PL-07-19-1631, 9923 NE 4th Avenue RdMiami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Parcel Number
9923 NE 4TH AVENUE RD, Miami Shores, FL 33138 1132060171290
Contacts
Permit NO.: PL-07-19-1631
Permit Type: Plumbing - Residential
Work Classification: Alteration
Permit Status: Applied
Issue Date: Expiration: 01/12/2020
BEVERLY MARKOWITZ Owner BEST PLUMBING SERVICES COMPANY Contractor
9923 NE 4 AVE RD, MIAMI SHORES, FL 331382439 JOSEPH RODRIGUEZ
251 E 44 ST, HIALEAH, FL 33013
Business: 3055588544
Description: REPLACE TILE IN TWO BATHROOMS, PAINT {` Valuation: $ 1,100.00 Ins ection Requests:
i BATHROOMS, INSTALL HARDWARE ACCESORIES, 305 762 4949
MISCELANEOUS REPAIRS Total Sq Feet: 0.00
0111 Al.: 37 ,H, A.,.;11P %, Gr,' ZIZI .151. 4111 /1 1/0; .:!/ Z1 A/- 0, AA, r, AM, 1, 7111: All 0. 'a
Fees
Amount
Application Fee - Other
$50.00
CCF
$1.20
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.40
Permit Fee
$50.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$111.10
Payments
Date Paid Amt Paid
Total Fees
$111.10
Credit Card
07/16/2019 $50.00
Credit Card
08/21/2019 $61.10
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 do the work stated.
Authorized Sign;#ure: Owner '�A Applicant / Contractor / Agent Date
August 21, 2019 Page 2 of 2
Miami Shores Village R-Ecj,-iTVED
BUILDING
PERMIT APPLICATION
Building Department J0 16 2 19.
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 �Y.
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20I��
Master Permit No. EC,-o� -
Sub Permit No.L V 1�
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑■ PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOBADDRESS -`1 Z3 )Nt-' `p?&�CQ a4
City: Miami Shores County: Miami Dade Zip: 33138
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder):
Address:
Tl— Phone#: 3 0 a-- 6 V'Z- a2Py
City: ��unMI Shiix-,_S State: �FL_. Zip: 3 3) --3 9'
Tenant/Lessee Name: Phone#:
Email
CONTRACTOR: Company Name: Best Plumbing Services Co. Phone#: 305 558-8544
Address: 251 East 44th street
City: Hialeah State: Florida Zip: 33013
Qualifier Name: Joseph Rodriguez Phone#: 305 558-8544
State Certification or Registration #: CFC1426732 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ L'� Square/Linear Footage of Work:
Type of Work: ❑ `Addition ❑ Alteration ❑ New i❑ Repair/Replace ElDemolition
Description of Work: _ e vfce V) `ctC e, 2.0 r s j cfld
r I�� RCPC; CC_ C,uc -e
Specify colok of color thru'tile:
Submittal Fee $ :.�U Permit.Fee $ CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $
Structural Reviews $
Double Fee $
Bond $
(Revised02/24/2014)
TOTAL FEE NOW DUE $ ',-" ! 10
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 7, Signature
NER or AGENT r. CONTRACTOR
The fore -going instrument was acknowledged before me this
"17 r
C day of �f Ly 120 by
. eyegri- z aA-reKgW r —'-;-?who is personally known to
me or who has producedas
identification and who did take an oath.
NOTARY PUBLIC:
Print
The foregoing instrume as�acknowledged before me this
Y 2 day of 20 /1 by
is personally known to
me or ho has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: G?j�" i�Z- 76`- j
Seal: ^._ MARIA A RAMLJ26&5%824
MY COMMISSION # GEXPIRES: March 28Pubic
**************************************************************
APPROVED BY "'' 1L Plans Examiner
*****************************
Zoning
Structural Review
(Revised02/24/2014)
Clerk
04
❑ �1
�.y R1
RICK SCOTT, GOVERNOR JONATHAN ZACHEM, SECRETARY
FIo�da
d
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD
THE PLUMBING CONTRACTOR HEREIN IS CERTIFIED UNDER THE
PROVISIONS OF CHAPTER 489, FLORIDA STATUTES
RODRIGUEZ, JOSEPH
BEST PLUMBING SERVICES COMPANY
251 E 44TH ST
H IALEAH FL 33013
LICENSE NUMBER: CFC1426732
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.
Local Business Tax Receipt
Miami- Dade County, Slate of Honda
OC4Ne I' T PAY
392006
SUMNSSS NAME/LOCATION
DUAISNIC SERVICES CO
33013
RECEIPT NCI EXPIRES
RENIEVIAL SEPTEMBER 30,2019
4092946
001041tfl 'IF C I ypt Of BUSINS SU
HST �LUI,!SAG 5E;'V'CFS CT) PAYMENT RECEIVED
Hy TAX COILECIOR
CRE:)"'rA-q,) IS 05M53
P"twit w a temli-ca4" of me to d4 btmimsm. Holdw mav, vemp1twith ",' V'Ovemomoutol
f'r reowotorr laws "A mgLztotrW-4 wb"h appl? to U°t hvfAness.
Th"C' PRUP, No oho",am' bv dml:14' trsd,'m 44 toffillmr1o"I V�-t"O*N — m4roi—odde Code Slvr 44-4h,
;w mtv Osix qvwftxcoftea
L 1.i jj CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
07/11/2019
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 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
Agency
Proper Insurance A
P 9 Y
471E 49th St
Hialeah FL 33013
CONTACT MARIA A RAMOS
NAME: ME:
a oNE : 305-681-1645 AID No ; 305 688-9362
SS: PROPERINS@GMAIL.COM
ADDRESS:
INSURERS AFFORDING COVERAGE
NAIC #
INSURER A: WESCO INSURANCE CO
INSURED BEST PLUMBING SERVICES CO
INSURER B :
251 EAST 44TH ST
INSURER C :
HIALEAH FL 33013
INSURER D :
INSURER E :
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
LTR
OF INSURANCE
ADDLTYPE
NSp
SUBR
POLICY NUMBER
MM/ POLDIIYYYY Y EFF
MM LICY EXP
/DD/YYYY
LIMITS
A
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
500 DED ON PD/BI
LJ
WPP1425853-03
12/07/2018
12/07/2019
EACH OCCURRENCE
$ 1,000,000
DAMAGEN
PREMISES Ea occurrence
$ 100,000
MED EXP (Any one person)
$ 10,000
PERSONAL & ADV INJURY
$ 1,000,000
GENT AGGREGATE LIMIT APPLIES PER:
POLICY PRO ❑
JECT LOC
OTHER:
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS -COMP/OP AGG
$ 2,000,000
$
AUTOMOBILE LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
COMBINED SINGLE LIMIT
Ea accident
$
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
UMBRELLA LIAR
EXCESS LIAB
CLAIMS -MADE
EACH OCCURRENCE
$
HOCCUR
AGGREGATE
$
DIED I I RETENTION$
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANYPROPRIETOR/PARTNER/EXECUTIVE ❑
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes, descr be under
DESCRIPTION OF OPERATIONS below
NIA
PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT
$
Li
EJ
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
PLUMBING SERVICES(RESIDENTIAL & COMMERCIAL) LIC CFC1426732
CERTIFICATE HOLDER CANCELLATION
Miami Shores Village
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Building Department
THE EXPIRATION DATE THEREOF, NOTICE
WILL BE DELIVERED IN
10050 WE 2nd Ave
ACCORDANCE WITH THE POLICY PROVISIONS.
Miami Shores,F1 33138
REPRESENTAT11Y
/ @ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
Produced using Forms Boss Web Software. www.FormsBoss.com (c) Impressive Publishing 800-208.1977
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: 8/29/2018
PERSON: JOSEPH RODRIGUEZ
FEIN: 650811170
BUSINESS NAME AND ADDRESS:
BEST PLUMBING SERVICES COMPANY
251 EAST 44TH STREET
HIALEAH, FL 33013
SCOPE OF BUSINESS OR TRADE:
Licensed Plumbing Contractor
EXPIRATION DATE: 8/28/2020
EMAIL: BESTPLUMBINGSERVICES@HOTMAIL.COM
I MPORTANT: Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by fig a certificate of election under
this section may not recover benefits or compensation under this dopier. Pursuant to Chapter 410.05(12), F.S., Celificates of election to be exempt.. apply
only within the scope of the business or trade listed on the notice of election to be exempt. Pursuaird 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 Bing of the notice or the issuance of the certificate, the
person named on the notice or certificate no Longer meets the requkemen s of this section for issuance of a cedWicate. The departrnent 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
��ro wee
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: 5/17/2018
PERSON: GUILLERMO E BASABE
FEIN: 650811170
BUSINESS NAME AND ADDRESS:
BEST PLUMBING SERVICES COMPANY
251 EAST 44TH STREET
HIALEAH, FL 33013
SCOPE OF BUSINESS OR TRADE:
Licensed Plumbing Contractor
EXPIRATION DATE: 5/16/2020
EMAIL: BESTPLUMBINGSERVICES@HOTMAIL.COM
IMPORTANT: Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by fifing 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. Pursuard to Chapter 440.05(13), F.S., Notices of election to be
exempt and certificates of election to be exempt shag be subject to revocation if, at any time after the fling 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 certificaEe. The department shall revoke a
certificate at any time for failure of the person named on the certificate to meet the requkements 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:
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: �U
Owner Qf
State of Florida
County of Miami -Dade
The foregoing was acknowledge before me this 6 q
day of V 20
By'EVr-zaW qAR.W- o who is personally known to me or has produced
as identification.
Notary:
SEAL:
<�? SINDIA ALVAREZ
==� MY COMMISSION # GG 238273
Bonded Thru Notary public U,nderwMers
Local Business Tax Receipt
Karni—Dade County, State of Florida
_ T. H t S 18 N 0 1 A SELL - 010 N 0 11FA y
3920056
BUSINESS NAIADLOCATzON AREIPT NO
BEST PLUM III SERVICES CO RENEWAL
251 E 44TH ST 4092946
HJALEAH FL 33013
SEPTEMBER 30,2020
Mug' be d!splayod at 1plac-e of bus,twc-
porsijana -.0 County Cocie
Chapter 8A - Art, 9 & 10
MW Slt' - TYPE OF BUSINESS PAYMENT RKFIM
BEST PLUMBING SETAES CO 196 CILUMBING CONTRACTOR BY TAX COLLEf,70F
-C42673Z
S45.00 07/71/2019 - -
'Wc� r k P r 3 CREDITCARD— 19-059104
This Local Rtisinass Tax Receipt only confirms payment of the tocal Butortess Tax. The Receipt is out a license,
permit, or a certification of the holder's qualificmions. to do business. Holder must comply with any governmental
ur nongovernmental regulatory laws and requirements which apply tv the basiness.
The RECEPT NO above must be displayed on aA commercial vehicles - Miami-Uade Code Sec Be-D&
For more information, visit Avvw Iq -W - , W4 _� p.
1