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EL-18-425 Permit NO. EL=4-1.8-425 �sµO1S y� Miami Shores Village ot Perrrrit Type:Electrical-Residential F 10050 N.E.2nd Avenue NW z p,. Work Classification:Alteration Miami Shores,FL 33138-0000 Permit Status:APPROVED Phone: (305)795-2204 FioR,vA Expiration: 08/25/2018 Issuelaate:2t26/2018 Project Address Parcel Number Applicant 195 NW 96 Street 1131010250160 Miami Shores, FL 33150- Block: Lot: ALVARO DIEGO VALERIANI BOI Owner Information Address Phone Cell ALVARO DIEGO VALERIANI BONAVITA 195 NW 96 Street (305)302-7597 MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 500.00 SUNSHINE ELECTRICAL CONTRACT( (305)268-4958 Total Sq Feet: 0 Type of Work:DEDICATE CIRCUIT FOR MOTOR Available Inspections: Additional Info: Inspection Type: Classification:Residential Review Electrical Scanning: 1 Review Electrical i Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 Invoice# EL-2-18-66493 DBPR Fee $2.25 DCA Fee $2.00 02/16/2018 Check#:550 $50.00 $108.85 Education Surcharge $0.20 02/26/2018 Check#:558 $ 108.85 $0.00 Permit Fee-Additions/Alterations $150.00 Scanning Fee $3.00 Technology Fee $0.80 y Total: $158.85 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 myselfX agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORSrand FING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is acc a that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above-n ed cc or to do the work stated. February 26, 2018 Authorized Signature:Owner / Applicant '/ tr ctor / Agent Date Building Department Copy ` February 26, 2018 1 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-298010 Permit Number: EL-2-18-425 Scheduled Inspection Date: February 27, 2018 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: ugh Owner: VALERIANI BONAVITA,ALVARO DIEGO Work Classification: teration Job Address: 195 NW 96 Street Miami Shores, FL 33150- Phone Number (305)302-7597 Parcel Number 1131010250160 Project: <NONE> Contractor: SUNSHINE ELECTRICAL CONTRACTORS CO Phone: (305)268-4958 Building Department Comments DEDICATE CIRCUIT FOR MOTOR Infractio Passed Comments INSPECTOR COMMENTS False ' a Inspector Comments Passed< 1� Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. February 26,2018 For Inspections please call: (305)762-4949 Page 30 of 39 _ A Miami Shores Village ~' ,, g F . i 6 201 xo� Bullding Department B 8 10050 N.E.2nd Avenue,Miami Shores, Florida 33138 Y' Tel:(305)795-2204 Fax:(305)756-8972 �\ INSPECTION LINE PHONE NUMBER:(305)762-4949 6 FBC 20 BUILDING Master Permit No.-Fu iq PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑E ELECTRIC ❑ ROOFING ❑ REVISION EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL F-1 PUBLIC WORKS CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 195 NW 96 ST 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):Alvaro Valeriani Phone#:305 302-7597 Address: 195 NW 96 ST City: Miami Shores State: Florida Zip: 33150 Tenant/Lessee Name: Phone#: �U Email: alvarovaleriani@hotmail.com S _--�k co l� CONTRACTOR: Y Com an Name: t P 1I1I11 Address:�ul�A .(,C,-I A,� . ,,�� W City: yni, State: Florida �_ Zip: Qualifier Name: An , �� Y-) Phone#: 7 6 i State Certification or Registrations�M '1�� �, ,}C�eerrtificate of Competency M DESIGNER:Architect/Engineer: y)e CL ur t Cl & ' � /o-ra toneM Address: N lA� G`1 (n City: State: Zip:, C�1 b Value of Work for this Permit:$ _ �� Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑■ Repair/Replace ❑ Demolition Description of Work: O /t ._ o /L e'3 26 sf s S., (�e �o 2�U a s. ttJ 1 t dt 1 Q�Qc i t W_0'\0C' c f tM MT v Specify color of color thr tile: Submittal Fee$�q Permit Fee$ 1✓ra/ell> CCF$ _ CO/CC$ Scanning Fee$ Radon Fee$ ( DBPR$-, 1 o9-__�> Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ I (Revised02/24/2014) i f i F � I 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..... x 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 ccurs seven ffJ days after the building permit is issued. In the absence of such posted notice, the inspection will not be apVved-onddction fee will be charged. Signature Signature l OWNE or GE T CONTRACTOR The foregoing instrument w ackno ed before me this The foregoing instrument was acknowledged before me this day of 20 t by S day of 201 by IBJ flffl/Y (who is personally known to is personally known to me or who has produced as me or who has producedas identification and who lidd take @R- identification and w . ANTONIO E.GOMEZ J ANTONIO E.GOMEZ NOTARY PUBLIC: 2°`Y",N� Y CCP�Pe11S #FF913115 NOTARY PUBLIC: W%lMYCOMMISSIOI`l#FF913115 AUG 25,2019 EXPIRES:AUG 25,2019 „nded through?st State Insurance j Bonded through 1 st State Insurance Sign: Sign: Print: Print: Seal: Seal: APPROVED BY l Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) r 1 r } V t SUNSHINE ELECTRICAL CONTRACTORS CORPORATION LICENSE # EC 13005807 PHONE NUMBER 786 443 9590 Date; 02 15/2017 i COUNTY OF MIAMI SHORES VILLAGE Building Department t Before me this day personally appeared Mariano Santiesteban who, been duty sworn deposes and says: That he will the only person working on the property located at 111'5 'Al Cordially: F _ I Ma fano Santiesteban Sworn to and subscribed before me this C day of - Q 20 byC7� Personally Knowiz Or produced Identification i Type of identific j tim iANIUNIUoMEz S/RY PUB MY COMMISSI( #FF913115 a, EXPIRES:AUG 25,2019 Bonded through 1st State Insurance d Print,Type or stamp seal of Notary l t t , 1 t i. OR A 193 s� ��► Miami shores Village, "'l Building Department lv*ree �0 10050 N.E.2nd Avenue ORIDp` 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. i No more than three corporate officers per corporation or limited. liability company members are allowed to be exempt. Construction exemptions are valid fora 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 and has acknowledge that he or she will not use day labor,part-time e of yees or subcontractors for your project.The contractor has provided an affidavit stating that he or she.will be the only person all wed to work on your project.In these circumstances,Miami Shores Village does not require verification of ' workers'compensate n insurance coverage from th contractor's company for day labor,part-time employees or subcontractors. BY SIGNING ,BE 'OW OU ACKNOWLE GE THAT YOU HAVE READ THIS 'NOTICE 'AND UNDERSTAND ITS CONTENTS. V Signature: Y wner State of Florida County of Miami-Dade The foregoing was acknowledge before me this a�day of YV ,20i-L. BY 0 1671, who is personally knows to me or has produced UA 1—Sasidentification. Notary: SEAL: _ NOWY Pubk State of Flonda Won Lorenzo Moya Ovt�7 i