EL-15-1655 e
YL
Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-252136 Permit Number: EL-7-15-1655
Scheduled Inspection Date: February 04,2016 Permit Type: Electrical- Residential
Inspector: Devaney,Michael Inspection Type: Final
Owner: BONAU,JOSE AND MARIA Work Classification: Alteration
Job Address:1250 NE 102 Street
Miami Shores,FL 33138-2618 Phone Number
Parcel Number 1132050250030
Project <NONE>
Contractor: APR ELECTRIC CORP Phone: (305)318-3692
Building Department Comments
REMODELING BATHROOM. ELECTRICAL WORK Infractlo Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-251957. 2 out of 5 smoke
u detectors not installed.
Failed
Correction
Needed ❑
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid
February 03,2016 For Inspections please call: (305)762-4949 Page 28 of 35
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CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORMA WORKERS'COMPENSATION LAW �
CONSTRUCTION INDUSTRY EKEMPTION
This cwffwe thltt dw kWbktml ilk below hn shuted to be exaffVtran FkwWa Vi re'CcffWon&stbon 8w.
EFFECTIVE DATE: &13911016 E)(PIRATION DATE: BMW T
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SUSPAW NAM AND ADDRSW
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CERTIFICATE OF ELECIM TO BE EXEMPT REMSED 0&11 QUESTk7M87(SM)412-1899
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MIAMI Fl. 33120 Fax ALTER COVERAGE AFFORDED BY THE FOLrC1ES BELOW.
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SUBJECT TO POLICY FORIK CONDITION.ENDORumENT,LIMITATIONS AND EXCW81ON8
CONYRACTOR LICENSE NUMBER 014
CERTIFICATE CANCELLATION
VILLAsHolu oArnroFriEaeorsFoun��CARCIE9 LEDEEROR6Tt@leJtplluTLON
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10050 NE 2 E aTR THMEW T7WMWJ=a W"mmvm TO MAI 10 OILYB
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Miami Shores Village
10050 N.E.2nd Avenue NE
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Mi s •... 3. 3 :3 ..t.Ci
ami Shores,FL 33138-0000
Phone. (305)795-2204
' Expiration: 01103/2016
Project Address Parcel Number Applicant
1250 NE 102 Street 1132050250030 JOSE AND MARIA BONAU
Miami Shores, FL 33138-2618 Block: Lot:
Owner Information Address Phone Cell
JOSE AND MARIA BONAU 1250 NE 102 ST
MIAMI SHORES FL 33138-2618
Contractor(s) Phone Cell Phone Valuation: $ 1,200.00
APR ELECTRIC CORP . (305)318-3692 Total Sq Feet: 0
Type of Work:REMODELING BATHROOM.ELECTRICAL WOR Available Inspections:
Additional Info:
Inspection Type:
Classification:Residential
Review Electrical
Scanning:1
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.20 Invoice# EL-7-15-56198
DBPR Fee $2'25 07/07/2015 Check*2556 $ 115.70 $50.00
DCA Fee $2.25
Education Surcharge $0.40 07/02/2015 Cash $50.00 $0.00
Notary Fee $5.00
Permit Fee-Additions/Alterations $150.00
Scanning Fee $3.00
Technology Fee $1.60
Total: $165.70
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 zo ' ore,I authorize the above-named contractor to do the work stated.
_ July 07,2015
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
July 07,2015 1
Miami Shores Village
Building Department
� '�` `
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 JUL
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(30S)762-4949 BY: -
FBC20 ( .14
BUILDING Master Permit N4.�_o_ j s:- y
-::)
PERMIT APPLICATION Sub Permit No.:--.I. 15-�G1510-
❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
�^' CONTRACTOR DRAWINGS
JOB ADDRESS: 1250 �G ®� S��ee,G
City: Miami Shores County: Miami Dade zip: -33/3j,7
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
`` ,
OWNER:Name(Fee Simple Titleholder): ase &. 6c • ^f,� A0,cAo Phone#: atil -7rr54''?d0r
Address: 4?we- of f d e- t® o2= Moby.- D q7 n UZI-
City: S State: ..C/��e Zip: _IX.A7 e
Tenant/Lessee Name: Phone#: .(-
Email: �Q�• �D�a.Gtr� /• q0 l0
CONTRACTOR:Company Name: APIC e.1 e- 1 Y t a Cor Phone#: 306 31 8�l�
Address AAe ta3 WW jagr� C— q
City: Ivt State: t--- Zip:
Qualifier Name: �Cde �� � Phone#:
State Certification or Registration#: F-e 130140'13 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: ,,�,� City: State: Zip:
Value of Work for this Permit:S 1=?-iW Square/Linear Footage of Work:
Type of Work: ❑ Addition X Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: Re ynocke 1%v1av�+
Specify color ooff\color
�thru tile:
Submittal Fee$ ""`�-'�' l� Permit Fee$ &W-449 CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ 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 be approved and a reinspection fee will be charged.
Sign re Signature
OWNER or AGEN CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of 20 _,by 2-b day of To 20 �� ,by
�A L1 Vp6M>d r0k),who is personally known to who is personally known to
me or who has produce--=we— umc' C�'s me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sig •� +�r� 4-J g
Print: Print: I VA fe -54 e4 ri e
Seal: ;,sem° Notary public state or Fiorfda Seal:
JACQUELINE TAPANEI
Sindia Alvarez �': ^"= MY C0�114A133101U EE91716 9
My Commission FF 1S67so a EXPIRES Feb
ev A ExPIreS 08 M-0-16 . ® .� =W A7.2016
3880163
APPROVED BY r� Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
a CTQw
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USINESS CERTIFICATE OF COWETENCY
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SII
08EO00914
PR ELECTRIC CORP
it
D B A �!s
DE LA PAZ LEX
S cof~ UndW " proms tit Ctapoi in M Mmms Dedp f
VALID FOR CONTRACTtNt UNTIL 091301201
Local Business Tax Receipt
M lam I--Dade County, State of Florida
=fiFt�S IS Cyr A SiCL �- DO NOTPAY6317176
SU NESS 11MAM1AE/LCCAInON RECEIPT NO, 'EMPIRES
APR ELECTRIC CORP RENEWAL SEPTEMBER, 30v 2015
8183 NW 8 ST C-4 6583570 Must be displayed .at place of business
MIAMI, FL 33126 Pursuant to Counter Cam
Chapter SA _ An9 6 10
OWNER SEC. TVPE OF BUSINESS PAYMENT REC+le VED
APR ELECTRIC CORP 196 ELECTRICAL ew TAX C XLECTOIR
CONTRACTOR 75.00 O9r2412014
work s) GBE OOO9'14 0228-U-M91 T 1
This lscal 8vwrtess Tax 110CSO#"IV camas pay="at taw Local / sa#ss Tax.IM OVA*
isno a UcrrAM.
permit, or a c�srirl�icotion a♦ do +r's guali�cafticer�s.to do business
"Older must � �o�WV vvnwqpww�
of redulat"laws mod nMoreawft which a"ht to*A
bmebM
The RE WT NQ above WO be d4layed cm all camoweial e"kt—NO' `
MiAM Fir mom i f "DWS& 4'
'��
RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY
STATE:OVFLORIDA
DEPARTMENT OF BUSIIE'SS AN ,PROFESSIONS L-REGULATION
ELECtMAL CgNTRACTOSS IN�r-BpARD
Thi ELECTRICAL AEONTRACTbR :
Named be10w. HAS REGIStERED,
Un le Ute prcfwsioiis t -Qh tht 4&9 f'S, �
(tNDMD�tAL MUSETA�.i sI�C
REQUIREMENTS P} t3 T WANY AREA)� 1.
DE LA PAZ;-a4LEX
APR EtEC ICCORP ' _ 4 ■
8183 IAI 8T#t
+nq Y F
ISSUED: 0&242014 DISPLAY AS REQUIRED BY LAW SEQ# L1408240004641
AcoRU® CERTIFICATE OF LABILITY INSURANCE DATE = Q"'�;5'"Y'
PROMX:ER Phone THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
SAFE INSURANCE GROUP 305-264-8964 HOLDER.
AND CONFERS NO RIGHTS UPON THE CERTIFICATE
7901 NW 2ST HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Fax ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
MIAMi.Fl. 33126-0000
305-267-1576
INSURERS AFFORDING COVERAGE NAIC 0
IINSURED INSURER AACCIDENT INSURANCE COMPANY E E
APR ELECTRIC CORP -
8183 NW 8 ST#C4 INSURER
INSURER C C'
MIAMI FL 33126
011579 INSURER D
INSURER E
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING
ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
mm ADD?. - _.— --.- _ - - POLICY NUMBER.. POLX: EFFECTIVE IO
EFFECTPOLICY EXPIRATION LOWS
A BENERAL QTY CPP 0005531 03 9AM014 9/09@015 EACHDAIAOCCURRENCE s
-. 1. X000
X COMMERCIAL GENERAL LIABILITY PREMISES
SC O cc(%6
) $-- 100.000
CLAIMS MADE X OCCUR MED EXP(Any ane Pau!) -. .S. 5=
PERSONAL 8 ADV INJURY_ S 1,0OQ000
GENERAL AGGREGATE S 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMPIOPAM S 2,000,000
POLICY RRO LOC
AUTOMOME LI401LITY COMBINED SINGLE LIMIT
ANY AUTO ,(Fa u=demt) -$
ALL OWNED AUTOS
BODiLY(INJURY S
SCHEDULED AUTOS (Per )
_.HIRED AUTOS BODILY INJURY
NON-OWNED AUTOS (per amort) S
PROPERTY DAMAGE S
(Paraccidem)
GARAGE LW80.11TY AUTO ONLY-_EA ACCIDENT S
ANY AUTO OTHER THAN EA ACC-S
AUTO ONLY AGG S
EXCESS I UMBRELLA LABILITY ,EACH OCCURRENCE ..S
OCCUR CLAWS MADE .AGGREGATE.
. . DEDUCTIBLE
. .RETENTION/ S .$
WORIMRSCOMPENSAITM WC STATU- OTH-
AND EMPLOYERS'LL48MM YIN ---TORY.LIA91T5 ER _.
ANY PROPRIETORIPARTN EWEXECLITIVE ❑ E L.EACH ACCIDENT S _
OFFtCERIMEMBER EXCLUDED? -
(Mr In NH► E.L.DISEASE-EA EMPLOYEE_ S
tt tea,lMttWa ta10er - _--
SPECIAL PROM below E L DISEASE-POLICY LIMIT S
OTHER
DESCRIPTION OF OPERATIONS I LOCATK=I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
SUBJECT TO POLICY FORM,CONDITIONS,ENDORSEMENTS,LIMITATIONS AND EXCLUSIONS.
EIOCbiCat Sub CordraCtor
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BECANICHd.®WOAE THE EXPIRATIOIN
MIAMI SHORES VILLAGE BUILDING DEPT DATE THEREOF,THE ISSUING muRER WILL ENDEAVOR To MAIL 10 DAYS wmrnm
10050 NE 2 AVE NOTICE TO THE CERTMATE HOLDER MUM TO THE LEFT.BUT FARAIRE TODD SO MALL
MIAMI SHORES FL 33138 WPM NO OBLGATM OR LUU31 TY OF ANY UPON THE INSURER,ITS AGENTS OR
REPRESENTATIVES.
AIITHORow REPi�
ACORD 23(200M) ® 2008 ACORD CORPORA . U rights nmenred.
The ACORD name and logo are registered marks of ACORD
,A
AL
JEFF ATM78t
STATE OF FLORIDA
CHIEF
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 hKlvMual dated below has elected to be exempt from Florida Workers'Compensation lana.
EFFECTIVE DATE: 9/342014 EXPNtATION DATE: 9=16
PERSON: DE LA PAZ A-«
FEIN: 262663989
BUSINESS NAME AND ADDRESS:
A P R ELECTRIC CORP
8183 NW 8 ST C-4
MIAMI FL 33126
SCOPES OF BUSINESS OR TRADE'
LICENSED ELECTRICAL ELECTRICAL WIRING
CONTRACTOR WITHIN BUIL
punwwjorinp, 4141 FJL en ofa cpmap=vdw eteds kmn ch"WbyifflmacedfflcoWcfebcffunundweboadon
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WN080sooPe r&gbw*0asartredsvdedcn8rermd=afe%c0=t*bee=MPLPt toCkWW44M%FA,NOW cid0dw0be
#0 person nerved m the nodo cr o d9 om0 " of aa
of oft sawaniorof aa .Me d8PauB0dd0Rmv010 a
DFS-17243WC-2662 CERTIFICATE OF ELEC7M N TO IE EXEM"f!NISEI)07--12
QUESTIONS?($50)4131E09
a
t
A.P.R.ELECTRIC CORPORATION
Alex de la Paz
8183 N.W. 8 Street C-4
Miami,Florida 33126
LIC#08E000914
Date:July 1,2015
State of:Florida
County of: Miami Dade
Before me this day personally appeared Alex de la Paz who,being duly sworn,deposes and
says:
That he or she will be the only person working on the project located at: 1250 N.E. 107
STREET,MIAMI SHORES 33161.
Sworn to for(or affirmed)and subscribed before me this�_day of -Io
20 1� ,by At e x clo ( A Y�#..-r
Personally know x
OR Produced Identification
Type of Identification Produced
Print,Type or Stamp Name of Notary
EjACOUELINE T ESCOMMISSION 1z 01167119P91�E^I"sb9+07,2016
• ,SLiG 193a
Miami Shores Village
Building Department
1pR�pA� 10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Notice to Owner - Workers' Compensation Insurance Exem tion
mullim
Florida Law requires Workers' Compensation insurance ance covarag' a 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-rime
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.
Signat
Owner
State of Florida
County of Miami-Dade —c
The foregoing was acknowledge before me this day of c.� U NK�- ,20_L5
By Mtge-lAT N�. — -P>U''q-o,,) who is personally known to me or has produced
as identification.
Notary:
SEAL: ip+ °e4� Notary Public Stage of Florida
Sindia Alvarez
y, �v My Commission FF 958750
mor r►d" Fwxpires 08!0342018