EL-13-720 (2) Miami Shores Village APR 1 P)
,\ Building Department ByAOdm.......�ooq e
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel: (305)795.2204 Fax:(305)756.8972
INSPECTION'S PHONE NUMBER:(305)762.4949
BUILDING Permit No. EJ )5
PERMIT APPLICATION Master Permit No.
FBC 20
Permit Type: Electrical , p
OWNER:N `k
p Name(Fee Simple Titleholder): 0 �0�' Phone#: lq 11) S13-C7q
Address: t�� N \,u
S
City: K I
PIN "NK S State: Zip: 3 315t)
Tenant/Lessee Name: Phone#: I pC
Email: 0hncAfCiA @ yr•sn -Corr\
JOB ADDRESS: 6 G� N 104-,A\ SA_
City: Miami Shores County: Miami Dade Zip: 33150
Folio/Parcel#: lk` 213(f `013-1310
Is the Building Historically Designated:Yes NO Vol Flood Zone:
CONTRACTOR:Company Name: t / Phone#:
Address: •!rte //a S
City: State: zip:—. 3 3ple
Qualifier Name: o l' Phone#: s
State Certification or Registration#:, Certificate of Competency#: ® l
Contact Phone#: Email Address:
DESIGNER:Architect/Engineer: Phone#:
Value of Work for this Permit:$ 7�� 0®®� Square/Linear Footage of Work:
Type of Work: ❑Address Alte-rati/on ONew ORepair/Replace ❑Demolition
Description of Work: r'c1r22/�c�' ��L°G � i ��y1/L�� C�✓ `2C�
Submittal Fee$ Permit Fee$ Agf�,1,0'.0 CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$
TOTAL FEE NOW DUE$ WJ n
Bonding Company's Name(if applicable) t
Bonding Company's Address
City State Zip
I
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$2500, the applicant must
promise in good faith that a opy of,the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject nt. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first ins p on w ch occurs 'e (7) days after the building permit is issued. In the absence of such posted notice, the
inspection wi not be ap oved c ud a ins action fee will be charged.
Signa a Signature
O nt V Contractor
The foreg ' grin ment was ac ow ged be re ,,e/�thi The foregoing instrument was acknowledged before me this
day of r 20 y tI day of A?R-k L ,20 6_3,by "f A� GUI{ ,
who is rsonal y iswn a or who has produced who is personally known to me or who has produced
ntification and who did take an oath. as identification and who did take an oath.
NOTARY UBLIC: rue«�os NOTARY PUBLIC:&- Comm#EE135383 CARLOS J.AVILA
P` pV 1 of Florida NOTARY PUBLIC
' 5tale p15
ps Sep 23.2 STATE OF FLORIDA
Sign m' pis EE 1258 R.O. Sign
� oo nm�s Natiooa� y F F "es ""2015
Print: tough Print: r/
ee 1
My Commission Expires: ""' My Commission Expires: O 3120
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
STATE OF FLORIDA
PEPARRTMENT OF BUSINESS AND PROFESSIONAL REGULATION
=r ELECTRICAL CONTRACTORS LICENSING -BOARD (850) 487-1395
1940 NORTH MONROE STREET
TALLAHASSEE FL 32399-0783
GUTA, RAFAEL
MAJESTY ELECTRIC SERVICE. CORP
8704 NW 112 ST
HIALEAH GARDENS FL 33018
s�+re dF r�onion ACS e. 6 4 5 96 2'a
Congratulations! With this license you become one of the nearly one million Dgpg�T OF;SfSES3 AiD i
Floridians licensed by the Department of Business and Professional Regulation. P$C7 'ESSI0ITAL;.REGUI&TICtN
Our professionals and businesses range from architects to yacht brokers,from '
boxers to barbeque restaurants,and they keep Florida's economy strong. ,
ER0015i82 1270;13762
Every day we work to improve the way we do business in order to serve you better.
For information about our services,please log onto www.myfloridallcense.com. REG `ELEC ,�CItN' AACTOR: ti
There you can find more information about our divisions and the regulations that GUTA,' i
impact you,subscribe to department newsletters and learn more about the }} MAJESTY :*tM� C '.fir . CORE+
Department's initiatives. t {INaxvtlioi�iE� I�' } T ill L LOCAL
4 LICF�NSII�`G R8¢'iT���� "NTS:` E!�'tIOR
Our mission at the Department is:License Efficiently,Regulate Fairly.We TO CONTRACTI39G > MANY AREA)
constantly strive to serve you better so that you can serve your customers. sra aaGxsa ,, � ha $ �., � .bE.cli.4s9
Thank you for doing business in Florida,and congratulations on your new licenses s lira ioa a�ez AUC'31, 24,14 rT,12D 1041580
DETACH HERE
1131112
.
STATE::OF FLORID/'.
DEPARTMENT OF BUSINES AND PR:UFESS-IONAL RtGULATI.ON
ShECTRICAL .�CPNTRCTORS LICENSING BOAR ? SEQ#L1209.1001580
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Expiration date AUG 31, 20.14
(INDIVID.LfAL MUST' MEET ALL LOCAL` � r Irr
REQI7IREMENTS PRIOR TO d-6 TRAC��+��
GUTAr .RAFABL
MAJESTY" CORD
8704 NW 112 ST
HIALEAH. GARDENS FL: -.3.3-018
RICK COT KEN LAWSON
GOVERI?t?R SECRETARY i
DISPLAY.AS REQUIRED BY LAW
r
FIRST-CLASS
U.A.-POSTAGE 1
PAID
MIAMI,FL
OFTIMIT NO.231.
THIS-16-NOT A BiL:L—bO NOT PAY '
BUBINEA3@'A4/L OCAT10N RECEIpTWEWAL
MAJESTY ELECTRIC. SE'RVICE-CDOP CC # 01'E000164 466676-5
8704 NW 112, ST
33018 HIALEAH GARDENS
OWNER -
g8 §tTX, CTRIC SERVICE CORP
WORKER/S
..R.Mg TRICAL CONTRACTOR 1
• DOES NOT PERMrp 77}}{{E
HOLDER TO VIOLATE IWY
EXISTING REGULATORY OR
ZONING LAWS OF THE DO NOT FORWARD
COUNTY OR CITIES. NOR' '
DOES IT EXEMPT THE
HOLDER FROM ANY OTHER LICENSE
PERMIT REQUIRED YR LAW.THIS IS MAJESTY ELECTRIC SERVICE CORP '
THE HOIco�s CERTIFICATION OF RAFAEL GUTA PRES
TIONS. 8.704 NW 112 ST
PAYMENT RECEIVED HIALEAH GARDENS FL 33018
MIAMI-DADE COUNTY TAX •'
COLLECTOR"
09/26/2012
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MAJESTY ELECTRIC SERVICE CORP
RAFAEL .GUTA PRES
8704 .NW 11.2 ST
HIALEAH GARDENS. FL. 33018
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-BUSINESS CERTIFICATE OF COMPETENCY
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ACO ,M C�ERTi IFICATE OF LIABILITY INSURANCE 11/ 2012
PRODUCER . a THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CtIlt-FIC.ATE.
Insurance Center of Dade Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
3165 W. 4 Ave Suite B ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Hialeah FL, 33012 INSURERS AFFORDING COVERAGE
305-81T-1818
INSURED MAJESTY ELECTRIC SERVICE CORP INSURER A `
INSURER B `
8704 N.W. •11'2 ST. INSURER C: r
t HIALEAH GARDENS, FL 33018 INSURER D:
INSURER E:
COVERAGES
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 OPSUCH
i POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPE OF INSURANCE POLICY NUMBER DATE MMIDDCTNE PDATE MMPDD 110-N s LIMITS
L
GENERAL LIABILITY - EACH OCCURRENCE $1 000 0 00D_
COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any omfire) $
4AIMS MADE Fx-_1 OCCUR _ ._,.., MED EXP(Any one pkson) $
A GL-56932 __ _ : 1.1/01/12 . 11/01/13'. PERSONAL&ADV INJURY $1 00000000
GENERAL AGGREGATE $
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $
POLICY PRO LOC
PRO-
JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
ANY AUTO (Ea-ddent)
ALL OWNED AUTOS BODILY INJURY $
SCHEDULED AUTOS (Per pe )
HIRED AUTOS BODILY INJURY $
NON-OWNED AUTOS (Per w ddent)
PROPERTYDAMAGE $
(Par aoddant)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHER EAACC. $
AUTO ONNLLYY. AGG $
EXCESS LIABILITY EACH OCCURRENCE $
OCCUR FI CLAIMS MADE AGGREGATE $
$
DEDUCTIBLE ° $
RETENTION $ $
WORKERS COMPENSATION AND TORY LolITS I ER
EMPLOYERS'LIABILITY WC312 83 8 x.1/0 L.1/12 11/6 /] E. EACH ACCIDENT $
$ "' E.L.DISEASE-EA EMPLOYEE $
E.L.DISEASE-POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
ELECTRICAL WITHIN LIMITS
CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER: CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BECANNCEI IF BEFORE THE EXPIRATIQI
MIAMI SHORES BLDG. DEPT.
DATE THEREOF,THE ISSUING INSURER WILL ENDEAVO O L -- DAYS WRITTEN
1 O O 5 ON.E 2ND AVE NOTICE TO THE CERTIFICATE HOLDER NAMED E , UT FAILURE TO DO SO SHALL
•MIAMI, SHORES, FL. 33138 IMPOSE NO OBLIGATION OR UABILTY OF D U O E INSURER,ITS AGENTS OR
REPRESENTATIVES.
FAX: 305-756-8972 AUTHORIZED REPRESENTATIVE
ACORD 25-S(7197) BAC RD CORPORATION 1988