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RC-10-1168t Inspection Number: INSP - 146921 Scheduled Inspection Date: November 10, 2010 Inspector: Bruhn, Norman Owner: HOLDINGS, LLC, JAVIN Job Address: 131 NE 97 Street Project: <NONE> November 09, 2010 Miami Shores, FL Contractor: ESR FLORIDA CONSTRUCTION INC Building Department Comments 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 Number: RC -6 -10 -1168 Permit Type: Residential Construction Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1132060132470 Phone: (305)812 -2716 REPLACE CABINETWS & KITCHEN DRYWALL, PLASTER ALL INTERIO R AREAS WHERE NEED. NEW BASE BOARD RE -RILE EXISTING BATHS , PAINT INTERIOR RE FINISH EXISTING HARDWOOD FLOORS. P as se d / Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Page 5 of 23 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. IN,R LTR ADD L INSRE TYPE OF INSURANCE POLICY NUMBER POUCY EFFECTIVE DATE (MM/DD/YY) POLICY EXPIRATION DATE (MMIDDIYY) LIMITS A INSURER A: Old Dominion Insurance 'Co. GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY BINDER 817013 08/30/10 08 /30/11 EACH OCCURRENCE $ 1,000,000 X PREMISES (Ea occurence) $ 500,000 CLAIMS MADE X OCCUR MED EXP (Any one person) $ 10,000 PERSONAL BADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2 , 000 , 00 0 PRO- LOC POLICY ,JECT AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS,)_' , .. - NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE RE I LNTION $ $ $ $ WORKERS COMPENSATION AND EMPLOYERS' UABIUTY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below TORY LIMITS ITS O ER TOR E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS • ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID YG ESRFL -1 DATE(MMBDDWYYYY) 08/31/10 ATiORI R ESE ATIV� _ _ PRODUCER Lykes Insurance, Inc. - FTM P.O. Box 60043 Fort Myers FL 33906 -6043 Phone: 239- 931 -5600 Fax: 239 -931 -560 THIS CERTIFICATE IS ISSUED AS A MATTER OF NFORMATION 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 NAIC # INSURED E.' " FL Const Inc. P.O. Box 150472 Cape Coral FL 33915 INSURER A: Old Dominion Insurance 'Co. 40231 INSURER B: INSURER C: INSURER D: INSURER E: MIAM1 0 0 Miami Shores Village Hall 10050 NE 2nd Avenue Miami Shore FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 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. ATiORI R ESE ATIV� _ _ COVERAGES CERTIFICATE HOLDER ACORD 25 (2001/08) CANCELLATION © ACORD CORPORATION 1988 IMPORTANT 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form 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. ACORD 25 (2001/08) VI I BUILDING PERMIT APPLICATION FBC 20 Permit Type: BUILDING ROOFING Owner's Name (Fee Si Ll+�. Simple Titleholder) ✓ 77) / Owner's Address / J" v 0 S94 c3 City / k State g�... Tenant/Lessee Name Job Address (where the work is being done) / / /1/( / Email City Miami Shores Village County FOLIO / PARCEL # // — 3:02v‘ - 4/3 — pZ r Is Building Historically Designated YES NO Flood Zone Contractor's Company Name ec "' 1- l L Phone # c7 6 6) (2 — 02 . 1 4Cj Contractor's Address t \ , ( `! r 16'6 i(, L City 4- ti—t_ State l 5 1 -- Zip 3 c /6 Qualifier Name -r 1 ■/ Phone # 3 Of f 4/7-2-C- State Certificate or Registration No. C & C- 6 t) 5 - Certificate of Competency No. 5 ) ( 2 -- , , ' 4 E -mail Contact Phon( Architect /Engineer's Name (if applicable) Value of Work For this Permit $ 2 2 6 - `"' — Square / Linear Footage Of Work: I' � 2i 0a Type of Work: rfte. - - - - 'S ,k (t L T td A s W i - l s s I f),),1 Describe Work: I �/1S►-t r5°[ t [yt.►,7 \n9,q Notary $ Scanning $ Double Fee $ 1 c/ Submittal Fee $-U` Permit Fee $ Structural Review. $ Addition [Alteration ❑New. ❑ epair/Replace ❑ Demolition ****** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** F * * * * * * * * * * * * * * * * ** * * * * * * * * * * * ** Radon $ 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 Training /Education Fee $ Violation date: /J6L /11/4'6SI Z 4 1t ne .5 T1.5 '' ?SS ST Miami -Dade DPBR $ Permit No. Master Permit No. Zip 3 3 / 9.5 Phone # S Phone # CCF $ Total Fee Now Due $/UP `I' 2 2010 (L3 Zip d CO /CC $ Technology Fee $ Bond $ See Reverse side --> •00 Bonding Company's Name (if applicable) Bonding Company's Address City State Zip 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: 1 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 caner or Agent The foregoing ins tf ument was acknowledged before me this / ""x-- The foregoing ins /1 day of .e y' . , 20 t s2, by J✓v. day of '7 ' who is personally known to me or who has produced 'y' 1 ✓, who NOTARY P Sig Print: My Commission Ex * * * * * * * * * * * * * * * * * * * * * ** APPROVED BY (Revised 07 /10 /07)(Revised 06/10/2009) As id- ... ication and who did take an oath. SAWED SHABBAH ID Notary Public, State of Florida Commission# DD688386 M• comm. expires June 24, 2011 Plans Examiner Engineer Co actor rument was acknowledged before me thi /c' by e or who has produced entification and who did take an oath. NOTARY PUBLIC: 1 -.No rill gn: A% Si Print: NOTARY PUBLIC -STATE of FLORIDA gat«slia Marksman My Commis 3i rn #D ➢330223 Jxpires: OCT. 12, 2012 T bR U ■iTLAJTlc BONDING CO., INC. io Zoning Clerk checked NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. TAX FOLIO NO. 11 ` 3aD - 013 STATE OF FLORIDA: COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that Improvements will be made to certain real property, and In accordance with Chapter 713, Florida Statutes, the following information Is provided in this Notice of Commencement 1 AA')S Mov■E".S - L .? 3 f Interest in property: d r^'^"tc 1N Name and address of fee simple titleholder. 4. Co Swom to and subscribed Notary Public Print Notary's Name My commission expires: 123.01 -52 PAGE4 W02 Signature of Print • mer's Name 4Z?f /*J �� L ✓/ ;s 111111111111111111111111111111111111111111111 CF111 2010R0506175 OR Bk 27367 P9 4848; (1vs) RECORDED 07/28/2010 15:03:51 HARVEY RUVIHr CLERK OF COURT I1IAHI -DADE COUHTYr FLORIDA LAST PAGE 1. Legal deggription of property and street/address: t / NF 9 7 s > 1vi j A vo S d 1 rL ?13 Aim") ribi1s sec a i 0 Pt /0 -7c, Lo . _ L.a c2p gcR if Lei .rite- 7 2. Desr f ription of improveme t: N �Qy c ('/� i t in)1 n tor's n and addres : 3. Owner(s) name and address: . 25/V/4 A.)(1091 G L G . / r IAJ 5. Surety: (Payment bond required by owner from contractor, if any) Name and address: ci Amount of bond $ 6. Lender's name and address: 7. Persons within the state of Florida designated by Owner upon w notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes, Name and address: 8. In addition to himself, Owners designates the following person(s) to eive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name and address: 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a different date Is specified) THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED FOR THE POLICY PERIOD NOICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT -0 WHICH THIS CER IFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN L TR TYPE OF INSURANCE LIBUER .1. POUCYNUMBER POLICY ER ,:,, n ..ea 1 • POLIQYEXP . h. 1. • Ahab I LAIRS 'A GENERAL LIABILITY XV COP/MERCIAL GENERAL LIABILITY C LAIMS •MADE OCCUR GL30092 9/23/2009 1 . EACH OCCURRENCE . /23/2010 r1TE .. - I 9 rr0 n 51 .000 A 000 s 100,000 M D EXP (Apr or Peron) 5,000 $1,000,000 _ � PERSONAL &ADV INJURY dENERAL AGGREGATE $ , 000 , 000 NLAGGRET6 MIT APPLIES PR PRODUCTS - CO( ' /OP AGCZ,,3 1,000,000 PO 'PRO- LGC $ AUTOMOBILE — _ LIABILITY 9/23/2009 /23/2010 COMBINED SINGLE LIMIT fl $N _ ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED N� Pl -0WVEO AUTOS CA-24753 r BODILY IN.URY (Parpctnan) s15,000 SCOILYINJURY (For accident) $30,000 PROPERTY CAMAGE (P t int) $15,000 8 5 UMBRELLALW6 EXCESS LIAR OCCUR CLAIMS-MADE N/A EACH OCCURRE,NCt_ $ $ _ _ DEDUCTIBLE j GGREGATE RETENTION $ b WORKERS COMPENSATION AND EMPLOYERS' UABW Y1 N TY ANY PROPRIETOR/PARTNER /EXECUTIVE CFF'ICER,MEMBEREXCLJCE Dt ,w (maetety In NH1 ■ li s - . d c rt,e u DESCRIPTION OF OPERATIONS below NIA N/A i 1 WC STATU• I IoT TORY LIMITS FR L EACH ACCIDENT 5 E L DISEASE - EA EMPLOYEE F.L. DISEASE - POLCY LIMIT $ $ I DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHiCLE5 (mph ACORD lot. Additional Remarks ScMdul , If mere spew Is regslre ) RESIDENTIAL AND OOGGIERCIAL PLUMBING CONTRAC'T01t AC Rfa D THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAG BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISS REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER COVERAGES CERTIFICATE OF LIABILITY INSURANCE IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If 5 BROGATION IS WAIVED, subject to the terms end 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 KEY KNOWLEDGE INSURANCE, INC. 9101 - S. W. 19TH, PLACE FORT LAUDERDALE, FL. 33324 INSUREOvN. G. PLUMBING & SPRINGALBRS SVCS. , INC- MERVIN 'TROY GORDON 1265 NW 203TH STREET MLANM , FL 33169 CERTIFICATE NUMBER: MIAMI SHORES VILLAGE 10050 W.E. 2ND AVENUE MIAMI SHORES, PL. 33138 305- 756 -8972 SHOULD ANY OF THE ABOVE DE - IBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CATE THEREOF, NOTICE WILL se DELIVERED IN ACCORDANCE VITTM THE POLICY - ' OviSIONS AUTHOR12E0 REPRESENTATIVE MARIA A. RYALS, AG CERTIFICATE HOLDER ©1988.2009 AC o RD CORPORATION. -11 i1 • is reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD P odueed uetng Farms bass Roo 3oIhvare. uraw.FormsBoss. )mprvsslve PL5I MINg 803- 208.1977 TO 99Vd RNT RnalimnN)I A 1)1 Policy Number: CA •24753 E CERTIFICATE HOLDER. THIS AFFORDED BY THE POLICIES NG INSURER(8), AUTHORIZED CONT N(WIE! PHONE E (954)382-5259 IWC No. EMAIL Iteykstowlipagaal . COm Avagas, PRODUCER cuirrolaFa to v, _. WSII RER(S) AFFORDING COVERAGE "URERA :Ascendant Commercial Insurance, amc . IM$URER : Ascendant CoOmInerc al Insurance, Inc. N6uPERC: INSURER D = INSURER E INSURER F: CANCELLATION REVISION NUMBER: Date Entered: 9/21/2007 DATE INMtOOtYYYYI 7/29/2010 FAX (954) 382 -0080 NAIL N GIRGIn7P1'bcs FC :bT aT127 /F7 /1 Gi ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID FR ESRFL - 1 DATE(MM/DD/YYYY) 03/04/10 OR BELOW. PRODUCER Lykes Insurance , Inc . - FTM P.O. Box 60043 Fort Myers FL 33906 -6043 Phone: 239-931-5600 Fax:239- 931 -5604 THIS CERTIFICATE IS ISSUED ONLY AND CONFERS NO HOLDER. THIS CERTIFICA ALTER THE COVERAGE A AS A MATTER OF INFORMATION IGHTS UPON THE CERTIFICATE E DOES NOT AMEND, EXTEND FORDED BY THE POLICIES INSURERSAFFORDINGCOV RAGE NAIC# INSURED E.S.R. FL Const Inc. P.O. Box 150472 Cape Coral FL 33915 ("AA/PRA/:cc INSURER A Southern- Own.ra trams co. 10190 INSURER B INSURER INSURERD INSURER E Date: 3/4/2010 03:57 PM NOK WIJU L LTR NSRC OTHER THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED ANY REOUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY B MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CO POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE X OCCUR GEN'L AGGREGATE LIMIT APPLIES PER n POLICY n JH n LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS GARAGE LIABILr1Y ANY AUTO TYPE OF INSURANCE EXCESS/UMBRELLA LIABILITY I OCCUR n CLAIMS MADE DEDUCTIBLE RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED') It yes. descnbe under SPECIAL PROVISIONS below CERTIFICATE HOLDER ACORD 25 (2001/08) 20725355 Miami Shores Village Hall 10050 NE 2nd Avenue Miami Shore FL 33138 POLICY NUMBER Sender's Fax ID: 239 -931 -5604 MIAM100 YULICY tfhbl. I IVE DATE (MM/DD/YY) 11/09/09 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS carpentry noc CANCELLATION NULICY tXWHA 1IU DATE (MMIDDm') T R RE ESENTATIVE 11/09/10 SHOULD ANY OF THE ABOVE DESCR DATE THEREOF. THE ISSUING INSURI NOTICE TO THE CERTIFICATE HOLDS IMPOSE NO OBLIGATION OR LIABILIT REPRESENTATIVES. IOTWITHSTANDING ISSUED OR )ITIONS OF SUCH EACH OCCURRENCE UNWUDt I V KW CU PREMISES (Ea occurence) MED EXP (Any one person) PERSONAL 8 ADV INJURY GENERAL AGGREGATE PRODUCTS COMP /OP AGG COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) AUTO ONLY - EA ACCIDENT OTHER THAN AUTO ONLY EACH OCCURRENCE AGGREGATE TORY LIMITS ER E L EACH ACCIDENT E L DISEASE - POLICY LIMIT LIMITS EA ACC AGG E L DISEASE - EA EMPLOYEE $2,000,000 $ $ OR)i (0I NAL. $1,000,000 $300,000 $ 10,000 $1,000,000 $2,000,000 Page 1 oil' ED POLICIES BE CANCELLED BEFORE THE EXPIRATION R WILL ENDEAVOR TO MAR. 10 DAYS WRnTEN NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL OF ANY KIND UPON THE INSURER. ITS AGENTS OR @ ACORD CORPORATION 1988 LE L 6- Y E #:T AIL'S j Miami Shores Village 'APPROVED BY DATE 'ZONING DEPT BLDG DEPT i O CCMPIJANCE WITH ALL FEDERAL STATE AND eruN N MULES AND REGULATIONS .. ... • • a . . -- JUPJ 2 4 2090 6".I butt- c.-its-n . VkIA‘N c e A r \N Sri -t , kT 4 0 0N 0 Slr}c s Aa4 -A- . 4-Pp ywelre/d 13" ' "' 4 • • • • • •• • • • • • • • • • • • • • • • • • • •,. ...,._ • • • • • • • • • • t 1 e P /)- Ti7 S r 1 • • • frit'Y ›z- Au/4 ••• • • • • • ••• • • • • A eel-att.-ye? l ' /1 .. •. • • . . • •• • ••• • ,-• • • • • • . . . . . • . . • •• • kt:t. ••• • ••• • • 4;%. difittiee4f14 OU ( VL t.) 0 3P►J. $Crk -rIt :I -F*f : M- Ara 0 .n\fetsiiirtillet. . u k i \I / ' i - r PCw LAO eXiSrim b 1 /5 All dimensions .size designations given are subject to verification on job site and adjustment to fit job conditions. 20 TEC HNOtoc,es _A This is an original design and must not be released or copied unless applicable fee has been paid or job order placed. 24.DISHW PANN, JAMES NE 97 ST 1 All 1 rte..,;m, ii• 1 101 3DB15 13 W363612R Y+, ® W243612R w O All dimensions .size designations given are subject to verification on job site and adjustment to fit job conditions. 20 TEC HNOtoc,es _A This is an original design and must not be released or copied unless applicable fee has been paid or job order placed. Designed: 5/20/2010 Printed: 5/21/2010 PANN, JAMES NE 97 ST 1 All 1 rte..,;m, ii• 1 • ••• • • • • .••• • • • 00000 • • • • • p®ir'T frI' Pt - C eRbrr 'en re /5 ro He/t e 7 a 6 , rz® , n.e c teriB-el e, i u a apee,0-QA /zee, r 8 6' 6 -F Pize"r4et`"`ed- 9 fri#)4 /P-P".41 -L7 1f19Z" • • • • .. • • • •••• • •••• . . • • • • • • •• •• • • •.•••. •••• • • • •.•... • - . T • � Ig ••• • ••• • • -• -In z N .... • • • • •... • •. ••... • • • • • • • • • •• • • • • • .. • •• •• • •... •.•. • • ... • • .• .