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PLC-18-3648Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Issue Date:12/28/2018 Parcel Number 726 NE 92ND ST IL, Miami Shores, FL 33138 1132060440390 Contacts Permit No.: PLC-12-18-3648 Permit Type: Plumbing - Commercial Work Classification: Alteration Permit status: Approved Expiration: 06/10/2019 OSCAR ZARAGOZA Owner QUINTERO GENERAL CONSTRUCTION Contractor 726 NE 92 ST APT 1-L, MIAMI, FL 331382965 BERNARDO QUINTERO 8801 NW 112 TER, HIALEAH, FL 33018 Business: 7864875738 Description: REPAIR HOT WATER PIPE 1/2 REPAIR P-TRAP IN Valuation: $ 1,300.00 Inspection Re uests: BATHROOM SHOWER, REPAIR TOILET DRAINAGE PIPE. 305-762-4949 Total Sq Feet: 0.00 Fees Amount Application Fee - Other $50.00 CCF $1.20 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.40 Permit Fee $50.00 Scanning Fee $3.00 Technology Fee $2.50 Total: $111.10 Building Department Copy Payments Date Paid Amt Paid Total Fees $111.10 Credit Card 12/28/2018 $61.10 Cash 12/10/2018 $50.00 Amount Due: $0.00 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. Futhermore, I authorize the above named contractor to do the work stated. Authorized Signature: Owner / Applicant / Contractor / Agent Date December 28, 2018 Page 2 of 2 BUILDING Miami Shores Village s Building Department EC 1 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 ' Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20 f7 Master Permit No. Vim- PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION OLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF CONTRACTO JOB ADDRESS: Sub Permit No. ❑ EXTENSION ❑RENEWAL ❑ CANCELLATION ❑ SHOP DRAWINGS City: Miami Shores _ . _ _County: Miami Dade Zio: .3 3 S Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): �SC /y 1 • F 19RA i) 0 2A Phone#:_ 3 P% ; - of U 2 Address: % a b u E 9 -. s J~ 4:f 1 City: , i AA l I srt ne tS State: %L Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: _QU i )jZf2 O G ENC ZAL EVER AC- 7M Phone#: Address: lily 2- 7g-/� ^� City: :H ►jLEAH G l�)RliC�S State: �-- Zip: 33 y/ b p p Qualifier Name: 6f &A,) A A lib 2Q i u T EFA-' Phone#:7W6"q2%-S C%SU State Certification or Registration #: C r C I Lf2-S! PJ %3 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Value of Work for this Permit: $ 70 0. ° v Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition Description of Work: R EAO1 iZ- H !D T CV A TM .Pi PF t%2 " P i= eW i p- 'P -T►2 A P I Al VA71111,b o� S�/t7wE2 f2 i'Pr9i2 'i i 1 �T 'DRAT ;A"AGE P;PE. Specify color of color thru tile: Submittal Fee $ 1 Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ Technology Fee $, Structural Reviews $ (Revised02/24/2014) Training/Education Fee $ DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ Zip: 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. 1 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 a reinspection fee will be charged. Signature OWNE or ENT The foregoing instruqaQnt was acknowledged before me this Q� da of 1 `Q�'D' CJ`� V 20 by f , t'C�Ti�( ho is personally known to me or who has produced I" y 1' C �PY1S h as identificatio an ho d6take,an oath. C: Sign:_ Print: Seal: p. " °�• 1�71idADYPRIETO ` �'1v��`` EXF'9ES: 4larch 25, 2G1� s.f `%f.� S" 6a�dedFFvtiszrj?twucli:�,ril'�h(: Signature CONTRACTOR The foregring instrument was acknowledged before me this v day of 2ECiCh, L7 Ens 20 ' by &2AM9DD �iaMauChoispersonal-lyknonto mne or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign:_ Print: Seal: �#0 r,N Notary Public State of Florida Oscar M Zaragoza My Commission FF 939267 orp Expires 12/08/2019 APPROVED BY lJ /,��il Plans Examiner Structural Review (Revised02/24/2014) as *********** Zoning Clerk a 0 aSC � Z-A Ck S� M S 35 Goo � R f-f-F `t - -k-�o -.� r _I tv ...... • CE/ SEC OEC 17 7n. UMBING PLANS Date Il ��� 'O Vpizved Date )isapproved _. ami S` ares Vila ae A -)PROVED BY DATE 7r`RING DFP P' L^ D OT 4 'FCT TO CONIPLIANC: WI F-I ALL FEU--RAL Ty FBI P F4 /\N • ..