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REV-17-1196'N (ov 0 BUILDING PERMIT APPLICATION 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 ❑ ELECTRIC ROOFING RECEIVED MAY 15 1017 FBC 20 K-1 Master Permit No. Z C I G _G �p Sub Permit No. ?_ V � �} - 1194E ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 104 L211..) (D2 yJ SV City: Miami Shores County: Miami Dade Zip: 33150 Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): ALFkz-c=1A> ?�1i Phone#:6 35�, Address: City: Pl_� State: Zip: 336 S0 Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: 7 S+r�� VS L IID�n Phone#: 30!& 7 — 91 70 Address: l$Z.-V , L,5 , I S� City: h_Kk State: Zip: 3 3125 Qualifier Name: Le-K Phone#: State Certification or Registration #: C LC (3 Z 1( Zn Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Altetration ❑ New ❑ Repair/Replace ❑ Demolition �I- Description of Work: �t�`iSGc��n a Co� A��e��2 P�1(�(�,5poi•�� , ' Specify color of color thru tile:', Submittal Fee $ + " . ! , Permit Fee $� CCF $ CO/CC $ Scanning Fee $ 25:7 • � Radon Fee $ DBPR $ Notary $ Technology Fee Training/Education Fee $ Structural Reviews $ vtvp��- (Revised02/24/2014) -j7�c V �_ 2903 Double Fee $ Bond $ TOTAL FEE NOW DUE $n k4 • DO 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 $1500, 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 OWNER or AGENT The foregoing instrument was acknowledged before me this ��/� day of `20 f 1 by ho is personally known to me or who has produced identification and who did take an oath. Seal: 'I APPROVED BY (Revised02/24/2014) MAHARAI K. GONZALEZ Signature NTRACTOR The foregoing instrument was acknowledged before me this dayof 120 by 14 YA,( Cc 16124,0-Z, who is personally known to as me or who has produced identification and who did take an oath. NOTARY P BLIC: Sign: Print: d`sR EXPIRES: NoyPuber licU dery It Seal: � 7��1/ •, Jose A Giron Bonded Thru Notary Public Underwriters � �= Commission I FF990930 RRE)ires: September 3,NN2020 as Plans Examiner Zoning Structural Review Clerk `.. Department of Regulatory and. Economic Resources M AM-�dE Board Administration Section 11805 SW 2b Street (Coral Way) - Room 230 • Miami, Florida 33175-2474 Telephone 786-315-2573 Fax 786-315-2570 wwwrniamidade.gov/development MEMO TO:fBoard 'lding -i in Miami Dade County .FROM:retary f the Board o ules and Appeals DATE: March 3, 2017 SUBJECT: Certificate of Reinstatement AG Star Roofing Inc. Axel Randolfo Galdamez, Qualifying Agent State License #CCC1329029 1827 NW 111 Street Miami, Florida 33125 As a result of the Board of Rules and Appeals meeting held on February 1.6t", 2017, it was previously advised that the above Contractor's permitting privileges were administratively suspended in Miami -Dade County. This is to inform your Department that the above Contractor's permitting privileges have now been ADMINISTRATIVELY REINSTATED in Miami -Dade County. If you have any questions concerning this matter, please do not hesitate to contact Daniel. Vuelta, Code Enforcement Supervisor at 786-315-2562. JEFF ATWATER CHIEF FINANCIAL OFFICER 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: 6/13/2016 EXPIRATION DATE: 6/13/2018 PERSON: GALDAMEZ AXEL R FEIN: 464106001 BUSINESS NAME AND ADDRESS: AG STAR ROOFING, INC 1827 NW 1ST STREET MIAMI FL 33125 SCOPES OF BUSINESS OR TRADE: LICENSED ROOFING 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 STATE OF FLORIDA r.. DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD a� 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399-0783 GALDAMEZ, AXEL RANDOLFO AG STAR ROOFING, INC. 1827 NW 1 STREET MIAMI FL 33125 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations that Impact you, subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! RICK SCOTT, GOVERNOR LICENSE NUMBER a� (850) 487-1395 STATE OF FLORIDA W ilk DEPARTMENT OF BUSINESS AND _• PROFESSIONAL REGULATION CCC1329029 1 SSU ED: . 08/18/2016 CERTIFIED ROO NG CONTRACTOR GALDAMEZ AXEL,RAND.OLFO'�' AG STAR ROOFING, 0 IS CERTIFIED under the provisions of Ch.489 FS. Expirstion date • AUG 31, 2018 L16MI80001949 DETACH HERE KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD I ne KUUFINU UUN I KAG I UK Named below IS CERTIFIED . Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2018 r r'kys GALDAMEZ, AXEL RANDOLFO* AG STAR ROOFING, INC..,O--''' , 1827 NW 1 STREET �,. �,,,.��..,_�...,• . ,_ " ''* MIAMI FL,33.125. � .. .., 'S:- ,,. �`"� �.■ • ...........:.� '• .,,wry .; Issued: o$nerM" — 'DI PLAYAS REQUIRED B*LV{I' SEQ # L1608180001949