MC-16-1812 � .
Vis+ s i, Miami Shores Village ■
Permit +1t? a all Gr l Re'smvt�
10050 N.E.2nd Avenue NE � it
W0* , fi't t C Re t sl i 1
Miami Shores,FL 33138-0000 „ Plrn5t8i* k ' `
Phone: (305)795-2204
R Expiration: 01/07/2017
Isstt3 �7�11���}1� p
Project Address Parcel Number Applicant
30 NE 93 Street 1132060130200
Miami Shores, FL 33138- Block: Lot: JUDE 8,FRANCES FACCIDOMO
Owner Information Address Phone Cell
JUDE 8,FRANCES FACCIDOMO 30 NE 93 Street (305)374-5730
MIAMI SHORES FL 33138-
30 NE 93 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 2,000.00
AVR CONTRACTORS,CORP (786)818-0337 `
Total Sq Feet: 150
Tons: Available Inspections:
Additional Info: Inspection Type:
Classification:Residential
Final
Approved:In Review
Comments: Date Approved::In Review
Date Denied: Type of Work:
Scanning:1
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.20
DBPR Fee Invoice# MC-6-16-60391
$2.00 07/11/2016 Credit Card $ 110.20 $0.00
DCA Fee $2.00
Education Surcharge $0.40
Permit Fee $100.00
Scanning Fee $3.00
Technology Fee $1.60
Total: $110.20
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 inform tion is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore,I authorize the above-n med cogractor to do the work stated.
July 11,2016
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
July 11,2016 1
Miami Shores Village �McRr
Building Department Ju
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY.
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 2014! Soh
BUILDING Master Permit No. R C 7 6 - 1 19/
PERMIT APPLICATION Sub Permit No. �— ! (x-'16
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING MECHANICAL [:]PUBLICWORKS [:] CHANGE OF ❑ CANCELLATION ❑ SHOP
/ CONTRACTOR DRAWINGS
JOB ADDRESS: 30 ,U4 q 3 5 T
City: Miami Shores County: Miami Dade zip: 33/ 3 W s
Follo/Parcel#: Is the Building Historically Designated:Yes NO_
Occupancy Type: Load: Construction Type: n n Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder):&AhC4K`Qccialw"V rA kd4 raeei,&y ,o Phone#: -505 94 9 1/9 6 i'
Address: 3® Ale 9'3 5 7L
City:_ "C&--1-+ 5AD&CS State: Zip: 3 13
Tenant/Less a Name: Phone#:
Email: 4ftiacadomwo /. Wv,.L
CONTRACTOR:Compan Name: ��� dJ Phone#: �6!1 Mqmq
Address: ?
City: A State: Zip:
Qualifier Name: % Phone#: z
State Certification or Registration#: /i ~®�1h Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ 7-000,a a Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration //❑ New ❑ Repair/Replace ❑ Demolition
Description of Work:
Specify coot of'color thru tale:,
Submittal Fee$ Permlivi e$ `I o. ) • ciz) CCF$
Scanning Fee$ 1 r Radon Fee$ a -00p� DBPR$ � �.J Notary$
Technology Fee$ ! `�O ® Training/Education Fee$ V- ® Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ I 0 a
(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 m st be osted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the ab of uch posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature 0 &-_ Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
Z9 day of Tlolpi e P20 It by Z"? day of JUn 20 16 by
j5a gwc-0S /i4 C C 04Ai v ,who is personally known to Rl LI-e-4-61 who is personally known to
me or who has produced Ft NiL4ve tiv 1IC-nc e as me or who has produced,Pl- bXoAe44r L l Geti as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLI NOT P LIC:
Sign: Sign:
Print: Print:
so .aVINE,11*1111PBELL
Seal = <���•• ' Notary Public-State of Florida Seal ? �,= Notary Puelic-State of Florida
s,9j cPc My Comm.Expires Oct 30,2018 ,p� My Comm.Expires Oct 30,2018
Commission#FF 173189 ''FOF F�`(P� Commission#FF 173189
qn„N 44,IIN
APPROVED BY ns Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
AVR Contractors Corp.
Date: (D I(P
Stare of FinglDg
County of Minn—Nf)a
Before me this day personally appeared RIGI4zpo uoy--A who, being duly sworn,
deposes and says:
That he or she will be the only person working on the project located at:
Sworn to(or affirmed)and subscribed before me this Z8 day of June
20_LLP , by RICA RW I RRA
Personally known
OR Produced Identification
Type of Identification Produfed F
\-�Wr CAM15�- a
a
Print,Type or Sta ;Name of Notary
a•"' "�.,, yINET CAMPBELL
Notary Public.State of Florida
My Comm.Expires Oct 30,2016
�.;����� �..• Commission#FF 173169
SNoeEs Gil
s� Miami shores Village
£g- n Building Department
1:40;, S� 10050 N.E.2nd Avenue
on 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:
61 d Owner
State of Florida
County of Miami-Dade
The foregoing was acknowledge before me this day of �U ,20 16
By I--114/71C 25 F6T CC 4"'20 who is personally known to me or has produced
FL 1, A_ttl-e A 5- L ,nas identification.
