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EL-17-582�, ygonEs t�� IVCN�Ott �'toRivA Miami Shores Village 10050 N.E. 2nd Avenue NW Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit NO. EL-3-17-582 Permit Type: Electrical - Residential Pen` Wont Classification: Addition/Alteration Permit Status: APPROVED Issue Date: W/31/2017 I Expiration: 11127/2017 Project Address Parcel Number Applicant 36 NW 101 Street 1131010180240 Miami Shores, FL 33150- Block: Lot: JUAN RIVEROS Owner Information Address Phone Cell JUAN RIVEROS 36 NW 101 Street MIAMI SHORES FL 33150- Contractor(s) Phone Cell Phone HI -TECH ELECTRIC & FIRE CORP (786)326-0931 ape of Work: dditional Info: lassification: Residential -anning: 3 Fees Due Amount CCF $1.80 DBPR Fee $3.38 DCA Fee $3.38 Education Surcharge $0.60 Notary Fee $5.00 Permit Fee - Additions/Alterations $225.00 Scanning Fee $9.00 Technology Fee $2.40 Work without Permit Fee $225.00 Total: $475.56 Valuation: $ 2,500.00 Total Sq Feet: 0 Pay Date Pay Type Amt Paid Amt Due Invoice # EL-3-17-63191 05/31/2017 Credit Card $ 475.56 $ 0.00 rrvanaoie ins Inspection Type: Final Meter Box Relocation Fire Alarm Service Change Review Electrical Underground 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: 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 z9jingl F thermore, I authorize the above -named contractor to do the work stated. May 31, 2017 on na re: Owner / Applicant / Contractor / Agent Building Department Copy May 31, 2017 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 ELECTRIC ❑ ROOFING Master Permit No. Sub Permit No RECEIVED MAR 0 0 2017 i� FBC 2011--k I2Ck `7 —S '�6_ j Fl-1 -7 --S'�5-Z ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP /�" CONTRACTOR DRAWINGS JOB ADDRESS: _�/ (N ZO City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): "UAA/ g/ Vos Phone#: 9'� - �.�! " Yr2c? Address: 36 4 1,41 City: d 'Y� Tenant/Lessee Name: Email State: CIA Zip Phone#: 3 3/50 CONTRACTOR: Company Name: le Gi-g- r.Q,e, Phone#: Address: City: 14c1)i 01 & ` State: �<i� Zip: :�3 1,74 Qualifier Name �""46 ✓doe o"N Phone#: State Certification or Registration #: e56 1A-z295�V8 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: ! • Value of Work for this Permit: $ ,Sao dSquare/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New X Repair/Replace Description of Work: - NG..j /c 7L.1 'G. - 1 3 te: Zip: ❑ Demolition Specify color of color thru tile: Submittal Fee $ Permit Fee $ zx CCF $ CO/CC $ Scanning Fee $ Technology Fee $ Radon Fee $ Training/Education Fee $ DBPR $ Notary $ 1:5' Double Fee $ 2-2— �' Structural Reviews $ (Revised02/24/2014) Bond $ TOTAL FEE NOW DUE $ • S7 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 2S 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. j�&Signatur Signature OWNER or AGENT 62KNTRACTOR The foregoing instrument was acknowledged before me this day of 20 , by J IJGZlr1 I U�,4�� who is personally known to me or who has produced �(��p,r?�-4.[-ZZS as identification and who did take an oath -10 Y fCA NOTARYP-LIBLIC: -----7 Print: MAHARAI K. GONZALEZ The foregoing instrument was acknowledged before me this day of jy V' YZf t—\ 20 � , by t(iry ff-io who is personally known to me or who has produced j&45-0W - 54-W `'as) identification and who did take an oath. +,Oy- IC) d' NOTARY PUBLIC: EXPIRES: November 2, 202011 print: MY COMMISSION # GG 044602 11 �I Bonded Thru Notary Public Underwiters Seal: Seal: ^°r *******s*s*r***s*******s**s****s*********************s**************************s****t********r************* APPROVED BY � � R/f//2)-^ & Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) t. Miami Shores Village Building Department MAY 24 2016 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 gy. Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 BUILDING PERMIT APPLICATION ❑BUILDING )6 ELECTRIC ❑ ROOFING FBC 20 Master Permit No. /2- / ^ /6 -1 3` ' 2 ' Sub Permit No. C/ M ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING [—]MECHANICAL [:]PUBLICWORKS [:]CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 149 `5f - City: Miami Shores County: Miami Dade E —""Zip: b-2. `�!O Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: C Tenant/Le see Name: a Email: Phone#: CONTRACTOR: Company Name: A - 7� iQ !Ce 4�* Phone#: % —D Address: City: A fi State: // f`W- > Zip,&M/ 4 Qualifier Name: Vlv v �' "",��,,1%,,�%.,,lj Phone#: State Certification or Registration #:� ��Cl©F Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Valueof_Work_fo - is Pe� $+7� Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ElNew ❑ Repair/Replace ❑Demolition / e4-0 - -6;�e_T ��' k,'�elu/ Cv 1,d _'�7' A1157'�-1/ ,-' e (,U Specify color of color thru tile: Submittal Fee $ Permit Fee CCF $ 1- [Jiy CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ GO Technology Fee $ ( O Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ 0 TOTAL FEE NOW DUE $ _T L s - e .G (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 n - 1 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." r- 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 ` OW N ER or AGENT CONTRACTOR Thl foregoing instrument was acknowledged before me this day of I "'(�-� 20 by �P�.N�SOpL\XG26 who is personally known to me or who has produced a A--I07C(Q-JE�s identification and who did take an oath. NOTARY PU C: Sign: Print: Seal: ********************* APPROVED BY ,%a7Y 0&`Notary Pubiir. State of Florida a° Y4` Cindia NIrez Commission FF 156750 * o* * * x fires 119t03120111 i * P k* I*A �iAl#•rii�4SA The foregoing instrument wasacknowledged before me this 2/ day of ve Z — 20 15 by who is personally known to me or who has produced /=7 as identification and who did take an oath. NOTARY PUBLIC: Seal e ® el Joanna M Fell�ano y o My Commission t� 082753 °j?,oF0 Expires01/12/2018 ******************************************************* Plans Examiner Zoning (Revised02/24/2014) Structural Review Clerk BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000 VALID OCTOBER 1, 2015 THROUGH SEPTEMBER 30, 2016 DBA: Receipt #: E LECTRI CAL /ALARMS /CONTRACTOR Business Name: HI TECH ELECTRIC & FIRE CORD Business Type: (ELECTRICAL CONTRACTOR) Owner Name: EDMUNDO I JARQUIN Business Opened:12/20/2004 Business Location: 1500 SW 101 AVE State/County/Cert/Reg:EC13002608 MIAMI DADE COUNTY Exemption Code: Business Phone:786-543-5216 Rooms Seats Employees Machines Professionals 3 For Vending Business Only Number of Machines: Vendino TVDe: Tax Amount Transfer Fee NSF Fee Penalty Prior Years I Collection Cost I Total Paid 27.00 0.00 1 0.00 0.00 0.00 1 0.00 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non -regulatory in nature. You must meet all County and/or Municipality planning WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. Mailing Address: EDMUNDO I JARQUIN 1500 SW 101 AVE MIAMI, FL 33174 2015 - 2016 Receipt #10B-14-00011393 Paid 09/23/2015 27.00 - --- BROWARD-COUNTY LOCAL BUSINESS -TAX -RECEIPT- .-- - RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD LICENSE NUMBER The ELECTRICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 01 JARQUIN, EDMUNDO I - HI -TECH ELECTRIC & FIRE."CORP 1500 SW 101 AVE MIAMI FL 33174 " ISSUED: 08/28/2014 DISPLAY AS REQUIRED BY LAW SEQ # L1408280003319 05/24/2016 11:53 3058600907 MUTUALINTEREST PAGE 01/01 :ERTIFICATE OF LIABILITY INSURkNCE DATE(MMIDDIYYYY) `--� 05/2-4/2016 THIS CERTIFICATE, 15 ISSL ED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT ►FFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE C( VERAGE AFFORDED BY THE POLICIES BELOW. THIS CERT1FICA rE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN"HE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pOHCy(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 tl Is certificate does not Confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: ESTHER VIDAL MUTUAL INTEREST ASSURANCE aON°305 8602003 • • .. aroNo;305-860-0907 F_STHER VIDAL•MAIL Ml1fllA---�.__._..I ^ 1295 CORAL WAY INSURERS) APPO 101N4 COVERAGE -- NAIC N MIAMI, FL 33145 --- •- •-- - INSURED NSURMA:SECURITY NATIO JAL INSURANCE CO - -- .. _1NSUReR.9.: NORMANDY HARI OR INSURANCE CO. 29803 HI -TECH ELECTRIC & FIRE CORP INSURrRC:ASCENDANT UNG?RWRITERS LLC 1500 SW 101 AVE INSURER D : ^--- - — — --- - _... - --- -- -- - — MIAMI, FL 33174 INB..I]RER E ; ... ----.- ---- INSURER P COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUR' 'D NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER )OCUMF-NT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURAN(E AFFORDED BY THE POI.ICIES DESCRIBE ) HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED F3Y PAID CLAIMS .1tt TYPE OFINSURANCE - POI.IGY EFF POLICY 0_0_ --"' ""' -•'-"' ' ---- POWCYNUMFtER MWVDIYYYY MM/DD/YYYY LIMITS A cSNERALLIAe1tiITy SES1119418 10/10/201510/1012016 EACHOCCURRENCF, T�AMArP:TORE s _ 1,000,000 X COMMERCIAL GCNERA_ L I,IA' ILITY .DEMISES-(E; xcurrnrlcn _S -_ _ _ 100,000 _ , CLAIMS -MADE LJ I CCUR MEDE%P - .ono nrcc(# s 000 gl $500 DEb. - L r ._..P ....__ ,.— PFRSONAL & ADV INJURY S 1,000,000 Plal $500 bEQ. _-- - - - GENERAL AGGREGATE S 2 QQO QOQ GEN'L AGGREGA'TIE LIMIT APPLIEIS PER: PRODUCTS-COMP/OP AC�G S 2,000,000 X..� POLICY I I PCF I : nc - - --- C Au rongerLE uaeIL CA-43756-2-2 03/22/2016 03/22/2017 7OMeiM UINBLE LI SITY Al,ITOBODILY DWNF.DSC,I�t DULEb OS INJURY (Perperson) 8 2$000 JALLANY XAUTOS NON -OWNED BODILY INJURY (Pdr.•Icdldant) PROF CF T07�A?nAL� SOOOO SEDAI)10S AUTOS UMBRELLALIAB OCCUR '- EXCESS UAB CLAIMS -MADE EACH OCCURRENCE 1' - '' DFD I RETENTIONS AGGREGATE B WORKEkB COMPENSATION AND EMPLOYERS' LIAaIUTY YIN NHFL0027752015 09/23/2015 09/23/2016 X we STATu- oi'H_ S ANY PROPRIETORIrARTNERIEXECUTNE OFFICFR/MEMBER EXCLUDED? a N / A -�.T.O.RY,_LIN(ITS _EEL (Mandatory In NN) E.L. EACH ACCIDENT __.. - E 1,000,000 --- If yes, depCnbe Undor DESCRIPTION OF OPERATIONS below E.L. DISEASE, CA EMPLOYEE - S 1,00�,000 $ 1 .000,000 E,4. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS / vEHICLE3 (Attaeh ACORD 101. Addltlenal ROmdri. Sehodula, If more epaoe le ropulrod) ELECTRICAL CONTRACTOR - STATE LICENSE NUMBER EC13002608 MIAMI SHORES VILLAGE BUILDING DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 ACORD 25 (2010/051 SHOULD ANY OF THE ABOVE DI SCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THE QEOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLIO 'PROVISIONS. 01988.2010 AC The ACORD name and loco are reaisterod marks of ACORD CORPORATION. All rights reserved,