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EL-10-20-2502 �\��l �`,��15`�`\�'�����\t�i`,,1�`���`��:ti �t }\\� \\��\ _:�?} l`\�\� Y�tis'1���'�. `��`�.��\��;��<i�� ��\��}t ti�;�l�\�� L�����t�,� � \�lt `;�.,`� < `1��4 � �l�`� 4 � � :::��,� i��i����11:\`t ��\���1�,�,l�L»��� �\` �L�\���tl\��>���t��L.�. �t �1� t $�Z��. �\��a.-.::� �L� , ��, t ti��`\\`���`s����7i���\�<�t ��� ���\� 3` �������til� \�, t�r�1��� ��"i �f��c ��� ��C� �,�\ '�,:,-' . �` �t � ������5� ��Z��\ � �����\ ,��������� �����'��\\-?�,�4 \�``,���„':. r<'� �I2ltTtl S�'tOC@S VI��c3�L \� �Lf ���\\i �: 1 �� 4 t�i`��\��� ���'�� �O� ,?� Z }\}� � �"� �� � Z � t`c T� � �� r � ti �s s i � � 2dQ50 NE 2 AV2 � � � ` � \:��^`\ � � t` ``�����3 c�c �� `L�445 � � ��i r� ,..��� �� { � ��Z�\1�����i��?k����� �1�;,c���1�'t �t���, ��t�. �12tTtl ShOf@5 F�3��3� ? 3�zi,.kx�� ��\ ti���.. � .'{ } � �� �1,. �\ �� �i�.. 1 1`y i��, ��a �Z� ��t ���ytl\l O s..l` 'c}i:��.:���'`��1.;� .l } 2 x\``c.y`�..�..� �y;{ ��.�x+�\:ti�,�1'��S\.���`\`i��.�r�. �� �''��,.� ����`�.Sti �\l�\.�.;,��til��;�\��`�*.�14��,���,;\«��",a`���.�'�li�t��ti., yF,,,.h� \.G 305-79S-22Q4 ��z�;Y���ti����i`�\��;����, ���+\��'�`��`�`�2$��'�2����`s��`1��` "�f . \ 1 Eti7..�ta�`;,<� �����51��7���'�����e,,�tZ`\�i���c �g`����~1.� \\���i���s���\�tt s������`. � �, \ �.` �4 ��a�����.a�.�x� ��, �.tit� ,eti�����L,r���j.\}�� ..,�,��``.� � .ast.�,t4t �, A\�Z,���A��c��a a��,Z;�k'e�� ������'".,. ���1���\��,�,s�l�����'va�`��`;x\��..��t����\\��s�?t2��S ��r,'� � . ;<�;���Y�����ti��� �� � EXpIC��IOC�� t��k/27J2022 � i�����, ��+�.\� `;\���s�xi.�61�.a�,�2}l�?tt�.��,\ ��cation Address Parcel Numb�r � .�_�..��.�_._.�._._.n..._�r....._�..._�..� �.��� e�e.��.� �.._m�.�.�,.�a,m� � � ��.��� �,����, i 909 NE 99'TH ST,�tti�rr�i 5hores, FL 3313� 11320603�0230 � ����� � � Cczntaets �.._._._.��.�_�._._�..M. .�����.._ ���a_.���w..�..mm��_.� .�..�.��w.���.��.�,,.�w__H��..���._�.���������.�a._.�,�w� ���w�����_�_.��_.� j ' Vasco lopez Q�ner MESA BftC?TNERS INC Contrae#ar �� gpg�g RAUL M�SA vasc�pbls@gmaiLcom 5215 SW 1Q3rd Au�NfA,MIAMI,FG 33565 � Business:3C}5-630-2549 MESABRC?TNERS@ATT.NET Mobile:305-345-1974 � � � +��a� ,_��.M...,�.w.K_.m___�_.__�_.....__._��_m.__...__.m.m.__._.._....__._.....__.__,�_.__�_...._._.._...._..._..,_�._...._.._._._...�_........_n..� m.____,_..�...�_m�...._____.__,__�._._..._._...._�_._.._.__..___.............m.._., � = � IEIS @ChOtl RG UEStS � ��scriptian:NEW ELECTRICAt�t?R C�ARAGE CONVERSIQN AS � Va#uafiion: $ 3,OflC1.0U � 1��•���� � tz ,� �� ' � P�R P�ANS � �r���``��'�� ���� � , � l�ti� ` ' � � Tota l Sq Feet; 250.40 . s,���,`��ti� ``.1 �` `� � `�` ���.� � .�� �: � ���.� Fees Amount payments Date Paid Amt Paid Applicatian Fee-Other $SO.Od T�t�l FeeS $117.03 CCF $1,80 CreditCard 11f10j242Q �67.43 p�PR Fee $2.OQ Credit Card 20f 29(2Q24 $5�.00 DCA Fee S2.Q0 Education Surcharge S0.6Q Arnctt�nt Qta�: $Q.QO Rermit Fee $SS.00 � � � �� Scanning Fee $3.06 Techn�logy Fee $2.63 r�x�i: $i27,as uil ir� nt � y kn cansideration of the issuance to me af�hi� p�rmit, I agree�o per€orm fhe wc�rk cavered hereundee in eompiiance with aIi �€dinane�s and regulations pertaining th�r�tca and in strict conf�armity with the plans, drawings, �t�t�ment� or sp�cifications submitted to fih� praper autheariti�s of R/(iami �hores Village. In aecepting this permit I assume respansibilifiy fe�r aIl work done by eifher mys�If, my�genE, servants, ar employ�s. I understand that s�parate p�rmits�re required far ELECTFiiCAE�, PLUMBING,M�GHf�NICRC,WINC?OWS, [?t}OIZS, RC�OFING and SWIM[VIlt�ta PC?OL work. UV�N��S AFFIDAVIT: I certify that �II tt�e for�going information is accurat� and tt�at a(I work wiii he don� in complianee with ali applicabl� latn+s r�g�Iati g construction and zaning. Futhermare, f authoriz�the ab�v�named cantractar to d�the work stated. F � {� � � �w�.� �� i �' � 4 �r ,„� t r �.� P,uth�rl��d na e:Owner ( Applicant 1 Contractor I Agent C1a4 N�uember 10,202Q Rage 2 of 2 _ :�'��� ��.������:��.� � � t � S 1���1 ; � , �` � �11�{�I� +� �"� �� ���' ....,. �f3t►�t1 N.E.2nd,�vettu�,i�latrti S17�ares,�1or3�a 3�13F3 T�t�{�o�}��s-z2t�a��x;{�os����m�s�z ��s��cr�a�����������u����.{��s}�sz���� � � i IL 1 t��st�r��rm�t►��. �`"�,�,��� � �� � �� ��..t �� � s�.,t�P�rmit�1�. � � �"�` ���.