The URL can be used to link to this page

PL-17-977 Permit N 7 ft","4-17-977 a*Wiks i, Miami Shores Village Pennit yp#3: � "Residential _ 10050 N.E.2nd Avenue NE Work dassXficatiiri�GALS Miami Shores,FL 33138-0000 P,:e r It, I I Mme Phone: (305)795 2204 Permit Status:APPROV'Et) Issuer Dote:411712017 Expiration: 10/14/2017 Project Address Parcel Number Applicant 600 NE 97 Street 1132060171680 _w...�._.�. .. ._�.�.__ EDUARDO J GONZALEZ Miami Shores, FL 33138-2471 Block: Lot: �m Owner Information Address Phone Cell y LEDUARDO J GONZALEZ 600 NE 97 Street (786)459-2356 MIAMI SHORES FL 33138- 600 NE 97 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone $ 1,200.00 Valuation: ALLISON GAS PLUMBING CORP (305)303-9877 Total Sq Feet: p 1 Type of Work:NEW GAS SYSTEM Available Inspections: Type of Piping: Inspection Type: Additional Info: Final Bond Return: Press Test Classification:Residential Scanning:3 Review Plumbing Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 Invoice# PL-4-17-63635 DBPR Fee $2.25 04/07/2017 Credit Card $50.00 $121.70 DCA Fee $2.25 Education Surcharge $0.40 04/17/2017 Check#:583 $ 121.70 $0.00 Notary Fee $5.00 Permit Fee $150.00 Scanning Fee $9.00 Technology Fee $1.60 Total: $171.70 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,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is acp a that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the above-named.c r do the work stated. April 17, 2017 Authorized Signature:Owner / Applicant / Contr for / Agent Date Building Department Copy April 17,2017 1 4�egSr-Jry G%) 4404CA �' S 331-310 , 11 q11 -1 Miami Shores Village g � Lt Building Department artment 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 20s`� BUILDING Master Permit No. RC-2-77-480 PERMIT APPLICATION sub Permit No. e� ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [—]RENEWAL QPLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP Gas CONTRACTOR DRAWINGS JOB ADDRESS: 1660 N — W St City: Miami Shores County: Miami Dade Zip: 33138 Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: ��^^_IConstructionnType: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): Gjyw✓Jd Gon r4lez Phone#: 786-457—Dib Address: 600 NF- l t City: A i rAn1 a 5�60 V PS State: P l— Zip: 13133 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: ALLISON GAS PLUMBING CORP. Phone#: 3053039877 Address: 6180 SW 20 ST City: MIAMI State: FL Zip: 33155 Qualifier Name: ALEIDO A ACOSTA Phone#: 3053039877 State Certification or Registration#: 25916 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$1200.00 Square/Linear Footage of Work: Type of Work: ❑ Addition 0 Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: QW V6 S151911110% Specify color of color thru tile: Submittal Fee$ Permit Fee$ ' 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) Ir 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. Signatur Signature --�4� OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 64 day of 20 C4 by day of NP l._ 20 ( by 'R-A wU is personally known to AACwho is personally known to me or who has produced me or who has produced —®fel- identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC• Sign: Sign: VA4 i Print: Print: Seal: LINA CORREA gpaY�&® NotaryPubliCStateufFlorida Seal: MY COMMISSION#FF227871 Sindia Alvarez ag My Commission FF 156750 '•,a'� EXPIRES May 06.2019 oy�®Q Expires 0910312018 eu'as rw,a,no,�,s :.,,,.�u• APPROVED BY "6Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Florida Department of Agriculture and Consumer Services Bureau of Liquefied Petroleum Gas Inspection 2005 Apalachee Parkway Tallahassee, Florida 32399-6500 Master Qualifier Mailing Address Licensed Location Address ALEIDO ACOSTA ALLISON GAS PLUMBING CORP ALLISON GAS PLUMBING CORP 6180 SW 20TH ST 6180 SW 20TH ST MIAMI,FL 33155-2035 MIAMI,FL 33155-2035 Certificate Number License Number 24720 25916 This Master Qualifier Certificate is issued pursuant to Chapter 527, Florida Statutes. This certificate is valid only for the person and licensed holder listed. Any changes to the Master Qualifier status (such as transfer or termination of employment)must be reported to the Bureau of LP Gas Inspection at(850)921-1600 immediately. The Master Qualifier Certificate is valid only through the date noted on the Certificate. A notice of renewal will be sent to you in advance of your expiration date. A Master Qualifier Certificate may be renewed if certification of a minimum of 16 (sixteen)hours continuing education is provided along with the renewal form. If training cannot be documented, an examination must be taken. If there are any errors on the certificate, please submit all changes in writing to: Florida Department of Agriculture and Consumer Services Bureau of Liquefied Pet oleum Gas Inspection 2005 Apalact ee Parkway Tallahassee, Flor da 32399-6500 Cut lore---------------------------- State of Florida Department of Agriculture and Consumer Services Division of Con umer Services Certificate No.• 24720 Bureau of Liquefied Petroleum Gas Inspection Exam Date: June 19,2W8 GO (850)921-1600 Issue Date: July 16.2014 E Tallahassee, Florida xpiration Date: July 15,2017 Exam: 0601 MASTER QUALIFIER CERTIFICATE This Certificate is issued under authority of Section 527.02, Florida Statutes,to: ALEIDO ACOSTA Valid For License Number. 25916 ALLISON GAS PLUMBING CORP 8180 SW 20TH ST ADAM H.PUTNAM MIAMI,FL 33155-2035 COMMISSIONER OF AGRICULTURE Florida Department of Agriculture and Consumer Services P.O. Box 6700 Tallahassee, Florida 32399-6700 License Number: ,25916 Business Mailing Address Licensed Location Address ALLISON GAS PLUMBING CORP ALLISON GAS PLUMBING CORP 6180 SW 20TH ST 6180 SW 20TH ST MIAMI,FL 33155.2035 MIAMI,FL 33155-2035 The liquefied petroleum gas license at the bottom of this form Is valid ONLY for the company located at the address on the license. Each business location of a company must be licensed. All LP Gas licenses must be renewed annually. Any license allowed to expire shall become inoperative because of failure to renew. The fee for restoration of-a lio€ksGiG equal-to the odginnl;icvnsa fere arid-must be pari vefore-ft-Hoensee may resume- operations. IN THE EVENT OF AN OWNERSHIP CHANGE AT THIS BUSINESS LOCATION: This license may be transferred to any person,firm or corporation for the remainder of the current license year upon written request to the department by the original license holder. License transfers must be approved by the departmen All licensing requirements must be met by the transferee and a transfer fee of$50 will apply. To apply for a transfer,contawt the Bureau of LP Gas Inspections at(850)921-1600. Pursuant to Chapter 527, Florida Statutes, LP Gas licensees must present proof of licensure to any consumer, owner,or end user upon request when engaged in the business of servicing,testing,repairing,maintaining or Installing LI'Gas systems and/or equipment. For future correspondence,please make any needed corrections or changes to your business mailing address and/or your licensed location address and return the UPPER PORTION with corrections to: Florida Department of Agriculture and Consumer Services P.O. Box 6700 Tallahassee, Florida 32399-6700 Cut Here 4PState of Florida Department of Agriculture and Consumer Services Division of Consumer Services License Number, 25916 Bureau of Liquefied Petroleum Gas Inspection Expiration pate: August 31,2017 (850)921-1600 Date of Issue. SOptember 1,2016 POST LICENSE Tallahassee, Florida License Fes: 080o:oo Type and Class: 0 CONSPICUOUSLY 803 Liquefied Petroleum Gas License LP GAS INSTALLER GOOD FOR ONE LOCATION ONLY ANY CHANGE OF OWNERSHIP OR SALE OF THIS BUSINESS RENDERS THIS LICENSE INVALID This license Is Issued under authority of Section 527.02,Florida Statutes,to: ALLISON GAS PLUMBING CORP 6180'SW 20TH ST ADAM H.PUTN 'M MIAMI, FL 33155-2035 COMMISSIONER OF AGRICULTURE 009010 Local Business Tax Receipt Miami—Dade County, State of Florida —THIS IS NOT A BILL—DO NOT PAY 6306849 LBT BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES ALLISON GAS PLUMBING CORP RENEWAL SEPTEMBER 30, 2017 6180 SW 20 ST 6573050 Must be displayed at place of business MIAMI FL 33155 Pursuant to County Code Chapter SA-Art.9&10 OWNER SEC.TYPE OF BUSINESS ALLISON GAS PLUMBING CORP 205 DEALER/DISTR/INSTALLATION PAYMENT RECEIVED LPG25916 BY TAX COLLECTOR $450.00 07/23/2016 CREDITCARD-16-043294 This Local Business Tax Receipt only confirms payment of the Local Business Tax.The Receipt is not a license, Permit or a certification of the holders qualifications,to do business.Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT N0.above must he displayed on all commercial vehicles—Miami—Dade Code Sec ea-276. For more information,visit leww.miamidade.aav/texcollactor AC76R" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/Dt1/YYYYi _ I 04117/17 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS j CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES ! BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: Ef the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: l Infinity Insurance Group,Llc. PHONE (305)597-7787 - I FAX (305)597-6477 8181 N.W.36nd Street,Suite#1010 I aQDRESS: —infinitygroup@belisouth.net-- Doral,FL 33166 INSURERS)AFFORDING COVERAGE I NAIC N Phone (305)597-7787Fax (305)597-6477 INSURER A: -Catlin Specialty Insurance Company + ` ---- ----------- INSURED ? INSURERS rt Allison Gas Plumbing Corp INSURER C: 6180 SW 20 St INSURER D: _ ! � MIAMI,FL 33165 (305)303-9877 '_INSURER E ...................... _-- ---_-__-- -- _.— INSURER F: COVERAGES __ _ _ CERTIFICAT_E_NUMBER: _ _ REVISION_NUMBER: THIS ISO CE TRTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. i INSR, UBR ADD ' POLICY EFF j POLICY EXP LTR TYPE OF INSURANCE IIN 1 POLICY NUMBER MM/DD MMIDD LIMITS r GENERAL LIABILITY -- — EACH OCCURRENCE __ __$ 7_000,000.0.0_ �7 COMMERCIAL GENERAL LIABILITY I DMIBES EaEoccu encu $__100=000.0© LYJ I PRE-----( --- ---�- ---. _ ! CLAIMS-MADE (�j OCCUR 10900105734 MED ExP(Any one person)_. $ 5,000 00 - A } - - ---_--- Y I 09109/2016 09/0912017 - --0- PERSONAL 8 ADV INJURY $ 1 OOO,000.00 r- i — ---! GENERAL AGGREGATE I $ 2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMP/OP AGG- $ 2,000.000.00 PRO- i L.-------__.._._._�.._----------------_--_f Ll POLICY L_.1 L.� LOC $ I AUTOMOBILE LIABILITY , COMBINED SINGLE LIMIT Ea accident ANY AUTO ; BODILY INJURY(Per person) $ r ALL OWNED t...i AUTOS r� AUTOSU� BODILY INJURY(Per acc(de $ I HIRED AUTOS . NON-OWNED 1 PROPEP�AMAGE $ 1 L 1 AUTOS I ffk,aC6deni__-- L._-- - --�- ------ - ! . i UMBRELLA UAB � -- ----. ..---......- ---1...............----- ----•- --- - OCCUR EACH OCCURRENCE $ —_ EXCESS LIAR u CLAIMS•NADE A GREG GATE DED �.._' RETENTION$_....... --- i- --- - $ ! WC '' DT .. __ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y!N � O�LIMITS ��$—H-i ANY PROPRIETORtPARTNERIEXECUTIVE _ € I E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N 1 A i ( (Mandatory in NH) € �; { I E L.DISEASE-EA EMPLOYE$ i If es, IPTIOe under - - - - -- - ---- — - - i DESCRIPTION OF OPERATIONS below ; I � E.L.DISEASE-POLICY LIMIT j$ , y + 111 I DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,N more space is required) NEW GAS SYSTEM I , I I , I I i ... ......... . _ _—..-- CERTIFICATE HOLDER CANCELLATION - - --------------..__.. - --—---------- --- i SHOULD ANY OF THE ABOVE DE CRIBED POLICIES BE CANCELLED BEFORE MIAMI SHORES VILLAGE THE EXPIRATION DATE THEREO NOTICE WILL BE DELIVERED IN I BUILDING DEPARTMENT ACCORDANCE WITH THE POLICY ROVISIONS. 10050NE2AVE r I AUTHORIZED REPRES TA E i i MIAMI SHORE.FL 33138 I MARIA J.GRELA O 188 -2 0 ACORD CORPORATION. All rights reserved. ACORD 25(2010105)OF The ACORD name and logo are registered marks of ACORD F JEFF ATWATER CHIEF FINANICAL 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: 10/4/2016 EXPIRATION DATE: 10/4/2018 PERSON: ACOSTA ALEIDO A FEIN: 010907945 BUSINESS NAME AND ADDRESS: ALLISON GAS PLUMBING CORP. 6180 SW 20 ST MIAMI FL 33155 SCOPE OF BUSINESS OR TRADE: Plumbing NOC and Drivers Oil or Gas Pipeline Construction &Drivers IMPORTANT:Pursuant to Chapter 440.05(14),F.S.,an officer of a corporation who elects exemption frorr 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 electic4i 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 certificate at any time for failure of the person named on the certificate to meet the requirements of this section DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS?(850)413-1609 ,SNORES G, s� Miami shores Village "" Building Department 10050 N.E.2nd Avenue �LOR1Dp' 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: l. 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 WLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTE Signature: 1 Pu® Notary Pubft State o1 Florida Owner o° 3 Sindia Alvarez p 4 My Commission FF 156750 ®F woe Exp,,,s 091031201 B State of Florida County of Miami-Dade The foregoing was acknowledge before me this 0_� day of 7WR u ,20 ByFJMwho is personally known to me or has produced FL 7DOV�7_7z � Jt'� as identification. Notary: SEAL: Allison Gas Plumbing 6180 SW20 St,Miami,FL 33155 Ph.305-303-9877 4/13/2017 State of Florida County of Miami-Dade Before me this day personally appeared Aleido A Acosta who,being duly sworn,deposes and says: That he or she will be the only person working on the project located at.600 NE 97 St. Sworn to (TI ed)and ubscribed before me this day of 20a by S � Personally know OR Produced Identifications—F - Type of Identification produced �l�tlGe� PrinT rStamjq�g10eLo rrV My CONWISS10N k FF227871 w'�'�o;i �' EXPIRES Wiay o6.2C19 •r�'I Rri:c'�s Fiai K7alVu.r .J.::•.n c.:.ur