The URL can be used to link to this page

PL-17-559 { Pefinit o6�oRFs�� Miami Shores Village � Pef7t?1tT e:Plurmbingz-Res tiden at -.. 10050 N.E.2nd Avenue NW art ictatiorx:AidniAit Miami Shores,FL 33138-0000 P-e ' r'', 't Pemut Status.'APPRGI,'PE ' Phone: (305)795.2204 j ,• p ,trueOW— 017 Expiration: 09/25/2017 Project Address Parcel Number Applicant 133 NW 94 Street 1131010330710 KATERi GARCIA E1NVF2EW R JO Miami Shores, FL Block: Lot: Owner Information Address Phone _ Cell E�TERI GARCIA ANDREW R JOHNSON 133 NW 94th St 505 264 2794 Miami Shores FL 33150 Contractor(s) Phone Cell Phone $m1,501i.U0 Valuation: HORNE PLUMBING COMPANY (305)666-8583 Total Sq Feet 0 Type of Work:SET ON EXISTING KITCHEN AND GUEST B Available Inspections: Type of Piping: Inspection Type: Additional Info:SET ON EXISTING KITCHEN AND GUEST B Top Out Bond Return: Final Classification:Residential Scanning:3 Review Plumbing Underground i Fees nue Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 Invoice# PL-3-17-63160 DBPR Fee $2'25 03/03/2017 Check#: 1065 $50.00 $116.70 DCA Fee $2.25 Education Surcharge $0.40 03/29/2017 Check#: 1107 $ 116.70 $0.00 Permit Fee $150.00 Scanning Fee $9.00 Technology Fee $1.60 Total: $166.70 ' In consideration of the issuance to me of this perrr t, I agree to perform the work covered hereunder in compli ince with all ordinances and regulations pertaining thereto and in strict conformity with the plat s,drawings,statements or specifications submitted to the prol ar authorities of Miami Shores Village. In accepting this permit I assume responsibility for all � ork done by either myself, my ag-•', 3e-•ian'7, or em.,Ic es I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICA.,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 com)liance with all applicable laws regulating construction and zoning. Futhermore,I authorize the r bove-named contractor to do the work stated. Mar:h 29, 2017 Authorized Signature:Owner / Applicant / Contractor / Agent ate Building Department Copy March 29, 2017 1 K • • a Miami Shores MA Village 'I �R 3 2017 Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fa=(30S)756-8972 1111SPECTION LINE PHONE NUMBER:(305)7624949 FBC 20 It I BUILDING Master Permit No.P_' C Imo_ S ZC) PERMIT APPLICATION Sub Permit No. P 1 1")-5 f5l'-71 - ❑BUILDING ❑ELECTRIC ROOFING ❑ REVISION ❑EXTENSION ❑RENEWAL PLUMBING ❑MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 133 ntW_C114"0' 'COY City Miami Shores CaunM Miami Dade Zip 33151) FmRD/Parcellr: 11 -3101- Q33 'Q11 V Is the Building HblerigAy Designated:yes NO Occupancy TypeLoad: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder):_ i2..SChnsm Phonic: Address: In NMI S44 City.Mfbkkt cShC= State: 91. Zip:Raw- Tenant/Lessee Name: Phone#: Email: e-mac"-spm CONTRACTOR:Company Name: {40M4P. PI11,M6;AGi Phone#: acs l0(& 87y Address:(P'1(p"1 w lb I& &Iy. -- City: wliokm� State: �L Ip:33W3 Qualifier Name:9-IASSCII MO WiSOA Phone#: State Certification or Registration rr. Certificate of Competency a: DESIGNER:Architect/Engineer. Phoned: Address City State Zip: Value of Work for this Permit:$ 0 0 Square/Unear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New dRepair/Replace ❑ Demolition Description of Work � � �`� ,` `�"� \ T"is Specify color of color thru file: tt Submittal Fee S RC1 Permit Fee$ /✓6 ' CCF S 1 . co/cc$ SeanNng Fee$ Radon Fee$ Z•2 S DBPR$_2,ZS Notary$ Technology Fee$ 1 -CQ Q Training/Education Fee$ ® Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ 1 . (RwMdD=4/2M4) 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 fob 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 Signature V V-OWNER o AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of r-e V a Z-0 I >by �day of V� 20 r a by 1CCl Q 1 l 6(1 I C�C1 G V10 ^ �� /�>7(�rAe,,, � n. � .who is personally known to s�e \�)d`i t j �who i personally known o 0+ 0 me or who has produced d 6 C eyiSe,S as me or who has produced as Ua 0 m- identification and who did take an oath. identification and who did take an oath. -0 0 0 a NOTARY PUBLIC: NOTARY PUBLIC: M0kE C kUVWD Sign: I�VASign: Print Print: Seal: Consul Seal: U.S. Embassy BOgO1ti riltrM MARY STONE HARTMAN MY COMMISSION#GG008890 ♦!+►ltllt!!!!!!a!!!!filftiis:!!!!!t!!!!!!!!!!i!!!!!!!!!!!!!!a!t!!lalRf i �i�1(it�p(�►9e �lAr� !*! (407 398-0133 Flo►Idallotary3ervl�.com APPROVED BY �� Plats Examiner Zoning Structural Review Gerk (Rev4ed02/24/2014) STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 •a��, 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399-0783 MORRISON, RUSSELL THOMAS HORNE PLUMBING COMPANY 6767 S W 81 ST MIAMI FL 33143 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 DEPARTA fiQF-BUSINESS AND restaurants,and they keep Florida's economy strong. PROFE ULATION Every day we work to improve the way we do business in order CFC1426939 _ j 07/18/2016 to serve you better. For information about our services, please '! tog onto vwrw.myflorkWicense.com. There you can find more CERTIFIED P t , �R information about our divisions and the regulations that impact MORRISON, R = you,subscribe to department newsletters and learn more about HORNE PLUM 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 IS CERTIFIED under the provisions of Ch.499 FS. serve your customers. Thank you for doing business in Florida, EV�date: AUG 31 2018 L1607180000724 and congratulations on your new license! RICK SCOTT, GOVERNOR KEN LAWSON,SECRETARY! STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD CFC1426939 ' The PLUMBING CONTRACTOR . Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2018 :. ��t4 ■ MORRISON, RUSSELL TH ` HORNE PLUMBING C . 6767 S W 81 S'L MIAMI 7,,4•; ,..,..,.... ..-.,.�,..,... nionl wv we oeni 1100n ov 1 n1nI een a ,cn�,onnnn��e 009073 Local Business Tax Receipt Miami—Dade County, State of Florida -THIS IS NOT ABILL-00 NOT PAY LBT 5882676 BUSINESS NAME/LOCATION rid RECEIPT NO. EXPIRES HORNE PLUMBING COMPANY RENEWAL SEPTEMBER 30, 2017 6767$W 81 6135958 Must be displayed at place of business MW4111 L 33144 3 Pursuant to County Code Chapter 8A-Art.9&10 OWNER SEC.TYPE OF BUSINESS HORNE PLUMBING COMPANY 196 PLUMBING CONTRACTOR PAYMENT RECEIVED CFC1426939 BY TAX COLLECTOR Worker(s) 20 $125.00 07/11/2016 CREDITCARD-16-038182 This Local Business Tax Receipt only consnue payment of the Local Business Tax.The Receipt M not a license, Wmit ar a certifies of the holder's ifications,to do business Holder must comply with any governmental or tmngovemmental regulatory I requirements which apply to the business. The RECEIPT N0.above must be displayed on all commercial vehicles-Miami-Dade Code Sec 6a-276. For more inh mia6on,visit wwwmia HORNPLU-01 WENDY ACOR©m DATE(MMIDD/Y"Y) CERTIFICATE OF LIABILITY INSURANCE 2/28/2017 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 is an ADDITIONAL INSURED,the pollcy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If 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 certifloate holder in lieu of such endorsements. PRODUCER C ACT Acrisure,LLC d/b/a InSource ac No, 305 670-6111 FAX 305 670-9699 9500 South Dadeland Boulevard ) (ac,No): ) 4th Floor ESL .email@insource4nc.com Miami,FL 33156-2867 INSURER 8 AFFORDING COVERAGE MAIC# ____ INSURER A:Ohio Security Insurance Company 24082 INSURED INSURER B:North River Insurance Co 21105 Horne Plumbing Company INSURER c:FCCI Insurance Company 10178 6767 S.W.81 Street INSURER 0: Miami,FL 33143 INSURER E 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 TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMrrS LTRA X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE D OCCUR BKS1755951430 10101/2016 10/01/2017 DGETORENoccurrence) $ 300,000 MED EXP(Any oneperson) 15,000 PERSONAL&ADV INJURY $ 1'000'000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 2,000'000 POLICY I j a El LOC PRODUCTS-COMP/OP AGG 2'000'000 OTHER: $ A AUTOMOBILE LIABILITY COMB�NdED SINGLE LIMIT ent $ 1,000,000 X ANY AUTO BAS1755961430 10/01/2016 10/01/2017 BODILY INJURY PerPerson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY BODILY INJURY Per accident X AUTOS ONLY Ix AUTOS ONLY P More , AMAGE $ B X UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 5,000,000 EXCESS LIAR CLAMS-MADE 5821062228 10/01/2016 10/01/2017 AGGREGATE 5,000,000 DED I X I RETENTION$ 10,000 C WORKERS COMPENSATION AND EMPLOYERS'LIABILITY PTA TE ER AANYPROPRIIETgO� N I A RR/PARTNER/EXECUTIVE YIN 001WC17A65821 01/01/2017 01/01/2018 E.L.EACH ACCIDENT $ 1,000'000 W.F.1 d.E=in NH)EXCLUDED? ® E.L.DISEASE-EA EMPLOYEE 1'000'000 If ea,describe undOF Oer below 1,000,000 DESCRIPTION PERATIONS E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) License#CFC1426939 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 g ACCORDANCE WITH THE POLICY PROVISIONS. Building Department 10050 NE 2 Avenue Miami Shores,FL 33138 AUTHORED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD