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FW-18-2306Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Permit NO.. FW-8-18-2306 Permit IVR Number: 617671 Permit Type: Fence/Wall Work Classification: Wood Fence Permit Status: Approved Issue Date:10/10/2018 I Expiration: 03/13/2019 Parcel Number Project 9290 N BAYSHORE DR, Miami Shores, FL 33138 1132050270240 <NONE> Contacts RICKI LEE LONDON Owner RICKI LEE LONDON Applicant 9290 N BAYSHORE DR, MIAMI SHORES, FL 331382949 9290 N BAYSHORE DR, MIAMI SHORES, FL 331382949 CHICO'S CONTRACTORS INC Contractor OLGA L CHICO 14731 SW 150 AVE, MIAMI, FL 33196 Business: 7868535897 Description: NEW WOOD FENCE AND NEW ALUM FENCE Valuation: $ 7,860.00 Inspection Requests: TotalSq Feet: 77.00 Fees Amount CCF $4.80 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $1.60 P&Z Review Fee $35.00 Permit Fee - Wire & Wood $100.00 Scanning Fee $9.00 Technology Fee $6.40 Total: $160.80 Payments Amt Paid Total Fees $160.80 Credit Card $110.80 Credit Card $50.00 Amount Due: $0.00 Building Department Copy 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,kstjuqtjpn arad zoning. Futhermore, I authorize the above named contractor to do the work stated. SignaturA: Owner / Applicant / Contractor / Agent Date October 10, 2018 Page 2 of 4 BUILDING PERMIT APPLICATION Miami Shores Village Building Department AUG 29 018 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY_ Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 �FBC o2011 Wt Master Permit No. T W 0" �3 0 6 Sub Permit No. [—]BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑ PLUMBING ❑ MECHANICAL ❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: G'2 9D 1 0 91ft Pi&+SHOM City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: _ FFE: OWNER: Name (Fee Simple Titleholder): k..i lom pom Phone#: 7'C�'0 Z LaJ 2-1 9 IC , Address: TOO ��`1A ��uoQ� �2n q;' City: (7� ky-'PJUI. Tenant/Lessee Name: Email: CONTRACTOR: Company Name: Address: ►L4431 City: i &M I Qualifier Name: OLGA, S YY State: L Zip: � Phone#: V `� WS - —1. Phone#: /66 D5:) 50 - T T L Zip: :551W50 Phone#: J3 — ---)�� State Certification or Registration #:'_-CE41 151 %% Z9 Certificate of Competency #: DESIGNER: Architect/Engineer: ne#: Address: AlCity: State: Zip: Value of Work for this Permit: $ Square/Linear Footage of Work:' Type of Work: ❑ Addition ❑ Alteration ❑ New Pf Repair/Replace ❑ Demolition Description of Work: MsLu 1 oop fitK1 !4• A.Mt, MEC-) k'Um ?' cam' r Specifycolorof'color-thru.tile: Submittal Fee $ S OV Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ 2 ° DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Structural Reviews $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ (O V (Revised02/24/2014) Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip 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 $2. 00, 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. 2�Signature ! LA OWNER or AGENT The foregoing instrument was acknowledged before me this �-3r d day'of A �) c,uS 1 20 l O dby 121 Chi LO ItJ'I a Kwho is personally known to me or who has produced identification and who did take an oath. NI Si( Pr Signature Oil CONTRACTOR The foregoing instrument was acknowledged before me this LA of �' , 20 �� by 4 A/dOi is personally known to as me or who has produced identification and who did take an oath. NOTARY PUBLIC: Print: as FAUSTINO HERNANDEZ Seal: NOTARY PUBLIC Seal: I EXPIRES Seowftw 09, 20/9 STATE OF FLORIDA ��-0'� F�+•ry• Comm# FF970290 SCE 1s�� • �* **************************** ******************************* ****************************** APPROVED BY Plans Examiner v 470 Zoning Structural Review Clerk (Revised02/24/2014) Notice to Owner - Workers' Corn Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 nsation 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: l/ G . (AJG(///4 Owner State of Florida County of Miami -Dade *111-V Rebecca Ann Harshaw NOTARY PUBLIC STATE OF FLORIDA Comm# FF970290 Expires 3/10/2020 The foregoing was acknowledge before me this OBI day of f-1 a �' u5 T , 20 By 1 to NDo ► J who is personally known to me or has produced as identification. IF Rebecca Ann Harstha,,, Notary: NOTARY PUBLIC -+STATE OF FLOP %A SEAL: 19�s Comm# FF970290 nt Expires 3/10/202i; J:)j,"M 1, G -,�,�p T0 ALE M� Let,(' CCU' ovfoN, C r- - 7 S cvorr� SR�S' S�� Le.il�l UC Ol�r`� eC5C7�o � 4h�. foto �he �� . 10q"CJ�", qbc�t++ �Ys�(Jre -�, ADr �-E's �C 553 C�) ✓1 �l �( TO i 5��1 � �V F� . ��orn to �or af,�med d CArl bpOCr 2CiS chyco m6 � e cj no Lo L�j� �� So hC( MAHARAI K. GONZALEZ dIt +° MY COMMISSION # GG 044602 I I z O z ' =* w EXPIRES: November 2, 2020 Bonded Thru Notary Public Underwriters n� M Local Business Tax Receipt Miami —Dade County, State of Florida —THIS IS NOT A BILL — DO NOT PAY 6731807 BUSINESS NAME/LOCATION CHICOS CONTRACTORS INC 14731 SW 150TH AVE MIAMI, FL 33196 OWNER CHICOS CONTRACTORS INC Worker(s) RECEIPT NO. EXPIRES RENEWAL SEPTEMBER 30, 2019 7005242 Must be displayed at place of business Pursuant to County Code Chapter BA — Art. 9 & 10 SEC. TYPE OF BUSINESS 196 GENERAL BUILDING PAYMENT RECEIVED BY TAX COLLECTOR CONTRACTOR 75.00 08/28/2018 CGC1518829 CREDITCARD-18-064102 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 holders 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 Cade Sec Ba-276. n® for more information, visit www.mismidade.gov/taxcollector t JIMMY PATRONIS 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: 10/4/2018 PERSON: OLGA L CHICO FEIN: 272918790 BUSINESS NAME AND ADDRESS: CHICO'S CONTRACTORS INC 14731 SW 150 AVE MIAMI, FL 33196 SCOPE OF BUSINESS OR TRADE: Licensed Building Contractor EXPIRATION DATE: 10/3/2020 EMAIL: CHICOSCONTRACTOR@GMAIL.COM 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 10;0218 °"'"'' 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 endomement(al. I PRODUCER UUNIAU1 NAME: MARTA M ALONSO Florida Bankers Insurance PHONE 266-6493- FAX.262-0679 (305) /c No): (305) 6874 SW 8 ST . o IE . marta@floddabankersinsurance.com Miami, FL 33144 PRODUCER CUSTOMER ID Phone (305) 266-6493 Fax (305) 262-0679 INSURERS AFFORDING COVERAGE NAIC p INSURED INSURER A: AIX SPECIALTY INSURANCE CO Chico's Contractors Inc INSURER B : 14731 SW 150 AVE INSURER C : MIAMI. FL 33196 INSURER D : COVERAGES CERTIFICATE NUMBER: RFVIS(nN NIIMRFR- 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. ILTR TYPE OF INSURANCE ADDL lN,$R UB WVD POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MMIDD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000.000.00 ❑COMMERCIAL GENERAL LIABILITY _ $ 50,000.00 __ DAMAGE T RENTED PREMISES (Ea occurrence A ❑ ❑ CLAIMS -MADE ❑ OCCUR ❑ N N SIZGL1003B200072 01 /23/2018 01 /23/2019 MED EXP (Any one person) $ 5.000.00 PERSONAL & ADV INJURY $ 1000.000.00 ❑ GENERAL AGGREGATE $ 1000.000.00 GEN'L AGGREGATE LIMIT APPLIES PER: a POLICY ❑ JECOT- ❑ LOC _ PRODUCTS - COMP/OP AGG $ 1000.000.00 $ AUTOMOBILE LIABILITY ❑ ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) S