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EL-18-49f 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 91 ELECTRIC ❑ ROOFING ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS M R 1 018 ak-J FBC 20 Master Permit No. p-(- -( Sub Permit No. E L.-1 — ` ❑ REVISION ❑ EXTENSION [:]RENEWAL CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS Folio/Parcel#: 1, b)2� CA Do- O Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): P J�On C Phone#: Cj7Li'5ZQ--Zc.W& Address: �Ul ► Dj, VVtk— City: PQ O(A (Arl. Tenant/Lessee Name: Email: CONTRACTOR: Company Name: A Address: 3�5.5 Nw Ig City: `njd r)i 64,1deMS Qualifier Name: U State Certification or Registration #: DESIGNER: Architect/Engineer: State: VL-- —Zip: 33 P� Certificate of Competency #: lla—oo0 ':�0 1 Address: _City: State Value of Work for this Permit: $ ADM Square/Linear Footage of Work: _ Type of Work: ❑ Addition ❑ Alteration New _ ❑ Repair/Replace Description of Work: Specify color of color thru tile:, Submittal Fee Scanning Fee $ Technology Fee $_ Structural Reviews $ Zip: ❑ Demolition Permit Fee $AldI �� CCF $ CO/CC $ Radon Fee $ _ DBPR $ Notary $ _ Training/Education Fee $ Double Fee $ _ Bond $ 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 Zi 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 low 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_ OWNER or AGE The foregoing instrument was acknowledged before me this I day of.J 20 , by is personally known t. me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: C t4a Print: Seal: S APPROVED BY (Revised02/24/2014) Signature_11 _ VAA� CONTRACTOR The foregoing instrument was acknowledged before me this -- 1 5_ day of Cal i��► I 120 by M ate, ersonally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign:_ 4i Print: NATASHABOOKE Seal: °_ !; : BOOKS MY COMMISSION # GG 154422 NATASHA EXPIRES: Oetober7T, 2021 MY COMMISSION = GG 154422 i ed Ttw Notary PLM lMrd M"" EXPIRES: October 27, 2021 and Plans Examiner Structural Review _ Zoning Clerk P: 786-325-3383 F: 305-474-3276 E: jusefmunpz�ho�o.qqrn Ll C F 1 LE00040 I Lt-k- M Estimate L-i Sales Agreement CUSTOMER INFORMATION JOB INFORMATION Name: Rare Renovations Job Name., ob Address: 7021 nw 67 CT Parkland AddreJss: 420 NE 91 ST miami shores Phone: 9544268018 Job Number: Email: ail: DESCRIPTION OF WORK Electrical work will be done according to the plan. .. ........... ..... . .. ...... house done in romex type wire (mn). Lighting package supply by owner, including smoke detectors. Exhaust fan supply by owner. permit fees by owner. per plans .............. . .... ....... Total Contract: $14,000 .............. ....... --- . ........ ... . . ........ . ......... X 'Res Print Signature Date . . .. . ... . ... ............. ......................... THANK YOU FOR YOUR BUSINESS! I - — - - - .... . ....... .......... Miami shores Village MAR � i8 Building Department 13,1- - - 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 �HA=NGIE OF CONTRACTO ARCHITECT r�astcr N. QG-19-11-�$� Permit N.E L-I-IS -4q Owner's Name (Fee Simple Title Holder):'f%pi s Phone #: T54-52® Owner's Address: —►n? t �3W 0-1 C,7F City: State : i` L-_. Zip Code:33UD-7 Job Address (Of where work is being done): -420 N 'E7-- a City: Miami Shores State:_ Florida Zip Code: Contractor's Company Name: KpSU11be1 ,. GiCCidCOLI XRV, Phone #: 9<,A'415-4LOU-] Address: KQ� City: Qualifier's Name: Architect/ Engineer of Record Name: Address: City: Describe Work: State:' PL- Zip Code: iyi opt Lic. Number: ��'�(� � 4-11, i State: Phone #: Zip Code: hereby certify that the work has been abandoned and/or the contractor/architect is unable or unwilling to complete the contract. I hold the Building Official and the iami Shores harmless of Signature Signat Owner or Agent The foregoing instrument was aknowledge�d "before,,me this J-5- day of by M,I(,U11,Igi Ray Who ' sonally known or who has produced as indentification. MY COMMISSION54422 ~� Pg EXPIRES:OcbW27,2021 all legal involvement. ire V Contractor or Architect The foregoing instrument was aknowledged before me this � day of 201�by f'1 rl�i,P,o f 01 who is per mown to me or has produced as indentification. Nota ubli Sign. Seal: p�.p NA cuA pOOyE 11 :.• 4: MY COMMISSION # GG 154422 ! i�r EXPIRES: O*ber27,,2�0�2„1�� ,'•'kor %lo!•` ftW Thu fti P-i* U*MMel O 5/11/2018 10:13 AM PDT TO:13057568972 FROM:9544263011 Page: 2 Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to owner -- worKers' uompensation 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 (1.,L,C) in the construction industry may elect to be exempt if: i. Tile officer owns at least (0 percent of the stock of the corporation, or in the case of an LI-:C, a statement attesting to the rninirnurn 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 hoes 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 ACKNOWLE DGrE: THAT Y()U HAVE RE'A.D THIS NOTICE AND UNDERSTAND ITS CONTENT'S. Signature: Owner State of Florida County of Miami -Dade The foregoing was acknowledge before me this I ( - day of __J ` 20 i j By_j_L_ _�f lG.iC• ( k' R C-------------- wh6- ", ersonally known to tti' or has produced - -- ....- - -- --1 • -••-- as identi ficatrc WAImmBOOKE Nota ► c' jj- -- .? my ComMt "I GG 164422 SEAL: `' }or w°"•e: Bor" itru p+fric UrderwAMrfi 5/11/2018 10:13 AM PDT TO:13057568972 FROM:9544263011 Page: 3 M.B Electric Service Corp 3955 NW 195 ST Miami Gardens, FL 33055 786-325-3383 jusefmunoz@yahoo.com Date:05/11/2018 State of Florida County of Dade Before me this day personally appeared i'l 'cf HunCUB who, being duly sworn, deposes and says: That he or she will be the only person working on the project located at: 420 NE 91 ST X JAAA Contractor Si ature Sworn to ( or affirmed) and subscribed before me this (l n%day of _ ( ... 2017, By oL-- Personally Known Or Produced Identification Type of Identification Produced Print, Type or Stamp Name of Notary 5/11/2018 10:19 AM PDT TO:13057568972 FROM:9544263011 Page: 3 M.B Electric Service Corp 3955 NW 195 ST Miami Gardens, FL 33055 786-325-3383 jusefmunoz@yahoo.com Date: 05/11/2018 State of Florida County of Dade Before me this day personally appeared JJ SC f MLJi nc,?? who, being duly sworn, deposes and says: That he or she will be the only person working on the project located at: 420 NE 91 ST X MIA Contractor Si ature Sworn to ( or affirmed) and subscribed before me this I day of _�1_6ir¢-. 2017, By 1\.�a 1 iq— Personally Known %- Or Produced Identification Type of Identification Produced ft f' 71 t i i. Print, Type or Stamp Name of Notary .4Mr+rr'Awy�.�rr./��.nM�..�.V� CyIYM�1#�76W�f{IM�BOOK'. 64422 5/11/2018 10:19 AM PDT TO:13057568972 FROM:9544263011 Page: 2 Notice to Owner -- Workers' Com Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795,2204 Fax: (305) 756.8972 nsation Insurance Exemation 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 fir 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 entPlovs 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 (11.0 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 mrnilm.1tn 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 fior a period of hvvo years or until a voluntary revocation is filed or the exemption is revoked by tite 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 cmPloyecs or subcontractors. BY SIGN.IN<; BELOW YOU ACKNOWLEDGE TEIAT YOU .HAVE; R_g?AD THIS NOTICE AND UNDERSTAND ITS CONTENTS. ` Signature: s�`-`�—`-----------••------.._.....-------� Owner State of Florida County of Miami -Dade The foregoing was acknowledge i ft' g g z,c before ntc this I day of K AQ 70 By._.)EtL 1 1t~: -C.L whi5'~ ersonally known to�i., or has pro<luceci nt _ _-- ------ as identificattNAmwBOOKE ;dot. �) ,- -> , a cy/� 'i C MMISS t µY li�l M t3ti 1 S L. A I.... A" spP, q"�f god may, RJW Utk dwaftts Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit NO. EL-1-18-49 a Permit Type: Electrical - Residential iWork Classification: Addition/Alteration Permit Status: APPROVED Issue Date:1119/2018 1 Expiration: 07/18/2018 Project Address Parcel Number Applicant 420 NE 91 Street 1132060190070 Miami Shores, FL 33138- Block: Lot: PROPERTY HOUNDS LLC Owner Information Address Phone Cell PROPERTY HOUNDS LLC 420 NE 91 Street (954)520-2268 MIAMI SHORES FL 33138MKIMUMM - 7021 NW 67 Court PARKLAND FL 33067- Contractor(s) Phone Cell Phone ROSEMBERG ELECTRICAL SERVICE: (954)501-9267 (954)415-4667 of Work: REWIRE, 4 PANELS, UPGRADE SERVICES, onal Info: ification: Residential canning: 3 Fees Due Amount CCF $8.40 DBPR Fee $7.35 DCA Fee $4.90 Education Surcharge $2.80 Permit Fee - Additions/Alterations $490.00 Scanning Fee $9.00 Technology Fee $11.20 Total: $533.65 Valuation: $ 14,000.00 Total Sq Feet: 3995 Pay Date Pay Type Amt Paid Amt Due Invoice # EL-1-18-66070 01/19/2018 Check #: 1089 $ 483.65 $ 50.00 01/08/2018 Check#: 1231 $ 50.00 $ 0.00 AvauaDie Inspection Type: Final Meter Box Relocation Fire Alarm Service Change Review Electrical W. W. 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 regulating construction and zoning.,.Futhermore, orize the above -named contractor to do the work stated. January 19, 2018 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy January 19, 2018 1 RECEIVED Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION. LIMO PHONE NUMBER- (305� 76Z-4949 BUILDING PERMIT APPLICATION ❑BUILDING _j ELECTRIC ❑ ROOFING F-IPLUMBING ❑ MECHANICAL PUBLIC WORKS JAN 08 ZOD lX FBC' 20'14 4 Master Permit No. RC' U " 1"1- 15q� Sub Permit No. 01.1' L99 ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑ CHANGE OF CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 9 GA O WTI: 9L i City: Miami Shores County: Miami Dade Zip: 33133 Folio/Parcel#: 1 1-3200 "01C1-= n Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction, Type: ElCCt-nC Flood Zone. BFE: FFE. OWNER: Name (Fee Simple Titleholder): Qr OP�C�HIJ l%d S Phone#: 9 `)4 526' Vib Address: -7021 IVW [.a-1 CT City: Pa ( ILI and State: rL- Zip: '33() (0—I Tenant,/Lessee Name: Phone#: Email CONTRACTOR: Company Name: F�MtbUQ CIC( C-r- J� L 1�.1(.PhoneM .01S'I LA1 S\4U -7 Address: P V ?_)nX 5L City: yce u i g ld F,>C a Qualifier Name: ?--'OS Mb-el State Certification or Registration #: _State: FL Zip: J34 _L3 \C 0 k'V't\ K­C:�' Pliane#`0S_L_1 �i elaCo1 1 'A-1 a3 Certificate of Competency #: I H E 000 LA U k DESIGNER: Architect/Engineer: Phone#: City: State: Zip: Value of Work for this Permit: $ 4 i R I��W Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition - ��iLr�1L/���\Ili"[�T■�i•��'��1�1'<I�mII\I . ci WE •J Specify color of color thru tile: Submittal Fee $�Q X"O Permit Fee $ g'01a0 CCF Scanning Fee $ Radon Fee $ *'% •g�'i DBPR $ Technology Fee $ StrtrcWtai Reviews $. Training/Education Fee $ CO/CC $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $3 �S (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 Zlp 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..... OWNEWS AFFIDAVfr.: l .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. „WARDING TO OWNER: YOUR FAILURE TO RECORD, A NOTICE 4F 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 Signat re� OWNER or AGENT / / CONTRACTOR The foregoing instrument was acknowledged before me this k 2— day of b-C CerY16C f- 20 1-1 by MICi(X)ce1 �0.C•r S , w o' personally known to meor who -has produced as The foregoing instrument was acknowledged before me this day of pC'C2"A -e C 20 1- by 1,OSP.►kb _CrA D.OkI Y CkV;who is personally known to me or who hasp produced % cc% i ,� as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sig Sign , Print: wa::Lz=c�1 � �� Print: ...... ATALIE MEDINA Seat-.�; NAVBOOKE " 'Seal: MY COMMISSION # GG088190 MY COMMISSION # GG 154422 EXPIRES March 29, 2021 lo: EXPIRES:OcWW27,2021 ':xoRFeR., BodedTIO NOWYRbiCUrldElwl!f! APPROVED BY - 5_;t RIZ�70 / 8 Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Construction ides El BUSINESS CER, lualifying Board TIFICATE OF COMPETENCY 14E000461 ROSEMBERG ELECTRICAL SERVICES INC {{ D.B.A.: DE ROSEMSERG �LIVIRA 6A Is� under them.provisions of C hapter 10 of Harrwas* County 014417 Local Business Tax Receipt Miami —Dade County, State of -THIS IS NOT A BILL - DO NOT PAY ImBT 7176941 BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES ROSEMBERG ELECTRICAL SERVICES INC RENEWAL SEPTEMBER 30, 2018 DOING BUSINESS IN DADE COUNTY 7456895 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS PAYMENT RECEIVED ROSEMBERG ELECTRICAL SERVICES INC 196 ELECTRICAL CONTRACTOR BY TAX COLLECTOR C/O DE OLIVEIRA, ROSEMBERG B 14E000461 $75.00 07/13/2017 Worker(s) 1 CHECK21-17-063562 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit, or a certification of the holder 21 to do business. Holder must comply with any governmental or nongovernmental regulatory laws end requirements which apply to the business. The RECEIPT NO. above must be displayed on all commercial vehicles - Miami -Dade Code Sec 8a-276. For more information, visit www miamidade aovltaxcollector STATE OF FLORIDA DEPARTMENTOF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD (850) 487-1395 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399-0783 DE OLIVEIRA, ROSEMBERG BASTOS ROSEMBERG ELECTRICAL SERVICES, INC. rE 2NI0 otlt=NI IF #D3 DEER'FIELD BEACH `F'L 33441 Congratulations! With this license you become one of the nearly one minion Floridians licensed by the Department of Business and professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the wa we do business in order lease to serve you bette�r, l �r �nfa� i hereryou can servicesfind more �gg onto WFgiy0.7-71401 mom... Information-about"sac di Wons and the regulations tr rar,Srr:µBi YOU! subscf%e to departmervt newsletters and learn more about the Departments initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can Serve Coytour custoulatl me an Thank you for doing business in Florida, and "s STATE OF FLORIDA DEPARTMEM" OF,BUSINESS AND PROFE IOMI REGULATION ER13014723 xyl#E�. ;1 ?lii312016 REG ELECTR10Q. 6C N-RACTO nE 1ktEiRA� ;ig 8� . iau ROS)=MSE'RG.E1� t+TA", _ (INDIVIDUAL -MUTT, L}CEN ;ING REW.lke mt�$�#� cm TO CONTRACTdNG MAN MA$ REGY.' jsTERt.D :under the prQWision8 ar .Ch.40 TS- Kptcalorde►e A* 3l, zboe «snip oo6 DETACH HERE STATE r%c pi ORinA DEPARTMENT OF BUSINESS AND.PROfESSIONAt,. REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD ER13014723 heELECTI;tcALen�- rieTOR Named below HAS REGISTERED U>ider the provisurns ot-G hp eir 469 FS. Expirat}on delis, At1G 31; (INDIVIDUAL MUS`6 MEEK' ALL LGCAL� ICENStNG REQU}ftEMENTS PRIOR Tf3 C4INTITIt'IN ANY AREA}' DFt7L1VEiRAr tt�.�`iildi�i� 6ECTRtCA( $E VICES iirfC A66EMSER6 G 310'SE 2NDAVENUEE#Gf3 fEIzRFIELd E3EACN>3d41 4 ^ S' t J . E0 0611034ti ISSUED' 1110312016 plSPLAYAS R QUIRED`gY LAIIU'"" s00636