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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!