EL-19-1705Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date:08/06/2019
Location Address Parcel Number
955 NE 92ND ST, Miami Shores, FL 33138 1132060060050
Contacts
Permiumo.: EL-07-19-17, 5
Permit Type: Electrical - ReSidentiall
Work Ctarssificotion: Aiteration
Permit Status: Approved
Expiration: 02/03/2020
ERIC FLECHET Owner
SUNSHINE ELECTRICAL CONTRACTORS Contractor
955 NE 92 ST, MIAMI SHORES, FL 33138
CORP
Other: 3053350870
MARIANO SANTIESTEBAN
1300 SW 85 CT, MIAMI , FL 33144
Business: 3052654958
Home: 7864439590
Other:7862736194
Description: BONDING ON INSTALLATION OF PAVERS ON POOL Valuation: $ 500.00 Ins ection Requests:
DECK RENOVATIONS 305-762-4949
Total Sq Feet: 1,200.00
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 # 2052
08/06/2019 $60.30
Check # 2010
07/24/2019 $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 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 fiSat all work will be done in compliance with all applicable laws
regulating construction and zoning. Futhermore, I authorize the above named contr for to do the work stated.
Authorized Signature: Owner / Applicant / Contractor / IFAgent Date
August 06, 2019 Page 2 of 2
Miami Shores Village RECEIVED
Building Department J L 24 2019
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY�
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20
BUILDING Master Permit No. _
PERMIT APPLICATION Sub Permit No. _� "1�
BUILDING❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION DRENEWAL
❑PLUMBING [:]MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF CANCELLATION' [:]SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 955 NE 92 ST
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FIFE:
OWNER: Name (Fee Simple Titleholder): Maria Flechet Phone#:305-282-7728
Address:955 NE 92nd Street
City: Miami Shores State: FL Zip: 33138
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: -5y AjS 6, C'ctjT c- Phone#:
Address:4X. C� s—� �G� ,��/
City: z/21 �%�'%% • State: e�L Zip:
Qualifier Name: /Z 0 '-5 Phone#:
State Certification or Registration #: / 3 OU :5i C- �6 fc.17 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ Cm. Oa Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration Q New ❑ Repair/Replace ❑ Demolition
Description of Work: ,n1ki'1r4
Specify color of color thru tile:
Submittal Fee $ Permit Fee $
Scanning Fee $ Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
CCF $_
DBPR $
CO/CC $
Notary $
Double Fee $ _
Bond $
TOTAL FEE NOW DUE $
t (Revised02/24/2014)
' 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-wbichyoccurs seven (7);days after the building-permit_is, issued. In the absence of such posted notice, the
1.inspection will not be approved and a reinspection fee will be charged.
Signature - Signature /V29a.g-Jvo 77/e 5 ]"p_6,410
tOWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this
- n day of 7 120 J by
61721 < r- (- CC, c-1 who is personally known to
me or who has produced l ._ as
identification and who did take a ath.
NOTARY PUBLIC:
Sign:
Print: _. �'/r� . n 9'i C'�2l`'JCi
The foregoing instrument was
acknowledged before me this
day of eG320 19 by
M,✓Nk-k9 ��` J 1 a SkA'i,,"`f?o is personally known to
me or who has produced b l- as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:_
Print:
- ELOINA HERNANDEZ
Seal: Seal:
r!` Notary Pubk - State of Florida.
Commission #GG099009
my Commission Expim
APPROVED B KtILPi-Y Plans Examiner
.40 Notary State of Fonda
INN Jessicaa Ro Roselt
My Commission GG 207667
�YQV Expires 0411612022
Zoning
Structural Review
(Revised02/24/2014)
Clerk
Sunshine Electrical Contractors Corp
1300 SW 85t" Court
Miami, FL. 33144
Date: 8/6/19
State of Florida
County of Miami Dade
Before me this day personally appeared August 6, 2019 who, being duly sworn, deposes and
says:
That he or she be the only person working on the project located at:
955 NE 92nd Street, Miami Shores, FL. 33138
Contractor Signature
Sworn to (or affirmed) and subscribed before me this day of A�25- 20�,
by �qr►utno '�ai4if4k6b
�, 40 % Notary Public State of Florida
Jessica Rosell
a My Commission GG 207867
a wd� Expires 04/16/2022
Personally Known
OR Produced Identification
Type of Identification Produced
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:
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 V VE READ THIS NOTICE AND UNDERSTAND ITS
CONTENTS. 11
Signature:
State of Florida
County of Miami -Dade
�. The foregoing was acknowledge before me this � day of �-- , 20 `
By 1 �l i u -e la Q Coil L P'eNlY�7 who is personally known tome or has produced
as identification.
Notary: \ ,. 1 Notary Public State of Flonda
Jessica Rosell
My Commission GG 207667
SEAL: wn Expires04/1612022