Loading...
ELC-03-22-639Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address 1424 NE 105TH ST DID, Miami Shores, FL 33138 Permit NO.: ELC-03-22-639 Permit Type: Electrical - Commercial Work Classification: Alteration Permit status: Approved Issue Date: 03/24/2022 Expiration: 09/26/2022 Parcel Number Ffi.Fiti�L}YtirLIS] W Contacts EDWARD DUBOIS Owner MISTER SPARKY Contractor 1424 NE 105 ST #D10, MIAMI SHORES, FL 331382114 BRUCE FORT Home: 3059248123 permits@mistersparkyFlorida.com Description: REPLACE PANEL W LIKE AND JUNCTION INSIDE Valuation: Inspection Requests: p / $ 7,599.00 PANEL AND RELOCATE /INSTALL REPLACE S.D. 305-762-4949 Total Sq Feet: 0.00 Fees Amount Application Fee - Other $50.00 CCF $4.80 DSPR Fee $3.42 DCA Fee $2.28 Education Surcharge $1.60 Permit Fee $177.97 Scanning Fee $9.00 Technology Fee 55.70 Total: $254.77 Payments Date Paid Amt Paid Total Fees $254.77 Credit Card 03/11/2022 $50.00 Credit Card 03/24/2022 $204.77 Amount Due: $0.00 Building Department Copy 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 :onstruction and zoning. Futhermore, I authorize the above named contractor to do the work stated. Owner / Applicant / Contractor / Agent Date March 24, 2022 Page 2 of 2 Miami Shores Village RECEIVED Building Department 1 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 BY: -- INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20 BUILDING PERMIT APPLICATION ❑BUILDING P ELECTRIC ❑ ROOFING Master Permit No. 6. r -6 $-Z-L-to 3 � - Sub Permit N ❑ REVISION ❑ EXTENSION RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: )-1 a A AIC,- 10S S+. th1 City: Miami Shores County: Miami Dade zip: 331 3 �S Folio/Parcel#: 1I 'Da30 OS 3 0kA (o 0 Is the Building Historically Designated: Yes Occupancy Type: 451 . Load: Construction Type: Flood Zone: BFE: NO C FFE: OWNER: Name (Fee Simple Titleholder): C CX �li b� t S Phone#:3QS• Address: lyay )4V- I0SS4. .a DID WCSAd1 SlanVe C 3Fir City: mild it->2ou S State: 4=io ida Zip: 331 3 k Tenant/Lessee Name: Email: CONTRACTOR: Company Name: ws-Ile r ' Q5 Ck( S4 Phone#: aCi l; 3`77' q $ E%y Address:: (0aQ (0i d , S+ 01 YCjuC. City: e)rn .Qr') dt-) i State: P ( Qualifier Name: jbfuuQ P-0YT Phone#:94l'3-i7-QFSit% State Certification or Registration #: SbC1 Owi-u o b Certificate of Competency #: DESIGNER: Architect/Engineer: Address: City: State: Zip: Value of Work for this Permit: $ Square/Linear Footage of Work: 1 - a. Type of Work: ❑ Addition ❑ Alteration 0 ❑ New N Repair/Replace ❑ Demolition Description of Work: tuC�i IQ � O Q Y t c/�• W f i JLR, `i' —Jjn C J-4 c1 Vl i n S Qren-a and re Iota d.•e, + Sn Slant Specify color of color thru tile: Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ CCF DBPR $ Co/cc $ Notary $ Double Fee $ Structural Reviews (Revised02/24/2014) Bond $ TOTAL FEE NOW DUE $ G �� 44 Bonding Company's Name (if applicable) Bonding Company's Address City Si Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State r,E, 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 Signat`ti'2/�o>eC& ,�� Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this �I P "day of AoVro YI4at t' . 20 aa- • by day of /l.� lito vrSi2.C�. 20 as by rLf'(,(6 rd D L/looi S , who is personally known to 61yoie- pli -t7 who is personally known to me or who has produced F 1 T 0 as me or who has produced 1-2 as identification and who did take an oath. identification and who did take an oath. tL Zb� l�laD a3aN3 NOTARY PUBLIC: NOTARY PUBLIC: Sign: ���( Sign: Print: Print: VI3h'J&72- S/VoN /Ci o 5f —� o-- -.or"amerE.Sandigo quunui� Seal: _Seal: `APkyn&a, YamerE.Sandi Comm.:HH 137614 , o. ...... •.. go `•. - _'_: Comm.: HH 137614 ..• •; ' MY Commission Expires: June 3, 2025 a MY Commission Expires: APPROVED BY G� ri ,L�/}.'jz2rPjans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Replace inside main lug panel with like Junction existing inside panel and relocate less than 24" to new panel Install/replace smoke detectors Meter/main O RECEIVED I BY: All work to comply with NEC 2017 EtlsNg to renWn O 2' EMT [22kAlC 0mp 2. mr x3 Notary signature &7 Date Bruce H. Fort is personally known =I— State o! Floridammer Yonnssion322025 to to rema panel to j-box 2' p�c 2/0 cu 0 #4 cu xi 2' pc Less than 24' Dubois 1424 NE 105th St #D10 Miami Shores, FL 33138 amp I lug panel • •: Btace H;Fort: • ECgi4 098406 Replace inside main lug panel with like Junction inside panel and relocate less than 24" to new panel Install/replace smoke detectors First floor Living area Mafa lhstnta Panel Kitchen Dubois 1424 NE 105th St #D10 Miami Shores, FL 33138 Second floor Bedroom O Bath Bath O Bedroom O U ©= smoke detector Smoke detectors to be wireless interconnected vitb ten y@ar pal8d battAry 0 = electrical panel •• . ......... . Notary public State of Florida .. ... .. • . .• Christo her Hummer Moran @ • My Hj 74032 on °fp EXP. 9/9/2025 ... ... .. ... I/l7/2Z Bruce H. Fort EC#13008406 Notary signature vate Bruce H. Fort is personally known .... . . .... . 200 amp 22kAIC, 120/240 Single phase, 3 wire Dubois 1424 NE 105th St #D10 Miami Shores, FL 33138 Wire size And type OCPD Description Description OCPD Wire size And type # 14 cu 15 LIVING ROOM 1 2 DISHWASHER 20 # 12 cu # 12 cu 0 DINING ROOM 3 4 IDISPOSAL 20 # 12 cu # 12 cu 0 WASHER 5 6 WATER HEATER 30 # 10 cu # 6 cu 50 RANGE 7 8 WATER HEATER 30 # 10 cu # 6 cu 30 RANGE 9 10 SMALL APPLIANCE 20 # 12 cu 6 cu 50 AHU/AC 11 12 SMALL APPLIANCE 2o—g 12 cu # 6 cu 50 AHU/AC 13 14 BEDROOMS 15 #14 cu # 10 cu 30 IDRYER 15116 IBEDROOMS 15 #14 cu # 10 cu 30 1DRYER 17 18 MASTER 15 #14 cu # 10 cu 30 SURGE PROTECTION 19 20 MASTER BATH 15 #14 cu # 10 cu 30 SURGE PROTECTION 21 22 BATH GFCI 20 # 12 cu 23 24 KITCHEN LIGHT 15 #14 cu 25 26 HALL 15 14 cu 27 281 ALIN gy 15 #14 cu 29 30 31 32 33 34 35 36 37138 39 40 41 42s.--.-- .. Notary Public State of Florida I / (-7 / 2.Z +•,^1 + ChriStophef Hummer Moran < My commission HH 174032 ''awl Exp. 9/912025 EC13W �`IOG Managed? Enter All Appliances, Motors, and Low Power Factor Loads: 2 SPA?ALL APPLIANCE & t LAUNDRY RECEPTACLE (DISHWASHER DISPOSAL Q RANGE REFRIGERATOR O DRYER O WATER HEATER Appliances & Other Loads Total Load From Steps 1 & 2 : 1st 10KW @ 100% Demand : Remainder @ 40% Demand: Total General Load: Load 4,500 [] 1,680 [x] 7,680 [] 1,200 [] 5,000 4,500 Q EC\Soos`16l cute �s Perscmc,l I� 1. r-- i0' ` OW.`F Notary Public State of Florida 24,560 Christopher Mummer Moran MH� H 1) 032ion °•" Exp. 9/9/2025 29,744 1 /—La�-2a 10,000 7,897.60 Managed? System # Cooling Load Heating Load Q System2 Select Cooling 75KW HEAT S Tj- tP • • : : : • • • : : • • • 500 . ......... . 9 Add SUBTOTAL COOLING: 0 Discounted Load: Air Conditioning & Heating ... ... ... . SUBTOTAL AERiCING: • • •• 7,500 4,875 . ...:. . ... 