PL-19-300Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date: 02/19/2019
Location Address Parcel Number
431 NE 100TH ST, Miami Shores, FL 33138 1132060170500
Cnntaets
Permit NO.: PL -0249-300
Permit Type: PitiMbing - Residential
Work CiossUkatfon: Alteration
Permit Status: Approved
Expiration: 08/19/2019
ERIN HALLORAN Owner H. BETO'S PLUMBING INC Contractor
451 NE 91 ST, MIAMI SHORES, FL 33138 SAYDA WALESKA HERNANDEZ
Other: 3522623193 8454 NW 24 PL, MIAMI, FL 33147
Business: 7863681902
Inspection Requests:
Description: REPLACE PLUMBING PIPES AND FIXTURES INSTALL Valuation: $ 5,000.00 39-7614949
2 TANKLESS WATER HEATERS MASTER BATH BUILD OUT
Total Sq Feet: 500.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$3.00
DBPR Fee
$2.63
DCA Fee
$2.00
Education Surcharge
$1.00
Permit Fee
$125.00
Scanning Fee
$3.00
Technology Fee
$4.38
Total :.
$191.01
Payments
Date Paid Amt Paid
Total Fees
$191.01
Credit Card
02/19/2019 $141.01
Credit Card
02/08/2019 $50.00
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.
n _ ,r — —
re: Owner / Applicant / Contractor / Agent
Date
February 19, 2019 Page 2 of 2
Miami Shores Village �c I�F
� • � g 6B 0 8 019
-� Building Department,
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY'
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
Value of Work for this Permit: $ S 000 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ AlterationC _/ ❑ New ❑ Repair/Replace
/'1h9
Description of Work:
❑ Demolition
Specify color of color thru tile:
Submittal Fee $ 50 �' Permit Fee $ CCF $ CO/CC $
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
(Revised02/24/2014)
DBPR $
Notary $.
Double Fee $
Bond $
TOTAL FEE NOW DUE $ j `TI ` 01
IBC 20
BUILDING
Vic. j 2-19 -3�S�
Master Permit No. t
PERMIT APPLICATION
Sub Permit No. L -Z- 360
BUILDING ❑ ELECTRIC
ROOFING REVISION EXTENSION 7RENEWAL
PLUMBING ❑ MECHANICAL
[—]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
� 2 E
r� _j ,�
S
JOB ADDRESS: W I I
U� I f ek±
City: Miami Shores
County: Miami Dade Zip:
Folio/Parcel#: 11-39-01 D�7
t1
— 0500 Is the Building Historically Designated: Yes NO
Occupancy Type: Load:
Construction Type: Flood Zone: BFE:
OWNER: Name (Fee Simple Titleholder):
� �1FFE:
F—Y-1 H a � 1 o rai) Phone#:.1,)(c. -(26a--5183
Address: 931 NiE i c)n+"" S+,
city IMCA
r State: r L- Zip: ? 13
Tenant/Lessee Name:
Phone#:
Email:
CONTRACTOR: Company Name:
1 Phone#:
Address: Sy
`
City: !
State: Zip:
,
Qualifier Name: ' el Phone#:
State Certification or Registration #: �f�
/W
L� 1��i �%� Certificate of Competency #:
DESIGNER: Architect/Engineer:
Phone#:
Address:
City: State: Zip:
Value of Work for this Permit: $ S 000 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ AlterationC _/ ❑ New ❑ Repair/Replace
/'1h9
Description of Work:
❑ Demolition
Specify color of color thru tile:
Submittal Fee $ 50 �' Permit Fee $ CCF $ CO/CC $
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
(Revised02/24/2014)
DBPR $
Notary $.
Double Fee $
Bond $
TOTAL FEE NOW DUE $ j `TI ` 01
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
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 J
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
- day of 20 19 • by � day of � 20 10(J by
Erl !N ho is personally known to q01Q no l ho is personally known to
me or who has produced n . mO�who has produced rSC n O V� n -
identification and who did tale an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: d V N2 Sign:
NORMA G VALLE
Print: v;w4 NORMAGVALLE Print:olrrx.oacncri
EXPIRES: OCT 16, 2021 a EXPIRES: OCT 16, 2021
Seal: Seal:
A``. -Wo bonded through 1st State Insurance a Banded through 1st State Insurance , y
APPROVED BY . _ 7H Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
dir RICK SCOTT GOVERNOR JONATHAN ZACHEM, SECRETARY
a'
db
vm
STATE OF FLORIDA
DEPARTMENT -OF BUSINESS'.S:rA4NJ�}IM.2}\,,ROFESSIONAL REGULATION
CONSTRUCTlIO,�NkINY.DUST Y=LCEN'SI,NG BOARD
,THE PLUM BING<CONTRACTOR.'HEREI'N.IS CER54, IE,D UNDER THE
Rt A
PROVISION5 OF CHAPTER1�489 ORIDA SA�TUTES
M � -1 r� 'f +2i�_11�` .1t r .rte •
HERNAN'D1EZ, SAYDArWtALE=SKA
..,�
INC'
H., BETO_S.PLU'MBING'(51
84154 NW-24TH �PLACP
• t
M I44M l 33147..
-«r-
. LI'CE'NSENNUMBER�-sCFC;1428937
EXPIRATION.QATIt AUGUST 31, 2020
Always verify licenses online at MyFloridal-icense.com
a, a
r{ Do not alter this document in any form.
This is your license. It is unlawful for anyone other than the licensee to use this document.
002567
Local Business Tax Receipt
Miami—Dade County, State of Florida
-THIS IS NOT A BILI r0 NOT PAY
7164646
BUSINESS NAME/LOCATION
H BETOS PLUMBING INC
8454 NW 24TH P`
MIAMI FL 331 }=
RECEIPT NO. EXPIRES
RENEWAL SEPTEMBER 30, 2019
7442943 Must be displayed at place of business
Pursuant to County Code
Chapter 8A - Art. 9 & 10
7SEC. TYPE Of BUSINESS PAYMENT RECEIVED
H BE -TOS PLUMBING INC 196 PLUMBING CONTRACTOR BY TAX COLLECTOR
C/O SAYDA W HERNANDEZ CFC1428937 $75.00 07/16/2018
Worker(s) 1 CREDITCARD-18-054647
This local Business Tax Receipt only confirms payment of the local Business Tax. The Receipt is not a license,
permit, or a certification of the holders qualifications, to do business. Holder must comply with any governmental
or nongovernmental regulatory laws and requirements which apply to the business.
The RECEIPT N0, above must be displayed on all commercial vehicles - Miami -Dade Code Sec 8a-276.
For more information, visit wvvw.miamid�,goyltaxcollecwt
J
AC"R" CERTIFICATE OF LIABILITY INSURANCE GATE (MMlDD1VYYV)
02, 07, 2019
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER
ROYAL CARIBk3EAN INSURANCE AGENT, Y II
1772 WEST FLAGLER STREET
MIAMI, FL 33135
NAME: TUNON
.._JOHNNY
_(AIC -Ne EXII,305-642.45.11 _ SAX 305-642-1087
E-MAiI
At, :JT_IJN9NR9YALI1 GMA1L.00M _
!N$URERJ$ AkFFORO1NGCOVERAOE _
NAICa
INSURER A! UNITED STATES LIABILITY INS. M
_LTR.
A
INSURED _ m
H. BETO'S PLUMBING, INC.
8454 NW 24 PLACE
MIAMI, FL 33147
INSURER B: ASSOCIATED INDUSTRIES INS. CO.
INSURER C;
04115,'2018
INSURER D:
EACH OCCURRENNCE $ 1,000,000
INSURER E
--100,000
MED EXP (Any oneperson) $ 5,000
INSURER F:
/•ArI A/_00 r=oTN:IrATC 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.
INBR
TYPE OF INSURANCE
ADDL
SUBR
POLICY NUM ER
POLICY
MM/ODlYYYY
POLICY EXP
MM/D YYY
LIMITS
_LTR.
A
X COMMERCIALGENERALLIABILITY
CLAIMS -MADE �Xl OCCUR
MIAMI SHORES VILLAGE, FL. 33138
CL1746996
04115,'2018
04/15f2019
EACH OCCURRENNCE $ 1,000,000
TED
PREW 1 $
--100,000
MED EXP (Any oneperson) $ 5,000
PERSONAL & ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER;
GENERAL AGGREGATE $ 2.000 000
PRODUCTS - COMP/OP AGG S 1,000A00
POLICY lt�_11 JECTPRO_
(-1 PRO- ❑ LOC
'
$
THE H,
AUTOMOBILE LIABILITY
MBINED SINGLE LIMIT $
(Ea accidentL______
BODILY INJURY (Par pereon) $
ANY AUTO
BODILY INJURY (Per accident) $
ALL OWNED SCHEDULED
_ AUTOS AU OWNED
HIRED AUTOS AUTOS
PROPERTY DAMAGE $
Warawderill
UMBRELLA LIAR
OCCUR
EACH OCCURRENCE $
AGGREGATE S
EXCESS LIAR
CLAIMS -MADE
OED RETENTIONS
S
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY IN
ANY PHOPRIETOR,PARTNER,EXECUTiVE Y❑
OFFICEP,MEMBER EXCLUDED? Y
(Mandatory in NH)
NiA
AWC1103448
04,'1512018
4/15/2019
_
X PrATUTE
E.L. EACH ACCIDENT S _ 1,000,000.00
E.L. DISEASE • EA EMPLOYEE S 1,000,000.00
E.L. DISEASE - POLICY LIMIT S 1,000,000.00
ifes. describe under
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORO 101, Additional Remarks Schedule, maybe attached if more space is required)
PLUMBING CONTRACTOR/PLUMBING STATE CONTRACTOR LICENSE# CFC1428937
HOL DER CANCELLATION
CERTIFICATE
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
MIAMI SHORES VILLAGEP1fi
DATE THEREOF, NOTICE WILL BE DELIVERED IN
BUILDING DEPARTMENT
C TH LICY PROVISIONS.
10050 N.E. 2ND AVENUE
UTHORII D RESENTA VE
MIAMI SHORES VILLAGE, FL. 33138
V 1`J>lj,S-lU VtiU CUMF'VMA I IUPC Au F19IRS rnaory
ACORD 25 (2014101) The ACORD name and loan are registered marks of A ORD
DRIV' ^E. "E CLASS E
H6
SAYDA
8454 NW 241 n r DACE
MIAMI. FL 33147
DOB 11-24-1983 SEX
- -.cUED 10-04-2011
14-24-2019
?SE
-ACED-