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EL-18-660Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Permit Permit NO. EL-3-18-660 Permit Type: Electrical - Residential Work Classification: Pool - Private Permit Status: APPROVED Issue Date: 4/2/2018 Expiration: 09/29/2018 Parcel Number Applicant 1070 NE 93 Street Miami Shores, FL 33138-2932 1132050160010 Block: Lot: ALFONSO DEL CASTILLO Owner Information Address Phone CeII ALFONSO DEL CASTILLO 1051 NE 92 Street MIAMI SHORES FL 33138- (305)613-5552 1051 NE 92 Street MIAMI SHORES FL 33138- Contractor(s) Phone CARABALLO ELECTRICAL INDUSTRI (786)715-6056 CeII Phone Valuation: Total Sq Feet: Type of Work: ELECTRICAL WORK FOR POOL Additional Info: 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 $4.50 $3.00 $0.40 $300.00 $3.00 $1.60 $313.70 Pay Date Pay Type Invoice # EL-3-18-66779 03/13/2018 Credit Card 04/02/2018 Credit Card Amt Paid Amt Due $ 50.00 $ 263.70 $ 263.70 $ 0.00 $ 1,500.00 0 Available Inspections: Inspection Type: Final Light Niche Bonding Review Electrical Alarms 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 ELECTRIC , -LUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT. I c rtify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoni thermore authorize the above -named contractor to do the work stated. April 02, 2018 Authoriz>:',= j.y ature: Owner / Applicant / Contractor / Agent Date Buildin • "-'partment Copy April 02, 2018 1 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 cErvED R 18.2018 FBC20 14 ' Master Permit No.` t 8 "'—� Sub Permit No. - 6 ❑BUILDING U ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 1Cq° q3 S i City: Miami Shores County: Miami Dade Zip: ;2)138 Folio/Parcel#: -© ) OI (p. COO Is the Building Historically Designated: Yes NO Occupancy Type: Load: _ Construction Type(5)) Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): , 1 V)<S lam-( (2,A4100 Phone#: - g— C-I Address: OR? tJ 9.V SI-. City: f A c ck r" r State: (, Tenant/Lessee Name: ikt Email: AfA Zip: 3) Phone#: W/A CONTRACTOR: Company Name: ctIon, a1eC'Z71CO ,ur.uS \nr, Phone#: }(p (26, Address: 5 1D (SW 1125 C City: WOW", State: fiL Qualifier Name: gene, (Avon State Certification or Registration #: EC I ( Certificate of Competency #: -7 cs DESIGNER: Architect/Engineer: ilf.q- Oro)- of pt. Phone#:.7 71S"— 7% Address: 9 (' ) .UL) " 12? City: 14!C(r)1 State: ' . Zip:. jj�` LJ. Value of Work for this Permit: $ 600 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Description of Work: TpCAI 44oUk_ Op Zip: 33RS Phone#::?i7S 525 SIGR ❑ Repair/Replace ❑ Demolition V.40111.;IJ' ,Ah:� ee�y„nr.-.dtA..... Nw.:6ta. •' n.+•e's...t.. v.Ai Specify color of ccir§i r Permit Fee $ YtQinZe> Submittal Fee $ Scanning Fee $ Technology Fee $ Structural Reviews $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Bond $119 TOTAL FEE NOW DUE $ 2.(a DBPR $ (Revised02/24/2014) Sign: Print: Seal: Bonding Company's Name (if applicable) Bonding Company'sifAddress City i,,' 4 11 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 tliat: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 perm it is Issued. In the absence of such posted notice, the inspection will not be approve ' d a reinspection fee will be charged. Signature ER or AGENT The foregoing instr m,�--nt was acknowledged before me this I' 1 day of. 00-91 , 20 1 , by 1 day of 1pt-C,\n. Signature +\t c) t Oathi6 , who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: 1 - DORIS ANAYS MARTINEZ Notary Public - State of F:orida Commission # GG 156732 My Comm. Expires Feb 14, 2021 *********************** APPROVED BY **************** CONTRACTOR The foregoing instrument was acknowledged before me this , 20 153 , by ex. IAAaGn , who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: Print: N►i Seal:▪ • ah ▪ #i i71 - !!l111111111\ ********************** Plans Examiner Liar Mirelis L. Martini comiessioN oscine EXPIAIS: DaeaMOrx 1.) Bonded TAru Aaron *troy as ************************************* Zoning (Revised02/24/2014) Structural Review Clerk STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD (850) 487-1395 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399-0783 ' CANCIO, GEORGE CARABALLO ELECTRICAL INDUSTRIES INC. 1825 PONCE DE LEON BLVD UNIT 469 CORAL GABLES FL 33134 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' LICENSE NUMBER STATE OFtELORIDA, , , DEPARTMENT O, F.,BUSINESS AND PROFESSIONAL REGULATION EC13008168 1 ` ` ;4tS UED • 11/20i2017 CERTIFIED EL. CTRI{CA'L CONTRACTOR A4,CANCIO,,GEORG' ' 1 '�' CARABALLO ELEC RI A "f t tl RIEs iN 1418`CERTIFIED.under the;'. provisions' of:Ch:489,FS. c! Ezprratkn dais , AUG 21, 2018 ▪ L171120o0Is0484 ...>-y--w�. DETACH HERE JONATN- STATE OF FLORIDA DEPARTMENT OF BUSINESS AND!PROFESSIONAL>.REGUI ATION,, ELECTRICAL CONTRACTORS LICENSING BOARO EC13008168, x `ADDITIONAL`-Bl1SIf+lESS QUA LXFIOTION; The ELECTRICAL CONTRACTOR Named below,IS CERTIFIED- Under the provision's of'Chapterw489 FS. 'Expiration date: °AUG°31; `2018 CANGIO:GEORGE '`""?"' CARABALLO ELECTRICA(LNDUS i RIES INC 5810 SW 113TH":GTT MIAMI ; .FL"33z173' . CHEtvt,•SECRETAR'f 1 ISSUED: 11/20/2017 DISPLAY AS REQUIRED BY LAW SEC) # L1711200000484 Local Busi ness Tax Recei pt Miami -Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 7235491 BUSINESS NAM E/LOCATION CARABALLO ELECTRICAL INDUSTRIES INC 5810 SW 113 CT MIAMI, FL 33173 OWNER CARABALLO ELECTRICAL INDUSTRIES INC (.10 (;F0R(4F (.AN'In (311AI IFIFR Worker(s) 3 RECEIPT NO. NEW BUSINESS 7521398 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 BY TAX COLLECTOR CONTRACTOR 75.00 11/27/2017 EC13008168 0237-18-001011 This Local Business Tax Receipt only con"ms payment ct the Local Business Tax. The Receipt is not a license, permt, or a certi "cation of the holder's qua! i "catio s, to do business. Hdder mist comply with any governmental or nongovernmental regulatory laws and retpirements which apply to the business, The RECt3 PT NQ above trust be displayed on all consmrcial vehicles - Miami -Dade 03de Sec 8a-278. MIAM For more information, visit www.rrianidade.gov/taxcd lector ,A RL` CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYY1f) 03/07/2018 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 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 Yes Insurance Agencies, Inc. 9507 Bird Road Miami, FL 33165 Phone (305) 225-5757 Fax (305) 223-8158 CONTACT Madeline Estrada NAME: (A/CNr o. Ex. (305) 225-5757 FAX No): (305) 223-8158 ADDRIESS: madeline@yesins.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Granada Insurance Comp. INSURED Caraballo Electrical Industries, Inc 5810 SW 113 CT Miami FL 33173 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 TYPE OF INSURANCE INSR SWVD POLICY NUMBER (UBR MM/DD/YEYYY) (MM/DD/Y EXP LIMITS A 1,/ COMMERCIAL GENERAL LIABILITY ❑CLAIMS -MADE 0 OCCUR ❑❑ N N 0185600103611 11/22/2017 11/22/2018 EACH OCCURRENCE $ 1,000,000.00 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000.00 MED EXP (Any one person) $ 5,000.00 PERSONAL & ADV INJURY $ 1,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: • POLICY ❑ JECT ❑ LOC GENERAL AGGREGATE $ 2,000,000.00 PRODUCTS - COMP/OP AGG $ 2,000,000.00 II OTHER $ AUTOMOBILE LIABILITY ❑ ANY AUTO OWNED . SCHEDULED ❑ AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ AUTOS ONLY HIRED . NON -OWNED AUTOS ONLY PROPERTY DAMAGE (Per accident) $ AUTOS ONLY • $ ❑ UMBRELLA LIAB ❑ OCCUR ❑ EXCESS LIAB ❑ CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ ❑ DED • RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / NER ANY PROPRIETOR/PARTNER/EXECUTIVEn OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A ❑ SPER TATUTE ❑ OTH E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Electrical Work -inside or outside building State LiC # 13008168 CERTIFICATE HOLDER CANCELLATION l Miami Shores Village Building Department 10050 NE 2 Ave Miami Shores, FI 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 REPRESENT TIVE Madeline Estrada t tom. �r / / vAllo ACORD 25 (2016/03) QF ©1988-2019ACORD CORPO . All ri. reserved. The ACORD rjame and logo are re l istered marks , f ACORD ACORO® CERTIFICATE OF LIABILITY INSURANCE ia.---- DATE(MMIDDIYYYY) 03107/2018 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 1191.1 of such endorsement(s). PRODUCER Automatic Data Processing Insurance Agency, Inc. 1 Adp Boulevard Roseland, NJ 07068 CONTACT NAME: FAX PAIC�. No. Est): (NC, No) AADDRESS: INSURER(S)AFFORDING COVERAGE RAC 0 INSURER A: Travelers Indemnity Company of America 25666 INSURED CARABALLO ELECTRICAL INDUSTRIES INC 5810 SW 113TH CT Miami, FL 33173 INSURER B : INSURERC: INSURER D: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 848022 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. IN LTR TYPE OF INSURANCE INSOL WVVDD POLICY NIMNBER El-F _MM0oY YYY) POLICY ESP (MM/DWYYYY1 LIMITS COMMERCIAL GENERAL UABILITY EACH OCCURRENCE 5 CLAIMS -MADE OCCUR DAMAt,E its REN u PREMISES (Ea accunence) S MED EXP (Any one parses,) S PERSONAL & ADV INJURY 5 GENTL AGGREGATE POLICY OTHER: LIMIT APPLIES PO - PER: LOC GENERAL AGGREGATE S PRODUCTS - COMP/OP AGG $ AUTOMOBILE - - -NONWNED LJABIuTY ANY AUTO ALL OWNED AUTOS HIRED AUTOS - SCHEDULED NON-OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) 5 BODILY INJURY (Per accident) S i d accident), $ 5 UMBRELLAUAB EXCESS UAB _ OCCUR CLAIMS -MADE EACH OCCURRENCE S AGGREGATE $ DED RETENTIONS 5 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICERMIEMBER EXCLUDEDANY ? PROPRIETOR/PARTNER/EXECUTIVE (Mandatory in NH) If yes describe under DESCRIPTION OF OPERATIONS below YNN N I A N UB4K598858317 12/13/2017 12/13/2018 X PER UTH- STATUTE ER E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE -EA EMPLOYEE 5 100,000 E.L. DISEASE - POLICY UMI T S 500,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Contractor License: State LIC # 13008168 CERTIFICATE HOLDER CANCELLATION Miami Shores Village BLDG Department 10050 NE 2 Ave 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 ) AI)1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD