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RC-09-1791 Z " s .� Miami Shores Village 10050 N.E. 2nd Avenue A it, h Miami Shores, FL 33138-0000 Phone: (305)795 -2204 _h L" Ns ., 3 0 .:. Expiration: 051 1 9f2010 Project Address Parcel Number Applicant 410 94 Street 1132060140360 Miami Shores, FL 33138 Block: Lot: MARIA DOCAL Owner Information Address Phone Cell MARIA DOCAL 410 NE 94 ST MIAMI FL 33138 -2846 Contractor(s) Phone Cell Phone Valuation: $ 7,000.00 F BARBAT DEVELOPMENT (954)943 -1151 Total Sq Feet: 1100 Approved: In Review For Inspections please call: Comments: (306)762 -4949 Date Approved:: In Review Available Inspections: Date Denied: Inspection Type: Type of Construction: BATHROOM & KITCHEN REMODEL Occupancy: Single Family Drywall Stories: Exterior: Final Front Setback: Rear Setback: Framing Left Setback: Right Setback: Insulation Bedrooms: Bathrooms: Plans Submitted: Certificate Status: Certificate Date: Additional Info: Bond Return: Classification: Residential Fees Due Amount Invoice # Total Amt Paid Amt Due CCF $4.20 RC -10-09 -36267 $ 241.20 $ 191.20 DBPR Surcharge $5.50 *j Education Surcharge $1.40 RC- 10-09 -36267 $ 241.20 $ 241.20 $ 0,00 Permit Fee - Additions/Alterations $210.00 Check #: 2086 Permit Technology Fee $0.00 Radon Surcharge $5.50 Scanning Fee $9,00 Submittal Fee $50.00 Submittal Reversal Fee ($50.00) Technology Fee $5.60 Total: $241.20 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. December 03, 2009 Authorized Signature: Owner / Applicant ! Contractor / Agent Date Building Department Copy December 03, 2009 1 �� ID John Miami Shores Village 5 111 3o�n Bui Department Coq 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 _ INSPECTION'S PHONE NUMBER: (30S) 762.4949 BUILDING Permit No. PERMIT APPLICATION Master Permit No. FBC 20 Permit Type: BUILDING ROOFING Owner's Name (Fee Simple Titleholder) J n r Phone # 3 f! >' 5 -(- 3 L r 2 Owner's Address s N City W4 a M S �, yr *i State C. Zip 3 i Tenant/Lessee Name Phone # Email Job Address (where the work is being done) W I d i✓ Z `j Y th 3' t City Miami Shores Village County Miami -Dade Zip 3 7 t 7 r FOLIO / PARCEL # Is Building Historically Designated YES NO X Flood Zone `_ Contractor's Company Name i /5 �l `'�� , � - yd Phone # 4 ?a 3V3 ��7f Contractor's Address __ 6q2- 6t4,) 15y� cJ✓ Aee _=j City we e C State �r -� Zip 3 Qualifier N . me F Oer AC .9 13 ,4el_37'�r Phone # State Certificate or Registration No. 0 6 / Certificate of Competency No. - Contact Phone qdh 303 47 E -mail Architect /Engineer's Name (if applicable) Phone # Value of Work For this Permit $ 7 ( ` Square / Linear Footage Of Work: Type of Work: ❑Addition ❑Alteration ❑New Repair/Replace ❑ Demolition Describe Work: I< t'! k ✓ k o, F a �.a 4 Submittal Fee $ Permit Fee $�CCF $ `` Notary $ Training /Education Fee $ Technology Fee $ Scanning $ Radon $ 5 ` DPBR $ ` Bond $ Double Fee $ Violation date: Structural Review. $ Total Fee Now Due $ ��l 'L See Reverse side Bonding Company's Name (if applicable) A l l Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) 00C 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 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.. Signature i,A _ eA,,,` A Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this G' The foregoing instrument was acknowledged before me this 2 1 day of 0 C i , 20 t�, by IV A , 4 4 C t�`4tt 1� r`G�f O � . c y Lcr'k'ii� S d C _ 20 ? b � o rs persona y own to me r who has produced who is personally kno me or - who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: 4� Sign: .,,�'` . `�' Sign: ,( � .