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EL-18-3341Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address issue Date:12/04/2018 Parcel Number 128 NE 94 ST, Miami Shores, FL 33138 1132060132980 Contacts Permit NO.: L-10-18-3341 Permit Type: Electrical - Residential Work Classification: Temp for Test Permit Status: Approved Expiration: 06/03/2019 SALVATORE INVESTMENTS INC Owner SALVATORE INVESTMENTS INC Applicant JOSE SBARRA JOSE SBARRA 128 NE 94 ST, MIAMI SHORES, FL 33138 128 NE 94 ST, MIAMI SHORES, FL 33138 Mobile: 3057785961 Mobile: 3057785961 Other:3057581169 Other:3057581169 R.Q ELECTRICAL INC Contractor RODOLFO QUINTANA 9801 NW 123 TER, HIALEAH GARDENS, FL 33018 Business: 3057909769 Description: TEMP POWER FOR TESTING Valuation: $ Inspection Requests: 200.00 305-762 4949 In my opinion the job cost estimate provided does not does not reflect the actual job cost for this project. Provide Total Sq Feet: 5,329.00 a detail itemized iob cost for the entire proiect. Fees Amount Application Fee - Other $50.00 CCF $0.60 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.20 Permit Fee $50.00 Scanning Fee $3.00 Technology Fee $2.50 Total: $110.30 Building Department Copy Payments Date Paid Amt Paid Total Fees $110.30 Credit Card 10/31/2018 $50.00 Credit Card 12/04/2018 $60.30 Amount Due: $0.00 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 constructioWnd zoning. Futhermore, I authorize the above named contractor to do the work stated. Authorized mature: ner / Applicant / Contractor / Agent Date December 04, 2018 I Page 2 of 2 it 2 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 7S6-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 BUILDING PERMIT APPLICATION F-IBUILDING 0 ELECTRIC ❑ ROOFING RECEIVED OCT 31 1018 0-M-1 CA " FBC 201"1 Master Permit No. 18-424 Sub Permit No. Vf - 3.� ❑ REVISION ❑ EXTENSION MRENEWAL PLUMBING [:]MECHANICAL PUBLIC WORKS ❑ CHANGE OF [:]CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 128 NE 94 ST City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 11-3206-013-2980 Is the Building Historically Designated: Yes NO X Occupancy Type: residertai Load: Construction Type: CBS Flood Zone: X BFE: FFE: OWNER: Name (Fee Simple Titleholder): SALVATORE INVESTMENTS INC Phone#: 305-778-5961 Address: 6130 NE 4th Ct City: Miami State: FL ZIP: 33137 Tenant/Lessee Name: Phone#: Email: alsba@bellsouth.net CONTRACTOR: Company Name: RQ ELECTRICAL INC e#: 305-790-9169 Address: 92801 NW 123 TERRACE City: HIALEAH GARDENS State: FL Zip: 33018 Phone#: 305-790-3769 Qualifier NameRODOLFO QUINTANA Certificate of Competency #: State Certification or Registration #: 11 E000505 DESIGNER: Architect/Engineer: Phone#: 786-312-6060 CARMEN T. DIAZ Address:5001 S.W. 74th CT# 100 City: MIAMI State: FL Zip: 33155 Value of Work for this Permit: S 200 Square/Linear Footage of Work: 5,329 Type of Work: ❑ Addition ❑ Alteration Q New ❑ /Re lace Re air p p ❑Demolition Description of Work TEMPORARY POWER FOR TESTING Specify color of color thru tile: 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 $ 6eO , n Q (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 applic ant 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 I OWNER r GENT CONTRACTOR The foregoing instrument was a knowledged before me this The foregoing instrument was acknowledged before me this 31 day of OCTOBER 20 18 by 31 day of OCTOBER 20 18 by JOSE A. SBARRA who is personally known to RODOLFO QUINTANA who is personally known to me or who has produced as me or who has produced as identification and who did take an th. identification and who d' take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: t _ -,; Print _ dNk? is ion 8 FF 950062 1.1j(%j �p0jission 8 FF 950062 • Print •- Seal: ''rF;;;` Jon ry 12. 2620 Seal: ��°�` January 12, 2020 •,,, , APPROVED BY/c--✓ tf'��� l Plans Examiner Zoning Structural Review 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 AFFIDAVIT FOR 30 DAY TEMPORARY -ELECTRIC SERVICE NOTE: ELECTRIC SERVICE WILL BE DISCONNECTED "WITHOUT NOTICE" UPON 30 DAY TERMINATION UNLESS APPLICATION IS RENEWED. It is understood that the temporary -electrical approval by the Miami Shores Village, Building Department given in connection with the building being constructed under: Building Permit N: 424-i8 Electrical Permit N: At Address: 128 ne 94 st Miami Shores, FL 33138 _ For Owners: salvalurs investments Incl losealberto Sbarra , and is being given only for construction purpose or for testing the following equipment in said structure: lights, pool equipment, water heater The owner does herby agree to assume the responsibility of maintaining the installation in such manner that there is no hazard to life or property. Such approval is in no event to be considered a RELEASE of said structure for the purpose of use and occupancy, and no occupancy shall be granted or permitted until further inspections have been called for and approved by the inspection divisions concerned, and/or a Certificate of Occupancy or Completion is obtained. The undersigned also understands that the temporary electric approval is subject to rescission and incellation and electric power can be cut off at the discretion of the building official and will be disconcerted of ie building concerned is occupied before final inspections are approved and/or obtained a Certificate of Occupancy or Completion. Note: Failure to comply with the provisions of this affidavit will result In your beingg un ble to obtain future Temporary for Test permits. 11 JoseaA. Sbarra , being first duly sworn, depose and say that I m the owner of the above described property, and that I agree that the structure covered in this agreeme t shall not be occupied until the building contractor has obtained approval of final inspections and/or obtaineAa Certificate of Occupancy of Com letion. Note: Failure to comply with the provisions of this Idavit will result in your bein jna of future Teipporary for Test permits. ♦ Q i..+`:a"!•,.AAK wh A A L E J A N D R A L U N A Signature of Own ssion Expires Rodolfo Quintana i op1", January 12. 2020 I, being duly sworn, depose and s r for the abo escribed property and that the electrical installations as now existin wiI of create a safe hazan if to o servic is connected. `� �� .�+r ry�p RINA ALEJANDRA LLINA ^� ommission N FF 950062 Signa of ElectriLTContractor Si -f mission xpires Off, , an ary 12, 2020 I, Jose A. Sbarra , being first duly sworn, depose and say that am the Building Contractor of the above described property and that I will not permit occupancy of this building until final inspections have been called for by the contractors and sub -contractors concerned and final approval by the i spection division obtained and that I have the authority insofar as the owner of said property is concerned to ohibit occupancy until such final inspegtions are obtained and/or a Certificate of Occupancy or Completion i issued. gnature of Build �� �Awrny49�tVANDRA LUNA Com issio M FF 950062 MY Commission Expires re of Inspector Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to uWner - worKers, c:ompensatlon Insurance txemption 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 -rime 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. k Signature: State of Fh County of Miami -Dade The foregoing was acknowledge before me this 3( day of Oc7;(0 F5 2 , 20 [8 . By �O �, A- who is personally known to me or has produced aycif `� as identification. Notary: RAI K. GONZALEZ ?� MY _,:11, h41SSION # GG 044602 SEAL: *. �; E-`'-IRES: November2, 2020 Mocary Public Underwriters •�L��B�F ��;Y r 0 m — o> 2 r�Tt�D o N iv o Q < 0. U3 zG> Q 3 0 � � z c iv G�Nj m N N o 0 � N