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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