``; P' Eva Varkonyi Print: e� — FVa Varkonv�i Print: _B ° �. "GB My Commission Expires: `' Commission #005 Comm ission Ex pi m 71575 My C m i p �� ir Expires: I SEP. 29, 2010 ' -9 Expires: SEP. 29 2010 •.of ' WWwAARONNOTARY.com OF F� rF. ,0 www.AAFONNOTARY.com APPROVED BY lans Examiner Zoning Engineer Clerk checked (Revised 07 /10 /07)(Revised 06/10/2009) STATE OF FLORIDA, COUNTY OF DADS f HE EBY ER IFY f6hat Bfua pp of do 0 Of ,AD W1 I t: it d and 1: i I Sea. HAIR I Vuk courts tw G�00 we ev 11 M I D.C. MW 1 116M air %dWM1"4ffV 1 7A RECW= COPY MIST BE pW= ON To JOB SM R TIME OF FIRST ffMTMGN CFN 20017R07 OR 8k 27066 Ps 23961 rises) PERMIT NO — TAX FOLIO NO RECORDED 10/30/2009 09:12:50 HARVEY RUVINi CLERK OF COURT MIAMI-DADE COUNTYP FLORIDA STATE OF FLORIDA: LAST PAGE COUNTY OF MIAMI -DADS THE UNDERSIGNED hereby gives notice that I wip be made to certain real property, and in accordance with chapter 713, Florida StatUteS, the following Information Is provided In this Notice of Comment t. Spam abum reoned for Lwe of r 1. Legal description of property and strwVaddrew, t(, S 1 4 4 — , . 2. Description of Improvement r 4% ' t.. A. 3. Owner(e) name WW address- fn Interest In pmpW. vg2 Name and address of too simple titleholder. :j 4. Contractor's name. address and phone POM Wo G 3 _ g. urW. payment bond required by owner from 4 It any) Name, address and phone n Amount of bond $_ a. Lender's name and address 7. Persons within the State of Florida dwWnoftd by owner upon whom notices or other documents may be 4erved as P Ided by Section 713.13(1Xq)7., Florida Staftdos, 4 Name, address and phone number A_(�A n a. In addition to himself, Owners designates the following persons) to receive a copy of the Uenors Noti ws provided In =60 713.13(1)(b), Florida Statutes. Name. address and phone number 9. Expiration date of this Notice of Commencement. (tho dM is 1 Year ftm the doe of rawrtum urdew a TffWW_ �d-% i. ; �d) WARMNOT00w"m ANY PAYMENTS MADE BY THE OWNER AFTER THE EWIRATION OFTHE NOTICE OF COMMENCEME A R E NSIDIERED I oLlR ' IMPROPER PAYMENTS UNDER CHAPTER 713, PAFM 1. SECTION - 713.13. FLORIDA STATUTES. AND CAN RESULT IN 11 r FOR! impAOVF-MENTS TO YOUR PROPERTY. A NOTICE OF Commr MUST BE RECORDED AND POSTED ON TEE JOB Wt 0 THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FIMM rxK OINO, CONSULT WITH YOUR LENDER OR AN ATTORNEY BRE CommENC 10 OR RECORDING YOUR NOTICE OF COMMENOEMIgNT. Signature(s) of Owneqs) or OwneW Authorized Offloer/Director/Partner/Manage• 9 � � Prepared By C Prepared --- Print Name "` f K1W Print Name C 4-1V Titie/Office Titwoll STATE OF FLORIDA 66" _'b'qV"C- COUNTY OF MIAMI -DACE The foregoing Instrument was acknowledged befole me this Z day o (9 ❑ By e ividually, or for Z1 ersonay known, or produced the following "of iderdifloatiorr Signature of NotW Public: Print Name (SEAL) Eva W ny! A ig 'MCOmmission #DD571575 VERIFICATION PURSUANT TO E A;?V SEP 29,2010 Under penalties of perjury, I declare that I have read the foregoing and www.AARONNOTARY.com that the facts stated In It are true, to the best of my knowledge and belief. SIgnatur*) of Ownerts) or Owner(s)'s Authorized Officer/Director/Partner/Manager who signed above: By ZLJLqD 'Q -21 y A&=__ ply ... 