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MC-18-2183Permit No. MC -8-18-2183 ■ Permit Type: Mechanical - Residential Work Classification: Addition/Alteration Permit Status: APPROVED Issue Dom: 9/7/2018 1 Expiration: 03/06/2019 Project Address Parcel Number Applicant 873 NE 98 Street 1132060142520 Miami Shores, FL 33138- Block: Lot: MAURICIO VELAZQUEZ Owner Information Address Phone Cell KARLA UTTING 873 NE 98 Street (786)444-0602 MAIMI SHORES FL 33138- 873 NE 98 Street MAIMI SHORES FL 33138- Contractor(s) Phone Cell Phone INFINITY CONSTRUCTION SERVICES; (786)443-9590 nal Info: MECHANICAL WORK FOR COMPRESSOR RELO ication: Residential ed: In Review Comments: Date Denied: Scannino: 1 Fees Due Amount %sO1i£s y,� Miami Shores Village �f 10050 N.E. 2nd Avenue NE DCA Fee Miami Shores, FL 33138-0000 Education Surcharge Phone: (305)795-2204 FLOR1Dp' $150.00 Permit No. MC -8-18-2183 ■ Permit Type: Mechanical - Residential Work Classification: Addition/Alteration Permit Status: APPROVED Issue Dom: 9/7/2018 1 Expiration: 03/06/2019 Project Address Parcel Number Applicant 873 NE 98 Street 1132060142520 Miami Shores, FL 33138- Block: Lot: MAURICIO VELAZQUEZ Owner Information Address Phone Cell KARLA UTTING 873 NE 98 Street (786)444-0602 MAIMI SHORES FL 33138- 873 NE 98 Street MAIMI SHORES FL 33138- Contractor(s) Phone Cell Phone INFINITY CONSTRUCTION SERVICES; (786)443-9590 nal Info: MECHANICAL WORK FOR COMPRESSOR RELO ication: Residential ed: In Review Comments: Date Denied: Scannino: 1 Fees Due Amount CCF $0.60 DBPR Fee $2.25 DCA Fee $2.00 Education Surcharge $0.20 Permit Fee $150.00 Scanning Fee $3.00 Technology Fee $0.80 Total: $158.85 Valuation: $ 900.00 Total Sq Feet: 0 Date Approved:: In Review Type of Work: MECHANICAL WORK FOR COMPRE; Pay Date Pay Type Amt Paid Amt Due Invoice # MC -8-18-68573 08/16/2018 Credit Card $ 50.00 $ 108.85 09/07/2018 Credit Card $ 108.85 $ 0.00 Available Inspections: Inspection Type: Final Rough Duct Review Mechanical Underground �J: 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, PL MBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I e that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zonin ,/F h,prmoyp, I authorize the above-named contractor to do the work stated. V Vw Authorized Sign ure: Owner / Applicant / Contractor / Building Department Copy September 07, 2018 Agent September 07, 2018 r' Miami Shores Village Building Department All 16 2 18 10050 N.E.2nd Avenue, Miami Shores, Florida 33138' Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER 1305 762 4949 FBC 20116-�' BUILDING Master Permit No. R- - y� l v //0 I�' C PERMIT APPLICATION Sub Permit No. . IO—ZIS3 ❑ BUILDING ❑ ELECTRIC ROOFING ❑ REVISION ❑ EXTENSION [:]RENEWAL ❑ PLUMBING -® MECHANICAL [:]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS /� JOB ADDRESS:'? �� "1 ':�>t City: Miami Shores County: Miami Dade Zip: J J 3 r> Folio/Parcel#: Is the Building Historically Designated: Yes NO X Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): C -V\ PQn uC_(_U U AZCS UQ. -1 Phone#: 10-510 3 IV n Address: C 3 f- "1 % tl� Si - City: Qv\�-(r. l S�'" o 1) State: l Zip: 3313 &0 Tenant/Lessee Name: Email: CONTRACTOR: Company Name: Address: (001's� � �'V_Pj Phone#: phone#:1 L� 6,4 y 5!) z 9,3 City: M % CXY)1 State: r Zip: ?3 16,b Qualifier Name:A411-11,u-[h oc, c 0... Phone#: State Certification or Registration #- C A C:., it f brl .5 Certificate of Competency #: i. DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ O o Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: O Q- nN� (6 Specify color of color thr tile: Submittal Fee $ Sb al Permit Fee $ 0 V(VO CCF $ Scanning Fee $ Radon Fee $ C�G DBPR $ 2 ZS Technology Fee $ Structural Reviews $ (Revised02/24/2014) Training/Education Fee $ CO/CC $ Notary $• Double Fee $ Bond $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding Company's Address City 'i 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. Signature ✓ Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this I da of of4gU�l0.G 1-20 193 by kaUr;c 'Y • i who is personally known to o me or who has produced ^ 1 �Yt� r l h�,�l �L� as identificati nan ho didXalt,an oath. NOTARY P LIC: Sign: Print: Seal: — �`;«"Y'•PYQ(i APPROVED BY (Revised02/24/2014) L%d WtNADY PRIEM MY COMMISSION # FF 214031 EXPIRES: March 25, 2019 ,nded Thru Notary Public Underwriters The foregoing instrument was acknowledged before me this day of ,20 Ig by jQ 0P � v ��� who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: as Sign:J1�— ,�.. :��;• $ Print:. •�y� •• ,r RAUL NAVARRO Seal: I MY COMMISSION #FF972714 '*LEXrIRES: L'.AR 20, 2020 Bonded through 1 st State Insurance uc+;rr-nr'..,. •,. i,.:, ;":ova . �pr�;. Plans Examiner Structural Review Zoning Clerk License: CFC#1428288 License CAC1816795 4156 SW 96 Ave. Miami F1 33165 Phone #786 443 9590 Date: July 25, 2018 COUNTY OF MIAMI SHORES VILLAGE Building Department Before me this day personally appeared Antonio Luvara who, been duty sworn deposes and says: That he will the only person working on the property located at �3 Qgsf k�iCd,S saes Cordi ly: I ntonio Luvara Sworn to and subscribed before me this (/)? Personally Know_ Or produced Identification Type of identification Print, Type or stamp seal of Notary '' ` "` RAUL NAVARRO MY COn1PfISS"0"J #FF972714 ° ti^ �(r,RES' MAR 20, 2020 Bonded through 1st State Insurance day of A0_— 20r_by 4,oru oc r` 679 N Miami Ave, Loft #3, Miami, FL 33136 Office 305.200.3131 1 Fax:305.200.3422 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 mouce to owner — vvorKers- compensation Insurance txemption 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 AG9NOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: ± O ner State of Florida County of Miami -Dade The foregoing was acknowledge before me this day of 1-' �E (Z 20 (c' is personally known tome or has produced �ZI C1�CJF(`J sL as identification. Notary: VNDIA ALVAREZ MY COMMISSION # GG 238273 EXPIRES. September 3, 2022