The URL can be used to link to this page

ELC-18-1186Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Permit NO. EL.C-5-18-1186 Permit Type. Electrical - Commercial Wor%,Classification: ,Additian/Alteration Permit Status: APPROVED Issue oats:' 5/8/2018 Expiration: 11/04/2018 Parcel Number Applicant 9501 NE 2 Avenue Miami Shores, FL 33138- 1132060133920 Block: Lot: DVS LLC Owner Information Address Phone Cell DVS LLC 201 NE 95 Street MIAMI FL 33138- (305)756-3711 201 NE 95 Street MIAMI FL 33138- Contractor(s) WELL ELECTRIC TECHNOLOGY Phone Cell Phone (305)726-7098 (786)473-8455 Type of Work: INSTALLATION OF NEW LIGHTS AND NEW Additional Info: INSTALLATION OF NEW LIGHTS AND NEW Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $7.80 $5.47 $3.65 $2.60 $364.67 $3.00 $10.40 $397.59 Pay Date Pay Type Invoice # ELC-5-18-67410 05/04/2018 Credit Card 05/08/2018 Credit Card Amt Paid Amt Due $ 50.00 $ 347.59 $ 347.59 $ 0.00 Available Inspections: Inspection Type: Final Meter Box Alteration Relocation Fire Alarm Service Change Review Electrical W. W. Underground In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinancesand regulations pertaining thereto and ip strict.. • ormity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume resp• 'sibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUM ING, ECHANI AL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDA ' : I c at all the going information is accurate and that all work will be done in compliance with all applicable laws regulating construction aryl z= ins. F t r e, I au - ize the ae-named contractor to.d the work stated. / ii/)47 / 72 er / Applicant / Contractor / Agent May 08, 2018 Date Buildin• ment Copy 0 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 APPLATION ❑BUILDING ZELECTRIC ❑ ROOFING ❑PLUMBING ❑ MECHANICAL El PUBLIC WORKS JOB ADDRESS: RECEIVE, MAY 0 47018 ae h FBC 2034 Master Permit No. ('C- ��QQ� - Z /5 Sub Permit No. E1 K� 1 1 n! ❑ REVISION ❑ EXTENSION El RENEWAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS City: Miami Shores County: Folio/Parcel#: // 3Zo,60t337 /Q Z-O Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction/Type: Flood Zone: BFE: -FIFE: OWNER: Name (Fee Simple Titleholder): L)1/ S ZZ t� Phone#: 305 2$6 3-9// Address: - 0/ /I/ G 9 $ SZf t-/ City: //l9A1/ State: /7G- Zip: 3 3/ 39 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:/Company Name: U &2 g- g eer1G z 'a //2C Address: / J/Z N� //$'6 AW/ /W7 ' , / State: _" Qualifier Name: ./%� Gf 1--/-Z v / State Certification or Registration #: ce /300 //a / City: Miami Dade DESIGNER: Architect/Engineer: Address: Value of Work for this Permit: $ Zip: 33/38 t'5 .41gX 3744 Phone#: Tfs' 7 9ga Zip: 3 3J Z Phone#: � (1. .3 99 9ifi Certificate of Competency #: Phone#: City: State: Zip: Square/Linear Footage of Work: Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: //% 56A Ce4 /O� D7J ��LU // �1� GE/ c' /� P� C�ci�l�/c,2c ,/ Specify color of color thru tile: .��`-ono Submittal Fee $ Permit Fee $ 00 CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ (Revised02/24/2014) Bonding Company's Name (if applicable) Bonding,omparry'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 inspe :ch occurs s • . (7) days after the building permit is issued. In the absence of such posted notice, the inspection w of be approved and a reinspe • n fee will be charged. Signatur: J-�� Signature /7" r AGENT CONTRACTOR The foregoing i ' rument was acknowledged before me this The foregoing instrument was acknowledged before me this :J day of M f a_ 4 , 20/ r� , by --�� /J day Hoff �/ , 20 / 8 , by / /io<e - ekeeQ n.p. j', who is personally known to 70 92 1/d /� , who is personally known to ,_gor who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: Seal: / )/--/) 4 5 ELIZABETH ELORRIAGA •'c MY COMMISSION p FF953536 EXPIRES January 25.2020 140/1 :WS-0' b3 FlortlallotaySorv,ce car NOTARY PUBLIC: Sign: Print: Seal: APPROVED BY ?"' A/A / /8 Plans Examiner Structural Review MARIA DE LA FE t l MY COMMISSIONS GG 117058 EXPIRES: June 26, 2021 Bonded Nu Notary Public Undewlters Zoning Clerk (Revised02/24/2014) Miami 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: 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 co • _ - • • s the contractor's company for day labor, part-time employees or subcontractors. BY SIG CrBEi`OW YOU ACKNOWLEDTHAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS C • NTS. State of .rida County of Miami -Dade The foregoing was acknowledge before me this '! day of l � BY I `Plr' -- l eGJ l /cCQ Nota SEAL: ,20d who is personally known to me or has produced as identification. ELIZABETH ELORRIAGA '•c MY COMMISSION* FF953536 .... • EXPIRES Jan__.. rptirrrmn. ,3 bnaaHaaryseMca cow WELL ELECTRIC TECHNOLOGY, INC. Qualifier Tony Well License #EC13001181 4312 NW. 11 St. Miami, FL 33126 weiltechnoIogy�w.. @hotmoit rrom PH: 786-399-9180 02/26/ 2018 State of Florida County of Miami Dade Before me this day- personally appeared Tony Well who, being duly sworn deposes and say: That he will be the only person working on the project located at: 9537 NE 2 Ave Miami Shores Fl. 33138-. Zr �Coignatre Sworn to (or affirmed) and subscribed before me thus 02/22/2018. Maximo Rodrigues Personally know 14'""""' t MAXIMOA.RODRIGUEZ ., :, z Mrc�oytiJuly GG005481 AMA ��K� WxpIREs.nl 5,2020 W ` -4 N� Bolded Thu wrd Pubic MH.M`� _a