The URL can be used to link to this page

EL-10-18-3290, 1316 NE 105th StOR07- Miami Shores Village 9-rj_-5ej- --5 + Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 CA; I IN CTION LINE PHONE NUMBER: (305) 762-4949 m0ne set askN'%1�� ,C I I -� oor e FBC 20 t'? BUILDING 10,2 Master Permit No. PERMIT APPL CATION Sub Permit No. ❑BUILDING ® ELECTRIC ❑ ROOFING ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ REVISION ❑ EXTENSION ❑ RENEWAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 1,31( A/E 7 S t 16 City: Miami Shores County: Miami Dade Zip: ��Iz7 - 212j Folio/Parcel#: // 2 2 32 0 �� - v /S o Is the Building Historically Designated: Yes NO X Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): US LL (f Phone#: / S y - S / 2 �7 '� x- �1 Address: P050 X 5U 2.3 06 City: A//a / 3-eaC Tenant/Lessee Name: V Email: vem,< State: F1 Zip: 53/ (2. one#: CONTRACTOR: Company Name: C1 En kuLelI C i "eCTr%"(- Phone#:(,WS) 351- Address: 31 G Z. r� yy -}5TV) :!> T h City: fvl «mn I State:- Zip: 7 Qualifier Name: O(YyAY C-10 taY--) Phone#: (3�� 20 7) - 4� State Certification or Registration #: DESIGNER: Architect/Engineer: Certificate of Competency #: Phone#: Address: r City: State: Zip: Value of Work for this Permit: $ L.�J� ® Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ElRepair/Replace ❑ Demolition Description of Work: U-I L T Y) CCO Y-e. [ 1 r \A % V i C' Specify color oof. color thru tile: Submittal Fee $ `% Permit Fee $ 102pr �'"'G CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ (Revised02/24/2014) Bond $ TOTAL FEE NOW DUE $ 11Ci . 30 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. _ n Signature Signatu OWNER or AGENT The foregoing instrument was acknowledged beforye this _� day of T j 20 1 , by ti�cArtc�nr �� who i personally know to me or who has produced s�lC�GI as identification and who did take an oath. NOTARY PUBLI Sign: PrintIm Seal: r WASE Expires: July 17, 2021 Bonded thru Aaron Notary C`_' .-K R The foregoing instrumenj was acknowledged befor me this day of J 20 by who is personally known to me or who s produced'&J 0 1050 �� 'ACA�aas identification and who did take an oath. NOTARY Sign:_ Print: Seal: ExpppifA: July 17, 2021 Bonded thru Aaron Notary APPROVED BY /%& / r'& j Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION 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. D. 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, FL 33138 Certificate must specify the description of operations or contractor license number. ............................................................................................ BUSINESS NAME: BUSINESS ADDRESS: 31 CI Z NW " '' 5 r CITY M I C4 yyl 1 STATE F- ZIP-3 0 2 BUSINESS PHONE: O _2310- 1 - �� FAX NUMBER ( ) CELL PHONE 575 QUALIFIER'S NAME: Ono y I (-to 1 ci I QUALIFIER'S LIC NUMBER: EC 13 W'✓ 3 RICK SCOTT, GOVERNOR JONATHAN ZACHEM, SECRETARY d blar STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION EXPIRATION DATE: AUGUST 31, 2020 Always verify licenses online at MyFloridaLicense.com Do not alter this document in any form. This is your license. It is unlawful for anyone other than the licensee to use this document. 003119 Local Business Tax Reipt Miami —Dade County, State of Pfbrida —THIS IS NOT A BILL — DO NOT PAY 6555735 BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES G BRICKELL ELECTRIC LLC RENEWAL SEPTEMBER 30, 2019 3192 NW 45TH ST 6826318 Must be displayed at place of business MIAMI FL 33142 Pursuant to County Code Chapter 8A - Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS G BRICKELL ELECTRIC I LC 196 ELECTRICAL CONTRACTOR PAYMENT RECEIVED C/O OMAR GALAN PRES EC13005903 BY TAX COLLECTOR $45.00 07/10/2018 Worker(s) 1 CHECK21-18-064475 This Loral Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit, or a certification of the holder's qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory law§ and requirements which apply to the business. The RECEIPT NO. above must be displayed on all commercial vehicles - Miami -Dade Code Sec ila-276. For more information, visit www.miamidede.gov/taxcollector ^CC> R" CERTIFICATE OF LIABILITY INSURANCE " DATE(MM/DDNYYY) 05/25/18 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 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: geatrlZ Bruno Excellence Insurance Agency PHONE: E,rt): (305)226-3900 FAX No): (305)226-3997 3801 SW 107Avenue ADDRiess_: bbruno@Excelienceinsurance.net Miami, FL 33165 INSURER'S) AFFORDING COVERAGE NAIC # _ 1 Phone (305) 226 3900 - Fax (305) 226-3997 INSURERA: Mapfre Insurance Company 16870 INSURED I g Granada Insurance Company N URER B . G Brickell Electric, LLC INSURERC;_ 3192 NW 45 St INSURER D : _ Miami, FL 33142 305 _INSURER E-; INSURER F COVERAGES CERTIFICATE NUMBER: 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 _ LTR - TYPE OF INSURANCE ADD SUER - - - - POLICY EFF POLICY EXP GENERAL LIABILITY I { WVDf POLICY NUMBER (MM/DDIYYW),,(MMtDD/YYYYI , LIMITS INSR AD EACH OCCURRENCE $ 1,000,000.00 � DAMAGE TO RENTED 'J COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ 100,000.00 A F1 ❑ Y Y CP-000324643-7/000 03/10/2018 MED ExP (Any one person) $ 5,000.00 CLAIMS MADE �� OCCUR 03l10/2019 t--- - �/ PD $500 Deductible I PERSONAL & ADV INJURY _ $ 1 ,000,000.00 GENERAL AGGREGATE $ 2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG$ 2,000,000 00 PRO- V' PO ❑ $ _ � POLICY aECT — LOC I _— --- AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED ❑ SCHEDULED B AUTOS '.__. AUTOS BODILY INJURY (Per accident) $ ❑ (-� I PROPERTY DAMAGE $ HIRED AUTOS �� AUTOS NON -OWNED _ .f Per accident) _ _ _ 77 UMBRELLA LIAR U ❑ OCCUR I EACH OCCURRENCE EXCESS LIAB L,J L✓ CLAIMS -MADE i AGGREGATE $ DED I_1 RETENTION$ _—. i_--i— _ —. _ $ --. WORKERS COMPENSATION I "1 WC STATU- OTH- (-1 TORY LIMITS ❑ ER AND EMPLOYERS' LIABILITY Y / N -- ANY PROPRIETOR/PARTNER/EXECUTIVE GBWC892004 I E L. EACH ACCIDENT $ 100,000.00 OFFICER/MEMBER EXCLUDED? N/A 04/01/2019 - _ It yes, describe under r E L. DISEASE - EA EMPLOYE $ 100 000.00 (Mandatory in NH) I Y - _ _.— .. .. _ -- — B DESCRIPTION under OPERATIONS t�elow Y Q4/01/201 a EL DISEASE -POLICY LIMIT $ 500 000.00 i DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Electrical Contractor CERTIFICATE HOLDER Miami Shores Village Building Department 10050 NE 2 Avenue Miami Shores Florida 33138 Fax 305-756-8972 ACORD 25 (2010/05) QF CANCELLATION ` SHOULD ANY OF TH VE ICIES BE CANCELLED BEFORE THE EXPIRATION T HE IC ILL BE DELIVERED IN ACCORDANCE H HE I RO ONS. AUTHORIZED EPR N----- 01 CORD CORPORATION. All rights reserved. OR name and logo are registered marks of ACORD Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Permit NO.: EL-10-18-3290 Permit Type: Electrical - Residential Work Classification: Repair Permit Status: Approved Issue Date:12/17/2018 Expiration: 04/24/2019 Location Address Parcel Number 1316 NE 105TH ST, Miami Shores, FL 33138 1122320270150 Contacts _...__._.. ..._ _ _,.., ......_ _ ........ _ ...___.. _.... __... ._.... ... . FLUS LLC Owner G BRICKELL ELECTRIC LLC Contractor C/O GFB TAX SERVICE LLC OMAR ) GALAN a 5210 SW TER, SOUTH WEST RANCHES, FL 33332 3192 NW 45 ST, MIAMI, FL 33142 Other:3056092522 Business:3053516954 MENESESASSOCIATES@GMAIL.COM Mobile: 3052974655 Valuation: Inspection Requests: Description: ELECTRICAL METER REPAIR 305-762-4949 Total Scl 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 Permit Fee $50.00 Scanning Fee $3.00 Technology Fee $2.50 Total: $110.30 Building Department Copy Payments Date Paid Amt Paid Total Fees $110.30 Check # 2390 12/17/2018 $110.30 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. AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws :on§4ction and zeping. Futhermore, I authorize the above named contractor to do the work stated. Signature: / Applicant / Contractor / Agent Date December 17, 2018 Page 2 of 2 GROUND FLOOR APARTMENT 101 ELECTRICAL ROOM ON GROUND FLOOR ON GROUND FLOOR. EXISTING 1201208V,30 �IN NEMA 1 PANEL A 1100 AMPI MCB LT-1 I O I L — — — — — EXIST. GUTTER AS PER NEC-373 f L— — — — — — -- — — — — — 3#3 THWN (CU) 1 #8 THWN (CU) G IN 1-114" COND. PROVIDE PERMANENT PLAQUE IN ELECTRICAL ROOM FOR ARC FAULT & SHOCK HAZARD: WARNING Arc Flash and Shock Hazard Appropriate PPE Required PPE: PERSONAL PROTECTIVE EQUIPMENT F----� I I I I EXISTING 600 AMP. MAIN SWITCH i I PROVIDE NEW ELECT. METER 100 A RATED, 1201208V,30 FOR APARTMENT #101 ELECTRICAL PARTIAL RISER DIAGRAM N.T.S SCOPE OF WORK THIS ELECTRICAL SCOPE CONSIST OF REPLACEMENT OF EXISTING DAMAGED ELECTRICAL METER ON EXISTING LOCATION AS SHOWN ON ELECTRICAL RISER. NEW — — — — EXIST. Revisions 8g 3 s W .••••• w �w a s �. •••�'' fir; • LU J cp�•, •.r Uj nsm•+� J'[L ±�•;I 0••6L g LU r�••• W 8 J W • 11� C �O 41O a oLL w�II �� >0I° g EL —Q 0a g I000 V F oI �a om Q� �w, U�OW o �7 jib, s a �s E -.f�S✓• , °'"..-... Job No. 'Date L• DAB !0 1126.18 cale SHOWN -P'°N 0 V N 8 _ `•}'p�° � Seal AA-26001560 Sheet No S E-1 • A I w ••• A•• • 1 Y i 4• •• •w• •w • • • •♦ V^ 'v f"1