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PL-18-1119Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Permit NO.: PL-4-18-1119 Permit Type: Plumbing - Residential, Work classifacatian: Addition/Alteration Permit Status: Approved Issue Date: OS/01/2018 Expiration:10/29/2018 Location Address Parcel Number Project 1296 NE 99 ST, Miami Shores, FL 1132050090140 <NONE> Contacts FILPO PROPERTIES LLC Owner FILPO PROPERTIES LLC Applicant 1296 NE 27 ST 2904, MIAMI, FL 33137 1296 NE 27 ST 2904, MIAMI , FL 33137 Other:9147140878 Other:9147140878 KDF CONSTRUCTION INC Contractor KERRITH FIDDLER 841 NW 173 TER, MIAMI GARDENS, FL 33169 Business: 3052448781 kdfconstruction@live.com Description: replace plumbing fixtures in two bathrooms Valuation: $ 1,800.00 Inspection Requests: and kitchen sink Total Sq Feet: 0.00 Fees Amount CCF $1.20 Change of Contractor $110.00 DBPR Fee $4.50 DCA Fee $3.00 Education Surcharge $0.40 Permit Fee $300.00 Scanning Fee $3.00 Technology Fee $1.60 Work without Permit Fee $300.00 Total: $723.70 Payments Date Paid Amt Paid Total Fees $723.70 Check # 1484 04/26/2018 $50.00 Check # 1486 05/01/2018 $563.70 Credit Card 10/19/2018 $110.00 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 regulating, the foregoing information is accurate and that all work will be done in compliance with all applicable laws more, I authorize the above named contractor to do the work stated. / Applicant / Contractor / Agent Date October 19, 2018 Page 2 of 2 �`5µort�sLi 'spew' FtoRivA Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit NO. PL-4-18-1119 Permit Type: Plumbing - Residential riI ' Work Classification: AdditionlAlteration Permit Status: APPROVED Parcel Number issue Date: 61112018 ] Expiration: 10/28/2018 Applicant 1296 NE 99 Street 1132050090140 Miami Shores, FL Block: Lot: FILPO PROPERTIES LLC Owner Information Address Phone Cell FILPO PROPERTIES LLC 1296 NE 27 Street MIAMI FL 33137- 1296 NE 27 MIAMI FL 33137- Contractor(s) Phone Cell Phone UNIVERSAL PLUMBING CORP (305)887-3131 of Work: replace plumbing fixtures in two ba of Piping: onal Info: Return : ification: Residential Scanning: 1 Fees Due Amount CCF $1.20 DBPR Fee $4.50 DCA Fee $3.00 Education Surcharge $0.40 Permit Fee $300.00 Scanning Fee $3.00 Technology Fee $1.60 Work without Permit Fee $300.00 Total: $613.70 Valuation: $ 1,800.00 Total Sq Feet: p Pay Date Pay Type Amt Paid Amt Due Invoice # PL-4-18-67324 04/26/2018 Check #: 1484 $ 50.00 $ 563.70 05/01/2018 Check #: 1486 $ 563.70 $ 0.00 Avaname Inspections: Inspection Type: Top Out Final Review Underclr 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�V�tra II the foreg_eing.information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zor er re �.abD4-named contractor to do the work stated. AuthorWd Sicy(a]urbjOWrMr�/ Applicant Building Department Copy J / Contractor / Agent May 01, 2018 1 Miami Shores Village RECE/VEt Building Department Or.r zp�� 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 61Y1� FBC 20�'� BUILDING Master Permit No. PERMIT APPLICATION Sub Permit No. PL (4'-)9 -1 M ❑ BUILDING ❑ ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑ RENEWAL �LUMBING ❑ MECHANICAL ❑PUBLIC WORKS CHANGE OF ❑ CANCELLATION ❑ SHOP - A n CONTRACTOR DRAWINGS JOB ADDRESS: I a q(o I V C� `'l q City: Miami Shores County: Miami Dade Zip: 33 191 Folio/Parcel#: / — 3�2 Ds-—co(9— o / 4/U Is the Building Historically Designated: Yes NO x Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Phone#: Address:: 12 9 (0 NE1 !29 City: M, G i--G Shtre_s State: �[.0►2� (JA Zip: 33 Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: "cl0&3 C. Phone#: Address: O�11 / City: �5 �t-AVA� State: FC.o�i"� l�� Zip: 3 3-Y Qualifier Name: U79_1\+1 4AL,/i� ��1 w r w -,.�F71 N_,i�"�. Phone#: State Certification or Registration #: U 2 CcS13,5 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ CT) - 0_0 Square/Linear Footage of Work: Type of Work: ❑ A dition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: �.n IGce+f�S I (U�%'© _ arcS Specify color of color thru tile: Submittal Fee $ Permit Fee $ .V� CCF $ CO/CC $ Scanning Fee $ Technology Fee $ Structural Reviews $ Radon Fee $ Training/Education Fee $ DBPR $ Notary $ Double Fee $ Bond $ I r,� TOTAL FEE NOW DUE $ A 101 Q (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 no be approved and a rei ection fee will be charged. Signature �X/� Signature OWNER or AGENT CONTRACTOR The for going instrument was acknowledged before rye this day of 20 1 0 by who is personally knowCn0to me or who has produ d��tl ICQ� a� identification and who did take an oath. Zday ing instrument was acknowledged before me this of G OAer 20 �� by / r0r �ol !6l , who is ersonally know o me or who has produced identification and who did take an oath. as NOTARY PUS NOTARY PUBLIC: 1 Sign: — Sign: Pn`nt )/ 1>. Yi-, a Print: r- r C I ,� 0`�'"y PO«,� _ • = JAMAL L SCOTT Notary Public - State Florida Seal: ";Y;,� JAMIEJENKINS Notary Public - State of Florida Commission 8 GG 088443 , ?ate* �Z of Commission # FF 898220 ':' r s'" My Comm. Expires Apr21,2021 **'i#�*>k's**�IR'YFYaR9t�R�9lr�ty�'** *****s***** APPROVED BY Plans Examiner Zoning Structural Review (Revised02/24/2014) Clerk 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: 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' compAnsation insurance coverage from the contractor's company for day labor, part-time employees or subcontractors. BY S T BELOW YOU AC O EDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS Col. Signature: ICA Owner State of Florida County of Miami -Dade The foregoing was acknowledge before me this day of �� , 20 I \� By who is personally known to me or has produced 4C 0,Ykle as identification. JAMAL L SCOTT Notary Public - State of Florida My Comm. Expires Jul 12, 2019 License No: CFC 1428135 F 830 N. John Young Parkway Kissimmee, FL 34741 Ph: 305-244-8781 kdfconstruction@live.com Date: /Q _S'_/1' State of 110 ►�G�q County of Mllf M - Before me this day personally appeared Lrl'lk riiJ0( '� f who, being duly sworn, deposes and says: That he or she will be the only person working on the project located at: Contractor Signature Sworn to or affi ed) and subscribed before me this S day of A- o p N f Personally know OR Produced Identification �';•;; • JAMIEJENKINS o . Notary Public - State of Florida •W�p., Commission i GG 088443 M Comm. Expires Apr 21, 2021 ! Bonded through National Notary Assn. Print, Type or Stamp Name of N . 