EL-18-1319Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Pe
mit
Permit NO. EL5-18-1319
Permit Type: Electrical - Residential
Work Classification: Service Change
Permit Status: APPROVED
Issue Date: 5/24/2018
Expiration: 11/20/2018
Parcel Number
Applicant
130 NE 98 Street
Miami Shores, FL 33138-
1132060132400
Block: Lot:
MARIA GROSSO
Owner Information
Address
Phone
CeII
MARIA GROSSO
130 NE 98 ST
MIAMI SHORES FL 33138-2337
Contractor(s) Phone
CEDOE ELECTRIC CORPORATION (786)333-3612
CeII Phone
Valuation:
Total Sq Feet:
$ 900.00
0
Type of Work: SERVICE UPGRADE INSTALL DUAL METER
Additional Info:
Classification: Residential
Scanning: 3
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
$0.60
$3.38
$2.25
$0.20
$225.00
$9.00
$0.80
$241.23
Pay Date Pay Type Amt Paid Amt Due
Invoice # EL-5-18-67570
05/24/2018 Credit Card $ 191.23 $ 50.00
05/16/2018 Credit Card $ 50.00 $ 0.00
Available Inspections:
Inspection Type:
Review Electrical
i
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 and zoning. Futhermore, I authorize the above -named actoo the work stated.
Authorized Signature: Owner / Applicant
o 'actor ent
May 24, 2018
Date
Building Department Copy
May 24, 2018 1
BUILDING
PERMIT APPLICATION
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
MAY 16 Md
Master Permit No.�A
Sub Permit No.
❑ BUILDING — ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑ PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: r? fgs'/
City: Miami Shores County: Miami Dade
Folio/Parcel#:
Zip: ,.7 1 3
Is the Building Historically Designated: Yes NO
Occupancy Type:/ �s3 Load: Construction Type:..-S j/b ee Flood Zone: BFE: FFE:
N �/f y) �1 %Ze, a-1 i .
OWNER: Name (Fee Simple TitIeehholder):/�' ! /7/` /, ` /zeS��'U
Address: f 1 o ,V 7 eV--
'-
/,9
City: M( ( CA ) $7 State: f;>
Tenant/Lessee Name: / Phone#:
Email: / ,/fi ,5 1/ 3 V �i�Q// C � gf' l
CONTRACTOR: Company Name: CZ,749�
Address: /2s / A/Z1,30` c�
Phone 0032Y3
Zip: 3 9-
Phone# )5 3'/ Z
City: State: Zip: 3 ! /
Qualifier Name: /�/ i/�'' 1 -�� _ / Phone`y �,� 7�;
State Certification or Registration #: Certificate of Competency #: / 1 .401 /5?
DESIGNER: Architect/Engineer: Phone#:
Address: C� City: State: Zip:
Value of Work for this Permit: $ { .e Square/Linear Footage of Work:
Type of Work: ; ❑ Addition ❑ AlterationT❑ New/ /�n ❑ Repair/ReplaceRe❑ Demolition
Description of Work: 1 0 1 .9 6 Ci2., C —I 1-4\7 S
Specify color of co/or;tlirutile:.:
Submittal Fee $ »> .•; .. P.errriit Fee'a76 e GP CCF $ . " ? ,CO/CC $.7 ,,
Scanning Fee $ Radon Fee $ DBPR $ . 3. Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $
(Revised02/24/2014)
Bond $ �-
TOTAL FEE NOW DUE $ ' 1 ! 23
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
r
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."
4
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
ti.
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. ti
Signature
OWNER or AGENT
Theforegoing instrument was acknowledged before me this
//isJ (o day of / a / a , 20 / , by
F}i/i G SD___,. who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
",.."'..,, MY E GALE
.p ConxMssion # GG 137334
1s Expires November 21, 2021
Signature
CTOR
The foregoing instrument was acknowledged before me this
day of /7ii4 ' y , 20 / , by
4�lpda
� who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
we/Y 77 6A9.sso
MARIAT. GROSSO
MY COMMISSION * FF 231889
EXPIRES: May 17, 2019
*************************s*T*K **Beahaa lekakaasyiStela**************
APPROVED BY Plans Examiner
Structural Review
Zoning
Clerk
(Revised02/24/2014)
C 11 tI t 11 ELFC/RlCCORP.
1251 NE 130TH ST NORTH MIAMI FL 33161
Wednesday, May 16, 2018
State of FLORIDA,
County of: MIAMI-DADE.
Before me this day personally appeared DIOMEDES DIAZ who, being duly sworn, deposes and says:
That he or she will be the only person working on the project located at: 130 NE 98TH ST
MIAMI SHORES, FL 33138.
Contractor
Sworn to (or affirme and subscribed before me this 4 days of
By�/�
r/Ac/
,20 /B
Personally Know
OR Produced Identification
Type of Identification Produced
, Type or Stamps Name of Notary
7'.00 MARIA T. GROSSO
MY COMMISSION i FF 231886
EXPIRES: May 17, 2019
Bonded Thru Budget Notary Scrim
•
4.
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 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:
State of Florida
County of Miami -Dade The foregoing was acknowledge before me this IC i day of
By
,20/ 0.
who is personally known to me or has produced
as identification.
Notary:
SEAL: �� U
KEU.Y E. GALE
Commission # GG 137334
�O�P`•' Expires November21, 2021
R" BandedTlwTroyFainIswwno0000-3AJ4119
�•r
ifeu
W
a
.3 `250 yrlL141/ Zcii7r
-
CO
J J
0 u z
0 z 0 1-
a oopt
/11 ; Cit re) / r.-/.P(
/
a
z
al
•SiECT TO COMPI. ANCE WITH ALL FEDERAL
z
0
15), Pi";
BY•
Zg
Pole
JAN 0 3 017
016,0
6,L / Ayes(c.x,
2i`2Y6
i 7 /ti 3w
• ...
. •
• ••
.•..
. •
• • •
.... ...• • .
• • ••
•••• ••••
•
• • • • •
••• •• ••••
•
• • •
• • • •
• •
.•
• • • • •
• • •
•• • ••• • • •
••
! 2./2 ybj i yµ, 3i', tr
zt �.
wlr
i2
13 a /Ui, S•f.
•
•
MAIN HOUSE
Exiting
Electric
Serv.
120v
New
O2
New
• 0 ••• • • • •••
•• •• • • • •• •• •
• • • • •
• • • • • • • • •
• • • • • • • •
• • 000 4 • • • 0.9
•
• •
• •
• •
• •
• • •
• • • •
• •
• • di* • •
• • • • •
Of • •• ••• •
BACK
•
• • • • • 140 1 • 4
•
• •
BEDRGUM I • •
Ov
11
LIVING ROOM
•
• • I • •
•
WALK-IN
CLOSET
MASTER
BEDROOM
BATHROOM
KITCHEN
Ref
I III 1VI!II
FRONT
128 NE 98TH ST MIAMI SHORES, FL 33138-2346
ELECTRICAL REVIEW
LLI