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PL-06-21-1609
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A � �� tik ���,�t �; l �� � V ���Y�t�������t �`� • '��.������a��� ` � �1�ti l�t \ � \ p �� \� � \``,�z ��. \����'��.L� Mi�rni S�ores Vill��e � �,����?���'`� � �� ,�. ���:� � � � � � � , t k� ,��r � � 10050 NE 2 Ave � � � � �� ��` \� �� � �`L�1� ��� ` � � � �� Miarrri Shores FL 3313$ �� � t ,` `� o�� � � � ���� � � � l�i�� r� � � �: � Z � �\ � ���\a �� �,..,., �� 305-795-2Z44 �� t v �� i �i � �` ���.�?����'5����'��' �•, B �.,� 1\��� �s � ��� �� � � � � � �.ti�����..�.01<�..1 . ..� �,tt.A..�;i.l�z�.,.�:.>% ��t �.s�'�� . ������° �� �V" � ��� \s� \� � � � ��. � �, ���������,��z���; Expirat�on:�12j21j2021 �,,..���.t.. ,���< Lo�ation Add�ess Parcel Numk��r ���.�.�.�,u_ F.� � �.�.�.���.nm�n. �� �,__��. __an,�_,M�.� . .� w w.u..� �_wM_. ..e�_ Mm..�. � �w,�N . ..�m�, ; 123 NE 99 51° 2132Q602321�1 � �, . �antaets � �HE Q�IVINE�RC}UP NOMES��C C3�nrner IN�INITY CONSTftuCTkON SEftVICES INC Contractc�r � 293 NE 61 ST,MEAMI,FL 33137 ANTONIC}LUVARA Business:3053QQ5274 4156 46 AVE,M(AMI,Fl.33165 � �usiness:786443959C? , � �,. :.�� �� w�.�d..F.� ����.... � ������� ��.__e�.�.�...�.�w��,. Ins ect��n Re uests E Deseription:SUB PEftMfT FOR MA�TER PER�IT. � Valu�tion; $&{},0��.�Q �������4��� �`'��t�`�� �;�,�`; < �� � ' � . �; �;�,�� = Total Sq Feet: 3,600.00 , ����,? i Fees Amaurst paym�nts Date Paid AmL Paid Applicatican Fee-Other $SO.OQ Tota!F�es $205.0� CC� $36.Q� CreditCard Q612112Q21 $145.40 DBPR Fee $2.00 oca F�E �z.ao �+mount�ue: 50,00 Education Surcharge $12.00 Scanning Fe� $3.Q0 T�tal: $1d5.00 lltlt�l C1t Q Y In con�id�ration of the is�uanc� ta me of this permit, 1 agr�e to perform the work covered h�reunder in carr�pli�nce with all ordir�ances and regu(�tions pertainir�g theret� end in strict confarmity with the pEans, dr�wings, sfiatements ar specifieations submit4ed to the peaper authe�rities of Nfiami Shores 11illage. In accepting Ehi� perrrtit I assume responsibiEity for aIi work don� by either myself, my agent, senfants, or emplayes. I understand that separate permits are requir�d for�CEGT€2IGA�., P�UM�I(VG, MECFiANICAL,WIRlDO , DQORS, OOFING and SWIf�N�ING P�O�work. taW�lERS AFFIDAVfT: I eertify th�t alI the for�gaing informatian is aceu t� � t ��t ali work will be done in cQmpliance with a!1 app6e�ble Iaws reguiating constructian and zoning. Futhermare, I authorize the above name co rac or ta a the w+ork stated. ! Authoeized Signature:�wner t Appiicant! Contractar 1 A ent Date June Zl,2€�ZS Fa�e 2 of 2 � 1 1 �' I�� ��.���������"���� � !� I � � i ,., , 1005Q fV.E.2nd Avenue,Miami Shores, Florida 3313� ��"�� �e�:(��S)���-zz������{�o�}��s-���� � o.�.,.a, INSF�EC`fICI�U LIN�PHQPVE NUMBER:{3Q5}�62-49�i9 � � ��St@C P�CfYti� �. � � � �� � � ' I $U��@Yt711f NO. � `� `"" � ❑au���i�� � E�Ee�rRwc � �c�c�F��� � ��visio� � Ex-r��s�c�ry ���N�v��� ��ur��eN� ❑ �ECNa�dcaL ❑�uaL�ewoR�s ❑ c��a��E oF ❑c��c�l��rio� � sNOP CC}NTRACTOR DRAWiNGS �o��Q���ss: ��'- `� ���� ��-�—'� � —�°`� Citv� Miami Shores Caunt� tVliami Dade Zi� � �� ��--� Falio/�arc�l#: �� �' � �� � � Is th�Building Historically Desi�nated:Yes NC? ���m Occupancy Type: load: Construction Type:____ Fiood Zane: BFE: F�E: OWidER:Narr��{�e�Simple Titleholder�: � � � Phone#k. ��� �ddress: f* �� City: �� �� State: � Zip: � �� Tenae�t/Lessee Name: F�h�ne#: E�,���: � �� � � �e � j Ct}�ITR�C�'(}�:Cc�rnpany[Vame: '�°? ���� t°�E �� ����� � %� � ���"�`� ` #'hone#�: Address: f'� ��� ,� �--` �"' °.� �" City: f� P�".:� �' State: _..�� Zip: '�.� � � °� Qualifier fVame; ���`��?lc� �� c��'���.�.��`� Phane#:��"`�� °��� �,.��r� r Stat�Certificatian or Registration#:� � ��Certifieat�c�f Campeteney#: �ESl�NER;Architect/Engineer: Phc�ne#: Address: Gity: StaCe: Zip: Value Qf Work for this Permifi;$ ��"��� SquareJCinea�Foatage of Work: Typ�of W�rk: 0 Addltion ❑ Alte atian ew � ❑ Repair/Replace ❑ Demofition 6escripti�n af W�rk� �' S���i catc�r��f e�lor�thru �it�; 5uk�mEtt�l�ee$ Permit Fee$ CCF$ C(3f CC$ �cannen�F��$ Radon Fee$ �BPR$ Ne�tary� TeehnolQgy Fee� � Trainin�/Educatian Fee$ Double Fee$ Stre��t�arai Reuiews$ �on�$ TOTAL�EE t�OVf!�C1�� (Revi��daz/z4/zoi�} E3�nding C�rr�pany°s E����{i��ppE��bf�� �c�nding��ar�pany's�ddress _ Ciey�� SCate Zip r tukc�rt��g�Ler�der's[d�m�(i��pplicabl�) �lor��ag�C�nder`��ddr�ss City St�t� Zsp �ppllc�ticrn is h�r�by r��de tc��bt�in a permit to dc�th���ark�nd in��all�t�cans as ir�die�t�d. I c�rtify�h�t n�wc�r��ar inst�lEatic�n has ccarr�menc�d pricar t+� th� �ssuaraee of a p�rmit and �h�t all �,rcark enrill be p�rfoervr�d to m�c the standard� of �11 I��as r��ulaeing corastrucCic�n i� this jurisdict�ean. 3 �nderst�rrd �h�t a se��rat� perrrtit rn�ssf b� secur�d f�r ELE�'TRIC, Pi�UM�IP��, SI��ES, PC}Q�S, FURN�CES, �E�E�.ERS,hdEATERS,TAPdKS,�6R CC�N�ITIf�NERS,�T�,,.,. C�6t4d1�ER`S �F�1[�AItE�': I ��rtiFy ttrat aCl the €eare�c�ing Er�fiearrnatioe� is ae�ur��� ar�d that�li w�rk �nril{ k�� dc�n�* in cocnpliae�ce uvi�h alE �ppli��bl�I��nrs r�g�alatin�constr�actican�nd z�nin�. df . E ! . � . � A� . ..� / i � � . � �i � � � � . � �� �� � i . �. : �� � � � 6� 6.Ak'7 i�A1� ��I��I`6�ll��p �����J�9 �ii��� I l/�� ��1T���B4 &�F��� �I 1 i.