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PL-18-786Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Permit Permit NO. PL-3-18-786 Permit Type: Plumbing - Residential Work Classification: Addition/Alteration Permit Status: APPROVED issue Date: 4/2/2018 Expiration: 09/29/2018 Parcel Number Applicant 1070 NE 93 Street Miami Shores, FL 33138-2932 1132050160010 Block: Lot: ALFONSO DEL CASTILLO Owner Information Address 1051 NE 92 Street MIAMI SHORES FL 33138- 1051 NE 92 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone REGOSA ENGINEERING SERVICES Its (786)262-2964 (786)344-8720 Phone Valuation: Total Sq Feet: Cell $ 4,000.00 0 Type of Work: NEW BATHROOM FOR CABANA Type of Piping: Additional Info: Bond Return : Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Amount $2.40 $3.38 $2.25 $0.80 $225.00 $3.00 $3.20 Total: $240.03 Pay Date Pay Type Amt Paid Amt Due Invoice # PL-3-18-66932 04/02/2018 Credit Card $ 190.03 $ 50.00 03/27/2018 Credit Card $ 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 r-sponsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL P U / BING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: .- •i� that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zonin • . ' 'ermore, I authorize the above -named contractor to do the work stated. • April 02, 2018 Authoriz=;a• ure: Owner / Applicant / Contractor / Agent Date Buildin - e'• artment Copy April 02, 2018 1 Scanning Fee $ 3 -00 Technology Fee $ Training/Education Fee $ 0 - O/, Structural Reviews $ ❑ Repair/Replace ❑ Demolition Address: BUILDING PERMIT APPLICATION 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 BY. c 7 D �R272018 i j FBC20(1 Master Permit No96-5-fl - 12. Sub Permit No. BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL ILUMBING MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 1010 NE a3 ST City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 44 320 50160o 10 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): AL.FOIVSO DEL C,AST1 L.L.O Phone#: 837 3q D W74/ Address: 1070 NE 013 s-r City: MIA MI SHORES State: ?L. Zip: 33138 Tenant/Lessee Name: Phone#: Email: O.GA,Sh Sekureo nth CONTRACTOR: Company Name:EC-ADSA S UI CE-c •i ►' Phone#: `11 (0) 2G2. 2 (0 1 15406 A-0 City: IA l IV\-% ii State: T--LO (t ,t O 4 zip: 3 31 62 - Qualifier Name: el V' 4 CVO 'J E-\ � 1 Q Phone#0- p(O 262 Z� (04{ State Certification or Registration #: C C ILI- , — , 2-�Z Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value ofilVork tag Peril (WOO `tWOO Square/Linear Footage of Work: Typeype o f.Wock:❑ Addition lt Alteration ❑ New ,Description of Work: IOW (t eik CC) r r.2_.b Speafy T color of color t►iru tile: r..,. Submittal Fee $ w CPermit Fee $ iil CCF $ 0 • CO/CC $ Radon Fee $ D OG DBPR $ S • Sce 9:9; Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE$ i l 0 -3 (Revised02/24/2014) « Sign: I4YNy Print: 't-ttk.ii'e) Seal: APPROVED BY I " Bonding Cdrnpany'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 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. " .; ? j4 "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 YOURNOTICE`OF,COMMENCEMENT. •.� �, ..:.; Notice to Applicant: As a condition to the issuance of a building permit with an estimated value'exceeding promise in good faith''that a copy of the notice of commencement and construction lien law brochureill whose propeFfy is'subject to attachment. Also, a certified copy of the recorded notice of commencement for the first inspection which occurs seven (7) days after the building permit is issued. In the absent inspection will not be approved and a reinspection fee will be charged. Signature The foregoing instrument was acknowledged before me this 2.I day of rviARCJ-r , 20 Ip , by Arm() b J Cash II o , who is personally known to me or who has produced.I©1 t ri Lye/rice, as identification and who did take an oath. Signature CTOR The foregoing instrumacknowledged before me this ?Co day of I ' 20 to, by CjU -IX•Y Volt - , who is personally known to me or who has produced as identification and who did take an oath. •$2500, the applicant must be delivered to. the person b posted at the job site uch posted notice, the NOTARY PUBLIC: NOT • ' PUBLIC: Sig �, Pri � Natalie King State of Florida My Commission Expires 12116,20tal: Commission No. FF 944254 Vir Plans Examiner EDGAR SOSA �41 Cotamissipn A GG 098329 1�-ri& eicr;? My Comm. Expires May 4,2021 t ! .,,, gdndedthrough National Notary Assn. ***************************************** Zoning Structural Review Clerk (Revised02/24/2014) STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 VELEZ, GUSTAVO DANIEL REGOSA ENGINEERING SERVICES INC 15700 NE 2 AVENUE MIAMI FL 33162 RICK SCOTT, GOVERNOR LICENSE NUMBER k"* dr CFC1427292 ie• rov 010015 Local Business Tax Receipt Miami —Dade County, State of Florida -THIS IS NOT A BILL - DO'NOT PAY 5996336 BUSINESS NAME/LOCATION REGOSA ENGINEERING SERVICES INC 15700NE2AVE MIAMI FL 33162 RECEIPT NO. RENEWAL 6256317 LBT: OWNER SEC. TYPE OF BUSINESS REGOSA ENGINEERING SERVICES INC 196 PLUMBING CONTRACTOR CFC1427292 Worker(s) 1 EXPIRES SEPTEMBER 30, 2018 Must be displayed at place of business Pursuant to County Code Chapter 8A — Art. 9 & 10 PAYMENT RECEIVED BY TAX COLLECTOR S75.00 07/11/2017 FPPU02-17-018782 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Roceipt is not a license, permit, or a certification of the holder's qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT NO. above must be displayed on all commercial vehicles - Miami -Dads Code Sec 8a-276. For more information, visit www.miamidade.govltaxcollector DETACH HERE KEN LAWSON, SECRETARY STATE OF FLORIDA OF. DEPARTMENT BUSINESS AND PROFESSIONAL REGULATION, CONSTRUCTION INDUSTRY LICENSING BOARD .: ThePLUMBING .CONTRACTOR Named below '„._.. IS -CERTIFIED , Ulider tl isions`of Chapter'489 FS: ".. P Expiration date`-AUG'31r2018 A VELEZ GUSTAVO DANIEL , •`�. "'` y:�, �"`"`a° ‘;Ns 'REGOSAxENGINEERING;SERVICES INC * ;15700°NE-2°AVENU1.E. ,,. � + �* - _ SUITE.9,..e.` MIAMI --"`-FL-?3162 „:' �` - ...,,.- "N'*\ ,. �a.,. M "*1'�M� 14 ISSUED: 06/01/2016 DISPLAY AS REQUIRED BY LAW SEQ # 11606010001562 ACORU® �� CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD TYYY) 0 18 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. CONFERS NO RIGHTS UPON THE CERTIFICATE OR ALTER THE COVERAGE AFFORDED BY THE HOLDER. THIS POLICIES AUTHORIZED A CONTRACT BETWEEN THE ISSUING INSURER(S), 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 Finney Insurance Corporation 5601 Sheridan Street Hollywood, FL 33021 NAME CT ismary Cardoso FAX jaC,NNo. Eat): 954-966-5533 (AICJNo): 954-989-8208 E-MAIL ADDRESS: johnf@finneylnsurancecorp.com INSURER(S) AFFORDING COVERAGE NAICi INSURER A: Kinsale Insurance Company INSURED Regosa Engineering Services Inc. 15700 NE 2 Ave Miami, FL 33162 INSURER B : Progressive American Insurance Company INSURER C : Evanston Insurance Company INSURER D : Lloyds of London INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 00000000-1454587 REVISION NUMBER: 225 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MDDryYYY► POLICY EXP (MWDD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY 0100047660-1 02/18/2018 02/18/2019 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR MAGE TO RENTED PREMSES(Ea occ rr nce) $ 100,000 MED EXP (Any one person) $ Excluded PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES JPER �( PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE X LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY X X SCHEDULED AUTOS NON-0WNED AUTOS ONLY 01673815-3 06/13/2017 06/13/2018 COaccBIKED SINGLE LIMIT $ 1.000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ C _ X UMBRELLA LIAR EXCESS LIAR X OCCUR CLAIMS -MADE EZXS1017139 02/18/2018 02/18/2019 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' UABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, descibe under DESCRIPTION OPERATIONS below N/ A PER STATUTE OTH- ER El. EACH ACCIDENT $ E.L. DISEASE- EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ D Professional Liabili 17206886A 09/22/2017 09/22/2018 1,000,000 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached H more space is required) General Contractor, Plumbing Contractor, Mechanical Contractor & Roofing Contractor Insurance. CERTIFICATE HOLDER CANCELLATION Miami Shores Village Building Department 10050 NE 2 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. AUTHORQE REPRESENTI11. (INC) ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Printed by IHC on March 06, 2018 at 12:40PM Aco EP CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 01-19-2018 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 FINNEY INS CORPORATION 5601 SHERIDAN STREET HOLLYWOOD, FL 33021 • CONTACT NAME: PHONE IFAX (A/C, No, Ext): (A/C, No): DDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : FLORIDA W.C. JUA INSURED REGOSA ENGINEERING SERVICES INC 15700 NE 2ND AVE MIAMI, FL 33162 INSURER B : INSURER C: INSURER D : INSURER E : INSURER F : COVERAGES • • 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS C COMMERCIAL GENERAL (CLAIMS -MADE LIABILITY OCCUR EACH OCCURRENCE $ DAMAGE TORENTED$ PREMISES occurrence) MED EXP (My one person) $ PERSONAL & ADV INJURY $ GENL AGGREGATE POLICY OTHER: LIMIT APPLIES PRO- JECT PER: LOC GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO OWNED _ SCHEDULED AUTOS NON -OWNED AUTOS ONLY CC (EOa aBINED SINGLE LIMIT $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ p pAMAGE OPER (f er accidTYent) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENTION $ S COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER! EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y/ N y N / A 6FR13UB 7H755001 10-02-2017 10-02-2018 I STATUTE I I ERH E.L. EACH ACCIDENT $ $1,000,000 E.L. DISEASE - EA EMPLOYEE $$1,000,000 E.L. DISEASE - POLICY LIMIT $ $1 ,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarl6 Schedule, may be attached If more space is required) GENERAL CONTRACTOR, PLUMBING CONTRACTOR, MECHANICAL CONTRACTOR, ROOFING CONTRACTOR CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE BUILDING DEPT. 10050 NE 2ND AVE 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 ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All: rights reserved The ACORD name and logo are registered marks of ACORD