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RC-17-466 Y f Inspection Worksheet Miami Snores Village 10050 N.E.2nd Avenue Miami Shores,FL F Phlone:,(305)795-2204 Fax:(305)758-9972. Enspection Number: I tSP-.299642Permit Number: RC-2-'17-466 E Inspection Date:Marchi 19;2018 Permit Type: Residential Construction Inspector-Naranjo,Ismael Inspection Type: Fina[ Owner: P Work Classification: Alteration 'Job Address:265 NE 92 Street Miami Shores,FL Phone Number Parcel Number 1132060133561 Project: <NONE> i Contractor: ALZATE CONSTRUCTION,INC Phone:(954699-6434 I Building Department Comments REMOVE SOME"PARTI"T"ION WALLS, REPLACE € In Patsod Comments KITCHEN CABINETS, REPLACE BATHROOM FTXTURES INSPECTOR COMMENTS False INSTALL NEW LIGHT (AT LIVING AREA)REPLACE Ed ELECTRICAL PANEL 08128/2017 NEED MC PLANS FO IKITCHEN HOOD AND AC DUCT Inspector Comments Passed Failed" Correction i Needed Re-inspection Fee No Additional Inspat6ons can be scheduled until re-inspec on fee is paki i March 16,2018 For Inspections please call (305)762.4949 Page 1 of ., Miami Shores Village _ TVED BuildingDepartment FEB. . 02017 C � 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 ''�'_ Tel:(305)79S-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 6-�--1. ✓� /� FBC 20 4 rt BUILDING Master Permit No. rl c r7 ^l�G PERMIT APPLICATION Sub Permit No. Q'BUILDING E31ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING n MECHANICAL PUBLIC WORKS F] CHANGE OF n CANCELLATION n SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 2 (:>5 g•r q2. S� City: Miami Shores County: Miami Dade zip: 33%36 Folio/Parcel#: 11 -321D6-0%'3-35W Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): zb S #ev C. -1 2 g� Go Q Phone#: Address: SQ OG Cnttn g 6t^ ,/ � %AMI City: �'�l A't-kt bcA c'1 State: Zip: 33) Tenant/Lessee Name: ' Phone#: Email: CONTRACTOR:Company Name: k1w�e OjciiSiwc1 nw Phone#: R54 •Sga•9434 Address: ghCJ "2_110M U) , Ail N ��O Fu City: A Wi State: 7F( zip: 331754 Qualifier Name: A W Q A\M�e_ Phone#: q 8Q 84254, State Certification or Registration#: CGC (S 11-421 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$�S Q U CJ 2:- Square/Linear Footage of Work:x 600 S.1! Type of Work: ❑ Addition F1 Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: RetYbu2 S��MP ��1 T tGn t.KA1151 Azept a l�_e kl:�\V671em sc�b,�-�S�, SZen\ace ncr�-1nrc��r(� �- i X�-vceS� i ►.�s�-al\ uvw LAG G hers 0-� Qjea) T2P ol Q OP P \4PC: 1,t cin j p 1'e-,-- Specify color of color thru tile: Submittal Fee$ Z.M Permit Fee$L _— CCF$ CO/CC$ Scanning Fee$ 2 Radon Fee$��• DBPR$ 7�S Notary$ 5 Technology Fee$ ` Z Training/Education Fee$ Double Fee$ Structural Reviews$ � Bond$ TOTAL FEE NOW DUE$ (JLu � � (6vised02/24/2014) I 1. r `l 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." k 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 a roved and a reinspection fee will be charged. Signature Signature RAIL OWNER or AGENT CONTRACTOR The of�egoing instruF5b�who was acknowledged before me this The foregoing instrument was acknowledged before me this lJ dayo J�� 20 / : ,by �d day of T�e1��UAr� 20 7 by �� SI is personally known to AM ISAVA( MZa:-e ,who is Personally known to me or who has produced �� !� f�P� L4 c�I1� me or who has produced Driw l t C'ch-AY as 1 identification and who did take an oath. identification and who did t e an oath. NOTARY PUBLIC: NOTARY P LIC: Sign: Sign: Print: ! Print: 1 Seal: g�;:`yP;;eir NANCYGOLORING Seal: MY COMMISSION#GG 059089 6' YANnJA Ly�N�'% MY COMM031EXPIRES:February 15,2021 a i=_EUf ft� Bond B t a= EXPIRE19P Bonded Thru wr to s#' isssssssss*ss* APPROVED BY Plans Examiner Zoning fi Structural Review Clerk (Revised02/24/2014) � , by: CFN:20170055649 BOOK 30402 PAGE 3998 8801 fliaayrA SM.9oite la DEED D/3012/98 04:43:48 PM 1 �� DEED DOC 3,198.00 HARVEY RUVIN,CLERK OF COURT,MIA-DADE CTY I I t Folio No.11-37A640%V%1 I SP Aa_0ftT aaLD aKM rROC1115MG DATA MACNAWVXTMLDWWCRRMDDRM4DATA PERSONAL REPRESENTATIVE'S DEED THIS INDENTURE,made this_day oflanwvy,2017 between LAURA DAIGLE,as Pciisonal Reprmatadt e of the Estate of Gloria F.Destefeno,Deceased,fli st pnuty,and MIAMI SHORES 265 NE 92 ST CORP.,a Florida corporation, whose post office address Is:5900 Collirrt Ave.,#907,Miami Beach.FL 33140,second party. WITNESSETH,that the said first parry,acting m pursuance ad by virtue of the powers vested in me under appolaftnent of the Circuit Jtdge of the Circuit Count,m and for Martin County,Stoart,Florida.Probate Division,File No.16- 000504 CP AXNIX,and for and in consideration of the sum of Ten and 00/100 Donna(510.001 to him In hand paid by the seaoad party,the raaipt whereof is hereby ac nowledV4 has granted,bargained,and sold to the sound party,the following described land,situate and being In Miami-Dade County,State of Florida,to wit: The East 30 fent of Lot 12,all of Lot 13,in Block 26,an Amended Plat of Miami Shores Section No 1,according to the nap or plat tbereof,as recorded is Plat Book 10,Par T% of the Public Records of Mismi•Dade County,Florida SUBJECT TO: -Taxes for the current and all subsequent years. a -Reasons,reservations,casements,and limitations of record wtdxM hereby n+ehruposimg same. •Applicable writing regulations and ordinances. + GRANTOR COVENANTS with Grantee dart Grantor has good right and lawful authority to sell and convoy the property and wanwft the title to the property for any acts of Grantor and will datiod the title against the lawful claim of all parsons claiming by,throug%or under Orator. And the party of the First part does covenant to and with the Party of the ; Second Part,his heirs and assigns,that In all things Pm4imiaary to and about the safe and this conveyance the orders of the above-named Court and laws of Florida have bow followed and complied with in all mspeats. a Wherever used herein the terms"first party'and"second patty"shad include siWbr and plural,beim,legal representatives,and assigns of individual,and the sucoossors and assigns of ewl)WAdons,and in the usage of personal pronatus,the masculine shall include the femurime and the neuter,wberever the context so admits or requires. IN WITNESS WHEREOF,the said party of the fust pert has hereunto set his hand and sad the day and year first above written. 1 Signed,sealed,and delivered M the resemce of. i Vwk Estate of Gloria F.Deuvfano,Deceased 1404 N.W.Spruce Ridge Dr,Stuart,FL 34994 mel ✓!.✓a�i✓'r �2��v STATE OF FLORIDA ) COUNTY OF MARTIN ) I HEREBY CERTIFY that our this drj betnte me,an ofilcm duly authorized to administer oaths and tetra admowle , Personally LAURA DAIGLB,as Peraanal Representative ofthe Fsaee of Gloria F Deatefaao,Decemed,tiD ruin well Imown to be the person desetibed h and who execrated the ibregft int , -annd aelraowledged beim itac that sue exaeuted the surae Bso)y and volataily for the purposes draeh a --,I A i WITNESS my hard and olRdal seal at flee State and County last afbeaetd our this�day o=,2017. NOT ;0191MR •STATE RIDA a v " JOANNE RAllING ° Notary Public-Stare of humma ' My Comm.Exores May e.2019 COMMISS1018FF099771 Page 1 of 1 T r Detail by Officer/Registered Agent Name Florida Profit Corporation MIAMI SHORES 265 NE 92ND ST CORP Filing information Document Number P17000002798 FEI/EIN Number NONE Date Filed 01/09/2017 State FL Status ACTIVE , Principal Address 5900 COLLINS AVE 807 MIAMI BEACH, FL 33140 Mailing Address t 5900 COLLINS AVE 807 MIAMI BEACH,'FL 33140 Registered Agent Name&Address SILBERSTEIN, JORGE, MR 5900 COLLINS AVE 807 MIAMI BEACH, FL 33140 Officer/Director Detail Name&Address Title P SILBERSTEIN,JORGE, MR 5900 COLLINS AVE MIAMI BEACH, FL 33140 Title VP AGOPIAN,ALEXIS, MR 5900 COLLINS AVE MIAMI BEACH, FL 33140 Annual Reports No Annual Reports Filed Document images 01/09/2017—Domestic Profit View image in PDF format 1 Florida Department of State,Division of Corporations , Permit NO. RC-2-17-466 OR Miami Miami Shores Village Permit Type:Residential Construction 10050 N.E.2nd ANE venue �� Work Classification:Alte rzttiotf Miami Shores,FL 33138-0000 Permit Status:APPROVED fu A Phone: (305)795-2204 <o Issue Date:3/21/2017 Expiration: 09/17/2017 Project Address Parcel Number Applicant 265 NE 92 Street 1132060133561 Miami Shores, FL Block: Lot: MIAMI SHORES 265 NE 92 ST CC Owner Information Address Phone Cell MIAMI SHORES 265 NE 92 ST CORP 265 NE 92 Street MIAMI SHORES FL 33138- 265 NE 92 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 15,000.00 ALZATE CONSTRUCTION INC (954)599-8434 (305)949-4526 Total Sq Feet: 600 4 Approved:In Review Available Inspections: Comments: Inspection Type: Date Approved: :In Review Final PE Certification Date Denied: Window Door Attachment Type of Construction:REMOVE SOME PARTITION WALL Occupancy:Single Family Framing Stories: Exterior: Insulation Front Setback: Rear Setback: Drywall Screw Left Setback: Right Setback: Window and Door Buck Bedrooms: Bathrooms: Fill Cells Columns Plans Submitted:Yes Certificate Status: Review Building Certificate Date: Additional Info:REMOVE SOME PARTITION WALLS Review Structural Review Planning Bond'Return: Classification:Residential Review Electrical Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Review ElectricalReview Plumbing CCF $9.00 DBPR Fee Invoice# RC-2-17-63041 Review Mechanical $6.75 03/21/2017 Check#: 1383 $424.50 $200.00 DCA Fee $6.75 Education Surcharge $3.00 02/22/2017 Check#: 1370 $200.00 $0.00 Notary Fee $5.00 Permit Fee $450.00 Plan Review Fee(Engineer) $120.00 Scanning Fee $12.00 Technology Fee $12.00 Total: $624.50 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 LECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS FIDAVIT: I certi that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction nd zoning Futh re,I authorize the above-named contractor to do the work stated. 2 G, March 21, 2017 Aulhorized Sig atur :Owner / Applicant / Contractor / Agent Date Building Department Copy March 21,2017 1 A��® DATE(MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 3/17/2017 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 policy(ies)must have ADDITIONAL INSURED provisions or 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). ACT PRODUCER SUNZ Insurance Solutions, LLC. ID: (TLR) NAAME: Workers'Comp Department c/o TLR of Bonita, Inc PHONE 727-520-7676 x 3 aC No: 727-525-3862 700 Central Ave, Suite 500 E-IAAIL St. Petersburg, FL 33701 ADDRESS: Certs encorehr.com INSURERS AFFORDING COVERAGE NAIL# INSURERA: SUNZ Insurance Company 34762 INSURED INSURER B: TLR of Bonita, Inc EnterpriseHR INSURER C: 700 Central Avenue Suite 500 INSURER D: St. Petersburg FL 33701 INSURER E: INSURER F: { COVERAGES CERTIFICATE NUMBER: 34690025 REVISION NUMBER:, THIS IS TO CERTIFY 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. INSR ADDLSTYPE OF INSURANCE WVDUB POLICY NUMBER MMMIUDDI EFF POLICY UMC EXP LTR COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS MADE OCCUR PREMISES Ea occurrence $ DAMAGE TO RENT MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'.AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ JECT POLICY PRO ❑LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANYAUTO BODILY INJURY(Per person); $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-0WNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per acddent $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LUU3 CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ A WORKERS COMPENSATION WCPE0000000112 6/1/2016 6/1/2017 ,/ PTA TE ER AND EMPLOYERS'LIABILITY Y I N ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000.00 OFFICER/MEMBEREXCLUDED? NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000.00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000.00 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached H more space Is required) Coverage Provided for all leased employees but not subcontractors of:Ana I.Alzate Studio,Inc.DBA-Alzate Construction Client Effective:3/15/2017 CERTIFICATE HOLDER CANCELLATION } 2124 Miami Shores Village Building Department SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 9 9 P THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 NE 2nd Ave. ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores FL 33138 AUTHORIZED REPRESENTATIVE / Glen J Distefano ) ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 1 ' 34690025 1 Master.Certificate I Aimee Gray 1 3/17/2017 7:09:06 AM (CDT) I Page 1 of 1 i !' 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: 1/4/2017 EXPIRATION DATE: 1/4/2019 PERSON: ALZATE ANA I FEIN: 650961991 BUSINESS NAME AND ADDRESS: ANA I.ALZATE STUDIO INC. ALZATE CONSTRUCTION 915 N.W. 1 AVE.APT H2110 , MIAMI FL 33136 SCOPES OF BUSINESS OR TRADE: LICENSED GENERAL CONTRACTOR 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 f<,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 I DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS?(850)413-1609 I f 1 .4 oo� 02/17 CERTIFICATE OF LIABILITY INSURANCE DATE D/YYYM7 � o2/nn7 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: H the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed. N SUBROGATION IS WANED,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 CONTACT AN Insurance Services PHONNo,Exti:E (305)822-4472 FAX No): (305)5564354 18 W.37 St. 'MNL 54jfemandez@aisrv.com Hialeah,FL 33012 INSURERS AFFORDING COVERAGE MAIC e Phone (305)822-4472 Fax (305)556.4354 INSURER A: UNITED SPECIALTY INSURANCE COMPANY 12537 INSURED INSURER B: .I ANA LALZATE STUDIO,INC/DBA ALZATE CONSTRUCTION INSURER C: 915 NW 1 AVE H2110 INSURER D: MIAMI,FL 33136 (954)599$434 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY 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, 1 EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ADDLILTR TYPE OF INSURANCE UBR POSY NUMBER MPMOLICDY EFF J.-I'M P-YY EXP LIMITS GENERAL LIABLLRY EACH OCCURRENCE S 1.000,000.00 © COMMERCIAL GENERAL LIABILITY REAGE TO RENTED M SES(Ea occurrence) $ 50,000.00 ❑ ❑ CLAIMS-MADE R] OCCUR CGD00004836-01 MED EXP(Any one Person $ 5,000.00 A F] 06/27/2016 06/27/2077 PERSONAL a ADV INJURY E 1,000,000.00 ❑ GENERAL AGGREGATE s 2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s 2.000.000.00 ❑POLICY ❑ PRO- ❑ LOC $ AUTOMOBILE LIABILJTY COMBINED SINGLE LIMIT Me accident ❑ ANY AUTO BODILY INJURY(Per person) $ ALL❑ AUTS OWNED ❑ AUTOS ULED BODILY INJURY(Per accident S ❑ HIRED AUTOS ❑ AUTOS ED P�dent) $ ❑ ❑ $ ❑ UMBRELLA LIAR ❑OCCUR EACH OCCURRENCE E J ❑ EXCESS LIAB ❑CLAIMS-MADE AGGREGATE $ El DED El RETENTION s S WORKERS COMPENSATIONWC STATL- OTH- AND EMPLOYERS'LIABILITY Y I N El ANY PROPRIETORIPARTNERIEXECUTNE E.L EACH ACCIDENT $ B OFFICERIMEMBFR EXCLUDED? N I A (eandsk"M NH) - E.L.DISEASE-EA EMPLOYE $ K describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,K mon space Is required) Description of operations:General contracting services. { CERTIFICATE HOLDER CANCELLATION + SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE MIAMI SHORES VILLAGE BLDG DEPT THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 10050 NE 2nd AVE ACCORDANCE WITH THE POLICY PROVISIONS. MIAMI SHORES,FL 33138 AUTHORIZED REPRESENTATIVE ®1988-2010 ACORD CORPORATION. All Tights reserved. ACORD 25(2010105)QF The ACORD name and logo are registered marks of ACORD � E d 003801 Local Business Tax Receipt Miami—Dade County,State-of Florida THISIS NOTA BILL—DO NOTPAY 5876389 BT _ BUSHO sHANWRI.oe naw rNo. EXPIRES WATE C0 0"� n�LEWAL SEPTEMBER 30, 2017 915 NW I AVE 2110 6129217 Must be displayed at place of business MM R 33136 Pursuant to county code Chapter SA—Art S&t0 OWNER sec.me CW a ALZOVE ANA SMWO INC 186 GENERAL BUILDING CONTRACTOR BY TAX COLLECTOR CGC1611721 Wbrker(s) 1 $45.00 08/0Zt2016 CREWCARD-16-045338 ItdsLwlsedaeesTior�aeoil tddiet alOw"wTiL Raftedpisode Neem,, /aaitarrcatl�iardM s biabwisses awift"Manypsaessp_ rrold r ap*%*AbMbess. TleB�Pl'N0.abewo�st<,siigirpd trap aesiaeW —16si-Brie Osie See>I�i. . � fwwrs Irhnrntler,�& . i r STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 a � 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399-0783 ALZATE,ANA ISABEL ALZATE CONSTRUCTION 915 NW 1 AVE APT H2110 MIAMI FL 33136 Congratulations! With this license you become one of the nearly - y one million Floridians licensed by the Department of Business and r _- ". Professional Regulation. Our professionals and businesses range �� !STATE:OF from architects to yacht brokers,from boxers to barbeque DEPARTMENT OF=BUSINESS AND-- restaurants,and they keep Florida's economy strong. ) PROFESSIONAL'REGUL'ATION ---- Every day we work to improve the way we do business in order CGC1511721 4j pISSUED-,'F'08/16/2016" to serve you better. For information about our services, please ,,,-�' tog onto www.myfloridalicense.com. There you can find more CERTIFIED GENERAL CONTRACTOR information about our divisions and the regulations that impact ALZATE,ANXISABEL.,, „ "'+4 ----�` you,subscribe to department newsletters and learn more about ALZATE"CONSTRUCTION r 4� 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 ..-- serve your customers. Thank you for doing business in Florida, Is CERTIFIED•under•4he:provisions 6f,"Ch.489.FS:�•-.-•�,� and congratulations on your new license! Eua,aye. AUG 31;2018..- ""—'"�' L1608160002364 DETACH HERE RICK SCOTT,GOVERNOR KEN LAWSON, SECRETARY . TE OF FLDA 4TA-� •' DEPARTMENT OF'BUSINESS:AND PROFESSIONAL,REGUTION l,CONSTRUCTION INDUSTRY-L'ICENSING,BOARD� The"GENERAL--CONTRACTORS- - Named:below IS`CERTIFIED_ ,� !Jndefrthe rovisions�of.'Cha ter,489•FS. 1 Exp ation,date-AUG'31'201'8 AL"ZATE;ANAI EL- AL-ZATE;CONSTRUCTION 1 AVE APT H211.Q •� . -._ t„ _ .' 915'NW. �+ MIAMIV,%I ISISSUED: 01/16/2016 DISPLAY AS REQUIRED BY LAW SEQ# L1608160002364 �jJ