Loading...
PL-16-2274 X2274 I ""'s Lle Miami Shores Villagepia' `i Permif��k PhjMb1n4,-ReSidentl4l ' p 10050 N.E.2nd Avenue NE � �, t7t COla�cafrO t. dll t l_lrtllA)to"tion Miami Shores,FL 33138-0000 �= Phone: (305)795-2204 artttia APPQVEt} issue taat3101 Expiration: 02/26/2017 Project Address Parcel Number Applicant 1199 NE 92 Street 1132050270330 REY WHITEHORN Miami Shores, FL Block: Lot: Owner Information Address Phone Cell REY WHITEHORN 1199 NE 92 Street (954)612-8850 MIAMI SHORES FL 33138- 1199 NE 92 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 1,000.00 ECO 1 PLUMBING LLC (786)281-6355 Total Sq Feet: 0 Type of Work:INSTALL NEW TOILET TUB SHOWER AND S Available Inspections: Type of Piping: Inspection Type: Additional Info: Top Out Bond Return: Final Classification:Residential Scanning: 1 Review Plumbing Underground Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 DBPR Fee Invoice# PL-8-16-60965 $2.25 08/11/2016 Check#: 136 $50.00 $114.10 DCA Fee $2.25 Education Surcharge $0.20 08/30/2016 Credit Card $ 114.10 $0.00 Notary Fee $5.00 Permit Fee $150.00 Scanning Fee $3.00 Technology Fee $0.80 Total: $164.10 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: certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and in Futhermore,I authorize the above-named contractor to do the work stated. / August 30, 2016 Aut ig ature:Owner / Applicant / Contractor / Agent Date Build ng epartment Copy August 30,2016 1 Miami Shores Village - - T� T4- Building Department AUG 11 2016 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 206°1 BUILDING Master Permit No. 0c, I PERMIT APPLICATION Sub Permit No. Pu(0 - �y BUILDING r-] ELECTRIC ❑ ROOFING ❑ REVISION 0 EXTENSION [:]RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF [:] CANCELLATION ❑ SHOP �J CONTRACTOR DRAWINGS JOB ADDRESS: `/ / q ` " � q� City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): Kr1���d®,-� Phone#: 95W-412- 0 Address: City: (Y),\G+"�I S� State: 1 _ Zip: 3 3 ( 3 'o Tenant/Lessee Name: Phone#: Email: �.1�, �aIa (2) CONTRACTOR:Company Name: Phoe#: ���lJ Address: `fl��i�atrJ City: G, `e ` / State: Zip: Qualifier Name: IVOIF �3s2 / Phone#: State Certification or Registration#: Com/ /� Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ Square/Linear Footage of Work: Type of Work: ❑ Addition Alteration ❑ N ew ❑ Repair/Replace ❑ Demolition Description of Work: //,Is �2,w ��s�Ej�' li<'3 e su �% ✓ S e s1 K� Specify colo;�o color thru tile: Submittal Fee$ "10Permit Fee$ CCF$ ®� �6 CO/CC$ 116 Scanning Fee$ '3 ° C):�) Radon Fee$ �2 DBPR$ 2 2-i; Notary$ E) Technology Fee$ (0'524::) Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$�f(�� • (. (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 r nspection fee will be charged. Signature Signature CNOWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this tI day of 20 by day of (� U US �- 20 I-(z> , by who is personally known to I\)OYoeY�O who is personally known to me or who has produced as me or who has produced DriiNley ��C`p 'l as identification and who did take an oath. identification and who did take NOTARY PUBLIC: I It NOTA PUBLIC: i Sign: ��4�.� ,6?oar Sign: C t Print: v s o. Print: ra 1 1��C) e ey 60 bet= - Seal: '� ��o5a� bz Seal: A%i�'O�'•. nor Dunb :°•' 60F ;nAY ej YAWY PRIEro j0i °•.:'y;:. Q���w` '1V ;__ MY COMMISSION FF 214031 •a EXPIRES:March 25,2019 � B n ed Th.N!- Pubflc Underwr ters APPROVED BY /✓ti'/ ��� Plans Examiner Zoning Structural Review Clerk (RevisedO2/24/2014) A� CERTIFICATE OF LIABILITY INSURANCE �'�„`'�o,"s' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO F6GHTS UPON THE IOLDER THIS CEIMFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,OffEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISM UIIIG n AUTHORIZED RE WSENTATWE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the mate holder Is an ADDITIONAL INSURED,the pollcy(les)must be endorsed. ff SUBROGATION IS WAIVED,subject to Ow terms and conditions of the policy,certain palms may require an endorsement. A staffianent on this cardficale dares not confer rights to the certificate futklar in lieu of such endomemerd(s). PRODUCER CONTACT Best Option Insurance Brokers,Inc PHONE 305 859-7303 FAX 866 910-0983 3440 Coral Way Suite 500 ADDR ludys@bestopfimm u mmaxist Coral Gables,FL 33145 AFFoRDINGCOVERAGE NAIC$ Phone 305)859-7303 Fax 866)910-0983 INSORERA: GIC UNDERWRITERS INSURED INSURER 8: ECO 1 PLUMBING LLC INSURER C: 247 SW 88T Street APT.178 INSURERD INSURER E MIAMI,FL,33130 786-2816355 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. INISR LTRTYPE OF INSURANCE AD UB POLICY NUMSM POLICY EFF POLICY EXP L�.S ® MID COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000.10 ❑ CLAIMS-MADE © OCCUR DAMAGE RENTED mma ce $ 140,000.00 000.00 A Fi N N 0185FLOOD42892 02/17/2016 02/17/2017 MED ONEXP(Amu o�person $ 1,000,00 PERSOTIALBADV MARY $ i,�,�.00 GEN1 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,004,000.00 ❑POLICY ❑ JERCT ❑ LOC PRODUCTS-comploP AGG $ 2,000,000.00 ❑ OTHER $ AUTOMOBILE LiABBM (COMBINED E SINGLE LIMIT ❑ ANY AUTO BODILY INJURY(Per person) $ ❑ AUT OWNED ❑ SCHEDULED BODILY INJURY(Per acdderd) $ OS OS ❑ HIRED AUTOS ❑ NON-OWNEDAUTOS WE- El $ ❑ UMBRELLA A UAB [:]OCCUR EACH OCCURRENCE $ ❑ EXCESS LIAB ❑CLAIMS-MADE AGGREGATE $ ❑ DED ❑ RETEN m$ $ WORKERS COMPENSATION ❑PER ❑OTH AND EMPLOYERS'LIABILITY Y I N ANY PROPRiETORIPARTNERroXECClmvrr= Ek EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? N I A 1Y In NRA E.L.DISEASE-EA EMPLOYE $ If yam,des;cr2a under F I DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS below $ DESCRIPTION OFOPERATIONS!LOCATIONS/YE Cj Es(Attach ACORD 101,Additional Ruamarks If more spam Is requkecQ PLUMBING CONTRACTOR LIC#1428373 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Mianre shores Budding Department THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCIE WITH THE POLICY 10050 NE 2 Ave Mbnii Shores FI 33138 AUTHOR®REPRESENTATIVE L�1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014181)QF The ACORD mane and logo are registered marks of ACORD �► CERTIFICATE OF LIABILITY INSURANCE Tm LATE 19 ISSUED AS A MATTElt OF[NFORMATION ONLY AND COMM NO RtMTB UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AKEMD. EXTEND OR ALTER THE COVERAGE:AFFORDED BY THE POUCIES BELOW. THIS CERTOCATE OF BAIJRANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE UNKRUG RM009M AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER MIPORTANT: U ere cevtMcate b~Is an ADDITIONAL BSD,the les)mml be endamedL N SUBROGATION IS WAIVED,subject to the ter..W aa"eoTNtil ons of the pofty,eeitaft polfcteB may require an andwswulft A I I an Itis ceilcate does not coaft rwds to#0 corolcata hofderIn um olsuch sl• Neal V PF 0DUCER NPV hie DSA BUstr ess Sobillovis P1 sing),. 304 hen Trace X21 amu.FL 33328 BMAH03M AouzVERAGE NAcs USA:AMTnastN0IthAffl8fka MMURED oMUREaa: ECOIPLUMBLLC INCI oC 247 SW STH ST APT0178 BIND: MP ,FL 33130 M pE: ■ F: COVERAGES CERTIFICATE RI i MUN11>ER: 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 PERTAK 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. TYMOF04SURANCE POLwv UMIB133 Lam (SAI.LIRER r EACH OCCURROICE a CON011EIKSAL GENERAL LABIUTY PREMMS fEmaauma a aAamwADE El OIX:UR I MED EXP&V am a PERSONAL&AMfPLI3RY $ GENERALAGi>REQATE $ OEMLAGGREGATEUbBTAPPLIES PER: _ PRODUCTS-OOMRJOP Atli $ POLICY FI PRO- LOC $ AUTonoSILELIAeam cda au Y KJURY"'.) a ANY AUTO ALLOwxIED � B rnuaauY� a AUTOS $ HUREDAUrOS H AUTOS a UMBRELLA LulaOCCUR EA04 $ mommum p,AINlS.dAcE AL TE $ gtXTRIN X 1MAr STA ANDEaPLOMRS'LlAGlLnY YIN 100.000 A Aror O NIA TWC3561410 07/2312018 07113 17 E.L.MSEARF-EAE a 6FFlt E><Cdlll� E.L.DISEASE-EA a 100000 If 7R8, r ELS-POLICY LOOT a 5.0O0 I DESCRIPTIONOFOPERRIFIONSILOCATMUSI;E (Ae�nA+ +m.Ae IRmoml�s o�rmwew�mn CONTRACTOR LIC 01428M CERTIFICATE HOLDER CANCEUATWN HOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED Miami Shy BuB&M Depadment T E PIR101011 DATE THEREOF, NOTICE WILL BE DEUVE'RED IN 10050 NE 2 Ave AC NCE VOTHIMPOUCYPROVISIOW MWW Shores F1 33138 au> wE arAmE @I 0 A �RATKM A0 rW is reserved. ACORD 25(20101) The ACORD nam and logo arra A