PL-17-518 Miami Shores Village �
.� 1
fix` Building Department FEB 2 2017
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY'-- -- —
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC20
t BUILDING Master Permit No._ 1,/� 1 7- 2LL1
PERMIT APPLICATION Sub Permit No. 7, 1_:�- S 1(,;s
I ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
1
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
�J CONTRACTOR DRAWINGS
1 JOB ADDRESS: / W
i City: Miami Shores County: Miami Dade Zip:
r
Folio/Parcel#: Is the Building Historically Designated:Yes ]NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder): // I'Gt_I� Phone#: S
S"3 9�-Z
Address: L � L� tl-,
{ City: tdq AV/-P}` State: 71`__4 "Zip: L
r
Tenant/Lessee Name: Phone#:
Email: t.
CONTRACTOR:Company Name: l/� 15 _ `` Phone#:
� Address:
City: ✓ State: Zip:
Qualifier Name: Phone#:
State Certification or Registration# �f�27_! �4.'.2I9�p Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: //-- _ City: State: Zip:
Value of Work for this Permit:$ L1,f 7h�.`-'� Square/Linear Footage of Work:
t
T e of Work: ❑ Addition }
r yp ❑,jAlteration. ❑ New Repair/Replace ❑ Demolition
Description of Work: i f
7Z��44 - ' GSH ��� �s / Si�4- /4�--
r t ' t '4 • r�4
Specify color of'color;thhU tile:,
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Submittal Fee$ Permit Fee$ ,f CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$ n
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
r TOTAL FEE NOW DUE$ `�1 • —
(Revised02/24/2014)
Bonding Company's Name(if applicable)
Bonding Company's Address
Y' -
City State Zip '
Mortgage Lender's Name(if applicable)
Mortgage Lender's Address
City" � ` 4 State Zip
s ,
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. t*
"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 commencementmust be posted at the job site
for the first inspection which occurs seven (7) days after the building permit s i ued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signa re
OWNER or AGENT CONTRACTOR
The foregoing instrument
was acknowledged before me this Th f egoing instrument was acknowledged before me this
day of �R�'J�y°�� 20 by, day'_ f44> / 20 1 by
Lary Cc`�� N IF
ho is personally known to E('��P40 F-5 ,who is personally known to
me or who has produced 13(CS 3.5 3 )•(oa toy i O as me or who has produced as
identification and who did take an oath. identif' ion and w e an oath. �.
NOTARY PUBLI���olu1►Ugrr NOTARY PUBLIC:
• ,�- kP;.� � � �.�� .mac �
Sign: 5 Sign:
Print:= r �J ( � Print:
�y '• #FC144306 0¢z + F M VAREZ
I Seal SSION#FF 238149
°aa o Seal: * * MYCOMMI
.'%o:pe 1sk5;:• ��c�`�`� ar EXPIRES:June 13,2019
RIMMAN1140 Notarysenim
*****s**s*******sr***s***********s*sx**#**r*********************s***s******s**s*:*************:***•r*****r*r
APPROVED BY eld —.; ,/ Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
i
STATE OF FLORIDA n
DEPARTMENT OF BUSINESS AND PROFESSI NAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOA D (850) 487-1395
2601 BLAIR STONE ROAD
TALLAHASSEE FL'i 32399-0783
PAUL, DECINOB
DPAUL PLUMBING INC k
1710 NE 139 STREET I
MIAMI FL 33181
G
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 b� `at. STATE OF FLORIDA
from architects to yacht brokers,from boxers to Nirbeque , DEPARTMENT.'OF BUSINESS AND
restaurants,and they keep Florida's economy strong. V-1.7" PROFESSIQNAL'REGULATION
CFC1428259 ISSUED� 06/30/2016
Every day we work to improve the way we do business in order ,
to serve you better. For information about our services,please _f
I
onto www.myfloridalicense.com. There you i;an find more CERTIF�ED PLUMNT
BING'CORACTOR
I
about our divisions and the regulations that impact PAUL;I ECINOB CA;'7
you, subscribe to department newsletters and learn more about DPAUL PLUMBING IN ,
the Department's initiatives. 11
Our mission at the Department is: License Efficiently, Regulate
Fairly.We constantly strive to serve you better so that you can IS CER IFIED under the provisions of Ch.489 FS.
