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PL-18-212Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Parcel Number It Permit NO. PL-1-18-212 Permit Type: Numbing - Residential rk Classification: AdditionlAiteration Permit Status: APPROVED Issue Date: 2/13/2018 Expiration: 08/12/2018 Applicant 89 NE 109 Street Miami Shores, FL 33161-7039 1121360040550 Block: Lot: JAGRUTI & HEMENDRA PATEL Owner Information Address Phone Cell JAGRUTI & HEMENDRA PATEL 89 NE 109 Street MIAMI SHORES FL 33161-7039 89 NE 109 Street MIAMI SHORES FL 33161-7039 Contractor(s) DR PIPE Phone Cell Phone (305)262-6886 (786)222-1568 Valuation: Total Sq Feet: $ 4,000.00 0 Type of Work: REMODELING KITCHEN LAUNDRY AND TWO Type of Piping: Additional Info: REMODELING KITCHEN LAUNDRY AND TWO Bond Return : Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $2.40 $2.25 $2.00 $0.80 $150.00 $3.00 $3.20 $163.65 Pay Date Pay Type Invoice # PL-1-18-66251 02/13/2018 Cash 01/26/2018 Cash Amt Paid Amt Due $ 113.65 $ 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 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. FuthermorI authorize the above -named contractor to do the work stated. Authle(ia6d Signature: O n'er / Applicant / Contractor / Agent February 13, 2018 Date Building Department Copy February 13, 2018 1 j Erie 22 2018 10:44AM Fax HP 3052626886 pag, 4 RICK SCOTT, GOVERNOR LICENSE NUMBER KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD The PLUMBING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2018 INFANTE, YULIESKY DR PIPE 7458 NW 8 ST MIAMI -FL ISSUED: Ene 22 2018 10:45AM Fax HP 3052626886 • pag. 5 0013624 Local Business Tax Receipt Miami -Dade County, State of Florida THIS IS NOT A BILL - DO NOT PAY 6981311 BUSINESS NAME/LOCATION DR PIPE PLUMBING CONTRACTOR INC 7458NW8ST MIAMI FL 33126 RECEIPT NO. RENEWAL 7258989 TLBT, EXPIRES SEPTEMBER 30, 2018 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS DR PIPE PLUMBING CONTRACTOR INC- .196 PLUMBING CONTRACTOR .... PAYMENT RECEIVED C/O OSKY INFANTE.... - . ..CFC1428603' BY TAX COLLECTOR E75.00 07/06/2017 CREDITCARD-17-044199 This Laud Business Tax Receipt Daly octanes payment of lba Local Business Tax. The Receipt Is not linens, panalLeraaarNficaionofthe hddersaNMicatlemtodolmans. holder must cateptywhitaaygerarnnrwttel or nonpevarnmeabrl regularity laws and requirements which apply to the beams. The RECEIPT NO. above ream he displayed on all comsrsrcial vehicles - Mlami-Dads Cods Sec U.-21 . For more Information, visit www.miamidede aovhexcallactar Jan 22 18 11:08a Agustin Edil-las 305-351-8461 p.1 CERTIFICATE OF LIABILITY INSURANCE DATE (MMIOOJYYYYI THJS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CgRTIFICATE 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 pollcy(les) must have ADDITIONAL INSURED provisions or be endorsed If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certAln policies may require an endorsement. A statement on Toils certificate does not confer rights to the certificate holder In Ileu of such endorsement(s). PRODUCER -- General Insurance Group Corp. 10350 SW 64th St. Miami, FL 33173 Phone (786)280-4113 Fax (305)351-8461 INSURED Dr.Pipe Plumbing Contractors,lnc., d/b/a Dr. Pipe 15602 5W 63rd Ter Miami FL 33193- 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 PEitIOD 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. ILT NSR ADDL.SQ R POLICY EFF POLicY EXP JINSR,yyyp POLICY NUMBER „ jMM?ODJYYYY) I MM:DotYYYY) LIMITS CONTACT Agustin Eafil-las PHONE lA1NAME; C. NO_ p<;, (78[1)260-4113 E-MAIL DDItL'S5: Ngtist1ngenlne,not 4 1 FAX Naj (305)351-8481 INSURERS) AFFORDING COVERAGE NA IC# INSURER A. CAPITOLSPECIALTY INSURANCE COMPANY 10328 INSURER 6: ASSOCIATED INDUSTRIES INS. COMPANY,'IN 25372 INSURER C _INSURER D INSURER E : INSURER F: A TYPE ar INSURANCE COMMERCIAL GGNERALLIABILrry ❑ CLAIMS -MADE INd OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: ❑ POUDY ❑ JECT PRO- D LOC �] OTHER AUTOMOBILE LIABILITY ❑ ANY AUTO 01MVED 1 AU" SONLY ❑ HIRED ❑ AUTOS ONLY u ❑SO-ImULED AUTOS NON -OWNED AUTOS ONLY ❑ UMBRELLA LJAB ITI OCCUR 0I. II EXCESSLJAB ❑ CLAIMS -MADE _- DEC I I RETENTIONS WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY ii B OVFICER OL l MB EXCLUDSo7 v N I A (Mandatory In NHI 1Tye0. descrks under DESCRIPTION OF OPERATIONS below CS17001978-01 AVVC1084733 03/15/2017 03/15/2018 _EACH OCCURRENCE DAMAGE" O RENTED PREMISES (es occurrence MED DCP (My ann person PERSONAL & ADV I GFNFNAL AGGREGATE PRODUCTS - COMP/OP AGG INJURY COMWNED SINGLE LIr.11I _.{Ca accident) BODILY INJURY (Pnr person) BODILY INJURY (Per accident) PROPERTY DAwAGE 06/25/2017 08/25/201 B DESCRIPTION OF OPERATIONS I LOCATIONsI 'Iumbing Contractor VEHICLES (Attach ACORD 1bt, Additional Remarks Sehodulo, q moro space Is rogWrrd) .loense # CEC 1428603 CERTIFICATE HOLDER Miami Shores Village Building Department 10050 NE 2 Avenue Miami Shores, FL 33138 1C0RD 25 (2016/03) QF CANCELLATION PAGH OCCURRENCE AGGREGATE f 500,00D,00 3 100,000.00 $ 5,000.00 $ 500,000.00 s 1,000,000.00 _ 1 1,000,000.00 1 s S STATUE ❑ o?H- E.L. EACH ACCIDENT EL DISEASE - EA EMPLOYE t. L. DISEASE . PO LILY U MIT a 1,000,000,00 s 1,000,000.00 s 1,000,000,00 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 REPREBENTArryE ll I 1988•2016 ACORD CORPORATION. Alf rights reserved. The ACORO name and logo are registered marks of ACORD Miami Shores Village RECEIVED `� Building AN 2 61018 Department ` ��3 p � 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 ^ ' f �• Tel: (305) 795-2204 Fax: (305) 756-8972 (�� I INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 2014 g}`' BUILDING Master Permit No. Fl>c 1(j—Z8°(8 PERMIT APPLICATION Sub Permit No. �I, `8j— 217 ❑BUILDING ❑ ELECTRIC ❑ ROOFING. ❑ REVISION ❑ EXTENSION ❑RENEWAL ['PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 89 NE 109 St City: Miami Shores County: Miami Dade Zip: 33161 Folio/Parcel#: 11-2136-004-0550 Is the Building Historically Designated: Yes NO 'X. Occupancy Type: Resident Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): HEMENDRA PATEL & JAGRUTI PATEL phone#: 305-281-6559 Address:89 NE 109 St City: Miami Shores State: Florida Zip: 33161 Tenant/Lessee Name: N/A Phone#: 305-281-6559 Email: dpate029@gmail.com Address: ��-7 S/S S A%Ll-/ e S-' /'- City: 4.4-7,/,' State: f—G Zip: 33193 CONTRACTOR: Company Name: ✓ P 7�v m�� 6n ✓4�y/ phone#: 786 Z Z Z /5 6 0 Qualifier Name: y(//e 5 /4 2Z G "1 %G State Certification or Registration #: e• i�C /VZ 8 a O 3 Certificate of Competency #: , DESIGNER: Architect/Engineer: Phone#: Address: City: State. Zip: Square/linear Footage of Work: Type of Work: ❑ Addition Alteration ❑ New /❑ Repair/Replace Description of Work: . /Z� �,v `/�� is -7 ,4 ' --2� �.t, �iGv rtZs' G tom, ‘G.7hyOT tvv, r.�r%_ r;rC�yc S. / Value of Work for this Permit: $ O6'0' `74) 116/ Phone#: 7g6 '1-'2i 2 .0 9 ❑ Demolition ...4 Specify color of color thru tile:. -,:. •: •. " F" /7 ,-.tF�?'' .rc t Submittal Fee $ Permit Fee'$ CCF $ • -..,, rr, CO/CC $ Radon Fee $ 2- C.A. DBPR $ 2 ZS Notary $ Double Fee $ Scanning Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ 113 • Gc (Revised02/24/2014) Bonding Company's Name (if applicable) N/A I tt, ti„ N/A Bonding Company's Address I ry City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City , ' 9� 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 wills 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 apprnved.and a reinspection fee will be, charged..,;; _ Signature OWNER or AGENT The foregoing instrument was acknowledged before me this 7 idol — day of ri/✓/,/ri/' , 20 / O , by /.io/t,(e d ti r/� ,.Z(�'(�/f ho is personally known to n A �/ � me or who has produced ',o-foil/4 /,/ /cX.IGW s identification and who did take an oath. NOTARY PUBLIC: Sign: Print/ /-4f /e yA .V oRy Dawn Marie Leighton NOTARY PUBLIC STATE OF FLORIDA • ' = Comm# GG110341 Seal: APPROVED BY 601 a Signature — ✓ CONTRACTOR The foregoing instrument was acknowledged before me this Pi day of AA.I(/G/' , 20 / 8 , by /,5S/e '7,//,. who is personally known to me or who has produced /-,3d/r/ei/j/ A'✓/dai as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: ce/,(/QI"end �� Mho/fit! Seal:Q :. • NOTARY PUBLIC STATE OF FLORIDA Plans Examiner Structural Review Comm* GG110341 E 19��' Expires 5/31/2021 ********************************************* Zoning Clerk (Revised02/24/2014)