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PLC-11-20-2545l Permit NO.: PLC-11-2t Miami Shores Village Permit Type: Plumbing-Gomr 10050 NE 2 Ave Miami Shores FL 33138 �e F Work Classificdtibn • Alt 305-795-2204 . E Permit Status: A01 Expiration:08/09/2021 1 Location Address Parcel Number 790 NE 91ST ST 4, Miami Shores, FL 33138 1132060390040 Contacts RICARDO PADULA Owner SMN PLUMBING CONTRACTOR LIMITED Contractor 790 91st 4, Miami Shores, FL 33138 SEENAUTH M NARAIN Business: 3058965144 padulabox@icloud.com 7444 SW 128TH CT SW, MIAMI, FL 33183 Business: 3053228242 smnplumbing@aol.com Inspection Requests: Description REMOVE AND REPLACE SHOWER LINE AND Valuation: $ 1,500.00 FIXTURES. REMOVE AND REPLACE KITCHEN APPLIANCES AND05 ?62 449 SINK. Total Sq Feet: 720.00 Fees Amount Application Fee - Other $50.00 CCF $1.20 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.40 Permit Fee $50.00 Scanning Fee $3.00 Technology Fee $2.50 Total: $111.10 Payments Date Paid Amt Paid Total Fees $111.10 Credit Card 02/09/2021 $111.10 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. i AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws cortttuction ancbzonino. Futhermore. I authorize the above named contractor to do the work stated. / Applicant / Contractor / Agent Date February 09, 2021 Page 2 of 2 Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Parcel Number 790 NE 91ST ST 4, Miami Shores, FL 33138 1132060390040 x, Contacts RICARDO PADULA Owner mVVYSMN PLUMBING CONTRACTOR LIMITED Contractor 790 91st 4, Miami Shores, FL 33138 SEENAUTH M NARAIN Business: 3058965144 padulabox@icloud.com 7444 SW 128TH CT SW, MIAMI, FL 33183 Business:3053228242 smnplumbing@aol.com Inspection Requests: Description: REMOVE AND REPLACE SHOWER LINE AND Valuation: $ 1,500.00 s FIXTURES. REMOVE AND REPLACE KITCHEN APPLIANCES AND 3054 4949 � SINK. Total Sq Feet: 720.00 Fees Amount Application Fee - Other $50.00 CCF $1.20 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.40 Permit Fee $50.00 Scanning Fee $3.00 Technology Fee $2.50 Total: $111.10 Applicant Copy Payments Date Paid Amt Paid Total Fees $111.10 Credit Card 02/09/2021 $111.10 Amount Due: $0.00 For Inspections, Call (305) 762-4949 or Log on at https://bldg.miamishoresvillage.com/cap/. Requests must be received by 3pm for following day inspections. NOTICE: In addition to the requirements of this permit, there may be AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER additional restrictions applicable to this property that maybe found in the GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, public records of this county. STATE AGENCIES, OR FEDERAL AGENCIES. February 09, 2021 Page 1 of 2 Miami Shores Village u1EcE1VEE) Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 BY:. INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20 BUILDING Master Permit No. �C �,— 20 PERMIT APPLICATION Sub PermitNo7Lc` i(_2_0_2_54f5 ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: Citv: Miami Shores County: Miami Dade Zip:` Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: �``�}��,tr Flood Zone: BFE: �—� ` FFE: OWNER: Name (Fee Simple Titleholder): (Z C-��`�\ y � 0 \ Phone#: `� Address: I � � Cc �L�� \ Aj)�— 2-z)% City: �i .c,l��(1i�-��f� State: Tenant/Lessee Name: �.� Email: F� U �'r � ne#: p: ' 1 ( CONTRACTOR: Company Name: -S"��l "� �%��C T7�1. -Phone#: Address: 7Y c y /Z.s-" City: /�" °'''+1 v State: Zip: 2 3 i 6L3 Qualifier Name: S �_ Phone#: 3 or .3Z2- 7—ky State Certification or Registration #: GFGi `� rs "�D G Certificate of Competency #: DESIGNER: Architect/Engineer. U Au D) a A . 'S 9 f=/1 Phoneme�#:, Address: 06 City: l� � A/2l j�?Sffite: _V� Zip: Value of Work for this Permit: $ l 4S 0 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New [Repair/Replace ❑ Demolition Description of Work: Specify color of color thru tile: Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ _ C`!J I S I hJ CCF $_ DBPR $ Notary $ Double Fee $ 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 W 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the'pdrson whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which oc rs Vven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be a ed onc a rein pec ' ee will be charged. Signat Signature_ OWNER or AGENT The foregoing instrument was acknowledged before is r day of ® 20 by L) �1�LJ who is Hall— y know to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: Print: CONTRACTOR The foregoing instrument was acknowledged before me this A day of ( 20 �, by wlispersonally known_to as me or who has produced ,Notary Public -State of Florida .. oov` My Commission Expires '�nn��'� April 07, 2023 identification and who did take an oath. NOTARY PUBLIC: Sign:, Print: ' Ly ''�% //s fL` �✓C '7 %� as Seal: Seal: ' : �; �,NTHC)�fyE, �, ll(�ir�2' Fxp res 0f,Mrber 12U, BondauThrugar,'ratr\'�:+_�� APPROVED BY �— iI/O/- Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) .t lSissilless Tau PLt'e i.._ it t i €. y SSftYmI Kst t�P;rv.r c3, oft VLAP 6HFvffifYsi a •, • `n . •• _ �� Yi sO +vwiemc..axAC.+xxaN +rt'f4i'v' a+� .-..•.� °=�Ftrc.KafBTR�§virtids rxatas'7 iaxpMes f AA ESN i..2 TY'9 :<': Y ++ aegr.anat rtf 4ditt 3 L JA„gi93AH3 : ti dsi[ e. ._ma as * awaxee+aSGw s,.v wttu* se+..eewmso- tta r��p:e. #9— 4;.Ld9A$R9mm mx tA,a. r•;K A,flrta.Y aa3t >`as�'Yt'fYAC'Tt�f: iS :Xi t7''d'i _'!3 =asaa�,�.t r.,.en�Paw� ,. ,a&s�w 4�ca:r3t�:a�at�a 5we.lYnct�a,W�:' *Oww ftw wmI.'ws'w .4 r a+aamm ke ae#"pp+bra +.r +aM aeVpiE*00— a. : as a s-Miwelr» iie Me 4w.e Aw,.YAt mere AC"RE® CERTIFICATE OF LIABILITY INSURANCE DATE oi23/2o20 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 endorsement(s). PRODUCER CONTACT Zachary Morris NAME: ry PHONE 954-343-5151 ac No): Insurance Medics E D lESS: zach@insurancemedics.com 5450 S. State Rd 7Suite 35 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Covington Specialty Ins. Co. Davie FL 33314 INSURED INSURER B : Progressive INSURER C : USLI SMN Plumbing Contractor, LLC INSURERD: NEXT INSURER E : 7444 SW 128 CT INSURER F : Miami FL 33183 COVERAGES CERTIFICATE NUMBER: 732 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MM1DDD� POLICY ID Y P LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE OCCUR PRAEM SES EaEoccurrence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 A Y Y VBA72839700 11/01/2019 11/01/2020 GEN.L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY ❑ JECOT- LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO B OWNED V SCHEDULED AUTOS ONLY AUTOS /� 02468310-0 08/11/2020 08/11/2021 BODILY INJURY (Per accident) $ PROPERTYDAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000 X AGGREGATE $ 1,000,000 C EXCESS LIAB CLAIMS -MADE Y Y XL1591433A 11/05/2019 11/05/2020 DED I I RETENTION $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y!N ANYPROPRIETORIPARTNERIEXECUTIVE OFFICER/MEMBEREXCLUDED? ❑ (Mandatory in NH) N/A Y NXTOSYRCEL-00-WC 05/06/2020 05/06/2021 PER OTH- STATUTE I I ER E. L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached iF more space is required) Certificate holder is listed as an additional insured. CFC1428106 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN The Village of Miami Shores Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd Ave Miami FL 33138 ININEPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD