EL-18-1443Miami Shores Village
10050 N.E. 2nd Avenue N
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit
Parcel Number
Issue Da
Permit NO. E L-5-18-1443
Permit Type: Electrical - Residential
Work Classification: Alteration
Permit Status: APPROVED
Expiration: 11/27/2018
Applicant
9290 N BAYSHORE Drive
Miami Shores, FL 33138-
1132050270240
Block: Lot:
RICKI LONDON
Owner Information
Address
Phone
Cell
RICKI LONDON
9290 N BAYSHORE Drive
MIAMI SHORES FL 33138-2949
9290 N BAYSHORE Drive
MIAMI SHORES FL 33138-2949
Contractor(s)
Phone CeII Phone
G BRICKELL ELECTRIC LLC (305)297-4655
Valuation:
Total Sq Feet:
$ 2,800.00
0
Type of Work: KITCHEN RENOVATION ELECTRICAL WORK
Additional Info: KITCHEN RENOVATION ELECTRICAL WORK
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Notary Fee
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Amount
$1.80
$2.25
$2.00
$0.60
$5.00
$150.00
$3.00
$2.40
Total: $167.05
Pay Date Pay Type Amt Paid
Invoice # EL-5-18-67706
05/25/2018 Credit Card $ 50.00
05/31/2018 Credit Card $ 117.05
Amt Due
$ 117.05
$ 0.00
Available Inspections:
Inspection Type:
Review Electrical
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
constructiorypnd zoning. Futhermore, I authorize the above -named contractor to do the work stated.
A�/tr
May 31, 2018
Authorized Signature: Owner / Applicant / Contractor / Agent
Date
Building Department Copy
May 31, 2018 1
City: m i U State: ( Zip:
Qualifier Name: I l Ivi r no lU n
State Certification or Registration #: EC ( 3(X ✓' V 3 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: rr .. ., City: State: Zip:
l
Value of Work for this Permit: $ ,.;t 5•LJ
Type of Work: El Addition L� Alteration ❑ New ❑ Repair/Replace
Miami Shores VillageTED
AY2. 8
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
BUILDING
PERMIT APPLICATION
❑BUILDING ELECTRIC ❑ ROOFING
❑ PLUMBING [J"MECHANICAL ❑ PUBLIC WORKS
JOB ADDRESS: 1,
City: Miami Shores
FBC 200 (1+1,
Master Permit No. I??C-18 — 2.0
Sub Permit No. _1C?)_.144-3
❑ REVISION ❑ EXTENSION 0 RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
Bak t -C.. OiLlyt
County: Miami Dade
Folio/Parcel#: Is the Building Historically Designated: Yes NO V
Occupancy Type: Load:
Construction Type: Flood Zone:
OWNER: Name (Fee Simple Titleholder): /R C/Z€ Lc e 1,"0 ? !7
Address: /YG yY9c2 �O N 8G y 5{2t/re- d o/_Je
City: i / l �JW c t it--
State:
BFE: FFE:
Phone#: 776 -4 Z3 -7Y-14
Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: C—, ' —eisr 1 F-e l 1 -EI eCTY (�
Address: 3I"12 Nw ST
Phone#:c50s)ZG- O SS`
Phone#:
314Z
Description of Work: \ kO/Qii I LAW O' V1
Square/Linear Footage of Work:
❑ Demolition
Specify color of .:y` f_
r`'`" �< ,,•"«gym
Submittal Fee $ so° � r4, Permit Fee $ I t0 0
Rj! ti r
Scanning Fee $0.. Radon•Fee'$
Technology Fee $ Training/Education Fee $
Structural Reviews $
(Revised02/24/2014)
•
CCF $ -CO/CC $
DBPR $ Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ I )* • OS
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: (`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. I x 1
"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'$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to -the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signatur (MAW
OWNER or AGENT
The foregoing instrume t was acknowledged before me this
I , 20 (&
day of 1...�,
j� , by
(.JCL. • o ` , who pis personally �knownntoo
me or who has produced. .1. .Dk320 L^ EI 48
identification and who did take an oath.
NOTARY IC:
Sign:
Print:
Signature
The foregoing instrument wa acknowledged before me this
2 - day of /M(/<�1/1'� , 20 ( , by
OfrOl ¥1- 2 ( k 1L )whoo is personally
�know to
_!-�
me or who has produced �'.)-1'' KCO" 1O T 'as l/
identification and who did take an oath.
NOTARY PUBL C:
Seal: r�rYtirv,,r-,�-,r•„�r,:.Y N., 'it •,r e v� ,"•, Seal:
y .rRY Pus Notary Public State of Florida
y :' .r, .{
�, ;•• • Sindia Alvarez
'0 a it.< My Commission FF 156750
Af i 0910312018
APPROVED BY
:oi/./ ;*ti/,-- //$ Plans Examiner
Structural Review
Marshina Meneses
I Coz.mmission # GG1ee25093
***' ***Mid* 7750�
/1«************
Bonded thru Aaron Notary
Zoning
Clerk
(Revised02/24/2014)
-il.„:•-••,,•••• STATE OF FLORIDA
DEPARTMENT 9F BUSINESS AND
PROFE, ..• UtATK)N
EC13005903 •••StJEft 11115/2016 ,;-•
CERTIFIED ELET
GALAN, OW*
0 BRICKEU. ELE
ONTRACOR
• • -
".• .S CEfiflP1E1 tinifet'itifi'priitipres at 61:481) PS: .••••
EN?titosh oats -rfitferi. OM • • f.iii1i19ioo2.374
• • -Ricrscurr,-smiERNoR
KEN LAWSON, SECRETARY
STATE OF FLORIDA
DEPARTNIeNT QF suamEtrie AND PROFESSIONAL OSOULATION
ELECTRICAL CQNTRACTORS LICENSING BOARD
The ELECTRICAL CONTRACTOR
Worried below IS CERTIFIED •
Under the provisions otChaptar 409 FS.
