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PL-10-19-2408
� � � tii i ��3` � 1�s �� \\.�\ �L l � �\��� Zi�� t� c)13 t� � �\ � A y �V � .� V\ �\ A�� \ � � � � �1� �\ 3 � S � �Sj � ���� � � � �� � � Z � � ���� � �� � � �� +p� � �'°t° . . � ,� ��A i��A� � � .��V� t�z�Z ����g ��f I�Ill9 ��it?1'€S�I�It��@ � < � �: � �ti �� 1�� � �� � � �r � S\ 4 �� � \ � � � �� �oaso�v�z Av� : �, �,��� � ��� , , �'� � z Z ���A �� �`�:�. � z ��0. +"� � � t'a�.� �� �� � ��i '�� ��z 1 � \c t� �� ti��\% �� �a�� �� Miami Shores F�33138 ��� '� ���z � A�������� �`� ` d»� ��<. 3Q5-795-22Q4 � �i �` i � � i; � � ������ � t� � � ��b�� � A � � �0 ��V��� i "�. ^�` �` �� �� � �1�� A� � � � � � ��� .3�� ��t-��������� . ,{r�'�.,,tN� l �1 ) � � �. `, � ��4�� '�.1.� .o�<.., i.mia�ti.. ,;.����. �..., \..:la`3 � t... ��.c�����.� � �� �.� },,1�:������.`�����`��'���, Expkr�fie�n: 04j13j2Q2Q Lcac�Cion Address Parce[EVeamber ���w.�a� _� e� �. _�,� �r���_v��� �_ �,..���.�� ���.�,m�_�� m�.�.��.��,w��.�,�.,� n......�,�_...__.rtit..u..,�.�.__.......�� � ��s tv�4�°��s�,�s��m�sn�r�s,��.����� is�a€�s�s�a�aa .. � ��.. �.� ..�� � � contacts f CUES�R[AS Qwr��r 5 STAR Pk.U(t�1�ING SEftVICES CORP Canteacfior � 1496 NE 104 ST,MIAtVIE SHQRES, FL 3313� IVIANU�C RAMRIN�IMENEZ � Other:3057990529 12720 SW 18Q ST,I�IAMI,F�33177 � Business.3Q57963607 � , _:������ �.�_.� �,���,.���..�._ �__�_��_.�� �_.�aw��_��.�.��_� � m��..._..A_.� __.._�.__.M.� ; Descr� ti�r�:tV�W P�UR��(N6 TQ ADDITION:GAS IINES � Valu�tion: tns ec�ion fi� u�s4s p � $6,8�0,40 �� � i � ������ � �� � �. � � �otal Sq Feee: 7S0_t�� � � � F ,..,:.....�.<:�& . ,...,�!. ..�i.i ... �. ::�r,fi,a,,.�..... :;: `� �. .... �,���. . .�', . . F�es Amec�nt p�yments C?at�Pa�d Amt Paid Applicatian Fee-Other $SQ.00 Total Fe�s $25$.5d CCF $4.20 Credit Card 1QJ1d/2019 $�p,�� dBPR Fee $3.57 Credit Card 10j16f 2019 ��p�.�p Dca Fee $2.38 Edueation Surcharge $1.40 ��������e: $�.�� Permit Fee $2$&.00 Scanning Fee $3A0 Technology Fee $5.95 Total: $25�.5m k.l l� l � En eonsideration af the issuance to me c�f this permit, f agree to perfarm the work covered hereunder in c�mpiiance with ali �rdinances and regulatians pertaining tMereto and in strict canformity with the plans, drawings, statements ar specificatians submitted ta #he praper auth�rities �f �iami Shores �fillage. In accepting this permit I assume responsibility foe�II work de�ne by esther myseifi, my agent, seruants, �r errrpioyes. I understand that s�parate permits ae�required for�LEGTRICAL, PLIJN€BING, PYIECFIAN(C,�L,WINDC?WS, DOC}RS, RQt)FElVG and SWfMMEN�PQOL wcark. C?WNERS AFFIQ I ��rtify that ail the for�goi�g informatian is �ccurat� and th�f all work wili be done ir� campliance with aEl applic�ble laws r�gulafing co�ru�ian an zaning. Futh�rmor�, I autharize the ab�ve named contractor ta do the work stated. � � , Autharized i �atCiee:Owner f F�ppiicant t Contractor f Agent �ate � 9ctaber 16,2019 Ra�e 2 of 2 1 1 � �-� � �"� � ° : �:� - �._,�.� ���`��� � 1 � . � �`� ������ � f 10Q5Q IV.E.2nd�ver�u�, 111�iami Shores, Flc�rida 3313� ����.� '�� $ � ��ie(�o�}7�s-22o����:{���}�r��-s��2 ��.�. ��� ��sP�c°r�c��LN�e��t�����[vi��R.g��s}7�2�a��g � �� �st�r R�rr�it �l�. ��� � � � � �� PE���T �RP�I��T'1� ��-��-� � ���. �'� 5�ab P�rrr�it 1U�. �u������ � ��E�-ra�c � ��c����� � ��vM��c�� � �x���s�c�� �����w�� R��►��rrv� � r�Ec����c,a� �Pua��c�r�R�es � c����� c�� � c��c�c��-r«� � sr�c�� �0 NT`Rd��1�C�R D RA�/VI�I C�S 1����t��ESS� � �` f�' � �''._._....____.� C[t : tVEiami Shores Count : (Vliami t�ade Zi : FaEi�jP�r��l#: �� � ��, Is the�uEldie►�F�istoric�lly��s��nated:Yes R!0 Crcc�apaney Type: Load: Constructior�Type: F{c�od Zone: BFE: FFE: � � � ��RIER:Name(�ee Sirnple Titlehc�fd�rj� � � � Phane#: ��� �� � � �� � � � �ddress: Cit�+: � � St�t�: �j�: � � �� T�n�nt/l�ss�e Narne: Phone#: Email: ���1°R��T��:Cc�rr�parsy Rlame: � { Phone#:��a° � � � Address: �, City:-� � �_.._.State: y Zip: _ � <,, C�ualifi�r Rlame: Phone#: � _ State Certification or Registratian#: �.�- �-. � � ��.`j'��� Certific�te afi Campetency#: �ESI��ER:�rehit�ctjEngineer:� Phane#: Addr�ss: Cit�: Stat�: Zip:_ ��io��c�f 1�f�rk f�r BF�ss P�rrv�it:$ ���' Squ�r�JGin�ar Fa�t����f V1P�rko Topp��f�8�arke Adc�i�ic�n [� Alteration ❑ €�ew+ [� Repair R�plaee � Demolitic�n [9��erip2iear��f UVc�rk> � � `' 0.�_ ����ify��1������1���h�� �i/�e subr�t���i����� ����,i�F��S ��F S cc�/��S Sc�r�r����F��� ��dc�n���$ ��PR$ t�ot�ry$ �'���rt�l��yv���$ ____Tr�i�ingJEdue�t3c�r�F��$ ��ubl�F��$ Structc�r�6 RevRe��$ _____ 6�rad$ T�'��k F�E P�t�Vlt�l�E$ ��j • ��� (R�vised�2T24120141 �c�ndir�g Cc�mp�ny's F�ame(if a�plic�ble} Bc�nding Ccamp�ny's,4ddress � CitY St�te ��� _ Evlc�rt���e Gender`s�lame(if applicable} � IVicart�a�e Lender`s�ddr�ss _ Cify Sta�e zf� Application is hereby rn�de t�obtain a permit tp dc�the wark and installatior�s as tndicated. 1 certify that na��ark or installation has c�mmenced pric�r tc� the issuar�ce of a permit and that all v�rork wiil �e p�rfc�rmed tc� meet the standards a� all lavus re�ulating construction irr �his jurisdietican. I understand th�t a separate permit must be secur�d far ELECTRIC, P�U��fM1lG, SIGNS, P��GS, FUR�ACES,�OlLERS,MEATECS,TANKS,�IR CC�i�DITIC}(�ERS, ETC..... �l��Eft`� �FF9tA���T': 1 ce�tify ChaY all the fear��oin� in#orrv�afiion is accurate and eh�t ail �+�rk v�ill be dt�ne ir� eompliance �ith alE applic�ble laws r�guPating cc�nstruc�ic�n and zonin�. s� � �° � e � � �� � � � ��� � � � � � '� � � � �� � � �� � �� �� � �� � ��� �� � � �� � � � � � �� � m � � � �� �� ������ ���������$ ����������� ���� ������ �� �� ������� ������ ��������� � ��� � � �m°` IVatice to Ap�licant. �s a conditic�n te� [he issutance of a burlding�aermit wifh an estr`mated vatue exeeec9irag$2Sd�C1, tt�e a�ap/icant r»ust prQrrxis� i� good fcrrthr that a capy af tt��raotic� c�f cnmmencem�nt crnd constructicara (ierr laav broehure �itl be delivered tcr the persearr wF�cas�propert�y is su6ject ta aftachrrt�nt. �Jsca, a certified ec�py of the reec�rde�r��atice vf camrrreneement must be pc�seed at the job site �car the first inspectic�ra which occurs .�even (7J days after the bu{fdinq p�rmit is issued. ln Ttae n6senee of sue}� pt�sted rtvtice, the inspec�ion wrill not�be appre�vee�and a reinsp�ct�ion fee�it!be ch�rrged, . ,��.... ���� �� ,�� � �, � � � r' �`�� � Si�n��ure S��natu�e °'�� � �'�. � R c�r,4GERT CC7�TRA�1"QR Th��f�are�caing instrumen�w�s aeknc�wEed�ed b�fore me this The fear��cain�instrument was ackrra�rled�ed b�fcar�me�his . �`i,,day of , Y d�y of � , °� .._.._.__, �ay ,uv i onally kn�w ` �. ,v�+ i n to me�r vvho has p duced "a�� �„�,�_`a me car who has pra^ ced � �s identi�ication a d uvhc�di,d�tak�an oath. ide�tifieatican and ho id take an oath. .� �C�T�R�Pll� �: 6UC3TAE2�P�D�l.��: �, i Si�rt: S Frir��; °`� Frint: ��� � Seal: �°"��s��`�� L�RE�i'A�C��S Sea�� � � � � �VC��PS��'#FF���_ � x � MY C4P�I�SI��F��46�4 � E�AIfiES �3arc���,�Q2(� �kPi��S,�stGft21t��20 �'�c�e��''� 9cu�di�t�t�����,�t�vi�s �'�����``�� �o, `�€���N�ry+S��a� ����������������,�����s������������:��������*������*���������������w�����*��������������a�:��*�ra�����zm���w����n����� _�w � APPR(�VED�V ____ _ � � � Plans Examiner Zonin� ��ruetur�l Revie�r CP�rk (�e����do2f2�l��z�) � ���� � :��c.��.�x ��s� � � i � h�re� ill� � ���. �.,.�� �lll�d�r�g D�p�r�r�+�r�t � -� �``��;�,�������� � �oo�o �v.�.��,d ,������ � �'�t���*� � Mi�mi Sh�r�s, Fl�rid� 3313� 1'�l0 {305} 795.2204 Fa�: (3Q5} 756.�972 � ti 1 — ' 1 t� � � � � r , � ,�� � ,, �� �., . � �, � ,�, �.�� �_ Florida Law rec�aires �t�`carkers' Cc�r��p�nsatiQzl it�s��ra���e cc�verage ut�der Ch�pter 44(} of tl�e Flarida Stat��tes, F[a. St�t. � 44(}.4S aliows corparate af��ers ir�the c-onstructian iz7dustry ta exetnp�therzlse[ves fro�����is rec�uir�mel�t fo�-any cans�ructic�n�rajeet prior ta ' abtaining a buiiding�aern�ig. Fursuan�ta the�larida Divisiat�c�f�`orkers' Comp�tlsatiola Emplc�yer Facts Bro�huee: t�n �mployer in tl�e eonstruetion industry �r�ho emplay�s on� or nlas�e part�titne or fizlt-tin�� i e€��pic�yees, inc[udir��;the owner, must obtain wor�ers' cor��pensation ea��erag�. Corporate officers or enembers of a lirnited [iabilitv compan}= (LLC) in t}�e constructiar� industry� may elect to be exen�pt if; 1. The o�cer owr�s at least 1 f�percent of the stoch of the�orporation, or in the c�se c�f an LI1C,a s�atement attesting to the rnininlam I O p�reent awnership; 2. `I�he o�c�r is Iisted as an offieer of�he cc�t•pc�ration in the r�;cards of rhe Florida Departmez�t of State,I3ivision of Corpor�tiaxis; and � 3, T6�e ca��oratian is registered and listeci as ac�iv� �itl� the F'lorida I3epartr�lent af State,Divisian af Carporatia�s. \c� more than ti�r�e eorporate officers per corporatior� or Eunited Iiability campa��y= znefnbers �tre allowed to be exe«��at. Construction exemptiorls are valici for � periad af two ye�rs ar until a �°oluntar��revacatioPl is fil�d or the exernptian is r�voked by tl�e IJivi4ion, Y`our conYrac�or is req�xestin�a permit u�ld�r this tivorkers'campensation�xen�ptio€��nd has aeknou�led�e that he o�-st�e will nQt�se day= I�bor,part-tin1�enlploy�ees or subcontraetors for your praject.'i'ha cantrautor I�as�rovided an affida��it statin�tt�at E7�or she��ill be t11e only�person allow�ci to wc�rk ozi}=our praject.In these cireumsgai�ces,MiaFni Si��res�'illa�e does not r�equir��veritication of ���orkers' compensatic�n insurance coverag�frazn the con�raetor's cc�sl�pan}� fc�r day labor,part-ti�ne entployees ar subcontractc�rs. BY SIGNING BELC�t�' YQI�' �CKNOWLEDGE `I'}-IAT YOLJ HA�'E I�E:�i� TT�IS Iv1QTIC� AND LiNL�ERSTAtiD 1TS Ct)I�!TENTS. �f� � � Signat�re: �_ � ' —r— � � ix�� � �.�_.�.. State af Florida Count}�of?viiaF��i-L�3ade The foregoing ti��as acknawled�e before me this �.�' day of `-� ������ .20�? . EE...��=S�-�� `�����"�� ����pe onally knotivn to me or has produced By,�t31 � -------— �`�� _' _ �= = as ideniifica�iQn. NOt32}': SEAL: :=o`•""'''4R<<, --- SI1�1QIfk ALV4REZ a' � t�tY^C`�P�1t��1:�Slt?�3#��GG 2382'3 -`�:=���'n:� �XPEi?ES:September 3,202'� �°��C��F�4��`� t, � � � � a� � 117�� �� 1$� �tr��t, �i�t11i, FL� 3317? �F'�142�573 �t�� ��pt�rr�b�r 16, 2019 �t��� �� Flcarid� ���r��� �f ��rt�i�C��d� ��f�r� r�n� this� d�y p�r��r��ll� �pp��r�d QC��� � � � �h�, b�i�g ��I� ��c�r� d�pc���� �rtd ����: T'h�� h� �vi6� b� th� �r�E� p�rscar� ��as�kir�g �r� �h� prc�j��� ��: 31 t" tr��t �� � �r��� F!. 3�13 a # � � ��r��r�ct�r�wgr��t�r� ��c� tc� {� �f�irrn�d� �r�d ��b��rib�d f�r� r�� thi� d�� c�f , 20 � b� � ��, � F'�r� �11 kn��r� �� �r�du�� Id tifi��fii�� Typ �f Id�n�ifi� tic� �'rc�d� �r6��, Ty �r p N�rr�� �f 6�ca��rr}d ������ ��a a����s �. � � �Y GQMMISSft}N#FF � 64 �. EXPIRES;Ma�ch 21,2Q2� ����� 60�Thr�Eu�et��ary S�tv��