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EL-18-1984Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Permit Permit NO. EL-7-18-1984 Permit Type: Electrical - Residential Work Classification: Alteration Permit Status: APPROVED Issue Date: 7/26/2018 Expiration: 01/22/2019 Parcel Number Applicant 474 NE 95 Street Miami Shores, FL 33138- 1132060140440 Block: Lot: ANNE & NESTOR MORALES Owner Information Address Phone CeII ANNE & NESTOR MORALES 474 NE 95 Street MIAMI SHORES FL 33138- (305)283-7233 (305)733-6534 Contractor(s) JD ELECTRIC INC Phone (305)299-2482 CeII Phone Valuation: Total Sq Feet: $ 2,500.00 0 Type of Work: RELOCATE EXISTING PANEL 200 AMP 6 R Additional Info: RELOCATE EXISTING PANEL 200 AMP 6 R Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Amount $1.80 $3.38 $2.25 $0.60 $225.00 $3.00 $2.40 Total: $238.43 Pay Date Pay Type Invoice # EL-7-18-68326 07/25/2018 Credit Card 07/26/2018 Credit Card Amt Paid Amt Due $ 50.00 $ 188.43 $ 188.43 $ 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 certi that - i e foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Fu r� :�,- thrize the above -named contractor to do the work stated. July 26, 2018 Authorized ner / Applicant / Contractor / Agent Date Building Department Copy July 26, 2018 1 Miami Shores Village REC GOBuilding Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY: Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 BUILDING PERMIT APPLICATION FBC 20n' 018 Master Permit No. ? C 3/6 r8 Sub Permit No. t _ I g I BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL El PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: a i. /VG 95 5r City: Miami Shores County: Miami Dade Zip: 7 2 3/ .3 9 Folio/Parcel#: Is the Building Historically Designated: Yes NO X. Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: �S OWNER: Name (Fee Simple Titleholder): y/(/� ��� /v, /U4/1 /' Phone#: 3c ? 3-.> 3,3 Address: yi c /1/65S 5/- City: 11/ r S State: ` Zip: 3/ 3 d Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: +L1 & l 7-/C, iii1C• Phone#: 5 a'T}- / Address: 07.v1/�1Lt' 1(O� ,L4 City: " fr 47L-f1 OC-f-I k-S State: K_ Zip: 33o • Qualifier Name: L'•S L 5' Phone#:''OS- ? 9?- RZ State Certification or Registration #: Certificate of Competency #: /(, -O se - DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: eEL0C1 7 .- ,039/IYEL ,00 .09H 6 /Ze5fEse) Z.6 r s Specify color'`ofkcolor thru tile: , r sr $YCI ' �6 8,: # Permit'Fee $ XZ.�Pe, 7" TCF $ CO/CC $ Submittal Fee "' ` r Scanning Fee $ ^"Ni, ‘• � . t x -11 Radan'Fee $ Q . pis DBPR $ 3 Notary $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ ( E3B • L{ 3 Technology Fee $ Training/Education Fee $ (Revised02/24/2014) BondingCompanyssName (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip 0,4 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 ATTORNEYBEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be p'osted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the Absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature 'OWNER or AGENT The foregoing instrument wasack/nowledged before me this May of 4��, 20 , by � c' J ��f who is�. personally+��known to and or who has produced _1 I ) C. .... fr -as identification and who did take an oath. NOTARY PUBLIC: Sign: ,, Z I C Print: I Pf M ;pPr t: (1i��/�t' � � , EXPIRES:November 20 Seal: ' • Fo� q o Bonded Thru Notary Public Undervrt tee Signature CONTRACTOR The foregoing instrument was ack wledged before me this 0 8 dey of — , 20 / e , by CA►Zi-OS 23 N, , who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLI : ttt**tt tt t t tt********+kit*** APPROVED BY *****tttttttt t ttt tt*** ttt****** tt tttt t**** Y xj-LUh y Plans Examiner Structural Review Jodi Ellis Cardenas NOTARY PUBLIC V, _ STATE OF, FLORIDA Omo 4.7a8D6'JOttttt#t#t##t# 410E141 Expires 2/14/2022 Zoning Clerk (Revised02/24/2014) "y T B ConstructionTrades ualifying tion fY 9 Board BUSINESS CERTIFICATE OF COMPETENCY 1 6E000056 JD ELECTRIC INC D.B.A.: SOSA JUSTO � is certified under the provisions of Chapter 10 of Miami -Dade County QUALIFYING IN TRADE S) 1 ELECTRICAL 0002 BURGLAR 0004 FIRE E LT arta H Salas P E.. cretary of the Board CountY r€ Local Business Tax Receipt Miami -Dade County, State of Florida THIS* NOT AEtAI- (XNOTPAY 7215886 SU$eNU$$ NA•M$dtOCATION1 3D ELECTRIC. INC 8877 NW 168 LN MOW If 33018 Ott N$Al )0 ELECTRIC, INC C1O JUSTO L SOSA Woc+rfsl 1 Nac$w►r NO. RENEWAL 7499914 EXPIRES SEPTEMBER 30, 2018 Wool be displayed of otoce oft s.nein PPftvent to County Coda CTI410/ a 8A - Art 9 6 10 NC TYt>III Of <UIWIIRis 196 SPEC ELECTRICAL CONTRACTOR 16E04X056 PAYMtNT RIC$,VED BY TAX cOLLsCToq S45 00 09/ 18l2017 CREDITCARD-17-059058 This l.c:N Me,eew Tait Soule onto confirm* p.ywea sf Ss 1, .t w►aNs list nis Remy is ewe IKses.. ►eria vie twilit/Neel rler Mi an • erstliie.f,.ws to do iywlr+w M111.r nee ci.py woe any ! er es ngeowsreee.l oolpoletry lows noopeneserrtf wee* sooty to tie Mswq The T N Mote rust N dnpl.r,d se eilsetsssn.rciel sswlc+ao • Worm -Bade Cad. Sot 144 f or nets IM.rouen•ok elegy grookiembitsoldoocoItoctoo Municipal Contractor's Tax Pace pt Miami-DadeCounty, State of Fiona -TNtj IS NOT A Eft i - 00 NOT PAY CC NO. 16E000056 t.D fl T IiON rLOiA esnNW166LN MVO. F 33016 °wNts UTRC, INC OOJ$ID 1 SDSA RECEIPT NO 7510618 EX PIRES SEPTEMBER 30, 2018 TYPE Of DVSMNESS SECOILT/ ELECT/CAL ODP(IFIACTCP Puteasrt to County Coda Sec 10-?4 PArV ENt PECElvED t3Y tAR COLLECTOR 200 00 10r 18/ 2017 0237E 18-000212 7hwsrscrMprs!otAOKIInreIttlaruratlt r►c.Drit:cs Avert"' . Okra !oilcan oar" Fi s�erytne. Mom Or4Ma Woo L*.t Ise/motto Eiaf. Ftnsctcmt. Sorry tee) bawl Town ay claw esv Fay more • rkpr bon. esst rrwfp.Q11a[1 i OCYJt RICK SCOTT', GOVERNOR JONATHAN ZACHEM, SECRETARY FI rida d STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD THE ELECTRICAL CONTRACTOR HEREIN HAS REGISTERED UNDER THE PROVISIONS OF CHAPTER 489, FLORIDA STATUTES d • • • t'; SOSA, JUSTO 14` JD ELECTRIC, INC. 8877 NW 168 LANi_' MIAMI LAKES FL 33018 v M till • 1 • • • • • s LICENSE NUMBER: ER13015195 EXPIRATION DATE: AUGUST 31, 2020 Always verify licenses online at MyFloridaLicense.com Do not alter this document in any form. This is your license. It is unlawful for anyone other than the licensee to use this document. A v CERTIFICATE OF LIABILITY INSURANCE DATE(M D $ ') 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. f IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or 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 Interassurance 9190 Biscayne Blvd., Suite #201 Miami Shores, FL 33138 Phone (305) 758-8322 Fax (305) 758-4456 CONTACT ARIEL AJO NAME: PHONENo Ext) (305) 758 8322 FAX (NCC. No): (305) 755 -4456 ReSS: ariell)�interassuranc.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: WESCO INSURANCE COMPANY INSURED JD Electric, Inc 8877 NW 168th Lane Miami Lakes FL 33018- INSURER B : 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 ADDLSUBR INSR WVD POLICY NUMBER POLICY EFF (MMIDINYYYY) POLICY EXP (MMIDINYYYY) LIMITS A n COMMERCIAL GENERAL LIABILITY ❑ CLAIMS -MADE M OCCUR n INLAND MARINE INCLUDED Y WPP1474200 - 01 06/28/2018 06/28/2019 EACH OCCURRENCE $ 1,000,000.00 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000.00 MED EXP (Anyone person $ 5,000.00 ❑ PERSONAL & ADV INJURY $ 1,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: PRO- n POLICY ❑ JECT❑ LOC GENERAL AGGREGATE $ 2,000,000.00 PRODUCTS - COMP/OP AGG $ 2,000,000.00 ❑ OTHER DEDUCTIBLE $ 500.00 B AUTOMOBILE LIABILITY ❑ ANY AUTO OWNED ❑ SCHEDULED ❑ AUTOS ONLY AUTOS ❑ HIRED ❑ NON -OWNED AUTOS ONLY AUTOS ONLY ❑ ❑ COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ C ❑ UMBRELLA LIAB ❑ OCCUR ❑ EXCESS LIAB ❑ CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ ❑ DED ❑ RETENTION $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIV N / A ❑ PEATl1TE ❑ OTH ER E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE -POLICY LIMIT $ E DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) LICENSE NUMBER: 16E000056 CERTIFICATE HOLDER CANCELLATION I MIAMI SHORES VILLAGE BUILDING DEPARTMENT 10050 NE 2ND AVE MIAMI SHORES, FL33138 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 Ariel Ajo'" ACORD 25 (2016/03) QF © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORio CERTIFICATE OF LIABILITY INSURANCE `,---- '• °Att(i""�"'°"'"Y' / 07/2i/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 Automatic Data Processing Insurance Agency, Inc. 1 Adp Boulevard Roseland, NJ 07068 CONTACT NAME: PHONE No, EXt): INC. No): ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : NorGUARD Insurance Company 31470 INSURED . JD ELECTRIC INC 8877 NW 168TH LN Hialeah, FL 33018 INSURER B : INSURER C INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 945710 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 POLICY NUMBER POLICY EFF (MMIDDIYYYY) POLICY EXP (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS MADE OCCUR DAMAGE TO RENTED , ", PREMISES (Ea occurrence) r S. MED EXP (Any one person) $ PERSONAL & ADV INJURY $ 'GEN'L AGGREGATE LIMIT APPLIES JPERCOT PER: GENERAL AGGREGATE $, PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE LIABILITY SCHEDULED COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY(Per accident) ^t) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAR EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS LIABILITY OFFICER/MEMBER ANY EXC EXCLUDED? PROPRIETOR/PARTNER/EXECUTIVE (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N NIA N JDWC992399 05/21/2018 05/21/2019 X PER STATUTE OTH- ER EL. EACH ACCIDENT $ _ 1,000+000 EL. DISEASE- EA EMPLOYEE $ 1,000,000 EL DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Contractor License: 16E000056 CERTIFICATE HOLDER CANCELLATION Miami Shores Village Building Department 10050 Northeast 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) A© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD