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PL-16-1482Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit Permit NO. PL -5-16-1482 Permit Type: Plumbing - Residential Work Classification: Addition/Alteration Permit Status: APPROVED Issue Date: 12/27/2016 Expiration: 06/25/2017 Parcel Number Applicant 103 NE 99 Street Miami Shores, FL 33138- 1132060132180 Block: Lot: GEORGE FISHMAN Owner Information Address Phone Cell GEORGE FISHMAN 103 NE 99 Street MIAMI SHORES FL 33138-2340 Contractor(s) Phone Cell Phone EDWARD ROJAS PLUMBING CORP (305)944-6788 Valuation: Total Sq Feet: $ 5,970.00 00 Type of Work: REPLACE 3 FIXTURES IN BATH Type of Piping: Additional Info: Bond Return : Classification: Residential Scanning: 3 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $3.60 $3.38 $3.38 $1.20 $225.00 $9.00 $4.80 $250.36 Pay Date Pay Type Invoice # PL -5-16-59967 05/27/2016 Credit Card 12/27/2016 Credit Card Amt Paid Amt Due $ 50.00 $ 200.36 $ 200.36 $ 0.00 Available Inspections: Inspection Type: Top Out Final Review Plumbing Underground 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 ELECT] ICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFI construction a I certify that all the foregoing information is Futhermore, I authorize the above -nam-• accurate and that all work will be done -in compliance with all applicable laws regulating ctor to do the work stated. ignature: Owner / Applicant // Contractor / Agent Buildin • Department Copy December 27, 2016 Date December 27, 2016 BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC t'PLUMBING ❑ MECHANICAL JOB ADDRESS: Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 7564972 INSPECTION LINE PHONE NUMBER: (3(5)762-4949 ❑ ROOFING PUBLIC WORKS RECEIVED MAY 2 7 2016 BY: FBC201y� Master Permit No. JZ+IO - 1 �7 Sub Permit Noel L t -J F2 - 0 Z❑ REVISION ❑ EXTENSION DRENEWAL ❑ CHANGE OF ❑ CANCELLATION 11 SHOP CONTRACTOR DRAWINGS City: Miami Shores County: Miami Dade Zip: 3 Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE OWNER: Name (Fee Simple Titleholder): E:: -1,11A -(e S 1 ti'l C Address: L' • q q City: MIA ta'[ Zvi . " — State: Tenant/Lessee Name: e44 - Phone#: FFE: Tip: 31 Phone#:3V.r=7/3 r2. -r, Email: CONTRACTOR: Company Name: d %e/GGea%% C3 /g 5p/rnhI'41., Phot 7F 4' 3 cif 1 Address: Ed Iv C. (/ / ,cit? [ 3 1 se A.Q /3/0 2 e State: i---1 Zip: 3 3/o/ Qualifier Name: nZG4 it. -rd ��' /.14 S -�� Phare#' Stat Certification or Registration #: CC C / -C 0 1 74 .3/ Certcate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $' 5720 Square/Linear Footage of Work: Type of Work: ❑ Addition Alteration ❑ New n Repair/Replace El Demolition 3 P/xii Huth Description of Work: to p ki C.Q Specify color of color thru tile: Submittal Fee $ Permit Fee $ 223 ca $ co,cc $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ ill au( earlm mahf 1a1 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 o building permit with an estimated value exceeding $2500, the applicdnt 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 • - approved and a reinspection fee will be charged. OWNER or AGENT The foregoing instrument was acknowledged before me this ''1.-47 day of1'1,4 1/4/ fe -o me or who has produced as identification and ho did take an oath. NOTARY PUBLIC: ,20'1 V Signature NTRA OR The foregoing instrument was acknowledged before me this by •2A' day of •A- y to h t1�ttA.A. f1aC 1 , who 'L personally k Sign: Print: Seal: ss*ss****ss*****s********* APPROVED BY /RasrieoiiM Pm HM A% by n to me or who has produced as identification and who did take an oath. NOTARY P Sign: /,, ri . r , Print: ` `='" Seal: 4a�9Fs'�iFq t, `l''LN 4'p fe94',0..-`f ssss*****************s**s******s*** '*** Plans Examiner Structural Review ** *MR **s***s** Zoning Clerk RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTIQN INDUSTRY LICENSING BOARD The PLUMBING CONTRACTOR Named below 1S CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 ROJAS;:_EDWAR ED VARD ft0jA 880.NE. 1 - BiZCA'YNEn ISSUED: 08/052014 DISPLAY AS REQUIRED BY LAW SEQ # L1408050001639 Local Business Tax Receipt Miarrli=-Dade County, State of Florida -Tin IS NOT A BILL - 00 NOT PAY 5175658 BUSINESS•NAME/LOCATION• EDWARD ROJAS PLUMBING CORP 880 NE 111 ST **** BISCAYNE PARK, FL 33161 OWNER.PAYMENT RECEIVED EDWARD ROJAS PLUBING CORP 196 PLUMBING BY TAX COLLECTOR CONTRACTOR 45.00 06/31/2015 Worker(s) 1 CFC049431 0235-15-005999 ibis tie* Beess Tex Neel* onlpceniiimi prom oi tio Local litaions Tam Tlio Receipt is sot pm*. or I ollificotion of the Boldots toodikoMMt. to IN hosions. Bolder most Googly with say loveramulil " -of mootwoMotootol mouton lows sad raipoisommas velOeli apply io **hokum The RECEIPT NO. Aim* awl bit displayed as all ciaraorebt volidoi!!Niad-lhalt Coda S.c14* MIMI Fay lasia istomatioa. Pasnlainaidallilliyalltallialat • RECEIPT NO. RENEWAL • 2371250. SEC. TYPE OF BUSINESS LBT EXPIRES SEPTEMBER 30, 2016 [Vilest be displayail at place of business • Pursuam ID COUMY Cod. Chapter - Art. 9 St 10 AG[3Rl- CERTIFICATE OF LIABILITY INSURANCE ku.;.---` DATE(MMIDONYYY) 12/04/15 THIS CERTIFICATE 18 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER IMPORTANT: If 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). PRODUCERe Accurate 8300 West Flagler Suite 114 Miami, FL 33144 Phone (305)226-8727 Fax (305)226-8767 T Lucia Estrella IAC No. gm (305)226-8727 (AIC. Not (305)226-8767 �D ; kiciaestrena@beilsouth.net INSURERS) AFFORDING COVERAGE NAIC d INSURER A: Arch Specialty Insurance Company Y INSURED Edward Rojas Plumbing Corp 880 NE 111 St Biscayne Park, FL 33161- INSURER B ; 08/06/2015 INSURER C: EACH OCCURRENCE INSURER D : MAGE TO RENTED PREMISES SES occurrence) INSURER E MED EXP (My one person) INSURER F : PERSONAL &ADV INJURY COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDmON 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. . INSR LTR TYPE OF INSURANCE ADDLSUBR INSR WVD POLICY NUMBER POLICY EFF (MMIDDIYYYY), POLICY EXP (MMIDDIYYYY) LIMITS A GENERAL LIABIUTY ® COMMERCIAL GENERAL LIABILITY III CLAIMS -MADE 5 OCCUR l Y AGL0028426-00 08/06/2015 08/06/2016 EACH OCCURRENCE $ 1,000,000.00 MAGE TO RENTED PREMISES SES occurrence) $ 100,000.00 MED EXP (My one person) $ 5,000.00 PERSONAL &ADV INJURY $ 1,000,000.00 • GENERAL AGGREGATE $ 1,000,000.00 GENT AGGREGATE LIMIT APPLIES PER ® POLICY • ,1RO- • LOC PRODUCTS - COMP/OP AGG $ 1,000,000.00 $ AUTOMOBILE LIABILITY • ANY AUTO • ZIT O5 OWNED • AUTOS ® • HIRED AUTOS • A SEED 0 0 COMBINED USINGLE LIMITfEa $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROP Y DAMAGE $ $ ❑ UMBRELLA LIAB II OCCUR O EXCESS LIAB • CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ • DED • RETENTIONS $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A • WC STAT 1•S ❑ KH" EL EACH ACCIDENT $ EL DISEASE - EA EMPLOYEE $ If yyeess describe under DESCRIPTION OF OPERATIONS below EL. DISEASE - POLICY UMrr $ DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (Attach ACORD 101. Addldonai Remarks Schedule, If more space Is required) Plumbing Contractor: State Certified: License # CFC -049431 Dept. of Professional Regulation State of Florida CERTIFICATE HOLDER CANCELLATION Miami Shores Village Building Department 10050 NE 2nd Ave Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DES - • THE EXPIRATION DATE THEREO./ACCORDANCE WiTti THE PO i ©1988-2010 • • CO ORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AUTHORIZED REPRESENTATIVE Lucia Estrella ACORD 25 (2010/05) QF ICIES BE CANCELLED BEFORE BE DELIVERED IN Report Viewer 1009E Page 1 of 1 JEPP AIWATER CHIEF FIN/WC/AL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SER1RCES DMSION OF WORKERS COMPENSATION CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS COMPENSATION LAW* CONSTRUCTION INDUSTRY EXEMPTION TMs certifies that the Individual fisted below has elected 10 be exempt from Florida Workers' Compensation taw. EXPIRATION DATE: 711112017 EFFECTIVE DATE: 7112/2015 PERSON: ROJAS FEIN: 433073611 BUSINESS NAME AND ADDRESS: EDWARD ROJAS PLUMBING CORP 880 NE 111 ST BISCAYNE PARK FL 33181 SCOPES OF BUSINESS OR TRADE: PLUMBING NOG AND DRIVERS EDWARDO Putman to Cmpef MOA'�1m. F.R, tla[tral•OdF p oho Wets HteTolid1004liseil_ by Mao• eatiato WNodesYMeIYNttM �waal nowaleNMamm. ewondOrthi =t. PaywniteCNolp mosson exit, 4etetdoom19 asseiL=0811, IMOelam a me�inicerw r....e dsapKmOee 5 maasp4 CiarMrE m. a. 0FS-F2.0WG252 CERTIFICATE OF ELECTION TO 8E EXEMPT REUSED 0613 QUE5Ttons? 1850)/131509 file:///C:/Users/RUTHL/AppData/LocalfTemp/5PNQSA1C.htm 6/3o/2a15% EDWARD ROJAS PLUMBING CORP Date: 5/25/2016 State of: FL -o Q-. i? t4 County of: b,4 b Main Address: 880 NE 111TH ST BISCAYNE PARK Florida 33161° County: DADE Before me this day personalty appeared EIW4{LD P'97A-S who, herein duly sworn, deposes and says: ,w�rr �7 That he or she will be the only person working on the project at: 10 `V.6 _ qq ` sr. Sworn to ( or affirmed) and subscribed before me this '1' day of MAI 20410_, by Personally known OR Produced Identification Type of Identification Produced Miami Shores Village Building Department 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: caner State of Florida County of Miami -Dade The foregoing was acknowledge before me this 12- day of ' . , 20 t (p.. B � fi"t L 44,44* -` who is personally known to me or has produced LSO vt �VI.O ' L) as identification. Notary: SEAL: JOSE A. VEGA MY COMMISSION # G038362 dle EXPIRES; October 13, 2020 AC D CERTIFICATE OF LIABILITY INSURANCE DATE (MWDD(YYYY) _ 11/07/16 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 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: If the certificate holder is an ADDITIONAL INSURED, the policyges) must be endorsed. If SUBROGATION 1S 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 endorsemeM(s). PRODUCER ` Accurate 8300 West Fiagler Suite 114 Miami, FL 33144 Phone (305) 226-8727 INSURED Edward Rojas Plumbing Corp 880 NE 111 St [Biscayne Park, FL 33161 - COVERAGES Fax (305) 226-8767 CONTACT NAME: Lucia Estrella (No . Est): (305)226-8727 itMAi ORSS: luCiaestrella@DellsOulh.net INSURER(S) AFFORDING COVERAGE INSURER A : Arch Specialty Insurance Company FAX No}: (305)226-8767 NAIL N INSURER 8 : INSURER C INSURER D : INSURER E : J INSURER F : CERTIFICATE NUMBER: REVISION NUMBER: (—THIS . INDICATED. CERTIFICATE EXCLUSIONS I NR IS TO CERTIFY THAT THE POUCIES OF NOTWITHSTANDING ANY REQUIREMENT, MAY BE ISSUED OR MAY PERTAIN, AND CONDITIONS OF SUCH INSURANCE POLICIES. INS THE LISTED BELOW HAVE BEEN ISSUED TERM OR CONDITION OF ANY CONTRACT INSURANCE AFFORDED BY THE POLICIES Lff4ITS SHOWN MAY HAVE BEEN REDUCED POLICY NUMBER AGL0028426-01 TO THE OR DESCRIBED BY PAID POUCY EFF (M D/YYYY) 08/06/2016 INSURED NAMED OTHER DOCUMENT HEREIN CLAIMS. POLICY EXP (MNIDOIYYYY) 08/06/2017 ABOVE FOR THE POLICY WITH RESPECT TO IS SUBJECT TO ALL THE LIMITS EACH OCCURRENCE PERIOD WHICH THIS TERMS, $ 1,000,000.00 TYPE OF INSURANCE AIlli GENERAL LIABILITY cn COMMERCIAL GENERAL LIABILITY Y DAMAGE TO RENTED LPHEMISMEe occurred e1_- MED EXP (Arty one person) O 00,0 s 100OO.00 • ❑ CLAIMS -MADE J OCCUR —_-- s 5,000.00 PERSONAL 8 ADV INJURY $ 1,000,000.00 a GENERAL AGGREGATE $ 1,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: M POLICY • JECT ❑ LOC PRODUCTS - COMP/OP AGG $ 1,000,000.00 $ AUTOMOBILE ❑ ANY AUTO • p TpS D ❑ SCHEDULED UTOS 1::] HIRED AUTOS • AUTOS BINERe LIMIT SINGLE BODILY INJURY (Per person) i $ BODILY INJURY (Per acciden $ $ PROPERTY DAMAGE (Per aoddent) II • $ ❑ UMBRELLA LIAR • OCCUR • EXCESS UAB • CLAIMS -MADE 1 EACH OCCURRENCE $ AGGREGATE s • DED II RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I NER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMOER N 1A ❑ TORY MITS Am OTH EL EACH ACCIDENT $ EXCWDED? Mandatory NM I_�1 If -ym,. desaibe under DESCRIPTION OF OPERATIONS betow EL DISEASE - EA EMPLOYEE{ $ $ El. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Adddonal Remarks Schedule, If more space Is required) CSC049431 CANCELLATION City of Miami Shores Building Department 10050 NE 2nd Ave Miami Shores, FL 33168 1305-756-8972 ACORD 25 (2010105) QF SHOULD ANY OF THE ABOVE DESCRI THE EXPIRATION DATE THEREOF, ACCORDANCE WITH THE POLICY AUTHORIZED REPRESENTATIVE Lucia Estrella S BE CANCELLED BEFORE DELIVERED IN ®1988-2010 AC : ' o C a -7 `i : TION. All rights reserved. The ACORD name and logo are registered marks of ACORD RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD The PLUMBING CONTRACTOR Named below IS CERTIFIED Under the provisions ofha .r 489 FS. Expiration date: AUG 31, 2013 ROJAI; EDWARDO EDWARD ROJAB. PLU 380 NB 111Th ST,,,:,;:< BISCAYNE P':, -, ISSUED: 07/28/2016 DOM DISPLAY AS REQUIRED BY LAW Local Business Tax Receipt Miami—Dade County, State of Florida -THIS IS NOT A BILL - 00 NOT PAY 5175658 BUSINESS NAME/LOCATION EDWARD ROJAS PLUMBING CORP 880 NE 111 ST "*'" BISCAYNE PARK EL 33161 OWNER EDWARD ROJAS PLUMBING CORP Workers) 1 RECEIPT NO. RENEWAL 2371250 SEQ # L1607280001584 LatEXPIRES SEPTEMBER 30, 2017 Must be displayed at place of business Pursuant to County Code Chapter BA - Art. 8 & 10 BEC. TYPE OF BUSINESS 198 PLUMBING CONTRACTOR CF0049431 PAYMENT RECEIVED BY TAX COLLECTOR $45.00 07/31/2016 CREDITCARD-16-044804 This local Business Tex Receipt only confirms payment of the Local Business Tax. Th. Receipt is not a license, perm %ar a certification of the holder';ualeicatiois,to do business. Holder mast comply with ley goverumeetal or aoneoverernental regulatory laws sad requirements which apply to the business. The RECEIPT NO. above must be displayed on all commercial rehieles - Miemi-Dade Code Sec Ba -278. For more information. visit www.miaaddarlp.00vftaxcollectot Report Viewer Page I of I aaOg FINANCIAL OFFICEROF DEPARTMENT STATE FINANCIAL ERVICES DIVISION OF =RICERS' COMPENSATION CERTIRCATEOF ELECTION TOREUMW FROM FLORIDA aR KERie COMPENSATIONLAW" CONSTRUCTION INDUSTRY EXEMPTION Tlds metes But Um ixhitteal Ned betty Reselected TEt be exempt itbat Rarity Waiters' Coapatmarnt fax EFFECTIVE DATE: 7n2/201S =PIRA7I=N DAM 7/11/201/ PERSON: RO.MAS EMARRDO FEIN: 483OT3811 SLIMNESS MAISANO ADDRESS: EDWARD RO,IAS PLUMBING CORP MO NE 111 ST BISCAYNE PARK FL 33161 SCOPES OF SLIMNESS OR TRADE: DRIVERS NND OCA 1...:=1:821=11111.1" r..1�as .�.. R. aP114.913WC452CERTIFKMOF A1OREMOW Rt OM CUESIENSM 1t • . file:///0/Users/RUTHLIAppData/Localfremp/SPNQSAIC.htm 6/$ki/2O15%