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EL-18-2014
Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Pe •mit Parcel Number Issue Date.; Permit NO. E L-7-18-2014 Permit Type: Electrical -Residential Work Classification: Alteration Permit Status: APPROVED 2018 Expiration: 02/09/2019 Applicant 10611 NE 11 Avenue Miami Shores, FL 33138-2120 1122320280380 Block: Lot: STEPHEN LENSI Owner Information Address Phone Cell STEPHEN LENSI 10611 NE 11 Avenue MIAMI SHORES FL 33138- (860)490-6310 Contractor(s) Phone FLORIDA ELECTRIC SOLUTIONS INC CeII Phone Valuation: Total Sq Feet: $ 2,600.00 0 Type of Work: KITCHEN REMODELING AND PANEL REPLAC Additional Info: Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $1.80 $3.38 $2.25 $0.60 $225.00 $3.00 $2.40 $238.43 Pay Date Invoice # 07/27/2018 08/13/2018 Pay Type EL-7-18-68361 Credit Card Credit Card Amt Paid Amt Due $ 50.00 $ 188.43 $ 188.43 $ 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,UMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVI I certify th- t e fore.oing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zo ipg. _ • - ! t 5 €named contractor to do the work stated. Authf6rized Signatur •: Owner / Applicant / Contractor / Agent August 13, 2018 Date Building Department Copy August 13, 2018 1 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 UL2,72018 B FBC 20\ BUILDING Master Permit No. RL e 1)O'6 PERMIT ArPLICATION Sub Permit No. I.LI e 20 ( y ❑ BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑ RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 4 0611 City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE::1 FFE:) OWNER: Name (Fee Simple Titleholder): S` ce \.1 - LN S' iPhoneT "f g4."`7, P —16°C) i 0-6(1 ,L dw Address: City: I) prvA,N, C State: F L- Zip:z.33e Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: ! G \\ Address: Ij i S bn,C7Qc1 NDYL �d Phone#: e6" J.90StiO City: KA / AM % State: rt_ Zip: 63 l (/ 9 Qualifier Name: y) 3(t4.YJtl J t6 (Ora) Phone#: a ` v State Certification or Registration #: t t ao 1,9J s i Certificate of Competency #: j i E ©O DO L DESIGNER: Architect/Engineer: Phone#: Address: x City: State: Zip: Value of-Work•for this.Rermit:.$ �,6ho _ C71�' Square/Linear Footage of Work: Type of Work: ❑ Addition `` ElAlteration❑ New Description_of;Work:---. 6 TAiN(-0-) ) IM-L-)cC (I ❑ Repair/Replace ❑ Demolition Specify color of color thru tile: cil "; Submittal Fee $ S) , Permit Fee $Z/ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ 3 . 3 Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ 1 8• LQ (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. Signature 0 ERorAGENT Signature!//l/�}� CONTRACTOR The foregoing instrument was acknowledged before me this TYie'foregoing instrument was acknowledged before me this '-k—day of Lens 20 by '2 day off✓a.. , 20i " , by 9 Vi er1 L_C ts� , who is personally known 5-6,"-et. 01. 40.0-1, who is personal) own to on me or who has produced pers�ncu►k as me or who has produced/ � s identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: APPROVED BY DEBRA A. JARBOE Notary Public - State of Florida Commission # GG 071308 My Comm. Expires Jun 4, 2021 Bonded through National Notary Assn. identification and who did take an oat NOTARY PUBLIC: Si: Prin Seal: 2 ) #2 i/ Plans Examiner Notary Public - State of Florida Commission # GG 032324 Expires Sep 21.2020 AI Notary Assn. Zoning (Revised02/24/2014) Structural Review Clerk CTCB Construction Trades ualifying Board BUSINESS CERTIFICATE OF COMPETENCY 11E000018 FLORIDA ELECTRIC SOLUTIONS INC .B A. MARRERO YOISLANDY Is certified under the provisions of Cha ter 10 of Miami -Dade County Miami -Dade County - Building and neighborhood Compliance Office Page 1 of 1 Horne J Product Control I Contractors I Building Officials I Contact us Contractor Number: Contractor name: Address: City, St, Zip: Phone: Other Phone: Fax: Email: D/B/A: Contractor Status: Contractor License Information 11E000018 FLORIDA ELECTRIC SOLUTIONS INC 9115 BROAD