EL-14-1729 (2) Miami Shores Village r
t �
Building Department DEC 1 14
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:�756-897INSPECTION LINE PHONE NU -4949
FBC 20
BUILDING Master Permit No. tq 1 ZS
PERMIT APPLICATION Sub Permit NO.le� q-I__1 T9
❑BUILDING ELECTRIC ❑ ROOFING a REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 3(00 N E" 1 O3 SS1'►2XCX_
Miami Shores County: Miami Da de Zi : e�$
Folio/Parcel#: I i — 324(a 000 Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): V1'7 I L',44f_-U L Phone#:_'j 2S Z Gs
Address: '2•(60 WE, 103 S1q.£Jr -T_
City: rin I_e^I SLA® State:
Tenant/Lessee Name: N Phone#:
Email: "
CONTRACTOR:Company Name: t,( � V�) kl ecfA)Ca��(cPe-TnG Phone#: a (0 Q
Address: 1 8� I AXA) C7 01 cr
City: 41_ J?Q State FL Zip: �f�D 15
Qualifier Name: 040 Phone#• o?{D"��7_7
State Certification or Registration#: 3�0J� Certificate of Competency#:
DESIGNER:Architect/Engineer:1. U,ELLO 1ACk '1 1 M01A�L Phone#: '11. (0--1 02-03
Address: 9 11 Std IG St''2.CXx- city:7-CLA, 2�ra"Q State:T�_ Zlp:33q8t0
Value of Work for this Permit:$ 1-00 Square/Unear Footage of Work:
Type of Work: ❑ Addition ® Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: 0_M',- OF
Specify color of color thru tile:
Submittst Fee$ Permit Fee$ 9 i CCF$ CO/CC$
Scanning Fee$7 Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(ReviseW2/24/2014)
i
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$250 0, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site
for the first Inspection which occurs seven (7) days after the building permit is issued. in the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
I___day of Q—r_c ,hA .20----�•�by P I day of A'OYe"Q to ,20 by
Rlazzcd r, G�f w s e wn to t� D g g l� .who is personally known to
me or who has produced as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
az
Si Sign:
' Feliciano EXPIRES:April 8 2016
Tint: 75 Print: oa P '
Expires01/1212018
Seal: I:
APPROVED �Z�� �" Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
12110=4 ScerlIM34pg
�►clr�� CERTIFICATE OF LIABILITY INSURANCE Pt-,
9111312014
THIS CERTIFICATE IS ISSUED AS A MATTER OF iNPDRMATION ONLY AND CONFERS NO RtGHT8 UPON THE CERTIFICATE HOLDER TM
CERTIFICATE DOES NOT APPMMTIMY OR NEGATIVELY ANOMD,EXTEND OR ALTER THE COVERAGE AFFORIDED BY THE POLICIES
mLow THN3 CLRTif9CATE OP mumum DO1ES NOT CONSTITUTE A CONTRACT BTWEEN THE 03UNG INSURBR(S),AUTHMI D
REPRESENTATIVE OR PRODUCER,AND THE CERTEWATE HOLDER
W{PORTANR It Bre Certificate holder Is an ADWTIONAL MURED.the polao0s)MUSt be endorsed. B$<NW ATOM IS WAIVED,SUbj0ct is
themats and candWorm of the policy.cambdu pOBctes may nwpdre an ergiotsemest.A stetedlerlt on lids cute does not oonbr d"to the
cert hotter In Neu of emb j
P ESTHER VIDAL
MUTUAL INTEREST ASSURANCE X305 820ai r -> O-01107
1295 CORAL WAY MUTUi1l.�COR9
SUITE 3 I AFFOROMCOVERAIM - Naha
MU>t11d1,FL 33145 e091GRw:ASCENDANT UNDERWRITERS
ot>at P a:CASTLEPOINT FLORIDA INSURANCE CO. _
M.V.ELECTRICAL SERVICES,INC Rimae: _
18311 NW 132ND COURT INSUREN O:
MIAMI,FL 33015 E:
F:
COVERAOEB C@RTIFlCATE NU83BER: REVWH NLgM3E R:
THIS IS TO CERTIFY THAT THE POLICIES OF BiBJRAA IllE LISTED BELOW HAVE BEEN ISSUED TO TIE INqJRtp NAWA8MX FOR THE POLY PEt80D
INDICATED. NOTWITHSTAN GING ANY CEMENT,TERM Oil CONDITI?PI OF ANY CONTRACT OR OTHER O MT VM RESPECT TO Yobi�Fl Tt95
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE VMRANIE AFFORDED BY THE POLICIES DESCRIBED HEFSH 18&"CT TO ALL THE TEEM
EXCLUSIONS AND comonmms OF SUCH POLICIES.LINTS SHOWN MAY HAVE BEEN REDUM BY PAS CLAM.
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oErueRAL AOrREaA:E a_ 1.000.00
EEa LAt OReGATE LAUr APPLES ver+ PRODUCTS•COrIPIOPAM s 9.Otl0,000
. _POLICY .LOC .8 _.
AW AUTO •SODLY NAM 1Per Petwnl d _.
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DWPROP>tQ70R4�A�Q MIA EL EaCMACC�T :s 100.000
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a aeaama~ E t OWASE•EA EMPLOYEE s 500.00
OOPERAT10 OS. E L OMEAW-POLICY Laur S 10000
QSSCWPRON OF OPGRAI-I LOCAIMMI VEM Alt sM ACCRDI .AdOW"RamamsSdm*o.Ummaaynm hrsmkam
ELECTRICAL WORK
CERTIFICATE HOLDER CAN<ELLATM
SHOULD ANY OPTHE ABOVE 6ESCRUIED POLICM BE CANCELLED BEFCIRE
THE E04RATUM DATE Ttr6RBOF, NOTICE MALI. BE CEINEIM IN
MIAMI SHORES VILLAGE ACCORDANCE WfTH THE POLICY PROVISMIMS.
10050 NE 2ND AVE
MIAMI SHORES VILLAGE,FL 33138 AUTHORIZED
0 j"8-2018 ACORD CORPORA N.All Rghis reserved.
ACORD 25(2010108) The ACORD nerlo and loon are reablered nmrlrs of ACORD
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BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT
115 S.Andrews Ave.,Rm.A-1 00,Ft, Lauderdale,FL 33301-1895—954-831-4000
VALID OCTOBER 1,2014 THROUGH SEPTEMBER 30,2015
DBA'MV ELECTRICAL SERVICES INC Receipt#:��I7AL5
ELECTRICAL/ALARMS/CONTRACTOR
Business Name: Business Type:
Owner Name:MARIO A VALDES Business Operred:09/21/2009
Business Location:18311 NW 82 CT StateJCpuMy//CerFJR":EC13005608
MIAMI DADE COUNTY Exemption Code:
Business Phone:
Rooms Seats Employees tiAschMes Pr�sslonals
1
ForVendhV Onkme 0*
Number of Machirres: vendsT
Tsx AmotsO TmnsW Fee NSF Fee Penally Primo Yews Comic lim Cost Total Paid
z7.00 0.00 0.00L- 0.00 0.00 1 0.00 a7.00
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 witltin Broward County and is
non-regula>3ory in nature.You must meet au County and/or Municipality planning
WHEN VALIDATED and zoning requirements.This BuW Tax Receipt must be transferred when
the business is sold, business name has changed or you have moved the
business location.This recelpt does not Indicate that the business is legal or that
it is in compliance with State or local laws and regulations.
Mailing Address:
MARIO A VALDES Receipt ti1CP-13-00017184
18311 NW 82 CT Paid 09/10/2014 27.00
MIAMI, FL 33015
2014 - 2015
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