EL-18-1820Miami Shores Village
10050 NE 2 Ave
Miami Shores Village FL 33138
305-795-2204
Issue Date: 09/25/2018
Permit NO.: EL-7-18-1820
Permit Type: Electrical - Residential
Work Classification: Alteration
Permit Status: Approved
Expiration: 01/01/2019
Location Address Parcel Number Project
240 NE 97 ST, Miami Shores, FL 33138 1132060134020 <NONE>
rnntnt+c
Owner Applicant
240 NE 97 ST, MIAMI SHORES, FL 33138 240 NE 97 ST, MIAMI SHORES, FL 33138
VENUR CONSTRUCTION, LLC Building Contractor ONLY ELECTRIC CO INC Contractor
2950 W 84 ST 103, HIALEAH, FL 33018 348 NW 102 TERR
(305)903-1795 (305)785-6059
Inspection Requests:
Description: ELECTRICAL ALTERATIONS Valuation: $ 2,000.00 Inspec ion Re
LIGHTS, OUTLETS, INTERIOR BOX SERVICE
Total Sq Feet: 0.00
Fees
Amount
CCF
$1.20
DBPR Fee
$3.38
DCA Fee
$2.25
Education Surcharge
$0.40
Permit Fee - Additions/Alterations
$225.00
Scanning Fee
$9.00
Technology Fee
$1.60
Total:
$242.83
Permit Received By
Payments
Amt Paid
Total Fees
$242.83
Credit Card
$50.00
Credit Card
$192.83
Amount Due:
$0.00
Inspections:
Inspection Type
Electrical Final
Review Electrical
Date
Building Department Copy
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores
Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate
permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFII' : I certify that all he foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating const oning. F ermore, I authorize the above named contractor to do the work stated.
thorized Signature: Owner ( Applicant / Contractor / Agent Date
September 25, 2018
Page 2 of 4
Miami Shores Village
JUN 3 2 18
l Buiding Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
°I—Ii- 2271 I FBC 20
BUILDING Master Permit No._ Rcv
PERMIT APPLICATION sub Permit No. EQ 8 — I$ 20 CI P
❑BUILDING j'ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL r
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS [:]CHANGE OF [:]CANCELLATION ❑ SHOP
a I �7�j CONTRACTOR DRAWINGS
JOB ADDRESS: Z �/1l D - q�'! ' s� 2 /
City: Miami Shores County: Miami Dade Zip: � 3 / 39
Folio/Parcel#: 4 I - ;F2 '00-013- '�020 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FIFE:
OWNER: Name (Fee Simple Titleholder): P"Pf7Y Af� t1 e, Phone : 18 6 - g_T 8 "
Address: Z'/a fit' q�- g-r 1` lGb-c It Lk
City: /t-z/ iris/ s State: Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company N'/
a -me:
� Address: l( T (J V" 0
City: State: L Zip:t
Qualifier Name: d — O C Phone#:
State Certification or Registration #: - f 3 Off% Z3 1 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State:
Value of Work for this Permit: $ 2,000 Square/Linear Footage of Work:
Zip:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
_ I
Description of Work: $ / #ak 11J7F7teD/P, , OOTLETS, Ui '61-%7A)
Specify color of color thru tile:
Submittal Fee $ ScD { Permit Fee $ 7 Zw4"l or-' CCF $ CO/CC $
Scanning Fee $ Radon Fee $ 2' 2--19 DBPR $ 7�3 Notary $
Technology Fee $ Training/Education Fee $
Double Fee $
Structural Reviews $
(Revised02/24/2014)
Bond $ Q
TOTAL FEE NOW DUE $ -1 Z
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
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
OWNER or AGENT
The foregoing instrument was acknowledged before me this
3118 day of UI 20 18 by
Mab�1t
• S G who is personally known to
me or who has produced\dJ• 111`Q Y 1 C`el"6'e as
ide ntificatiorfa n*L who did take a
NOTARY PUBLIC:
Signature
CONTRACTOR
The foregoing instrume was acknowledged before me this
day of 20 k* by
�Aav who is personally known to
me or who has produced y MM,4 as
identification and who d
NOTARY PU
Sign: 6 Sign:
Print: 6r 0 i"r O Print:
Seal: Seal:
YANADY PRIEM
*: MY G()K.MISSION # FF 214031
EXPIRES: March 25 2519
;a niedThruhbtxY?L',
APPROVED BY �����/� —4-1-44Y lf"% Plans Examiner
n oath.
YANADY PRIETO
MY COS'�MS51041 i'f 21401
EXPm" k`xch 2s, ?'i1!
Zoning
Structural Review
(Revised02/24/2014)
Clerk
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- uompensation 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 3K' day of , 20160'.
By 1r, V re >> A �'C ► — P0+�( Ow- ho i J� s�erson ly known tome or has produced
t'ivky ` as identification.
YANADY PR
IETO
Notary: '''=
=�; +_ MY COMMISSION # FF 214031
o ` EXPIRES: March 25, 2019
SEAL: ^;,44 '` Bonded ThruWtary?uVcUnderwriters