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EL-18-2152Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Pe it Permit No. EL-8-18-2152_ Permit Type: Electrical - Residential Work Classification: Alteration Permit Status: APPROVED Issue Date:°8/1612018 Expiration: 02/12/2019 Parcel Number Applicant 221 NE 104 Street Miami Shores, FL 1121360130560 Block: Lot: FELIPE AND OLGA GODINEZ Owner Information FELIPE AND OLGA GODINEZ Address 221 NE 104 ST MIAMI SHORES FL 33138-2015 Contractor(s) NP ELECTRIC CORP Phone (786)357-9837 Cell Phone Phone (305)751-1771 Cell Valuation: Total Sq Feet: $ 1,500.00 0 Type of Work: BATHROOM REMODELING ELECTRICAL Additional Info: BATHROOM REMODELING ELECTRICAL Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $1.20 $2.25 $2.00 $0.40 $150.00 $3.00 $1.60 $160.45 Pay Date Pay Type Invoice # EL-8-18-68530 08/14/2018 Credit Card 08/16/2018 Credit Card Amt Paid Amt Due $ 50.00 $ 110.45 $ 110.45 $ 0.00 Available Inspections: Inspection Type: Review Electrical 1 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. l S/ Authorize Signature: Owner/ / Applicant / Contractor / Agent August 16, 2018 Date Building Department Copy August 16, 2018 1 a\o\'1 gO) Miami Shores Village Building Department REC AUG cO:8 BY:_ — --i FBC2017c0 ' BUILDING Master Permit No. C-18 --308 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 PERMIT APPLICATION ❑BUILDING ELECTRIC ❑ ROOFING Sub Permit No. - 18 — ZJ SZ ❑ REVISION ❑ EXTENSION PLUMBING ❑ MECHANICAL (PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION CONTRACTOR JOB ADDRESS: z a NC / o c�- ❑RENEWAL SHOP DRAWINGS City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 7 Occupancy Type:O(J NCR Load: Is the Building Historically Designated: Yes NO Construction Type: C 13S Flood Zone: BFE: OWNER: Name (Fee Simple Titleholder): lJ 6/► L96—ix.r/U -- Address:(U/ov.st (,..-Q- City:fill.�'/Yl! (�U (4 S State: F7L Tenant/Lessee Name: vfeN4--- FFE: Phone#:3 a 75(-- h 7/ Phone#: Zip: 33 /M Email: CONTRACTOR: ompany Name: OP TATC?Q IC C©2U Ad dress: ess: City: OV ' 2 /Ur / 9 cT A.�w1i State: / ) Phone#: ?66 ' /9 J1 Qualifier Name: � )ao04cP )� State Certification or Registration #: fEC \300- 6626 Zip: "33 / 9 Phone#: • PLCl.7 YS a;r Certificate of Competency #: ]? S• 1 DESIGNER: Architect/Engineer:. Phone#: - e , Address: City: State: Zip: Valiieiof Work for this Permit: $ j,5-GO Ev , Type of Work:.+'❑ '_Addition 2 Alteration Description of Work:. o��j "-co "4 Square/Linear Footage of Work:.( r9ei) ❑ New ❑ Repair/Replace ❑ Demolition / / Specify color of color thru tile: Submittal Fee $ SO 1 Permit Fee $ /.4/ Scanning Fee $ Radon Fee $ 2 - CJ'7 Technology Fee $ Training/Education Fee $ Structural Reviews $ CCF $ CO/CC $ DBPR $ z • 2"S. Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $��- (Revised02/24/2014) i , Bonding Company's Name (if applicable) Bonding Company's Address • City State Zip Mortgage Lender's Name (if applicable) • Mortgage Lender's Address City "! •- `J I. -r'� 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. Signature OWNER or AGENT — -- The foregoing instrument was acknowledged before Qme this The foregoing instrument was acknowledged before me this t` I 4th day of f-�-L (4USI' , 20 I a , by ' 0 _ day of l , 20 / l� _ , by O` a GO�i Z - ,who is personally known to 4►VClua✓lLevi d PGI.Y)vwho is personally known to me or who has produced JrilMr 1ICO1S•Q as me or who has produced as Signature identification : , ho did take an oath. TARY PU = NOTARY PUBLIC: CONTRACTOR identification and who did take an oath. 0111111110,/, ��•IURI Pq k,:"//, ▪ • D�vaty20,,�de m *: �om� Sign:- ,a- • MFF 933020 Q . Print: �'G/d L��sa: O� +!u �..,w�:.•.,. . Seal: '/,�& ••........................... i..cd;:o�(�\��• s'-1 ., Py4Y ADY Pf lETQ .... _ .. liq�/ I H 1 1111N,�.\\ : s MY COMM'S&OI'd s' k'; '1 +:;: a EXPIRES; Mael , .. ',tee4F Tpp.� dx n r� « i.,. PPROVED BY ��y(! 4 l*1 ,4Q&'/p Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) ACORL? CERTIFICATE OF LIABILITY INSURANCE `...--- DATE (MM/DD/YYYY) 08/03/2018 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 Blanco Insurance Assoc., Inc. 1462 E 4 Ave Hialeah FL 33010 CONTACT NAME: Maria Vila Almolda PHONE Fide (305) 888-0524 ac. Not: (786) 272-0044 ADD Ess: mariaQblancoinsurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: MT. HAWLEY INSURANCE COMPANY 41297 INSURED Np Electric Corp. 20432 NE 14 CT Miami FL 33179 INSURER B : GUARD INSURANCE COMPANIES 42390 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POUCY NUMBER POUCY EFF (MMIDD/YYYYI POUCY EXP (MM/DD/YYYY► LIMITS A X COMMERCIAL GENERAL LIABIUTY GGL0000934 10/20/2017 10/20/2018 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAGE TO PREMISES SES (EaENTED occurrence) $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 100,0000 GEN'L X AGGREGATE POLICY OTHER: LIMIT APPLIES PRO JECT PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ AUTOMOBILE _ _ UABIUTY ANY AUTO ALL OWNED AUTOS HIRED AUTOS _ SCHEDULED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA UAB EXCESS UAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITYANY OFFICER/MEMBER EXCLUDED ECUTIVE (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below YYN N/A NPWC941185-1 05/24/2018 05/24/2019 PER STATUTE V /� OTH- ER E.L.EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) NP Electric Corp./Nacho Patino/License EC1300GG26 CERTIFICATE HOLDER CANCELLATION Miami Shores Village Building Department 10050 NE 2nd 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. AUTHORIZED REPRESENTATIVE ACORD 26 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD