RC-15-1269 Miami Shores Villager9
MAY 26115
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
FBC 20 10
BUILDING Master Permit No. :jRC_o5-1 2 6 I
PERMIT APPLICATION sub Permit No.
)(BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION F-1 RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: Q L-O . C _ I O 11 T -
City: Miami Shores County: Miami Dade Zip: 3,3(3 fl
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
( p a�au5ec4!.c>is. S-7S1—aS'o�-
OWNER:Name Fee Simple Titleholder):—Svc► rLLv" W e s wt a,,� a Phone#: 3D
Address: Q `f0 12• C - lD( 57-
City: i _5A01-e5 State: Zip: 33/3
Tenant/Lessee Name: Phone#:
Email: F e'�vv-'a G®k to c `-V\Cu. e Cr,M
CONTRACTOR:Company Name: ��`�^CO,�� f @ ��q :`.p�� Phone#: S$-1
Address: Nt INS-T"... l'e�
city: State: Zip: n, eo A-
Qualifier Name: Phone#:
State Certification or Registration#: a°a I✓ e ` '�S�5 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New`r l ❑ Repair/Replace ❑ Demolition
Description of Work: Vb "')CA C, C) Ys T
ff Y t
�e
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ CCF$ CO/CC$ 9Z)'a
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(Revised02/24/2014)
r
Bonding Company's Name(if applicable)
Bonding Company's Address
City State Zip
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.
Signatur� -ate Signature O–"-X-1P1
OWNER or AGENT CONT R
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me
day of _1"4 20 �Si .by day of 20 S by
10i.> A� .who is personally known to a w�is per y kno�to
me or who has produced OL as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC: 1
Sign: Sign:
Print: Print:
c r .°°a�;•, DOUGLAS MARIANO �
Seal: Seal: ;ckaar Ppai% DOUGLAS MARIANO
_ Notary Public-State of Florida ;a. .
N. �oec My Comm.Expires Aug 27,2017 ; Notary Public-State of Florida
Commission#FF 046776 MY Comm.Expires Aug 27,2017
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
4♦
FELMAT CORPORATION CGC#1519922
3921 N.E. 15TH Ave,Pompano Beach,FL 33064
954-729-5877
felmatcorp(iDamailcom
DATE: MAY 27, 2015
STATE OF: � . ii- �C_
COUNTY OF: 0 m Lo-)a-o A_
BEFORE ME THIS DAY PERSONALLY APPEARED MAURYSIO DOS SANTOS WHO,BEING DULY SWORN,
DEPOSES AND SAYS;
THAT HE OR SHE WILL BE THE ONLY PERSON WORKING ON THIS PROJECT LOCATED AT: 640 NE
101ST STREET,MIAMI SHORES,FL 33138
SWO T (OR AFFI D) jSBrSD BEFORE ME THIS 20TH DAY OF MAY,2015,BY
PERSONALLY KNOW
OR PRODUCED IDENTIFICATION
TYPE OF IDENTIFICATION
,•t:A"pL:jy, DOUGLAS MARIANO
'� °y Notary Public-State of Fiorlda
�=
My Comm.Expires Aug 27,2017
'•.;;�F,o?•• Commission#t FF 046776
PRINT,TVPE OR STAMP NAME OF NOTARY
Miami shores village
Building Department
R� 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 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-
State of Florida
County of Miami-Dade
The foregoing was acknowledge before me this�—day of O?tt ,205
By Im who is personally known to me or has produced
as identification.
Notary: '• DOUGLAS MARIANO
Notary Public-State of Florida
SEAL: My Comm.Expires Aug 27,2017
Commission#FF 046776
A
t
ts.n.. ..:..
I
Contract
FELMAT CORPORATION DATE: MAY 6, 2015
3921 N.E. 15T1-1 Ave,Pompano Beach,FL 33064
954-729-5877
felmatcorpna,gxnail.com CGC#1519922 CrHVPD
T( ):): Mr. &Mrs. Grandhauser/WeismantleY X015
640 Ne 1016`St.
Miami Shores, FL 33138 BY
DESCRIPTION
SCOPE OF WORK
Pool appt.Renovation
NEW INSTALLATION:
• Install new furring strip/ceiling in all designated areas.
• Install new furring strip/walls in all designated areas.
• Install new R-19 insulation ceiling area.
• Install new vapor barrier insulation on all CBS walls.
• Install new 5/8" drywall ceiling area.
• Install new 1/2"drywall walls.
• Tape and finish ceiling and walls ready for painting.
• Patch any existing holes (concrete walls)in kitchen,Dining and Bed as needed .
• Prime and paint ceiling and walls (kitchen,Dining and Bedroom 1).
• Install new baseboard in all 3 rooms.
• Prime and paint baseboard.
• Paint existing closet and install 2 doors bottom section.
• Install 2 new pre-hung doors/casing 1-kitchen/dining 1-Bedroom.
• Prime and paint 2 doors/casings both sides.
• Upgrade all electrical per Florida Building code (to be done by a licensed contractor)including GFCI,hard
wired smoke detectors, switches, outlets,designated lines for all appliances,install lights and fans(customer
providing fans and light fixtures).
• Install new sink,new shut-off valves,ice-maker box per new Florida building code (to be done by a licensed
contractor)
• Re-install 2 existing mini-split A/C units (Unit was removed by others Felmat not responsible for any
defected machines after installation).
• Re-install existing kitchen cabinets (as is) back to original layout.(labor only)
(Fehnat not responsible for any damaged cabinets that occurred during removal/if any
removed by others).
• Clean-up job debris.
• Felma.t Corporation to provide material and labor
r
• All material is guaranteed to be as specified.All work to be completed in a workmanlike manner according to all standard
practices.Any alteration or derivation from specifications involving extra costs will be executed only upon written orders,and
will become an extra charge over and above estimate.
Exclusion: Permit fees,counter-top (material&labor),back-splash,crown-molding, appliances,light
fixtures,fans,sink&faucet,flooring,windows,bathroom renovation,new kitchen cabinets and all its
components.
We propose hereby to furnish material and labor in accordance with the above specifications for the sum of:
$ 13.650.00 (Thirteen thousand six hundred and fifty 00/100)
$ 1.700.00 (Add on) existing kitchen installation(Seventeen hundred 00/100)
$ 15.350.00 Total price of contract (Fifteen thousand three hundred and fifty)
Payment Schedule:
25% : $3.837.50 upon signing contract
25% : $3.837.50 upon start
15% : $2.302.50 upon electrical rough inspection
15% : $2.302.50 upon drywall inspection
10% : $L535.00 upon completion
10% : $ L535.00 after final inspection
Miscellaneous:This contract contains the entire contract of the parties.It may not be changed orally but only by a signed change
order or written amendment.The waiver by any party of a breach of any provision of this contract shall not operate or be construed as a
waiver of any subsequent breach by any party.
Acceptance of Contract: The above prices, specifications and conditions are satisfactory and are hereby
accepted,you are authorized to do the work as specified.
Owner/Date Contractor/Date
Owner / Date
PLEASE MAKE ALL CHECKS PAYABLE TO FELMAT CORPORATION
Any questions related to this contract please feel free to contact me.
Thank you for the opportunity of doing business with you!