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EL-13-38 Miami Shores Village JAN Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Y. Tel:(305)795.2204 Fax:(305)756.8972 INSPECTION'S PHONE NUMBER:(305)762.4949 FBC 20 BUILDING Permit No. .1 3 PERMIT APPLICATION Master Permit No. � ® Permit Type: El'e'ctrical JOB ADDRESS: R. It yi �® ��• �, City: Miami Shores dCounty: Miami Dade Zip: C�c � Folio/Parcel#• l` �s I () ()i D I Is the Building Historically Designated:Yes NO A/ Flood Zone: OWNER:Name(Fee Simple Titleholder): .-O g� 166 fWILO: Address b City: 5. State: Zip: Tenant/Uessee Name: Phone#: Email: CONTRACTOR:Company Name: bio co V%9-e '1✓ g,ol' n C"np Phone#: 305-515 Address: 119 015 911CA�j a Lr- RSV 11 A 313 City:Jew M tAft 0 Mclax tl State: Qualifier Name: 'T( .J �J j j Phone#:S 0C—JUT_-1 If Z`i State Certification or Registration#: Z"C Certificate of Competency#: Contact Phone#:.306_ni_17 T)&Z.Q Email Address:C'C�C?R 105�1A� � 64.no L a Cdr^ DESIGNER:Architect/Engineer: Phone#: Value of Work for this Permit:$ W Od Square/Linear Footage of Work: T of Work: DAddress 5;/Alteration UNew ORepair/Replace ODemolition Ddscription of Work, .Sty 4nn r'p ng2j zqD GF� � �9aSf�OSn l Cat 2cyo -' smpyc 2 ?,D W?C-Lnr(AS l,a,-�:Q c 0,4,10 c L Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$. Double Fee$ o Structural Review$ TOTAL FEE NOW DUE$ ° Bonding Company's Name(if applicable) Bonding Company's Address City State zip Mortgage Lender's Name(if applicable) Mortgage Lender's Address 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 ELECTRICAL WORK,PLUMBING, SIGNS, WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS and 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. Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before ime this day of��w� ,20-!�,by day of F t0 tI F O ,20)1,by )�jDx�-,1� who is personally known to me or who has produced r�— who i erson y ffio-w n to me or who has produced or,,V aY t'L-°3L As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: g Print `� ✓ 1 Print: My Commission Expires: My Commissi Tstoxi. NotarL� J Davi EVELYNARTOLA My C Mw PWft�B of Florida Ex ph �x My mm.expires Feb.7,2016 APPROVED BY s Examiner Zoning Structural Review Clerk (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) -�� LYNCO-2 OP ID: DK CERTIFICATE OF LIABILITY INSURANCE DA01I08ION 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 pollcypes)must be endorsed. If SUBROGATION IS WAIVED,s"ct 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 Phone:954759-7171 NO.N.T Customers Rule Ins.Agency PHONE 1830 S.E.4th Avenue Fax:954759-7170 Arc No): Ft.Lauderdale,FL 33316 AQDRESS: Lynn Remon INSURER(S)AFFORDING COVERAGE NAIC 9 INSIIRERA:`Scottsdale Insurance Co 41297 INSURED Lynco Fire&Alarm Corp. INSURER B: Jeffrey N.Lynn 13899 Biscayne Blvd Suite 313 INSURER C: N.Miami Beach,FL 33181 INSURER D: INSURER E: WSURERF: 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. NOTWITHSTANDWG 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 MURANCE POLICY NUMBER LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1.000, A X COMMERCIAL GENERAL LIABILITY PS1664997 09/2012012 09128!2013 PREMISES oca,rron. $ 1001 CLAIMS-MADE I A I OCCUR MED EXP(Any one person) $ 5, PERSONAL&ADV INJURY $ 11000, GENERAL AGGREGATE $ Z 0001 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000, X POUCY PRO- LOC $ AUTOMOBILE LIABILITY M N LE L Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OSNED SCHEDULED 130DILY INJURY(Per accident) $ AUTOS HIRED AUTOS AUTTOSOWNm PROPERTY $ UMBRELLA LLAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION $ WORKERS COMPENSATION WCSTA H- AND EMPLOYERS'LIABILITY YIN T Y ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ OFRCERiMEMBEREXCLUDED? F1 NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOY $ Dyyes describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A O CPS1664997 09/20/2012 89120/21113 Ialm/Agg $1MM1$2MM A Lost Key Coverage CPSI OUS97 09/2012012 09/20/2813 25,ON DESCRIPTION OF OPERATIONS I LOCATIONS I VEKCLES(Attach ACORD 141,AddiBorrai Remarks Schedule,U more space Is required) ALMIS AND ALARM SYSTEMS — INSTALLATION,SERVICING OR REPAIR CERTIFICATE HOLDER CANCELLATION MIAMI S SHOULD ANY OF THE ABOVE DESCRIBED POLICE$BE CANCELLED BEFORE Miami Shores Village THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Fax#305.756.8972 10050 NE 2nd Ave AUTHORIZEDREPRESENTATIVE Miami Shores,FL 33139 O INS-2010 ACORD CORPORATION. All righte reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD OW Mg-opyxMY a x h le RAS 01 age, MON � s �, 1 Z 5. "�' d Y k Sw t� Y 4 1 fJ �' Y} ! WI r� '� �� 1 _: fl > �',&,•§..� .'are u c x ,r,.. ..x m4r X ,M, "2 A ` -".rs--. ms's a "}.,='•-z*-1'+; �,' y- ?,t x s ,s 1d' ! Z 6 cW. Y •. « a3" 3 F i �*,, ,r gc r ram �. r� ° ! F s r r rc ate s 3`; M Swim R04NZR 5 CERTIFICATE OF LIABILITY INSURANCE 01-08-2013 THIS CERTIFICATEIS 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 ADDITIONALINSURED,the policy(ies)must be endorsed. If SUBROGATIONIS 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 T NAME PAYCHEX INSURANCE AGENCY INC PHONE (%R No): (888)443-611 210705 P: () - F: (888)443-6112 PO BOX 33015 ADDRESS: SAN ANTONIO TX 78265 MISURER(S)AFFORDING COVERAGE NAIC INSURER A: Twin City Fire Ins Co MISUM INSURER 0. LYNCO FIRE & ALARM CORP. INSURER C: 13899 BI SCAYNE BLVD STE 313 INSURER D: MIAMI FL 33181 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. m� rfM OF -P0UVr_ANAkVW IMIWDD/yyyY/ nrmamv/vrrn LMM-MM WVD OPAL u4mi/Y EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES(Ea o eurcence) $ CLAIMS-MADE M OCCUR MED EXP(Any over person) $ ❑ ❑ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT PER: PRODUCTS-COMPlOP AGG $ POLICY Ro LOC $ AUIVAIDA"VAaLW COMBINED SINGLE LIMIT $ we accMerrt) ANYAUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED ❑ ❑ BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE HIRED AUTOS NON-OWNED $ (Per AUTOS $ fAt4)iR&tA LAB HCLAIMSMADE OCCUR EACH OCCURRENCE $ EXCESSLme ❑ ❑ AGGREGATE _ $ D RETENTION $ $ YYOII10018 C0A9VMn0N WC STATU- OTH- AAD MMOMW r X Y/N TORY LIMITS AN Y PROPRIErORIPARTNER/EXEC E.L.EACH ACCIDENT $ 100,000 A O RRAE&tMBEEXCLUDED7 � NIA ❑ 76 WEG DF9547 05/16/2012 05/16/2013 EL DISEASE-EA EMPLO $ 100 OOO mumblary DESCRIPTION N Fo OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 5 0 0,0 0 0 ❑ ❑ DESCIWwrMOFOMIAMM/LOCA7I ORS/VEIDCIES(AraiACDRD101,AddvndAenwfaS d&IFnwm b raqukea Those usual to the Insured's Operations. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED Miami. Shores Village BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE Building Department DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2ND AVE `MSEWA7M MIAMI SHORES, FL 33138 01988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD i � ' ® a s- o : a •®• - - NAM i� I AC# 6164198 STATE OF FLORIDA i DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD SEQ#L12061901066 .. - LICENSE NBR j 106/15/20121110432527 EC13003767 Additional-;Business , uglification ( ` The ELECTRICAL. CONTRACTOR i Named below IS CERTIFIED ; Under the provisions of Chapter 489 , FS Expiration date: AUG 31, 2014 LYNN, JEFFREY NEIL LYNCO FIRE& ALARM CORP t � 13899 BISCAYNE BOULEVARD STE 313 - j SUITE 313 NORTH MIAMI BEACH FL 33181 RICK SCOTT KEN LAWSON ( GOVERNOR SECRETARY DISPLAY AS REQUIRED BYLAW °t � LYNCO FIRE & ALARM CORP. 13899 Biscayne Boulevard Suite 313 NORTH MIAMI BEACH, FLORIDA 33181 TEL: 305-847-5966 FAY-- 31as95-1-1?--°°� STATE LIC#EC1 003767 MAR 2 2013 February 24, 2013 BY-------- Miami Shores Village aJ Electrical Inspector Mike Devany 10050 N.E. 25nd Avenue Miami Shores, Florida 33138 CC: Hester Builders, David Hester HesterBuilder(aAOL.com -- _--` - - - =FRMIT EL-1-13-380-1175 N.E. 105 STREET: Mike, I am respectfully requesting a hold on any Electrical Inspections for the above mentioned permit until yon, near from me personally, i have strapped all my work can this project until the owner or owners �r--.cept My a ie� n3 time € i�, € _ : hgly� €p i iportpti n thm mnme- i cim heinn� more than fair with my additional cost. 1 [ 2Ve Et c€; inctrz it-fm-4 fn nn n h nre3 anti ane% rv3ct®th®;wnria that o aS included in my original contract and not worry about the rest. i coo not want my name on a permit where some=unlicensed electrician"will be performing work for the owners under the cuff. Best regards, Jeffrey N. Lynn President I EC-13003767 " 4� -100406-827 WFIRE&ALARM CORP. Jeffrey N. Lynn President Ph:(305)947-5966(FIRE) Ph:(305)947-9878(ELECTRICAL) 13899 Biscayne Blvd., Email:ElectricJeff85 @gmail.com LYNCOELE Suite 313 CTRIC.COM North Miami Beach,FL 33181