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PL-17-715 1 � Y IS Miami Shores Village v P [ft�[1 �iC�t18 � r 10050 N.E.2nd Avenue NE Wt7t Ott t trpt Addition/Al-"'r M Miami Shores,FL 33138-0000 .. #{., Ap�y `. r - b �I��Ei�. �-�� Phone: (305)795-2204 01 Expiration: 09/19/2017 Project Address Parcel Number Applicant 600 NE 97 Street 1132060171680 EDUARDO J GONZALEZ Miami Shores, FL 33138-2471 Block: Lot: Owner information Address Phone Cell EDUARDO J GONZALEZ 600 NE 97 Street (786)459-2356 MIAMI SHORES FL 33138- 600 NE 97 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone LIVING WATER PLUMBING SERVICE 305 362-2863 Valuation: $ 3,300.00 ( ) (305)807-6796 Total Sq Feet: 0 Type of Work:RELOCATE MASTER BATH WITH 2 LAVATOR Available Inspections: Type of Piping: Inspection Type: Additional Info: Top Out Bond Return: Final Classification:Residential Scanning:1 Review Plumbing Underground �JEE Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $2.40 DBPR Fee Invoice# PL-3-17-63336 $3.38 03/16/2017 Credit Card $50.00 $196.16 DCA Fee $3.38 Education Surcharge $0.80 03/23/2017 Credit Card $ 196.16 $0.00 Notary Fee $5.00 Permit Fee $225.00 Scanning Fee $3.00 Technology Fee $3.20 Total: $246.16 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore,I authorize the above-named contractor to do the work stated. March 23,2017 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy March 23,2017 1 Miami Shores Village RECEIVED Building Department MAR 16 ? 1! 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Ck Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20H BUILDING Master Permit No. g C. 2 t � q bD PERMIT APPLICATION sub Permit No. 7t-@ -� `-'-� Is BUILDING ❑ ELECTRIC ❑ ROOFING REVISION EXTENSION DRENEWAL PLUMBING ❑ MECHANICAL PUBLIC WORKS CHANGE OF CANCELLATION SHOP CONTRACTOR DRAWINGS JOB ADDRESS:C,oc N C g i City: Miami Shores County: Miami Dade Zia: 33 1 3 2) Folio/Parcel#: is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Tiitleholr Titleholder): Cdyu✓J® GO-A 7(A IQ � Phone#: Address: (ano N� l tl� Jk City: A-,U(yrs ;6e Si State: FL Zip: 3313,q 3,q / Tenant/Lessee Name: Phone#: T� - QS I -2W& Email: is ' n CONTRACTOR:Company Name: Lt V l V� Phone#: -�cis- 3 hZ Z 103 Address: ?0 (AV U City: State: EL. Zip: _K301(o Qualifier Name: Phone#: ®s � State Certification or Registration d C C-C t 2 -3 l -4 12) Certificate of Competency#: C Fic- -q I H Q DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: a� Value of Work for this Permit:$ Square/Linear Footage of Work: Type of Work: ❑ )Addition 0?r A'l_teration ID New ❑ Repair/Replace F-1Demolition Description of Work: li t yry- A,! h ��JCX� 2- LaudT&", + Specify color of color thru tile:03 Submittal Fee$�® ' Permit Fee$ CCF$ '�� CO/CC$ Scanning Fee$ Radon Fee$ DBPO Notary$ Technology Fee$ 10 Training/Education Fee$ e V Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (Revised02/24/2014) 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. ,J Signature — Signature OWNER or AGENT ONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of 20 l byrLM day of 120 I by 0 Cc—q co Ids personally known to Vim' CAN NUYNiN EZ.. who is personally known to me or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Si Print: = a ®. Print: �b Seal: f�oz's 4'3 C.) Nino *` Seal: MY COMMISSION#OC302�38 66 N 1 EXPIIiBB August ZS,2010 0 APPROVED BY �'�1�� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 tea$ 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 MARTINEZ, OSMANY LIVING WATER PLUMBING SERVICE CORP 7880 WEST 20TH AVE STE 42 HIALEAH FL 33016-1848 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 :, STATE OF FLORIDA from architects to yacht brokers,from boxers to barbeque DEPARTMENT OF BUSINESS AND restaurants,and they keep Florida's economy strong. PROFESSIONAL REGULATION Every day we work to improve the way we do business in order CFC1427148 ISSUED: 05/18/2016 to serve you better. For information about our services,please log onto www.myfloridalieense.com. There you can find more CERTIFIED PWMStNG CONTRACTOR information about our divisions and the regulations that impact MARTINEZ,OSMANY you,subscribe to department newsletters and seam more about LIVING WATER PLUMBING SERVICE CORP 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, & CERTIFIED under the provisions or Ch.489 759 and congratulations on your new license! vRaacn aa�a :AUG 3,,zo9e L160518=759 DETACH HERE RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD o� CFC1427148 - The PLUMBING CONTRACTOR Named below IS CERTIFIED " as . Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2018 0 MARTINEZ, OSMANY LIVING WATER PLUMBING SERVICE CORP 7880 WEST 20TH AVE STE 42"r`"_ '" - HIALEAH FL 33016-1848 n x ISSUED: 05/1812016 DISPLAY AS REQUIRED BY LAW SEQ# L1605180000759 005255 . Local Business Tax Receipt Miami-Dade County, State of Florida THIS IS NOT ABILL —DO NOT PAY 6371108 BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES LIVING WATER PLUMBING SERVICE CORP RENEWAL SEPTEMBER 30, 2017 7880 W 20 AVE 42 6115976 Must be displayed at place of business HIALEAH FL 33016 Pursuant to County Code Chapter 8A — Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS LIVING WATER PLUMBING SVC CORP 196 PLUMBING CONTRACTOR PAYMENT RECEIVED CFC1427148 BY TAX COLLECTOR Worker(s) 2 $45.00 09/13/2016 CHECK21-16-122815 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit,or a certification of the holder's qualifications,to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT N0. above must be displayed on all commercial vehicles—Miami—Dade Code Sec 8a-276. For more information,visit www.miamidade.govAaxcollector AI� INSURANCE:r-�� CERTIFICATE OF LIABILITY INSURAN E DATE(MM/DD/17 _ _ 03/13/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder fs an ADDITIONAL INSURED,the policy(les)must be endorsed. H SUBROGATION IS WAIVED,subject to -� the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER - - -CONTACT E DelfO DeletoRe - - NAM Delatorre Insurance PHONE (305}400-8746 Fax 786 (NC.No=EaU: -- — AtC No:_ _( }362-6851 12900 SW 128 ST Ste 207 E-MAILSS� delfo04pdelatorreinsuranc a net Miami,FL 33186 ! --- - INSURERS AFFORDING COVERAGE NAIL_! Phone (305)400-8746 Fax (786)362-6851 — J INSURERA: Evanston Insurance Co. INSURED INSURER B_ Associated Industries Insurance Co T _ Living Water Plumbing Service Corp INSIIRERC: 7880 W 20 Ave#42 INSURER D - — Hialeahwsu E FL 33016 — —- - - — — INSURER F: -- —� COVERAGES CERTIFICATE NUMBER: _ REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. - INSR! ADDLSUBR' POLICY EFF - - LTR I _ __--—TYPE OF INSURANCE f INSR NND -POLICY NUMBER DDYYY � LIMITS ® COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000.00 ❑ CLAIMS-MADE 0 OCCUR DAMAGE TO RENTED PREMISES tEa oxurrencel $ 100,000.00 ..... A El _ - Y ! 3AA117319 08/24/2016 08/24/2017 MED EXP(Any one person) $ 10,000.00 PERSONAL&ADV INJURY $ 1,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: El POLICY ❑ - GENERAL AGGREWIE $ 2,000,000.00 JEC ❑ LOC -- - —� ❑ PRODUCTS-CO OTHER MP/OPAGG S 1,000,000.00� i'- -- $ - AUTOMOBILE LIASRM COMBINED SINGLE LIMIT Ea accident ❑ ANY AUTO BODILY INJURY(Per person)ALL $ B ❑ OSS ❑ AUTOESUIED BODILY INJURY(Per accident $ ❑ HIRED AUTOS ❑ AUTOSWNED PROPERTY DAMAGE $ ❑ ❑ tPeraccrdent�--- _-- _ -- $ ❑ UMBRELLA LM ❑ -- EACH OCCURRENCE _ i $ ❑ EXCESS LIAO_ CLAIMS-MADE._- - � AGGREGATE $ ❑ ENTION$ DED Ej RET — _ } WORKERS COMPENSATION — --- PER TH I -- AND EMPLOYERS LIABILITY Y 7 N ❑STATL 0 E ❑ R_ _ ANY PROPRIETORiPARTNER/EXECUTiVE— E.L.EACH ACCIDENT B OFF CERI(MandatorIn NH) EXCLUDED? Y N/A AWC1076978 102/13/2017 102/13/2018 - -- $ 1,000,000 If yes,describe under E.L.DISEASE-EA EMPLOYE$ 1,000,000.00 j DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000.00 j I I i I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,AdcNonal Remarks Schedule,it more space Is required) Plumbing-Commercial and Industrial Plumbing-Residential or Domestic Plumbing-Subcontrated work-in connection with construction,reconstruction,repair or erection of buildings I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE MIAMI SHORES VILLAGE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 10050 NE 2nd AVE ACCORDANCE WITH THE POLICY PROVISIONS. MIAMI SHORES,FL 33138 FX:305-756-8972 ULT_MoR¢ED REPRESENTATIVE - ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101)QF The ACORD name and logo are registered marks of ACORD