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RC-14-721Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 nspection Number: INSP-222947 Permit Number: RC -4-14-721 Inspection Date: November 06, 2014 Permit Type: Residential Construction Inspector: Rodriguez, Jorge Owner: MENGE, ROBERT Job Address: 1102 NE 105 Street Miami Shores, FL Project: <NONE> Contractor: HOME OWNER Buildina Department Comments Inspection Type: Final Budding Work Classification: Alteration Phone Number (305)778-9835 Parcel Number 1122320280110 REPLACE BATHROOM TILES Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. For Inspections please call: (305)762-4949 November 06, 2014 Page 1 of 1 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 JUI DING PERMIT APPLICATION Permit Type: BUILDING JOB ADDRESS: ,//,Q - 7-- /✓ �- / City: Miami Shores County: - Folio/Parcel#: Is the Building Historically Designated: Yes OWNER: Name (Fee Simple Titleholder Address: lld,�,7— City: ✓� Tenant/Lessee Name: Email: FBc 20 1 Permit No. Master Permit No. C i �-A "--1 -2-1 ROOFING Zone: State: �- Zip: CONTRACTOR: Company Name: Phone#/g e5;1 -71 Address: / City: �4 / J -_ ©A� State: eP / Zip: Oualifier Name: Phone#: State Certification or Registration #: Certificate of Competency #: Contact Phone#: Email Address: DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ Fir ",} " `? Square/Linear ;7epair/Replace e of Work fes^ 3�"6/�� Type of Work: ❑Addition ❑Alteration ❑New 9 ❑Demoliti'on Description of Work: _�% ��� ��� �J��'✓-�1�G d�����`-'6"/ q :i . lr. t t %'nlnr thrn tiln• .: .•.. :'+sem Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CCF $ CO/CC $ DBPR $ Bond $_ _ Technology Fee $ TOTAL FEE NOW D Bonding Company's Name (if applicable) /it , Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip A, 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 Signature Owner or Ag t Contractor The foregoing instrument was acknowledged before me this 14 Itc day of 1l-. , 20 1k , by who i personally known o me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: L�Z� Print: CeiQ-ck 9-E-�. SLAIEKaZs My Commission u141iq Ell", 16160 a : '1 CARO SHEKELS Notiky PutNk - State of Florida COnnMsttiiM • FF 052016 The foregoing instrument was acknowledged before me this day of 20 _, by who is personally known to me or who has produced Structural Review (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: Zoning Clerk Miami Shores Village Building Department 10050 N;E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 OWNER BUILDER DISCLOSURE STATEMENT I a+7 NAME: ADDRESS: Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, F.S 489.103(7). And I have read and understood the following disclosure statement, which entities me to work as my own contractor; I further understand that I as the owner must appear in person to complete all applications. . State Law requires construction to be done by a licensed contractor. You have applied for a permit under an exception to the law. The exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license. You must supervise the constructionyourself. You may build or improve a one -family or two-family residence. You may also build or improve a commercial building at a cost of $25,000.00 or less (The new form states 75,0010). The building must be for your own use and occupancy. it may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the construction is complete, the law will presume that you built for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as a contractor. If is your responsibility to make sure the people employed by you have licenses required by state law and by county or municipal licensing ordinances. Any person working on your building who is not licensed must work under your supervision and must be employed by you, which means that you must deduct F.I.C.A and with -holdings tax and provide workers' compensation for that employee, all prescribed by law. Your construction must comply with all applicable laws, ordinances, buildings codes and zoning regulations, Please read and initial each paragraph. 1. I understand that state law requires construction to be done by a licensed contractor and have applied for an owner -builder permit under an exemption from the law. The exemption specifies that 1, as the owner of the property listed, may act as my wn contractor with certain restrictions even though I do not have a license. Initial 2. I understand that building permits are not required to be signed by a property owner unless he or she is responsible for e construction and is not hiring a licensed contractor to assume responsibility. j Initial 3. 1 understand that, as an owner builder, I am the responsible party of record on a permit. I understand that I may protect myself from potential financial risk by hiring a licensed contractor and having the permit filed in his or her name instead of my oyn name. I also understand that the contractor is required by law to be licensed in Florida and to list his or license be on permits and contracts. Initial 4. 1 understand that I may build or improve a one family or two-family residence or a farm outbuilding. I may also build or improve a commercial building if the costs do not exceed $75,000. The building or residence must be for my use or occupancy. If may not be built or substantially improved for sale or lease. If a building or residence that I have built or substantially impro myself is sold or leased within i year after the construction is complete, the law will presume that I built orally improved it for sale or lease, which violates the exemption. j Initial 5. 1 understand that, as the owner -builder, I must provide direct, onsite supervision of the construction. Initial _"Z 6. l understand that I may not hire an unlicensed person to act as my contractor or to supervise persons working on my building or residence. It is my responsibility to ensure that the persons whom I employ have the license required by law and by county or municipal ordinance. Initial �; Jk # . . Y ' Y 7. 1 understand that it is frequent practices of unlicensed persons to have the property owner obtain an owner -builder permit that erroneously implies that the property owner is providing his or her own labor and materials. I, as an owner -builder, may be held liable and subjected to serious financial risk for any injuries sustained by an unlicensed person or his or employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as n owner -builder and am aware of the limits of my insurance coverage for injuries to workers on my property. Initial — 4_� 8. 1 understand that I may not delegate the responsibility for supervising work to be a licensed contractor who is not licenses to perform the work being done. Any person working on my building who is not licensed must work under my direct supervision and must be employed by me, which means that I must comply with laws requiring the withholding of federal income tax and social security contributions under the Federal Insurance Contributions Act (FICA) and must provide workers compensation yf the employee. I understand that my failure to follow these may subject to serious financial risk. Initial 9. 1 agree that, as the party legally and financially responsible for this proposed Construction activity, I will abide by all applicable laws and requirement that govern owner -builders as well as employers. I also understand that the Construction must comply with all applicable laws, ordinances, building codes, and zoning regulations. Initial ylZ 10. 1 understand that t may obtain more information regarding my obligations as an employer from the Internal Revenue Service, .the United States Small Business Administration, and the Florida Department of Revenues. I also understand that I may contac the Florida Construction Industry Licensing Board at 850.487.1395 or hfti)://www.mygoridalicense.com/dbpr/pro/cilb/indelml Initial 11 I am aware of, and consent to; an owner -builder building permit applied for in my name and understandq that i am the narty legally and financially responsible for the proposed construction activity at the following address: If 7 12. 1 agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of th have provided on this disclosure. Licensed contractors are regulated by laws designed to protect the public. If you contract with a person who does nothave a license, the Constr4uction Industry Licensing Board and Department of Business and Professional Regulation may be unable to assist you with any financial loss that you sustain as a result of contractor may be in civil court. It is also important for you to understand that, if an unlicensed contractor or employee of an individual or firm is injured while working on your property, you may be held liable for damages. If you obtain an owner -builder permit and wish to hire a licensed contractor, you will be responsible for verifying whether the contractor is properly licensed and the status of the contractor's workers compensation coverage. Before a building permit can be issued, this disclosure statement must be completed and signed by the property owner and returned to the local permitting agency responsible for issuing the permit. A copy of the property owner's driver license, the notarized signature of the property owner, or other type of verification acceptable to the local permitting agency is required when the permit is issued. Was acknowledged before me this P&L- day of Ovc,1,N , 20 I t4 By'' whoas pers�al�fo me or who has Produced there License or 0 N identification. NOTARY ••""""'" Crista Stefanick T ;��� � s Carxr�ion � FFO$5515 Expires: FEB. 03, 2018 WWW.AAKWNOTAR`Gwm PQM V Miami Shores Village P ROVED BY DATE T S R F) -'Al ECT TO COMPLIANCE WITH ALL FEDERAL F AND COUNTY RULES AND REGULATIONS V RDF . 