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PLC-19-2396Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address 9022 NE 8TH AVE 1K, Miami Shores, FL 33138 r'nntartc Issue Date:12/17/2019 Parcel Number 1132060420110 Permit NO.: PLC-10-19-2396 Permit Type: Plumbing - Commercial Work Classification: Alteration Permit Status: Approved Expiration: 06/15/2020 9022 NE 8 AVE 1 K LLC Owner EPOCA CORP Contractor 501 GRAND CONCOURSE, MIAMI SHORES, 33138 DAVID BRADLEY Home: 3059864803 Business: 3057785103 ana@infantryconstruction.com Description: KITCHEN & BATHROOM REPLACEMENT OF Valuation: $ 4,000.00 Inspection Requests: FIXTURES 305 762-4949 TotalSq Feet: 70.00 Fees Amount Application Fee - Other $50.00 CCF $2.40 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.80 Permit Fee $70.00 Scanning Fee $3.00 Technology Fee $3.00 Total: $133.20 Payments Date Paid Amt Paid Total Fees $133.20 Check # 2295 12/17/2019 $83.20 Check # 2259 10/09/2019 $50.00 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 construgtion arA zoning. Futhermore, I authorize the above named contractor to do the work stated. Signat6re: Owner / Ap—pTGant / Contractor / Agent December 17, 2019 Page 2 of 2 Itt � w 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 PERMIT APPLICATION BUILDING ❑ ELECTRIC ❑ ROOFING FBC 20 v Master Permit No.cc — 10 — 1q" 9JY4 Sub Permit NO.PLC,--10',9' ;'39V ❑ REVISION ❑ EXTENSION RENEWAL 4�LUMBING ❑ MECHANICAL ❑PUBLIC WORKS [:]CHANGE OF CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: q 0 z(5 Folio/Parcel#: ( 1 -3 a C6 - &*2Z - c q tO Is the Building Historically Designated: Yes NO _ Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): L?ba2, "t ^ • � L"�—L Phone#: 3e6^ - 99-y Address: S61 64—A��Y.)�tr7�� cep- � r ^^��? City: l` 14*4( �✓Hl7-t'�� State: R_. Zip: JJ/V Tenant/Lessee Name: _ Phone#: • Email CONTRACTOR: CompanyName:r �QC�yC ��C� Phone#: � \ Address: Co�G City: kk (A r� , Qualifier Name: c �� State Certification or Registration #: State: �� Zip: _ Phone#: Certificate of Competency #: DESIGNER: Architect/Engineer: ? /1°t- Phone#: Address: City: State: Zip: Value of Work for •this Permit: $ D Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New nn �^, � wair/Replace ❑1 Demolition Description of Work: b(( 1 (-H G N /�I 5/a ( 1 1 OLEJ Specify color of color thru tile: Submittal Fee $ Scanning Fee $ Technology Fee $_ Structural Reviews $ (Revised02/24/2014) Permit Fee $ Radon Fee $ Training/Education Fee $ CCF $, CO/CC $ DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ e 20 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 $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 A-% MO�At gW77-^E N Qr .JEN �-1�4 L. LL The foregoing instrument was acknowledged before me this dayD �--t'o / of , 20 by — c v �� who ' ersonally known o me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign:'` Print: as _. Signature • CONTRACTOR The foregoing instrument was acknowledged before me this day of �.\,�( , 20 i�1 by who is personally known to me or who has produced as identification and who did take-- EW SIERRA NOTARY P LIC: ' Nly COMMISSION # GG086906 EXPIRES Match 26, 2021 Sign: ..._ Print: 514(1k Seal: Seal: 1:P� P '•., LISA CHRISTINA FLORES Notary Public State of Florida /• `'�'• Commission # GG 286706 ##***************************************************************** Bonded through National Notary Assn. APPROVED BY Cc y F Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) MI® DARE 7077928 DBA/BUSINESS NAME: EPOCA CORP BUSINESS LOCATION: 335 NE 69TH ST MIAMI, FL 33138 OWNERICORP. EPOCA CORP PHONE # 3058517100 800 NE 125 ST NORTH MIAMI, FL 33161 NAICS CODE: 23822 MIAMI-DADE COUNTY - STATE.OF FLORIDA LOCAL BUSINESS TAX 2019 -2020 APPLICATION If no longer in business, please notify us in writing. Review and correct the information shown on this application. A 25% penalty will be assessed to anyone found operating without a paid local business tax, in addition to any other penalty provided by law or ordinance (Sec 8A-176(2)). A Certificate of Use and/or City Business Tax Receipt may also be required. MIAMI-DADE COUNTY - STATE OF FLORIDA LOCAL BUSINESS TAX 2019 - 2020 APPLICATION 7077928 BUSINESS LOCATION: 335 NE 69TH ST MIAMI, FL 33138 OWNER/CORR EPOCA CORP EPOCA CORP DAVID BRADLEY PRES 800 NE 125 ST NORTH MIAMI, FL 33161 BUS. COMMENCEMENT DATE:12/0112012 SEC TYPE OF BUSINESS PLUM PLUMBING CONTRACTOR 3 N/A October 02, 2019 RENEWAL RECEIPT. 7355746 STATE # CFC1428595 APPLICATION DETAILS FEE AMOUNT Receipt Fee 30.00 UMSA Fee 0.00 Beacon Council Fee 15.00 Bingo Permit Fee 0.00 Nightclub Permit Fee 0.00 Multi -Municipal Contractor Fee 0.00 Restricted Contractor Fee 0.00 Library Fee 0.00 Transfer Fee 0.00 Doing Business without a License Penalty 0.00 Late Penalty 0.00 Collection Cost 0.00 NSF Fee 0.00 Prior Years Due 0.00 Amount Recently Paid - 45.00 TOTAL AMOUNT DUE: 0.00 To pay online go to www.miamidade.gov/taxcollector To pay by mail, make check payable to: Miami -Dade County Tax Collector Business Tax 200 NW 2nd Avenue, 3rd Floor Miami FL 33128 To pay in person go to: 200 NW 2nd Avenue, 1st Floor (305)270-4949 local.businesstax@miamidade.gov A service fee of not less than $25.00 up to a minimum of 5% will be charged for all returned checks. t RETAIN FOR YOUR RECORDS t J' DETACH HERE AND RETURN THIS PORTION WITH YOUR PAYMENT + �IIIIIlIO���I�IIIIIRIIIV� BUS. COMMENCEMENT DATE:12101/2012 N/A October 02, 2019 RENEWAL RECEIPT: 7355746 STATE #CFC1428595 SEC TYPE OF BUSINESS PLUM PLUMBING CONTRACTOR 3 APPLICATION IS HEREBY MADE FOR A LOCAL BUSINESS TAX RECEIPT OR PERMIT FOR THE BUSINESS PROFESSION OR OCCUPATION DESCRIBED HEREON. I HAVE BEEN INFORMED OF ALL ZONING RESTRICTIONS IMPOSED ON THIS RECEIPT. I SWEAR THAT THE INFORMATION IS TRUE AND CORRECT. SIGNATURE REQUIRED SEE INSTRUCTIONS ABOVE Please pay only one amount The amounts due after Sept 30th include penalties per FS 205.053. if Received By Oct 31, 2019 Nov 30, 2019 Dec 31, 2019 Jan 31, 2020 Please Pay $0.00 $0.00 $0.00 $0.00 7000000000000000000000007355746202000000004500000000000007 October 8, 2019 State of Florida County of Miami Dade Before me this day personally appeared David Bradley who, being duly sworn, deposes and says: That he will be the only person working on the project located at: 9022 NE 8 Ave, Unit 1-K, Miami Shores, FL 33138 Sworn to (or affirmed) and subscribed before me this 08 day of October, 2019, by Personally know Or Produced Identification Type of Identification Produced or Stam rr> o; y tqtary hMIC - stab of Florida Commission # FF 979238 s:= My Corbm. Expires Jul 25, 2020 Bonded tWough National Notary Assn. CFC1428595 800 N.E. 125th St. North Miami FL 33161 R305.851.7100 F.305.851.7143 Notice to Owner — Workers' Com 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. § 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 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 0c4pb� , 20 11 By r I- k D -�x who is ersonally know to me or has produced as identification. Notary: C-t� -h4 , SEAL: _ LISA CHRISTINA FLORES •?°(`�`_ Notary Public - State of Florida My Comm. Expires Jan 28, 2023 Bonded through National Notary Assn.