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SGN-16-2664 U / : Ora Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-273069 PermitNumber: SGN-9-16-2664 Scheduled Inspection Date: December 15,2016 Permit Type: Sign Inspector: Naranjo, Ismael Inspection Type: Final Owner: , Work Classification: New Job Address:9830 NE 2 Avenue Miami Shores, FL 33138-2347 Phone Number Parcel Number 1132060132240 Project: <NONE> Contractor: KLEAN POWER ELECTRIC INC Building Department Comments CUT OUT VINYL LETTERS APPLIED TO GLASS Infractio Passed comments WINDOW DOOR INSPECTOR COMMENTS False UNIT#9802 COLOR:WHITE 4 EDGED Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-268102. not Ready Yq- Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid December 14,2016 For Inspections please call: (305)762-4949 Page 22 of 33 ma 64, Miami Shores Village �.s 10050 N.E.2nd Avenue NE NOW Miami —.•• �+ Miami Shores,FL 33138-0000 Phone: (305)795-2204 �,�.. Expiration 4109J17 Project Address Parcel Number Applicant 9830 NE 2 Avenue 1132060132240 MIAMI SHORES CENTER LLC Miami Shores, FL 33138-2347 Block: Lot:2 Owner Information Address Phone Cell MIAMI SHORES CENTER LLC 210 71 Street MIAMI BEACH FL 33141- Contractor(s) Phone Cell Phone Valuation: $ 95.00 KLEAN POWER ELECTRIC INC Total Sq Feet: 14.3 Type of Sign:Wall Sign Available Inspections: Electrical Sign:No Inspection Type: Height: Final Width: Review Building Color:WHITE 4 EDGE Elevation: Review Planning Plans Submitted:Yes Additional Info:CUT OUT VINYL LETTERS APPLIED Classification:Residential Scanning:3 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 Invoice# SGN-9-16-61502 DBPR Fee $2.00 09/28/2016 Credit Card $50.00 $64.60 DCA Fee $2.00 Education Surcharge $0.20 10/11/2016 Credit Card $64.60 $0.00 Permit Fee $100.00 Scanning Fee $9.00 Technology Fee $0.80 Total: $114.60 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,P UMBING,M ANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFID ce tha I the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction in F e reWyjthorize the above-named contractor to do the work stated. October 11,2016 th ed Signa wrier / Applicant / Contractor / Agent Date Building Department Copy October 11,2016 1 t Miami Shores Village -� Building Department r� 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 SS Tel:(305)795-2204 Fax:(305)756-8972 7113jyl — INSPECTION LINE PHONE NUMBER:(305)762-4949 �- FBC 20 jq ` BUILDING Master Permit No. GG N b'20 PERMIT APPLICATION Sub Permit No. BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP )—� l,, CONTRACTOR DRAWINGS JOB ADDRESS: ��� Z �� Avg �4—i 9 30 2 4\)E City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Epee Simple Titleholder): 21 ot • • I Phone#: �1 . Address: ftl" 3 City: /;?4m y2.)dp6A.Gh State: �� Zip: 33`\t 1 Tenant/Lessee Name: Phone#: Email: — — '42"3_ oz)2_+ CONTRACTOR:Company Name: Phone#: L`S r Address: 13 z� City: State: Zip: ,33--5 Qualifier Name: A lerlA;-o Phone#:"�>k-�� l State Certification or Registration#: CO "a->Certificate of Competency#: e c DESIGNER:Architect/Engineer: 6�e- �c,4aA'`nti �u(y���n+�S Phone#: 75(4 Address:__ t2 i 6 5c,v ZI - car City: h State: FL Zip: 9 145 Value of Work for this Permit:$ �a G Square/Linear Footage of Work: l4- 3 34. ;t+- Type 4• ;t+- Type of Work: ❑ Addition ❑ Alteration ErNew ❑ Repair/Replace ❑ Demolition Description of Work:��, v� v.n ( ar (� fj[(zjs w ►� COY F Specify color of color thru tile: L � �n t�1 Submittal Fee$ Permit~Fee$ 10 CCF$ ry CO/CC$ Scanning Fee$ Radon Fee$ Zi DBPR$ Notary.") (5779 Technology Fee$ • Training/Education Fee$ ` ® Double Fee$ ICY-- Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (RPV1%Pdn7/?4/9n141 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 SignatuVVV 1 OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of 20 1,by // ST day of i� 20 , by who is personally known to L-34w Uav VA� 4 4 L h 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. NOTARY PUBLIC: NOTARY PUBLIC: Sign: G Sign: !� C Print: k Print: Seal $01�' � YOWNR�Z► r'd• ORR MIMOUN Seal: koy Pnbt•swe o1nftwm MY COMMISSION 9 FF 064212 c Ny Comm.Eip=JUNE 21,4019 +_ EXPIRES:Decem�r 14,2017 e Commis�OnF.Pi9014Dy Bonded Thu Notary PuWx Und-Afl- APPROVED BY '� Plans Examiner Zoning Structural Structural Review Clerk f RnvieniJll9 HA!9119 A 1 Prope Search Application- Miami-Dade County Page 1 of 1 OFFICE OF THE PROPERTY APPRAISER Summary Report Generated On:9/28/2016 Property Information , �• Folio: 11-3206-013-2240 9830 NE 2 AVE £ } Property Address: u , Miami Shores,FL 33138-2347 MIAMI SHORES CENTER LLC Mailing Address 210 71 STREET#309 y MIAMI BEACH,FL 33141 Primary Zone 6400 COMMERCIAL-CENTRAL 1211 MIXED USE- Primary Land Use STORE/RESIDENTIAL:RETAIL " ` OUTLET Beds/Baths/Half 0/6/0 Floors 2 ' ,F, f f Living Units 0 � Actual Area Sq.Ft Living Area Sq.Ft Adjusted Area 16,735 Sq.Ft Taxable Value Information Lot Size 13,459 Sq.Ft 2016 2015 2014 Year Built 1947 County Exemption Value $0 $0 $0 Assessment Information Taxable Value 1 $573,100 $521,0001 $490,000 Year 2016 2015 2014 School Board Land Value $349,934 $296,098 $296,098 Exemption Value $0 $0 $0 Building Value $350,066 $224,902 $193,902 Taxable Value 1 $700,000 $521,0001 $490,000 XF Value $0 $0 $0 City Market Value $700,000 $521,000 $490,000 Exemption Value $0 $0 $0 Assessed Value $573,100 $521,000 $490,000 Taxable Value 1 $573,100 $521,000 $490,000 Regional Benefits Information Exemption Value $0 $0 $0 Benefit Type 2016 2015 2014 Taxable Value 1 $573,100 $521,0001 $490,000 Non-Homestead Cap Assessment Reduction $126,900 Note:Not all benefits are applicable to all Taxable Values(i.e.County, Sales Information School Board,City,Regional). Previous OR Book- Sale PricePaQualification Description 9e Short Legal Description 02/01/2002 $1,244,000 20241-3676 Other disqualified MIAMI SHORES SEC 1 AMD PB 10-70 05/01/1985 $500,000 12511-0993 Deeds that include more than one LOT 2&E57FT OF LOTS 3&4& I f parcel N4.92FT OF E57FT OF LOT 5& S19.71 FT OF E49.67FT OF LOT 5 BLK 17 The Office of the Property Appraiser is continually editing and updating the tax roll.This website may not reflect the most current information on record.The Property Appraiser and Miami-Dade County assumes no liability,see full disclaimer and User Agreement at hftp:/twww.miamidade.gov/info/disclaimer.asp Version: http://www.miamidade.gov/propertysearch/ 9/28/2016 Dejail by Entity Name Page 1 of 2 YL Detail by Entity Florida Limited Liability Company MIAMI SHORES CENTER, LLC Filing Information Document Number L02000000072 FEI/EIN Number 02-0533246 Date Filed 12/26/2001 State FL Status ACTIVE Last Event LC AMENDMENT Event Date Filed 05/12/2016 Event Effective Date NONE Principal Address 210- 71 ST STREET SUITE 309 MIAMI BEACH, FL 33141 Changed: 04/03/2009 Mailing Address 210-71 ST STREET SUITE 309 MIAMI BEACH, FL 33141 Changed: 04/03/2009 Registered Agent Name&Address PIOTRKOWSKI, JOEL SESQ 317 71 ST STREET MIAMI BEACH, FL 33141 Name Changed: 01/04/2011 Address Changed: 01/04/2011 Authorized Persons) Detail Name &Address Title Managing Member Mussaffi Investments, Inc. http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 9/21/2016 Detail by Entity Name Page 2 of 2 210 71ST STREET, SUITE 309 MIAMI BEACH, FL 33141 Title TRUSTEE YEHEZKEL, HAIM, TRUSTEE OF THE HAIM YEHEZKEL REVOCABLE TRUST DATED 05/30/02 210-71 ST STREET SUITE 309 MIAMI-BEACH, FL 33141 Annual Reports Report Year Filed Date 2014 03/12/2014 2015 03/04/2015 2016 02/10/2016 Document Images 05/12/2016-- LC Amendment F View image in PDF format 02/10/2016--ANNUAL REPORT View image in PDF format 03/04/2015--ANNUAL REPORT View image in PDF format 03/12/2014--ANNUAL REPORT View image in PDF format 04/12/2013--ANNUAL REPORT View image in PDF format 01/31/2012 --ANNUAL REPORT View image in PDF format 01/04/2011 —ANNUAL REPORT View image in PDF for 02/16/2010 --ANNUAL REPORT View image in PDF format 04/03/2009 --ANNUAL REPORT View image in PDF format 02/06/2008 --ANNUAL REPORT F View image in PDF format 01/29/2007 --ANNUAL REPORT View image in PDF format 03/21/2006 --ANNUAL REPORT F View image in PDF format 02/21/2005 --ANNUAL REPORT View image in PDF format 03/29/2004 --ANNUAL REPORT F View image in PDF format 04/24/2003--ANNUAL REPORT F View image in PDF format 07/30/2002 --ANNUAL REPORT View image in PDF format 12/26/2001 -- Florida Limited Liabilites View image in PDF format Coovrioht;D and Privacy Policies State of Florida,Department of State http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 9/21/2016 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD (850)487-1395 2601 BLAIR STONE ROAD TALLAHASSEE FL 32389-0783 ALONSO, GUILLERMO A KLEAN POWER ELECTRIC INC 5101 SW 160TH AVENUE SOUTHWEST RANCHES FL 33331 Congratulations! With this license you become one of the neatly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range STATE OF FLORIDA from architects to yacht brokers,from boxers to barbeque DEPARTMENT OF BUSINESS AND restaurants,and they keep Florida's economy strong. .. PROFESSItIAL REGULATION Every day we work to improve the way we do business in order EC13002068SU7=[3: 09!18!2016 to serve you better. For information about our services,please log onto www.myfforidaticense.com. There you can find more CERTIFIED ELE Iir;�,„.CONTRACTOR information about our divisions and the regulations that impact ALONSO,GUI , you,subscribe to department newsletters and learn more about the Department s initiatives. KLEAN Pt3WER E INC Our mission at the Department is:License Efficiently,Regulate Fairly.We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, as CERTIFIED under the provisions of Ch-489 FS. and congratulations on your new license! ExpValmn date:AUG 31,2018 OW91MMM2 DETACH HERE RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD ` EC13002068 The ELECTRICAL CONTRACTOR Named belo*IS CERTIFIED ' Under the provisions of Cheer 489 FS. Expiration date: AUG 31,2018 ALONSO, GUILLERMO A KLEAN POWER Uld- 5101 5101 SW 160TH AVENUE,,`, ,... w, ..W SOUTHWEST RANCH FL 33331 ISSUED: 09/18/2016 DISPLAY AS REQUIRED BY LAW SEQ# L1609180002722 JEFF ATWATER wra 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: 81412016 EXPIRATION DATE: 8/4/2018 PERSON: ALONSO GUILLERMO A FEIN: 650591554 BUSINESS NAME AND ADDRESS: KLEAN POWER ELECTRIC,INC 5101 SW 160 AVE SOUTHWEST RANCHES FL 33531 SCOPES OF BUSINESS OR TRADE: LICENSED ELECTRICAL ELECTRICAL WIRING CONTRACTOR WITHIN BUIL Pursuant to Chapter 440.05(14).F.S..an 01111cxer of a c4rporaUan who eteds exemption from this chapter by ftihtg a certificate of election under this section may not recover benefits or compensation under this chap.Pursuant to Chapter 440.05(12),F.S..CaA boats of election to be exampt...apply only within the scope or the business or trade Used on the notice of election to be exempt.Pumuent to Char 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 atter the filing of the notice or the issuance of the certificate, the person named on the notice or cwWk*te no ager meets the requirements of this section for issuance of a certificate.The depmtrient shalt revoke a DFS-F2-DVC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS?{$50}413-1609 BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S.Andrews Ave., Rm.A-100, Ft. Lauderdale, FL 33301-1895—954-831-4000 VALID OCTOBER 1,2015 THROUGH SEPTEMBER 30,2016 DBA:KL� POWER ELECTRIC INC Rss Type:Business Name: Business Type:(ELECTRICAL CONTRACTOR) Owner Name:ANGEL ALONSO GUILLERMO Business Opened:10/11/2004 Business Location:5101 SW 160 AVE State/County/Cert/Reg:EC13002068 SOUTHWEST RANCHES Exemption Code: Business Phone:954-252-1535 Rooms Seats Employees Machines Professionals 1 Only For Vwu"Business Number of Machines: Vending Type: Tax Amours Transfer Fee NSF Fee Penalty Prior Years Collection Cat �27.00 27.00 0.00 0.00 0.00 0.00 0.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and Is non-regulatory in nature.You must meet all County and/or Municipality planning WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location.This receipt does not indicate that the business is legal or that it Is In compliance with State or local laws and regulations. Mailing Address: ANGEL ALONSO GUILLERMO 5101 SW 160 AVE Receipt #Wine-14-00132929 SOUTHWEST RANCHES, FL Faid09/29/2015 27.00 33331 2015 - 2016 September 21,2016 State of Florida County of Miami-Dade Before me this day personally appeared Rafael E Gomez who,being duly sworn, deposes and says: That he will be the only person working on the project located at: 9802 NE 2nd Ave, Miami Shores Village,FL 33138. Sworn to(or firmed)and subscribed before me this 21st day of September 2016, byPOJM�X Ap2 &fteZ. Personally known Or Produced identification 'R-01Z kpyA Type of Identification Produced G S Z®-Z 7-S- k bcb O e�7 D k'l VMASA J.DAVIS NaC& uisne P -S1Ne of Florida Co . •� annlaaion#FF 242$25 ''N ..• My Comm.Cti*m Jul 12.2018 Print, Type or Stamp Name of Notary Mean Power Electric Inc. 15101 SW 160 Ave, SW Ranches, FL 33331 1305.669.8154 OR s� Miami shores Village Building Department artment 10050 N.E.2nd Avenue IORNp' 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. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: Owner State of Florida County of Miami-Dade The foregoing was acknowledge before me this day of ,20 . By fla who is personally known to me or has produced as identification. Notary: Stgti'Y Py n: OW MIMOUN SEAL: :_; :; MY COMMISSION#FF 064212 7 ; EXPIRES:December 14,2017 gip, 4t Bonded Th ru Notary Pubf c Underwr tars is s LUCIO CAFE WINDOWS SIGN Cr Facade: 60'W P 1 Ic �T\ ✓ J L ` 'e AOL Aff— Location: 9802 NE 2nd Ave, Miami Shores, FL 33138. South-West Elevation •....• 0.00• Windows: 6 windows 49.5" x 97.5"• 1 Over the door window 38"x isee�'� • •• . . 00*00 Total Window Area: 207.5 sq.ft •••••• • Proposed window sign Dimentions: 46"x40" +281lx8" = 14.3 sq.ft ... - . . . .... . . 0000•• ••.• 0000 09 •• •• • 000.0 •••••• F✓ Window Left to Door •..• ; ••�• 0.00 SEP 016 g 2 .. - - Over the Door su LUC10flz§ BE LO M STORE Mp 1'1'1 38" 49.5"