$190.00 Business Category:SERVICE/LICENSED BUSINESS Classification:Contractor/Electrical Tax Basis:1 WORKER(OWNER) i