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PL-17-354
Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit Permit NO. PL -2-17-354 Permit Type: Plumbing - Residential Work Classification: Addition/Alteration Permit Status: APPROVED Issue Date: 2/1612017 Expiration: 08/15/2017 Parcel Number Applicant 640 NE 98 Street Miami Shores, FL 33138- 1132060171820 Block: Lot: IAN & CORY ROSS Owner Information Address Phone Cell IAN & CORY ROSS 640 98 Street MIAMI SHORES FL 33138- (305)979-3879 640 98 Street MIAMI SHORES FL 33138- Contractor(s) Phone HURRICANE PLUMBING CONTRACT( Cell Phone Valuation: Total Sq Feet: $ 4,000.00 238 Type of Work: RECONFIGURE PLUMBING AS PER PLANS M Type of Piping: Additional Info: RECONFIGURE PLUMBING AS PER PLANS M Bond Return : Classification: Residential Scanning: 3 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $2.40 $3.38 $3.38 $0.80 $225.00 $9.00 $3.20 $247.16 Pay Date Pay Type Amt Paid Amt Due Invoice # PL -2-17-62908 02/10/2017 Credit Card $ 50.00 $ 197.16 02/16/2017 Credit Card $ 197.16 $ 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 onformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assum= responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PL BING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: construction and zonin hat all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating o =, I authorize the above-named contractor to do the work stated. February 16, 2017 Authorized Signature:_ner / Applicant / Contractor / Agent Building Depart •'ent Copy Date February 16, 2017 1 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 1k-ECEIVVi. FEB 1 0 2017 BY: FBC 20 BUILDING Master Permit No. 12 1 1 - 105- 26)1 PERMIT APPLICATION Sub Permit No. P 1 1-4 5Lf ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL • [PLUMBING ❑ MECHANICAL ❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: &4k) N C g v . City: Miami Shores County: Miami Dade Zip: 3S138- -241 2 Folio/Parcel#: 11 - 6206 - p I� - \ E?� Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): co f2 -1 d 1A N eoSS Phone#: .505 61 lc t '-459C°) Address: G 40 a ST. City: 1,11 W M l S 1-10 CE S State: 't= L Tenant/Lessee Name: ►.1 1 A Phone#: Zip: 3313$ - Z412 Email: CO-xier 00 rine-L., 1, corn CONTRACTOR: Company Name: i -1`0212 -ICA t-1 E Coi-Y['QAccoasPhone#: �04 4a Address: 164 CO --N--1.4 Do '-1 ¶LSD 42i City: K-1 LY-a4aE State: Zip: "3314q Qualifier Name: 1._AwQ-EMt Lickt-AzA Phone#: -4-SC 4 -SC, \C"� State Certification or Registration #: G iCG- tU 2.."4-0-1 Certificate of Competency #: DESIGNER: Architect/Engineer: 12tCGA-Qpp Q . CNNSPAQ-1 1 Phone#: 4QC, Slat Address: Sl SW 14 'S SZ , City: M iA MI State: R. Zip: 331'IG Value of Work for this Permit: $ 4, GOc› Square/Linear Footage of Work: 2?8 •sp Type of Work: ❑ Addition u Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of,Work: .2.GCa r--1 F .rA� U E n t- (--) kE3 t 06, A S , 'E'i? P f:Yev.r-->.S I N.Ad`1,E'y-i'--ri n.10, 131A -r I1e_oC:31`-l. A v._) "Ti✓lj 4 . 1'-: i{{ Specify color of color thru tile: Submittal Fee $ Permit Fee $ �'� CCF $ 2 •4° CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ - TOTAL FEE NOW DUE$ (Revised02/24/2014) Bonding Company's Name (if applicable) ti\ 1 lk 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."ti. _ — "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 wilrnot be approved and a reinspection fee will be charged. Signature NER or AGENT Signature The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this '61” day of.I:15/ ) 1,4)/til , 20 / 7 , by Rr.�a- , 20 1'by � t Ir day of �3( , who is personally known to as me or who has produced t'DL L5) Si3b3 -'17° as , who is personally known to me or who has produced %PL identification and who did take an oath. NOTARY PUBLIC: Sign: Print: (Lr lir 395 DISa Seal: yN RO ROJAS 18�1ON # FF229202 C ES May 11. 