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PLC-09-22-2321Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address 421 GRAND CONC, Miami Shores, FL 33138 Contacts Permit No.: PLC-09-22-2321 Permit Type: Plumbing - Commercial Work Classification: Septic/Drainfield Permit5tatus: Approved Issue Date:12/22/2022 Expiration: 06/22/2023 GRAND CONCOURSE CONDO ASSN INC Owner A 1 ABLE ROOTER INC Applicant 421 GRAND CONC GR UN6 MICHAEL ZERO 5722 S FLAMINGO RD 270, FT LAUDERDALE, FL 33330 Mobile: 9544106957 zerossmokedfish@yahoo.com MICHAEL ZERO 5722 S FLAMINGO RD 270, FT LAUDERDALE, FL 33330 Mobile:9544106957 zerossmokedfish@yahoo.com Description: INSTALL SEPTIC TANK AND DRAINFIELD Valuation: $15,785.00 Inspection Requests: 305-762-4949 Total Sq Feet: 0.00 Fees Amount Application Fee - Other $50.00 CCF $9.60 DBPR Fee $6.99 DCA Fee $4.73 Education Surcharge $4.80 Notary Fee $5.00 Permit Fee (Manual) $423.55 Scanning Fee $9.00 Technology Fee (Manual) $47.36 Total: $561.03 Date Paid Amt Paid Total Fees $561.03 Credit Card 09/12/2022 $50.00 Check if 12041 12/22/2022 $511.03 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 AFF I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulatintructjolf4ncl zoning. Futhermore, I authorize the above named contractor to do the work stated. 12- ?- 2- - 99- / Applicant / Contractor / Agent Date December 22, 2022 Page 2 of 2 Miami Shores Village ENTERED BUILDING PERMIT APPLICATION 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 12 2022 a:t— ., FBC 20 Master Permit No. PLc - o ll - Z% 23 L i Sub Permit N ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION 12/PLUMBING ❑ MECHANICAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP /1 l CONTRACTOR p DRAWINGS l� JOB ADDRESS: I-Q l^tol. Y I Folio/Parcel#: Mul 'P, e. Is the Building Historically Designated: Yes Occupancy Typ� 1 J Load: Construction Type: Flood Zone: BFE: _ OWNER: Name (Fee Simple Titlel Address: 41;L/ �r9��r//lir s/ City: f/'(�i,lc-o Clf—Ai( Tenant/Lessee Name: /Qif f Email: CONTF Addres Email: Qualifi State: State Certification or Registration #: ��"I��Certificate of Competency #: DESIGNER: Architect/Engineer: I_T:l._ Value of Work for this Permit: Type of Work: ❑ Addition Description of Work: 1 5.-7�5 .0 5 . M Square/Linear Footage of Work: ❑ Alteration ❑ New 5� RepairrllReplace nll `\,oA�er. -�nr\ r-rttPI /' Specify color of color thru tile: ❑RENEWAL NO FFE: zip: 33(- ��-S'352 _Zip: ❑ Demolition 00 Submittal Fee $ `� • Permit Fee $ CCF $ 1. 60 CO/CC $ Scanning Fee $ '�l -CO DCA Fee $ q DBPR $ (o •n'r `T Notary $ 4L• ( -30 Technology Fee $ u�I.3(O Training/Education Fee $ '/ • 80 Double Fee $ Structural Reviews $ P&Z Review $ Bond $ TOTAL FEE NOW DUE $ ll (Revised04/05/2022) 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. 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. 1 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_ i/ �� a� Signature OWNER or AGENT CONTIRKCTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this .� day of 6W 11! + 20 Z 1 by , day 1of-7 p 20 LZ O . by A 1 5 aaKl De e�ir o i*✓ . who is personally known to r v 1 C 1 It��A t_t �� , who is personally known to me or who has produced F( D l . as me or who has produced n V ( L/1 I�� as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: e Sign: L1�/l�I Print: . 6 EMr6t19Ai�0A ':v^r Print: �I[^_�y �� , nr� N U V, , Notary Public, State of Florida31, Seal: Commission# GG 273249 Seal: ........ My comm. expires Oct. 2022 61ERUNE CHERY :a` My COMMISSION#HH2=6 +o '.?:vrv?•:• EXPfRU:ApaIZ20M •asses»rasrsrsssq►asa►►r►st►s►Qs ra»sssssrsaass►aNgrrrssas aarsarra arar►raaraaas t� Y Z!- APPROVE BY Plans Examiner Zoning Structural Review (Revised04/05/2022) Clerk � •+ �Vi.Kfi� ��(.! \i nl,I�ry d:Ri C1SV� ►sR 3•i ��r-, •~: S; �''�+...�� ' ��ft. �°" Detail by Entity Name Page 1 of 3 ;r. �.- drg �' 51 C>� >11 Department of Stale / Division of Corporations / Search Records / Search by Entity Name / Detail by Entity Name Florida Not For Profit Corporation GRAND CONCOURSE CONDOMINIUM ASSOCIATION, INC. Filing Information Document Number N05000005775 FEI/EIN Number 20-2972125 Date Filed 06/03/2005 State FL Status ACTIVE Last Event AMENDMENT Event Date Filed 10/30/2006 Event Effective Date NONE Principal Address 421 GRAND CONCOURSE MIAMI SHORES, FL 33138 Mailing Address 421 GRAND CONCOURSE MIAMI SHORES, FL 33138 Registered Agent Name & Address De Oliveira, Lois 421 GRAND CONCOURSE Unit 10 MIAMI SHORES, FL 33138 Name Changed: 03/16/2021 Address Changed: 03/16/2021 Officer/Director Detail Name & Address Title Secretary DE OLIVEIRA, LOIS 421 GRAND CONCOURSE MIAMI SHORES, FL 33138 Title Board Member ROMANIK, GEORGE DIVI$10N 0^ CORPORATIONS https://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entit... 9/ 12/2022 Detail by Entity Name Page 2 of 3 421 GRAND CONCOURSE MIAMI SHORES, FL 33138 Title Treasurer Stephens -Harrison, Casandra 421 Grand Concourse Miami Shores, FL 33138 Title President Bao, Jose A 421 Grand Concourse Miami Shores, FL 33138 Title Board Member O'Brien, Deanna 421 Grand Concourse Miami Shores, FL 33138 Annual Reports Report Year Filed Date 2020 03/04/2020 2021 03/16/2021 2022 01/31/2022 Document Images 01 -11 ANNUAL REPORT View image in PDF tormat 03116!2021 ---ANNUAL REPORT View image in PDF forin 03iO4,2020 ANNUAL REPOKI*r, View image in PDF format Q1/23/2019 ANNUAL REPORT View image in PDF format 04104i'20 IS --ANNUAL REPORT View Image in PDF format 03128.2017 ANNUAL REPORT View image in PDF format 05103/2016ANNUAL REPORT F View image in PDF formal 04/0312015 AMENDED ANNUAL REPOR•t View image in PDF formal 02/13/2015 ANNUAL REPORT View image in PDF format 031,1312014 ANNUAL REPORT View image in PDF tonmat 02122:2013 ANNUAL. REPORT View image in PDF format 02104-*2012ANNUAL REP01"ZIT imag,? in PDF form PFP()1:: r View: iniage in PDF form 0 10 - A NN LIAL R EPOR I' View image in PI)Fformat 0,111;20`2009 W.—A.NNUAL REPORT F le in PDF f0ml lev, ,-,3 ANNUAL. REPORT F rtlat mage in PIN fo , le7w-� N 007 — At REP()F) f F gin view -m3e in PDF for .1.2;30,'2006 Amendminit View image in PDF format 051,2512006 ANNUAL. REPORT View image in PDF format OWOW2005 Domestic Non -Profit View image in PPF fomiatLj https:Hsearch.sunbiz.org/lnquiry/CorporationSearchISearchResultDetail?inquirytype=Entit... 9/12/2022 The Grand Concourse Condominium Association, Inc. CLI "Wdrtu t'Quc acw:' - Miami Shores, FL 33138 1way 25. 2022 i't r'ar. aea 77. FeClrgOang at rrantt ronCnUi:ce cra d'Is' I tic DrOL UG'"I" rof io tt L9 is: Unit I has I bedroom and 1-bathroom sq ft 827 Unit 2 has 1 bedroom and 1 bathroom sq ft 82 Umt j = L oCCIMCM8 ana 1 offinroom sq rr !tia Unit 4 has 2 bedrooms and I bathroom sq ft 916 Unit 5 is a smdio '.:7tii 1 bathroom sq ft 394 .1� unit o is a Stu= 'XIM 1 'DaiarW1II sq iI -i4`1 Unit 7 has 2 bedroom and 1 bathroom sq ft 949 Unit 8 Is a studio with 1 bathroom sq ft 3:+4 Unit H is a scutrrc 4l'IIa 1 bamroom sq ri 4,t`l Unit I0 has 2 bedrooms,, and 2 bathroom sq ft 1106 Unit 11 has 1 bedroom and 2 bathrooms sq SL 112.5 WILL IL = 1 VC,'YI{' um atia I tiartWoon, sq rt aw Unit 14 has I bedroom and I bathroom sq R 800 Unit 15 has 2 bedrooms and 1 ba1h ooni s(I ft 916 Up -it 16 has 2 bedrooms and 1 bathroom sq fl 916 Unit 18 has 1 bedroom and 1 ba broom sY it .94 totat 22 ncmvotus tula I rsarutxxatus: There are also 8 garages and I laundry room/office Laundry room/orrice is lyumber 6 and is 200 square feet. The garage numbers are 1,2,3,4,5,7,8,9 and they are 200 square Feet each. i'irc inept {F.inpire Eleehnd') can Connrin Lois de Oliveira On -Site MAnager 4,'•t .^.,^.,ran.i Marni Shores. YL 33139 (IPanfl ('onrn.ia:5? Crt:sinc As rrriaiinn 421 Grand Concourse, Miami Shores, FL 33138 www. thegrandaonccnoovrro.=4 The Grand Concourse Condominium Association, Inc. September 12, 2022 To whom it may concern: I will allow A-1 Able Rooter to perform septic tank and drain field services. ih;' //- /' Lois de Oliveiry 421 Grand Concourse Apt 10 Miami Shores, Florida 33138 786 942-5382 421 Grand Concourse, Miami Shores, FL 33138 www.thegrandconconcourse.com e'NTERED STATE OF FLORIDA PERMIT n:13-SM-2549675 DEPARTMENT OF 13EALT8 r 122022 APPLICATION 6: AP1569152 ONSITE SEWAGE TREATMENT AND DISJ(Vft SYSTEM .BY DATE PAID: CONSTRUCTION PERMIT FEE PAID' RECEIPT N: DOCUMENT 4: PR1799473 CONSTRUCTION PERMIT FOR: OSTDS Repair APPLICANT: (List Of Owners in manage does) PROPERTY ADDRESS: 421 Grand Concourse Miami, FL 33138 LOT: BLOCK: SUBDIVISION: PROPERTY ID k: 11-3206-052-0010 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] [OR TAX ID NUMBER] SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION 381.0065, F.S., AND CHAPTER 64E-6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS, WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NUTS AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY. SYSTEM DESIGN AND SPECIFICATIONS T [ 4,900 ] GALLONS / GPD New Seolic Tank CAPACITY A [ 0 ] GALLONS / GPD CAPACITY N ( 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] K [ 1,900 ] GALLONS DOSING TANK CAPACITY ( ]GALLONS @( ]DOSES PER 24 HRS YPumps D [ 938 1 SQUARE FEET R [ 938 ] SQUARE FEET A TYPE SYSTEM: [K] I CONFIGURATION: 1x1 N F LOCATION OF BENCHMARK: New Drainfield Trench Con SYSTEM New Drainfeid Trench Con SYSTEM STANDARD ( ] FILLED [ ] MOUND ( ] TRENCH [ ] BED [ ] C/L NE PL 9.80 NGVD I ELEVATION OF PROPOSED SYSTEM SITE E BOTTOM OF DRAINFIELD TO BE L D FILL REQUIRED: E 0,00] INCHES 0 T H F R [ 3.60 ]( INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT [ 33.601E INCHES FT ]E ABOVE BELOW BENCHMARK/REFERENCE POINT EXCAVATION REQUIRED: [ 42.001 INCHES 1: Invert elevation and Bottom of drainfield to be no less than 8.10 - & 7.60 - NGVD respectively Z - Instal[ a 4800 gal. septic tank with an approved filter 3 - The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with s, 64E-6.013(3)(f) FAC. 4: Install two 937.5 sf. of drainfield in ...TRENCH... configuration. 5: Install 12 " of slightly limited soil at the bottom of the drainfield. THIS PERMIT IS NOT FOR ANY ADDITIONS. The system is sized for 22 bedrooms with a maximum occupancy of 44 persons (2 per bedroom), for a total estimated flow SPECIFICATIONS BY: Anth y S Johnson TITLE: Owner APPROVED BY: TITLE: E_nvironmental.. Specialist II - Dade CH DATE ISSUED: 07/28/2022 DE 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC EXPIRATION DATE: 10/26/2022 Page 1 of 3 •, 1 1.4 "1t 63152 r 6 U'a �cL/'6 ,ERED 12 2022 ApPro 6AQ4+5, PLAN ae`�3 -- Miami Sho es Village B jilding Dep rtment Zoning D pt. Date Date Building -ept. with all Federal, and reguk Subject Io compliance State anq County rule tions. Permit# I QLC - C' i I 5 I co'z� yw- ACORAO CERTIFICATE OF LIABILITY INSURANCE `....�" DATE (MM/DD/YYYY) 12/22/2022 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 pollcy(ies) must have ADDITIONAL INSURED provisions or 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 Jackson Agency Inc DBAAIIied Risk Partners Corp 6971 W Sunrise Blvd #206 Sunrise FL 33313 CONTACT Maria Benitez NAME: HONN Ext : (305) 824-3464 ac Nc ; (954) 473-3705 E-MAIL mbenitez@jacksonagency.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Evanston Insurance Co. 35378 INSURED. A-1 Able Rooter, Inc. 5846 S. Flamingo Road #270 Cooper City FL 33330 INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : r-nV=Qef.'r-c CERTIFICATE NUMBER! COI 2022-2023 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 I LTR TYPE OF INSURANCE INSO WVD POLICY NUMBER POLICY EFF MMIDD POLICY EXP MM/DD LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 A 3AA607982 10/14/2022 10/14/2023 PERSONAL & ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS- COMP/OP AGG $ 2,000,000 PRO- a POLICY 'RO_JECT LOC $ OTHER: AUTOMOBILE LIABILJTY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ EXCESS LIAB DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNERIEXECUTIVE PER ER E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? a (Mandatory In NH) N / A E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) This certificate is solely for the use as " Evidence of Insurance" Septic Tank Contractor Al Able Rooter -5846 S. Flamingo Road #270, Cooper City, FL 33330 CERTIFICATE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Village Bldg Dept ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2 AVE. AUTHORIZED REPRESENTATIVE MIAMI SHORES FL 33138 I @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD 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 Exem 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: 6 1 ///�' P-N_ R� _ /L Owner State of Florida County of Miami -Dade The foregoing was acknowledge before me this I Z day of Sy s , 20 ZZ By {IW i 5 JeQ t Ve who is personally known to me or has produced Lt r, as identification. oy P0., Vivienne Yao Notary: �� .�UV_-Lo VtV"��"Q VCLO �PrPUB`�e Comm.:HH222410 . Expires: Jan,31,2026 SEAL: 111,; t? 1 tt Notary Public- State of Florida ENTERED 1L Z022 A-1 Able Rooter, Inc. 5846 S. Flamingo Rd. #270 Cooper City, FL 33330 954-680-8831 Date: State of Florida BY. % Before me this day personally appeared Michael Zero who, being duly sworn, deposes and says: That he or she will be the only person working on the project located at: 421 Grand Concourse Contractor Sign r Sworn to (or affirmed) and subscribed before me this I Z day of ur, 2022 Personally know OR Produced Identification FL- Type of Identification Produced r-1- .b,-,'I-e x I-, c- ,-7 Gvo "0 G H I y 3- O l*t/l e-vi✓ia y0-o Print, Type, or Stamp Name of Notary VivienneYao ` 4'PY PVe ii n_ Comm.:NN222410 =s; �.. - Expires: Jan.31,2026 Notary Public • State of Florida