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EL-04-22-996
� \ \ l\ U�� �cy�� � z � �� � 3 ` �` "� � ��.� � ���r�� Mi�rr�i Shc���s 11i11��e � ����� ' � �������,� � ��: � �4`� �'� 10054 NE 2 AVe � a ��`'�r� �.����,�:i.,.� ��11�?�e � < r �. 9� �:�.� ��, w: �� :' � � .. � � a� .._ Miami Shores F�3323� �;�.: '' � � ,������������ �� � ���� �a � ��� 305-T95-22Q4 > , y ,a �` � „� , : ��� ``1),:..,;�b.7 �:�. , :� ` ...� ��E���#��\.�..,.1;�`\....tz \ .....t� Z ��� . : ���.�{�� �. �, . .�..:. . .. .�<, ., . . � ��,�� z�,�� �7E�atrax`IC1#t: 1£}��{?/2{�22 ,�� ,�,�.. ��� locaiion Address Rarcel I�umber _... .m. ...�..,�,�,N„v,w��,.. __.,_ ��„ �..,.��.. _„ _,, . .�.��,.,. e._,.._.,,.__ _., �. _.� m_.�. � __..r . . ,.._�_ _.�..0 �..v... 2G7.i[♦[.�'f�B7 JE J tY11C���,JIBQ{'�?§J����,{�CF 11JGu�V.6Ve.aiV.6 ��3.� �. .. . . . �,1�..... l�. .. . .L�.... . . . . . , , ,�e.„ _%:3a .. . . . . . . .. ... .. . . C9P1t�CtS i JONFITNAN SERQME Own�r FE E�EGTRICAL SERVICES,CC7RP Contracter � 2292 NE 94 ST ORESTES ESCALADA,-DIAZ � 449 E 32 ST,FffALEAH,�L 330�3 i ( ;�a.:, e�������e��,�a.�� � v. _��.;;��,. x,uP.n���,� .� ����.�a ����_� _��_ �,.M..� �_.,.� ,___.�.�..�n_.....�___ �, ,�__.��___..__ ? `� � Ins ec�ion R� uests: E �eseription.REPLACE ELECTRfCAL US�OUT(�ETS�e 2 ELECTRlCAL ''� VaEuatioer: $ 2,500.00 � [ ����� �� � ` j FfXTURES IN 2 BATHROOMS Total$q Feet: 4.Q0 Fees Amaur�t Payments C�ate Paid ,Amt Raad Application Fee-Other $SO.QO 1'4ta1 Fees $120.9Q CCF $1.84 Cr�ditCard 04J2QJ2022 �y�p,gp D€3PR Fee S2.OQ DCA Fee $2.00 �maunt Due. §0.09 Edueatian Sureharge $d.6Q Permit Fee $SO.QO Scanning Fee $12.00 TechnoPogy Fee $2.SQ T�cal: $120.90 uil in �nt �PY In cansider�tion of Ehe issuance k� me c�f this permit, I agrr��to p�rform fhe work covered hereunder in ce�mpliance wiEh �II ordinances and raguiatit�ns pertaining Ehereto �nd 1n strict c�nf�rmity with th� pi�ns, dr�wings, statements or speoifi�ations submitFed to th� prc�p�r �uthorities of fVliami Shor�s Vi(I�ge. In aecepting this parmit ! assum� responsibility fior ali work dane by either myself, my�gent, s�rvants, or�mplayas. E und�rstand that s�parate permi4s are requir�d far EL�CTRICRL, P�UM�ING, MEGHANICAL,WINDC7WS, DOQF2S, ROC}FENG and SWlMN1ING PQOI.work. t)WNERS AFFIDAVIT: I certify that a(I the foregoing infoemation is accurat� and Ehat all work wrili be dane in compliance with ali applicabie laws r�gulating canstructi�n and zoning. �utherme�re, I authorize th�above named contractor to do the work sta4ed. Au ed Signature:C?wner i Applicant/ Cantractar / Agent Date �pril 20,2022 � �"'��� � � � �.C���.`.�, Page 2 of 2 � ' iarni ��r�s Villa � � B�ildir�g D�partmer�t ,���'� � �� ���� 20050 N.