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PL-18-348Location Address Permit NO.: PL-2-18 348 Permit IVR Number. 625447 Miami Shores Village Permit Type: Plumbing - Residential 10050 NE 2 Ave Miami Shores FL 33138 �— Work Classification: Addition/Alteration 305-795-2204 R ���,,,—��� Permit Status: Approved Issue Date: 02/14/2018 Expiration: 08/14/2018 Parcel Number Project 25 NE 108 ST, Miami Shores, FL 33161 1121360110430 <NONE> Contacts Owner Applicant 25 NE 108 ST, MIAMI SHORES, FL 33161 25 NE 108 ST, MIAMI SHORES, FL 33161 KDF CONSTRUCTION INC Contractor KERRITH FIDDLER 841 NW 173 TER, MIAMI GARDENS, FL 33169 Business: 3052448781 Description: NEW BATHROOM ADDITION Valuation: $ 3,000.00 Inspection Requests: 3135-762-4949 TotalSq Feet: 0.00 Fees Amount CCF $1.80 Change of Contractor $110.00 DBPR Fee $2.25 DCA Fee $2.00 Education Surcharge $0.60 Permit Fee $150.00 Scanning Fee $9.00 Technology Fee $2.40 Total: $278.05 Building Department Copy Payments Amt Paid Total Fees $278.05 Check # 2201 $50.00 Credit Card $110.00 Check # 2202 $826.35 Amount Due: $-708.30 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. Futher or , I authorize the above named contractor to do the work stated. Authorized Signature: Owner / -*74prant / Contractor / Agent Date October 09, 2018 Page 2 of 4 Miami shores Village Building Department . 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: c" [h a;l �Y Q f A. COPY OF QUALIFIER'S STATE LICENCES �n4"74 1 B. COPY OF LOCAL BUSINESS TAX RECEIPT" or C. COPY OF LIABILITY INSURANCE* D. V COPY OF WORKERS COMPENSATION INSURANCE* # (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 Certificate must specify the description of operations or contractor license number. ........................................................................................... BUSINESS NAME: BUSINESS ADDRESS: t c)(0 Se-va o VI�CITY S STATE.�ZIP-3 CLq-qL BUSINESS PHONE: (30T) d4 4 31g� FAX NUMBER ( ) CELL PHONE O QUALIFIER'S NAME: QUALIFIER'S LIC NUMBER: 0,VC, 14 23 13S— Notice to Owner - Workers' Com 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: Owner State of Florida County of Miami -Dade The foregoing was acknowledge before me this By IE Notary: SEAL JAMIEJENKINS _ Notary Public - State of Florida Commission # GG 088443 S f� day of 0 C 1011t r 20 /� who is personally known to me or has produced as identification. Bonded through National Notary Assn. License No: CFC 1428135 830 N. John Young Parkway Kissimmee, FL 34741 Ph: 305-244-8781 kdfconstruction@live.com Date: f D r/ 'dState of 1' (©f I � County of � I FlIdd Before me this day personally appeared ff l �'I� le- i who, being duly sworn, deposes and says: That he or she will be the only person working on the project located at: aS A)r /Dff s -r,1W I Y1, `Shores , FL Contractor Signature Sworn to (or affirmed) and subscribed before me this -� day of �G- 0 L e20 15 by r fk Personally know. OR Produced Identification Type of Identification Produced JAMIE JENKINS Notary Public - State 8 Florida 43 Commission it GG 088443 Q-L� My Comm. Expires Apr 21, 2021 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 F(�BC4 20 Master Permit No. — I r4 -x) I ,Nv-,-► m - Pl.-a-19- 3 42f Sub Permit No. ❑ REVISION ❑ EXTENSION ❑ RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS VCHANGE OF ❑ CANCELLATION [:]SHOP CONTRACTOR DRAWINGS JOB ADDRESS: City: Miami Shores County: Miami Dade Zip: 33138 Folio/Parcel#:11-2136-011-0430 Is the Building Historically Designated: Yes NO X Occupancy Type: Residential Load: Construction Type: Flood Zone: BFE: FIFE: OWNER: Name (Fee Simple Titleholder):_ Phone#: Address: _ City: M 1 o M i S hU re s State: FL Zip:. 3138 Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: KDF CONSTRUCTION, INC. Phone#: 305-244-8781 Address: 4206 SEVAN WAY City: KISSIMMEE State: FL Zip: 34746 Qualifier Name: KERRITH FIDDLER Phone#: 305-244-8781 State Certification or Registration #: CFC1428135 DESIGNER: Architect/Engineer: Certificate of Competency #: Phone#: Address: City: State: Value of Work for this Permit: $ 3000 • Square/Linear Footage of Work: Type of Work: LYJ Addition ❑ Alteration ❑ New ❑ Repair/Replace Description of Work: Specify color of color thru tile: Submittal Fee $ Scanning Fee $ Technology Fee $_ Structural Reviews $ Permit Fee $ Radon Fee $ Training/Education Fee $ CCF $, DBPR $ Zip: ❑ Demolition CO/CC $ Notary $ Double Fee $ 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 a reinspection fee will be charged. OWNER or AGENT The foregoing ins men, was acknowledged before me this day of 20 by me or who has produced who is personally known to as Signature CONTRACTOR The fore ,ping instrument was acknowledged before me this day of 4Z b Err , 20 le by 15� L (P),L�- / IG� 1t ' who is ersonally known o me or who has produced identification and who did take an oath.