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EL-11-744Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION FBC 20 Permit Type: Electrical OWNER: Name (Fee Simple Titleholder):/e/,� / `✓y 14AR v 8 2� Permit No. - Master Permit No.P,7---" Aaaress:s L. -v v City: G�/% �!? Z7 S 40'& State: f�� Zip: T -� Tenant/Lessee Name: Phonek Email: JOB ADDRESS: City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes CONTRACTOR: Company Name: .5utf) Addr( City: NO Flood Zone: Qualifier Name:�P `/ 64 '�`f l�-0 Phone#: State Certification or Registration #: t ® tG �c7� Certificate of Competency #: IDC7 / Contact Phonetk_, C' �—� `'e-!5" Email Address: DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ �cb' � Square/Linear Footage of Work: Type of Work: ❑Address Wdteration ❑New ❑Repair/Replace Description of Work: aA, -fr0A� 41 Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ ❑Demolition M 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 The foregoing instrument was acknowledged before me this day of , 20 J.Z-, by , who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: anon My Commission fires: � rp4, A. Jule, COMMISSION # DD992825 EXPIRES: MAY 17, 2014 Signature Contractor The foregoing instrument was acknowledged before me this day of gW , 20 JL by , who is personally known to me or who has produced as identification and who did take an oath: APPROVED BY 92r/ it Plans Examiner Structural Review (Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) NOTARY PUBLIC• Sign: hZ& Print: 111 My Commissi xpires: p,,�� Julio A. 0jelvo a�L' , a COMMISSION f DD992825 EXPIRES: MAY 17, 2014 Zoning Clerk MIAMI-DADE COUNTY 2091 MUNICIPAL CONTRACTOR'S 2012 FIRST-CLASS TAX COLLECTOR TAX RECEIPT U.S. POSTAGE 140 W. FLAGLER ST. MIAMI-DADE COUNTY - STATE OF FLORIDA PAID 1st FLOOR PURSUANT TO COUNTY CODE SEC. 10-24 MIAMI, FL MIAMI, FL 33130 EXPIRES SEPT: 30, 2012 PERMIT NO. 231 RECEIPT NO. 30-5073093 CC NOt 02E000493 BUSINESS NAME / LOCATION RECEIPT HOLDER MAYDO BUSINESS AS A CONTRACTOR SUNSHINE ELECTRICAL CONTRACTORS AS SPECIFIED HEREON. CORP 1300 SW 85 CT OWNER :SUNSHINE ELECTRICAL CONTRACTORS SEE BACK OF RECEIPT FOR ELECTRICAL CONTRACTOR A LIST OF NONPARTICIPATING MUNICIPALITIES Receipt holder must 00 NOT FORWARD y enthe city wherew e work la to be SUNSHINE ELECTRICAL CONTRACTORS wher done. CORP �It MARIANO SANTIESTEBAN PRES 1300 CT PAYMENTRE'CEIVED MIAMISFL833144 MIAMI-DADE COUNTY TAX `oLLWIFY 28/2011 J 02240025001 ``J g`' I, 000200-00 111'1111111 Is 11111141111111 IsIfill U afil�r1II1IIII'll,total11 i -DADE COUNTY 2011 LOCAL BUSINESS TAX RECEIPT 2012 FIRST-CLASS COLLECTOR D ELAGLER ST. MIAMI-DADE COUNTY - STATE OF FLORIDA ' U.S. POSTAGE I LdOR EXPIRES SEPT. 30, 2012 PAID Aillll, Ft. 33i3d MUST 08 DISPLAYIID AT PLACE OF BUSINESS MIAMI, FL I PURSUANT Tb COUNTY CODE CHAPTER OA 6 BART. 9 10 PERMIT NO. 231 486076-4 -311,x.,,.I1,_11k7asa RENEWAL SINESS NANIS / LOCATION RECEIPT NO. 507309-3 SUNSHINE ELECTRICAL CONTRACTORS CC # 02E000493 CORP 1300 SW 85 CT 33144 UNIN DADE COUNTY INER SUNSHINE ELECTRICAL CONTRACTORS s. Type o4 Business WORKER/S 196p ELECTRICAL CONTRACTOR 1 ONLY A LOCAL TAX RECEIPT, IT IT PERMIT 1146 rO VIOLATE ANY R66ULATORY OR on C ES THE on cross. NOR DO NOT FORWARD EXEMPT THE 'RM ANY OTHER 'YnLAW ENNSE rl118 I 1 CAnAb�vl pP SUNSHINE ELECTRICAL CONTRACTORS CORP MARIANO SANTIESTEBAN PRES RficE:v" 1300 SW 85 CT )Rt TAX MIAMI FL 33144 09/28/2011 02240025002 000075.00 237 07-21-2011 JEFF ATWATER STATE OF FLORIDA CHIEF DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COWENSATION LAW * * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation lave. EFFECTIVE DATE: 07/21/2011 PERSON: SANTIESTEBAN FEIN: 651009473 BUSINESS NAME AND ADDRESS: SUNSHINE ELECTRICAL CONTRACTORS CORP 1300 SW 85 COURT NIANI FL 33144 SCOPES OF BUSINESS OR TRADE: 1- ELECTRICAL CONTRACTOR EXPIRATION DATE: 07/20/2013 MARIANO J implifiTAi . Pursuant to chapter 440 . 05114% F.S., as officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may ant recover benefits or compensation ander this chapter. Pursuant to Chapter 440.05!121 F.S., certificates of election to be exempt.. apply only within the scope of the business or trade listed on the notice of election to be exempt Pursuant to Chapter 440.0913). F.S., Notices of election to be exempt ad 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 parson named an the notice or certificate no longer meets the requirements of this section for Induce of a certificate. The department shall revoke a certificate at any time for failure of the person named so the certificate to meet the requirements of this section. QUESTIONS? (850) 413-1609 OWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01-11 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS COMPENSATION CONSTRUCTION INDUSTRY cminFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPEINSArON LAW 10 EFFECTIVE: 07/21/3011 EXPIRATION DATE: 07/20/2013 PERSON: MARIANO J SANTIESTEBAN FE:U1R 651009473 BUSINESS NAME AND ADDRESS: SUNSHINE ELECTRICAL CONTRACTORS CORP 1300 SW 85 COURT MIAMI. FL 33144 SCOPE OF BUSINESS OR TRADE: 1- ELECTRICAL CONTRACTOR IMPORTANT FO Pursuant to Chapter 440.05114), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election L under this section may not recover benefits or compensation under this D chapter. Pursuant to Chapter 440.05(12), F.S, Certificates of election to be H exempt_ apply only within the scope of the business or trate listed on E the notice of election to be exempt R E Pursuant to Chapter 440.05113), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, 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 met the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person nulled on the certificate to meet the requirements of this section. CUT HERE QUESTIONS? (850) 413-1609 e Carry bottom portion on the job, keep upper portion for your records. , z v. --ge - ?:'•^--'• ]A4_•: '+:................................. 1 :v::::::vv.:: •vvz+•; L,{.. v.._... v_......:S........ • v �.......... 3: _}- - MAIC pgN1AlU/TT/ I. :z {@ ?; :: •- �� '.:Y•�: •`i+:v:••?X'.. �' h.... . ..v:::.. ...s..s ..:... ....z..... ..z.:. > ....__..a.....:4:... r.: _:a............:.__...v... z... v...... :._..,:.:.......»..:...:..............:x>t,,:,..... .tF a .vh...._'"-_____ ..stz...•a=.:y~•'.•ss':vh . ._ !.� z . .L h:�t>>?:�h??>LL=:>��:�.v{'{. J?,ter- - - .�>�:.�.•{{:�.:. x.�{:;::��.��-_:_ri:� 04/06/11 PaoDUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE DISCOVERY HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ENTR INS AGENCY, INC ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 10733 NW 58TH STREET COMPANIES AFFORDING COVERAGE DORAL, FL 33178 (305) 718-8919 FAX: 718-3584 COMPANY A PENN AMERICA INSURANCE COMPANY INSURED COMPANY SUNSHINE ELECTRICAL CONT. CORP. B 1300 SW 85 CT COMPANY MIAMI, FLORIDA 33144 C COMPANY D ••••• .i::•:::.:v:.:v::z:v::.•.:...r.>.. ._:�zz.. v. v.v........... ...-....z..._... .... 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LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR TYPE OF INSURANCE POLICY lWMB� POLICY EFFECTIVE POLICY EXPIRATION, LIMITS DATE IMM/DD/YYI DATE 00M/D01M GENERAL LIABILITY GENERAL AGGREGATE 01,000,000. X COMMERCIAL GUMIAL LIABILITY PRODUCTS - COMP/OP AM $1,000,000. CLAM MADE Q OCCUR PERSONAL & ADv INJURY ;1,000,000. A omwrs & comRAcroR's PROT PAC6 8 6 617 9 04/07/11 04/07/12 EACH OCCURRENCE sl , 000, 000. X P. D. & B. I. FIRE DAMAGE (Any ww Tue) s 100,000. .$500. DED . MED EXP IAor aye ISR 0. 5,000. AUToMomm LIAiIJTY ANY AUTO COMBINED SINGLE LIMIT a ALL OWNED AUTOS BODILY INJURY a SCHSXR D AUTOS ow penmw HRRED AUTOS BODILY INJURY S NON -OWNED AUTOS (Pm accww* PROPERTY DAMAGE S ril GARNM LIABILITY AUTO ONLY - EA ACCIDENT S OTHER THAN AUTO ONLY: ANY AUTO EACH ACCIDENT $ AGGREGATE S EXCESS LIABILITY EACH OCCUiWMCE S AGGREGATE a UMBRELLA FORM g OTHER THAN UMBRELLA FORM WORKERS COMP131SATION AND WC`1STATIU-OTH..., i ? :j j:: _51 I EMPLOYED' LIABILITY E. EACH ACCIDENT 8 THE PROPRIETOR/ INCL P EL DISEASE - POLICY LOW 9 EL DISEASE - EA EMPLOY& S OFFICERS ARE: EXCL OTHER DESCRIPTION OF ITEMS ELECTRICAL WORK — WITHIN BUILDINGS ..... ..... ... .: v: :. ..,..... {-•. _:. .. z:• :.::v :..}rvizh. vv.:J?:tii•t•L{L- •• .... ... z}}}:: :r:Yr:::.i}' }.�Y. :iiL>}>'•::.-.L; ., .; :: .vy:-_• •. - v-Nw: :�Ic{>..::,vr: _ fr� � t+� :..i,.... _ .... •:=sir':: �-}:•. .:?y ; :;•i; .:':f ::.•:.>.>:: .£ .:� •{{moi •:+>}'cr. - : •r>?!+ :.3+%: '- ' - :,-...?:.. ::}. ^•+•{':?=--�??rpt t•..svra+v. ..>}.z.:i... ��i.�:rr z�.-.. nt .. .::} z .. f... �{v�� is:':=:{i-a.-?i} {•^>>J}?.??i :::z:{>z __ p "~h {..... {:,<..: 1vF:::=+t::•.:•h-:v, J. f.... +•::? '�~:t�4{i=irirv:Y�t��.r: �vzi}{iry : .:. .{.- : .. ... ... .... .. ........ .._.. ......:. ......: v.:\:•':- .�k::.....�.. ...v..z.._...:...:;;.5,• ._:. .{ ..z:.v _ht.._._O.v ..._.__._: .vv.:..pv:.. .. .... .».i x{{...t ... ..a+l .. _.Y :v .::5. .rv.� rs:..4:: u:uav:,Js �., �.y ..,.....:.}......a........:.......:......:,.a'J:..v...:_.r_.:'��r....-..>r.......f.>..as....t�.r._._.rma>s'r.-a•r.::.:....{..4s'sxi{:{:r::�Si.-:a.�i-J>r...._:r: �r.::•,:•r..r3>r.::::..: — — — - ----- --. SHOULD MY OF THE ABOVE DESCRIBED POLICES BE CANCELLED MOM THE EXPIRATION DATE THEREOF. THE MINS COMPANY WILL ENDEAVOR TO MAIL 3 0 DAYs WRITTEN Norm To THE CEHTIRCATE HOLDER NAMED To THE LEFT. D BUT FAILURE TO MAH SUCH NOTICE SHALL INFOSE NO OBLI"TION OR LIABILITY OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REFINESENTATIVES. AUTHOR1ZED REPRESENTATIVE .....::-::::::-:rxr.}••J::•:c{Lt-v::.r:::.�:.�::-r: _.r :.,�:::•_::::::.::> :.:-,.•r :- ::-:_::,.:..:..:a:-.:::-:::....+,r>: _ .. _ .....:.:-: •..:-:::::•.:-::> :-_ '- :•. ::- :. ::::::: -::- • , {:: _•:::::::...,.::---------- • --- :•r.} -.ter:::::-_._. _:�.:_:::._:..�. L-: a.' .r ---r........: �::---•--... --+--•---.:::. .: - :. - v. :-'_..,I:v=:G -:}K -i• �s {{th._}..:..:...........— .:.............:x:•??J�iii.:v:{::•::t::-,::-:z:v}::•.• .{D r__ -..:....a..:....'._.._'..__ t ..........n............................• - .... ._ ... '-"•?``v -:xci :;{- .:.,r.• ....:::: i•:.. ..._• ...............:::?:ice}i}i{S?=}}:{ta?:-:•}:...:>.._::::}rv}{_.....:iv:::i.{%:•%{•+_..._..:isiAh_.>:hi{.__.__._...Yn...?.rCt._.>i.�.•:xN.r..___..fi.•:.::.. ____f•_: rli.: Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 2004 Permit Type: -Electrical Owner's Name (Fee Simple Titleholder) Permit No. Master Permit No. Tenant/Lessee Name Phone # Job A44688 (where the work is being done) I '-b Q _71 77 APR 2 8.211 BY: ....................... City �Vie.. County Miami-Dado zip FO1!Q,/ PARCEL # t 3=5 0 1 �o Is "' j Historically Designated YES NO Contra6iJils Company Name r , Phone # Contractdi's Address le9& 990 A, -'W -3 I -S-7 - city Meal kcl- Qualifier Name State ro Zip, State Certificate or Registration N046W,/-b6Q- c30/7, -Certificate of Competency E-MAIL: Architect/Engineer's Name (if applicable) .. -Value of Work For. this Permit $ I H C[ Phone # Square / Linear Footage Of Work: Type of Work. MAddition OAlteration ONew M Repair/Replace 0 Demolition Describe Work: Submittal Fee $ Permit Fee $ zg:—e- " �� -e� CCF $ - COICC. Notary $ Training/Education Fee $ Technology Fee $ Scanning S Radon S. DPBR S zoning $ Bond $ Code Ki&rcemeut Double Fee $ Structural Review. $ Total Fee Now Due See Reverse side -> Bone"ing 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 INTENI) 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged Signature Owner or Agent The foregoing instrument was acknowledged before me this day of , 20 ,_, by Signature Contractor The foregoing instrument was acknowledged before me this—L'-1 day of -1 20 IL, by who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. _a0identification and who did take an oath. NOTARY PUBLIC: NOTARY P ) C: ,� Sign: Sign: Print: Print My Commission Expires: My Commission Expires: * * MYOf9�41$Slt)N#R3©t19181i2 s EXPIRES: Jwm 24,2813 APPLICATION APPROVED BY:� Engineer Zoning (Revised 02108/06)