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EL-16-2710Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 P mit Permit NO. EL -10-16-2710 Permit Type: Electrical - Residential Work Classification: Low Voltage Permit Status: APPROVED Issue Date: 10/12/2016 Expiration: 04/10/2017 Parcel Number Applicant 1263 NE 94 Street Miami Shores, FL 1132050100070 Block: Lot: NUHOUSE INVESTMENTS INC Owner Information NUHOUSE INVESTMENTS INC Address 15751 SHERIDAN Street FORT LAUDERDALE FL 33331- Contractor(s) Phone PROSTAR ELECTRICAL CONTRACTC (786)307-4295 Cell Phone Phone (954)288-7886 Cell Valuation: Total Sq Feet: $ 780.00 0 Type of Work: LOW VOLTAGE 5 PHONE AND 5 DATA OUTL Additional Info: LOW VOLTAGE 5 PHONE AND 5 DATA OUTL Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $0.60 $2.00 $2.00 $0.20 $100.00 $3.00 $0.80 $108.60 Pay Date Pay Type Invoice # EL -10-16-61560 10/04/2016 Credit Card 10/12/2016 Credit Card Amt Paid Amt Due $ 50.00 $ 58.60 $ 58.60 $ 0.00 Available Inspections: Inspection Type: Review Electrical 1 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either my f, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOOR ,-OOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing informati iii ' acc .te and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above -name f too do the work stated. Authorized Signature: Owner / Applicant / fContr:c .r / Agent Building Department Copy October 12, 2016 Date October 12, 2016 1 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 �Q(g -11s3 Inspection Number: INSP-269095 Permit Number: EL -10-16-2710 Scheduled Inspection Date: October 19, 2016 Inspector: Devaney, Michael Owner: Job Address: 1263 NE 94 Street Miami Shores, FL Project: <NONE> Contractor: PROSTAR ELECTRICAL CONTRACTOR INC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Low Voltage Phone Number (954)288-7886 Parcel Number 1132050100070 Phone: (786)307-4295 Building Department Comments LOW VOLTAGE 5 PHONE AND 5 DATA OUTLETS Infractio Passed Comments INSPECTOR COMMENTS False Passed Failed Correction Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP-268997. No access at 3:20 P. M.. ‘5)-.7-'/, October 18, 2016 For Inspections please call: (305)762-4949 Page 19of26 BUILDING PERMIT APPLICATION Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 r.J`th FBC 20Iq Master Permit No. /2-(7.— 3/5//53 Sub Permit No. f I W-1(40'7910 ❑BUILDING E-f'LECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP 9z/57 -CONTRACTOR DRAWINGS JOB ADDRESS: /9-460 ,JE 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): NUNWQSE 1fJ1/4)6ATN► ftp -cS IUC. Phone#: 9S1 -I Address: 15151 5`41'-2-1 Dick) 5T . i,,lacU1) kt> , f -t- 33"53 1 city: AT- tAvMF--IZ'pK(,% State: Tenant/Lessee Name: Phone#: Email: Zip: 3333 1 CONTRACTOR: Company Name: P/2964Y-4 er/O/a( 6/77/219007Phone#: 7goo .1-e//3 2g Address: /5'‘'q c'} 537 City: /,/Y'9/19/ /4-G State: r, Zip: 3 3//1 Qualifier Name: /7,12/76/0ZZ6-04)Phone#: 7G 6 307 2/5 State Certification or Registration #: e----0(9.00 r" L Certificate of Competency #: DESIGNER: Architect/Engineer:• Phone#: Address: p City: State: Zip: Value of Work for this Permit: $ 7Q 0.0d Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ 'A/lteration ❑ New ❑ Repair/Replace Description of Work: / ��4-- t*I J /9Aor)e ani b(Z%T 004 ❑ Demolition Specify color of color thru tile: Submittal Fee $ '. 0 -Permit'Fee $ /6" OU CCF $ ° (.0 0 CO/CC $ Scanning Fee $ 3 Radon Fee $ Z- DBPR $ 2Notary $ —4:::::)--- Technology ...Technology Fee $ ' 3 0 Training/Education Fee $ • 2_0 Double Fee $ Structural Reviews $ Bond $ �e.---p r ^ TOTAL FEE NOW DUE $ 5 0 . C/ 0 (Revised02/24/2014) 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 vP OWNER or AGENT The foregoing instrument was acknowledged before me this 04- day of OC'TC' D.wr- , 20 1 6 , by aot3C i C.ARKLEcwho is personally known to me or who has produced Ft r'\ #C I66--q&D•-C �-031-Oas identification and who did take an oath. NOTARY PUBLIC: Sign: Print: SoN.DCIA I -1/4)G 7 Seal: SANDRA LUGO MY COMMISSION #FF065861 EXPIRES: OCT 24, 2017 ********************** APPROVED BY (Revised02/24/2014) Signature CONTRACTOR The foregoing instrument as acknowledged before me this p7)-54 day of r/}144 -71.6o me or who has produced 1114L.roo-000-I9 -22 .a -s0 20 ] , by , who is personally known to identification and who did take an oath. NOTARY PUBLIC: a>•l4 Sign: Print: Seal: I.Cla • ************************************ 4'0Z7/ 6 Plans Examiner Structural Review PQ Notary Public State of Florida Nila Rizzo My Commission FF 081061 orpf Expires 01/06/2018 * ** ***************************** Zoning Clerk RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD LICENSE NUMBER The ELECTRICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2018 LEON, ARMANDO r-; -. PROSTAR ELECTRICAL,C ®. • CTOR INC 11569 SW 5T1-1 ST 1.` -j'_` `_ " �......, ..MIAMI FL334f74 ISSUED: 07/19/2016 009576 •, $' WA_ DISPLAY AS REQUIRED BY LAW Local Business Tax Receipt Miami—Dade County, State of Florida -THIS IS NOTA BILL -DO NOT PAY 7059538 BUSINESS NAME/LOCATION PROSTAR ELECTRICAL CONTRACTOR INC 11569SW5ST MIAMI FL 33174 RECEIPT NO. RENEWAL 7337256 SEQ # L1607190001490 .[LBT EXPIRES SEPTEMBER 30, 2017 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS PROSTAR ELECTRICAL CONTRACTOR INC196 ELECTRICAL CONTRACTOR E00000405 Worker(s) 1 PAYMENT RECEIVED BY TAX COLLECTOR $45.00 07/27/2016 FPPU11-16-013765 This Local Business Tax Becaptonly coefums payment of the Local Business Tax. The Receipt is not a license, permit or a emanation Was sgnalifcations, to do business. Kohler must fly with aim governmental or nongovernmental regulatory laws mad requirements which apply to the business. The RECEIPT NO. above minuet be displayed ea all cemsnercial vehicles- Miami -Dade Code Sec 8a-276. For mese hibernation. visit www.mhemridade.ge rt j Qr ACCPR aCERTIFICATE OF LIABILITY INSURANCE DAT 0/10/20i6W' 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 POUCIES 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 G -Mar Insurance 8200 W 33 Ave #7 Hialeah, FL 33018 Phone (305) 267-4541 Fax (305) 267-4543 CO TACT MARY URREGO PHONmice. Ne. ): (305) 267-4541Ilam. No (305) 2674543 AEDDRESS: quotes®gmarinsurance.Com INSURERS) AFFORDING COVERAGE NAIC s INSURER A: SCOTTSDALE INSURANCE COMPANY 0 COMMERCIAL GENERAL LIABILITY • CLAIMS -MADE n OCCUR ❑ INSURED Prostar Electrical Contractor, Inc 11569 S.W 5 STREET MIAMI FL 33174 INSURER B : ASCENDANT INSURANCE COMPANY DAMAGE TO RENTED PREMISES PREMISES (Eaoccurrence) INSURER C : AMTRUST NORTH AMERICA MED EXP (My one Sarson) INSURER D : No INSURER E : $ 1,000,000.00 INSURER F : GENERAL AGGREGATE 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 CONDmONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE INS N WP N POLICY NUMBER EFF (DDLSUBR MMIDDNYYY) UCY UP IM M YY) 11/18/2016 UNITS EACH OCCURRENCE $ 1,000,000.00 A 0 COMMERCIAL GENERAL LIABILITY • CLAIMS -MADE n OCCUR ❑ CPS2347004 11/18/2015 DAMAGE TO RENTED PREMISES PREMISES (Eaoccurrence) $ MED EXP (My one Sarson) $ 5,000.00 No PERSONAL aADV INJURY $ 1,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: n POLICY • TCT • LOC GENERAL AGGREGATE $ 2,000,000.00 PRODUCTS - COMP/OP AGG $ 1,000,000.00 ❑ OTHER $ B AUTOMOBILE UABYJTY n ANY AUTO ❑ ALL OWNED AUTOS LiJ AU�T7OSCHEDULED NON -OWNED ❑ HIRED AUTOS 1 AUTOS ❑ ❑ N N CA -38268-1 06/06/2016 06/05/2017 fag BINED SINGLE LIMIT $ 1,000,000.00 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per dodder iS $ $ 10,000.00 PIP ❑ UMBREUA UAB ❑ OCCUR EXCESS LIAR ❑ CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ rr• LJ DED ❑ RETENTIONS 3 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNEC OFFICERIMEMBER EXCLUDES D? CUT J (Mandatory in NH) If yes, desalbe under DESCRIPTION OF OPERATIONS below NIA N AWC7057723 12/01/2015 12/01/2016 -SAT TUTS fl Eir E.L EACH ACCIDENT $ 1,000,000.00 E.L. DISEASE -EA EMPLOYE $ 1.000,000.00 E.L DISEASE - POLICY LIMIT $ 1,000,000.00 DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If mors span u raquirsd) ELECTRICAL WORK LICENCE EC.0000405 ERTIFICATE HOLDER CANCELLATION I MIAMI SHORES VILLAGE BUILDING DEPARMENT 10050 N.E 2 AVE MIAMI SHORES VILLAGE 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 ��; l (` MARY URREGO ..„ CJ^M " /� - -p�1I _ ACORD 25 (2014/01) QF ®1988-2014 ACOI�D CORPORA TjON. All rights reserved. The ACORD name and logo are Istered marks of ACORD