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PL-18-1838Miami Shores Village �sw°Res 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 F�ORIDp' Permit NO. PL-7-18-1838 Permit Type: Plumbing - Residential er it Work Classification: Addition/Alteration Permit Status: APPROVED Issue Date: 8/3/2018 1 Expiration: 01/30/2019 Project Address Parcel Number Applicant 150 NE 94 Street 1132060132970 Miami Shores, FL Block: Lot: STEFANO CARNIATO Owner Information Address Phone Cell STEFANO CARNIATO 150 NE 94 Street (786)210-0789 MIAMI SHORES FL 33138- 150 NE 94 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone BARRIO AIR CONDITIONING INC (954)815-5961 (954)815-5969 of Work: LAUNDRY CONNECTION of Piping: onal Info: Return : ification: Residential Scanning: 1 Fees Due Amount CC F $6.60 Dl Fee $5.78 DCA Fee $3.85 Education Surcharge $2.20 Penalty Fee $100.00 Permit Fee $385.00 Scanning Fee $3.00 Technology Fee $8.80 Work without Permit Fee $385.00 Total: $900.23 Valuation: $ 11,000.00 Total Scl Feet: 0 Pay Date Pay Type Amt Paid Amt Due Invoice # PL-7-18-68160 08/03/2018 Credit Card $ 850.23 $ 50.00 07/09/2018 Credit Card $ 50.00 $ 0.00 Avauaoie inspections: Inspection Type: Top Out Final Review Plumbing Review Plumbino 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 zoning. J ; �%lam f1F�u)thermore, `authorize the above -named contractor to do the work stated. V. l I -1 .�J C o1 c1 Authorized Signature: Owner / Applicant Building Department Copy / Contractor / Agent August 03, 20 8 August 03, 2018 1 �� Miami Shores Village '�� Building Department J L092018 (\�� 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 j 1 ..- � ' Tel: (305) 795-2204 Fax: (305) 756-8972 ]� �\ INSPECTION LINE PHONE NUMBER: (305) 762-4949 ` FBC 20 1 BUILDING Master Permit No. PERMIT APPLICATION Sub Permit No R-1 r`� 38 ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL (PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION [:]SHOP T[ p�� / CONTRACTOR DRAWINGS JOB ADDRESS: %� %�.Y s �e4 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 Sriim'pllejitleholder): C . /U`19�j� Phone#: Z /0 a Address:�lj Citv." State: Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company ame: Address: l,1142 9ax City: -4 j a / S Qualifier Name: / / 1/ /r' /' aCIa &62 t State Certification or Registration #: DESIGNER: Architect/Engineer: / Certificate of Competency #: (,, �p %' 6 11y'22F Phone#: Address: City: State: Value of Work for this�Permit: $' MOO() Square/Linear Footage of Work: Type of Work: " ❑ Addition ,/ l Alteration ❑ New y�,.t Repair/Replace Description of Work • ' t U/ v o a N� ��4� /; 1W n. otk Ph(,t� i)-1 _%.-1 .1 v Zip: ❑ Demolition Specify color of color thru tile: n Submittal Fee $ Permit Fee $ a �� c' CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ (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 $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 reinspection fee will be charged. ,1 1 r r / c Signature JSignature OWNER or AGENT / CONTRACTOR The foregoing instru ent was acknowledged befor me this (� day of 14 20 by �AA who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLI Sign: Zvr Print: AMARILIS SOLARES Seal: MY COMMISSION # GG034902 EXPIRES October 02, 2020 as The foregoing instrument was acknowledged before me this O`d of � 20 l� , by %� who is personally known -to _ me or who has produced Y �-- as identification an_glo ►l+tr id take �o�ary ilblbC NOTARY PUB%. State of Florida Nor SION # FF 220584 •114, 2019 Sign: 0— 1 � Print: Seal: ************************************************************************************************************ APPROVED BY C✓ q��i�� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) KEN LAWSON, SECRETARY RICK SCOTT, GOVERNOR STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD CK1427618 The PLUG CONTRACTOR Named below IS CERTIFIED Under the provisions at Chapter 489 FS. Expiration date: AUG 31, 2018 BARRIO, ALFRED BARRIO AIR CONDITIONING INC '1950 SOUTH HALLANDALE BEAACH R �3 009 SEQ # L1607070000818 ISSUED: 07r0712018 DISPLAY AS REQUIRED BY LAW BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000 VALID OCTOBER 1, 2017 THROUGH SEPTEMBER 30, 2018 pBA; Receipt#:pLU2MBING/LWN SPRNKL/C Business Name: BARRIO AIR CONDITIONING INC Business Type" (PLUMBING C:ONTRAC'YOR) Owner Name:ALFRED BARRIO Business Opened:12/01/2010 Business Location: 1950 S OCEAN DR #7G State/County/Cert/Reg:c FCl 27618 HALLANDALE Exemption Code: oA-AGE 65 OR OLDER Business Phone:954-458-4779 Rooms seats Employees Machines Professionals 2 For Vending Business Only IJ,nnHn� of MarAin�• Vendine Tune: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 0.00 0.00 0.00 0.00 0.00 1 0.00 0.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non -regulatory in nature. You must meet all County and/or Municipality planning WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. Mailing Address: ALFRED BARRIO Receipt #02C-16-00005643 1950 S OCEAN DR #7G Paid 07/28/2017 0.00 HALLANDALE BEACH, FL 33009 2017 - 2018 06/26/2018 14:02 3053872918 A AND D ALL LINES PAGE 01/01 AC(:)RV CERTIFICATE OF LIABILITY INSURANCE16/26/2018 MMMONYW' THLS•CERTIFICATE 18 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 CONSInVII A CONTRACT OETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PROOUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: It the CerttRcate holder Is an ADDITIONAL INSURED, the Pollcy(ISS) must be endorsed. If SUBROGATION iS WAIVED, subject to On terms and conditions of the Policy, certain policies may require an endorsement. A statement on this certif cats does not corNer rights to the ce,Mflcate holder In lieu of such endoleementia . PRODUCER ASND ALL —LINES INS ASSOC INC 5600 SW 135 Ave Ste 106 Miami, FL 33183 CQNTA adlP .(305 463-6701 ;(305)3$7-2918 AD Bs;samador@bellsouth.not aaun AFFORDMD CovenAaE wear ISu A•CATLIN SPECIALTY INS CO. INSURED BARRIO AIR CONDITIONING, INC. 1965 S . OCEAN DRY . # 4G HALLANDALE BEACH, FL 33009 INSURERS; INSURER C : IN §URER D INSURER E ; INSURER F : IFaT NTI3-LrA3 Sd3Zi 13T�7•fi 3�[117;f-_T3 ely�1F_Li�l <JHL<<fdam: 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. LTR TYPE OF INSURANCE =WvD POLICY NUMBER M LIMITS A GENERAL LIABILITY COMMERCIAL GENUM L"ILITY CLAIMSMADE L^—1 OCCUR 1700517902 5/3/2018 5/3/2019 EACH OCCURRENCE $ 1,000,000 IJAIV 13 r $ 100,000 MED EXP one peteat Is 51000 pERSONALrRADVINJURY _ -_ 8 1,000,000 GENERAL AGGREGATE Is 2,000,000 GENL AGGREGATE LIMIT APPLIES PER: POLICY MPRO LOC PRODUCTS - COMP1OP AGC $ INCL $ AUTOMOBILE LIABILITY ANYAUTp AUTOSYMW > NTODSM ?Y� HIRED AUTOS ANUOTO$WNED aocidard $ BODILY INJURY (Per peraan) _ s BODILY INJURY (Per WC40M) $ .1 = $ UMBRELLA LIAR =risS I" OCCUR CLAIMS -MADE EACH OCCURRENCA $ AGGREGATE S �_ DED RETENTION $ _ ..r.- WORKERS COM SATIO AND EWLOYEW LIA8ftI7Y YIN ANY PROPRIEr0KTARTNeRw Lrnw OFFICEPA06411A O(CLUDED9 (Mandatory an NMI D S�,>i p17 OFF E Tlb B be,. NIA �} CL. EACH ACCIDENT $ ILL. DISEASE - EA EMPLOYE 9 E.L. DISEASE - POLICY L WT S DESCRIPTION OF OPERATIONS I LOOATIONB / VEHICLES (AlLeoh ACORD 101, Additional Remark* SchWtft, N=m wade N required) AIR CONDITIONING AND PLUMBING CONTRACTOR. MIAMI SHORES VILLAGE SHOULD ANY OR THE ABOVE DESCRIBED POLICIES Bra CANCELLED BEFORE WILDING DEPARTMENT THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 NE 2nd AVERM ACCORDANCE WITH THE POLICY PROVISIONS. MIAMI SHORES, FL 331313 AUTHORIZED REPRESENTATIVE FAX: 305-756-8972 01988.2010 ACOR C RATION. All rights reserved. ACORD26 (2010105) The ACORD name And logo are registered marks of ACORD WIL JEFF ATwATER STATE OF FLOWDA CHIEF FINANICAL OFFICER 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 few. EFFECTIVE DATE: 2/13/2017 PERSON: BARRIO FEIN: 061648288 BUSINESS NAME AND ADDRESS: BARRIO AIR CONDITIONING INC. 1950 S OCEAN DR. APT. 12J HALLANDALE FL BEACH SCOPE OF BUSINESS OR TRADE: t.icensed Plumbing Contractor 33009 Heeling, ventilation, Air- Condilioning and Refrigeration Systems installation, Senrkx and Repair, Stop. Yacd & Drivers EXPIRATION DATE: 2/13/2019 ALFRED tion s chapter by filing a certificate of election under this section may not Pursuant to Chapter benefits orOcompensetron under this chapter. Pursuantion t to Chapter 4elects 40 05(12), F.S., Certificates Of election o be exempt... be apply only within the scope of the business or trade listed on the notice of election o be exkny timeempt. Pursuant a Chapter 440.ing of the tice orthe issuance of the , F.S., Notices of election o certificate, exempt and certificates of election o be exempt shall be subject ocation if, of this section fo assurancelof a certifficate The depa men shall revoa the person named on the n0dw or c"rx no longer meets the requirements oartiflcate at any time for falture of the person named on the certificate to meet the requirements of fts se ction+• DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS? (850)413-1609 Rifrad Barrio to&cAamiml W Air Conditioning lic CMC124944O State of r�iC D ivlau County of�� Before this day personally appeared6"aVho being duly sworn, Disposes and says: That he or she will be the only person working on the project located at: Co a t nat e . bA Swor (or affirmed and subscribed before me this —�L day of, 2010 by v ` /�✓ Personally know Or Produced Identification Type of Identification Produced J%%%11111/111 .� V ITIVk :Q��P N�TAq 'Q�9 • Y m MY Comm, MaY 26, 2020reg .. N No. FF 9W � • 96 ? y� • A Commercial Industrial Type or El Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner - Workers' Compensation 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: I . 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 SIGNINONErOW YOU AC NOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: Owner State of Florida County of Miami -Dade The foregoing was acknowledge before me this O" - day of !)' , 20 & . By ��%(1 �+��d who is personally known to me or has produced as identification.;;.;:;; AMARILIS SOLARES Notary: MY COMMISSION # GG034902 ry V EXPIRES October 02, 2020 SEAL: