ELC-18-1459 I
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-307373 Permit Number: ELC-5-18-1459
Scheduled Inspection Date: June 28, 2018 Permit Type: Electrical - Commercial
Inspector: Devaney, Michael Inspection Type: Final
Owner: CONDO, SHORES PLAZA EAST Work Classification: Low Voltage
Job Address:715 NE 91 Street BLDG A
Miami Shores, FL 33138-0000 Phone Number
Parcel Number 113206044001
Project: <NONE>
Contractor: 3 WAVES ELECTRIC CORP Phone: (305)221-3780
Building Department Comments
SECURITY CAMERAS INSTALLATION Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re-Inspection
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
June 27,2018 For Inspections please call: (305)762-4949 Page 33 of 34
Permit No. ELC-5-18-1459
2,s Miami Shores Village Permit Type:Electrical•-Commercial
10050 N.E.2nd Avenue NE 0 Pen t Work Classification:Low Voltage
Miami Shores,FL 33138-000 Permit Status:APPROVED
Phone: (305)795-2204
FtoRroA
issue Date:611/2018 F Expiration: 11/28/2018
Project Address Parcel'Number Applicant
715 NE 91 Street Number: BLDG A 113206044001 SHORES PLAZA EAST CONDO
Miami Shores, FL 33138-0000 Block: Lot:
Owner Information Address Phone Cell
SHORES PLAZA EAST CONDO
MIAMI SHORES FL 33138-0000
Contractor(s) Phone Cell P.hone Valuation: L$ 3,8L70.00
3 WAVES ELECTRIC CORP (305)221-3780 0
Total Sq Feet: 0
Type of Work:SECURITY CAMERAS INSTALLATION, Available Inspections:
Additional Info:SECURITY CAMERAS INSTALLATION Inspection Type:
Cl6ssification:Commercial'
Review Electrical
Scanning:3
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $2.40 Invoice# ELC-5-18-67724
DBPR Fee $2.25 05/29/2018 Check#:20579 $50.00 $ 113.65
DCA Fee $2.00
Education Surcharge $0.80 06/01/2018 Check#:20580 $ 113.65 $0.00
Permit Fee $150.00
Scanning Fee $3.00
Technology Fee $3.20
Total: $163.65
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 authorize the above-named contractor to do the work stated.
I ��a 4,(/ &,0 June 01, 2018
Authotized Sign—a—t—u'reF.-Mner / Applicant / Contractor / Agent Date
Building Department Copy
I
June 01, 2018 1
Miami Shores Village AY s 018
; '0 g p
Building Department
p --�
(� 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 20(1h
BUILDING Master Permit No.
PERMIT APPLICATION Sub Permit No.
BUILDING 0 ELECTRIC F—] ROOFING F-1 REVISION Ej EXTENSION RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 715 N E 91 st Street
City: Miami Shores Countv: Miami Dade Zip:
Folio/Parcel#:113206044001 Is the Building Historically Designated:Yes NO X
I
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee simple Titleholder):Shores Plaza East Condo Phone#:305-759-9069
Address:745 NE 91st Street i
City.. Miami Shores State: FL Zip: 33138
Tenant/Lessee Name: N/A Phone#:N/A
Email: spe123@att.net
CONTRACTOR:Company Name: 3 Waves Electric Corp. Phone#: 305-962-5889
Address: 1303 SW 124 Concourse' -76b --5 4 t — ( Dp j(j;�
City: Miami state: FL Zip: 33184
Qualifier Name: Victor A. Couillard Phone#: 305-962-5889
State Certification or Registration#: ER0013736 Certificate of Competency#: {
DESIGNER:Architect/Engineer: Phone#:
,r
Address: City: State: Zip:
Value of Work for this Permit:$3870.00 Square/Linear Footage of Work: E
Type of Work: ❑ Addition ❑ Alteration New ❑ Repair/Replace ❑ Demolition
Description of work: Security cameras installation ,
�p?'"•.c''Rr ,,�.4r-ani'�+�:"'r�ti+.N'y/"v+`�,s'6 ,.#q '•:..,.�bs°�F* �`...s'si'�"."`}a,.o'+;"y�',�:.�'i4,'w-
;r " .thy, �, F hI:t' } *1tA "i"`s `` a# �✓i t �tirrr 'n i
Specify color of color thr tile:
Submittal Fee$n76'{��� �1:a,Permit Fee$ .-�.J�Oe00 CCF$ 'rE. �,y.�•� R. r °�-CO/CC$r'�' ^ F
Scanning Fee$ Radon Fee$ DBPR$ Notary$ [.
