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EL-06-21-1587, 304 NE 93rd St (3)Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Permit No.: EL-06-21-1587 Permit Type: Electrical - Residential Work Classification: Alteration Permit Status: Approved Issue Date:06/29/2021 Expiration:05/08/2023 Location Address Parcel Number 304 NE 93RD ST, Miami Shores, FL 33138 1132060136350 Contacts BRADLEY JOHNSON Owner ONLY ELECTRIC CO INC Contractor 304 NE 93 ST, MIAMI SHORES, FL 33108 YOAV ADIKA Mobile: 3106330330 bjohnson.bja@gmail.com 348 NW 102 TERR, FL Business:3057856059 onlyelectriccompany@gmail.com - ---- .----- ____. _ ... ..___m._._.. Inspection Requests: Description: INTERIOR REMODEL, KITCHEN/BATHROOMS AND Valuation: $ 27,100.00 305-762-4949 OTHER AREAS. REPLACE ELECTRICAL PANELS OUTLETS. Total Sq Feet: 2,300.00 Fees Amount Application Fee - Other $50.00 CCF $16.80 Change of Contractor $145.00 Contractor Registration Fee - First Time $50.00 DBPR Fee $14.23 DCA Fee $9.49 Education Surcharge $5.60 Permit Fee $898.50 Scanning Fee $3.00 Technology Fee $23.71 Total $1,216.33 Building Department Copy Payments Date Paid Amt Paid Total Fees $1,216.33 Credit Card 12/29/2022 $145.00 Check # 003998 06/29/2021 $1,021.33 Credit Card 10/12/2022 $50.00 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 consyrkj , and zoning. Futhermore, I authorize the above named contractor to do the work stated. / 2/? i / 2z Owner / Applicant / Contractor / Agent / Date December 29, 2022 Page 2 of 2 Gl -(5-1-7 ,O° CERTIFICATE OF LIABILITY INSURANCE ACOR 16- . ' DATE (MMND/YYY1r) 1 03/2512022 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 ADD17IONAL INSURED, the pollcy(tes) 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 endorsements . PRODUCER KAVA INSURANCE AND FINANCIAL SERVICES 1217 N W 401h Ave CNOAMEAC Vladimir Laibhadoorsingh _ PHONE sr , (954) 583.5377 uc. Not: (954) 727.9206 ADD . vladimirl@kavainsurance.com INSURER AFFORDING COVERAGE 14AIC G INSURER A: RPS-PROASSURANCE Lauderhill FL 33313 INSURED INSURER B INSURERC: ONLY ELECTRIC CO INC, Only Electric INSURER D: 348 NW 102nd Terrace INSURER E : _ INSURER F: Plantation FL 33324- e-^WC6A/2Ce PPOTIF1reTF MIIIJIRFR• 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. TYPE OF INSURANCE AO a POLICY NUMBER w'Dor EFF POU/norr XP L1MRS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 rA _ C.AIMS•MADE OCCUR A7AACE T�-R wrw- PREttSEStEaog*ww a S 100,000 MED EXP Arr1 one pennon) $ 5,000 PERSONAL&ADVINJURY S 1,000,000 CPS3031379-04 04/14/2022 04/1412023 GENLAGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE S 2,000,000 PRODUCTS - COMPIOP AGG S 2,000.000 POLICY 2] PRI F LOC CT OTHER: AUTOMOBILE LIABILITY Me scr dcn NGLE I.IA (Ea erfJdtnU $ BODILY INJURY (Per person) S ANY AUTO BODILY INJURY(per soddent) S OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PRO PERfYDA1,lACE ( t $ S UMBRELLA LIAS OCCUR EACH OCCURRENCE - $ AGGREGATE S EXCESS LIAR C1A11AS-MADE nE0 1 RETENTIONS WORKERS COMPENSATION AND EMPLOYERS' UABILI7Y ANY PROPRIETORIPARTIIERIEXECUTNE Y� 4 AT ERH $ E.L. EACH ACCIDENT S E.L. DISEASE • EA EMPLOYEE S OFFICERA.IEIdBER EXCLUDE07 (Mandatory In NH) NIA E.L. DISEASE • POLICY LIMIT S Ilyyeess desTc6be urlder D SdRIPTION OF OPERATIONS haaa DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) ELECTRICAL WORK. GCKI Irm AI C nVLu Gr( ^••�---• •••-- SHOULD ANY OF THE ABOVE DESCRIBE/POLICI 8 i3E C NCELLED BEFORE THE EXPIRATION DATE THEREOF, YILL E DELIVERED IN Mieml Shore Villa a Buiidin De artment 9 g P ACCORDANCE WITH THE POLICY PROVIS 10050 NE 2nd Ave AUTHORIZED REPRESENTATIVE VLADIMIR LALSHADOORSINGH Miami Shores FL 331138 w IyOG'<V la ri"%aw a.vr�r vrir� „v... �.,, ..y,..•, ....,... ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD /