PL-18-1838 (2)Miami Shores Villagesw°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 9axCity: -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 NorSION #
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 REGULATIONCONSTRUCTIONINDUSTRYLICENSINGBOARD
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 FLOWDACHIEFFINANICALOFFICERDEPARTMENTOFFINANCIAL 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
9Y
mMYComm,
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 # GG034902ryVEXPIRESOctober02, 2020
SEAL: