The URL can be used to link to this page

ELC-18-3560Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address 716 NE 92ND ST iM, Miami Shores, FL 33138 Contacts Issue Date:12/28/2018 Parcel Number 1132060440510 Permit No.: ELC-11-18-3560 Permit Type: Electrical - Commercial Work Classification: Alteration Permit Status: Approved Expiration: 06/25/2020 ROBERT GONZALEZ Owner MG ELECTRICAL CONTRACTOR Electrical Contractor 9120 NE 8 AVE UNIT 4G, MIAMI SHORES, FL 331383247 MARIO R GUIDETTI Business: 7863855637 Other: 7863855637 Inspection Requests: I Description: INSTALL NEW TR GFCI MOVE LIGHT SWITCH TO Valuation: $ 680.00 305-762 4949 NEW LOCATION (KITCHEN) NEW PENDANT LIGHT FIXTURE Total Sq Feet: 0.00 Fees Amount Application Fee - Other $50.00 CCF $0.60 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.20 Permit Fee $50.00 Scanning Fee $9.00 Technology Fee $2.50 Total: $116.30 Payments Date Paid Amt Paid Total Fees $116.30 Credit Card 12/28/2018 $116.30 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. OWNERS AFFIDAVIT: I certify that all the foregoing informatioif is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the a e-named contractor to do the work stated. Authorized Signature: Owner / Applicant / r / Agent Date December 28, 2018 Page 2 of 2 Miami Shores Village RECEIVED Building Department Nov g0 10 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FFBC 20 n BUILDING Master Permit No. C C( H 1 S PERMIT APPLICATION Sub Permit No. L4'-.) a — 351(pv ❑BUILDING Z ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL [--]PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP q CONTRACTOR DRAWINGS JOB ADDRESS: 710_ City: Miami Shores County: Miami Dade zip: 33/3.1�!5 Folio/Parcel#: V 3 ?oG - og¢ os i Q Is the Building Historically Designated: Yes Wo Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): 6"r-f bi2NOI*re- Phone#:_ Address: 212GA/6 64 A _ 1 City: /Iy ehw to State: Zip Tenant/Lessee Name: Phone#: Email: 3 313t CONTRACTOR: Company Name: 4LECr12 CA-L (,0/V3 Me-eeV42 (Phone#: Address: 442.42 v-5W c W 154�-- C I City: /c'L i,q.y' ' State: Zip: 3 3 f c rd Qualifier Name: fIA lZ i, G 6 U i AN5=/ / Phone#: Z o -385 JiS33 State Certification or Registration M f4 e 000 5V Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ �o 6 0 . 0.,0 Square/Linear Footage of Work: Type of Work: ❑ Addition II ❑ Alteration ❑ New ❑ Repair/Replace Description of Work: —TAI$ L l V&W -4e 11 de i New toc~,� 4J o W l ` k- Jam.., ) A � 4,.A ❑ Demolition 'CA,/ 4 f-e- Ai 00I Specify color of,co pr hru tile: fl` U Submittal Fee_$ Permit Fee $- �+� ,�'t��' CC Scanning Fee $ qa I Radon Fee $ z— DBPR $ 7 Notary Technology Fee $ 2 • -S Training/Education Fee $ io- 2 () Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ 11(o.30 (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. Signature QOWNE r AGENT The foregoing instrument cknowledged before me this Z� day of �G re�� , 20 % &' by Z-44;e - who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Print: Seal: PATRICIA ROMERO S. 3,� '.'? Commission # FF 908556 My Commissron Expnes ••'ti,',,;, '�� August 1 1, 2019 as r Signature r ,if 4 CONTRACTOR The foregoing instrument was acknowledged before me this day of 20 ! , by /vzo 6'aou—"-y who is personally known to me or who has produced -J> , L • as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: t"t,.4 rCiarz, Seal: ' PATRICIA ROMERO �o....�,�,,,- :. Commission N FF 908556 My Commission Expnes August 1 1 , 2019 **************************************************************** APPROVED BY A�� 1,g Plans Examiner Structural Review Zoning Clerk (Revised02/24/2014) RICK SCOTT, GOVERNOR JONATHAN ZACHEM, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS:AND PROFESSIONAL REGULATION 0-7 ELECTRICAL CONTRACTORS4LICENSI:NG BOARD THE ELECTRICAL.CONTRACTORHEREiN HAS'REGISTERED UNDER THE PROVISIONS OF'CHAPTER 489, FLORIDA'STATUTES 'f • 9 +' g .rµr. . } MG'kECTRICAL CONTRACTOR CORP:r of 14242 SW154CT i xk FL 33196 �'� 3; LICENSE,NUM ER Oi5049 EXPIRATION OATEAUGUST 31, 266 Always verify licenses online at MyFloridaLicense.com Do not alter this document in any form. This is your license. It is unlawful for anyone other than the licensee to use this document. Local Busl ness Tax Cep Pt M iami-Dade County, State of Florida THIS IS NOT A BILL - DO NOT PAY 7179913 BUSINESS NAM EILOCATION MG ELECTRICAL CONTRACTOR CORP 14242 SW 154TH CT MIAMI, FL 33196 OWNER MG ELECTRICAL CONTRACTOR CORP r.In MAPIO P ni unF-TTi Worker(s) I RECEIPT NO. EX P I R E S RENEWAL SEPTEMBER 30,2019 7460227 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 SEC. TYPE OF BUSINESS PAY tA ENT RECEIVED 196 ELECTRICAL BY TAX COLLECTOR CONTRACTOR 75.00 07/12/2018 14EO00507 0200-18-004934 -erA te I" se dL Business Tax The Paceipt is ncA alicer- -.0 jUs Local Business Tax FeceiPt oral Y cOn"Mr, Pay IVne% permit, or a certi,,cafi13 mon ct the rader s qual cabo,1000DUSM-5- Helder must scW4 ;4h y -111 wrayental ornorgovemmental regulatory laws and req.Arementswlei ch appi y- to the business. - mac, v3oTK&n tahrmarrvvd be ckadayedon all COCOMTlercial vehicles -Miarni-Dade0xIeSec 83 ACORN►® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDYVYY) �n...►i' 11 /29/2018 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(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If 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). PRODUCER Acceptance Insurance Services 6887 SW 40 St CONTNAME: Mabel Felipe PHONN Ezt. (305)740-0515 aC No: (305)740 0518 ADDRESS: mabel@acceptanceinsservices.com INSURER(S) AFFORDING COVERAGE NAIC N Miami, FL 33155 INSURER A: United States Liability Insurance Company INSURED INSURERB: National General INSURER C : MG Electrical Contractor Corp INSURER D : 14242 SW 154th Ct INSURER E : INSURER F : Miami, FL 33196- (786) 385-56 COVERAGES CFRTIFICATF Nt1MRFR- 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. INSR LTR LT OF INSURANCE ADDTYPE INSR WVD POLICY NUMBER MM DDPOLICY EFF POLIC MM DDY EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000.00 X COMMERCIAL GENERAL LIABILITY DAMAGETO R NTED PREMISES Ea occurrence $ 100,000.00 MED EXP (Any one person) $ 5,000.00 CLAIMS -MADE FXI OCCUR PERSONAL & ADV INJURY $ 1,000,000.00 A N N CL - 1840268 11 /06/2018 11 /06/2019 GENERAL AGGREGATE $ 2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000.00 $ X POLICY PRO LOC AUTOMOBILE LIABILITY CMBINED Ea SINGLE LIMIT accident) $ BODILY INJURY (Per person) $ 10,000.00 ANY AUTO BODILY INJURY (Per accident) $ 20,000.00 B ALL OWNED y SCHEDULED AUTOS AUTOS /� NON -OWNED HIRED AUTOS AUTOS N N 2003385986 11 /05/2018 11 /05/2019 PROPERTY DAMAGE Per accident $ 10,000.00 $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE C STATUS OTH- TWRY IMIT E E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N/A E.L. DISEASE - POLICY LIMIT 1 $ If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) ELECTRICAL CONTRACTOR GtH I It-IGA I t_ MULULH liAl\IiGLLM 1 1yn Miami Shores Village 10050 NE 2 AVE Miami Shores, FI 33138 305-795-2204 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) v latals-zuIV Auvrsu �.vnrvni+11V1...,11 11y11.a The ACORD name and logo are registered marks of ACORD 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: 12/11 /2018 PERSON: MARIO GUIDETTI FEIN: 270868971 BUSINESS NAME AND ADDRESS: MG ELECTRICAL CONTRACTOR CORP 14242 SW 154 CT MIAMI, FL 33196 SCOPE OF BUSINESS OR TRADE: Licensed Electrical Contractor EXPIRATION DATE: 12/10/2020 EMAIL: MARIOELECTRIC54@YAHOO.COM IMPORTANT: Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this dtapter by filing a certificate of election under this section may not recover benefits or oompensation under this chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt.. apply only within the scope of the business or trade Wed on the notice of election to be exempt. Pusuwd to Chapter 440.05(13), F.S., Notices of election to be exemot and certificates of election to be exempt shall be subied to revocation if. at anv time after the fifmst of the notice or the issuance of the certificate, the person named on the notioe or certificate no ktnW meets the reghrrernents of this section for issuance of a rartitkate The deperbrwnt shall revoke a cwhficaW at arty lane for failure of the person named on the certificate to meet the regtmemerrts of this section. DFS-F24)WC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS? (850)413-1609 MG ELECTRICAL CONTRACTOR CORP. 12/27/2018 State of Florida 14242 SW 154 CT MIAMI FL 33196 PH 786 385-5637 Miami Dade. County Before me this day, personally appeared /1 Al2 i D C U 0 t= Tel who,being duly sworn,deposes and says: That he or she will be the only person working on the project located at: 7116 Contractor signature No 5 F `/7,? 4'q I Sworn to (or affirmed) and subscribed before me this ILday of 20-t8 By , --0'0 ' 6� Personally know Or produced Identification Type of Identification Produced PATRICIA ROMERO commission # FP 908556 �L My Commission Expues °�•• ";'� August 1 1 , 2019 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Vwner — 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 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: Owner State of Florida County of Miami -Dade �^ The foregoing was acknowledge before me this day of ( 20_6 BY o btr-k_ El or\:UD( to who is personally known to me or has produced as identification. +� MAHARAI K. GONZ LEZ N _ i'� MY COMMISSION # GG 044602 'v EXPIRES: November 2, 2020 SEAL: Bonded Thru Notary Public Underwriters „A�;,