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EL-17-645 Permit No. EL-3-17-646 Miami Shores Village Permit Type: Electrical-Residential 10050 N.E.2nd Avenue NE "t ' ' Work Classification:Alteration Miami Shores,FL 33138-0000 PerPermit Status:APPROVED'tea` Phone: (305)795-2204 F1 RtOp' Issue Date:3/31/2017 Expiration: 09/27/2017 Project Address Parcel Number Applicant 1255 NE 99 Street 1132050090100 Miami Shores, FL 33138-2642 Block: Lot: JOSH WOLLOWICK Owner Information Address Phone Cell JOSH WOLLOWICK 1255 NE 99 Street (305)531-0970 FL 33142- 1255 NE 99 Street FL 33142- Contractor(s) Phone Cell Phone Valuation: $ 22,000.00 MEP CONTRACTORS (786)930-7700 Total Sq Feet: 0 Type of Work:INSTALL NEW ELECTRICAL AS PER PLAN Available Inspections: Additional Info: Inspection Type: Classification:Residential Review Electrical Scanning: 1 d v Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $13.20 DBPR Fee Invoice# EL-3-17-63257 $11.55 03/31/2017 Credit Card $781.30 $50.00 DCA Fee $11.55 Education Surcharge $4.40 03/09/2017 Credit Card $50.00 $0.00 Permit Fee-Additions/Alterations $770.00 Scanning Fee $3.00 Technology Fee $17.60 Total: $831.30 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. 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 and zoning. Futhermore,I authorize the above-named contractor to do the work stated. March 31, 2017 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy March 31, 2017 1 Miami Shores Village RF Building Department Fo 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 ( ?Q� i Tel:(305)795-2204 Fax:(305)756-8972 I INSPECTION LINE PHONE NUMBER:(30S)762-4949 I FBC 20,1W 5� BUILDING Master Permit No. Ac-1L ; ?SZ- PERMIT APPLICATION Sub Permit No.VK--\7 -- Lis BUILDING M ELECTRIC ROOFING ❑ REVISION ❑ EXTENSION 0RENEWAL ❑PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP Q, p CONTRACTOR DRAWINGS JOB ADDRESS: 2. S N C / / l C 7 City: Miami Shores County: Miami Dade Zip: 33/ Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: v v u11 L ) a OWNER:Name(Fee Simple Titleholder): �0 3 (� Phone#: Address: 12- SSS N/ e q 9 S City: M ),9 "/ S�d a i-State: FL Zip: .33/.37 Tenant/Lessee Name: Phone#: �3�-`� ZoJ /Z Fig Email: Sd�4 SAsA c�+oc.vt • G. r"► CONTRACTOR:Company Name: 1 `E—p C 'wA Q�W-5 Phone#: Address: ( 2L40 C7 rSWl k 4S City: I� State: t�L Zip: -33 Qualifier Name: (E)A&t 1?G <� - Phone#: �� State Certification or Registration#: Certificate of Competency#: i DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ 0646 'c Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace Demolition /� ❑ �Description•of•Work:.._ N 3 A l i j '�' �� r, Oma/ .f��AN Specify color of color thru tile: Submittal Fee$ () Permit Fee$ CCF$ � co/cc$ �— Scanning Fee$ _ Radon Fee$ (I •!3-S DBPR$ • SS Notary$ s Technology Fee$ (CIQ _Training/Education Fee$ G • Double Fee$ Structural Reviews$ Bond$ Q TOTAL FEE NOW DUE$ �S I 30 (Revised02/24/2014) 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 i Application is hereby made to obtain a permit to do th'e 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. r "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. Signature Signature 0 NER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of HAILG4 20 1- by I� day of I A I d a1 r li 20 by J oS� lima�lvw��,who is personally known�o ��i ` ��.,who is personally known to who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. i NOTARY PUBLIC: NOTARY PUBLIC: Sign:4 ' Sign: Ul a-WLO� Print: 12461 Print: (SGV ra L 6+) (JIB Seal: Seal: ;�`' �` ;: LAURA LEBRON` My COMMISSION#GG046338 Ana Maria Canto EXPIRES n�iMiSSt(3tJ FF129133 '"•'�''� November 09.2020 *ssrsrsrs�e*rte*��.• i�"ts#s �,# s *ss*ss*s�:r*err*r**see*s:s. # rers.ssssss RY.COM APPROVE6'B°4"� %Z /6/�1'f� �YPlansExaminer Zoning Structural Review Clerk (Revised02/24/2014) DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD (850) 487-1395 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399-0783 BODDEN, EMIL M.E.P. CONTRACTORS CORP. 12401 SW 134TH CT UNIT 15 MIAMI FL 33186 i 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 STATE OF FLORIDA from architects to yacht brokers,from boxers to barbeque DEPARTMENT017 BUSINESS AND restaurants,and they keep Florida's economy strong. I `° PROFESI. 43EGULATION Every day we work to improve the way we do business in order EC13007464 �„ _ �-08/23/2016 to serve you better. For information about our services,please log onto www.myfloridalicense.com. There you can find more CERTIFIED ESE.. , information about our divisions and the regulations that impact SODDEN,EM(l you,subscribe to department newsletters and learn more about 4" the Department's initiatives. M.E.P.CONT = Our mission at the Department is: License Efficiently,Regulate Fairly.We constantly strive to serve you better so that you can s ° :•,:, ;. serve your customers. Thank you for doing business in Florida, IS CERTIFIED under,the`provisions of Ch.489 FS. and congratulations on your new license! Ekpiationdete Auc3+.2ota L1608230003248 t s DETACH HERE RICK SCOTT,GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD EC13007464 ADDITIONAL BUSINESS QUAL'.' TION The ELECTRICAL CONTRACTOR ! Named below IS CERTIFIED E_ Under the provisions of Chapter 489 FS. .,: ::;:::=,Y ```�oD�,e cs�`• Expiration date: AUG 31, 2018 BODDEN, EMIL M.E.P. CONTRACTORS 8345 NW 66TH ST UNI,. MIAMI ME ISSUED: 08423/2016 T DISPLAY AS REQUIRED BY sEQ# L1608230003248 4 k � � 005453 Local Business Tax Recei t BT Miami Dade Count, ;.State=of Florltla Z; "`-THISIS NOT A BILL=DO NOT PAY. ? 7199777 it?, BUSINESS NAMFJLOCATION - RECEIPT NO "'EXP�RES AE P CONTRACTORS CORP, RENEWAL SEPTEMBER''30 2017 f 7482337 12401 $W.134 CT,15 Must b_dAisplayed at,plaae of business MIAMI FC 33186 Pursuant to County Code j - Chapter 8A—Art..9&10 - . OWNER SEC.TYPE OF BUSINESS, PAYMENT RECEIVED f 196 ELECTRICAL CONTRACTOR MEP.CONTRACTORS CORP'- ev TAX cou.EcroR C/O EMIL BODDEN PRIES' EC13007464 $75.00 08/18/2016 Worker(s) 1_6 -048118CREDITCARD-16 This Local.Business Tax Receipt only confirms payment of the Local business Tax The Receipt is not a license,,_ permit,ora certification of the holders dWifiications;to do business.°Holder must comply with any governmental or nongovemmerdal regulatory laws a�Tequiremerds which apply to the usiness The RECEIPT N0.above must be displayed on all commercial vehicles-Miami-Dade Cade Sec 6a-276. F For mme nrtorniation,visit v ^v miamidade eoyRexcollector r I I i 1 _ I 1 i r { 1 1 ACOATE(MMIDD/YYYY) RD ° D `� CERTIFICATE OF LIABILITY INSURANCE 02/22/2017 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(les)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). CONTACT PRODUCER - NAME: Maximo Dopazo CPIA Dopazo s Associates Inc PHONE (305)470-8500 FAX No: (066)647-9673 8725 NW 18th Terr Ste 300 E-MAIL max@dopazo.com ADDRESS: i INSURERS AFFORDING COVERAGE NAIC N Miami FL 33172 wsURERA:Granada Insurance Co 16870 INSURED INSURER B:RetailFlrst Ins CO 10700 MEP Contractors Corp INSURER C: 12401 SW 134th Ct Unit 15 INSURER D: INSURER E: Miami FL 33186 INSURER F: 8 COVERAGES CERTIFICATE NUMBER:CL1721316002 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 A L SUBR POLICY EFF POLICY EXP LIMITS LTR -POLICY NUMBER MMID MMID X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE OCCURS DAMA To RENTED 100,000 PREMIE Ea occurrence) $ 0185FL00079114 02/05/2017 02/05/2018 MED EXP(Any one person) $ 5,000 , PERSONAL&ADV INJURY $ ,1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY JET LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea acddent ANYAUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED I AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS AUTOS Per accident $ UMBRELALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE I AGGREGATE $ DED I I RETENTION ) $ WORKERS COMPENSATIONX STATUTE PER OTH- ( AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? l N B (Mandatory In NH) 1 /A 0520-53980 04/25/2016 04/25/2017 E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under • DESCRIPTION OF OPERATIONS below I I I E.L.DISEASE-POLICY LIMIT $ 500,000 1 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more spats is required) Electrical work- within buildings i 1 ' } • 1 i CERTIFICATE HOLDER CANCELLATION i r SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Miami Shores Village ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2 Ave Miami Shores, FL 33138 AUTHORIZED REPRESENTATIVE I Dopazo CPIA/MAD ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(2o1401)