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EL-15-1193
R . Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 "2 nspection Number: INSP-251703 Permit Number: EL-5-15-1193 Inspection Date: January 27,2016 Permit Type: Electrical - Resid ntial Inspector: Devaney, Michael Inspection Type: R gh Owner: MSM REALTY ASSETS LLC, MSM Work Classification: Alteration OCAI ry weecrc I I r Job Address: 131 NE 93 Street Miami Shores, FL 33138- Phone Number (305)335-3515 Parcel Number 1132060133020 Project: <NONE> Contractor: AP POWER ELECTRIC CORP Phone: (954)822-4496 Building Department Comments KITCHEN AND BATHROOM REMODELING PLUS NEW Infractio Passed Comments BATHROOM INSPECTOR COMMENTS False Inspector Comments Passed EJ CREATED AS REINSPECTION FOR INSP-240907. CREATED AS REINSPECTION FOR INSP-240809. Wall rough O. K. Hi hats to be I. C. rated. Failed E] 01/26/2016- NEED TO VARAFAY HI HATS ARE IC RATED. Correction %>/ Needed 60/ Y Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid. For Inspections please call: (305)762-4949 January 26,2016 Page 1 of 1 >ormNd: EL-4-'115-1193 , �sH,°im� Miami Shores VillageE PBmtif Tyj e trica1 ,:R481t enda1 10050 N.E.2nd Avenue NE Wt 3� �.., an� t CtasStflGatit}t2;Altelratl€�n Miami Shores,FL 33138-0000 ; FOrmit Status:AP RED Phone: (305)795-2204 �YORNp' Issue Da $1,27/ A15 Expiration: 11/23/2015 Project Address Parcel Number Applicant 131 NE 93 Street 1132060133020 Miami Shores, FL 33138- Block: Lot: MSM REALTY ASSETS LLC Owner Informatlon Address Phone Cell MSM REALTY ASSETS LLC 131 NE 93 Street (305)335-3515 MIAMI SHORES FL 33138- 10155 COLLINS AVE BAL HARBOUR FL 33154- ° Contractor(s) Phone Cell Phone Valuation: $ 3,000.00 AP POWER ELECTRIC CORP (954)822-4496 Total Sq Feet: 00 I' Type of Work:KITCHEN AND BATHROOM REMODELING PLU Available Inspections: Additional Info: Inspection Type: Classification:Residential Review Electrical Scanning:3 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.80 Invoice# EL-5-15-55628 DBPR Fee $2.25 05/27/2015 Credit Card $ 118.30 $50.00 DCA Fee $2.25 Education Surcharge $0.60 05/19/2015 Credit Card $50.00 $0.00 Permit Fee-Additions/Alterations $150.00 Scanning Fee $9.00 Technology Fee $2.40 Total: $168.30 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 Futhermore,I authorize the above-named contractor to do the work stated. May 27, 2015 Autho a Signature: r / Applicant / Contractor / Agent Date Building Department Copy May 27,2015 1 C ®IvWD • � Miami Shores Village MW N15 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 2016 BUILDING Master Permit No PERMIT APPLICATION Sub Permit No.�D ❑BUILDING 0 ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [:]RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 131 NE 93 ST City Miami Shores County Miami Dade Zip: Folio/Parcel#:11-3206-013-3020 Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder):MSM REALTY ASSETS LLC Phone#:3053021400 Address:10155 COLLINS AVE #1004 City: BAL HARBOUR State: FLORIDA Zip: 33054 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: A.P POWER ELECTRIC CORP Phone#: Address: 3758 SW 16 ST City: FT LAUDERDALE State: FLORIDA Zip: 33312 Qualifier Name: HECTOR ARZOLA Phone#: 3053021400 State Certification or Registration#: ER13014434 Certificate of Competency#: DESIGNER:Architect/Engineer: MOINO FERNANDEZ Phone#: 954-554-0708 Address:15552 SW 15 ST city. WESTON State: FL Zip; 33326 Value of Work for this Permit:$3009 Square/Linear Footage of Work: Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: KITCHEN AND BATHROOM REMODELING + NEW BATHROOM Specify color of color thru tile: Submittal Fee$ Permit Fee CCF$ �`� CO/CC$ Scanning Fee$ C( ••��0� Radon Fee$ .�i� DBPR$ Notary$ Technology Fee$_ � Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ •�® (Revised02/24/2014) v 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. Signature--"" — Signature OWNER or AGENT CONTRACTOR i EA-(j1Pk ing instrume t was acknowledged before m ,ibis The f egoing instrument�as acknowledged before meetthis III day of 20 J J by / day of /"� - 20 �� by who is personally known to kkcbt W14 who is personally known to me or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTAU C: NOTARY PUBLIC: Si n: Sign ,, /� Print: J Print: 4-�--i' Seal: IO"da Seal: N�ryP, state of f Notary Public State feZ 011 Heise%Alvarez 198 o11 4ietcom p5r1812016 ;ssion EE 198 MY Commission EE °FIMLMY F res 05%2 8r2o18 APPROVED BY �/� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) C 1 QB. µ Cotpruotlan Trades Qc�altfyin9 Board USINE*J�SS CERTIFICATE OF COMPETENCY 50 2 t?Vt CTW CORP k: .BA.. ARZO HECTC7R Is oerfified under the rovisions of Chapter 10 of Miam'rE3ade Co Local Business Tex Receipt Miami-Dade County, State Of Florida -THIS IS NOT A BILL_-DO NOT PAY LBT 6879558 BUSINESS NAME/LOCATION RECEIPT NO. AP POWER ELECTRIC CORP RENEWAL S 2015 DOING BUSINESS IN DADE 7154727 SEPTEMBER EXPIRES COUNTY Must be displayed at place of business Pursuant to County Code Chapter SA--Art.9&10 OWNER SEC,.TYPE OF BUSINESS PAYMENT RECEIVED AP POWER ELECTRIC CORP 198 ELECTRICAL BY TAX COLLECTOR C/O HECTOR ARZOLA PRIES CONTRACTOR 75.00 09/1772014 Worker(s) 1 t0E000121 CREDITCARD-14-037873 This Local Business Tax Receipt only oodrms payment of the Local Business Tax The Receipt is not a license, permit,ora certification of ftholder's qualifications,to do business.Holder must comply with any governmental or nongovermnentel regulatory laws and requirements which apply to the business TheRECEIPT N0.above must be displayed on all commercial vehicles-Miami-Dade Code Sac 83-276. MSS For more information.visit+Z Ww.miamidade oovJtaxpollector Mttnitipal Contr4ctot`s Tax Receipt Miami—DadeCourrty,State of Florida THIS IS NOT It BILL—DO NOT PAY CC NO: 1'OE000121 BU StAlE35�NAME&OCATION R9cVIPT NO. + PI S AP POWER:ELECTRICCORP NEW BUSINESS tEpTr;,M8ER 3Q 2015 IJOING BU31NES5 IN DADS COUNTY 7455004 Must_be displayed at piece Of business Pursuant to county Code Chapter 9A—Art 9&'10 OWNER TYPE OF BUSINESS PAYMENT RECEIVED AP POWER ELECTRIC CORP ELECTRICAL:CONTRACTOR BY TAX COLLECTOR C/O HECTOR AR70LA PRE$ 200.00 09/19/2014 0225-14-005658 i Forawrs inlormatioa:Nisitwww.miemjde(�,,ggy areatleetar STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD (850)487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 ARZOLA, HECTOR A AP POWER ELECTRIC CORP 3758 SW 16TH STREET FORT LAUDERDALE FL 33312 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range *1ll STATE OF FLORIDA from architects to yacht brokers,from boxers to barbeque restaurants, OEPARTME. OF BUSINESS AND and they keep Florida's economy strong. PR I ��t GULATION Every day we work to improve the way we do business in order to ER13014434f UW '�09/24/2014 serve you better. For information about our services,please log onto www.myfloridalicense.com. There you can find more information REG ELECTRlCt3NTRACTA , about our divisions and the regulations that impact you,subscribe ARZOLA tiECTA to department newsletters and learn more about the.Department's initiatives. AP POWER E ONt31ViDUAL MU �7 AL Our mission at the Department is:License Efficiently,Regulate Fairly, LICENSING RE 'U T, IOR We constantly strive to serve you better so that you can serve your TO CONTRACTING IN tY AREA} customers. Thank you for doing business in Florida, HAS REGISTERED under the provisions of Ch.488 FS and congratulations on your new license! Expiration date•AUG 31,2016 L1409240002624 DETACH HERE RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD ER730't4434.. " The ELECTRICAL CONTRACTOR ' Named below HAS REGISTERED Under the provisions of Chapter 489 FS. Expiration date: AUG 31,2016 (INDIVIDUAL MUST MEETALL LOCALLICENSING REQUIREMENTS PRIOR TO CONTRACTING IN ANY AREA) ARZOLA, HECTOR A �. Q AP POWER ELECTRIC� f�� 3758 SW 16TH S FET FORT LAUDREr L 33312 '3 ©: } ISSUED: 09/24/2014 DISPLAY AS REQUIRED BY LAW SEQ# L1409240002524 coR CERTIFICATE OF LIABILITY INSURANCE �5/15!2015 � ► THIS CERTIFICATE 13 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terns and conditions of the policy,certain policies may require an endorsement. A statement on this Certificate does not confer rights to the certificate holder In lieu of such endomemen s. PRODUCER 786-573-4485 786-573-4486 Ma leen Blandon Insurance NOW Agency PZRE..: -;786-573-4485 Na:786-57311486 12915 SW 132 Street suite 4-B ma leen insurancenowa en com Miami, FL 33186 : ER 10 111, INSURED INSU S AFFORDING COVERAGE NAIL A INSURER A:Western He raCo. AP Power Electric Corp. INSURER 0: 3758 SW 16 Street INSURER C: Fort Lauderdale, FL 33312 INSURER D: INSURER E INS ITER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LSR TR TYPE OF INSURANCE -AMJMPOLICY NUMBER M EPF P LIMITSGENERAL LIABILITY A EACH OCCURRENCE S COMMERCIAL GENERAL LIABILITY PR $ CLAIMS MADE ©OCCUR MED EXP ane person S SCP1509617-01 03/18/2015 031%2016 PERSONAL&ADV INJURY s GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS•COMP/OP AGG S POLICY PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Es acdderd) $ _ ALL OWNED AUTOS BODILY INJURY(Per Person) $ SCHEDULED AUTOS BODILY INJURY(Per wddwM S HIRED AUTOS PROPERTY DAMAGE S (Per aaddent) NON-OWNED AUTOS S $ UMBRELLA LIAR OCCUR EACH OCCURRENCE S EXCESS UAB CLAIMS-MADE AGGREGATE S DEDUCTIBLE S RETENTION S WORKERS COMPENSATION VIC TATO O H AND EMPLOYERS'LWBILr1' ANY PROPRIETORIPARTNEWEXECUTIVE YIN E.L.EACH ACCIDENT S and If OFFICERIMEMBER EXCLUDED? N I A (Mandatary in E.L DISEASE•EA EMPLOYE S yea,desaihe met DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(AURch ACORD 101,Addhlanal Remarks Schedule,a mon$papa Is regWnd) License# 10E000121 ER13014434 CERTIFICATE HOLDER CANCELLATION Miami Shores Village Building Dept SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 10050 NE 2 Ave. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERS IN Miami Shores, FL 33138 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOR&=REPRESENTATIVE Fax:305-7 6-8972 Mayleen Bienn ©1988-2009 ACORD CORP ION.JAII rig reserve . ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD JEFF ATWATER 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: 4/13/2014 EXPIRATION DATE: 4/12/2016 PERSON: ARZOLA HECTOR A SR FEIN: 271635909 BUSINESS NAME AND ADDRESS: AP POWER ELECTRIC CORP 3758 SW 16 ST FORT LAUDERDALE FL 33312 SCOPES OF BUSINESS OR TRADE: LICENSED ELECTRICAL CONTRACTOR Pursuant to Chapter 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 Chapter 440.05(12),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 440.05(13),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 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-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 07-12 QUESTIONS?(850)413-1609 C1 .... p�..� Miami s Village Building Department �OR10050 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. 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.. Therefore,you may be Personally liable for the worker compensation injuries of any person allowed to work under this permit. Please check with your insurance carrier since most property insurance policies DO NOT cover this type of liability. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Owner Contractor Signature. Signature: i 0 State of Florida State of Florida County of Miami-Dade County of Miami-Dade The foregoing as acknowledge before me this y� The foregoing was acknowledge before me this lI day of 20_ day of ,20 By �' By C!- who is perso alb known to me or has produced who is personally known to me or has produ ct�ds as identification. ot�toa as identification. Nom ave as E Notary: v�tosta� �a°1 Notary. ocenziep 11 SEAL: �0tsGoF��5s�a\0 SEAL: VIne11 P E A.P POWER ELECTRIC CORP. 3758 SW 16 ST FT. LAUDERDALE, FL, 33312. MAY13, 2015 STATE OF FLORIDA COUNTY OF MIAMI-DADE BEFORE ME THIS DA Y PERSONALL YAPPEARED4 C f �� I WHO, BEING DULYSWORN, DEPOSES AND SAYS: THIS LETTER WILL CONFIRM THAT WE SHALL NOT EMPLOYANY WORKERS ON THE FOLLOWING LISTED PROJECT A T 131 NE 93 ST, MIAMI SHORES, FL, 33138, OTHER THAN MYSELFAND PROPERL Y LICENSED AND INSURED SUBCONTRACTORS, IFANYSUBCONTRACTORS SHOULD BE HIRED THEY WILL REGISTER ALL PROPER LICENSEAND INSURANCE WITH THE CITY UNDER SAID PERMIT, SWORN TOAD UBSCRIBED BEFORE ME THIS i VDA YOF 4-C4 2015, BYttC( r d C PERSONALLY KNOWN al OR PRODUCED IDENTIFICATION TYPE OFIDENTIFICATION Notary Public State of Florida Heiael Alvarez PRINT TYPE STA NAME OF NOTARY a My Commission EE 1 96011 / Expire.05/2812018 c