ELC-01-22-13Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Permit NO.: ELC-01-22-13
Permit Type:Electrical - Commercial
Work Classification: Alteration
Permit Status: Approved
Issue Date:01/14/2022 Expiration:07/14/2022
Location Address Parcel Number
9101 BISCAYNE BLVD, Miami Shores, FL 33138 1132060090010
Contacts
LEUNG VENTURE INC Owner
LEUNG VENTURE INC
9101 BISCAYNE BLVD, MIAMI SHORES, FL 331383223
Other: 3057549575 tkleung@bellsouth.net
ELECTRIC LINK, I.I.C. Contractor
RAMON PANFILO BENITEZ
6725 6725 CROOKED PALM LANE
rbelectriclink@gmail.com
Description: INSTALLATION OF THREE 120 V 20 A RECEPTACLES
FOR NETWORK
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
Building Department Copy
Valuation: $ 1,350.00 Inspection Requests:
Total Sq Feet: 0.00
Payments Date Paid Amt Paid
Total Fees $117.10
Credit Card 01/14/2022 $117.10
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 POOLwork.
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.
T
Authorized Signature: Owner / Applicant / Contractor / Agent Date
January 14, 2022 Page 2 of 2
Miami Shores Village JAN 0520ZZ
Building Department By
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
BUILDING Master Permit No. && `C,f' gz7x�?
PERMIT APPLICATION Sub Permit No.
❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [-]RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS [:]CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
Cit • Miami Shores V County: Miami Dade Zip: 3i5 J-3g
Folio/Parcel#: . is the Building Historically Designated: Yes NO
Occupancy Typ Load: Construction Type: Flood Zone::�c`.-/BEEE: FFE:
OWNER: Name (Fee Simple Titleholder) L LLC
City: M 1�i'Nt i i` d)) State: tl Zip:
Tenant/Lessee Name: _ Phone#:
Email:
CONTRACTOR: Company Name: Z'1P-c ,,1 le. by LLe. Phone#: `30S)323-i5p'93
Address: 1rl7 C.7 L.wo K 4=-cf V" r •i/ wqL
City: 141am/ Lq&er State: F/o�d, zip- 330/y
Qualifier Name: PQr�r a P Fef91-k-T Phone#:C/ZIS)3Z3-6293
State Certification or Registration #:EC 130 US a 70 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#: �/`
I
Address: �J� \' City: Y State:�Zip:�
Value of Work for this Permit: $- 35-o Square/Linear Footage of Work: -grr
O reGy'
Type of Work: ❑ Addition ❑ Alteration E New ❑ Repair/Replace n❑ Demolition
Description of Work: rN LUG-i/Ol7 O � Le l.J� ��y / �i0 A- /CC44-A xU
Ak
Specify color of color thru
Submittal Fee $ Permit Fee $
Scanning Fee$ Radon Fee$
Technology Fee $ Training/Education Fee $
Structural Reviews $
(Revised02/24/2014)
CCF $ CO/Cc $
DBPR$ Notary1
Double Fee $
Bond $
TOTAL FEE NOW DUE $-,
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. \ 1
"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 be approved and a reinspection fee will be charged.
Signature Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this
day of .20 . by
. who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
The foregoing instrument was acknowledged before me this
day of . 20 . by
who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign: Sign:
Print: Print:
Seal: Seal:
as
************************************************************************************************************
APPROVED BY
(Revised02/24/2014)
Plans Examiner
Structural Review
Zoning
Clerk
Bonding Company's Name (if applicable)
Bonding Company's Address
City S
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 be approved and a reinspection fee will be charged.
Signature
OWNER or AGENT
Thefgoing instrument was acknowle ged before methis
day of a QVivV 0.r�J .20 by
T%l?.rttC, M. Le U A e who is personally known to
me or who has produced br 1Vti' L CA11bt as
identification and who did take an oath.
Pri
YAMILE KOE<ESECK
,votary Public - State of Florida
Commission. t HH 150558
My Comm. Expires Sep 13. 2025
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
S day of a VOLC 20 ;L� by
u1410 h .k r,-&- fte, who is personally known to
me or who has produced J)y i V-e—r L�C�Ci ,S-C- as
identification and wtjo-did take an oath.
tlttttttttittRRRRRitRRtiiiiitittttttttltttkRtRRiRyitttitltlt•
APPROVED BY{ �, > L<--� Plans Examiner
Structural Review
(Revised02/24/2014)
YAMILE KOELK3ECK
-x,cz
Notary Public - 5tzte o�
Commission r"'Sc5S8
My Comm. Expires Sea ' S. 2025
Rii Rtti
Zoning
Clerk
JAN 0 5 zon
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F-(-C-6i-vZ-i3
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. Star. § 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:
State of Fli
county or miamf-ioaae
The foregoing was acknowledge before me this /3— day of Ila" UC0. f i , 20,)�.
ByJ h e CG50. )-I - L-e— V V1 3 who is personally known to me or has produced
-1-L )' � ve. r ��GY of as #n�cotyp.
A
YAMILE KOELKESECK
Notary Public - State of Florida
Commission # HH 160558
ELECTRIC LINK, LLC.
6725 CROOKED PALM LANE
MIAMI LAKES, FLORIDA 33014
PHONE: (305) 323-6893
E- MAIL: rbelectriclink@gmail.com
DATE: 1 112 / Z Z
STATE OF FAD✓i GILL
COUNTY "f;am l I�ud
4�
BEFORE ME THIS DAY PERSONALLY APPEARED t\QtYy-, Cu-�c--44NHO, BEING
DULY SWORN, DEPOSES AND SAYS:
THAT HE OR S�i E WILL BE ONLY PERSON WORKING ON THE PROJECT LOCATED AT:
C4ICi( F�J)-�ru t �;C)'Ile 'k,I, 14ficm 1keyre',r/
CONTRACTOR SIGNATURE
SWORN TO (OR AFFIRMED) AND WBSCRIBED BEF E THIS /0 DAY OF
w ,20�_ BY �� f / —
PERSONALLY KNOW
OR PRODUCED IDENTIFICATION
TYPE OF 3d 7 D
MIRIAM NE U
k\:�kW'..
''. ':obry Pcplic -State of Florida
Commission N GG 258860
?�;FyRf My Comm. Expires Sep 26, 2022
landed through National Notary Assn.
PRINT, TYPE OR STAMP NAME OF NOTARY
1
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