Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
PL-18-473
Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000' Phone: (305)795-2204 Project Address Perini t Permit NO. PL-2-18-473 Permit Type: Plumbing - Residential Work Classification: Addition/Alteration Permit Status: APPROVED Issue ate 5/8/2018 Expiration: 11/04/2018 Parcel Number Applicant 144 NE 99 Street Miami Shores, FL 33138- 1132060132260 Block: Lot: ANDINO LIBERTAD HOMES LLC Owner Information Address Phone Cell ANDINO LIBERTAD HOMES LLC 144 NE 99 Street MIAMI SHORES FL 33138- (305)989-7870 144 NE 99 Street MIAMI SHORES FL 33138- Contractor(s) M&C CONTRACTORS Phone (305)992-7443 Cell Phone Valuation: Total Sq Feet: $ 1,500.00 0 Type of Work: REPLACE BATHROOM TOILETS , VANITIES Type of Piping: Additional Info: REPLACE BATHROOM TOILETS , VANITIES Bond Return : Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $1.20 $2.25 $2.00 $0.40 $150.00 $3.00 $1.60 $160.45 Pay Date Pay Type Invoice # PL-2-18-66558 05/08/2018 Credit Card 02/23/2018 Credit Card Amt Paid Amt Due $ 110.45 $ 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. Futhermore, I authorize th above -named con ractor to dot k stated. AuthorizedJignature: Owner / Applicant / Contractor / Agent May 08, 2018 Date Building Department Copy May 08, 2018 1 BUILDING PERMIT APPLICATION gi BUILDING 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 IRE FEB 23 2018 BY: FBC 20 IL Master Permit No. PAC —18 — 225 Sub Permit No. ILL- 2-- a_ 4:3 ECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ®PLUMBING ❑ MECHANICAL ❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 1 Li4 M11 clqiv jT2-1 EiT City: Miami Shores County: Miami Dade Zip: 3 31 3'S Folio/Parcel#: VI- "2.06 ~ 013- 2260 Is the Building Historically Designated: Yes NO )° Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): 41 G b-eitalf9 y S (LC Address: i "[ 4 N E City: ic. Y &\0,r eS State: Phone#: 30S9 t3(19-131-0 Tenant/Lessee Name: Phone#: Email: -a-kiaJLtil6 eho{ rnq :l . c CONTRACTOR: Company/Name: )J4!C. CoLLfiielC-0�S Phone#: Address: naT) l I 6siPCA ? Cic-- City: Wo, prA; Z�-- State: "�, � Zip: V.i`� Qualifier Name: G( YYl®,vl QAi i 5 tt M .Z Phone#: State Certification or Registration #: Cam. t 42Qo&"t Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ Al 60-- Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration Description of Work: P_Q004- Q - ikk) - U3(% I h(TVLCO Juo;ocieS ‘ r-e(Ac -�o� �-e{S `�cta in( flo S • N\o.5 t 1 . Q- \ Zip: 3 JS. .\E ❑ New ® Repair/Replace ❑ Demolition Specify color of color thru tile: 41 Q Submittal Fee $ 30 PC( id Permit Fee $ ( tj 6 CCF $ -1 CO/CC $ Scanning Fee $ Radon Fee $ 2 - Cc, DBPR $ oL aG Notary Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ t' TOTAL FEE NOW DUE $ f 1 i0 • (Revised02/24/2014) Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mbrtgage 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. "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. Signature......_ `'tom Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before ma this k2 day of -( , 20 \ Q" , by day of ��vl.f , 20 1 �j , by Ml4ylaS 19CN tni(+ I , who is personally known to! Me+v1 i f kg C�w`tro is personally known to me or who has produced as me or who has produced identification and who did take an oath. NOTARY PUBLIC: The foregoing instrument was acknowledged before me this identification and who did take an oath. NOTARY PUBLIC: Sign: — t Sign: Print: .... _ Print: Seal: * �� Seal: 2°`PaY ue(,o NADIAAI,EI NDRASUBIRATSCRRRERA MY COMMISSION # FF 912061 APPROVED BY TA1AMA INEL MEAN f MY COMMISSION f FF 169001 EXPIRES: October 15, 2018 " Bonded Thru 8udget Nary Servias Plans Examiner Structural Review EXPIRES: August 2, 2019 Bonded Thru Budget Notary Services as Zoning Clerk (Revised02/24/2014) L..tJt t.,ovc.ruNurs Ntr4U-111VJVINI, amk....rcm I !AM Y STATE OF FLORIDA. LICENSE NUMBER CFC1426809 , DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD • ?"4:1-7 The PLUM13ING CONTRACTOR- ,..N...,- : Named below,1S,,CERTIFIED 'Underthe-, provisions of C haOfet."489 FS.... I ' -Expiration dat&-AUG 31-2018. , .. - , -- „, .,,,,,.„„._ ,.. 1 7, __.,900ARTHUR,GODEREYr 1(6AD**!—SLI — •r_ , ' N178. CCONTRACTORS.--4" ,'"-*-'-- --•,':---"MIAMI:BEACH FQ3314`0-4---%-ttrEr"'":7-----":"":7--.-17.7.7„--- i''' /1-- .----... --2.---;;;:.---z.e.r.... ...".-#,---:-...t:-Jr:..4„.- •' - — / / - - ' •- ,,,,- --;.,------- t'' .404-k---- -4-, "*.-77'''''.• .'"4:. ._-'7 , '":::(1":',""-"<"':;f''''.:'; 4‘;':**,.,4:''''r(r.V"'t ' ''' ''''''''''' t ''i: , . ---$ -0- '',,,,• . .., !,4; N: 7‘ ISSUED: 06/12/2016 DISPLAY AS REQUIREDBY \L' \\:t SEO # L1606120001253 009331 r Local Business Tax Receipt Miami -Dade CoCounty,,,St to of Florida -THIS IS NOT A SILL - 00`.NOT PAY 5669941 ,&3UtSINE5S NiAMEII:OCATIiiat M &',C CONTRACTORS 96041 `ST.#304• MIAMI"BEACH fL 33140 RECEIPT NO. RENEWAL 5914008 SEC. TYPE OP BUSINESS MANAGEMENT & CONSULTING INC 196 PLUMBING CONTRACTOR - "CEC14268ti9 t Workers) 1 EXPIRES SEPTEMBER 30, 2018 I Must_be displayed at place ,of business Pursuant to County Code Cyrzpfer 8A - Art. 9 &': 10 ,r. This or ns k � usirtpast.Tekt Aecsipt col y confirms Paymetd of the toast Business Tax. The Receipt 13 not a license, nertificatianafthe holdars nalificatioas.Isfnbusiness. ,lioidarmust comply with arty gave merttel eaual regaIatoty latitre enrepuiramante which apply to Eta business. PT NO, above mast be displayed on all commercial vehicles - Miemt-Dade Cade Sec da-276. for Mara information visit I xaiiemIdatI010611xcollgE101 PAYMENT RECEIVED BY TAX COLLECTOR S45.O0 07/11/20 7. CHECK21-17-058977 -`` L'® CERTIFICATE OF LIABILITY INSURANCE DA01/25/18 PRODUCER Florida Bankers Insurance 6874 SW 8 ST Miami, FL 33144 Phone (305) 266-6493 Fax (305) 262-0679 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED MANAGEMENT & CONSULTING INC D/B/A M&C CONTRACTORS 960 ARTHUR GODFREY RD. STE. 304 MIAMI BEACH, FL. 33140 INSURER A: EVANSTON INSURANCE COMPANY INSURER B: EVASTON INSURANCE COMPANY INSURER C: • INSURER D: INSURER E: COVERAGES INSURER F: THE POLICIES OF INSURANCE LISTED 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR ADD'L INSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXPIRATION DATE (MM/DD/YY) LIMITS A GENERAL n ME ... LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE m OCCUR 3C07429 04/19/17 04/19/18 EACH OCCURRENCE 1,000,000.00 DAMAGE TO RENTED PREMISES (Ea occurence) 1 00 000.00 MED EXP (Any one person) 5,000.00 PERSONAL & ADV INJURY 1,000,000.00 GENERAL AGGREGATE 2,000,000.00 PRODUCTS - COMP/OP AGG 2,000,000.00 GEN'L n AGGREGATE POLICY LIMIT APPLIES a PROJECT PER: LOC B AUTOMOBILE M NI • 111 NI III LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) BODILY (Per person) INJURY BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) • • GARAGE • LIABILITY ANY AUTO AUTO ONLY- EA ACCIDENT OTHER THAN EA ACC AUTO ONLY: AGG EXCESS/UMBRELLA • • OCCUR DEDUCTIBLE RETENTION LIABILITY • CLAIMS MADE $ EACH OCCURRENCE AGGREGATE WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER / MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below Ill WC STATU- Ill OTH- TORY LIMITS ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT B OTHER INLAND MARINE IMS38982 07/13/17 07/13/18 MAX. ANY ONE ITEM $100,000.00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS LIC # CFC1426809 CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2nd AVE MIAMI SHORES, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE x e ACORD 25 (2001/08) QF © ACORD CORPORATION 1988 CERTIFICATE OF LIABILITY INSURANCE Date I 12/14/2017 Producer: Plymouth Insurance Agency 2739 U.S. Highway 19 N. Holiday, FL 