DEMO-12-2384 (2)lrl141111 CUM Gl 1' 111dgG
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
FBC 20 `D,
BUILDING Permit Nof.Er0111.
PERMIT APPLICATION Master Permit No.
Permit Type: PLUMBING
JOB ADDRESS: 1 � t' ` 6/2, gt(?4
City: Miami Shores County: Miami Dade Zip: 3.3
Folio/Parcel #:
Is the Building Historically Designated: Yes
NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): /41 1 • ?t4444 I\i€(:) gAr
Address: V 3'7 Ale ?L qT it
Phone#:
City: State: Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: 7.--€ & 4 S ?/Lw'6c / 11•- Phone#: /a° -3°1- ZSc/
Address: 3 (S SG) / 2 2 tI0de. 4delvat(
City: A-P / „•e4 ` / State: "Z Zip: 3 % /esc
Qualifier Name: -g f4 1 4�% /E1 a Z.” Phone#: 7 ?& 36S - 247O/
State Certification or Registration #: J IZ F 110 (ei 7 S5{0 Certificate of Competency #:
Contact Phone#: We' - 210/ Email Address:
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $, Square/Linear Footage of Work: ss
Type of Work: ❑Address ❑Alteration ONew ORepair/Replace E emolition
Description of Work:
&7 c eq $ •/Dic S (�� a 5')
4 64 k * 63Aele 772 6M,R6iu C.
a..----
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 $ 36
T-
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which oc M. rs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will ,. be ; pproved 0 • • • reins � ' ction fee will be charged.
Owner or Agent
The foregoing instrument was knowledged before me this 13 The foregoing instrument was acknowledged before me this /1
day of , 20 la, by C r) CA mu I ' , y of � , 20 /09, by &IcQ
who is rsonally kno to me or who has produced --- . who iiersonally known to r who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC:
Signature
Contractor
NOTARY PUBLIC:
Sign:
Print �an 1,4
My Co�ion Ex _21,o
1c MY COMMISSION EE 034203
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EXPIRES: November 229, 2014
IN
APPROVED BY
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Print:
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Public - State of ftortda
Comm. Expires Apr 28, 2015
Commission • EE 54585
k12 / v Plans Examiner Zoning
Structural Review Clerk
(Revised3 /12/2012)(Revised 07 /10 /07)(Revised 06/10/2009)(Revised 3/15/09)
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CERTfFMCATE ROO ROT AFFffturivELY OR tERPMVELYARM, EXTEND ORALIER7RE COVIMSAFPCSIOSO WIVE POUIXES
MOW. INS CERIFICATE OF INSURANCE DOES NOT t S'RTUTE A CONTRACT SETINISiN THE I$SUtl4O INSURER(S), AUTHOR= :
RenumarraiwE OR PRODUCER, ADVISE CF.RTW CATS H5:4.nER.
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345 SW 122 ave
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PLUMBING
iICATT_ labeR
MIAMI SHORES VILLAGE HALL
10060 NE 2ND AVENUE
MIAMI SHORES, FL 33138
FAX #: 305- 7564972
ACORD 25 (2010/0 qF -
CANCELLATION
SHWA MVO: REARM DEsCRSEDPOUcass BEGANCELLEDOEMs
D A T E MEEXPRIMIN M I M E D
MCOMANCEiNflit T ePOUCY
iirepoweeepestoreeetwe
®9 ` ; ' GORPORAVON. A0 M A * reserved.
TReACORII toga are regleteted matte afACORD
07 -18 -2012
JEFF ATWATER 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:
PERSON:
FEIN:
07/18/2012 EXPIRATION DATE: 07/18/2014
RODRIGUEZ RELDY
455315466
BUSINESS NAME AND ADDRESS:
THE BIG ONES PLUMBING INC
345 SW 122ND AVENUE
MIAMI FL 33184
SCOPES OF BUSINESS OR TRADE:
1- PLUMBING NOC AND DRIVERS
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 440.051121, 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 440.05113), 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
DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01 -11
PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE
STATE OF FLORIDA
DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS' COMPENSATION
CONSTRUCTION INDUSTRY
CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA
WORKERS' COMPENSATION LAW
EFFECTIVE 07/18/2012 EXPIRATION DATE: 07/18/2014
PERSON: RELDY RODRIGUEZ
FEiN: 455315466
BUSINESS NAME AND ADDRESS:
THE BIG ONES PLUMBING INC
345 SW 122ND AVENUE
MIAMI, FL 33184
SCOPE OF BUSINESS OR TRADE
1- PLUMBING NOC AND DRIVERS
IMPORTANT
OF 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
L under this section may not recover benefits or compensation under this
D chapter.
Pursuant to Chapter 440.05(12), F.S., Certificates of election to be
H exempt.. apply only within the scope of the business or trade listed on
E the notice of election to be exempt
R
E 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
CUT HERE
* Carry bottom portion on the job, keep upper portion for your records.
DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01 -11
PURSUANT TO COUNTY CODE CHAPTER 8A - ART 9 & 1
THIS IS NOT A BILL -- DO NOT PAY
DUPLICATE
RECEIPT NO. 729266-7
CC # 12P000257
701682-7
BUSINESS NAME / LOCATION
BIG ONES PLUMBING INC THE
345 SW 122 AVE
33184 UNIN DADE COUNTY
FIRST -CLASS
U.S. POSTAGE
PAID
MIAMI, FL
PERMIT NO. 231
OWNER
BIG ONES PLUMBING INC THE
Sec. Type of Business WORKER /S
THIS IS 0111 PLUMBING CONTRACTOR 1
BUSINESS TAX RECEIPT. IT
DOES NOT PERMIT THE
HOLDER TO VIOLATE ANY
EXISTING REGULATORY OR
ZONING LAWS OF THE
COUNTY OR CITIES. NOR
DOES IT EXEMPT THE
HOLDER FROM ANY OTHER
PERMIT OR LICENSE
REQUIRED BY LAW. THIS IS
NOT A CERTIFICATION OF
THE HOLDER'S QUALIFICA-
TIONS.
PAYMENT RECEIVED
MIAMI-DADE COUNTY TAX
COLLECTOR:
09/26/2012
60090000365
000000.00
SEE OTHER SIDE
DO NOT FORWARD
BIG ONES PLUMBING INC THE
RELDY RODRIGUEZ PRES
345 SW 122 AVE
MIAMI FL 33184
5
Construction'Trades tla fylnc ° c�a
USINESS CERTIF!GAT. 'Q C OM1/IF�
12 P000 57
HE BIG ONES PLUMBING 1I
Z RELY;
ertifi d u
der the provisions of Chapter ;0 of I�J12j111 -Da
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD
1940 NORTH MONROE STREET
TALLAHASSEE FL 32399 -0783
RODRIGUEZ, RELDY
THE BIG ONES PLUMBING INC
345 SW 122ND AVENUE
MIAMI FL 33184
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 leam 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!
(850) 487 -1395
DETACH HERE
THIS DOCUMENT HAS A COLORED BACKGROUND • MICROPRINTING • LINEMARK' PATENTED PAPER