Loading...
EL-19-925co EL1s-2109 E�1Na9-925' .� _ __ �-- » Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Issue Date: Parcel Number 270 GRAND CONC, Miami Shores, FL 33138 1132060136210 Contacts Permit MO.:'EL-04-19 9 6 Permit Type: Eiectrical - Residential (Nark Ciassifrcataorr. Addition/Alteration Expiration: 10/23/2019 ERHAN KOSTEPEN Owner AMERICAN EAGLE ELECTRIC Contractor 78 NE 47 ST, MIAMI, FL 33137 CORPORATION Other: 7863190562 ERHANKOSTEPEN@GMAIL.COM JIMMY SUAREZ Mobile: 3052001010 Description: NEW ADDITION AND REMODELING TO REPLACE Valuation: $ 8,000.00 Inspection Requests: PERMIT#EL-16-1965 & EL8-15-2109 j3115-'i6'2- Total Sq Feet: 2,600.00 Fees Amount Payments Date Paid Amt Paid Permit Fee $280.00 Total Fees $280.00 Credit Card 05/02/2019 $280.00 Total: $280.00 Amount Due: $0.00 Building Department Copy 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 myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above named contractor to do the work stated. Signature: Owner / Applicant / Contractor / Agent Date May 02, 2019 Page 2 of 2 Permit Type: Electrical - Residential Application Date: 08/19/2015 Owner: ERHAN KOSTEPEN Work Class: Addition/Alteration Issue Date: 08/26/2015 Parcel 1132060136210 Status: Cancelled Expiration Date: Address: 270 GRAND CONCOURSE Miami Shores, FL IVR Number: 614779 Subdivision: 113206013 Scheduled Actual Reinspection Date Start Date Inspection Type Inspection No. Inspection Status Primary Inspector Required? Complete 08/19/2015 08/19/2015 Review Electrical INSP-241743 Passed Michael DeVaney No Complete 09/15/2015 09/15/2015 Bonding 11/17/2015 11/17/2015 Rough Reinspection of INSP-131606 Checklist Item COMMENTS Approved General Comments PLAN REVIEW COMMENTS Yes INSP-241736 Passed Michael DeVaney Reinspection of INSP-131606 No Complete Checklist Item COMMENTS Approved General Comments INSPECTOR COMMENTS - Footer steel ground is O. K. Yes Need temp for construction pole. INSP-247923 Passed Michael DeVaney Reinspection of INSP-131606 No Complete Checklist Item COMMENTS Approved General Comments INSPECTOR COMMENTS Yes m May 01, 2019 10050 NE 2 Ave Miami Shores FL 33138 Page 1 of 1 Miami Shores Village RECE✓ E® Building Department APR 2g101y 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 201"-) � BUILDING Master Permit No.( --004-(1) -k33 PERMIT AP PL ATION Sub Permit No. aN — -1 —C7� ❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION [:]SHOP CONTRACTOR DRAWINGS JOB ADDRESS: City: Miami Shores County: Miami Dade Zip: 3 1 Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFFE:Q OWNER: Name (Fee Simple Titleholder): �f�� / ��K Phone#: 7 Q/ 6 � J/ / ��aZ Add City, Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: f le-14 Phone#: 3A e6 '—IVID Address: #L' C, City: I State: Zip: 4'3 301,9 Qualifier Name: — ' / i" sU U./C Z Phone#: ?/% 7j- State Certification or Registration #: EC.) . oQ 910 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑ Ar/A ''n f❑ Alter ion ❑ New ❑R'eppair/Replace ❑ Demolition Description of Work: Specify color of color thru tile: ^ r Submittal Fee $ Permit Fee $ CCF $ .. CO` cc $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ 2—�i (Revised02/24/2014) Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Zip Application is hereby m"ade 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 OWNER or AGENT The foregoi instrument was acknowledged before me this day of p(t( L 20 by �-111K65TN who is personally known to me or who has produced✓ — 2t Vkf— U(a- as identification and who did take an oath. NOTARY LIC: Sign - Print: Print: Seal: VP SINDIA ALVAREZ gA MY COMMISSION # GG 238273 a`, EXPIRES: September 3, 2022 C� Bonded Thro Notary Public Underwriters ################# Signa CONTRACTOR The foregoing instrument was acknowledged before me this day of �PY" ( 20 ,/2 by ,Ti NM SL)A&eZ who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: I'VCV✓ILAA1 ✓1 e Seal: n��rpu Notary Public State of Florida ? Nancy Nunez rr My Commission GG 166008 a �� Expires 03128/2022 ################0%###### APPROVED BY �E �A I 2�> I 1 1 Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. ✓ COPY OF QUALIFIER'S STATE LICENCES B. COPY OF LOCAL BUSINESS TAX RECEIPT C. ✓ COPY OF LIABILITY INSURANCE* D. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 Certificate must specify the description of operations or contractor license number. ............................................................ 0 N a w a M ...... 0 0 0 0 0 0 0 0 0 N N E 0 0 N w 0 N■ BUSINESS NAME: 1qMeri3O-a-n C:�%e-C�t j'C 00 t/2 . BUSINESS ADDRESS: 095� W ez�, S4i6cITY > � STATE ZIP Of BUSINESS PHONE: (. 0S) 200 —/0/0 FAX NUMBER ( 057) -4--3) — 654 CELL PHONE QUALIFIER'S NAME: O • &a —fez — QUALIFIER'S LIC NUMBER: e5C l 3 005 f/Cl RICK SCOTT, GOVERNOR JONATHAN ZACHEM. SECRETARY' dbpr STATE OF FLORIDA DEPARTMENT OF BUSINESS:,- AN:0--P:ROFESSIONAL REGULATION "RAkY ? 4 1 ELECTRICALZON � TOR� LICENSING BOARD THE ELECTRIRE NIS CERTIFIED UNDER THE C-AL,�C--ONTR-�A�CTO,'R'�, E I PROVISIONSOF"CHA489TE-ORIDASTATUTES EXPIRATION bA" M'� -A'y GiiST31,2020 Q, Always verify licenses online at MyFloridaLicense.com o, a Do not alter this document in any form. This is your license. It is unlawful for anyone other than the licensee to use this document. City of Hialeah ciTy°f 2018-19 H L EAH Business Tax Receipt Mayor Carlos Hernandez No: 238210-96 (OLD-1731-1063) Amount: $ 150.00 The person, firm or corp. listed here has paid the business tax required to engage in or operate the business specified subject to the regulations and restrictions of the City of Hialeah; Florida Owner: JIMMY OLMEDO SUAREZ / AMERICAN EAGLE ELECTRIC Type of Business: Electrical Contractors and Other Wiring Installation Contractors AMRICAN EAGLE ELECTRIC CORP. 2954 W 84 ST BAY #8 HIALEAH, FL 33018 Validating No.: 461378 THIS IS NOT A BILL Business Location: 2954 W 84 ST 8 Expires September 30, 2019 ACC>ROCERTIFICATE OF LIABILITY INSURANCE °ATE(MM,D°"'"'r' oan 7/zo1 s THIS CERTIFICATE IS ISSUED ASA 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 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 CONTACT NAME: ANGELA DENARY GOMEZ Morgan Insurance Group Inc aG No,.E><e) (305) 222-9001 jac, No);(305) 222-9006 MAIL 13155 SW 42nd St # 107 ; ADDRESS: angelatii;morganinsgrp.com Miami, FL 33175 INSURER(S)-AFFORDING COVERAGE NAIC # _ ..._ _.. Phone (305) 222-9001 Fax (305) 222-9006 ; INSURER A : WESTERN WORLD INSURANCE COMPANY ! INSURED -- - - INSURER B : ..._.__. _ _._---- ...... AMERICAN EAGLE ELECTRIC CORP INSURERC: 2954 W 84TH STREET BAY 8 ;_INSURER o : - BERKSHIRE HATHAWAY GUARD INSURANCE 1 INSURER E - ! HIEALEH FL 33018 - - - — -- 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 FORT HE 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 PAID CLAIMS. 'ADDLSUBR ...._.._._. ... - ...-.--TYPE Of INSURANCE INSR WVD; POLICY NUMBER- -- .......... ._....... _.. .. .....__ POLICY EFF POLICY EXP : (MM/DD/YYYY) (MMIDU/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY __-..._ EACH OCCURRENCE $ 2,000,000.00 CLAIMS -MADE/; OCCUR ;DAMAGE TO RENTED 100 000.00 --' PREMISES (Ea occurrence) $ A ' I Y N OYRDK-R MED EXP (Any one person) ! $ 5,000 00 01/08/2019 01/08/2020. - -'' PERSONAL & ADV INJURY 1 s 2.000 000.00 j GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s 2,000,000.00 ;- POLICY PRO LOC i --..._..._ _... ..._ JECT PRODUCTS - COMP/OP AGG $ 2,000,000.00 OTHERi __...._....._._ .__.....----_._ _...._. _._..... _.... $ AUTOMOBILE LIABILITY ; COMBINED SINGLE LIMIT ' I ! (Ea accident) .._... ._ . $.. ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED 1 -- ._.. BODILY INJURY .._. AUTOS . __ AUTOS _. ...... NON -OWNED HIRED AUTOS AUTOS - (Per accident) $ ......... . .... ... .._ _. ! PROPERTY DAMAGE s ; _ (Per accident) UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB :CLAIMS -MADE N AGGREGATE _... _ _._ ._... ..__.. .._ $ WORKERS COMPENSATIONPER I AND EMPLOYERS' LIABILITY YIN !--,.STATUTE_ERH ANY PROPRIETOR/PARTNER/EXECUTNE E.L. EACH. ACCIDENT $ 1,000,000.00 D j OFFICERIMEM13ER EXCLUDED? I1 N I A N , AMWC821596 08/06/2018 08/O6/2019 • - (Mandatory in NH) -__-.___.- -_.___ _-.. E.L. DISEASE -EA EMPLOYEE s 1,000 000.00 If yes, describe under --._ .. DESCRIPTION OF OPERATIONS below ! E.L. DISEASE - POLICY LIMIT $ 1,000,000.00 - - _ .._ 1 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) ELECTRICAL CONTRACTOR LICENSE # EC13005910 CERTIFICATE HOLDER IS LISTED AS AN ADDITIONAL INSURED. ....... CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village BLDG Dept THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 NE 2nd Avenue ACCORDANCE WITH THE POLICY PROVISIONS. Miami -- Shores, Florida 33138 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26 (2014101) QF The ACORD name and logo are registered marks of ACORD fl JIMMY PATRONIS CHIEF FINANICAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 9/21/2018 PERSON: JULISSA SUAREZ FEIN: 201333840 BUSINESS NAME AND ADDRESS: AMERICAN EAGLE ELECTRIC, COR.P 2954 WEST 84 STREET BAY 8 HIALEAH, FL 33018 SCOPE OF BUSINESS OR TRADE: Licensed Electrical Contractor Electrical Wiring Within Buildings and Drivers EXPIRATION DATE: 9/20/2020 EMAIL: AEELECTRIC@BELLSOUTH.NET IMPORTANT: Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS? (850)413-1609 a •��„r JIMMY PATRONIS CHIEF FINANICAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 9/26/2018 PERSON: JIMMY O SUAREZ FEIN: 201333840 BUSINESS NAME AND ADDRESS: AMERICAN EAGLE ELECTRIC CORP 2954 WEST 84 STREET BAY 8 HIALEAH, FL 33018 SCOPE OF BUSINESS OR TRADE: Licensed Electrical Contractor Electrical Wiring Within Buildings and Drivers EXPIRATION DATE: 9/25/2020 EMAIL: AEELECTRIC@BELLSOUTH.NET IMPORTANT: Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS? (850)413-1609