No P6ELL
fl Notalftblic- a of Florida
SE L: MY Comm.Expliea Oct 30,2016
''•.;,o��„o:: CommlaSioa#FF 113169
STATE OF FLORIDA
..4 DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395
1940 NORTH MONROE STREET
TALLAHASSEE FL 32399-0783
VERA, RICARDO
AVR CONTRACTORS, CORP
8177 WEST 36TH AVENUE APT 6
HIALEAH FL 33018
Congratulations With this license you become one of the nearly
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.- ' PROFESSIONAL REGULATION
Every day we work to improve the way we do business in order CMC1250516 ISSUED: 10/27/2015
to serve you better. For information about our services, please
log onto www.myfloridalicense.com. There you can find more CERTIFIED MEtCHANICAL CONTRACTOR
information about our divisions and the regulations that impact VERA,RICARDO
you,subscribe to department newsletters and learn more about AVR CONTRACTORS,CORP
the Department's initiatives.
Our mission at the Department is:License Efficiently, Regulate
Fairly.We constantly strive to serve you better so that you can d
Fiep u
CERTIFIED under the provisions or ch.aas Fs.
serve your customers. Thank you for doing business in Florida, is IS CE,TI AUG n er us�o2�000,s.s
and congratulations on your new license!
DETACH HERE
RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION LTi a
CONSTRUCTION INDUSTRY LICENSING BOARD ck
CMC1250516
The MECHANICAL CONTRACTOR
Named below IS CERTIFIED �y we
Under the provisions of Chapter 489 FS.
Expiration date: AUG 31, 2016
i
VERA, RICARDO .
AVR CONTRACTORS, CORP _
8177 WEST 36TH AVENUE APT 6
HIALEAH FL 33018
■
ISSUED: 10/27/2015 DISPLAY AS REQUIRED BY LAW SEQ# L1510270001519
l al Busi ness Tax Fbcd pt
Miami-Dade County, State of Florida
THIS IS NOT A BILL-DO NOT PAY UBT
7194129 �+
BUSINESS NAM E/LOCATION RECEIPT NO. EXPIRES
AVR CONTRACTORS CORP NEW BUSINESS SEPTEMBER 30, 2016
8177 W 36 AVE APT 6 74766197
HIALEAH,FL 33018 Must be displayed at place of business
Pursuant to County Code
Chaoter 0A-Art.9&10
OWNER SEC.TYPE OF BUSINESS PAYM ENT RECEIVED
AVR CONTRACTORS CORP 196 GENERAL MECHANICAL BY TAX COLLECTOR
C,0 RICARDO VERA CONTRACTOR 45.00 11/17/2D15
Walker(S) 1 CMC1250516 0223-16-000770
This Local Bush s Tax Rao dpt cdy c on"rrns paynent d the Local BuWnsss Tax.The Receipt is not a IICR�e
penrit,ora certi'cation dthehoicWs%di"cations,todo business,Hider rust cwVlywith anygmernntm1at
regulebwoawsanciregldrenm whichappiytnthebusiress.
The FEMPTNQabwenWbecyspiayedoneJlcmmmr ielveiddes-Miami-Dado0oftSwea 2Ta
r51Ai7�" rrnrehdo neticn,visitwww.nia"idadavvlffixcdlectar
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jL=F AIVILA1LC
CHIEF FINANCIAL OFFICER STATE OF FLORIDA.
DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS'COMPENSATION
r CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS'COMPENSATION LAW
CONSTRUCTION INDUSTRY EXEMPTION
This certifies that the lndwidual Isted below has elected to be exempt from Florida Workers'Compensatlon law_
EFFECTIVE DATE: 5112/2016 EXPIRATION DATE: 5112/2018
PERSON: VERA RICARDO
FEIN: 473999893
BUSINESS NAME AND ADDRESS;
AVR CONTRACTORS CORP.
6177 WEST 36 AVE UNIT 6
HIALEAH FL 33018
LICENSED GENERAL LICENSED PLUMBING HEATING,VENTILATION
CONTRACTOR CONTRACTOR AIR-GOND
PiifSiian to Crawlq 440.051141 F.S..an dfim or a capamrm VWM elects Mumum fmm Ods d1wff by MM a mukate of a crater Ods aecdon
my nm recover mets or mmomMan undar tlds doer.Pu om tto t 440.05{14 F.S..Cas of elan to be exalt...appy only
WMM Ore scaoe of the uwkw s or trade vted on an fmom of etecfim to be exempt Pum to Chapter 440 W31 F.S,Nofta of +to be
exempt and cwfficates of election to be exegt shag be subject to ravaradon B at anytime atter Beam afOo rxdlca or Ore bawnw of Om fie.
an person named an Om nobw or cwftate no wr4w meals ft mqutrerrrerds of Ods saddr for bum=of a cert kabL Tba dopartrnent stmn revan a
DFS-F2-0WG262 CERnFICATE OF ELECTION TO BE EXEMPT FtEVISED 08.13 QUESTIONS?(850)413-1609