EL-14-3300` Miami Shores Village
Building Department LAN 0121013
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 --
INSPECTION'S PHONE NUMBER: (305) 762.4949
FBC 20 ko
BUILDING Permit No. G_ U >
PERMIT APPLICATION Master Permit No. 'Zc I � 1
Permit Type: Electrical
JOB ADDRESS: '35- k e7 q q- S -f�'E,%
City: Miami Shores County: Miami Dade Zip: 3 3 / 3 t
Folio/ParceW 11® 3"61 - 013 9- qC)
Is the Building Historically Designated: Yes
NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): M SMP'T16 (c VO - 0dW �° UC Phone #:
Address: :3 S— rj 57 qg-
City: M l I .J wog* =3 State: Zip:
Tenant/Lessee Name: tJ I A- Phone#:
Email:
CONTRACTOR: Company Name: COIJ 44 �s
Address:
City:
Qualifier Name: A
*hone#:
-a86- 45?- jZ 0 Y
i=OL Zip: 3s19�:
State Certification or Registration #: C-f.;._301 Y-33 Certificate of Competency #: G7 q iFWQS63
Contact Phone#: 7� $6- Z f2— (2 8'�/ Email Address: �eoe,14=40* LG ® yh2l-loo .. Cry
DESIGNER: Architect/Engineer:
Phnnp -*-
Value of Work for this Permit: $ 6000.40 ��//Square/Linear Footage of Work:
O L4
Type of Work: DAddress:
Alteration New _ ORepair/Replace ODemolition
Descripf6h FW,ork• ,..t,, TaN New Jwly 1AM; (41na-
GeMeb
Submittal Fee $ Permit Fee $ , � CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
Technology Fee $
TOTAL FEE NOW DUE $ '� • I V
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.
"WARMING 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 absen of such posted notice, the
inspection will not be approvpdfnd a reinspection fee will be charged.
.,,� /1 , A -A % N/1 B
Signa �'
O er or Agent
The foregoing instrument acknowledged before me this 0-�
day of (•P , 0 L, by ei to 2, (2°
who is personally known tome or who has produced v
u, CA.SP_ As identification and who did take an oath.
NOTARY
Sign:
Print: 1 Q
My Commission Expires:
APPROVED BY
RONK
I
SM&
Contractor
The foregoing instrument was acknowledged before me this'^
day of emy /, 20 t�—, e,@AaA�a
who is personally known to me or who has produced-1(/t' VPYJr
14 e2nl S G% as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My -
MpRIABAN4S.
MY COIu SSION I p38457
EXPIRES:NOVOMbsr11,201n
Plans Examiner Zoning
Structural Review Clerk
(Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
CONTRACTORS' REGISTRATION FORM
ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS
SUBMITTED OR THE VILLAGE MAY MAINTAIN A FILE WITH YOUR INFORMATION FOR A $30.00 FEE PER YEAR.
IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR:
A. COPY OF QUALIFIER'S STATE LIC CARD
B. COPY OF LOCAL BUSINESS TAX RECEIPT
C. COPY OF LIABILITY INSURANCE (CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPT)
D. c -0-MOF -mil T MPTION)
A. V COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER
B. I/ COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT
C. COPY OF LIABILITY INSURACE (CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPT)
D. COPY OF WORKER COMP INSURANCE (EITHER CERTIFICATE OR EXEMPTION)
YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW:
MIAMI SHORES VILLAGE BLDG DEPT
10050 NE 2ND AVE
MIAMI SHORES, FL 33138
COMPLETE CONTRACTOR'S INFORMATION
BUSINESS NAME: Coymt fo�s Q leC'fyl Col & f Vt. C r- S
BUSINESS ADDRESS: W H S W I q i- *V'G # 3c CITY W41",
STATE FL ZIP CODE 33113
BUSINESS PHONE: ( FAX NUMBER (�
CELL PHONE (37� 1 ` -SY QUALIFIER'S NAME: iila,l'i O a-. d 4 StV
QUALIFIER'S LIC NUMBER:
SWUM
� t� , I
e
E -MAIL ADDRESS (IF APPLICABLE): �'e o 'c' ( e G = wm
Created on 3119109 BY MLDV I RV 3126(09 MLDV
t�
CTQ�
Construction Trades Qualifying Board
BUSINESS CERTIFICATE OF COMPETEN
09E000563
r' !CONTRACTORS ELECTRICAL SMICES INC
w - D.B.A.:
R &DRIGUEZ LEONARDO A
is celled under the provisions of Chapter 10 of Miarrti -Dade
QUALIFYING TRADE(S)
0001 ELECTRICAL
0002 BURGLAR ALARM
0004 FIRE ALARM SPECLT
Chadee Danger P.E.
Seeretwv of the Board
mc
EXPIRES
SEPTEMBER 30, 2b14
Must be displayed at Fine of business
Pursuant to County Code
Chapter 8A - Art. 9 & 10
Far mom taferowdoo.visi www.mismidade,ggo oslisatsr
PAYMENT RECEIVED
BY TAX COLL6CTORj
200.00 07/24/2013
FPPLJD6-13 -002779
EXPIRE4
Must be displayed at
Ater BA- Art. 9 do 10
i
OWNER SEC' TYPE OF BUSINESS PAYMENT RECEIVED
CONTRACTORS ELECTRICAL. SVGS INC 19 ELECTRICAL CONTRACTOR BY TAX COLLECTOR
Workw(s) 1 $75.00 07/24/2013
FPPU06 -13- -002779
This Local Basins Tax Receipt oaly confirms payment of the Local Business Tex. The Receipt is not a ficenst.
;wit; era ceRification of the holders qualification to do busluess. Holder mud comply"any govemmental or
nesgovemmostat F00018tOff hrwa and tegnuoments which Orly to the business.
Thy RECEIPT IN& abuse most be displayed on all commial vehicles+ -AI mi -lode Coda Sec 8a -276
Cnr mma 1Mem�iom; visat �
•;
i
� co CERTIFICATE OF LIABILITY INSURANCE
° 01//106//2014 2014 06 '
0
THIS CERTIFICATE 18 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 poilcy(les) must be endolseL H SUBROGATION IS WANED, subject to
the term 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 endorsements).
PRODUCER Pablo M Conde
A&A Underwriters, Inc. 2613
8778 SW 8th St
Miami, FI33174
CONTACT
NAME, Pablo M Conde
PRONE 305- 220 -7447 11M 305 -220 -4821
PDI pmc@aaunderwriters.com
AFFORDINGCOVERAGE
NAIC#
MSURERA: Scottsdale Insurance Company
41297
INSURED
Contractors Elecbic:al services INC 11146
6821 SW 147 th. Ave Ste 3E
Miami FL 33193
INSURER B: Mapfre Insurance Company of Florida
23876
INsuRERc: RetailFirst Insurance Company
10700
INSURER D :
$ 1,000,000
INSURER E:
DAMAGE PREMISES°
INSURERF:
r_nVGRerr_c Cr- RTIFICATE 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.
IN R
TYPE OF91S1RANCI3
ACCORDANCE WITH THE POLICY PROVISIONS.
Miami Shores, FL 33138
NUMBER
P%% 7F
LR1178
A
X
COMMERCIAL GENERAL LIABMM
CLAIMSMADE a OCCUR
CPS1854027
09/08/13
7PERSONAL
EACH OCCURRENCE
$ 1,000,000
DAMAGE PREMISES°
$ 100,000
MEDEW( am t)
$ 5,000
✓gADVINJUR Y
$ 1,000,000
GERL AGGREGATE LIMIT APPLIES PER:
X POLICY ❑ El LOC
OTHER:
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMPIOPAGG
$ 1,000,000
$
B
AurolmeaE LuuauTY
OWNED SCHEDULED
X AUTOS Uros Tx AAUTOS
X UM 10/20 PIP $10,000
4150120007043
11/16113
11/16/14
Ewa COMBINED SINGLE u IT
$ 300,000
BODILY INJURY (Pa pa=)
$
)
$
P
P.
$
UMBRELLA A LIAR
EXCESS LIAB
OCCUR
EACH OCCURRENCE
$
HCI.AIMS-MADE
AGGREGATE
$
DED I I RETENTION$
$
C
WORD COMPENSATION
AND EMPLOYERS' LU BLITY Y / N
ANY PROPRIETOWPARTNER CU7IVE ®N
OFFlCERIMEMBER IXCWDED?
(Mandatory yyee88 in NH)
DESCRI OOFOPERATIONSbelow
/A
520.40493
04/06/13
04/06/14
X STATUTE ER
EL EACH ACCIDENT
$ 1,000,000
EL DISEASE - EA EMPLOYEE
$ 1,000,000
EL DISEASE - POUCYUMIT
$ 1,000,000
DESCRIYION OF OPERA71M I LOCATION$ / VEH=M (A I Rem Schedule, maybe aft If rare apace Is mquheM
CERTIFICATE HOLDER CANCELLATION
Miami Shores Village
Building Department
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
10050 NE 2nd Ave
ACCORDANCE WITH THE POLICY PROVISIONS.
Miami Shores, FL 33138
AUTRORIZEDREPRESENTATNE
®1988 -2013 ACORD CORPORATION. All rights reserved.
ACORD 26 (2013104) The ACORD name and logo are registered marks of ACORD
PDF created with pdfFactory Pro trial version --dF_ fjij-iiareIjry.com
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
ELECTRICAL CONTRACTORS LICENSING BOARD
1940 NORTH MONROE STREET
TALLAHASSEE FL 32399 -0783
RODRIGUEZ, LEONARDO SR
CONTRACTORS ELECTRICAL SERVICES, INC.
6821 SW 147TH AVENUE APT 93
Congratulations! With this license you become one of the nearly one million
Floridians licensed by the Department of Business and Professional Regulation.
Our professionals and businesses range from architects to yacht brokers, from
boxers to barbeque restaurants, and they keep Florida's economy strong.
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.myfloridalicense.com.
There you can find more information about our divisions and the regulations that
impact you, subscribe to department newsletters and learn more about the
Department's initiatives.
Our mission at the Department is: License Efficiently, Regulate Fairly. We
constantly strive to serve you better so that you can serve your customers.
Thank you for doing business in Florida, and congratulations on your new license!
DETACH HERE
(850) 487 -1395
STATE of FLowDA AC# 6 L4367;
DEPARTMENT OF BUSINESS AND
PROFESSION�.L REGULATION
EY12000264 O)/25/12 110402207
REG ALARIK SYSTEX CONTRACTOR I
RODRIGUEZ, LE010-RDO SR
CONTRACTORS - ICAL SERVICES,
CD RE-,- t LOCAL
LICENSING PRIO
TO CONTRACTIY
AREA)
AAS REGISTERED under the provieimm of ch.489
ftpiration data. AUG 31, 2014 L12 052 9 0 14 6 3
05/29/20121110402207 JNY12000264
The ALARM SYSTEM CONTRACTOR Z
Named below HAS REGISTERED
Under the provisions of chapter,-489
Expiration date: AUG 31, 2014
(INDIVIDUAL MUST BEET ALL LOCAL L1C
REQIIIREMENTS PRIOR TO CONTBACTNG T
RODRIGUEZ, L13ONARDO SR
CONTRACTORS ELECTRICAL SERVICES
6821 SW �47TU-`AVENUE- APT 3E
MIAMI'r FL 33193
RICK SCOTT KEN LAWSON
GOVJRPTOR I SECRETARY
DISPLAY AS REQUIRED BYLAW
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
ELECTRICAL CONTRACTORS LICENSING BOARD (850) 487 -1395
1940 NORTH MONROE STREET
.��we+g'�`•
TALLAHASSEE FL 32399 -0783
RODRIGUEZ, LEONARDO SR
CONTRACTORS ELECTRICAL SERVICES INC
66821 SW 147TH AVENUE APT
MIAMI 93
Congratulations! With this license you become one of the nearly one million
Floridians licensed by the Department of Business and Professional Regulation.
Our professionals and businesses range from architects to yacht brokers, from
boxers to barbeque restaurants, and they keep Florida's economy strong.
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.myfloridalicense.com
There you can find more information about our divisions and the regulations that
impact you, subscribe to department newsletters and learn more about the
Department's initiatives.
Our mission at the Department is: License Efficiently, Regulate Fairly. We
constantly strive to serve you better so that you can serve your customers.
Thank you for doing business in Florida, and congratulations on your new license!
STATE of FLORIDA AC# 60,3661
DEPARTMENT OF BUSINESS AND
PROFESSIONAL REGULATION
ER13014334 OS129112 110402206
REG ELECTRICAL ,CONTRACTOR
RODRIGUEZ, , SR
CONTRACTORS ELECTRICAL SERVICES
(INDIVIDUAL MOST MEET ALL LOCAL
LICENSING- REQUIRMOWS PRIOR
TO CONTRACTING,= ANY AREA)
SAS REGISTERED under the provisions of Ch.489
ssgiration dates AUG 31, 2014 L120S29014S6
DETACH HERE
DOCUMENT HAS A COLORER BACfCCaF�OUN •A�9lORRP@ON i6j dNEIN%lRK TM, "PATENTED PAPQFi
• J OF FLORIDA
s • s + . i,.a�.a� ..�ci aaa�
05/29/2012-1110402206 IER13614334
The ELECTRICAL CONTRACTOR
Named below HAS REGISTERED*
Under the ,:provisions of Chapter 4S9 ; =ID'S;.
Expiration date: AUG 31, 2014
(INDIVIDUAL MUST MEET ALL LOCAL+ LICSNSING
REQUIREMENTS PRIOR TO CONTRACTING IN ANY AREA)
RODRIGUEZ, LEONARDO SR
CONTRACTORS ELECTRICAL SERVICES' ,INC.
6821 SW 1947TH" - AVENUE APT 3E
MIAMI `r " • FL 33193
RGOi� SCOTT
R
DISPLAY AS REQUIRED BY LAW
SEW 1,12052901456
KEN LAWSON
SECRETARY