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DEMO-06-19-1298, 9353 NE 9th AveMiami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Parcel Number 9353 NE 9TH AVE, Miami Shores, FL 33138 1132060010040 Contacts 9353 FLORIDA LLC Owner GLOBAL ELECTRIC SERVICES LLC Contractor OSMANI GONZALEZ z Business: 3052180752 Inspection Requests: Description: DEMOLITION ON TWO BATHROOMS Valuation: $ 500.00; 3f75-ib2�9 �� Tot alSq Feet: 0.00 Fees Amount Application Fee - Other $50.00 CCF $0.60 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.20 Scanning Fee $3.00 Technology Fee $1.25 Walls, Signs, Other Demolition Fee $50.00 Total: $109.05 Building Department Copy Payments Date Paid Amt Paid Total Fees $109.05 Credit Card 10/15/2019 $109.05 Amount Due: $0.00 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 constructiora/anStoning. Futhermore, I authorize the above named contractor to do the work stated. Sig6ature: Owner / Applicant / Contractor / Agent Date October 15, 2019 Page 2 of 2 P1zCEIVEID 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 JUV A 6 2 19 FBC 20 1 BUILDING Master Permit No. PERMIT APPLICATION Sub Permit No. ❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS [] CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS:''- r 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): '�� `1 C")1C�C • L `_ 6- Phone#: Address: i City: �. �i1 �) ►�� State: Zip: Tenant/Lessee Name: Phone#: Email CONTRACTOR: Company Name: L(le- Iiz C4-4'//`'[E � Phone#:,." � �2 - Address: l ✓ l' 5'( City: C.-1jfi-ei State: �. C Zip: ` : / Qualifier Name: i l i C %// 7Gr' 16 <' Phone#: State Certification or Registration #: % /3C" (�'6 x Certificate of Competency #: / Z ✓� ?<? /�' DESIGNER: Architect/Engineer: Address: Value of Work for this Permit: $ < Cat- 9 Phone#: City: State: Zip: Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New/ ❑ Repair/Replace ❑ Demolition Description of Work: 7i%t!` �/ 7i c 1 t . / CT Specify color ofcolorthru tile: Submittal Fee $ 56 Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ DBPR $ Notary $ Double Fee $ Structural Reviews $ (Revised02/24/2014) Bond $ TOTAL FEE NOW DUE $ (0 9 , 0 rJ 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 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 charged. r Signature ��—�^-,�^-.-�_,.�[��c _,� Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this day of 20 / �% by wh is ersonally known me or who has produced The foregoing instrument was acknowledged before me this J �I day of e'l) L''20 t by D:1)W O ►11 (�- C )17u 1f swho is ersonally known to as me or who has produced identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: as Sign: Sign: Ll Print: Ev-C ►y l 6761r r - ICi Print: FvJO.-in C-IC y'CI Seal: •o Notary Pubk State of Florida c State of Florida Seal: �.'"Y=garcla 'f evelyn garde a r y • My Commission GG 101334 csion GG 10 3334Expires 05/OM202t F q4/2021 ss * ss s s*sssss*s* APPROVED BY Plans Examiner Zoning (Revised02/24/2014) Structural Review Clerk Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756.8972 IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LICENCES B. COPY OF LOCAL BUSINESS TAX RECEIPT C. --.----COPY OF LIABILITY INSURANCE* D. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) IF,,CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL33138 Certificate must specify the description of operations or contractor license number. BUSINESS NAME: C-110k3W �ACC%c �)eeLccs , ajc, BUSINESS ADDRESS: i5905'M 1070 CT —CITY L -STATE ZIP 3515-1 BUSINESS PHONE: (� -D18.0_15Z1 FAX NUMBER (,3C5) U15- 5-110 CELL PHONE (��)05 �18,052 QUALIFIER'S NAME: a-MON b10MJGL1f_7_ Miami -Dade County - Building and neighborhood Compliance Office Page 1 of 1 Contractor License Information Contractor Number: 12E000422 Contractor name: GLOBAL ELECTRIC SERVICES LLC Address: 15905 SW 105 CT City, St, Zip: MIAMI Phone: (305) 218-0752 Other Phone: Fax: Email: D/B/A: Contractor Status: ACTIVE FL 33157 Class Category Category Description Expiration Date ELEC 1 ELECTRICAL 09/30/2019 ELEC 2 BURGLAR ALARM 09/30/2019 ELEC 4 FIRE ALARM SPECLT 09/30/2019 CONTRACTOR INQUIRY COMPLETE BCCO Contractor Inquiry and Complaint Search I BCCO Home Page I State License Search Menu 0 Home I About I Phone Directory I Privacy I Disclaimer © 2001 Miami -Dade County. All rights reserved. http://egvsys.miamidade.gov:1608/WWWSERV/ggvt/BNZAW941.DIA?CNTR=12E000422 6/4/2019 !fir Local Business Tax Receipt o G Miami -Dade LunLyrState of Horida de CABILL,-SIaPAY 7052889 LBT s.«E9a wAmErwennad c9tpr.ao. EXPIRES CLOSAL ELECTRIC SERVICES LLC RENEWAL SEPTEMBER 30, 2019 75905 SW 10S'TN CT 7330376 Mret ue Ulx(/Iayg<I xz yxa,m mt urml�n+. Mihtaf FL 33157 n,.wmrzt w Gmumy coax Cnnntmr NA �Art.9 & t0 OWNFq SE C.T pEOm Er GLOBAL ELECTRIC SERVICES LLG 196 ELECTRICALRICAL CONT CChiRA:TO?t 12EL'C0922 573.00 07/06170p1R6 Vtorkmr(z) t CREOITCARO-16-050a36 1.: L 9 T E a hc9+w rmr m.r.wrgmacocre .man.cagnmt. nc .r. en:9�.i NAolddti ual Es Mr�gtla9ltanm Rta a sYv,+Wrm'r9se„ s,fel yy oq<om i g msn� 1 91 terylaw#mn9 4W vp shP9P1X N nesr. iPe 9EGfIPi N9.mmwx�9sdRrrlaystl en Nl sgmvis[skl vsAxier-ifl0ml�datll Cada Bee 9a-SIB .. /armed ip[pPomibgvW[yarytLN31Rl4pQA.pgp�paV(llfstra Municipal Contractor's Tax Receipt Miami —Dade County, State of Florida —THIS IS NOT A BILL — DO NOT PAY CC NO: 12E000422 BUSINESS NAME/LOCATION RECEIPT NO. GLOBAL El ECIRIC SERVICES I LC 15905 SW 105TH CT 7573696 MIAMI, FL 33157 EXPIRES SEPTEMBER 30, 2019 Pursuant to County Code Sec10-24 OWNER TYPE OF BUSINESS GLOBAL. ELECTRIC SERVICES LLC ELFC TRICAL CON IRACTOR Restricted to City of Miami Shores MI®M For more information, visit www.miamidade. ov taxcollector PAYMENT RECEIVED BY TAX COLLECTOR 18.75 06/04/2019 0208-19-006132 ._' "", V- ----------- - ------- CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) a+- 06/04/2019 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 Nirma Garcia NAME:PHO_ _ Lucky Day Insurance Corp. (AM, N Q. Ex : (305) 227-7001 1a No): (305) 227-7004 13256 SW 8th Street EMAIL ngarcia@luckydayinsurance.com ----.._............._ . _ _.._..... ...... ........._.._.------- -- ---- Miami, FL 33184 INSURERS AFFORDING COVERAGE NAIC # Phone (305) 227-7001 Fax (305) 227-7004 INSURER A: Granada Insurance Company INSURED INSURER B : Berkshire Hathaway Guard Insurance Co Global Electric Services LLC INSURER C : 15905§Wy105thKT Miami COVERAGES FL 33157 CERTIFICATE NUMBER: INSURER D : 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 __ ... ADD INSR SUBR WVt).. __...POLICY NUM_BE_R_ POLICY EFF 1MM/DD/YYYY) POLICY EXP (MM/DD/YYYYl..._.........._ -- ... .................. LIMIT `IJ COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000.00 1 _.- CLAIMS -MADE [�I OCCUR -_.-_......__._........----._................................._.............................. DAMAGE TO RENTED PREMISES Ea occurrence -.._......_._...._.. $ 100,000.00 MED EXP (Any one person $ 5,000.00 A Y 0185FLOO100084 08/21/2019 08/21/2020 PERSONAL & ADV INJURY $ 1,000,000.00 GENERAL AGGREGATE $ 2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: ❑ POLICY ❑ PRO ❑ LOC JECT PRODUCTS - COMP/OP AGG $ 2,000,000.00 J OTHER .....-. .. - .. $ AUTOMOBILE LIABILITY $ COMBINED SINGLE LIMIT Ea accident _ BODILY INJURY (Per person) $ ❑ ANY AUTO OWNED ❑ SCHEDULED AUTOS ONLY AUTOS HIRED NON J -OWNED L AUTOS ONLY - AUTOS ONLY __J ! BODILY INJURY (Per accident) — -- --- -- $ PROPERTY DAMAGE Per accident -- -- - $ I $ UMBRELLA LIAB -]OCCUR EACH OCCURRENCE $ [-I I EXCESS LIAB ❑ CLAIMS -MADE ( _ AGGREGATE $ CI DED❑ RETENTION $ $ - WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N _ r PER 1 OTH- TAT TE LJ ER E.L. EACH ACCIDENT ------ --- -- E.L. DISEASE - EA EMPLOYE $ 500,000.00 $ 500,000.00 ANY PROPRIETOR/PARTNER/EXECUTIV B OFFICER/MEMBER EXCLUDED? (Mandatory in NH) - N / A I W C817934 12/21/2018 12/21/2019 If yes, describe under DESCRIPTION OF OPERATIONS below j ...__..........__.---_- ...................-_...__-- E.L. DISEASE - POLICY LIMIT ------.._............... _.- $ 500,000.00 it DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Contractor's License Number 12E000422 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shore Villages THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1050 NE 2ND Avenue ACCORDANCE WITH THE POLICY PROVISIONS. Miami shores FL 33138 AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) QF The ACORD name and logo are registered marks of ACORD