serve your customers. Thank you for doing business in Florida, E�;ratio,d de AUG s,,20 8 L160630MM728
and congratulations on your new license! -
f
t
t
DETACH HERE
RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFEE SIONAL REGULATION a
CONSTRUCTION INDUSTRY LICE SING BOARD
428259-
The
28259`
The PLUMBING CONTRACTOR .4 ~=, f
Named below IS CERTIFIED .,, ,VM
Under the provisions of.Chapter 489 FS. «"_ * �,�•
Expiration date:"AUG 31;"2018 �` '"�
PAUL,,DECINOB--
DPAULPLUMBING INC ",,�., 11_ `s
1710-NE 139 STREET y� �' �' ' '
MIAMI "_FL*33' $ , 4.- -
ISSUED. 06/30/2016 DISPLAY AS REQUIRED BY LAW SEQ# 11606300000728
i
Local Business Tax Receipt
Miami=Dade County,State of Florida
-THIS IS NOT A BILL-DO NOT PAY'
6650908 LBT
~Y
F - y
BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES
" DPAUL PLUMBING INC RENEWAL SEPTEMBER 30,1017 '
21005 NW 14 PL 146 6921846 Must be displayed at place of business
MIAMI GARDENS FL 33169 Pursuant to County Code
Chapter 8A-Art.9&10..
OWNER SEC.TYPE OF BUSINESS
DPAUL PLUMBING INC 196 PLUMBING CONTRACTOR PAYMENT RECEIVED
CFC1428259 BY TAX COLLECTOR
Worker(s) 1 845.00 08/09/2016
CHECK21-16-110234
This Local Business Tax Receipt only continue payment of the Local Business Tax.The Receipt is not a license,
permit or a certification of the holder squalifications,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 Ba-276.
For more information,visit www miamidada.govitexcollector
t
ti. CITY OF MIAMI GARDENS BT
! 2016 BUSINESS TAX RECEIPT 2017
lP EXPIRES September 30, 2017
MUST'BE-DISPLAYED
AT PLACE OF BUSINESS
LICENSE ITEM DESCRIPTION/RESTRICTIONS Business Name/Location 0047403
BT-010072 I 0840 CONTRACTORS-GENERAL DPAUL PLUMBING INCA
21005 NW 14TH PL
'1 APT 146
PLUMBING-CONTRACTOR MIAMI GARDENS, FL 33169-2882
Owner/Corp. Name
DPAUL PLUMBING INC PAUL, DECINOB
21005 NW 14TH PL, APT 146 This is an business tax only.It does not permit the payee to violate
MIAMIGARDENS, FL 33169-2882 any existing regulatory or zoning laws of thwCity ofMiarni'Dade
Courty.Nor does it exempt the payee from any other tax or permit
required by law.This is not a certification of the payee's qualificatio
V rI
City of Miami Gardens Enforcement Department 18605 N.W.27th Avenue Sui',e 118,Miami Gardens FL 33056
CITY OF MIAMI GARDENS Cu
2016 CERTIFICATE OF USE 2017
r EXPIRES Sebtember 30, 2017 x.
' MUST BE DISPLAYED AT PLACE OF BUSINESS
LICENSE ITEM DESCRIPTION/RESTRICTIONS Business Name/Location 0047403
CU-005961 c042 Home Office DPAUL PLUMBING INC
21005 NW 14TH PL, APT 146
MIAMI GARDENS, FL 33169-2882
Owner/Corp. Name
DPAUL PLUMBING INC PAUL, DECINOB
21005;NW 14TH PL, APT 146
MIAMI GARDENS, FL 33169-2882 Use as permitted within zone.
Feb 28 1701:52p AALL SOUTHWEST INSURANCE 305-692-9213 p.1
'402/228/28/2CERTIFICATE OF LIABILITY INSURANCE DAA D/YY"
017
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 NTA
A ALL SOUTHWEST INSURANCE NAME`
PHONE
1827 NE MIAMI GARDENS DRIVE (N��- ►:3059 -9212 arc�;305-692-9213
E-MAIL
NORTH MIAMI,FL 33179 ADDRESS:SININSl1RANN(: FI I SQUTH NET
PRODUCER -•
INSURED "- - INSURERS)AFFOROENG COVERAGE NAIC R
DPAUL PLUMBING INSURER A.-GRANADA INSURANCE COMPANY
1710 NE 139 ST _uvsuRER D: PROGRESSIVE INSURANCE GOMPANY
MIAMI,FL 33181 INSURER c;ASSOCIATED INDUSTRIES INS COMPANY INC
INSURER D
INSURER E
COVERAGESINSURER F:
CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE; RED 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,
EXCLUSIONSAND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR TYPE OF INSURANCE AD OE S-U1NR- POLICY NUMBER POUCY EFF POLICY EXP
GENERAL LIABILITY MMlUD/YYYy MMIDD/YYYY LIMITS
A 0185FL00036779 06/07/2016 06/07/2017 EACH OCCURRENCE
COMMERCIAL GENERAL LIABILITY (� OiVAAGI'TO-RENTED- E 1 OOO 0�
CLAIMS-h1ADE 1 Pf2EMISES Ea occurren.�e $ _1
OCCUR Go onn
MEO EXP(An P"
person) s --- QDD_
'PERSONAL&ADV INJURY S_ 1 Q0. 0.00
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 5 2,000,OOD
•-- POLICY X PRO- I LOC PRODUCTS-COMP,'OP AGG E
AUTOMOBILE LIABKJTY E
B 03158034-1 06)07/2016 06/07/2017 COMBINED SINGLE LIMIT
ANY AUTO j"— (Ea accident) E
ALL OWNED AUTOS J BODILY INJURY(Per person) S 10,000
X SCHE DU LED AUTOS EODiLY INJURY(For accident) 5 _20,000
HIRECAUTOS PROPERTY DAMAGE
(Par accident) 5 10,000
NON-OWNED AUTOS
E -
UMBRELLA LIAS OCCUR S
-_ ,EXCESS LIAB CLAIMS-MADE JEACHOCCURRENCE g -
._ DEDUCTIBLE ` AGGREGATE - ;
RETENTION S ___-.._ 5
C WORKERS COMPENSATION S.. l�
MIDEMPLOYERSMART1 ERI AWC1067170 06/10/2016 06/10/2017 x 1 T RY;jh11U- GET►t-
ANYPROPRIETORfPARTNER/EJCECUTNE YIN
OFFICER/MEMRER EXCLUDE09 NIA E.L.EACH ACCIDENT(Mandatary in NH) T g-- -NT _ 100 OQO
If yes.describe ender I I EL.DISEASE-EA EMPLOYE S - - 100-OOQ
�,I-•— E.L.DISEASE-POLICY LIMI- E
DESCRIPTIONOF OPERATIONSI LOCATIONS!VEHICLES(Attach ACORD 101,Additional Remarks Schedule,iF more space is required)
CC#CFC 1428259
J
CERTIFICATE HOLDER CANCELLATION
MIAMI SHORES VILLAGE BUILDING DEPT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
10050 NE2 AVE OLICYPION DATE ROVISIONS.THEREOF,NOTICE WILL BE DELIVERED IN A DANCE WITH THE
MIAMI SHORES,FL 33138
305-756-6972 AUTHORIZED REPRESENTATIVE
%A1 E G KENNEDY \ 4CO
ACORD 25(2009/09) 1988-2009 ACORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD