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PL-19-924old PL15-2i3a 'PLI 5-�13 h Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 P&mit No.: PL-04-19-924 �* Permit Type: Plumbing - Residential Work Classification: Addition/Alteration Permit Status: Approved Issue Date:05/02/2019 Expiration: 10/23/2019 Location Address Parcel Number 270 GRAND CONC, Miami Shores, FL 33138 1132060136210 Contacts ERHAN KOSTEPEN Owner 78 NE 47 ST, MIAMI, FL 33137 Other: 7863190562 ERHANKOSTEPEN@GMAIL.COM WALTER PLUMBING CORP Contractor WALTER GUTIERREZ 4054 SW 113 AVE, MIAMI, FL 33165 Business:3059707116 WALTERPLUMBING@BELLSOUTH.NET Other:7862342816 Inspection Requests: Description: NEW ADDITION AND REMODELING TO REPLACE Valuation: $ 6,500.00 Inspec i Re PERMIT#PL16-1966 AND PL-8-15-2138 49 TotalSq Feet: 2,600.00 Fees Amount Payments Date Paid Amt Paid 100% Permit Renewal Fee $175.00 Total Fees $225.00 Application Fee - Other $50.00 Credit Card 05/02/2019 $225.00 Total: $225.00 Amount Due: $0.00 Building Department Copy 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 the above named contractor to do the work stated. AuthoVd Signature: Owner / Applicant / Contractor / Agent Date May 02, 2019 Page 2 of 2 - 3 Miami Shores Village . RECEIVED Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 APR 2 610 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 15) GA FBC�20(�- BUILDING Master Permit No. Qc v— ( I —K3 PERMIT APPLICATION Sub Permit No. V( f-)q —19 - 9Z� ❑B DING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [—]RENEWAL MBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP '�? V CONTRACTOR DRAWINGS 6 JOB ADDRESS: ,--M; City: Miami Shores County: Miami Dade Zip: 3 J 13 y Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): n �-y PLO /✓ Phone#: �6 311 ^0 J p-2— Address: %d (✓Q (Iz6d�, 2 City: I G j�� SL T,-( State: Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: W ei u," � l HA Phone#: Address: 7y S i SK1 City: Aju Cl State: F I Zip: .2.3 /6 f- Qualifier Name: Phone#: _30S 4L0 IIlk-;I State Certification or Registration #: C PC a y L f 510 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Ad Value of Work for this Permit: $ Type of Work: ❑ Adder Description of Work: City: Square/Linear Footage of Work: ❑ Repair/Replace Zip: ❑ Demolition Specify color o olor thru tile: Submittal Fee $ Permit Fee $ ' CCF $ -+--. — —.:1—.1CO/CC1$- Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ (Revised02/24/2014) Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Zi 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 $1500, 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. I Signature Sign OWNER or AGENT The foregoing instrument was acknowledged before me this day of t�-iIrL�—� 20 (G) by } �8j"t I �CG�� who is personally known to me or who has produced- identification and who did take an oath. The foregoing instru9lieen't was acknowledged before me this A'p day of k l / 20 / 9 by G),4/fir (A e lY'e Z who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: W Print: is n Seal: �!"""! SINDW ALVARE2 Seal: MY COMMISSION 8 GG 238273 �00 EXPIRES: September 3, 2022 Bonded Thru Notary Public Undemitors mr APPROVED BY ez' 5 Plans Examiner Structural Review L/I Notary Public State of Florida Nancy Nunez My Commission GG 166008 Expires 03/26/2022 as Zoning Clerk (Revised02/24/2014) 003646 Local Business Tax receipt Miami —Dade County, State of Florida —THIS IS NOT ABILL — DO NOT PAY 6121 131 BUSINESS NAME&OCATION _ RECEIPT NO. WALTER PLUMBING CORPORATION RENEWAL 4054 SW 113TH AVE 6384093 MIAMI FL 33165 EXPIRES SEPTEMBER 30, 2019 Must be displayed at place of business Pursuant to County Code Chapter 8A — Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS WALTER PLUMBING CORPORATION .196 SPECIALTY PLUMBING CONTRACTOR PAYMENT RECEIVED BY TAX COLLECTOR $75.0.0=:07/23/"201.8.