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EL-17-697Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Permi Permit NO. EL-3-17-697 Permit Type: Electrical - Residential Work Classification: Addition/Alteration Permit Status: APPROVED Issue Date: 4/3/2017 Expiration: 09/30/2017 Parcel Number Applicant 347 NE 98 Street Miami Shores, FL 33138- 1132060135621 Block: Lot: ARTHUR BAKER Owner Information Address Phone Cell ARTHUR BAKER 347 NE 98 Street MIAMI SHORES FL 33138- Contractor(s) SAME & Q ELECTRIC INC Phone (305)219-0427 Cell Phone (917)345-4387 Valuation: Total Sq Feet: $ 20,818.00 0 Type of Work: KITCHEN BATHROOM REMODELING AND MAS Additional Info: KITCHEN BATHROOM REMODELING AND MAS Classification: Residential Scanning: 3 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $12.60 $10.93 $10.93 $4.20 $728.63 $9.00 $16.80 $793.09 Pay Date Invoice # 03/15/2017 Pay Type EL-3-17-63318 Check #: 145 04/03/2017 Check #: 149 Amt Paid Amt Due 1 $ 50.00 $ 743.09 $ 743.09 $ 0.00 Available Inspections: Inspection Type: Final Meter Box Alteration Relocation Fire Alarm Service Change Review Electrical Underground W. W. 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 ert I th= or-,".ing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and z. n. F ; ,iT•'' , I _ .,t. above -named contractor to do the work stated. Aut o 'ed nature: 0 pplica t / Contractor / Agent April 03, 2017 Date Building Department Copy April 03, 2017 1 Miami Shores Village BUILDING PERMIT APPLICATION Ft El BUILDING ® ELECTRIC ['PLUMBING ❑ MECHANICAL ❑ ROOFING ❑ REVISION 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 MAR 1 5 2017 ..---�---1 FBC 2010� Master Permit No. � R (r `(C) Sub Permit No. ❑ EXTENSION ❑RENEWAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: /"{ 1 NO 0 s-' City: Miami Shores``__ County: Miami Dade Folio/Parcel#: / 1— 3 Z2' l9 " 013 ` SCe Z iI Is the Building Historically Designated: Yes Occupancy Type: Load: Construction Type: Flood Zone: Zip: Afi gi NO }D BFE: FFE: OWNER: Name (Fee Simple Titleholder): Ai 4t,' PC. �Phone#: iI�- 3'1J f'I3S Address: . n ¥ ' ! f S' r City: YVL 1GGIM lit f?4' State: Zip: Tenant/Lessee Name: Email: PO✓ 1%KCtBlrt ite-r 1/V4L'er144 CONTRACTOR: Company Name: Same & Q Electric Inc Phone#: Phone#: 305-989-9854 Address: 950 SW 104 Court City: Miami State: FI Zip: 33174 Qualifier Name: Manuel E.Quesada Phone#: 305-989-9854 State Certification or Registration #: EC 13007128 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ t % 1 Square/Linear Footage of Work: Type of Work: ❑ Addition❑ Alteration ElNew ❑ Repa r/Replace ❑ D molition Description of Work: Yit� �e�e r0'C � `�0‘l Nc.Q NM:0 �� 0-•� •cbO-M . �� vJ i �� �� : %c� ,�,� c� >�� ceS Specify color of color thru tile: Submittal Fee $ Permit Fee $ jJ€i i .1 CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE$ \43 OG (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 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not bepprpved and D reigspection fee will be charged. Signatur OWAIER.or AGENT Signature CONTRACTOR Seritgoingoinstrument was cknowledged befo a this fore ing instrum was cknowledged befoe rthis 1 day of %�� , 20 _ by day of , 20 , by #s +Q ? who is personally known to > -. -. C SPA who is personally known to me pr who ha_ pr,, uced identificati • - . n ho did ake : n oath. NOTARY ',iw7,aaM„ , r1� Sign Prin Seal DANGER lorlda P$ My Comm. Expire �•ep 1, 2019 �"4?i ,d'��, Bonded through National Notary Assn. as ..me -or who has produced identification : nd o did take an oath. NOTARY PU' C: I Sign: ' '� .mod Print: p:"�i!l`if\��► Seal:+*I��0�' My Comm. Expires S t. 1.2019 ,� t,,, Bonded through National Notary Assn. as *************************************************************************************************#*********# APPROVED BY y�L a/ >9-,& />Plans Examiner Zoning (Revised02/24/2014) Structural Review Clerk Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LICENCES B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE* D. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 Certificate must specify the description of operations or contractor license number. BUSINESS NAME: Same & Q Electric Inc. BUSINESS ADDRESS: 950 SW 104 Court CITY Miami STATE FI ZIP 33174 BUSINESS PHONE: ( 305) 989-9854 FAX NUMBER ( ) CELL PHONE �_� QUALIFIER'S NAME: Manuel E.Quesada QUALIFIER'S LIC NUMBER: EC 13007128 A LF CERTIFICATE OF LIABILITY INSURANCE DAo (MMI 01 ) 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 condkions 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 EXCLUSIVE INSURANCE AGENCY 7175 SW 8 ST #204 MIAMI FL 33144 CONTACT Reina Seade NAME: (PQ �). 305-283-4855 jyc, No): 305-263-4856 E-MAIL EXclusivelns©comcast.net ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC 0 INSURERA: GRANADA INSURANCE COMP INSURED SAME & Q ELECTRIC INC 950 SW 104 CT APT 301 C Miami FL 33174 INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : ERAGES 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 A-bbt INS° R MO POUCY NUMBER POLICY EFF IMMIDD/YYYYI POUCY EXP IMMIDDIYYYYI LIMITS A XCOMMERCIAL GENERALUIBIUTY 0185FL00087723 09/29/2016 09/29/2017 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE OCCUR PREMISES 1� ooeurr PREMISES (Ea occurrence) $ 100,000 MED EXP (Any one person) $ 5.000 PERSONAL & ADV INJURY $ 1,000.000 GEN'L — AGGREGATE LIMIT APPLIES PRO - POLICY _ JECT OTHER: PER: LOC GENERAL AGGREGATE $ 1,000.000 PRODUCTS - COMP/OP AGG $ 1,000,000 $ AUTOMOBILE _ UABIUTY ANY AUTO ALL OWNED AUTOREDSAUTOS SCHEDULED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) S BODILY INJURY (Per accident) S PROPERTY DAMAGE (Per accident) $ $ UMBRELLA UAB EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I RETENTIONS $ WORKERS COMPENSATION AND EMPLOYERS' UABIUTY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE �'j OFFICER/MEMBER EXCLUDED? I (Mandatory In NH) I1 yes deauibe under DESCRIPTION OF OPERATIONS below N 1 A PER OTH- I.9It17f ER E.L. EACH ACCIDENT $ E L. DISEASE - EA EMPLOYEE $ E L DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space la requl ed) ELECTRICIAN CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE BUILDING DEPARTMENT 10050 NWE 2 AVE MIAMI SHORES FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 01988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD PLEASE CUT OUT CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CONSTRUCTION INDUSTRY EXEMPTION CERTIFICATE OF ELECTION TO SE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW EFFECTIVE DATE: 411812015 EXPIRATION DATE: PERSON: OUESAOA MANUEL FEIN: 271514399 BUSINESS NAME AND ADDRESS: SAME 6 Q ELECTRIC INC . 