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EL-14-1635 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-216781 Permit Number: EL-7-14-1635 Scheduled Inspection Date: February 12, 2015 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: MIAMI PROPERTY SOLUTIONS LLC, Work Classification: New IIAIAIIAI DDf1DCDTv Qr%1 I I7If1A1C 1 1 f` Job Address:38 NW 108 Street Miami Shores, FL 33168- Phone Number (305)807-4045 Parcel Number 1121360110120 Project: <NONE> Contractor: DEVELOPMENT ELECTRICAL CONTRACTORS INC Phone: (786)273-0025 Building Department Comments AS PER PLANS DEMO GARAGE CONVERSION AND Infractio Passed Comments BUILD OUT MASTER BATH AND BEDROOM LAUNDRY INSPECTOR COMMENTS False ELECTRICAL. Inspector Comments Passed Failed 12 Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. February 11,2015 For Inspections please call: (305)762-4949 Page 5 of 22 CEIVED JUL 2014 Miami Shores Village BY: 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 AFBBC MO BUILDING Master Permit No. PERMIT APPLICATION Sub Permit No. — 3� ❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑EXTENSION ❑RENEWAL [-]PLUMBING ❑MECHANICAL ❑PUBLIC WORKS ❑CHANGE OF ❑CANCELLATION ❑SHOP CONTRACTOR DRAWINGS $ JU •W• 10"I �i1Rr JOB ADDRESS:-31k. City: Miami Shores County: Miami Dade Zip: J31 6 e Folio/Parcel#: I t-7-13 4-o 11- 0 17-0 Is the Building Historically Designated:Yes NO •� Occupancy Type: Load: ''Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): rA%AtA• 1�tJ t4 S �/� Phone#:.365' 4/00- Address: Igo /U.6• III �AE67 9� City: I,.1.1A�% 5 *"S State: ?Z-` Zip: 351 rl Tenant/Lessee Name: Phone#: AGS 90-7- Y6 S- Email: 6'03)%'f ' mAct i•CLA CONTRACTOR:Company Name: i6je56gQT cZ PcAL hone#: T o IG Z-3 3 o0Z Address: 15-:) If S W -S.1'-t-oz p City: Ki Q wlT State: Zip: Qualifier Name: LVl's -6-, MV k n-e- Phone#: $OS S/019 6 State Certification or Registration#: �O y 5gi 3 Certificate of Competency#: I I E moo® DESIGNER:Architect/Engineer: Phone#: Address: City: State: r Zip: Value of Work for this Permit:$ 31 t5o• O Square/Linear Footage of Work: yYJ fF Type of Work: ❑ Addition ❑ Alteration ® New N Repair/Replace ® Demolition Description of Work: AS -M ' O 6 0.&AJ VMSI,6-0 4 >L7vt --T AhSTEVL ( TW S DRocM N —L��4"�• L Specify color of color thru tile: Submittal Fee$ Permit Fee$ :72 SiOy CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ / TOTAL FEE NOW DUE$ 6 (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. SignatureEQ— Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this -OSr day of `1VLy ,20 ,y by �day/of' zrau 20 ,by $� v�PREZp��ii who is personally known to Ly%s.� Myna who is ersonalp ly known to MSbN;c0�� p ` p �4�ach6,2o 9 9% me or who has produced �I J(/M� M•(L � as me or who has produced as t identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY LIC: ��; #EE 176492 Sign: CWtMJ C""W Sign: 11; \\\ Print: 1 cu-do '376 G(+e— Print: 11th Q Seal: RICARDOIRIARTE seal: A .o; �'. MY COMMISSION#FF088736 ####### #i#��.#`1i##ts#i)#f tt�'#�##Y�i#M#✓!!�k>k�Xs ssssssssssssssssssss#####ssssssss essssessssssssss#s####ss*s# .(407)398-0153 FloridallotaryService.con) a,fiJ"(/L y a-e-,* APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) s � 3', CTQB Construction Trades Qualifying Board BUSINESS CERTIFICATE OF COMPETENCY l l E000008 DEVELOPMENT ELECTRICAL CONTRACTOR INC � 6666 6666.. MU Z LUIS E • Is certified under the provisions of Chapter 10 of Miami-Dade County •••;•• • • VALID FOR CONTRACTING UNTIL 09/3012015 .••• •••• ;••••; 6666 6666 6666. 6666•. 6666 6666. .. .. .• 6666.. • V6000 6 .. . . 6666.. 6666.. O 6 . . 6 . 6666.. .. 6666 � 6666 TAS DEPS AND PROFfSS4CJNA,L REG ELECTRICAL CONTRACTORS LICENSING BOARD Lo Riss(flYiiwi �� IVA lCAt PE'L FE C.0 TF4 C TC l,. ISS f-r?P WOW tt ptovlows4 E, z W I 1 EET ' C Lai MJ \� ,,.�� , W3773 Local Business Tax Receipt Miami-Dade County, State of Florida [LBT -THIS IS NOT A BILL-DO NOT PAY 1 6842687 1 BUSINESS NAME/t..00ATtON RECEIPT NO. EXPIRES DEVELOPMENT ELECTRICAL CONTRACTOR INC RENEWAL SEPTEMBER 30, 2014 I 15711 SW 59 TERR 7116684 Must be displayed at place of business MIAMI FL 33193 Pursuant to County Code Chapter BA-An.9&10 OWNER SEC.TYPE OF BUSINESS PAYMENT RECEIVED DEVELOPMENT ELECTRICAL 196 ELECTRICAL CONTRACTOR BY Tax COLLECTOR CONTRACTOR 11E000008 $75.00 09/12/2013 Workers) 1 ECHECK-13-007713 .... . . .... ...... This Local Business Tax Receipt only confirms payment of&Local Business Tax.The Receipt is net li • MO, • permit.or a certification of thebolder•s quelifiatiens,to do business.Holder must comply with any gil6Lmmdbfal or •• • • nongovemhoeetd regulatory laws and requirements which apply to the businem 000000 •. .. •. •; The RECEIPT N0.above oust be displayed on all commercial vehicles-Miami-Daft Code Sock. • For more information,visit www.miamidsdo jWftaxoelleetar •••• •••• . . 4 JEFF ATWATER -CHIEF FINANCIAL 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: 6/14/2013 EXPIRATION DATE: 6/14/2015 PERSON: MUNOZ LUIS E FEIN: 274013230 BUSINESS NAME AND ADDRESS: DEVELOPMENT ELECTRICAL 15711 SW 59 TER MIAMI FL 33193 SCOPES OF BUSINESS OR TRADE: ELECTRICAL WIRING CONDUIT ELECTRIC LIGHT OR BURGLAR AND FIRE WITHIN BUIL CONSTRUCTION FOR POWER LINE C ALARM INSTALL CAB 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 07-12 QWF.$TIQNS?(85Q)413-1609 • • • •••• •••• • • •••••• •••• ••••• 5NORoil s Miami shores Y �2 0 Building Department OR 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner - Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees, including the owner, must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if: 1. The officer owns at least 10 percent of the stock of the corporation,or in the case of an LLC,a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State,Division of Corporations;and 3. The corporation is registered and listed as active with the Florida Department of State,Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption. In these circumstances,Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company. Therefore,You may be personally liable for the worker compensation injuries of any person allowed to work under this ermit. Please check with your insurance carrier since most property insurance policies DO NOT cover this type of liability. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Owner Contractor Print Name: ! p2 rint Name: AAOA Z Signatur �`v6n—� Signature: State of Florida) State of Florida) County of Miami-Dade) County of Miami-Dade) Sworn to ands bscribed before me this day 2 Z day of 20 6 —� to and subscribed before me this —� day of ,20 !�, By �!/�j v " B -----------Y Y Pv y��` -�'•.• RICARDO IRIARTE : RICAR O IRI(S ibIt. (S ,�) MY COMMISSION#FF088736 Ty) `fi atron cgni T e` „ ifi�flZifit ggt*dary 2,201 a (407)398-0153 Floridallotaryservice.com (407)398-0153 Floridallotaryservice.com