Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
PL-15-2922
Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Permit Permit; N©. PL-11-15-2922 Permit Type: Plumbing -Residential Work Class cation: Addition/Alteration Permit Status: APPROVED Issue Date 12/4/2015 Expiration: 06/01/2016 Parcel Number Applicant 1050 NE 107 Street Miami Shores, FL 33161-7374 1122320280520 Block: Lot: GABRIEL MARTIN KUSKUNOV t4 Owner Information Address Phone Cell GABRIEL MARTIN KUSKUNOV 1050 NE 107 Street MIAMI SHORES FL 33161-7374 1050 NE 107 Street MIAMI SHORES FL 33161-7374 Contractor(s) D&D PLUMBING CORP Phone (305)979-0516 Type of Work: ROUGH AND SET 3 SHOWERS 3 TOILETS 6 Type of Piping: Additional Info: Bond Return : Classification: Residential CeII Phone Scanning: 3 U CANCE Valuation: Total Sq Feet: $ 13,300.00 00 ti Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning'Fee Technolo y Fee Total: = Amount $8.40 $6.99 $6.99 $2.80 $466.00 $9.00 $11.20 $511.38 C=7 Pay Date Pa g Ti C t" Amt Paid Amt Due Invoice # PL-11-15-57815 12/04/2015 Check #: 567 $ 511.38 $ 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 :tJijs permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required fq-ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. r.. 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 the above -named contractor to do the work stated. x, December 04, 2015 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy December 04, 2015 1 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 BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC ❑ ROOFING ■❑PLUMBING ❑ MECHANICAL JOB ADDRESS: 1050 NE 107 Street FBC 2017Xh.- Master Permit No. (2L 1 S t Z10 7, Sub Permit NoPJJ ' aq4.9A., ❑ REVISION ❑ EXTENSION ❑ RENEWAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION SHOP CONTRACTOR DRAWINGS City: Miami Shores County: Miami Dade Folio/Parcel#: Is th u '`{1Hig a y nated: Yes NO Occupancy Type: Load: Construction Type:1 (Fliopdi&gk BFE: FFE: OWNER: Name (Fee Simple Titleholder): Gabriel Kuskunov 'Phone#: Address: 1050 NE 107 Street City: Miami State: FI Zip: 33/6 (wc) y= �•� r Zip: g3 1 v Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: D & D Plumbing Address: 3145 SW 19 Street Phone#: 305-979-0516 City: Miami State: FI Zip: 33145 Qualifier Name: David Diaz r State Certification or Registration #: C CFC1426173 ti5 ,j i.,l ert f4cat'elof Competency #: DESIGNER: Architect/Engineer: Phone#: Address: Zip: Phone#: 305-979-0516 Value of Work for this Permit: $ Type of Work: ❑ Addition Description of Work: Rough and City: State: Square/Linear Footage of Work: • Alteration ❑ New ❑ Repair/Replace ❑ Demolition set 3 showers, 3 toilets, 6 lavatories, 1 sink, 1 dishwasher, 1 garbage disposal and 1 water heater Specify color of color thru tile: Submittal Fee $ , 76 L..'Y CCF $ CO/CC $ Scanning Fee $ DBPR $ Notary $ Technology Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ 51 1 I. —3 8 Permit Fee $ Radon Fee $ Training/Education Fee $ (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 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 a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of�o e cement and construction lien law brochure will b • eliver d to the person whose property is subject to attachment. Also, a c l p' to t b A.r corded notice of commencement m� . o ed at the job site for the first inspection which occurs seven (7) days after'tI i• di g rit is issued. In t• - a.s _ •� .osted notice, the inspection will not be a. proved and a r 'nsp - o ee will be charge Signature OWNER or AGENT The foregoing instr ment was acknowledged before me this S day of _(06 fob r , C b ;e1 20 by me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: GEOROINA SALVATORE M COMMISSION • wet lido *******************3*****f*** fia Signatur CONTRACTOR The foregoing instrument was acknowledged before me this day of C/�/ , 20 /f , by tomA L)J cliiri--)erSonally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: ALICIA L VANDAMA e MY COMMISSION # FF 028557 EXPIRES: October 18, 2017 Bonded Nu Notary Public Underwrs ************************************************************* APPROVED BY - /- : ' J.s Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) 001428 aM 5. calBusiness Tax:Receipt• dllarni'-Dade, County,. State. of Florida' -THIS IS' NOT BILL, - DO NOT PAY 5268586 BUSINESS NAME/LOCATION D & D PLUMBING' CORP 3145 SW .19 ST MI�1MI"FL 33145 • OWNER rD&•DPLUMBING CORP I `, Worker(s) 1 ,7 RECEIPT NO:, , EXPIRES' Z4' ° K .RENEWAL' SEPTEMBER,30, 2016r 5505483 , Must bedisplayed at place of business i 5. Pursuentto'County Code. , SEC. TYPE OF BUSINESS 196 PLUMBING CONTRACTOR CFC1426173 �---+, osiness. • -The RECEIPT NO o r above must be displayed on all c mme sal vehicles - Miami -Dade Code Sec8a-276. Chapter 8A - Art. 9 &10` PAV M ENTIRECEIVED� t3Y TAX COLLECTOR r. $45.00 07/27/2015" "' • CHECK21'-15-105518 I ji ( \ g e ,ram This`Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, , permit, or a certification of the holders qualifications, to do business. Holder must comply"with any governmental 1 , or nongovernmental regulatory laws and requirements which apply to the b N For more information, vfiisit www.miamidade.gov/taxcellector x. RICK SCOTT, GOVERNOR CFC14261730 STATE OF FLORIDA; DEPARTMENT,OF.BUSI31ESSAND„PROFESSIONAL`REGULATION '� Y---CONSTRUCTION wINDUSTRY,LICENSING..BOARD.': KEN LAWSON, SECRETARY The.,PLUMBING= CONTRACTOR"""". "'"Named'below IS'CERTIFIED "` - 1.- nderNthe provision of Cha ter 489 FS .'� ""Expiration date--AUG 3,1' 2016 . - -- DlAZ'DAVD .~ ff'D G.C;EO E.RTP '0"4,' ' 3145µSW»27MIAMImow,..33145*19 �... ISSUED: 08/11/2014 DISPLAY AS REQUIRED BY LAW rr. j ' 4r . e. SEQ # L1408110001168 CI El • ACGRc CERTIFICATE OF LIABILITY INSURANCE ih.....----'' DATE(MMIDONYYY) 11/30/15 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 policypes) 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 Accurate 8300 West Flagler Suite 114 Miami, FL 33144 Phone (305)226-8727 Fax (305)226-8767 RALACT LUCie Estrella laNico un, (305)226-8727 No); (305)226-8767 ADDREss: Iudaestreila@beilsouthnet INSURERS) AFFORDING COVERAGE NAIL # INSURER A : United States Liability Insurance Comp INSURED D & D Plumbing Corp 3890 NW 2 Terrace Miami, FL 33126 - (305) 979-0516 INSURER B : ` INSURER C : INSURER D : INSURERS : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED 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 HERE N IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POUCIES. LIMITS SHOWN MAY HAVE BEEN REDUCEDpp�BY PAID CLAIMS.Lj R TYPE OF INSURANCE iIN RAW pR POLICY NUMBER .LMMIDDIYYYY) (MMIUDDIYYY 'i • LIMITS A GENERAL UABILITY ® COMMERCIAL GENERAL UABILITY ❑ IICLAIMS-MADELI% OCCUR 0 Y Y CL1679197A 11/26/2015 11/26/2016 EACH OCCURRENCE $ 1,000,000.00 ENTED PREMISES MO aoccurrence) $ 5,000.00 MEDEXP(Any one ) $ 100,000.00 PERSONAL & ADV INJURY $ 1,000,000.00 III GENERAL AGGREGATE $ 1,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: • POUCY 0 7a 0 LOC PRODUCTS - COMP/OP AGG $ 1,000,000.00 $ AUTOMOBILE LIABILITY COMBINED eSINGLE LIMIT $ • ANY AUTO ❑ AU. O IED • SCHEDULED HIRED AUTOS WI TS NON -OWNED ❑ ❑ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPaEEZ DAMAGE ffePoett l) $ $ UMBRELLA UAB 0 OCCUR ❑ EXCESS LIAR III CLAIMS -MADE EACH OCCURRENCE S AGGREGATE $ II DED 0 RETENTIONS $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N A YIF PCEWME 6ER EXCLNER/E ECUTrE (Mandatory In NH) ® If yes describe under DESCRIPTION OF OPERATIONS below Y Y WCV01600510-00 11/26/2015 11/26/2016 • TORVOIT TS ❑ W- EL EACH ACCIDENT $ 1,000,000.00 EL DISEASE - EA EMPLOYEE $ 1,000,000.00 EL DISEASE - POLICY UMfr $ 1,000,000.00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 1a1, Additional Remarks Schedule, if more space Is required) State Plumbing Contractor CFC 1426173 CERTIFICATE HOLDER CANCELLATION Miami Shores Village 10050 NE 2nd Avenue Miami, FL. 33138 ACORD 25 (2010/05) QF SHOULD ANY OF THE ABO THE EXPIRATION DATE ACCORDANCE WITH AUTHORIZED REPRESE Lucia Estrella D POUCIES BE CANCELLED BEFORE WILL BE DELIVERED IN ONS. 01988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD