PL-18-1313Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Permit NO.: PL-5-18-1313 Permit IVR Number: 626494
Permit Type: Plumbing - Residential
I4 l Work Classification: Addition/Alteration
Permit Status: Approved
Issue Date:10/02/2018 I Expiration: 11/19/2018
Parcel Number
Project
138 NE 109 ST, Miami Shores, FL 33161-7042 1121360090130 <NONE>
Contacts
EAL INVESTMENT INC Owner EAL INVESTMENT INC Applicant
138 NE 109 ST, MIAMI SHORES, FL 33161 138 NE 109 ST, MIAMI SHORES, FL 33161
Other:7863160828 Other:7863160828
INFINITY CONSTRUCTION SERVICES INC Contractor
ANTONIO LUVARA
4156 96 AVE, MIAMI, FL 33165
Business: 7864439590
Description: CHANGE BATHTUB, TOILET VANITY AND SHOWER Valuation: $ 2,500.00 Inspection Requests: _
VAVLE IN BATHROOM 1 CHANGE SHOWERPAN, VANITY TOILET F-762-4949
AND SHOWER VALVE IN THE BATHROOM 2 CHANGE TOILET Total Sq Feet: 0.00
AND VANITY IN BATHROOM 3 CHANGE SINK AND FAUCET IN
THE KITCHEN INSTALL TANKLESS WATER HEATER
Fees
Amount
CCF
$1.80
DBPR Fee
$2.25
DCA Fee
$2.00
Education Surcharge
$0.60
Permit Fee
$150.00
Scanning Fee
$3.00
Technology Fee
$2.40
Total:
$162.05
Payments
Amt Paid
Total Fees
$162.05
Check # 1667
$50.00
Check # 584
$112.05
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 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. Futhermore, I authorize the above named contractor to do the work stated.
Authorized Signature: Owner / Applicant / Contractor / Agent Date
October 02, 2018 Page 2 of 4
Miami Shores Village K
Building Department MAY I G poe
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 n ,�
4-1
Tel: (305) 795-2204 Fax: (305) 756-8972 V `
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 201-A
BUILDING Master Permit No. eizc 10 -131 o
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
QPLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 138 NE 109th St, North Miami, FL 33161
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#:11-2136-009-0130 Is the Building Historically Designated: Yes NO X
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): EAL INVESTMENT INC Phone#:786 316 0828
,,,4,4.-«.13499 BISCAYNE BLVD # TS3
City: M IAM I
State: FL Zip: 33144
Tenant/Lessee Name:
Email: israelcamposdeleon@hotmail.com
ne#:
CONTRACTOR: Company Name: Infinity Construction Services INC Phone#: 305 761 7937
Address: 4156 SW 96 Ave
City: Miami State: FL Zip: 33165
Qualifier Name: Antonio Luvara Phone#:
State Certification or Registration #: CFC1428288 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 2,500.00 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ® Repair/Replace ❑ Demolition
Description of Work: Change bathtup , toilet, vanity and shower valve in bathroom 1, Change showerpan, vanity,
toilet and shower valve in the bathroom 2, Change toilet and vanity in bathroom 3,
Change sinc and faucet in the kitchen. Install tankless water heater.
Specify color of color thru tile: GO
Submittal Fee $�0�) Permit Fee $ � CCF $ CO/CC $
Scanning Fee $ Radon Fee $ 2 ' Co DBPR $ 2 ' Z s Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ 1 Z 0 cJ '
(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
0.
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 reinspeSon fee will be charged.
Signatu
OWNER or AGENT
The foregoing instrument was acknowledged before me this
q +-h day ofLA � Z� 20 i by
We a kA&C 0.d0—� , who is personally known to
me or who has produced i'_e ('1 St as
identification and who did take an oath.
NOTARY PUBLIC:
Sign: V c aYWc''
Print: 0 4vw SiCr
Signature lAa
CONTRACTOR
The foregoing instrument was acknowledged before me this
Ck day of 20 - by
Drub �ya�• who is personally known to
me or who has produced L -k_ ✓S
identification and who did take an oath.
NOTARY PU
Sign:
Print:
Seal: Seal: *.,,
NOTARY PUBLIC
y p""r• VANESSA FUNDORA 4 _STATEOFFLORIDA
? MY COMMISSION # GG170001eComm# GG119046
°'+ EXPIRES: December 20, 2021 Expires 6/26/2021
*********** * ** ********** **************************************************************************
APPROVED BY ✓rAvhf Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
INFINITY CONSTRUCTION SERVICES INC
I7�
4156 SW 96 AVE
MIAMI FL 33165
Jun 01/2018
State of Florida
County of Dade
Before me this day personally appeared Antonio Luvara who, being duly sworn, deposes and says:
That he will be the only person working as a plumber on the project located at:
138 NE 109 Street, Miami Shores, FL 33161
Contractor Signature
Personally Know
OR Produced Identification
Type of Identification Produced - (G�-�- �aRy Christy M. Cruz
Q s�o NOTARY PUBLIC
a —STATE OF FLORIDA
Z i Comm# GG119046
e 1��0 Expires 6/26/2021
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' compensation insurance coverage from the contractor's company for day labor, part-time employees or subcontractors.
BY SIGNING BELOW YOU ACK WLEDGE 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 day of h , 201
By who is personally known to me or has produced
as identification.
Notary
SEAL: Notmypuhj-SutidFlVdi
CwwrissiontGG1385S9
MYCamm,Wm%Aug28.202T