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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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspe which occurs seven (7, days after the building permit is issued. In the absence of such posted notice, the inspection will n be a proved and a reinspection fee will be charged. Signature Si rAGENT /inginstrument CONTRACTOR The foreg was acknowledged before me this The foregoing instrument was acknowledged before me this 1' I It^ 'Oki � � day of 20 by day of 20 by L P� J) • T whoispersonally known to S who isj personally known to me or who has produce ►\A V `�� 1J/// as me or o pro d �I�i V l� C�i� as identifi ti n a d wh id take an oa>a�►��\\• �.-�H� • �r04� entif ation an who di take an oath. NOTA PU LI _ ; S� ?� OTA Y PUBLIC \\`�Illlllllq////// \\\\ �•''Y 2 XGG 28?X$ �' 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 .. ... . . . . . . • •. . . . • • . .. . . . . ... . . . • . .. .. • .. ... . • • •. . .. . .. . . . . . • . •. • • .J . • . • • • • • • • • • • • •• •• • • • •• ••