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RC-10-259Inspection Number: INSP - 135948 Permit Number: RC -2 -10 -259 Scheduled Inspection Date: April 27, 2010 Permit Type: Residential Construction Inspection Type: Final Owner: SALYER, THOMAS Work Classification: Addition /Alteration Job Address: 311 NE 94 Street Miami Shores, FL 33138- Inspector: Bruhn, Norman Project: <NONE> Contractor: BUILDING EXPRESSIONS LLC Building Department Comments REMOVE TUB ADD SHOWER NEW TILE AND FIXTURES. BATHROOM REMODEL NO INSPECTIONS SCHEDULED UNTIL OWNER BRINGS NOC Passed Failed Correction Needed April 26, 2010 Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspector Comments For Inspections please call: (305)762 -4949 Phone Number Parcel Number 1132060136100 Phone: (305)224 -8154 Page 3 of 29 wr. » ...M. rM NM " ' kw= s .nsa SUM i . W . NOM Ot a W M on eali on c .r r C:) � � 0 C tm N 4. C a. . Ha N er. and d address: c 6 � X"l" 11 -S.OI,S, U. G,, b- Ph number. ,�a,� , M 1 5� Surely �.--+ a t 1, at;t�� s� !•. sr';.. t t,. t, ce n = d address: Li( a . Name an 1 . f\ . . ` ,_, `y or t� b. Amount of bond $ ' V ,-, La ¢ c. Phone number. >`d � � isiour :at c i 6 L ender �1p/11 >C t�AitV RUVIN, CLE�2, u� ;c r ,o C o - tini.a' cur ' N ,, <, t 15 a. Name and address: j = ®� Q' 9 b. Phone number: By f Thais Insl-= e �pare ,.�0/� Adre aaas N � P( Address -1-i -s' � y Permit No. Tax Folio No. II��►►,�` NOTICE OF COMMENCEMENT STATE OF 6�L.v / ^ COUNTY OF �z _.( � 0C - THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided In (his Notice of Commencement. 1. Description of properly: (legal description of property, and street address N available) 311 I `10. R 1js 1444c Aw t tz s ,mac.. .�3� , 2. General description of improvement: Q af9 -'7ff w • - a. Namnformadd ID WI 5 � 3// �� " s 33�� g .l� a. N ame sod N ame and address: 7 5 b. Interest in property: CILA) AWL.— c. Name and address of fee simple titleholder (if other than owner): 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Floride Statutes: a. Name and address: C U b. Phone number. J 6. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienors Notice as provided In Section 7.13.13(1)(b), Florida Statutes: /J 4- a. Name and address: b. Phone number. 9. Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a different date is specified)_ WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART • I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. (..er Saki Signature of Owner or Owner's Authorized Hirer /Director Partner /Manager Signatory's.Titl ffice of ment was acknowledged before me this %. da , , lJ" •, year) by (name of person) as t��1t_��r,1(,jiiI' authority, .e.g. officer, trustee, attorney In fact) for behalf of whom instrument was executed). ( j l i 5: NoTARY SuBLie-s'!!!TE Sig -' re of Notary • T • lic - State of Florida �.e" "' +,, • C� C11b4 Print, Type, or Stamp Commissioned Name of Notary Public +;; Cpga�D Commission Number • �' p SE 23 2011 Q" T1 OUP B ONDED VAS ATLANTIC BONDING CO,ING Personally Known _ or Produced Identification v (type of (name of party on Verification Pursuant to Section 92.626, Florida Statutes Under penalties of perjury, t declare that I have read the foregoing and- that the facts stated In. It are true to the best of my knowledge and belief. • , Signature of Natural Person Signing bove Project Address 311 94 Street Miami Shores, FL 33138- 1132060136100 Block: Lot: THOMAS SALYER C. Owner Information Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795 -2204 Fees Due CCF DBPR Surcharge Education Surcharge Permit Fee - Additions/Alterations Radon Surcharge Scanning Fee Submittal Fee Submittal Reversal Fee Technology Fee Total: Amount $0.60 $0.27 $0.20 $225.00 $0.27 $3.00 $50.00 ($50.00) $0.80 $230.14 Building Department Copy Address Contractor(s) AMPSTRONG ELECTRIC INC Phone Cell Phone (305)468 -7988 Authorized Signature: Owner / Applicant / Contractor / Agent Expiration: 09/14/2010 Parcel Number Phone Applicant THOMAS SALYER 311 NE 94 ST MIAMI SHORES FL 33138 -2831 wairmaramr- Valuation: Total Sq Feet: Type of Work: ELECTRICAL FOR BATH Additional Info: ELECTRICAL Classification: Residential Pay Date Pay Type Invoice # EL -3-10 -37209 03/18/2010 Credit Card 03/05/2010 Credit Card Amt Paid Amt Due $ 180.14 $ 50.00 $ 50.00 $ 0.00 March 18, 2010 Date Cell $ 500.00 54 Available Inspections: Inspection Type: NOC 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. March 18, 2010 1 BUILDING PERMIT APPLICATION FBC 20 Permit Type: ELECTRICAL Owner's Name ee Simple Titleholder) r S � ol P C ) V I � � ���" % t�- Phone # 7 7 ZS Owner's Address .a /I /\) City Y ° : SHOillatate r= L_ Tenant/Lessee Name City Miami Shores Village FOLIO / PARCEL # " Email l&'i CQ Job Address (where the work is being done) 3 // 1' E Value of Work For this Permit $ 5 CO Type of Work: DAddition Describe Work: ci 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 DAlteration Miami Shores Village Building Department Permit No. EL o 0 — 3 Master Permit No C ` 0 — 2-69 Zip Phone # Is Building Historically Designated YES NO ">' Flood Zone / Contractor's Company Name In s/13t7 /2a7 -i / �/C C Phone # Contractor's Address (62 j 4//) , SA ba City L1)-i4 ibq State fl— Qualifier Name 0011 6 OArr U ' State Certificate or Registration No. ..0 /3604/ ?`/ h Certificate of Competency No. ! Contact Phone 7 S; ^ 4 g40. _ 9 2 .7 5 Zip 4 P Phone # `t bO 2- 7 County Miami -Dade Zip E -mail ( 0 rnJ 4 f7 4-1 Architect/Engineer's Name (if applicable) Phone # Square / Linear Footage Of Work: :New E Repair/Replace ❑ Demolition "064-/ / c. * * ** *** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** F * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ J 2 —$ / ®4 CCF $ O CO /CC $ Notary $ Train' CC��ducation Fee $ 0-2,0 Scanning $ ' Radon $ 0:1 DPBR $ (O. a Double Fee $ Violation date: Structural Review. $ Total Fee Now Due $ 160 Bond $ See Reverse side —> 110 TFIER MAR 5 ZU11.! Technology Fee $ V' D Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work willbe 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 deliv'red to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commenc' 'nt must be p r ted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the e o such pi ted notice, the inspection will not be approved and a re- inspection fee will be charged. Owner or Agent The foregoing instrument was acknowledged before me this 5 day of rn , 20 C p , by SW W who is personally known to me or who has produced tip As identification and who did take an oath. NOTARY PUBLIC: \`���\1111to a / 1,114.911///,./ 1 n .� Ar Sign: l " ��C ��� Print: co . ®f 0 C4 ' ' �`1 My Commission Expires: _ —+ . O o 0 . o �� . /,... ••• ' ... � 1 1111 f i1 \\ * * * * * * * * * * * * ** * * * * * * * * * * * * * - , a 4 ........................... ......... *................. ./zhv ... /! /!lIIIIII111 \\ /® APPROVED BY (Revised 07 /10 /07)(Revised 06/10/2009) Engineer Signature Contractor The foregoing instrument was acknowledged before me this 5 day o ,20:10 V C 42x who is personally known to me or who has produced 1) as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: Plans Examiner Zoning Clerk checked 03/08/2010 15:50 3054687989 • AC# 4410835 0 51:j / 2009 00014.47.1 3.2 001 Tint) Eti,EC*14:20, -.00 004 trin Nalltivot 10:elotir tS EkEitt.MEE trkaot : bite pt: Expirati date: AITO 11, 10 4 ..0011A-Vo ALOgam ot logo ..141V -4343tn T-Ikkr EAY # 3 'Ft 3.31-6-6 SIMS OF 'FIIVIVVA AMPSTRONG_ELECTRIC_I PAGE 04/05 DfLM AS .11 LAT I oN SEQ# L09.052100242 TA DRAGO ZitERY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 CARDOZA, OSVALDO ALFREDO AMPSTRONG ELECTRIC INC P 0 BOX 771446 MIAMI FL 33177 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Regulation. Our professionals and businesses range from 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.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and team 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! DETACH HERE (850) 487 -1395 STATE OF FLORIDA AC# 4 110 8 3 5 DEPARTMENT OF BUSINESS AND PROFS- StONAL 1 MATION EC13004184 CZRTIFIRD 41W0zA, AMPSTgONG U'5/21./08 080447732 RI CAA COTRACTOR 0 IS CERTIFIED under the provisions of ch.489 expiration date: AUG 31, 2010 L09052100242 1 • O . QUALIFYING TRADE(S) 0001 ELECTRICAL GOItratez P.E. , Seixetary of the Board /1-..`"'"- Wald-Dade Cotmty retains al property rights herein. 02E000 AMPSTRONG ELECTRIC INC D.B.A.: CARDOZA OSVALDO A Is cettified under the provisions of Chapter 10 of Miami-Dade County - — AMtDDE ye eintaredetessvitel dn a cude CTQB Construction Trades Qualifying Board BUSINESS CERTIFICATE OF COMPETENCY STATE OF FLORIDA AC# 441 0835 DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Ec13004184 -- 0.812. 1 1/09 080447732 , - CERTIFIED ELECTRICAL CONTRACTOR ' . CARDOZA, ,OSVALDO ALFREDO AMPSTRONG- ELECTRIC INC IS.,-PERIFIEID under al43 provisions of ch. 489 Fs likpil4tioni.4atei 'AUG '31, -. 2010 LD9052100242 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR QTR ADD'L INSRD TYPE OF INSURAN POLICY NUMB POLICY EFFECTIVE DATE (MMIDDNYYY) POLICY EXPIRATION DATE /MMIDDIYYYYI LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY 04 —GL- 770914 6/16/2009 6/16/2010 EACH OCCURRENCE $ 1,000,000 X DAMAGE TO PREMISES (Ea occurrence) $ 50,000 I CLAIMS MADE 1 X 1 OCCUR MEDEXP(Any $ 1,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENII AGGREGATE LIMIT APPLIES PER: POLICY n IECT n LOC PRODUCTS - COMP /OP AGG $ 2,000,000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 04 —GL- 770914 6/16/2009 6/16/2010 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ EA ACC $ OTHER THAN AUTO ONLY AGG $ EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ WORKERS AND EMPLOYERS' ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER (Mandatory If yes, describe SPECIAL PROVISIONS COMPENSATION LIABILITY WC STATU- r OTH 1 TORY LIMITS I I ER EXCLUDED? E.L. EACH ACCIDENT $ in NH) under below E.L. DISEASE • EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS / VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS Electrical Contractor 14:40 MAR 05, 2010 AC RE) COVERAGES ACORD 25 (2009/01) INS025 (200901) FR: AMANDA 4067632 PAGE: 1/1 CERTIFICATE OF LIABILITY INSURANCE PRODUCER (305) 595 -3323 FAX: (305) 595 -7135 Eastern Insurance Group, Inc. 9570 SW 107 Avenue Suite 104 Miami FL 33176 INSURED Ampstrong Electric, Inc. 6965 NW 43rd Street Bay #3 Miami 1 FL 33166 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURER A: Mid-COntinent Casualty INSURER B: INSURER C: INSURER D: INSURER E: DATE (MMIDD/YYYY) 3/5/2010 NAIC # CANCELLATION (305)756 -8972 Village of Miami Shores 10050 NE 2 Avenue Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WLL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE David Lopez /AMANDA ©1988 2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 03/17/2010 08 :52 SEE OTHER SIDE 3054687989 DO NOT FORWARD AMPSTRONO ELECTRIC INC OSVALDO CARDOZA PRES PO BOX 771446 MIAMI FL 33177 hdhulluahaufffludImuhhLhduhlhiHN AMPSTRONG_ELECTRIC_I PAGE 01101 ACORD. CERTIFICATE OF LIABILITY INSURANCE R0 SXM 45 03 -08 2 010 PRODUCER AUTOMATIC DATA PROCESSING INS AGCY 250717 P: (877)287 - 1316 F: (888)443 - 6112 PO BOX 33015 SAN ANTONIO TX 78265 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. CERTIFICATE DOES ALTER THE COVERAGE AFF RDE:DBY OW. INSURERS AFFORDING COVERAGE INSURED AMPSTRONG ELECTR2IC, INC. 6965 N. W. 43 ST. BAY 3 MIAMI FL 33166 POLICY NUMBER INSURER A: Twin City Fire Ins C o INSURER B: INSURER C: INSURER D: INSURER E: ANY MAY POLICIES. r nnvc occn, ioaucu ■ u I nt INAUMCU NANItU AIWUVI FUR T Ht POLICY RECIUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH PERTAIN; THE t SURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, AGGREGATtE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. PERIOD INDICATED. NOTWITHSTANDING THIS C ERTIFIC:ATE MAY BE ISSUED OR EXCLUSIONS AND CONDITIONS OF SUCH INSR GENERAL TYPE OFINSURANCE UAB LITY COMMERCIAL GENERAL UABIUTY POLICY NUMBER POLICY EtM ,D DATE/MEM EXPIRATION LIMITS EACH OCCURRENCE $ FIRE D {:MADE (Any ono fire) 9 CLAIMS MADE I OCCUR MED EX? Any oho person) 8 PERSONAL & ACV INJURY 8 GENERAL AOORIiOATE 8 DEN'L AGGREGATE LIMIT APPLIES PER: — 1 PRODUCTS • COMP /OP AGO 8 ( POLICY I�I JMRECT I I LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON •OWNED AUTOS COMBINED SINGLE LIMIT (Ea acolient) 8 BODILY INJURY IPer person) 8 BODILY INJURY (Per acctdontl 8 PROPERTY DAMAGE (Per accident) 8 GARAGE LIABIL/TV ANY AUTO AUTO ONLY - E. ACCIDENT $ OTHER THAN EA ACC 8 AUTO ONLY: AGO 8 EXCESS LIABILITY OCCUR k - 1 CLAIMS MADE DEDUCTIBLE RETENTION 8 EACH OCCURRENCE 8 — I AGGREGATE $ 8 8 8 A WORMERS COMPENSATION AND EMPLOYERS LIABILITY 76 WEG TS3571 06/16/09 06/16/10 X ITIIRVLIMT O TH- El. EACH ACCIDENT e100, 000 8100,000 8500, 000 E.L. DISEASE • EA EMPLOYEE E.L. DISEASE - POLICY LIMIT OTHER DESCRIPTION OF OPERALIONS /LOCATIONS/VEMICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Those usual to the Insured's Operations. 03/08/2010 15:50 3054687989 CERTIFICATE HOLDER Miami Shores Village 10050 NE1 2ND AVE MIAMI, FL 33138 ACORD 25 -S (7/97) ADb)TIWNAL INSURED; INSURER LETTER: AMPSTRONG_ELECTRIC_I CANCELLATION PAGE 02/05 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE (10 DAYS FOR NON- I'AYMENT) TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND 'JPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHOR RESENTA ACORD CORPORATION 1988 Inspection Number: INSP - 140662 Permit Number: EL -3 -10 -345 Scheduled Inspection Date: April 19, 2010 Inspector: Devaney, Michael Owner: SALYER, THOMAS Job Address: 311 NE 94 Street Project: <NONE> Miami Shores, FL 33138- Contractor: AMPSTRONG ELECTRIC INC Building Department Comments April 16, 2010 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 For Inspections please call: (305)762 -4949 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1132060136100 Phone: (305)468 -7988 Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Page 21 of 28 Inspection Type: Top Out Re Pipe Main Drain Heater Water Service Final Water Main Lavatory Underground Project Address Owner Information March 18, 2010 Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 311 94 Street Miami Shores, FL 33138- 1132060136100 Block: Lot: THOMAS SALYER Contractor(s) BOB'S PLUMBING CO INC Phone 305 -229 -9932 CeII Phone Fees Due CCF DBPR Surcharge Education Surcharge Permit Fee - Additions/Alterations Radon Surcharge Scanning Fee Submittal Fee Submittal Reversal Fee Technology Fee Total: Amount $1.20 $0.30 $0.40 $150.00 $0.30 $3.00 $50.00 ($50.00) $1.60 $156.80 Address Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy 'errrtrl ;Pl iil� R esi d Parcel Number Phone Type of Work: BATHROOM REMODEL Type of Piping: PLUMBING Additional Info: Bond Retum : Classification: Residential Pay Date Pay Type Invoice # PL -3-10 -37185 03/18/2010 Credit Card 03/04/2010 Credit Card Amt Paid Amt Due $ 106.80 $ 50.00 $ 50.00 $ 0.00 Date Expiration: 09/12/2010 Applicant Cell THOMAS SALYER 311 NE 94 ST MIAMI SHORES FL 33138 -2831 Valuation: Total Sq Feet: $ 1,200.00 60 Available Inspections: 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. March 18, 2010 1 BUILDING PERMIT APPLICATION FBC 20 Permit Type: PLUMBING Owner's Name (Fee Simple Titleholder) ' 25141 L-�� - Phone # ZO S ) S 6- 7 6 ‘ Owner's Address `/ i E 1 14 ST- City fr 12 f -tom State t Tenant/Lessee Name Email L 31/ tit � , 7 Sf l--cf t'la o -ayt- Job Address (where the work is being done) S01,4,-/ City Miami Shores Village FOLIO / PARCEL # Is Building Historically Designated YES NO Architect/Engineer's Name (if applicable) Value of Work For this Permit � 2-Q 0 ` Type of Work: ❑Addition []Alteration ll ENeew Describe Work: Q1 J 'vef _ 4 I] Submittal Fee $ 50 • Permit Fee $ 3 \ Lir Miami Shores Village Building D e MAR 0 4 �d. g p artmen t 2010 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BY: INSPECTION'S PHONE NUMBER: (305) 762.4949 Permit No. Zkp € 3/3 Phone # Master Permit No. Re— — 5 County Miami -Dade Zip Flood Zone Contractor's Company Name Q S ?ti-i ■ is Al G, C 0 C.- . Phone # 2 2 q -q C( 3 Contractor's Address 40 S City ' 4 Ni r State ft. - Zip 3 31 C.0V Qualifier Name . / Qt.cj.( ---g'L9 S- Phone # Q ' s- c3 ` ( - 4 2 z S State Certificate or Registration No C C 4 J 4, F Z, Certificate of Competency No. 9 4 i J'^ Contact Phone 3 C S- 2 qq 3 Z E -mail Training/Education Fee $ 0 40 Radon $ 0' DPBR $ OW) ) Violation date: Phone # Square / Linear Footage Of Work: Ly CCF $ Notary $ Scanning $3'OO Double Fee $ Structural Review. $ Total Fee Now Due $ 10(0 eP a .-_cq ft-- Repair/Replace ❑ Demolition * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ** * * ** Fee ************* * * * * * * * * ** * * * ** * * * * * * * * * * * * *r ** 1 CO /CC $ Technology Fee $ I' Bond $ See Reverse side - Bonding Company's Name (if applicable) Bonding Company's Address State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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. Sign: '( - Print: Owner or Agent The foregoing instrument was acknowledged before me this ` day of 'V\ 0 4-C- 4 4, 20 kl) , by `TAG �'" J 3411-f, 1- f._oL who is personally known to me or who has produced As identification and Xtb i111 04/#,oath. ` 120 Og10 I\Ytk,\t1 = 0 1/4V1 E � ' �� gT / / 11 1 jl nn nnl\\\ \ � � NOTARY PUBLIC: My Commission Expires: * * * * * * *stile led: * * * * * * * * * * * * * * * * ** APPROVED BY (Revised 07 /10 /07)(Revised 06/10/2009) Engineer Signature Contractor The foregoing ins ent was acknowledged before me this 1 day of j ,20 lb, b 01.3N 13 L ) . ,s (La- , who is personally own to me or who has produced 1.. 8 i' as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: \ \\ \\11 1111111 /U!/1 \ e r es • � • �p��R� 4 i°n � .... * * * * * * * * * * * * * * * * ** de * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Plans Examiner Zoning Clerk checked 03/05/2010 09:12 3052299665 D '28 "008`, ciar M` 8055 ' e PL`CTl�fl3ZNZygi '. _.. zained 46 '' tEERxIF Tacpixatioafe 33 4C .016e 05 BOB'S PLUMBING CO. '�I I ruc 6 14+e( Sf- PAGE 02/03 Miami Shores Village 10050 NE 2 Avenue M'iaxa . shores FL 33138 'SHOULD ANY OP THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION PATE. THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL *30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, OUT FAILURE TO DO SO SHALL IMPOSE NO OBLI ATIONORLIABILITYOFANYKINDUPONTHEINSURER .ITSAGENTSOR REPRESENTATIVES. AUTHORI7,Eb REPRESENTATIVE )Here LTR A THE POLICIES ANY REQUIREMENT. MAY PERTAIN, POLICIES. AGGREGATE " • OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 1S SUBJECT TO ALL THE TERMS, EXCLUSIONS LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. PERIOD INDICATED. NOTWITHSTANDING CERTIFICATE MAY BE ISSUED OR AND CONDITIONS OF SUCH _ )Here LTR A AvN 1. N$RE "•' " " — TYPE OP INSURANCE POLICY NUMBER -p (� +p0 DATE IMM ICY EXPIRAION AA�61MM10D NY OMITS GENERAL X LIABILITY CaMMKRcIAL GENERAL UABIUTY VI GP011439 11/28/09 11 /28/10 EACH OCCURRENCE $1,000,000 PREMISES(Etloxurenr,_ $50,000 OI,AIM5 MADE I ^^ 1 OCCUR MED EXP (Any one person) $ 5 , 0 0 0 PERSONAL & ADV INJURY $ 1, 0 0 0, 0 0 0 GENERAL AGGREGATE $2,000,000 _ GEM. AGGREGATE LIMIT APPLIES PER: POLICY n Tai. 1 - 1 LOG PRODUOTS - COMP/OP AGG $ 2,000,000 AUTOMDSiLE Luau'? ANY AUTO ALL OW NO b AUTG+S SCHEDULED AUTO MIRED AUTOS NON•O'NNEDAUTOK CA1,000225352 (BINDER) 02/28/1,0 02/28/11 COMBINED SINGLE LIMIT (aeaald") $ _ BODILY INJURY (Per perm) $100,000 A_ X X BODILY INJURY (ParnaoIdonl) $300,0°0 (P o $50,000 GARAGE LIABILITY ANY AUTO AUTO OM.Y- EA ACCIDENT $ OTHER THAN EA AGO $ AUTO ONLY: AGO $ EXCESS 1 UMBRELLA LIABILITY EACH OCCURRENCE $ 7 OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY AN Y PR�aa�� c cu1DED EC vIU (Mandatory In NHI tfyea. deaallDq un <ler SPEOIAL PROVl$II. N4 b,+low ` 09/01/09 09/01/10 CSTATU. I UTH UMITS I ER " - TORY E.L.EACHMMIDENT $ 500000 E.L. DISEASE • EA EMPLOYEE $ 500000 E,L, b1$MASE - POLICY LIMIT $500000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS (VEHICLES 1 EXCLUSIONS AbbRb EY ENbOREEMENT / SPECIAL PROVISIONS Plumbing contractor *10 Day cancellation for nonpayment of premiUM Master Permit #RC 10 -259 311 NR 94 Straet 03/16/2010 15:32 3052299665 PRODUCER 4 R» CERTIFICATE OF LIABILITY INSURANCE (Rio ym " BaaSP -1 01/20 10 THIS C r ONFERS NO R HTS UPON T H E OF HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Global Risk LLC 5959 Blue Lagoon Dr Suite 101 Miami FL 33125 Phone:305 -455 -7250 Fax:305- 4557251 INSUREn COVERAGES CERTIFICATE HOLDER Bob's plumbing Co., Inc. 4055 aii 3165 BOB'S PLUMBING CO. PAGE 01/02 INSURERS AFFORDING COVERAGE INSURER A; Gemini InsUr1:'ai ce Company INSURER B: $ pfta Inannance Company e£ PL INSURER C: VIe1inoiogy I>anusginee company INSURER D. INSURER 5: CANCELLATION NAIC .All rights reserved. The ACORD name and logo are reg stered marks o CORD 03/16/2010 15:32 3052299665 ACORD 25 (2009/01) IMPORTANT DISCLAIMER BOB'S PLUMBING CO. If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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), This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. PAGE 02/02 03/05/2010 09:12 3052299665 SEE OTHER SIDE BOB'S PLUMBING CO. PAGE 03/03 DO NOT FORWARD BOBS PLUMBING CO INC ROBERT BLDSSER 4055 SW 89 AVE MIAMI FL 33165 V -QC 14a4it r arKl,. - (Zc ho -259 3 Oc- 4144A.Z . Inspection Number: INSP- 137012 Permit Number: PL -3 -10 -337 Scheduled Inspection Date: April 23, 2010 Inspector: Hernandez, Rafael Owner: SALYER, THOMAS Job Address: 311 NE 94 Street Miami Shores, FL 33138- Project: <NONE> Contractor: BOB'S PLUMBING CO INC Building Department Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments c(4-3/td. April 22, 2010 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 For Inspections please call: (305)762 -4949 RC- Z• 10s 2C)j cu. Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132060136100 Phone: 305 - 229 -9932 Page 1 of 6 Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795 -2204 311 94 Street Miami Shores, FL 33138- Owner Information THOMAS SALYER 311 NE 94 ST MIAMI SHORES FL 33138 -2831 Valuation: Total Sq Feet: $ 4,200.00 54 Contractor(s) BUILDING EXPRESSIONS LLC Phone CeII Phone (305)224 -8154 Approved: In Review Comments: Date Approved: : In Review Date Denied: Type of Construction: BATHROOM REMODEL Stories: Front Setback: Left Setback: Bedrooms: Plans Submitted: Certificate Date: Bond Retum : Occupancy: Exterior. Rear Setback: Right Setback: Bathrooms: Certificate Status: Additional Info: Classification: Residential Fees Due CCF DBPR Surcharge Education Surcharge Permit Fee - Additions/Alterations Radon Surcharge Scanning Fee Submittal Fee Submittal Reversal Fee Technology Fee Total: Amount $3.00 $0.27 $1.00 $150.00 $0.27 $8.00 $50.00 ($50.00) $4.00 $164.54 Address 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. Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy March 18, 2010 Add fln/Al t utus : APt Phone Pay Date Pay Type Invoice # RC -2 -10 -37084 03/18/2010 Credit Card 02/19/2010 Credit Card Amt Paid Amt Due $ 114.54 $ 50.00 $ 50.00 $ 0.00 March 18, 2010 Date Expiration: 09/12/2010 Cell Available Inspections: :eratio OVED Inspection Type: Final PE Certification Drywall Miscellaneous Window Door Attachment Tie Beam Final Framing Insulation Truss lnsp Columns Foundation Window and Door Buck Fill Cells Columns Wire Lathe Declaration of Use F. Termite Letter F. Elevation Certificate 1 k Tenant/Lessee Name Email •Contact Phone v e- - roptAS y _ ' M" State Certificate or Registration No. e 1 02_45' l 2_S 5 s — F 1 SCI Describe Work: gam 4; 14_, tJ e Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 ECEIIV4 FEB i 8 zoto BY: "VS' BUILDING Permit No. ` 4 C — 2 PERMIT APPLICATION Master Permit No. Permit Type: BUILDING ROOFING. � 3o6 33z- 6enq - VOW Owner's Name (Fee Simple Titleholder) �^`P eholder) Se Phone # & t� S ) 7 a' Owner's Address An N 11 41 Li -r t Sr City 1m-7- t1Z `_ 'r Zip 3i 3 S —4 Phone # E -mail yy d 774 RcxMI R- 400 L__. • Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Zip 3 a 1 FOLIO / PARCEL # Is Building Historically Designated YES NO )( Flood Zone AV a Contractor's Company Name I a ,` tvx c� (--)( z ) o ff Phone # Contractor's Address P1, 3 19., • p I 1-w i 4— City i' v 1 j �i , t l State FL Zip 3 ) 3 4 5 Qualifier Name r 1a Phone # Certificate of Competency No. �e Na loco t' ? ry - A)e z K (fi a v Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ " 7 O C) Square / Linear Footage Of Work: 5 j 4 Type of Work: ['Addition ['Alteration []New Repair/Replace [' Demolition ******* ** ** ****** * * ** * * * * * * * *** * * * * * ** F ees * * *** * * * * * * * *, * *, * * * * * * * **x * * * ** * * * * * ** * * ** Qc+9 1 Submittal Fee $ � Permit Fee $ /yQstrx) CCF $ 300 PA Notary $ Training/ cation Fee $ 1'00 Technology Fee $ � ' 00 Scanning $ Radon $ O ' O'% DPBR $ Q O9fl Bond $ Double Fee $ Violation date: Structural Review. $ Total Fee Now Due $ 114-'54 See Reverse side - Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State N OG 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of-skdh posted notice, the inspection will not be approved and a reinspection fee will be charged. APPROVED BY Signature ' '� g Signature Owner or Agent / Contractor The foregoing instrument was acknowledged before me this 1. tp The foregoing instrument was acknowl edged before �m ee this t C R l' day of , 20 " -, by , day of h 6 , 2010 , by (R ICA_ F 3 who is personally known to me or who has produced� ( cc ��k who is personally known to me or'who has produced L l 1) As identification and who did ta4 Welf. as identification and who did take an oath. NOTARY PUBLIC: a \`%∎Innultrtl/ � � �, NOTARY PUBLIC: Sign: �-r - —• -- a " • 't' ' ? g _ d . `�' _ Sign: - i O c' friCi 9rie' kdYicikkaY**** fttktY*9eictY**** 4e4e** * *tktk**4etkA'tk*::1:*1 4 e 4 ePeie�ie 9 c�' tir Ytk9e4etk4t4e�kie�e�fe4e9e9etY4e4citit9F9c4Ytk4ritdttktFdr�e9t4es @$t9t4e4frdedc***ptbe9 **.••••••• s � / / / ll lll ll 111111 ���� Zoning Print :. � ' o p r %• •••••...... Print: 40,2 My Commission Expires: q y � �o My Commission Expires: (Revised 07 /10 /07)(Revised 06/10/2009) NCO P/.fro • Plans Examiner Engineer Clerk checked Permit No: 10 -02 Job Name e2y , 2010 v/ /nr,.dG Srope a 1 G't)2/t- o/1. ,45 Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Norman Bruhn CB® 305 - 795 -2204 Building Critique Sheet M iami Shores Vivage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 A:I.:COUNT : 617850-3 r: 02/2008 y J S I E S S : ;:3ELETE-8T'4 NAME: BUILDING EXPRESSIONS LLC ADDR: 16a.1 5W 11 ST SUITE __ : ���: 33125 MUN: 01 .2::O'RP / OWNER (MAILING): NAME: BUILL)ING EXPRESSIONS LLC C/O� ADDR: 1631 SW 11 6T �� �-' .. PAUL ITY: MIAMI ZIP: Z.3135 �7 HER INFORMATION: PR 00 000000 :-;!E-FOLIO: 01 4110 063 0690 ��=MENU CLE�R=PREV SCR F RCT E IPT IMPORTANT: THE INFORMATION HEREIN DOES NOT NECESSARILY CONTAIN PERTINENT FACTS WITH REGARDS TO REAL ESTATE CLOSINGS AND OTHER SIMIuAR ACTIVITIES. �EC �ATE: :.E:.E/03/200c; �/�3/200 `IME: 12/8;',47 ^ ^ ~^^ ^ ^ ^ ^~ ^^^^~^~^ .... RECEIPT IFqCRIPTlON AMOUNT-DUE D/R PD LEGAL ~ 64L293 SUB-GENERAL BLDG CONTRACTOR P DATE: .12/03/2009 TlME 13:48:48 `C�OUNT: 617850-3 ,.. -. ... a, ^ ^ ' ^ ^~^^ ^ ^ ' ' ' STATUS: TYPE ITEMS BLDG2 /GB CLASS: ?TATE: CBC1255887 :XEMPT-CD: RECEIPT/ZONING �OLD HOLD -EGAL: LOCAL BUSINESS TAX RECEIPT INQUIRY BUILDIN8 EXPRESSIONS LLC ' TRANSF~TO: |4ICS: CAT/NAICS: 238990 FLORIDA MIAMI COUNTY, LOCAL BUSINESS TAX PUBLIC ACCOUNT INQUIRY FLORIDA MIAMI COUNTY, LAST 11/18/2009 CC: .... ���� VET-ID PERMIT: _ ESTEVEZ FINANCEIMMUUMENT TAX COLLECTION DIVISION 140 W'FLAGLER STREET MIAMI, FLORIDA 33130 LET YEAR 010 Uai_MY17 ftwooms LBTR 1631 SW 11 ST ENTRY -DATE!.! O2/0/00 ENTRY-TYPE: W FINANCE DEPARTMENT TAX COLLECTION DIVISION 140 W. FLAGLER STREET MIAMI, FLORIDA 33130 YEAR: 2010 OC LM0108 . .... ... . .. ,. ENTRY -TYPE -DTE: W 02/06/20O8 INSP - ID - DTE: _____ 00/00/000O DESCRIPTION PRV-YRS SUB BLDG CONTRACTOR CURRENT: PENALTY HOLM Y _ DELQPEN: SVC-CHG. MUN-CONT TRANSFR: SHERIFF: ADJUST EXEMPT .00 TOTAL Y PAID ORIG DUE 1=MEMU CLEAR=PREV SCR F2=FMHIST F3=PYMTS F4=MORE REC �=MEMINC F6=MUNINQ F12=PRNT F13=HELP F14=PI F15=CONTR IMPORTANT: THE INFORMATION HERMN DOES NOT NECESSARILY CONTAIN ALL PERTINENT FACTS WITH REGARDS TO REAL ESTATE CLOSINGS AND OTHER SIMILAR ACTIVITIES. 45.00 6.75 .0t PAUL D ESTEVEZ PAUL D ESTEVEZ Employer ID: 004155408 Name: BUILDING EXPRESSIONS LLC Streett 3409 DAY AVE PROCESSED Street2: City: MIAMI MEMBER MEMBER Exemption Unit Specialist Bureau of Compliance Division of Workers' Compensation REPRESENTING CHIEF FINANCIAL OFFICER A FLORIDA DEPARTMENT OF FINANCIAL SERVICES 401 NW znd Ave., Suite S-321, Miami, FL 33128 Tel (305) 536-0306 Option 3 Fax: (305) 377-7239 www.myfloridacfo.COm/ OF FLORIDA DMSION OF WORKERS COMPENSATION BUREAU OF COMPLIANCE EMPLOYER EXEMPTIONS REPORT State: FL Zip: 33133-5030 First Name MI Last Name SF Title Effective Date Expires/Revocation Date Form Type 02/11/2010 01/29/2008 02/11/2012 01/28/2010 4 11" 4 40, EB 8 Gomdiance FEIN/SSN: 141996019 CONSTRUCTION CONSTRUCTION -?OCESSED LI 1 INSURANCE j DATE . THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALDER THE COVERAGE AFFORDED BYJHE POLICIES BELOW. INSURERS AFFORDING COVERAGE I NAIC # INsuR A: AMERICAN VEHICLE INSURANCE CO 1213130. INSURER B: INSURER C: 1 INSURER D: INSURER E: INSURER I': 4ED ABOVS FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING JMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR IN LS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH MS. ■LICY EFFECTIVE ATE (`!INUDDI1fY1 POLICY EXPIRATION DATE (MMIDDIYYI LIMITS EACH ;OCCURRENCE 1,000.000.00 X /09/09 06/09/10 DAMAGE TO RENTED PREMISES (Ea occurencel 100, 000 MED EXP (Any one person) 5,000 PERSONAL & ADV INJURY 1,000,000.00 GENERAL AGGREGATE , 2,000.000.00 1,000.000.00 PRODUCTS - COMP/OP AGG COMBINED sINGLE tMr (Ea adoident) BODILY INJURY (Per Pelson, BODILY INJURY (Per gooiden) . PROPERTY DAMAGE (Per accident) AUTO ONLY - EA BCCID.ENT OTHER THAN y• ' EA ACC AUTO ONLY:; = AG yi% :I► "- EACH AGGRO JIIIIntt ❑ ORYru7S ❑ RR • e.L. F,ACH ACCIDENT E.L DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT AC Rte' INSURED Building Expressions Llc 3409 Jay Ave MIAMI, FL 33133- CERTIFICATE OF LIAB PRODUCER Morgan Insurance Group 13155 SW 42nd Street, Suite 5107 Miami, FL 33175 Phone (305)222 -9001 Fax (305)222 -9005 COVERAGES THE POLICIES OF INSURANCE LISTED HAVE BEEN ISSUED To THE INSURED N!N ANY REQUIREMENT, TERN OR CONDITION OFANY CONTRACT OR OTHER D OCI MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HERE POLICIES. • AGGREGATE LIIVIITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLA POLICY NUMBER p INSR ADD'L LTR INSRD A TYPE OF INSURANCE GENERAL LIABILITY . ID COMMERCIAL GENERAL LIABILITY 00 CLAIMS MADE ® OCCUR ❑ • ❑ GEN'L AGGREGATE LIMIT APPLIES PER: ❑ POLICY ❑ PROJECT ❑ LOO AUTOMOBILE LWBILTTY ❑ ANY AUTO ❑ ALL OWNED AUTOS ❑ SCHEDULED AUTOS ❑ HIRED AUTOS ❑ NON OWNED AUTOS 0 GARAGE LIABILITY ❑ ❑ ANY AUTO 0 EXCESS/UMBRELLA LIABILITY ❑ ❑ OCCUR ❑ CLAIMS MADE ❑ DEDUCTIBLE ❑ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER / MEMBER EXCLUDED? If Yes, describe under SPECIAL PROVISIONS below OTHER GL -0504001716 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS, REMODELING INTERIOR CERTIFICATE HOLDER ACORD 25 (2001 /0a9 QF T006 ZZ0'ON MIAMI SHORES VILLAGE FAX: (305)756 -8972 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO TITS LEFT, BUT FAILURE TO DO 50 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD CORPORATION 1988 Z2.689SLS02 - 30NI3 IfISNI Nti9dOW 9T:60 0T0Z /6T /Z0 PRODUCER ° R CERTIFICATE OF LIABILITY INSURANC • Morgan Insurance Group 02119/10 13155 SW 42nd street, Suite #107 TE IS ISSUED AS A MATTER OF INFORMATION Mlaml, FL 33175 C ERTIFICATE DOES NOT AMEND, EX Phone •(3Q5)222-8001 COVERAGE AFFORDED �Y THE POICIES EXTEND Fax (305)7224008 INSURED Building Expressions Llc 3409 Jay Ave MIAMI, FL 33133- POLICY NUMBER GENERAL LIABILITY - 00 COMMERCIAL GENERAL LIABRITY 0❑ CLAIMS MADE LLI OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: ❑ POLICY ❑ PROJECT ❑ LOC GL- 05040Q1716 06/09/09 AUTOMOBILE LLABILITY ❑ ANY AUTO ❑ AU. OWNED ALn•oS ❑ SCHEDULED AUTOS ❑ HIRED AUTOS ❑' NON OWNED AUTOS ❑. EXCESS/UMfl ELLA LIABILITY 0 OCCUR ❑ CLAIMS MADE El ❑ DEDUCTIBLE ❑ RETENTION 06/09/10 PROF;ERTY DAMAGE Per . .iden AUTO ONLY- EA ACCIDENT OTHER THAN AUTOS ONLY: EA ACC AGG EACH ;OCCURRENCE 100,000 WORKERS GONIPENSATION AND EMPLOYERS' L' LABILITY ANY PROPRIETOR / PARTNER/ EXECUTIVE MEMBER OFFICER / MEMBER EXCLUDED? If yes, describe Linder SPECIAL. PROVISIONS hd(ow GENPRAL AGGREGATE PRODUCTS - COMP/OP AGG AGGREGATE E.L. EAQH ACCIDENT E.L DISEASE - POLICY LIMIT 2,000,000.00 CERTIFICATE HOLDER CANCELLATION POLICY IXPIRATION i DATE MM1D LIMITS EACH OCCURRENCE DAMAGE TO RENTED PREMISES a occurenoe PER = ONAL '& ADV INJURY 1213130 INSURER D: -' COVERAGES intE INSURER F: THE POLICIES OF INSURANCE LISTED HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE PO Jcy PERIOD Ii?►DIOATEb. 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, EXC AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE•BEEN REDUCED BY PAID CLAMS. INSR AMYL TYPE OF INSURA E 1,000.000.00 5,000 1 000.000, 00 1 000.000.00 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES•BE CANCELLED BEFORE THE • EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILLTY OF ANY KIND UPON THE INSURER, ITS AGEN1TS OR REPRESENTATIVES, AUTHORIZED REPRESENTATIVE A,C DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY BY ENDORSEMENT / SPECIAL PROVISIONS REMODELING INTERIOR ACORD 25 (2001 /08) QF TOOd £Z0'ON MIAMI SHORES VILLAGE FAX; (305)756 -5972 (M DATE M/ppfYY) THIS CERTIFICA ONLY AND C ONFERS NO RIFTS UPON TH!" CERTIFICATE HOLDER, is D ALTER THE COVE TEND OR INSURERS AFFORDING COVERA E T INSURER A: AMERICAN VEHICLE INSURANCE CO NAIL IC Z2.,689SLS02 N199?IBW ® ACORD CORPORATION •1988 LT:60 OTOZ /6T /Z0 ATION Seth I. ea* 0 420 5T up/ • • • • • • • • • • • : • • • • • • • • • • • • ••••• •• •• • • • * • • • 4110 • • • , • • • • • • 4•;4•• • • • • • • • • • • • • • • • • • • • • • • •.; Tom and Kathy Salyer 311 NE 94th Street Miami Shores, FL 33138 305-757-0766 6131.S.1 0 w W u 0 (r) 0 Q cn g oz w 5 Lt. F2j < z < ' o Z D < LlJ W/7,71/2e A -ec ke/71 g:,/1 caf, _ /fp p �t x , e7_ wc74n 9 r GIs .-�- 1 �o A p L JG � v � Wr -� A e a t . s 4� 10-L! Iowl &t: K 4i i'E 3 /1,i gte S, 1 - 3J3e 3o - 757- 4,744