EL-07-21-1804, 1298 NE 95th StMiami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
��'���' �.9J2�
Expiration:01�19�2022
Parcel Number
1298 NE 95TH ST, Miami Shores, FL 33138 1132060144030�
Contacts
Yuri Morales Owner Yuri Morales Applicant
302 Ne 92 st, Miami, FL 33138 302 Ne 92 st, Miami, FL 33138
Business: 3057903849 yurimorales@gmail.com Business: 3057903849 yurimorales@gmail.com
Mobile: 3057903849 Mobile: 3057903849
RISING SUN ELECTRIC, LLC Contractor
AUDLEY E RUSSELL
5782 POWERLINE RD, FORT LAUDERDALE, FL 33309
Inspection Requests:
Description: WIRING AND INSTALLATION OF 1 SECURITY 1 £ Valuation: $ 10,000.00
CAMERAS 2 SPEAKERS 3 INTERCOMM 4 WIFI 3
E /
Total Sq Feet: 1.00
L
Fees
Amount
Application Fee - Other
$50.00
CCF
$6.00
DBPR Fee
$5.25
DCA Fee
$3.50
Education Surcharge
$2.00
Permit Fee
$300.00
Scanning Fee
$3.00
Technology Fee
$8.75
Tota I :
$378.50
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$378.50
Credit Card
07/19/2021 $378.50
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 certifyAt all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating instruction and zoniVt. I authorize the above named contractor to do the work stated.
Applicant / Contractor / Agent
July 19, 2021
Date
Page 2 of 2
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
1=11114 T►�Cr
PERMIT APPLICATION
LOW Volta
c-,fie
BUILDING LJ LECTRIC ROOFING
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS
JOB ADDRESS: 1298 NE 95 Street
B
jl�_ ___
FBC 20 1 :
Master Permit No.�RRC-07-19-1576
Sub Permit No.�L ` O _4- 2S - { PW
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑ CHANGE OF ❑ CANCELLATION [:] SHOP
CONTRACTOR DRAWINGS
City: Miami Shores County: Miami Dade zio:33138
Folio/Parcel#: 11-3206-014-4030 Is the Building Historically Designated: Yes NO _X____
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Yuri Morales Phone#: 305-790-3849
Address: 302 NE 92 Street
city: Miami Shores state: FL zip: 33138
Tenant/Lessee Name. Phone#: 305-790-3849
Email: yurimorales@gmail.com
CONTRACTOR: Company Name: Rising Sun Electric, LLC Phone#: 954-448-2220
Address: 5782 POWSrline Rd
City: Fort Lauderdale state: FL zip: 33309
Qualifier Name: Audley Russell Phone#: 954-448-2220
State Certification or Registration #: EC13006131 Certificate of Competency M
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 10,000 Square/Linear footage of Work: )
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of work: Wiring and Installation of: 1 Security cameras 2. Speakers 3. Intercomm 4. Wifi
Specify color of color thru tile:
Submittal Fee $ Permit Fee $
Scanning Fee $
Radon Fee $
Techn ogy Fee $ Training/Education Fee $
Struct ral Reviews $
CCF $_
DBPR $
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 Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
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 fie c(pproved a9d a reinspectioake will be charged.
Signature,
OWNER or
The for going instrument ,w�as acknowledged before me this
o�f,� Jt^A 20 2( by
AVM
9 day
�1 VM 1 i ((i,1V _, who is personally known to
me or who has produced r �— 0 (� as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:_
Print:
Seal: SELENA ARANDA
MY COMMISSION # GG 971705
:ate• EXPIRES: March 22, 2024
FOF F�°P' Bonded Thru Notary Public Underwriters
########
APPROVED BY
Signature
CON CTOR
The foregoing instrument was acknowledged before `me this
A5 day
—of RC� 1 1 , 20 EA by
�1UC` F>✓C j��L 4ho is personally known to
me or who has produced
identification and who did tak
oY P�m� KAREENAH ENNI3
NOTARY PUBLIC: Commission # GG 331447
_ Commission Expires 05M-2023
ill Bonded Through - Cynanotary
Florida - Notary Public
Sig
Print: �r� U 1rin
as
Seal:
#################################################################
Plans Examiner
Structural Review
Zoning
Clerk
(Revised02/24/2014)
5r
LLC
July 14, 2021
State of Florida
County of Broward
0
Rising Sun Electric, LLC.
State Certified EC13006131
5782 Powerline Road, Fort. Lauderdale, FL 33309
Phone: 954-448-2220 / 754-301-2927 Fax: 754-206-4927
Email: Patrick@risingsunelectricllc.net
Before me this day personally appeared Audley Russell who, being duly sworn, deposes and says:
That he or she will be the only person working on the project located at 1298 NE 95' Street Miami Shores FL 33138.
Contracto Signat re
Sworn to (or affirmed) and subscribed before me this 14111 day of July 2022by Audley Russell.
Personally know L
Or Produced Identification
..:..�. _ Type of Identification Produced.
lie
KAREEW ENNIS
Commission # GG 331447
Commission Explres 0546-2023
Bonded Through - Cynanotary
Florida - Notary Public
Print, Type or Stamp Name of Notary
For a Brighter Tomorrow...
Call Us Today!
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:
l . 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. A A
Signature:
State of FL
County of Miami -Dade
The foregoing was acknowledge before me this ( 2 day of , 20 _-2J .
By Y V-12J �` ,o P—C�, who is personally known to me or has produced
as identification.
Notary:
c
SEAL:
SINDIA ALVAREZ
MY COMMISSION # GG 238273
Bonded Thru NoUty Pulik UnderNifets
Rising Sun Electric, LLC.
State Certified EC:13006131
57K Po�.verline Road. Fort. Lauderdale. FL 33309
Phone: 954-448- 2-20 / 754-301-2927 Fay: 754-206-4927
Email: Pats°ick`u)risingsunelectricllc.net
201
cat , k�lIda
('ounti� of Browrard
Before me this day personally appeared Audley Russell who, being duly sworn. deposes and says:
That her she>i ie only person xNorking on the project located at: 1298 NE 9-�"' Street. Miami Shores, FL 3 3138
Contractdc Signature
ti 7rn to (or affirmed) and suh�cribed hefoe me this I0`i' dav- of November. 2021 by AUdley Russell.
Personally know
Or Produced identificat
Type of identification Produced_,
KAREENAHENNIS
Commission # GO 331447
x r Commission Expires 06-06-2023
Bonded Through - Cynanotary
Florida - Notary Public
11
Print, Type or Stamp Name of Notary
For a Brighter Tomorrow... ■
Call Us Today!