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EL-14-1212 , 60, Miami Shores Village Building Department artment FEB D9 2015 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-0949 U AV FBC 20 M AVIS10 lag BUILDINGREster Permit No. ►Zt. 4 — Cl . PERMIT Al Sub Permit No. ' - ❑BUILDING C24LECTRIC ❑ ROOFING 'REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL F-1 PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: (�3�') N �' ' 7 S� E City: Miami Shores County: Miami Dade Zip: folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): �l'1 l�.11 't' S�� Phone#: Address: �iC� 'r`i Vi City: State: T Zip: Tenant/Lessee Name: Phone#: Email: `' ItsAk-t CO ? �Q�•N 5 �1 I I CONTRACTOR:Company Name: CLI, t I�ICY �Q cirk' E�JICcC/3 Phone#: �'� 7I Address: City: o,'- Com- Tv,acj _State: ] Zip: p Qualifier Name: J �'rC l C4 Phone#: /C 6`'77 State Certification or Registration#: t::,-2 /�l)r 2 Certificate of Competency#: 124570001 DESIGNER:Architect/Engineer: C:j4(2;, Phone#: Address: / City: State: Zip: Value of Work for this Permit:$_� Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: C TtZI CA, '�C,�s� . (vCLf N)oe ce C) Itz) y N Specify color of color thru tile: Submittal Fee$ Permit Fee$ �_A rp® CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ \ (Revised02/24/2014) 1z C /L/- Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 inspection Number: INSP-241198 Permit Number: EL-6-14-1212 Inspection Date: August 12, 2015 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: KURLANDSKI, GUY&SELIN Work Classification: Alteration Job Address:9301 N BAYSHORE Drive Miami Shores, FL Phone Number Parcel Number 1132050270560 Project: <NONE> Contractor: UNITED ELECTRICAL SERVICES INC Phone: (786)797-2188 Building Department Comments ELECTRICAL OUTLETS AND FIXTURES AS PER PLANS Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction -� Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. For Inspections please call: (305)762-4949 August 11, 2015 Page 1 of 1 r Bonding Company's Name(if applicable) Bonding Company's Address – City State Zip 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 ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES,BOILERS,HEATERS,TANKS,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. Signature Signature _ A i�—� NER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this _o day of Ji 10eUQ&k 120 15 by day of 20 by eLq �'O Ki ho is personally known to I��'0C1- �iplf-Ci R who is(/personally known to L as me or who has produced r`�1 ! (1 as me or who has produced F Q L - identification and who did take an oath. identification and who did take`�+�\oat o0M�ggj�N� NOTARY PUBLIC: NOTARY PUBLIC: O�akch 3,2o�* •hr,.- j,, * • � Lam✓ #♦ '7k CAROLINA MIA CARRION = • . _ Sign: =2' '. = Notary Public-State of Florida Sign: p #EE 878322 :Q • P. - mm. FF 033389 / 9•'% °�dedthN Print: p mmi Print: AOd4- �° i�9`'•.yPU ae�.• O ��. Seal: Seal: // \ ��iii BIIC, STASE ��/Hf 1I11111�1�� #iRiRR#RRRRRtit##iRit#itRt#RiRt#t#tR#ttt#tRRRRtt##Rt#tt###RRtR#tR4RRtttR##t#RRRtttRRRRRtt##tiR##tt#RRttt#R#4 APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) �• Miami Shores Village Building Department ' JUN 10 2014 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY: Tel:(305)795.2204 Fax: (305)756.8972 --- INSPECTION'S PHONE NUMBER:(305)762.4949 FBC 2010 BUILDING Permit No. 49 6z--l o_/1�? PERMIT APPLICATION Master Permit No. Permit Type: Electrical? JOB ADDRESS: 1.301 oi S ex 10 ft City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: ((— ?j 205^ 4 2-j- 0616 O Is the Building Historically Designated:Yes NO ✓ Flood Zone: OWNER:Name(Fee Simple Titleholder): �q V yt-V" Phone#: 305 . 