MANOR RD MIAMI (786) 704-9840 YOISLANDYMARRERO@HOTMAIL.COM ACTIVE FL 33147 Class Category Category Description Expiration Date ELEC 1 ELECTRICAL 09/30/2019 ELEC 4 FIRE ALARM SPECLT 09/30/2019 ELEC 37 LOW VOLTAGE SPECIALT 09/30/2019 CONTRACTOR INQUIRY COMPLETE BCCO Contractor Inquiry and Complaint Search I BCCO Home Page I State License Search Menu Home I About I Phone Directory I Privacy I Disclaimer © 2001 Miami -Dade County. All rights reserved. http://egvsys.miamidade.gov:1608/WWWSERV/ggvt/BNZAW941.DIA?CNTR=11 E000018 7/27/2018 THIS BECOMES A TAX RECEIPT WHEN VALIDATED A -� ors �fi o 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000 VALID OCTOBER 1, 2017 THROUGH SEPTEMBER 30, 2018 DBA:FLORIDA ELECTRIC SOLUTIONS INC Business Name: Owner Name: YOISLANDY MARRERO (QUAL) Business Location: 9115 BROARD MANOR RD MIAMI DADE COUNTY Business Phone: 786-280-9840 Rooms Seats Employees 1 -Receipt #:E8ECTRI CAL/ALARMS/CONTRA Business Type: (ELECTRICAL CONTRACTOR) Business Opened:11 / 2 5 / 2014 StatelCounty/Cert/Reg:12 - CME -18 2 3 0 - R Exemption Code: Machines Professionals For Vending Business Only Number of Machines: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 6.75 0.00 25.00 58.75 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS This tax is levied for the privilege of doing business within Broward County and is non -regulatory in nature. You must meet all County and/or Municipality planning and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. Mailing Address: FLORIDA ELECTRIC SOLUTIONS INC 9115 BROARD MANOR RD MIAMI, FL 33147 2017 - 2018 Receipt #03C-17-00003751 Paid 02/12/2018 58.75 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL:REGULATION ER13014581 REG ELECTRIC MARRERO, YOI FLORIDA ELE& (INDIVIDUAL MO' LICENSING REQ1JL. TO CONTRACTING:IN-6 li .4' ...'t ' V A). ': i'• HAS REGISTERED undert14-Orovisions of Ch.489 IS. Expiration date : AUG 31, 2018 .. -. L1609010004649 : ',',:-'11,44eti...01','SU 0'9.• .X.44 .: ," '''....7.1 '..1', '''t'''''.i:'....:'. 'f'p:v.,....,.: . ' ..., j'., ',;,;'..;.;1..t.;::..1,WHA?..7-Fi.: .' .' • r --'',.:..1"..... ...7:.14, .- f..1::....il ..: .. 4f.. _ H HERE .,-,-09/01 /2016 TQR t'AL , KEN LAWSON, SECRETARY JIMMY PATRONIS 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: 4/21/2017 EXPIRATION DATE: 4/21/2019 PERSON: MARRERO FEIN: 274625762 BUSINESS NAME AND ADDRESS: FLORIDA ELECTRIC SOLUTIONS INC 9115 BROAD MANOR RD MIAMI FL SCOPE OF BUSINESS OR TRADE: Licensed Electrical Contractor 33147 YOISLANDY 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 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 time 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? (850)413-1609 Florida Electric Solutions 9115 Broad Manor Road Miami Florida 33147 Phone# 786-290-9840 License # EC11E000018 E-mail:floridaelectricsolutions@gmail.com Date State of Before me this personally appeared l hStttN ,.iiatiez who being duly sworn And says That he or she will be only person working on the project located at 10611 ne 11av Miami shores fl 33138 Contractor signature Sworn to (or) ed ) nd subscribed me this I day of 20 ► eg w4 Personally know Or produced identification Mgp Type of identification produced Print ,type or stamp name of notary 9‘o 1 6,3� o o,ir"'••,, DAYSI RODRIGUEZ d 14. Bonded through Natlonatary Assn. Notary Public - State of Florida Commission N GG 032324 My Comm. Expiresi k 8 ti 1YSt RODRIGUEZ fJut<ay Public - State of Florida Commission # GG 032324 My Comm. Expires Sep 21, 2020 Bonded through National Notary Assn. Notice to Owner — Workers' Com p Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 ensation 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: Owner State of Florida County of Miami -Dade The foregoing was acknowledge before me this 3r`� day of ByS't L.-ems , 20 (% . who is personally known to me or has produced as identification. Notary: fit. SEAL: YANADY PRIETO MY COMMISSION # FF 214031 EXPIRES: March 25, 2019 Bonded Thru Notary Public Undeneiters