2019 F •.rid.NnIMySorvro CAM identification and who did take an oath. NOTARY PUBLIC: Seal: MY COMMISSIQN # FF229202 4)046.4• 11. 7910 t-•rrM.aN tarvSarwra CAM *******************************************************************************ssssss*************ssss****** APPROVED BY (Revised02/24/2014) Plans Examiner Zoning Structural Review Clerk RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY _ STATE•O_F'FL'ORID'A-Z‹..'`. �DEPARTMENT'OF BUSINESS1AND PROFESSIONAL REGULATION ' = •t.--►- -�': "_: rCONSTRUCTION INDUSTRY LICENSING BOARD �� LICENSE NUMBER "" ,s _- ._ '_-e---" -7 ----- 7,--.- ,7.'-'7\,.. " ^```"- •N.N. - ..•`.y..'4 :• c.' }*a \ CFC.1427078 \•W.'"' \\. -1:1'`x-. ^. -"-,+ .., .-,`l <`.,p`'. +':* —The•PLUMBING,CONTRACTOR.. Named;,below.IS'CERTIFIED. Under the'provision_"s.of;Chapte1489 FS .-Explra 6'n'date--AUG'.31- 2018 LANZZA71_AWRENCE_CHRIS HURRICANE:ELU_IABING" 15TRACTORS LLC �" .. 1"04 CRANDON'B.OUL - ;N:\s\'k\ KEY-BISCAYNE L-33149•x-:-'�,r�``ti 1417- ISSUED: 08/07/2016 DISPLAY AS REQUIRED BY LAW '. 0-- • SEQ # L1608070002376 006785. . — Local Business Tax Receipt Miami Dade County, State ofFlorida —THIS IS NOT A BILL — DO NOT PAY 5819470 BUSINESS NAME/LOCATION HURRICANE PLUMBING CONTRACTORS LLC 109 TRUXTON DR MIAMI SPRINGS FL 33166 OWNER 1 1 HURRICANE PLUMBING CONTRACTORS Worker(s) 11 RECEIPT NO. RENEWAL 6067748 LBT EXPIRES SEPTEMBER 30, 2017 SEC. TYPE OF BUSINESS 196 PLUMBING CONTRACTOR CFC1427078 Must be displayed at place of business Pursuant to County Code Chapter 8A — Art. 9 & 10 PAYMENT RECEIVED . BY TAX COLLECTOR $45.00 07/31/2016 ECHECK-16-172191 + w 1 1 a 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 holders 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.vehioles. Miami—Dade Code Sec 8a-276. 1 ' •/ For more information, visit www.miamidide.gov/tioicollector ACORO®DATE AC� CERTIFICATE OF LIABILITY INSURANCE (MWDDnYYY) 5/10/2016 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 policy(ies) must 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 certificate holder in lieu of such endorsement(s). , PRODUCER Gil, Garden, Avetrani Insurance Group 10689 N. Kendall Drive Suite 208 Miami FL 33176 CONTACT Yamile Corral NAME: (AHC No. Ext): NE (305) 630-4777 FAX NO): (305) 279-3022 E-MAIL ADDRESS: gg g' YCorral@ ai com INSURER(S)AFFORDINGCOVERAGE NAIC# INSURERA:White Pine Insurance COMMERCIAL GENERAL LIABILITY INSURED Hurricane Plumbing Contractors, LLC 104 Crandon Blvd, Suite 420 Key Biscayne FL 33149 INSURER B :Normandy Harbor Insurance Company WPCP006569 INSURER C: 5/10/2017 INSURERD: $ 1,000,000 INSURER E : INSURERF: X COVERAGES CERTIFICATE NUMBER:CL1651008512 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 LTRINSD TYPE OF INSURANCE ADDL SUBR WVD POLICY NUMBER POLICY EFF (MM/DDYYY) POLICY EXP/Y (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY WPCP006569 5/10/2016 5/10/2017 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR PRRENTED TA PREEMIMI ESESS (RENTED Ea occurrence) 100000 $ � MED EXP (Any one person) $ 5,000 PERSONAL &ADV INJURY $ 1,000,000 GE X 'L AGGREGATE POLICY OTHER: LIMIT APPLIES PRO- JECT PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A NHFL1430552016 11/14/2016 11/14/2017 X PER STATUTE OTH- ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1, 0x00 , 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certified Plumbing Contractor License number: CFC1427078 CERTIFICATE HOLDER CANCELLATION Miami Shores Village Building Department 10050 NE 2nd Avenue Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Joe Avetrani/MS .' ACORD 25 (2014/01) INS025 (201401) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD