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ELC-19-1314Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Issue Date: 06/12/2019 Location Address Parcel Number 770 NE 91ST ST 7, Miami Shores, FL 33138 1132060380070 Contacts Permit NO.: ELC-06-19-1314 Permit Type: Electrical - Commercial Work Classification: Alteration Permit Status: Approved Expiration: 12/09/2019 ELISE CHAMBERS Owner SUNSHINE ELECTRICAL CONTRACTORS Contractor CORP Home: 2252057042 ELISEWCHAMBERS@GMAIL.COM MARIANO SANTIESTEBAN 1300 SW 85 CT, MIAMI , FL 33144 Business: 3052654958 Other:7862736194 Inspection Inspection Requests: Description: INSTALL CFI OUTLET IN KITCHEN AND BATHROOM Valuation: $ 2,000.00 4949 , INSTALL CEILING LIGHTS, OUTLETS AND SWITCH REPLACING LOAD CENTER AS PER PLAN. REWIRE KITCHEN AND Total Sq Feet: 325.00 BEDROOM. ADD SMOKE DETECTORS. TO REPLACE PERM IT#EL-12-14-2808 Fees Amount Payments Date Paid Amt Paid 100% Permit Renewal Fee $225.00 Total Fees $225.00 Credit Card 06/12/2019 $225.00 Total: $225.00 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 regulating construction and zoning. Futheyr(ore, I authorize the above named contractor to do the work stated. / Applicant / Contractor / Agent Date June 12, 2019 Page 2 of 2 dr t 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 BUILDING PERMIT APPLICATION ❑BUILDING ZELECTRIC ❑ ROOFING CIPI' MI) JUN 0 7h019 OWIWI� F C20 per( Master Permit No. _ 04'-1 Q 1-OJ 1 Sub Permit No. �kO �" (1 - 1314 ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS [:]CHANGE OF [:]CANCELLATION [:]SHOP CONTRACTOR DRAWINGS JOB ADDRESS: :7 City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): �"use (i'� C !�J/°� J<%✓ S Phone#:.;Q Addre�ss:�� City: �`yy"> Z2,2V i _ �� State: ✓% zip �:� Y Tenant/Lessee Name: Phone#: Email: c,i-' CONTRACTOR: Company Name: 9bn !_2hj a L�LJz�ylfl�=9 GjV hone#: Address: City: Wqynt State: V[f Qualifier Name: A/W klIMOO ` a Y- i Q Q `r) Phone#: State Certification or Registration #: ��r-oS2- Certificate of Competency #: e �-/ 5:12<23 c? �- DESIGNER: Architect/Engineer: Phone#: Address: Citg4�4'i}i1lElrir:lyi�, State: Zip: Value of Work for this Permit: $� �Squik�e/Linear Fof Work: S__ Type of Work: ❑ Addition Alteration ❑ New • u � Re`I%air/Replace ❑ Demolition Description of Work: l'�7 G a c-h i'a�c� Z_ Specify color of color thru tile: Submittal Fee $ W Permit Fee $ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ _ �r+LH�iiOW" N CCF $ CO/CC $ DBPR $ Notary Double Fee $ . Bond $ TOTAL FEE NOW DUE $ G 2-5 • C/� ' o.ZA- 2$GB (Revised02/24/2014) 6CI 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. 1 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 on 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. �_, o Signatur Signature OWNER or AGENT The foregoing instrument as acknowledged before Qme this I' day of r� I 20 1 I , by 'iS-c ChQ�,b-eY� who is Personally known to me or who_has produced identification aTtd wh Sign:_ Print: Seal: c�� t as an o y►��,pY PRtE7 ��// • VA- • r iJ ; lK9G �� t• • �c . CONTRACTOR The foregoing instru qN was a cnowledged before me this .`l 2 day of 20by LP JI*Wpersonally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: ON -1W UC.5 0t vv % Seal: `O 1�GO�Z 3. ■s*■****s*ssss****�* * * APPROVED BY '" Plans Examiner`11*7** Zoning Structural Review Clerk (Revised02/24/2014) t SUNSHINE ELECTRICAL CONTRACTORS License #13005807 Phone # 7864439590 Date: State Of Florida County: Before me this day personally appeared tV�QW7'[QM GQ.M� 0,A Q "Who being duly sworn, deposes and says: That he or she will be the only person working in the project located at -77D ti\A) g--� �il Cont or Signature Sworn to (or affirm) and subscribed before me this a2Z— day of @Iola 20 ' Personally Know Or produced identification - Type identification Produced Print, type or stamp name of ary 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 tion 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. Signatur,,& �%- Owner State of Florida County of Miami -Dade The foregoing was acknowledge before me this day of A 0 11U , 20 By_ i� i Stt Cr`l'�rn�.lr S who is personally known to me or has produced ntification. ypY P�0�� •�,1426 •� • • z NGG 2812Ba