\ identification and who did take an oath. as NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: 1/ *%kIns Print: Print: Ar"�1 t Seal: Seal: ��; ;:�•, JAMIEJENKINS , , -. Notary Public - State of Florida • = Commission I GG 088443 k7, My Comm. Expires Apr 21, 2021 APPROVED BY Plans Examiner Zoning (Revised02/24/2014) Structural Review Clerk Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 HHA�N. GE OF CONTRACTOR / ARCHITECT Permit N. _ PL_- Owner's Name (Fee Simple Title Holder):_ Owner's Address: City: Phone #: State: P Of i GL, Zip Code:. 13 Job Address (Of where work is being done): 25 NE 108 Street Miami Shores City: Miami Shores State: —Florida Zip Code: 33138 Contractors Company Name: KDF CONSTRUCTION, INC. Address: 4206 SEVAN WAY City: KISSIMMEE State: FL Qualifier's Name : KERRITH FIDDLER Architect/ Engineer of Record Name: Address: City: Describe Work: State: Phone #: 305-244-8781 Zip Code: 34746 Lic. Number: CFC1428135 Phone #: Zip Code: hereby certify that the work has been abandoned and/or the contractor/architect is unable or unwilling to complete the contract. I hold the Building Official and the Signature Miami Shores harmless of all legal involvement. Signature Owner or Agent Contractor or Architect The foregoing instrument was aknowledged before me The foregoing instrument was aknowledged before me ' � this _ day of 20 by this l ff day of �a 6f r , 20/f by Grrl"/ / Cl Who is personally known to me or who has produced who is ersonally known o me or who has produced as indentification. Notary Public: Sign: Seal: as indentification. Notary Public* : - Sign: �— Seal: JAMIEJENKINS Notary Public - State of Florida • . Commission # GG 088443 4. My Comm. Expires Apr 21, 2021 Bonded through National Notary Assn. R 1AM-1-SKYLINE. CONSTRUCTION SERVICE CORP. Phone: 305-899-9696 Fax: 305-899-8840 License: CBC 1260660 September 27, 2018 Universal Plumbing Corp. Mechanical & Plumbing Sub -Contractor 141 E. 60t' Street Hialeah, Florida 33013 Attention: Osvel Castellon RE: Project: All Smiles General Dentistry 12402-12404 West Dixie Highway North Miami, Florida 33161 NOTICE OF TERMINATION AND CHANGE OF CONTRACTOR Sent via: E-mail and Certified Mail Receipt #7018 0680 0000 9541 8191 Mr. Castellon, This letter is to formally inform you that our agreement is being terminated due to your decision to abandon the job causing serious delays to the project. We have repeatedly requested for you to return to work and you have failed to do so. With the numerous emails, countless phone messages, text messages and a 48 Hour Notice of Intent to Terminate sent, you still refused to communicate with us and have ignored our appeals. We requested several times your attendance at the jobsite to complete work in progress and those requests also have gone ignored. At this point we find no other alternative but to terminate our agreement. Please be advised we will immediately replace. you with another Mechanical and Plumbing Subcontractor to complete your work. All expenses incurred due to your abandonment will be deducted from any balances owed to you. Please _let this. serve. as notice -that you or any of your representatives are not to rty.- Any attempt to do so will be considered illegal trespassing: :Sincer y/ Claudio Rodriguez; President Miami Skyline Construction Service Corp. Sent via: E-mail and Certified Mail Receipt #7018 0680 0000 9541 8191 Cc: ClaudiogMiamiSkylineConstruction.com Maria(c ,MiamiSkylineConstruction.com Office(a,Miami SkylineConstruction.com universalpmsg=ail. com MIAMI SKYLINE CONSTRUCTION SERVICE CORP. Miami, Phone: 305-899-9696 Fax: 305-899-8840 Email: office(a)miamiskylineconstruction.com Website: www.iniamisliyli►ieconsruction.com Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 tarsin� Permit NO. PL-2-18-348 Permit Type: Plumbing - Residential Pen 1 It Work Classification: Addition/Alteration Permit Status: APPROVED Issue Date: 2/1412.018 1 Expiration: 08/13/2018 Project Address Parcel Number Applicant h 1121360110430 SHARAD & PUJA MOTIANI Miami Shores, FL 33161- Block: Lot: Owner