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PL-18-1922r�a� yFt'.�z-'��e Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 rermit Permit NO. PL-7-18-1922. Permit Type: Plumbing - Residential Work Class cation: Addition/Alteration Permit Status: APPROVED Issue Date: 7/25/2018 Expiration: 01/21/2019 Parcel Number Applicant 10611 NE 11 Avenue Miami Shores, FL 33138-2120 1122320280380 Block: Lot: STEPHEN LENSI Owner Information Address Phone Cell STEPHEN LENSI 10611 NE 11 Avenue MIAMI SHORES FL 33138- (860)490-6310 Contractor(s) OTTO PLUMBING INC Phone (786)344-2837 Cell Phone Valuation: Total Sq Feet: $ 8,500.00 0 Type of Work: NW PLUMBING FIXTURES FOR 2 BATHROOM 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 Total: Amount $5.40 $4.46 $2.98 $1.80 $297.50 $3.00 $7.20 $322.34 Pay Date Pay Type Amt Paid Amt Due Invoice # PL-7-18-68253 07/25/2018 Credit Card $ 272.34 $ 50.00 07/17/2018 Cash $ 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 AFFIDAV T: 1 ce '. mat all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction an. .. Fµthe or: , I authorize the above -named contractor to do the work stated. ized Signature: Owner / Applicant / Contractor / Agent July 25, 2018 Date Building Department Copy July 25, 2018 1 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 FBC 20 (4 Master Permit No. RC18-706 (01'4 Sub Permit No. VL 9 - ( 22 ❑BUILDING ❑ ELECTRIC 111 ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL V;IPLUMBING ❑ MECHANICAL El PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 10611 NE 11th Ave City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): STEPHEN LENS! Address:10611 NE 11 th Ave Phone#:860-490-6310 City: Miami Shores State: FL Zip: 33138 Tenant/Lessee Name: Phone#: Email: stephen.lensi@gmail.com CONTRACTOR: Company Name: OW° iii /122 /A) Phone#: 70- 3 2"J3, '' '' ll Address: i� �0 � �/ /'? V Oil City: +B as j5 State: Zip: . 3e3 /40 Qualifier Name: b'ejDo-7/ Z•g - S I /2J Phone#: State Certification or Registration #: (,,. ``'- /U7 � 6 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ 9' %—r)d Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ►��� Repair/Replace+ Description of Work: ij& l.) ` /61,71 ":7Y4)' 0 5 r2; P7-4,1A TWO 4 e-3— C n chzV ❑ Demolition Specify c1 color //of��color,thru:tile: , r7 3, Submittal Fee $ 91J' CO Permit Fee $ -5G CCF $ �1 (I CO/CC $ Scanning Fee $ Radon Fee $ a_ . 0 DBPR $ —1 • 'f" G Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ -1 Q ' 3q (Revised02/24/2014) Bonding Company's Name (if applicable) Bonding Company's Address .:.fir 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 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 Signature OWNER or AGENT CONTRACTOR 1` The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this- 5 day of c � 20 b by (, V% day,of b c� 20 1 Q , by Sk e-pkan Ler 9- J /who is personally know o �n , who is personally known to me or who has produced as me or who has produced t--L DL) G` e.Ie as identification and who did take ��mo oath' *°92Y 4S Ya Ramcharan NOTARY PUBLIC: cP ° NOTARY PUBLIC STATE OF FLORIDA Comm# GG218511 w S/NCE 1S1 , Expires 5/16/2022 Sign: /1<—" �� Sign:' Print: Print: 1\1-tYv16.J -cv Seal: Seal: identification and who did take an oath. NOTARY PUBLIC: a•••,.0 GABRIELMONTERO * MY COMMISSION 0 FF 184292 EXPIRES: February 15, 2019 ''EOF Fvs$9 Bonded Thru Budget Notary Services ********************************************************************************* *************************** APPROVED BY . 41—A, Plans Examiner Zoning (Revised02/24/2014) Structural Review Clerk STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ' CONSTRUCTION INDUSTRY LICENSINBOARD 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399-0783 GONZALEZ, ELICIEL OTTO PLUMBING INC 4606 HAZEL AVENUE SOUTH LEHIGH ACRES FL 33976 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range friain'architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myftoridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and leam more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing -business in Florida, and congratulations on your new license! (850) 487-1395 ;....STATE OF FL'ORIDAY.- - «_ 'DEPARTMENT. OF: BUSINESS AND--- - PROFESSIONAL'REGULATION "" a CFC11429613 �,,, ISSUED:x' 07/24/2016,`::.._.�,_ ' ----- ta,yy�' CERTIFIED PLUM8INGGCONTRACTOR GONZALEZ,-ELICIEL'�' ' '`a OTTOCUMBING1NCIC JIS CERTIFIED.under,the,prov s ons of,Ch i89.FS,. Ei and '`AUG'31„2Q18,,..•�""'• ,t1607240� 774� DETACH HERE RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY t. . x... ^. '. ' STATE OF FLORIDA,:.1+ ^L. Nr- -. , % ''r % %. .--- "^-DEPARTMENT OF=BUSINESS AND,PROFESSIONAL REGULATIONw •::: CONSTRUCTION INDUSTRY LICENSING BOARD %. :-.\ ...r-,.,^.---.. --2.7---.... _ ..,.,—'�-: .`,---„:N ,.\; 7-.., °`.. ',,,NN \' ` V +" 2CFC1429613 7..---,---- .,..,.r . -.2 ^ +�, �- ;' ,,,t-7,..:,: ` ' "..,,,, .The PLUMBING CONTRACTOR -- - -•-. -„ �- ~ .`".... -'''- ,`AN-' '._�., ''`--,,\ .� +�'Named'below IS�CERTiF1ED._' w �, -" �'�-.��; •^-���"�...�����`�,�� Underahe provisions of;Chapter 489 FS ���A�",'/'�,_',,.✓�^^'@''"j��.r.J•^ rJ �.w*,.e.w.n ..a5s .b .y`�, �. .T.. � �� ``� ..-,.".�10250`NW'80-COURT ��,�....... _ " .. •� �£'"�a� ,. HIALEAH GARDENS,, FL-33016 `- ---�. ISSUED: 07/24/2016 DISPLAY AS REQUIRED BY LAW SEQ # L1607240000474 001123 Local Business Tax Receipt Miami -Dade County, State of Florida -THIS IS NOT A BILL - DO NOT, PAY 7205984 RECEIPT NO. BUSINESS NAME/LOCATION RENEWAL OTTO PLUMBING INC 7489143 11620 SW 181 TER MIAMI FL 33157 OWNER OTTO PLUMBING INC C/O OTONIEL HERNANDEZ PRES ' ' Worker(s) 1- EXPIRES SEPTEMBER 30, 2018 Must be displayed at place of business Pursuant to County Code Chapter BA - Art. 9 & 10 SEC. TYPE OF BUSINESS 196 PLUMBING CONTRACTOR.. CFC1429813 PAYMENT RECEIVED BY TAX COLLECTOR. .,.. $78.00 10/30/2017- CREDITCARD-18-003857 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 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 -Dade Code Sec 8a-276. For more Information, visit mait.81111MONARAYitengillIM 1 h44) r- __ _ ..a...t,K- a j �, riorEER OF INFORMATION ONLY AND COI, Do I Y OR NEGATIVELY AMEND, EXTEND OR AL. _.. • • °- - OW. M DOES NOT A of IN CE DOES NOT CONSTITUTE A CONTRACT BETWEEN Th. BELOW. MS cA� of III �� fikl�. 0lRTIFICATE HOLDER.------ REPRESEMTATIVE OR PRODUCE, confer I,, {( it .- - holder is aADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, Ibl/ORTAf�� y'� ��� urtalin policies may require an endorsement. A statement on this certificate does not § mg feilm3 and Q t F,eNNicstc **let NI lieu el such endot erit(s). i� anoouceR 1, West Coast Insurance Consultants In 1 P.O Box 520574 Miami, FL 33152 Phone (305) 888-1880 Fax (305)888-1885 INSURED lOTTO PLUMBING INC 10250 NW 80 Ct No 504 INSURER A : INSURER 8_ _INSURER C: INSURER D : INSURER E : HIALEAH FL 33016- INSURERF: REVISION NUMBER: COVERAGES CERTIFICATE NUMBER: THIS IS TO CERTIFY THE A ANY REQUIREMENT, TERM OR CONDITION OF LISTED BELOW HAVEANY CONTRACEEN ISSUED OTHE INSURED T OR OTHER DOCUMENT EW WITH RESPECT POLICY PERIOD CH THIS INDICATED. NOTWITHSTANDING CERTIFICATE MAY CBEOISSUED OR NDITIONS OF PERTAIN, THE S�HOWNFMA AFFORDED BEEN REDUCIES DESCRIBED EO BY PAID CLAIMS. HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS ANDPOLICY EFF POLICY EXP (MM/DDIY YYY1.ILMM/DD/YYYY) , 1,000,000.00 EACH OCCURRENCE S DAMAGE TO RENTED PREMISES Ea occurrence) FAX (305) 888-1885 NAIL 0_ ADDLSUB INSRI POLICY NUMBER LTR j TYPE OF INSURANCE__ ` IySR NryDL-- ❑ COMMERCIAL GENERAL LLABLfTY L�J CLAIMS -MADE ❑ OCCUR A GEN'L AGGREGATE LIMIT APPLIES PER. ❑ P• OLICY ❑ jE T ❑ LOC ❑ OTHER AUTOMOBILE LIABILITY A• NY AUTO ALL OWNED 1_ AUTOS ❑ HIRED AUTOS ❑ U• MBRELLA LIAB • EXCESSSLIAR • DED 0 RETENTION S ❑ Li SCHEDULED AUTOS NON•OWNED AUTOS 0185FL00063100 CONTACT NAME: PHONE (3p5) 8881880 (NC —NC _EXt)_- E-MAIL ADgE�§. sage199@msn.com INSURERS AFFORDING COVERAGE GRANADA INSURANCE CO BERSHIRE HATHAWAY GUARD INSURANCE C 09/24/2017 ❑ OCCUR ❑ CLAIMS -MADE WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE0 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) It yes, describe under DESCRIPTION OF OPERATIONS below i NIA OTWC991055 09/25/2018 04/05/2018 04/05/2019 LIMITS MED EXP (Any one person PERSONAL iiADVINJURY $ Cs �S GENERAL AGGREGATE S 2,000,000.00 100,000.00 PRODUCTS - COMPIOP AGG 1 5 s COMBINED SINGLE LIMIT -I aaccident) BODILY INJURY (Per person) ,t S 5,000.00 1,000,000.00 BODILY INJURY (Per accident)) S PROPERTY DAMAGE 5 (Per accident) EACH OCCURRENCE AGGREGATE 5_ tS ❑PER OTH- A R , E.L. EACH ACCIDENT❑ Er S 1 ,000,000.00 E L. DISEASE- EA EMPLOYES S 1,000,000.00 E.L. DISEASE - POLICY LIMIT I $ 1,000,001100 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101. Additional Remarks Schedule, if more space is required) certificate holders included as additional insured as respects general liability LICENCE NO OFC-1429613 CERTIFICATE HOLDER MIAMI SHORES VILLAGE 10050 NE 2 AVENUE MIAMI SHORES FL 33138 CANCELLATION 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 (2014/01) OF © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD