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EL-03-21-706, 970 NE 100th StMiami Shores Village PuF,-cjFzvjEjD Building Department MAR 1 9 2021 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20 ZO BUILDING Master Permit No. a?C-12-zo-2999 PERMIT APPLICATION Sub Permit No.F_L'03 -21 - "4O(0 ❑BUILDING PfELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: QC10 NE 100 ST City: Miami Shores County: Miami Dade Zip: -3$138 Folio/Parcel#: 11 - -32,%- 034 - 1010I0 Is the Building Historically Designated: Yes NO V Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): 614-r4 tQr11D¢6 em., Ot!�u Phone#:3M- ZIT-4T1Lc1 Address: ay70 N£ 100 -.T City: M11wiN( CAM& State: FL Zip: 3a1-319 Q Tenant/Lessee Name: Phone#: Email: �pf i 5 QfUnc (9i gala • Co%�(� CONTRACTOR: Company Name: SUIlSWAQ.-de00'W I Q0Y1,-imo%p/S COyID • Phone#: '1&6.8o0•0q`74 Address: 11005W QSC,+ City: AA ( oy(vV State: -PL Zip: 33144 Qualifier Name: ftictyro/lA 'T• SOLV 54�60y) Phone#: 7%•1600 • 0991 State Certification or Registration #: FEC 1300 5R01 Certificate of Competency #: _ DESIGNER: Architect/Engineer: Phone#: Address: City: State Value of Work for this Permit: $ " , I Square/Linear Footage of Work: Type of Work: ❑ Addition m❑ Alteration ❑ New II❑ Repair/Replace Description of Work: V' e(e' ») 1'1 G 2Ym Specify color of color thru We: Submittal Fee $ Permit Fee $ Scanning Fee $ Technology Fee $ Structural Reviews $ Radon Fee $ Training/Education Fee $ CCF $ DBPR $ Zip: ❑ Demolition Pn�NyTl1 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 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 low 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 issu�d� !n the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. 1 Signature Signature OWNER or AGENT CON The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this l S day of X62- Gel,— 20 Z ( by day of `' 20 by who is personally known to JVOViQkQ SOvlt454�OVN who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: as me or who has p identification arld Wo diclAake an oath. NOTARY PUBLI RTI Print: 2 1 -i✓ Gin/ Print:-Li���� Seal: �fd; PLNotary Public State of Florida Sea I: .r+' NotaryPublic State of Florida Zion Hay Cohen f % Peter Lerperger My Commission HH 075363 i'T�" My Commission GG 287104 Expires12/29/2024 �pw� Expinss02/2412023 ************ * * ********************* ********* APPROVED BY Plans Examiner Structural Review Zoning Clerk (Revised02/24/2014) Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Permit NO.: EL-03-21-706 Permit Type: Electrical - Residential Work Classification: Alteration Permit Status: Approved Issue Date:04/15/2021 Expiration: 10/13/2021 Location Address Parcel Number 970 NE 100TH ST, Miami Shores, FL 33138 1132060340190 Contacts BORIS ARANGO Owner 970 NE 100TH ST, Miami Shores, FL 33138 Home: 3052184729 SUNSHINE ELECTRICAL CONTRACTORS CORP MARIANO SANTIESTEBAN 1300 SW 85 CT, MIAMI , FL 33144 Business: 3052654958 Home: 7864439590 Other:7862736194 Inspection Requests: Description: interior remodeling: demolition of existing Valuation: $ 11,180.00 305 762 4949 kitchen and closets in bedroom # 2 for layout reconfiguration, demolition of existing master bedroom Total Sq Feet: 305.00 and bath #1 for remodeling/ removed and replace existing doors as de icted Fees Amount Application Fee - Other $50.00 CCF $7.20 DBPR Fee $5.87 DCA Fee $3.91 Education Surcharge $2.40 Permit Fee $341.30 Scanning Fee $18.00 Technology Fee $9.78 Total: $438.46 Building Department Copy Payments Date Paid Amt Paid Total Fees $438.46 Credit Card 04/15/2021 $438.46 Amount Due: $0.00 Contractor 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 authorize the above named contractor to do the work stated. Authorized Signature: Owner / Applicant / Contractor / Agent April 15, 2021 Page 2 of 2 SUNSHINE ELECTRICAL CONTRACTORS CORP. 1300 SW 85CT DATE: 02, 1(. O2^ STATE OF FLORIDA COUNTY OF MIAMI-DADE Before me this day personally appeared Mamw 1 • 0,4 4k6 who, being duly sworn, deposes and says: That he or she will be the only person working on the project located at: 970 NE 100th St. Miami Shores, FL 33138 owuiii w kui aiiirrneu) anu suuscnueu uefore me this day of 20 21 by 0-bp 2. Personally Know Or Produced Indentification Type of Identification Produced Miami Shore's Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 VAuuce LU owner — vvorKers- compensation insurance txemwion 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 BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: wn State of Florida County of Miami -Dade The foregoing was acknowledge before me this J day of M AatG ' ByJzv52 A&n who is personally known to me or has produced as identification. Notary: DEYSI J. SANCHEZ SEAL; Commission # GG 312634 Expires July 12, 2023 0 e Or f�oP Bonded Thru Budget Notay Services %n D#Sanft Gavwnar STATE OF FLORIDA Halwy Bofhmn, Secretary Em" DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD THE ELECTRICAL CONTRACTOR HEREIN IS CERTIFIED UNDER THE PROVISIONS OF CHAPTER 489. FLORIDA STATUTES SANTIESTEBAN, MARIANO J. SUNSHINE ELECTRICAL CONTRACTORS CORP. 1300 SW 85 CT MIAMI FL 33144 LICENSE NUMBER: EC13005807 EXPIRATION DATE: AUGUST 31, 2022 Always verify licenses ontirte at MyfloridaLicense.com Do not alter this document in any form. ar This Is your license. It is unlawful for anyone other than the licensee to use this document.