6.O"� ` CERTIFICATE OF LIABILITY INSURANCE TE DDMM °A `M2/20132013 12/ 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 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 Brown & Brown of Florida, Inc. dba T.R. Jones & Co.E-MAILADDRESS 1780 N Krome Ave Homestead FL 33030 CO CT Kathy Nicotra PHONE(305)247-5121 AteFAX, Nok (305)248-11543 :knicotra@bbhomestead.com INSURERS AFFORDING COVERAGE NAK:It INSURERA:Crum & Forster Specialty 4520 INSURED Branching Out, Inc. 23300 S.T . 134th Avenue Homestead FL 33032 INSURERB:ScottSdale Indemnit COm ny 15580 INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES _ CERTIFICATE NUMBER-CL1312204075 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE 13EEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWTHSTANDING 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 I TYPE OF INSURANCE ADDL UBR POLICY NUMBER POLICY EFF WDD POLICY EXP WDDiYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR PK -102426 2/01/2013 2/01/2014 DAMAGE TO RENTED PREMISES Ea occurrencel occurrence $ 50,000 MED EXP (Any one person)$ 5,000 PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER; PRODUCTS-COMP/OPAGG $ 2,000,000 PRO LOC X POLICY F1 $ AUTOMOBILE LIABILITYeBINED SINGLE LIMITMe 11000,000 B X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS CAI0056537 2/01/2013 2/01/2014 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per a dent $ Medical payments $ 5,000 UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3,000,000 AGGREGATE $ 3,000,000 A X EXCESS LIAR CLAIMS -MADE DED I X I RETENTION$ 10,00 $ FX -100912 2/01/2013 2/01/2014 WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N i A ddd _ E.L. EACH ACCIDENT $ _ E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT 1 $ A Environmental Consultants PK -102426 2/01/2013 2/01/2014 Occurrence Limit $1,000,000 A Errors & Omissions PK -102426 12/01/2013 2/01/2014 General aggregate $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Certificate holder included as additional insured as respects general liability where required by written contract. This form is subject to policy terms, conditions, and exclusions. s L-1-01.1111A,Mcl (305)762-5253 Miami Shores Village Building Dept 10050 NE 2 AVE Miami Shore, FL 33138 ACORD 25 (2010105) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Jones Jr./KN ©1988-2010 ACORD CORPORATION. All riahts reserved. INS025 rgnimsi m Tha ACnpn name anr( lana area ranieforari mance of ar-nRl1 AGORL�0 ` 40 CERTIFICATE 4F LIABILITY INSURANCE DATE (MMlOONYYY) 3/27/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGA77VELY 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 be endorsed. If SUBROGATION IS WAIVED, subject to the terns 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). PRooucER Alliance Insurance Solutions LLC 7405 N Tamiami Trait Sarasota, FL 34243 CONTACT PHONE 941-306-3077 � No), 727-497-1280 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC 0 INSURER A : SUNZ Insurance Company 34762 INSURED Essential HR, Inc., Essential HR 11 Inc dba First Star HR INSURER B: Aspen Re - London - Best Ratin "A° INSURER C: Catlin Syndicate - Lloyds -Best Rating "A" INSURER D: Brit Syndicate - Lloyds - Best Rating "A" 251 O'Connor Ridge Blvd Suite 370 Irving TX 75038 INSURER E: INSURER f : COVFRAGES CFRTIFICATF NI1MgFR_- 1QR91898 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. 1NSR LTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICYEFF MFS POLICY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MARE F] OCCUR DAMAGE TO PREMISES Eao RENTEa urrenee $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG POLICY 0 JPERCO-- LOC $ OTHER: AUTOMOBILE LIABILITY COEMBINaccident ED SINGLE LIMIT $ a BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ ALL OWNEDSCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS � I PROPERTY DAMAGE $ Per accident $ UMBRELLA UAB Ld OCCUR EACH OCCURRENCE AGGREGATE $ EXCESS UAB CLAIMS -MADE DEO RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' UABIUTY ANY PROPRIETOR/PARTNER/EXECUTIvE YINN WCPE00000184 01 10/1/2013 I 10/1/2014 STAT E ORH E.L EACH ACCIDENT $ 1,000,000 E.L. DISEASE -EA EMPLOYEE $ 1,000,000 OFFICERIMEMBER EXCLUDED? (Mandatory in NH) / A E. L. DISEASE - POLICY LIMIT $ 1,000.0 "yes, describe under DESCRIPTION OF OPERATIONS below B lWorkers Compensation This is for informational purposes C Excess Coverage and nothing shall create any right D under such reinsurance. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Coverage provided for all leased employees but not subcontractors of: BRANCHING OUT, INC. Effective date: 10/1/2013 r Miami Shores Village Building Dept 10050 NE 2nd Ave Miami Shores FL 33138 ACORD 25 (2014/01) TION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOWZEOREPRESENTATWE Glen J Distefano ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CERT NO.: 19621828 Todd Trowbridge 3/27/2014 1:30n46 PM. Page l of i Local Business Tax Receipt Miami -Dade County, State of Florida -THIS IS NOTA BILL- DO NOT PAY 5248463 BUSINESS NAME/LOCATION RECEIPT NO. BRANCHING OUT INC 'RENEWAL EXPIRES �SEPTEIVIBER 30, 201 21355 SW 192 AVE 54 [ 5724 Must: be displayed at place of business MIAMI FL 33187 Pursuant to Cc�unty Code Chapter BA—Art. -9 & 10 OWNER SEC. TYPE OF BUSINESS PAYMENT RECEIVED 196 ELECTRICAL CONTRACTOR - BRANCHING OUT INC ECO002781 BY TAX COLLECTOR Worker(s) $75.00, 08/06/2013 TXHSI-'713-043004 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is nota license, -Termit, or azertification of the holder's qualifications, -to do business. Holder must comply with any governmental or nongoiLmrnmental regulatory laws and requirements which, applyto the business. `The RECEIPTNO. above must fie displayed on all commercial vehicles Miami—Da de. Code See Ba -276. For more information, vishww-w.mismidade.uovAaxcolleator MIAMI-DADE.-I 15 Tax Collector 140 West Fla;fler Stree, For information regarding Transfer of Business/Owner, please visit First -Class US PostacE www.miamidade.gov,/-La--collec-Lor/ PAID Miami, FL p L. I IT,231 BRANCHING OUT INC MICHAEL S BURCHELL 21355 SW 192 AVE MIAMI FL 33787 DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD (850) 487-1395 1940 NORTH TALLAHASSEEEMONROE STRFLT32399-0783 BURCHELL, MICHAEL S BRANCHING OUT INC 12595 SW 137 AVENUE SUITE 312 MIAMI FL 33186 DETACH HERE 11111111140 R thkl:I.l�:IeF`ie�[7i].i�►I:#t[a3(N:i113�It�Trii�IZUiM�i1.����t1:iflif`Y�I�tlal'J1Ja. .�� A# 6 2 4 7 712 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD SEQ# L12080400689 STATE OF FLORIDA AC# '1 4 7 7 4 2 Congratulations! With this license you become one of the nearly one million DEPARTMENT OF BUSINESS AND Floridians licensed by the Department of Business and Professional Regulation. PROFESSIONAL, REGULATION Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. EC0002781 0-8/04/12 12-6001992 Every day we work to improve the way we do business in order to serve you betteri For information about our services, please log onto www.myfloridalicense.com. CERTIFIED ELECTRICAL : CONTRACTOR There you can find more information about our divisions and the regulations that BURCHELL, MICHAEL S impact you, subscribe to department newsletters and learn more about the BRANCHING OUT INC . Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. IS CERTIFIED under the provisions of ch.489 FS Thank you for doing business in Florida, and congratulations on your new license! ssanfoa date: AUG 31, , 2014 L12080400689 DETACH HERE 11111111140 R thkl:I.l�:IeF`ie�[7i].i�►I:#t[a3(N:i113�It�Trii�IZUiM�i1.����t1:iflif`Y�I�tlal'J1Ja. .�� A# 6 2 4 7 712 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD SEQ# L12080400689 001642 Local Business Tax Receipt Miami—Dade County, State of Florida —THIS IS NOTA BILL —DONOT PAY 4155255 BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES BRANCHING OUT INC RENEWAL SEPTEMBER 3Q, 2014 21355 SW 192 AVE 4339321 Must be displayed at place of business MIAMI FL 33187 Pursuant to County Code Chapter BA — Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS PAYMENT RECEIVED BRANCHING OUT INC 196 PLUMBING CONTRACTOR BY TAX COLLECTOR Worker(s) 10 CFC05 1 7075 $75.00 08/07/2013 TXHSI-13-043668 This Lo6al Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit or a certification of the holder's qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT NO. above must be displayed on all commercial vehiclds — Miami—Dade Code Sac Ba -276. for more information, visit www.rWiamidade.coyltaytollecto MIAMI Tax Collector 140 west Flagler Street Miami FL 33130, 1.07 01-222 061 2 001842 For information regarding Transfer of Business/Owner, please visit www.miamidade.gov/taxcollectorl BRANCHING OUT INC STEVEN HURST PRES 21355 SW 192 AVE MIAMI FL 33187 First -Class US Postage PAID Miami, FL Permit #23,1 DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD 1940 NORTH f TALLAHASSEE STREET EFL32399-0783 HURST, STEVEN HOWELL BRANCHING OUT INC 23300 SW 134 AVE HOMESTEAD FL 33032 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better.: For information about our services, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! DETACH HERE (850) 487-1395 STATE OF FLORIDA j DEPARTMENT OF ' PROFESSIONAL- `.057075 {i8/s0 2L, 340:;5 kTION 128027054 JNTRACTOR inions rrf,,Ch ='4_:89 Fs X1208:0201`776 DISPLAY AS REQUIRED BY LAW