__ - Vdrker(s) ' 1 CREDITCARD-1-8=0:56432""- t 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 andsequirements 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 www.mismidade:gov/taxcollector ACORO® CERTIFICATE OF LIABILITY INSURANCE kk.� DATE(MM/DD/YYYY) 1 04/15/2019 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 endorsemen s . PRODUCER CONTACT AdNAME:riana L Clavijo Mauri Excellence Insurance, LLC. DBA ABTA Underwriters. 3801 SW 107th Ave PNONE , (305) 220-7447 A/� No): (305) 220-4821 ADDRIE : certificates@aaunderwriters.com INSURERS AFFORDING COVERAGE NAIC N INSURERA: SECURITY NATIONAL INSURANCE COMPANY 19879 Miami FL 33165 INSURED INSURER B : BRIDGEFIELD EMPLOYERS INSURANCE CO 12158 INSURER C : WALTER PLUMBING CORPORATION INSURER D : 4054 SW 113th Ave INSURER E : INSURER F : Miami FL 33165 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 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 rypE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD YY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE �X OCCUR Blanket Additional Insured SES1662478 00 10/25/2018 10/25/2019 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence) ccurrence $ 100.000 X MED EXP (Any one person) $ 5,000 X Blanket Waiver of Subrogation PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY JET LOG X OTHER: Primary and Non Contrib GENERAL AGGREGATE $ 2,000,000 PRODUCTS- COMP/OP AGG $ 2,000,000 Deductible $ 1,000 AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY - F COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ BODILY INJURY Per accident) $ PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY N ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? N� (Mandatory in NH) H yes, describe under DESCRIPTION OF OPERATIONS below N / A 830-38516 10/26/2018 10/26/2019 X1 PER STATUTE 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 I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Plumbing Contractor License #CFC142751 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, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Permit Type: Plumbing - Residential Application Date: 08/21/2015 Owner: ERHAN KOSTEPEN Work Class: Addition/Alteration Issue Date: 08/26/2015 Parcel 1132060136210 Status: Cancelled Expiration Date: Address: 270 GRAND CONCOURSE Miami Shores, FL IVR Number: 627400 Subdivision: 113206013 Scheduled Actual Reinspection Date Start Date Inspection Type Inspection No. Inspection Status Primary Inspector Required? Complete 08/21/2015 Review Plumbing INSP-241957 Passed OSVALDO DIAZ No Complete Reinspection of INSP-131606 Checklist Item COMMENTS Approved General Comments PLAN REVIEW COMMENTS Yes 10/27/2015 10/27/2015 Rough INSP-246506 Canceled OSVALDO DIAZ No Complete Reinspection of INSP-131606 Checklist Item COMMENTS Approved General Comments INSPECTOR COMMENTS No 10/27/2015 Underground INSP-241954 Re -inspection OSVALDO DIAZ No Complete required Reinspection of INSP-131606 Checklist Item COMMENTS Approved General Comments INSPECTOR COMMENTS - NEED TO OPEN FLOOR FOI No INSPECTION 10/29/2015 10/28/2015 Underground INSP-246749 Partial Pass OSVALDO DIAZ Yes Incomplete Reinspection of INSP-241954 Checklist Item COMMENTS Approved General Comments INSPECTOR COMMENTS - partial less garage bathroom No 11/13/2015 11/13/2015 Underground INSP-246750 Passed OSVALDO DIAZ Yes Complete Reinspection of INSP-246506 11 /25/2015 11 /25/2015 Top Out 12/01/2015 12/01/2015 Rough Checklist Item COMMENTS Approved General Comments INSPECTOR COMMENTS - garage bath and washing Yes machine INSP-241955 Passed OSVALDO DIAZ Reinspection of INSP-131606 No Complete Checklist Item COMMENTS Approved General Comments INSPECTOR COMMENTS Yes INSP-248558 Passed OSVALDO DIAZ Reinspection of INSP-131606 No Complete Checklist Item COMMENTS Approved General Comments INSPECTOR COMMENTS Yes April 26, 2019 10050 NE 2 Ave Miami Shores FL 33138 Page 1 of 1