Loading...
EL-13-309 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-185959 Permit Number: EL-2-13-309 Scheduled Inspection Date: September 18,2013 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: PIMIENTA, ERIC Work Classification: Addition/Alteration Job Address:6 NE 106 Street Miami Shores, FL Phone Number (786)280-3974 Parcel Number 1121360060080 Project: <NONE> Contractor: THREE WAY ELECTRIC CORP Phone: (786)367-5604 Building Department Comments INSTALL FIXTURES AND OUTLETS Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. September 17,2013 For Inspections please call: (305)762-4949 Page 4 of 17 CERTIFICATE OF LIABILITY INSURANCE DATE(IM9/DD/YYYY) 03/05/13 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 policypes)must be endorsed. If SUBROGATION IS WANED,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 CONTACT NAME: Occidental Insurance PHONE (305)221-9859 FAX No; (305)221-6464 11400W.Flagler St.#111 E-MAIL occidentalinsure @bellsouth.net ADDRESSo Miami,FL 33174 INSURERS AFFORDING COVERAGE NAIC# Phone (305)221-9859 Fax (305)221-6464 INSURER A: GRANADA INSURANCE CO. INSURED INSURER B Three Way Electric Corp. INSURER C: 1588 SW 154 Ct INSURER D: miami,FL 33194- (786)367-5604 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. iCTR TYPE OF INSURANCE ADD UBR POLICY NUMBER POLICY EFF POLICY EXP UMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000.00 © COMMERCIAL GENERAL LIABILITY PR EM SES(Ea ocNTEcu ence) $ 100,000.00 A ❑ ❑ CLAIMS-MADE ❑ OCCUR 121022 MED EXP(Any one person) $ 5,000.00 ❑ 03/05/2012 03/05/2013 PERSONAL&ADV INJURY $ 1,000,000.00 ❑ GENERAL AGGREGATE $ 2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000.00 ❑ POLICY ❑ PRO- El LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT a accident ❑ ANY AUTO BODILY INJURY(Per person) $ ❑ ALL NED ❑ ACHEEDULED BODILY INJURY(Per accident) $UTOS HIRED AUTOS NON-OWNED ROPER'Y DAMAGE $ F1 ❑ AUTOS er accident ❑ ❑ $ ❑ UMBRELLA LIAB ❑OCCUR EACH OCCURRENCE $ ❑ EXCESS LIAB ❑CLAIMS-MADE AGGREGATE $ ❑ DED ❑ RETENTION$ $ WORKERS COMPENSATION ❑WC S�ATU- ❑OTH- AND EMPLOYERS'UABIUTY Y/N ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? F] N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yyes describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,H more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Miami Shores THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 10050 N.E.2nd Avenue, Miami,FL 33138 AUTHORIZED REPRESENTATIVE OCCIDENTAL INSURANCE @ 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05)OF The ACORD name and logo are registered marks of ACORD Miami Shores Village Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 )s`°•�° - Tel: (305)795.2204 Fax:(305)756.8972 INSPECTION'S PHONE NUMBER:(305)762.4949 FBC 20 BUILDING Permit No.'s C13o p PERMIT APPLICATION Master Permit No.1[2-c I —� Permit Type: Electrical JOB ADDRESS: �0 1� e t® �0 <'T— City: Miami Shores County: 5'%g� Miami Dade Zip: 5 t� Folio/Parcel#: L 1 r��� f�0�D Is the Building Historically Designated:Yes NO x Flood Zone: OWNER:Name(Fee Simple Titleholder): r �- \ MA 41n (� Phone#:������o �� Address: 6 0a l® (+ G-F City: _YA 1`&-Yn j 5 AOce-s State: F L-- Zip: 1°?� Tenant/Lessee Name: ` Phone#: Email: 1 Yir1 I eVt Mai, t f�t) Yn (� 1 _ - /,,, -7 CONTRACT R:Company Name: r c-TY I� 6 hone#: ®�®J �'� ®I l-3 Address: /try PT I City: --State: Zip: Qualifier Name: Phone#: L�o� State Certification orRegistration#: !®� Ce l ca te of Competency#: Contact Phone#: /1� �✓ /�et� u-Email Address: 22 DESIGNER:Architect/Engineer: Phone#: Value of Work for this Permit:$ �� ®® Square/Linear Footage of Work: Type of Work: ❑Address ❑ Itera'o ❑New ❑Repair/Re lace 013enjoWtion Description of Work: 7 �e Submittal Fee$ Permit Fee$ /gym mid CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ 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 Prochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice co a ement must be o d at the job site for the first i ec 'on whit ccurs seven (7) days after the building permit is is e . n absence of c p ted notice, the inspection ill not be a ove and a reinspection fee will be charged. Signature ® Signature Owner or Agent Contractor y The for Ing instrument was acknowledged before me this 1 ` The foregoin instrument was ackno��wleedged before me this ` day of � ,20 :�by �lc° in n'1 I�z�A day of ' ,20 12,by A/ILJ(�5 P►f111 ft67(& who is personally known to me or who has produced e`L" who is personally known to me or who has produced 45* 7C— LD As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: `\,\\\\\1i1 Jilliii Ari ,,�i NOTARY PUBLIC: es %, Sign: �i �`: - Sign: Print: w :F �/ � Print: Z�� -' My Commission Expires: My Commission Expires: %.��; �� � r0 APPROVED BY f�/O��� Plans Examiner Zoning Structural Review Clerk (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) 03/05/2013 10:47 FAX 3052216464 OCCIDENTAL INSURANCE 1A001 MwP MEN _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 THIS CERTIFICATE HOLDER. e holder Is an ADDITIONAL INSURED,the poiicy(ies)must be endorsed. if SUBROGATION IS WAIVED,subject to IMPORTANT: If the certlficat confer rights to the e does not co g may require an endorsement. A statement on this certiflcet the terms and condttiotts of the policy,certain policies y roa certificate holder In lieu of such endorsement(s). NT PRODUCER ME Occidental Insurance PHONE {305)221-9859 FAX Nei, (305)221-6464 11400 W.Flagler St.#111 L occidentalinsure@bellsouth.net INSURE S � AFFORDING COVERAGE C a Miami,FL 33174 Phone (305)221-9859 Fax (305)221-6464 M INSURER A: GRANADA INSURANCE CO. INSURED INSURER B Three Way Electric Corp. INSURER C: 1588 SW 154 Ct INSURER D: — INSURER E: — miami,FL 33194- (786)367-5604 INSURER F NUMBER: COVERAGES CERTIFICATE NUMBER: REVISION _ THIS IS TO CERTIFY THAT THE POLICIES OF INSUfiANCE LISTED BELOW HAVE BEEN ISSUED 70 THE INSURED NAMED ABOVE FOR THE POLICY PERIOD I 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,IHE INSURANCE AFFORDED BY THE POLICIES DESCRIED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ADDIJSUBRI POLICY Epp POLICY EXP LIMITS INSR TYPE OF INSURANCE POLICY NUMBER MAD 1,000.000.00 LTR GENERAL LIABILnY EACH OCCURRENCE $ MED EXP(An one person) $ 5,000.00 A ❑ ❑ CLAIMS-MADE ❑ OCCUR 121022 03/05/2012 03/05/2D13 ❑ PERSONAL&ACV INJURY $ 1,000,000.00 ❑ GENERALAGGREGATE $ 2,000,000.00 PRODUCTS-COMPlOP AGG $ 2,000.000.00 GEN'L AGGREGATE LIMIT APPLIES PER: $ ❑ POLICY ❑ P O- ❑ LOG COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY BODILY INJURY(Per person) $ ANY AUTO BODILY INJURY(Per accident S ALL❑ AUTOS OWNED ❑ SCHEDULED NON-OWNED P4rP£RIB AMAGE $ ❑ HIRED AUTOS ❑ AUTOS $ ❑ UMBRELLA LIAR ❑OCCUR EACH OCCURRENCE $ ❑ EXCESS UAB ❑CLAIMSAWE AGGREGATE $ I ❑ DED ❑ RETENTION$ WCSTATU- OTH- WORKERS COAMPENSATION To AND EMPLOYERS'LUBILITY YIN TE.L.DISEASE ACCIDENT $ ANY PROPRIETORIPARTNERIEXECUTIVE❑MIA A OFFICERiMEMBER EXCLUDED? SE-EA EMPLOYE $ (Mandatory In NH) I4 yas,describe under -POLICY LIMIT $ DESCRIPTION OF OPERATIONS belam DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more apace Is required) CERTIFICATE HOLDER _ _ CANCELLATION POLICIES SHOULD ANY OF THE ABOVE DESCRIBED BE THE EXPIRATION ATE THER OF,NOT CE WILL EDELIVERE ID CANCELLED BEFORE City of Miami Shares ACCORDANCE WITH THE POLICY PROVISIONS. 10050 N.E.2nd Avenue, - Miami,FL 33138 AUTHORIED REPRESENTATIVE l OCCIDENTAL INSURANCE __ O 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010106)OF The ACORD name and logo are registered marks of ACORD f CERTIFICATE OF LIABILITY INSURANCE °" ``""�'°°"'"Y' 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(les)must be endorsed. K SUBROGATION IS WANED,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 holller in lieu of such endorsement(s). PRODUCER ER CO ACT NAME nta Insurance HO P NE O FAX ccidental 11400 S.#111 'ss:::::;:?::::::::::>:: W.Flagler t cc>r rt{nuEllsl►l►:::::::•:::::::::.::::::.::::::::::,•:::•::::::•::.:::.::,•:::•::••::::::. Miami,FL 33174 INSURER(S)AFFORDING COVERAGE NAICS Pho ne (305)221-9859 Fax (305)221-6464 INSURED INSURER 8: ?i RER ::;.;,y,,is'::•::.;s.•`:':>::.;:y:>:;'. ': i: 3 F;:ii' isiiii'isi >'`j; ::: t < :is::::: 2:< :? '..................? ....:::.:....................................................... ...... INSURER c: U D: i< %i: INS RER ::;:';;;;•:?�`i ii.';...:i 2� ?iiE 'ii ?% ::ii:iiii:E}iEEis', :?:ii:is ii::.?::.... i?i is ii? i;:ii i:.... :::::<;:::;::::: :: i:::: i'i;:?'::i'is :%'i: ''•'•::i:Y:>::'•: :::: i: ::: :::::::::::::: '` :i'i E:Ei ::i:::�:::::i .............. :i:i:::::$+i:v is2::ii:<:?i:::::3::::::::::: :i:;:: `;'.: ;•',;::;:::#::::t<;; ::::`•::::::::: ::i8 ::;::i::$:. ,•C:.::;^.?2;^.;%:Y; INSURER E: s::::is:i::::i::c:r.'%:i::?a:;::::::::::t i::;i::;<::L;.`::%'v;:: iRa::i:::;v,;:::;;a;:;•c:;;::;5;:r. �(2ttiC..L 3;3394 ::: MOW ........................................:...:..................................................... :•..... U INS 2::::::::;:i:%�t<:::;;;%y.;;.:;•;;•:;•:;•:;•;;•::::•;;•r;:•;:•::;:•;:•::;:•::>;:;>;>::;;:•;:•::o;;:.::•»::.;::•:;::•:•:;::..:•:;:;::;::.'•;<;;;;<: ............................................................ . . . . 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. ILTR TYPE OF INSURANCE I�R WVO POLICY NUMBER ICY EFF POLI pY P LIMI.$ GENERAL LIABILITY y.u!c EACH OCCURRENCE $ •`•.�iS!��# '��'`r'>'�•`: ® COMMERCIAL GENERAL LIABILITY PREM SES RE000aDrence $ `• > > '""?? CLAIMSMADE OCCUR person) :....::.:. :..:::::::;.:.::::.:::.:::::::,:::::::.;..:::•:::::: MED EXP An ( Y one ROM :•::..................::.:.::::::::::::::::::::::::::::::::::. P ER SO NAL 8 A V INJU $ I GENERAL AGGRE ATE ❑ ''>'isi'is2i'isiiiii ;i %:4? ::?:>':?'i:ii:::3i`i5 � .�, r ,Q�........ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ PRC- ii!: $ :...... i..i'% ...... ❑ POLICY ❑ ❑ LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT a accident ANY AUTO BODILY INJURY(Per Person) $ ALL OW C D U L NIED ED❑ B OD ILY INJURY Y ara cciden $ NON-OWN AUTO ����deyy eacc $HIRED AUTOS AUTOS r P i ED p ROn i viii $ UMBRELLA L448 OCCUR OCCURRENCE R EA HOC R $ EXC ESS LIAR CLAIMS-MADE ❑ G ❑ 'E AGGRE ATE $ a? .... DED R -...:,,.. WORKERS COMPENSATION WC STATU. ;OTH- AND EMPLOYERS T S ❑ LIABILITY Y I N XCLUDED? ..............................................i......... i i G?iE % E.L.PROPRI ETOR/P ARTNER/EXEC UTIVE $ i < % i EAC C I E NIA " iOFFICERMEMBER E L DISESE(Mandato N nN H EA EM PL O YE $ If yes,describe under '•:'• DESCRIPTION PTI N OF OPERATIONS below E L.DISEASE-POLICY LIMB $ DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) XX LD CERTIFICA ER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL B E DELIVERED IN N11j�ENEE'��C�12:•�'",�.�'11:)�s::»>»>::»<>::>;::>::>::>::»»::>::>::>s»s»»::s>s:::::>::s»::s<ss>::>::>::»»» PROVISIONS. E POLICY PR CE WITH TH PO ' ACCORDAN 1>.`::;.;;:: :`:'.'.:`;`.'.' :;% y i ii' Zi% iii c i':•.`':'iiiiiyi'<ii 9 ;F ;�i8 t i'i' : .::::.,.::::::::::::;::::::::::.:::::::;: AUTHORIZED REPRESENTATIVE .•;::.```:'•:si?% isiis?rt% 5i?iciiir '> ''ii`%' 'SiiiS :<.::.::•::•;:.>::tr:•;:......;:.....i:;ii:i::•ri::::::::::::::::}::1;:;::;:::;2;:;;;;r;::'•::;:::•:iii::::i:::y::i:;:Gj i;•;:t%YY:::: .............................. ::»»»»::» :: > :>::>::>::>:::::::::>::>::>:<::<:::<>::><>»>::>::::»>':::::::>::>::>::>::::>::»<::>::>:><>>::>::><::>::>>.::«:::: :.' .. l T :lit .. t l .......... .........................:.,:::::.:.:.:...:::::.:...:...:......:.......... :.....:.:......:..,.....::::•. : ..:...............•..................................................::::.:::.:....:.:::.:.::................................ ;:.;:.;:.;:. ::.;:.::.;;:;;:.::.::.::::.::.::.;:.;>::.:.:>::.::.:>::.;:.;:.;:.;:.::.::.;:.>::.:::............::: :...... ©1888 2010 ACORD CORPORATION. All rights reserved. ACORD 28(2010 108)QF The ACORD name and logo are registered marks of ACORD 10-25-2011 JEFF ATWATER STATE OF FLORIDA CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 10/25/2011 EXPIRATION DATE: 10/2412013 PERSON: PIMIENTA ABILIO FEIN: 650739698 BUSINESS NAME AND ADDRESS: THREE WAY ELECTRIC CORP DBA THREE WAY ELECTRIC CORP 1588 SW 154 CT MIAMI FL 33194 SCOPES OF BUSINESS OR TRADE: 1- ELECTRICAL WIRING (5190) IMPORTANT. Pursuant to Chapter 440 . 05114), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.01(12), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if,'at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or cartificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. QUESTIONS? (850) 413-1609 OWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01-11 ru: -- ► ri ch dis z, i MIAMI-DARE COUNTY 2012 LOCAL BUSINESS TAX RECEIPT 2013 FIRST-CLASS TAX COLLECTOR MIAMI-DADE COUNTY-STATE OF FLORIDA U.S.POS®AGE 140 W FLAG ST. EXPIRES SEPT.30,2013 o a; , 9 ,st`FLOOR MUST BE DISPLAYED AT PLACE OF BUSINESS MIAMI,FL N L4 N it P ER sA-ART.9&10 PERMrr NO.231 ' MIAMI,FL 33130 PURSUANT TO COUNTY CODE CHA T 518038-5 THIS IS NOT ABILL-DO NOT PAY RENEWAL ,` U 541465-1 fx+. 0` Bus PAKR TMMIC CORP STATINC91501729 ► 1588 SW 154 CT' i 33194 UNIN DADE COUNTY OW f i1KEE WAY ELECTRIC CORP WORKER/S Rlp o �a`t H 4C1W1!ft"nCAL CONTRACTOR TWSINESS TAX R CEM.rr DOES NOT PERMIT THE ,. HOLDER TO VIOLATE ANY mas m REGULATORY OR DO NOT FORWARD ZONING LAWS OF THE NOR s rr°RE� THE THREE WAY ELECTRIC CORP "' f HOLDER FROM ANY OTHER PERMIT OR LICENSE PIMIENTA ABILIO PRES REQUIRED BY LAW.TM IS - - NOT A cERnFtcanoN of 1588 SW 154 CT THE 9° INATIOA- MIAMI FL 33194 PAYMENTRECEIVED r records. MIAMFDADE COUNTY TAX COLLWTORi 0/04/2012 09010084001 116 000082.50 SEE OTHER SIDE OWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01-11