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PT-10-161 t 3 Miami Shores Village ft 10050 N.E. 2nd Avenue ratt: NO Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Expiration: 091011201 r Project Address Parcel Number Applicant 142 103 Street 1132060131750 DADE CTY 142 TRS Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Celt DADE CTY 142 TRS 1480 LAKE VIEW Drive DELAND FL 32720 - Contractor(s) Phone Cell Phone Valuation: $ 1,000.00 GAIA CONSTRUCTION (954)882 -2672 _.._ _. Total Sq Feet: 0 Type of Work: Exterior For Inspections please call: Color: (305)762 -4949 Additional Info: PAINT Available Inspections: Classification: Residential Inspection Type: Color. Approved Code Comments: BEN MOORE - WALLS - WESTMI!, Final Color Approved_ Color: _Denied Fees Due Amount Invoice # Invoice Total Amt Paid Amt Due CCF $ PT -2 -10 -36946 Education Surcharge $0.20 $66.60 $66.60 $0.00 Notary Fee $5.00 Check #: 1133 Permit Fee $60.00 Technology Fee $0.80 Total: $66.60 Building Department Copy March 05, 2010 2 r err - 0 Pti DA im p tTItT OF HS E5S `Al+l1 PRC3ESSII�A� C3,ATQIIT LICE8; va,� Ciaata ACS C 3 _ BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A -100, Ft. Lauderdale, FL 33301 -1895 — 954 - 831 -4000 " VALID OCTOBER 1, 2009 THROUGH SEPTEMBER 30, 2010 s DBA: Receipt # 180-228252 Business Name GAIA CONSTRUCTION INC Business Type GENERAL CONTRACTOR (cert' j Owner Name OSCAR EDINSON ECHEVERRI general contractor) Business Location 915 NE 8 ST #201 Business Opened: 10/12/2008 HALLANDALE State /County /Cert/Reg: cgcl516136 Business Phone: Exemption Code NONEXEMPT Rooms Seats Employees Machines Professionals 01 1 r For Vending Business Only Number of Machines: Vending Type: r Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 0.00 0.00 0.00 27.00 "t! �a ins 4 la p.. 1 gY. . t 1j1� z 4� THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS j THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is i <<' WHEN VALIDATED non- regulatory in nature. You must meet all County and /or Municipality planning �i y; and zoning requirements. This Business Tax Receipt must be transferred when# t! the business is sold, business name has changed or you have moved the icl 9 Y business location. This receipt does not indicate that the business is legal or that � Mailing Address: it is in compliance with State or local laws and regulations. S I h GAIA CONSTRUCTION INC Receipt #13A -09- 00000345 Su y 915 NE 8 ST #201 Paid 10 /12/2009 27.00 4t HALLANDALE BEACH, FL 09/30/2009 Effective Date k4 33009 p? 2009.,.... v sdet 10 -08 -2008 ALEX SINK STATE OF FLORIDA CHIEF FINANCIAI.OFFICER 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: 10108/2008 EXPIRATION DATE: 10/08/2010 PERSON: ECHEVERRI OSCAR FEIN: 260219689 BUSINESS NAME AND ADDRESS: ( GAIA CONSTRUCTION INC 2210 MCCLELLAN ST HOLLYWOOD FL 33020 SCOPES OF BUSINESS OR TRADE: 1— JANITORIAL /WINDOW CLEAN 2- MAINTENANCE 3- DEMOLITION 4— CERTIFIED GENERAL CONTRACTOR IMPORTANT: Pursuant to Chapter 440 . 051[141, 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 shell 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. QUESTIONS? (860) 413-1609 OWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 �I 1a r � �s�l�ar �,. °y "` �r:,d' ��`t�r� �� d'^ i ce,. h °Etwv M WE APT t x0249-1976 -6 V IIWMc , A ►�' CERTIFICATE OP LIABILITY INSURANCE DATE (MMIDDIYY) 03/05/10 PRODUCER 1 10rida Bankers Insurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 7278 SW 8 Street ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Miami, FL 33144 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLI Phone (305)266-6493 BELOW. (305)266 -fi493 Fax (306)262 -0679 INSURERS AFFORDING COVERAGE NAIC # INSURED GAIA CONSTRUCTION, INC INSURER A: AMERICAN VEHICLE INSURANCE CO 915 NE 8 St Ste. #107 INSURER B: HALLANDALE BEACH, FL $3009- INSURER (786) 412 -7208 INSURER D: COVERAGES THE POLICIES OF INSURANCE LISTED HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANOING 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS ADD' TYPE OF INSURANCE POLICY NUMBER m� Tits cY ll"I O/>� LIMITS ;GENE GENERAL LIABILITY EACH OCCURRENCE 300,000.00 RAL GENERAL LIABILITY GL- 0504002067 -00 07/15/2009 07/15/2010 DAMAGEgO REu 100,000.00 A ❑ ❑� CLAW MADE Q OCCUR MED EXP (Anyone person) 8,000.00 0 PERSONAL 8 ADV INJURY 300.000.00 ❑ GENERAL AGGREGATE 300,000.Q0 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS COMP/OP AGG 300,000 00 0 POLICY [3 PROJECT f] LOC AUTOMOBILE LIABILITY ❑ ANYAUTO COMBINED SINGLE LIMIT ❑ ALL OWNED AUTOS (Ea zWdent) ❑ ❑ SCHEDULED AUTOS BODILY INJURY ❑ HIRED AUTOS (Per Pe —) ❑ NON OWNED AUTOS BODILY INJURY ❑ (Per awident) ' PROPERTY DAMAGE (Per aeelden GARAGE LIABILITY AUTO ONLY - EA ACCIDENT ❑ 11 ANY AUTO ❑ OTHER THAN EAACC I AUTO ONLY: EXCESS / UMBRELLA LIABILITY EACH ONLY., DICE ❑ ❑ OCCUR ❑ CLAIMS MADE AGGREGATE ❑ DEDUCTIBLE ❑ RETENTION S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ❑ TO YSTMTU- 13 OTH- ANY PROPRIETOR / PARTNER /• EXECUTIVE OFFICER/ MEMBER EXCLUDED? E.L. EACH ACCIDENT (Mandatory In NH) If E.1., DISEASE - EA EMPLOYEE describe under SPECIAL PROVISIONS below I E.L. DISEASE - POLICY LIMIT OTHER DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER ^� CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL MIAMI SHORES VILLAGE 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO 10050 NE 2nd AVE THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY MIAMI SHORES FL 33138 OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE FX. 954 - 337 -6113 MARTA M ALONSO )ACLILM 0" ACORD 25 (2009101) QF 19$8-2009 ACORD CORPORATION. All rights reserved. The ACORD name and [ago are registered marks of ACORD 1/1 'd NH'ON AV69:11 0M '9 "EN Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138..... - 1i4 5051 795.2 ,c 204 4 4 , (305) 756,897.2 1 BUILDING Permit Noi� I0 --1(01 PERMIT APPLICATION Master Permit No. FBC 2004 Permit Type: PAINT PERMIT Owner's Name (Fee Simple Titleholder) A" / /a &5� Phone # Owner's Address 14SIO 2,G 4 1�eL---) Cit /�� .� State zip 3� 7 Tenant/Lessee Name Phone # E - MAIL: e 1�7 Q Al-0 - Job .Add Tess (where the work is being done) � ¢ 1 � /o City Miami Shores 2 Villaee County Miami -pade Zip FOLIO / PARCEL # //-310 ^ D/l — 17 5 - f Is Building Historically Designated YES NO Contractor's Company Name �} -- C V VI Contractor's Address City State, Qualifier Name '� '� 1T' .. State Certificate or Registration No. �-��J 't� �t( (( : OWNER BUILDER: GO ' ' '` I �1( �t U" Value of Work For this Permit S � Type of Work: ❑ Addition / ❑ Alteration / []New / ❑ KepairJReplace Describe Work: ,y f e-' (c) 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 issuanc-c of s . 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 Seca ed 'or ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING "TWICE S0F IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN A'FTORNEI BEPOR1 RPCORDING YOUR NOTICE OF COMMENCEMENT," Notice'io Applicant: As a condition to the issuance o1a buildingpermit with an estimated value exceeding $2500, the applicant must promise in good faith ihai a copy of rrz rwiice 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 recor (it ,i no:i, , of commencement must be posted at the fob site for the Jlrst inspection which occurs seven (I) days offer the building permit is issued. In the absence of such posted nonce . r {,, inspection will not be approved and a reinapection fee will be charged. Permit Fee S CCF S Technology Fee: Training/Education Fee S Notary S_ Code Enforcement S Double Fee S Zoning S Total Fee Now Due S_ See Reverse siur PAINT COLOR APPROVAL AND AGREEMENT All elements on the site must be listed and indicate the color to be painted Directions: Please circle corresponding number to appropriate color sample. alls: 1 2 3 4 Atta, tic and ascia: 1 2 3 4 a Drip Cap/Drip Edge 1 2 3 4 i Soffit: 1 2 3 4 .. � Westminster gold 200 Roof: 1 2 3 4 Flower Bins 1 2 3 4 Shutters: 1 2 3 4 Awnings 1 2 3 4 2 Chi me 1 2 3 4 gold leaf 201 Doors and Door Jams: 1 2 3 4 Garage Doors: 1 2 3 4 Railings: 1 2 3 4 3 Fences: 1 2 3 4 All brick (simulated or regular): 1 2 3 4 Stucco Banding: 1 2 3 4 ( Any other Stucco Features: 1 2 3 4 Accessory Buildings Other: In tly yo 14 ' 4 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. Signature_ Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of 20 b who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: i Sign: Sign: Print `E. % CYNTHIA SELLERS Print My Commission Expires:'..,, • '` EXPIRES: September 17, 2011 My Commission Expires: Bonded n,ti Notw N* Unaei"em APPLICATION APPROVED BY: Plans Examiner Preservation Board \ til Code Enforcement (Revised 04/24/07) Miami Shores Village Building Department L0030 N.E.2nd Avenue_ Miami Shores, Florida 33138 Tel: (30.5) 795.2204 Fax: (305) 756.£39 - /2 ING Permit No. PERMIT APPLICATION Master Permit No. F 2004 Permit Type: PAINT PERMIT Owner's Name (Fee Simple Titleholder) _ # Owner's Address City State Zip _ Tenant /Lessee Name one # G NiA1L: Job Address (where the work is being done) City _ Miami Shores Villa < -;e County Miami -Dade Zip _ FOLIO / PARCEL # Is Building Historically Designated YES NO Contractor's Company Name ` � � 111U G 'C'lnl� �[`�C Phone # — ( 2Y'6 4 -- Contractor's Address " � t S N� � � t'tt � 1 �� l Cit State zi 33c Qualifier Name � G�f7i �Ck�fGy�C =�L Phone # 0 ( �8 Z — UP Z State Certificate or Registration No. C. (P C E Vo 1 fo Certificate of Competency No. OWNER BUILDER: Value of Work For this Permit $ °" C ' Type of Worlc: ❑ Addition / ❑ Alteration / ❑New / ❑ Repair /Replace Describe Worl:: i Application is hcrehy oracle to oblain a permit to do the work and installations as indicated. I certify tiatno work or installation has commenced prior to the issuance of a peanut and that all work will be perkxnxel to nice( the stanclards ofall laws regulatingeons(nietion in this jurisdiction. I understand (hat a