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EL-18-3524Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Issue Date:11/29/2018 Location Address Parcel Number 825 NE 915T TER, Miami Shores, FL 33138 1132060050250 Contacts Permit No.: EL-11-18-3524 Permit Type: Electrical - Residential Work Classification: Pool Permit Status: Approved Expiration: 05/27/2019 MARIALI ALVAREZ Owner ON CALL ELECTRICAL CONTRACTORS INC Contractor 825 NE 91 TER, MIAMI SHORES, FL 33138 KEVIN GILLIS Other:7863749810 Business: 7863885880 Description: ELECTRICAL FOR NEW POOL AND SPA Valuation: f 1,800.00 Ins ection Re uests: CONSTRUCTION 305-762-4949 TotalScl Feet:=503.000 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 $9.00 Technology Fee $2.50 Total: $117.10 Payments Date Paid Amt Paid Total Fees $117.10 Check # 4119 11/29/2018 $67.10 Check# 4024 11/26/2018 $50.00 Amount Due: $0.00 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. OWNE S AFFIDAVIT: certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws re gul ing constructio and zoning. Futherm0 authorize th ove named contractor to do the work stated. f go' u1 �e VV C, lSignature: Owner / Applicant / Contractor / Agent ate November 29, 2018 Page 2 of 2 J. BUILDING PERMIT APPLICATION 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 Dfl ELECTRIC ❑ ROOFING NOV 2 6 )218 BY. FBC 20 Master Permit No. ?)?P 1U -�) I 6 Sub Permit No. 1 SZ4 REVISION EXTENSION ❑ RENEWAL PLUMBING MECHANICAL PUBLIC WORKS CHANGE OF CANCELLATION SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 9/ -fe✓ City: Miami Shores County: Miami Dade Zip: 33?f.*s Folio/Parcel#: /i _ 3ZL-AO - 001---- 62-S-0 Is the Building Historically Designated: Yes NO _ Occupancy Type: Load: Construction Type: Flood Zone: BFE: FIFE: OWNER: Name (Fee Simple Titleholder): Norja Alvaro geknd . (,J4yj ev fa.4 ado Phone#: Address: Nr- 91 .%r City: MIA-41 ✓4a-,( State: A!01-� Zip: Tenant/Lessee Name: Email: Phone#: CONTRACTOR: Company Name: alIGGtI/ Phone#: -786- WS'-R60 / Address:7Y00 NW 7Sfi 4111 City: AA iatA 1 State: Fe- Zip: 3'9 Qualifier Name: )�G�,,.� r�T_)�� Phone#: State Certification or Registration #: E C. oo ©eD ` 4-1 Certificate of Competency #: DESIGNER: Architect/Engineer: _ Phone#: Address: City: Value of Work for this Permit: $ 00 Square/Linear Footage of Work: Zip: Type of Work: ❑ Addition ❑ Alteration A_New ❑ Repair/Replace U Demolition Description of Work: New ITee Specify color of Color t ru tile: Submittal Fee$-30 P11114 _ Permit Fee $CCF Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ DBPR $ CO/CC $ _ Notary $ Double Fee $ _ Bond $ TOTAL FEE NOW DUE $ (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 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. 9 Si AGENT The foregoing instrument was acknowledged before me this day of r5 N 20 by who is personally known to me or who has produced as identification and who did take an oath. NOTARY BORGES • MK " 0 GG 271799 •: EXPIRES: DeceMber 17, 2022 S i gn • .' itru lictary Pdit unde�wlers i Print: Seal Signature -- CONTRACTOR The foregoing instrument was acknowledged before me this �1 _ITi day of �� �; 20, by `�. �\1 � ,who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBL �.,.�... GLAD BORGES MYOOMMISSIOt 9 GG 211799 Sign: G EXPIRES: December 17.2= Print: Seal: lQ APPROVED BY 2 9 lVOl1 Plans Examiner Zoning Structural Review (Revised02/24/2014) Clerk Notice to Owner - Workers' Com Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 nsation 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 Y(�jU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. �f Signatur Owner State of Florida County of Miami -Dade The foregoing was acknowledge before me this day of N 03 t Bwho is personally known to me or has produced as identification. Notary: ' lu SEAL: " QMYS GORGE$ RICk SCOTT- WVM40R 1004AT�#AN ZAC,#4f#A- 5f.COFIARY dbpr STATE OF FLORIDA DEPARTMENT OF BUSINESS -AND PROFESSIONAL REGULATION ELECTRICAL CONTRACIrORS, LICENSING BOARD THE ELECTRICAL C0NTRACTOR44ERa1j`tS C0kTWtED UNDER THE PROVISIdNS;0F CHAPTER 489, FLORMASTATUTES I I - GILLIS, KEVIN. ON CALL ELECTRICAL CONTRACTORS INt 7400 N W 7TH STREET (SNIT111 MIAM)" FL $3126 N Sf IN U M b E I C-' EC 6 0 0 0 947 7 EXPIRATION bAT#--`A0Gtit '3i, 2o2o Always vei6 e Ikealces ovAirm at Myflorid,)Ucensexorn Do not after this document in any form, This is Your license. It is urAavvkd for anyone other than the licensee to use thi,, docutnent