PL-15-2788 Permit NO. PL-11-15-2788
`sgones��` Miami Shores Village Permit Type:Plumbing-Residential
1"'"-M 10050 N.E.2nd Avenue NE ' Work Classification:Addition/Alteration
I " Miami Shores,FL 33138-0000 Per
Permit States:APPROVED
Phone: (305)795-2204
F�OAIDA
Issue Date: 11/4/2015 Expiration: 05/02/2016
Project Address Parcel Number Applicant
161 NE 106 Street 1121360060380
Miami Shores, FL 33138-2036 Block: Lot: SECTION M INC
Owner Information Address Phone Cell
SECTION M INC 3821 EL PRADO Boulevard (786)408-3661
MIAMI FL 33133-
3821 EL PRADO Boulevard
MIAMI FL 33133-
Contractor(s) Phone Cell Phone Valuation: $ 1,980.00
INFINITY CONSTRUCTION SERVICES (786)443-9590
Total Sq Feet: 0
Type of Work:REPLACE BATHROOM FIXTURES AND KITCH Available Inspections:
Type of Piping:
Inspection Type:
Additional Info: Top Out
Bond Return: Final
Classification:Residential Scanning:3 Review Plumbing
Underground
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.20
DBPR Fee Invoice# PL-11-15-57635
$2.25 11/04/2015 Check#: 1084 $ 116.70 $50.00
DCA Fee $2.25
Education Surcharge $0.40 11/02/2015 Check#: 1077 $50.00 $0.00
Permit Fee $150.00
Scanning Fee $9.00
Technology Fee $1.60
Total: $166.70
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,MECHANIC WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that e r . g information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and z F e above-named contractor to do the work stated.
November 04, 2015
horized Siqlnat mLDa Date
Building Depart(hent Copy
November 04,2015 1
ss� Miami Shores Village FBY:
� =
. ,
Building Department 2 201
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949 01
FBC 20(y
BUILDING Master Permit No. PC IS — R
PERMIT APPLICATION Sub Permit No. ' ISL- f S - 2Weg
❑BUILDING ❑ ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION DRENEWAL
00 PLUMBING ❑ MECHANICAL F-1 PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
/ f f� / �� CONTRACTOR DRAWINGS
JOB ADDRESS: /(D /�/ `/Z —
City: Miami ShoresCounty: Miami Dade Zip: (�
Folio/Parcel#: >I- 2136 '-00b// -P O Is the Building Historically Designated:Yes NO ' \
Occupancy Type: Load: Construction Type: _Flood Zone: BFE: �F^�FE:
s /
OWNER: Name(Fee Simple Titleholder): eC./lb0 �-!- r�C. Phone#: 3 `7
0 0 �q
Address: 3?21 4E6 7�'12,40- 13«-0
City: M/Aft-44 State:_ Zip: 3
Tenant/Lessee Name: _ Phone#:,
Email: _
CONTRACTOR:Company Name: ��1 �� �-'� �ci `U4-P� Phone#:
Address: LA I t5 kn-v-\ A
City: rn�Crn c State:[ _ Zip:
Qualifier Name: A Cl4-c>n"o tC— _ Phone#:
State Certification or Registration#: C Fc-- I I-A QL Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#: _
Address: City: State: Zip:
Value of Work for this Permit:$ ay 0 ^Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition
Description of Work: T�`'` '`' S/N/C .
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ ze��_ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ _ _ Bond$
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 instrume_ntl was acknowledged before me this
day of 20 , by 2 G day of ®` _, 20 15 by
,who is personally known to Nl�.-:)01.0 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.
NOTARY PUBLIC: NOTARY PUBLIC: GOM�
E' 13115
PU,�c M�COMMtSSA Gf 2019 ce
1FE t�e�an
Sign: _ Sign: A.A hL1p4gklstState
Print: Print:
Seal: Seal:
APPROVED BY �'L 7� Plans Examiner Zoning
Structural Review Clerk
/24/2014)
10/26/2015 DBPR-LUVARA,ANTONIO;Doing Business As:INFINITY CONSTRUCTION SERVICES,INC,Certified Plumbing Contractor
• 1:46:51 PM 1012612015
Licensee Details
Licensee Information
Name: LUVARA, ANTONIO (Primary Name)
INFINITY CONSTRUCTION SERVICES, INC (DBA Name)
Main Address: 4156 SW 96TH AVENUE
MIAMI Florida 33165
County: DADE
License Mailing:
LicenseLocation:
License Information
License Type: Certified Plumbing Contractor
Rank: Cert Plumbing
License Number: CFC1428288
Status: Current,Active
Licensure Date: 08/06/2010
Expires: 08/31/2016
Special Qualifications Qualification Effective
Construction Business 11/16/2011
Alternate Names
View Related License Information
View License Complaint
1940 North Monroe Street Tallahassee FL 32399 :: Ernail: Customer Contact Center :: Customer Contract Center: 850.487.1.395
The State of Florida is an AA/EEO employer.Copyright 2007-2010 State of Florida. Privacy Statemertt
Under Florida law,email addresses are public records.If you do not want your email address released in response to a public-records
request,do not send electronic mail to this entity. Ins'iead,contact the office by phone or by traditional mail.If you have any questions,
please contact 850.487.1395. *Pursuant to Section 455.2?5(1), Florida Statutes,effective October 1.,201.2,licensees licensed under
Chapter 455, F.S. must provide the Department with an email address if they have one.The ernails provided may be used for official
communication with the licensee. However email addresses are public record. If you do not wish to supply a personal address, please
provide the Department with an email address which can be made available to the public. Please see our Chapter 455 page to determine
if you are affected by this chaige.
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ACORD CERTIFICATE OF LIABILITY INSURANCE 10cl:20,2016
PRODUCERTHIS CERTIFICATr IS MUM)rS A MXM 5F-INFORMATION
Floridit Insurance Agency of Miatni ONLY AND CONFERS NO RtG14T.S&ON THE CERTIFICATE
P.O.Sox 441340 HOLDER,THIS CERTIFICATE DOES NOT AMEND,EXTEND OR,
Miami,Fl.33144 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P;306446-9100
INSURER AFFORDING COVERAGE NAM,$11
INSURED INSURER A United Spec Co'
Infinity Contraction services Inc INSURER V
4156 sw 96 ave INSURER C:
Miami FI 33165 INSURER 0, -
INSURER E: __
INSURER F: NAAIED _
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THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED SO'Jt Fll
FOR THE POLICY PERIOD INDICAT ,NOT-
VITHSTANDING ANY REQUIRE 4ENT;I'ERNI,OR CONDITION OF ANY CONTRACT Olt OTHER DOt,`UNIENTWITH RESPECT TO WNCH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAKTHE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SLWECT TO ALL'I•ERMS,
EXCLUSIONS AND CONDITIONS 2E SUCH POLICIES,A6GRtirGATE LIMIT.SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS_
INISfR ADD EFFECTIVE= pipmntIN
LTR INSR TYPE OF INSURANCE POLICY NUMBER 'MN{ID17lYY) 3lYY) LIMITS
GENERAL LIABILITY EACH OCCURRENCE E 1.000.000
COMMERCIAL GENERAL LIABILITY PREMISESIES t)CCiINt nce) 5700,ItZiO
CLAIMS MADE OCCUR INFO EXP(.►ny one pe! on $5,000
A S11 1003818221' 10-1912015 10.'9t'ZQ18 PERSONAL&AIN INJURY 1A00.80
jGPJ% (AL AGGREGATE 7-11KOW
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ALMOMOSILE LIABILITY COAA61t�5 u /Ea1:'Cf1�AIT
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SPECIAL PROVISIONS below1i I Mks
DESCRIPTION OF OPERATIONS!LOCATIONS:VEHGLESIF.XCLUSIONS ADDED BY ENDIASEMEN'T r SPECIAL PROVISIONS:
Cfc 1428288 t
i
9 ,
z .CERTIFICATE HOLDER I
IA667L tNSUREC)
S,!�6=V ANY OF THE ABOVE"DESCRIBED POLICIES 8E CANCELLED,13FORE THE EXPIRAVO
Miami Shores Village DATETFIERECF;THE ISSUING INSURER VALL ENDEAVOR TO AiUKtt.N DAYS WRITTEN
10050 NE 2nd Ave NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE 10 00 90 SHALL
Miami Shores,FI 33138 IMPOSE NO 0BLIGATTON OR LIABILITY OF ANY KIND UPON THE WARM.ITS AGENT OR
A :DRE 7IVE -�
Tony Zoght;-
ACORD 25(2001M) ACOR ORPORAATION 1988
ogK"E'�A
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: 9/21/2015 EXPIRATION DATE: 9/20/2017
PERSON: LUVARA ANTONIO
FEIN: 364796470
BUSINESS NAME AND ADDRESS:
INFINITY CONSTRUCTION SERVICES INC
4156 SW 96TH AVE
MIAMI FL 33165
SCOPES OF BUSINESS OR TRADE:
< CENSED PLUMBING SHEET METAL WORK- HEATING,VENTILATION,
ONTRACTOR INSTALLATIO AIR-COND
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
DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS?(850)413-1609
Miami shores Vilfage
` ,-- ..Building Department
��OR11� 1.0050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305)795.2204
Fax: (305)756.8972
Notice to Owner— Workefs' Com en.sat on 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 thc.Ftorida 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.
i. The officer ovens at least 10 percent of the stock of the corporation,or in the case of
an LLC,a statementattesting to the minimum l0percent 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
voluntaryrevocation 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 circumstarnces,Mianai 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:
4
y.
State of Florida
County of 1vf ami-Dade
The foregoing was acknowledge before me this day of .1 6br—E7Z- ,20 l�
By who is personally known-to me or has produced
a dentiftcation.
otary;
W Gt, ION#FF24222
SEAL; EX.IBES:JUN 21,2019
Oft Bonded through 1st State Insurance
Infinity Construction Services Inc
Cfc 1428288
4156 Sw 96 Ave
786-443-9590 / 786-360-5499
Miami FI 33165
Date Oct 26,2015
I Antonio Luvara qualifier Infinity Construction Services Inc , Certify will be the
only person working on the project located at : 161 ne 106 st. Miami Shores FI
33138.
Regards,
Ant ioLuvara
Before me this day personally appeared Antonio Luvara who, being duly sworn,
deposes and says :
That he will be the only person working on the project located at : 161 ne 106 st.
Miami Shores Fl. 33138
Sworn to and subscribed me this 10 day of 2015 by, Antonio Luvara
Personally Kno ANIONIOE.GOMEZ
MY COMMISSION#FF913115
Or Produced Idenification `� E?IRE
S:AUG25,2019
Bonded through 1st State Insurance
Type Of Identification Prooduced