17,897 0 4,875 TnTA I S Ron DeSantis, Governor STATE OF FLORIDA Halsey Beshears, Secretary F � �(l lac d r DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD THE ELECTRICAL CONTRACTOR HEREIN IS CERTIFIED UNDER THE PROVISIONS OF CHAPTER 489, FLORIDA STATUTES Additional Business Qualification MISTER SPARKY 624 67TH ST CIR E BRADENTON FL 34208 LICENSE NUMBER: EC13008406 EXPIRATION DATE: AUGUST 31, 2022 Always verify licenses online at MyFloridaLicense. com Do not alter this document in any form. u 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, 2021 THROUGH SEPTEMBER 30, 2022 DBA: Business Name: MISTER SPARKY Owner Name: BRUCE HOWARD FORT JR Business Location: 624 67TH STREET CIR E OUT OF COUNTY Business Phone:954-933-5874 Receipt #:1-2736 ELECTRICAL/ALARMS/CONTRACTOR Business Type: (CERTIFIED ELECTRICAL CONTR) Business Opened: 12/16/2002 State/County/Cert/Reg:EC 13 0 0 8 4 0 6 Exemption Code: Rooms Seats Employees Machines Professionals 1 For Vending Business Only Number of Machines: Vendina Tvae: Tax Amount Transfer Fee NSF Fee Penalty Prior Years 1 Collection Cost Total Paid 27.00 3.00 0.00 0.00 0.00 1 0.00 30.00 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: MISTER SPARKY 624 67TH STREET CIR E BRADENTON, FL 34208-6087 2021 .2022 Receipt #WWW-20-00220090 Paid 07/08/2021 30.00 BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000 VALID OCTOBER 1, 2021 THROUGH SEPTEMBER 30, 2022 DBA: MISTER SPARKY Receipt #: 181-2736 Business Name: Business Type: ELECTRICAL/ALARMS/CONTRACTOR (CERTIFIED ELECTRICAL CONTR) Owner Name: BRUCE HOWARD FORT JR Business Opened: 12 / 16 / 2 0 0 2 Business Location: 624 67TH STREET CIR E State/County/Cert/Reg: EC1300840 6 OUT OF COUNTY Exemption Code: Business Phone: 954-933-5874 Rooms Seats Employees Machines Professionals 1 gnature For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee I NSF Fee Penalty Prior Years I Collection Cost Total Paid 27.00 3.001 0.00 0.001 0.001 0.00 30.00 Receipt #WWW-20-00220090 Paid 07/08/2021 30.00 .4`coRv® CERTIFICATE OF LIABILITY INSURANCE DAM(MMf 02Y) 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 Al Purmort Insurance 3340 Bee Ridge Road Sarasota FL 34239 CONTACT NAME: Furey PHONE FAX : 941-924-3808 A/c No ; 941-924-8799 ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: National Trust Insurance Co. 20141 INSURED Service Minds, Inc. d/b/a Mister Sparky INSURER B : Brierfield Insurance Company INSURER C : FCCI Insurance Group 10178 624 67th St Circle E INSURER D : INSURER E : Bradenton FL 34208 INSURER F : COVERAGES CERTIFICATE NUMBER: 334136445 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 OF INSURANCE ADDLTYPE Ina SUER POLICY NUMBER MOMIIDD LICY EFF MM1DDPOLICEXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE M OCCUR GL10002755504 8/25/2021 8/25/2022 EACH OCCURRENCE $1,000.000 DAMAGE TO RENTED PREMISES Ea occurrence $100,000 MED EXP (Any one person) $ 5,000 PERSONAL 8 ADV INJURY $1.000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY [X] JR O- LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 Is B AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY CA10000491205FL 8/25/2021 8/25/2022 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ A X UMBRELLA LIAB EXCESS LIAS X OCCUR CLAIMS -MADE UMB10001687805 8/25/2021 8/25/2022 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED I X RETENTION $ in nnn $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Ya OFFICER/MEMBEREXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A WC010006022602 8/25/2021 8/25/2022 X PER OTH STATUTE ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Electrical Contractor EC13008406 CERTIFICA Miami Shores Village Hall Building 8 Zoning 10050 NE 2nd Ave, Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE C6/wk azza--64r ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD