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EL-12-191 (2)Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-180460 Permit Number: EL -2-12-191 Scheduled Inspection Date: November 25, 2013 Permit Type: Electrical - Residential Inspector: Devaney, Michael Owner: LIBONATTI, BRUNO AND ALEXANDRA Job Address: 10343 NE 6 Avenue Miami Shores, FL Project: <NONE> Contractor: EAB EGINEERING SERVICES Isulding Department comments NEW SWIMMING POOL ELECTRICAL Inspection Type: Final Work Classification: Pool - Private Phone Number Parcel Number 1122310120210 INSPECTOR COMMENTS False Phone: (786)239-1808 Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-176080. CREATED AS I:z REINSPECTION FOR INSP-174444. CREATED AS REINSPECTION FOR INSP-169564. As noted on 10 apr. 2012 service not as per. plans. Need a permit to repair service. Failed ❑ Bell box cover missing and in the dirt. Lower the grade around the pool equipement. Meter enclosure is only rated for 100 amp. not 150. Need to meet electrician site. %J Correction Needed Re -Inspection ❑ �� Fee No Additional Inspections can be scheduled until re -inspection fee is paid. November 22, 2013 For Inspections please call: (305)762-4949 Page 5 of 33 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: 1 C 3 L4 2-> N t; Co -N-\j QSA u, --Q FBC 20 MAY 312013 �y• Permit No. G L- 2- 1 2_ 1 cl Master Permit No. 0 V P 11 Z t E)q City: Miami Shores County: Miami Dade Zip: --33 13 Folio/Parcel#: i I- 2'12- s` C 9 2- 0 '_ 10 Is the Building Historically Designated: Yes NO Flood Zone: V to (I U L OWNER: Name (Fee Simple Titleholder):!� l �s n%� wr c1; Ls 6' s c1 �� t t, Phone#:��?a �5� 7 5 -S Address: t 0 3 Ll �- V E: G7 A Qi City: tl C 1P1e State: I I Zip: 1'3 0 Tenant/Lessee Name: Phone#: Email: K0 CONTRACTOR: Company Name: C?, : a�L�_.t + +"+ SIC -0 Phone#: ( -7!F-,Cj 2- 3 ci - t005,_- Address: '15 ��� S t \I 2Z City: M I ' State: - I Zip: 3 3 15 Qualifier Name: & Ct6. r C C-4' K E t -c Phone#: (-7 Z 3 g e 1 &0 State Certification or Registration #: f�_ C, 1..-� 0 0 �,: i 1 35 Certificate of Competency #: N 1 %� Contact Phone#: (Lo 2-30?— Email Address: I DESIGNER: Architect/Engineer: ( nCK Z)r:a Arr _ �t1.'o Phone#: (0) �� 91 Value of Work for this Permit: $ 4 1 z c' C" Square/Linear Footage of Work: Type of Work: ❑Address ❑Alteration blew ❑Repair/Replace ❑Demolition Description of Work: Submittal Fee $ Permit Fee $ CCF Scanning Fee $ Notary Radon Fee $ Training/Education Fee $ Double Fee $ Structural Review $ CO/CC $ DBPR $ Bond Technology Fee $ 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 inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not he approved and a reinspect; fee will be charged. SignatureL Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this 24 day of H (4 2019,' , by r�, r u n u wr , who personally-1nown t ' e or who has produced As identification and who did take ay" - NOTARY .P. NOTARY Sign: Y,PPdl-euanu�H Print: s �1 f Florida My Commission14 ' � My Comm. Expires Jul 4, 2013 9r __.�? Commission # DD 903043 The foregoing instrument was acknowledged before me this �� day of \ , 20 a, by �� Q Q rd ��n'&4, t� who ' personall own a or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My My Comm. Expires Jul 4, 2013 Commission # DD 903043 APPROVED BY tz e- /1 Plans Examiner Zoning Structural Review Clerk (Revised 3/12/2012)(Reyised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) 1 Miami shores V Building Department CONTRACTORS' REGISTRATION 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED. IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: COPY,OF QUALIFIER'S STATE LICENCES B. OPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE (CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKERS COMPENSATION ,(EITHER CERTIFICATE OR EXCEMPTION) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT B. ACOPY 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 WORKERS 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: i1i F' ii: �, lImo_ it fj —i BUSINESS ADDRESS: i r_g N :SVI �J'J' (, f I'1-1 CITY M I (I r'r°a V STATE f L ZIP CODE BUSINESS PHONE:`" FAX NUMBER O, CELL PHONE_. a) kL � ' QUALIFIER'S NAME: FAU 9 rrl p- A LLe MAO QUALIFIER'S LIC NUMBER: -cc, E-MAIL ADDRESS (IF APPLICABLE): I` V n 1, `� 1 j I Created on 3119109 BY MLDV 1 RV 3126109 MLDV 1 RV 6127111 AS Smmm a ACI 2 a4j*a D M ON EC1300511� , t 12<0021517 FIRST-CLASS U.S. POSTAGE PAID MIAMI, FL PERMIT NO. 231 704390-4 THIS IS NOT A BILL - DO NOT PAY NEW BUSINESS NAME / LOCATION RECEIPT NO. 732031-0 EAB ENGINEERING SERVICES INC STATE# EC13005113 7355 SW 89 ST 422 33156 UNIN DADE COUNTY OWNER EAB ENGINEERING SERVICES INC Sc1TV6e ELECTRICAL CONTRACTOR WORKER/S THIS IS ONLY A LOCAL 1 BUSINESS TAX RECEIPT. IT DOES NOT PERMIT THE HOLDER TO VIOLATE ANY EXISTING REGULATORY OR ccoouKn OR�YCITIES, THE DO NOT FORWARD DOES IT EXEMPT THE HOLDER FROM ANY OTHER PERMIT OR LICENSE DRYLAW. THIS NOT A CERTIFICATION OOF EAB ENGINEERING SERVICES INC NOT A P THE HOLDER'S OUAUFlC0.- noxs. EDUARDO BARRETO7355 SW 89 ST 422 N PAYMENT RECEIVED MIAMI FL 33156 MIAW-DADE COUNTY TAX COLLECTOR: 09/28/2012 02210020001 ( ttii Il jj [E {{ ttjj / ( jj(( (( jj ff j IMP 000075.00 !}} �}1f 11 E}}} F11id I I III I IJI1111 E f1 fI}ilf I It is 111 IMP SEE OTHER SIDE EABEN-1 OP ID: NR ACO/e2U® `�- CERTIFICATE OF LIABILITY INSURANCE TE (MMIDDIYYYY) DA05/16/2013 THIS CERTIFICATE AS 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 Phone: 321-397-3870 Insurance By Ken Brown, Inc. PO Box 948117 Fax: 321-397-3888 Maitland, FL 32794-8117 David R. Griffiths CONTACT "E` AHt IN Et): A[ , No): E-MAIL ADDRESS: INSURERS) AFFORDING COVERAGE NAIC # INSURER A:Amerisure Mutual Ins. Co 23396 INSURED EAB Engineering Services, Inc. Eduardo Barreto 7355 SW 89th St. Ste 422 Miami, FL 33156 INSURER B: INSURER C: INSURER D: 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. INSR LTR TYPE OF INSURANCE 1kDDL IN&WVD SUBR POLICY NUMBER POLICY EFF WOONYYY) POLICY EXP (MWDDNYM LIMBS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 1 7X OCCUR GL20872250002 04/01/2013 04/01/2014 EACH OCCURRENCE $ 1,000,00 DAMAGE TO RENTED 1 OO 000 PREMISES Ea occurrence $ , MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER X POLICY PRO- LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS Ea accIdan SINGLE LIMB $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORWARTNERIEXECUTIVEE.L.EACH OFFICER/MEMBER EXCLUDED? ❑ (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WC STATU- OTH- TORY LIMITS ER ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space Is required) CERTIFICATE MOLDER CANCELLATION MIAMISH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building Department g ACCORDANCE WITH THE POLICY PROVISIONS. 10050 N.E. 2nd Avenue AUTHORIZED REPRESENTATIVE Miami Shores, FL 33138 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD a 1 a 10'-01-2012 .,OM1 r ei v'eD uv. tie 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: 10/01/2012 PERSON: BARRETO FEIN: 271562403 BUSINESS NAME AND ADDRESS: EAB ENGINEERING SERVICES INC 7355 SW 88TH ST, SUITE 422N MIAMI FL 33155 EXPIRATION DATE: 10/01/2014 EDUARDO A SCOPES OF BUSINESS OR TRADE: 1— BURGLAR ALARM INSTALLATION 2— ELECTRIC LIGHT OR POWER LINE C 3— ELECTRICAL WIRING WITHIN BUILD IMPORTANT: Pursuant to Chapter 440 . 05041, 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 440.05(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 an the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time forfeiture 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 Y , ck +&.X b' C15 M MAY � 12013 4 0PF--I -i2- tF°/ Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR/ ARCHITECT -Permit N. L L -'2 - 12 - I ci Of k -t n C L1 4 - Owner's Name .(Fee Simple Title Holder): A ltA o-fO xc4 L b t1 —(IM Phone #:( -,3 CJ Via) 7 S �-4 Owner's Address: 10 3 Ll 3 N 5 , City: 1\'" LA -M i 'f ii C'X Qj State : T- t Zip Code: 13 Job Address (Of where work is being done):_ 103 -13 s,j t� City: Miami Shores State:—Florida Zip Code: 3-3 a Contractor's Company Name: _ CA ® Phone #: 0 & Lr,) c? - ► ��� Address: -'7355 S S1 1 1-4 City: 1�1 State: ➢ Zip Code: 3 3 � 5 Qualifier's Name: SClacx'Z�Z eae:,,(rt*O Lic. Number: F- c:, i3 ov! (1 3 Architect/ Engineer of Record Name: Phone #: -7 &,G-)32Jc, -9 739 Address: zi .? o f i ca City: KM &— a I State: F I Zip Code: 3 5 i eS, Describe Work: _ S� ,Y� °�` �apc c i � ,K f c (-. s a t e ,,4 C -q I hereby certify that the work has been abandoned and/or the contractor/architect is unable or unwilling to complete the contract. I hold the Bu !ami Sh, -for all legal involve Signature Signature 66'nerorAgenttinse The foregoing)dstrument was aknowledged before me The foregoing this 2 day of M 0 Y 2M -,s ,by 5 v, LA rk 0 L ub c-1� (, m Who ' p ovale Irs` y knoti ° o me or who has produced as indentitication. °11„ Notary PU i�pRY PLBl��i LIZ M. GUA DI « ot�r,j } ida Sign: ' es d'ec 28, 2014 mission E 51872 Seal; Bonded Through National Notary Assn. thls2 `� da i o M �� &t by Lj 7 M • LjCvr� (I who rsonally known to a or who has produced Notary Public: Sinn - Seal: as indent Ication. 40tu1`ic =`State of Florida My Comm. xp res ec , 2014 Commission # EE 51872 Bonded Through National Notary Assn. York Electrical Contractor Corp. 10871 SW 100 Street, Unit 25. .Miami Florida 33157. Miami Shores Village. 10050 NE 2nd .Ave. Miami Shores, TL 33130. To Whom It May Concern: I, Lorenzo Torres qualifier of York Electrical Contractor, authorize and requested the Change of Contractor to be processed for permit #EL -2- 12-191 for job address 10343 NE 6th Ave, Miami Shores. I understand that Genie Pools will be contracting a new Electrical Contractor to furnish the additional work requested by the electrical inspector, but not related by this permit number, with the objetive to close the open pool permit. Sincerely, May 30', 2013 Mr. Lorenzo Torres York Electrical Contractor Corp. 10871 SW 188 Street, #25 Bruno Libonatti 10343 NE 6 Avenue Miami Shores, FL 33138 Ph: (305) 7544858 Miami, FL 33138 REF: 10343 NE a Avenue (Swimming Pool Project) SUBJECT: Electrical Work (Permit # EL 2-12-191 Mr. Torres, By this means, I wish to formally notify you that I will no longer require your professional services for the electrical work being done at my residence. Genie Pools will hire a new electrical contractor, and we will continue the work with said contractor. They have my permission and full authorization to process the change of contractor. ,_. d � �A Bjro�Uibonatti � STATE OF FLORIDA COUNTY OF DADE The foregoing instrument was acknowledged- before me this 36 day of t—IL"I 12013 by 1)0 tl o is personaWknown to r'ti a or has produced proper identification and who did/did not take an oath. Sworn to and subscribed before me is � day of M61"?' 2013 WITNESS my hand and official seal. Ay N LIZ M. GUARDIA My Commission Expires: ?r;�: Notary Public - State of Florida • « . • _ My Comm. Expires Dec 28, 2014 Commission # EE 51872 ,,OF, " 1o�r Bonded Through National Notary Assn. 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 FBC 20 Permit Type: Electrical FEB 0 2 24 if. Permit No.r—d `-- q) Master Permit No. OWNER: Name (Fee Simple Titleholder): 3 9111 L-4 6:7c rie tft� Phone#: Address: -77eTCity: M 14A M S jyxt;' State: fL Zip: ?I --77e- Tenant/Lessee enant/Lessee Name: 1 f Phone#: Email: JOB ADDRESS: 0-1b -1 b N r (0 Ad 0 n Def City: Miami Shores County: Miami Dade Zip: 9,7 Folio/Parcel#: ( I - 22921 - 012"02 0 Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name:%Wt43 �.l<C K C4A OZ VA C Phone#: WO - 53 Address: G: -T- Q K 1 ?_ S City: State: T Zip: _321 15 4 Qualifier Name: L -o C L v�, :�_z I -O r c - -- S Phone#: 7&p d S3 4 - ( t Z State Certification or Registration #: Certificate of Competency #: 0 3 F- 000 !- S t�; Contact Phone#: 119 IW -Ott Z — 0 3c R5f� Email Address: �orK e- cla'® �C__O- a -L, -*o ' �r`L DESIGNER: Architect/Engineer: Fegi>A ncl ® MORLfS Phone#: 1 &(P/ 3&6 •a-1 ®% Value of Work for this Permit: $ 1-1000 Square/Linear Footage of Work: Type of Work: DAddress OAlteration Description of Work: ❑New ORepair/Replace ODemolition m m I Y)/ -A I;aooL- F-4 66417-1 CA L Submittal Fee $ Permit Fee $ ?_!� ell - e O CCF Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CO/CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ . Bonding Company's Name (if applicable) Bonding Company's Address N City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address NIA I '� I 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 ection fee will be charged. Signature (( Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this 7) 1 The foregoing instrument was acknowledged before me this-1-2-- day his1 day of 161h 20 I?-, by 131RUYl® LAW Wh , day of I arum , 20 12-, by 1..orewoTDlr4:9 who is pq!s:�nallyknown o e or who has produced who is ersonally�o me or who has produced A,� NOTARY PUB IC: Sign: OLILA Print: FAA My Commission Expires: APPROVED BY (Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) Plans Examiner Structural Review as identifies NOTARY \\\1\1,1 Pfff I �OgPa [i8;ii Sign: r OF Q\� Print: ' My Commission Expires: Zoning Clerk STATE OF FLT A DEPARTMENTO'SINES3 AND PROFESSIONAL CJULATIOK ELECTRICAL CONTRACTORS LICENSING BOARD (850) 487-1395 � ►� NORTH1940 MONROE STREET TALLAHASSEE EEF'LL 32399-0783 TORRES, LORENZO YORK ELECTRICAL CONTRACTOR CORP 110887711 SW 188 ST UNIT 25 MIAMI 157 Congratulations! With this license you become one of the nearly one million SI333i3S 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.myfloridalleense.com. t a - 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. We4� y 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 CTQB Conaftudon Tradesi QW. J Soarct ` >IIr9ESS CER-nfMATE OF Ct1MPt ENCY BLEMUCAL f ONTIMTOR L: TOMES LOREt t3 is cerMo undWtheimot Chapter to of mi.ice " st0 A, PAID VW THIS is NOT A BILL DO NOT PAY PEI" V231 RENEWAL �^ A,7 s~ f '�t J. .lid. P 'CORP�:: ,� F -i� f i. vT 33165 UNIN DADE CMtjTV 25 OwVdk ELECTRICAL CONTRACTOR CORP Sw1WffftftftCAL CONTRACTOR WORMER/S M&W, A 1 ro a OR 'LAWS. Tg TM um MMMIMMMM DO NOT FORWARD A YORK ELECTRICAL CONTRACTOR CORP LORENZO TORRES PAA,. P aavaAx FRES 10871 SW 188 ST #25 MIAMI FL 33165 Oil 60000.Ar ®0073 • � 4m , SEF 'M 'falls ®®gg ppFF gqyj {{ gg jg a a pp@g gt g ! 3 a 8ffdl8f NBAfBiPA�Ipdrf /B 88�8d&g8, 2012-045 12:49 MARTINEZ INSURANCE 3054566839» 3052609777 P 2/2 .a►eIOR& CERTIFICATE OF LIABILITY' INSURANCE DATEIMMUD0/20) 1nOr2612 THIS CERTIFICATE 19 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 COVERAUE 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 andolsed. E SUBROGATION IS WAIVED, subject to the tome and Conditions of the pollCy, Certain policies may require an endorsement. A statement on this Certificate does not confer fights to the cardflcate holder in lieu of such endomme e . PkODUCER CONT MARTINEZ INSURANCE 8, ASSOCIATES E — 3�0�-4 --_• _•_•••••••• •.._.. _.._..�.....__ �••. 305 4566839 638 EAST 9TH STREET . MER64R RTINEZINS.COM HIALEAH, FL 33010 --._ —..—....... .__. _ ... _... t5 1X01000 _.__ _. • iNWRINO). AF'FORONG COVERAGE NAIC 0 COMMERCIAL GENERAL LIABILITY IN GURINA:_ GRANADA INSURANCE INSURED YORK ELECTRICAL CONTRACTOR COR INSURER a: ,• __. 10871 SW 188 ST UNIT 025 INSURERq;... --._... MIAMI, FL 33157 u WINkD: INSURER E INSURER F : GL]Yta"GC2I CERTIFICATE NIIMRFR! oeanelnu ul luoCb. 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. 3 • R �— TYPE OF INSURANCE R POLICY NU/dBER POL<EY Pate '- — LIMITSt�ENesaL Y. 0186FLOOD127992 7/15/2011 7/18/2012 EACH OCCURRENCE _ t5 1X01000 _.__ _. • COMMERCIAL GENERAL LIABILITY i)AIIfTGEITISI[EN(�`rJ PREMI •(lr�oCCURetIC@ 9 fOO,QOQ CLAIMS -MADE I J OCCUR S „_ 5, - MEO EXP IIu1l �reperaeR __—_ PERSONAL 6 ADV INJURY $ 1000 OOQ GENERAL AGGREGATE $ 1,060,0w GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO 3 E((r' POLICY PRO LOC $ AUTOIIMSILE LIAR U" COMBINED SINGLE LIMIT ANY AUTO BODILY INJURY (Per person) S EO LED ALL OWNNON-OWNED AUTOS AUCTOS BODILY INJURY (Per fift* G) S HIRED AUTOS AUTOS PROPERTY DAMAGE (Per srtad mom_.. a __ ...... S UM11MIL A UAB OCCUR EACH OCCURRENCE E EXCESS LIAa — • CLAIMS _MADE AOOREdATE 8 DED RETENTIONS S WORKERS COMPENSATION WC STATU- 0TH, AND EMPLOYERS• LUUgLRY YIN IM- U,11.T .. T E& -.— ANY PROPRIETOWARTNERIEXECUTNE OFMCERIMEMBER EXCLUDED, F N r A E.L. EACH ACC[DENT S . - — --,-- (MettdlRmy In NH) E.L. DISEASE - EA EMPLOYE S L886IR" tlMeN Utltter •3 —.- _•—, • ,• R PT10N OF O TIONS below E.L. DISEASE -POLICY LIMB BESCIUPTION OF OPERAMM I LOCATIONS i VEMCLES (A11�, AOORD 101, Atlmtlenel t�m+rils SettetlWe, U mere �lprtre !f nQllinti) l lmil"S' 11-1 MIAMI SHORES VILLAGE BUILDING DEPARTMENT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, 01888-2010 ACQRD CORPORATION. All rights reserved. ACQRD 26 (2010/05) The ACORD name and logo are mbletared marks of ACQRD 03/03/2009 22:01 7865730287 YORKELECT PAGE 01/01 CERTIFICATE OF LIA'BILIT'Y INSURANCE TMS CERMCAIM IS ISSUED AS A XATnW OF' A -11M ONLY AND C NO MGM UPON TETE ATE HOI..MM TN' CERiiFICATE DOES Plod AfT'imATNELY [K taGATNMY AtMD, EXTEND OR ALTER TW C(WEItME MWOMED BY YW PDLIC" BELOW. THS.GATE OF wsLwAN= DOES PICT CONSTITUTE A CONTRACT SErOM THE ig;aMG DURMI S), AMMM REPRESENTATWE OR PRODUCER, AND THE CERTWIGATO HOLDER t TANT a the oaniBeate is an ADMTKNAL NSURED, the poll Ww) mint be •aid. ff SUMMAMN -18 WAMMO suwd to the tomes and awwwons of the pollga oerf n poles may require art andmenonlL A statownt on this CaTt[ftWO dans aot confer fights to ON ca»lRCate holder in Ow of sudr rRODua� ' �trerm:e> AohWAaLLC s 4448350x tA>< 444M. e hww ror sgcvwcwme*rcap 10871 sw rse she urdas Mw R. M26 FL 33197 CERTIFICATE NUMBEW. B: RE'VIR10111 NUAAIER• THF$ 16 TO CEltM THAT THE POLICIES OF INSURANCE LISTED SMOW I-KVE BEEN MUM To T11> IN3UMU NAFNCt% 43 Y= t-tsm t" rv�eu a reruv� INDICATED. NOTWITHSTANDING ANY RMUREMENT, TERM OR GOIDFTFON OF ANY CONTPACT OR OTHER OOCIJMEKr WITH RESPECT TO WHICH Y"M GER'f1FFCATE t AY BE (&SUED OR MAY PERTAIN. THE INSURANCE; AFFORDED BY THE Pi}l.ICIES BESCFNEO t1EKON 15 SUBJECT TO ALL THE TERMS, EXCLilSKM AND CONDITIONS OF SUCH POLICIES. LIM TS SHOWN MAY HAVE BEEN REI)U= BY PAID CLAIM. WPE OF HCA RANCE Y NWBER ullm 11Y t islEts EAGM Gr.0I V<eKCE CLAI9J F-1 DCCUR NIM ERPtme PEFOON hAW Y $ G&NERALARG:iEAA b`+:t91-aQQATEL1A�fAT�i.[�4PER: PRODlTCTS-PAGQ S POLICY PRO- IOG S Au70140 E LIAa4JrY CONS° a `"r $ (jUDAYitAR>RY(T�rpeBat) 3 ANYA= I= ALLOWMAUM F IIfLYgiii�'tY11�er $ PROPUM AAMAC+E (Peter 3 . FdIRMAllf(33 S tdD�b.U16t� AUADS d LCAIE< JWOCC S 6 EIG� EAJAX UM=Mz E A VRIF60316 WUPEM4RO + AMP a0%*T *LIABILITY YIN xP#?fl�3WAW ER1003 unvF- El I (91 of tt � OF l5P2~RATfr3�iS ®9taw MIA cw+;a 12515-ia9 V221M y 12 y✓G BTA y flT11 F_L-FACHACCIDRIT S 1,000,1100 P� r�S-Ei9,�LQ 9,.000 I;L, DISEASE • PDUCY LUT $ O.QUO.Q90 !aE>'ii0T4OF OPStAIlQaB f LOCATI�S 1 Vi�HCLE3 ACORD 101. Atl�liotrel ReNtltl9ts StP�etlute, ff t06te 1H . ubed sh" vft' p, Buffft bapam" 10060 N.E 2ndAvwwo. A4i0ttri Slaorle ,f! 3313$. PX- 3o5.79$,2214. Fax 305-762-4849. AOM 25f" SHOULD ANY OF TH a ROVE CE$CKWO POLICIES BE CANCELLED BEFORE U t MMAZON DA -rt "WREOF, HOPM VAIJ. BE PEXAMREP IN ACCORDA1>MCE WY1 li THE POL IM PROVISIONS. Mkhael Alvew All rictus reserved. T=ai 141.5. POO'1'AGE SAW MIAMI, " PERMIT NO; 231 Y854�2 THIS 1S NOT A BILL — DQ NOT -FAY OT FLAY A 'Ou 'C4NRAC CORS'`F,41+52- 1 N71 5W, a� tf 25 33165 UN�N DAHE,:toU'NTY OK ELECTRICAL, CONT.RTOt CORP VENMCAt� -CON Joe1 tU9kik�i$ TAX flECBP7. fOE$--�NftT T)m JAY "fi! Y}TlLATE .ANY InWS GFTNE �i}xTY-oA _t�Tlss. No» DO NOT FORWARD %Qvwtoe tAA * YORK ELECTRICAL CONTRACTOR CORP t�iueI-IM!l�A "u }oAA LORENZO TORRES PRES 10871 SW 188 ST K25 olfxr��ux MIAMI FL 33165 OW 04!201 OOou� 00 5 1„tl,f,il.=„ll,1,1,if„1,lit,t„l,tl,►,,,,ll„Gt,l,t, P71 SEE �' zpDE MIAMI -DADS COUNTY 2011 MUNICIPAL CONTfU1C1f?R'S X12, TAX COLLECTORMUNICIPAL RECEIPT FIRST-CLASS ISS FLOOR W. FIAGLER ST. MG4MI-DADE COUNTY - STATE OF FLORIDA U.S. POSTAGE MIAMI! FL 33130 PURSUANT TO COUNTY CODE'SEC. 10-24 PAID MMIAMI! FL y EXPIRES SEPT. 30, 201.2A PERMIT N0.231 30-5346820 TCIS ISp T A BILL 3E000 55 Y RECEIPT NO. C N BUSINESS NAME / LOCATION RECEIPT HOLDER MAY DO YORK ELECTRICAL CONTRACTOR TORP BUSINESS AS A CONTRACTOR 10871 SW 188 ST AS SPECIFIED HEREON. OWNkR :YORK ELECTRICAL CONTRACTOR CORP A LIST OFONON:PARRTICIPATIt ELECTRICAL CONTRACTOR --MUNICIPALITIES -- -- -- Receipt holder must DO NOT FORWARD register in the city YORK ELECTRICAL CONTRACTOR CORP where work Is to be LORENZO TORRES PRES dwe' 10871 SW 188 ST R25 MIAMI FL 33165 PAYMENT PMCENM 1 02220008001 i 000200.00 IPl�11!!1!}It3} 9115l�!!t�l�)!fllf�}�itltfi7�1lf�}'Ifl�ti70 0 ... ia Miami Shores Village Building Department artment SEP 2 52012 90050 N.E.2nd Avenue, Miami Shores, Florida 33138 y` Tel: (305) 795.2204 756.8972 INSPECTION'S P E NU 762.4949 FBC 20 BUILDING Permit No. PERMIT APPLICAT N as Permit No. Permit Type: JOB ADDRESS: G V d City: Miami Shores County: Mia ade Zip:I !A Folio/Parcel#: 11 " -2-7-31 '0 I IN 0-,7_ Is the Building Historically Designated: Yes NOl ,' Flood Zone: OWNER: Name (Fee Simple Titleholder): f o n ® '�i Phone#: Address: City: M r M S h b f ?% State. Kp Zip: � Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: &1 4) V'— _. hone#: 9f 2-0 6 IC55'� Address: ' 3 io 9 City: 144 M Stater ` 3: a Zip: Qualifier Name: % I el °�„ Phone#: 305 % ® ' State Certification or Registration #: Certi e of Co_m tency #: Contact Phone#: —30'--!'j 2-0 0, " � ! 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 inspection which occurs seven (7) days after the building permit is issued. In the absenceof s osted notice, the inspection will not be approvedghd a reinspection fee will be charged. Signature —h�Am 1 � er or Agent n Contractor The foregoing"me � instrument was acknowledged b]The foregoing instrument was a owledged before me 1 day of se 1 20rZ,by UM Lday of r^ 20 _ byt! who is pe mown t wh as pro u e who is sonally no' o o has p ed n'fic 'nand wh take oath. iden ' t� n and who di tak NOTARY NOTA 10 °�e1, RP L E GUARDIA �� Sign: "Ry �'- GAB IE GU DIA Sign: - o Public - State of Florida mm. Ex Print: Cil N° IIG. male PT r1orlaa�: 041. Ex ires 14 2013 Print: rhe p'`-aj Co lssian 3043 My Commission Expir- Commission # DD 903043 My Commission Expires: APPROVED BY Plans Examiner Zoning Structural Review (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) Clerk