Loading...
PL-17-869 Permit N0, PL-3-17-869 �eN°1S o,� Miami Shores Village Permit Type:Pluming-Residential s� tr 10050 N.E.2nd Avenue NW � ' r � Work Classification:Addition/Alteration Miami Shores, FL 33138-0000 Per nF-- ` Permit Status:APPR0 Phone: (305)795-2204 1/�Q LORTOp' tssueoate:5130/20.17 Expiration: 11/26/2017 Project Address Parcel Number Applicant 10804 NW 2 Avenue 1121360020140 Miami Shores, FL 33168- Block: Lot: ANGELA M HENAO Owner Information Address Phone Cell ANGELA M HENAO 10804 NW 2 Avenue (305)793-2495 MIAMI SHORES FL 33168- 10804 NW 2 Avenue MIAMI SHORES FL 33168- Contractor(s) Phone Cell Phone Valuation: $ 4,000.00 A&L PLUMBING SPECIALISTS LLC (954)274-8915 Total Sq Feet: 0 Type of Work:PLUMBING FOR BATHROOM RENOVATION Available Inspections: Type of Piping: Inspection Type: Additional Info:PLUMBING FOR BATHROOM RENOVATION Top Out Bond Return: Final Classification:Residential Scanning:3 Review Plumbing Underground Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $2.40 DBPR Fee Invoice# PL-3-17-63502 $2.25 03/30/2017 Check#: 129 $50.00 $119.90 DCA Fee $2.25 t Education Surcharge $0.80 05/30/2017 Check#: 1719 $ 119.90 $0.00 Permit Fee $150.00 Scanning Fee $9.00 Technology Fee $3.20 Total: $169.90 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 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. Futhermo ve-named contractor to do the work stated. '- May 30, 2017 Aut ure:Owner / Applicant / Contractor / Agent Date Building Department Copy May 30, 2017 1 ' I Miami Shores Village RECEIVED Building Department artment MAR 30 017 10050 N.E.2nd Avenue, Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 S� (F�BC 201H, (� BUILDING Master Permit No. 1�C 1 j �Iq q PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF 0 CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: I O RD t1i 2 NVQ. city: Miami Shores County: Miami Dade. Zip:. 331 6� Folio/Parcel#: . - 2136 bo-2-- 101 y-C) Is the Building Historically Designated:Yes . 1\16 Occupancy Type: Load: Construction Type: Flood Zone: ., BFE: FFE: OWNER: Name(Fee Simple Titleholder): l v v f Pt t'tl A°rD Phone#: 3dS X13 " Z�gS Address: Iy1 4 We%' - N 3Z- Ad., 20b City: 104^1' 1WCA+ State: Zip: 3313° Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: 1 t `"• ?C-UPftbNa ?Llu f ufrS Phone#: Ac1dress:J a 12— � -be City: 1"^ft State: L Zip: 3612 Clualifier Name: r•r1�ZZl^U� Q9S: bF_S Phone#: 7-g6'2S�' State Certification or Registration#: Certificate of Competency#: DESIGNER:Architect/Engineer: Al L7� 6_19A_% P• Phone#: 30E- 4IN Address: 1302 ZT 01> City: N•MA AK 1 State: _Zip: 316 Value of.Work,for.this,Permit: Square/Linear•Footage of-Work: :.`.—._ Type of)Work V9 Addition Alteration ❑ New ]❑ Repair/Replace ❑ Demolition Description oMork: 'LL DMi3] ...ns .rr•..i:r:..�J 1 r +-gra ai r14.. f: ,,9 .e,.,.,: - •1 `_w _.., 's ;.ls;i Specify color of color thru tile: Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning"Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (q ' `I n O (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 staridards 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$2500, the applicant must promise in good faith that a copy of the notice o�(commencizment and conctructian lien law hrochure-wilae-d ed-tath'e-peaoa — whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days, after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. . 1. :. a , Signature [ "� Signature OWNER or AGENT CO REACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this y day of r-r'y U 20/6 by lo day of' /J21?/ 20 C by is per y knoWn Ull/ ' . V2, Id--e,s wh ersonally n wn to me or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: ;;r> CHRISTOPHER COX NOTARY PUBLIC: ;�•:: CHRISTOPHER COX MX COMMISSION#GG011522 :t MY COMMISSION#GG011522 EXPIRES July 13,2020 y+$•. EXPIRES July 13,2020 Sign: B&LIQFlorldallola Serv4e.00m Si n: oom g 153 FloddaNdaryServke• Print: -5 144- y )L Print: �l Seal: Seal: **********************�************************************************************************************** APPROVED BY �C/ Plans Examiner Zoning' Structural Review Clerk (Revised02/24/2014) 1 A;couNT NO 2016 -2017 HILLSBOROUGH COUNTY BUSINESS TAX RECEIPT EXPIRES SEPTEMBER 30,2017 222113 RENEWAL OCC CODE 090.020001 PLUMBING CONTRACTOR I Employees Receipt Fee 18.00 Hazardous Waste Surcharge 40.00 Law Library Fee 0.00 CFC1428028 VALDES HECTOR A BUSINESS 1712 W FORE DR TAMPA. FL 33612 VALDES HECTOR A NAME A&L PLUMBING SPECIALISTS LLC MAILING 1712 W FORE DR ADDRESS TAMPA. FL 33612 Paid 15-630-026739 08/04/2016 58.00 BUSINESS TAX RECEIPT DOUG BELDEN,TAX COLLECTOR E.RFP,F--D A.-RIVILEGE TAx TO ENGACL. 813-635•5200 ra a•�=INEss PROFESSION.OR OCcuoAnON SI>LC.F.ED HEREON THIS BECOMES A TAX RECEIPT WHEN VALIDATED. �a. STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CFC1428028 ISSUED 07/13/2016 CERTIFIED PLUMBING CONTRACTOR VALDES, HECTOR ALEXANDER A&L PLUMBING SPECIALISTS LLC IS CERTIFIED under the Prov slons of Ch 4 8 9 E.uuatlor.nate AUG31 2018 a DRIVER LICENSE CLASS E '1432-321-76-' —C,,OR ALEXANDER AIDES 9712 W FORE DR TAMPA,FL 336t2-0000 we 03-31-1975 'SF+ 68=34-4019 ]MST.A nL 0 VOLE ALSO• S1Ya,n 11R�'M`hf4 w nN}tf'Y vab[.MF C'lMRIrt W� .,i4wwv laer rwqu.xQ!,c-er- ACo CERTIFICATE OF LIABILITY INSURANCE °ATE'M""°°"""' 12/06/2016 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 NAME: Automatic Data Processing Insurance Agency,Inc. AIC, o Ext): aC No): 1 Adp Boulevard ADDRIESS: Roseland,NJ 07068 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Technology Insurance Company,Inc. 42376 INSURED INSURER B: A&L PLUMBING SPECIALISTS LLC INSURER C: 1712 W FORE DR Tampa,FL 33612 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 588314 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. INR ADDLISUBIR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DDIYYYY MM/DDIIYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACHOCCURRENCE $ CLAIMS-MADE FIOCCUR _OAMAPREMISES Ea occurrence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ JECT POLICY PRO ❑ LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY MBINED IN LE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATIONX - AND EMPLOYERS'LIABILITY YIN STATUTE ER A ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBEREXCLUDED7 NIA N TWC3587650 11/27/2016 11/27/2017 (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Job Reference:EVIDENCE OF INSURANCE Contractor License:CFC#1418028 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN MIAMI SHORES VILLAGE BUILDING DEPARTMENT ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2ND AVE Miami Shores,FL 33138 AUTHORIZED REPRESENTATIVE A©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD DATE(MM/DD/YYYY) .4COR0® CERTIFICATE OF LIABILITY INSURANCE F `� 10/31/2016 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 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 certificate holder in lieu of such endorsement(s). PRODUCER CONTACT EINSURERB: Harley Gambrell Etowah Insurance Group Inc Ext): (706)204AX -8276 (AIC,No): (706)378-3489 100 East Second Ave Suite 200 MAIL ADDRESS: harley@theetowahgroup.com Rome,GA 30161 INSURER(S)AFFORDING COVERAGE NAIC# A: Metropolitan Property and Casualty Insurance Company 26298 INSURED B:A&L Plumbing Specialist,LLC C:1712 WestFore Drive D:Tampa,FL 33612 E: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 VVITH 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. LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MWDD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 AUL'UCLAIMS-MADE 7 OCCUR PREMISES(Ea occurrence) $ 50,000 MED EXP(Any one person) $ 5,000 A BP005302P2016 08/06/2016 08/06/2017 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY O JE C LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ ------------------------ AUTOMOBILE LIABILITY (Ea accident)) $ ------------------------ ANY AUTO BODILY INJURY(Per person) $ ________________________ OWNED SCHEDULED ) AUTOS ONLY AUTOS BODILY INJURY(Per accident $ _______________________ HIRED NON-OWNED AUTOS ONLY AUTOS ONLY (Per accident) $ ------------------------ $ ----------------------- UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ ----------------------- EXCESS LIAB CLAIMS-MADE AGGREGATE $ ------------------------ DED RETENTION$ $ ________________________ ORKERS COMPENSATION ND EMPLOYERS'LIABILITY STATUTE ER Y/N NY PROPRIETOR/PARTNER/EXECUTIVE FFICER/MEMBER EXCLUDED? El N/A E.L.EACH ACCIDENT $ ----------------------- Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ f yes,describe under E.L.DISEASE-POLICY LIMIT $ - ESCRIPTION OF OPERATIONS below _______________________. ------------------------ ------------------------ ------------------------ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached IF more space is required) CFC#1428028 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Miami Shores Village Building Dept. ACCORDANCE WITH THE POLICY PROVISIONS. 10050 Northeast 2nd Ave AUTHORIZED REPRESENTATIVE Miami Shores,FL 33138 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD