The URL can be used to link to this page

EL-19-863Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Issue Date:-04/25/2019 Location Address Parcel Number 133 NE 102ND ST, Miami Shores, FL 33138 1132060131820 Contacts Pern NO.: EL-0449-M Permit Type: Bectrical - Residential Work classification: Alteration Permit Status: Approved Expiration: 10/22/2019 John Sasso Owner WELL ELECTRIC TECHNOLOGY Contractor 133 NE 102 St, Miami Shores, FL 33138 TONY WELL Other: 9548177299 johnjsasso@gmail.com 4310 NW it ST, MIAMI, FL 33126 Business: 3057267098 Other:7864738455 Description: RELOCATE ONE SWITCH Valuation: $ 200.00 Inspection Requests: Total Sq Feet: 48.00 305-76,4949 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 Building Department Copy Payments Date Paid Amt Paid Total Fees $110.30 Credit Card 04/18/2019 $50.00 Credit Card 04/25/2019 $60.30 Amount Due: $0.00 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 3,EF-1QAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws a i con uction a d zonina. Futhermore, I authorize the above named contractor to do the work stated. Authorized Signature: Owner / Applicant / Contractor / Agent Date April 25, 2019 Page 2 of 2 J 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 RECEIVED APR 18 tors U� In �-P-H FBC 201-:� BUILDING Master Permit No. p,�' d� p 17j30 qq 22 PERMIT APPLICATION Sub Permit No. BUILDING gtLECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [—]RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS 33 �rl � �0 2 S�A.�c�' JOB ADDRESS: � City: Miami Shores County: Miami Dade Zip: ��/ Folio/Parcel#: ((" 120 � — 0 13 ` t %U Is the Building Historically Designated: Yes NO !/ Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): , d h1j C'is % Phone#: Address: 13 3 N a / L (0-L 9 City: M.1 kA1 r l'Oy� State: (, Zip: 3 3 Tenant/Lessee Name: /V I /7 Phone#: Email: tbinn r qtiK gMAJ c �2m y - 9 �( � CONTRACTOOR:: Company Name: I& ie (_ caeg-n f- ��e Phone#: kos T T142 `7 9ety Address e -31d / W /45 City: State: �^ / Zip: .333►1 Z �,p qualifier Name: �� Phone#: 2p6 317 q.1 J 6 +a State Certification or Registration #: G 30 (-J//a L Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: - Address: City,:`';ik4"'`�°?/r:+•, State Value of Work for this Permit: $ %� �� Square/Lir)ear Footagg of"' rk: Type of Work: ❑ Addition ❑ Alteration '�/ p /J 9 ❑ N%ew ,�' Re air fie lace rYleerrii�t`inn'nf\A%n�4 ..' .//"!�/�%JfI��G /7/%i �/1��f-Y � `7A ♦ u;. ' .x-�: ^ ii r...1Y `r Specify color of color thru tile: Submittal Fee $ Scanning Fee $ Permit Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ CCF $ DBPR $ Zip: ❑ Demolition CO/CC $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ (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 'i 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 reinspection fee will be charged Signature OW ER or GENT The foregoing instrume t was acknowledged before me this day of 20 i� , by hh ASSO who is pefsonally known to ghe or wVhas produced--Ur%VkkY IACX P - as tdeni2onod take an oa��0��,��.p ////� ov B M7S*�MfiiiA.� Seal: Signature CONTRACTOR The foregoing inst ment as ackno%ledged before me this �d day of 1� l ( 20 / by who is personally known to me or who has produced —1 V e f— I—1 C enscas identification and who did take an oath. NOTARY PUBLIC: ) Sign: •�•'�:"""'• MARIADELAFE �� / / GL =y: MY COMMISSION # GG 117054 Print: Seal: / bonded 1Try Notary Pudic UndenMNerf APPROVED BY �� Plans Examiner Zoning 01 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: 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. --) If Signature: State of Florida County of Miami -Dade The foregoing as acknowledge before me this 2 ' day of f ; , 20A. By ��i1 OSY VI �ClsSo IV who is personally_known to me or has produced \ as identification. `Q �1�••..' ••, Notary: � `" �Q 3.'71'i •�� * SEAL: IN. aIR !:�A*A STA'ffa.�\\\�\ WELL ELECTRIC TECHNOLOGY,INC Qualifier Tony Well License #EC13001181 4312 NW.11 St. Miami, FI 33126 welitechnologv@hotmaii.com PH: 786-399-9180 04/24/2019 State Of Florida County of Miami Dade Before me this day personally appeared Tony Well who, being duly sworn deposes and say: That he will the only person working on the project located at:133 Ne 102 St Miami Shores A 33138 67;wv'�V_ 61, Contra r Signature Sworn to (or affirmed) and subscribed before me this Z day of ,20 / q Personally known / Notary: SEAL: ,.��s KAMDEUFE W COWAISSION I GG 117054 Am 25.2021 ' F JEXPIRyE�S. y� WINW /1� N./.r �, NR1w11w�a