ALL OWNED AUTOS BODILY INJURY (Per accident) $ ❑ SCHEDULED AUTOS PROPERTY DAMAGE (Per accident) $. ❑ HIRED AUTOS ❑ NON -OWNED AUTOS $ ❑ $ ❑ UMBRELLA LIAB ❑ OCCUR EACH OCCURRENCE $ ❑ EXCESS LIAB ❑ CLAIMS -MADE AGGREGATE $ ❑ DEDUCTIBLE $ $ RETENTION $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NIA T RY LIMIT ER E.L. EACH ACCIDENT $ E.L DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) LIC: CGC1518829 \.CK 1 IrIt A 1 C MULUCK MIAMI SHORES BUILDING DEPARTMENT 10050 NE 2 AVE MIAMI SHORES, FL 33138 ACORD 25 (2009/09) OF CANCELLATION 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 • 1355 NW 87 A V S&7TE 2W MIAMI, FLORMA 33172 A SURVEYNo. 14-MI511-1 TELEPHONE (305J 264.0229 (305) 264 2660 FAX: MQ U a, l uy i b � u ru Ply iT r8 . rJ It r. LAND SURVEYORS DRAWN BY.- AL SNEET Na 2 OF 2 Q o m Existing 900 gal to be replaced in the same area New 300 gl lift dosing tank F.I.P 'n 9,4'lC.L.F. gl LL ji U : 6.43: LOT-13 0 U J 4i M L1 f Z POOL PUMP BOUNDARY SURVEY SCALE - 1' = 20' Existing 300sf drainfield to be replaced in the same area LOT- 11 BLOCK-2 305 sf . T-6" 25.80' ONE STORY RES. # 9290 LOT -12 BLOCK-2 2 F.F,E.=7.83' 3• LF.E =7.31' GARAGE ELEV.-5.72' F.I.P 314' 8 NO CRP 7.30' a is PwY � i "� y r r_• S x4r t r 3.sa Ayrid' r *'� a� Qr.,.• 18 ASPFIALT: r_t 1 PYM'1: SURVEYORSNOu. ' There maybe Easements recorded in the Retw7s rhut$� y. 50.00, TOTAL R/W Cd 1.�425.00' QONC.DRNE•�..:.:�:i.y: 4.95 tA 4:15 4.92 4.92. , rN �rfrly r • A fyie`y%`• iK dv �7E h` yZ V F.N. trr:It,4'. NO ID. S a:,iH F.N. I NO ID. Water f WOOD FENCE DETAILS WOOD FENCE DETAIL I PICKETS FASTENED FENCE GOOD SIDE OUT. WITH TWO CORROSION THE VERTICAL AND RESISTANT FASTENERS HORIZONTAL SUPPORTING PER CONNECTION. MEMBERS OF A FENCE SHALL FACE THE INTERIOR OF THE PLOT ON WHICH THE FENCE IS LOCATED AND THE FINISHED SIDE SHALL FACE THE ADJOINING LOT OR ANY ABUTTING RIGHT -OF -WAY. • • • • •••• •••••• HIGHPOST SPACED AT """ " ' • •""' ON THE CENTER 4X4 PRESSURE TREATED AXIMUM POST EMBEDDED 2' INTO • • • • • • • • • CONCRETE FOOTING 10" • ' ' ' ' •••• • •• ••••• DIAMETER X 2' DEEP. •••••• • •• •• •• •••• • • ••••• •••••• ALL WOOD MUST BE PRESSURE TREATED. • • • • • • • • ; • ALL FASTENERS MUST BE CORROSION RESISTANT. • • • • • • • NO LESS THAN TWO FASTENERS IN ANY CONNECTION. i • • • • • • • i WOOD FENCE ELEVATION 2 x 4 WOOD RUNNERS TYPICAL TOP AND N.T.S. BOTTOM NAILED TO POSTS W/ 2-16 NAILS AT EACH W D. POSTS 4" x 4" WOOD P.T. p POSTS @ 4'-0" O.C. EMBEDDED 24" MIN. (p INTO CONCRETE 1 x 6 WOOD PLANKS NAILED W/ 2-16d NAILS TO WOOD RUNNERS GRADE 11=1 I I-1 11=1 11=1 11= 11-III-I I L=1 1=Il 1I 11_ _I 1 B I 1=1 I I-1 11=1 11=1 =1 11=11 I- I I I Il- 11=11 L=11-I 11=111-111-11 r 12"— 30" DEEP CONCRETE —111=11 EN-111 I ( F x =I I_ 1 I 1=1 11=1 I IEI 1 I El I=1 ENVELOPE Pc = 3000 P.S.I. 11J9`I 111=111=1 I� I-111=1 I �_11 =111-1 I I' 1=1 -III I F=1 I=1 F -11 L=1 J I-11 =1 1=1 1-_11 -111 U 111 12" WOOD FENCE SECTION NEW FENCE OM NORM BAYMOM DEW MAI snow. n 99188 r ALUM FENCE DETAILS �m X x� v 17 • . • F � O O N � Z NTsl 0 W J y W a zi U u- O Xi2 O •� � U N � ;, � J Q z NEW FENCE OM NORYH BAYSHORZ DRYS mum SHORES. n Mize ALUM FENCE DETAILS 2 " X 2 " X 0.093" ALUMINUM (HORIZONTALL TUBULAR MEMBER). 2 " X 2 " X 0.093" ALUMINUM POST (VERTICAL TUBULAR MEMBER). 