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RC-19-1524RC, a�-i�-�sZI Jv s�= #6� 1 d`J /s . 0.- Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address r- Issue Date:10/03/2019 Parcel Number 17 NE 107TH ST, Miami Shores, FL 33161 1121360070340 Contacts Permit NO.: RC-07-19-1524 Permit Type: Building (Residential) Work Classification: Alteration Permit Status: Approved Expiration: 03/31/2020 HOWARD HENRIQUES Owner 17 NE 107 ST, MIAMI, FL 33161 henriques3h@gmail.com NIGHT AND DAY CONSTRUCTION INC Contractor JUAN C ZEQUEIRA 18757 SW 69 ST, SOUTHWEST RANCHES, FL 33332 Business: 7864025117 jeffdelille5@yahoo.com Description: UPDATE PERMIT FOR INTERIOR REMODEL Valuation: $ 12,000.00 T tion Re uests: 2-4949 Total Sq Feet: 0.00 Fees Amount Application Fee - Other $50.00 CCF $7.20 DBPR Fee $5.40 DCA Fee $3.60 Education Surcharge $2.40 Permit Fee $310.00 Scanning Fee $30.00 Technology Fee $9.00 Work Without Permit 1st Offense $100.00 Work Without Permit 1st Offense $360.00 Tota I : $877.60 Building Department Copy Payments Date Paid Amt Paid Total Fees $877.60 Credit Card 10/03/2019 $877.60 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. AFFI IT: cefy that all the foregoing information is accurate and that all work will be done in compliance wall ap able laws -onsA ilction nd ing. Futhermore, I authorize the above named contractor to do the work stated. / l Signature: &ner / Applicant / Contractor / Agent Date October 03, 2019 Page 2 of 2 % Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 JUL 0 2 2019 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20P BUILDING Master Permit No. 1sG^ o1 k -` — i 5 24 PERMIT APPLICATION Sub Permit No. ER'dUILDING ❑ ELECTRIC [—].ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP / "jam (�%� CONTRACTOR DRAWINGS JOB ADDRESS: /y E, /o T V V ) j Citv: Miami Shores Countv: Miami Dade zip: _�3.311" 1 Folio/Parcel#: 11-'Z1,3R87a34M Is the Building Historically Designated: Yes NO _X Occupancy Type: old I Construction Type: C22-9 Flood Zone: / BFE: —tjltq ' FFE: OWNER: Name (Fee Simple Titleholder): &a)AV1_ EA C 14 U � Phone#: N19, Address: tq— I9 ,J �j__ 2 City: o l lGl lm G State: FL— Zip: , 3J I Tenant/Lessee Name: Email: eVl /L9'C otfl' C Phone#: CONTRACTOR: Company Name: ✓" r I� w6l2W e42,G G Phone#: �U o /� Z=;tZ� Address: 7 Gv City: ^f7�G�r'�✓rG�i��i' State: �� Zip:�`��✓ �— Qualifier Name: ,. )[/, C ?" (lelIg,g- Phone#: U Z,r:zz7 State Certification or Registration #: C�7C ��l V // Certificate of Competency #: DESIGNER:��A``rchhitect/Engine ao�. Phone#:, Address: /�K� JlJ� ,,n City: � r l 1 State: R__ Zip: 36 136 Value of Work for this Permit: $ :._JI. M 04-- Square/Linear Footage of Work: Type of Work: ❑ Addition [Alteration ❑ New ❑ Repair/Replace C// Description of Work: 4- Specify ,c61or,of<;color Submittal Fee Scanning Fee $ Technology Fee Permit Fee $ —3 G • p Radon Fee $ Structural Reviews $ _ . (' 00 Training/Education Fee $ CCF $_ DBPR $ ❑ Demolition CO/CC $ Notary $ Double Fee $ rob Q Bond $ TOTAL FEE NOW DUE $ 8 _� ? . GO (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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature S S /I Signature OWNER or AGENT The foregoing instrument was acknowledged before me this day of �) t�{�, 20, by Oily nZL, 5who is personally known to me or who has prod ced &Y- l- aU it, as identification and who did take an oath. NOTARY PUBLIC: Sign: YP FERNANDOMARTINEZ Print: �i! sue*`-,`: Publie Stste of Florida \�°± Commission : FF 924008 Seal: '? oa n°: My Comm. Expires Oct 16, 2019 CONT A OR The foregoing ins u ent was acknowledged before me this I day of 20 /9 by r ,ggyldf' 2e Cl C l'r-lt . who i personally known o me or who has produced identification and who did take an oath. NOTARY PUBLIC: Isb9 t: RA GARCIA MY COMMISSION # GG 22387T b`- EXPIRES: August 27, 2022 '''•:too a?°':' Bonded Thtu WNY Public tlndetr YW% ********************************** *********************************************************************** APPROVED BY u Plans Examiner =Zoning Structural Review Clerk (Revised02/24/2014) 0 RICK SCOTT, GOVERNOR JONATHAN ZACHEM, SECRETARY dIFI-Qdda I c)pr STATE OF FLORIDA DEPARTMENT OF BUSINESS AA P PROFESSION -REGULATION CONSTRUCTION INpLISTRY LIC t-S BOARD THE BUILDING CONTRACTOR HEREIN I 7�-IMUNDER THE PROVlSIC NSrOF +vHAPTECR}489, F`X-101F1 STATUTES 4-u; M 4 -N RA, t.�4N 664- ( NST 9�tr /t�/Yp,O'$OX27 YIL r .�SSCQ�TF� � l{i ES�. '1R . lirY!�.iM 7ii�i77r�`R�T'l�i�..r� EXPIRATION DATA"A-u.06sYi 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. . I BROWARD COUNTY LOCAL BUSINESS TAX RECEiPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954 831-4000 VALID OCTOBER 1, 2018 THROUGH SEPTEMBER 30, P19 DBA:NIGHT AND DAY CONSTRUCTION Business Name: Owner Name: J. CARLOS ZEQuEIRA Business Location: 18757 SW 69TH STREET SOUTHWEST RANCHES Business Phone:786-402-5117 Receipt #:GENE 2 L3 CONTRACTOR Business Type: (CON�RUCTION) Business opened: 09/21/2011 State/County/CertlReg : CB C a 5 7 619 Exemption Code: Rooms Seats Employees Machines Professionals 1 i vondina Tvoe: Tax Amount Numoer or macnnwa. Transfer Fee NSF Fee Penatty - - - Prior Years Collection Cost Total Paid 27.00 0.00 0.00 0.00 0.00 0.00 27.00 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 withip 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 air you have moved the business location. This receipt does not indicate that thel business is legal or that it is in compliance with State or local laws and regulations. Mailing Address: J. CARLOS ZEQUEIRA P.O. BOX 327955 SOUTHWEST RANCHES, FL 33332 2018 - 2019 Receipt #034417-00001344 paid 07/17/246 27.00 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 DBA:NIGHT AND DAY CONSTRUCTION Business Name: Owner Name: J. CARLOS ZEQUEIRA Business Location: 18757 SW 69TH STREET SOUTHWEST RANCHES Business Phone:786-402-5117 Receipt#:0-243833 GENERAL CONTRACTOR Business Type: (CONSTRUCTION) Business Opened:09/21/2011 State/County/Cert/Reg:CBC0 5 7 619 Exemption Code: Rooms Seats Employees Machines Professionals 1 For Vending Business Only VwwAtnn Tvnw• Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 0.00 0.00 0.00 27.00 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- J. CARLOS ZEQUEIRA P.O. BOX 327955 SOUTHWEST RANCHES, FL 31332 2017 - 2018 Receipt #02A-16-00005570 Paid 07/12/2017 27.00 CERTIFICATE OF LIABILITY INSURANCE DATE(MMOMrirYY) 7/26/2018 THIS CERTIFICATE IS 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 CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder 13 an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to tho terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsements . PRODUCER TACT Frank H. Furman, Inc. 1314 East Atlantic Blvd. PHONE (954) 943-5050 FAX (954)942-6310 E-MAIL P. 0. Box 1927 o INBeach FL 33061 INSURERS AFFORDING COVERAGE NAIC i INSURERA:COlon Insurance Co 39993 INSURED SUREO Night and Day Construction, Inc. 18757 Bw 69th street southwest ranches, FL NSURER S : NSURERC: INSURERD: NSURERE: NSURERF: ns:v,arvn nLIMP=n: 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. INTR TYPE OF INSURANCEA UBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS-MADE�X OCCUR 1030L002056100 12/12/2017 11/12/2018 EACH OCCURRENCE s 1,000,000 PRf:MISES1 4occurrence) $ 300,000 MEDEXP(Any one person) S 5,000 PERSONALdADVINJURY i 11000,000 Go rL AGGREGATE LIMIT APPLIES PER: POLICY a PRO- LOC JECTPRODUCTS OTHER: Ded 2500 eZ PD Per Occ GENERAL AGGREGATE S 2 1000,000 - COMP/OP AGO S 2,000,000 X Policy Aggregate S 51000, 000 AUTOMOBILE LIABILITY ANY AUTO ALL OMED SCHEDULED AUTOS AUTOS HIRED AUTOS AUTOSVNJED COMSINED,,SINGLE LIMIT1 Eat vocrosin _ BODILY INJURY (Per person) 5 BODILY INJURY (Per accident) $ p r PERTY; AMAGE $ S UMBRELLA LIAO OCCUR EXCESS LIAB CLAIMS -MADE EACH OCCURRENCE S AGGREGATE is D I I RET NTI N f Is WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED7 (Mandatory in NH) H yos, describe under DESCRIPTION OF OPERATIONSbelow NIA R H- T E.L. EACH ACCIDENT f E.L. DISEASE - EA EMPLOYE f _ -- S E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remrks ScMduis, may be attached N more space is required) Carlos State of Florida License Number CBC057619 MIAMI SHORES VILLAGE BUILDING DEPARTMENT 10050 N.E. 2nd AVENUE MIAMI SHORES, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Dirk DeJong/MR 01988-2014 ACORD CORPORATION. All rinhta ra-awed ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS025 (2oi4o1) .a►coRo CERTIFICATE OF LIABILITY INSURANCE DATEIMMMNYYY) 7/26/2018 THIS CERTIFICATE IS 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 CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in Ileu of such endomemen : . PRODUCER Insurance Office of America, Inc. 1855 West State Road 434 Longwood FL 32750 ME Beve Weed PNONE 407-788-3000 FA" Alc e • 407-788-7933 "s°`IL beveri .weed ioausa.com INSURERS AFFORDING COVERAGE NAIC0 INSURER A : Normandy Insurance Company 13012 INSURED WELCONE-01 Welco One, LLC INSURERS: INSURERC: dba Worksite Employee Leasing Alt Emp: Night and Day Construction, Inc. 2579 INSURERD: INSURER N Toledo Blade Blvd North Port FL 34289 INSURER F t.UVCI[AbCa CtRTIFICATF NI IMRFR• 11'1A!Q0'5An s-1 n.w -- -- L q� lVry r\VrerUGR. 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, INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFF MIN POLICY EXP MIDoryyyyi LJMrfb COMMERCIALGENERAL LIABILITY CLAIMS -MADE OCCUR EACHOCCURRENCE S PREMISES S MED EXP (Any oneperson) $ PERSONAL d ADV INJURY $ GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 3 POLICY ❑ 17 JJECT LOC PRODUCTS -COMPgPAGG S E OTHER: AUTOMOBILELJABILnY COMBINED SINGLELIMIT accident) S ANY AUTO _(Es BODILY INJURY (Per person) S OWNED SCHEOULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) S HIRED NON -OWNED AUTOS ONLY AUTOS ONLY I PROPERTY DAMAGE p4cc S s UMBRELLALNB OCCUR EACH OCCURRENCE E AGGREGATE S EXCESSLJAS CLAIMS -MADE DED I I RETENTION $ _ $ A WORKERS COMPENSATION NHFL0068B52018 5/1I201S 511/4018 TgTUT ERH AND EMPLOYERS' LIABILITYX Y 1 N E.L. EACH ACCIDENT S 1,000.000 ANYPROPRIETORrt+ARTNER/F7(....... OFFICERMIt71sBEREXCLUDED9 � NIA A E.L. DISEASE - EA EMPLOYEE S 1.000,000 (Mandatory In NK) deaalbe under E.L. DISEASE - POLICY LIMIT S 1,000 000 DESCRIPTION OF OPERATIONS below I DESCRIPTION OF OPERATIONS f LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached IF more space Is required) Coverage Is provided for only those employees leased to but not subcontractors of the Alternate Employer for any job, operation or project performed during the above mentioned policy period. "State of Florida License Number CBC057619•• Miami Shores Village Building Dept 10050 NE 2nd Ave. Miami Shores FL 33138 ACORD 25 (2016103) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE U'R. A-4':-'J Hsu 1 VOO-LUTE AGURD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD