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EL-12-2221Miami Shores Village Building Department 10050 N.E.2nd Avenue, Nand Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION Permit Type: Electrical JOB ADDRESS: 1 -3S 1 ) �=- \ 0 \ City: Miami Shores County: Folio/Parcel#: 1 I - 2.O -0 0(30 NO 6 2012 FBC 20 Permit No.� t Master Permit No. Miami Dade Zip: 33L3 S Is the Building Historically Designated: Yes NO Flood Zone: L OWNER: Name (Fee Simple Titleholder): ®Y.S. 4Phone#: 01-5\-if-5-z9 qS5Z__ Address: A 1 1 "-6 'I 14. E, k 0\ City: KA \O W i L e 'v- ) State: t---- Zip: 13 3 Tenant/Lessee Name: Phone#: Finail• CONTRACTOR: Company Name: 0 V-A(.-- . C-" /lC- °-'e) ' "Phone#: (40- '33,- Ort>1. Address: Li S (1#1/4) ) 5 City: Qualifier Name: State Certificatio AAA f fate: -Al - Zip: , 1 LI T _____ bz 3 �C�'- tom'�� -� Phone#: ?� Co " 331- Sd 01 on or Registration #: 13 00 '4-1.-/ 1 Certificate of Competency #: Contact Phone#: Email Address: DESIGNER: Architect/Engineer: Phone#: $ Square/Linear Footage of Work: 'Y 0 I '1 . ONew 1 epair/Replace °Demolition V °45) -C te--OLV -P S E�vV Value of Work for this Permit: Type of Work: °Address Description of Work: °Alteration Chi * * * * * * * *** * *** * ***** * *** * ** *****a ***F * * *** ** ****** * * ** ** *** **s* * * ***x ** ****** Submittal Fee $ Permit Fee $ 44L0 Pte® CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ °' G 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 appro y a reinspection fee will be charged Signature The forego day of ent le ' instrument was acknowledged bef me this AR 20 121-by !S o ,_e2�''fT� who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: NOTARY PUBLIC-STATE OF FLORIDA °..' Zelda Andreu Commission # EE091055 'Exp. M4Y05,20 2015 BONDED ,•) LNG CO. , INC. Signature Contractor The forego' g instrument was acknowledged fore this day of 01/ , 20i Z by `�-d s f\A415)(tIA- who is personally known to me or who has produced tso^�___ as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: NOTARY PUBLIC-STATE OF FLORIDA My Commission Ex rest% Zeida Andreu 3 = „:a1, =Commission. # EE091055 I-. ,s Expires: MAY 05, 2015 an.a BONDED TRRC Al LrtXi 1 C F' "•�'D�'vG CO., II�TC. •A�i�******* *W ******* **** k+Y *�R+k******* ***R *** ***** ***** * * ******** ******* *f *"B*:* kR*!=�Ri∎iMi# *YnR #51:4to c.***** APPROVED BY �GL .2I04-1,f Plans Examiner Zoning Structural Review Clerk (Revised 3 /12/2012)(Revised 07 /10/07)(Revised 06d10/2009)(Revised 3/15/09) 5582 ht:W. Tth STREET SUITE 202 M1AM1, FLORIDA 33126 TELEPHONE: (306)264-2660 FAX: (305) 264 -0229 DRAWN BY: AL outt 'ururuars ,Jur. LAND SURVEYORS BOUN3ARy SURVEY SCALE _ "= 20' m! Shores VIII qe DATE SURVEY No. 12- 0000900 -1 SHEET No. 2 OF 2 2 2®12 ?.: l JBJECT ('O CCNIIPtir`NCE WI 1; I ALL FEDERAL 50.00' TOTAL R/W iA E ANu CD UN ( RULES AND RECWr�Cr;'; 0 o BLOcIt • T CO F.I.P 112" NO CAP N 89'50'$4" E 5' W.F. 112.59' F.LP 1/2° NO CAP 25.0(4' 0.60' 23.00' 20.75' ONE STORY RES. # 1351 LOT. 3 20.70' 20.10' F.t.P. 13 80' ' 16.40' 0.80' F.I.P 112" NO CAP N.E. 19' AgPHALT PVMT, SURVEYORS NOTE: 109th R=698.66' L= 87.31' Ten=43.71' 11=7°0937' CH=87.26' CHB=S87°14'14 "W STREET REET A) Asphalt Drive Encroaching onto Rlght-of- -way on the South side of Property. 8) Utility pole Encroaching onto Subject Property on the North side. SURVEYOR'S .NOTE: - Then maybe Easements recorded in the Public Records not shown on this Survey. - The purpose of this Survey is for use in obtaining Title Insurance and Financing and should not be used for Construction purposes. 1 w LOAD CALCULATIONS 1351 NE 101 st. Miami Shores 2660 s.f. x 3 VA 7980 VA Small Appliance 2x 1500 3000 VA Laundry 1x 1500 1500 VA Range 14 Kw 14000 VA Oven 5 Kw 5000 VA Water Heater 5Kw 5000 VA Dryer 4Kw 4000 VA Dishwasher 2 Kw 2000 VA 1/3 hp Disposal 7.2 A x 120V 864 VA Sprinklers Pump 2880 VA 1/2 hp Jacuzzi 9.8 x 120V 1176 VA 1/2 hp compactor 9.8 x 120V 1176 VA Future Pool Heater 8800 VA Future Pool Pump 2880 VA Future Spa Pump 2880 VA Future Pool Blower 1200 VA Future Pool Lights 450 VA A/C unit 1- 240V x 4.5 Kv 4500 VA 69,286 VA A/C unit 2- 5hp 28A x 240V= 6720 VA (smaller) First 10000 VA @ 100% 10000 VA Remaining 59286 VA @ 40% 23714 VA 10 Kw Heat 10000 VA 43714 VA / 240V = 182 A Table 310.15 b 6 200A - 2/0 Copper Table 250.66 #4 Copper Grounding 5582 H.W. Tth STREET SUITE 282 MIAMI, FLORIDA 33126 HQN (305) 264.2660 FAX: (305) 254.0229 Arrant 'urut jurz ,Jrtr. LAND SURVEYORS SURVEY No. 12-0000900 -1 BOUNDARY SURVEY SCALE— =1" = 20' #: Miami Shores Village ED DEPr DEPT NC V 6 201Z tti 'CT O CCNIPI i, NCE WTTH ALL FEDERAL 0 0 " 4.Niu L'r UN f MLLES AND REGJEMICINS '4 m FJP 1 2 NO CAP N 89'5034° E S W.F. 112.59' F.I.P 1/2* NO CAP 26. 23.25' ONE STORY RES. # 1351 LOT -3 BLOCK -2 0.80' CL. Fi,P1 ASPHALT DRIVE N.E. 9139th STREET R=25.00' L9.69' Tan=25.43' 6=90°58'09" CH.65' CH13=N461939'E SURVEYOR'S NOTE: R=698.66' 1.=87.31' Ten=43.71' A =7°09'37" CH=87.26' CHB=S87°1414 °W AJ Asphalt DriveRncroachIng onto Right- of-way on the South side of Property. 8) Utility pate Encroaching onto Subject Property on the North side S{ RFF.IORSNOTE: • Them may he Easements recorded in the Public Records not Ahumt on this Sure . The t?urin.te of this Survvr is fur ti* in olin ining Title Insurance and Financing and should not ha used for Construction LOAD CALCULATIONS 1351 NE 101 st. Miami Shores 2660 s.f. x 3 VA 7980 VA Small Appliance 2x 1500 3000 VA Laundry 1x 1500 1500 VA Range 14 Kw 14000 VA Oven 5 Kw 5000 VA Water Heater 5Kw 5000 VA Dryer 4Kw 4000 VA Dishwasher 2 Kw 2000 VA 1/3 hp Disposal 7.2 A x 120V 864 VA Sprinklers Pump 2880 VA 1/2 hp Jacuzzi 9.8 x 120V 1176 VA 1/2 hp compactor 9.8 x 120V 1176 VA Future Pool Heater 8800 VA Future Pool Pump 2880 VA Future Spa Pump 2880 VA Future Pool Blower 1200 VA Future Pool Lights 450 VA A/C unit 1- 240V x 4.5 Kv 4500 VA 69,286 VA A/C unit 2- 5hp 28A x 240V= 6720 VA (smaller) First 10000 VA @ 100% 10000 VA Remaining 59286 VA @ 40% 23714 VA 10 Kw Heat 10000 VA 43714 VA / 240V = 182 A Table 310.15 b 6 200A - 2/0 Copper Table 250.66 #4 Copper Grounding C 7C * 7C 7C 7C 7C 7C 7C 7C 7C 7C 7C 7C 7C 7C 7C 7C 7C MIAMI -DADE COUNTY TAX COLLECTOR 140 W. Flagler Street Miami, Florida 33130 Please keep your receipt for future reference. Thank you and have a nir' 10/26/2012 1300/224/001JAZ .ast Seq. #:0001 WI LBT #: .ocal Business Tax CK CHANGE IIAMI -DADE COUNTY TAX COLL .00AL BUSINESS TAX SECTIOP 40 W. Flagler St. - 1st f liami, Florida 33130 EMPORARY RECEIPT 012-2013 MUNICIPAL CONTRACTOR TAX ocal Business Tax #:30534 tate /CC #:03E000555 ssued to: ORK ELECTRICAL CONTRACTO ype of Business: LECTRICAL CONTRACTOR EE BACK OF OFFICIAL RECE ONPARTICIPATING MUNICIPA lIS RECEIPT IS ISSUED A, AYMENT FOR YOUR LOCAL Bl PFRMTT AC# 6158532 511854 -2 BusVtilV s ��2cYl�r CONTRACTOR 10871 SW 188 ST 33165 UNIN DADE COUNTY THIS IS NOT A BILL - DO NOT PAY RENEWAL #REciriuso555 CORP DWYuKK ELECTRICAL CONTRACTOR CORP sec]. Yee e CAL CONTRACTOR THIS IS ONLY A LOCAL BUSINESS TAX RECEIPT. IT DOES NOT PERMIT THE HOLDER TO VIOLATE ANY EXISTING REGULATORY OR ZONING LAWS OF THE COUNTY OR CITIES. NOR DOES IT FYFMPT THE HOLDER FROM ANY OTHER PERMIT OR UCENSE REQUIRED BY LAW. THIS IS NOT A CERTIFICATION OF THE HOLDER'S QUALIFICA- TIONS. PAYMENT RECEIVED MIAMI -DADE COUNTY TAX COLLECTOR: 07/27/2012 60040000279 000075.00 SEE OTHER SIDE 25 CC WORKER /S 1 DO NOT FORWARD YORK ELECTRICAL CONTRACTOR CORP LORENZO TORRES PRES 10871 SW 188 ST #25 MIAMI FL 33165 FIRST -CLASS U.S. POSTAGE PAID MIAMI, FL PERMIT NO. 231 534682 -0 Construction Trades Beard BUSINESS CERTIFICATE OF COMPETENCY tuyv TORRE5'LORENZO Is camel underthe P o. 03E000555 ELECTRICAL CONTRACTOR CORP. .BA.. THIS DOCUMENT HAS A COLORED BACKGROUND • MICROPRINTING • LINEMARK ' PATENTED PAPER STATE OF FLORIDA DEPARTMENT OF'EUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD SEQ #L12061100445 DATE BATCH NUMBER LICENSE. NBR 06/11/2012 0000000 00< ER0015257 The ELECTRICAL CONTRACTOR Named below HAS REGISTERED: Under the provisions of Chapter Expiration date: AUG 31, 2014 MUST MEET ALL LOCAL LICENSING REQUIREMENTS PRIOR TO CONTRACTING IN ANY ARE; TORRES, LORENZO -' YORK ELECTRICAL CONTRACTOR CORP 10871 SW 188TH ST UNIT' 25 MIAMI FL 33157 RICK SCOTT GOVERNOR DISPLAY AS REQUIRED BY LAW KEN LAWSON SECRETARY ' ' CERTIFICATE OF LIABILITY INSURANCE DA 07'71 3/1'2 "Y' 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: lithe cert holder Is an ADDITIONAL INSURED, the policy(hss) mart be endorsed. It SUBROGATION IS WAIVED, sutect to the terms and conditions of the poilcy, certain policies may require an endorsement A statement on this certificate does net corner rights to the certificate holder in lieu of such endorsement(s). PRODUCER Letitia Insurance Agency 5538 sw 8st Coral Gabes, FL 33134 Phone (305) 631-2094 Fax (305) 631-2184 CONtACT LETICIA RODRIGUEZ N a Ed (305) 631-2094 1 yvc yak (305) 631-2184 ADDRESS: letic iainsuranceagency @ hotmaiLcom INSURERS) AFFORDING COVERAGE NAIC 0 INSURERA: GRANADA INSURANCE COMPANY INSURED YORK Fl FCTRICAL CONTRACTOR 18071 SW 188 ST #25 / MIAMI, FL 33157 INSURER B 07/18/2012 INSURER C : EACH • « -{- ENCE INSURER D : PRE S• RENTED PREMISES (Ea 1 INSURER E MED Few (Any one pew) INSURER F : PERSONAL & ADV INJURY 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 PALO pp ILTR TYPE OF INSURANCE j SR $gip POLICY NULIBER (PMLICR/DDIYYYFY1 pCLLAIyMSS.. (MMIDD1YYYY) MOTS A GENERAL LIABILITY 2 COMMERCIAL GENERAL UABIUTY ❑❑ ❑ CLAMS -MADE Ci' occuR 0185FL000127992 07/18/2012 07!18/2013 EACH • « -{- ENCE $ 1,000,000.00 PRE S• RENTED PREMISES (Ea 1 $ 100,000.00 MED Few (Any one pew) $ 5,000.00 PERSONAL & ADV INJURY $ 1,000,000.00 0 GENERAL AGGREGATE $ 1,000,000.00 GENT- AGGREGATE LIMIT APPLES PER: El POUCY ❑ COI-r ❑ LOC PRODUCTS - COMP/OP AGG $ 0.00 $ AUTOMOBILE LIABILITY ❑ ANY AUTO ii ALL OWNED SCHEDULED AUTOS ❑ AUTOS ❑ HIRED AUTOS ❑ A NON-OWNED UTOS ❑ ❑ =MINED SINt+I F UMIT Ea $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ (Pet rangAMA' $ $ ❑ UMBREUA LIAR ❑ OCCUR ❑ EXCESS MB ❑ CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ ❑ LED ❑ RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' UABUUTY Y! N ANY PROPRETORWARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory NIH If yes, describe under tSCR1PT1ON OF OPERATIONS below N 1 A ❑ STATU- ❑ 1 O ER E.L EACH ACCIDENT $ • EL DISEASE - EA EMPLOYE $ EL DISEASE - POLICY LIMIT $ DESCMPTION OF OPERATIONS 1 LOCATIONS! VEHICLES (AtNlch ACORD 101, Ad Clonal Remarks Scheduled/ more space ts required) CERTIFICATE HOLDER CANCELLATION Miami Shores Village Building Department 10050 NE 2 nd Ave Fax 305- 7624949 1 Fax 305- 762 4949 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 LETICIA RODRIGUEZ U0#D087160 ACORD 25 (2010/05) OF 01988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD A:6 YORKELE -01 ELLAMAS CERTIFICATE OF LIABILITY INSURANCE DATE ( D/YYYY) 7723/2012 THIS CERTIFICATE 15 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 pol(cy(les) must be endorsed. If SUBROGATION IS WANED, 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 BenTrust ALB, LLC SuiteWaterford Way Miami, FL 33126 CONTACT NAME: Puc. E Extr. (305) 444-8350 AODDRESS: 1 a., (305) 444-8501 INSIIRER(S) AFFORDING COVERAGE NA=C 0 INSURED York Electrical Contractor Corp 10871 SW 188 Street Unit 25 MflamI, FL 33157 INSURER A:Guarantee Insurance Company INSURER B : 11398 INSURER C : INSURER D : 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 POLIC ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAJMS LTR TYPE OF INSURANCE INNER � $ POLICY NUMBER POLICY (M DIYYYY( (DpDD/YYYY) LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES (Ea occurrence) $ I CLAIMS -MADE OCCUR MED EXP (My one person) $ PERSONAL. & ADV INJURY $ GENERAL AGGREGATE $ GENT. AGGREGATE LIMIT APPLIES PER —I POLICY 7 28: 7 LOC PRODUCTS - COMPIOP AGO $ $ AUTOMOBILE LIABILITY ANY AUTO AU. OS WNED HIRED AUTOS — SCHEDULED AUTOS COMBINED SINGLE Miff (Ea aoddent) BODILY INJURY (Per parson) $ BODILY INJURY (Per =Mor) $ (Per a� DAMAGE $ $ UMBRELLA UAB EXCESS IJAB r OCCUR CLAIMS-MADE EACH OCCURRENCE $ AGGREGATE $ DED 1 RETENTION $ $ A VYORitERS COMPERSSATION AND EMPLOYERS LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE 1 OFFICERIMEMBEREXCLUDED? (Mandatory In NH) DESCR OF OPERATIONS beam NIA GWG0334002518-112 7122/2012 7122/2013 WC STATU- TORY LIMITS rOTH- FR E.L. EACH ACCIDENT $ 1,000,000 E.L DISEASE - EA EMPLOYEE $ 1,000,000 E.L DISEASE - POLICY LDAIT $ 1,000,000 OPTION OF OPERATIONS 1 LOCATIONS 1 VEtmC1-ES (Attach ACORD 101, AddElonal Remarks Schedule, M ems space Is req,dred) CERTIFICATE HOLDER CANCELLATION Miami Shores Village Building Department 10050 NE 2nd Avenue Miami Shores, FL 33138 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 ACORD 26 (2010/05) ®1988 -2010 ACORD CORPORATION. An rights reserved. The ACORD name and logo are registered marks of ACORD