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EL-18-3230Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 r issue Date:10/24/20 Permit No.: EL- 10- 18-3230 Permit type: Electrical - Residential Work Classification: Alteration Permit status: Approved Expiration: 04/17/2019 Location Address Parcel Number Project F868 NE 100 ST, Miami Shores, FL 1132060340020 <NONE> Contacts MOHAMMED AUEHANI Owner MOHAMMED AUEHANI Applicant 868 NE 100 ST, MIAMI SHORES, FL 33138 868 NE 100 ST, MIAMI SHORES, FL 33138 Other:4126133587 Other:4126133587 BILMAR ELECTRIC INC Contractor WILLIAM HARRINGTON 12220 SW 119 PL, MIAMI, FL 33186 Business: 3053459005 Description: 10 feet to 1-200 tank for range portable bbq Valuation: $ 250.00 Inspection Requests: and water heater Total Scl Feet: 10.00 Fees Amount Application Fee - Other $50.00 CCF $0.60 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.20 Permit Fee $50.00 Scanning Fee $3.00 Technology Fee $2.50 Total: $110.30 Payments Date Paid Amt Paid Total Fees $110.30 Credit Card 10/24/2018 $60.30 Credit Card 10/19/2018 $50.00 Amount Due: $0.00 Building Department Copy 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 re9st o d uthjermore, I authorize the above named contraactor to do the work stated. 7gulati7 Authorized Signature: Owner / Applicant / Contractor / Agent Date October 24, 2018 Page 2 of 2 r 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 BUILDING PERMIT APPLICATION ❑ BUILDING Nf ELECTRIC ❑ ROOFING ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS RECETVFD CT 19 2018 i BC 20R Master Permit No. ? L 9 - 1 p - 22 93 Sub Permit No37,3 ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 10 IV� too 5� City: Miami Shores County: Miami Dade Zip: 33 138 Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): /v I(-> kammIJ k l 664A � Phone#: q l ?, — 6 1 3 - 34 7 Address: �62 A)G I On Sf City: ! v` r wm i S14D(L°S State: F Zip:: 3 ) 3 ' Tenant/Lessee Name: Phone#: '111-6 %3 —ZY7 Email: CONTRACTOR: Company Name: al l mac PeLtr1c Tic Phone#: 34� 3 yS 9o5 Address: 1 ZZZO 5 W I P L �^ry G / City: 1 U1W11 State: T` L Zip:3 Qualifier Name: NAI i k9�0\ IaL r i n4 orl Phone#: 3C75 - State Certification or Registration #: G� Z� 7� Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ Z) Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ew ❑ Repair/Replace ❑ Denolition Description of Work: PLV\ I f-�C. woJeA Specify color �o(f�color thru tile: Submittal Fee $ ) Permit Fee $ f©G ll-2 CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $bo 30 (Revised02/24/2014) ,V a Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip 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 Signature �/ ' W4,�� NfR or AGENT CONTRACTOR The foregoing instrument w acknowledged beforemethis day of O 20/ a by /%WunthgP f& ouv% , who is personally known to me or who has produced The foregoing instrument was acknowledged before me this day of 20`�4Jby w 1�(am qr rri-h4�01 , who is personally known to as me or who has produced identification and who did t k no identification aUA•e1�eQtlrt!�� TAMMy B. VALDES ....Y P I" TAMMY B. VA ,.)FS " ' NOTARY PUB 'o�� °'%''- NOTI .�`pY P �4, G.r • • �,- Notary Public Sta+ Florida allotary Public -State ofFlorida = c Commission # Gr 038648 Commrssron # GG 038648My Comm Expires Oct 26. 2020 =";r P, My Comm Expires O t 25 2020 Sign:o< ""nett through National Notary Assn. gig". °� Bonded through Naliona N ;a y Assn. Print: Print: Seal: �" ��v� Seal: as APPROVED BY ��Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) r RICK SCOTT, GOVERNOR JONATHAN ZACHEM, SECRETARY 1 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGI ELECTRICAL CONTRACTORS LICENSING BOAR[ THE ELECTRICAL CONTRACTOR HEREIN IS CERTIFIED UNDER T PROVISIONS OF CHAPTER 489, FLORIDA STATUTES BILMAR ELECTRIC INC 12220 SW 119 PL MIAMI FL 33186 LICENSE NUMBER: EC13002578 EXPIRATION DATE: AUGUST 31, 2020 Always verify