Loading...
EL-14-578 Miami Shores Village Building Department artment 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795.2204 Fax: (305)756.8972 - - INSPECTION'S PHONE NUMBER: (305)762.4949 FBC 20 b BUILDING Permit No. :z PERMIT APPLICATION Master Permit Ne Permit T e.-.. E_ledikal JOB ADDRESS: �� City: Miami Shores County: Miami Dade Zip: 5 / Folio/Parcel#: y _ 3 2 U G ' U 3 - 0 5-6 o ` e Is the Building Historically Designated: Yes NO X Flood Zone: 'J OWNER:Name(Fee Simple Titleholder):_ U �� 1� tL A Phone#: Address: , /\-( t 12 (71 City: State: ¢ Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: �'4j&dAX%Lge. Phone#: y- Address: City:, State: Qualifier N Phone#: State Certification or R gistration#: � /3 D OSyG Y Certificate of Competency#: Contact Phone#:l V ( f- �1 U 1r Email Address:#-, A446 (2 40,4. Cp fir., DESIGNER:Architect/Engineer: Phone#: Value of Work for this Permit:$ IID Q , Square/Linear Footage of Work: Type of Work: ❑AdripsAlteration ❑New ❑Repair/Replace ❑Demolition *. Work,,,,,Description-of Submittal Fee$ Permit Fee$_ CCF$ 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 PAYIN TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INT ND 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 excee4ling$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 commencemen r 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 Sigrsatur Owner or Agent Con ctor The foregoing instrument was acknowledged before me this� The foregoing instrument was ac owledged bpfore me this_ day of �r'! 2C�{,20 l , � by/`�� 11'1C , day of ,,LO 11,by Acid who is personally known to me or who has produced who is oiialll 1 to me or ho has produced As identification and wbo did,take an oaths as identificati nand who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: !2� Sign:c JUA Ale Print: / ���°� b.�L� . Print: 4. 99 My Co ssion Expires: =?� HEMBERTO PADILLA My Commissio VP 3 7// MYC0MM680N#EEIT �t�.�P ,, ELIZABETH A.FOX ` E MOft�.�0� ;•;� ` Notary Public-State of Flartila ;071�e+e ctsa ; _ My Comm.Expires Apr 20,2016 ���y •,4;,;t.��� Bonded Through National Notary Asso. APPROVED BYPlans Examiner Zoning Structural Review Clerk it (Revised 3/12/2012XRevised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) 4Q0998 Local Business Tax Receipt Miami—Dade CounttV,State of Florida —THIS IS NOT A BI DO NOT PAY 6818190 LB BUSINESS NAMEILOCATION RECEIPT NO. EXPIRE SS PENCE&HEATON ELECTRICAL CONTRACTING INC REERMA L SEPTEMBER 2014 DOING BUS IN DADE CO '70,8 162 MIAMI FL 33000 Must be displayed at place of business Pursuwd to County Code Chapter lIA-Art 9&io OWNER SEC.TYPE OF BUSINESS PENCE&HEATON ELEC CONTRCTNG INC 196 ELECTRICAL CONTRACTOR PAYMENT RECEIVED Worker(s) 2 11 EWO119 BY TAX COLLECTOR $93.75 01/15/2014 TXHS1-14--045676 ibis Local Business Talc Rers- amdn�Pd1�of the Local Business lax. The Recelpt Is not a I en a ewdfl:r of OIe baWe d to da Hofdw must co aply with nam bwa and requig"Wob which apply to the business. The M=PT NO.above must bedhqdayed as all commercial weWea- nde Code Sec Aa-178. We OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD (850) 487-1395 ��W 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 HEATON, PAUL S JR PENCE&HEATING ELECTRICAL CONTRACTING, INC. 5715 TAFT ST HOLLYWOOD FL 33021-4528 Congratulations! With this license you become one of the nearly - one million Floridians licensed by the Department of Business and STATE OF FLORIDA Professional Regulation. Our professionals and businesses range DEPARTMENT OF BUSINESS AND from architects to yacht brokers,from boxers to barbeque restaurants, PROF1GULATION and they keep Florida's economy strong. ; EC13005464 y �Q8/213 Every day we work to improve the way we do business in order to r Y. serve you better. For information about our services,please log onto I£ CERTIFIED E((.+1; T .CjOR www.myfloddalicense.com. There you can find more information �, } about our divisions and the regulations that impact you,subscribe HlATON,..PA ju.. to department newsletters and learn more about the Department's PENCE&HFJ1fICA1✓ C initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. ,_�� We constantly strive to serve you better so that you can serve your is c� T1FjE0 under the'prDvision&ot Cia:4BS S customers. Thank you for doing business in Florida, i = dais 9tUG s1 zw4 L1�Q4_ and congratulations on your new license! , it The Department of State is leading the commemoration of Florida's 500th anniversary in 2013. For more information, please go to www.VivaFlorida.org. MINA N500 DETACH HERE NATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION 0 '� ELECTRICAL CONTRACTORS LICENSING BOARD EC13OD5464 The ELECTRICAL'CONTRACTOR — • Named below IS CERTIFIED Under the provisions.of,Chapter 489 FS. Expiration elate: AUG 31,2014 P� y .. 1 !, "EATON, PA UL JR PENC1:914EATINf3 ELEC C 5715 TAFfT T �dGTG��'I y.. H01= _W ... FL,302146128 VIY1 Fl81161500_ . .,, � .�._ ._. .__'�'# a _:;....,__. .. •"`...�_..'.�;'�_ ',.�a�.__ ._�. ._. o�� .._��_ �_'� `S m�v _"a.��ry'4�t° .L.u._���{��_�� RICK SCOTT ISSUED: 08QW013 SEQ# L1308260OW204 KEN LAWSON GOVERNOR DISPLAY AS REQUIRED BY LAW SECRETARY Date CERTIFICATE OF LABILITY INSURANCE 1/6/2014 produmr Lion Insurance Company This CerSflcate Is Issued as a matter of Information only and confers no 2739 U.S. Highway 19 N. arita�coverage a pandasdoes not amend,eublrrtd Holiday, FL 34691 (727)938-5562 Insurers Affording Cove�ge NAIL# Insurer' Lion Insurance Company 11075 insured: South East Personnel Leasing, Inc. &Subsidiaries 2739 U.S. Highway 19 N. Insurer B. Insurer C: Holiday, FL 34691 Insurer D: Insurer I- Coverages %MPM-11r.of Iragence usfad celowtowto twinsured named Mov-91driher3N"MBMMMgaMmqWmnwtffnorcmaoncrfmy=Thdcrwwd=miem with respect to which We caltifieaW maybe issued or may pertain,the Insurance afforded by the policies described herein is subject to all the terms,exciusions,and conditions of such policies.Aggfegate limits shown may have been reduced by paid claims. ADDL Policy Effective Policy Expiration Limits !NSR LTR ADOLINSRType of Insurance Policy Number Date Date (MM/DD/YY) (MM/DD/YY) ENERAL LIABILITY Each OcccTence Commercial General Uabii'ity Damage to rented premises(EA Claims Made 0 Occur occurrence) Med Exp Personal Adv Injury neral aggregate limit applies per. General Aggregate Policy ❑Prasat ❑ LOC Products-ComplOpAgg UTOMOBILE LIABILITY Combined Single limit (EA Acciderd) Any Auto Bodily Injury All Owned Autos (Per Person) Scheduled Autos Badly Injury Hired Autos (Per Accident) Nan-Owned Autos Property Damage (Per Accident) EXCESSIUMBRELLA LIABILITY Each Occurrence pacer ❑Claims Made Aggregate Deductible A Workers Compensation and WC 71949 01/01/2014 01/01/2015 X wC Statu- OTH- Employers'Liability tDry Limns ER Any proprietor/partnedexec utive oRoedmember E.L.Each Accident $1,000.= • . excluded? No E.L.Disease-Ea Employee $1,000,000 If Yes,describe under special provisions below. E.L.Disease-Policy Limits $1,000,000 Other Lion Insurance Compny is A.M.Best Company ratted A- EXceltent. AMB#12616 Descriptions of Operations/LocationsfVehicleslExclusions added by EndonsementlSpeclai Provisions: Cliff M: 91-67-169 Coverage only applies to active employee(s)of South East Personnel Leasing,Inc&Subsidiaries that are leased to the following"Client Company": Pence And Heaton Electrical Contracting,Inc. Coverage only applies to injuries Incurred by South East Personnel Leasing,Inc&Subsidiaries active employee(s,,while worldng in:FL Coverage does not apply to statutory employees)or Independent oontractur(s)of the Client Company or any other entity. A list of the active employee(s)leased to the Client Company can be obtained by faxing a request to(727)937-2136 or by calling(727)938-5562. Project Name: ISSUE 10-09-13(MT)/Reissued 12/9/13(SH) SaWn Gate 313112013 CERTSCATE HOLDER CANCELLATION MIAMI SHORES VILLAGE Should any of the above described polides be cancelled before the expiration date thered,the Issuing Insurer will emfeavor to mail 30 days written notice to the certificate holder named to the telt,but failure to BUILDING DEPARTMENT do so"1 impure no obiigation or liabirdy of any Land upon the insurer,its agents or representafim. 1005 NE 2ND AVE MIAMI SHORES, FL 33138 �� i 115 S. Andrews Ave., Rm.A-100, Ft. Lauderdale, FL 33301-1895—954-8 THROUGH SEPTEMBER 30,2014 VALID OCTOBER 1,2013 000 i ' DBA: Business Name:PENCE & HEATON ELECTRIC CONTR Receipt#:181-19358 Business Type:ELECTRICAL/ALARMS/CO CTOR Owner Name:PAUL S (MASTER ELECTRICIAN) Business Location:5 715 T,�R HF TON Business Opened:07/16/1993 HOLLYWOOD State/County/CerrtfReg;EC13 0 0 54 64 Business Phone:983-3059 Exemption Code: Rooms ET0;0yq 4.b'i Machl i2 p�- 1 Professionals 51 Number of Machines. For Vending Hess o Tax Amount Transfer FeeVendl Type; NSF Fee Pena 54.00 0 ' 0 �Y Prior Years Collecflon Cost Total Paid 0}�0 0.00 54.00 i THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE THIS BECOMES A TAX RECEIPT OF BUSINESS ' This tax is levied for the privilege of doing business within Broward County and Is WHEN VALIDATED non-regulatory in nature. You must meet all County and/or ANunici al and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or o p 8Y planning business location.This receipt does you have moved the I that the b it is in compliance with State or local laws and regulations.usiness is legal or that Mailing Address; PAUL S JR HEATON 5715 TAFT STREET HOLLYWOOD, FL 33021 #02B-12-00001370 33021 Paid 09/06/2013 54.00 2013 - 2014 i Seo- 23. 2013 3:21PM Contractor Licensing No- 7260 P. 2/2 MIAMI—DMX Cott IMPART14M OF PSRMI'1'PING, ENVIRONMENT AND RBWLATORY AFFAIRS 118Q5 SN 26 ST. SUM 207 MIAMI, FX, 33175 (786) 315-2880 TRAPN9WW PBRSONAL CERTIFICATE OF COMPETENCY ISSUED LARCH 18, 2011 TBI$ XS TO CERTIFY THAT HEMS PAUL, S JR TRADESMAN NUMSERa 201-10-0272 0000-00000 TWOE: ELECTRICAL CERTIFICATE EXPIRATION DATE: 08/31/2014 HAVING MET THE CODE R=IRXMMTS OF MIAMI-VPD3 COUNTY, AS AMMMED, IS CERTIFIED AS A ST QUALIFIER IN THE FOLIi aNG CATZQORYeS) : 0001 ELECTRICAL THIS CERTIFICAT79 IS NOT VALID FOR CONTRACTING. ALTERATION, RNPRODUCTION OR TRANSFER OF THIS CERTIFICAT& IS PROHIBITED, CHARLES DAN C•i$R, P.B, SECRETARY, CONSTRUCTION TRAWB9 QUA,LIFYIN© BOARD HEATON PATA 8 o7R 5715 TAFT ST HOLLYWOOD Pli 33021 Sep- 23. 2013 3:21PM Contractor Licensing No. 7260 P. 1/2 MIAMI-DAVE COUNTY DEPARTMENT OF PERMITTING, ENVIRONMENT AM REGULATORY AFFAIRS 11805 SW 26TH ST. SUITE 207 MIAMI FL, 33175 (786) 3152880 STATE CONTRACTOR'S CHRTYFYCATE OF VOLUNTARY REGISTRATION WITH MIAMI-DARE COUNTY ISSUED SEPTEMBER 23, 2013 THIS IS TO CERT%FY THAT PENCE & HEATON ELECTRICAL CONTRACTING INC CONTRACTOR CERTIFICATE NO. : EC13005464 TRADE: EZ,ECTRICAL, REGISTRATION EXPIRATION DATE: 08/31/2014 HAVING MET THE REGISTRATION REQUIREMENTS OF MIAMI-DADS COUNTY, IS REGISTERED AS A STATE CONTRACTOR IN THE FOLLOWXNG CATEGORY(S) : 0001 ELECTRIdAL WITH ALL WORK TO BE DONE UNDER THE SUPBRVISXON, DXRBCTXON AND CONTROL OF QUALIFYING AGENT HEATON'PAUL S JR S.S.N. - -8552 ALTERATION, REPRODUCTION OR TRANSFER OF THIS CERTIFICATE IS PROHIBITED, CWMLES DANGER, P.E. SECRETARY, CONSTRUCTION TRADES QUALIFYING BOARD PENCE & HEATON RLECTRZCAL CONTRACTING 5715 TAFT ST HOLLYWOOD FX, 33021 I DURABLE POWER OF ATTORNEY State of Florida County of M i A rtii -_7i le KNOW ALL MEN BY THESE PRESENTS,that I, l�.gT2�C�A Hr�E 'of I ` 'SAM, (name) (county) Florida,as authorized by Florida law,do hereby appoint, i` -411-1-t 5 w '806+4611`15- (name) To manage and conduct my affairs. This power of attorney shall be non-delegable except as otherwise provided in Florida Statutes, and shall be valid and effective from date hereof until such time as I shall die or revoke the power. This durable power of attorney is not affected by subsequent incapacity of the principal except as provided in Florida Statutes. i The property subject to this durable power of attorney shall include all real and personal property owned by me, my I interest in al property held in joint tenancy, my interest in all non-homestead property held in tenancy by the entirety, and all property over which I hold power of appointment and shall also include authority to sell, mortgage or convey my homestead property. Without limiting the broad powers intended to be conferred by the preceding provisions, I expressly authorize my attorney ` acting hereunder in a fiduciary capacity to do and execute all or any of the following acts,deeds, and things for my benefit and on my behalf. 1. COLLECTION POWERS: To ask, demand, sue for, recover, collect, receive all sums of money, bank deposits, chattels and other real or personal property, tangible or intangible, of whatsoever nature or description that may be due, owing,payable or belonging to me,and to execute and deliver receipts,releases,cancellations or discharges. 2. PAYMENT POWERS: To settle any account or reckoning whatsoever wherein I now am or at any time hereafter shall be in any way interested or concerned with any person whomsoever,and to pay or receive the balance thereof as the case may require. 3. SAFE DEPOSIT BOXES: To enter any safe deposit or other place of safekeeping standing in my name with full authority to remove any and all the contents thereof and to make additions, substitutions and replacements, specifically including any safe deposit box in my name jointly with my spouse or any other person. 4. BANKING POWERS: (a) To borrow any sum or sums of money on such terms and with such security,whether real or personal property belonging to me, as my attorney may think fit, and to execute any and all notes, mortgages and other instruments which my attorney may deem necessary or desirable. (b) To draw, accept, make, endorse or otherwise deal with any checks, promissory notes, bills of exchange or other commercial or mercantile instruments, specifically including the right to make withdrawals from any savings account or building or loan deposits. (c) To redeem or cash in any/or all bonds issued by the United States Government or any of Its agencies, any other bonds and any certificates of deposit or other similar assets or securities belonging to me. (d) To sell all or any bonds, shares of stock, warrants, debentures, or other securities belonging to me, and to execute all assignments and other instruments necessary or proper for transferring the same to the purchaser or purchasers thereof,and to give good receipts and discharges for all monies payable in respect thereof. (e) To invest the proceeds of any redemptions or sales aforesaid, and any other of my monies, In such, bonds, shares of stock and other securities as my attorney shall think fit, and from time to time to vary the said investments or any of them. Page 1 of 3 I I 5. MANAGEMENT POWERS: To vote at all meetings of stockholders of any company or corporation,and otherwise to act as my attorney or proxy in respect of my shares of stock or other securities or investments which now or hereafter shall belong to me,and to appoint substitutes or proxies with respect to any such shares of stock. 6. TAX POWERS: To sign and execute in my behalf any tax return, state or federal relating to income,gift, ad valorem, intangible or other taxes, state or federal, and to act for me in any examinations, audits, hearings, conferences or litigation relating to any such taxes,including authority to file and prosecute refund claims,and to enter into an effect any settlements. 7. TRUST POWERS: (a) To execute a revocable or irrevocable trust which provides that all income and principal shall be paid to me or the guardian of my estate, or applied for my benefit in such manner as I or my attorney hereunder shall request or as the trustee shall determine,and that on my death any remaining assets,including income,shall pass according to my will or intestate succession if l have no will. (b) To make additions of funds and assets,real and personal,to any trust established by me. 8. BUSINESS INTERESTS: {{ (a) To sell,rent,lease for any term,or exchange,any real estate or interests therein,for such considerations and upon such terms and conditions as my attorney may see fit;specifically Including the power and authority to execute acknowledge and deliver deeds, mortgages, leases and other instruments conveying or encumbering title to property owned by me and my spouse jointly. (b) To commence, prosecute,discontinue or defend all actions or other legal proceedings touching my estate or any part thereof,or touching any matter in which I or my estate may be in any way concerned. (c) The powers herein conferred upon my attorney shall extend to and Include all of my right,title and interest in and to any real and personal property, tangible or intangible,in which I may have an estate by the entirety, joint tenancy,tenancy in common,as trustee or beneficiary of any trust,or in any other manner. 9. PERSONAL INTERESTS: (a) To make gifts, outright or in trust, in an amount not greater than $10,000.00 per donee per year or the amounts allowed without gift tax consequences under the appropriate Internal Revenue code provisions (including my attorney hereunder appointed). (b) To arrange for my entrance to and care at any hospital, nursing home, health center, convalescent home, retirement home or similar institution. (c) To renounce or disclaim any interest acquired by testate or Intestate succession or by Inter vivos transfer. 10. HEALTH CARE POWERS: (a) To authorize,arrange for,consent to,waive and terminate any and all medical and surgical procedures on my behalf(including any election or election and agreement under the Life-Prolonging Procedures Act of Florida with request to providing, withholding or withdrawing life-prolonging procedures should I fail to make a declaration hereunder)and to pay or arrange compensation for my care. (b) To make health care decisions for me and to provide informed consent if I am incapable of making health care decisions or providing informed consent. (i) To be the final authority to act for me and to make health care decisions for me in matters regarding my health care during any period in which I have the incapacity to consent. (ii) To expeditiously consult with appropriate health care providers to provide Informed consent In my best interest and make health care decisions for me which my said Surrogate believes I would have made under the circumstances if I were capable of making such decisions. (iii) To give any consent in writing using the appropriate consent form. (Iv) To have access to appropriate clinical records regarding me and have authority to authorize the release of information and clinical records to appropriate persons to insure the-continuity of my health care. i Page 2 of 3 i (v) To apply for public benefits, where necessary,such as Medicare and Medicaid, for me and have ° access to information regarding my income and assets to the extent required to make such application if necessary. (vi) To make all health care decisions on my behalf including but not limited to those set forth in F.S. Chapter 765. 11. GENERAL POWERS: (a) In general to do all other acts, deeds, matters and things whatsoever in or about my estate, property and j affairs,or to concur with persons jointly interested with me therein in doing all acts,deeds,matters and things herein particularly or generally described, as fully and effectually to all Intents and purposes as I could do myself. (b) This instrument is executed by me in the State of Florida but it is my intention that the powers and authority herein conferred upon my attorney as authorized by the laws of Florida now or hereafter in force and effect shall be exercisable in any other state or jurisdiction where I may have any property or assets. I hereby ratify and confirm,and promise at all times to ratify and confirm all and whatsoever my duly authorized attorney hereunder shall lawfully do or cause to be done by virtue of these presents, including anything which shall be done between the revocation of this instrument by my death or in any other manner and notice of such revocation reaching my attorney; and I hereby declare that as against me and all persons claiming under me everything which my said attorney shall do or cause to be done in pursuance hereof after such revocation as aforesaid shall be valid and effectual in favor of any persons claiming the benefit thereof who,before the doing thereof,shall not have had notice of such revocation. IN WITNESS WHEREOF,I have executed this Durable Power of Attorney. 6 " 8 k 0-0 13 0g, at o2613 Witness ign ure Date Signature Date I. vow (Jar, 13 -7-�,?U CA A 7�?Mclyfya 0/2 Witness Signature Date Print Name i Page 3 of 3