•3• • • 1IN . ..1r) • • ....c •... ..... • • .. • • • • • \\ N DANAT T NF Q'7 ST 63612R WF3 EBF3Z 23 4 " „25 " 2 P1 1 All dimensions _size designations given are subject to verification on job site and adjustment to fit job conditions. TECHNOLOGI This is an original design and must not be released or copied unless applicable fee has been paid or job order placed. Designed: 5/20/2010 Printed: 5/21/2010 Inrrwino #• 1 • • • • • • • .. • r IN • ( e ) ••• • .. . • • . • •• • • •.•. • • • • . co..•• �/ • • • N . •, .• • P 36R D A'ATM TAAATRC NIP Q? CT 119 2" 36" 12 30 " W362028L EF -3DI V12361 0 01 0 0, 3DB'BF a al W302112L MW.HOOD W1236WF3PCW36R 00 12' 2 PCBAR36R F1 2 All dimensions _size designations given are subject to verification on job site and adjustment to fit job conditions. TECHNOLOGIES -� This is an original design and must not be released or copied unless applicable fee has been paid or job order placed. Designed: 5/20/2010 Printed: 5/21/2010 Thawing #: 1 1V 24" PCW36R PCBAR36R 36" PANN .TAMPS NF. 97 ST 33" W333612R 10 01 B21 R 21' 123 4" 4 4 664 TCDL159024 24.DISHW 1 n nn 3n All dimensions size designations given are subject to verification on job site and adjustment to fit job conditions. TECHNOLOGIES This is an original design and must not be released or copied unless applicable fee has been paid or job order placed. El 3 Designed: 5/20/2010 Printed: 5/21/2010 Drawins #: 1 All dimensions size designations given are subject to verification on job site and adjustment to fit job conditions. 9n T EC H N O L O G f E S J This is an original design and must not be released or copied unless applicable fee has been paid or job order placed. Designed: 5/20/2010 Printed 5/21/2010 PANN. JAMES NE 97 ST 1 El 4 1 Drawing #: 1 • • • - 1-1C■1 000 M • • O) . • • �• • • N . ,. .. • • • r- 1cfl • • • • • • • • • In •• ••• • • • • • • • .•• •• •• • • •.• .. • • •• • ...... • • • .. • • • • . •s•. • • - - / T( 424 1 1, 24" 0 COO ODD 1174" - 33" 39" i '1 1 0 01 0 01 DB15- 0 01 W363612R WF3 5" B24R BF3 24 REPLACE FIXTURE AND REWARER PIPE HOUSE. Passed Inspector Comments Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection Number: INSP- 147027 Permit Number: PL -6 -10 -1177 I Inspection Date: November 08, 2010 Inspector: Hernandez, Rafael Owner: HOLDINGS, LLC, JAVIN Job Address: 131 NE 97 Street Project: <NONE> Miami Shores, FL Contractor: MG PLUMBING & SPRINKLER SERVICE Building Department Comments November 08, 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 t 0 (0c8 Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Repair Phone Number Parcel Number 1132060132470 Phone: (305)525 -9236 Page 1 of 1 BUILDING Permit No. fit: (p - I (7 1111 PERMIT APPLICATION Master Permit No. Rf - (c -IC I `l0 FBC 20 Permit Type: PLUMBING j� Owner's Name (Fee Simple Titleholder) 4 /AJ / J °14/61 Phone # 'd-S � 9� 9 , SS Owner's Address / J t'V City 44 /'- J Email FOLIO / PARCEL # Contractor's Company Nam Describe Work: /lei" ZDeer Submittal Fee $ Notary $ Scanning $ O-00 L L. :' State 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 Job Address (where the work is being done) Zip Tenant/Lessee Name / Phone # /S'. City Miami Shores Village County Miami -Dade Zip / -3 0/2 — *=' 2 77 � Is Building Historically Designated YES NO Value of Work For this Permit $ / 2 0 0 Type of Work: ❑Addition ❑Alteration Contractor's Address G65 &ICO a0 City Mi 0,11 State Qualifier Name JD p 1 g / �� t"� j�—� (/77 State Certificate or Registration NoQ. od0 Certificate of Competency No. p Y Contact Phone v 70/ 4 E -mail Architect /Engineers Name (if applicable) Training /Education Fee $ `rte / fie w Permit Fee $ 1 ONew iliC.4Phone # ° 5,73-c74$86, Radon $ 1 ? DPBR $ • - (Q0 Flood Zone Zip .6V ( Phone #7 age /got - 4 Phone # Repair/Replace ❑ Demolition / fide= ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** CCF $ } -� CO /CC $ Technology Fee $ I . RAJ Bond $ Double Fee $ Violation date: Structural Review. $ Total Fee Now Due $ See Reverse side -3 Bonding Company's Name (if applicable) Bonding Company's Address City State Zip 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 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. Owner or Agent he foregoing instrument was acknowledged before me this /c The foregoing instrument was acknowledged before me this day of 410X, ' 20 / by Js7n- 1pf'/'2,n�A ay of // 20 '`-!by who is personally known to me or who has produced 4.L,,,,-9 ? k who is personally known to me or who has produced NOTARY PUB Sign: Print: My Commission E . ires: * * * * * * * * * * * * * * * * * * ** APPROVED BY (Revised 07 /10 /07)(Revised 06/(0/2009) As . ification and who did ake an oath. c 7,7 sek. lans Examiner Signature as ide, NOTARY NOTARY P. Print: My Commission Expires: ntractor tietOrtrilitiFILIMP4 take an oath. tasha Marksman a'tssion > 1)D23G223 OCT. 12, 2012 SAIYED SHABBAR JAWAID Notary Public, State of Florida �. Commission# DD 386 My comm. expires June 24, 2011 uallowiatAkookdo.1,4*******,&-mboik.******************************************************** Zoning Engineer Clerk checked Inspector: Devaney, Michael Project: <NONE> Building Department Comments November 08, 2010 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 pkv446 Inspection Number: INSP - 147036 Permit Number: EL -6 -10 -1178 Scheduled Inspection Date: November 09, 2010 Permit Type: Electrical - Residential Inspection Type: Final Owner: HOLDINGS, LLC, JAVIN Work Classification: Addition /Alteration Job Address: 131 NE 97 Street Miami Shores, FL Contractor: SUNSHINE ELECTRICAL CONTRACTORS CORP For Inspections please call: (305)762 -4949 Phone Number Parcel Number 1132060132470 Phone: (305)265 -4958 REMODEL OF KITCHEN, CHANGE LIGHT FIXTURES AND CELING FANS (7 OUTLETS) Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Page 12 of 33 BUILDING PERMIT APPLICATION FBC 20 Architect /Engineer's Name (if applicable) 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 Permit Type: ELECTRICAL } , Owner's Name (Fee Simple Titleholder) ,..74Yf.A., j�,��/�,(,,S 4 Phone # - 99s SS Owner's Address / 906 -f J City Al /.4^• -/ State / 0/ - aZ St 2c Contractor's Company Name J 4.1 e6. Contractor's Address /1 .r,..s Ctr City /-j i 'ar11 State 'F Qualifier Name Pf2ii.y14,,rD dcL,> State Certificate or Registration No. r= /? O D o 4 y 73 Contact Phone 776 - ,4Z73- 6/ V E -mail Master Permit No. RC (o (O - \ ( DS Zip 2,r Ps Tenant/Lessee Name Email ' y, , 0 • / 4 . k Job Address (where the work is being done) /,/ /1/6 e 16 ' s 7: City Miami Shores Village County Miami -Dade Zip 3 ?/ 3 7 FOLIO / PARCEL # / / ^ � e P t f ) ' - Phone # Is Building Historically Designated YES NO X Flood Zone Permit No. C L- 10 (0- I 11g Zip ,„17 Phone # 20C. der- y 98 Certificate of Competency No. O2 , E D a a " Q3 Phone # Value of Work For this Permit $ 0 A'P1 t"4- Square : 15 pC D Type of Work: ❑Addition ❑Alteration [New ❑ Repair/Replace ❑Demolition Describe Work: RC o 0Ct, O f Kucs4p✓ 1 GH4 ^O6 L%G fiKrot 4.67 e4 F■ -7 rI rS **** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ***** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ _' Permit Fee $ r �� CCF $ I•p CO /CC $ Notary $ Training /Education Fee $ Q .4 Q Scanning $ ' 00 Radon $ •l1Ll J DPBR $ 1 •(QC Double Fee $ Violation date: Structural Review. $ Total Fee Now Due $ am° f Technology Fee $ 1 • (a / Bond $ See Reverse side -a 4 Bonding Company's Name (if applicable) Bonding Company's Address City State Zip 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 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 re- inspection fee will be charged. Signature !Owner or Agent The foregoing ins {rument was acknowledged before me this /�-- day of ./1^ /21' , 20 lo , by FL . .� who is personally known to me or who has produced 2.&? L • Print: My Com f /Jlyis.rp Y� As ide ;. ication and who did take an oath. P ��'` Plans Examiner • # � (Revised 07 /10, /07)(Revised 06/10/2009) 1 AMIN JAWAID Notary Public, State of Florida Commission# DD668386 My comm. expires June 24, 2011 T ***-17 F WWWWW************************ * * * * * * * * * * ** * * * * * * * * * * * * * * * * * ** Engineer Signatu Contractor The foregoing instrument was acknowledged before me this/ 5 day of s t , 20 /0, by *aft Oci who is personally known to me or who has produced as identification and who did take an oath. NOTARY ' 1 ► LIC: MY COMMISSION # DD 619936 EXPIRES: December 5, 2010 Bonded Thru Budget Notary Services Zoning Clerk checked THE POUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTW THSTAIDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WTH RESPECT TO VU UCH 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 UMfTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR t. AMYL ■. - -:o. GENERAL u: . ..- _ .....!. UAB UTY COMMERCIAL GENERAL UABIUTY I CLAIMS MADE n OCCUR POUCYNRUMBER POLICY EFFECTIVE ,, 1_ t..._.,._._.uu POLICY EXPIRATION __ ► t ..:r.. - iuu I.BAtTS EACH OCCUR ML E S PFD S ( oowsve'l S MOW FXP (Am one person) S GENL PERSONAL. & ADV INJURY S GENERAL AGGREGATE S PLIE PER AGGREGATE LIMIT AP PRODUCTS - COMP/OP AGG S — 1 POLICY n . I ( LOC AUTOMOBILE UA8LITY ANY AUTO ALL OWED AUTOS SCHEDUUED AUTOS HIRED Afros NON AUTOS COMBINE) SINGLE LIMIT (Ea as nt) S BODILY INJURY (p il p) S — i BODILY INJURY (Per t) S PROIPERTY GE (Per accident) $ GARAGEUABIUTY AUTO AUTO ONLY - EA ACODENT S OTHER THAN EA ACC S ___1 ANY AUTO ONLY: AGG S SUCCESS — 1 / UMBRELLA UAERITY EACH OCCURRENCE S OCCUR I I CLAIMS MADE AGGREGATE S DEDUCTIBLE RETORTION S $ S A WORKERSCONIPE AND EMPLOYEiSTJ ANY PROPRIETOR1pARTNERRX6CUTIV ( MAL SATION ABRHTY ( NiC07078169 7/16/2009 7/16/2010 % J lJW S' rat EL EACH ACCIDENT S 100,000 IX I I In E1_ DISEASE - EA EMPLOYEE $ 100, 000 N H) PROVISIONS below EL DISEASE - POLICY UNIT 5 500,000 OTHER R . DESORPTION OF OPERATIONS/ LOCATIONS /VEHICLES /E XCLUSIONS ADDED BY ENDORSEMENT/SPEC/AL PROY190NS electrical contractors INSURERS AFFORDING COVERAGE mmmiRkAequiCap Insurance Company Suite 104 Miami FL 33176 INSURED Sunshine Electrical Contractors Corp 7512 NW 55 Street Miami FL 33166 INSURER II INSURER G INSURER Q INSURER E NAIC U# 9570 SW 107 Avenue COVERAGES CERTIFICATE HOLDER Village of Miami Shores Building Department 10050 NE 2 Avenue Miami Shores, FL 33138 ACORD 25 (2009101) INS025(2aso1) I1ULLIC11. 1 fl1J LORI Ir8.A 1 WCJ sm. I euma.Iw, I..n. I-I.• v.. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. CANCELLATION SHOULD ANY OFTHEA80VE 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 FALURE TO DO SO SHALL 1 IMPOSE NO OBLIGATOR OR LIABWTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHOR ®TATLVE David Lopez /AMANDA ©1988 ACORD CORPORATION. All rights reservec The ACORD name and logo are registered marks of ACORD Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 147026 Scheduled Inspection Date: November 09, 2010 Inspector: Perez, JanPierre Owner: HOLDINGS, LLC, JAVIN Job Address: 131 NE 97 Street Miami Shores, FL Project: <NONE> Contractor: MANCO AIR INC. Building Department Comments A/C CHANGE OUT 3.5 Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments November 08, 2010 For Inspections please call: (305)762 -4949 Permit Number: MC -6 -10 -1176 Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: A/C Replacement Phone Number Parcel Number 1132060132470 Phone: 305/409 -7719 Page 11 of 33 1 12 ,110 - tt(',t -i l ) L;-1 •itit k to _ '3Am(5 ' ' t.N BUILDING PERMIT APPLICATION FBC 20 Permit Type: MECHANICAL Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PI/ONE NUMBER: (305) 762.4949 Owner's Name (Fee Simple Titleholder) ,...13 /�OL✓l,te S t6hone # Owner's Address S 7 7 City Ai/ ? /Y /� t) State Z ipi.?/ 2S Tenant/Lessee Name ,, J Email 4" / »,,) Ci' 7A-7El L, 7 A la Job Address (where the work is being done) City . Miami Shores Village County FOLIO / PARCEL # / — off d 6 0 /3/ Nb" 9 2A s'T Zip .T?/ J� Is Building Historically Designated YES NO Flood Zone Contractor's Company Name /1/14( 0 A VMS Contractor's Addrress /9,2 l) / C 4L City r-4 / ,�/'74 t State Qualifier Name i F / -; 4 I fv' r > � p Phone # j(1):":3 - 2 2/ State Certifica or Registration No.+;,,.„:/` T ; '7 ° - '.3 --) ` Certificate of Competency No. Contact Pho S D JS qqk— a 7-� E -mail Architect/Engineer's Name (if applicable) Value of Work For this Permit $ Type of Work: ❑Ad Describe Work: cco Double bl Fee i$ V 1 t d t Miami -Dade Phone # j , Phone # -} lJ` Submittal Fee $ Permit Fee $ (/ (/ t " (J CCF $ Permit No. M G - (o - l 0 I Ft Master Permit No. RC - Co l0 110 8 Zip 33 e-).. / Squ ❑New E ' .epair /Replace ❑ Demolition ** * *** * * * * * * * * * * * * * * * * * * * * * * * * * ** * *�asr es * * ** * * * * * * * * * * * * * ** * * * * * * ** * * * * * * * * * * * ** Notary $ Training /Education Fee $ Technology Fee $ Scanning $ Radon $ DPBR $ Bond $ o a ion a e: Structural Review. $ Total Fee Now Due $ 14 • ?os ygs 73S:5- 151 CO /CC $ See Reverse side Bonding Company's Name (if applicable) Bonding Company's Address City State Zip 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 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 / Agent The foregoing instrument was acknowledged before me this / 2--- day of / y, r , 20 A) , by .-. 'el1? -s da y of PL . ti who is personally known to me or who has produced )9/7. , R w ho is personally known 4 d C A err:,.. 'fication and ho did take an oath. as NOTARY Print: My My Commission E * * * * * * * * * * * * ** * * * * * * * * * * ** * * * ** * * * ** * * * * * * * * * * * * * * * * ** APPROVED BY SAWED SHASRAR Notary Publics, State of Florida Comm!ssione D 65';x586 ±arum, e7Ares June 24, 2011 (Revised 07/10/( I}(I,eviSe696 /I0/2009) Plans Examiner The foregoing instrument wa NOTARY P Sign: Print: ' s CHIQUITA DELTOSHA POSTELL MY COMMISSION # DD 658478 I EXPIRES: June 1,2011 Bonded mm Notary Pi Undenw sere denti BLIC• r who hasinroduced tion and L , 20 My�Commission Exp Contractor acknowledged before me this by ho did take an oath. :_*************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Zoning Engineer Clerk checked H te_Synove. y7 1 0 r1 , r + Price Yz. / D �-- "' ) +'� -- 1i , r (� - r - a:s J • P 9/. 2� j/ ' � �as . • 1., .. � • SV. CHG. PICKUP & ESTIMATE CHARGE LABOR TOTAL TAX TOTAL esn.. MARCO AIR, Inc. No 197 N.W. 104TH AVENUE CORAL SPRINGS, FL 33071 305 - 409 -7719 Lic.# CACO 58505 SERVICE ORDER N ame 4 ,F a". Address / 3l (tie c/ 7 Phan o r , �L-- S/N Com.Iaint REPAIRS AUTHORIZED BY M I A PM PICKUP DEL. DATE C® 2b Make M/N This estimate includes only repairs mentioned above. There will be a storage charge for merchandise left over 30 days. Customer agrees tha. = expense incurred in the collection of this repair char. will be paid ustomer.