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CC-17-265 Permit NO. CC-2-17-265 `SDORES�� Miami Shores Village 0 t Perrnit Type:Commercial Construction 10050 N.E.2ndvenue NE l)t � A �' r Work Classification:Alteration Miami Shores,FL 33138-0000 Permit Status:APPROVED Phone: (305)795-2204 LORIDP Issue Date:2/14/2017 Fxpiration: 08/13/2017 Project Address Parcel Number Applicant 716 NE 92 Street Number: 1-M 1132060440510 Miami Shores, FL Block: Lot: BETTY BARRY Owner Information Address Phone Cell BETTY BARRY 716 NE 92 ST UNIT 1M MIAMI FL 33138-2958 Contractor(s) Phone Cell Phone Valuation: $ 1,350.00 QUINTERO GENERAL CONSTRUCTIO (786)487-5738 Total Sq Feet: p Approved: In Review Available Inspections: Comments: Inspection Type: Date Approved:: In Review Window Door Attachment Date Denied: Tie Beam Type of Construction: REMOVE AND REPLACE TILE IN K Occupancy Load: Slab Stories: Exterior: Termite Letter Front Setback: Rear Setback: Framing Left Setback: Right Setback: Store Front Attachment Plans Submitted:Yes Certification Status: Insulation Certification Date: Additional Info: Drywall Screw Bond Return: Classification:Residential Final PE Certification Scannin :3 Window and Door Buck Gelling Grid Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Fill Cells Columns CCF $1.20 Review Building DBPR FeeInvoice# CC-2-17-62795 Review Planning $2.00 02/01/2017 Credit Card $50.00 $71.20 DCA Fee $2.00 Review Electrical Education Surcharge $0.40 02/14/2017 Credit Card $71.20 $0.00 Review Plumbing Notary Fee $5.00 Review Structural Permit Fee $100.00 Review Mechanical Scanning Fee $9.00 Technology Fee $1.60 Total: $121.20 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 zoning. F hermore, I authorize the above-named contractor to do the work stated. February 14, 2017 Auth gnature:Owner / Applicant / Contractor / Agent ate Building Department Copy February 14, 2017 1 Miami Shores Village �Eo BuildingDepartment R p FEB 011 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 1 1 5 FBC 20 BUILDING Master Permit No. CGS - ` 2-OS PERMIT APPLICATION Sub Permit No. PKfBUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL F-1 PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 716 N E X12 NGI ST rem i /-I a City: Miami Shores County: Miami Dade zip: 38 Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder): 3bo I✓el lCR� Phone#: Address: ic' T 1 M n� 1.44% City: L"� !!9n '« os State: R- Zip: L )3u Tenant/Lessee Name: Phone#: Email: CONTRACTOR: TO � �e: KN,�Rd� 0 � S 4�1� �a CONTRACTOR:Company NamLU NT�(�D Phone#: Address:V Vol 1001 a �e uv City: WZ4&A 6- State: IC Zip: Qualifier Name: ;S eA1j l\ 2—QzDcy Phone#: State Certification or Registration#:, GCS S1 S? ` Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: v Value of Work for this Permit:$ 3-5Square/LinearrFFo/ootage of Work: Type of Work: ❑ Addition ❑ Alteration El New ^�- u Repair/Replace1 ❑ Demolition . Description of Work: -- •I N ►''t 'Ctrl s a�k�.�rc�,.�••t,�•.t--=--�,.•. Specify color of color thru tile: $� ^►,:a:a�"s'"�. Submittal Fee$ w' Permit Fee$ CCF$ '3'a r,,?® Scanning Fee$ Radon Fee$ Z DBPR$ Z Notary$ O Technology Fee$ Training/Education Fee$ 640 Double Fee$ Structural Reviews$ Bond$ ZO 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. Signature Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this zny day of��,12g4I 61 20 1 9 by /�� day of Pry- 20 (77 , by who is personally known to n!A"40 QV1�w o is pe' n 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: Sign: �� :•�� o i C13 a Print: g i Print: -rn:�� • "� �c�n= Sea-,:, Seal: o>•.0� ter+ Notary Public data d Fbtlra X66 •.o,Ih, �QJ� Oscar M Z My CwdW*Wm IFF a t4/0a/40 99 T '///,��//NI 1111Aq\V\ExO \\`� r*******r *******ss**rr*** ******* **s*******sus*e****s******************* * APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) ORE'S G ,.,. ,,,,,� Miami Shores Village - —��d Building Department �XOR rIDp' 10050 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. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: rl caner State of Florida County of Miami-Dade ,�/� The foregoing was acknowledge before me this day of_�� 520 By FEr7-YY who is personally known to me r has produced as identification. Notary: SEAL: -0 P Popsy P Ic sb 1 FWW- _ Oscar M Zaragoza „ My CommWW FF 939267 _ Excires 1ZVM19 QUINTERO GENERAL CONTRACTOR CORP Bernardo Quintero 8801 nw 112 terrace Hialeah Gardens fl 33018 Date: OZ/0 9/17 State of 1:5 d.A - County of l Q Before me this day personally appeared /Je"W-¢-19bO ai`�vl who, being duly sworn,deposes and says: That he or she will be the only person working on the project located at -7/6 A✓r 9C;� s7< y vr� Sworn to(or affirmed )and subscribed before me this I day of. .2014; by _?)ernordo nu inte.ro Personally know Or produced identificationQ 53(v Type of identification producec!Ao6 -:A cirivevz G�c_a.rtst. � ;. MY 0 MSI 3 ON GN�EZ #G 04460 EXPIREs G 2 ,,o,Fo,,•' Bond :November2,2020 Thru Notary Public Under,,dtare Print,type or stamp name of notary 745 North East 91 n Street Miami Shores,FL 33138 305-759-9069/FAX 305-759-2101 E-MAIL:spel23@att.net January 24, 2017 Miami Shores Village Building Dept. 10050 NE 2nd Avenue Miami Shores, FL 33138 Dear Sir/Madam: This letter will serve as your confirmation that "Quintero General Contractor, Corp" has been contracted by the owner of Unit 1 M, at 716 NE 92 Street, Miami Shores, Fla., and is authorized by the Board of Directors of the Shores Plaza East Condominium Association to perform alterations to said Unit. This involves the removal of current floor tiles in Kitchen and install new floor til'es in Kitchen. Should you have any questions regarding the enclosed, please feel free to contact the condominium office. Sincerely yours, c---Y Oscar Zarag a Say / Treasurer cc: file scoee FI© 0000 AI— see 00.0 000090 0000. •�•• . 0000.. ... . . 0000 , ... 0000.. '•' • 'RE•CE11�Eja. 000 . • • .00.00 •...: • F000 0 EB o , Ll ..� . ... 0000.. F i 1 f� 1 CIO Oq CL Ll L C LL r