Information Address Phone Cell (305)323-1964 Contractor(s) Phone Cell Phone UNIVERSAL PLUMBING CORP (305)887-3131 Type of Work: NEW BATHROOM ADDITION Type of Piping: Additional Info: Bond Return : Classification: Residential Scanning: 3 Fees Due Amount CCF $1.80 DBPR Fee $2.25 DCA Fee $2.00 Education Surcharge $0.60 Permit Fee $150.00 Scanning Fee $9.00 Technology Fee $2.40 Total: $168.05 Valuation: $ 3,000.00 Total Sq Feet: p Pay Date Pay Type Amt Paid Amt Due Invoice # PL-2-18-66412 02/12/2018 Check #: 2201 $ 50.00 $ 118.05 02/14/2018 Check #: 2202 $ 118.05 $ 0.00 Avanaoie 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: �ertify thatallhe foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. uthe,Lr)?ore, I authorize the above -named contractor to do the work stated. February 14, 2018 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy February 14, 2018 1 3\ RECEIV Miami Shores Village ED Building Department FEB 12 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 1`419 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 O: FBC 20 BUILDING Master Permit No. C� �—' ;� I, PERMIT APPLICATION Sub Permit No. �LI - 346- ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: City: Miami Shores County: Miami Dade Zip - , Folio/Parcel#: 112 13 (-Po I I 043 LD Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder):_ Phone#: 3oS- qC-q -110 32 Address: City: State: Tenant/Lessee Name: Phone#: Email: '7 U 1 Q Q ( 6D hc; Y Cu - c6 m u CONTRACTOR: Company Name: _l�yJiy�l S�C�C/tti! � CCi&/7 Phone c Address: O s City: & % —'O' -e-y- State: (_ Zip: 33E/3 Qualifier Name:,-' MCA e,/ Phone#: / State Certification or Registration #C�.Z� Certificate of Competency #: DESIGNER: Architect/Engineer: hone#: Address: City: State: O Value of Work for this Permit: $ -,�� Square/Linear Footage of Work: Type of Work: 0 Addition Description of ❑ Alteration ❑ New _ ❑ Repair/Replace Zip: ❑ Demolition Specify color of color thru tile: Submittal Fee $ .. Permit Fee $�4" CCF $ CO/CC $ Scanning Fee $ Radon Fee $ 2 Q1 DBPR $ z 2.5 Notary $ Technology Fee $ Structural Reviews $ Training/Education Fee $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ 05 (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 a reinspection fee will be charged. J OWNER or AGE Theforegoinginstr nt was day of me o who�hprorfiuced identific ion and who did tak Sign:_ Print: k� Signatu edged before me this The foregoing instrume t was acknowledged before me this 20 by day of e 20 Ik by is personally known to ,./�L���z,AVC.`o9Cnrho is personally known to as me or who has produced rJl •.'i/�l///liov��SG as Seal: ', '.,W1 'i%�- YANADY 0 + := COMMISSI FF214031 a EXPIRES: March 25, 2019 aF �QFP Bonded Thru Notary Pubic Underwriters identification and who did take an oath. NOTARY PUBLIC: Sig Print - Notary Notary Pub c State M ��ft LourdesNarin Rive My Corr- lion GG 124638 Law Exoiresorarz!?21 ****************************************************************** APPROVED BY Y/ Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) USPS.com® - USPS Tracking® Results Page 1 of 3 USPS Tracking® FAQs > (https://www.usps.com/fags/uspstracking-faqs.htm) Track Another Package + Tracking Number: 70180680000095418191 Remove X This is a reminder to arrange for redelivery of your item or your item will be returned to sender. Delivery Attempt Reminder to Schedule Redelivery of your item m cu 0- CT v 0 X, Text & Email Updates u Tracking History n Reminder to Schedule Redelivery of your item This is a reminder to arrange for redelivery of your item or your item will be returned to sender. October 1, 2018, 1:11 pm Notice Left (No Authorized Recipient Available) HIALEAH, FL 33013 October 1, 2018 In Transit to Next Facility https://tools.usps.com/golTrackConfinnAction?tRef=fullpage&tLc=2&text28777=&tLab... 10/ 19/2018 USPS.com® - USPS Tracking® Results Page 2 of 3 September 29, 2018, 8:10 pm Departed USPS Regional Facility MIAMI FL DISTRIBUTION CENTER September 28, 2018, 8:42 pm Arrived at USPS Regional Facility MIAMI FL DISTRIBUTION CENTER September 28, 2018, 6:05 pm Departed Post Office MIAMI, FL 33153 September 28, 2018, 4:28 pm USPS in possession of item MIAMI, FL 33153 m Product Information See Less ^ Can't find what you're looking for? Go to our FAQs section to find answers to your tracking questions. FAQs (https://www.usps.com/fags/uspstracking-faqs.htm) https://tools.usps.com/golTrackConfirmAction?tRef=fullpage&tLc=2&text28777=&tLab... 10/ 19/2018