••.. • .,..,• ... ... • ... •••••• • f • -1000 • •••• • • • ••••• •• •••••• • • • • 01•••• • C,L) (A in- D . ,Av f) -�� fir© K€ rJ r- Lr� Q L P • UJG (")r)-j C-2 i UA L s(='c,�, Dom/'s'T -ttffl- wAS .R+CN Kxs.�[-Acm 2018 FLORIDA NOT FOR PROFIT CORPORATION ANNUAL REPORT DOCUMENT# 726432 Entity Name: SHORES PLAZA EAST CONDOMINIUM, INC. Current Principal Place of Business: 745 N.E. 91ST ST MIAMI SHORES, FL 33138 Current Mailing Address: 745 N.E. 91ST ST MIAMI SHORES, FL 33138 FEI Number: 59-0597536 Name and Address of Current Registered Agent: ZARAGOZA,OSCAR 745 NE 91ST ST MIAMI SHORES, FL 33138 US FILED Apr 27, 2018 Secretary of State CC0406970476 Certificate of Status Desired: Yes The above named entity submits this statement for the purpose of changing its registered office or registered agent, or both, in the State of Florida. SIGNATURE: Electronic Signature of Registered Agent Officer/Director Detail Title PD Name DE ROJAS, JORGE Address 9140 NE 8TH AVE, APT 4H City -State -Zip: MIAMI SHORES FL 33138 Title TD Name ZARAGOZA,OSCAR Address 726 NE 92ND ST, APT 1L City -State -Zip: MIAMI SHORES FL 33138 Title D Name OCAMPO, DAVID Address 755 NE 91 ST 4F City -State -Zip: MIAMI SHORES FL 33138 Title VD Name TALAVERA,CARLOS Address 726 NE 92ND ST, APT 7L City -State -Zip: MIAMI SHORES FL 33138 Title SD Name WARD, DAVID Address 488 NE 90 ST City -State -Zip: EL PORTAL FL 33138 Date I hereby certify that the information indicated on this report or supplemental report is true and accurate and that my electronic signature shall have the same legal effect as if made under oath; that I am an officer or director of the corporation or the receiver or trustee empowered to execute this report as required by Chapter 617, Florida Statutes; and that my name appears above, or on an attachment with all other like empowered. SIGNATURE: OSCAR ZARAGOZA TD 04/27/2018 Electronic Signature of Signing Officer/Director Detail Date %!rc Sla�red i &14 E4dr 69d"cGrGs m 1646a4trml 90c. 745 North East 91 n Street Miami Shores, FL 33138 305-759-9069 / 4 E-MAIL spel23@att.net December 10, 2018 Miami Shores Village Building Dept. 10050 NE 2"d Avenue Miami Shores, FL 33138 Dear Sir / Madam, This letter will serve as your confirmation, that "Quintero General Contractor Corp." has been contracted by the owner of unit 1L, at 726 NE 92 Street, Miami Shores, Florida, 33138, and it is fully authorized by the Board of Directors of the Shores Plaza East Condominium Association to perform plumbing repairs at said unit. Should you desire any additional information, please feel free to contact our office at your earliest convenience. Sincerely yours, Carlos Talavera Vice -President Shores Plaza East Condominium Asso. cc: file Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 IVoilce to UWner — WorKers• compensation Insurance txemotion 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 :�� _ Ow r19 State of Florida County of Miami -Dade tr The foregoing was acknowledge before me this �� day of ���M iI- �f, 201 ?) . By SCG r • NAlam ck o Z41 who is personally known to me or has produced Y AV Q ► I �' `R r�s `P as identification. Notary: ' i YANADY PRIETO L� 1 '+.k° M1' C01'MISSION # FF 214031 SEAL: , �,•`� EXPIRES: Mzrch 25.2019 %; ��'„ .•' Bonded Thou NOtary Fut:.e Underimters g_ QUINTERO GENERAL CONTRACTOR Date: State of S1�`C���� County of 1" \11Gfnl —bc `� Before me this day personally appeared �Kmoyh (1-tink-, Y- who, being duly sworn, deposes and says: That he or she will be the only person worki g on the project located at: C tractor Signature worn to (o aff• ed) and subscribed before me this �� 6day of 1�t(qrn .20 18, by Y(1MD ulnl A'fo Personally know OR Produced Identification Type of Identification Produced 16V-Q IC-nSJ YANADY PRIETO w COMMISSION # FF 214031 2019 EXFIRE& March 25, bonded l...0 dot r� Pub :c UrderNriters