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CC-19-1711Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Issue Parcel Number 723 NE 91ST ST IC, Miami Shores, FL 33138 1132060440090 Contacts Perm NO.: CC-07-19-1711 Permit Type: Buildin lCotrmerciai) Work Ciassftation: Permit Status: Approved Expiration: 03/16/2020 Eduardo Caram Owner 850 NE 70 ST 1C Contractor ADOLFO GONZALEZ AR CONSTRUCTION GROUP LLL33145 2050 CORAL WAY 502, MIAMI,Business:3054158782ddesign.inc@gmail.com Description: KITCHEN CABINETS REPLACEMENT Valuation: $ 3,500.00 Inspection Requests: 305-76-4949 Total Sq Feet: 16.00 ...j Fees Amount Application Fee - Other $50.00 CCF $2.40 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.80 Permit Fee $55.00 Scanning Fee $12.00 Technology Fee $2.63 Work Without Permit 1st Offense $105.00 Total: $231.83 Payments Date Paid Amt Paid Total Fees $231.83 Credit Card 07/25/2019 $50.00 Credit Card 09/18/2019 $181.83 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 at all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above named contrac or t4 do the work stated. Authorized Signature: Owner / Applicant / Contractor ! September 18, 2019 Date Page 2 of 2 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 PERMIT APPLICATION ®BUILDING Q ELECTRIC ROOFING .(LojI 1 I BC 2� j j j Master Permit No Sub Permit No. ❑ REVISION EXTENSION ❑RENEWAL ❑PLUMBING MECHANICAL ❑PUBLIC WORKS [:]CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: -40,3 N E q! S I • ' �t ` C- City: Miami Shores County: Miami Dade zip:J'J Folio/Parcel#: it3a20 60 c/W 0010 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): '-p0 44446 Phone#: 3o5 Is-6 3?g� Address: C-60N F- �0 Sf City: /mot/ 4-11. State: Zip: 33t 3 Tenant/Lessee Name: Email: CONTRACTOR: Company Name: g 4 R• L `^�' Phone#: 305 5(l5 5- 9 �� �� Address: �D 5t7 66 City: State: Zip: Qualifier Name: ado jf 1s 4 State Certification or Registration #: Certificate of Competency #: DESIGNER: Architect/Engineer: n G� 4 Phone#: 3OS ���5 83 K2- Address: 15 64 n1 L4 City: "k-4. State: zip: �1 Value of Work for this Permit: $ 35Square/Linear Footage of Work: 4 f Type of Work: ❑ Addition Description of Work: ❑ Alteration ❑ New ® Repair/Replace ❑ Demolition Specify color of color thru tile: Submittal Fee $J�Q I Permit Fee $ Scanning Fee $ Technology Fee $_ Structural Reviews $ CCF $ CO/CC $ Radon Fee $ DBPR $ tary $ _ Training/Education Fee $ Double Fee $ OO Bond $ (Revised02/24/2014) TOTAL FEE NOW DUE $ 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 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 low 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 te abse>ca of such posted notice, the inspection will not be approved and a einspection fee will be charged. Signature �cf Signature OWNER or AGENT The foregoing instrument was acknowledged before me this day of c, % ✓ 20 M by 21 ('�.,. " , who is personally known to me or who has produced -yG - (.:,K 5y wy644010as identification and who did take an oath. NOTARY PUBLIC: Sign: G r Seal: 't APPROVED BY R The foregoing instrument w s acknowledged before me this / GI day of �I ✓ n , 20 / Gi by /-U5 � ,,r,N D who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign:_ Print: t4Y -OMMISSION # GG041861 I Seal: EXPIRES Ociobor 25. 2020 Plans Examiner Structural Review 1 '� � : M•; C~ t �AIc,C,(!'::S : GGC4/i81 =;k,,r.• .:r.� 7,t �.25.2020 Zoning Clerk (Revised02/24/2014) Notice to Owner - Workers' Corn Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 nsation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. S 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 SIGNING BELOW YOU ACKNOWLEDGE 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 /GI day of . 20 / -'l By [-✓,�`.. �j �,. �•,., who is personally known to me or has produced _ G . 6 (, S (.) jJy 6 (+ L)20 as identification. SEAL S Ociober 25, 2020 1FM ❑� RICK SCOTT, GOVERNOR JONATHAN ZACHEM, SECRETARY FI rida pr STATE OF FLORIDA DEPARTMENT OF BUSINESSAAN-DcPR.OFESSIONAL REGULATION CONSTRU THE GENE PROVI i'F CH TER U--FRO_R g j '05Q;�0-0-,RAL WAy� T -502 MI'AMI 145" % ,d EXPIRATIONDATE.."'A�U�GUST 31, 2020 Always verify licenses online at MyFloridaLicense.com Do not alter this document in any form. NDER THE UTES This is your license. It is unlawful for anyone other than the licensee to use this document. Local Business Tax`Receipt Miami —Dade County, State of Florida -THIS IS NOT A BILL -DO NOT PAY 7244410 BUSINESS NAME/LOCATION RECEIPT NO. AR CONSTRUCTION GROUP LLC RENEWAL 5 2050 SW 22ND Sr 502 MIAMI FL 33145 LBT EXPIRES SEPTEMBEK-3E1,r2019 Must be displayed at plamof.bushress Pursuant to County:Codo Chapter 8A - Art. 9•&10 SEC. TYPE OF BUSINESS OWNER 196 GENERAL BUILDING CONTRACTOR PAYMENT RECEIVED AR CON5TRUCnON GROUP LLC SV TAX COLLECTOR ADOIFOI GOWAa QIIAUFIER CGC1519902 $45.00 08/29/2018 CREDITCARD-18-064342 worker(s) 5 This Local Business Tex Receipt only cordirms payment of the Local Business Tax. Tin Receipt Is not a licaase. permit or a certification of the holder's qualifications, to do business. Holder must comply with any porernxoenW or nongovernmental regulatory lava and requirmeents which apply 10 the business. The RECEIPT NO. above must be displayed on all commercial vehicles - Miemi-Dade Cede See 8a-216. for more inrarmad r, visit eYMny miemidada movttaxcalledor Oggp'ie Local Business Tax Receipt Miami -Dade County, State of Florida -THIS IS NOT A BILL -DO NOT PAY 7244410 BUSINESS NAMEILOCATION AR CONSTRUCTION GROUP LLC 2050 SIN 22ND ST 502 MIAMI FL33145 RECEIPT NO. EXPIRES RENEWAL SEPTEMBER 30, 2018 7530815 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 OWNER Se'. TYPE OF BUSINESS PAYMENT RECEIVED COPbTRUCi10A GROMUC 1 WZENERAL BUILDING CONTRACTOR SY TAX COLLECTOR ADOLFO) CONZAUZ, QUALIFIER CC�T519902 $5615 08/24/2019 Worker(s) 5 CREMTCARD-W- SI64W: This Local Business Tax Receipt only tartans payment of the Local Business Tax. The Receipt is not a liiee w. permit or a certification of thellolder's qualHicatiens to do business Holder mass comply wiMmy goeeww'at or nongovernmental regulatory laws and requirements which apply to the business . � : The RECEIPT NO. above most be displayed on all commercial vablgfw-4T+mR:, +y,.�,.�t9; sof,s-•Y7E. For more iaforraation, rises WWW..... W JIMMY PATRONIS CHIEF FINANICAL 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: 3/29/2018 PERSON: GONZALEZ FEIN: 900756939 BUSINESS NAME AND ADDRESS: AR CONSTRUCTION GROUP LLC 2333 BRICKELL AVE # 1205 u1 TNTA FL 33129 SCOPE OF BUSINESS OR TRADE: Licensed General Contractor EXPIRATION DATE: 3/28/2020 ADOLFO IMPORTANT: 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 certificate at any time for failure of the person named on the certificate to meet the requirements of this section. DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS? (850)413-1609 At AR CONSTRUCTION GROUP 2050 coral way, Suite 502 Miami F1 33145 305.415.8782 Date 7/27/2019 State of County of Before me this day personally appeared 6WW4'who, being duly sworn, depose and say: he will be the only person orking on the r o.. ectjlocated at: Aq r ; I /"-, n J ,, k4ftP&. All Subcontra_oefs Will provide Workers Comp. as need it, vl��X Signature Sworn to (or affirmed) and subscribed before me this )i day of .2011 By_ Personally know Aw-ro (:jwzxsL�c ) Or Produced Identification- 4ML_ Type of Identification Produced- BORIS MORALES _-z' Z�-, Notary Public -State of Florida *E Commission # GG 295287 Wz- My Commission Expires March 20, 2023 Print, Type or Stamp Name of Notary 745 North East 91 st Street Miami Shores, FL 33138 305-759-9069 / ' E-MAIL spel23@att.net July 26, 2019 Miami Shores Village Building Dept. 10050 NE 2nd Ave. Miami Shores, FL 33138 Dear Sir / Madam, This letter will serve as your confirmation that General Contractor "AR Construction Group" has been hired by the owner of apt. I C at 723 NE 91 Street, Miami Shores, FL 33138, and is authorized by the Board of Directors of the Shores Plaza East Condominium Association to perform "kitchen remodeling" at said unit. Should you have any questions regarding the enclosed, please feel free to contact our office. Sincerely yours, Carlos Talavera Vice -President Cc: File