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ELC-12-2435Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-204559 Permit Number: ELC-12-12-2435 Scheduled Inspection Date: December 16, 2013 Inspector: Devaney, Michael Owner: CHURCH, . Job Address: 602 NE 96 Street Miami Shores, FL Project: <NONE> Permit Type: Electrical - Commercial Inspection Type: Rough Work Classification: Addition/Alteration Phone Number (305)754-9541 Parcel Number 1132060141410 Contractor: CEI LLC Phone: (954)255-0371 tsul comments REPLACE EXISTING ANTENNAS AND CABINETS stop work order until new electrical contractor is on board. GR send a letter to cancel, but work is in progress. must have a change of contractor to proceed. INSPECTOR COMMENTS False Inspector Comments Passed !� i� Failed Correction ❑ Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. December 13, 2013 For Inspections please call: (305)762-4949 Page 39 of 40 3L-/' y ELECTRIC CORP. ELECTRICAL CONTRACTOR •Industrial, Commercial, and Residential State Certified Electrical Contractors • Electrical Design -Build • Fire Alarm Work and Monitoring Taking Care of (Business since 1986 • Bucket Truck Service September 4, 2013 Miami Shores Village 10050 Northeast 2nd Avenue Miami Shores, Florida 33138 Re: Permit Hold Request Permit #: ELC12-2435 Address: 602 Northeast 96 Street Miami Shores, Florida Dear Sr. or Madam: This letter is to let you know that our company never performed any work under the above reference permit Therefore, we request that you place a hold on this permit No inspections or electrical work can be performed unless I, Gonzalo Planas, Qualifier for G&R Electric Corp (EC13002165) request such inspections or work in person at your building department If you have any question please do not hesitate in contact me. Since Gonzalo Planas President G & R Electric Corp. EC # 13002165 STATE OF: FLORIDA COUNTY OF: MIAMI D SWORN TO AND SUBSCRIBED BEFORE ME THIS `L DAY aota`:;.ue�,c MARIA E. H8WMEZ ** W COMMISSION # EE 047208 EXPIRES: April 7, 2015 -XI a Bold TIN Mod " 6VAM Print, e ol Sta p Name of N Florida Licensed Electrical Contractors: EW002165, Ec13003998 1 4450 East 10th Court, Hialeah Flo 'da, 33013 J ®� Office: (305) 558-0217 * Fax: (30 688-5025 Listed www.grelectriccorp.com ��A� I Miami Shores Village Building Department 90050 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 Mb SEP 1, 013 j FBC 20 � 2 -. 2 y :F -/o i v5. Permit No. -'e Master Permit No. CC -12-12-2434 JOB ADDRESS: 602 N E 96 ST. City: Miami Shores County: Miami Dade Zip: 33138 Folio/Parcel#. 11-3206-014-1410 Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): NORTHEAST PRESBYTERIAN CHURCH US phone#: 305-754-9541 Address: 602 NE 96 ST. City: MIAMI stare: FL gip: 33138 Tenant/Lessee Name. SPRINT Phone#: 913-315-8081 Email: CONTRACTOR: Company Name: CEI, LLC Phone#: 954-255-0371 Address: 3859 NW 124TH AVE. 6A city: Coral Springs State: FL Zip: 33065 Qualifier Name: Joseph A. Nappi Phone#: Q1- y- .°SSS-'® 3 % I State Certification or Registration #: 62'52— Certificate of Competency #: Contact Phone#: - j 70- DT Y Z Email Address: Tb5e J I& C e ► ele cj, r. c . .4eA DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ 43, Sa 0 Square/Linear Footage of Work: Type of Work: ❑Address alteration ONew ❑Repair/Replace ODemolition Description of Work: TUBI AM A," ?'ell- - Rao Pb w e r 2 Te r Submittal Fee Permit Fee $ CCF $ CO/CC $ Scanning Fee $ .l Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ Technology Fee $ TOTAL FEE NOW DUE $ a.- $onding'Company's Name (if applicable) Bonding Company's Address City State 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 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 approved and a0inspection fee will be charged. d Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this �o The foregoing instrument was acknowledged before me this day of -54f. 20L-3 , by Aa V 1 W Z�1;1C4 f `1 day of C k.O `� 20 4 by , who is onally known tom or who has produced who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: lot � C d lL& Print: S IVA, ET1lf YLQAIDA My Commission Expires: ,°"'O• Sylvia Halter Commission # EE098053 %,,.„54 Expires: JUNE 08, 2015 IWQVDID TffitII ATLANTIC BONDL'M ca. INC. APPROVED BY �11/11) Plans Examiner Structural Review (Revised 3/12/2012)(Revised 07/10107)(Revised 06QW009)(Revised 3/15/09) "<- as id tifinatinn yind_W&QAWA e an oath. p�tX UWA@ALIA A GUZMAN MY COMMISSION #FFOOA646 +s�Fopop,, EXPIRES April 39' 7 S N a Service.ca Print: My Commission Expires: �'� f -:4 d Zoning Clerk 08/08/2013 11:18 FAX 1 800 685 7580 DATA SCAN FIELD SERVICES 0 0011001 .?? -max::: •... ��' _ � : ` _ �...._�. Miami $polesills e 9 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tet: (305) 796.22011 Fax: (305) 756.8972 CHANGE of CONTRACTOR / ARCHITECT Permit NCC -12-12-2434 Owner's Name (Fee Simple Title Holder): Northeast Presbyterian church IIs Phone #: 305-754-9541 Owner's Address 602 NE 96 St. Oily: Miami State: FL Zip Code: 33138 Job Address (Of where work is being done): 6 0 2 NE 9 6 St . City: — --.Miami Shores— State:_Florida Zip Code: 33138 Contractor's Company Name: CEI, LLC Address: 3859 NW 124th Ave. Phone #: 954-255-0371 amity: Coral Springs State: FLZiF Gpde- 33065 Qualifier's Name: Joseph A. Nappi — Lic. Number. EC13005252' W Architect/ LEngineer of Record Name: Address: City. __... __......_ Describe Work. State: Phone #: Zip Code:...__,......_., I hereby certffy that the work has been abandoned and/or the contractorlarchitect is unable or unwilling to complete the contract. I hold the Building Official and the Miami Shores harmless for all legal involvement. Signage Signature owmof or Agent Contractor or Architect The foregoing instrument, was aknowledgod before me The foregoing instrument w s aknowiedged before me I;iso?� cry of 20/3 b Du ✓, d naeeL this e Y day of - °...�, 208by ho is rsonatly known o me r who has !produced who ' ersonaG k me or who has produced w as indentirication. a �� 4 as inderlt+f�caii0n. Notary Public: Nobly P 41cf Sign: kll&gn: NOTARY PUBLIC -STATE OF FLORIDA e� Notary Public state of Florida a►°� °L ••'••••, Sylvia Halter :P ,lossie Acosta : . Commission # BE098053 ;`= MY Commission 00952F69 'k-, -,,, Y Expires' JUNE 08r 2015 '�oFv�o Expires 01/27W14 BONDED THRU ATLANTIC BONDING CO., INC. 0 W"E LINK C Rpofwim Delivered by Certified Mail G & R Electric 4450 East 101h Court Hialeah, FL 33013 Date: August 12, 2013 403 Palm Drive Islamonada FL. 33036 Office: 786-427-7576 Fax: 305-328-6628 E-mail: gguzmanOqwavelinkcorp.com 4141011MMKOUNIO-11 Re: Permit for site M103XC065 Attn.: Gonzalo Planas and Gonzalo Planas Jr. Hello Gonzalo, IU This is to inform you that Electrical permit # CC -12-12-2434 will be changed from G & R Electric to CEI, LLC with Miami Shores Village Building Department. This permit is for site 103 0065 located at 602 NE 96 St., Miami Shores, FL 33138. � 00 Gabriela Guzman President, Wave Link Corp. I USPS.com® - Track & Confirm What's your label (or receipt) number? English Customer Service USPS Mobile . RFIL.. _ PSCOM LEGAL Quick Toots Privacy Policy > Track & Confirm Ship a Package Enter up to 10 Tracking Wind FOIA, Find USPS Locations No FEAR Act EEO Data > Buy Stamps Ca9c & Confirm JW( PSJCW ( Copyright* 2013 USPS. All Rights Reserved. Find a ZIP Code's Hold Mail Change of Address GET EMAIL UPDATES PRINT DETAILS YOUR LABEL NUMBER SERVICE 70922290000230328174 First -Class Made' Send Mail Manage Your Mail Page 1 of 1 Register I Sign In Search USPS.com or Track Packages Shop Business Solutions STATUS OF YOUR ITEM DATE & TIME LOCATION Delivered August 13,2013,2:17 pm j HIALEAH, FL 33013 Arrival at Unit Processed at USPS Origin Sort Facility Processed at USPS Origin Sort Facility Depart USPS Sort Facility Dispatched to Sort Facility Acceptance Check on Another Item What's your label (or receipt) number? 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August 13, 2013, 8:46 am August 13, 2013,12:15 am August 12, 2013,10:48 pm August 12,2013 August 12, 2013, 4:56 pm August 12,2013,4:20 pm ON ABOUT.USPS.COM About USPS Home, Newsroom > USPS Service Alerts > Fortes & Publications > Careers , HIALEAH, FL 33013 MIAMI, FL 33152 MIAMI, FL 33152 MIAMI, FL 33152 ISLAMORADA, FL 33036 ISLAMORADA, FL 33036 FEATURES Scheduled Delivery Day: Augustl3,2013 Certified Mail' Return Receipt OTHER USPS SITES Business Customer Gateway > Postal Inspectors > Inspector General > Postai Explorer > https://tools.usps.com/go/TrackConfirmAction.action 9/10/2013 0911512013 23:48 (FAH) P.0011006 MiamiShores'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. 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 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 ■rrrrrssrsrrrrrrrrrrrrsrrrrrrrsrrrrsrrwrrrsrrrrrrrssrrrrrrsrrsrrrsrrrrrrrrrrrrrrsrrrrsrrrrr COMPLETE CONTRACTOR'S INFORMATION BUSINESS NAME: �. c— \ LL' -r"j BUSINESS ADDRESS: T) l.� -) (;�� clow (to/a � ��(1 f � STATE rZIP � CODE BUSINESS PHONE:r( JI ��) `"j T FAX NUMBER (9-A_t� ✓'1 CELL PHONE (.( 1 6 aZ666 QUALIFIER'S NAME: _ k� Cs `, X' V) t QUALIFIER'S LIC NUMBER: E-MAIL ADDRESS (IF APPLICABLE):e- Created on 3119109 BY MLDV I RV 3126109 MLDV MIAMI SHORES VILLAGE 10050 NE 2ND AVE MIAMI SHORES, FL 33138 (305) 795-2207 Phone/Web ID: 75175372 Re{ U: 0w 0701/13 12:39:44 Batch b: 512 AVS: ZIP MATCH Z VISA MMMKOM Or Cade; 10 Invoiced: 0@0903 CVV2 Code: MATCH M iran5I9: 231925998 % amount: $19.1 lax: $ U total: $ INA Customer Copy 0911512013 23049 (FAX) P.0021006 OP In, _IN CERTIFICATE OF LIABILITY INSURANCEDATE(MMIDDIYYYY) 08/13/13 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 pollcy(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 an this certificate does not confer rights to the certificate holder In Ileu of such endorsement(s). PRODUCER Phone: 772-286-4334 Stuart Insurance, Inc. 3070 S W Mapp Fax: 772-288-9:389 Palm CI , FL 34990 Joseph 1 Coons, CPCU. GIC. coCT NAME: PHONE Ext): Fvc NO E AIL ADDRESS: COMBINED SINGLE LIMIT $ (Ea accident) CUSTOMER ID CEIAL-1 INSURER AFFORDING COVERAGE NAIC 0 INSURER A: Nationwide Insurance 25453 INSURED CEI, LLC 3859 NW 124th Avenue INSURER 8: Coral Springs, FL 33065 INSURER C: INSURER D: INSURER E : ' INSURER F : COVERAGES r�o�r'rcrr�w�rr �n ��s.-.�. �L.YVJ v,r 1■VIYIGG Ri 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE POLICY NUMBER MMa]D LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,OQO,O00 A X COMMERCIAL GENERAL LIABILITY ACPGLP05904400744 04/12/13 04/12/14 PREMISES Eaoccurrewnce $ 100,000 CLAIMS -MADE a OCCUR X Contr. Liability MED EXP (Any one person) $ 10,000 X XCU PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY FXPRO- LOC JECT AUTOMOBILE LIABILITY A X ANY AUTO X ALL OWNED AUTOS X SCHEDULED AUTOS X HIREDAUTOS X NON OWNED AUTOS X UMBRELLA LIAB X OCCUR A EXCESS LIAR CLAIMS MADE DEDUCTIBLE X RETENTION $ 10,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY IN OFFICERIMEMEEXC UD�oRiPARTN�VE Y❑ N I A (Mand°teN In rim 04112M 3 1 04/12/14 DESCRIPTION OF OPERATIONS) LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Electrical - MIAMS-2 MIAMI SHORES VILLAGE BLDG, DEPT 10050 Northeast 2nd Avenue M)am I Shores, FL 33138 E.L. DISEASE - EA EMPLOYEEI $ E.L. DISEASE - POLICY LIMIT 1 $ tented .quipment 1,000, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOP, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE O 1988-2009 ACORD CORPORATION. All rights reserved. -. Fa kcuwarva/ The ACORD name and logo are registered marks of ACORD GENERAL AGGREGATE $ PRODUCTS- COMP/OP AGG $ hired/non $ 04/12/13 04/12/44 COMBINED SINGLE LIMIT $ (Ea accident) BODILY INJURY (Par person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ (Per accident) $ $ EACH OCCURRENCE t 04112M 3 1 04/12/14 DESCRIPTION OF OPERATIONS) LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Electrical - MIAMS-2 MIAMI SHORES VILLAGE BLDG, DEPT 10050 Northeast 2nd Avenue M)am I Shores, FL 33138 E.L. DISEASE - EA EMPLOYEEI $ E.L. DISEASE - POLICY LIMIT 1 $ tented .quipment 1,000, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOP, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE O 1988-2009 ACORD CORPORATION. All rights reserved. -. Fa kcuwarva/ The ACORD name and logo are registered marks of ACORD 09/1512013 23:49 (FAX) P.003/006 °'` " CERTIFICATE OF LIABILITY INSURANCE °A'E`M""'°`x"'�"' 08/14/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTiFlCATE 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 endamiamant4cl PRODUCER ACT Bouchard Insurance for WBS PHONE P.O.Box 6090 866 293-3600 ext. Clearwater, FL 33758-6090 Anoa�se INSURED INSURERA: American Zurich Workforce Business Services, Inc Alt. Emp: CEI LLC INSURERS: 1401 Manatee Ave. West Ste 600 INSURER c : Bradenton, FL 34205-6708 iNStntFR n. 40142 COVERAGES CERTIFICATE NUMBER:12FLO79807099 _ 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. -48R _ GENERAL LIABI LITY MERCIAL GENERAL LIABILITY CLAIMS -MADE D OCCUR LIMIT APPLIES PER: AUTOMOBILE LIABILITY ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS AUTOSNON-0WNED UMBRELLA LIAB OCCUR EXCESS LIA8 CLAIMS -MADE DED RETENTION WORIa RS COMPENSATION AND EMPLOYERS' LWBIIJTY A OPFIANY C9PJmEM R EXCLUDED? CUTIVE N / A fMandstary U . WC 90-00-818-02 Location Coverage Period: 12/31/2012 112/31/2013 12/31/2012 1 12/31 DESCRIPTION OFOPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, AddlilonalRemarM Schedule, if more apace Is required) Coverage Is provided for CEI LLC only thoseemployees 3859 NW 124th Ave leased to but not Coral SArings, FL 33085 subcontractors of: Miami Shores Village 10050 NE 2nd Ave Miam( Shores Village, FL 33138 MED ADV $ BODILY INJURY (Per person) $ BODILY INJURY (Par accident) $ PPROPE tlTY MAGE— IS 1 1 Client# 050340 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE --k A—� (c)44Rft.9n4n L1rnRll rnRDnRA77nN All rink+, rece..ea.l 0911512013 23:49 (FAX) P.0041006 Ile401940 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD NORTH MONROE STREET (850)487-1395 TALLAHASSEE FL 32399-0783 NAPPI, JOSEPH ALBERT CEI, LLC 1439 NW 126TH DRIVE CORAL SPRINGS FL 33071 Congratulationsl With this license you become one of the neariy 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 toimprove 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 licensel STATE OF..FLORIDA DEPAR F BUSINESS AND'- •PRJO ULATiON ' .. • 01/28 py.3•._ F'-xCtFRTIFJEb• a' .•Yi.�'G1rR',TIFIED' ::..:..,:'°Y,a,_ ^.,,.'M.; ..,:_.'" ; 0.... '•" •8ifpira4t4t[date'• A•LI"G,�7d�Y;�h'�:�^�YJsitl'n5 Gf irh.46,8..F,g.,;�:'� L13L7t26h'nnn�w.,---- The Department of State is leading the commemoration of Florida's 500th anniversary in 2013.: For more Information, please ga to www.VivaFforfda.org. UIYdFIDDiDa�Dr• DETACH HERE 8TATE O'F FLORIDA 'DEPARTMENT QF BUS'INESS•AND•PROFESSIONALREGULATION ELECTRICAL C(jNTRACTORS LICENSING BOARD � I'� �C13(}05252 AbDITIONAL B ` - 0SINESS .QVA'LVU(;;ATION The .EL'ECTRICAL CONTRACTOR:', NamtT.d below.IS CERTIFIED Vridertlae provisions of Chbpter:489 FS. ' Expiration'. date:. Q. $1:, 2014 �. NAPPt;y..OSEPH :ALBERT' CEI, LLQ ----r.:.. 1439• NU11&6 CORAL•SPRINGSFL 33071 ISSUED: -------- _ VIVA FtoRlus 1?, 0911512013 23:50 (FAX) ft.0. I LOCAL BUSINESS TAX RECEIPT AaNnkCitt,bf.Coral Springs — other informationg Sue AM ql.- A.P4:4 -- 19firlb. — CHI, LLC JOSEPH A NAPPI - QUALIFIER 3859 NW 124 AVE CORAL SPRINGS FL 33065 P.0051006 Payment Date : 8/01/13 Amount Paid : 126.00 Business Tax#; 14-00061819 Expires on .1 9/30/14 ** DETACH AND POST THIS BUSINESS TAX RECEIPT IN A CONSPICUOUS PLACE ** ALL WINDOW SIGNS SHALL COMPLY TO LAND DEVELOPMENT CODE CHAPTER 18 TH LOC PLEASE DISPL, Y. N N N THIS I K S:' .00 FrIPAA fiinto maws 010 IPT ION AND GLACE Si v K. 1W rNOT PAY a 1PURFOxtr11V1i-It1:11taM'ru lnH an:.g fYl10'�-.;XC 06S NCITICC 01; CWIMENCQVIENT CFN: 20130044922 BOOK 28448 PAGE 2912 DATE:01t1712013 08:22:19 AM HARVEY RUVIN, CLERK OF COURT, MI/-DADE CTY 'lllc uRdelmglw that iquo rment all lu nuulu m ccrtain teat propen '. and m acwutmcc -tw4i Ch:qua 713. 11mida Slaueatlle liilhnvtag inlivurmion is IttutddcJ in the Ntacc lircomlmmnmem I. uWRtwltkN urrxtlrrtrrl lt.e_ i aaa4mim t. mice; mores, tramblelel r.A.>: t tn.tu NIL tiI11D;11'tSl<IN „_ Illdr('li 'IYLie'1' I.tr7' nt31C ItNIT k-s�2 �•� �-llr.�_`�"�.v,�,.tL�- �'1r1�t-�t�n:t t "'� �`��1`3S 4 J RImIa wrI JJ,r..,a t�,myr ul4twldr� pr.clw awn uxv�) r 4. c9NVTIL1c'r[1nSNAIi1Q.;urinR,y4lNnrltc3NCNt191u1?R: = Gb"► ,.�1,n�S�?��yS' ,�\t�cv��,('ChCld. -��-1 �'3Ci�)c S AINU'1'SNAAtt:,ADDRESSANumttWRMtl6faFnANDpMtIAhlaltigl, fi LI holm'SNAD1t;,ADIJIUMANDrtlONlntlMj3eW 1 7. Persons within the State of t%rida desigomed by Oww upon ,.vktm mmicts ol• mbar dui ll amts mny be - served as prolrhlal 11y 5axtitro 7IS.13 [ I) (n) 7., lloridn Sluttuot. KAM At]Duk q$Alfp Mich%Nlil HER: � 1f1 6. to Qdd icon In I10D5[lC m' fieralr, Qwnty dtsigrtoas Iia fdluuting to IL'CCIVe a co�ly of tllc Lienor's Notice ns pmvalal in StxUon 713.13 11)(b), PlawkSm uses NAaI$.1DDRkSSAb*P PaIOK NU11tOt:R: 9. Egima cin date arrattimarwlnmmrxlneul Ilhee1tphuion dmc Is I yem'trmlt dle rinse arrecarding' nkm a di(R=acline is slmifiad). 20 S)gaotora of Qw r Print Name and P e F aul Owner's Aatlto rlDI'morlParlaerAtanuger Store orFwdo Cmmtyofa ward llmfuregoinginimmm5uumnkm)wlWpdbelbneamthis 46 INA dayur-a'G••Rl k 2Q 11 By 5 w p -2 y ;- fa r.AS 1 S %-rE o e, . r, t -+c Fur S P r t— r(" i i j y yra mix of autlmrity,..: a.S. alricer: vustr . wlrmley h, faro) (nwne ufputy on htilallfafwhom instrmnelti uas exel.:ut«I) Parsctnally known or` WvlwW Ula fulloNvrg L•7pe ol'Wmtt&=wiar' MY COMMISSION ft D090M ISig of Publicl E)GgRES dufy 15 2013 a foreguing wW that lbe racts in it un: true to the bemofmy krmwldp mrd beltef(Sadum (P -52S, Florida Statutes}. AS@aara ' iarOwncrts)arOwmr(WAadrorizedWad Db*cmrIVwmerhtlma%wwkasipedabam 11Y Sy ReL .05.09 -QP 10 f1Cn ELECTRIC CORP. ELECTRICAL CONTRACTOR - Industrial, Commercial, and Residential State Certified Electrical Contractors - Electrical Design -Build - Fire Alarm Work and Monitoring Taking Care of Business since 1986 - Bucket Truck Service June 20, 2013 Miami Shores Village 10050 Northeast 2nd Avenue Miami Shores, Florida 33138 Re: Permit Cancellation Request Permit #: ELC12-2435 Address: 1005$..,N£ ZAve Cao;— Miami o; -Miami Shores, Florida Dear Sr. or Madam: This letter is to let you know that our company never performed any work under the above reference permit. Since our work does not exist, we request to cancel or void these permits to prevent any problems in the future. If you have any question please do not hesitate in contact me. Sincerely,___--__ Gonzalo Planas President G & R Electric Corp. EC # 13002165 STATE OF: FLORIDA COUNTY OF: MIAMI DADE SWORN TO AND SUBSCRIBED BEFORE ME THIS' Florida Licensed Electrical Contractors: EC13002165, Ec13003998 4450 East 10th Court, Hialeah Florida, 33013 V� Listed Office: (305) 558-0217 * Fax: (305) 688-5025 141 � www.grelectriecorp.com 11"1 ,-,iuh L HERNANW MY COMMISSION # EE D472M EXPIRES: April 7, 2016 BmtedftBu*N*sySW= Florida Licensed Electrical Contractors: EC13002165, Ec13003998 4450 East 10th Court, Hialeah Florida, 33013 V� Listed Office: (305) 558-0217 * Fax: (305) 688-5025 141 � www.grelectriecorp.com 11"1 p f ELECTRIC CORP. ELECTRICAL CONTRACTOR •Industrial, Commercial, and Residential " State Certified Electrical Contractors • Electrical Design Build • Fire Alarm Work and Monitoring 7aFUng Care of Business since 1986 • Bucket Truck Service June 20, 2013 Miami Shores Village 10050 Northeast 2nd Avenue Miami Shores, Florida 33138 Re: Permit Cancellation Request Permit #: ELC12-33138 Address: 10050 NE 2 Ave Miami Shores, Florida Dear Sr. or Madam: This letter is to let you know that our company never performed any work under the above reference permit Since our work does not exist, we request to cancel or void these permits to prevent any problems in the future. If you have any question please do not hesitate in contact me. Sincerely, Gonzalo Planas President G & R Electric Corp. EC # 13002165 STATE OF: FLORIDA COUNTY OF: MIAMI DADE SWORN TO AND SUBSCRIBED BEFORE ME THIS � DAY OF .?��13. MAR#A E HERNAt1DEZ * * W C0LUSSION l EE 047206 I Q EXPIRES: April 7, 2015 r°rFOF�"10 OondadThruBudg�Ns�ysary s _— Print, Type or Stamp Name of Notary J l Florida Licensed Electrical Contractors: EC13002165, Ec13003998 4450 East 10th Court, Hialeah Florida, 33013 U� Listed Office: (305) 558-0217 * Fax: (305) 688-5025 101 www.grelectriccorp.com HF%K 4-KELECTRIC CORP. ELECTRICAL CONTRACTOR 4450 East 10th Court, Hialeah Florida, 33013 U$A 3. @Uod !!!!!!i!!�llJ!!Jlt�!!!►��1[J�J JJlIJ /J�tt�!!�l�JI��lJr!!lIIJIJ�!! r Miami ami Shores Village Building Department DEC 2 2012 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 7624949 BUILDING Permit No. PERMIT APPLICATION Master Permit No. 12.7 rBC 20 Permit Typ Eiectrieai OWNER: Name (Fee Simple Titleholder): a t<. ?0-E5y'tf-L1Ani cot KR itl e • Phone#: Address: 661 91L O[OL 5T. City: R "km% 5ROLF-S State: �Lzip. TenandLessee Name: spr w Phone#: Ir Email: [0. " d (OY 5171u JOB ADDRESS: (ph Z 0.)eL1 b `�" ST City: Maud Shores County Miami Dade 3 3 13 Folio/Pmei#: it 32-019 01LA HtD Is We Bmlding Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: e 12 Address: ity: — '°�1� '' State• zip: Z2 rD -3 Qualifier Name:/�%� a� Phone#: 5� State Certification or Registration # ®,3 Certificate of Co/mpetency #: Contact Phone#: Email Addiessk�i ?122= 6106,ISa�7`tea DESIGNER: Architect/Engineer. AL -1-f iLD L01J9U1»11NC, 0"UP 9c,- Phone#:1-tto $MOAT& Value of Work for this Permit: $ '�_ CW Square/Linear Footage of Work: Type of Work: DAddress Iteration l3New OltepaidReplace a ODemolition Description of Work: & Submittal Fee $ Permit Fee $ %��✓ CCF $ COICC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ TMIDing/Education Fee $ Tedmology Fee $ Doable Fee $ Structnral Review $ TOTAL FEE NOW DUE $•S 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 alt 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 ATFIDAVI'T: 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 COM AENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR 119PROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicata: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicata must promise in good faith that a copy of the notice of commencement and construction lien hav brocuhre will be delivered to the person whose property is subject to attachment Also, a certified copy of the recorded notice of comunencement must be posted at the job site for the first inspection which occurs seven (7) days gjter the building permit is issued In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Siputure Signature__ Owner or Agent The fimlTow .instrument was acknowledged before me this, n� day of 2OL,by �etvrJ 12. -mc t.ei4 o is personally knownto—m—e-4 who has produced As identification and who did take an oath. NOTARY PUBLIC: Contractor The foregoing instrument was acknowledged before me this ,,"7 day of 20D ®, bya'� 2 i jtl �is personally known to me or who has produced as identification and who did take an oath. Sign: Print: ale /Via'- 2 �� My Commission Expires -NOTARY PUBLIC -STATE OF FLORIDA """''. Sylvia Halter Commission # EE098OS3 NZ,e' Expires: JUNE 08, 201S Structural Review (Revised 07/10107KRevised ffinQa{lo9}(Revised 3t15109) NOTARY My Commission Expires: ao< :.";aioMAAJA E. HERWAp M * * MY COMMISSION # EE 047206 EXPIRES: April 7, 2015 Inning Clerk