RC-12-871 Miami Shores Village P-,7D
Building Department + JUL 002012
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 j
Tel:(305)795.2204 Fax:(305)756.8972 -_
INSPECTION'S PHONE NUMBER:(305)762.4949
BUILDING Permit No. k 2- 1
PERMIT APPLICATION Master Permit No. R.C- 12 103
FBC 20
Permit Type: PLUMBING /
OWNER:Name(Fee Simple Titleholder): S Phone#: 7-d p6 Zd -0 -�
Address: 3(o Z A)C— C112 e7LY S`f1
city: ( i a In- Sh®rc,,3 State: Zip: _33J13"?
Tenant/Lessee Name: Phone#:
Email:
JOB ADDRESS: 70? i2/ zw
City: Miami Shores County: Miami Dade Zip: 0—
Folio/Parcel#:
Is the Building Historically Designated:Yes NO Flood Zone:
CONTRACTOR:Company Name: �S Phone#: :ZZ
Address: 7.0 lo / ST
City: State: El Zip:336/
Qualifier Name: Phone#:.786977
State Certification or Registration#: /Q'ot- O 0'64& Certificate of Competency#:06 Poop 2� S
Contact Phone#: 7,9,� 0 Email Address:
DESIGNER:Architect/Engineer: Phone#:
Value of Work for this Permit:$ /$"OD•D 4 Square/Linear Footage of Work:
Type of Work: ❑Address Alteration ❑New ❑Repair/Replace ❑Demolition
Description of Work: 04,.7",2.7
i
Submittal Fee$ Permit Fee$ �� CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$
TOTAL FEE NOW DUE$
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 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$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the
inspection will not a approved and a r inspection fee will be char
Signature Signatur .
Owner or AgentContractor
The foregoing instrument was acknowledged before me this 75 The foregoing instrument was acknowledged before me this 5
day of 20�by 1 ►,►► ►►v t "'�. ��U1, day of 3� ,20 !g by �t ��
who isersonally know a cam')k$tl�;�ap9ilved who is personally known to me or who has produced
As iden&c1io>�' ��11�,pr�d takan oath. as identification and who did take an oath.
NOTARY PUBLIC: _ ����` SS►pp NOTARY P IC:
Sign: Sign: t -RFS CRFSPO
tum a ► STssion#EE 025113
Print: Print
,,,4� anwT�rireula�s
My Commission Expires: My Commission Ex
APPROVED BY � Plans Examiner Zoning
Structural Review Clerk
(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
S
S�,oC.193
REs y
Miami Shores Village
"1111" Building Department
10050 N.E.2nd Avenue
P R Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
CHANGE OF CONTRACTOR I ARCHITECT
Permit N. RA 2 ?11
Owner's Name(Fee Simple Title Holder): 26%J Phone#: 2-f
Owner's Address: 36 2 DV-- `JI 2 ho' S:-Yee -
City: M(Ot ►Nli S State : Z-- Zip Code: 33I3�'
Job Address(Of where work is being done): 36 Z m-( C(2 y`-01
City: Miami Shores State:—Florida Zip Code: 313
Contractor's Company Name: S74,7` .z?7c Phone#: yT
Address: 231e2 &W 166 3T'
City: State: Zip Code:33I
Qualifier's/Name : �e/ Lic. Number: O6Pvoo?-2 —
1
J
Architect/Engineer of Record Name: Phone#:
Address:
City: State: a Zip Code:
Describe Work: a- `i&wn-f fl al--rL, s
I hereby certify that the work has been abandoned and/or the contractor/architect is
unable or unwilling to complete the contract. I hold the Building Official and the
Miami Shores harmless for all legal involvement.
Signature Signature
owner or Agent Contractor or Architect
The foregoing instrument was aknowledged before me The foregoing instrumfnt was aknowledged before me
thrWay of ,2011-,by VVMa- S0Pr11':(-4 this, _day of avto 2WAy
Whoi personally known to me or who has produced who is personally known o me or who has produced
sp y p p Y p
as indentification. a7incation.
Notary Pr:
Notary P li
Sign: �X �s6~� Sign:
a R Commission#EE 025113
Seal: = NOT pOBl�C _ seal: s:
Dom November 20,2014
commission # 1edTM°T� ' '01�
FIRST-CLASS
2011 LOCAL BUSINESS TAX RECEIPT 2012 U.S.POSTAGE
MIAMI-DADE COUNTY MIAMI-DADE COUNTY-STAT OF FLORIDA PAID
TAX COLLECTOR EXPIRES SEPT.30, MIAMI,FL
1440 W.FLAGLER ST. MUST BE DISPLAYED AT PLACE OF BUSINESS PERMIT NO.231
1st FLOOR
MIAMI,FL 33130 PURSUANT TO COUNTY CODE CFIAPTER 8A-ART.9&1
-Fi;S:S DO'1OT PAY RENEWAL
089798-4 RECEIPT NO. 089798-4
BUSINESS NAME/LOCATION CG # 0 6 P 0 0 0 9 9 5
STATE
SWUNG I4IINC
ST
33144 UNIN DADE COUNTY
OWNER
STATE PLUMBING INC WORKER/S
Sec.Type of Business 10
196 PLUMBING CONTRACTOR
THIS
BUSIN SS T XLY RECEIPT R
DOES NOT PERMIT THE
HOLDER TO VIOLATE ANY OR DO NOT FORWARD
ZONINGO AWS OFR THE
COUNTY OR CITIES. NOR
DOES IT EXEMPT TME STATE PLUMBING INC
HOLDER FROM ANY OTHER
PRIGOBERTO RANGEL PRES
ERMIT OR LICENSE
REQUIRED BY LAW.THIS IS 7 310 SW 14 ST
NOT A CERTIFICATION OF
TME HOLDERS QUALIFICA- MIAMI FL 33144
TONS.
PAYMENT RECEIVED
MIAMI-RADE COUNTY TAX
COLLECTOR:
07/19/2011
60060000423 4}a��a}abet}}i�}�aa�a�Lalala }Itlla!}}1}altt}a}t ���v}}WVSA
000075.00
SEE OTHER SIDE
- AC# 5638829
STATE OF FLORIDA
Y DEPARTMENT OF BUSINESS AND
a PROFESSIONAL REGULATION
RF0042771 07/02/11 118000 ^^
REGISTERED PLUMBING CONTRACTOR
RA TGEL, RIGOBERTO O
STWXE .PLUbMING INC
(INDIVIDIIAL MZ'T MEET ALL LOCAL
TO CONTRACTILICENSING NG IN ANY ARER,-nEVTS PR A)R
HAS REGISTERED under the Provisions of Ch.489
E pirati=date- AUG 31, 2013 L11070200094
MIAMI-DADE COUNTY 2011 a MUNICIPAL CONTRACTOR'S 2012 FIRST-CLASS
TAX COLLECTOR TAX RECEIPT U.S.POSTAGE
140 W.FLAGLER ST. MIAMI-DADE COUNTY-STATE OF FLORIDA PAID
1st FLOOR PURSUANT TO COUNTY CODE SEC.10-24 MIAMI,FL
MIAMI,FL 33130 EXPIRES SEPT.30,2012 PERMIT NO.231
THIS IS NOT A BILL—DO NOT PAY
RECEIPT NO. 02-0897984 CC NO: 06P000995
RECEIPT HOLDER MAY DO
BUSINESS NAME/LOCATION BUSINESS AS A CONTRACTOR
STATE PLUMBING INC AS SPECIFIED HEREON.
7310 SW 14 ST
OWNER :STATE PLUMBING INC
RESTRICTED TO THE PLUMBING CONTRACTOR
CITY OF:
MIAMI BEACH
DO NOT FORWARD
Receipt holder must
register in the city STATE PLUMBING INC
where work is to be RIGOBERTO RANGEL PRES
done. 7310 SW 14 ST
MIAMI FL 33144
PAYMENT RECEIVED
MIAM
02210010001 61
000077.65 ,£
JQB
r Construction Trades Quall ying Board
BUSINESS CERTIFICATE OF COMPETENCY
.;. 06P000996
l
STATE PLUMBING INC
,(D.B.A.:
NGEL RIGOBERTO
Is certified under the provislor>s of Chapter 10 of Miami-Dade County
.F'�ctee�F
.y,
K bi
12-06-2010
ALEX SINK STATE OF FLORIDA
CHIEF FINANCIAL 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: 12/06/2010 EXPIRATION DATE: 12/05/2012
PERSON: RANGEL RIGOBERTO
FEIN: 205067760
BUSINESS NAME AND ADDRESS:
STATE PLUMBING INC
7310 SW 14TH ST
MIAMI FL 33144
SCOPES OF BUSINESS OR TRADE:
1— REGISTERED PLUMBING CONTRACTOR
IMPORTANT: 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.
QUESTIONS? (850) 413-1609
WC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09-06
July 3, 2012
To Whom it May Concern:
The purpose of this letter is to inform your company that your services are no
longer needed at my house located at 362 NE 92nd Street,Miami Shores, FL 33138;
therefore,your company is not part of the project anymore.
The permit that was taken under your company's name will be transferred to the
name of the company I have hired to finish the job.
Sincerely,
Renata Santeli
Miami Shores Village
Building Department MAY 16 Z012
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795.2204 Fax:(305)756.8972 .
INSPECTION'S PHONE NUMBER:(305)762.4949
BUILDING Permit No. Z _S:3
PERMIT APPLICATION Master Permit No.
FBC 20 (iD
Permit Type: PLUMBING
OWNER:Name(Fee Simple Titleholder): OIL G`'��� Phone#:
Address: 2 �(� �� 902 5-f
City: t o an t T hc,� State: L Zip: 33 /
Tenant/Lessee Name: Phone#: -)kt, Cx)
Email:
JOB ADDRESS: -3 /J 65 �l �;tr oj�&
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#:
Is the Building Historically Designated:Yes NO Flood Zone:
CONTRACTOR:Company Name: L [v�2� , &-sti le- Phone#: J-3ZL l
Address: ) c A__, 2
City: 17 'e State: F L Zip:
Qualifier Name: a 0` a Phone#: I
State Certification or Registration 0-Fe? ®5-6 75--5C rtjfi
ate`o`f'� cy#.
Contact Phone#: Email Address: ���`C. .� -
DESIGNER:Architect/Engineer: Phone#:
Value of Work for this Permit:$ Square/Linear Footage of Work:
Type of Work: ❑Address ❑Alteration 9,New" ❑Repair/Replace ❑Demolition
Description of Work: acor ozai—_3�
OP--1 H C1—Pick�L e e'r1 7-70 �-tCll_(zfl-
Submittal Fee$ SOA CLQ _ Permit Fee$ CCF$ CO/CC$
D
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$
TOTAL FEE NOW DUE$�
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 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 inspec ion which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will t approved d a inspection fee will be charged.
Signature Signature�--<�-
Owner or Agent f Contractor
The foreg ment was ac owled d befo a this ` The fore mg instrument was
acknowledged before me this
�
day o ,2010,4y day of 20 1 v E A2aA Q n
ho is erso al no to a or who has produced o is personally known to me or who has produced- fMI
S] i entification and who did take an oath. as identification and who did*matt+
NOTARY PUBLIC% - NOTARY PUBLIC: ° �.............X16-''%
f6siwwo�
Sign: C����,"' oda Sign: _
Print: C�POMC S�ai eP23.2p1 Print: '•,��OZ�94��� r
Y ' p `,4Pµ _My�cmm�ssi0� E�,Nota�YAssn Y P -101/1
10
M Commission Ex ire r� � om uo M CommissionEx fires: ,� ✓� ••• V `.
s,' eE Bonded Zhto�9h Na �
APPROVED BY r Plans Examiner Zoning
Structural Review Clerk
(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
J
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7422 SO 67 AVE
NIAM FL 33343
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YOUR LABEL NUMBER SERVICE STATUS OF YOUR ITEM DATE&TIME LOCATION FEATURES
70121010000078625394 First-Class Maifl' Notice Left July 05,2012,1:59 pm MIAMI,FL 33166 Expected Delivery By:
vmw.usps.00mlredeiivery or calling SW-ASK-
July 5,2012
USPS,or may pick up the item at the Post Certified Mail'"
Office Indicated on the notice.It this item is
'., unclaimed after 15 days than It will be returned Return Receipt
to the sender.information.If available, Pt
updated periodically throughout the day.Please I
check again later.',
Depart USPS Son July 05,2012 MIAMI,FL 33152
Facility
Processed at USPS July 04,2012,9:54 pm MIAMI.FL 33152
Origin Sort Facility
Dispatched to Sort July 03,2012,6:33 pm MIAMI,FL 33144 ,
Facility
Acceptance July 03.2012.12:20 pm :MIAMI,FL 33144 '..
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