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MC-11-20-2564Miami Shores Village 10050 N E 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Parcel Number 730 NE 94TH ST, Miami Shores, FL 33138 1132060141690 Contacts MARTA GIERCZYK Owner Marta Gierczyk Applicant 730 NE 94 ST 730 94th ST NE 730, Miami Shores, FL 33138 Mobile: 305-639-0194 MARTAGIERCZYK@GMAIL.COM martagierczyk@gmail.com INFINITY CONSTRUCTION SERVICES INC Contractor ANTONIO LUVARA Business: 7864439590 _...� ._ Description: INSTALL KITCHEN HOOD DUCT Valuation: $ 800.00 Inspection Requests: 1305-762-4949 TotalSq Feet: 116.00 Fees Amount Application Fee - Other $50.00 CCF $0.60 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.20 Permit Fee $50.00 Scanning Fee $3.00 Technology Fee $2.50 Total: $110.30 Payments Date Paid Amt Paid Total Fees $110.30 Credit Card 11/06/2020 $50.00 Credit Card 11/20/2020 $60.30 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 constru tion and zoning. Futhermore, I authorize the above named contractor to do the work stated. Sign Owner / Applicant / Contractor / Agent Date November 20, 2020 Page 2 of 2 RECEIVED Miami Shores Village Building Department BY:, 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20 I1 BUILDING Master Permit No. RC-10-20-2305 PERMIT APPLICATION Sub Permit NoMcj�— 250 BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL ❑PLUMBING ❑■ MECHANICAL [—]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 730 NE 94th ST. Folio/Parcel#: 1 / � L�pkc,) { q Occupancy Type: Load: 0 Is the Building Historically Designated: Yes Construction Type: Flood Zone: BFE: _ OWNER: Name (Fee Simple Titleholder): MARTA GIERCZYK Phone#: Address:730 NE 94th ST City: Miami shores State: FL Zip: 33138 Tenant/Lessee Name: Phone#: Email: NO_ FFE: CONTRACTOR: Company Name: INFINITY CONSTRUCTION SERVICES INC phone#: 7864439590 Address: 12260 SW 8 ST. SUITE 224 City: MIAMI State: FL Zip: 33184 Qualifier Name: ANTONIO LUVARA Phone#: State Certification or Registration #: CAC 1816795 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: 7 r'rr-i Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration �' New ❑ Repair/Replace ❑ Demolition Description of Work: INSTALL KITCHEN HOOD DUCT Specify color of color thru tile: Submittal Fee $�Permit Fee $ Scanning Fee $ r V Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ (Revised02/24/2014) CCF $ CO/CC $ _ DBPR $ Notary $ Double Fee $ _ Bond $ TOTAL FEE NOW DUE $ _ 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 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. i , Signature ✓. 11 Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this e day of /1 5-- 20 P-� by t I LIZ 0 \ (7 ( vale , who is personally known to me or who has produced 'CC _ Dl ZiyoT as identification and who did take an oath. NOTARY PUBLIC: ARLENIS SILVERA EXPIRES: March 6, 2024 Bonded Thru Notary Public Underwriters The foregoing instrument was acknowledged before me this r day of ��rr.0 �' 20 2 (J by vexiO t—�e � r , who is personally known to me or who has produced QPhF> G"lnC i **n.,L as identification and who did take an oath. NOTARY PUBLIC: 0 Sign:_ Print: ti Seal: **ss*s**s**sssss*sssss*sss*ss*sssssssssssss***ssss**ss*****s*s*sss* APPROVED BY (Revised02/24/2014) Plans Examiner Structural Review L9 S +Ff gpP ol" Pubitt StMe of Ronda F Jorge Rouasesu +� • My Comrmsmvn GG 193011 f ti pre% 05J04'2022 s*s Zoning Clerk ❑■E ❑ Fi 0 Ron DeSantis, Governor STATE OF FLORIDA Halsey Beshears, Secretary d F�alor DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD THE CLASS A AIR CONDITIONING CONTRACTOR HEREIN IS CERTIFIED UNDER THE 9, FLORIDA STATUTES i INFINITY CONSTRUCTION SERVICES, INC 12260 SW 8TH ST SUITE:224 MIAMI FL 33184b LICENSE NUMBER: CAC1816795 EXPIRATION DATE: AUGUST 31, 2022 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, State of Florida -THIS IS ENO' A BILL - i3O NO I FA`+ 6987813 64,MPOESS NAMElLOCATION INFINITY CONSTRUCTION SERVICES INC 12260 SW 8TH ST STE 224 MIAMI, FL 33184 OWNER INFINITY CONSTRUCTION SERVICES INC r-In ANTn Nin I I IVARA 01 IAe IGOfiR Wotker(s) 1 RECEIPT NO, RENEWAL 7263353 EXPIRES SEPTEMBER 30, 2021 Must bee displayed at peace of business Pirsuen: to County Codc Chapter 8A - Art. 9 & 10 196 SPEC MECHANICAL CONTRACTOR CAC 1816795 PAYMENT RECEIVED BY TAX COLLECTOR 75.00 09.24,2020 ECHECK-20-248706 Tiffs tacai Raaiew Tan Roe" edy ceaMers powswo e1 de Lech Bomess Tax. TM Racers is rm a license. Penait a s ewakesisa M de iaddar's >s b lrrsieess IMHar swat l w0 set fewervine" sr aegoeaaseatal r"wwary lwrs aM te"" ees wbwb "Ov to am beaw "L Tie RECHPT N0. aisee a" be as all cowwwre el waiicfe s - Miami-OWe GM See r►►-M man Far aers alwaeOM. visit df � W.F., 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: 9/20/2019 PERSON: ANTONIO LUVARA FEIN: 364796470 BUSINESS NAME AND ADDRESS: INFINITY CONSTRUCTION SERVICES INC 12260 SW 8TH STREET SUITE 224 MIAMI, FL 33184 SCOPE OF BUSINESS OR TRADE: Plumbing NOC and Drivers Wallboard,Sheetrock,Drywall, Plasterboard, or Cement Board Installation Within Buildings & Drivers EXPIRATION DATE: 9/19/2021 EMAIL: I N FI N ITYCONSTRUCTI ON7@GMAT L.COM Heating, Ventilation, Air - Conditioning and Refrigeration Systems Installation, Service and Repair, Shop, Yard & Drivers IMPORTANT: Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing 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. Pursuant 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 filing 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 certificate. The department 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 E01029493 QUESTIONS? (850) 413-1609 INFINITY CONSTRUCTION SERVICES INC. LICENSE #CFC1428288 PHONR #786 443 9590 DATE: September 18, 2020 County of Miami Shores Village Building Department Before me, this day personally appeared Antonio Luvara who, been duly sworn, deposes and says: That he will be the only person working on the property located at: 1178 NE 99 St. Miami Shores, FL 33138 Cordially: Antonio Luvara (Qualifier Contractor) Sworn to subscribe before me this 05 Day of 1 / %Z � 20 2-D by Personally know Or produced identification Type of identification �- - % " %� O`— —'.4 7 C) r Print type or -stamp Notary N+4Y PUW4 SI&W Ot F1*44 Ft,�/ orge Rousseau Y CO;" *nGG ±93011x�rces 052Td 2022 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 fib, .' �. ;�^' �... .x � ;�'.. -•," i 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 / ✓t r1 ,�•C� .` The foregoing was acknowledge before me this day of V�WI. 20 /t . By ����i� �� WL (�— who is personally known to me or has produced as identification. Notary: _ J SEAL: