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DEMO-12-20-2858, 1175 NE 105th S
Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Parcel Number 1175 NE 105TH ST, Miami Shores, FL 33138 1122320280281 Contacts Pedro Chevalier Owner SPECIFIC ELECTRICONIC ENVIRONMENTS, Contractor 1175 NE 105 ST INC 1AMES NEWTON 12485 NW 76, PARKLAND, FL 33076 Description: REMOVE UN -PERMITTED BRANCH CIRCUITS. PER Valuation: $ 1,000.00 Inspection Re uests E ' CODE COMPLAINCE VERBAL DEMAND.NO VIOLATION # AT THIS TIME. Total Sq Feet: 0.00 �� r Fees Amount Application Fee - Other $50.00 CCF $0.60 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.20 Electric, Plumbing, Mech, Gas Demolition $50.00 Fee Scanning Fee $3.00 Technology Fee $2.50 Total: $110.30 Building Department Copy Payments Date Paid Amt Paid Total Fees $110.30 Credit Card 12/10/2020 $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 ormity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting is permi I as responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required f -ELECT 'CAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNEt AFFIDAVI : I certi that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulati jconstruction nd zoning. F�thermore, I authorize the above named contractor to do the work stated. Signature: Owner Applicant / Contractor / Agent Date December 10, 2020 Page 2 of 2 -- I2ECEIVEI, Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 BY: INSPECTION LINE PHONE NUMBER: (305) 762-4%9 FBC 20k-:k- BUILDING PERMIT APPLICATION ❑BUILDING ELECTRIC ❑ ROOFING Master Permit No. )c M o- (2-2-o- tegB Sub Permit No. ❑ REVISION ❑ EXTENSION ❑ RENEWAL []PLUMBING M MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: � �, 7 C ! 'L 'T City: Miami Shores County: Miami Dade Zip: -3-31 -Hl Folio/Parcel#: it 2232. 028 OM Is the Building Historically Designated: Yes NO Occupancy Type: OWNER: Name (Fee Simple Load: Construction Type: Flood Zone: Address: // S- lVc— /0-r-'7�5' s% /Lt" T— City: Y-44 i /;-, i __w/o .'L� State: BFE: FFE: W6-2-1-6r 2'3 Tenant/Lessee Name: Phone#: Email: �!i r CONTRACTOR: Company Name: -s=F "' �.� 'e c�.L• . ,r 1: Phone#: Address•2_q�9`� City: A4.t( State: EL Zip: Qualifier Name: , Tvl V_�L &_ C tv '' Phone#:O !S�y'Z�- State Certification or Registration #: ►. -C - 61C I `�IC 7/ Ai Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ 1,00D Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ,LEI Repair/Replace ❑ Demolition Description of Work: Specify color of color thru tile: Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ ©'v Bond $ Tr%TA1 ccr AWMw nI IV ! U- 2 0 Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address Zip City State 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. Signatur, OWNER or AGENT The foregoing instrument was acknowledged before me this VQ day of D eCeM19e i 2020 by .ro E OYS 4 C �I4ho is personally known to me or who has produced L Q �— as identification and who did take an oath. NOTARY PUBLIC: Signature. CONTRACTOR The foregoing instrument was acknowledged before me this day of Dare . 20 Z. G by who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: as r Sign: Sign: 1L'' Print: G Print: eeen ee- ew I ) 1 Seal: '" MY COWIMISSION ARANGG 971705 DA Seal: _te Notary Public 5tf F p o IpJ0 17(PI RES: March 22, 2024Renee NeNron ,p Y COmMiss sn GG 133373 BOt1d8d Thtu i10t91y PUbYC Unden�itersgF A{P Expires R2'2 t :021 ######### ################################# ############ `' APPROVEDKAI vu,- Plans Examiner Zoning Structural Review Clerk va_I I I II IvrII L. We r.rr„vn`11 1 ' 12/10/2020 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 Brown & Brown of Florida, Inc. 14900 NW 79 Court Suite 200 Miami Lakes FL 33016 CONTACT NAME: Carolina Orozco PHONE (305) 714-4400 (305) 714-4401 ADDRESS: corOZCOQbbmia.com INSURERS) AFFORDING COVERAGE NAK: 0 INSURER A; FCCI Insurance Group 05432 INSURED Specific Electronic Environments, LLC 12485 NW 76th Street Parkland FL 33076 INSURER B : FCCI Insurance Company 10178 INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 20.21 Master COI 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, ILTR TYPE OF INSURANCE INSD POLICY NUMBER MMIDO/YYV MM/DDNYYV LIMITS A COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ® OCCUR GL10003787402 02/18/2020 02/18/2021 EACH OCCURRENCE S 1.0w.000 PREMISES Ea occurrence) $ 100'000 MED EXP (Anv one person) S 5,000 PERSONAL&ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PEC LOC OTHER: G£NERALAGGREGATE $ 2,000.000 PRODUCTS - COMP/OP AGG S 2,000'000 Employment Practices $ 100.000 A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY CA10002863202 02/18/2020 02/18/2021 GOWINED SINGLE LIMIT Ea accident S 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) S PROPERTY DAMAGE Per accident $ Medical payments s 5,000 A UMBRELLA LIAR EXCESS LIAB OCCUR CLAIMS -MADE UMB10002161103 02/18/2020 02/18/2021 EACH OCCURRENCE S 5.000.000 AGGREGATE s 5.000,000 DED I X RETENTION S 10.000 S B WORKERS COMPENSATIONOTH- AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE V / N OFFICER/MEMBER EXCLUDED �N (Mandatory In NH) If ves, describe under DESCRIPTION OF OPERATIONS below N /A 001 WC20A70160 02/18/2020 02/18/2021 STATUTE ER E.L. EACH ACCIDENT S 1.000.000 E.L. DISEASE - EA EMPLOYEE S 1,000,000 E.L. DISEASE - POLICY LIMIT S 1.000 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Electrical Contractor - wiring within Buildings Lic # EC13007946 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Village ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd Avenue AUTHORIZED REPRESENTATIVE Miami Shores FL 33138 —' r 0 1988-2015 ACORD CORPORATION. All rights reserved. Ron DeSantis, Governor Halsey Beshears, Secretary STATE OF FLORIDA FI rich pr DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTF PAI r` TH � r EXPIRATION DATE: AUGUST 31, 2022 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. BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000 VALID OCTOBER 1, 2020 THROUGH SEPTEMBER 30, 2021 DBA: Receipt #:ELECTRI6CAL/ALARMS/CONTRA Business Name: SPECIFIC ELECTRONIC ENVIRONMENTS Business Type: (ELECTRICAL CONTRACTOR ) Owner Name: JAMES E NEWTON Business Opened:0 7 / 0 2 / 2 013 Business Location: 12485 NW 76 ST State/County/Cert/Reg:EC13007946 PARKLAND Exemption Code: Business Phone: 954-234-6520 Rooms seats Employees Machines Professionals 4 For Vending Business Only Number of Machines: Vendina Tvoe: Tax Amount Transfer Fee NSF Fee Penalty Prior Years I Collection Cost I Total Paid 27.00 0.00 1 0.00 0.00 0.00 0.00 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non -regulatory in nature. You must meet all County and/or Municipality planning WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. Mailing Address: JAMES E NEWTON 12485 NW 76 ST PARKLAND, FL 33076 2020 - 2021 Receipt #01A-19-00008301 Paid 07/10/2020 27.00 1I0r1UUA Or% r`f11 1kITV 1 ^1%A 1 01 101k1C00 TA V 13C1%C1n'r Specific Electronic Environments, LLC 12485 NW 76`" Street Parkland, FL 33076 EC 13007946 EC 0002023 (954) 270-5200 December 10, 2020 Pedro Chevalier 1175 NE 105`h Street Miami Shores, FL 33138 RE: Electrical Repair for Code Compliance Q20-121001 Dear Pedro, Specific Electronic Environments (SEE) is pleased to provide the following quotation, which includes providing products listed below. Scope of Work: 1. Provide permit to complete work required by code compliance. Owner will process permit and pay all fees. 2. Remove unpermitted electrical work and repair to original condition. Scope includes replacement of broken keyless fixture, removal of exposed MC cable and seal open KO in existing box. T&M not to exceed.....................................$1,000.00 The bid price is good for 30 days from the above date. Additional work required by AHJ to close permit will be priced as an extra. Owner agrees to pay for all work required by building department to finalize and close permit. Owner agrees not to let permit expire. Upon your review, if you have any questions or require additional information, please do not hesitate to contact me. Sincerely; /(idnes Newton Specific Electronic Environments Page 1 of 1