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EL-18-221Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Permit issue Date: 211 Pernik NO. EL-1-18-221 Permit Type: Electrical - Residential Work Classification: Alteration Permit Status: APPROVED 12018 Expiration: 08/12/2018 Parcel Number Applicant 10682 NE 11 Court Miami Shores, FL 33138-2123 1122320280500 Block: Lot: MARC ALBERT ILLOUZ Owner Information Address Phone Cell MARC ALBERT ILLOUZ 7934 WEST Drive NORTH BAY VILLAGE FL 33141- (954)505-6766 7934 WEST Drive NORTH BAY VILLAGE FL 33141- Contractor(s) METPLANET ELECTRICAL Phone (754)214-1695 Cell Phone Valuation: Total Sq Feet: $ 1,600.00 0 Type of Work: ELECTRICAL OUTLETS SWITCHES, LIGHTS Additional Info: Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Notary Fee Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $1.20 $2.25 $2.00 $0.40 $5.00 $150.00 $3.00 $1.60 $165.45 Pay Date Pay Type Invoice # EL-1-18-66259 01/29/2018 Credit Card 02/13/2018 Check #: 1015 Amt Paid Amt Due $ 50.00 $ 115.45 $ 115.45 $ 0.00 Available Inspections: Inspection Type: Review Electrical i 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 t e foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futherm. -, a, thoyrze the above -named contractor to do the work stated. Auth ized e.Ownepplicant / Contractor / Agent Building Department Copy February 13, 2018 Date February 13, 2018 1 BUILDING PERMIT APPLICATION ❑ BUILDING Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 ELECTRIC ❑ ROOFING ❑ PLUMBING ❑ MECHANICAL ❑ PUBLIC WORKS JOB ADDRESS: `Oh O 2 / I! C• // C� City: Miami Shores County: RECEIVED JAN 2 9 201$ pc Master Permit No. L Z'-2; Sub Permit No. izc1 CJ dR ❑ EXTENSION RENEWAL? CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS Miami Dade Zip: Folio/Parcel#: I I 2-1 1 2- D 2 8 - ©5 o 0 Is the Building Historically Designated: Yes Occupancy Type: Load: Construction Type: Flood Zone: BFE: OWNER: Name (Fee(FSimple Titleholder): M�J2, ikede .17ZZOIf Z Phone#: �. Address: / i7 g Z if/ City: �1e2,r1W. � � State: Tenant/Lessee Name: Email: CONTRACTOR: Company Name: Address: e7Z- City: Qualifier Nam GArtJ-�o T . Phone#: NO FFE: cos- ( ' Zip:33/31 `21 Oho' Sci "5 o4Y one#: L (%y 7 /V Phone#: State Certification or Registration #: - G G --3av %- Certificate of Competency #: . DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ ii __ a) Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ,esy Descriptionttof Work: ❑ New pair/Replace n Demolition Specify color of color thru tile: Permit Fee $ fc�1 (-44' CCF $ CO/CC $ Radon Fee $ DBPR $ Submittal Fee $ Scanning Fee $ Technology Fee $ Training/Education Fee $ Double Fee $ Notary Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ l 1 �• "1 (Revised02/24/2014) ' I 4..4! - c- _1 • Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) r Mortgage Lender's Address r R � City State Zip a • , �! 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 willhbe charged.. A 11 Signature OWNER or AGENT The foregoing instrument was acknowledged before me this I n day ofT'ECEM , 20 I , by ' a ! L LC - who is personally known to me or who has produced-T:42-( Q as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: C(1.4 Seal: osyar;o Notary Public State of Florida s ; , ; Sindia Alvarez , My Commission FF 156750 .r 'ao;po*. Expires 09/03/2018 d (Signature ONTRACTOR The for instrument was acknowledged before me this day of�((`/1�-,���� , 20 , by -3.E r' I:ES tlE�vfio s personally known to q- me or who has produced t-T'l\(.. Lki identification and who did take an oath. NOTARY PUBLIC: as Sign: �_f(041"� Print: ` ` } NI �pt�°YY`aGn Notary Public State of Florida Seal: . . Sindia Alvarez * q�. _ 4� My Commission FF 156750 ' 0'A.o Expires 09/03/2018 ************************************************************************************************************ APPROVED BY Zq-.%/�71/!v Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) '�• STATE,0F FLORIDA -` -=�-- �'~ 'OEPARTMN10FrB0S1ESS ANu .» L•REGULATION ,.-.