Loading...
EL-19-2813Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address 395 NE 100TH ST, Miami Shores, FL 33138 Contacts Issue Date:12/02/2019 Parcel Number 1132060135400 Permit NO.: EL-11-19-2813 Permit Type: Electrical - Residential Work Classification: Service Change Permit status: Approved Expiration: 06/01/2020 Jose Herrera Owner CEDOE ELECTRIC CORPORATION Contractor 395 100 DIOMEDES F DIAZ DE LEON 1251 NE 130 ST, NORTH MIAMI, FL 33161 Business: 7863333612 ns ecti Description: REPAIR AND RELOCATE SERVICES Valuation: $ 1,800.00 Ion Requests: 762-4949 Total Sq Feet: 0.00 Fees Amount Application Fee - Other $50.00 CCF $1.20 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.40 Permit Fee $50.00 Scanning Fee $9.00 Technology Fee $2.50 Total: $117.10 Building Department Copy Payments Date Paid Amt Paid Total Fees $117.10 Credit Card 11/22/2019 $50.00 Credit Card 12/02/2019 $67.10 Amount Due: $0.00 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 regulating construction and zoning. Futhermore, I authorize the Ob vie naAd contractor to do the work stated. Authorized Signature: Owner / Applicant / Date December 02, 2019 Page 2 of 2 BUILDING PERMIT APPLICATION 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 RECF, ; -Er,, NOV 2 2 `?,,M BY: 67 FBC 20 1� Master Permit No. t`-' 0 -1l - 283 Sub Permit No. ❑BUILDING F?!; ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOBADDRESS: City: Miami Shores County: Miami Dade Zip:o���_ Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee �Simple Titleholder)SpSE_ WCS(Ae(�/ae jyAQ'_L G 0CAA1%Phone#:a0T 10'5 `_7(o1L'( • Address: SCaNC-1 Ibl% S l G City: M IA-^1 PL-- Zip: S C�fz�..S State: Tenant/Lessee Name: Email: ?� CONTRACTOR: Com an Name: �.a Phone#%9Z Address City: Quall State DESIGNER: Architect/Engineer: Phone#: Address: State: Value of Work for this Permit: $� Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace Description of Work: Specify color of color thru tile: Submittal Fee $ 50 ,M Permit Fee $ Scanning Fee $ Technology Fee $ Structural Reviews $, Radon Fee $ Training/Education Fee $ CCF $ DBPR $ Zip: ❑ Demolition CO/CC $ _ Notary $, Double Fee $ _ Bond $ (Revised02/24/2014) TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address Zip City 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. 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. 4:z Signature Signature OWNER or AGENT CO ACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 2 2 day of l wVtP/lJ- , 20 (mil by Z Z day of N '(13Ce 20 1 ,-,7 by �Ior�t� �NGsa who is personally known to , who is personally known to me or who has produced t_ P•�as me or who has produced �NLa identification and who did take an oath. identification and who did take an oath. NOTARY LIC: NOTARY PUB Sig Sign: Print: �( NDIA oQ t Print: SI lVbt�1�•t2�� Seal: szos'"YP °� SINDIA ALVAREZ Seal: MY COMMISSION # GG 238273 SINDIA ALVAREZ �?'; EXPIRES: September 3, 2022 _ ,. MY C0MIv11SSIC•N it GG 238273 i "EPEE;° 13ondeclThruNota Public Underwriters EXPIRE Se rube 2*0 Notary :�•. :oc S !,e �ii ondec� hrMot rt' Pub6Niderwriters APPROVED BY . /1.,1��1l1 Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) CEDOE ELECTRICAL CORPORATION DIAMEDES F. DIAZ 4 MASTER ELECTRICIAN RESIDENTIAL AND COMMERCIAL CELL: 786-333-3612 LICENSED AND INSURED FAX: 305-456-1481 CEDOEELECTIC@YAHOO.COM Date: State of County of ZYL'f y1 r 'a�& Before me this day personally appeared�rw'lv���/�Z who, being duly sworn, deposes and says: That he or she will be the only person working on the project located at: Sworn to (or affirmed) and subscribed before me this S day of -t;7�PdeE�20 ft by 4Pk r Personally know OR Produced Identification Type c Produced Print, Type or Stamp Name of Notary !'► • SINDIA ALVARU .;', My COMMISSION # GG 238273 •P.i 1a",.j EXPIRES. September 3, 2022 t Bonded lriru Notary Public Ur�ler rs Notice to Owner - Workers' Com Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 nsation 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: State of FIi County of The foregoing was acknowledge before me this e,27� day of ; 20 Bye who is personally known to me or has produced as identification. Notary:G,N SEAL: $INDIA ALVAW , .. MY COMMISSION # GG 238273 .• EXPIRES: September 3, 2022 . -. ELECTRICAL CORPORATION DIAMEDES F. DIAZ MASTER ELECTRICIAN ;SO)ENTlAI. MO COMMERML CELL: 780-333-3812 LICENSED AND INSURED CEDOEELEC @YAHOO.COM lJ7'a�3.fJiy o";�xW RECEIVED ,;7� G �yTifh�� • ...... . ...... .... . .. ..... ...... .. . ..... • • • • • • • • • • • • • . . . . ...... '' -1I`Iq-251� I Mami Shores Village APPROVED BY DATE XN NG DEPT BLDG DEPT St 11 U1 CT TO COMPLIANCE WITH ALL FEDERAL S I rr AND COUNTY RULES AND REGULATIONS AS A'�cp%X2�7 ELECTRICAL CORPORATION DIAMEDES F. DIAZ MASTER ELECTRICIAN iSIDENTIAI. AND COMMERCIAL CELL: 788-333-3812 LICENSED AND ENSURED CEDOEEIECT @YAH00.COM col/ F, -G, g z m,-�.