ExpiratiOn date: AUG 31, 2016
,GALAKONIAtl JESUS
13RICKELL e.LEcTR
• 3192NV1/ 4.1 ST
•
• . -
•
. • .
SEO It Li-6/1150002374
007718
Local`Bus ne
Aiarni-Dade County, State- offtortda
THIS IS NOT A BILL - DEYNOT PAY
1_, -
6555735 -
BUSINESS NAME/LOCATION
G BRICKELL ELECTRIC uC
3192NW45ST
MIAMI FL33142
OWNER
• G BRKCKELL ELECTRIC i.LC
C/O.OMAR GALAN PRES ---
Wortter(s) • 1 •
`,RECEIPT NO.
RENEW-
6816318
EXPfRES
SEPTEMBER 30,- 2018
Mast be d splaayed at place of business
Pursuant to Cn`unty Code
Chapter 8A — Art. 9 & 10
SEC. TYPE OF BUSINESS •
196 ELECTRICAL CONTRACTOR
EC13005903: - _ e
PAYMENT RECEIVED
8Y TAX 'COLLECTOR
$45.OG 07/Ofi%2017
CHECK21-1.7-052108
Tkis EsmaBnainessTaz Roca .,.;.
� mt[p-c�frets payment:Oft Local Bnsiaa:s:Tatt. The tkcalpt is not n lice,
past or a certification of the hotdW* tifitxtin,#o'dobnsiness. _fielder aiot conply wNR any governmental
or nengovs nmentaltegaiatmy laves s . irearentswltieh apply tether bush .
the RECEIPT NO. above most be displayed on ill commercials les -1 i-pade Code See 8e-736.
For mere information, visit wvvw niamidada,gowlaxcotiectar
i
i
(111#11DOIYYTY)
•
ACC,R1) CERTIFICATE OF LIABILITY INSURANCE
msustea
G ancAell Electric. LLC
3192 NW 45 St
05/25118
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATEHOLDER. THIS
_
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED SY 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.
)141PORTANT: 11*Nicertificate holder Is an ADDITIONAL INSURED, the pelloy(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 dots not confer Molds to the
certificate hokler In thou of such endoraement(s).
hitooucEn
Excellence Insurance Agency
3801 SW 107 Avenue
Miami, FL 33165
PhOne (305) 226:3900 Fax (305) 226-3997
Miami, FL 33142 305
_... •_••••••••••_•_••• •, • „„ , .,, _, , ,..... ...
CERTIFICATE NUMBER
' COVERAGES „
REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICTES6FiNSURANCELISTED BELOW HAVE BEEN ISSUED TO Tfieliitifit0 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 ! AO EFF ' T o
.4.17I _ TYPE OF INSURANCE _ IN
_ _ POLICY NUMBER
S
....i
GENERAL Ltaaturr
yi COMMERCAL GENERAL LIABILITYCOASZCE.TCURRtNCENYEE6 1 ,000. 0 COM
— n1
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1 PERsostai, a ADV DLIURT I $ 1,000,000.00
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pkieL . (305)226-3900 ratio;
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Apolless, bbrurto*Excellenosifisurance net
INSUReifielAFFOROINOCOvERAGE
_INSURER A ti4oPfie Planar(' ComParIT
OrStntErt ; Granada Insurance Company
trtsuRER c
INSURER :
URERE :
(305)226-3997
A
ANY AUTO
• ALL OWNEO vi SCHEDULED
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0 HIRED Auros I
AN&Nos-owNED
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UMBRELLA UAB 0occoR
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WORKERS COMPENSATION
..' , AND ESIPtOYERSUAGIU'TY Y
, 1 AMY PRDPRIETOR/PARTNER/ExECUTIvE
B ' OFFICERAAERNIER EXCLUDED?
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(Illandatery es NH)
ttirio, cieecrem under
DESCRIPTION OF OPERATIONS *Mow
, — -
PD $590 Deductible
I INSURER F
WATTS
GENERAL AGGREGATE s 2,000,000.00
; GEWL AGGREGATE Lit/AT APPLIES PER 0 PRODUCTS - cOmProP AGG s 2.000,000 00
tA MC P14°- LOC
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AUTOMOBILE JflJ 1 LOMIRINEO.SINGLE LIMIT
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BODILY INJURY (Per etvidenN T
PftQPERTY DAMAGE
A
DESCRIPTION OF OPERATIONS LOCATIONS /VEHICLES
Electrical Contractor
CERTIFICATE HOLDER
Miami Shores Village
13u4oing Department
10050 NE 2 Avenue
Miami Snores Florida 33138
F ax 305-756-8917
ACORD 26 (MOAK) OF
Y
GEMC892004
^ ^
EACII OCCURRENCE
= AGGREGATE
$
•rtfal.TATu- 01-04-1
04/0112019 ACCOE- $ 100,000,00
E L DISEASE - EA EMPLOYE $ 100,000.00—
E L DISEASE -Poucy
ACORD tot, Addttionei Remarks Ss/mettle, If mow space is taquiredi
CANCELLATION
SHOULD ANY OF
THE EXPIRATION
ACCORDANCE
AUTWORCED
CIES BE CANCELLED BEFORE
U. BE DELIVERED IN
RD CORPORATION. All rights reserved.
rife and logo are registered ma*, of ACORD