20/f�, by Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR / ARCHITECT Permit N. Owner's Name (Fee Simple Title Holder): FILPO PROPERTIES LLC Phone #: Owner's Address: 600 NE 27 ST 2904 City: MIAMI State : FL Zip Code: 33137 Job Address (Of where work is being done): 1296 NE 99th Street Miami Shores, Florida City: Miami Shores State: —Florida Zip Code: 33138 Contractor's 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 Miami Sh es harmless of all legal involvement. Signature Signature Owner or Agent Contractor or Architect The f regoing ins um nt was a owledgeI" Wd before me The foregoing instrument was aknowledged before me this day of '20 y ( this �sf day of OG O 20/fby el"(1 V 1 \� Who ispers�?nall known t�om�e or who has produced who i ersonally know to me or who has produced ytT1 r as indentification. as indentification. tw7 Public Notary Publi Sign: Seal: JAMAL L SCOTT ?� 'Y° s Notary Public - State of Florida a;Y�`; NotaryPublicE,StateNofFlorida N,� Commission # FF 898220 . ; Commission #GG088443 %FOFF.oQ;•'� My Comm. Expires Jul 12, 2019 =; ' � My Comm. ExpiresApr21. 0 Fro,'• Bonded through National NotaryAssn. MIAMI 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. 60' Street Hialeah, Florida 33013 Attention: Osvel Castellon RE: Project: Filpo Residence 1296 NE 99 Street Miami Shores, Florida 33138 NOTICE OF TERMINATION AND CHANGE OF CONTRACTOR Sent via: E-mail and Certified Mail Receipt 47018 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 tc .e proj e 1 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: ClaudioDa MiamiSkylineConstruction.com Mari agMiami SkylineConstructi on. com Office(,MiamiSkylineConstruction. com universalpmsngmail.com MIAMI SKYLINE CONSTRUCTION SERVICE CORP. 12864 Biscayne Blvd. # 176, North Miami, Fl 33161 Phone: 305-899-9696 Fax. 305-899-8840 Email: office( anmiamislcylineconstruction.com Website: www.iniamisicylineconsruction.com A2,uspsrom, P-tw St... ,:.: M� M LISPS Tracking* ��, FAOs Track Mother Package f- Tracking Number: 70160,68(160i)ogfi418191 :Ks-1114 X Status Rde is d fWm Kda ro end kr radoNrpy 01 Va .-tQm a Delivery Attempt PI itnm wo 0819CJtivd fU Servsw. Rin.nder jo SN:.+rfc {ixSN+rrry ci g-+N ;+.r:.^. Dezivwy Attempt Text & EntaY Updates v Sraa-i,.g Hiwo y ^ IN5is a re.-,-'hder t, amen$. f; fs,.<s.. —i 0' ;u• :,t n, ar ya:z it— are: Lw rs+.xnrr_3 Ott 1.201& 1.11 pn t zv`.ce LeP? `yflp Nl.,—n-A.,? Rase, Y, .4. aileh'zj WP.iEAH Rai° Oe>obw 7.2018 tether 20. 2011L &'te pm dam"•=d LISPS RaEy-x F—'iy b'WA'1 F4 Cr,7F:,EWTFCFd CEO rER 9ep4 the 2k 2078. RA2 pm A,md.d LISPS Rtyi.W P-fif . NIAW FL DMTREIJ IDN CE tTER Sep@m4C 20. 20t8. 6205 Px Cepened FSA CM - Lim FL S3"3 RICK SCOTT, GOVERNOR JONATHAN ZACHEM,SECRETARY Florida r STATE OF`FLORIDA DEPARTMENT OF BUSINESS 4ND -ROFE! CONSTRU THE PLUMB[ NAL REGULATION UNDER THE EXPIRATION -A E��.Al'JGt1ST 31, 2020 Always verify licenses online at MyFloridaLicense.com Do not alter this document in any form. This is your license. It is unlawful for anyone other than the licensee to use this document. NOR I THIMIAMI Issued Date: 10/92018 Expiration Date: 9/3012019 Business Tax Receipt #: BT-005720 KDF CONSTRUCTION INC 4206 SEVAN WAY KISSIMMEE, -FL 34746 NON -TRANSFERABLE - City of North Miami 776 N.E.125 Street - North Miami, FL 33161 * 30"93-6511 Business Tax Receipt Construction Company (Plumbing) Business'Name I Address: KDF CONSTRUCTION INC 830 N JOHN YOUNG PKWY KISSIMMEE, FL 34741 IN-ACONSPICUOUS PLACE - DATE (MM/DD/YY) .acc�rrr� CERTIFICATE OF LIABILITY INSURANCE 03/19/18 C T S ISSUED AS A MATTER OF INFORMATION AND PRODUCER Annette Willis Insurance THIS CI A E I ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 18401 N.W. 27 Ave HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Miami, FL 33056 Phone (305) 625-2403 Fax (305) 625-6472 INSURED KDF Construction Inc. 4206 Sevan Way Kissimmee, FL 34746 COVERAGES INSURERS AFFORDING COVERAGE I NAIC # 1NCIIRFR A• Catlin SDecialty Insurance COm Dany INSURER E: THE POLICIES OF INSURANCE LISTED 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR ADVIL IN RD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YYYY POLICY EXPIRATION DATE MM/DDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence 1 OO,000 ❑�/ COMMERCIAL GENERAL LIABILITY 0901703376 03/17/2018 03/17/2019 MED EXP (Anyone person) 5,000 A ❑ ❑❑ CLAIMS MADE © OCCUR ❑ PERSONAL BADVINJURY 1,000,000 GENERAL AGGREGATE 2,000,000 ❑ GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG 2,000,000 R POLICY ❑ PROJECT ❑ LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ❑ ANY AUTO (Ea accident) BODILY INJURY (Per person) ❑ ❑ ALL OWNED AUTOS ❑ SCHEDULED AUTOS ❑ HIRED AUTOS ❑ NON OWNED AUTOS BODILY INJURY (Per accident) ❑ PROPERTY DAMAGE Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT OTHER THAN EA ACC ❑ ❑ ANY AUTO AUTO ONLY: AGG EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE AGGREGATE ❑ OCCUR ❑ CLAIMS MADE ❑ DEDUCTIBLE ❑ RETENTION $ WORKERS COMPENSATION AND ❑ WC STATE- ❑ OTH- EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR / PARTNER / EXECUTIVE ORY E.L. EACH ACCIDENT OFFICER / MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT If yes, describe under SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS GENERAL CONTRACTOR Roofing is CCC1328850 Plumbing is CFC1428135 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL MIAMI SHORES VILLAGE BLDG DEPT 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO 10050 NE 2 AVE THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. MIAMI SHORES, FL 33138 AUTHORIZED REPRESENTATIVE i ACORD 25 (2UU9/U1) QF v I V60-LUMP Ak UKU GUM-U CA I IUN. Hu ngnrs reservea. The ACORD name and logo are registered marks of ACORD JEFF ATWATER CHIEF FINANCIAL OFFICER aMa 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: 1/17/2017 EXPIRATION DATE: 1/17/2019 PERSON: FIDDLER KERRITH D FEIN: 030597899 BUSINESS NAME AND ADDRESS: KDF CONSTRUCTION, INC. 4206 SEVAN WAY KISSIMMEE FL 34746 SCOPES OF BUSINESS OR TRADE: LICENSED GENERAL LICENSED PLUMBING LICENSED ROOFING CONTRACTOR CONTRACTOR 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 City of Kissimmee 101 North Church Street Kissimmee, ,FL 34741 BUSINESS TAX RECEIPT BUSINESS TAX RECEIPT VALID FROM OCTOBER 1, 2018 THROUGH SEPTEMBER 30,•2019 LIC #: BTR-07464 CODE: CONTACT: KERRITH FIDDLER CATEGORY: CONTRACTOR 2016 Mailing Address KDF CONSTRUCTION INC 830 N JOHN YOUNG PKWY Kissimmee, FL 34741 LATE PENALTIES: AS OF OCTOBER I - OPERATING A BUSINESS WITHOUT A BU FEE PENALTY TOTAL VALIDATION 9.00 0.00 1 $19.00 1 09 0 20 8 Business Address KDF CONSTRUCTION .INC 830 N JOHN YOUNG PKWY Kissimmee, FL 34741 AS OF NOVEMBER I -15% AS OF DECEMBER 1 - 20% AS OF JANUARY I - 25% iS TAX RECEIPT IS SUBJECT TO CIVIL ACTIONS AND A PENALTY OF UP TO $250 City of Kissimmee 101 North Church Street Kissimmee, FL 34741 BUSINESS TAX RECEIPT BUSINESS TAX RECEIPT VALID FROM OCTOBER 1,.2018 THROUGH` SEPTEMBER 30, 2019 LIC #: BTR-08392 CODE: CONTACT: KERRITH FIDDLER CATEGORY: SUB-CONTRACTOR/PLUMBING Mailing Address KDF CONSTRUCTIONINC 830 N JOHN YOUNG PKWY Kissimmee, FL:34741 FEE I PENALTY I LIDATION 1900 0.00 9.00 1 09120/2018 Business Address KDF'CONSTRUCTION INC 830 N JOHN YOUNG PKWY Kissimmee, FL 34741 LATE PENALTIES: AS OF OCTOBER I - 10% AS OF'NNOVEMBER I -15% AS OF DECEMBER 1 - 200% AS OF JANUARY I - 25% OPERATING A BUSINESS WITHOUT A BUSINESS TAX RECEIPT IS SUBJECT TO CIVIL ACTIONS AND A PENALTY OF UP TO $250 City of Kissimmee 101 North Church Street Kissimmee, .FL 34741' BUSINESS TAX RECEIPT BUSINESS TAX RECEIPT VALID FROM OCTOBER 1,2018 THROUGH SEPTEMBER 30, 2019 LIC #: BTR-08391 CODE: CONTACT: KERRITH FIDDLER CATEGORY: ROOFING CONTRACTOR 2016 Mailing Address KDF CONSTRUCTION INC 830 N JOHN YOUNG PKWY Kissimmee, FL 34741 FEE 1, PENALTY TOTAL IVALIDATION 9 00$0.00 $19.00,09/20/2018 Business Address KDF CONSTRUCTION INC 830.N JOHN YOUNG PKWY Kissimmee, FL 34741 LATE PENALTIES: AS OF OCTOBER I - 10% AS OFNOVEMBER 1 - 15% AS OF DECEMBER 1 - 20% AS OF JANUARY 1 - 25% OPERATING A BUSINESS WITHOUT A BUSINESS TAX RECEIPT IS SUBJECT TO CIVIL ACTIONS AND A PENALTY OF UP TO $250 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 F� Master Permit No. �IR C, Sub Permit No.P I ❑ REVISION ❑ EXTENSION EJRENEWAL fXPLUMBING/ ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS �l JOB ADDRESS: 1 NE —I q"-� City: Miami Shores _ (? ` (County: Miami Dade Zip: ) � 13p Folio/Parcel#: 1 1 3 2-0 S �d —I O I �-Y O Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Ty pe: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): tI py P-f rPhone#: Address:i ZFe(o N F- nq 3i4e-- City: )vy, Qr\-li LSi(-rr2--, �-SState: �IC�r �g Zip: Tenant/Lessee Name: "CX1 i CC, -is i � Qb Phone#:_ Email: CONTRACTOR: Company Name: 6" %2 �/elZ,S�C Address: G`6,l & 4©57 y`1f�• ,-1 iJ COq1? Phone#:���0 �� y City: - I e *-e State: Zip: 3 �� Qualifier Name:it4, ,K -c c,? Poy,,- it Phone#: State Certification or Registration #��(��,� ��i2 f Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ { , ��'� 61::1 Square/Linear Footage of Work: Type of Work: ❑ Addition Alteration New ❑ Re-`pair/Replace ❑ Demolition (❑ �,❑ Description of Work: 6� _F "\ \C� 0 t>\ \�J( YUQ_� kA-0 �\ V T t �-y,-0 n ( NN, Specify color of color thru tile: "`t'''�'t !, !.i r it '}: M Submittal Fee rr CO $ �) Permit Fee $ �r� CCF $ Scanning Fee $ Technology Fee Structural Reviews $ Radon Fee $ Training/Education Fee $ DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ ' (Revised02/24/2014) 4. 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 a approved and a reinspection fee will be charged. Signature' \ Signature OWNER or AGENT CONTRACTOR The foregoing instrument was a knowledged before me this rr II? b day of 20 I D , by L 10nicc, C e I 100 , who is personally known to me or who has produced F(.OI. FH lb-5k3-73-0-0 as identification and who did take an oath. NOTARY PUBLIC: Sign:_ Print: I. Seal: s��►n ",CARLOS J 2ELAYA Notary Public • State of Florida Commission #r GG 031309 My Comm. Expires Sep 18, 2020 APPROVED BY The foregoing instrument was acknowledged before me this -2'0 day of 20J by `G&61 �;4VZ-J4 , who is personally known to me or who has produced identification and who did take an oath. as NOTARY PUBLIC: Sig Print: Z0, Notary Public State of Florida Seal: Lourdes Morin Rivera �Y; My Commission GG 124638 ExnireF 0?/18/2021 *****ss*ssssss•r*s******s**********s*�*************** T '," Plans Examiner I if Zoning (Revised02/24/2014) Structural Review Clerk