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12-12909
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12-12909
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Last modified
2/12/2013 11:43:44 AM
Creation date
2/12/2013 11:43:41 AM
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Building Department
Building Department - Doc Type
Permit
Permit #
12-12909
Building Department - Name
MCDORMAN,ROBERT
Address
5929 18TH ST
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Jd::FF ATW,ATER S 1 A E t UF" rViR[I{JA <br /> G1��FkTiANCWILd�FiG6R DEPARTM�NT' OF �iN�►NC1AL 5�tVICES <br /> DIVISIOM OF WORK�RS' CDMP�SATION <br /> � � c�rn�ca►� a� ��rroN �ro � �x�a�r �aw� �.eRro�► wo�s� ca��sA�ncuaa �aw � � <br /> CI�NSTFtUCT1QN INDUSTAY EX�IIAPTION <br /> T�is certi�ies that thg irnfividnai listed below has ei�ted to he exempt fram Florida Workers' Campertsa�fian law. <br /> �FF�CTIVE DA7E: 01/72/2411 �XPIRATION I�AT�: �7111l2013 <br /> �RSOr+� �a JAnul� <br /> P�EIN: �fl829�5A0 <br /> �USINESS NANI� AND ADDRESSc <br /> �Ail� CEKi'RAt AIR GONDtTI01�lIER A1� FI�A�'IN�r �PECxAI-IST U.0 <br /> �!8825 'i'AYI.GM ftAY <br /> d�QESSA FL 338se <br /> 4CCIPES OP BUSINESS �i TfiA�E: <br /> '�- AIR GOIQTTlONIIM� CON'�ACTaR 2- REPAIR SERHxC� <br /> }I- HEATING & AIR COI�x?20NXN6 <br /> ��� <br /> IINPGIiTAn74 Purmaar !e CMqNr.r RAO . O5�t41. F_S_. an eliicer af � carperntlnn rMO e1M�s exeMMtan h� IMix ch�prer hy �i�+^9 r �.n`���Shce nl cleerie� aodr.r �h�s <br /> eq�[nn mm� fM rec�var U+!rtefib 9Y eeepe�liee e�Mr fMie cMpter. Par!ir�M te �pf�► R�II.Od(121, F.S_, Gr1lNales M r.tetliert m � e�!aqn..- �FTiy nnly .:H+In ihn <br /> c�:npe p! �he bvNa�.ss or tt� iis�e� �n t�c rrc�n M slec�an to Iw e�e*bl. Pmso�l N CM►t�t 'M0.061133, f.3.. llNiecs o1 efeelimr � dr. exntq+� ond snrtalka�ea af <br /> r.�nHinn ta h� a�c�t Wfl be 5p�rest m �oeation iL al M!y thee �It!►t� 111tng al th. notlee ar �Oe N+�e�ee M !Me eenNione. M. p�sa+ n.nm� en n�c nnr;r.e n. <br /> a„rNF�ane nn Inqer r�nah IMe r�irenMMS el p�1s reetlon Far is�o� ol e teellfica�e. T�e dn0�e�t 1AN1 re�eRC ■ eerliltale �n wy �tnir 1•�� failRr. af mc p�rzm� <br /> rr�rnMa oe nic �1�enr a� mMt �ler. r�ep�mhs M ihls uertr�e. D.UESTION$� {R5[f1 h13-7609 <br /> rnNC•T.52 CERTIFICATE OF ELEC'C10N TO 8E EX�NIPT RE11iSE0 Q1-11 <br /> pLEA$E CUT OUT tHE CARD BELOW AND R�'�AIN FI?R �U'fVR� REFE�t�p'� <br /> S�na�aF�oa�o�a IMPORTArirt' <br /> ����.� F pyr�t to Chaprer 44Q0511a1. F.S, an aftice• af a corporarian wno <br /> f,MDIrS"!'�IL?�O�E Il�plS7'RY Q eNCCis eXemP� fram thi5 che�ter bY 'Filin9 x certificate nf eler.tion <br /> �R'r�ICATE 0F B.Eet1oN1'Fd a�F.�MIP1'FRo�FLORmA L aMe� this section nroY ►mt rceover ber►ef its o� cemper9at'on urn�Fr th;s <br /> wa►mc�'cotAP�a1Ya+i.aw D chepter. . <br /> EF•'FEG7IVE: 01/12/'1411 �XPIIlA'TxON pATE: 01/tt/'�013 p��yp�� to LTIBP�► 444.45{721. FS. C¢rtifi�-s of election to be <br /> P�FiSOPI: •!A� ��'EitO H exe+nOt- �PP�Y mily within tfte scape of the �usinass or trixle lisi�d m, <br /> 208Z9A54Q E�fic natice of etecNO+� to bc exemat <br /> ��nr. R <br /> ����E�� �� �� ���r,�,�r; �p�� �m (�epter �1�40.05�iS}, P.S, NatiGCS oF aiecrinn to be exempt <br /> .i,�,e,�E CEUrrrni a� col+DmoNIEp iwo r1�A'rv�G sPEC�ntts'r�.�.c a�d eertificeAes of Ne4Kion to be exempt sPali bc subj¢c't ta reunr.ation <br /> �g9xs Tnv�ew wnr if. � any tilne afSer fhe firx►g at fhc natir.e ar tn� fssum�r.c af the <br /> dc�ssn. F�, sassa eertifieate. t� peYSOrt r�arned on the aotice or certlficnte �I� 1n11qEr meFts <br /> the Peq�'ttlenedtS Of 'IMiS seet�on fo► i55venCe sf 0 certifFCatr.. The <br /> Aepertr,ront ShPll re�oke a ce�'�iffcate at anY ri�e fot Fail�ne ot thc <br /> Si:�PE OF BUSINESS OR TRAD� persen rAmed an ehe eertifi�tc to n,eet tfie rc�ui�mments ni thi� <br /> d. nm cornsmotiMO ewrfRAC1'AR �- REPAIR SEA� sBCtion_ <br /> ro�snowsr �aso� ��3-,�os <br /> .- r�nrwc a e,�n ca+omonn.o �-- <br /> CIJT HERE <br /> * Carry bottom portion on tt� ��6, ke�p upPor pa�oft for your recarn�s. <br /> Dw`•y�252 CERTIFIGA7E 0� ELECTION �0 BE EILEM�' RErn5ED 07-1Z <br /> ru <br />
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