EL-05-20-1045, 9119 N Miami AveScanned with CamScanner
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
co 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....
OWNEWS 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,
OWARNING 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
YOURNOTICEOF COMMENCEMENT."
Alb0ce tii, AWicant; As o condition to the Issuance of a building permit with an estimated volue exceeding $2500, the applicant must
fibraoure WYN be deffi-ered to the Person ft VW a copy of the notice of commencement and construction Ilen kw
I "' Also, a cI copy ofthat oI 111,111 1 IIIIIII'l I or the Job site
the, I ffetler, the
I rel" 4" 4�iilli
rispec onfee will be charged.
Signature L Signature
OWNER or AGENT CONTRACTOR
The to regoing instrument was acknowledged before me this The fortgWrig instrumenfs acknowledged before me this
.1 #1 4
i) day of 20 -L-0� by ,I Oday 0 ULU/—) .20 by
lt�ho is personally known to wKX R.
who Is personally known to
meorwho has produced— 1- L DL. as me or who has produced k� as
Wentif—flon and who did take an oath Identification and who did take an oath.
NOTARY PUBLIC. NOTARY P II
Sign
e,)
.,JJ 4WELA VAR
Print: tePrint: ------- J_mTrrmwy VOLA.-
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7
Seal: [-T seal: 01 G W*T#To
Expires 2
APPROVED BY Plans Examiner
Structural Review
(9,0,00=4/2014)
Zoning
Clerk
I
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Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue
.ocation Address Parcel Number
i119 N MIAMI AVE, Miami Shores, FL 33150 1132060130070
ontacts
Permit NO. EL-05
PermitTvDe: Electrical -
Expiration: 01/26/2021
CONSTANCE NORTELUS Owner CONSTANCE NORTELUS Applicant
9119 N N MIAMI Ave, Miami, FL 33150 9119 N N MIAMI Ave, Miami, FL 33150
(305)979-7216 simplicity212@yahoo.com (305)979-7216 simplicity212@yahoo.com
PERRY ELECTRICAL CONTRACTOR L.L.0 Contractor
1831 LEE JANZEN DR, KISSIMMEE, FL 34744
I Inspection Requests:
Description: Electrical for kitchen remodel Valuation: $2,000.00
305.76 49 3
Total Sq Feet: 0.00
E
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
Technology Fee
$2.50
Total:
$108.10
Issued By: Sindia Alvarez
Payments
AmjPaid
Available Inspections:
Total Fees
$
Inspection Type
Credit Card
$
Electrical Final
Amount Due:
July 30, 2020
Date
Permit Received By Date
July 30, 2020 Page 1 of 1
Ron DeSantis, Governor Halsey Beshears, Secretary
STATE OF FLORIDA dr)pr
L-VrpA nrkArKi"r r%r o"eikAipec kir,% pnr%irrcqAr%ki i or"t ^K Arii
Always verify licenses online at MyFloridaLicense.com
NEW. riM
r a
L.- Do not alter this document in any form.
This is your license. It is unlawful for anyone other than the licensee to use this document.
BRUCE VICKERS, TAX COLLECTOR
OSCEOLA COUNTY, STATE OF, FLORIDA
T =N0,
158327
1011512019 168074
Oper N/A TRANSFER 0.00
Till Internet ORIGINAL TAX 30.00
Paid AMOUNT 0.00
P,0,. BOX 422105,
TAX CCLLZCCTOR�
4MEE FL 34742-2105
407-742-4000
THIS PECFIPT IS TN ADC NON AND NOT IN UEJ Of ANY OTfIER LICENSE REQUIRF-D BY LAW OR MUNICIPAL ORDINANCE AND LS SUWECT TO REGJLATIONS OF ZOWNG, --A—iH, AND ANY OTHER LAWFUL AUTH'W-rry,
THIS LOCAL BUSINESS TAX RECEIPT IS FURNISHED PURSUAIN7 TO CHAPTER 205 LANNIS OF
FLORIDA AND OSCEOLA COUNTY ORDINANCE 95-10, AS AMENDED
The law requires this Local Business Tax Receipt to be displayed conspicuously at the place of business in such manner that it can be open to the view
of the public and subject to inspection by all duly authorized officers of the County.
Pursuant to State Law, all Local Business Tax Receipts shall expire on September 30th of the succeeding year. Those Local Business Tax
Receipts renewed beginning October Ist shall be delinquent and subject to a delinquency penalty of 10% for the month of October, plus all
additional 5% penalty for each month of'delinquency thereafter until paid; provided that the total delinquency penalty shall not exceed 25%
of the Local Business Tax Receipt for the delinquent establishment. A 25% penalty shall be imposed on any person engaged in any new
business, occupation or profession without first obtaining an Osceola County Local Business Tax Receipt, PLUS: if delinquent more than 150
days, subject to civil actions and penalties, and a penalty of up to $250.
This receipt is a Local Business Tax only. It does not permit the Local Business Taxpayer to violate any existing regulatory or zoning laws of
the state, county, or cities, nor does it exempt the licensee from any other license or permits that may be required by law.
This form becomes a receipt when validated by the Tax Collector. Note: Display in accordance with the county ordinance. Local Business Tax
Receipts are subject to change according to law,
Ravel M. Perry - MGR
1831 Lee Janzen Dr.
Kissimmee, FL 34744
forek
N'P(o)ttiaac' goin was kkwld e before tile ibj� day of,
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SEAL: J
"It YURIS F Ef ALTA ESTEVEZ
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1831 Lee Janzen Dr
Kissimmee Fl. 347" 4070498166
Date : 07/24/20
State of Florida
County of Osceola
Before me this day personally appeared L/J
Who, being duly sworn, deposes and says:
That he or she will be the only person working on the project located:
vo I Q'M k
Contractor Signature
Swom to (or affirmed) and subscribed before me This .2 C day of J,"-( 20
Personally know
OR Produced Identification v'
Types of Identi ion produced
Ricardo Vega
NOTARY PUB
STATE OF FL
CO"r# GG9
mp Name of Notary QvIres 21M
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Print Type or Sta
Uc
ORIDA
50581
024
JIMMY PATRONIS
CHIEF FINANCIAL OFFICER STATE OF FLORIDA
DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS' COMPENSATION
* * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * *
CONSTRUCTION INDUSTRY EXEMPTION
This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law.
EFFECTIVE DATE: 3/9/2020
PERSON: ROVEL M PERRY
FEIN: 464650311
BUSINESS NAME AND ADDRESS:
PERRY ELECTRICAL CONTRACTOR L.L.0
1831 LEE JANZEN DR
KISSIMMEE, FL 34744
SCOPE OF BUSINESS OR TRADE:
Electrical Wiring Within
Buildings and Drivers
EXPIRATION DATE: 3/9/2022
EMAIL: ROVELP(PYAHOO.COM
IMPORTANT: Pursuant to subsection 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under
this section may not recover benefits or compensation under this chapter. Pursuant to subsection 440.05(12), F.S., Certificates of election to be exempt issued
under subsection (3) shah apply only to the corporate officer named on the notice of election to be exempt and apply only within the scope of the business or
trade listed on the notice of election to be exempt. Pursuant to subsection 440.05(13), F.S., notices of election to be exempt and certificates of election to be
exempt shall be subject to revocation it, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate
no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person
named on the certificate to meet the requirements of this section-
DFS-F2-DWC-262 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 E01134407 QUESTIONS? (850) 413-1609