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PL-14-209200 Ll Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972' a Inspection Number: INSP-224425 Permit Number: PL -9-14-2092 Scheduled Inspection Date: December 04, 2014 Permit Type: Plumbing - Residential Inspector: Diaz, Osvaldo Inspection Type: Final Owner: AVENDANO, JOSE Work Classification: Addition/Alteration Job Address: 9130 NE 10 Avenue Miami Shores, FL Phone Number (786)376-9915 Parcel Number 1132060030020 Project: <NONE> Contractor: AA MASTERS MECHANICAL AIR MOVING AND ENGINEERIN Phone: (305)559-7004 tiunaing uepartment comments 1 toilet 1 tub 1 hand sink. bathroom plumbing work for tnfractio Passed Comments bathroom. I INSPECTOR COMMENTS False Passed El� Inspector Comments 0 4 Failed 14,11 b� Correction Needed ❑ Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. December 03, 2014 For Inspections please call: (305)762-4949 Page 45 of 46 BUILDING PERMIT APPLICATION ❑ BUILDING dPLUMBING Miami Shores Village 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 ❑ ELECTRIC ❑ ROOFING R. SEP 2 5 2014 m FBC 20 nn�� Master Permit No�o—tai' �)O `'1 Ci Sub Permit No. V�—N-20qrz-n ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: koAa *�, City: Miami Shores County: Miami Dade Zip: ) 1 Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder):_ J �; `VA0 Mp Vj u Phone#: -"'J A -S Address: ®� City: d IY LS State: Fu Zip: 47 Tenant/Lessee Name: ) �/A Phone#: CONTRACTOR: Company Name: Al -A, Adtj1'&Phone#: Address: a'r Cit :&�Q Kr,fEe State: � Zip: Qualifier Name: ,�.1' 0'_ 4,0"4 g!/Y,4 Phone#: %?4 74V33-0 State Certification or Registration #: OCC / Vim.( / 6 % Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Value of Work for this Permit: $ 36 -0 Square/Linear Footage of Work: Zip: Type of Work: ❑ Addition ❑ Alteration ❑ New D epaiReplace F-1Demolition Description of Work: -7'0t 14 � (� �� Co)(edea �IIGc /14 `/" t®0 .44 aG aJ A-' d 'rA I _ uJ49A0if Specify color of color thru tile: Submittal Fee $ L.( Permit Fee $� / J� CCF $ �0-v CO/CC $ n�f11 Scanning Fee $ Radon Fee $ e DBPR $ `0-5 Notary $ 0U Technology Fee $ C) > Training/Education Fee $ -C 1� Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ / t 0 (Rev1sed02/24/2014) 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 w4notproved and a reinspection fee will be charged. Signature\ Signature Af I A 66�� O N R r G CONTRA OR The foregoing instrument was acknowledged before me this -y day of 20 by X jU)gi 1 , who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: Y Print: Seal: ae ) JORGE ROSSEAU as The foregolpo instrument was acknowledged before me this day of SQ—f ____.20 1'4 by who is personally known to me or who has produced ✓�. cCl@rM% as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: APPROVED BY �Z'I% Plans Examiner Structural Review (Revised02/24/2014) Fisc ��i►fil�Y'� 2 • Zoning Clerk ®TATZCF f e DO*RTMENT OF viii WS/�NESS-iANO 9 CONSTRiJC'it 1N 7NG11ST1 TRA ' t . N 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 . f: 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. In these circumstances, Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company. Therefore. You may be personally liable for the worker compensation injuries of any person allowed to work under this permit Please check with your insurance carrier since most property insurance policies DO NOT cover this type of liability. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Print Nam, Signature: State of Fl, County of Miami -Dade ) Sworn to and subscribcdi day of Owner 11'11 1II-illIMI' (SEAL) t I ' Type of Identification U U Contractor Print Name: -�-i ✓ i tom— l !� Signature: Tel MY COMMISSION #FF 119045 OWNER/CORP. AA MASTERS MECH AIR MOVING ENGR PHONE # 305-259-7006 15591 SW 105 TER 525 MIAMI, FL 33196 NAICS CODE: 23822 If no longer in business, please notify us in writing. Review and correct the information shown on this application. A 25% penalty will be assessed to anyone found operating without a paid local business tax, in addition to any other penalty provided by law or ordinance (Sec 8A-176(2)). A Certificate of Use and/or City Business Tax Receipt may also be required. N/A October 01, 2014 RENEWAL RECEIPT 5667754 STATE # CFC1426169 FEE AMOUNT Receipt Fee 30.00 UMSA Fee 30.00 Beacon Council Fee 15.00 Bingo Permit Fee 0.00 Nightclub Permit Fee 0.00 Multi -Municipal Contractor Fee 0.00 Restricted Contractor Fee 0.00 Library Fee 0.00 Transfer Fee 0.00 Doing Business Without a License Penalty 0.00 Late Penalty 0.00 Collection Cost 0.00 NSF Fee 0.00 Prior Years Due 0.00 Amount Recently Paid TOTAL, AMOUNT DUE- 0.00 To pay online go to www.miamidade.gov/taxcollector To pay by mail, make check payable to: Miami -Dade County Tax Collector Business Tax 200 NW 2nd Avenue Miami FL 33128 To pay in person go to: 200 NW 2nd Avenue (305) 270.4949, fax (305) 372-6368 A service fee of not less than $25.00 up to a minimum of 5% will be charged for all returned checks. t RETAIN FOR YOUR RECORDS t ................................................................................................................................................................................................................................................................................................................. MIAMI-DADE COUNTY - DETACH HERE AND RETURN THIS PORTION WITH YOUR PAYMENT + N/A October 01, 2014 STATE OF FLORIDA LOCAL BUSINESS TAX RENEWAL 2014 - 2015 APPLICATION I II I�IIIIIIIIIIIIIIIIII�DIIIIIII� I IIS I IIID VIII STCEIPT, 5667754 ATE #CFC1 6169 5428180 BUSINESS LOCATION: 15591 SW 105 TER 525 MIAMI, FL 33196 BUS. COMMENCEMENT DATE: 10/01/2004 SEC TYPE OF BUSINESS OWNERICORR PLUM PLUMBING CONTRACTOR AA MASTERS MECH AIR MOVING ENGR 1 APPLICATION IS HEREBY MADE FOR A LOCAL BUSINESS TAX RECEIPT OR PERMIT FOR THE BUSINESS PROFESSION OR OCCUPATION DESCRIBED HEREON. I HAVE BEEN INFORMED OF ALL ZONING RESTRICTIONS IMPOSED ON THIS RECEIPT. I SWEAR THAT THE INFORMATION IS TRUE AND CORRECT. AA MASTERS MECH AIR MOVING ENGR FELIX DE JESUS GUERRA 15591 SW 105 TER 525 SIGNATURE REQUIRED SEE INSTRUCTIONS ABOVE MIAMI, FL 33196 Please pay only one amount. The amounts due after Sept 30th Include penakles per FS 205.053. /f Received By Oct 31, 2014 Nov 30, 2014 Dec 31, 2014 Jan 31, 2015 Please Pay $0.00 $0.00 $0.00 $0.00 7000000000000000000000005667754201500000007500000000000007