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Pl-17-742 Miami Shores Village - ' Y , Building Department MAR 17 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 FBC 20 4 BUILDING Master Permit No. K C PERMIT APPLICATION Sub Permit No. -tom I ( : --4(A 2•- ❑BUILDING ❑ ELECTRIC ROOFING ❑ REVISION ❑ EXTENSION [:]RENEWAL PLUMBING F-1 MECHANICAL ]PUBLIC WORKS [:] CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: \A/ r/ (G 3 S + ' ��y� City: Miami Shores County: Miami Dade Zip: '33 ' i;`� Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: (� Flood Zone: BFE: FIFE: OWNER: Name(Fee SimpleTitleholder): O`1 G*J Y 7 Phone#: Address: Q 11�_ " `!V City: /Ow ( ,5 0t-Q4. State: � � Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: AA N`aGJ t C. kA W10 l W!� Phone#: Address: 1 /350 �+ City: t Q A State: —I. Zip: U Qualifier Name:. A "s d o Phone#:C,3 Off, /Sil-O 19 Va ,X •; a� � q,s - State Certification or Registration#: ' •�—� / ti0 7 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ 2so Square/Linear Footage of Work: Type of Work: ❑ Addition Alteration ❑ New \b,\\0.1111iltE ,Repair/Replace ❑ Demolition Description f o M (`J ,°.ri �ll y� l ' 1 .63A j MjAQAMA* �r� �•. iw! F (r Sus ii i fi0 @tbs.i sou ,�,i,„0 3r<.•�'f Specify c o► ' Submittal Fee$ Permit Fee$ CCF if CO/CC$ -- Scanning Fee$ Radon Fee$ DBPR$ Notary$ v Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ I' TOTAL FEE NOW DUE$ ti (Revised02/24/2014) A D i / Bonding Company's Name(if applicable) A`i /I ��( �1 � p � � AJ Bonding Company's Address f 7i 50 f5 Ly City d M.i State Zip 3 1 Mortgage Lender's Name(if applicable) Mortgage Lender's Address City `� i 1 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 reinspection fee will be charged. lk Signature - Signature kgii� or AGENT rtas TRACTOR .,The foregoing instruments was acknowledged before me this � The foregoing instrumcknowledged before me this « (^- . `` of G ' '�lC� / ,20 f 4, by Jday of !%• 20 4 7 by �W who is . z personally known to Ct,yYl p �fotASiG ,who is personally known to me or who has produce as me or who has produced as identification and who did take an oath. identification who did take an oat NOTARY PUBLIC: NOTARY P BLIC: 1 \\1111111111//�/ A Sign: , e N . i 0� ,• * ' Print: F—int: Seal: J Qa�o V2al: of 08 1111 flow JW 1.101e <y, flea?'I;�k;.,�a: 1 IrnIM N�IUI�I APPROVED BY R IAU 3-2/- Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) I Permit NO. PL-3-17-742 10050 N.E.2nd Avenue NW Miami Shores Village Plumbing Type:Plubing-Residential Miami Shores,FL 33138 = � Work Ciassfcation:Addition/Alteration ..,. 'P e r -0000 � Phone: (305)795-2204 Permit Status:APPROVED FLORIDA issue Date:3/24/20117Expiration: 09/20/2017 1 F Project Address Parcel Number Applicant 45 NW 93 Street 1131010340270 r Miami Shores, FL 33150- Block: Lot: JOHN CURRY Owner Information Address Phone Cell JOHN CURRY 45 NW 93 Street (954)770-4549 MIAMI SHORES FL 33150- 45 NW 93 Street MIAMI SHORES FL 33150- Contractor(s) Phone Cell Phone Valuation: $ 250.00 AA MAGIC PLUMBING INC (305)981-8197 Total Sq Feet: 0 Type of Work:UPDATE PLUMBING LINES AND DRAINING Available Inspections: Type of Piping: LtionType:Additional Info:UPDATE PLUMBING LINES AND DRAINING Bond Return:Classification:Residential Scanning:3 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 Invoice# PL-3-17-63367 DBPR Fee $2.00 DCA Fee $2.00 03/24/2017 Cash $64.60 $50.00 Education Surcharge $0.20 03/17/2017 Credit Card $50.00 $0.00 Permit Fee $100.00 Scanning Fee $9.00 Technology Fee $0.80 Total: $114.60 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 ELECTRI AL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVI . I cerjty that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zo g F rmore,I authorize the above-named contractor to do the work stated. March 24, 2017 Authoriz d Si re:Owner Applicant / Contractor / Agent Date Buildin artment Copy March 24, 2017 1 E DATE(MM/DD/YYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 11/28/2016 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 CONTACT Mar Zuni a NAME: g Gil, Garden, Avetrani Insurance Groupa/c°NIJo (305)630-4777 FAX No;(305)279-3022 10689 N. Kendall Drive E-MAIL ig a@ gg g'tom m ADDRESS:mzun Suite 208 INSURERS AFFORDING COVERAGE NAIC# Miami FL 33176 INSURER A:Scottsdale Ins. Co. INSURED INSURER B RetailFlrst Insurance Company A.A. MAGIC PLUMBING, INC INSURERC: 11350 SW 52 TERRACE INSURER D: INSURER E: MIAMI FL 33165 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1692109144 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 POLICPOLICY NUMBER MM/DDYEFF/YYYY MMIDDIYYYY LIMITS LTR X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 Al A CLAIMS-MADE ❑X OCCUR PREM SESOEa occu RENTEante $ 100,000 MVMHR-D 2/10/2017 2/10/2018 MED EXP(Any one person) $ 5,000 PERSONAL BADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY F7JECT PRO ❑ LOC PRODUCTS-COMP/OP AGG $ 1,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON--OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAR HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION Y/N STAPER OTH- AND EMPLOYERS'LIABILITY TUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? B (Mandatory In NH) 0520-51892 9/16/2016 9/16/2017 E.L.DISEASE-EA EMPLOYE $ 100 000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) A.A Magic Plumbing Lic #: CFC1428995 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 10050 NE 2 Avenue ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores, FL 33138 AUTHORIZED REPRESENTATIVE Joe Avetrani/MARGY ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025 n014nn