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RC-19-1214�4"�� r ✓;, y - F. '..en- � - 't�yt a �� 0?l`�'4,• 4 . .±. � a ,�R ? i :° �9 } 's t++5. � ;d � • d��:515 .Y ��.+ �'1 �:�.51' 'e i '.r 3dt & �'i �t4 ��1+G° �t'p pa, V �Y/§4't"2`�: ' �. `+t�`�1A +t a+Sr �±y"� �. j�• �° �? t r 5 . R„y°�r :'+d ,nF. ... �;� e4, ± �l,$�� .,,.�....� < ��, , ",SI�$±. , (t., yid., ,.�5�+ .i' nrt H• �Cc r'� �' � t3£4i'4. +I!"�', '4f 5;. -. es�t� ;i'�d. `�. Il��" - 4�'i;' . +C, �s� ram'$'.: , k..'�''� rrK,,. 'fit, - - ��i'*'�,'.". _ S }K'�° r � ,,.�"fit 1M:s`-'�yf �+ a,� �' .. +� . �± Lr'#��f *"� R fr:. ?tt''' �,,�.�,'.�' .,;""i. : � ' ,?r�`�+X,;•i � :s �.�� _+} ..�R ,.._>r'�'45.^s -.v _ ;�_. r- . .�c<.�. �._c}'.t4t+_. .5:. -� • .tt-v mac..;:: ..„.,_, "x` .kt...-,:. xi-��.dT �". _'.__.`�'�.r.. ..._ 'i4-„„ i'• °,µ..... r$ }�� + � . +.... � � �''x..,..: .a+... �>4 �z7- %� •ri '..fir t d'�`n, '1 i . � _ ,�"}.'•. t _ . e 4: -s �, y,sn „t • '� 1-" $ 5. ..,«... .'a.k., > <7h d A' r.:. .. ?—`. �S { . ^r �'� h":iet y ms-.., _ ..P t i r+ , s ,.-k d , ry-�— `','�` N,,;:- �^"` ��t .c. ...w" a� t. Certificate of Completion Miami Shores Village 10050 N.E. 2nd Ave, Miami Shores, Florida 33138 MR. if'#...'.t l YJr4 Tel: 305-795-2204 Fax: 305-756-8972 Building Inspection Department M� Description: INTERIOR RENOVATION OF KITCHEN, DINING, FOYER AND LIVING ROOM. k i Permit Type Building (Residential) Bldg. Permit No. RC-05-19-1214r+'' Owner WEI E CHEN Contractor ELITE AMERICAN INC r; f7 s Subdivision/Project Date Issued 03/04/2020 3 Construction Type V-B Occupancy Single Family Type �> R •y �� <1 � �� Square Footage 380.00 Flood Zone X .;,� Location If the building is located in a special flood hazard area documentation of the as -built lowest floor A- ' ^' elevation or lowest horizontal structural member has been provided and is retained in the records of 4y g r 9330 NE 12TH AVE Miami Shores, FL 33138 Miami Shores Village.. ORE 32 This certificate issued pursuant to the requirements of the Florida Building Code certifying that at the �SN�Nc 19 s time of issuance this structure was in compliance with the various ordinances of the jurisdiction regulating building construction or use. Building Officials Approval Not Transferable POST IN A CONSPICUOUS PLACE i, ) , i fk y.e• r �� Slt .1° 4s''�p Zpit�r' ♦�, �ls?"'s�r �4i R. Ismael Naranjo, CBO Miami Shores Village Building Deuartment 10050 NE 2 Ave Miami Shores FL 33138 Permit NO. RC-05-19-1214 Type Building (Residential) Workclass: Alterabct Issue Date: 6/14/2019 INSPECTION REQUESTS: (305)762-4949 or log on at hftps://bidg.msvfl.gov/energov_prod/selfservice Requests must be received by 3 30pm WORK IS ALLOWED: MONDAY THROUGH FP.ICAY, 8 OOAM - 7:OOPM SATURDAY 8'OOAM-6:OOPM. NO WORK IS ALLOWED ON SUNDAYOR HOLIDAYS BUILDING AND ROOFING INSPECTIONS ARE DONE MONDAY THROUGH FRIDAY NO INSPECTION WILL BE MADE UNLESS THE PERMIT CARD IS DISPLAYED AND HAS BEEN APPROVED . PLANS ARE READILY AVAILABLE. IT IS THEIPERMITAPPLICANT'S RESPONSIBILITY TO ENSURE THAT WORK IS ACCESSIBLE AND EXPOSED FOR INSPECTION PURPOSES, NEITHER THE BUILDING OFFICIAL NOR THE CITY SHALL BE LIABLE FOR EXPENSE ENTAILED IN THE REMOVAL OR REPLACEMENT OF ANY MATERIAL REQUIRED TO ALLOW INSPECTION . Owner's Name: WEI CHEN i Job Address: 9330 NE 12TH AVE 3 { Miami Shores, FL 33138 Owner's Phone; Expires: 03/18/2020 POST ON SITE 1132050070160 Total Square Feet: 380 dotal Job Valuation: $ 20,000.00 Contractor(s) Phone Address ELITE AMERICAN INC (954)812-6907 9740 SEA TURTLE DR, PLANTATION-, FL 33324 Description: INTERIOR RENOVATION OF KITCHEN, DINING, FOYER AND LIVING ROOM. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Page 1 of 1 'ZpR�p Miami Shores FL 33138 INSPEC ►ssue Date: 61141 TION REQUESTS: __„ 62-4 Requests must be received by0330pm 949 or log on at https:11bldg.ms".govJenergov Prod/selfservice WORK IS ALLOWED.- MONDAY THROUGH FP.IDAY, 8:00AM SATURDAY 8 00AM - 6' 00P.M- 7:OOPM NO WORKISALLOWED ON SUNDAYOR HOLIDAYS 80ILDINGAND ROOFING INSPECTIONS ARE DONE MONDAY THROUGH FRIDAY . NO INSPECTION WILL BE MADE UNLESS THE PERMIT CARD IS DISPLAYED AND HAS BEEN APPROVED PLANS 4RE READILY AVAILABLE. IT IS THE PERMIT APPLICANT'S RESPONSIBILITY TO ENSURE THAT WORK IS ACCESSIBLE AND EXPOSED FOR INSPECTION PURPOSES. NEITHER THE BUILDING OFFICIAL NOR THE CITY SHALL BE LIABLE FOR EXPENSE ENTAILED IN THE REMOVAL OR REPLACEMENT OF ANY MATERIAL REQUIRED TO ALLOW INSPECTION . Owner's Name i Job Address: WEI CHEN 9330 NE 12TH AVE Miami Shores, FL 33138 Owner's Phone: POST ON SITE 1132050070160 Total Square Feet: 380 total Job Valuation: $ 20.000.00 Contractor(s) Phone ELITE AMERICAN INC ( Address 954)812-6907 9740 SEA TURTLE DR, PLANTATION, FL 33324 Description: INTERIOR RENOVATION OF KITCHEN, DINING, FOYER AND LIVING ROOM. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Page 1 of 1 I Is V l v % • � a — ' . — — — - STRUCTURAL INSPECTION DATE INSP Foundation Stemwall Slab Columns (1st Lift) Columns (2nd Lift) Tie Beam Truss/Rafters Roof Sheathing Bucks Interior Framing Insulation Ceiling Grid Drywall Firewall Wire Lath Pool Steel Pool Deck Final Pool Final Fence Screen Enclosure Driveway Driveway Base Tin Cap In -Progress Roof Installation Roofing Final Shutters Attachment Final Shutters Rails and Guardrails ADA compliance I N i"i V DOCUMEN Soil Bearing Cert Soil Treatment Cert Floor Elevation Survey Reinf Unit Mas Cert Insulation Certificate Spot Survey Final Survey Truss Certification STRUCTURAL COMMENTS WINDOWSDOORS INSPECTION DATE INSP Attachment PUBLIC WORKS INSPECTION DATE INSP Excavation ELECTRICAL INSPECTION DATE INSP Temporary Pole 30 Day Temporary Pool Bonding Pool Deck Bonding Pool Wet Niche Underground Footer Ground Slab Wall Rough Ceiling Rough Rough Telephone Rough Telephone Final TV Rough TV Final Cable Rough Cable Final Intercom Rough Intercom Final Alarm Rough Alarm Final Fire Alarm Rough Fire Alarm Final Service Work With ELECTRICAL COMMENTS INSPECTION DATE INSP Final Sprinkler Final Alarm PLUMBING INSPECTION DATE INSP Rough Water Service 2nd Rough Top Out Fire Sprinklers Septic Tank Sewer Hook-up Roof Drains Gas LP Tank Well Lawn Sprinklers Main Drain Pool Piping Backflow Preventor interceptor Catch Basins Condensate Drains HRS Final r� PLUMBING COMMENTS INSPECTION DATE INSP Underground Pipe Rough Ventilation Rough Hood Rough Pressure Test Final Hood Final Ventilation Final Pool Heater Final Vacuum MECHANICAL COMMENTS R tl Y�`�`'teS 1N 50 �ORtDp' Miami Shores Village Building Department 10050 NE 2 Ave Miami Shores FL 33138 Permit No. RC-05-19-1214 r, Type: Building (Residential) Workclass: Alteration ermit Status: Approved Issue Date: 6/14/2019 Expires: 12/11/2019 INSPECTION REQUESTS: (305)762-4949 or log on at https://bidg.msvfl.gov/energov_Prod/selfservice Requests must be received by 3:30pm WORK IS ALLOWED: MONDAY THROUGH FRIDAY, 8:OOAM - TOOPM SATURDAY 8:OOAM - 6:OOPM. NO WORK IS ALLOWED ON SUNDAY OR HOLIDAYS BUILDING AND ROOFING INSPECTIONS ARE DONE MONDAY THROUGH FRIDAY . NO INSPECTION WILL BE MADE UNLESS THE PERMIT CARD IS DISPLAYED AND HAS BEEN APPROVED . PLANS ARE READILY AVAILABLE. IT IS THE PERMIT APPLICANT'S RESPONSIBILITY TO ENSURE THAT WORK IS ACCESSIBLE AND EXPOSED FOR INSPECTION PURPOSES. NEITHER THE BUILDING OFFICIAL NOR THE CITY SHALL BE LIABLE FOR EXPENSE ENTAILED IN THE REMOVAL OR REPLACEMENT OF ANY MATERIAL REQUIRED TO ALLOW INSPECTION . Owner's Name: WEI CHEN Job Address: 9330 NE 12TH AVE Miami Shores, FL 33138 Owner's Phone: POST ON SITE 1132050070160 Total Square Feet: 380 total Job Valuation: $ 20,000.00 Contractor(s) Phone Address TINO'S CONSTRUCTION CORP (3051\781-0673 14521 BONITO DR, CORAL GABLES, FL 33158 Description: INTERIOR RENOVATION OF KITCHEN, DINING, FOYER AND LIVING ROOM. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Page 1 of 1 INSPECTION P,ECOP.D INSPECTION DATE INSP Foundation Stemwall Slab Columns (1st Lift) Columns (2nd Lift) Tie Beam Truss/Rafters Roof Sheathing Bucks Interior Framing Insulation Ceiling Grid Drywall Firewall Wire Lath Pool Steel Pool Deck Final Pool Final Fence -�---reen Enclosure Driveway Driveway Base Tin Cap in -Progress Roof Installation Roofing Final IShutters Attachment Final Shutters IRails and Guardrails ADA compliance DOCUMENTS Soil Bearing l.el t Soil Treatment Cert Floor Elevation Survey IReinf Unit Mas Cert Insulation Certificate Spot Survey Final Survey Truss Certification STRUCTURAL COMMENTS I WINDOWSDOORS INSPECTION DATE INSP Attachment PUBLIC WORKS INSPECTION DATE INSP Excavation ELECTRICAL INSPECTION DATE INSP Temporary Pole 30 Day Temporary Pool Bonding Pool Deck Bonding Pool Wet Niche Underground Footer Ground Slab Wall Rough Ceiling Rough Rough Telephone Rough I I I (Telephone Final TV Rough TV Final Cable Rough Cable Final Intercom Rough Intercom Final Alarm Rough Alarm Final Fire Alarm Rough Fire Alarm Final Service Work With ELECTRICAL COMMENTS V1 INSPECTION DATE INSP Final Sprinkler Final Alarm PLUMBING INSPECTION DATE INSP Rough Water Service 2nd Rough Top Out Fire Sprinklers Septic Tank Sewer Hook-up Roof Drains Gas LP Tank Well Lawn Sprinklers Main Drain Pool Piping Backflow Preventor Interceptor Catch Basins Condensate Drains HRS Final PLUMBING COMMENTS A p V qP471 eTp MECHANICAL INSPECTION DATE INSP Underground Pipe Rough Ventilation Rough Hood Rough Pressure Test Final Hood Final Ventilation Final Pool Heater Final Vacuum MECHANICAL COMMENTS I9 Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Parcel Number 9330 NE 12TH AVE, Miami Shores, FL 33138 1132050070160 Contacts WEI CHEN Owner TINO'S CONSTRUCTION CORP Contractor 9330 NE 12 AVE, MIAMI SHORES, FL 33138 CONSTANTINO BARRIAL 14521 BONITO DR, CORAL GABLES, FL 33158 Business: 3057810673 Inspection Requests: Description: INTERIOR RENOVATION OF KITCHEN, DINING, Valuation: $ 20,000.00 305 762 4949 "y FOYER AND LIVING ROOM. Total 5q Feet: 380.00 �j....' Fees Amount Application Fee - Other $200.00 CCF $12.00 Certificte of Completion for Single Fam $50.00 and Duplex DBPR Fee $9.00 DCA Fee $6.00 Education Surcharge $4.00 Permit Fee $400.00 Scanning Fee $30.00 Technology Fee $15.00 Total: $726.00 Payments Date Paid Amt Paid Total Fees $726.00 Credit Card 05/28/2019 $200.00 Credit Card 06/14/2019 $526.00 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 d1 the wo/rk�s ated. cc Authorized Signature: Owner / Applicant / Contractor / Agent Date June 14, 2019 Page 2 of 2 BUILDING 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 RECEIVED M Y 2 8 2019 BY: FBC 20 Master Permit No (-__ PERMIT APPLICATION sub Permit No. BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS [:]CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 9330 NE 12 AVE City: Miami Shores County: Miami Dade Zip: 33138 Folio/Parcel#: 11 -3205-007-0160 Is the Building Historically Designated: Yes NO X Occupancy Type: Load: Construction Type: CBS Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): JOHN MITCHELL & WEI-EN CHEN Phone#: 305-457-8088 Address: 9330 NE 12 AVE City: MIAMI SHORES State: FLORIDA Zip: 33138 Tenant/Lessee Name: Phone#: Email: Weienl8@gmail.com CONTRACTOR: Company Name: TINO'S CONSTRUCTION CORP Phone#: 305-781-0673 Address: 14521 BONITO DRIVE City: CORAL GABLES state: FLORIDA Zip: 33158 Qualifier Name: CONSTANTINO BARRIAL Phone#: 305-781-0673 State Certification or Registration #: CGC 1515958 Certificate of Competency #: DESIGNER: Architect/Engineer: KIRK WENG ARCHITECTS, LLC. Phone#: 786-266-0909 Address: 7901 LUDLAM ROAD, SUITE 205 city: MIAMI State: FL Zip: 33143 Value of Work for this Permit: $ 20,000.00- Square/Linear Footage of Work: 380 SF Type of Work: ❑ Addition ❑■ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: INTERIOR RENOVATION OF KITCHEN, DINING, FOYER AND LIVING ROOM. Specify color of color thru tile: Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ �;(M . TOTAL FEE NOW DUE $ �rG� (Revised02/24/2014) r C� 2j c Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lenders Address City State Zip Zip Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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 Signature OWNER or AGENT The foregoing instrument was acknowledged before me this �_dayof (y .20 by LW n l )JfD who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign:_ Print: Seal: ''+ " ''• CAYTEN CLARK MY COMMISSION # GG069356 EXPIRES February 03, 2021 ************ 17 APPROVED BY4�� w CONTRACTOR The foregoing instrument was acknowledged before me this day of 20 �� by r who is personally know�,o me or who has produced L��ii�� as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: y (..� Seal: .�Y" % ,NP CAYTEN CLARK MY COMMISSION # GG069356 EXPIRES February 03, 2021 Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Property Search Application - Miami -Dade County Page 1 of 2 OFFICE OF THE PROPERTY APPRAISER t. Summary Report Property Information Folio: 11-3205-007-0160 Property Address: 9330 NE 12 AVE Miami Shores, FL 33138-2931 Owner JOHN MITCHELL WEI EN CHEN Mailing Address 9330 NE 12 AVE MIAMI SHORES, FL 33138 PA Primary Zone 1400 SGL FAMILY - 3001-3250 SQ Primary Land Use 0101 RESIDENTIAL -SINGLE FAMILY: 1 UNIT Beds / Baths / Half 3/2/0 Floors 1 Living Units 1 Actual Area 2,460 Sq.Ft Living Area 1,839 Sq.Ft Adjusted Area 2,096 Sq.Ft Lot Size 10,890 Sq.Ft Year Built 1954 Assessment Information Year 2018 2017 2016 Land Value $392,040 $392,040 $364,815 Building Value $174,230 $162,901 $164,117 XF Value $398 $403 $408 Market Value $566,668 $555,344 $529,340 Assessed Value $363,097 $355,629 $348,315 Benefits Information Benefit Type 2018 2017 2016 Save Our Homes Assessment Cap Reduction $203,571 $199,715 $181,025 Homestead Exemption $25,000 $25,000 $25,000 Second Homestead Exemption $25,000 $25,000 $25,000 Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). Short Legal Description 5-6 53 42.25 AC PL OF GOVT LOT 4 PB 5-90 BEG NE COR OF LOT M W110.59FT SW109.21 FT E94.41 FT N ALG E/L OF LOT M TO POB Generated On : 5/28/2019 Taxable Value Information 2018 2017 2016 County Exemption Value $50,000 $50,000 $50,000 Taxable Value $313,097 $305,629 $298,315 School Board Exemption Value $25,000 $25,000 $25,000 Taxable Value $338,097 $330,629 $323,315 City Exemption Value $50,000 $50,000 $50,000 Taxable Value $313,097 $305,629 $298,315 Regional Exemption Value $50,000 $50,000 $50,000 Taxable Value-+ $313,097 $305,629 $298,315 Sales Information Previous Sale Price OR Book -Page Qualification Description 02/20/2009 $397,500 26773-4437 Qual by exam of deed 09/01/2001 $324,000 19923-3341 Sales which are qualified 09/01/1997 $191,000 17793-2794 Sales which are qualified 10/01/1993 T$155,OOOT 16110-1123 Sales which are qualified The Office of the Property Appraiser is continually editing and updating the tax roll. This website may not reflect the most current information on record. The Property Appraiser and Miami -Dade Countv assumes no liability, see full disclaimer and User Agreement at hfto://www.miamidade.aov/info/disclaimer.asr) https://www8.miamidade.gov/Apps/PA/propertysearch/ 5/28/2019 1' ❑E RICK SCOTT, GOVERNOR JONATHAN ZACHEM, SECRETARY a Florida STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD THE GENERAL CONTRACTOR HEREIN IS CERTIFIED UNDER THE PROVISIONS OF CHAPTER 489, FLORIDA STATUTES BARRIAL, CONSTANTINO TINO'S CONSTRUCTION CORP 14521 BONITO DRIVE CORAL GABLES FL 33158 E '-*"'-'7-`--e...!R'W iLb.S.w,.^+ d"ri �`8QZW6 ., LICENSE NUMBER CGC1515958 EXPIRATION DATE: AUGUST 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. 003751 Local Business Tax Receipt Miami -Dade County, State ofFlorlda -THIS IS NOT A BILL - DO NOT PAY I DT 6458939 BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES TINOS CONSTRUCTION CORP RENEWAL SEPTEMBER 30, 2019 14521 SW 66TH AVE 6727490 Must be displayed at place of business CORAL GABLES FL 33158 Pursuant to County Code Chapter 8A - Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS TINOS CONSTRUCTION CORP 196 GENERAL BUILDING CONTRACTOR PAYMENT RECEIVED CGC1515958 BY TAX COLLECTOR $45.00 08/06/2018 Worker(s) 1 FPPU11-18-017672 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit, or a certification of the holder's qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT NO. above must be displayed on all commercial vehicles - Miami -Dade Code Sec 8a-276. For more information, visit www.miamidade.govA@xcollector E 4a .� 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: 10/15/2018 PERSON: CONSTANTINO BARRIAL FEIN: 262628702 BUSINESS NAME AND ADDRESS: TINO'S CONSTRUCTION CORP. 14521 BONITO DRIVE MIAMI, FL 33158 SCOPE OF BUSINESS OR TRADE: Licensed General Contractor EXPIRATION DATE: 10/14/2020 EMAIL: SPARKLEEN43@AOL.COM 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 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: 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 day of 40w 120 BY e (e n �ike, � who is personally known to me or has produced as identification. 'A CAYTLN CLARK Notary:� �- MY COMMISSION # 00069354 EXPIRES February 03, 2021 SEAL: ,I.e57RU0r/0 Date:05/24/19 tir CGC# 1515958 14521 Bonito Dr Coral Gables, FI 33158 Tel: 305-781-0673 Date: State of /c/ovi'da, County of �G�'awi • fl%,& Before me this day personally appeared who, being duly sworn, deposes and says: That he or she will be the only person working on the project located at: �33 0 Al & /Z due. , o'" �� SAIK&S , /r� ; 3/38 Contractor Signature Swon to (or affirmed) and subscribed before me this day of , 20 ) byCArS1f\�,r\ro 341_1_�AIC `�� '��'• RAGUI RAMON LOVO . . Notary Public - State of Florida Commission # GG 027870 My Comm. Expires Sep 7, 2020 Personally know OR Produced Identification Type of Identification Produced 4Z- OL Print, Type or Stamp Name of Notary AC R CERTIFICATE OF LIABILITY INSURANCE106/12/2019 DATE(MM/DD/YYYY) 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(ies) must 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 lieu of such endorsement(s). PRODUCER Advanced Insurance Services 744 Noah Drive Suite 113-326 Jasper, GA 30143 CONTACT E. PHONE FAX ADDRESS. agent@aisagency.com INSURERS AFFORDING COVERAGE NAIC • INSURER A • Evanston Insurance Company INSURED Tino's Construction Corp 14521 Bonito Drive Coral Gables FL 33158 INSURER RE C : INSURER D : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 DDL UB LIYN MBE POLICY EFF POLICY EXP LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X❑ OCCUR 3AA317835 12/30/2018 12/30/2019 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED 100000 MED EXP (Any oneperson) 5,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO LOC PRODUCTS - COMP/OP AGG $1,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS COMBINED SINGLE LIMIT BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE tPar $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE AGGREGATE WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIV� OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DFSCRIPTION OF OPERATIONS below N / A WC STATU- I JOTH- E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYE E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) License#- CGC#1515958 CERTIFICATE HOLDER CANCFI I ATIAN Miami Shores Village Bldg Dept. 10050 NE 2nd Ave SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores, FL 33138 AUTHORIZED REPRESENTATIVE Representative of InsiMa/li> Phone:(305)795-2204 Fax: 305 756-8972 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 26 (2010/05) The ACORD name and logo are registered marks of ACORD