PL-18-958Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
ermit
Parcel Number
Permit NO. PL-4-18-958
Permit Type: Plumbing - Residential
Wok: Classification: AdditionlAlteration
Permit Status: APPROVED
issue Date. 4/3012018
Expiration: 10/27/2018
Applicant
1104 NE 98 Street
Miami Shores, FL 33138-
1132050180360
Block: Lot:
DADA FAMILY LLC
Owner Information
Address
Phone
Cell
DANIEL NAVA FELIPE
1104 NE 98 Spur
MIAMI SHORES FL 33138-
(786)707-9445
1104 NE 98 Spur
MIAMI SHORES FL 33138-
Contractor(s) Phone CeII Phone
SYSTEMATICS PLUMBING & DESIGN (786)326-7354
Valuation:
Total Sq Feet:
$ 2,200.00
0
Type of Work: REMODELING KITCHEN AND BATHROOM CH
Type of Piping:
Additional Info: REMODELING KITCHEN AND BATHROOM CH
Bond Return :
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$1.80
$2.25
$2.00
$0.60
$150.00
$3.00
$2.40
$162.05
Pay Date Pay Type
Invoice # PL-4-18-67129
04/11/2018 Credit Card
04/30/2018 Check #: 3720
Amt Paid Amt Due
$ 50.00 $ 112.05
$ 112.05 $ 0.00
Available Inspections:
Inspection Type:
Top Out
Final
Review Plumbing
Underground
J
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 g. Futhermore, I_aCuthorize the _above -named contractor to do the work stated.
t -1ki ti''ot G-CI(br- ,t e
Auth. = :`: nature: Owner / Applicant / Contractor / Agent
April 30, 2018
Date
Building Department Copy
April 30, 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
FBC 20
Master Permit No. RC IS S 6
Sub Permit No. p `_1 P— 9 S p
❑ REVISION ❑ EXTENSION ❑ RENEWAL
rB4UMBING MECHANICAL EPUBLIC WORKS ❑ CHANGE OF
CONTRACTOR
JOB ADDRESS: ,�.,,
City: Mianli Shores County: i (lle 3 ` Miami Dade Zip: 1 c3(
Folio/Parcel#: ` 3 ZOO Ow GO Is the Building Historically Designated: Yes NO
CANCELLATION ❑ SHOP
DRAWINGS
Occupancy Type:
1 log{ ►- °$ Sr
Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): bAtot,►.ti�
Address: ,\GOO', -
City: 13()I. { tl"i. State: '{"L. Zip: 7 3 1. 1
Tenant/Lessee Name:
Email:
Olk
Phone#: th-(
Phone#:
CONTRACTOR: Compa iy Name: .Sc.�1e f.046jj0. be1 snL Phone#:
Address: at9.1k`,ll.) J . skt et 2 2 ca2c fv
_' p
City: O -QI & State: - Zip: 1'&31,b
Qualifier Name: f e_k \J W\t S
Phone#: 75E6 -r 3 Z 7 8.
State Certification or Registration #: Ct tkZq,C°'Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $
27 Zdd,
Square/linear Footage of Work:
Type of Work: n Addition El Alteration -1 New ❑ Repairr/Replace ❑ Demolition
Description o Work: VOCD0 Cc 0 4c6.01 1-rvL,Io ,tc> pL
e/AoAvv-iva pi,-6-e -
Specify color of color thru
Submittal Fee $
Scanning Fee $
Technology Fee $
Structural Reviews $
tile:
Permit Fee $ ( 7f''�,,1l� CCF $ CO/CC $
Radon Fee $ 2 - W DBPR $ 2 . p9-5 Notary $
Training/Education Fee $ Double Fee $
Bond $
TOTAL FEE NOW DUE $ t ( 2 G
(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 sub'ect 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.
Signature ('
OWNER or AGEN
The foregoing instrument /was acknowledged before me this
2A ' day of /'lS-t,un , 20 4a , by
b(�illAi .e,A1*04 ✓' , who'is personally known to
PA 6, /64; t
,O SE riAN MODERNELL NEVAREZ
on, i ssion # GG 34000
mission Expires
27, 2020
me or who has produced
identifical
NOTARY
Sign:
Print:
Seal:
APPROVED BY
Signature
NTRACTOR
The foregoing instrument was acknowledged before me this
, 20 f' .. by
c?`3 day of
as me or w
identifi
NOTA
Sign:
PIO Pee-kg/Print:
Seal:
IZ /g Plans Examiner
Structural Review
l
VA/4et,
, who is personally known to
produced /4e ts,/`ii "'teas
"4,,MARCELO SESASTIAN MODERNELL NEVAREZ
Commission M GG 34000
My Commission Expires
September 27, 2020
Zoning
Clerk
(Revised02/24/2014)
DATE(MM/DomYY)
ARO CERTIFICATE OF LIABILITY INSURANCE 9/28/2017
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 be endorsed. N 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).
-.....,.""'1
PRODUCER
ADVANTAGE INSURANCE OF AMERICA
4520 NW 7th St
Miami, FL 33126
CONTAC r
NAME.
PHONE (E
Ext)(305) 649-5566 NG. .
ADDRESS• jackiebatista`749@h0tmail . com.
INSURERISI AFFORDING COVERAGE
Fri I Not:(305) 649-5559
AMC"
INSURER A WESTERN WORLD INS CO
INSURED SYSTEMATICS PLUMBING AND DESIGN INC
2211 W 52ND ST APTO 202
MIAMI, FL 33016
INSURER 8
INSURER C
INSURER D •
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,
ND TIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
EXCLUSIONS AND CO 1
INSR (
( TYPE OF INSURANCE
AODL (SUER ' 1`�bCICY-E
wan ,EDE POLICY NUMBER MM/DD/YYYY)
OLICY EXP
(MMDD1YYYY)
LIMITS
LTR
q
GENERAL
I—,
LIABILITY
( COMMERCIAL GENERAL
t CLAIMS-MAOE
LIABILITY
1 '� I OCCUR
i f
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I
NPP8319298 09/12/17
' i
09/12/18
EACH OCCURRENCE s 1,000,000
UAMAUL TO RENIEU $ 100, 000
PREMISES (Es occurrence)
I $
�
MED EXP (Arty one person)
s 5,000
PERSONAL&ADVINJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,0001000
PRODUCTS - COMP/OP AGG
$ 1,000,000
1 GENT AGGREGATE LIMIT
APPLIES PER
LOC
I I POLICY 7JECT
.
,
AUTOMOBILE
LIABILITY
NY
ALL WO
AUTOS OWNED
HIRED AUTOS
,
_
-OWNED
i
i } i
j
j i
COMBINED SIN(,Lb Lt I
(Ee accident)
$
BODILY INJURY (Per Person)
$
i
j
BODILY INJURY (Per aaldeni)
$
,
_
AUTOS SCHEDULED
PROPERTY DAMAGE
(Per accident)
$
•---III NON
( AUTOS
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UMBRELLA LAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
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EACH OCCURRENCE
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WORKERS,
AND
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(Mandatory
If yes,
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I
1 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 1(11, Additional Remarks Sctiea,eit more space is squired)
,
1 PLUMBING
i
i
CERTIFICATE HOLDER
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
10050 NE 2ND AVE
MIAMI SHORES FL 33138
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXP TION DATE THEREOF. NOTICE WILL BE DELIVERED IN
ACCORD ICE WITH THE POLICY PROVISIONS.
AUTHORIZE REP(ESENTATNE
ACORD25 (2010/05)
1988-2010 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
RICK SCOTT,.GOVERNOR
. ' ; ,`, •Ir ' ... ..-.,, , '.. f . It ..
?.....-*' '
STATE•OFiFI:ORIDA-
....-..-----__
—x-----.:---,,-,......,, •-.. ...
riDEPART,MENZPE:BUSINESS2AND,RROFESSIONACREGULATION`
pusTEty.Ltc.gNsiNg,Bomtp.....:::\.N.N\
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-The-PEUMBING.CONTRACTOR'
::Nafrigairslow:ISZERTIFIEp,
QfrapterT489X.S
7....Ekri*On.d4tirA.VG:33,,-2q,18
VALTES:: ,
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HIAIEAR;itr.4—.4.41,Elle-3301.6
"4•Pwi"449Mi.r"*1.16111.11:117.411.00U
ISSUED: 06/22/2016
DISPLAY AS REQUIRED BY LAW
,.'.-KEN,LAWSOWSECRETARY
SEQ # L1606220000275
I 009974
I Lo Local Business Tax Recgipt
Miami —Dade County,,<State of Florida
—THIS IS NOT AE11L.L :-:DO.NOT PAY
I,. --
7204035
RECEIPT NO. - ...
EXPIRES.
I BUSINESS NAME/LOCATION
9 SYSTEMATICS PLUMBING11DISIGN'INC'' "' "RENEWAL" SEPTEMBER 30, 201$"w"
7486950
2211 `W '52 ST 202
;HIALEAH FL 33016
OWNER
R `• j �� ),"I SEC. TYPEOF BUSINESS
r 4
SYSTEMATICS PLUMBING & DESIGN INC196 PLUMBING CONTRACTOR
�f.
I CFC1429600
C/O KAREL VALDES PRES z I•
Worker(s) •
Must be displayed at place of business
Pursuant to County Code
Chapter 8A - Art. 9 & 10
PAYMENT RECEIVED
BY TAX COLLECTOR a
$45.00 07/19/2017:/
CREDITCARD 17-0490227,
payment of the Local Business Tax. The Receipt is not a license,
This Localcertification
Business Tax of the h lodely scqua ins qualifications,
permit, or a certification of the holder's qualification, to do business. Holder must comply withny 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-216.
For more information, visit•
A,
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: 6/28/2016 EXPIRATION DATE: 6/28/2018
PERSON: VALDES KAREL
FEIN: 811742071
BUSINESS NAME AND ADDRESS:
SYSTEMATICS PLUMBING & DESIGN INC
2211 W 52 STREET UNIT 202
HIALEAH FL 33016
SCOPES OF BUSINESS OR TRADE:
LICENSED PLUMBING
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 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
DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS? (850)413-1609
�) ri ( O1. sZfi ue same
COL CLASS
V432-500-73-310-0
KAREL
VALDES
2211 W 52ND ST UNIT 202
HIALEAH. FL 33016-00b0
DOB 08-30-1973 sEr N
_ ,rn 08-30-2013r,[ii 5-a5
xfrs._> 08-30.2021
HEST r`•
*EPLAc;,D: 07-17-20 , 4
SAFE 01UvER
Qp*.. af0[; pr a mMer nb$ij rf, 4t1 ems CHmSM to any sa*rtV test raalr1W br Iwo