2 )4 .0b03 Address: 0%30 1 N Qp"S yrzi ; 1)rL . City: fel1"1 5MVLZS State: :PL Zip: 33 i 3b Tenant/Lessee Name: Phone#: Email: q V y �•U( I l S�E,I how Lori^ CONTRACTOR:Company Name: UNITED ELECTRICAL SERVICES INC Phone#: 786-797-2188 Address: 26453 SW 135 CT City: HOMESTEAD State: FL Zip: 33032 Qualifier Name: MAN UEL O GARCIA Phone#: 786-797-2188 State Certification or Registration#: ER 13014669 Certificate of Competency#: 13-CME-18404 R Contact Phone#: 786-797-2188 Email Address: unitedelectricalsery@gmail.com DESIGNER:Architect/Engineer: � Ctif'Z Phone#: ' 3 Value of Work for this Permit: $ To Square/Linear Footage of Work: Type of Work: ❑Address eAlteration ❑New ❑Repair/Replace ❑Demolition Description of Work: ` Q,� CA (NI L Submittal Fee$ Permit Fee$��/5t%� CCF$ 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 Zip 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 pr d and a reinspection fee will be charged. LSignature i Signature wner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of M.r 20 ,by _kVY j (JCc7k I day of HO&A 20 by K&ftlju 1 who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: �f Print: rlva I Print: —J My Commission Expires: = .►+�P ` CLAWIA BER14AL My o *1EXPt ES February 21,2017 g. ,? Notary Public-State of Florida 739s.oM .=m 's"r� •A� My Comm.Expires Nov 17,2017 Commission#FF 47927 APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) A`�! � DATE(MM/DDM'YY) Ilia. """" CERTIFICATE OF LIABILITY INSURANCE 04/08/14 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 CONTACT NAME: MARTA ALONSO Florida Bankers Insurance PHONE . (305)266-6493 In,No): (305)262-0679 7278 SW 8 Street EA DRESS, "MAIL marta@floridabankersinsurance.com Miami,FL 33144 INSURERS AFFORDING COVERAGE NAI;x Phone (305)266-6493 Fax (305)262-0679 INSURER A: FEDERATED NATIONAL INSURANCE CO. INSURED INSURER B: SOUTHERN INSURANCE CO United Electrical Services Inc INSURER C: 26453 SW 135 COURT INSURER D: HOMESTEAD,FL.33032 (305)262-6743 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. INS TYPE OF INSURANCE ADDL UBR POLICY EFF POLICY EXP LTR INSR WVO POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000.00 COMMERCIAL GENERAL LIABILITY PAMAGE TO TED REM SES(Ea occurrence) $ 100,000.00 ❑ ❑ CLAIMS-MADE R] OCCUR GL-0504008126-02 MED EXP(Any one person) $ 5,000.00 A N N 10/06/2013 10/06/2014 ❑ PERSONAL&ADV INJURY $ 1,000,000.00 ❑ GENERAL AGGREGATE $ 2,000,000.00 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000.00 d❑ POLICY ❑ PRO- JECT ❑ LOC $ AUTOMOBILE LIABILITY COMBINED LIMIT $ ❑ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident $ B ❑ AUTOS ❑ AUTOS ( ) HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ ❑ ❑ AUTOS Per accident ❑ ❑ $ ❑ UMBRELLA LIAB ❑OCCUR EACH OCCURRENCE $ ❑ EXCESS LIAB ❑CLAIMS-MADE AGGREGATE $ ❑ DED ❑ RETENTION$ $ WORKERS COMPENSATIONWC STATU- OR TH- AND EMPLOYERS'LIABILITY Y/N El ANY PROPRIETOR/PARTNER/EXECUTIVE PWC008467-13 E.L.EACH ACCIDENT $ 100,000.00 B OFFICER/MEMBEREXCLUDED? F—] N/A 11/19/2013 11/19/2014 (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 100,000.00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000.00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more apace Is required) ELECTRICAL CONTRACTORS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF MIAMI SHORES BUILDING DEPARTMENT THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 10050 NE 2 AVE ACCORDANCE WITH THE POLICY PROVISIONS. MIAMI SHORES,FL 33138 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05)OF The ACORD name and logo are registered marks of ACORD STATE OF FLORIDA AC# 6322630 Congratulations! With this license you become one of the nearly one million { DEPARTMENT OF BUSINESS AND Floridians licensed by the Department of Business and Professional Regulation. { PROFESSIONAL REGULATION Our professionals and businesses range from architects to yacht brokers,from boxers to barbeque restaurants,and they keep Florida's economy strong. I ER13 014 6 6 9, 08/3;G/12 120099072 Every day we work to improve the way we do business in order to serve you better.f For information about our services,please log onto www.myfloridalicense.com. REG ELECTRICAL CONTRACTOR There you can find more information about our divisions and the regulations that GARCIA, MANUEL O impact you,subscribe to department newsletters and learn more about the UNITED` ELECTRICAL SERVICES INC. Department's initiatives. (INDIVIDUAL MUST MEET ALL LOCAL LICENSING REQUIREMENTS PRIOR Our mission at the Department is:License Efficiently,Regulate Fairly.We i TO CONTRACTING 1N ANY AREA) constantly strive to serve you better so that you can serve your customers. HAS REGISTERED under the provisions of Ch.489 Thank you for doing business in Florida,and congratulations on your new license! i Expiration date: AUG 31, 2014 L12083003901 DETACH HERE I AC# 6 3 2 2 6 3 0 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION i ELECTRICAL CONTRACTORS LICENSING BOARD SEQ#L12083003901 D, LICENSE NBR j � 08/30L2017120099072 IER1301466.9 I The ELECTRICAL CONTRACTOR I Named below HAS REGISTERED Under the provisions of Chapter 4$9 FS. i Expiration date: AUG 31, 2014 i (INDIVIDUAL MUST MEET ALL LOCAL ,LICENSING i REQUIREMENTS PRIOR TO CONTRACTING IN ANY AREA) j GARCIA, MANUEL O UNITED ELECTRICAL SERVICES INC. 26453 SW 135TH COURT { HOMESTEAD FL 33032 iiI I iREN LAWSON RIC SNORSCOTT SECRETARY j DISPLAY AS REQUIRED BY LAW WWME JEFF ATWATER CHIEF FINANCIAL OFFICER STATE OF FLORIDA 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: 10/17/2013 EXPIRATION DATE: 10/17/2015 PERSON: GARCIA MANUEL FEIN: 452648508 BUSINESS NAME AND ADDRESS: UNITED ELECTRICAL SERVICI 26453 SW 135 COURT HOMESTEAD FL 33032 SCOPES OF BUSINESS OR TRADE: LICENSED ELECTRICAL CONTRACTOR Pursuant to Chapter 440.05(14),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 on 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. DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 07-12 QUESTIONS?(850)413-1609 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895—954-831-4000 VALID OCTOBER 1,2013 THROUGH SEPTEMBER 30,2014 DBA: Receipt#:181-253881 ELECTRICAL/ALARMS/CONTRA, TOR Business Name:UNITED ELECTRICAL SERVICES INC Business Type:(ELECTRICAL CONTRACTOR) Owner Name:MANUEL GARCIA Business Opened:02/20/2013 Business Location:26453 SW 135 CT State/County/Cert/Reg:ER13014669 MIAMI DADE COUNTY Exemption Code: Business Phone:786-797-2188 Rooms Seats Employees Machines Professionals 1 For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 0.00 0.00 0.00 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non-regulatory in nature. You must meet all County and/or Municipality planning WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location.This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. Mailing Address: UNITED ELECTRICAL SERVICES INC Receipt #04A-12-00012765 26453 SW 135 CT Paid 07/26/2013 27.00 HOMESTEAD, FL 33032 2013 - 2014 l CTQB r Construction Trades Qualifying Board -e BUSINESS CERTIFICATE OF COMPETENCY 12E000192 UNITED ELECTRICAL SERVICES INC —D.B.A.: CA CIA MANUEL O is certified under the provisions of Chapter 00 of Miami-Dade County CERTIFICATE OF COMPETENCY MANUEL G ARCIA MASTER ELECTRICIAN ` UNITED ELECTRICAL SERVICES, INC. CC# 13-CME-18404-R Ref. 28213415 Expires 8/31/14 Ctrl#14-22709