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RC-14-1656Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-234814 Permit Number: RC -7-14-1656 Scheduled lospection Date: May 18, 2015 Inspector:Aodriguez, Jorge Owner: / BRUTZI, MARCO Job Address: 10433 NE 6 Avenue Miami Shores, FL Project: <NONE> Contractor: JOSEPH S. ROBBIO INC suuaing ueparltment comments Permit Type: Residential Construction Inspection Type: Final Building Work Classification: Alteration Phone Number (786)691-0933 Parcel Number 1122310120180 Phone: (954)663-6743 REMOVE AND REPLACE EXISTING KITCHEN CABINETSI Infractio Passed Comments AND DRYWALL REPAIR INSPECTOR COMMENTS False May 18, 2015 For Inspections please call: (305)762-4949 Page 20 of 28 Inspector Comments Passed Nck Failed Correction Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. May 18, 2015 For Inspections please call: (305)762-4949 Page 20 of 28 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 it it � I; !• '�� L .�;' BUILDING ❑ ELECTRIC ❑ ROOFING I., JUL S 0 2014 FBC 20/0 Faster Permit No. & - 1&6;� Suis Permit No. REVISION ❑ EXTENSION MRENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS [_� CHANGE OF ® CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 10433 NE 6 Ave City: Miami Shores County: Miami Dade Zip: 33138 Folio/Parcel#: 11-2231-012-0180 is the Building Historically Designated: Yes NO X Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Kiluan, Inc Phone#: Address: 10433 NE 6 Ave. city: Miami Shores state: Florida zip: 33138 Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: Joseph S. Robbio, Inc Phone#: 4954) 663-6743 Address: 9400 S. Meadows Circle city: Miramar State: Florida zip: 33025 Qualifier Name: Joseph S. Robbio Phone#: (954) 663-6743 State Certification or Registration #: CBC 059462 certificate of Competency M 'i�+i� DESIGNER: Architect/Engineer: JOSeph S. DObOS Phone#: kl:R'+1 VcV JY r: Address: 3550 Powerline Rd. City OaklandPark TState' t Zep: 33309 Value of work for this Permit: $ 16,000 square/tineas Footage 9' twofli r Type of Work: ❑ Addition ❑ Alteration ❑ New YIN w ~ Repair/ReolacV'.14 ❑Demolition Description of Work: Remove and replace existing kitchen cabinets,_Mmll repair 4 ' Specify color of color thru tile. rr\\ Submittal Fee$ . Permit Fee $ V CCF $, Scanning Fee S _. Technology Fee $. Structural Reviews $ (Revised02/24/2014) 1. Radon Fee $ Training/Education Fee $ DBPR $ CO/CC $ V V� Notary $ Double Fee $ Bond $ � TOTAL FEE NOW DUE $ 53 Z ' (C,J 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 Signature OWNER r AGENT CONTRACTOR The foregoing instrumen!v as acknowledged before me this The foregoing instrument was acknowledged before me this day of U/ 20 y by day off 20 , by ..4y1d&0© 113 day -d o is personally known t (�����, �. /® ID , who is personally known to me or who has produced identification and whVVtdta L"aff NOTARY PUBLIC: Print: Seal: as me or who has produced ALDO PUSCHEN®ORF, MY COMMISSION 0 EE185149 j E MREB Aid 01, 2010 6 0 identification and who did take an oath. NOTARY PUBLIC: Sign:_ Print: Seal: MY COMWSSION & FF035456 WIM: July I L 2017 as C APPROVED BY Plans Examiner Zoning Structural Review Clerk (RevisedO2/24/2014) STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 ROBBIO, JOSEPH SALVATORE JOSEPH S. ROBBIO, INC. P O BOX 7376 HOLLYWOOD FL 33081 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.rnyfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters- and team 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 ,IOSEP-3 a OP ID: KD m ar CERTIFICATE OF LIABILITY INSURANCE 06/30/20D 14 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 cer0cats holder Is an ADDITIONAL INSURED, the policy"es) must be endorsed N SUBROGATION IS WAIVED, Subject to the terns and conditions of the policy, certain policies may require an endorsement A Statement an this carttficate does not conn rights to the certificate holder in lieu of such endorsement(s), PRODUCER CONTACT W.F. Roemer Insurance Agency 3775 NW 124 Avenue Cora! Springs, FL 33065 William F. Dowd ill NABM PHONE FAx No. Eft E-MAIL : ADDRE Ra AFFORDING CIIVERAGE MAIC s PREMISES Ea ar . m:e $ 1001 _ INSURER A: NUd-C-4-9 C -U t Co 23418 PERSONAL & ADV INJURY S 1,000, INSURED Joseph S. Robbio Inc P. O. Box 817376 wsuRER e: INSURER C : Hollywood, FL 33061 INSURERD: INSURER E LIABILITY ANY AUTO OWNED SCHEDULED � OS AMOS HIRED AUTOS AUTOS SURER F }_ } GOVE tA©ES CERTIFICATE NUMS>`R» RFVISIrfN NttMRER 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 HEREN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTRNSR TYPE OF RISURANCE -AMPOLICY NUMBER !O ACCORDANCE WITH THE POLICY PROVISIONS. LIlII1TS A GENERAL LtA UM X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX OCCUR i 04GLODO899M S 03/2412014 I 03/2412015 FAO► GE $ 1,000,00 PREMISES Ea ar . m:e $ 1001 A1Et7E71P{AnymisperrsoRj $ Excluded! PERSONAL & ADV INJURY S 1,000, GEPIERALAGGREGATE $. 2,000,00 GELAGGREi AGGREGATELIMIT APPLIES P IPRO- t 2,000,001 $XNPOLICY AUTOMOBILE Hi LIABILITY ANY AUTO OWNED SCHEDULED � OS AMOS HIRED AUTOS AUTOS }_ } SINGLE UNllT BOTfTLY INJU" Mer persm) S BOUILY1Nd[if2Y{PeeaAcidmvj S $ $ UMSRELLA UAB EXCESS LIAR OCCUR CLAIMS-MAD€� EACH OCCURRENCE $ _ AGGREGATE ff QED RETENTION S $ WORKERS COMPENSATION AND EMPLOYERS` UABRJTY ANY PROPRIETORIPARTNERtEXECUTM Y t N OFFICERIMEMBER EXCLUDED? (MandataryinNH) tt yyeess desCnbeurM9r D1S"d T10N'0FOPEWU below N I A WCSTATtJ 0TH T EJ- EACH ACCIDENT $ F–L.DISEASE-EA EMPLOYE S _ E1. DISEASE -POLICY LIMIT :$ I DESCRIPTION OF OPOtATICM t LOtAMONS t VEHICLES (Attach ACORD jo% AddiBwml Remarks stinduts, it mere spate is nMelted) State Certified Building Contractor # CBC059462 CERTIFICATE HCLflER r_aarr-I I ATtnN 01980-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Village ACCORDANCE WITH THE POLICY PROVISIONS. 10050 ALE 2nd ,Ave. AUTHORIZED REPRESEN rATI E Miami Shores, FI.. 331311 01980-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD JEFF ATWATER CHIEF FINANCIAL 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: 7/12/2013 PERSON: ROBBIO FEIN: 650824459 BUSINESS NAME AND ADDRESS: JOSEPH S ROBBIO INC 9400 S. MEADOWS CIRCLE MIRAMAR EXPIRATION DATE: 7/12/2015 JOSEPH FL 33025 SCOPES OF BUSINESS OR TRADE: LICENSED BUILDING CONTRACTOR 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 07-12 QUESTIONS? (850)413-1609 SROWARDJ-COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000 VALID OCTOBER 1, 2014 THROUGH SEPTEMBER 30, 2015 DBA: Receipt #;18 0 - 902 9 Business Name: JOSEPH S ROBBIO INC GENERAL CONTRACTOR (BUILDING Business Type:CONTRACTOR) Owner Name: JOSEPH S ROBBIO Business Opened:12/23/1997 Business Location. 9400 s MEADOWS cIR S1tatWCounty1Cer11Re9:CSC 059462 nzzRAlviAR Exemption Code: Business. Phone: 954-647-6743 Rooms Seats Employees Machines Professionals 1 For Vending Business only Number of Machines: Vending Tye: Tax Amount Transfer Fee NSF Fee Penalty PriorYears Collection Cost Total Pad 27.00 0.OU 0.0Q 0:00 0. b0 0.00 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tan is levied for the privilege of doing business within Broward County and is non -regulatory in nature. You must meet all County and/or Municipality planning WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business Dation. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. Mailing Address: JOSEPH S ROBBIO Receipt #10B-13-00003150 P 0 BOX 817376 Paid 07/0812014 27.00 { HOLLY1400D, FL 33081 2014 -2015 rami ShoresVillage 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. In these circumstances, Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company. Therefore, yqu 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. Owner Print Name: Mism-0 Print Signature: Signa State of Florida ) County of Miami -Dade ) Sworn to and .s4scribed before me this day of �_/Q l d , 20�Lll . (SEAL) "!�:. AWS iII PUSCHNDORF `:-my COMlumau id EEIM48 Type of Identification tii meed .�... y..� State of Florida ) County of Miami -Dade) ` Sworn to�Arud subscribed before me this o? day of LI ✓& _ —,20/Y . Lo Of Detail by Entity Name Detail by Entity Name Florida Profit Corporation KILUAN, INC. Filing Information Document Number FEUEIN Number Date Filed State Status Principal Address 150 S.E. 2ND AVENUE SUITE 1010 MIAMI, FL 33131 Mailing Address 150 S.E. 2ND AVENUE SUITE 1010 MIAMI, FL 33131 P14000001904 NONE 01/08/2014 FL ACTIVE Registered Aqent Name & Address BOLOGNA, STEFANIA, ESQ. 150 S.E. 2ND AVENUE SUITE 1010 MIAMI, FL 33131 Officer/Director Detail Name & Address Title D BRUZZI, MARCO 9915 NE 4TH AVENUE ROAD MIAMI SHORES, FL 33138 Title D MELOTTI, MONICA 9915 NE 4TH AVENUE ROAD MIAMI SHORES, FL 33138 Annual Reports Page 1 of 2 http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetiMntityNameldomp-p... 7/5/2014