EL-19-1400Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date: 07,
Location Address Parcel Number
61 NE 108TH ST, Miami Shores, FL 33161 1121360110460
Contacts
Permit NO.: EL-06-19-1400
Permit Type: Electrical - Residential
Work Classification: Service Change
Permit Status: Approved
Expiration: 12/30/2019
JOSEPH FULTON Owner OMG ELECTRIC INC Contractor
61 N 108 ST, MIAMI SHORES, FL 33161 OSLVADO MARRERO
Mobile: 3059057188 20140 NE 3 CT, MIAMI, FL 33179
Business: 7862944336 omg.electric@yahoo.com
Description: REPLACE OVERHEAD POWER LINES TO Valuation: $ 1,730.00 Inspection Requests:
ti
UNDERGROUND. 4949
TotalSq Feet: 0.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$1.20
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.40
Permit Fee
$50.00
Scanning Fee
$9.00
Technology Fee
$2.50
Total:
$117.10
Payments
Date Paid Amt Paid
Total Fees
$117.10
Credit Card
07/02/2019 $67.10
Credit Card
06/19/2019 $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 that all work will be done in compliance with all applicable laws
regulating construction and zoning. Futhermore, I aye zp the above named contractor to do the work stated.
Authorized Signature: Owner / icant / Contractor / Agent
Date
July 02, 2019 Page 2 of 2
`' \\C\ Miami Shores Village
' Building Department
Y 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 APPLICATION
❑BUILDING ELECTRIC ❑ ROOFING
❑PLUMBING [:]MECHANICAL PUBLIC WORKS
c iv�
JUN 19 20 9
BY: l�<<
FBC 20
Master Permit No. ` 2 `' " I` 4 o o
Sub Permit No.
❑ REVISION ❑ EXTENSION ORENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: lPl l� f:: l-0&41, S
City: Miami Shores County: Miami Dade Zip: 33J L 1
Folio/Parcel#: 111 213` —O / i -Mil) Is the Building Historically Designated: Yes NO
Occupancy Type: SQL Load: Construction Type: L �, Flood Zone: _N_ BFE: FFE:
OWNER: Name (Fee Simple Titleholder): —.\\ %<0� . LT-o;j Phone#(30T) 7 0 $-%i88
Address: (o ( we I a�\- SJ1 _
City: ml own S)J-c--, State: 1'--L Zip: 331 L 1
Tenant/Lessee Name: Phone#:
Email: (M i NSW t L ._>•DF � C�r►n L , (_o ►�'1
CONTRACTOR: Company Name: t EIG.Phone#:(7SQ2544 /33C—
Address: Z o i y 0 N F 3 9-,D C V
City: 0/I1r,91'►'11 State: r—L Zip: 3�17
Qualifier Name: 0 5V tam Q b MA C' c•c r 0 Phone#:
State Certification or Registration #: IE 000 q i I Certificate of Competency #:
DESIGNER: Architect/Engineer:
Address:
Value of 1Wr k'for this Permit: $
Type,[!T%Addition ❑ Alteration
Description of Work: ojz
,.
"Specify -color of color thru tile:
fir,• c�\"
Submittal Fee $ —�6 t Permit Fee $ .
Scanning Fee $
Technology Fee $
Structural Reviews $
Radon Fee $
hone#:
State Zip:
Sr care/Linear Footage of Work:
❑ New RepairzRepl'ace ❑ Demolition
Training/Education Fee $
CCF $ CO/CC $
DBPR $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ (09L-
(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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement
must be posted at the job site
for the first inspe which occurs seven (7, days after the building permit is issued.
In the absence of such posted notice, the
inspection will n be a proved and a reinspection fee will be charged.
Signature Si
rAGENT
/inginstrument
CONTRACTOR
The foreg was acknowledged before me this The foregoing instrument was acknowledged before me this
1' I It^
'Oki � �
day of 20 by day of
20 by
L
P� J) • T whoispersonally known to S
who isj personally known to
me or who has produce ►\A V `�� 1J/// as me or o pro
d �I�i V l� C�i� as
identifi ti n a d wh id take an oa>a�►��\\• �.-�H� • �r04� entif ation an who di take an oath.
NOTA PU LI _ ; S� ?� OTA Y PUBLIC
\\`�Illlllllq//////
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�•''Y
2
XGG 28?X$ �'
Sig Sign:
_ �`�
Print: Y01 ,a, {�i ��\� Print: (i
f
Seal: //////ill! 11STA11 IN�N��\\ Seal: C
��y? ;°nded t ���•��A
�i ONc Unde�'• 0
zic
IIH1111�\\
APPROVED BY Examiner
Zoning
Structural Review Clerk
(Revised02/24/2014)
Notice to Owner - Workers' Corn
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%BEL YO NOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS
CONTENTSI
Signature:
State of Florida
County of Miami -Dade
ru ��
The foregoing was acknowledge before me this day of , 20�.
By S� �1 1 V ` Ci r> who is persoNall`,l cto me or has produced
N\0 V �cgv)Sy as identification.
Notary:
SEAL: OW 26726$
iiP/. ••; °uz undo ��
Val F,7
E UEMIC
INC.
7654W335
r. +
r t4 CLV
20140 N E 3 CT APT 8
Miami, FL, 33179
Cell: (786) 294-4336
omg.electric@yahoo.com
06/25/2019
TO WHOM IT MAY CONCERN
RE: Workers Compensation Exemption
Please be advised that I do not have any employees.
OSVALDO MARRERO
(President)
STATE OF FLORIDA
COUNTRY OF I Vt( Jp
Sworn to (or affirmed) and subscribed before me this _A Z— day of �V� . 20 l� by
(name of Pearson making statement).
(Notary Seal)
(signature of Notary Public -State of Florida)
(Name of Notary Typed, Printed, or Stamped)
Personally Known or Produced Identification
Type of Identification It- -D-gi U:-5-C— UjC5EN r
thHYP,: SINDIA ALVAREZ
MY COMMISSION # GG 238273
:,tea EXPIRES: September 3, 2022
^FOR F��t'•, goaded Thru Notary Public Underwriters
all
o
N /r
PANEL
6 (1) EXISTING METER
.. (2)EXISTING WIRES
(3) EXISTING PANEL
« » (2) (4) NEW UNDERGRQIJKD j
A SERVICE •,,,,' ......
200 A EMT 2"(3#2.
/0)EXISTING(Cu) • • ,
200 A ...... .. ....
...:..
MAIN •••• •
EXISTING
.,, 000
,
1V,'' ...... ,
,,,,,,
1#4THHN(CU)in3/4;PVP. 0 ••0,
„ ,
GROUND LINE
6' BETWEEN EACH� MINIMUIi•:-
_ �
10'-0" DEED GROUNDING
i
ROD-1/2 DIAMETER
NEW 120/240V UNDER PVC 2" i - T IT
GROUND ELECTRICAL _
SERVICE FROM UTILITY _ _ _� ' ' �^ ' ` -r�yi'
COMPANY
DATE
-- —
POWER RISER DIAGRAM I , -- ::L�.1 -1� --
O 1t' :E t:' �H Al l FE6-
JOB ADDRESS OMG ELECTRIC INC.
61 NE 108th ST j ELECTRICAL REVIE0140 NE 3rd CT APT#8
Miami Shores FL,33161 APPROVE _DATE
Miami FL,33179
' - LIC#11000499
MAIN RESIDENCE
GENERAL LOADS PER 220.40
LIGHTS & RECEPTACLES - 2,511sf x 3VA1sf =
7,533
VA
KITCHEN (4 GFCI @ 1,500) —
6,000
VA
RANGE =
8,000
VA
MICROWAVE —
1,200
VA
DISHWASHER =
1,600
VA
WASHER —
500
VA
DRYER =
5,000
VA
REFRIGERATOR =
500
VA
GARBAGE DISPOSAL =
1,000
VA
SUBTOTAL =
31,333
VA
1st kW OF ELECTRIC LOAD @ 100% =
10,000
VA
REMAINDER OF ELECTRIC LOAD (21.333) @ 40% —
8,533.2
VA
TOTAL NET ELECTRIC LOAD
=
18, 533.2
VA
HVAC LOAD:
COMPRESSOR =
7,040
VA
HEPA FILTER =
13,196.5
VA
TOTAL =
....... ..
.. 38,769.7
VA
SERVICE SIZFs 27:569.Z1240— ••.
•• •.• •• io•
162
AMPS
••
JOB ADDRESS
61 NE 108th ST :�:
Miami Shore FL,33161
.
.. ...
.`0W ELECTRIC INC.
': ;, • W1UtNE 3rd CTAPT#8
It/tiami FL,33179
Lic#11000499
. ..... . ...
. ...... . ....
.... . . .... .
N
A
ELECTRICAL PANEL A
Type: GE 200 AMP
Mountain: Flush Voltage: 120/240
1- A/C
2-A/C COMPRESOR
3- A/C
4- A/C COMPRESOR
5- COOK TOP
6- WATER HEATER
7- COOK TOP
8- WATER HEATER
9-SPARE
10- DRYER
11- GENERAL LIGHT
12- DRYER
13- GARAGE OUTLET
14- OVEN
15- MASTER BETHROOM
16- OVEN
17- BATHROOM LIGTH
18- LAUNDRY LIGTH
19- BATHROOM
20- GENERAL OUTLET
20- GENERAL OUTLET
22- ELIOT BETHROOM
23- LIVING ROOM OUTLET
24- BETROOM LIGHT
25- GENERAL LIGTH
26-REFRIGERATOR
27- GENERAL LIGHT
28- SMALL APPLIANCE
29- GENERAL LIGHT
30- GARBAGE DISPOSAL
31- BATHROOM
32- DISHWASHER
33- GENERAL OUTLET
34- GENERAL OUTLET
35- GENERAL OUTLET
36- SMALL APPLIANCE
37- GENERAL LIGHT
38- GARAGE DOOR
39- WASHER
40- KITCHEN LIGTH
41- HOOT
42- KITCHEN LIGTH
.. ... . . . .
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