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EL-17-1903Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address �m it Issue [late: 12/ Permit NO. EL-7-17-1903 Permit Type: Electrical - Residential Work Classification: Alteration Permit Status: APPROVED /2017 Expiration: 06/03/2018 Parcel Number Applicant 1050 NE 107 Street Miami Shores, FL 33161-7374 Owner Information Address 1122320280520 Block: Lot: Phone GABRIEL MARTIN KUSKUNOV Cell GABRIEL MARTIN KUSKUNOV 1050 NE 107 Street MIAMI SHORES FL 33161-7374 1050 NE 107 Street MIAMI SHORES FL 33161-7374 Contractor(s) RAMALEX ELECTRICAL CONTRACTC Phone Cell Phone (786)329-0101 (786)315-3586 Valuation: Total Sq Feet: $ 4,000.00 0 Type of Work: NEW LIGHTS NEW OUTLETS Additional Info: Classification: Residential Scanning: 3 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $2.40 $3.38 $2.25 $0.80 $225.00 $9.00 $3.20 $246.03 Pay Date Pay Type Amt Paid Amt Due Invoice # EL-7-17-64683 12/05/2017 Check #: 105 $ 196.03 $ 50.00 07/26/2017 Check #: 102 $ 50.00 $ 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 NDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I e e foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating � . yr ize the above -named contractor to do the work stated. construction and zoning. fy oill ,/,!•• December 05, 2017 Authorized Si.ri re• ner / Applicant / Contractor / Agent Date Building Department Copy December 05, 2017 1 BUILDING PERMIT APPLICATION ❑BUILDING ❑■ ELECTRIC DPLUMBING D MECHANICAL Miami Shores Village Building Department 10D50 N.E:2rid Avenue, Miami Shores, Florida 33138' Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 ❑ ROOFING ❑PUBLIC WORKS JOB ADDRESS: 1050 NE 107 ST City: Miami Shores County': Folio/Parcel#:11-2232-028-0520 Occupancy Type: RES Load: Construction Type: REMODEL Fiood Zone: OWNER: Name(Fee Simple Titleholder):GABRIEL MARTIN KUSKUNOV REC b: UL 26 2017 BY FBC20(l' y St Master Permit No. 5 RCI V R ' Sub Permit No. "''1 l 15-' .44:EL 1cO3 ❑ REVISION Q EXTENSION *RENEWAL ❑.CHANGE OF ❑..CANCELLATION. ❑.SHOP. CONTRACTOR: DRAWINGS • Miami D.ade Is the Building Historically Designated: Yes NO X BFF: FFE: Phone#: 78 6-48 8-8315 Address: 1050 NE 107-S T city: MIAMl SHORES Ste: FL zip: 33161 Tenant/Lessee Name: N/A Email: GABRIEL@NATURALISTONE.COM Phone#: CONTRACTOR:Company Name: RAMALEX, ELECTRICAL CONTRACTOR INC Phone#_ 786-329-0.10.1 Address: 11351 SW 1ST UNIT *305 City: MAW State: FL Zip: 33174; Qualifier Name: RAMON E. CABRERA Phone#: 786-315-3586 ,/,� ` G State Certification or. Registration #: Certificate of Competency #: 1jS 1 DESIGNER: Architect/Engineer: JUAN FERNANDEZ BARQUIN P.E. 786-336-0881 Phor�#: Address:;2:520 NW'97TH 4WE ValunofWork for this Permit: `$ 4,000 Type of Work: ❑ Addition Alteration Description of Worts: electrical sub permit extension NEW HIGH. HATS, NEW KITCHEN OUTLETS'; NEWAPPLIANCES, GFI IN 2-112 BATHROOMS; JBOX FOR CHANDELIER EXTERIOR LIGHTS IN SOFFIT,, JBOX AT LIVINGROOM FLOORING, 02 SCONCES HEADBOARD. 02SCONCESATMASTER .BATH City: DORAL state: FL Zip: 33172 Square/Linear Footage,ofWork: 1800 ❑ New El Repair/Replace ❑ Demolition Specify color of color thru the Submittal Fee $ Permit Fee $ 4714.4/ dd Scanning Fee $ Radon Fee $ `*"• CCF $ CO/CC $ DBFR $• Notary .$ Technology Fee $ Training/Education Fee '$ Double Fee '$ Structural Reviews$ Bond $ TOTAL FEE NOW ,DUES ( 91,) 1 J < 03 (Revised02/24/2014) Bonding Company's_ Name (if applicable) Bonding Company's Address _ _I City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address H Zip i 1 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'p'rior'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 pioperty 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 approd and a reinsp ion fee will be charged. Signature The foregoing instrument was acknowledged before me this ` , 20 1'r ,-by 04 U-4 , who is personally known to me or who has produced 3'K V-..Z%-1- 2y 3-, 4, 761( s` identification and who did.take an oath. NOTARY PUBLIC: � .n.11y� Sign:" ,-Qti"w Print: day of ULIAN A CAROONA N;,try Pala. - Staie of Honda Signature CONTRAC OR - - - The forgoing instrum as acknowledged beforee me this /Q� - day of ;,'20 1 / by RES -HMO V'1 CA is per-; me or who has produced • -identification and who did take an oath. NOTARY PUBLIC: Sign: ONELIO SANCHEZ NOTARY PUBLIC STATE OF FLORIDA Cann* FF076789 - 4aE s�" Expires 3/26/2018 •*******************rs* bca�***s**************#i***r**+*************ss****s****ss****************************s Zoning as t1 IrT� 913 x� es t1 2019 ' Seal: x v'Bonded through National Notary Assn. APPROVED BY Print: -- Seal: (' /(. -r&IY Plans Examin'er`" (Revised02/24/2014) Structural Review Clerk CTQB Construction Trades Qualifying Board BUSINESS CERTIFICATE OF COMPETENCI 1 3E000059 RAMALEX ELECTRICAL CONTRACTOR INC D.B.A.: CABRRA RAMON E Is certified under the provisions of Chapter 10 of Miami -Dade County Miami -Dade County - Building and neighborhood Compliance Office Page 1 of 1 Horne Product Control Contractors Building Officials Contractor Number: Contractor name: Address: City, St, Zip: Phone: Other Phone: Fax: Email: DIB/A: Contractor Status: Contact us Contractor License Information 13E000059 RAMALEX ELECTRICAL CONTRACTOR INC 11351 SW 1 ST UNIT #305 MIAMI (786) 329-0101 (305) 228-7542 RAMALEXELECTRICAL@GMAIL.COM ACTIVE FL 33174 Class Category Category Description Expiration Date ELEC 1 ELECTRICAL 09/30/2017 CONTRACTOR INQUIRY COMPLETE BCCO Contractor Inquiry and Complaint Search I BCCO Home Page I State License Search Menu Home I About I Phone Directory I Privacy I Disclaimer © 2001 Miami -Dade County. All rights reserved. http://egvsys.miamidade.gov:1608/WWWSERV/ggvt/BNZAW941.DIA?CNTR=13E000059 7/26/2017 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399-0783 CABRERA, RAMON E RAMALEX ELECTRICAL CONTRACTOR, INC. 11351 SW 1 ST UNIT 305 MIAMI FL 33174 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 from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! RICK SCOTT, GOVERNOR (850) 487-1395 STATE OF FLORIDA i DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ER13014852 ISSUED: 07/31/2016 REG ELECTRICAL CONTRACTOR CABRERA, RAMON E RAMALEX ELECTRICAL C+lTCTOR, INC (INDIVIDUAL MUST MEET A LLOCAL LICENSING REQUIREMENTS PRIOR TO CONTRACTING IN ANY AREA) HAS REGISTERED under the provisions of Ch 489 FS Expiraton date AUG 31 2018 L1F0 3lc 0= 8 DETACH HERE KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD LICENSE NUMBER ER13014852 The ELECTRICAL CONTRACTOR Named below HAS REGISTERED Under the provisions of Chapter 489 FS. Expiration date' AUG 31, 2018 (INDIVIDUAL MUST MEET ALL LOCAL LICENSING REQUIREMENTS PRIOR TO CON RAC ING IN ANY AREA) CABRERA, RAMON E RAMALEX ELECTRICALCONTRACTOR, INC. 11351 SW 1 ST UNIT 30 " "`","- MIAMI FL 33174 lecltGr n,nironia n1CMr AV AC DCr1111DCn RV I A\AI cFn 1 l 1607310004368 013686 Local Business Tax Receipt Miami —Dade County, State of Florida -THISIS NOT A BILL-DONOT PAY 7159612 "BUSINESS NAME/LOCATION RECEIPT NO. RAMALEX ELECTRICAL CONTRACTORS INC RENEWAL 11351 SW 1 ST APT 305 7436933 MIAMI FL 33174 OWNER RAMALEX ELECTRICAL CONTRS INC CIO RAMON CABRERA, PRESIDENT Worker(s) 1 EXPIRES SEPTEMBER 30, 2018 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art_ 9 & 10 SEC. TYPE OF BUSINESS 196 ELECTRICAL CONTRACTOR 13E000059 PAYMENT RECEIVED BY TAX COLLECTOR S45.00 07/13/2017 CREDITCARD-17-047507 This Local Business Tax Receipt only confirms payment of the Local Business Tax. TM Receipt is not a license, permit, or a certification of the holder's qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT NO. above must be displayed on all commercial vehicles - Miami -Dade Code Sec Ila-276. For more information, visit ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDJYYYY) 07/11/2017 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(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 Absolute Choice Insurance 9415 Sunset Drive Suite 151 Miami INSURED Ramalex Electrical Contractor Inc 11351 SW 1 ST 305 Miami FL 33173 FL 33174 CONTACT NAME: Jeremiah Perez INC. No. Ext): (305) 275-1777 FAX No): (305) 275-1711 E-MAIL A m ADDRESS: � Y info absolutechoice.com A INSURER(S) AFFORDING COVERAGE INSURERA: GRANADA INSURANCE COMPANY INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : NAIC # 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 ADDLSUBR; POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD, POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) : LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS -MADE X OCCUR PREMISES (Ea occurrence)_ $ 100,000 X Deductible $500 MED EXP (Any one person) $ 5,000 A N 0185FL00042858-2 02/04/2017 02/04/2018 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: ' GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- ._. .. _ . JECT LOC PRODUCTS - COMP/OP AGG _.. ,..... $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) AUTOS AUTOS $ NON -OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS (Per accident) $ UMBRELLA LIAB OCCUR. EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ ' DED RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY Y / N STATUTE ER._ ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N / A' " - (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Electrical Work CERTIFICATE HOLDER CANCELLATION MIAMI SHORE VILLAGE 10050 NE 2Ave 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 © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD 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 Worke 2/2112019 E EFFECTIVE DATE: 2/21/2017 PERSON: CABRERA FEIN: 460744279 BUSINESS NAME AND ADDRESS: RAMALEX ELECTRICAL CONTRACTOR INC EXPIRATION DATE: RAMON 11351 SW 1ST ST UNIT# 305 MIAMI FL 33174 SCOPES OF BUSINESS OR TRADE: LICENSED ELECTRICAL CONTRACTOR Pursuant to Chapter 440.05(14). F.S.. an officer of a corporation who erects exemption from thl5 chapter by filing a cert;ftoate of e=enon uoder this sect.so may not;recdver benefits or compensation under this chapter. Pursuant to Chapter M40 05(12). F Certificates of election to be exempt apply urrly vrithin the scope of the: business or trade frstcd onthe notice Of electron to be exempt. Pursuant to Chapter 440 05 t3), F Notices of electron to & i exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice`es the rss„erne pf the Cerrtificate, the person named on the notice or certificate. no longer meets the requirements of this sc_ban for issuance of a muff cote TM >k3attrrent shah revoke a CFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 05- i3 OUESTIONS0 i8°0 413-1600 ampensation Ramalex Electrical Contractor Inc 11351 Sw 1st St Apartment 305 Miami, FL 33174 Phone: (786) 329-0101 Date: October 06`h, 2015 State of : Florida . County of : Miami Dade Before me this day personally appeared Mr. Ramon E. Cabrera who being duly sworn. Deposes and says: That he or she will be the only person working on the project located at : 1050 NE 107 ST, Miami Shore, FL 33161 Sworn to (or affirmed) and subscribed before me this / day of aov6lg .20 i , by Personally Know Or Produced Identification Type of Identification Produced Ramon E. Cabrera Qualifier zAlt. JUG/A 11 a ao.id Print, Type or Stamp name of Notary JUUAN A CARDONA 0 tUe` % Notary Public - State of Florida s Commission 0 FF 191910 :'., My.Comm. Expires Jan 21, 2019 ''E °` " �° , Gonad Uuough National Notary Assn. Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner — Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees, including the owner, must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if: 1. The officer owns at least 10 percent of the stock of the corporation, or in the case of an LLC, a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State, Division of Corporations; and 3. The corporation is registered and listed as active with the Florida Department of State, Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption and has acknowledge that he or she will not use day labor, part-time employees or subcontractors for your project. The contractor has provided an affidavit stating that he or she will be the only perso a wed to work on your project. In these circumstances, Miami Shores Village does not require verification of workers' compens. do insurance coverage from the contractor's company for day labor, part-time employees or subcontractors. BY SIGNING B LO Y • AC NOW DGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. EMIR Signature: State of Florida County of Miami -Dade The foregoing was acknowledge before me this day of , 20 By (742.12 t � 05 I4 who is personally known to me or has produced Notary: SEAL: 'ver as identification. 50.1Var4ore_ VA TORII D�ti.,; At':' FF,911,A0 Ei r;F:S .•..,c..,: 14. 201$ Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Ave, Miami Shores, Florida 33138 Tel: 305-795-2204 Fax: 305-756-8972 -ye Inspection Number: INSP-001004-2018 Permit Number: EL-7-17-1903 Scheduled Inspection Date: October 25, 2018 Inspector: DeVaney, Michael Owner: GABRIEL MARTIN KUSKUNOV Address: 1050 NE 107 ST Miami Shores , FL 331617374 Project: <NONE> Contractor: RAMALEX ELECTRICAL CONTRACTOR INC RAMON E CABRERA Permit Type: Electrical - Residential Inspection Type: Electrical Final Work Classification: Alteration Phone Number: Parcel Number: 1122320280520 Phone Number: 7863290101 Building Department Comments NEW LIGHTS NEW OUTLETS Checklist Item General Comments Passed False Comments Passed C�J Failed Correction Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. Inspector Comments /z_ 61(9i/e October 24, 2018 For Inspections please call: 305-762-4949 Page 22 of 30 Aco CERTIFICATE OF LIABILITY INSURANCE DATE (MMJDD/YYYY) 05/02/2016 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 endorsementis). PRODUCER Absolute Choice Insurance f)415 Sunset Drive Suite 151 Miami INSURED Ramalex Electrical Contractor Inc 11351 SW1 ST 305 Miami COVERAGES FL 33173 FL 33174 CERTIFICATE NUMBER: CONTACT NAAME: Jeremiah Perez PHONE .(A1c..Na ixtL_(305 ........ ) 275-1 .._......777 _ _.... EMAIL ApDrs..,";"s, infoemyabsoluteohoice ,com INSURER(S) AFFORDING COVERAGE ji RAk 305 275 1711 INSURERA: GRANADA INSURANCE COMPANY INSURER B INSURER C ; INSURER0 ; INSURER E INSURER F : NAIC 0 THIS INDICATED, CERTIFICATE EXCLUSIONS LT1 IS TO CERTIFY THAT THE POLICIES NOTWITHSTANDING ANY REQUIREMENT, MAY Be ISSUED OR MAY AND CONDITIONS OF SUCH TYPE OF INSURANCE OF PERTAIN, POLICIES. .. A'DDL 1Ns0 INSURANCE SUaR WVO LISTED BELOW HAVE BEEN TERM OR CONDITION OF ANY THE INSURANCE AFFORDED BY LIMITS SHOWN MAY HAVE BEEN . .... POLICY NUMBER ISSUED TO CONTRACT THE POLICIES REDUCED BY POLICV ELF .. (MM)DD/YYYY) THE INSURED NAMED ABOVE FOR THE POLICY PERIOD OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, PAID CLAIMS. ....fSOL"fCY l�XP................................................_...................----..................._.............................................. (MM1DDlYYYY) LIMITS A X ....................... X GENT, X.. COMMERCIAL GENERAL LIABILITY _.. CLAIMS -MADE .X OCCUR DetlUCllble $500 ,._.._...._...._..............--.................................. AGC117E�1ATE LIMIT' ApPLIE'y` pen. POLICY ........... JFR4. LOC ........... OTHER: Y 0185FL00042858-2 02✓04/2016 02/04/2017 EACH OCCURRENCE ...DAM/CotTO'RENib'CI....................................._.._._....................................... PREMI:SES•SEa occurrenes).,,.,.,•„ MED ['XP (Arty one person) PERSONAL riADVINJURY GENERAL. A( REGATt/ PRODUCT$- COMP/OP A( $ 1 ,000,000 ?....._i 00,000 5 5,000 $ 1,000,000 $ 2,000,000 $ 2,000,000 5 AUTOMo$ILF .........._, LIABILITY ANY AUTO ALLOWNEO ALITOe HIRE() AUT04: ..,,..,,,,., SCHEDULED AUTOSBODILY NON -OWNED AUTOS C:OMSINFp:ANGLE LIMIT BODILY INJURY (Per person) INJURY (Per accident) PROPERTY DAMAGE Fer aceklent $ ............................................ $ S S S _•................ UMBRELLA LIAB EXCESS LIAB DED I RETENTIONS OCCUR CL.AIMS•MADE EACH OCCURRENCE _...... ......._.............................................................................. S $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN. ANY PRQPRIFTQR/PA R TN ER/E:XEtiUl IVF �� OFFICER/MEMBER EXCLUDED? (Mandatory in NH) It yet, deBcribe under N / A : PEN : OTH• i STATUTE j,. : ER EE. L. (•:ACI$ ACCIDENT 5 E.L. DISFAE - EA EMPLOYEE- ..._.__......._........_........._._......... _......�.._.... E L. DISEASE: • POI„lCCY LIMIT S ... $ DESCRIPTION OF OPERATIONS! LOCATIONS / VEHICLES (ACORD 101, Addltlonal Rornerks Saheduio, rndy he attached Ir more spacers requrrecu Electrical Work CANCELLATION Miami Shores Villas 10050 NE 2nd Ave MiOml Shore$, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WrtH THE POLICY PROVISIONS. AUTHORIZED REPRESNNTATIVE ACORD 25 (2014/01) ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD BUILDING PERMIT APPLICATION 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 FBC 20/1-/ - Master Permit No Jv JG[�ZQ� Sub Permit NoS1 Lc- 299/ ❑BUILDING ELECTRIC C] ROOFING ❑ REVISION ❑ EXTENSION DRENEWAL ®PLUMBING JOB ADDRESS: 1 oD Kre o SPI"Pr . City: Miami Shores County: Miami Dade Wq . Zip: 3 3) (a ( ❑ MECHANICAL OPUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTACTOR DRAWINGS Folio/Parcel#: 11 - ll 7_ - QZS-OS 2.0 is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): G=.gf'bR 1t1- k'5 Ku Kip V Phone#: MO y M -l$3 j F Address: %Os° N l0-4 City: :.-) I A I-' 'r'JFtO—" State: r1-- Zip: 3-3 1 1 Tenant/Lessee Name: Email: r t CONTRACTOR: Company Name: TPN & I-, A L 1 a( EL c.t R re At 0...01v-thlSCrilriiie#: le c., - 3Z. -4 ) © I Address: 1\ 3 S\ SW 1 S [S'� City: ���T lEILED Zip:Qualifier Name: RA.t-&Ok QQZREka1 Phone#:'84-3Z9-C'\O\ State Certification or Registration #: Ir=Tc 13 01 els 5 Z ` 1 Certificate of Competency #: 13 E.- �0©CS neR :TALI Architect/Engineer: tLI �J >iaJtLAX. R •A 14. h 2n 64 31 Phone#: Address: City: State: Zip: !!�� Value of Work for this Permit: $ /d0e SquarejLinear Footage of Work: Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: rOakz. l tc. k1 S i N� Ou""LsT A Phone#: / Specify color of color thru tile: Submittal Fee $ Permit Fee $ ;i{7 / dr' CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ a. T (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 ail taws 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 taws 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, Ali '. ertified copy of the recorded notice of commencement must be pasted at the job site for the first inspection which occurs seve i J%. ftec„ttle building permit is issued. in the abssuch posted notice, the inspection will •e approved and a reinsp !�■ u = tth rifed It Signature OWNER or AGENT The foregoing instrum- t was acknowledged before me this day of i_-A c,„,A0 - ..11. , who is personally known to , 20 r , by Signature Theforegoing instrume // /2 day of Ca'TRACTOR as ackno edged before me his G'bY known to me or who has produced as me or who has produced identification and who did take an oath. NOTARY PUBLIC: who is perso identification and who did take an oath. NOTARY PUBU Sign: Print: , , k_ as Seal: LUiS FERNANDEZ MY COMMISSION N EE 838180 EXPIRES: November 7, 2016 Bonded Thru Budget Notary Services •**•**att•t t•••t•**•*•*Wile**Wilt* •••***SW*t• ***** 0****•****••*SOWw11 II.*•kS4.►************* t4,41• r•****** APPROVED BY �%/ C- 3 /1-"4°//tlans Examiner Zoning Structural Review Clerk isedti2/24/2ola) STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 CABRERA, RAMON E RAMALEX ELECTRICAL CONTRACTOR, INC. 11351 SW 1 ST UNIT 305 MIAMI FL 33174 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 from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myflorldalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and leam more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! DETACH HERE RICK SCOTT, GOVERNOR (850) 487-1395 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ER13014852 � .. ' ISSUED:--06/02/2014 REG ELECTRICAL;CONTRACTOR-,. CABRERA, RAMON E'" `" RAMALEX ELECTRICAL CONTRACTOR. INC (INDIVIDUAL MUST MEETALL.LOCAL LICENSING REQUIREMENTS;PRIOR TO CONTRACTING IN ANY'AREA) HAS REGISTERED under the provisions of Ch.488 FS. Expiration date : AUG 31, 2016 L1406020001476 _. KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD LICENSE NUMBER - ER13014852 The ELECTRICAL, CONTRACTOR Named below HAS REGISTERED • Under the`provisiolis of Chapter 489 FS. =-Expiration date: AUG 31, 2016 (INDIVIDUAL MUStMEETALL :LOCA • REQUIREMENTS PRIOR TO'CONTRACTING IN ANY AREA) 'CABRERA, RAMON E . RAMALEX ELECTRICAL CONTRACTOR If4C -zr �,, -11351 SW 1 ST UNIT305 } " - " �`"j' , `" %: , ', MIAMI < - FL 33174 -17-.3.7 L LICENSING ISSUED: 06/02/2014 Scanned by CamScanner DISPLAY AS REQUIRED BY LAW SEQ # L1406020001476 002825 ti Local Business Tax Receipt Miami —Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 1 7159612 BUSINESS NAME/LOCATION 'RAMALEX ELECTRICAL CONTRACTORS INC 11351 SW 1 ST APT 305 MIAMI FL 33174 -1-_� OWNER �� ,h RAMALEXELECTRICAL CONTRS°INC t Worker(sY 1 .f� RECEIPT NO. RENEWAL 7436933 EXPIRES SEPTEMBER 30, 2016 Must be displayed at place of business_" Pursuant to County Code Chapter'8A - Art: 9 & 10 SEC. TYPE OF BUSINESS' 7196 ELECTRICALIGONTRACTOR " 13E000059 PAYMENT RECEIVED rBY TAX COLLECTOR $45.00 07/04/2015—" CREDITCARD-15-032888 1 p 11 This-Loca Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit, or a certification of the holder's qualifications, to do business. Holder must comply'witti any governmental /or nongovernmental regulatory laws andrequirementswhich apply to the business. `'" The -RECEIPT NO. above must be displaye1d on all commercial vehicles - Miami=Dade Code Sec�8a-276. ' For more information, vis www.miamidade.gov/taxcollector,. Scanned by CamScanner ACORD CERTIFICATE OF LIABILITY INSURANCE �./.-- DATE(MM/DDIYYYY) 11 /18/2015 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 Absolute Choice Insurance 9415 Sunset Drive Suite 151 Miami FL 33173 CONTACT NAME: Jeremiah Perez (ACNN , ). (305) 275-1777 vac, No): (305) 275-1711 E-MAILDDE info m absolutechoice.com ADDRESS: G Y INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: GRANADA INSURANCE COMPANY INSURED Ramalex Electrical Contractor Inc 11351 SW 1 ST 305 Miami FL 33174 INSURER B : INSURERC: 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 LTRINSD TYPE OF INSURANCE ADDL SUBR WVD POUCY NUMBER POUCY EFF (MMIDD/YYYY) POLICY EXP (MWDD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY 0185FL00042858-2 02/04/2015 02/04/2016 EACH OCCURRENCE $ 1,000,000 DAMAGE TO PREMISES (EaENTED occurrence) $ 100,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 5,000 X Deductible $500 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L X AGGREGATE POLICY OTHER: LIMIT APPLIES JE PER: PRODUCTS - COMP/OP AGG $ 2,000,000 $ AUTOMOBILE UABIUTY — 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 O OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' UABIUTY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A PER STATUTE OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Electrical Work CERTIFICATE HOLDER CANCELLATION Village of Miami Shore 10050 NE 2nd Avenue Miami, 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 25 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 01-26-2015 JEFF ATWATER 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. CHIEF FINANCIAL OFFICER EFFECTIVE DATE: PERSON: FEIN: 02/22/2015 EXPIRATION DATE: 02/21/2017 CABRERA RAMON E 460744279 BUSINESS NAME AND ADDRESS: RAMALEX ELECTRICAL CONTRACTOR INC 11351 SW 1ST ST UNITN 305 MIAMI FL 33174 SCOPES OF BUSINESS OR TRADE 1- LICENSED ELECTRICAL CONTRACTOR * * IMPORTANT: Plumate Is Caapa 440 . 061141. F.S., se otlicer of a nrporetiee wits elects elemeties free this chapter by filial a certificate et electlee seen Ibis settles Noy all *corm beet/Ills or cowpnsnlse mule, this Uepter. Paneled to Chapter 440.054121, F.S.. Comilla** el N,[tlaa to be exeap... Imply eely witfis tea atop el the heslaess or bode listed ea the notice al Marilee to be exempt. Petulant to Cbsper 440.06113). F.S., Notices o1 'Wise to be exempt est certnitaes at elettl u to be neap pall be settled to *vault's 11, st soy time aster t►e 11IIal N 1N mace et the ism** et Me tsrtllitate. the peso aimed es Om attics a nrtllitae ea leper meets the s*4olumsms at this sect*, let Issssece e1 a certificate. TN **putout 'fall revel' a certificate at ally time 1a lollies of tse paioa famed ea the cetillute le Neel the raasitemests al this wile,. OWC-252 CERTIFICATE Of ELECTION TO 8E EXEMPT REVISED 01-11 QUESTIONS? t850) 413-1609 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OP FLORIDA OEPARTMENT OP FINANCIAL SERVICES DIVISION OP WORKERS' COMPENSATION CONSTRUCTION INDUSTRY CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW EFFECTIVE 02/22/2015 EXPIRATION DATE: 02/21/2017 PERSON RAMON E CABRERA FEIN 460744278 BUSINESS NAME AND ADDRESS ameAttx tltCTaicA: COSTRACTOR INC 11331 SW 1ST ST UNITS 305 MIAMI. rl 33174 SCOPE OF BUSINESS OR TRADE 1. LICENSED ELECTRICAL CONTRACTOR IMPORTANT nPursuant to Chapter 44(105114). F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election L under this section may not recover benefits or compensation under this D chapter. H E R E Pursuant to Chapter 440.05112), F.S. Certificates of election to be exempt.. apply only within the scope o1 the business or trade listed on the notice of election to be exempt Pursuant to Chapter 440.05113). 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 turned on the notice or certificate no longer meets the repuirements of this section for issuance of a certificate. The department shill revoke • certificate at any time for failure of the person named an the certificate to meet the requirements of this section. QUESTIONS? WO) 413-1609 CUT HERE • Carry bottom portion on the job. keep upper portion for your records. P is r 1 DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01-11 Scanned by CamScanner