� �a�r��r���� ������-��c � �c����r�� � ��u�s��� � �xT��sr�r� ����v�vu�c �����n���� ���c��ar��c�� �u���c v�c���s � c����� c�� �cA���G�a°r��� � s��� cc����c`rc�� ��,�wrnt�s ��������ss� �Q9 �� ��fih �tr��t, �rli�rrrti �hc�r�� FL 33'f 3� Cit : Mi mi h Ccaunt � M�a�i E� �atlofParcef�: ��-����"���6��3� !s the t3uf3dln�N#stc�rlc�ity�r�sl���ted;Yes NC? C}ceu�ancy Ty�e. Lc�ad. Constrc�cti�t�Type: �6ocad Zar3e: �FE. 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It is �anlavv�ul far�r�yc�ne oth��r th�r� �he �icens�e tca use th6s d�curr��nt. : � � TI I� T F �1 1LtTY 1 �E °�T�`��`° '�1+� a2��o�zo2� TF#1� ��RT�PIGATE tS tSStJ�C} AS,A MATT�R �F tNg�Rtt�ATlt}N €?NI�Y.4N� C{}NF�RS NO RIGMTS UPON THE �ERTIFICAT� F��LC1�R. THiS '��RTIFIGATE D@E8 N�'� AFFIR T'IV�I.Y �� [4�GATtVEGY A�+I�ND, �ND QR �LT�F� THE �4V� G� �4�F�R@lED BY 'PH� Pt)[.0�1ES B�l.OW. THE� ��RTiFlCA1'� �F IN�U NCE D��� NOT GQhISTiTUTE A CQNT C°T B E�PI TMIE I�SU(Nfa tP1�URER{S}, Al�TFIQRI��D R�F*R�SENTATIV�4R PRC>CkUC�Ra AMC9 THE G��2TIFE�ATE HOt�D�R. tA�PC?i�1'ANT: If th���rEific�t�hoEd�r is�n,�pC�E`TftJNAL tN�k1R�C�,tF��pcsliey{i�s)mu�t t��v�AD[}ITlQCdAL IhlStJFtEE?provisi�ns or ba�erador.e+d. If SUE3R��i�T10N IS W�IV��, sub��ct ko th�te s�nd cnndEtior��af th�policy,c� Ir► Eicie�rr►:�y �uir��n endors�ment, A�t�#em�nt�n this�ertific�te da��not�onf�r ri hts ta th�c�rtifi�ate h�lder in(ieu of such�nd�r��m�nt�. c r�°r� r •, ��oouc�:�z rtnra�: _ F3n�R�ti� Insurance Exchan e c�f Am�riea Cc� P�+ � ��_ .��_ - —,-F� — — �' �- ��t�e � sz;_ ��77)373-�iQ�3 _-- �,�rc��3{�S�4Q3-0HQ1 8&(3f�?v'� I7t�St�-�et SuiFe IQl $�s�, ie��ande��vritiu��hestrat�-insurunce.cc�na _ _--- T�aral FL33126 --�--- ______.__________ � _�_ .._.___ � �wsvR���s�aF�e��i�c�cov��a�� _ � r�,a�� _._. _ ___.-} ���u���� WESTEF2N WQF2Lt�lR]S I^T � � �_ �_�____ --- — ---�-� — [r��u��r� iNsu��x�: M�s��rc�fhers Ine rr�su���c: -� ----- � � - ----�- �-- 5215 sw 1 fl3 ave iN�u��R o. ----- --- _------ ____ - --_.. . --- ----- � ._ - miami FfQ€ida 33165 �wsv�erz�: _ _ , ._ r INSURER F: G"QVEFt�4,CsES CEFZT1FICeAT� NU{W�E�: REV1SlC}N PIUMBER: TNIS ES Tt�CERFIFY THRT THE FTOLICIES fJF IN�'URRNCE LISTED�ELQW WAVE B�E� tSSUED TO TH� INSUREC}NAf+��D