01 3" X 1 " X 1 /8" ALUMINUM (HORIZONTAL MEMBER) 2 " X 2 " X 0.093" ALUMINUM (HORIZONTALL TUBULAR MEMBER):- Q FENCE SECTION N.T.S. d- 0 m.. ONCRETE FOOTING, NEW FENCE 90 NORM HATMOM DMU mum SSORES. n s3in STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD DWE 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399-0783 CHICO, OLGA L CHICO'S CONTRACTORS INC 14731 SW 150TH AVE MIAMI FL 33196 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 Fiorida'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 LICENSE NUMBER (850) 487-1395 STATE OF FLORIDA ' DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CGC 1518829 ISSUED: 08/07/2016 CERTIFIED GENERAL CONTRACTOR CHICO, OLGA L CHICO'S CONTRACTORS INC IS CERTIFIED under the provisions of Ch.489 FS. Expiration date AUG 31, 2018 L1608070000538 DETACH HERE KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD The GENERAL CONTRACT UR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2018 CHICO, OLGA L CHICO'S CONTRACTORS INC 6182 SW 129TH AVENUE. MIAMI FL 33183 icci i =n• nRimjgn1F ^ nv;PI AY AS REOUIRED BY LAW SEQ # L1608070000538 003517 Local Business Tax Receipt Miami —Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 6731807 BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES CHICOS CONTRACTORS INC RENEVIAL SEPTEMBER 30, 2018 6182 SW 129 AVE 7005242 Must be displayed at place of business MIAMI FL 33183 Pursuant to County Code Chapter 8A - Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS CHICOS CONTRACTORS INC 196 GENERAL BU.LDING CONTRACTOR PAYMENT RECEIVED CGC1518829 BY TAX COLLECTOR Worker(s) 1 S75.00- 08/15/2017 CREDITCARD-17-054252 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 veN05s-Miami-Dade Code Sec 8a-276. For more information, visit www.miarridrdt__ v_Raxcollectw i 11/202016 -Report Viewer • 1 100% PLEASE CUTOUT CARD BELOW AND RETAIN FOR FUTURE REFERENCE -------------------------------------------------------------------------------------------------------------------------- "t IMPORTANT STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES s whoPursuantlec to mpfi 4firorn Fis F.S., r offiwr of a con cats of who elects exempoan from this chapter q'filing acerticafe of dection benartts under this section may not re —a, or comperoatimudns this chapter. DIVISION OF WORKERS' COMPENSATION ��``"' O Pursuant to Chttap�tfera 440. 12), F.S., Certificates of election to beexernpL..apdroNrwi�tlYnthe business CONSTRUCTION INDUSTRY EXEMPTION L the scope orortrade listed on the notice a ection to be exempt ' CERTIFICATE OF ELECTION TD BE E7(EMPT FROM FLORIDA wORKrRF COMPENSATION LAW ; D ttapt 051 ). F.S,Noficesofdectiontobe Pursuant to C a 440. 13 exemptend cerfificates of ection to be exempt shell be FFFECnVE GATE 9/202016 FJIPIRAnON DATE 9/2o/20t 8 H subject to reNocalim If, at any time after the filing of the notice issuance the the the PERSON: CHICO O.GA t ; E «the of certificate, person named on notice tr certificate no longer meets the rat�lremerdS of this FEIN: 212918790 �R section for iatalce of a certificate. The department stall revoke a certificate at arty tlmeta fallueofthepersonremedonthe 1E certificate tomcet the regirent eres of Otis section. BUSINESS NAME AND ADDRESS: ' CHICO'S CONTRACTORS, INC 6182 SW 129 AVE MIAMI FL 33183 SCOPES OF BUSINESS OR TRA LICENSED GENERAL CONTRACTOR L------------------------------------------------------------------------------------------------------------------------= DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS? (850y413-1609 https://apps8.fldfs.com/crreportviewer/reportViewer.aspx?data=kdvpginc9D7Q3gH6TER6ePlKMZa/D2fSz5bXKYfBxkrekeESoPVylv4NPOPN42XeirDRGXVW I... 1/2