9S0 SW 104 CT K C301 MIAMI FL 33174 SCOPES OF BUSINESS OR TRA 411012015 IF Io IL ID E SR I H IE IR E IMPORTANT Pursuant to Chapter 440.05(14). F.S., an officer of a corporation who elects exemption from this chapter 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 440.05(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 the 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 certificate at any time for failure of the person named on the certificate to meet the requirements of this section. LICENSED ELECTRICAL ELECTRICAL WIRING CONTRACTOR WITHIN BUIL ELECTRIC LIGHT OR POWER LINE C IFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 r,. al, DRIVER LICENSE CLASS E Q230-545-56=058-0- MANUEL E iOUESADA r sso SW 10011 CT APT 301C MIAK FL $31744834. , C oo82-1s+i1t1S8 slat: Mies* 02 8-2S $ '4L A:1L } ... IIEt1r�" '�« a tileoltSeZr QUESTIONS? (850)413-1609 -- - SPTRAO1FtEOSSF IOFNOODRAEGU'DEPARTMENTFBUSINESS AND LATION • ---EC13007128.', fbsr •CERTIFIED"ELE ICI QUESADA MAN rte. SAME &',Q ELEC . IC`1 UED 08/3d/2016 r 1L CONTRACTOR tvL CERTIFIED.under_theprovislons'of Ch.489 FS. t xpMfon date: AUG 31: 2018. - - •--0**""" .»• L1608300003161 .- 7.4 t Scanned by CamScanner- PLEASE CUT OUT CARD BELOW AND RETAIN FOR FUTURE REFERENCE • STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CONSTRUCTION INDUSTRY EXEMPTION CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA ; WORKERS' COMPENSATION LAW EFFECTIVE DATE: 411812016 EXPIRATION DATE: 4r18r2018 E SR PERSON: OUESAOA FEIN: 271614399 BUSINESS NAME AND ADDRESS: SAME & Q ELECTRIC INC MANUEL . 950 SW 104 CT # C301 MIAMI FL 33174 SCOPES OF BUSINESS OR TRA IE .R IE IMPORTANT Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter 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 440.05(13), F.S., Notices of election to be exempt and certificates of election to be exempt shay be subject to revocation if, at any time after the 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 shaft revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. LICENSED ELECTRICAL CONTRACTOR __ ELECTRICAL WRING ELECTRIC LIGHT OR WITHIN BOIL POWER LINE C DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS? (850)413-1809 Scanned by CamScanner Local Business Tax I cei pt M iam i-Dade County, State of Florida -THIS IS NOT A BILL - 00 NOT PAY 6607734 BUSINESS NAM E/LOCATION SAME & Q ELECTRIC INC 950 SW 104TH CT APT 301 C MIAMI, FL 33174 OWNER SAME & C ELECTRIC INC CIO MANUEL E QUESADA PRES Worker(s) 1 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL-; REGULATION EC13007128 ,- CERTIFIED EI:EOTR QUESADA;.MANUEL- SAME & Q ELECTRIC, IN RECEIPT NO. RENEWAL 6878350 SEC. TYPE OF BUSINESS 198 ELECTRICAL CONTRACTOR EC13007128 EXPIRES SEPTEMBER 30, 2017 Must be displayed at place of business Pursuant to County Cod• Chapter SA - Art. 9 & 10 PAYM ENT RECEIVED BY TAX COLLECTOR 75.00 09/15/2018 0224-18-005818 1Ns Ural Sullins Tim Rxelptarty ean•rmspapyri dthe Local Business Tax. Tlr Receipt Is not sllarw, wit, oraearl "a98nd91s hddsfsquil•a9ats. bdobusiness. Wilder mat oonplywith atyporarmsMal arnapvrormskalreel:gmlawsadregrlremotawhidfapplytitheManes& The FECEIPFNQ Athenat bedsptaysd cc all alrmlydal taades- Mind -pads tads Seces-ae. ra ntdeUternation, OsItwormalmaidslogransaffilor UED? •.08/30/2016 CONTRACTOR IS CERTIFIED under'ths piovisions of Ch.469--FS. Expiration daft r AUG31.201e. - Lteoaa00003101- .. DRNER LICENSE CLASS E 'ti-{]234-545-,56-058-0 kd -mama to MI !AV MONCT APT MC MIA* R. 01744113400M: Mt ♦S Mt 0111�F2 1S sr..l (1S411 ds1$ 414 -_c� te.` - • • soot— omen.: o•••+iw• r a=OW wMaYY erwrn eramas aA tri-g arr •erAa eV Ya Scanned by CamScanner