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EL-18-1166` gt{ .1Es L��t �'Cp'FBR1"pA Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Parcel Number Permit NO. EL -6-18-1166 Permit Type: Electrical - Residential WO*Classification: Addition/Alteration Permit Status: APPROVED Issue Date: 7/27/2018 1 Expiration: 01123/2019 Applicant 100 NE 92 Street 1132060133290 SCOTT ALEXANDER Miami Shores, FL 33138- Block: Lot: Owner Information SCOTT ALEXANDER Address 100 NE 92 Street MIAMI SHORES FL 33138- 100 NE 92 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone SMART ELECTRIC INC (954)882-4646 of Work: UPDATE ELECTRICAL ADD RECESSED LIGH ional Info: UPDATE ELECTRICAL ADD RECESSED LIGH ification: Residential ning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $1.20 $2.25 $2.00 $0.40 $150.00 $3.00 $1.60 $160.45 Cell (786)282-2104 (305)414-9998 Valuation: $ 1,500.00 Total Sq Feet: 200 Pay Date Pay Type Amt Paid Amt Due Invoice # EL -5-18-67383 05/02/2018 Credit Card $ 50.00 $ 110.45 07/27/2018 Check #: 1208 $ 110.45 $ 0.00 Available Insnections: Inspection Type: Final Meter Box Alteration Relocation Fire Alarm Service Change Review Electrical Underground W. W. 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: t all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoniyt_Futhermore, I a xtize the above-named contractor to do the work stated. July 27, 2018 Authorized Signa —ura Mner / Applicant / Contractor / Agent Building Department Copy July 27, 2018 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 RECEIVE. MAy � 21018 FBC 201-4 BUILDINGMaster Permit No. izC IP- I I Cou PERMIT APPLICATION Sub Permit No.b I �- 111QCP ❑BUILDING `ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑ PLUMBING ❑ MECHANICAL ❑ PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOBADDRESS: IOo NG- C1'a gl�' City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 11;--3.0b'ot 3- .�Q () Is the Building Historically Designated: Yes NO _ Occupancy Type: izes Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder):, �� WA MPw A&4�l�tg. a Phone#: % }i6 - 001 oi /VK Address: City Tenant/Lessee Name: Email State: Zip: ACONTRACTOR: Company Name: �Mo�`\ _.��2L`t'T tC Phone#: Address: %D 11 A) w /U A L!F City: !a -C State: f --t Zip: Qualifier Name: �'([�%.le- Osae__ Phone#: qJzl- gad- ., 76 ,,gy�pp � 3 d 1 �F S State Certification or Registration #: tt`-" 1 S Certificate of Competency #: DESIGNER: Architect/Engineer: Ad City: State: Value of Work for this Permit: $ !J f�Z) Square/Linear Footage of Work: Type of Work: ❑ Addition I❑ Alteration ElNj n VIoRepair/Replace Description of Work: E1 Specify color of color thru the: eSS Zip: afl0 ❑ Demolition Submittal Fee $ Permit Fee $ lvr�< ©O CCF $ CO/CC $ Scanning Fee $ Radon Fee $� • DBPR $ 2 - 6 Notary $ Technology Fee $ Training/Education Fee $ Structural Reviews $ (Revised02/24/2014) Double Fee $ Bond $ L' TOTAL FEE NOW DUE $ f I O T 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 issuedr1n Bence of such posted notice, the inspection will not be approved and a reinspecti fee will be charged. g y /�g Si nature Signature OWNER or AGENT I #O,,'NTRACTOR The foregoing instrument was acknowledged before me this O It day of ft- 20 LS by Qdr; N's 1% A�A.%r=A who is personally known to me or who has produced 11-u— as identification and who did take an oath. NOTARY PUBLIC: Sign:_ Print: The foregoing instru,, A"t was acknowledged before me this lik day of Ii°K'J�d , 20 18 by sna&ca- Q SpA who is personally known to me or who has produced %L— as identification and who did take an oath. NOTARY PUBLIC: Iii�'�:��r��_ ��1rt�i► MY COty[IvtISSION # FF930543� JERYL C. BOYCE Seal: V`1 EXPIM:October25,2019 Seal: MY COMMISSION # FF930543 EXPIRFS. October 25, 2019 APPROVED BY J/,4!g Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Smart Electric Inc. ER13014595 State of Florida Miami -Dade County Tamarac, Fl. 954-882-4644 May 16, 2018 Before me this day, Jorge Posada Being duly sworn, deposes and says: That he will be the only person from his company working on the project located at 100 NE 92 St. Miami Shores, Fl. Jorge Posada Sworn to and subscribed before me this 18' day of May, 2018 by Jorge Posada. Drivers License rvrYc � oB0YC EXPIl # Fp930 Oa-� 25, 2019 to Owner — Workers' Corn Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 tion Insurance Exem 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 dnly 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. i I Signature: e. Owner State of Florida County f Miami -Dade The for going was acknowledge before me this 1_ day of , 20 �t_. M who is personally known to me or has produced as identification. Notary: 1 SEAL: I JER ws13 Y�� _r 25, 20193