ELC-18-1734Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit NO. ELC-8-18-1734
Permit Type: Electrical - Commercial
Work Classification: Low Voltage
Permit Status: APPROVED
Issue Date: 8/28/2018
Expiration: 12/25/2018
Parcel Number
Applicant
9140 NE 8 Avenue Number: BLDG H
Miami Shores, FL 33138-0000
113206044001
Block: Lot:
SHORES PLAZA EAST CONDON
Owner Information
Address
Phone
Cell
SHORES PLAZA EAST CONDOMINIUM 621 NE 92 Street
-- • - FL
Contractor(s) Phone
3 WAVES ELECTRIC CORP (305)221-3780
Cell Phone
Valuation:
Total Sq Feet:
$ 3,620.00
0
Type of Work: SECURITY CAMERAS INSTALLATION
Additional Info: SECURITY CAMERAS INSTALLATION
Classification: Commercial
Scanning: 3
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology fee
Total:
Amount
$2.40
$2.25
$2.00
$0.80
$150.00
$3.00
$3.20
$163.65
Pay Date Pay Type
Invoice # ELC-6-18-68035
06/28/2018 Check #: 20605
06/25/2018 Check #: 20604
Amt Paid Amt Due
$ 113.65 $ 50.00
$ 50.00 $ 0.00
Available Inspections:
Inspection Type:
Review Electrical
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:
construction find zonin
I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
I authorize the above -named contractor to do the work stated.
Authorized Signa Applicant / Contractor / Agent
June 28, 2018
Date
Building Department Copy
June 28, 2018 1
,cP"
Miami Shores Village
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
BUILDING
PERMIT APPLICATION
El BUILDING Q ELECTRIC ❑ ROOFING
PLUMBING ❑ MECHANICAL PUBLIC WORKS
JOB ADDRESS: 9140 NE 8th Ave
FBC20\1bfi4\
Master Permit No. UCI
Sub Permit No.
❑ REVISION ❑ EXTENSION RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
City: Miami Shores
Folio/Parcel#: 113206044001 '
Occupancy Type: Load:
County:
Construction Type:
Miami Dade Zip:
Is the Building Historically Designated: Yes
OWNER: Name (Fee Simple Titleholder): Shores Plaza East Condo
Address:745 NE 91st Street
Flood Zone:
NO X
BFE: FFE:
Phone#: 305-759-9069
City: Miami Shores
Tenant/Lessee Name: N/A
Email: Spe123@att.net
State: FL Zip: 33138
Phone#: N/A
CONTRACTOR: Company Name: 3 Waves Electric Corp.
Address: 1303 SW 124 Concourse
Phone#: 305-962-5889
City: Miami
Qualifier Name: Victor A. Couillard
State: FL
Zip: 33184
Phone#: 305-962-5889
State Certification or Registration #: ER0013736 Certificate of Competency #:
DESIGNER: Architect/Engineer: _ , Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 3620.00 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration
Description of Work: Security cameras installation
❑■ New
❑ Repair/Replace ❑ Demolition
Specify color of color thr
Submittal FeiSt,r,50.:..
Scanning Fee $
Technology Fee $
Structural Reviews $
}
,zy+' 49
Permit F e $ t'l. e" 'c)
f e° i 1, L+ ,_. 1 r151t3tr?
Radon Fee $ a •
co
Training/Education Fee $
rs.rk. CO/CC% $
DBPR • c-26- Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ 13 '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.
cC' 3 g-w
Signature Signature
OWNER or AGENT
CONTRACTOR — •
The foregoing instrumenttww acknowledged before me this The foregoing instrument was acknowledged before me this
Z C day of , 20 41_, by 2- s".day of 1t'I £ , 20 O , by
C Lps' 1:41.0 Y e72 : r io is personally known to V IOW k -c eld;1 '_ ho is personally known to
mayor who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign: �i•—•-
Print:
Seal:
0,5 M
A244
i °us Notary Public State of Florida
4
Oscar M Zaragoza
'orj My Commission FF 939267
f^,d' Expires 12/08/2019
r who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: D �/q
OSG//z i 19/2 �
Seal:
*********** ********************
APPROVED BYi43Y/l/-122- CL1-' /8
Plans Examiner
Structural Review
Zoning
Clerk
(Revised02/24/2014)
iami Shores Village
Building Department
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:
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 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
County of Miami -Dade
The foregoing was acknowledge before me this "I day of
i/eM
as identification.