��'1s61A�� 67��k.d�� 6'9�\c�i:€���(�qi� { . � ���,+ � F edJ Ncatace t�,��pticcrnt� As ca e�nditicar� tc�th�issue�rrc�r�f�bui�din���rrr�ft uvit6s an�sclrrr�ted vatu�ex���ding S�5t1� the a�pfieant rr�cest �rsrr�ise kra gooef far`th �hat cr c��aye�f C�re notic��f ce�rnm�rr��m�rat rand cc�t�str�rct'r`an �F�ra �a�u brt�ehur� �itt be dcri�rer�d�o �he�erse�rr auhe�sc�pro�a�rty rs subject�o crt�crchmerat. ,41sr�,c�e�rCi,�i�cl cc�pyr v�th�r�c�rd�d notic�c�f cc�r�rrta�n��en�nt rrrust b�qcrsted art ehe jo�sit� �'�ar [he,�Ir.st ir�s��ct�c�rr �rhfc�a o�ccars severa ��,? dc�ys cr,�ter th� 6uifdirag p�rr�r�i� is is u��'. 1n tt�e �k�s�nc��caf s�rch �acast��' nc�ti��, Fh� rnsp�ctica�u�ill r�a�i 6�a�prcaved�r�c�cr��insp��tior�f�e aaritl b�chazrged. �� K Si�n�ture � Si�r���ur� �� ��� "�C1�NER or��EI�T C�E��RRCT�R The fe�r�g�ia��irtstrum�n��+a�ackno�led�ed befare rr�eachis °�he fc�re�c�ing ir�sYrurr�en�v��s ackr��v�l�d�ed b�for�rr�e this d�y t�f � .2� by � day caf � ,20 b}� = a ,�rh�is p�rs r�o�un t� scara�ll kn�wr�t� � m��r whc�h�s pr�duc�d as rr��car uvhaa has prc�duc�d �s iden�ific�ticar�ar�d whc�did��ke�n oa�h. id�c�fiific�2iorr�nd who di • � ` ;. � ,���A�,r� RAU�. NAIIt�RRC? �1�TAR�Pll�Gf�: i��T�R��lD����; `` e���, N�c�ry Pubtio-Stat�04 Fiarid� ' ¢ Coeramissicrn#GG 962��3 ,% ��� �,�� hAy�a�mm. Expires 03�24-Zt}2A � � ".���e�Fto�; 8ond�d Throo�h �6��: �1��. Huckl�b�rry Natary�onding{�e �1`ICEt: � � �'CitSk: �taktie St�k��af F Seal: S�a#: � a C���G�t�C T�E.IQN ta�y �rs� MM 0�7435 ��� � e� � ����*������:������������z��������������a����������������e����������������:�������������������������������a�������� ARPRC?VED�V P1ar�s Ex�min�r Zonin� 5truct�aral Revie� Cl�rk {Rewis�doz(zaf z�141 ������� � �� i�ml ��re� ill�g� ..`" � � ".".���� �uildir�g D���r�m�nt �������'� �oo�o �,�.��,� ���n�� *����i���"' �viiami �hc�r��, FCc�rida 33138 1'�I: (305} 79�.22Q4 F�x: (3Q5} 756.�3972 �1 � �' °� C t"S' t1 �1 C1 � 1" 1 ���' �. � \ �<i .A � �� � 3., Flc�riciz� Law zecluires ��arket�s' C;c�tn�7et7s<�ti�tl instu�znc�e cc�verszge ui�cier C"la��ter �=�(} c�f tl�e Flc�ri�1G� Stf�tutc�s. FI:3. Stat. y �4(1.t)� allc�ch�s uot��raCe c�fficet�s ii�tF�e cot�strnettc�a inciustr� ta exen��t thezalscli�es trom this reqc�irement fc�� �n}=ct>ttstructior���rQj�ct�rtzor fo � c�t�t�inint�a builcli��g pe��mit. Pua�stii�t�t t��t�e�laz•ida I)ivisic�tl c�f l�c�rkers'�€�rt����sez�satic�n�m��Ic���ar E��aets�3rochure� � i 1�n etr��I��yei- in the c�nstruction indusCry who empia}�s on4 or inore part-tit7ic or full-tir�� ( etnplayee��ii�ch�ditag the o�vlzer,t�ust abtain wc�z-hers' �;�tn�ensation coverage. Ca�aoi•at�offlcers or inetnbc��s af a Iimited �iat�ilit}� coYnp<�i�y (LLC) in th� canstruetion industry may elect tc� be exem�k if: 1, Tl�e c�ffice��c�wns at Ieast l4 pe�-ceF�t af the stock Qf the cc�rporation,or i«th�ease af ��n I.LC,�statetz�en[attesting to the mF��in�un� 10��eE�c�€�t aw�tershi�; 2. "Ck�e €>fticer is tisted as ��n c�fficer c�f the corp�ratiaci in ttae recc�rds i�f�the Fl�rid�s Department ofStat�,L?i�°isit�n c�f Gorporatio�is;and 3. TF�e ec>r�oratic�n is re�iste��eci �aci listed as aetitj� ��Tith tlte �larida I)cE><�rta�t�iat of Stae��Divzsiu�l of Cc�rpc�rations. Na r��ore than tkn�ee carparate ofticers p�a ec�r��c�ratian ar lirnited lial�ilit��� company �z-��rt�ber� are allo���ed t��, 6e exem�at� Coustrua�inn exer�i�tic�e�s are vdlid f€�r a peric�d of two years c�r untii a voluntary revocati�z�is filed or tl�e exe��l�tia�� is resrakecl by the I�i�rision. �'Qt.3r cc�ntra�tor is t��questit�g a�ern�it ti�ndc�-Cl�is workers'con����ns�tion�;?�enzpti�n afld h�s�ackz�owled�e�hat h�or she�rili nc��use dav Iab��r,part-time�inplQ��ee�c�r subcontractc�rs t�r y�c�t�r prt�j�et.Tl1e cc�ntr�ctor h�s���c��=id�cl an at�id��=i�st�ting th�t he e�g•she will k��th�csr�ly person allc�wec�e�u�ark an yatzr projeet. [n these eirc�iznst�nces,4�i,�mi�t�c�res�'ill�ge do�s i�ot require veri#�zcation c�F wc�rkers'campens�tion insuranc;e e���er��e frc�m tl�e coittraetc�r's co�n���ny t€�rt-da}�C�bor,p�t�t-tinze�en�l��`ees�r sixbcc�ntractars. I3�` �1CIvING I3L;LC)�' Ytlt� :1,C",K1�C�4t'LL:i�G� TII,�T YC�L FIAi'L: I2E.�I� TFIIS Iti{�TIC`[: �iNI) C?NDF�R�T.�1NI? [T5 c c���r�:��r�. �w„�-w-:�.-�� , ._ �,:� szb��������: � �.-�rwner St<ite c�f F�Ec�ricia Cc�uzatv c�f Miatni-Dade Tt�e foregoi was ackiz�r���led�e Mefore me this day of � � �,24 F3}= � � � � � �I�c�is personall�°knc�wn to���e ar has produced ,.� �� as ic3entiEicati�n. Not�ir}: �f �,; SL,F�L: �,�,at�c�, Vc�Sar;�='�a:�i,c St�te raf Flot�d�� �' C:Ai����L G.A�T�k.tC)Pd ,,�; ,; �viy�csnu�,tssxc�n htH . t 024 ,,a.�: ,��'b��� .�.,. a ' . 4��.5Ei S 9�'i AVetiU� i� i, i�z�i a 331�5 ele n� '7 � 4�43 �59 �I�ENSE# �AC 1$�6795 E,ICE SE# �FC 242�2�� Date: June 20, 2019 State af F{e�rida Caunty� �� Befc�re me �his day p�rsonally appe�red—,�� �� ���_`�� � ����`�� 't:�,�, Who bein�duly sworn, dep�ses ar�d says: Th�t h� or she will be the only person �,rc�rking in the pr�jec� iocated �t ��..,�� �� ��_ �� �� °� �� � � �� l � �`�`��� ��,��`'`�°`,� � � ..�� F���.. Ceintract�r �i�n�tt�re Sworn to (�ar�ffirm� and subseribed before m� this � d�y c�f ��� 20 `,�? � By �t��t ���,�w�..�#��� �t.��'.� �.�..�- ��� P�rsanally Know �'� �...� � ��.�-.�.m�-�' Or produced identifiication - # �. „��,,, RAI�L NAV�RRC3 <'�^��'��'�� Notary Pubiie-St�te e�f Florid� ^z Commi�si�n�GG 962853 F. *4 T e id�ntification Prod�aced �e; My Ce�mm. Expir��Q3-20-2024 Y� *''�'�e'�#�«t�d�z` �afld4d ThrtSuy�h rtns�� Nuoki�b�rry NRiary�ginding inc Prin�, type or starrtp name c�f Notary