PL-15-2684 Miami Shores Village ,Ec
Building Department DEC 0 9 2015
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY:
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION UNE PHONE NUMBER:(30S)762-4949
FBC 20
BUILDING Master Permit No.RC-915-2307
PERMIT APPLICATION Sub Permit No Z-
❑BUILDING ❑ ELECTRIC ❑ ROOFING ® REVISION ❑ EXTENSION ❑RENEWAL
]PLUMBING ❑MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 9959 Biscayne Blvd.
City: Miami Shores County: Miami Dade Zip:
Folio/Parcet#:11-3205-019-0470 is the Building Historically Designated:Yes NO X
Occupancy Type: Res Load: Construction Type: Flood Zone: SFE: FFE:
OWNER:Name(Fee Simple Titleholder):Global Reel Estate Acquisitions and Investments phone#:305.979.1781
Address:20817 SW 92nd Court
City: Cutler Bay State: FI. Zip: 33189
Tenant/Lessee Name: do Samantha Gardner Phone#:
Email: Samantha8873@hotmall.com
CONTRACTOR:Company Name: Phone#
Address:
City: State- Fl.
Qualifier Name: Phone#:
State Certification or Registration#: SMD Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$� t L7 Square/linear Footage of Work:
Type of Work: ❑ Addition U1 Al erat on New ❑ Repair/Replace ❑ Demolition
. ori C
AAlkr bj &�/SJ -rPA6Y,,11
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ CCF$ CO/CC$
Scanning Fee$ C) Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ c D
(ReA%W02/24/2014)
r
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$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the Job site
for the first Inspection which occurs seven (7) days after the building permit is Issued. In the absence of such posted notice, the
Inspection will not be approved and a reinspection fee will be charged.
Signature 61A Signature
ly
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of 120� ,by _t day of L N 4y .20 l5 •by
o is personally known to f.-w2s4escD f o— rnTeh oa- ,who Is personally knownto
me or who has produced r as me or who has produced as
Identification and who did take an oath. Identification and who did take an oath.
NLT,l1R 'PU` NOTARY PUBLIC:
Sig Si
W1. �ONPrint: Print:
6&0r�sgisa A ERO
y ommisslo Expires
Seal: o � ''ti"�+*, Seal: November 14, 201rf 8
' John M F s. of Fbwa
4erad aYCO mfasi0 Fr1o'C,
############# WW
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
{I s
003�01
nici olControctor's Recei t
. .i
Mlam�—Dade CountV;'- State of 'Flon a.
THIS•1S NOTA g11.I. DO NOTPAY
000014319...
i BySI"E"NAMQ/LOCATION RECEIPT NO. a EXPIRE$ '
"DIAL:PLUMWN000RP 7470740 SEOTEMBER'30 'Z0'I,S'
9940 CORAL WAY .
MIAMITL 33165 Pursuant to County Code j
Pursuant.to
1 _... ......_ _
OWNER ! VS �( BEC.TYPE OF BUSINESS I PAYMENT 1►ECEIVSD 1 ., .E i.
DIAL PUIM ING CORP PLUMB[NG CONTRACTOR.' '
3 (�00014313 i RY TAX OO LECTtik' I
rCat4ory(s) ,i 3 P00.00 !08/11/ U'15 `I
FRPU03-1�-01942]. i
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• ?�_-.._ Fpr'moreipfpnnaton,>fisit' _ .- - m�' ,_._-.�.-... _ ' 'I
:a
000353. -
:`,' `�LB Local Business' Tax Receipt
.? _
n Miaml=Dade County; State of Florida ;
a THIS IS ;NOTA BILL -_DO NOT`PAY
-1004886 i
141 BUSINESS NAM@fLOCATION? RECEIPT NO. ;1 IIEXPIR,ES !
DIAL PLUMBING(CORP RENEWAL SEPTEMBER'-30, 2016
9940 CORAL WAY! 1004886 Must be displayed at place of business ;
MIAMI FL 33165 Pursuant to County Code
Chapter SA-Art:9&10
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j + •
OWNER SEC.TYPE OF BUSINESS
YTAX
DIAL'P1.UMBING CORP 196 PLUMBING CONTRACTOR BY
PAYMENT-necBlvED
Y TCOLLECTOR'
Wcwker(t) ia'' .000014319 $75.00''08/1.1/2015
FPPU03-15-01.9421
This Local Soolness Tax'Receipt only coafiron paymot of the Local Business Talc.The Receipt 10.10 a license,
psrmit or a dt Wcodon of the holder'sqe�M to do business.Holder must comply with pay govennuenial j
or dongavern luplatcr lows and m"I which apply to the baslass.
RECEIPT N0.above mast be displayed on all akionercial vehicles—Miami—Bade Code Sec 8a-VIL t
t
.-.:Fclr-mmitdprinataa.adsitwww.miamidade.goy/lexcollector___-.----.;___:_.._._
COU iYfl t
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: 10/27/2015 EXPIRATION DATE: 10/26/2017
PERSON: FONTEBOA FRANCISCO A
FEIN: 592248413
BUSINESS NAME AND ADDRESS:
DIAL PLUMBING CORP
9940 SW 22 STREET
MIAMI FL 33165
SCOPES OF BUSINESS OR TRADE:
LICENSED PLUMBING PLUMBING NOC AND
CONTRACTOR DRIVERS
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
DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS?(850)413-1609
r WER LICENSE CLAS
' F531-241-39-0
FRANCISCO ALBERTO
FONTEBOA
9*40 SW 22 ST
ML40M FL 33185 7516
DOS:01-27.1939 SEX:M'
xSUED, %1W2011 HOT:S-09
y��fl�$7-26Y9 i
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SAFE DRIVER
opera(-,o1 a mold rotas constotfi"conssrt t
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RICK,SCOTT,GOVERNOR KEN LAWSON,SECRETARY )
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ISSUED: 01/20/2015 DISPLAY AS REQUIRED BY LAW SEQ L15012000006V
ICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY
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