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