1Z.1- Jn Ad rn'rr!W rocs 3 il A i �y ERs M iami shores Village ones oo ,M Building Department 10050 N.E.2nd Avenue "WE Miami Shores, Florida 33138 R Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No: 09 -111e Job Name: ✓� , 2009 Page 1 of 1 Building Critique Sheet 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 CBO 305 - 795 -2204 M iami shores Village ,,,, Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 R Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No: 09- 1 `t �� e Job Name: 7'�E 1 /7"' Af P4041 , 2009 Page 1 of 1 ELECTRIC Critique Sheet A-"'O J r 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. Mike Devaney 305 - 795 -2204 LAZ � � � � r_ �_.' -_ - - � V DATE C) 7-1 0 - �C D 5 . L L LO SLIBJECTTO - - - Wl-HALI FEDF A L -J. co c 0 04 t IM GOUKUY OCLZM r FiN 0 'T • • ILE u0s -/ 3 — 0 7 ----- - - - - -- y ---- - - - - -- Office: 954- 327 -8831 CROSSROADS ; ELECTRICAL 1 460 S.W. 21 Terrace FAX: 954 327 - 8839 SERVICES CORMRAT /ON Ft. Lauderdale, FL 33312 - - - - -- T ------- - - - - -- a 4 F2, jjepi (I � .. nI 42 ff I � U t E � . o O's �U 3 ew us !,300,3 3 9 Af BRENDA L. GRIGGS My COMMISSION # DD 697317 4`= EXPIRES: November 20, 2011 A,� „4+ Bonded 7hru Notary Public Undowrit,, ------ - - - - -- y --- - - - - -- Office: 954- 327 -8831 CROSSROADS ! ELECTRICAL 1460 S.W. 21 Terrace FAX: 954 - 327 -8839 SERVICES CORPORATION Ft. Lauderdale, FL 33312 --- ____ -- T - - - - - - - - - - - - - pa e - e 0 5D O� r3o ©.33.38' IL Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INS P- 128215 Permit Number: RC -10 -09 -1791 Scheduled Inspection Date: March 02, 2010 Permit Type: Residential Construction Inspector: Bruhn, Norman Inspection Type: Final Owner: DOCAL, MARIA Work Classification: Kitchen Cabinets Job Address: 410 NE 94 Street Miami Shores, FL 33138 - Phone Number Parcel Number 1132060140360 Project: <NONE> Contractor: F BARBAT DEVELOPMENT Phone: (954)943 -1151 Building Department Comments KITCHEN REMODEL INCLUDING COUNTER TOPS AND CABINETS. BATHROOM TILE AND FIXTURES REPLACEMENT Inspector Comments Passed RONALD TEMKIN 305.519.0134 Failed Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. March 01, 2010 For Inspections please call: (305)762 -4949 Page 7 of 27 14 Nom: "" f 4°'�� h 34 3 �a.''� rfi_ �C L rnY ' xNMI��{ ,+s Miami Shores Village 10050 N.E. 2nd Avenue� Miami Shores, FL 33138 -0000 �r u Phone: (305)795 -2204 x" � Expiration: 06//91201 Project Address Parcel Number Applicant 410 94 Street 1132060140360 Miami Shores, FL 33138- Block: Lot MARIA DOCAL Owner Information Address Phone Cell MARIA DOCAL 410 NE 94 ST MIAMI FL 33138 -2846 Contractor(s) Phone Cell Phone Valuation: $ 1,175.00 CROSSROADS ELECTRICAL SERVICE ... . ...... . . ........ _ Total Sq Feet: 1800 Type of Work: ELECTRICAL For Inspections please call: Additional Info: KITCHEN REMODEL (305)762 -4949 Classification: Residential Available Inspections: Inspection Type: Final Fees Due Amount Invoice # Total Amt Paid Amt Due CCF $1.20 EL- 1I- M36427 $ 166.20 $ 166.20 $ 0.00 Education Surcharge $0.40 Permit Fee - Additions/Alterations $160.00 Check #: 1502 Scanning Fee $3.00 Technology Fee $1.60 Total: $166.20 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. 1 understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated. November 23, 2009 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy November 23, 2009 1 'Al C� Miami Shores . es Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305). 762.4949 BUILDING Perirut No. � G— PERMIT APPLICATIO t EOV Master Permit No. FBC 20 N V 13 9 Permit Type: ELECTRICAL _ ° , Name (Fee Simple Titleholder) /Kk,: h Phone # 30X- Owner's Address ` 3 j G.s r' r1 f ` IX City � : e. r h e r ! State L= t., Zip - 2 / Tenant/Lessee Name Phone # Email 1 1ob Address (where the work is being done) `1 / City Miami Shores Village County Miami =Dade Zip FOLIO / PARCEL # _ l 1— 3 2. 0 6 0 1 4 0 3 6 6 Is Building Historically Designated YES NO Flood Zone ✓°Contractor's Company Nam 0$.SAOO s CL cC Phone # 9�— 3 2 7 r Fr3l Contract 'Address /q(, j .tiff . z j 7 (t(�/� - C i �� City State ` f'4 Zip —T — l L Qualifier Nam L kAA)S Phone # SW --00 -00 State Certificat tration No. GC j-3 00333 b Certificate of Competency oN . Contact. one p E - mail ;rteh s 1. Ajig &a ga k no No-r Architect/En ' Ica le) --- Phone # Value of Work For this Permit $ �/ �� Square / Linear Footage Of Work: Type of Work: []Addition ❑Alteration New [ Repair/Replace ❑ Demolition � ;ibe.Work , lL c Submittal Fee $ Permit Fee $ 4K40 e P CCF $ OGO CO /CC $ Notary $ Training/Education Fee $ Technology Fee $ I� �Qjfo Scanning $ 0 Radon $ DPBR $ Bond $ Double Fee $ Violation date: /j� Structural Review. $ Total Fee Now Due $ lSZtsL�� V See Reverse side _ I Bonding Company's Name (if applicable) Bonding Company's Address City State Zip i 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 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 toApplcant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a re= inspection fee will be charged. Signature \,1'v� �-� � ,ta,��cw•_ Signature �t Owner or Agent Contractor The foregoing instrument was acknowledged before me this The for ing instrument was acknowledged before e thi day of , 20 by day of ."flO U , 20C 1, by ,6 r? AJOeI�, who is personally known to me or who has produced who is personally known to me or who has produced 1111 As identification and who did take an oath. brut % e as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: G ° Sign: S n: az� Print: t PG + + +� Eva Varkon i / ?•' mission #DD571575 ,�q4 "P �� My Commission Ex o4e Expires: SEP. 29, 2010 : U` y t�v h 9 ®�.1p WWW./�ARONNOTARY.com EXPIRES, NDV�i W 20, 201 '�' ° q Sond®d Thru (��I�ry �UHIi ®6�0ddF�ti[@F® oYkoY3esE9e3: +inY�k9eFr4eie3e�k�:kSr9eaY�•• 4e3: 3e3rde�te4rk�kk9r4: Y9roY�YoY: Yic�dekB: 9c�Y9rok$ rAr4r�Sr9e9r�Y�Yk�kdckkk4ifk4ehk�oY�& oY9zYoYkksY:r e: troYle�k4eicdroYk9ck�Yde�kiek��Yk APPROVED BY, G Bans Examiner Zoning Engineer Clerk checked (Revised 07 /10 /07XRevised 06/10/2009) Y y Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 12 C n — nq 1 Inspection Number: INSP- 129330 Permit Number: EL -11 -09 -1892 Scheduled Inspection Date: December 21, 2009 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: DOCAL, MARIA Work Classification: Repair Job Address: 410 NE 94 Street Miami Shores, FL 33138- Phone Number Parcel Number 113206014036 Project: <NONE> Contractor: Building Department Comments Inspector Comments Passed Ef_ Failed Correction Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. December 18, 2009 For Inspections please call: (305)762 -4949 Page 8 of 19 Y^ , "i Miami Shores Villageh� 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 9 tti ` Phone: (305)795 -2204 j Expiration: 0511 9f201 Project Address Parcel Number Applicant 410 94 Street 1132060140360 Miami Shores, FL 33138- Block: Lot: MARIA DOCAL Owner Information Address Phone Cell MARIA DOCAL 410 NE 94 ST MIAMI FL 33138 -2846 Contractor(s) Phone Cell Phone Valuation: $ 200.00 PRONTO PLUMBING INC (305)978 7755 _. Total Sq Feet: 1100 Type of Work: PLUMBING For Inspections please call: Type of Piping: BATHROOM REMODEL (305)762 -4949 Additional Info: Available Inspections: Bond Return: Inspection Type: Classification: Residential Top Out Re Pipe Main Drain Underground Rough Heater Water Service Final Water Main Lavatory Fees Due Amount Invoice # Total Amt Paid Amt Due CCF $ PLA 0-09 -36269 $ 179.60 $ 129.60 Education Surcharge $0.20 r Permit Fee - Additions/Alterstions $175.00 PL -10 -09-36269 $ 179.60 $ 179.60 $ 0.00 Permit Technology Fee $0.00 Check #: 2086 Scanning Fee $3.00 Submittal Fee $50.00 Submittal Reversal Fee ($50.00) Technology Fee $0.80 Total: $179.60 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. November 23, 2009 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy November 23, 2009 1 < 1[09 Miami Shores Village � -� i ,. g Buildin g De p artment OCT 2009 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY. + .___ - -- Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING Permit No. 91 PERMIT APPLICATION Master Permit No. FBC 20 Permit Type: PLUMBING t iI`G.f'�r°e P7✓�s.ry t.0 A +C, s>� -i .v./c a,"� e! � /,.�f_ Owner's Name (Fee Simple Titleholder) M + i T : -N L; , 1 ., ,! w �� . s Phone # 9 y S Owner's Address `l R 9 N' t A City Y a, .w f State Zip 3 3 i 3 $ Tenant/Lessee Name Phone # Email Job Address (where the work is being donee City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES NO Flood Zone s Contractor's Company Name r : c ,. f v � �. -. r.- Phone # 3Ur— 17 r S S �� Contractor's Address J City tate Zip (® Qualifier Name - � Phone # 3Pj State Certificate or Registration No. 55 7 , Certificate of Competency No. Contact Phone E -mail Architect /Engineer's Name (if applicable) Phone # Value of Work For this Permit $ QM Square / Linear Footage Of Work: Type of Work: ❑Addition ❑Alteration ❑New f Repair/Replace ❑ Demolition Describe Work: Jti r C v UVl 0 v pp Submittal Fee $" S ' V Permit Fee $ CCF $ CO /CC $ Notary $ Training /Education Fee $ Technology Fee $ Scanning $ 00 Radon $ DPBR $ Bond $ Double Fee $ Violation date: Structural Review. $ Total Fee Now Due $ See Reverse side -� Bonding Company's Name (if applicable) Bonding Company's Address City State GlA Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address 