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EL-10-21-2692 �1����:,\.�fi��;�''��1i3�.�,�.���'`�,�����1���»�'S�`�`��\�'��i��'�71i SC��'��"\`��l`s�,t{�\�til.���'t."���e�t�,.�a�.,":.\�.�"i�i',`s�t�l \)D1���+'��'z�}.�'c�\,' �1�`t�`�• `\�`C� l�� � ����, S. Ci'���� '�3��LSxZ�,..s�l'<.�,.�.1h�����i�tlzL��:t,�;��t�������',4\t14}����'�'j�'�i�2`"t�",\,��'. �' . �,., � � ` � �, x" �1�5 �R r���,���_ �«a�4�z� c�ti s�;���4.��.�����i���� :���� .� = i , �, �c �'.��� t S G�, ��f�...�;��� �i��ti��i l�o�y\}\��1��� �?,���1; �s�;,�����i�`,���\ � ,. ,. 1�, t; f ���`"' ��i �; � �� `�t..'�f' � �����i'.�y`�`",ti�'�,��Z.��`�'`�s4 ..��i ��'�������e,�,.��,����� ��,t�:t�i�`,���,,,,t����� �.�,`�, �e,�� �`; ,,t ME8C111 $It�l"85 VIIIB�� ��� ��} ���,��i��„��i�Z���z'��sti��,� {� �������.� `�� �', � v,t, �,. y�'.,'� `� `��, �.�.ti� `; \ � t\2� t3 '� �s s`,������ i 'sl '�*u �`� ty,�t i �`� lOQSQ NE 2 Ave s �� c r\\,� � � L� ���������`����� t��� ��l ����`t���. �? s� �;i, ����. �E� ��"z S\1��i�S4.t 1��14 tt 1�1, � l�l 1r v �iil'���\���� � `�'t 1 \�,t `��' iZ\� ��1 it l �, Miami Shares F�33138 3 ,f� �� ��4 � t �� �z���� ` �Z�s.� ����,�, r� '�L s, t 1��t > 1t � t;,�,t��,�����?: �.� � '�.,s � .., } t 1 � r��, }.1�� - ���'��\ls�:�?t`-4\"�'��`�t,\1�.�;,;.���`�..��ss����.C,1��1�z�,4�'��"�l ���.�''��,�y�`;?`w?.�'i,�;����'�'`'.��^����Y.'����'"`�� z`: ,� .. �. 305-795-2204 4��\i�,4.������\��`;1�� \7��11��� ��`��� ������ ����\����2 1s�����v 1,,z �a 1�\� �< ��. �c.��� .5�"4' `�^'`�is�`�'�,�'���.. �`�y��`:'.,t�ti������'�`�j".���ti�t`'`�.�'`;,.;';��,��'���y���,t��,..��4rli�, . ., ��.:� , �,,, *'T'F5,N ��� �\1`��R��l Y �,A'l�l�`,� ��s� `�a��`C.,.���������.�� i t i � � }r�����`�t����'����1���q?��,lti��t��������' ��� t\',��s.� �iti,�..��.,��`i`,.:�,a��.,;;��s� ��,:�t11��U�,;t: �t1 1D � �i�`���������� `� � � �� < �;'�z 3��,�`a 1��� � �1, ��������,���t;;���� £ �����,� � �,�.��,' Expiratian: a�/a�/ioaa �,�t��� �ocation Addr�ss Parcel Number ,.._w�_��_,.__��._ m,�_.�.mr._,_��__��_�w. �.�� �.��._.�����.ro,�. �.��m�.�.�_�� ��.�KF��. � � 77 NW 101ST ST,Miami Shores,F�33150 1131010180I90 Contacts �...��,�.�..�w_.�__�,�_���..� �.��a�� �.,�.�...�...��.._,�� .._ �s���.�_...��� � � �.�.� ���,,m_� mm� � � 1UAN GARCIA Owner SCORPIO ELECTRIC INC CantraCtor � � � 77 NW 101 ST,MIAMI SHORES,FL 3325Q MANUEL MURATO Home:856261&314 JGARCIA616@GMAIL.COM 6855 SW 0.2 ST,MIAMi,FL 33155 � Business 3056652&79 Other:3d52817567 �,�.�...�_____j_�___._.�.� �v_�_�____���.,�._�.�.�__re__,..�m.__��.,.n.�..___�..x,__..�..�r._..�_. �ww ,._w�w..n..Rm��.__��__j____.._._�_._��._�_�_. Ins ectton Re uests ; Descrtption:NEW UNDERGOUND SERVICE � Valuatian: $40Q.00 �� <<t � 4t,�����}�l�,t��}�,t ,���4~�l5 � z},.. ti �����`������,���������\�����r������+�i'�ti�i��;, "_ � �1� ti.. 4 ������l.��� �SS t S z,��S `���`�i\�i c�l.� ; Tota!Sq Feet: 450.QQ ���'���s�r��`������?t����q„����,����s�,'��r��`t�,�\}1���� Fees Amount p�y�ents Qate Paid l�mt Paid Application Fee-Other $SO.OQ Total Fees $123.3d CCF $0.60 Credit Card 11/05/2021 $113.30 DBPR Fee $2.Q0 DCA Fee $Z aQ Amount Due: $p.pp Education Surcharge $d.20 Permit Fee $50.00 Scanning Fee $6.Q0 Technology Fee $2.50 Total: $233.34 Building Department Copy In �onsideration 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 autharities of Miami Shares VilEage. In accepting this per it( assume responsibility for alE work dane by either myseif, my agent, servants, or empioyes. I understand that s�parate permits are required ` TRICAI., P�UMBING, MECHANICAL,WI(VDf}WS, DQQRS, ROQFiNG and SWIMMING PC}OLwork. � OWNERS AFF A IT: �i that ail the faregoing informafian is accurate and that all work wili be done in compEiance with alI applicabie laws regulating co tru i"rh � ni Futhermore, I authorize the above named contractor to do the work stated. £ � �:�,� � �� Authorized Signa �'J ner ( Applicant! Gantractor t Agent ate November 05,2Q21 Page 2 of 2 i� i r � i��� � �� �Idin� [�ep� r�r�n�r�� ��� � � ��� � 10050 �l.E.2nd Avenue, Uliami Shores, F[orida 33138 �°� T�G. (3as�7�s-zzo�Fax: (�o�} 7�s-s�7� ��� � ����� o��p��-roo� �.��� ��csr�� �um���. {��s���2-���� � � �sfier ��r�'sfi R��. ��""�-� ��` .� I �I I S�b Per��t ��, ��u������ ����c�-��c � RQ�F��� � �Ev�sica� � �x-rE�vs�o� ����v�v��� ���u��G�� ❑ ��cHA�v�c,�� ❑�u�L���ro��s ❑ cc�a��� o� � cA������-e�o� � s��� CONTRACTOR QRAWl��GS �-� �������Ess; .� � ,�� .�� � � s Citv' MEtam�Shc�res CountV' �Viiami Dade Zip: � _ FcaEmc��Pare�l�a ��� '� � "� "� " � Is the����dart��('c�t�rica��y�esigr�at�e{:Yes NO Qc�upaney Type: Laad: Cor�struetiQn Type: Flood Zc�ne: �FE: FFE: �ti� r � ; , ;,� Phone#: �� . , � , ` ... `�� �9�lR1ER: Name(Fee Sirnple Titlehalder).°�; �` � Address: �' �� � City: ��' �� �o ` , State: � 2ip: ' � : - Tena�t/Gess���ame: Fhc�ne#: Email: � , � �,�. ...�l�, � � '; � � ��4��'�2,A�T'C}�; Company iVame: ��'� � ' '� � Phca�e#: � �� ��� � Address, � ��� � �e ,w �.� �,. C[ty: ����,�. Sta�te: � C Zip: �f�. Q�alifier Narr-�e: ���� �� ,�-�� �� Phone#: ��"��� ���� ���,� .��-- State Certifieati�n o� Registrati�n#:� �����`�`� CerCificate cafi Campeteney#: � '� �4 � C��56C�N�1�:ArchitectJEngineer: Phona#: Acldress: City: St�te: Zip: �J���t��f Ui(�rk fc��thos R�rmito$ � �• �� Ss��aa�-e,{�d�a�ar Fo�tage cs�t1Vca�k� T�t�e�a�d��rk; ❑' Additior� ❑ Alter�tion ❑ N�tiv epairf Replace I� Demolition �e�cr�pt6�r��afi!r�/c��k: � }� `�°�-- �„`i�,, � ,", `°� `'��,f !� S�?��9f� �����` �f���C'�C�`�'t�'� �'t��a �-� �� �..,� ��� ���� �� s�a��,���ae ��e� ����� �Pe��i��e�� � � ���$ � �c�,�c�� � ,�;r� S�as����g Fee$ � __ ° g�adcaa� F�e� � ���'F�$ � M11ca�arp$ �.� �"�'"� �'•�=�i �'�chn�ica��F�� $ � � ����ti— ��'a�a�ie���E�#�acati�r� Fee$ � � f '�,E E�ea�lsl� �e�$ E�carad $ St�e���s�r'a9 Ftea���vvs$ � �€.� " � �"f)1"���EE IVt��f?t3E� �_��,.,� ��� Bonding C�msaanv's Name�if ar���ica"a!e! Eiondit��Company's Adefress C�ty State �[p l�flortgage Lender`s �1amc (if applicab�e} Mortgage �ender's A�€dress City Sta�e Zip Applfca�ian 'ss hereby made t� �btain a permit to do the work and installations as indicated. } c�rtify that no work ar insta(1�tion h�s ee�rnmencecE ���rar to the issu�nce of a perm,it and tha� a�t u�rt�rk wil! be perF€arm�d to mee� the s�an�fi�rds af al( {au�s r�gu�atir�g coristruction in this jurisdiction, I understand that a separate perr�nit must be secured for ELECTRi�, F�(.lMBINC�, S2GIV5, P�QIS, FURNACES, �fJ�LERS,H�ATERS,�ARlKS,,�lR�t}N[?ITIO•�fERS, ETC..... C}WNER°5 AF�I�AViT: I certify that all ihe fore�oirtg informatian is accurate and that all work will be done in campliance with all applicable laws re�ulaiin�eonstructian and zonin�. � ra�R;����� �� �����a ���� ������ �� ������ � �Q���� �� ������`������ ��� ���:�'�,� �5'� ���€'■ �,��.��v ��r'�v��� e��ffi ��'�c�-���sa'���c�.t�t�a � ��i�� ��v'�`r���"!e i m �t� i�� ������[� I o Ll�T��t`Y �E#V!'l�LE#ryB4'�j i,.�T��kX�# �f�t-7 i�V� L����E1 WLS !"^ifY � il�l��� G7��V'�� ��ia������ � � ���� � � ' � �� � S��i Notiee t�Applicant: ,�s a caradition t� the issuarrce af c� �rurkting permit with an estimated vc�lue exce�dine}$25Q�, the apptica�r�mt�st prornise in gvod fai�h that a cc�py c�f tl�e no€�ic� of comrrre�acerraent crnr!cc�nstruetrc�n 1re,� faw braehur� wit(6e deliv�red Y�o ti�e perscan whose prc�perty is su6fect to attachmen�. Atso, a cer�ffr�d copy of fhe recc�rded notree��eomrnencement must be pasted at'the jc�6 site for the�lrst �r�specti�rr v�far`eh c�e�€��-s �even (�� days after €�he t�uiddir�g permit is rssued. in th� absence af suE� �e�s�e� rr€rt��eA ��e Inspectie�n wif(nat be approved and a reinspection f€e will be eharged. � , ;, ; � � � � ; , , �, ; : . �.,. . -�'�"'_,,r�'r�;',,�'`,,� ,°, t� �,,,,��� .. i' . Si�nat�are .�t,. � � � �� Signa�ure � � � �' , ,oa C�WNER or,4G�NT CE�NI"RACTC�R T���fore�c��n��strurr�ent u��s aeicnawFedged ta�fore me this ��h�fQregoir,�instr�. . �t�as�e�n���rled��� �a�fere!�e t�sis _.��__._day of ���" , 20 , by �r�''� day of �..� , 2Q d��� by ,�� l �' � ' ��'�.�� ;nth�is��r�s���liy kr�€awn to �i '� ����P`�`�-- ...�?P�,�,.a������..knovvn,to me car whcs h�s prc�d�ced �s rr�e�r wl�� I�as produced � � as icEentificati�an �nd�rvh�dsd t�ke an c�ath. identificatican�r�wh�did take an o�?�h. N��',AftY Pt1BLICe fi�t�l'�l�Y PlJ,�`���� ��'`��'o '� � ���_�� . 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I also ut�derstand t��at an�7 �ertifica�e of Re-C)ccupan���that �zati= be issued l�5� Mi�r�3i Shores Villa�e c;�rtifies ��ly that the refe�-enc�� pz��pert}� is ��ing used f�or si1��1e f�mi]y purpose� ar�ci that such c�rti��ate cloes rat�[ cc�r�stit�tte �ny= rep�-esentatiotl, ��arrar�t�= or-c�t-tifie�ti�� as to the cc�nditic�r� of th� ciw�ellin� c�r o�her structures on tl�e �rc�pert}=. AP�'LICANT'S AFFIDA�'IT: I c�rtify that all the���e�gain�infc�r�atian is�ccur���. �p�l�cant 1V�ame: Sign�tul°e. Tha:fc�re�c�in� iF1at�-u»ent ��=as ackt�r���rlerigec�l�c fc�rz me this . da��f�f__— ___,�0____,bv , .. . :...:� . . �s • • •����s who is pc,rsonally knotit>n tc� �ne r���«�kt�h�s produced ' • ' " • • . . . . . .. . .s«.•a . . . . r'�.S li"}CClTt�7Cc"itf�tl<7TiC� t1��10 t�lt�Tr�}C�1E1 Oc1��i a��i r s e e • i����t��1'�Z1�i�.l�o s��es� ����+�� a���as •iriof •• • il�i• O • St�n. •O�. iONYs . . ...�.a ..�. . � � . Aa...� Print: .....+ . . � . •ei�a• •�as •r�sas �Iy C<�r�zrr�issit�P� Fxpit-es: • • • .. . .��. . . s . . � . . �a...� �o..�m . � ��ildi�ig t�#'�iee�ls�pg�ro���o �te-Occ $60.00 Nc�tary �S.Ot� 'Total � �� ��,�r�-r o , . � . . �.r... . . . �..m.. . . . . �. . ...« . . M . ...... ..8. .�.... . ...��. . . . a:.... .... . . . . . . ...... .r.. . .W... . . ...��. .. . .,... . : . . . .. .. .. . .* ... �..... . . . . � � . . . .. « ...... . . . • • a •m r s • r s s�sK�• es a • • • • •��ss• • � . ���_���.,..., s , . f � ; ���� t � e , " �'� .. : .... �'�*�{� ;� , , ,..., 3 ....... - `',, t_.. � ��..w.r,�.� H� .. �w� T�sx � ..�,..,.-<.; £ ,,.�. ,.�,...t..�,. i � ...a..��.... ..�,z,a,.:, � ? � � � �2�� � t3 1` 4 t ,� � _! p� �_q_,„„� �: ��` . ""r � __�-_____ _ { � _� _` , , {'� �����j � �_ �� � f � _. � �.. �, F"� g� � .��_�"�.� �, F * "�� �%�� �" �� ,`� _ - C`. �� . . ... . . � . . .. .. . . . .. .' . . . . . . � . . . � �t . . . . � ' �C� � '" � � � � � . . . .'� :"�°- •` �' �� ` } . . ... . ` ..: . . . . . . `�, � � �� �� s a • �i i`w � f t�� s� �� i� l�✓ � 1�� �� �....✓ �� •w• • •s• � •�• •s• •� • • • s• •�• a• � • • • • • • s s • i •�• • • i f•i • • • ! i i ii i i • • • • A • • { • !• • • • i • i•• •• t� � � � � 6 � � � .. � � � {p[ k �E ! � E � � --`--_ 4 � .� " A f f �t\.! t '� •4� # • • •�� 6 # • f0 BA • i i �# �0 • ♦ Y • i • • • O � i • • •4• O O P • 4 • b • � 0 i•• • 8 O • 4g4 ! 6 • • • E � • i• • • # • •0 @ ♦ O# • f O • 6 � W # b • • O O • 4 • 0 ♦ • 0 � • O • • •i• •M• • ••• • f60 •• •09 �W b • # i• • • # i 6 � B 9 • • •! ♦ i O 6 9,i ! i • i• 4 � • � 4 • Y • • � • � i � 9• •Y• # • b i • #• � E� f�� F j� t � L, � 4� .e.+� � ..s...A �y tQ f � �� � � � � 5 �3 i j � } i � � � � A � + � �{ S g � 3 CaMPANY L.�TT�R �I�A� Dat�: �fi�t� of �d �t� � � County o� ��. - � �efc�r� m� this d�y per�or��lly appe�red �� �i '� ��,� �� wha, being d�ly svJ�rr� d�pases and says: Tt�at he or she will be the �nly person working�r�t pre�ject locat�d at: � �� �� � 4� ��'���-� ����� . Contracfiar Sign�ture .�` �wc�rn (�r affi F subscribed befflre m� this �day o��� __._.__.._. 2Q�� � b}� '� � ; �� ��. � ��� P�rsonally know tJ� Prcaduced Id�ntific�tican Type of Iden�� Produced �Y� �UlS F 75t `'�",....,� Commi ��� b �� �` r�s N��� 7,2Q2& � �� Expi � "`�n�fs°� �on�sea�u Print, Type, or 5tamp Name of Natary ������� �� � �,� iami hores illag� .�«� �.�.�� u 1� !t� �1� �`'�� ,�,���� �oo5a �.�.2�,a aVen�� '�^��!�ti��`°� Mi�mi Shor�s, Florid� 3313� Tel: (305) 795.2204 Fax: {305} 756.�97� o►tic� to wn�r � �rkers' om er�sation Ir��uranc� xem fiican t� ;:� �� t � � ti�- \ � A 1 \ i ' � �� � �1�� � i�� � :���� .� ,�. ..�t tex.. A� ..,�\.. �S� t� .� �,1 � .1�A� ?��\.�.t ,\ .A�.,t tii : .�� ,.tit, ,�� .A.. �.,. Flarida Law reqaires ��varkers' Cc�rnpensatian irtsurance cav�rage uncler �'hapter 440 �f the Fiorida Statutes. Fla. St�t. � �40.05 � �11ows corpc�rat�afficers in the co«struction industry to exempt�h�n2selves fra�27 this requireme��t far attv cor�st�-uctian p�•aject��riaz•to � obtaiilin��buiidiila permit. Pursuant to the Floritta I�it��isio��of��orl�ers' Cam}�ensation Employer Facts Broch��re: U i � An employer in tl�e cortstructi�r� is�dustry� u�}�o emplo}�s ot�e or n�ore �aart-time or fi�11-ti�1�e ; i i esn�a(avees>ir�cludi«Q tt�e ounee,mc�st obCai�� �orl:ers`ec����pensation cover���. Corparate officers ; jor members af a lirnited liability con�pany (Lt.C`} in the construetioxl industry may elect to be � ' exen�pE if: 1. TI�e affieer c��=ns at least 10 percent c�f tl�e stack of tl�e corporation,or in �he cas�of � an LLC,a statert�ent attestin�to the mznin�um 1(7 percent ow��eesf�ip; ; � 2. The officer is listed as an afficer of the ca�•pc�r�tioF� in tl�e reeords of the Florida � 1 C�epart���ez�t of St�t�g Di��zsic�n c�f CocparatioFls;and ; � 3. `I�he cor�oration is f•egistered a��c� listcd as active with t}le Flc�rida De}�artment of ; St�te.Diuisic�n of Cor�or•ations. i � j �a �r�o��e thar� three eorpor•ate affzeer�s per cor���ration ar Ii17�itecf Iiabilit�� cor��p�r�y nle���t�ers are i � allowed to be exempt. Coi�struetion exemptions are valid for a per•iod af t�uo ��ears or until a i � �=olur�tar}revoc�tion is frled c�r ttl�exetnption is re��c�ked b�<t]�e Division. ; . i = l'our conirac2or is reqti�esti��5 a�ea7nit ur�dea�this w�ekers' can7�er�s�tion exernptic�r�at�d has ackr�c��rledge ti�at he ar she���ill nc�t use � � dati� tabar,�>art�tiine er��ployees ar subcontractars far yot�r prc�ject.The calatractar has pra��ided an a"fida��it s�atir��that t��ar sE�e wili � be tl��only persdn allowed to work on yout•�rojeet, In tl�ese circun�stances.��liami S1lores Villa�e does nat rec��tir-e verification of i ���orkers' coln�easation insuranc�coverage froit�tl��contractc�r's can�pany�for day labor,part�ti»1e erl�p]t�ye�s or subeontracto�•s. i �3�' SICNf�G �EI..Q��' YQC.' :�C�K��3��'L�DC�E TFI.�T l't�L' NAl`E RF.�D TFII� '�C)TiC`E ,�1?tiD U'�I�ERST:�?�C? ITS � C'E�'tiTE�TS. � I � 'l � � I � Si�?��atttre: � . - � � i j vFl-12@t' .._ � ( i ; State�f Flarida � i �ounty of�f�arni-I}ade � , ��''`� i Tti�forega�n�u�s�ck��o�xlec�ge b��or�r�e t�is-�� day of��1�-- _.20°�� I i� _ a.� �- - �,t � 8� ' "�. R ry _ who is personally known ta me ar has�rc�dueed � � � _ _ as iderltifrcaiior�. i °u� IUtS FE�ttdAP1�EZ : C �c�tar}: n _.���� �"•,` �.c��ti�an#F4N�4575f _ — , �� a�� � E ' s Wo�et� 7,2424 � °k� �,v i SEAL= Fc�r e��� �" � I,