34691 (727) 938-5562 This Certificate is issued as a matter of information only and confers no rights upon the Certificate Holder. This Certificate does not amend, extend or alter the coverage afforded by the policies below. Insurers Affording Coverage NAIC # Insured: South East Personnel Leasing, Inc. & Subsidiaries 2739 U.S. Highway 19 N. Holiday, FL 34691 Insurer A: Lion Insurance Company 11075 Insurer B: Insurer C: Insurer D: Insurer E: Coverages 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. Aggregate limits shown may have been reduced by paid claims. INSR LTR ADDL INSRD Type of Insurance yp Policy Number Y Policy Effective Date (MM/DDM') Policy Expiration Date (MM/DD/YY) Limits GENERAL ]: LIABILITY Commercial General Liability Claims Made Occur ... Each Occurrence $ Damage to rented premises (EA occurrence) $ Med Exp $ Personal Adv Injury $ General DPolicy aggregate limit applies per: ❑ Project ❑ LOC General Aggregate $ Products - Comp/Op Agg $ AUTOMOBILE LIABILITY Any Auto All Owned Autos Scheduled Autos Hired Autos Non -Owned Autos Combined Single Limit (EA Accident) $ Bodily Injury (Per Person) $ Bodily Injury (Per Accident) $ Property Damage (Per Accident) $ EXCESS/UMBRELLA LIABILITY Occur ❑ Claims Made Deductible Each Occurrence Aggregate A Workers Compensation and Employers' Liability Any proprietor/partner/executive officer/member excluded? NO If Yes, describe under special provisions below. WC 71949 01/01/2018 01/01/2019 xl WC Statu- 1 tory Limits I I OTH- ER E.L. Each Accident $1,000,000 E.L. Disease - Ea Employee $1,000,000 E.L. Disease - Policy Limits $1,000,000 Other Lion Insurance Company is A.M. Best Company rated A (Excellent). AMB # 12616 Descriptions of Operations/LocationsNehicles/Exclusions added by Endorsement/Special Provisions: Client ID: 92-68-800 Coverage only applies to active employee(s) of South East Personnel Leasing, Inc. & Subsidiaries that are leased to the following "Client Company": Management & Consulting, Inc. dba M & C Contractors Coverage only applies to injuries incurred by South East Personnel Leasing, Inc. & Subsidiaries active employee(sj, while working in: FL. Coverage does not apply to statutory employee(s) or independent contractor(s) of the Client Company or any other entity. A list of the active employee(s) leased to the Client Company can be obtained by faxing a request to (727) 937-2138 or by calling (727) 938-5562. Project Name: GERMAN ALEXIS PREVISDOMINI LICENSE NUMBERS CGC1504760, CFC1426809, CAC1815162 AS QUALIFIER. ISSUE 07-01-15 (AF) Begin Date: 9/22/2014 CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE BUILDING DEPARTMENT 10050 NE 2ND AVE. MIAMI SHORES, FL 33138 Should any of the above described policies be cancelled before the expiration date thereof, the issuing insurer will endeavor to mail 30 days written notice to the certificate holder named to the left, but failure to do so shall impose no obligation or liability of any kind upon the insurer, its agents or representatives. wiwpip CONTRACTORS Date: 02/21/2018 State of: Florida County of: Miami -Dade Before me this day personally appeared German Previsdomini who, being duly sworn, deposes and says: That he or she will be the only person working on this project located at: 144 NE 99th Street, Miami Shores, FL 33138 Con actor Signature Sworn to (or affirmed) and subscribed before me this day of r oaVd , 20 g . By eryvy\Q (\ .Tl Q v SCkfr11 n; Personally Know Or Produced Identification Type of Identification Produced -o`;*:t-::°A�. NADIAAIEJANDRASU&RAT CARRERA * MY COMMISSION # FF 912061 EXPIRES: August 2, 2019 yFOF voe9 Bonded Thru Budget Notary Services Pri , Type or Stamp Name of Notary M&C Contractors. OX1504760. CR1426809 - (A0815162 960 Arthur Godfrey, Suite 304 I Miami Beach, FL 33140 O. 305.763.8166I F. 305.531.4440