EL-18-3207Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
J 9A
issue Date:10/19/2018
Parcel Number
Permit NO.: EL-10-18-3207
Permit Type: Electrical - Residential
Work Classification: Pool
Permit Status: Approved
Expiration: 04/17/2019
Project
890 NE 92 ST, Miami Shores, FL 1132060050130 <NONE>
Contacts
MIGUEL AND CARLINA ARRONTE Owner MIGUEL AND CARLINA ARRONTE Applicant
890 NE 92 ST, MIAMI SHORES, FL 33138 890 NE 92 ST, MIAMI SHORES, FL 33138
G3 ELECTRIC CORP Contractor
GONZALO FERNANDEZ
Business: 3053222489
Description: ELECTRICAL FOR POOL Valuation: $ 1,000.00 Inspection Requests:
305-762-4949
Total Sq Feet: 450.00
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
$3.00
Technology Fee
$2.50
Total:
$110.30
Payments
Date Paid Amt Paid
Total Fees
$110.30
Credit Card
10/19/2018 $110.30
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 information is accurate and that all work will be done in compliance with all applicable laws
regu!Ating construction and koning./gi,thermore, I authorize the above named contractor to do the work stated.
Authorized Signature: Owner / Applicant / Contractor / Agent Date
October 19, 2018 Page 2 of 2
Miami Shores Village Ra. CEIVED
Building Department OCT 19 2018
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972 0__1 J-1
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING
PERMIT APPLICATION
❑BUILDING Q ELECTRIC ❑ ROOFING
FBC 20 J-'
Master Permit No. 13PP-18-1279
Sub Permit No. !F I I& 5 W
❑ REVISION ❑ EXTENSION [:]RENEWAL
❑PLUMBING [:]MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 890 NE 92 ST
City: Miami Shores P County: Miami Dade Zip:
Folio/Parcel#:1132060050130 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Miguel & Carolina Arronte Phone#:
Address:890 NE 92 ST
City
Tenant/Lessee Name:
Email:
State:
Phone#:
CONTRACTOR: Company Name: G 3 ELECTRIC CORP Phone#: 305/322-2489
Address: 8724 SW 72 ST #449
City: Miami State: FL Zip: 33173
Qualifier Name: Gonzalo Fernandez Phone#: 305/322-2489
State Certification or Registration #: EC 13006290 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State:
Value of Work for this Permit: $ i7 l Square/Linear Footage of Work:
Type of Work: N Addition ❑ Alteration ❑ New ❑ Repair/Replace
Description of Work: Pool
Specify color of color thru tile:,
Submittal Fee $
Scanning Fee $
Permit Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
Zip:
❑ Demolition
CCF $ COAC $
DBPR $ Notary $
Double Fee $
Bond $
(Revised02/24/2014)
TOTAL FEE NOW DUE $
K
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 low 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 r inspection fee will be charged.
Signature Signature
OWNER or AGENT
The iforegoing instrument was acknowledged before me this
day of Ck ff rr 20 1, by
�A 1��1 I Wo s ersonally know to
me or who has produced s
identification and who did take an oath.
NOTARY PUBLIC:
Sign:`
Print:
Seal
MY COMMISSION # GG 044602
CO NIrRh)CTO R
The foregoing instrument was
day of
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Si
Print:
Bonded Thru Notary Public Underwriters t Seal:
dged before me this
0 _, by
,nal known to
1�1
MY COMMISSION # GG 044602
EXPIRES: November 2, 2020
Bonded Thru Notary Public Underwriters
************************************************************************************************************
APPROVED BY
Plans Examiner
Zoning
(Revised02/24/2014)
Structural Review
Clerk
Miami shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
11UL1ce Lv owner - worKers compensation insurance txemption
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 0(, 20_6
By r y 1 ny1 who is personally known to me or has produced
as identification.
Notary: :GONZAI-E-Z
MA4ARA1 K46u2
MYCOMMISSISEAL: `*: *= EXPIRES: No0^0Bonded thtuNotabriec
ELECTRIC
ER 13006290
Date 1 1 !�2a) 40
State of R.4' lD4-
County of t41 A M t D.A-Wr-,
Before me this day personally aNNeared QI)�Awho, being duly sworn, deposes
and says:
That he or she will be the only person working Qthe project to ted at:tjr
Contractor
Sworn to (or affirme ) and su
by
me this 1 Y da ofb4'�t-y\ , 20 A
Personally know
OR Produced identification
Type of Identification Produced
L• " �'. JQ.N"�"
Print, Type or Stamp Name of Notary
,•,;::'"�;�,,, LISANDRA MONDEJAR
Commission M FF 207109
My Commission Expires
�'%'•����`P�� March 05, 2019