Loading...
EL-16-187Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address P ■ rl Issue D Permit NO., EL-1-16-187 Permit Type: Electrical - Residential Work Classification: Alteration PenPit Status: APPROVED : 1/25/2016 Expiration: 07/23/2016 Parcel Number Applicant 1201 NE 94 Street Miami Shores, FL 33138- 1132050100010 Block: Lot: BERNARD LEE Owner Information Address Phone Cell BERNARD LEE 1201 NE 94 Street MIAMI SHORES FL 33138- (954)673-6513 1201 NE 94 Street MIAMI SHORES FL 33138- Contractor(s) Phone POWER POINT ELECTRIC, INC (954)882-2822 Cell Phone Valuation: Total Sq Feet: $ 14,000.00 0 Type of Work: REMOVE, REPLACE AND RELOCATE SWITCH 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 $8.40 $7.35 $7.35 $2.80 $5.00 $490.00 $3.00 $11.20 $535.10 Pay Date Pay Type Invoice # EL-1-16-58426 01/25/2016 Check #: 206 01/22/2016 Check #: 205 Amt Paid Amt Due $ 485.10 $ 50.00 $ 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, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I c foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhe(more, uthorize the above -named contractor to do the work stated. Authorized Signa January 25, 2016 / Applicant / Contractor / Agent ate Building Department Copy January 25, 2016 1 Construction Type: Flood Zone: infra ice.oei' s Address: City: VtntS� o for this Permit: $ T eof Work ❑ +Addition �AI eration Decriation of Work..: - .:Z coiid, Y it.h :1ii?Lli•sr - :aru'xr+yv+'r'�,""'+t„•:� Address •(o23 A BUILDING PERMIT APPLICATION ❑BUILD,ING 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 N222016 r—S6•10,-- FBC 20 Master Permit No. - R C / 5 161 Sub Permit No. (),y 1 ❑ REVISION ❑ EXTENSION ❑ RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR p JOB ADDRESS: C / o2 0/ NE < P� Swc--er City: Miami Shores County: Miami Dade DRAWINGS Zip:tf 3 3 / 3-6 Folio/Parcel#: Is the Building Historically Designated: Yes Occupancy Type: Load: OWNER: Name (Fee Simple Titleholder): Address: ! / 2of /V6 l TK * 57Q City: NL/A,4( •SffOR j State: "r—L Tenant/Lessee Name: Email:. ,.._ At/4 NO BF.E• FFE: Phone#: Zip: Phone#: r� CONTRACTOR: Company Name: ?Dlv\\(';' \�lr►, } � ` City: i1jO\`\it-A-K, 9(lk State: Qualifier Name: Ui)S 9 Phone#: A Zip: 3?a n .2.-L Phone#: State Certification or Registration #: C \ 0 52 4'kCl Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: State: Zip: Square/Linear Footage of Work: ❑ New ❑ Repair/Replace ac74.4c& , )c' i9 OLA-7D 5 a't1 ❑ Demolition A DJiGMS Specify color of color thru Submittal Fee $ (.5b Scanning Fee $ 3 •i(3z) Technology Fee $ 1 1 • 2--° tile: Permit Fee $ 1174,, Radon Fee $ ' "35 CCF $ • `I 0 CO/CC $ ~T/ DBPR $ • 3 S Notary $ 5 • W Training/Education Fee $ Double Fee $ Structural Reviews $ (Revised02/24/2014) Bond $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City ti 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 O or AGENT The foregoing instrument was acknowledged before me this / y day of , J QV/oar-4/ , 20 << , by '&/%I / 1) Lo , who is personally known to me or who has produced /—'T) as identification and who did take an oath. NOTARY PUBLIC: Si t Print• Seal: 1 Notary Public State of Florida , Joanna M Feliciano er My Commission FF 082753 ptl" t:kpires 01/12/2018 Signature �CONTRAC OR The foregoing instrument was acknowledged before me this L4 day of V 0-1) ,20 /{_0 ',by aJ , who is personally known to me or who has produced AA 1r S kv-\ as identification and who NOTARY PUBLIC: Print: Seal: RENNY PUENTE. Notary Public- State o1 Florida My Comm. Expires Mar 7; 2016 Commission # EE 177136 Bonded Through National Notary Assn. ************************************************************************************************************ APPROVED BY 23T11",— Plans Examiner Zoning (Revised02/24/2014) Structural Review Clerk DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD EC13005249 The ELECTRICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 BARBOZA, LUIS DIEGO POWER POINT ELECTRIC, INC 6235 GRANT COURT HOLLYWOOD FL 33024 ISSUED: 07/06/2014 DISPLAY AS REQUIRED BY LAW SEQ 4 L1407060000637 Er BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000 VALID OCTOBER 1, 2015 THROUGH SEPTEMBER 30, 2016 DBA: Business Name: POWER POINT ELECTRIC, INC. Owner Name: LUIS DIEGO BARBOZA Business Location: 6235 GRANT COURT HOLLYWOOD Business Phone: Rooms Seats Employees 1 Receipt #'ELECTRICAL/ALARMS/CONTRACTOR Business Type: Business Opened:o1/25/2013 State/County/Cert/Reg: EC13 005249 Exemption Code: Machines Professionals For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 0.00 0.00 0.00 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT WHEN VALIDATED Mailing Address: LUIS DIEGO BARBOZA 6235 GRANT COURT HOLLYWOOD, FL 33024 U.S.A. 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 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. 2015 - 2016 Receipt #WNW-14-00124657 Paid 07/28/2015 27.00 City of miami shores 10050 NE 2nd Ave Miami Shores FL 33138 Fax 3057624949 Gracias, buen dia Sent from my T-Mobile 4G LTE Device AC Ie0 D CERTIFICATE OF LIABILITY INSURANCE DATE (NMaMYYYYY) 01/152018 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: ■ the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed If SUBROGATION IS WANED, subject to the tans and corafitlons of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder hi 8eu of such endorsement(s). PRODUCER UNIWORLD INSURANCE INC 12555 Orange Drive Suite 271 DAVIE FL 33330 R°NTRerNeon Marla RICRE ELM954343 0055 1 ray, „ot 954-843 0058 VIIN IN. ADDRESS: malbf©unMm oddinsunce.com IISURERIS) AFFORDING COVERAGE NAICI A: Ascendant Underwriters INSURED Poweryant FJeG3iic IndLuis Bamoza 8235 (Gala Ct Hollywood FL 33024 INSURER a INSURER : 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. NOTNRTHSTANDING 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 COIRM11ONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. RSR I1R TYPE OF SIWRNCE NI AWL n WEIR WW POLICY MAWR FOUCYEFF nisvoc YWY) POUCYEP DINOD/YYYf UNITS A XCOMERCIALGENEtAL UAWTy CAI SMAOE P OCCUR GL41585-3 01/29/2018 01/29/2017 EACH OCCURRENCE s 1,000,000 OAMAGRNTED PREES/Eaosunerce) $ MEDEXP(Arm one penon) $ 5'000 PERsoHAL a AlWINORY $ 1,000,000 GEML _ AGGREGATE LIMIT APPLES PER: PRO - PCUCY 1111 ALT II LOC OTHER: GENERAL AGGREGATE S 2,000400 PRGOIICTS-COMmAPAEG $ 1•0°°•°°° $ AC 110811EU WTY ANY AUTO ALL ONNED AUTOS HREO Atm]S SCHEDULED AUTOS NON-OA ED AUTOS INSINGLE UNIT Ma NONNI $ BODILY INURY(Per penes) $ BOULV INJURY (Per anclidM) $ PROPERTY DAMAGE (Per Lindell S s _UNBREI.LALAB EXCESS LMIB _ OCCUR CLAIMS -MADE EACH ECCURRENCE $ AGGREGATE $ pED 1 JRETENTION $ $ ANINERS COMPENSATION D EMPLOYERS LIABILITY YIN N/A IS ATUTE I 2RTH- EL EACH ACCIDENT $ ANY PROPRIETORNNONEREXECUNYE OFFICEULEMBEREXCLUCEo, ■ D•FbyMn� AlaIn NH) DESCRIPTION OF OPERATIONS Wow EL DISEASE- EA EMPLOYEE $ EL DISEASE -POUJCY LINT $ ONSCRIItlN OF OPEIATONSI LOCATONSI YBICLFB (AGGRO 101, Ad50...SRmarksa 1rdu4, nmy be Ala and N mom epee Is npWed) Electrician CERTIFICATE HOLDER CANCELLATION City of Mimi Shores 10050 NE 2 Ave MOOR Shores 1_ FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN At,horu MWF NTH THE POLICY PROVISIONS AUTHORIZED REPRESENTATIVE �/v'r . ACORD 25 (2014/01) ©1988-2014 ACORD CORPORATION. All rights reserved. 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 BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW EFFECTIVE DATE: 1/17/2016 PERSON: BARBOZA FEIN: 371709829 BUSINESS NAME AND ADDRESS: POWER POINT ELECTRIC, INC 6235 GRANT COURT HOLLYWOOD EXPIRATION DATE: 1/16/2018 LUIS FL 33024 SCOPES OF BUSINESS OR TRA D 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 !CONTRACTOR DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS? (850)413-1609 PowerPoint Electric 6235 Grant Court Hollywood, FL 33024 Date: 1 f I L \ 6-t State of: �-LU County of: OND Before me this day personally appeared ) J Qr llLwho, being duly sworn, deposes and says: That he or she will be the only person working on the project located at: IZvI ti ,� (ALA. S� \I)OcM iAivres 33i6 Sworn to (or affirmed) and subscribed before me this 1U day of 1 1UL-6y 2016, by „,� P,,,, RENNY PUENTE 1 Notary Public - State of Florida ' Type of Identification •1 My Comm. Expires Mar 7, 2016 -,dk " cloy Commission # EE 177136 , iervo\•' Bonded ThroughNational Notary Assn. Personally know OR Produced Identification Print, Type, or Stamp ame 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 person allowed to work on your project. In these circumstances, Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company for day labor, part-time employees or subcontractors. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: State of Florida County of Miami -Dade The foregoing was acknowledge before me this :ILO By ✓XMEir JOJ Loos- Notary: SEAL: day of Oa, N U , 20 fC who is personally known to me or has produced as identification. �Q •91 VB� Notary Public State of Florida Sindia Alvarez My Commission FF 156750 �oFc�fl� Expires 09/03/2018