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EL-15-2167 Permit N ? ,-�8- h Miami Shores Village Pfd# 11f Type. El: Resld$nti�tl ; 10050 N.E.2nd Avenue NW �, � .-� }. C'i„+' 'a�"J�^ CiC"+if�" �•w " tit ` Miami Shores,FL 33138-0000 I` h � Phone: (305)795-2204 A OvIED. Y Ex irat!on: 5/29/2016 p. Project Address Parcel Number Applicant 96 NW 92 Street 1131010160070 MATHIAS GERVAIS Miami Shores, FL 33150- Block: Lot: Owner Information Address Phone Cell MATHIAS GERVAIS 96 NW 92 Street (786)942-7767 MIAMI SHORES FL 33150- 96 NW 92 Street MIAMI SHORES FL 33150- Contractor(s) Phone Cell Phone Valuation: $ 1,500.00 YORK ELECTRIC CORP (786)287-7380 ........ Total Sq Feet: 0 Type of Work: Available Inspections: Additional Info: Inspection Type: Classification:Residential Scanning:3 Main DrainFinal Rough Review Plumbing Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 DBPR Fee Invoice# PL-8-15-56844 $4.50 12/01/2015 Check#:2364 $271.20 $50.00 DBPR Fee $0.00 DCA Fee $4.50 08/24/2015 Credit Card $50.00 $0.00 DCA Fee $0.00 Education Surcharge $0.40 Permit Fee $300.00 Scanning Fee $9.00 Technology Fee $1.60 Total: $321.20 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compli nce 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 the the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. th re,I authorize the above-named contractor to do the work stated. December 01,2015 Authorize�ertment n to :Owner / Applicant / Contractor / Agent Date Building Copy December 01,2015 1 r • Miami Shores VillageFBY: IVED Building Department UG 24 2015 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 /V _ BUILDING Master Permit No. 6?P - 9- 21 �S PERMIT APPLICATION Sub Permit Noz- 1,5- - 21 0- ❑BUILDING f4ELECTRIC F--j ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP I CONTRACTOR DRAWINGS �/ JOB ADDRESS: l/ N W 12—n�- '6� City: Miami Shores County: Miami Dade Zip: Folio/Parcel#:11-3101-016-0070 Is the Building Historically Designated:Yes NO X Occupancy Type: SFH Load: Construction Type: Flood tone: FE: FFE: OWNER:Name(Fee Simple Titleholder):Mathias Gervais Phone#:786-942-7767 Address:92 NW 96 st City: Miami Shores State: FL 33150 Tenant/Lessee Name: Phones: Email: mgervais@thesetaihotel.com CONTRACTOR:Company Name: York Electric Corp. Phone#: 786-287-7380 Address: 2517 SW 13 st City: Miami state: FL Zip: 33145 Qualifier Name: Roberto Moreno Phone#. 786-287-7380 State Certification or Registration#: EC 13004787 Certificate of Competency M DESIGNER:Architect/Engineer: Vicente Franco Phone#: 305-305-5631 Address: 10776 nw 84 In #5 City: Miami State: FL Zip: 33178 Value of Work for this Permit:$ `5 Square/Unear Footage of Work: Type of Work: ❑ Addition Alteration KNew ❑ Repair/Replace ❑ Demolition Description of Work: L i Specify color of color thru tile: Submittal Fee$ Permit Fee$ CCF$ C O/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ y TOTAL FEE NOW DUE$ 1 6 (Revi5ed02/24/2014) 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 ATTORN Y 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 ab'ence 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 res acknowledged before me this The foregoing instrument was acknowledged before me this day of 20 1'5_.by day of 20 15 , by who is personally known to U e- who l&RgmanaUxIcnown to me or who has prolluced as me or who has produced as identification and who did to n oath. identification and who did tagkepn oath. NOTARY PUBLIC: NOTARY PUBLIC: 1-14t1r— Z— Sign: SANCHEZ Sign: ""' E 0NANCHEZary u ca tary Pu cPrint: - .•e Commission#FF 245271 Prin . = missionMy Comm.Expires Jun 29.2019of`` My Comm.Expi019 Seal: ;;;°� Bonded through National Notary Assn Seal: %;a °;:` Bonded through Nssn *w************w*****sw***s*w***a****awes*****ss*ass****ss**********s*assess**w****s*****w****s************** APPROVED BY ' Z 0-' 6��l�ans Examiner Zoning Structural Review Clerk (Revised02/24/2014) 2016 details - Business Tax Account YORK ELECTRIC CORP - TaxSys - Miami-Dade ... Page 1 of I miamdade ',c--o\/1P Tax Collector Home Search Reports Shopping Can Please do not include any special characters in the name,address,and e-mail field such as#,8,hyphens,comma, dashes. We have moved.Our new address is: 200 NW 2nd Ave,Miami,FL 33128 The information contained herein does not constitute a title search or property ownership. 2015 Tax Bills are Payable on Sunday,November 1,2015. 2016 DetaitS— Business Tax AQ=mt YORK ELECTRIC CORP Business Tax Account#6060040 Account details i`, Account history 2016 — � �� .., 010' 201x5 2014 v_ -_...._2013...._.._._( _e... .._.__._ PAID PAID PAID PAID PAID Account number: 6060040 Owner(s): YORK ELECTRIC CORP Business start date: 06/01/2007 C/O ELIO MOREJON PRES Business address: YORK ELECTRIC CORP 4�NW 27 AVE 45 NW 27 AVE MIAMI,FL 33125 MIAMI,FL 33125 Mailing address: YORK ELECTRIC CORP Physical business location: MIAMI C/O ELIO MOREJON PRES 45 NW 27 AVE MIAMI, FL 33125 qL Print account application (PDF) Receipts And Occupations cei t 6321731 PAID 2015-09-23$45.00 Contracting 10/01/2015 NAICS code: Receipt#0229-15-008322 IR" Print this ELECTRICAL —09/30/2016 23821 bill CONTRACTOR Units: 1 Documentation Required by Occupation: State/County License or Certificate Document Received: EC13004787 -taxes htts://www.miamidade.councom/ ublic/business_tax/accounts/6060041 11/25/2015 P tY . P YORK ELECTRIC CORPS August 21, 2015 Sate of Florida County of Miami Dade Before me this day personally appeared Roberto Moreno, who being duly sworn, deposes and says: That he will be the onlyperson working on the project located at 96 NW 92 st Miami Shores p g p J ► ► Florida. Sworn to and subscribed before me this 211 day of August, 2015 by Roberto Moreno,who is personally known. RO ERTO Stiff= a Notary is-Stee 81 Flod" C lsslon N FF 245271 • Eames Jun 29,2019 .y Nay Assn, Not ry 2517 SW 13 st.Miami,FL 33145 PH 786-287-7380 FAX 305-815-2735 �logo Miami 'shores village %--- Building Department R�OR`1D�' 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner — Workers' Compensation Insurance Exem ption 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-ti a or full-rime employees,including the owner,must obtain workers'compensation coverage. Cooiporate 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-rime employees or subcontractors. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: er State of Florida County of Miami-Dade Thefor oin as acknowl before me this day of ,20 1 By who i ersonally kno to me or has produced 'de ti MURTO SAlrC►E i � Notary: ft- - of FWMa, #FF 245271 SEAL: yti, a` COM.ExWn Jae 29,