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
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LUCIO CAFE WINDOWS SIGN
Cr Facade: 60'W
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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 ... -
. . . ....
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••••••
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1'1'1 38"
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