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EL-16-971Miami Shores Village PXCEIVED. ., A I 1 2016 Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY: Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20 y BUILDING Master Permit No. kk16) PERMIT APPLICATION Sub Permit No. 1=--,L ( (�— ❑BUILDING ® ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP `- CONTRACTOR DRAWINGS JOB ADDRESS: 104 " Iaw � z SA" City: Miami Shores County: Miami Dade zip: 33 )SC) Folio/Parcel#: I I - 31© ( — ?- Z - 0 130 Is the Building Historically Designated: Yes NO X Occupancy Type: i�. Load: Construction Type: Flood Zone: BFE: FIFE: OWNER: Name (Fee Simple Titleholder):_ Address: 101A i.JV) ( O2 Im hone#: -3 S6 ' 35'6 - o I IU City: V-kl f -, lid !& ADQC 611 State: -r- �-- Zip: 33 150 Tenant/Lessee Name: Email: cStkP4� CONTRACTOR: Company Name: _ Address: I S9 OS SLo &IObGI I✓IT-- C.-12iG IOS C-T City: M , c' State: _ Qualifier Name: n 2c>' U Z State Certification or Registration #: E e- 130l LI $O -6 DESIGNER: Architect/Engineer: Address hone#: hone#: zip: 331 S -4 lone#: a -9 (o • SSS (oO SO Certificate of Competency #: I Z E 000 ut 2 Z Phone#: City: State: Zip: Value of Work for this Permit: $ s Op`= Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑Demolition Description of Work: C M•F KkA 6 C ?N,)QwL. ou%.j Ov�z1-e�S Specify color of color thru tile: Submittal Fee $ Vv Permit Fee $ Z2s i Ol/ CCF $_ Scanning Fee $ 3 - 00 Radon Fee $ DBPR $ Technology Fee $ O - �i'rl7 Training/Education Fee $ • go Structural Reviews $ ' d CO/Cc $ 3 " Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ (Revised02/24/2014) Bonding )mpa: '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 charge The foregoing instrument was acknowledged before me this J, day of 4)0E! -1 k 120 (,6 _, by AI E3—�kIAoPpersonally known to me or who has produced 0— 1>0 1 de s identification and who did take an oath. d. Signature CONTRACTOR The foregoing instrument was acknowledged before me this day of �i�C 4 � , 20 - 145�- , by USY��Ii)�J/�QS/Z CZ who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: Print: PY U , DONATO AW Seal: r vie e of Florida NotaLA s = ' My Comm. Expires Aug 13, 2016 :°�:Seal: Sind 9, PP:Commission # EE 200674"� c ` .Expi8 My CF 156750 F°`Bonded Through National Notary Assn. ************************************************************************************************************ APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) 3/29/2016 i m agej peg_O.j pg FS. "f 7° STATE OF FLORIDA ' F BUSINESS AND DEPARTMENT CJ To.II, . PROFESSIONAL REGULATION EY12000297 ISSUED: 06/08/2014 REG ALARM SYSTEM CONTRACTOR GONZALEZ, OSMANI GLOBAL ELECTRIC SERVICES LLC (INDIVIDUAL MUST MEET ALL LOCAL LICENSING REQUIREMENTS PRIOR TO CONTRACTI I`IO 'lt-: ANY AREA) HAS REGISTE:: Expiration date : A-, L . r : er the provisions of Gh.489 ', 1 L1406080001834 condition throughout the term of the Lease and shall cause usual service and maintenance to be performed on such equipment, as required by any warranties given by or as suggested by the manufacturer of such equipment. Tenant shall be responsible, at its ole cost and expense, for repairing such equipment and for replacing the same with equip ent of similar quality and capacity in th event replacement shall become necessary during t e term of the Lease. Any such replacement quipment purchased by Tenant shall automatic y become the property of the Landlord upo termination of the Lease. The Tenant's o igations under this section shall include, but n t be limited to, repairing and maintain' g items as are required by any governmental ag ncy having jurisdiction thereof, walls (o er than the exterior face of outside walls), ceilings, 'lity meters and conduits inside the emised Premises or outside of the Demised Premises i used exclusively by Tenant, all xtures, carpeting and other equipment within the Demised P mises, all the Tenant's signs, s urity grilles or similar enclosures, locks and closing devices, an all exterior and interior wi dows, window sash, casement or frames, doors and door frames, si s, floor coverings, lightin , electrical, plumbing and sewage facilities. The Tenant shall permit no ste, damage or injury o the Demised Premises and the Tenant shall initiate and carry out a progr of regular main enance and repair of the Demised Premises, including the painting or refinish g of all areas o the interior and the entire Demised Premises so as to impede, to the extent possible, deterioratio by ordinary wear and tear and to keep the same in attractive condition. Throughout t e term o this Lease, Tenant shall maintain a maintenance and service contract for the air conditi ing d heating equipment serving its Premises, with a reputable company acceptable to Lan r , and including regular quarterly servicing and maintenance. The Tenant will not overload e electrical wiring serving the Demised Premises or within the Demised Premises, and will ns 11 at its expense, but only after obtaining the Landlord's written approval, any addition elect 'cal wiring which may be required in connection with the Tenant's apparatus or equipm t. The enant's obligations to maintain the Demised Premises in good and tenantable condition and to in e the repairs required under this Paragraph 6 shall not be affected by whether the * em which requi es maintenance or repair was installed by the Landlord or the Tenant, nor by t e cause of the nee for such repair or maintenance. If the particular item which requires maint nance or repair is to b maintained or repaired by the Tenant under the provisions hereof, such aintenance or repair shal be the responsibility of the Tenant. Any and all service companies d vendors which perform services or maintenance in the Demised Premises at the in st of the Tenant shall be licensed by the applicable governmental authorities and i sured with respect to any dama s which may occur on the Demised Premises due to their ctivities. Landlord shall repair d maintain those portions of the Comme ial Units which are not the responsibility of the Te an or other tenants of the Commercial Units r of the Association, with the expense the/eloyees be a part of the Operating Expenses, unless su maintenance and repairs are caused in or in part by the act, neglect, fault or omission of an uty by Tenant, its agents, servants, or invitees, in which case Tenant shall pay to andlord the reasonable cost of suntenance and repairs. Landlord shall not be liable for an failure to make any such re rs or to perform any maintenance unless such failure shall persi for an unreasonable time after written notice of the need for such repairs or maintenance is given to Landlord by Tenant, and in any case Landlord's liability shall be limited as set forth in the last paragraph of Paragraph 13 below, and shall be subject to the terms of Paragraph 28 below. 9 AcoRL7 CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) �..� 8/25/2015 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(iss) 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 this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER iRAMEacr Jackie Ortega Fortun Inaurance, Inc. ) PHONE (305) 445-3535 :FAX (866)415-0825 (AIL.)fb.Eltt.t:__....._.._..___.._-_. 365 Palermo Ave. EMAIL ackie.ort.e a@fortuninsurance.c ADQRE$S: 7_ am A _ INSURER(SLAFFOROING COVERAGE ____ ___ __ ___ _NAIC_% _ Coral Gables FL 33134-6607 - - - INSURERA2aAPFRE Insurance Co INSURED INSURERS RetailFlrat Insurpance CO 8n Global Electric Services LLC 15905 SW 105 CT INSURER D: _.__._._.._._._..__.........._._._._._�._..__._....___.._.___.._. _.. ............. . ' iHSURER E: ! Miami F L 33157 : INSURER F i Cr1VFRArFS f;:PTIPI' AT= Aft HU192G9D•f:TA SR9 SnQ 9 QQ - OC4rrCrnsl kit rseoeo. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED 5CLOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH 'I HIS CERTIFICATE MAY BE ISSUED OR MAY PFRTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THG TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR�;A110L',S171I7iT.._T_.___.—.—__._—______•..._._.,._.._____..—_._._......_.___.._.._.......__ LTRTYPE OF INSURANCE POLICY NUMBER MMrOUY YYY I WM%+ipjYYXYv ! LIMITS i X i COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE ' S 1,000,000 A i L"tAihiS-hLAOE X ; OCCUR : •) _ __•_.-.__.__. i I _. _._____. __. 100, DOD ; PN kAi�-F�tD N ttY.. r 0I1CA1 5 1425015002136. ' - ' je/3D/2015 ! B/3D/2U165,000 IAED EXP IAn one parsonl + S -... I PERSONAL A ACV INJURY ;S 1, 000, DOD 'GEN'LAOGREGATELIEIITAPPLIEX,PER! i �CENERALAOGREGATE !s 2,000,ODO ..._...., . X J POLICY ( r....._JECT :. __.} LOC ? ! PRODUCTS - CO!JIFYOP AW, ' ,S 2,000,000 OTTER' ( Employee Ben11t4 S AUTOMOBILE LIABILITY • COMBINED SINGLE LIYiT i S ' rEu I �AN'fAllfO accNe_ i BCC:L'YINnt�JLIRY(Parperscnj_: i ALL OWNED SCHEDUL70 I — -- -------'-- -" - ' ----- ! ._..1 AUTOS I AUTO& --� j I BODILY INJURY (Per accidwnt); S , ' HIREL' AUTOS i NCN-ONdJEU I AUTOS E._ PkORE_RTY D_PF.IAG.._ :S UMBRELLA LUtO ' 1 OCCL'2 I ! ? +EACH OCCURRENCE S i EXCESS LIAR + I CIAI`AS•MADE ,._......4__..__.T.__...I_-. ._ ' + t I i AGOREGAT'c $ ' Or.D ! RETENTIONS WORKERS COMPENSATION PER (J!H- AND EMPLOYERS' LIABILITY ` IN: � � I__. _i_STAT)j')_c',._...._..L !ANY PROPR:ETORiPARTNER.+F)(FCUT!VE r N I A; j ' I S. EACH ACC DE^1?.__.,______ IOFFICERRdEM6@R EXCLUDED'': B i(Mandatory InNH) i 520-96297 7/15/2015 ! 7/15/2016 ELDISEASE J cU? OYC� S t 000 000 III yes. ;;escxi.w undar :DESCRIPTION OF OPERATIL`NS belay I i E.L. DiCEASE - POLICY LIMIT S 1,000 000 I 1 a i I UESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES jACORO 101, Additional Remarks Schedule. mey be attached if more space is requited) Electrical Work Im City of Miami_ Shores Village 10050 NE 2 Ave 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 01988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INSWS nntaor+ `gNoREs Miami Shores Village Y 10050 N.E. 2nd Avenue NW Miami Shores, FL 33138-0000 Phone: (305)795-2204 �YOAtDP' Permit NO. EL-4-16-971 Permit Type: Electrical - Residential P e n Work Classification: Alteration Permit Status: APPROVED Issue Date: 5/6/2016 1 Expiration: 11/02/2016 Project Address Parcel Number Applicant 104 NW 102 Street 1131010220130 ALFREDO R PATINO Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone uen ALFREDO R PATINO 104 NW 102 Street MIAMI SHORES FL 33138- 104 NW 102 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone GLOBAL ELECTRIC SERVICES LLC (305)218-0752 /pe of Work: CHANGE PANEL AND OUTLETS. Jditional Info: lassification: Residential canning: 1 Fees Due Amount CCF $0.60 DBPR Fee $3.38 DCA Fee $3.38 Education Surcharge $0.20 Notary Fee $5.00 Permit Fee -Add itions/Alterations $225.00 Scanning Fee $3.00 Technology Fee $0.80 Total: $241.36 Valuation: $ 800.00 Total Scl Feet: p Pay Date Pay Type Amt Paid Amt Due Invoice # EL-4-16-59373 05/06/2016 Credit Card 04/11/2016 Credit Card $ 191.36 $ 50.00 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Review Electrical 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, I authorize the above -named contractor to do the work stated. ��_7 v May 06, 2016 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy ay 06, 2016 1