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EL-18-1840yFCA Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit No. EL-7-18-1840 Permit Type: Eletriial - Residential t ert Work Class cation: Addition/Alteration Permit Status: APPROVED Issue Date: 7/13/2018 1 Expiration: 01/09/2019 Project Address Parcel Number Applicant 975 NE 94 Street 1132060350020 Miami Shores, FL 33138- Block: Lot: SEVEN BALCONIES LLC Owner Information Address Phone Cell SEVEN BALCONIES LLC 6815 BISCAYNE Boulevard (786)387-1483 MIAMI SHORES FL 33138- 6815 BISCAYNE Boulevard MIAMI SHORES FL 33138- Contractors) Phone Cell Phone REGENCY MAINTENANCE & ELECTRI (305)728-9171 ype of Work: KITCHEN & BATHROOM REMODELING dditional Info: KITCHEN & BATHROOM REMODELING lassification: Residential canning: 1 Fees Due Amount CCF $6.00 DBPR Fee $5.25 DCA Fee $3.50 Education Surcharge $2.00 Penalty Fee $100.00 Permit Fee - Additions/Alterations $350.00 Scanning Fee $3.00 Technology Fee $8.00 Work without Permit Fee $350.00 Total: $827.75 Valuation: $ 10,000.00 Total Sq Feet: 0 Pay Date Pay Type Amt Paid Amt Due Invoice # EL-7-18-68164 07/09/2018 Credit Card $ 50.00 $ 777.75 07/13/2018 Credit Card $ 777.75 $ 0.00 iavanaoie inspections: Inspection Type: Final Meter Box Alteration Relocation Fire Alarm Service Change W. W. Underground 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. OWN FfBj ify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating co ction and/z Wing. Futh rmore, I authorize the above -named contractor to do the work stated. AutWorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy July 13, 2018 1 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 �LECTRIC ❑ ROOFING JUN 0 9 a018 FBC 2011 "4 Master Permit No.�^^ C 8 I29 Sub Permit No. 'Gl- 8 �4c ❑ REVISION EXTENSION [:]RENEWAL ❑PLUMBING [:]MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP �f CONTRACTOR DRAWINGS JOB ADDRESS: City Miami Shores County Miami Dade Zip: Folio/Parcel#: Is the Building,Hi'sftbrically Designated: Yes NO Occupancy Type: Load: construction Type:_Fone: IT BFE: FFE: OWNER: Name (F a Simple Titleholder): P Address: 1 S City: ` Tenant/Lessee Name: _ Email: 0 CONTRACTOR:Company Name: *e Address: _ 4 � � rs _� City: 1:1�//L4—rC Qualifier Name: State Certification or Registration #: DESIGNER: Architect/Engineer: aoj 72S W7/ Zip: of Competency #: _ Phone#: Address: City: State: _ Value of Work for this Permit: $X4t7z� 03 Square/Linear Footage of Work: Type of Work: ❑ Addi ion Alteration ❑ Repair/ place i Description of Work: �v ' 4 Zip: ❑,DemolVion, Specify color of color ihhi tale Submittal Fee $ Permit Fee $�d:_� b CCF $ CO/CC $ Scanning Fee $ Radon Fee $ 3 ' DBPR $ S Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ ) QO , CD TOTAL FEE NOW DUE $ (Revised02/24/2014) 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 wh' h occurs seven (7) days after the building permit is issued the absence of such posted notice, the inspection will not be ap pokd and a reinspection fee will be charged. lof Signatu or AGENT The foregoing instrument was acknowledged before me this Ci _ day of AU VA 20 i $ by AA I Ams _ V • A Ir, who is U personally known to me or who has produced Y'NI -t CArS`-1 as NOTARY P BLIC. Sign: Print: Seal: ************* APPROVED BY (Revised02/24/2014) who did takean oath. YANADY PRIETO MY COMMISSION # FF 214031 EXPIRES: March 25, 2019 Ifia C NTRACTOR The foregoing instru`m�X acknowledged before a this day f id 20 by l/ � wh ersonall k w me or who has produced as identification and who did taK an oath. NOTARY Plans Examiner Structural Review NotaryPubic Soft ofFlOrld Jor" L OAFS - MY CMWAISM0n GG 039747 Q., Jorge w Exom 10/1612020 Zoning Clerk Ali " CERTIFICATE OF LIABILITY INSURANCE DATE DI18 07/03/201 s 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: Nthe certificate holder Is an ADDITIONAL INSURED, the poiicy(les) must be endorsed. H SUBROGATION IS WAIVED, subject to the terms and conditions of ttIs 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(a). j P CER Insurance for Less, Inc. TACT M• PH NE ( 380 8350 ,). 305)380 8352 j 15150 SW 72nd Street '�L INS4LESS1957(IDAOL.COM _ INSURER S) AFFORDING COVERAGE NAIL a Miami, FL 33193 INSURERA: GRANADAINSURANCE _ Phone (305)38D-8350 Fax (305)380-8352 INSURED I INSURER B : Elephant Air Conditioning CORP INSURER C : INSURER D : 5823 SW 149 Ave INSURER E : Miami FL 33193 INSURER F : '.'vv=J%Auea cER11PIGATE NUMBER: REVISION NUMBER: THIS 15 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. ILN RRI TYPE OF INSURANCE ADDLSUBR AI POLICY NUMBER MAD E� MM/DY LIMITS A COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Q OCCUR � 0185FL00075254-2 10/05/2017 10/06/2018 EACH OCCURRENCE $ 1,000,000.00 DAMAGE TO RENTED 1 PREMISESa oxurrence $00.000.00 MED EXP (Any one person S 5,000.00 _ LJ PERSONAL & ADV INJURY S 1,000,000.00 GENL AGGREGATE LIMIT APPLIES PER: V POLICY LJ jE�7 LOC OTHER GENERAL AGGREGATE S_2,000,000.00 — — — PRODUCTS - COMP/OP AGG S 2,000,000.00 S AUTOMOBILE LIABILITY j 17 ANY AUTO r— ALL OWNED SCHEDULED U AUTOS LI AUTOS jNUTSNED HIRED AUTOS A COMBINED SINGLE LIMIT Ea otldeni BODILY INJURY (Per person) S BODILY INJURY (Per accident) S PROPEMFdgAMAGE $erec S (� UMBRELLA LIAR C OCCUR EXCESS LIAB CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEC) 0 RETENTIONS ; S j WORKERS COMPENSATION f AND EMPLOYERS, LIABILITY Y I N ` ANY PROPRIETOR/PARTNER/EXECUTI OFFICER/MEMBER EXCLUDED? (Mandatory In NH) —J If yes, describe under DESCRIPTION OF OPERATIONS below N / A PER OTH- E.L. EACH ACCIDENT S E.L. DISEASE - EA EMPLOYE S E.L. DISEASE - POLICY LIMIT S f DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, N more space Is required) LICENSE # CAC 1816007 I i�iet<i iriuA I E MVLUER CANCELLATION MIAMI SHORES VILLAGES 10050 NE 2 AVE MIAMI SHORES 33138 ACORD 25 (2014101) OF 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 01988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD