EL-17-2227 Permit No. EL-9-17-2227
�eKO1S t,� Miami Shores Village Permit Type:Electrical-Residential
10050 N.E.2nd Avenue NE ' Work Classification:Alteration
"'�' Miami Shores,FL 33138-0000 Perl' '11
a t � Phone: (305)795-2204 Permit Status:APPROVED
�[ORiDA
Issue Cate: 12/2112017FExpiration: 06/19/2018
Project Address Parcel Number Applicant
1430 NE 102 Street 1132050240230
Miami Shores, FL Block: Lot: BROWSING 4 HOUSING LLC
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Owner Information Address Phone Cell
"BROWSING 4 HOUSING LLC 1430 NE 102 Street (917)703-6010
MIAMI SHORES FL 33138-
1430 NE 102 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 12,500.00
M.B. ELECTRIC SERVICE CORP (786)325-3383
_.,. . .. _.� ��. . ,_...,. Total Sq Feet: 3146
I
Type of Work:NEW ELECTRICAL SYSTEM FOR WORK AREA Available Inspections:
Additional Info:
Classification:Residential ' Inspection Type:
Review Electrical
Scanning: 1
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $7.80
DBPR Fee Invoice# EL-9-17-65072
$6.57 12/21/2017 Credit Card $422.25 $50.00
DCA Fee $4.38
Education Surcharge $2.60 09/06/2017 Credit Card $50.00 $0.00
Permit Fee-Additions/Alterations $437.50
Scanning Fee $3.00
Technology Fee $10.40
Total: $472.25
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: Icertify th II the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futher re 1 �tho67A rhp above-named contractor to do the work stated.
December 21, 2017
Authorized Signatre:Ow r / Applicant / Contractor / Agent Date 1
Buildiing Dep ent Copy
December 21, 2017 1
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Miami Shores Village C
Building Department LP 01 0,1
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 B
Tel:(305)795-2204 Fax:(305)756-8972 y�
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20jq ,
BUILDING Master Permit No Rel 1 1�93
PERMIT APPLICATION Sub PermitNo.'ELI�-�Z?7��
❑BUILDING (ELECTRIC' ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: r430 V i= X02— cwt
City: Miami Shores County: Miami Dade ___ Zio: 33�
Folio/Parcel#:_11 Is the Building Historically Designated:Yes f NO ✓ °
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Occupancy,Type: Load: . Construction Type: Flood Zone: BFE:._ ., FFE:
OWNER: Name(Fee Simple Titleholder): t�JQ�U 7 1�QK7I1VEi, LLC, Phone#:(1'k ka)-10360 V0
Address: 6C)o L-->'E S3 Si'
City: M%NJA L State: T-L ° Zip.;
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Tenant/Lessee Name:. Phone#:
Email: n
CONTRACTOR:Company Name: l 1 11 " .n — UUu,L d (-6fv'12' Phone#: 'Wk o• X5.3 3.?3
Address: �l S S P t,U Ili 5
City: hlA m'i State: Zi
p: SSS
Qualifier Name: j d se—C P d0AI1)?5 Phone#: 3�G 32'S 3381
State Certification or Registration#: Certificate of Competency#: ( 2 E.GbO q
DESIGNER:Architect/Engineer: ',Phone#:
Address: City: State: Zip:
Value of Work forthtisPermit $<' 12 �p0 "" Square/linear Footage,of,Work
Type-of Work: ❑;Addition.'., ❑ :'Alteration ❑ New "t1 ' a ' �'� a,
❑ Repair/Re,plce ) ❑ Demolition
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Description of Work: x_L2t�,o �--Lg-xg%(AS G�kS' e,44 WV— kPo0L -AZ�w5 P O eyJ Ns, k44aS 'i jw �t'L�
Specify color of color thru tile:
Submittal Fee$ '�V •0�3 Permit Fee$ �/� �' S b CCF$ 80 CO/CC$ ,-
Scanning Fee$ 3' Radon Fee$ 44 • 38 DBPR$ (0• Notary$
Technology Fee$ 10, "4 0 Training/tducation Fee$ 2- 60 Double Fee$ --,
Structural Reviews$ 2 Bond$
TOTAL FEE NOW DUE$ 2�
(Revised02/24/2014)
Bonding Company's Name(if applicable)
Bonding Company's Address
City Al State = Zip
co
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 td the issuance of Ya 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:....
00 NB3'SAFRDMAT: 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.
"0 ARNING TO 00 N 'YOUR FAILURE TO FE09U A NOTICE OF OOM M BNaM ENT 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 NMCEOFOOM M BVCBVI BVT." , ,
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 oopy 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 Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this:
t day of &QScycA ,20. 1'�,by t day of bC*xio,* ,20 C4 by
160b0n %L_A&X-1 1 a who is personally known to nLJAZ--r— W0�7 ,who is personally known to
me or who has produced 't V JW S LlCc-fn� as me or who has produced 'h'i11Lt`SV-v Lktbj ' � as
` -Ricardo DoV1958686
guez
identificatio"Pti�PUv ,di
identificatio\2Q Rb ;did to pMinguez _ �b i e� 1
Commission FF958686`
NOTARY KISLI _ Expires:February 8,2020 NOTARY P0%
Q �Ezpires:February 8,2020
=s TFOFFic Bonded thru Aaron Notary
Bonded thru Aaron NotaryIr 1
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Sign: �_ ----� Sign:
Print: VAC1\-11t-)a Print: IZW410W �j[ Vafic�t�'
Seal: Seal:
,...- .., .... ..._ - 4, 3 �` els� ♦.
APPROVED BY Plans Examiner, A Zoning
CTQB'� `�£�
Construction Trades Qualifying,Board, '
"' f} BUSINESS CERTIFICATE OF COMPETENCY,
12E000401s x
M B.ELECTRIC SERVICE CORP
D.B.-A.-
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MUI�Z JUS EE P
Is certified under the provisions of Chapter 10 of Miami-Dade County
ALID F R CONTR CTI G UNT L 9 ' •20
SNF, „ STATE OF.FLORIDA
Y DEPARTMENT OF BUSINESS ANDPROFESSIONAL REGULATION
^ P ELECTRICAL CONTRACTORS LICENSING BOARD (850).487-1395
�.. �� 2601 BLAIR STONE.-ROAD
TALLAHASSEE FL 32399-0783
MUNOZ, JUSEF P
M.B. ELECTRIC SERVICE CORP
3955 NW 195 ST
MIAMI GARDENS FL 33055
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Congratulations! With dhis license you become one of the nearly ">----�-- ----------- "�Y�
one million Floridians licensed by the Department of Business and - l
Professional Regulation. Our professionals and businesses range ` * STATE OF FLORIDA ,
from architects to yacht brokers,from boxers to.barbeque f DEPARTMENT OF BUSINESS AND
restaurants,'and they keep Florida's economy strong. PROFESSIONAL REGULATION
Every day we work to improve the way we do business in order ER13014793 "f= ISSUED: 08/08/2016
to serve you better. For information about our services,please
!og onto www.myfloridalicense.com. There you can find more' REG ELECTRICAL CONTRACTOR."
information about our divisions and the regulations'that impact MUNOZ,JUSEF P
you,subscribe to department newsletters and learn more about - M.B.ELECTRIC SERVICE CORP h
the Department's initiatii -
i ves. - (INDIVIDUALMUST MEET ALL LOCAL
Our mission of the Department is:License Efficiently,Regulate LICENSING REQUIREMENTS PRIOR
� TO CONTRACTING 1N ANY AREA
Fairly.We constantly strive to serve you better so that you can
serve your customers. Thank you for doing business in Florida, HAS REGISTERED under the provisions of 6h.489 FS.-.
and congratulations on your new license! ( r rmmion dale r AUG 31,2018 0608080001665
DETACH HERE
RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY
.STATE OF FLORIDA ... . -_= _....�. _._......._,�...;....._....._____..:_...:..._.__�,,,...
r` DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
C
' ELECTRICAL CONTRACTORS LICENSING BOARD ' `
e
I ER 13014793 a.r=.`• c ,�h/' ,�
The ELECTRICAL CONTRACTOR
'1 Named below HAS REGISTERED 4 �'�` `4 ;' ` ` � ;*' g
Under the provisions of Chapter 489 FS.
Expiration date: AUG 31, 2018
(INDIVIDUAL MUST MEET ALL LOCAL LICENSING, ,
_1 4r�REQUIREMENTS PRIOR TO CONTRACTING IN ANY AREA)
MUNOZ ,IUSEF P ,�` `" . ` , RE
M.B. ELECTRIC SERVICE:CORP
13955 NW 195 ST
MIAMI GARDENS 4 ,`, ': "� .'''`•'. � f^ w ,, ; N-
ON,
FL 33055 ,�' °
`c{.�c.-.••.•!.:.. £.._....f" „"r•"..,,.. ._,..w .�+...wp..'r�:.... ... :._""R»,' `}'• "'?r'�.►, '*,,. "!a1kw:. .Ys a.:u.,. �,mak. *� L .1..�T..,,,":'�c
tssuED. o8i08no18 DISPLAY AS REQUIRED BY LAW SEQ r t.1so8080001s65
JEFF ATWATER
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: 5/22/2017 EXPIRATION DATE: 5/22/2019
PERSON: MUNOZ JUSEF P
FEIN: 208556856
BUSINESS NAME AND ADDRESS:
M.B:ELECTRIC SERVICE CORP
3955 NW 195 STREET ,
' MIAMI GARGENS FL 33055
k
SCOPE OF BUSINESS OR TRADE:
Licensed Electrical Contractor
{ 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
j 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 tufie 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?(8 j)413-1609
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MB ELECTRIC SERVICE CORP.
a
August 23rd, 2017
State of Florida
County of Miami Dade
Before me this day personally appeared JUSEF MUNOZ who,being duly sworn,deposes and
says:
That he will be the only person working on the property located at 1430 NE 102°a Street
Miami Shores FL 33138.
Sworn to (or affirmed) and subscribed before me this 23day of 4—c--,k . 20 t- ,
by _
Personally Known
OR Produced Identification
Type of Identification Produced �'-Nevv
;�4.. '9 Ricardo Dominguez
�= Commission # FF958686
"= Expires:February 8,2020
. OF Bonded thru Aaron Notary
Print,Type or Stamp Name of Notary
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3955 NW 195 STREET MIAMI GARDENS FL 33055
1
♦ OR
1
Miami shores Village
"' Building Department
artment
r— e 10050 N.E.2nd Avenue
ES 10
ORIDp' Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
{
Notice to Owner — Workers' Compensation Insurance Exemption
i 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 and has acknowledge that he or she will not use
day labor,part-time employees or subcontractors for your project.The contractor has provided an affidavit stating that he or she will
be the only person allowed to work on your project.In these circumstances,Miami Shores Village does not require verification of
workers'compensation insurance coverage from the contractor's company for day labor,part-time employees or subcontractors.
BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS
CONTENTS.
Signature:
Owner
State of Florida
1
County of Miami-Dade
4 �
The foregoing was acknowledge before me this Z3rd day of OC-4()b-e r ,20
By ,(4111AC1 k/
O V M CAhVP,yG' who is personally known to me or has produced
as identification. y
YANADY PRIEr0
Notary: ''
MY COMMISSION#FF 214031
EXPIRES:March 25,2019
Bonded Thru Notary public Underwriters
SEAL: �.m