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ V Bond$
TOTAL FEE NOW DUE$
(Revised02/24/2014)
Bonding Company's Name(if applicable)
Bonding Company's Address _
City State Zip 1
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 Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of 20 by �day of ry 20 f by
hby3 / i6dj,67R-jgwho is personallyknown to VIG TVC fbLj GG o who is personally known to
me r Ll
r who has produced as me or who has produced 4• kivas". LIG as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC: ;
Sign: Sign:
Print: nGw 2 l/- Print: SC 2
Seal: gv0 Notary Nbme State of Fbrwa Seal: �r Notary PubNc State of Fbdda
Oscar M Zaragoza �° Oscar M Zaragoza
,fi My Commiasio 9FF 939187 My Commiaafon FF 939287
or R Expires 12/08/2019 ? Expireb 12/08/2019
APPROVED BY Plans Examiner Zoning
' Structural Review Clerk
(Revised02/24/2014)
' 7446 SdMed ;Vlaga 54at e44d W4a4W Ad4Od&O*, 76-
745 North East 91 sc Street
Miami Shores,FL 33138
305-759-9069/e';
E-MAIL,spel23@att.net
May 24, 2018
Miami Shores Village
Building Dept.
10050 NE 2nd Avenue
Miami Shores, FL 33138
Dear Sir/ Madam,
This letter will serve as your confirmation, that "3 Waves Electric Corp." has been
contracted by the Shores Plaza East Condominium Asso., Miami Shores, Florida,
33138, and it is fully authorized by the Board of Directors to perform work in the
installation of "security cameras" in building 715 NE 91 Street, Miami Shores, FL
33138.
Should you desire any additional information, please feel free to contact our
office at your earliest convenience.
Sincerely yours,
Carlos Talavera
Vice-President
Shores Plaza East Condominium Asso.
cc: file
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y,
gnu ,, ,M Miami E3 hores Voillage
Building Department
�Lpt1U�* 10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel:;(305) 795.2204
Fax: (305) 756.8972
a
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-tinge
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.
I. 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 apermit under this workers' compensation exemption and has acknowledge that he oeshe 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 `_ \
(—V%Lk—
State of Florida
County of Miami-Dade
The foregoing was acknowledge before me this_ V1 day of
./' 1h,47' 20 / ...._.
By 1-19 Ile who ispersonally known to me r has produced
_ as identification.
i
Notary:
1 SEAL: X40 Oua� Notary Public to of F rias
Oscar M Zaragoza
a� My Commission FF 939267
'rE�nd� Expires 12108/2019
3 Waves Electric
1303 SW 124 Concourse
Miami,Florida 33184
(305)962-5889
Date S- /3 )-0/
State of Rt mit
County of I Y I 1 6-41 L— l APC-
Before me this day personally appeared V ) C- r2 2 COC') U'OtaD who, being
duly sworn, deposes and says:
That he or she will be the only person working on the project located at:
/.�' IV ► S7� Imo ; �► ; s4 PR-
Ut
Contractor Signature `
Sworn to(or affirmed)and subscribed before me this,3 1 day of 201z,
by 0-5--An M. aAaA60�i9
tnow
OR Produced ation'''
Type of Identification Produced ,`A, Divi o-c L,�c
Print,Type or Stamp Na of Notary
, NNotary Public State of Florida
Oscar M zaragoza
My Commission FF 939267
a Expires 12/08/2019
LOCATION +°+
Miami Shores Plaza ,.
' 715 NE 91St Street 4
Miami Shores, FI 33138 '
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Antenna Eitlft�
R.a.pexN
Equipment, Cables Specifications & Power Consumption
I
Legend Model Description Watts QTY Total-W
i0mugh9wLit—ch 150 1 150
Gigabit PoE 8-Port Managed Switch
,A NASO �tation M5-US 12 • %200
Ubiquity Indoor/Outdoor PoE Antenna ••• * 0 •••�:•
=` HIKVISION DS-2cd2t42wd 8 ••• 48•
4M P Dome Network Camera •••• :•. •
Tota 1 •••••
...... • .
r HONEYWELL GENESIS 50781106 ....:.
Category 5e, 4 pair Riser Rated, Unshielded twisted pair(LtT P),24 AWG• ••••
solid copper, GIG Ethernet for power limited circuits, sunii ht`reSlstartC•.••
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-ate 0,16
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PERW #: -
Miami Shares Village
APPROVED BY DATE
ZONING DEPT G pp_//_'�_�
<!y�Y
BDG DEPT
SUBJECT 1,0 CcNjP11tPICE WITH ALL.FEDERAL
STATE ANL)C UNi"t jtUL:_S AND REGULATIONS
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