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EL-12-0660 (2)
Miami Shores Village Building Department 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 APPLICATION Permit Type: Electrical JOB ADDRESS: 479 A G FBC 20 Permit No. 1 Master Permit No. 2 _ City. Miami Shores County: Miami Dade Zip: 3 a l Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: e OWNER: Name (Fee Simple Titleholder): ,z Z jZ,;Aee Phone #: J50�� -- 7Z ✓— 60 O Address: lei q4 City: �a ��C Pd� `I State: 2= 6� - ce,� Zip: %' A _5�. Tenant/Lessee Name: Phone #: Email: CONTRACTOR: Company Name: � f � . �' _Phone #: Address: z-� . /,0 !; �- l-,,- 0 City: Qualifier Name• State Certification or Regi Contact Phone #: :.7,_00__ DESIGNER: Certificate of Competency #: 7 41' Email Address: of Workinr'er_ Square/Linear Footage of Work: of Wdfk ?L'' Alt tion ❑New gRepair/Replace Zip: -3 zo le C1_* Submittal Fee $ Permit Fee $11, "X a 'tCF $ . 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 Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip 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 inspecti which occurs seven (7) days after the building permit is issue . In the a n such posted notice, the inspection will not b pov and a reinspection fee will be charged. i\ 9 e Signature Signature Owner oNAgent \,,_ Contractor The foreg - g instrument was a o e e re ]Z-1 The foregoing instrument was acknowledged before me thisz� day o 20 11 �by , day of IV•tecAL , 20�, by , w . is personally kno me or who has produced who is personally known to me or who has produced identification and who did take an oath. 'bQrV' �, as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My C APPROVED BY Plans Examiner Structural Review (Revised 3 /12/2012)(Revised 07 /10 /07XRevised 06 /10/2009XRevised 3/15/09) NOTARY PUBLIC: Sign: Print: My I 11 j Zoning Clerk MESAB.1 OP ID: AG CERTIFICATE OF LIABILITY INSURANCE 712118112. 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., N the cmtltloste holder is an ADDITIONAL INSURED, this poll ) must be endorsed. N SUBROGATION IS WAIVED, subject to the terms and conditions of tim policy, certain Policies may require an endoreemenf. A statement on this certificate does not confer rights to the cardlicabe holder in Neu of such end s . PRODUCER 305-364-7800 BROWN & BROWN OF FLORIDA INC 14.4401 14900 NW 79th Court SuibsS200 Miami Lakes, FL 33018.5869 Ramon A Rodriguez MF 22=1111111011 im: AFFORDING COVERAGE NAnc e INSURERA:FCCI Insurance Company 10178 SOURED Mesa Brothers Inc. 5215 SIN 103rd Avenue (Rear) Miami, FL 33185 B: c 01/01M3 12N 8N2 NSURSR EACH OCCURRENCE $ LOBO, Pig $ 100, MED EV ("one t«Wii 1r7 -'ral;:�-' a=�:A1l:1'97Nd:J!III ".I_l=i: :7=k`j{:i(*?!I`III "Ia:i: 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 0 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. um INSURANCE ANX SUSK 22=1111111011 Building Deparbnent U111TS AuTIORMtrATlve A GENERAL. LIABILITY XgMERC1ALGfiN6RALL1ASILITY MAIMS-MME a OCCUR GLA0147281 GLOOD31919 01/01M3 12N 8N2 01I01M4 01/01/13 EACH OCCURRENCE $ LOBO, Pig $ 100, MED EV ("one $ 51 PERSONAL & ADV INJURY $ 110001 GENERALAGGREOATE $ 2,000, GENLAGGREGATELIMITAMESPER: X 2 PRODUCTS -COMPIOP AM $ 2.000. $ AUrOMOBILB UABILRY ANYAUTO BONED OS AUTOS HLREDAUTOS AUT NON-OWNED I 1 t SOWI.YINJURY(Perperaon) $ 60DBYINJURY(Pereodder:<! $ $ 8 u UAB BXCw" AB OC = CLAMO MADE EACH OCCURRENCE $ AGGREGATE 8 W COMP13mrbli ANDEMPL.OYOWLLABILITY p ANY P"R*WWE OMMEA)RiNERIE7fECUi W O� EXpt�D7 � (Wed1duyInNH) hh desame undw N / A w A ER E.L. EACH A=DENT E.L DISEASE - EA EMPLOYEE $ uMrr DESCRmTIONOFOPERATgrRILOCATIONB /vim LA1rad1ACORD101.Addf kxWRWWftSOlydtftII` .epeebnq*aO L. I CERT1FtCATE NOLDER CANCELLATIAN MIAMISH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores village Acc�DAANCE WlrH DATE POLICY FS WILL BE DELNERED IN Building Deparbnent 10050 Northeast 2m1 Avenue AuTIORMtrATlve Miami Shores, FL 33138 ® 78110 -ZO10 ACORD CORPORATION. Ali rights rroswuVed. ACORD 25 (2010105) The ACORD name and logo we registered marks of ACORD E ?RD" CERTIFICATE OF LIABILITY INSURANCE D12/2712012m 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. 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 Andrew Atsaves c% Artex Risk Solutions, Inc, 8800 E. Chaparral Rd, Suite 230 Scottsdale, AZ 85250 NT MCA e PHONE 480 951 -4177 FAX o . 480 951 -4266 E-MAIL ADD INSURER(S) AFFORDING COVERAGE NAIC d INSURERA: American Zurich Insurance Company 40142 P Ea occurrence) INSURED INSURER 8: $ First Financial Employee Leasing IV, Inc. Alt. Emp: Mesa Brothers Inc 11400 Parkside Dr Ste 500 INSURER C : GENERAL AGGREGATE Knoxville, TN 37934 INSURER D PRODUCTS - COMPIOP AGO INSURER E $ INSURER F: AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED NON -OWNED HIRED AUTOS AUTOS COVERAGES CERTIFICATE NUMBER: 13TNOOSS41622 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 • YPE OF INSURANCE ACCORDANCE WITH THE POLICY PROVISIONS. POLICY NUMBER larrA P LICY ExP UMITS GENERALLIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS-MADE 7 OCCUR EACH OCCURRENCE $ P Ea occurrence) $ MED EXP one rson $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY I I PRO LOC PRODUCTS - COMPIOP AGO $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED NON -OWNED HIRED AUTOS AUTOS UUMBINEU +0dent) BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE P $ UMBRELLA LIAB EXCESS LAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ RETENTIO $ A WORKERS COMPENSATION AND EMPLOYERS' LIABUM ANY PROPRIETORRARTNERIEXECUTNE Y� (Mandatory in H) EXCLUDED? (Mandatory M NH) If yes describe under E RI N OF OPERATIONS NIA WC 47 -58- 218 01 01/01!2013 01!01!2014 X WIC STATU- OTH- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1,000,000 F.L. DISEASE - POLICY LIMIT $ 1,000,000 Location Coverage Period: 01/01/2013 01/01/2014 Client# 5362 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORD I01, Additional Remarks Schedule, H more apace to required) Coverage Is provided for Mesa Brothers Inc only those employees 5215 SW 103rd Ave leased to but not Miami, FL 33165 -7016 subcontractors or: CERTIFICATE HOLDER CANCELLATION Miami SHores Village 10050 NE 2nd Ave SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores, FL 33138 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORCED REPRESENTATIVE 0 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 26 (2010106) The ACORD name and logo are registered marks of ACORD '6270686 gg�� STATE OF FLORIDA DZPARTIKBNTTOICALSCONTRAAJ LI8jNjING1 HOARD ��zL+�RCC RR R �' �TAL RZfiGIILATION SECOL12061901003 OS 1 012 000000000 EC13001870 The ELECTRICAL, CONTRACTOR Named' below IS C1jRTIFjLD tsxder the Provisions of Chaplre :4 'r 'S Iag RxPiration date: AUG 31, 2014 2; ' I r RAUL MESA BROTHERS IN C MIAMI SW 103 AVE FL 33165 i ltt0 �RNORT KEN BLAWSON SEC R ... AS REQUIRED BY LAW J d s -P r° •" 8l -Y 040577-9 THIS IS NOT A BILL — 00 NOT PAY ®UN"y WhTCOfrNC 5215 Sw 33165 O UNINDADEECOUN.Y O W9RSA BROTHERS INC tss(*TAX M8%0I6Y c O r NT Nrr T ATE AY KRWORY OR ;91�a an a R4 8 P01 A NOR NOT A ORWTI ATtON OP 1_'�6_�IOWHR'8 OUAWgOA. PAYAMW RBCBIY@O L4 p,000M TAX 60010000347 000075.00 SEE OTHER SIDE CONTRACTOR RENEWAL STATEVY8798b1870 040577 -9 WORKER /S 10 DO NOT FORWARD MESA BROTHERS INC RAUL MESA PRES 5215 SW 103 AVE MIAMI FL 33165 1111 11„1 1,„ 111, 11���I�i ,i,,,lll"11,1433,11 RECEIPT IcLORIDA 2013 FIRST- Ci,AB$ • t t 4 ,A43 U.8. P08TAGiE 8U81NE88 PAID 8p • ART. 9 A 10 MIAMI, FL MIAMI. NO, 231 040577-9 THIS IS NOT A BILL — 00 NOT PAY ®UN"y WhTCOfrNC 5215 Sw 33165 O UNINDADEECOUN.Y O W9RSA BROTHERS INC tss(*TAX M8%0I6Y c O r NT Nrr T ATE AY KRWORY OR ;91�a an a R4 8 P01 A NOR NOT A ORWTI ATtON OP 1_'�6_�IOWHR'8 OUAWgOA. PAYAMW RBCBIY@O L4 p,000M TAX 60010000347 000075.00 SEE OTHER SIDE CONTRACTOR RENEWAL STATEVY8798b1870 040577 -9 WORKER /S 10 DO NOT FORWARD MESA BROTHERS INC RAUL MESA PRES 5215 SW 103 AVE MIAMI FL 33165 1111 11„1 1,„ 111, 11���I�i ,i,,,lll"11,1433,11 F-- Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 March 28, 2013 Permit No: RC12 -658 Building Critigue 1. The plans must be clearly marked to identify the proposed revisions. 2. Identify all interior bearing walls in the area of work. 3. Provide separate permits for new patio. Provide HRS /DOH approval. Norman Bruhn CBO 305 - 762 -4859 Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. d Miami Shores Village Building Department 10050 N.E2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 1) �g IZ— (g—z( Permit No: 3/7,1/13 13 Structural Critique Sheet V N 'D EW--!31(*T i ,D -A) 'L L Page 1 of 1 fi 2 -TV 4f., -S e-®Pie 2F w ©Rae. P Le 4-9C- Pgo vCDe A- L4-S -1 e-r— "mac. -we4ri, W®P_4'. %2 P40 V c ® E; T) e -rft"s ® J'X- 1,1C' w II t✓ c0e-v g as it PY4tSa 44-, 4\0PC-.i vs-e RE- S4-o,-j &-(J' Q too'( gttis �P -T1 � U G7 Skt-eie'r B e4AV ; -Tct Sc� C,S '� "( ��Ll1 GD A-0--c- Aa 1" y eoVOrtO nE-- tA-►vS t FSE (ti scotloeQ wil-Af co-P SP.A-e.GS l3�yD� frJ E-P0�of (q �U- t ( '(v i 4 AID qrto tr. W 7YC'(A-i *be G+- q1 lxc, L,,j ' (A v , STOPPED REVIEW Plan review Is not complete, when all Items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Mehdl Asraf .i ' Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 April 3, 2013 Permit No: RC12 -658 Electrical Critique — Michael Devaney 1. Switch and light added to new french door area. Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. DEVELOPMENT ORDER File Number: PZ06 -1026 - 05 Property Address: 54 NE 102 °d St. Applicant: Mike and Claudia Devine (Owner) Address: 54 NE 102 °d St. Miami Shores FL 33138 Agent: Mark Campbell Address: 373 NE 92"d St. Miami Shores FL 33138 Whereas, the applicant Mike and Claudia Devine (Owner) has filed an application for site plan review before the Planning and Zoning Board on the above property. The applicant sought approval as follows: Site Plan Review, Sec. 600, Addition and Remodel. Whereas, a public hearing was held on October 26, 2006 and the Board, after having considered the application and after hearing testimony and reviewing the evidence entered, finds: 1. The application was made in a manner consistent with the requirements of the Land Development Code of Miami Shores Village. 2. The conditions on the property and the representations made at the hearing merit consideration and are consistent with the requirements of the Land Development Code. The Board requires that all further development of the property shall be performed in a manner consistent with the site plan, drawings, and the conditions agreed upon at the hearing: 1) Applicant to comply with Village Code for parking on the right -of -way Section 521(b) (2) b. and remove paving that does not comply with the Village Code prior to receiving a Certificate of Occupancy. 2) Applicant to obtain a building permit before commencing work. 3) Applicant to meet all applicable code provisions at the time of permitting. 4) Color -Thru tiles to be utilized. Page 1 of 2 Additionally, the applicant must, satisfy all applicable Miami Shores Village Codes, Miami -Dade County Codes, the applicable building and life safety codes required for development, and provide a copy of the development order to the Building Dept. The application with conditions was passed and adopted this 26th day of October, 2006 by the Planning and Zoning Board as follows: Mr. Abramitis Yes Mr. Ulmer Yes Mr. Reese Yes Mr. Sastre Yes Chairman Fernandez Yes Date Chairman, Planning and Zoning Board Page 2 of 2 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 RECEIPT PERMIT M l '— S DATE: 4 3 • Contractor • Owner • Architect Picked up 2 sets of plans and (other) Address: From the building department on this date in order to have corrections done to plans And /or get County stamps. I understand that the plans need to be brought back to Miami Shores Village Building Department to continue permitting process. Acknowledged by: PERMIT CLERK INITIAL: e 5��,,A� RESUBMITTED DATE: " l -> PERMIT CLERK INITIAL: 6z,--