-- = P_ROFESSbO ‘,,- ISSI.1EO 08Y14/2016 ri' EC130 T_ , �OR CERTIFIED ELEGTRICp`L CONTRA TEL'FORT'JJEjAN, LESLIE �- ©T TOR: -''(METPL'ANET)�ELErC . a,,.e,,. -,r, .. ion0f Ch"'5489`'FSv._.... +r'' L•i60n,A06046s4 pro I CER'IF/AIG ;`1 - i atOfl date BRR Ab-COUNTV ALB 81 SST4X-RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000 VALID OCTOBER 1, 2017 THROUGH SEPTEMBER 30, 2018 DBA: Receipt #:1s1-2s65 Business Name: METPLANET ELECTRICAL CONTRACTORS Type: Business TELECTRICAL/ALARMS/CONTRA( INC(ELECTRICAL CONTRACTOR) Owner Name: JEAN L TELFORT Business Location: 6231 GRANT CT HOLLYWOOD Business Phone: Rooms Seats Employees 1 Tax Amount Business Opened:o4/30/2006 State/County/Cert/Reg:EC 13 0 0 7 3 9 7 Exemption Code: Machines Professionals Number of Machines: 27.00 Transfer Fee 0.00 NSF Fee For Vending Business Only Penalty Vending Type: Prior Years Collection Cost Total Paid 0.00 2.70 0.00 0.00 29.70 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: JEAN L TELFORT 6231 GRANT CT HOLLYWOOD, FL 33024 Receipt #03A-17-00000191 Paid 10/09/2017 29.70 2017 - 2018 PROD CER Silva and Jael Insurance Agency 5939 Johnson St Hollywood, FL 33021 Phone (954)965-6940 Fax (954)985-6941 INSU ED (METPLANET) ELECTRICAL CONTRACTOR INC. 6231 Grant Court HOLLYWOOD, FL 33024 CERTIFICATE OF LIABILITY INSURANCE DATE 01/29%18 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALigR THESQVERAiEMFORPED BY TIJE POLICIES_ BE L..... - INSURERS AFFORDING COVERAGE _ NAIC # _ INSURER A:_..Ascendapt Insurance Company INSURER s Infinj Auto Insurance Company INSURER _�.. ..__..—_.... ..— ..._..__......_ INSURER E: CO RAGES THE MA PO INSRI LT.R .I INSURER F: POLICIES OF INSURANCE LISTED HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH CIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. D'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVEPOLICY EXPIRATION DATEIMM(DD!YY) DATELMMvI)Wl GENERAL LIABILITY © COMMERCIAL GENERAL LIABILITY 04/07/17 ❑❑ CLAIMS MADE 2 OCCUR GEN'L AGGREGATE LIMIT APPLIES PER Q POLICY ❑ PROJECT LJ LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON OWNED AUTOS n-._-_...._ -GARAGE LIABILITY 0 ANY AUTO EXCESS/UMBRELLA LIABILITY ❑ OCCUR ❑ CLAIMS MADE ❑ DEDUCTIBLE ❑ RETENTION 5 GL-44228-2 509-80000-8283-001 DES ORKERS COMPENSATION AND MPLOYERS' LIABILITY NY PROPRIETOR / PARTNER / EXECUTIVE FFICER / MEMBER EXCLUDED? (yea, describe under PECIAL PROVISIONS below OTHER 03/13/17 04/07/18 LIMITS EACH OCCURRENCE DAMAGE TO RENTED PREMISES (p$ occurence),_ MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS-COMP/O COMP/OP $1,000,000.00 $100,000.00 $5,000.00 $1,000,000.00 $2,000,000.00 $1,000,000.00 COMBINED SINGLE LIMIT 03/13/18 (EasccidBnt). _ _ -- BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE --. -- (Peracdident) AUTO ONLY - EA ACCIDENT OTHER THAN EAAACIt.— AUTO ONLY: AGG EACH OCCURRENCE AGGREGATE 10,000.00 20,000,00 10,000.00 0 WC STATU- .. ORH E.L. EACH ACCIDENT E,L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT RIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS EL: CTRICAL CONTRACTOR / ELECTRICAL INSTALLATION AND REPAIR. CE TIFICATE HOLDER VILLAGE OF MIAMI SHORES 10682 NE 11 CT MIAMI SHORES,FL 33037 FAX# 305-756-8972 ORD 25 (2001108) QF CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30_ PAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE LEYNNI MARRERO ®ACORD CORPORATION 1988 JEFF ATWATER CHIEF FINANCIAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * " CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW" " CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 4/24/2016 EXPIRATION DATE: 4/24/2018 PERSON: TELFORT JEAN L FEIN: 134331852 BUSINESS NAME AND ADDRESS: (METPLANET ELECTRICAL CONTRACTOR INC 6231GRANT COURT HOLLYWOOD FL 33024 SCOPES OF. BUSINESS OR TRADE: LICENSED ELECTRICAL CONTRACTOR Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this duipter by filing a certificate of election under this section may not recover benefits or compensation under this chapter: Pursuant to Chapter 440.05(12), F.S Certificates of election to be exempt... apply only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.06(13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation If,'at any time after t ie'filing of the notice or the Issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS? (850)413-1809 • -p" -;fir :_,.—.tea-...�F �._.,s.-�.yr=+F -Y,}•=, _ . ',e.,..` - .. -,ems \ A s s& y ...st.+'�•-=3-w�.•,' '.'-` 5t(r) uL) 00 lei