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ELC-19-453Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 ��11-fl-fuY Issue Date: 03/04/2019 Location Address Parcel Number 421 GRAND CONC 18, Miami Shores, FL 33138 1132060520160 Contacts Permit NO.: ELC-02-19-453 Permit Type. Electrical - Commercial Work Classification: Alteration Permit Status: Approved Expiration: 09/03/2019 PAULA VITALE Owner UNLIMITED ELECTRICAL TECHNOLOGIES Contractor 421 GRAND CONC 18, MIAMI SHORES, FL 33138 INC Home: 7862869097 OMAR VILLAR Business: 7862999500 Inspection Description: ADD KITCHEN GFI OUTLETS Valuation: $ 1,000.00 Inspection Requests: 4949 TotalSq Feet: 780.00 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 Check # 459 03/04/2019 $60.30 Credit Card 02/28/2019 $50.00 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,qre required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWN RS' )�A\AT:1 gertify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regul ti gl d oning. Futhermore, I authorize the above named contractor to do the work stated. Signature: Owner ~ / Applicant / Contractor / Agent Date March 04, 2019 Page 2 of 2 Miami Shores Village 3� g 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 ELECTRIC ❑ ROOFING V •� FEB 18 1019 OE FBC 0— 20/n� Master Permit No. —i "I — 9 S Sub Permit No. LL Z-I 1 —�13 ❑ REVISION ❑ EXTENSION [-]RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS [:]CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: v ? City: Miami Shores County:_- Miami Dade Zip: J 9 /3() Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction /Type: Flood Zone: BFE: FFE: �j OWNER: Name (Fee Simple Titleholder): �1yl V (��/ " l/ Phone#: (& 2 !� Address: Z7-'2-1 Alw City: W10-Q21 State: Zip: Tenant/Lessee Name: Phone#: Email: 11 q► 1 1 CONTRACTOR: /Company Name: V Yi \i VV� 1 `SAC -' 1v 1"CA • Phone#: '3nis • 2o3 - 10 �-S . Address: �/ �� ��t—�9 /� �� Ut^c� r,- z/ City: / State: �(1 h-�C)A. Zip: 03%L Qualifier Name: Q/1�� / ��U�2- Phone#: 5's-y State Certification or Registration #: e Z--- © 0 G -2- O Jy Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New 91 Repair/Replace ❑ Demolition Description of Work: AM k��cW r, CZT;S 0 AI0 {�- Specify color of color thru tile: Submittal Fee $ Permit Fee $ Scanning Fee $ Technology Fee $ Structural Reviews $ Radon Fee $ Training/Education Fee $ CCF $ CO/CC $ _ DBPR $ Notary $ Double Fee $ Bond $ (Revised02/24/2014) TOTAL FEE NOW DUE $ (0-6 , 3 0 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 reinspecpion fee will be charged. Signa or AGENT The foregoing instrun' ent was acknowledged before me this 2. V day oft 20 L�t by PAa "1k o is personally known to me or who has produc identification and who NOTARY PUBLIC: Sign: Print:• wzt,k Signature CONTRACT9.L_— The fore o ng instrument was acknowledged before me this 9 fore of 7 `_— 20 11 by AII&Y _, who is personally known to h. IVONNE LANDERO Notary Public - State of Florida Commission # GG 006859 My Comm. Expires Jun 28, 2020 e or who has produced as entification and OTARY PUBLIC: Sign: Print Seal: Seal: - 11, R14ARD0 J NARENCO tea,• , :� Notary Pubme a;••p- State of Florida Commission # FF 946818 APPROVED BY aLI Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner - 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: l . 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 n Theforegloi-ng was acknowledge before me this (�8� day of fb�00, 20 . 'Ai VW 1 V (�Y10►yi�—� C�-�, who is personally known to me or has produced tVQr ( cgvl4-k as identification. a Notary: '`� MY COMMISSION # FrF P14031 JX7*° e- EXPIRES: March 25, 2019 SEAL: '' f Rd ' Bonded Thru Notary Public Underwriters