ELC-18-3571Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
_
Issue Date:12/06/2018
Parcel Number
9600 NE 2 AVE, Miami Shores, FL 33138 1132060132510
�mr�ni�nnni
Contacts
Permit NO.: EiC-12-18-3571
Permit Type: Electrical - Commercial
Work Classification: Alteration
Permit Status: Approved
Expiration: 06/03/2019
PALAZZO LEONI LLC Owner PALAZZO LEONI LLC Applicant
TODD LEONI TODD LEONI
PO BOX 381703, MIAMI, FL 33238 PO BOX 381703, MIAMI, FL 33238
J V PALMA ELECTRIC CORP. Contractor
JULIO C ALVAREZ
525 E 27 ST, HIALEAH, FL 33013
Business: 7869423757
Description: ELECTRICAL FOR INSTERIOR RENOVATION Valuation: $ 1,500.00 Inspection Requests:
UNIT# 175 NE 96 ST Total Sq Feet: 617.00 r-762-4949
Sarahl-ou Confections
Fees
Amount
Application Fee - Other
$50.00
CCF
$1.20
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.40
Permit Fee
$50.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$111.10
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$111.10
Credit Card
12/06/2018 $61.10
Credit Card
12/03/2018 $50.00
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 construction and zoning. Futhermore, I authorize the above named contractor to do the work stated.
Owner / Applicant / Contractor / Agent Date
December 06, 2018 Page 2 of 2
` UAY-35�1
JV Palma Electric Corp
Date:
State of 2y"� h I d (a -
County of 111A Y t DA E G-F-
Before me this day personally appeared To Li O C A (U�h ho, being duly sworn,
deposes and say:
That he or she will be the only person working on the project located at:
Contractor Signature
Sw rn to (or affirmed) and subscribed before me this KJ day of 'I�.20 t �—
by A LV 4- 2 ,--L
Personally Know
OR Produced Indentification
.,, I• RA
• of t(*ntification Prod
•c,�c /I
6,2020
nt_ TVDe or Stamo Name of Notary
F-LC-I�_-35-7 1
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 - vvorKers- compensation insurance txemption
Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. r 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 Fmployer 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 industy 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 I,1,C, 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 I3EL�W YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS
CONTENTS. 1
Si nature: Oil/
Owner
State of Florida
County of Miami -Dade r--
The foregoing was acknowledge before me this 4 —day of r"V , 20_�� .
13y___D l� I _____________._____.__._ ___ who is personally known to me or has produced
as identification.
Notary:_A4A�t
_._...
4 pN )REW VOGEL
SEAL: (') MY COMMISSION a FF919683
s+� EXPIRES: Novembc 25, 2019
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
BUILDING AELECTRIC ❑ ROOFING
FBC 20 tit
Master Permit No. L' ` - ) _ Z Z 57d
Sub Permit No. a-C-P V 35-4'
❑ REVISION ❑ EXTENSION ORENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
., q ` CONTRACTOR DRAWINGS
JOB ADDRESS: I 15 1y e JO� � vT
City. Miami Shnres Cnuntv: Miami Dade Zio: -3 3 Z -3 i
Folio/Parcel#: 0 - 320(o - 0 i 3 - 2610 O Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Nam (Fee Simple Titleholder): T��D 1 �' 6 Phone#:
Address: A )( 3 � / -�t u-3
city: Ivy, a m;
Tenant/Lessee Name:
Email: kviv V
J
CONTRACTOR: Company Name: :S V FAL1I A FLe mzi C C6 0 Phone#: r/-y 6 "
Address: G Z S E 7 7 T H 517
City: 141 kL.F A k State: I=Lo TZ i r�k Zip: 5-30 13 C�
Qualifier Name: -To L( U C A LOA 2.5 Z Phone#: -/ 8� � - ?p��/✓e(� /
State Certification or Registration #: Certificate of Competency #: 1-1 F- D 0O 3
DESIGNER: Architect/Engineer: Phone#:
Address: �fCity: State: Zip:
Value of Work for this Permit: $ 1.50 0 ® Square/Linear Footage of Work:
Type of Work: ❑ Addition ' , ,Alliteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: 1 P- l -co r i_ 0 0 CJ Aa U
Specify co1or;.of color thru'tile:
Submittal Fee $V. `;� .. ' Permit Fee $ �'�� 3��7CCF $ CO/CC $
Scanning Fee^$ Ridon}Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $(01.10
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
City State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
Zip
Zi
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 app oved and a reinspection fee will be charged.
Signature Signature
OWNER or AGENT CO TRACTOR
The foregoing instrumentwas a knowledged before me this The foregoing instrument was acknowledged before me this
day ofD 20 by - 4 day of � �M'� 20 (� by
-9U/� l.,ed / who is personally known to `1 VU 6 C i-� wA�� , who is personally known to
me or who has produced as me or who has produceul—L� 17 L � E N as
identification and who did take an oath. identificatinBL
who did take an oath.
NOTARY PUBLIC: n NOTARY P
Sign: Sign: Imo! _'
_�.
Print: Print: 911A -�
Seal: Seal:
ANDREW VOGEL ::+i�► SINDIA ALVAREZ
: z
MY COMMISSION # FF919683 F *, MY COMMIS51% # GG 2382733• ��
EXPIRES: November 25, 20►9 . of EXPIRES' September
APPROVED B j / Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
%.. 1 a
Construction Trades Qualifying Board
JSINESS CERTIFICATE OF COMPETENCY
11E000393
V PALMA ELECTRIC CORP
ALVAREZ JULIO C
Is certified under the provisions of Chapter 10 of Miami -Dade County
75487
Local Business Tax Receipt
Miami —Dade County, State of`Florida
-THIS IS NOT A BILL - DO NOT PAY
6893466
BUSINESS NAME/LOCATION
JV PALMA ELECTRIC CORP
525 E 27TH ST
HIALEAH FL 33013
RECEIPT NO. EXPIRES
RENEWAL SEPTEMBER 30, 2019
7169089 Must be displayed at place of business
Pursuant to County Code
Chapter 8A - Art. 9 & 10
OWNER SEC. TYPE OF BUSINESS
1V PALMA ELECTRIC CORP 196 ELECTRICAL CONTRACTOR PAYMENT RECEIVED
11E000393 BY TAX COLLECTOR
$45.00 09/18/2018
Worker(s) 1 CREDITCARD-18-070362
This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license,
permit, or a certification of the holder's qualifications, to do business. Holder must comply with any governmental
or nongovernmental regulatory laws and requirements which apply to the business.
The RECEIPT NO. above must be displayed on all commercial vehicles - Miami -Dade Code Sec 8a-276.
For more information, visit www.miamidade.gov/taxcollector