Loading...
EL-18-2320OL ,AMLA4. �`gKonFs Li<r yFC<r Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Parcel Number Psennft No. EL-8-18-2320 Permit Type: Electrical - Residential Work Classification: Addition/Alteration Permit Status: APPROVED issue Date: 8/31/2018 1 Expiration:02/27/2019 Applicant 1223 NE 102 Street 1132050250140 Miami Shores, FL 33138- Block: Lot: LEMAY & ALEJANDRA SANCHE Owner Information Address Phone Cell LEMAY & ALEJANDRA SANCHEZ 1223 NE 102 Street (786)514-0776 MIAMI SHORES FL 33138- 1223 NE 102 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone JJ&JJ ELECTRICAL CONTRACTOR C (786)312-9794 of Work: REMOVE AND REPLACE 2 ELECTRICAL OUT itional Info: REMOVE AND REPLACE 2 ELECTRICAL OUT >sification: Residential nning: 1 Fees Due Amount CCF $0.60 DBPR Fee $2.25 DCA Fee $2.00 Education Surcharge $0.20 Penalty Fee $100.00 Permit Fee - Additions/Alterations $150.00 Scanning Fee $3.00 Technology Fee $0.80 Work without Permit Fee $150.00 Total: $408.85 Valuation: $ 250.00 Total Sq Feet: 0 Pay Date Pay Type Amt Paid Amt Due Invoice # EL-8-18-68730 08/31/2018 Credit Card $ 408.85 $ 0.00 Avanaoie inspections: Inspection Type: Final Meter Box Fire Alarm Service Change Review Electrical W. W. Underground In consideration of the issuance to me of this it, agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity wit a plan , drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibil- for all ork done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, M CHANI L_WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foP6g9k%l-aferraption is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I auf09fiz§4he above -nod contractor to do the work stated Authorized Signature: Building Depaw August 31, 2018 nt / Contractor / ent Copy nt August 31. 2018 f IC11 1 II JI IUI CJ V IIIdgC Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (30S) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 BUILDING PERMIT APPLICATION ❑ BUILDING "LECTRIC ❑ ROOFING ❑PLUMBING ❑MECHANICAL ❑PUBLICWORKS RECEIVED AUG 3 0 1018 cp+l �4L-1 FBC 201-4 Master Permit No. IC,(— ?-Z Sub Permit No. qk 116— ZS C ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS:( 2,7 ( 0 Z J 1 City: Miami Shores County: Miami Dade Zip: 33 13 Folio/Parcel#: I I 32C7� S U 1 ,y Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Le S'G Phone#: �G cL C% S J Address:IL2-�> �// (02-4 City: I QAA S 4� State: Zip: /3 Tenant/Lessee Name: Email hone#: CONTRACTOR: Company Name: _Tj y' : 9 �' c-.k, CJ w• Phone#: 10 - 361 • -` )q7 Address: M� S W (� �-*-I 02 City: 1 i ^ �t� State: Y Zip: Qualifier Name: 61&-C Phone#: Q-7 State Certification or Registration #: 1- E o0o s-?? Certificate of Competency #: /-76 GO00 Z DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ Z-SI Type of Work: ❑ Addition ❑ Alteration Description of Work: (-4e VKVI_Q CJ vu Specify color of color thru tile: Submittal Fee $ Scanning Fee $ Technology Fee $ Structural Reviews $ City: State: Zip: Square/Linear Footage of Work: ❑ New Eg-rcepair/Replace ❑ Demolition lG c e • 2 2� e c;6,�cj O,.41 Q:� Permit Fee $ aG--> CCF $ CO/CC $ _ Radon Fee $ 2 • og::> DBPR $ Z Z S Notary $ Training/Education Fee $ tJ AIC � : I oc�) • (Do Double Fee $ 1190, (50 Bond $ TOTAL FEE NOW DUES V .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 secureA for ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, AIR CONDITIONERS, ETC.....p,Qy �, �s r i n G �c�S l�:+�-�---Q ;� ^ o t 4-0 ism.--{ .c -A Q -Q-► � ,A f • �' N.Q,s l- �,�' �xn�� •9-�. Q �y . OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable haws regulating construction and zoning. S "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 ,ien 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 bf�pprovr6`o`nZ11a reinspection fee will be charged. SiCnature _ Signature OWNER or AGENT The foregoing instrument was ackn [edged before me this day of 20 by J who is personally known to me or who has produced C� —Qv1c as identification and who clicIA'P an oath. NOTARY PUBLIC: Sign:_ Print: Z — CONTRACTOR The foregoing instrument was a �cnowledged before me this day of 20 by Uyt- who is personally known to me or who has produced c � as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: HILDAE.GARCIA Seal: ;-Y COMMISSION 9 G0 207279 Seal: HILDA E. GARCIA EXPIRES: 15 MY C P s Apnl , 2022 ; . OMMISSION # GO 207279 P.onded Thru Noma Pd* LhMm n '�P :'' EXPIRES: April 15, 2022 diRwded Thru Notary Pubk *********** APPROVED BYPlans Examiner Zoning Structural Review Clerk Image (7).jpg 8/29/18, 9:33 PIVI CTQB , 8"ZrC; 6�;SsNE-S-S CERTWICATtit, 0'crnvu.tqcy 17EO00672 kD SA- BETANCOURT JOSE LUIS Cettified 0,4 prijis" Lf CtW 0, )rk4QfN_;, dgCOWI, QUAUFYIIWG TRADEis) ELECTRICIAN 0fxl2 BURGLAR ALARM OWA FIRE ALARM about:blank Page 1 of 1 Image (8).jpg 8129/18, 9:33 PM Local Business Tax Receipt RAU _r nI- Dade County, t LB _..3. E i 3 J � ^ N "�MLii A i3�C�tr"'�' f3Y3_..e�_t.'- i .._�g.,......__,.,✓ ram �y �a t'a9 sir(, Pf y(_ is, RENEWAI, EXPIRES �@�.y I �`^°ig aw'�?^�a �"'"9 M[„7 iC)' i.�ai 81 i8 ib m e IAA' id ni sYs I18 �yEi x � 1 { #.) <� �avn�esu-s rar 't�is 6YTAX CGLLECTOr4 ;kerb} 575.00 47fi8f2Li.>; CREDITCARD-18 : . 1� [, Lb'�4� 3 a�X PhiR�83 f )i3 f+i L.if6 3S 'f}Y3fiY3(Cp{i I.Y �, 41 £"nS T 4Y ib eii31})fi8�3tlOU%EIi817U)fIS �. j(e I�5?$flalBlaennsar y;[ 31FPi aFitltl9, 9S {t#I DYE7/3 $iHB;; ik'gi(i6iDiY laws dr;U CP. Lji31i$P33¢3$t$ Vdh1 h Apgl £; lilt, bl Mllli any pyountatafal S)t'�' isg. 'hHECEiPTN{b.aixevemirsi6et�iFp;ay�du,.a9"srrmnacrci�t-veh3sic�- Cade Set 8s-7b. Fo Mato lafar matted, Vihii.P_I&W4i'M-pl�yUd S I ATI, OFF LORIL"ADEPAR-rMENr F AND PROFESSioNAi. ER1301.5374 ELECTRICALCONaTRA17k)p i >: 07/081201F PETAtda„OURT, j0 19&11 ELECTRIC yz C aPq VRAC�r r s, - '7 <.:. la% LICENSED i NDEj EXPiRATiON DATE: AUGUST 20 �Rli3 TAT �c.o about:blank Page 1 of 1 0 0 ACORD CERTIFICATE OF LIABILITY INSURANCE °"TE'MM'°a""" _ 08/29/2018 THI IS CERTIF_ICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS I 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(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. I N SUBROGATION IS WAIVED, 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 endorsement(s). _ I i PRODUCER CONTACT ARIEL ROORIGUEZ NAME: Royal Prestige Insurance Agency P r M. . (305) 512-8806 NE ac No • (305) 820-2077 1275 West 47 Place # 103 E-MAIL prestigeinsured@hotmall.com Hialeah, FL 33012 INSURER(S) AFFORDING COVERAGE NAIC B _ Phone (305) 512.8806 Fax (305) 820-2077 INSURER A: GRANADA INSURANCE CO INSURED INSURER B : JJ & JJ Electrical Contractors Corp INSURER C INSURER D 8788 SW 12 ST # 102 Miami FL 33012 INSURERF: 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. ILTR TYPE OF INSURANCE INA& UBR POLICY NUMBER MMIDID�V EFF MMMIIDDIYYYY _ LIMITS A © COMMERCIAL GENERAL LIABILITY ❑ CLAIMS -MADE ❑ OCCUR ❑ Y 0185FLOO101574 10/04/2017 10/04/2018 EACH OCCURRENCE $ 1,000,000.00 DAMAGE TO RENTED PREMISES Ea occurrence S 1,000,000.00 MED EXP (Any one person) $ 5,000.00 ❑ PERSONAL & AOV INJURY $ 1,000,000.00 GEN.L AGGREGATE LIMIT APPLIES PER, ❑ POLICY ❑ ECTT ❑ LOC ❑ OTHER GENERAL AGGREGATE S 2,000,000.00 PRODUCTS - COMPIOP AGG S 2,000,000.00 FIRE DAMAGE S 100,000.00 AUTOMOBILE LIABILITY ❑ ANY AUTO OWNED SCHEDULED AUTOS I ❑ AUTOS ONLYHIRED NON-OVM❑ ONLY AUTOS ONLY El ❑ I i ( CEa accOMBIidentNED SINGLE LIMIT s BODILY INJURY (Per person) $ BODILY INJURY (Per accident) s OERTY P err aoocide t DAMAGE $ $ ❑ UMBRELLA LIAB ❑ OCCUR ❑ EXCESS LIAB ❑ CLAIMS -MADE EACH OCCURRENCE S AGGREGATE s DED ❑ RETENTIONS $ WORKERS COMPENSATION AND EMPLOYERS LIABILITY YIN ANY PROPRIETORIPARTNERJEXECUTIVEEj OFFICERIMEMBER EXCLUDED? (Mandatory In NH) It yes, describe under DESCRIPTION OF OPERATIONS below N I A PER ❑ OTH- E.L EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE S E.L. DISEASE - POLICY LIMIT $ I i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101. Additional Remarks Schedule, if more space is required) Electrical I CERTIFICATE HOLDER CANCELLATION Miami Shore Village Building Department 10050 NE 2 Ave Miami Shores FL 33138 ACORD 26 (2016103) CIF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 01988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Worker's Comp.jpg 8/29/18, 9:33 PM V JIMMY PATRONIS CHIEF FINANICAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS'COMPENSATION CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law, EFFECTIVE DATE: 10/1912017 EXPIRATION DATE: 1011912019 PERSON: BETANCOURT JOSE L FEIN. 8122253457 BUSINESS NAME AND ADDRESS: JJ&JJ ELECTRICAL CONTRACTOR CORP 8788 SW 12 ST MIAMI FL 33174 SCOPE OF BUSINESS OR TRADE: Licensed 06--iricai cvrtrator MPORTANTT Pursuant is Chapter 440,0504). F S. an officer of a, corporat-ion who elects exemptionfromthis Chapter by filing a ccrtificate of election under his section may not recover benefits or com,pensabon tinder this chapter. Pursuant t to Chaplet 440 05(12), F.S., Certificates of, a4e,,-,ton to be exempt.-. apply only within the scope of the business or trade listed On the nonce of eIacbor� to be exempt. Pursuant 11 Chapter 440.05(13). F.S., Notices of olcfia"iit,, be exempt and certificates of election to be axempt siiali he s�jLj--ct fo;evrca*,j"j if, at any time after the filing of the notice Or the issuance Of Vise certffcate, the parson named on the notice or certificate no lunge, meets fhe ri,,quirementri of this section for mmiance of a certificate. The department snall revoke a certificate at any time for failure of the person Ranled On the certificate to meet the terfuiraments of this secdom DFS-F2-DWC-252C,ERTIFfCATEOFELECT!Otqr BE EXEMPT REVISED 08-13 QUESTIONS? (850)413-1609 about:blank Page 1 of 1 JJ & JJ ELECTRICAL CONTRACTORS CORP. 8788 SW 12 ST # 102 MIAMI, FL 33012 17E000572 8/27/2018 STAT FLORIDA DADECOUNTY BEFORE ME THIS DAY PERSONALLY APPEARDED-JOSE LUI_S BETANCOURT WHO, BEING DULY SWORN, DEPOSES AND SAYS: I JOSE LUIS BETANCOURT WILL BE THE ONLY PERSON WORKING ON THIS PROJECT LOCATED AT: 1223 NE 102 ST MIAMI SHORES. FL 33138 JOSE LUIS BETANCOURT SWORN TO (OR AFFIRMED) AND SUBSCRIBED BEFORE ME THIS AUGUST 29 2018 BY: JOSE LUIS BETANCOURT. PERSONALY KNOWN: OR PRODUCED IDNTIFICATION: TYPE 054I3ENTIFICATIO r .., HILDA E. GARCIA MY COMMISSION # GG 2072n EXPIRES: MM 15, 2022 PRINT, T PE OR STAMP NAME OF NOTARY Borbed nw No1awy Pubdc Un*wrlten 4 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 person allowed to work on your project. In these circumstances, Miami Shores Village does not require verification of workers' compensation msurAqce coverage from the contractor's company for day labor, part-time employees or subcontractors. BY SIGNING BE L W O ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: Owner State of Florida County of Miami -Dade The foregoing was acknowledge before me this _ day of O, 20 ( By r �v�.h,,H Sn� ,,,►,�., - who is personally known to me or has produced Notary: SEAL: as identification. HILDAE. GARCIA ( EXPIRES: Apra 15, 2022 - - 80"dw TM+NoftYPu*tlodennkas