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