kBC?VE Ff�R TNE PC?t�ICY PERIOD INDIGATED. {UC?TW1TFiSTAPlC}ING ANY REQUtREMENT, TERM OF2 C9N[?fT(QN 4F ANY CC}NTRRGT OR 4TFiER RQCU(�9ENT WITH RESPEGT TC?WHICht THfS CERTiFIC�T� NiAV BE iS�UED OR MAY PERTAIN, THE INSURANCE AFFOFtPED BY THE POLI�tES DESCRtB�C} FtEREIN !S �UBJECT TQ ALL THE TERMS, �XGL.t1S1ONS ANR Cf�NDITiOEV�QF�UCH PQLICIES.�I�I�['S SH{�WN R�d�Y NAVE BEEN RE�UG�L}�Y PAfD GLAt�S. IN&R�� � I�DDI 8�BFt{ _ �� P{t�tC'f EF !Pt?I,iCY EXP tIN1iY5 � T TYRE i?F INSUR,4NCE ��k.iGY P1U�58ER � M144A10[>tYYYY ' �ARR�} � GQMt��FK�lAL f3EN�RAL LtRBII�ITY ' � � I EACN QCGURRENf.E I S �,C}OCI,OOQ 1 I _� C[.111MS-PAADE �QCGUR � � � � I �-PREt�AI�S�E�S�aoocurreny��� 1QE3,QQ{� _ ��} � � i I i i �tEP EXP{Rny one pars�_ $ 5.(}(1� �_ _� � �_--__.._.._---- � ��-- � �. ._,__._.___.__ j � Ql�IWTU-Y ;01101I2{�20 j Q110112Q21 i P�RSQNAL e ADY I�tJURY '� 1,{30fl,OR(3 � ��rv��a���a���r��kn�ir�Re�ti�s Re�: � j 1 j i c�wa�n������r� �� 2 Q40,C�4Q — r�� �o�icY����`o- r��oc �' � i ' i ���oaucrs-co�a�rcaP a��� 1 t?QQ,OQt7 E_ a�aT t____ 1 i �____ _____�� � i QTHER: �� 'AUTOPAi�tLRtiABt4C1"f . . . � I j ' Ea ae�:oMen�iSiNGLE LlP41Y� i S �. _�...--- �RNY AUTO � i ( � �C}DttY tNJ RU v(Per person} i$ ���O'htN�fl (-- `SCMEDUC..ER i � � i BODFLY INdU6?Y jFer aar.�dent) $ _.—�....___.__.._ �AUTOS ONLY -AUT�S ( � , �HIRER �N¢�N-QWNED i � ' � rPRC}PE€Z'fY[7AAAIat;E � �AUTC}S t1Nl Y � RUTOB UNI.Y t � 1 � �r accidenE} � j �� 7 i � � �� �m � �U&1�#RELL�L!� � 4GCUR j � i EACN OGCURRENCE ;$ . E—-� T � G— — t----- — I I 1 AGGREGfiTE $ ��XC�SS UA� �CLAit�fB-h�A6� � I ----- �-1.�..� i � _.. . �---- . m�'.-E- _._ j �.-. `D�L} �RE7ENTlON$ � 1 S ;WBRK�RS GQh4FENSRTft�N ; ' , F'�ft ; �!1'N- �N0�A1PLt�YER�'4l��fi.lYY � ; �T�TUT� ER I ,__ � `ANYPROPF2I�TQRtPRRTNEfL'EXECUTEVE Y t P2 � � I I �_l ERCH RGCICiENT �� �O�F(GEftlt�hEMBEft EXC�UDED? ���f A� ( � �-- _ _.._. _ � .—_ '{R9�nd�fory In NH} . � E L QtSEASE•EA ERAP�G7YEE $ 'ti ye5,d�xs�riTke�undezr � , �..-�-... _. m_._(� DES�R(PTlON QF LkFERATiQNS Paatow i � ! � � E_L.QiSEASE-ROEICY ttCr4IT S I I , I ( k � � � � � I � � � I � ' D�SGRlPTIQN QF t?P�PtAT1AW8I COGFIS�QNS t VEHlGL�5{AGORD 16t,Additbnal Remarks Sehedule,may b�att�et�ed i4 more���c�a is r�e}uired} EC1304187� CERT�FI�ATE N�L�ER CAN�EL TI{?N SNQtl1.D ANY O�1'FfE A�flVE tA�S�RE�ED�CDl.ECE���E GANCEl.LE��EFC}R� THE P6F2RTdAN �AT� TNEivEOP, NCiTE�� WtLL �E C}E6.IYER�A IN MIf�MI SNC?R�S VtLI�AG� ACCURDAN�� H TH�Ps�t�iCY PROV#S�c�NS. 1Q050 Rl�2 AVE �IA(�hi SHE�F2ES,F�33138 auratc��t�e�aE���sE�rar�u� ARAYS GARGIA Q 19��-201§AC�R����P{� TIt�N. A11 rlghts r��eru�d. A�ORD 25{20�61Q3} The A�OR�name and Ic�go�re r�gi�fi� m�rks c�f a4�igR� ��agc{nsaste�€�tYYv�Y} .�+�N �+� �ER�"IFtC�4TE Q� �IA�tLITY IN�EJRAN�E ���sr�o�� ° Tiit5 CER7IFIGAT�IS iS�UE�A3�M�Tt�R OF INFGU��AATt{#N CtNG.Y A�N�Cd?Pd�'ERS N�RlCNTS t�P{}PS TME�ER'CIFICAT�H�I.t?ER.TNE5&ERT�FIGAT� DO�3 WC?T AFF[RF�A ELY OR N�QATt�ElY EPi�,� �Rk6 OR�k.TER THE C�VERAC'aE AFFORp�I�BY THE�'Q�.CC1�S B�C.d)W. TH65 GEt21'(FtCAT�OF 1P1SU NCE CtAES NC?T C9N�TITUT�A GQNT GT B �EN TtlE[SSUING�lStJRER{S}.AUTHAf�l�ZEp REPRESEIV'1'4TIVE C�R�R�CYUGER,AND TH� CERT[F6CATE H��DE�, IRfPC3RT�NT:tf th�c�rtiflcate hoFdee i�ara A��FTION�,L INSURE,�,th�#��6icy�i�s}must h�v�A�[7IfIf3M�L INStIREID pre�vi�Eons or���ndors�d. � SU�R4?CATFQN IS�AIVEp,subj�ct to the terms and c�nditPon�of th�peldcy,c�rtain p�ticaes may r�quire an�ndorsernee�t. A st�tern�nt on this�ertifc�te doas not confer rlghts tc�the certi�c�te hald�r ia t1�u ofi such endor��m�nt{s). PF2t7C}l10ER CQNTAGT Nt1ME: FF{QNE: {8flt}}277_16�0 X 480tt � (727�797d�7tl4 E-It9AI�.AQDRESS: FrankCrum Insuranc�.�e,�ency,7nc. t IIR�RS{S}a�FF4��2�INC GAY� G� N.0. 1(?0 South�ii�aouri Av�nu� Cle�rwater.F!.39T66 INSUREF2 A: Frank WinsCan Crum fet�ur�nc�Gvmp�ny 1960U ItdSEJRED INSURE�.�: INSURER G: s�susa�r�c�: Fra�kGrum UCfF A4esa Brott2�:rs Irtc INSUFiER E 1tK3 SczuE�i�Aissc�uri Avenue Cleaiwatar.FL 33756 INSUREI�F: C�VE G�5 G�RTE�ICAT�NU���R: 594741 RfVt31C?N N!l�B�R: TN#.S�3 TC?CEFtT(FY 7N�T TNE P4L���C}F tNSU NCE E�IS7E�BEI.�W HAVE���N ISSUED TO TH�IN3UFtEC}NAMED A�OVE FC3R THE PC?L�Y t*Ei2fOE} �CdDtC�TE!?. hlt7 TNSTANDING APIY REQUER��A�NT„TE�l�C?R CONQi'C10N OF ANY CONTRAGT�R ATHER DC}�UMEtdT H RE3REGT'T()VYkICH't'NIS CERTEFiGATE R��Y BE ESSUER QR PAR1Y PERTAfN,THE IN�U NCE A�fORD�D�Y THE PtJt�iCE�S���CRE�ED H�R�11d[S S�€B,l�GT Tt7 AE,�.TNE TEFtAA�, EXCt�U�tCbNS AND CC3NRfTtONS t?F SUGH F�tAt�lGlES. �.PM1TS St90WN MAY HAV�BE�N R��UG�D�Y FAI�3 C[sA1MS. IN3�R TYF��F IM�URANGE �RO SKNQ ROItCY NUMBER R�I,tCY EFF PtTLF#'.Y EXP C�IT.� {MM7DOtYYYY} (A9Mf0#A'YYY} CCIRAMERCIAL qENE€tAL LVi61LfTY EAGh#t?G�UftEt�GE $ CLAIM8 MNDE �f}CCUk IIRMAC,F TQ RENT�R Pftc3k�iES t`�v � . P,�"@uPaR48j . . MER EXP fAny pr�?persPnj �����• $ . . .. . . PERSflNr1L 8 ADV fAWUF2Y � 6EN'L AGG1?EGATE IIMiT Ar�PLIES PER: �.+ENERAL AGGREt3ATE $ 1'OUGY PFt6dEGT lQC PRL3-�UGFS-GC}taSPitlP F�G+3 $ QTHEit . .. . . . § . AllT{EMC?BIL�LIA�ILITY . . . . . . Cp#tBiNh.D SINGLE UNlT{Ea�ccitl�m,= $ AGvYAUTO 80[1�lYINJtiRY{PeePerson} $ aWN�D nVre?� gcH„RUI.Eo 6NLY AUfi?$ �C�RI�YINJUftYfP�rAccidanq � $ H7ftEGAUR}5 �f7N.OkVN�� ONLY ftUTC�.x ONIY P*�OPERTY PAPAACiE{Per stxident} � § $ UPA�1$Ei.3.A UA� t1CGGt? EACF!C)CC!l12ENCE $ EXCE3S CtA6 i_AIMS RAA6E ACrGftFt'sttTE . . .$ C7EG ftcTE.NFl�N§ $ WpRI�RS COMPENSAtIUN X PGf2 S7Ai"U� (�Tt+EFi .. �,t�e csv�Hs�uaRita ry Y1N artv��xarRiE raw�aa�rra���cEe�?�v� OfPlCEi�tAAEM6�ft EXC�UDE�? E-l.EACH flCC@ENT $9.WdA0Q � � N!A WG2Q200Q000 �4f01f2p20 01109t2Q21 {AiarMAkeu'Y kn NEt} E.��418F.R5�-EA EMPt.tJV�F �$7,QOQ,QOfl h ye&C.�sc�ri�:urukr OESG�"IPT NTPt OP . . . . . . ttPERt1TiQN$b�twv �.k�pESG.ASE-POli'.�"Y t,MiiT $1,04�,td DES�RiPTiON t1F QPERdTlflN5/I.CXCaTkC�N51 VEtdICt,ES(AGQR€t 101,Add}tional Remarks 9ch�dule,may he aCtaahed if mvre spac�i$reyaired} Effsactive p6(2512418,c�v�rage is far 10p%of the amplcayees of FrankGrum I�ased ta Pviesa Brc�thers!nc{CGent)fcar wham th�client is reporting haurs ta FrankCrum. Cove€age is nat e�ended to statutc�ry errrpbye�s, G�ITTlFlGATE NOt�DER GANCELLA°FK?N 3HOUl.D ANY OF THE ABOV�D�SCRI6E[?POl ICI��8�CRNC�C GED��FQft� TFfE EXPIRATIQN G��TE THEF2Et?�,Nt�YIGE WiLL 8�DEIIV�RED EN GCQ€iC1ANC�WITH THE POLEGY PROV[SlCkNS. UTHORI�ED REPRE�EMTAYN� Nfi�mi Shores VIE6age ��,,. 10Q�a NE 2 Ava. Mi�mi Sharas,FL;339�8 �?99�8-2�1&AG�RE�CflRPO T!C?N.AII righ#s e�served, AGAR�25{2U16103} The ACORD name and Iogo are�regiskered marks o��CQRD