�.2nd Avenu�, Miam�Shores, Florida 33138 � ����,-R ������ se�: (�o�}��s-��o� �ax:(��s���s��s7a r�s��czra�u u�v��wo�r��u����t(�o�}'�a-��4� F�� �Q (,��L � Master Permifi No. ���Z.� -�.. PE�MIT APPI.ICATIQN su���rmrt �vo. ��=� ��R� �� �°�����'� ��ui����� ���c���c ❑ �QOF��v� 0 R�v�s�o� ❑ �x�E�vsron� �����v�r�� ❑Plur�a��� � nnECHa�v�ca� ❑ �r�a���a� ❑ c��ac�«aT�an� ❑ s��a� CQNTRACT�Fi DRAWINGS �oa aa���ss: � � ��� �� � �°"��� Ci�v: Miarrti Sh��ares Caur�tv: Mia�i C�ade Zir�: Folia/Parcel#. Is the Building His�torically Designated:Yes Nf? C}ceupancy Type: Load; Construetion Type: Flood Zone: BFE: FFE: awNE�: ���,e(�ee s�m�i�T�t�enood�r}: �C� �"1 � �` �none#:�`�� ����� Address: � �' City:� �k C� � � S�ate: Zip: �� " TenantJ�ess�e N�me: Phcane#t: Email: `��A�� �' � � �.�"� _�.. CQNT G°TaR:Comp�ny Name: t" �» � Phcane#:��� ��-� � Address: � � � � �� Email.��� �`: � ��t � ��t�� <� '��. � Qualifier Name: � � Phone#: �� � State Certification or Re�istration#:�c„�� C�. '� ��'" Certificate of Competency#: DESIGIVER:Architectf Er��ineer: Phone#: Address: City: State: Zip: Va{ue of Work for thts P�rmit:$�� `� � SquarejLinear Foota�e of Work: Type of Work: ❑ Addition Alteration [� New Repair/Replaee ❑ Demolition } , , DescriptionofWork: �lW�='��{ f"�� �.,,��;�>-it il:a�� t};; E' �' ��'a"�`� C'�- ��.. �{��..�¢�C L�� �s`.iL�f�' � ;�� � ��:�-��i�"�.`�_-"��:� , ,. , � � . � ��.,o- , �.��_. Specify cc�lor of cQtQr thru �ile:=� �: � n,.. _ , Submittal Fe�$ . P,e��t�����$ C�F$ GO/CC$ Seanning Fee$ DGA Fee$ E�BRR$ Natary$ Technolo�y Fee$ Training/Education Fee$ Double Fee$ S�tructural Reuiews$ P&Z Review$ Borrd$ �rQ�r��.��e n►c�w�u�� ��-� . �' � (RevGseao�fosfzozz) � ��ndln�Campany's Name(if�pplicabl�) �c�ndin�C€�mpany's Address City State Zip Mortgage�end�r's PUame(if applicable) Mart�age Lend�r's�4ddress City State Zip Applicatian is h�reby m�d�to ab��in a p�rmit t� ds�the work and installations as i�dteated. I e�rtify that nca Uv�r�or installatic�n has c�mmer�cet9 �r9c�r to the issuance c�f � permit �nd t#�at ail work will b� perf�rr�ed to meet the st�ndards c�f a!E �aws regu�atit�g eonstruction in this jurisd�ction. 1 undersCand th�t a s�p�rate permit must be secured for ELECTRfC, PLUMBING, SIGNS, Pfl�LS, FURNACES, �OIL�RS, �iEATERS,TANK�,A!R GQ��I�ITIC?Iti1�ERS,�TC,.... OWNER'S AFFIDAVIT: 1 certify that all the faregoi�g infc�rmatian is aceurak� and that all work will be dt�ne in c�mplianc� with all applicable laws re�ulating construction and zc�ning. "WARNIN� TQ t3WNER: YC}UR FA�[.URE TQ REGQRD A Nt3TICE £)F CQMMENC�MEIVT 111f��4Y RESUl.1" IN YQUR RAYINC; TWI+CE FCtR IIVIP'Rt?VEMENTS TCt YtJUR PRQP�RTY. IF YQU IIV1`END gt? Q��'AIN F�NAI�CIRtE�, CC3NSUL.T W��� Yt�UR LENC►El� �R AI� A�'TQ�RI�EY BE�QRE �E��R[?�I�i� YQUR IVflT10E C}F CQ�IIMENCEMENT." Notic� to Appliccant: ,4s a condition to the lssuance c�f a buildrng permit with an �stimat�*d value exceeding$25Qt?, the applr`ccrnt rrtust prcamise in gocad��ith thcrt e�ccrpy of the natrce of cc�mmerrcem�nt and constructic�n fren faur brc�cfaure will be dellvered to the person whose prvperty is subject t�o attachment. Alscs,a c�rtified�opy of the recorded notice of cdmmencement must be posted at the jab site for ttre frrst inspectior� which oecurs seven (7) days crfter £he buiJt�in� permit is fssued. 1n the a6sen�e e�f such p�asted ncatice, the inspection wrFl nat be approued and a reinspectian fee wil!Eae charged. �,_�. . '`�° �� �.�..- � ,�.,��M.. ����..��°� � Signature �`t �" Signature ,� ° � OWFVER or A�EiVT CONTRACTQR The f�regain�instrument was acknowiedged before m�this The foregoin�ir�steument was acknowledged b�fc�re me this , :� day of � .20� by �s ," day of tt� ,2(� 2,�. __, by � ' � � ,who is pers�nall kna�n to �`�°°" �t � ,whc�is person�lly knc�wn to me or who has produced as me ar who has produced as identification and who did take an aath. identification and wl�o did take an oath. �I�JTAFt�'RU�lBC: Nf��'AFt4°P11�L1C: Sig': Sign:` � Print: �,,..,.. ��t�����s a Print: � ;` �ommisstp�#GG 2�i6a1 �+�°`� MYRtAA#R�JAS Sea1: � ��*���� �y co�m.exp�res���2,zo2z Seal. � ����'� � 1�: N�ta€ F�blie�St�t€�a!Flarida ��n��d Rhr�ugh�at3�n�l�datary Assr�. l� �� Co�rr�lssfo��GG 247642 � ��`�r��:�� �!y Comm,Fxpit^�3 S�+p 2�1022 . �anded thr�u�h,��tiortal�d�tsry Assn, ��a:**��*�:»:������s*��*����:�a���**��a�x�m�a��****�*��*���:��:»:a�*�*:�**�a�u*�****���� � *�a�***a��* APPROVED BY Pl�ns Ex�miner Zc�nin� Structural Reviewr Clerk (R�vis�dC}�JCt512022} ��r�,t��L,� �� � � ..�� � M.���� [�11"11 �1C�!C�S 1����� �" l�1� I1'1 �1� ��'��o����*� �oo�o N.E.z�,a aV�n�� Miami �hores, Florid� 33138 T�1: (305} 795.2204 F�x: (3Q5) 756.�972 NT T ' E I T TI N 6� CC�NT CTQ� IS ,4 FLQRI�A STATE GERTIFIED CONTRACTQRa A, ��PY t�F QUALIFIER'S STATE �IC�NCES Ei, COPY QF I.�CAL BUSIN�SS T,4X RECEIPT C. CaPY QF �IA�I�ITY IN��1(�ANCE� D. CC}PY QF WORKER� GQMPEN�RTIQN INSURANCE* {l�l�rkers Gor�pens�ti�n EXEN�PTI�N r�ust have NQTICE TQ OWNER farm and C�ntrac#or Affidavit} IF CaNT CTOR HAS A MlAMI DADE CQUNTY CERTIFIC�4TE OF C�MIPETENCY� A. Gt�PY OF CERTIFIGATE QF C�MPETENCY OF Ql�ALIFlER �. ��PY QF LC}CA� BUSINES� TAX REGEIPT C. COPY �F STATE R�CISTERED GQNTRACTQR �ICENSE OR (�IAM! DADE CUUNTY Ml��IICIPAL C��4TRACTOR'S TAX RECEIPT. D. COPY �F I�IA�I��TY INSURACE� E. CQPY QF WC7RK�R� CC�MPEf�SATIQ(� INSUR�NCE* (Workers Camp�nsatian EXENIPTIC�N must h�ve NQTIGE TO OVIINER form �nd C�ntractor Affidavit) �`Y{�UR INSI�FtANGE CQ�P�It�Y MUST ISSUE A CERTEFICATE AS FQ�LQVV: Certif�cat�F��Ider: � MIAMI SHCIRES Vi��.AGE B�DG �EPT 1U050 NE 2ND AVE I�IAMI SH�RES,FL 3313� Certificate mc�st specify the descriptian of operatians�r contractor license num�er. ■�Brr�������rrrr�E�m�ar■r��r��rrwrarr��rsrrrra�n���oer■.aw�seom���se�ssrr�e�oasEe�rt�■rie�eaee BUSINESS NANIE: � ` �t �' � �� �USINESS ADDRESS: � !� _��� �_GITY � ��;�__STATE �- ZIP�.�,,�,��... �us���ss ��o��: { � } �� - ���� �� �t�����{�� �� ,�. , };. � � . � CELL PHQNE ( } � � QUAt�IFIER'S NAME:. � �"��� � QUALIF#�R'S LIC IVUM�ER: �..� �� t���� � � ,��C���,� , � y�+�r�,�� � iami hores ill�g� ..�« ������ �� 1 � �� �oo�o �.�.��,a Au��,�� � '��rpR`� �1liami Shores, FCorida 33138 Tel: (305) 795.2204 Fax: {30�� 756.8972 atice ta► n�r — ork�rs' +� en�afii+�n In�uran�� x ti . , � � t y � , i `, � , z, ,,, � , � � � � ,.S , . , :4� � �. r � , ,� �, ��� _� ,. , , s , � �..t ,1. ..7 .�ti3�.z ,.,,1, .11�..� � r,�....� ti�� .i.. \\ 4 „ � '�:r . . �.,� .,.,7 :t,.��,. .,�.. ,�. . 1�.. . . 1 .`. � 1 2 .. ��,, . 1 t �� . 3 ":�:�� ,,,,Z �.:'��.. �.., ,..���, � a- ..,,1. � �. . >.�� \\, ",t:. � 4\ . . t r,.4., ,<^..� ,,\\� \ �. ,\ .`:., ,` t.. .t . . `,.< .� , i.�,z�i,t �, ��., � �-1 . �.t �e... c�a�. � ..\� �+1,l 4. �� , \ .L.. .\ � ��i� \,,)c�a .,� t�2 x�.�.. \ 1.}a> >st, .�1���� � .:. .�,.. ti�,��.1 .t� ,��.,, E�� �. ;,,.t .?,�.-, .�:`l.� ` „1 ..� ,.\\, n \Y,. �s, .��,�`�,, �, \t 5 �, � s.? , �.y �.. �� , ti � �,. ��t\ Z ,.S� � ��.n ��c<u.,l,v ; „»�� ��, \1��`. .t � � ,E �.,<�� z, s 1� �„�� ��:. , ,,��\ v ti� .t� �`� �,t ,,, ,s»,i �, ,.,� , �� .v 1`. �Z:. � ��.�� la,.l� \ �,: r�. t ., � � ��`ti . ,\���t;��. ��,\�tijsf.,.,n, ��.���' a o, 5�,�; ,4<�.E,sl,1:�,�����.r� ,a�:��ti��4���,,�::��;;� ��°�il a.�c\��1 �.�� ,t?����, ?a,,r<,,;a �!5,.�„t�i���`���\�ti.<.;��t 1�.�\ty�' Flo�•ida La�u r�quires �Uc�rkers' Cd�rl�e�ssation insurance eovera�� under Chapte�- 440 0�' tt�e Fiorida Stahat�s. Fla, Stat. § 44C}.(?S ailotus cor�orate offie�rs ir1 the conserue,tian tndi�5try to exempt themsel��es frorr��1�is requiren�ef�t for ar�y co�lstructi�i� praject��rio�•to c�t�tainilag a build�ng�aer���it. Pu�-suant to the Flos•ida TJivision of�G'orkers' Cam�ens�tion Employez-Factfi Brocll��re: At� e�s��aloyer in t�le c���structior� ii�d�tstry ��Tho el�ploys of�� or more �ar�-eime c�r full-time ez��ple�yees, ineh�din�the c���;zzer, must c�beain wc��•kers' Gc�n�pensation eaverag�. Cat-por�te officers or meznbers of a li��aited liability company (LI.C} in the coastruetion indus�r�r may �Iect to be e�empt if: I. Tl�e officer awns at least l 0 pe�•cee�t of tl�e �to�k c�f tl�e cor�oration, or in t�e case of an I�LC,a statetn�nt attestinQ ta tl��r��inimurs� I Q p�rcent o�ur�ership; 2. The offieer is listed as an officur c�f the corporatiat� in th� rccards of tl�e Florida Dep�rtn�ez�t of State,�i��ision of Go�pot-atians,aT�d 3. T}�e cc�rpc�ration zs re�istered and listed �s activ� ti�ith the Florida Department of State,I�ivision c�f Cat-�oratians. No mare tl�an thr�ee corporate officers per cat-poration ar limited liabitiry cotz�pany men�bers are a1la�ua;d tQ be �xem�t. Constru�tian exern�tians are valid fox� a period �af t�=o vears ar until a �Toh�niary revacation is filed ar tl��exell�ptiox�is r���oked hy tl�e Dit•>ision. Yo�tr cot�traetor is requestix��a�et-mit u�cier t]�is���TQrk��rs' cotn��ilsation exen��tic�E�and l�as ackt�ou�ledge t}�at i�e or s1�e wi�] not use day labar,part-Czme en�ployee�s or subcantractors for your�aroject. Tl�e coz�traetor has provid�d an a�davit statil7g that l�e or sl�e u�ill 1�e tlie a1�1}���ae��son allawed to�rork t�1�your�t•oject.I��th�se circumstat�ces,?vtiar�si Shores�'il�age does nat rec}uire ti=erificatian c�f ��=orkers' ec�mpe�sation insurance ec�vea-��e from tl�e contractar's company fo��day labor,part-tin�e et��plQyees or subcontz-�ctars. BY SIGI�ING BELC�Vti' YOL� ACI�NC?t�'LEDGE THAT Y{�L� NA�1E REr�D THIS NOTICE t1NL� U�3DEFZST.�i�D ITS C`E}NTEIv TS. � ����� � Sibnature: _ _— __ Qwner State of Florida Cc�c�nty of Miami-Dade The foregaing�r�s aeknou�}edge t�efore me tl�is_���dAy of-- � -----,20��. By ��� �� � �uha is�ersonal]y kz�o��,rr� to me c�r}�as�eoduced as idex�tiYication. Nota �q�Y�� nav�a���+ftt��as SEAL: �� ��:� r�otary Pub€�c•State��Fiarida '��,,°���:' Cemre�issi�ri#GG 247642 `°'v€���'` My Comrr�.Expire�Sep 2,2422 PE Electricai Servzce�, Corp 4�9 E 32 Str�;et I-�iai�ah, FL 33�13 T�ate: (�4/�4/2Q22 Sta�e af � Gouraty c�f �� �efore me this day persa�a�ly appeared Qrestes Escalada who, bein� duly �urarn, de�ac�ses and says: That he wiil be the �nly person warking on the project located at: I2�1 NE 94� �tre�t Miami Shores FL 3313$ �.�� ntractor Si�nature �worn to (or affirmed) and subscribed before me this �Q day af A ri1, 2Q22, �y �� Fersor�ally kn€�cvn �� Or produced IdentificatiQn Type of Tdenti�cation produced � � Print, type or s�arr��a naz�e of notary �a�`'^" �4YR4APA ROJAS �54 '����`: Ntatary Fubllc•SCaFe of Florida `�a �° Cammissian�GG 247bk2 ��'�s f���` My Cam�t,��piee�Sep 2.2Q2� � ��6and�d thrt�i�qh Nationa!!�otary�asr. 1 Q � �` ,� ' � t; tructi�r�T �� u�lafyin����rd ��� ��' . �1351������RT€�t�f�T�C?�CC�3ME��TEP3�Y �v � � �������� � �,:� ��.. � �� ��E�1'�i��L����1����t3�#� � � L�.�.�.: ° ,<< �� t,�I��I�C�lA�4����TE��2 P� �a r Ek�pr �rns c�f C�pi�r 1t2 cr0�i�rrzi-Q Gaurtty �"��`�C�F��L?�tIC��A��PAt2�°�[�€�T f�F�E��$��SS e�t��'J PRC>FESSEAiV,�#� R��tJ �f�t►�t ER�3Q�57�7 lSStJEC7:U211712(P2i R�C���CT�21 LGC?P1i` Cl"�R E5 E.A��0.C3t , ,t�l�lE�T�S���L 5R P��LE�1"RPG�t SEI€W6��5��?RF � (fPd�111lf)tlAl P�iltS7 t+�#��"�[� Lt}��l. 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