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Home My Public Portal AboutJJ&D Home Improvementi [ S ti T cirp RECO t 00709727 310212-021. CITY OF TYBEE ISLA:D� ` v usiness =E a -cwt CONTRACTOR REGISTRATION APPLICATION TERMED t APPLI-- -- rtr r-��[�- - CAR Li-ifir 7; Business Name •17 Rome 1-141 ro ven <e'2 1L L I- C Location 2S W e //fii2 /O,7 i a/o ?4 JG -2 / Y/40 Mailing Address r. s» e O, j I of a h oh Phone 8f3„ 6%Ll-- 2OZf,2 Email dabhore/rprotren"e''f"A° � 1,2. - NAICS Code Federal ID # Business Type (circle one): Sole Proprietor Partnership Corporation (-L-Dc Other: Type of Contractor ❑ General ❑ Electrical ❑ Mechanical ❑ Plumbing [t Other 607e/9/7 ' Has this business or anyone connected with this business been cited or charged with any violation of Georgia Law, Federal Law, Local Ordinance, or any Rule or Regulation of the State Re nue Commissioner or any Rule or Regulation of the City or County within the past 12 months? (circle one) YES or (NO (If YES, list details) 1. Include a copy of your local bum. -- arise. v 2. Any business that requires state licensing must include a Coiw of state license. List person(s) authorized to request inspections: JGiyve A"'p art V c), I hereby make application to the City of Tybee Island for a Contractor Registration. I certify that the above statements are true and correct. I understand that the processing fee of $20.00 is non-refundable. I further understand that the provision of false information on this application ma resul in the revocation of this registration by the City of Tybee Island. Applicant Signature Printed Name 444/ Date /47/-28/.20 Received by Date ROUTING APPROVAL BY DATE FEE Administrator REQUIRED Contractor Registration 20.00 Zoning Approval REQUIRED Reason for denial: City of Tybee Island 403 Butler Avenue Attention: Contractor Registration, P.O. Box 2749, Tybee Island, Georgia 31328-2749 Telephone (912) 786-4573 FAX (912) 786-9539 www.citvoftvbee.orq ay of Tybee use only: Date New Renewal License # 00038s7 License # Affidavit Verifying Status for City Public Benefit Application By executing this affidavit under oath, as an applicant for a City of Tybee Island, Georgia, Business License or Occupation Tax Certificate, Alcohol License, Taxi Permit, Co tract, or other public b nefit as referenced in O.C.G.A. Section 50-36-1, the undersigned applicant representing lig ,D ii062e [iTrOV€ W1 f(name of business), verifies one of the following with respect to my application for public benefit: 1) OR I am a United States citizen. (document example: Driver's license, US Passport, US Military Card, etc.) 2) I am a legal permanent resident of the United States (document example: I-551 Permanent Resident Card, Certificate of Citizenship, etc.) 3) I am a qualified alien or non-immigrant under the Federal Immigration and Nationality Act with an alien number issued by the Department of Homeland Security or other federal immigration agency. My alien number issued by the Department of Homeland Security or other federal immigration agency is: (document example: Temporary Resident Card; Employment Authorization Card, etc.) --The undersigned applicant also hereby verifies that he or she is 18 years of age or older and has provided at least on secure and verifiable document, as required by O.C.G.A. § 50-36-1-(e), with this affidavit. The secure and verifiable document provided with this affidavit can best be classified as: ver S ti CE'/tle In making the above representation under oath, I understand that any person who knowingly and willfully makes a false, Fictitious, or fraudulent statement or representation in an affidavit shall be guilty of a violation of O.C.G.A. § 16-10-20, and Face criminal penalties as allowed by such criminal statute. Si ture6t Applicant //-o Z- Z(2,zO Date JA/'4-1P 4'a&trnr/o Printed Name ADAM WOERNLE Notary Public - State of South Carolina My Commission Expires May 30, 2028 SUBScAIFVFD AND SW I • BE ORE EON TM THE i<noi DAY OF 20wU Notary Public My Commission Expires: 41S -3d PLEASE COMPLETE THIS AFFIDAVIT AND SUBMIT A COPY OF THE IDENTIFICATION DOCUMENT (front and back) PRESENT IN PERSON AT 403 BUTLER AVE OR FAX TO 912-786-9539 OR E-MAIL TO: Ischaaf(a,cityoftybee.org REFERENCE YOUR BUSINESS LICENSE NUMBER IN THE SUBJECT LINE OF YOUR E-MAIL. If fax or email this form, please have this form notarized prior to submitting it to the City of Tybee Island at lschaaf@cityoftybee.org or 912-786-9539. The City of Tybee has a notary, if submitting in person. Note: O.0 G.A. § 50-36-1(e)(2) requires that aliens under the federal Immigration and Nationality Act, Title 8 U.S.C, as amended, provide their alien registration number. Because legal permanent residents are included in the federal definition of "alien", legal permanent residents must also provide their alien registration number. Qualified aliens that do not have an alien registration number may supply another identifying number below: Control Number : 19128937 STATE OF GEORGIA p yf®6, Secretary of State Corporations Division 313 West Tower 2 Martin Luther King, Jr. Dr. Atlanta, Georgia 30334-1530 CERTIFICATE OF AUTHORITY I, Brad Raffensperger, the Secretary of State and the Corporation Commissioner of the State of Georgia, hereby certify under the seal of my office that J J & D Home Improvement LLC (VA) a Foreign Limited Liability Company has been duly formed under the laws of Virginia and has filed an application meeting the requirements of Georgia law to transact business as a Foreign Limited Liability Company in this state. WHEREFORE, by the authority vested in me as Secretary of State, the above Foreign Limited Liability Company is hereby granted, on 09/25/2019, a certificate of authority to transact business in the State of Georgia as provided by Title 14 of the Official Code of Georgia Annotated. Attached hereto is a true and correct copy of said application. WITNESS my hand and official seal in the City of Atlanta and the State of Georgia on 10/02/2019. ,3J fj* a ^`7`. �(l M*�•Vy •ma';. 4 77[ Brad Raffensperger Secretary of State EPARTMENT i�� DNTERN VREVENUETHE SE CE TREASURY CINCINNATI OH 45999-0023 Date of this notice: 02-26-2014 Employer Identification Number: 46-4925172 Form: SS -4 Number of this notice: CP 575 G JJ&D HOME IMPROVEMENT LLC JJ&D 54- JAIME APARICIO SOLE MBR 9 COCKRELL ST ALEXANDRIA, VA 22304 For assistance you may call us at: 1-800-829-4933 IF YOU WRITE, ATTACH THE STUB AT THE END OF THIS NOTICE. WE ASSIGNED YOU AN EMPLOYER IDENTIFICATION NUMBER Thank you for applying for an Employer Identification Number (EIN). We assigned you EIN 46-4925172. This EIN will identify you, your business accounts, tax returns, and documents, even if you have no employees. Please keep this notice in your permanent records. When filing tax documents, payments, and related correspondence, it is very important that you use your EIN and complete name and address exactly as shown above. Any variation may cause a delay in processing, result in incorrect information in your account, or even cause you to be assigned more than one EIN. If the information is not correct as shown above, please make the correction using the attached tear off stub and return it to us. A limited liability company (LLC) may file Form 8832, Entity Classification Election, and elect to be classified as an association taxable as a corporation. If the LLC is eligible to be treated as a corporation that meets certain tests and it will be electing S corporation status, it must timely file Form 2553, Election by a Small Business Corporation. The LLC will be treated as a corporation as of the effective date of the S corporation election and does not need to file Form 8832. To obtain tax forms and publications, including those referenced in this notice, visit our Web site at www.irs.gov. If you do not have access to the Internet, call 1-800-829-3676 (TTY/TDD 1-800-829-4059) or visit your local IRS office. IMPORTANT REMINDERS: * Keep a copy of this notice in your permanent records. This notice is issued only one time and the IRS will not be able to generate a duplicate copy for you. You may give a copy of this document to anyone asking for proof of your EIN. * Use this EIN and your name exactly as they appear at the top of this notice on all your federal tax forms. * Refer to this EIN on your tax -related correspondence and documents. If you have questions about your EIN, you can call us at the phone number or write to us at the address shown at the top of this notice. If you write, please tear off the stub at the bottom of this notice and send it along with your letter. If you do not need to write us, do not complete and return the stub. Your name control associated with this EIN is JJ&D. You will need to provide this information, along with your EIN, if you file your returns electronically. Thank you for your cooperation. LLR South Carolina Reside ntial B uilders Commissio n Hereby Certifies that • 1 l r l L J JA IME JAVIER APA RICIO LAND A in ONLY the following Classification(s) of: CARPENTRY, , has met all of the requirements of the South Carolina Residential Builders Commission for 'Registration as a Residential Specialty Con tractor in the trades listed above. This Certificate is subject to biennial renewal of the license. License Nu mber: 61671 Expiration Date: 06/30/2021 Janet 13eet nberger, Administrator SC Residential Builders Commission r E i:_VJE=RSE SIDE FO R O PENING NS. RI iC1-!C".:r.;=. CHATHAM COUNTY P.O. BOX 8161 SAVANNAH, GEORGIA 31412 JJ & D HOME IMPROVEMENT LLC JAIME APARICO LANDA JJ & D HOME IMPROVEMENT, LLC 611 SANDY SHOALS PASS BLUFFTON, SC 29910 LICENSE NO: CLASSIFICATION: CHATHAM COUNTY P.O. BOX 8161 SAVANNAH, GEORGIA 31412 BUSINESS TAX CERTIFICATE 20-22432 S.I.C. CODE: 238290 OTHER BUILDING EQUIPMENT CONTRACTORS DOOR INSTALLATION - NO LOCAL OFFICE JJ & D HOME IMPROVEMENT LLC LOCATION' JAIME APARICO LANDA JJ & D HOME IMPROVEM ENT, LLC 611 SANDY SHOALS PASS RI LIFFTON, SC 29910 2020 EXPIRES: 31 Dec 2020 JS$UED CHATHAM COUNTY DEPT OF BUILDING SAFETY & REGULATORY SERVICES THIS CERTIFICATE MUST BE DISPLAYED PROM INENTLY IN THE BUSINESS