licenses online at MyFloridaLicense.com a o Do not alter this document in any form. Q�.. This is your license. It is unlawful for anyone other than the licensee to use this document. I Loca Rosiness 78K Recei[A Miami —Dade County, State of Florida7D T —THIS IS NOT A BILL — DO NOT PAY 5405634 BUSINESS NAME/LOCATION RECEIPT NO. LKE2� R ES BILMAR ELECTRIC INC (f8(# MIE1l1 AL 1[,:p L 30, %?P®q q 12220 SW 119TH PL 4151528 Must be displayed at place of business MIAMI FL 33186 Pursuant to County Code Chapter BA — Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS pAYM5NT RECEIVED BILMAR ELECTRIC INC 196 ELECTRICAL CONTRACTOR BY TAX COLLECTOR WIWAM HARRINGTON, QUALIFIER EC13002578 $75.00 07/31 /2018 Worker(s) 1 CHECI(21-18-076709 This Local 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 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 www.miamidade.goy/taxcollector To: Page 2 of 2 2018-10-19 18:49:08 (GMT) 13057352843 From: Bill Mickey CERTIFICATE OF LIABILITY INSURANCE 1 DATE 10/18/18NY) PRODUCER Alliance InsuranceAgency, Inc. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 2950 SW 27th Ave Suite 100 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE I j HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Coconut Grove, FL 33133 I ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Phone (305)444-8000 Fax (305)735-2843 I INSURERS AFFORDING COVERAGE NAIC # INSURED BILMAR ELECTRIC, INC. INSURER A: GRANADA INSURANCE COMPANY 09730 13012 12220 SW 119 Place I INSURER B: NORMANDY Miami, FL 33186 INSURER C: (305) 255-7594 !INSURER D: I INSURER E: COVERAGES r— -_ __:— _— _.—.— .—.. —_....—_..—.._...--...._._...---._.—.. i nt rvucrt;, Ur rNsuNANCE LIS I ED 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 OF MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH _POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR IM ADD'LSRO TYPE OF INSURANCE POLICY NUMBER _ POLICY EFFECTIVE POLICY EXPIRATION DATE MNI1OD/YYYY ,DATE ININIXIDlYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE 1,000,000 COMMERCIAL GENERAL LIABILITY 0185FL00040350-6 11/04/2018 i 11/04/2019 PREMISES Ea occurrence) 100,000 ❑ CLAIMS MADE [Z OCCUR i ME EXP (Any one person) 5,000 A ❑ ❑ PERSONAL & AOV INJURY 1,000 000 ❑ GENERAL AGGREGATE 2,000,000 GEITL AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG 2,000,000 I ❑ POLICY []PROJECT ❑ LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ❑ ANY AUTO (Ea accident) ❑ ALL OWNED AUTOS ❑ SCHEDULED AUTOS I BODILY INJURY person) ❑(Per HIRED AUTOS BODILY INJURY ❑ NON OWNED AUTOS 1 (Per accident) ❑ PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT ❑ � ANY AUTO OTHER THAN EA ACC AUTO ONLY: AGG EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE ❑ ❑ OCCUR ❑ CLAIMS MADE AGGREGATE ❑ DEDUCTIBLE ---- -- ---- ❑ RETENTION S WORKERS EMPLOYERS' LIABILITY ON AND NHFL0074232018 08/04/2018 i 08/04/2019 WCSTATU- ❑ OTH- B ANY PROPRIETOR / PARTNER / EXECUTIVEY/N TORY LIMITS ER OFFICER / MEMBER EXCLUDED? Y E.L. EACH ACCIDENT 10Q QQ0 (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE 500,000 If ves, describe under SrSECIAL PROVISIONS below ! E.L. DISEASE - POLICY LIMIT 100,000 _ OTHER�_—_..__....._._....._..._.—.—._.�._..............—_� DESCRIPTION OF OPERATIONS ! LOCATIONS —.._--i-._.._.._—.—.._.....__..._....... — .................. — ..._............ VEHICLES !EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS ELECTRICAL WORK EC13002578 I CFRTIFICATF Lent neo ------ — -- — — — - - - L.MiVI.cL.L A I [VN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL Miami Shores Village 30 _ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO 10050 NE 2nd Avenue THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY Miami Shores, FL 33138 OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE . _ _..... IlOt) QF 01988-2009 ACORD CORPORATION. All rights reserved. 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