separate permit must he secured fix FLI'VI'MC\I WORK. PI.ljN4RlNCi, SIGNS b1 P.1.,1_S- POOLS_ PL.IRNACI:S, BOI Lt: .RS, IIFATHS,] 'ANK S and AIR CONDITION RS, ETC..... "WARNING TO OWNER: YOUR FAILURE TO RECORD A NO'rwE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU IN'T'EN) TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY 6EFOR[ RECORDING YOUR NOTICE OFCONIMENC:ENIEN "r." Notice to .I pplicunl: ,4.c o condition to the issuance of cr buildin permit frith an estimated value exceeding %2500. 111P uhplicanl muss premise in,�oodJiriih that a cope' o the notice o/ conmtencernent oral construction lien lerw brochure will be delivered to the person whose properly is subject to attachment. Also. c1 ce ti/ied cop} ofthe recorded notice q/ Commencement must he posted a/ the job site for the first inspection which occurs seven (7) days ajier the building permit is issued hi the absence q /such posted notice. the inspection will not he approved and a reinspection fee frill he charged r.r,i :xd-acri:r.x #ri:>:xic r.r.i: xic r. r. xir r, is i:xr.xxt. is xi:xxz fl *xx * *xr, �Yx9c of icxi: *icxxic is i; r, is rxxi:xx r.xxicZ r,xx�x Permit Fee $ CCF $ Technology Fee: Training /Education Fee $ Notary $ Code Enforcement $ Double Fee $ Zoning $ Total Fee Now Due $ See Reverse side PAINT COLOR APPROVAL AND AGREEMFNT All elements on the site must be listed and indicate the color to be Painted Directions: Please cir�c�lorresPondirng number to appropriate color sample. w `` lI s — -- 2 = 4 =�= Attach color samples with name and Fascia: 4 number. Drip Cap /Drip Idge 1 2 3 4 4 Roof: I ? 3 4 Flower Bins_ 1 2 3 4 201 — - gold leaf Shutters: 1 2 3 4 Awnings I 2 4 2 Chimney-- 2 3 4 Doors and Door Jams: 1 2 3 4 Garage Doors: _1 2 3 4 Railings I 2 3 4 3 Fences: V 2 3 4 All brick (simulated or re(vular 1 2 3 4 Stucco Banding: l ? 3 4 Anv other Stucco Features: 1 2 3 4 J 4 Accessory Buildings Other: 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. Signature Signature Owner or Agent Contractor The foregoing instrument ryas acknowledged before me this The foregoing instrument was acknowledged before me this day of _ _. 20 _ by day ol - Y ^ A 4 0 -C" 20 by (;,S C442— �+4 f( . -VrleL 't W110 is pelson<tlly known to me or who has produced - _ who is personally known to me or who has produced � { As identification and who did take an oath. as identification <ul� vVvtiic4i�l ►tr�tee��ul oath. NOTARY PUBLIC: NOTARY PUBLIC: ��`\\\\\ C7 5 , 1 , �r , .--� es �> Sign: SIgll: Print: _ Print: My Commission [ :\pires: My Commission Expires: APPLICATION APPROVED BY: Plans Examiner Preservation Board Code En(brcement -- -- (Revised 04/24/0 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: I NSP - 134670 Permit Number: PT -2 -10 -161 Scheduled Inspection Date: March 09, 2010 Permit Type: Paint Inspector: Bruhn, Norman Inspection Type: Final Owner: 142 TRS, DADE Work Classification: New Job Address: 142 NE 103 Street Miami Shores, FL 33138 - Phone Number Parcel Number 1132060131750 Project: <NONE> Contractor: GAIA CONSTRUCTION Phone: (954)882 -2672 Building Department Comments PAINT EXTERIOR OF THE HOUSE Inspector Comments Passe � �� Failed Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. March 08, 2010 For Inspections please call: (305)762 -4949 Page 15 of 34