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PL-18-1480Miami Shores Village 10050 N.E. 2nd Avenue N Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Permit ue Permit NO. PL-5-18-1480 Permit Type: Plumbing - Residential Work Classification: Addition/Alteration Permit Status: APPROVED 6/1/2018 Expiration: 11/28/2018 Parcel. Number Applicant 9290 N BAYSHORE Drive Miami Shores, FL 33138- 1132050270240 Block: Lot: RICKI LONDON Owner Information Address 9290 N BAYSHORE Drive MIAMI SHORES FL 33138-2949 9290 N BAYSHORE Drive MIAMI SHORES FL 33138-2949 Phone Cell Valuation: Total Sq Feet: $ 2,500.00 0 Type of Work: KITCHEN RENOVATION Type of Piping: Additional Info: Bond Return : Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Notary Fee Permit Fee Scanning Fee Technology Fee Total: Amount $1.80 $2.25 $2.00 $0.60 $5.00 $150.00 $3.00 $2.40 $167.05 Pay Date Pay Type Invoice # PL-5-18-67749 05/30/2018 Credit Card 06/01/2018 Credit Card Amt Paid Amt Due $ 50.00 $ 117.05 $ 117.05 $ 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 ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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 zonigg. Futhermore, I authorize the above -named contractor to do the work stated. June 01, 2018 Author! 9f Signature: Owner / Applicant / Contractor / Agent i Date BuildinO'Department Copy June 01, 2 8 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 Master Permit No. PERMIT APPLICATION Sub Permit No. BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION PLUMBING ❑ MECHANICAL ❑ PUBLIC WORKS ❑ CHANGE OF �CONTRACTOR ((�� JOB ADDRESS: Cl.Pg0 ) Sit, City: Miami Shores County: Miami Dade Folio/Parcel#: Is the Building Historically Designated: Yes Occupancy Type: RECEIVED MAY 3 0 20186A fek FBC 2011 RC.s - i I to ❑ EXTENSION El RENEWAL ❑ CANCELLATION ❑ SHOP DRAWINGS Load: Construction Type: OWNER: Name (Fee Simple Titleholder): c Zip: ")13 NO Flood Zone: BFE: FFE: Phone#:'��� Address: Q—J 1�-���/1�j� �� �✓ City: �J► k-tr-c_t State: I l Zip: U3 ' Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: ypLu n/r3/1K3C, NC Address: ��2o S' q.QS4 , Sod, 408 City: L`"? (62 rn 1 State: FL Qualifier Name: (-\ ((7l^rsp o3 & .2f/�j`� 2 2b 'h State Certification or Registration #: 'l 1 4 � Phone#(?OS)3¢S T36g Phone Zip: 3� I L{- 5 30 3(4543 �8 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: 00 0 Value of Work for this Permit: $ (500 ' Type of Work: ❑ Addition Er Alteration ❑ New Description of Work: Wt l.h.Q ffl f pAswBrhol Square/Linear Footage of Work: State: Zip: ❑ Repair/Replace ❑ Demolition Specify co/or-of'co/or'tHru tile: °'''''""Y't Submittal Fee $ a . :• . Permit Fee CCF $ I.80 Scanning Fee $ , _.4 ,. Radon Fee $,_: 2-`D'1�BPR $ 7 . C..S Technology Fee $ .4o2V Training/Education Fee $ b 0 Double Fee $ ek Structural Reviews $ (Revised02/24/2014) CO/CC $ Notary $` S Bond $. TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lenders Address =t. __ City ! ? _. .t State Zip r 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. E k "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. Signaturaktitt ' tbk-CkLb( OWNER or AGENT The foregoing instrument was acknowledged before me this N who iskn wn known me or who"has produced)l1s iden NOT Sign: Print: Seal: day of , 20 ig , by tion and who did take an oath. UBLIC: *****s******i * * APPROVED BY 0IV Notary Public State of Florida c: . Bindle AlvproZ 4" My QottrrniAsioi FF 158750 b, * ipilltr6p08108ldASSI********4**************** . #. .aA . ^,... p.....,` �(9 /U . Plans Examiner yt 1 Signature goNTRACTOR The foregoing instrument was acknowledged beforeme this Z 61 day of !Q , 20 1 ) , by A140s4, ��c�iad�� , who is personally known to me or who has produced?? 3ricxi 2ice,ve n . • as identification and who did take an oath. NOTARY PUBLIC: • Sign: Print: Seal: Structural Review ti Notary Public State of Florida `F Melba Casado I* 4siveGemelissioe #86466 * * Expires 12/18/2021 Zoning Clerk (Revised02/24/2014) 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. Signature: State of Florida County of Miami -Dade The foregoing was acknowledge before me this 3l3 1' day of �! I I , 20 I S. By P) % C 1'1; Le.42 Lo flak vl who is personally known to me or has produced Tri '.r iC^QMs-e Notary: SEAL: U-O as identification. YANADY PRIETO MY COMMISSION # FP 214031 EXPIRES: March 25, 2019 Bonded 1 hru Nolan/ Public Underwriters ALLTECH PLUMBING, INC. 2520 S.W. 22 St, Suite 2-408 Miami, FL33145 Phone: (305) 345-4368 Date: State ofciei County of /4m I DdO Before me this day personally appeared A' (014 0 l.,i f ,9n 7 R who, being duly sworn, deposes and says: That he or she will be the only person working on the project located at: el io !1J, &lo(io(Q errv-e f-P(Cem I Shore F(. 33 (38 Contractor signature Sworn to (or affirmed) and subscribed before me this 30 day of 20 ( by # 6-0 60 C I,' 0,1 Personally know ✓ Or produced identification Type of identification produced ,�" "' Notary Public State of Florida ."� Melba Casado M . Commission GG 138425 ' ► txpwes 12/18/2o21 Print; type -or -stamp Name of otary 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: 2/27/2017 PERSON: CIFUENTES FEIN: 205828405 BUSINESS NAME AND ADDRESS: ALLTECH PLUMBING, INC 2520 SW 22 ST, SUITE 2-408 MIAMI FL SCOPE OF BUSINESS OR TRADE: 33145 Licensed Plumbing Contractor Plumbing NOC and Drivers EXPIRATION DATE: 2/27/2019 ALFONSO 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 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 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 �CERTIFICATE OF LIABILITY INSURANCE `—�'' DATE(MM/DD/YYYY) 05/29/18 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 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 Eguino & Associates 7229 Coral WayE-MAILNnFxu Miami, FL 33155 Phone (305) 266-1700 Fax (305) 267-1197 CONTACT NAME: Maritza Inclan PHONE FAX (305) 266-1700- ta/c, No): ADDRESS: Minclan@eguino.com PRODUCER CUSTOMER ID #: INSURER(S) AFFORDING COVERAGE NAIC # INSURED Alitech Plumbing, Inc 2520 SW 22nd Street, Suite 2408 Miami, FL 33145- (305) 345-4368 INSURER A : RSUI Covington Insurance INSURER B : INSURER C : INSURER D : INSURER E INSURER F : 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. !NM; TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF jMM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A GENERAL LIABILITY V COMMERCIAL GENERAL LIABILITY N VBA575916-00 10/23/2017 10/23/2018 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 CLAIMS -MADE V OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000,000 V POLICY PRO- LOC JECT $ AUTOMOBILE LIABILITY ANY AUTO LJ ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS r u NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ $ L UMBRELLA UAB OCCUR EXCESS LIAB CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ �� ; I I! DEDUCTIBLE $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N N / A WCSTATU- ❑ RH- TORY LIMITS ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? r E.L. EACH ACCIDENT $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Plumbing Contractor nmrrrlrtn AT', 11A1 earn, ELLATION Miami Shores Villages Building Department 10050 NE 2nd Ave Miami Shores, FI 33138 ACORD 25 (2009/09) OF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Local Business Tax a'=:eceipt Miami —Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 5957544 BUSINESS NAME/LOCATION ALL TECH PLUMBING INC 2520 SW 22 ST 2-408 MIAMI FL 33145 OWNER ALL TECH PLUMBING INC Worker(s) 1 RECEIPT NO. EXPIRES RENEWAL SEPTEMBER 30, 2018 6214860 SEC. TYPE OF BUSINESS 196 PLUMBING CONTRACTOR CFC1427250 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 PAYMENT RECEIVED BY TAX COLLECTOR $45.00 07/25/2017 CREDITCARD-17-050274 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 holder's qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT NO. above must be displayed on all commercial vehicles - Miami -Dade Code Sec 8a-276. For more information, visit www.miamidade.gov/taxcollector STATE OF FLORIDA °� DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399-0783 CIFUENTES, ALFONSO ALLTECH PLUMBING INC 2520 SW 22 ST, SUITE2-408 MIAMI FL 33145 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 from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about 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, and congratulations on your new license! RICK SCOTT, GOVERNOR STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CFC1427250 ISSUED: 08/14/2016 (850) 487-1395 CERTIFIED PLUMBING CONTRACTOR CIFUENTES, ALFONSO ALLTECH PLUMBING INC IS CERTIFIED under the provisions of Ch.489 FS. Expiration date : AUG 31, 2018 L1608140003368 DETACH HERE KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD CFC1427250 The PLUMBING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2018 CIFUENTES, ALFONSO ALLTECH PLUMBING INC 2520 SW 22 ST, SUITE2-408 MIAMI FL 33145 ISSUED: 08/14/2016 DISPLAY AS REQUIRED BY LAW SEQ # L1608140003368