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REV-19-974• _ Miami Shores Village Building Department R'=(- IVED 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 MAY 0 2 1)"19 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 Cj 1 ' 0 FBC 20[--A Master Permit No. �� - m— BUILDING - PERMIT APPLICATION Sub Permit No. .� DS [--]BUILDING FX� ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL F-IPLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 1191 NE 103 ST City: Miami Shores County: Miami Dade Zip: _33138 Folio/Parcel#: 11-2232-031-0050 Is the Building Historically Designated: Yes NO X Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): COBIA LLC Phone#: Address: 8045 NW 155 ST City: MIAMI LAKES State: FL Zip: 33016 Tenant/Lessee Name: Phone#: Email: MEGA �/ POWER LLC Phone#: 5y �65f �� / CONTRACTOR: Company Name: - Address: 3550 SW 48TH CT City: FT. LAUDERDALE State: FL Zip: 33312 Qualifier Name: NICOLAS LLUCH Phone#: State Certification or Registration #: EC13008454 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ Square/linear Footage of Work: 32d Ef Type of Work: ❑ Addition ❑ Alteration ❑ New ® Repair/Replace ❑ Demolition Description of Work: REPLACE GFCI'S IN KITCHEN TO COMPLY W.1 CODE REPLACE LIGHT FIXTURES IN BATHROOMS AND KITCHEN REPLACE SWITCHES IN BATHROOMS AND KITCHEN . REVISIOWADD 6 RECESSED LED LIGHTS IN KITCHEN, ADD 6 RECESSED LED LIGHTS IN LIVING ROOM, REPLACE ELCTRICAL PANEL *SAME LOCATION*,INSTALL NEW 240V LINE FOR LAUNDRY Specify color of color thru tile: Submittal Fee $ Permit Fee $ 160 CCF $ , ' 2-6 CO/CC $ Scanning Fee $ Radon Fee $ 2 Q0 DBPR $ • 60 Notary $ _ Technology Fee $? . 5 d Training/Education Fee $ G ' 4 % Double Fee $10 Structural Reviews $� Bond $ (711 TOTAL FEE NOW DUE $ I I - 10 (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 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 OWNER or AGENT The foregoing instrument was acknowledged before me this 2\ ti day of 20 by JNtibvho, s ersonally know o me or who has produced as identification and who did take an oath. NOTARY ➢ 1QLIC: 4 A A Print: l Seal: ************* APPROVED BY (Revised02/24/2014) Signature CA CONTRACTOR The foregoing instrument was acknowledged before me this day of Q-� s I 20 / `� by LW a- who is ersonally known me or who has produced as identification and who did take an oath. NOTARY 7IC- Si n: /� n Print: C0±4 VIs Seal:+ t�vtary P Arr State of Florida :F CamNa gnsion G o Notary PuWicArre Stall of Forida mission GG 282408 Camlla ArredOndo EMxpi�� OW-02022 �` My Commission GG 262408 1 101 Plans Examiner Structural Review Zoning 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, 2018 THROUGH SEPTEMBER 30.2019 DBA: Business Name: GAPuWER LLB `"E� Owner Name: t.;1 .. Business Location:: 5 SW 46 CT FT LAUDERDALE Business Phone: 954 465-9401 Receipt #:ELBEC P.ICA�/ALAPMSICONTRACTOP Business Type: (ELECTRICAL CONTRACTOR) Business Opened:06; 19/2018 State/County/CerUReg:E", 3008454 Exemption Code: Roorns Seats Employees Machines Professionals i For Vending Business Only v—li— T.r - Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27 0C, —--� —... .00 0.00 G.QO Cu 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, bLlSineSS 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: MEGAPOWER LLB 3550 SW "R C.I. HOLLYWOCD, I., L200-620-72-264-0 NICOLA& LL uc-- 3650 SW 49TH CT FORT LAUDROALE. FL 33312-8265 00,8 07�24.197: SEX 0— tSSUED 03-26-2013 +4'1� ^. @xPWES 07-24.20:- R F1�7 ' REPLACED 04-294C OWER 3M�i'rIHM y'-i `f1+ YMaiIW '—n fie, — <.•-'S bM1i .W '.0 M — Receipt #05B-17-00000832 Paid 09/11/2018 27.00 2018 - 2019 STATE OF FLORIDA DEPARTMENT dbpr OF BUSINESS AND PROFESSIONAL REGULATION EC13008454 ISSUED:05/25/2018 ELECTRICAL CONTRACTOR LLUCH, NICOLAS MEGA POWER LLC __. Signeft" LICENSED UNDER CHAPTER 489, FLORIDA STATUTES EXPIRATION DATE: AUGUST 31, 2020 ACoRDO CERTIFICATE OF LIABILITY INSURANCE DATE (MWDD/YYYY) 04/17/2019 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 CONTACT NAME: Automatic Data Processing Insurance Agency, Inc. PHONE FAX NO -MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC #r 1 Adp Boulevard INSURER A : NorGUARD Insurance Company 31470 Roseland NJ 07068 INSURED INSURER B INSURER C MEGA POWER LLC INSURER D : DBA: MEGA POWER LLC INSURER E : 3550 SW 48TH CT INSURER F : Ft Lauderdale FL 33312 COVERAGES CERTIFICATE NUMBER: 1137444 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 LTR TYPE OF INSURANCE ADDLISUOR POLICY NUMBER POLICY EFF MM/DD/YYYY P LIC EXP MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE 71 OCCUR PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO - POLICY PRC JECT❑ LOG PRODUCTS - COMP/OP AGO $ $ OTHER: AUTOMOBILE LIABILITY O I ccldent NIEDI t IT Ea a $ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE-- Per accldent $ UMBRELLA LIAB EACH OCCURRENCE $ HOCCUR AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) N/A N MEWC905846 08/11/2018 08/11/2019 STATUTE JER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Contractor License: EC13008454 mega power LLC EC13008454 ua MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVENUE Miami Shores 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 DL 33138 ACORD 25 (2016/03) m 1988-2015 The ACORD name and logo are registered marks of ACORD All rights reserved CERTIFICATE OF LIABILITY INSURANCE A`� o DATE //2019 I) 04/10/10® 019 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 Superior Insurance 1351 Sawgrass Corporate Parkway Suite 102 Sunrise FL 33323 CONTACT Superior insurance NAME: PHONE (954)752-9876 (954)752-9938 AIC No Ext : A/C, No): A -MAIL : ANITA@CITYINS.NET INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Granada INSURED Mega Power LLC 3550 SW 48th Court Fort Lauderdale, FL 33312 INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: CL186412763 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. ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDD MMroD LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR DAMAGE TO RENTEIT_ PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 A Y 0185FLOO111171 06/04/2018 06/04/2019 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY ❑ JECT PRO ❑ LOC $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAS OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DIED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE PER OTH- STATUTE I I ER E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ NIA (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below E. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) "CONTRACTOR LICENSE NUMBER: MEGA POWER, LLC- NICOLAS LLUCH-EC13008454 'MIAMI SHORES VILLAGE BLDG DEPT IS NAMED ADDITIONAL INSURED. CERTIFICATE HOLDER L:AN[:CLLAI IU MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVENUE MIAMI SHORES 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 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD JIMMY PATRONIS CHIEF FINANICAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 5/30/2018 PERSON: NICOLAS LLUCH FEIN: 804860915 BUSINESS NAME AND ADDRESS: MEGA POWER LLC 3550 SW 48TH CT FORT LAUDERDALE, FL 33312 SCOPE OF BUSINESS OR TRADE: Licensed Electrical Contractor EXPIRATION DATE: 5/29/2020 EMAIL: MEGAGROUP01 @GMAIL.COM IMPORTANT: Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS? (850)413-1609 BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000 VALID OCTOBER 1, 2019 THROUGH SEPTEMBER 30, 2020 zz DBA: Receipt #: E 81-2 9152 CAL/F.LARMS /CONTRACTOR Business Name: MEGAPOWER LLC Business Type- YP (ELECTRICAL CONTRACTOR) Owner Name: NICOLAS LLUCH Business Opened:06/19/2018 Business Location: 3550 SW 48 CT State/County/Cert/Reg:EC13008454 FT LAUDERDALE Exemption Code: Business Phone:954 465-9401 Rooms Seats Employees Machines Professionals 1 For Vending Business Only Numhar of Marhines: Vendino Tvoe: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 0.00 1 0.00 1 0.00 27.00 "06" 111111 DRft r R LICENSE CLASS E -^�► L200-620-72-264-0 :�'� "� Vito•...; LWtn IIli60 SW afTH CT tFORT UUlDRai1LE. FL 33312.82" DQp 07 2M !72 SE7fa MlMiD 0 2l11 6 0� .2a-zo2' d STATE, OF FLORIDA DEPARTMENT dN REGUUSINESS LA_TION AND PROFESSIONAL v:E EC13003454 ISSUE15:05/25/2018 ty ELECTRICAL CONTRACTOR i 8q LLUCH. NICOLAS { I MEGA POWER LLC t LICENSED UNDER CHAPTER 489, FLORIDA _ STATUTES EXPIRATION DATE: AUGUST 31, 2020 I 2019 - 2020 D COUNTY LOCAL BUSINESS TAX RECEIPT Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000 D OCTOBER 1, 2019 THROUGH SEPTEMBER 30, 2020 Business Name: c t c,ArUwER LLC Owner Name: NICOLAS LLUCH Business Location: 3550 SW 48 CT FT LAUDERDALE Business Phone: 954 465-9401 Rooms Seats Receipt #: 181-291522 Business Type: ELECTRICAL/ALARMS/CONTRACTOR (ELECTRICAL CONTRACTOR) Business Opened:06/19/2018 State/County/Cert/Reg: EC 13008454 Exemption Code: Employees Machines Professionals 1 Signature For Vending Business Only u.....w...i u.,..tii.. Venrlinn Tvna• Tax Amount 1 Transfer Fee I NSF Fee I Penalty I Prior Years I Collection Cost I Total Paid 27.00 0.00 3.001 O.Ouf 0.001 0.001 27.00 Receipt #WWW-18-00181246 Paid 07/19/2019 27.00