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EL-18-1363Peet No. EL-5-18-1363 �s�oreEs y,� Miami Shores Village 44 Pemtit Type: Electrical - Residential' 10050 N.E. 2nd Avenue NE n I Work Classification: Alteration -� Miami Shores, FL P� ' 33138-0000 Permit Status: APPROVED 'tea` Phone: (305)795-2204 FCOR'lDp' issueoate:6111t201'8 I Expiration:12/08/2018 Project Address Parcel Number Applicant 1296 NE 99 Street 1132050090140 Miami Shores, FL Block: Lot: FILPO PROPERTIES LLC owner mtormation Addresfif Phone Cell FILPO PROPERTIES LLC KJ 1 6 NE 27 Street (,�. - O� MIAMI FL 33137- ") 4�% NE 27 MIAMI FL 33137- Contractors) Phone Cell Phone CAMAGUEY ELECTRICAL SERVICE (305)984-1036 Type of Work: REMODELING OF BATHROOM, CLOSET AND Additional Info: Classification: Residential Scanning: 1 Fees Due Amount CCF $1.20 DBPR Fee $2.25 DCA Fee $2.00 Education Surcharge $0.40 Penalty Fee $100.00 Permit Fee - Additions/Alterations $150.00 Scanning Fee $3.00 Technology Fee $1.60 Work without Permit Fee $150.00 Total: $410.45 Valuation: $ 1,800.00 Total Sq Feet: 0 Pay Date Pay Type Amt Paid Amt Due Invoice # EL-5-18-67613 05/18/2018 Credit Card $ 50.00 $ 360.45 06/11/2018 Check #: 1534 $ 360.45 $ 0.00 Available Inspections: Inspection Type: Review Electrical Ll 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 th!retoand 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 0 work done by either myself, my agent, servants, or employes. I understand that separate permits are required for EVECTRICAL, PLUMBING, MECHAtL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS A IDAVIT: I rtify that all the fo go ng information is accurate and that all work will be done in compliance with all applicable laws regulating construction an in uthermore, I author e e above -named c ntra or to do�the wor stated. [�� June 11, 2018 AutF Xze"ignature:Owner / Applicant / Contractor / Agent Building Department Copy June 11, 2018 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 -Workers' Compensation 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 p son allowed to work on your project. In these circumstances, Miami Shores Village does not require verification of workers' co ensation insurance coverage from the contractor's company for day labor, part-time employees or subcontractors. BY SIGN BELOW YOU A KI QWMDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS State of Florida County of Miami -Dade ` The or oing was acknowledge' bkfore me this - day of , 20 I �. Bwho i rsonally known a or has produced ., i I as identification. Notary: SEAL: 'I— 1 LARITZA VAZDUEZ-CESPEDES Commission # FF 948571 Bonded through National Notary Assn. �JI ECF�Itz � Comm ELECTRICAL SERVICES CORP. 'ten Electrical Contractor J (305)984-1036 *SERV1�Lic:#ER13014584 Date: State of: County of: #4 ciLt' Before me this day personally appeared �ct 11,h, C`�,(J Q r'� , who, being duly sworn, deposes and says: That he will be the only person working on the project located at Contractor signature Sworn to (or affirmed) and subscribed before me this day of , 2018 By J oKZA� Z_ Personally know Or Produced Identification QR Type of Produced Identification�3liceScS� ;.'•PY'ry.,. MONICA CASTAGNA MY COMMISSION # FF 185740 • =, EXPIRES: December 28, 2018 w%ram or °P` Bonded Thru Notary Public Underwriters Print, Type or Stamp Name of Notary CAMAGUEV ELEfTRIEAL SERWES CORP. nElectrical Contractor J (305)98A-1036 SEW'( fRVW'(* Lic:#ER13014584 To whom it may concern Reference: Filpo Residence, 1269 NE, 99 St, Miami Shores Village, FI By this letter I certify that I will be the only person working on the residence of reference Samuel J. Gonzalez President and Qualifier CAMAGUEY ELECTRICAL SERVICES CORP. BUILDING PERMIT APPLICATION ❑BUILDING RrELECTRIC Miami Shores Village aBY�:� EWF 8 018_ Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 TT INSPECTION LINE PHONE NUMBER: (305) 762-4949ro FBC 201 Master Permit No. P C I �- rq Sub Permit No. E(-- I e + 13Cn3 e ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF [:]CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: I a qG� NE qct"A s-ye (J City: Miami Shores County: 06d e Miami Dade Zip: L 7 1 .tea Folio/Parcel#: 11 32U�- 00 `In - O i q O Is the Building Historically Designated: Yes NO Occupancy Type:. �t S Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Free Simple Titleholder):� i-i 100 �V'0Cw 1% es l _i� Phone#: 3 ©5-- R-9 7- ! Address: (� -/ N � / de`/7 s1N 4 p� city: I'-'( /iG". floor S State: Zip: lam"��' 130 Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company N Address: O City: ia_ e Qualifier Name: e#: ?o -9-(4 /03 State Certification or Registration #: zw/3a /q S 9-tl Certificate of Competency M // F 0040 / 0--3 DESIGNER: Architect/Engineer: Address: City: State: Zip: Value of Work for this Permit: $ 11 F<L)C) -b0 Square/Linear Footage of Work: Type of Work: ❑ Addition D Alteration ❑ New ❑ Repair/Replace Descriotion of Work: ❑ Demolition Specify color of color thru tile: �-ra Submittal Fee $ Permit Fee $ rc�®f 7 /0 CCF $ CO/CC $ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ Fl"'/95 1 eo.e'a DBPR $ Notary Double Fee $ ! ✓'tea b 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 Zip 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. 1 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 in ection which occurs se (7) days after the building permit is issued. In the -absence of such posted notice, the inspection will jot be approved arAa rei ctipn fee will be charged. :1 OWNER or AGENT The f egoing instrumgn/t� was pcknowledged befor this day of 20 . by who is . ersonally known me or who has produce !off as identification and who did take an oath. Sign:_ Print: CONTRACTOR The foregoing instrument was acknowledged beforemethis day of M 1 , 20 ` u by S� a7-,�/J�.q/,-;,whoisR rsonally kn <e,br who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: SAMANTHA>;AROLIAASANCHEZLOPEZ Seal: LLA. �inr'o"'e.. -?o � Notary Public •State of Florida Commission # FF 191928My Comm. Expires Jan 21.2019 ************** * •,,nua * **was **w APPROVED BY Plans Examiner _ Structural Review VLADIMIR LOPEZ MY COMMISSION # GG 132036 EXPIRES: August 17, 2021 Bonded Thra Notary public Underwaiters Zoning Clerk (Revised02/24/2014) Property Search Application - Miami -Dade County Page 1 of 1 OFFICE OF THE PROPERTY APPRAISER ..' Summary Report Property Information Folio: 11-3205-009-0140 Property Address: 1296 NE 99 ST Miami Shores, FL 33138-2643 Owner FILPO PROPERTIES LLC Mailing Address 600 NE 27 ST 2904 MIAMI, FL 33137 USA PA Primary Zone 1400 SGL FAMILY - 3001-3250 SQ Primary Land Use 0101 RESIDENTIAL - SINGLE FAMILY: 1 UNIT Beds / Baths / Half 3/2/0 Floors 1 Living Units 1 Actual Area Sq.Ft Living Area Sq.Ft Adjusted Area 2,346 Sq.Ft Lot Size 10,932.7 Sq.Ft Year Built 1951 Assessment Information Year 2016 2015 Land Value T$2269,T086$272,722 366,618 $333,868 Building Value $178,249 XF Value $0 $0 Market Value .............................._..._.....