0 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 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job s' e for the first inspection which occurs seven (7) days after the building permit is issued. In the abse ce of such posted notic , th inspection will not be approved and a reinspection fee will be charged. I /;Y Signature 1 c.L _ A Signatur A -- Owner or Agent C ntractor The foregoing instrument was acknowledged before me this The foreg ing ins men was acktqw4edged before me itlp__ day of 20 by day of , 20 � b who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. t44= O 04.LA 4ication and who did take an oath. NOTARY PUBLIC: NtTAI PUBLIC: Sign: iLi C`t? ► Sign: •� Eva Varkonyi Print: t.• v Pl!a °•, Print: - _: - ommission �E� = L►C -� � �pjl�Og My Commission Expires: .`O SEP. 29, 2010 My Commission Expires�pTpa 3 C1 ��71 2011 �„ a ° WWw.AARONIVOTARY.com "4 '- APPROVE BY Mans Examiner Zoning Engineer Clerk checked (Revised 07 /10 /07)(Revised 06/10/2009) Business .Tax Receipt From: 10-01-09 To: 09 -30--10 T R1 LICENSE <:. City of North Miami. (305) 895 -9817 Business Tax Receipt No.: 007383 Remarks: PINTO PI Ili, JW P[IMMC OMIRAM Fee Paid: (C MC E CINLY) Owner: Cad Nugent Business Type: Mailing Add: 12135 NE 11 Place North Miand FL Business Add: 11 if s� W13 3 6W 9 WA 1 NZ ,A h w l AM A c .s,'� - rnmw r DO NOT FORWARD PRONTO ` GERARD W P INC 12135 NE 11 PL N MIAMI FL 33161 1 �? ��' .._ IFF�# fFf��f} J€ i�jf�} t74t��t�Fl iiti Ff�i3.$�Y�33S }�fg�dff$3�371f1t# SEE OTHER SIDE ALEX SINK STATE OF FLORIDA CHIEF FINANCM OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed . beloW has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 07/05/2009 EXPIRATION DATE: 07/0512011 PERSON: NUGENT GERARD W FEIN: 650406190 BUSINESS NAME AND ADDRESS: PRONTO PLUMBING INC 05 -05 -2009 ALEX SINK STATE OF FLORIDA CHEF FINANCIAL. OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW t CONSTRUCTION INDUSTRY' EXEMPTION This certifies that the individual listed.below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 07/05/2009 EXPIRATION DATE: 07/05/2011 PERSON: NUGENT GERARD W FEIN: 650406180 ` BUSINESS NAME AND ADDRESS: PRONTO PLUMBING INC 12135 NE 11TH PLACE N MIAMI FL 33161 A SCOPES OF BUSINESS OR TRADE: 1- CERTIFIED PLUMBING CONTRACTOR IMPORTANT: Pursuant to Chapter 440 . 0504), F.S., an officer of a* corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits at compensation under this chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on� the notice of election to be exempt. Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation If, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. QUESTIONS? (850) 413 -1609 OWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 4 11/'23/2009 10:04 3058916367 INSURANCE INDUSTRIES PAGE 01/01 � =ATI DIYYI 'Y) CERTIFICATE OF LIABILITY INSURANCE 2009 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION INSURANCE INDUSTRIES INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 953 NF 125th St ALTER THE C OVERAGE AFFORDE BY TH E POLICIES BELOW. N Miami, FL 33161 ( 305)891 -2808 INSURERS AFFORDING COVERAGE NAIC# INSURED PRONTO PLUMBING, INCORPORATED INSURER A: tWITED STATES s,xAex"TY XNEURAVIO QMM INSURER 0: US SECURITY 114SVPJMCE INSURER C; INSURER 0: INSURER E: COVERAGES 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. aRD POLICY NUMBER OP ' Y EF IVE POL r I E G', RI�Dq�IY`fYY LIMITS GENERAL LIABILITY DA EACH OCCURRENCE $ 100. 000 COMMERCIAL 3ENERAL L1AB1L1iY REMWES engo i 50, 000 OLAIMSMADE CI OCCUR MED EXP ( Any oft person) 4 5 , 000 A CL2350439A 06/28/09 06/28/10 PERSONAL & AD INJURY $ 100 000 GENERAL A06REOATE $ 200, 000 OEML AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOP AGO $ 20 X POLICY PRO LOC - AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANYAUTO (Es amidenl) $ ALL OWNED AUTOS BODILY INJURY X SCHEDULED AUTOS (Per person) S 10 , 000 8 HIRED AUTOS CA ^ 0000086322 -03 02/11/09 02/11/10 ���� Y NON -OWNED AUTOS S 20,000 PROPERTY DAMAGE (Per vAddent) $ 10,0 GARAGE LIABILITY AUTO ONLY • EA ACCIDENT $ ANYAUTO OTHER THAN EAAOC S AUTO ONLY: AGO $ EXCESS I UMBRELLA LVBILITY EACH OCCURRENCE $ OCCUR ❑ CLAIMSMAOB AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION STATIk OTI�. AND BMPLOYBRV LIABILITY Y Y!W O ANY PRIMEM ID(RTNE RlEkECUTIVE � I E.LEACHACCIDENT $ FFICERI6AEMER IX (MmMa" In NH) Byes daudba under EL, DISEASE • EA EMPLOYEE $ SPEG PROVISIONS below E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS RXS=MTXAL aLM43ING CERTIFICATE HOLDER CANCELLATION MIAMI SNORES E c VILLAG gHOU6D ANY OF THE AEOVE 13ESCRMED POUCRW BE CANC - — EEmRE THE MMATION 10050 NORTHF., ST 2 AVZb= DATE TW - MCF, THE I U90 INSURER WILL ENDEAVOR TO MAIL 10 DAYS M im i SNORE r FWR3:I]lk NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, OUT nAftAM T o tw 70 3H/4LL 33138 IMF08E NO GIUMATION OR UAMLM OF ANY XIND UPON THE INBuRER, nN A60M OR REPRKRBNrATLV . AUTHORI 'JIVE t ACOR026(2009101) _ 'I� -1900�2009A ( - 'INRJCO& OFIATION. All Ngftreeerved. The ACORID name and logo are registered marks of ACORD 05 -05 -2009 we * ALEX SINK STATE OF FLORIDA CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation lave. EFFECTIVE DATE: 07/05/2009 EXPIRATION DATE: 07/05/2011 PERSON: NUGENT GERARD W FEIN: 650406180 BUSINESS NAME AND ADDRESS: PRONTO PLUMBING INC 12135 NE 11TH PLACE N MIAMI FL 33161 -' SCOPES OF BUSINESS OR TRADE: 1- CERTIFIED PLUMBING CONTRACTOR - IMPORTANT. Pursuant to chapter 440 . 0500, F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under ,this chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05{13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. QUESTIONS? (850} 413 -1609 OWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 9 tw Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 128229 Permit Number: PL -10 -09 -1793 Scheduled Inspection Date: December 18, 2009 Permit Type: Plumbing - Residential Inspector: Levrock, James Inspection Type: Final Owner: DOCAL, MARIA Work Classification: Addition /Alteration Job Address: 410 NE 94 Street Miami Shores, FL 33138 - Phone Number Parcel Number 113206014036 Project: <NONE> Contractor: PRONTO PLUMBING INC Phone: (305)978 -7755 Building Department Comments PLUMBING WORK FOR BATHROOM REMODEL If 0 3 i n for Comments Passed L E CALL: 305.798.1230 Failed Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. December 17, 2009 For Inspections please call: (305)762 -4949 Page 7 of 11