The URL can be used to link to this page

EL-11-1432Miami 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 'n OWNER: Nare (Fee Simple Titleholder): N i City: ffzA -L State: Tenant/Lessee Name: Email: At Permit No RECEIVEI3 AUG 0 82`011 BY: Master Permit No. A)"w— 3S/3 -A JOB ADDRESS: 17 lti? W too -t�. zL n (fir®2�.e � Z��/J'7� City: Miami Shores County: Miami Dade Zip: 31!5m Folio/Parcel#: //— 110 1 n �,� •- 217 15 Is the Building Historically Designated: Yes CONTRACTOR: Company Name: City: Qualifier Name: NO Flood Zone: State Certification or Registration #: �-• %�pJ� /h' -Certificate of Competency #: Contact Phone#:�A`G�./��?1174 Email Address: Phone#: 5M3 7A:� -� — �ZI q, DESIGNER: Architect/Engineer: Value of Work for this Permit: $ 5 -?-AC) 0-n3 Square/Linear Footage of Work: Type of Work: ❑Address Description of Work: Aepair/Replace ODemolition 'ooll'�� Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Notary $ Radon Fee $ Training/Education Fee $ DBPR $ Bond 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 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 a reinspection fee will be charged. Sign Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this /�� The (foregoing instrumen was ackno�edged before me this/ day of / 20 / / by Fr, �" ,�� ,-c--, ,I 41,�Ot �`y of /.- CoV , 20 �, by -� t� i �^ 0 who is perso�nown to me or who has produced t = who is pers ally known to me or who has produced As identification and who did take an oath. i . as identification and who did take an oath. NOTARY PUBLIC: Sign: " Print: / NOTARY PUBLIC-STArL U1111LUX UA My Commission Expires: •°°"'r�,, Fritzous 'Commission #DD867682 APR -23,2013 BONDIM THRU ATLANTIC BONDING CO., INC. APPROVED BY (Revised 07f10107)(Revised 0611012009)(Revised 3115109) Plans Examiner Structural Review NOTARY PUBLIC: Sign: Print: NOTARY P't UC -STATE OF FtARi1?A My Commission Exp rc°3"� Fritz Stljous Commission #DD867682 `'�, ,,r` EXPiM: APR. 23, 2013 BONDED THRVATLANTIC�D1 1 Zoning Clerk ADD SMOKE/CARBON MONOXIDE DET" AUG 0 8 2011 ANY AND ALL CLOTH AND RUBBER INSULATED CONDUCTORS TO BE REPLACED. "SIDENTIAL RISER NEW 2" EMT WITH BRANCH CIRCUIT DERATED ACCORDINGLY QUI -M32 � Miami Shores i ag APPROVED BY DATE TONING DEPT 6- 50 BLDG DEPT 5 8 `SUBJECT TO COMPUANCE MTN ALL FEDERAL STATE AND COUNTY R D T NEL 4 AS JB SCRIPTION 1 6 SU RANGE 3 6- 50 RANGE 5 8 30 W/H 7 8 30 W/H 9 10 20 REFRIGERATOR I1 10 20 WASHER 13 12 15 GEN. LIGHTING 15UOSQ' 3 VA LAUNDRY SMALL APPL RANGE W/H REFRIGERATOR DRYER TOTAL LOAD REMAINDER AT 40°/a-100)OVA 2" RIGID CONDUIT WITH 3 # 2/0 THWN NEW, 200 AMP METER COMBO, 120/240, 40CKT 1#4 THWN CONNCECTED TO. 2-GALV �— GROUND RODS 10' LONG CONNECT TO WATER PIPE SCHEDULE DESCRIPTION TRAP WIRE CKT A/C 60 6 2 A/C DRYER) 8 DRYER ) 8 SMALL ADPL. l()I SMALL ADPL. 1 U ! GEN.LIGHTI up, =45(N)VA =1500VA =30(X)VA -12(X)OVA =4500VA 1200VA -5000VA -31,700VA 10 10.000 VA AT 100% -18,6800VA + HEAT AT 65% -25180UVA/240 VOLTS =104.91 AMPS. _ .2 a/-, ,(,j' Sion #DD867682 r> i rP . 23, 2013 r t„r BMW C BONDING M INC. Aug. 8. 2011 12:OOPM NO. 1416 P. 1/1 racoMn" CERTIFICATE OF LIABILITY INSURANCE �--� DATE /20 1 1Y) 08/08/2011 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 SOUTHWESTERN INSURANCE SERVICES, INC 4375 PALM AVE HIALEAH, FL 33012 CONTACT NAME: PHONE 305-556-7399 AIC No: EL MAI ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC t INSURERA : GRANADA INSURANCE CO MED EXP (Any one person) $ 1,000 INSURED ALL PHASE ELECTRIC CORP 11899 NW 91 AVE BAY E INSURERB: CASTLE POINT INSURANCE CO INSURERC: GRANADA INSURANCE CO INSURER D : INSURERE: HIALEAH GARDENS FL 33018 TOODED INSURER F: 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, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BYPAID CLAIMS. TRW A TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FREOCCUR wqP vivn POLICY NUMBERPOLICYIYYFF 01/19/11 POLICY CYYI tYYEYPIMMI 01/19/12 LIMITS EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENT PREMISES Ea occurrence $_ 50,000 MED EXP (Any one person) $ 1,000 PERSONAL & ADV INJURY $ 1,000,000 TOODED GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC AUroMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS AUTOS NON-O�ED C 0110FL 0003913 02/19/11 02/19/1 PRODUCTS - COMP/OP AGG $ 1,000,000 $ Ee aBINED SINGLE LIMIT $ 25,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ WORKERS EMPLOY RS' LI A ILII ANDEMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/F�CUTIVE YIN OFFICER/MEMBER EXCLUDED? El (Mandatory NH) If describb yes, e under DESCRIPTION OF OPERATIONS below B N I A WCP760234401 02/11 /11 02/11 /12 $ C STATU OTH- X Two RY LIMITS ER E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE- EA EMPLOYE $ _ 100,000 E.L. DISEASE - POLICY LIMIT 1 $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) CC92TICIr1ATC Lint MOM MIAMI SHORES VILLAGE BUILDING DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 3057568972 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 Ov 1988-2010 ACORD CORPORATION All rink+c rnenrvn'1 AGUKU Z5 (ZU1U/U5) The ACORD name and logo are registered marks of ACORD ACC? L> CERTIFICATE OF LIABILITY INSURANCE �..-� DATE 812 0 1 1Y, os/os�2o11 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 poiicy(ies) 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 CONTACT NAME: A/C No Ext): - -FAX,rNo): SOUTHWESTERN INSURANCE SERVICES, INC E-MAIL ADDRESS: 4375 PALM AVE INSURER(S) AFFORDING COVERAGE NAIC N HIALEAH, FL 33012 INSURERA: GRANADA INSURANCE CO MED EXP (Any one person) $ 1,000 INSURED ALL PHASE ELECTRIC CORP 11899 NW 91 AVE BAY E INSURER I: CASTLE POINT INSURANCE CO INSURER CGRANADA INSURANCE CO INSURER D: INSURER E HIALEAH GARDENS FL 33018 C AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS 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 A L SUBR POLICY NUMBER POLICY EFF MMIDDIYYY POLICY EXP MMIDD/YYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FKOCCUR 01/19111 01/19/12 EACH OCCURRENCE $ 1,000,000 PREMISE111ASa occurrenceIEITI $ 50,000 MED EXP (Any one person) $ 1,000 PERSONAL & ADV INJURY $ 1,000,000 500 DED GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- LOC JECT PRODUCTS - COMP/OP AGG $ 1,000,000 $ C AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS 0110FL00003913 02/19/11 02/19/12 COMBINED SINGLE LIMIT 25,000 Ea accident $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? [7N (Mandatory In NH) Ifes describe under DESCRIPTION OF OPERATIONS below I A WCP760234401 02/11/11 02/11/12WCSTATU- OTH- X TORY LIMITS ER E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE- EA EMPLOYEE $ 100,000 EL DISEASE- POLICY LIMIT $... 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION MIAMI SHO RES VILLAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE BUILDING DEPT THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2ND AVE MIAMI SHORES, FL 33138 3057568972 AUTHORIZED REPRESENTATIVE CD, a��-> .- ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD AC# Ut STATE .OF° FLORIDA 1 XPAR'tV g 8 l'sWSs P ti1F sa 41 A% REt �iLA 30IJ MIAMI-DADE COUNTY 2010 - LOCAL BUSINESS TAX RECEIPT 2011 - FIRST-CLASS TAX COLLECTOR MIAMI-DADE COUNTY - STATE OF FLORIDA U.S. PQSTAGE t 140 W. FLAGLER ST. EXPIRES SEPT. 30, 2011 PAID 1St FLOOR MUST BE DISPLAYED AT PLACE OF BUSINESS MIAMI, FL MIAMI, FL 33130 PURSUANT TO COUNTY GODE:CHAPTER 8A - ART. 9 & 10 PERMIT NO. 231 THIS IS NOT A BILL - DO NOT PAY 057351-0 RENEWAL BUSINESS NAME / LOCATION RECEIPT NO. 057351-0 ALL PHASE ELECTRIC CORP SPATE# EC13003152 ' 11899 NW 91 AVE BAY - 33018 HIALEAH GARDENS , OWNER ALL PHASE ELECTRIC CORP Sec. Type of Business WORKER/S 196 SPEC ELECTRICAL CONTRACTOR` 10 HIS IS ONLY A LOCAL USINESS TAX RECEIPT. IT DES NOT PERMIT THE OLDER TO VIOLATE ANY XISTING REGULATORY OR ONING LAWS OF THE DO NOT FORWARD OVNTY OR CITIES. NOR DES IT EXEMPT THE OLDER FROM ANY OTHER ERMIT OR LICENSE OTTI'A CERTIFICATION o ALL PHASE ELECTRIC CORP HE HOLDERSDuauFlca-PEDRO LOPEZ PRES IONS. IO 11899 NW 91 AVE BAY -E AYMENT RECEIVED HIALEAH GARDENS FL 33018 UAMI-OADE COUNTY TAX OLLECTOR: ' 09/21/2010 02210004001 �• 000045.00 7#F 1111#111 111#111 liltI11)11#j] 1111#ij i3�3f# SEE OTHER SIDE -TATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS COMPENSATION .„ CONSTRUCTION INDUSTRY ';'TIr KATE OF ELECTION TO BE EXEMPT FROM FLORIDA J �f 4v,)RKERS' COMPENSATION LAW EFFECTIVE: 10/29/20.10 EXPIRATION DATE: 10/28/20 12 PERSON: PEDRO L LOPEZ DEIN: 591695047 BUSINESS NAME AND ADDRESS: ALL PHASE ELECTRIC CORP "801 SW 58TH AVE MIAMI, FL 33155 i-... FICOPE OF BUSINESS OR TRADE: , ELECTRICAL CONTRACTOR f>•