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MC-18-2018Miami Shores Village 10050 N.E. 2nd Avenue N Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Permit Permit NO. MC-7-18-2018 Permit Type: Mechanical - Residential Work Classification: Addition/Alteration Permit Status: APPROVED e Date: 8/2t2018 Expiration: 01/29/2019 Parcel Number Applicant 9290 N BAYSHORE Drive Miami Shores, FL 33138- 1132050270240 Block: Lot: RICKI LONDON Owner Information Address Phone Cell RICKI LONDON 9290 N BAYSHORE Drive MIAMI SHORES FL 33138-2949 9290 N BAYSHORE Drive MIAMI SHORES FL 33138-2949 Contractor(s) AAA MECHANICAL INC Phone Cell Phone (786)226-7577 Valuation: Total Sq Feet: $ 1,000.00 0 Tons: Additional Info: KITCHEN RENOVATION MECHANICAL Classification: Residential Approved: In Review Comments: Date Denied: Scanning: 1 Date Approved: : In Review Type of Work: KITCHEN RENOVATION MECHANIC Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $0.60 $2.25 $2.00 $0.20 $150.00 $3.00 $0.80 $158.85 Pay Date Pay Type Invoice # MC-7-18-68365 07/27/2018 Cash 08/02/2018 Credit Card Amt Paid Amt Due $ 50.00 $ 108.85 $ 108.85 $ 0.00 Available Inspections: Inspection Type: Final Rough Duct Review Mechanical 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 ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT. construction and zo ify t at all the foregoing information is acute an utherr re, (,authorize thr above-na ed co tradtor to /7/ k that all work will be done in compliance with all applicable laws regulating the work stated. Authorizyf'atute:Owher / Applicant / Contractor / Agent August 02, 2018 Date Building ' epartment Copy August 02, 2018 1 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 BUILDING PERMIT APPLICATION ❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION Master Permit No. Sub Permit No. ❑ PLUMBING ❑ MECHANICAL ❑ PUBLIC WORKS ❑ CHANGE OF CONTRACTOR JOB ADDRESS: O 14. 664 4JSYt OY U'1L City: Miami Shores County: Miami Dade - ~-171 N. ED 7 2018 FBC 2017 P C 16- 112o MCIs—ac ❑ EXTENSION El RENEWAL ❑ CANCELLATION Zip: ❑ SHOP DRAWINGS Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Tit eholder): g.c.k..4 Lva.0 ' Phone#: Address: 61gi3 N rca611414M, 0/ t City: 1.4 6 Allit <.3h54 it State: el Zip: i �� Tenant/Lessee Name: Phone#: lJ �as 3'141:f Email: CONTRACTOR: Company Name:. A A Lc Phone#: Address:) 3 72. /Ury /'76 ‘llr City: n _ Qualifier Name: L.V i/S �—(� (o & t (_ _ - (ro . . Phone#: r!0 226 7 .i 2 7 lac ' w State: 4& L Zip: 33 J 5'5 74-6 226 2577 State Certification or Registration #: C µe ' L q 3 3 G 3 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: pp -- City: State: Zip: Value of Work for this Permit: $`A.3511 1‘..5\3 • Square/Linear Footage of Work: Type of Work: ❑ Addition Fr Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: je,Asovorhin Specify color of color thru tile: � /� Submittal Fee $ - � � � Permit Fee $ � © l �� CCF $ V � . • 6,0, Scanning Fee $ 3 Technology Fee $ 2513 Structural Reviews $ (Revised02/24/2014) Radon Fee $ 2 DBPR $ 2- • 2 S' Training/Education Fee $ 0 . ZO Notary $ S Double Fee $ Bond $ TOTAL FEE NOW DUE $ 06 • sS i ), c, Bonding Company s Name (if applicable) _ Bonding Company's Address City _ State Zip Mortgage. Lender's Name (if applicable)• Mortgage Lender's Address City +,w. a > 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 RECORDA 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 Galue'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. tt Signature ` �i1.4 ��� Signature L27� r OWNER or AGENT e The foregoing instrument was acknowledged before me this 6111 day of '' ``Mpr� , 20 (9 , by IA N, who is personally known to me or who has produced.- .(U2(L (JttEf `�s identification and who did take an oath. NOTARYPUBLIC: Sign: Print: Seal: rib (o 4^,L JA ► ;°or °o Notary Public State of Florida ********* >_1. y CONTRACTOR t �hh -ti The foregoing instrum �.dayof acknowledged before me this' , 20 /J ', by Who �is,,peerso�j Ily known to me or who has produced�'�1 oeer as identification and who did take an oath. NOTARY PUBLIC: Sign: _,} Print: li ii: Seal: ?'/, SlndlaAlvare2-z- ' ' -- Magda Navarro • .? ,o; My Commission FF 15e750 = a: ' E COMMISSION #0G021113 of a Expires 09/03/2018 t{ — ti> ; EXPIRES: September 6, 2020 ****************************i4**g29481;li hnY :0t(ifleNdl8fyk************* i i, . APPROVED BY vp' 5/5't/iZ s Examiner : 6' , Structural Review Zoning s) / Clerk,. A '(Revised02/24/2014) 1, Local Business Tax Receipt Miami -Dade County, State of Florida -THIS IS NOT A BILL DO NOT PAY 7135015 BUSINESS NAME/LOCATION MA MECHANICAL INC 7478 W 29 LANE HIALEAH FL 33018 OWNER AAA MECHANICAL INC Worker(s) i macaws. ma. RENEWAL 7412026 EXPIRES SEPTEMBER 30, 2018 must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 SEC. TYPE•OP BUSINESS 196 GENERAL MECHANICAL CONTRACTOCAvmENT RECEIVED CMC1249563 V' TAX COLLECTOR $45AN1 07/24/2017_ FPPU02-17-019105 This Local Blaine** Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit, oa certification of the heldgf sqWifications. to de bus/new-Holder must comply with any governmental er nengoverpmentid teptiatery lam anerequireaauts tab" *ply to the business. The RECEIPT NOabove must be displayed on all commercial vehicles - Miami -Dade Code Sec 8a-278. ? For Mani information, visit vormmiamidadayeattaxcollector 4. J V L. t• UR KEN LAWSO STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL. REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD 1E14041111ER7 The MECHANICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2018 CABALLERO, LUIS A AAA MECHANICAL, INCA, 7478 WEST 29TH LANE -nst HIALEAH FL,33018 1.'",t;jph. `"`",,,„ k•$. A ISSUED: 07/04/2016 DISPLAY AS REQUIRED BY LAW SEQ # L160704 JIMMY PATRONtS 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: 12126/2017 EXPIRATION DATE: 12/26/2019 PERSON: CABALLERO FEIN: 272854317 BUSINESS NAME AND ADDRESS: AAA MECHANICAL. INC 3972 NW 176 TERR OPA LOCKA FL SCOPE OF BUSINESS OR TRADE: Haatinc. `Jenti?atior. Air- Ccndi; onErig 3rid Refnioeretion Sv ,ns installation. Service a^d Re;; -air. Shoop. Ya'C 8 Drve=s 33055 LUIS IMPORTANT: 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 oil 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 shalt 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 Notice to Owner — Workers' Com p Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 ensation 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. Signatur State of Florida County of Miami -Dade The foregoing was acknowledge before me this LD57-1-50-- - h 13' eg day of ,20 . By who is personally known to me or has produced 100 'as identification. SEAL: qa IrI/.r= , Magda Navarro 2' 'a COMMISSION #6G021113- =4. _ EXPIRES: September 8, 2020 ,� Bonded Thru Aaron Notary AAA MECHANICAL 3972 NW 176 TERRACE MIAMI GARDENS, FL, 33055 Date: August 01, 2018 State of Florida County of : Miami -Dade Before me this day personally appeared Luis Caballero who, being duly sworn, deposed and says: That he or she will be the only person working on the project located at: 9290 North Bay Shore Drive, Miami Shore, FL, 33138. Contractor Signature Sworn to (or affirmed) and subscribed before me this 1 day of August, 2018. Personally know OR Produced Identification Type of Identification Produced Print, or Stamp -game or Notary - + 4'Po ' .<v, Magda Navarro '+ciiel • _ COMMISSION #GG021113 : •��'L,,teiEXPIRES: September 6, 2020 % o��Fts •� Bonded Thru Aaron Notary Aa4