EL-19-1887C/-� G
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Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date:
Location Address Parcel Number
10420 NW 2ND AVE, Miami Shores, FL 33150 1121360161050
Contacts
•
Permit NO.: EL-08-19-1887
Permit Type: Electrical - Residential
Work classification: Alteration
Permit Status: Approved
Expiration: 02/19/2020
WILFRED JEAN Owner FARADAY ELECTRICAL CONTRACTOR INC Contractor
10420 NW 2 AVE, MIAMI SHORES, FL 331501226 JEAN CHARLES FRITZ MYTHO
10640 LAGO WELLEBY DR, SUNRISE, FL 33351
Business: 9549806128
Inspection Requests:
Description: NEW OUTLET GFI. ELECTRICAL PANEL TO BE Valuation: $ 1,500.00 3t5-712' 4949
ROTATED. TO REPLACE PERMIT#EL16-754
TotalSq Feet: 45.00
Fees
Amount
Application Fee - Other
$50.00
Permit Fee
$100.00
Total:
$150.00
Building Department Copy
Payments Date Paid Amt Paid
Total Fees $150.00
Cash 08/16/2019 $50.00
Check # 246 08/23/2019 $100.00
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 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. Futhermore, I authorize the above named contractor to do the work stated.
/ Contractor / Agent Date
August 23, 2019 Page 2 of 2
Miami Shores Village
APPROVED BY DATE
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FARADAY ELECTRIC44
CONTRACTOR INC.
10640 LA GO.WELLEq,) `OR.
SUNRiSF , r335-828a°�
RECEIVED
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
BUILDING
PERMIT APPLI ATION
BUILDING ELECTRIC ❑ ROOFING
UG 1�
BY:
F C20��( c, _I�
Master Permit No. np
Sub Permit No. - L u ov IJ��
❑ REVISION EXTENSION RENEWAL
❑PLUMBING ❑ MECHANICAL D PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: [�� Za Az6 J (J OVD
City: Miami Shores // County: Miami Dade Zip: 3�
Folio/Parcel#: 2 b " 01 /// b O Is the Building Historically Designated: Yes NO
Occupancy Type: 'Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder):
Address: 'I C2 L4 ?_ D IV W
City: 1-4 / of -lit
Tenant/Lessee Name:
Email:
CONTRACTOR: Company Name:
Address:
City
Qualifier Name: ,5 e—
state Certification or Registration #: C
OS
State: E c-- Zip: 331 i5—�
�WAY,
Phone#:
Phone#:
Zip:
Phone#:
Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address:
City:
v,
Value of Work for this Permit: $ O Square/Linear Footage of Work:
E
Type of Work: ❑ Addition eration ❑ New Repair/Replace
Description of Work: ,
-. b'°.+''�y''+:'•,F' •�; ter,. �,,,•� ..
ate: Zip:
❑ Demolition
R)
Specify:color of,'colorahru tile.
Submittal Fee $ a� Permit Fee $ IS p rCCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $
Structural Reviews $
Training/Education Fee $
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
State
Zip
Zi
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement st be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. in the absen o posted notice, the
inspection will not be approved and a reinspection fee will be charged.
U
A
Signature V Signature
OWNER or AGENT CONTRACTOR
The foregoing instrume was ack wledged before me this
�`¢ day of 20 by
-3T�
who is personally known to
me or who has produced as
identification and w o did take an oath/ /' L o-
NOTARY PUBLIC: qyo -
The foregoing instrum
_day o/f--�
before me this
20 J by
is personally known to
me or who has produced11 ✓
identification and who did take an oath.
NOTARY
Print: Print: gl&ublic StateofFlorid
Notary pubes glees of Florida Peter Villa
Seal: Peter Villa Seal: i My Commission GG 321383
• X My Commission GG 321383 or Expires 04/22/2023
a�df Expfts04=023 - -
as
************************************************************************************************************
APPROVED BY - Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
FARADAY ELECTRICAL CONTRACTORS INC.
FRITZ MYRTHO
MASTER ELECTRICIAN, P.E.
..(954) 980-6128
Service Repair & Upgrade
New Construction, Remodeling
Panels Changes, Fire Alarms, Cameras
Commercial - Residendal,.Industrial
0 Licensed arid'Insured ' License # EC 13007114
n
PROPOSALAUBMITTED TO
P ONE
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LNAMP
LDATEE
f .7
STREET,
.
CIT'6,�T,ATE, ZIP OtE•
JOB LOCATION
JOB PHONE
ARCHITECT
DATE OF PLANS
We hereby submit specifications and Ze* tes for* iN
I n.
k
VC VtOpOge hereby to furnishpkaterral and labor - complete in accordance with above,specifications, for the sum of:
Payment. to be made as follows:
d� dollars ($
Style of P
140to'l V 3
Notary 83
Ah-tj, Pelt CO
124
All material is guaranteed to be as specified. All work to be completed in a
workmanlike manner according to standard practices. Any alteration or
deviation from above specifications involving extra costs will be executed
only upon written orders, and will become an extra charge over and above
Authorized
Signature r_
the estimate. All agreements contingent upon strikes, accidents or delays
beyond our control. Owner to carry fire, wind damage, and other necessary
insurance.
Note: this pioposal ma be
withdrawn by us if not accepted ithin days.
3crptance of Propagal - The above prices, specifications and
conditions are satisfactory and are hereby accepted. You are authorized to
Signature
do the work as specified. Payment will be made as outlined above.
Notice to Owner - Workers' Com
Miami shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
nsation 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.
Signature: '''J 9,
I V Owner
State of Florida
County of Miami -Dade
The foregoing was acknowledge efore me this —7 day of , 20 .
r �
By AAA who is pers y known to me or has produced
Notary:
SEAL:
9 4,1
as identification.
Notary Public Stem of Floride
Peter villa
My Commission GG 321383
Expires 04/22/2023