__.. $662,995 $639,340 $512,117 Assessed Value $662,995 $639,340 _ $454,377 Benefits Information Benefit Type 2017 2016' 2015 Non -Homestead Cap Assessment Reduction $57,740 Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). Short Legal Description 5 53 42 EARLETON SHORES PB 43-80 LOT 1 & E25FT LOT 2 BLK 2 LOT SIZE IRREGULAR OR 18686-1393 07 1999 1 Generated On : 5/18/2018 Taxable Value Information 2017' 2016 2015 County Exemption Value $0 $0 $0 Taxable Value --+ $662,995 $639,340 $454,377 School Board Exemption Value $0 $0 $0 Taxable Value $662,995 $639,340 $512,117 City Exemption Value $0 $0 $0 Taxable Value $662,995 $639,340 $454,377 Regional _ Exemption Value $0 $0 $0 Taxable Value $662,995 $639,340 $454,377 Sales Information Previous Sale Price OR Book -Page Qualification Description 12/07/2015 $840,000 29881-2405 Qual by exam of deed 07/17/2012 $560,000 28215-3879 Qual by exam of deed 10/01/2004 $540,000 22759-4407 Sales which are qualified 07/01/1999 $215,000 18686-1393 Sales which are qualified The Office of the Property Appraiser is continually editing and updating the tax roll. This website may not reflect the most current information on record. The Property Appraiser and Miami -Dade County assumes no liability, see full disclaimer and User Agreement at hftp://www.miamidade.gov/info/disclaimer.asp Version: https://www.miamidade.gov/propertysearch/ 5/18/2018 Detail by Entity Name Page 1 of 2 Ronda Deoaitment of State .org •tt hj�ll: J4 .: i .trf !t �P`.!. :1;� ia.xf�i+:lf: Department of State / Division of Corporations / Search Records / Detail By Document Number / D ivislON of C0RPO!"in';(iN8 http://search. sunbiz. org/Inquiry/CorporationSearchISearchResultDetail?inquirytype=Entity... 5/ 18/2018 Detail by Entity Name Page 2 of 2 Annual Reports Report Year Filed Date 2016 05/05/2016 2017 02/22/2017 2018 03/03/2018 Document Images 03'03.12018 --.ANNUAL REPORT View image in PDF format Q212212917=.ANNUAL_REORT View image in PDf' fbmiret 05/05/2016 -- ANNUAL REPORT View image in PDF Format 11i1712015 -- Florida Limited Liability View image in PDF formal Fl- c1 ;;:,::e tf: tar.., Ci...t­.,-.....r.Z,i http://search. sunbiz. org/Inquiry/CorporationSearchISearchResultDetail?inquirytype=Entity... 5/ 18/2018 STATE OF FLORIDA � DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COUPENSATIQN � CONSTRUCTION INDUSTRY EXEMPTION CERf1 "TE OF&AC'nMTO BE EXW" FLAY fs_w6VA #ERS' CO f8 -OW I AW 011e1VE DATE" 2*z;7 EXWHAIY{ke T.ATE: :'y'iifti S Efto ^ G09ZALEY fbk: 2162"llf, BUSINESS NAME AND ADDRESS: CAMAGUEY ELECTRICAL. SERVICES CORP, 6160 W 28TIl Cl' HIALEAHI FL 33016 SCOPES OF BUSINESS OR TRA LICENSED ELECTRICAL CONTRACTOR il >' � STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ER 13014884 ISSUED: 0711012016 REG ELECTRICAL CONTRACTOR GONZALEZ, SAMUEL JORGE CAMAGUEY ELECTRICAL SERVICES CORP. (INDIVIDUAL MUST MEET ALL LOCAL LICENSING REQUIREMENTS PRIOR TO CONTRACTING IN ANY AREA) HAS REGISTERED uncle; the provisions of Ch.489 FS €xwauyn dwe AUfa 31 2 18 LI607f00wl959 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION FY12000268 ISSUED: 08/03/2016 REG ALARM SYSTEM CONTRACTOR I GONZALEZ, SAMUEL JORGE CAMAGUEY ELECTRICAL SERVICES CORP. (INDIVIDUAL MUST MEET ALL LOCAL LICENSING REQUIREMENTS 'PRIOR TO CONTRACTING IN ANY AREA) HAS REGISTERED under vie provisions of Ch.409 FS. €x,waW) "s AUG 31. 2018 Liwj60330GV23G vl Lq Board! nUSWIFS< ERTIs=ICATE OF COMPETENCY 11 F-000103 - ' Li CAMAGUEY ELECT'R.iCAL SERVICES CORP C.B.A.: NZAL 'Z SAMUEL JORGE Is certified under the provisions of Chapter 10 of Miami -Dade County IALID FOR CONTRACITI.ING Ugft."09 ;rC 2019 QUALIFYING TRADE($) 0001 ELECTRICAL 0002 BURGLAR ALARM 0004 FIRE ALARM SPECLT 'A&-0#UCd'e rut^air Fr ~111ST'dad®gd..acer�:r•:y i apwtyxgKaharan DRIVER !-,.E'vSE CLASS Y G524-790-54-380-0 SAMUEL JORG• GONZA:EZ 61" W 26TH C7 HIALEAH FL 330164M Dos 10-30-19U SE ■ 116 - vasu t1 1043-2417 nw 54T c c; 10-20-2025 +iest l SAFE i}RiVL. .,. re•Rx..M «.,iMlat.r• - .sere n . w.-+ANS.np„vwt, c, ..n 00443E Local Business Tax Receipt Miami -Dade County, State of Florida THIS IS NOT A BILL - DO NOT PAY 6797840 BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES CAMAGUEY ELECTRICAL SERVICES CORP RENEWAL SEPTEMBER 30, 2018 6160 W 26 CT 7071517 Must be displayed at place of business HIALEAH EL 33016 Pursuant to County Code Chapter 8A - Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS PAYMENT RECEIVED ELECTRICAL SERVICES CORP196 SPEC ELECTRICAL CONTRACTOR 11E000103 BY TAX COLLECTOR _. Worker(s) l $45.00 08/02/20,17.4: CREDITCARD-17-051689 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 govemmeMel or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT NO. above must be displayed an all commercial vehicles - Ulami-Dade Code Sec 89-275. For more infensation, visit www.m9a j jadeyovhaxcollector Muni ci pal Contractor's Tax lecei pt M iami-Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY OC Na. 11 E000103 mc BUSINESS NAM E/LOCATION RECEIPT NO. EXPIRES CAM93UEYEiBi x suum°°FF SEPTEMBER 30, 209 8 6160 W26 CT 7517581 HIAI.EAH, R. 33016 Pursuant to County Code Sec 10-24 OWNER TYPE OF BUSINESS CAMPY ELEI:MC& SE1iVCES SPECIALTY ELECTRIC -AL, CONTRRACTOR BY TAX COLLECTOR OOFP 200,00 09/26/2017 0237-17-005691 This receipt is not valid in the full owing Municipalities: Aventura, Dorm, Ffaleah, Key Biscayne, Miami Gardens. Miami Lakes, Palmetto Bay, Pinecrest, St" Isles Beach, Town of OAer Bay. ;M�IAM.;FAAD Fur moreinformation. visitwww.mamidadelector .00ftLp LEM A� 0 CERTIFICATE OF LIABILITY INSURANCE DAT50/070187/20181� 05 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(ft AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(tes) must be endorsed. If SUBROGATION IS WANED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements). PRODUCER BARBARA INSURANCE INC. 7105SW8ST MIAMI,FL.33144 CONTACT- I Barbara Rodriguez PHONE 305-263-6640 FFAXNo. 305-263-6641 Ess: =6 INSURER(S) AFFORDING COVERAGE NAIC A INSURERA: GRANADA INSURANCE COMPANY INSURED CAMAGUEY ELECTRICAL SERVICES CORP. 6160 W 26 CT HIALEAH,FL.33016 INSURER 8: INSURER c : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTRR TYPE OF INSURANCE POLICY NUMBER POLICY EFyy)F POLICY EXP LINKS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY I CLAIMS -MADE 0 OCCUR 0195FL00023477 12/30/2017 12/30/2018 EACH OCCURRENCE S 1,000,000 DAMRENTEIT PREMISE CEee Occurrence) S 100,000 MED EXP (Arty one person) $ 5,000 PERSONAL a ADV INJURY S 1,OQQ000 GENERAL AGGREGATE $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: POLICY PRO- Ll LOC PRODUCTS -COMP/OPAGG $ 1,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OS�D SCHEDULED HIRED AUTOAUTOS S AUTOS COMBINED BaBINE ht LIMIT BODILY INJURY (Per person) $ BODILY INJURY (Per noddent) i PROPERTY D S S UMBRELLA UAB EXCESS UAB OCCUR MANS MADE EACH OCCURRENCE S AGGREGATE $ DED RETENTIONS $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNERAD(ECUTNE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yyeena, dgibe under tDAN TION OF OPERATIONS bdw I NIA I I STATU' OTH- ER E.L. EACH ACCIDENT $ E.L DISEASE - EA EMPLOYEE S E.L. DISEASE - POLICY LIMIT 1 $ i DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 1ti1, Additional Remarks Sdhedule, B more space Is requires ELECTRICAL WORK CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shares Village Building Department THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 NE 2ND AVE ACCORDAN THE POLICY PROVISIONS. MIAMI SHORES, FL 33138 AUTH RESENTATIVE ACORD 25 (2010/05) 01988-201 ACORD COR TtON. AN rights reserved. The ACORD name and logo are registered marks of ACORD