Notary:
P14, Notary Public
SEAL: Oscar M Zagoza
AlMy Commission FF 939267
or nd"' Expires 12/08/2019
r has produced
3 Waves Electric
1303 SW 124 Concourse
Miami, Florida 33184
(305) 962-5889
Date / 7 / Za/
State of Florida
County of Miami Dade
Before me this day personally appeared Victor Couillard who, being duly sworn, deposes and
says:
That he or she will be the only person working on the project located at:
9140 NE 8th Ave Miami Shores, FL 33138
Contractor Signature
Sworn to (or affirmed) and subscribed before me this2 (day of
by Victor Couillard
.20)7,
Personally know ✓
OR Produced Identification
Type of Identification Produced
Print, Type or Stamp Name f Notary
LOCATION
Miami Shores Plaza
9140 NE 8th Avenue
Miami Shores, Fl 33138
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HONEYWELL GENESIS 50781106
Category 5e, 4 pair Riser Rated, Unshielded twisted pair (UTP), 24 AWG
solid copper, GIG Ethernet for power limited circuits, sunlight resistant.
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?de S4anei Playa Slat eatetomaream 4440ctartla c, Toe.
745 North East 9 I sc Street
Miami Shores, FL 33138
305-759-9069/ -
E-MAIL: spe123 raft
June 25, 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 9140 NE 8th Ave., 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
L' F
R- R
Detail by Entity Name Page 1 of 3
F orid& Department of State
Oki
r.,
Department of State / Division of Corporations / Search Records / Detail By Document Number /
DIv eioN OF CORvoecooN
Detail by Entity Name
Florida Not For Profit Corporation
'SHORES PLAZA, EA, ST_CONDOMINIUM'INC:7
Filing Information
Document Number 726432
FEI/EIN Number 59-0597536
Date Filed 05/17/1973
State FL
Status ACTIVE
Principal Address
745 N.E. 91 ST ST
MIAMI SHORES, FL 33138
Changed: 04/26/2012
Mailing Address
745 N.E. 91ST ST
MIAMI SHORES, FL 33138
Changed: 04/26/2012
Registered Agent Name & Address
ZARAGOZA, OSCAR
745 NE 91ST ST
MIAMI SHORES, FL 33138
Name Changed: 04/26/2012
Address Changed: 04/26/2012
Officer/Director Detail
Name & Address
Title PD
DE ROJAS, JORGE
9140 NE 8TH AVE, APT 4H
MIAMI SHORES, FL 33138
Title VD
tTAL'AVERA,.CA,RLOS
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Detail by Entity Name Page 2 of 3
726 NE 92ND ST, APT 7L
MIAMI SHORES, FL 33138
Title TD
ZARAGOZA, OSCAR
726 NE 92ND ST, APT 1 L
MIAMI SHORES, FL 33138
Title SD
WARD, DAVID
488 NE 90 ST
EL PORTAL, FL 33138
Title D
OCAMPO, DAVID
755 NE 91 ST
4F
MIAMI SHORES, FL 33138
Annual Reports
Report Year Filed Date
2016 04/19/2016
2017 04/26/2017
2018 04/27/2018
Document Images
04/27/2018 -- ANNUAL. REPORT
04126/2017 ,ANNUAL REPORT
04/19/2016 -- ANNUAL REPORT
04/28/20 15-:..:ANNUAL R EP,QRT
04/29/2014 -- ANNUAL REPORT
05/01 /2013 -- ANNUAL. REPORT
04/26/2012 -- ANNUAL REPORT
04/28/2011 -- ANNUAL REPORT
Q4127j1�1Q..:.:._! N.N-VAL. REPORT
04/20/2009 -- ANNUAL REPORT
05/01/2008--ANNUAL REPORT
04/27/2007 -- ANNUAL REPORT
...............................................................................................
02/11/2006 -- ANNUAL REPORT
05/02/2005--ANNUAL.._B.EE1 TR.T
09/22/2004 -- ANNUAL REPORT
04/21/2004 -- ANNUAL REPORT
03l2412G03,::.:- ANNUAL. -REPORT
04129/2002 -- ANNUAL REPORT
4234129Q1 -- ANNUAL F;FPQ.RT
03/20/2000 -- ANNUAL REPORT
04/29/1999 -- ANNUAL REPORT
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Detail by Entity Name Page 3 of 3
01/21/1998-- ANNUAL REPORT
04/01/1997 --ANNUAL. REPORT
02/20/1998 - ANNUAL. REPORT
03/02/1995 -- ANNUAL REPORT
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Florlr.a De art, er:t or State. .. - . oratio u
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