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PL-16-3111
Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Perms Ty pt `Pini bil! g - ent ark'C/ xi rc tJoi Addition/Alteration APPRQ1 D Parcel Number Applicant 1226 NE 100 Street Miami Shores, FL 33138-2604 1132050090060 Block: Lot: VALDIVIA HOLDINGS LLC c/o M Owner Information Address Phone CeII VALDIVIA HOLDINGS LLC c/o MELLAW 2601 S BAYHORE Drive COCONUT GROVE FL 33133- 2601 S BAYHORE Drive COCONUT GROVE FL 33133- Contractor(s) APA PLUMBING CORP Phone (305)992-4614 CeII Phone Valuation: Total Sq Feet: $ 6,975.00 0 Type of Work: 2 BATH, 1 KITCHEN AS PER PLUMBING R Type of Piping: Additional Info: Bond Return : Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Notary Fee Permit Fee Scanning Fee Technology Fee Total: Amount $4.20 $4.50 $4.50 $1.40 $5.00 $300.00 $3.00 $5.60 $328.20 Pay Date Pay Type Invoice # PL -11-16-62058 01/18/2017 Credit Card 11/15/2016 Credit Card Amt Paid Amt Due $ 278.20 $ 50.00 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Top Out Final Review Plumbing Underground 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 (DAVIT: rtify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating constructio a d zoipg. thermore, I authorize the above-named contractor to do the work stated. Authorized ature: Owner / Applicant / Contractor / Agent Building Department Copy January 18, 2017 Date January 18, 2017 1 f Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 BUILDING PERMIT APPLICATION ❑ BUILDING ❑ ELECTRIC ❑ ROOFING 7 El PLUMBING ❑ MECHANICAL El PUBLIC WORKS JOB ADDRESS: 03c Questions/Comments/Concerns ? Monique Smith, 786-253-2869 RECEIVED 1®VI 14 201i FBC 20 i' L� Master Permit No. KC r5 ® / /5 / Sub Permit No.17.( 4 3( I ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑ CHANGE OF CONTRACTOR ❑ CANCELLATION ❑ SHOP DRAWINGS City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Occupancy Type: Load: Construction Type: Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): VA l— / 04- /1-7) (b/N6-1 Address: ,% 1� / J /� D ST City:IL 1 /,4 a4 1 `P1'L� S State: Tenant/Lessee Name: Email: �I 0 Af AI i QuC t -LES x y Z BFE: FFE: Phone#: re - Zip: Phone#: CONTRACTOR: Company Name: . P • Phone#: Address: qq��)I °) r s Lv G City: A/"L'A 2,,v�` State: p i t24"16,4 Zip: \11 �( �' Qualifier Name: k t, r I1 • �� A t1 c.� a Phone#: ( �l �l 'I `t - - `K6/Si- State Certification or Registration #: CFC 1 A 2 9 s 3 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: ...---- Value Value of Work for this Permit: $ (47 175: Type of Work: ❑ Addition El Alteration D cription of Work: . 13.' 4 t \, i 4 % L A 11.42 L' a.1 Square/Linear Footage of Work: ❑ New Repair/Replace ❑ Demolition Specify color of color thru tile: Submittal Fee $ 50 ' c Permit Fee $ LAO()J CCF $ q •• npW l® co/as rrnrn Scanning Fee $ Radon Fee $ ® DBPR $ `�S - '3® Notary $5 • 04 0 Technology Fee $ Training/Education Fee $ 0 . OD Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE$ 2 Z • (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 prop�rty is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the firs in ection which occurs seve (7) days er the building permit is issued. In the absence of such posted notice, the inspection Will n be approved and ar in ectio ee will be charged. hit r WNER o GENT l The foregoing instrument was�acknowledged�before me this 5 day of N OV1t c l.�t—+wl- , 20 ice , by MON e 4.. S1 who is personally known to me or who has producedNOV- 1-10.EN identification and who did take an oath. NOTARY PU6ttC: Sign: Print: Seal: APPROVED BY (Revised02/24/2014) Notary Public State of Florida Sindia Alvarez My Commission FF 156750 Expires 09/03/2018 1 Signature The foregoing instrument was acknowledged before me this day of N.rfie.-E.e- , 20 L , by L) 2 4 who is personallyrknown to me or who has produced .1 UIS 614 A as identification 1k' who did take an oath. NOTARY PUB Sign. Print: Seal --ig`iLe- Plans Examiner Structural Review CLAS At8Y P0,,94 Notary Public State of Florida ▪ Sindia Alvarez aQ My Commission FF 156750 FopExpires 09/03/2018 ********** Zoning Clerk To: miami shores Page 4 of 5 2016-11-15 15:27:50 (GMT) STATE QF FLORIDA DEPA:RTMENT OF I:BUSINESS AND:PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD: (8S0) 487-1395 1940,NORTH MONROE STREET TALLAHASSEE FL 32399-0783 • 13056750833 From: Luis Garcia GARCIA, LIIIS ALBERTO AP A:PLUMBING CORPORATION 8741. SW 49TH STREET MIAMI FL33165-67.01 payk§ratt*ional. witpt this license you beeorneonsof the nearly one Tfijilion:Fiorilliang licensed by the.Department.of Busineos'0110. Professignaj Regulation, Ourprofessionals and.busineases range froOlaCcittaat W.Y.aoht broker% from boxers. to borbeque reetourantA, and theykeepflarielals.'omIrany'Strirg- EveryOaywework to linipmvo-tiap woy. we. do Nolooes in Orde!':, ta'serye you bettor.. rs.oplpes; pier:mo- le ontO.MllitYmirigolitlanOOnSe,Corn. Therou..ffnd more pr. -motion about our divisions anclAteregulatliaria :Mot:impact. Vat, SueScribetadeparirnentnewslellers and -learn roproabOot thaDepartmentsipitiotivoo.: Our mission atithopartrriordisfticensoEffidebt4f. gPlate. ponstantIrstrive to.serveyou bet:torso-that you can sante your costornemt Thank youfor doing business in Florida, and' congratulations on. yolk -new/ lIcensal RICK SCOTT GOVERNOR STATE OF FLORIDA, DEPARTMENT OF BUSINESS AND PROFESSIONAL REGOLATION =1427783 :ISSUED: 0611212016 •CERTIFIED PLUMBING CONTRACTOR GARCIA; LUIS.ALPERTO AP A PLUMBING CORPORATION 1$1-0:ERTIFJ.11 ,4,tyler tile:ps9v.istohW at: Ch:48.3,.FS. Ltsos-r2usoia25 DETACH HERE KEN LAWSON; SECRETARY STME QF .FLORIDA DEPARTMENTOF.BUSINESS AND P.IROFESSIOti.IAL REGULATION CONSTRUCTIOIsi.iNDUSTRY LICENSING BOARD C.FD1.47783 The PLUMBING CONTRACTOR. NarnettbeiowlS.CERTIFIED 1.1nderth-proyis.14ns p.f.Cliapt6r489 FS. Expiration AUG -31., 2018 GARCIA, Lijia.ALBERT.O. . A.P-A.PLUMBING:CORPORATION 87.41:.SW49TH- STREET ItillAfv11 • ISSUED: 08112(2016 DISPLAYM-REQUIRED BY LAW sea4- L16D6120001225 To: miami shores Page 5 of 5 ... tt7.246 • 2016-11-15 15:27:50 (GMT) 13056750833 From: Luis Garcia Local = usiness Tai :Race:1P M.iarn:i-Dude County, State'©.f :FIOrida -71 41,5 407r:A.13ui-DONOTPAY: 6281687 BusiNEs4 MEI OCATIOtN. A PA PL1JSa1Pf.G CORP 7075 SW 46 6T MIAMI .Ft.,:3.i.'(5 5. :i}1f.4'B nat: APA P.tA. Nitii,,NG CORR. Weser(s) 1. fECatpT NAa. RENEWAL ?:363 EXPIRES SEPTEMBER 30 2017 Must be dispiayeu 8tplace'of.busfness: ' Pursu'ant'to County Code • Chapter 11A. -Al f...91.n .'aEC. TYRg:QJ' qtyaohless. 196 PUJN1DWG CONTRACTOR CPC14277S3 pA•kmarr igECEIVE0 TA..X CQt.t. G'rOEt $754 0711i12QJ6 •CREI?ITC'ARD-165-037963 This toaateeaineseTex.ikeaeipt4alyteRtirws.payntantflttlletocal!Slimness ,ra>i:.711a.tiereipi)snula.liwnnn. Moak oraoerNiioattoeetthe tnthier`s.tpteakstiulrs,todq.fcskoasa. Hotalermustcemplywithany`goveramrnia of nentfgretanienmf reguletolry.lesul.reittarettotests which apply.to the leiSiness. The tlEi:EIATNt ishoYesnesttiutrtsployed'Ral!ii.ewrt? Otalvah les-lAtosa tade.CodeSecea-V 'FritinotetelamlaYlo4visittrlww,taisnidgt0-yvuvhxoaflH qor tf To: miami shores Page 3 of 5 • 2016-11-15 15:27:50 (GMT) POI Number ... 13056750833 From: Luis Garcia DateEniered: 3/21f2016 --,-- - 1—fia • tERTIF1CATE OF LIAalLITY.INSUAANCE .. DATE6151130DIYYTY) 3/2.1./2016' THIS- CERTIFICATE IS.ISSU go. AS • A IIIIATTER.O. INFORMATION ORMAN!? CERTIFICATE DOES NOT AFFIRMATIVELY OR: NEGATIVELY AMEND, BELOW ; THIS .CERTIFICATE. OF INSURANCE DOEs NOT CONSTITUTE REPRESENTATIVE ORPRODUCER, AND. THE CERTIF1CATE:HOLDER. CONFERS NO:RIGHTS UPON TtIE. CERTIFICATE HOLDER. THIS EXTEND OR ALTER THE COVERAGE :AFFORDED BY THE POLICIES A CONTRACT BETWEEN. THE ISSUING INSURER(S), AUTHORIZED' If SUBROGATION *IS WAIVED,.taMject to A statement -On thiscertificate does not center rights to the ----- MPORTANT; if the certificate holder is an. ADDITIONAL INSURED, the:nolIcy(1es.).muaehaentlmsed. the terms end .Cenditione cline: pollcy,reitaid policiesinay.renuire an endorsement- certificate holder in Iled.Of stich endorsoment(s). U PRODCER 3NM-r 'Options Insurance 7171 Coral. Way S-ite 41,9 miaati, FL. 33155 roteracT. ' • • • . 9.27 '''`I . (88.8)687-19 26 ""E 1305) 3V -1_ l extfo9yourop.txonsins . CORI DISURER1S) AFFORIHNO COVERAGE . NAM 5 mismenA:JA,,,-; River Insurance Company MED A...p .., A x..lued).ing. Corporation 7075 SIC 416th St Miami, OM 33.155: ENSURERM : INSURER C .7 EACH OCC_LIRRENCE CM4-4"81--.: INSURER D:: INSURERr. INSURER'E 7 - Go.70•84.0-6 CERTIFICATE NUMBER: REVISION NUMBER: 'THIS 1T0 CERTIFY THAT THE POLICIES:OF INSURANCE LISTED BELOW HAVE. BEENISSUED TO THE..INSUREI) NAMED -ABOVE FOR TI -IE. POLICY PERKO INOICATED. NOTWITHSTANDNG. E0UaEMENT TERM.DIT ..CONDITION'OF ANY. c.ONTRACT OR OTHER DOCUMENT:i•WITH RESPECT TO:WHICH THIS OERTIFICI.LTE• MAY BE ISSPEO OR MAY 'PERTAIN,THE INSURANCE, AFFORDED EY THE POI.ICIES DEB.CRIDED HEREIN LS SUBJECT TO 'ALL THE TERMS„ EXCLUSIONS AND- CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAIO..CLAINIS. [NOR VCR TYPE OFINsuRANcE ------745bL MD vAny pouoymeeek M N 51 . T • umma A. ' Xv-alamEnc.tA63E.1-44441.11-11T' EACH OCC_LIRRENCE CM4-4"81--.: 1::dLAIME-MADE OCCUR . Go.70•84.0-6 03/25/201E' 03/ 2E/2017PREMaeagg DA A-GE.Tektirltb— -11jA• occu .rumcf11 LSD1), .090 . NED OP voy one peraim) LS...066 • .. PERSONAL & ADY MOURY .5 3, , 000 ;000., GEN% AOGREOATE LINSTAPPLES PER:: GENERAL AGGREDATE :S. 2,..:.„.000 , o 00 ..__ ,..., poucy I mg: 71. LOC pnoouoTa..commopAGG 1LP:000,000 ..._.4 I OTHER: . .$ AUTDMDMIE.I.IARILITTCOtABIATED SINGLEUMIT a sacadanii • 5 ANY AUTO ODILY INJURY(PaanArsos) ALL OWNED — .SCHEOVLED BODJLTIN:AiRY (Iiiar accident) 5 .HIRED AUTOS' 1.1014.0WNED .AUTOSrPt.:pa__ri PRCEERTYDAMAGT—' j_clant ' s • 5 'MAMMA -A une 'EXCESS tiAll. 'OCCUR ... 'CLAISW.,-MADEAGGREGATE • 'EACH £5<1.C. LIRRENC•5 5 S, ..—,... DEO I i RETENTION 5 .5 ' WPRKERSCQMPEAISATION AND:EMPLOYERk PER• 1 07H- 14ASEPre VIN ANY PROERIETORMARTNER/EXECUTIVE , .STATUTE s El_ E.AC.HAOCIOENT OFFICERMEMBER.EXCLUDED? 1:1] (Nanctatorf in NH) IN.f A 1 El. DISEASE- EA EMI; LOYE 'S If yes, deactiba under selaw DESCRIPTION OF OPERATIONla . . • •. . S - CY LIMIT E.L.DISEAE POLI 4, I DESCRIPTION.OF OPERATIONS OLOCATIONSIVEHICLES (ACME* .1..01, P.:14000aI ROITIATIsa f.S4Ive:41041nay Ise 5tiicid It iikor9, SPAOS.WroSikaratO PLIONM.Z110; ftESIDEINCIAT, (98483): EuntOszNc. ccttetEttt.CIT.AT,.. t 98482) as pa r in.foratation withunderwriter policy covers policy installation LPG equipment CERTIFICATE HOLDER CANCELLATION ShOzeke VtUag Bulding .and Zoning 1.00s0 :gm. 2 AVE 1.4-tausi S.14OSEIS' Village, PL. 33138 faxi305)756-8972 ACORD 25 (2014101) SHOLOW ANT OE: THE ABovE DESPRIPED • POLICIES BE cANcELLE0 REFORE THE AxpiKA-rioN 11.ATE iliEREop., ,NOTICE WILL BE DELIVERED IN ACC.ORDANCEWITH THE POLICY PROVeSIONS: Atiii-toRgEaReelkestrilTxuyE MATILtHe CARE DO ©...19884914A0ORD 9-0.R-FORAT1011-All.TIOPts'rerv84 The ACOP.O.naroeand logo-arn..regIstered marks ofACORO callg Farms EassPluasanmara.wmii.ForrasBasacamirapieWvaNtilInong epe-aae.-pe7 To: miami shores Page 2 of 5 2016-11-15 15:27:50 (GMT) 13056750833 From: Luis Garcia . ,.....„......11 0 AC-CPEP.. . CERTIF ICATE OF LIABILITY :INSU RAN c.E 64. sammorrern THIS CERTIFICATE LS towel) AS A.MATTERO.FINFORMATIOICONLY MD CONFERS NO RIGHTS UPON THE CERTIFICATE ROPER, THIs CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY ANIMA EXTEND OR ALTER. THE COVERAGE AFFORDED BY THE POLIQIES BELOW. TH(S. CERTIFICATE OF INSURANCE Deo NOT CONSTITUTE A CONTRACT BETtritEEN THE ISSUING INSURER(S), ,AUTHORIZED: REPRESENTATIVE -OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT:. If the *certificate fielder *IS An:AMMON*. INSURED, the pelicYfiaa) most Pe endorsod. If :SUBROGATION :IS WAIVED, subject to the terms anci:ConditiOns of the policy, certain policies -may require an endorsement. A statement on this certificate 'gloss not .confer rights to the certificate holderin lieu Of such endorsements). FROOlicen SONZ. Insurance Solutions, LLC. . , ' • ID: (Atly)CONTACT ciOAIIV.111-1, Inc. 9016 Philip.s Hikt htivay Jacksonville, Ff 62256 NAME. MEH15t1 puom I FAX td,IC.Ns g 3: 504-739-Z722 ____LABEOffiveg 904 2S-22761) NAtc at S4762 ^,----- EMAIL .aDDs: MeshaniatriXonesOUroe.ccrn 11481.1RERiso_FFoRpikc rmYERAGE • .attaiRPIA ; SUNI„Jc_ragme*Co . -y • sisuRee sir Aspen Re - London - Best Ratim .7A" 1..imunao AInc.. lly HR 9016 ,PI;Iiiios Hwy Jacksonville FL 32256 • • iNsuFtER:c: Catlin Syndicate- Lloyds - 8estRatino "A" . ,. rusucteR o: Brit Syradicate - -Lloyds - Seat Rating EACH OCCURRENCE% ASSUBER.A : INSURER P ; REVISION NUMBER: THIS IS To. CERMFY TkIAT 'MEN:it-CIES OE INSURANCE LISTED:BELOWHAVE SEEN ISSUED TOTHE INSDRED NM/ED.:ABOVE-FOR THEPOLICY PERIOD INDICATED: NOTANIMSTANDINt ANY.' REQUIREMENT, TM OR .CONDITION *OF ANY CONTRACT OR OftIER DOCUMENT vYrr.Ft HESPECTTO WHICH Ttlts .CERTIFICATE MAY BE ISSUED OR IVIAY'PERTAIN,...TKE:INSURANCE.AFFORDED 8Y THEPOLICIES CIESCRI8E0.HEREE4 IS .SUBJECT TOLL THE TERMS .EXCLUSIONSAND:CONDMONS:OF SACH POLICIES. Li115/ITS SliOVVWNIAY HAVE BEEN REDUCEP:SY PAID *CLAIMS. 045R LIR . TYPE OP iNSURANM . • .--.... .. 70. -,:i ,,,- !. . POLICY NUMBER :PoUcV.E.P4T - '• turenaorevyyt Pouggil. while LIMITS - COMMERCIALONERAL 1,041ILITIr EACH OCCURRENCE% $ • C -ME •OGCUR takKOUrrinkERTED - • • PREMISES (E3:occugencia)• • AM PAP fmw ale pawn) • :PERSONAL &ADVINJURY '436,4, AguREGATE`1,1141TAFALIES PERI'. .. . . . OENERALAGGRROATE '5: 1301-ICX 71 JPRCEcr Fib= PRODuCTS -COMP/OP AGG S. '.• OTHER:' 5 ALITCINICBILE.L.IABlUTY. .COIMENEOMAIGLETIMIT $ ANY...furto -.wept INJURY if,Sr parson) :S AU. 041ED •:j..- *AUTOS i_____ ;SCHEDULED AUTOS 30DniFY.IN7DRY (Per amiMSUI) HIRED:AUTOS' NOCANNED .AUTOS FORTY IlAtviAGC5 •IPer acctfleral • 3 UMBRELLA LIAO • ..030..Ifi • EACH OCCURRENCE • iDICESS LIME • CLAIMS -MADE AGGREGATE - DED 1, 1 RETENTIONS - A INORKERS-COMITAISATION EMPLOYERSLILTY INCFEOCIODPUS 02 virms 1/1/2017 . , . NTure • 'ER: Pp 'Y i INN RROPRETOR~TNETOiXECOTIVg• VVCPE-041006323 04 1/1/201S.: :1/1/2016 • • , E.,L EACRACCIDENT T---1 DEP CERIMENBER,EXCLUDEDS Vil3miNoryin RR) ' N i A .. s • • EL DISEASE - EA ENIPLOYEE 5 1;000,000 11$:yEsAssateurlder• !,..... RIP/10NC* OPERATIONS • , e.L opEAsp--pottcYutarr . a 1;000,040 B ' C. 0 Workers Coinpensation. E.xcess.Coverage .Thialsprinfmnationalp.toms POO.Tiothir.7g *lag Crealeany right ender such.reinsurance . .. ossearanagov,oaseATIONsotas'iverieLes tAc.Oltaist. Aiiditrana RErsarlm§utreAtels, ton be sitaquell If mon spies is isEutradi Coverage proaideci Wall leasetteropley.ees but of A:PA...PLUMBING dORPORATK*1 Effectrue date: 3(10)2015 ' - CERTIFICATE HOLDER CANCELLAT1ON gtioo MIAMI SHORES VILLAGE HALL Fax: 305 796 8922 i:0080 NW 2 AVE MIAMI SHORES FL 33138 sHolitla ANY OF THE AtitovE DesCRIsED POLICIES sE cANCEI-LEB BEFORE THE EXPIRATION DATE THEREOF, NOTIcE WILL BE OEUVERED ea ACCORDANct WITH The POLICY PROVOSIONS. AUTTIROW RSPRESERTATNE ..,- Glen J Distefano ACQRP 25(25101) t14ORDCORPOi%ATtjN. AR rights TK ACORD name and logo aro regIaterf4 marks ofACORD 105,741$ 1 Water Certificate I Candice McDowell. I 2/412016 )1:.*123 AR (6611 i .6445a. e.