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POOL & DECKDate /0f/93 Job Address 7 . 0/, .5.� Legal Descriptionl5 / 9L/ %79/-/er Owner / Les6ee / Tenant 6/// yoc./Z <-5 Master Permit #A73 Owner's Address 9 / /0/ Sr. n7/44 / Phone 75 2 f' G Contracting Co. 49// 6 J/ / 4" � � � Address E(.,2/3 71i Ave iWa.F,.,/F Qualifier &Qce TOE D SS# $ Phone State #C{t C # Competency # Ins.Co. "Y 4 V .6/2Ow4U LE;(JC Architect Bonding Company Address Mortgagor Address Permit Type(circle one BUILDING := _ MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION J , Square Ft. (-I/ ,,. Signature of owner Date: Notary as to My Commission PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 4c i3ea/c_4 ** * * * * * * * * FEES: PERMIT ti/'o '■ RADON C.C.F. APPROVED: Fire Buildin Mechanical Plumbing Zoning Tax Folio /1,5.mo /9 If7o 713 < y Address 6SS/3 , M 1 . S:!/ SST. S'u,4 Estimated Cost(value) / O/ O oc74 WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. 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 cons ruction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. * p&p on!xp, • 1 !I NICOL Signa ure of tor or Owner- Builder Date: Notary as My Comniss NOTARY uilder ** TOTAL DUE 1 7 4. O, D© Other 4S' DD Electrical it/ Engineering .^. PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 3 Job Address ?3a 101 '57 Tax Folio Legal Description ��JJ /' Owner / Lessee / Tenant t /// 7rkl,� �iGI�.0 6�S Master Permit # Owner's Address i/ // Medk' s 4/ /U/ S7' Phone Contracting Co. ) 6/17° i4; Address SO2/ 3 7SL ( feat,/ Qualifier 461Fgr 1/43231 NSOA✓ SS# phone esci33 — D- State # GPC 32 S?7Municipal # Competency # Ins.Co. 1 /4.N1v 7'^c Architect /Engineer 1!, (7 H L.. E-2 . Address 6'8/3 S�1/, 67 Sr ``" Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL WORK DESCRIPTION �6 0 / C D�- ._ ANN NICOL State of Florida My Comm. Exp. Feb, 21, 1994 COMM A 739492 Date: Notary as to Owne Commission Exp APPROVED: Zoning sident MECHANICAL ROOFING PAVING PENCE SIGN Square Ft. Estimated Cost(value) WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. 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. Furthermore, I authorize the above -named contractor to do the work stated. a 4_ Signature of owner and or Condo President Signatu xpir NICO to of Florida My Comm. Exp. Feb. 21, 1994 COMM 739492 Date: Notary as' My Commis NOTARY e of Con r or Owner- Builder ■ • !..,, er-Builder * * * * * * * * * ** FEES: PERMIT *''YlI RADON C.C.P. TOTAL DUE SO `4 Fire Other Building Electrical Mechanical Plumbing' Engineering PERMIT APPLICATION FOR. MIAMI SHORES VILLAGE Date Job Address 1 / - 30 Ale_ /(0/- 7/71"/,Tax Folio - Legal Description Owner / Lessee / Tenant 6;// yetzAos Master Permit # Owner's .Address £3 a tie'. / e / S7 112/4-,77 ) �I ) Phone - 76 - / '71"D 3 Contracting Co. V S ' U f €G7 te.-1C. Address 3=2- ?1 -'W o2 5 Qualifier 40 7 /UI 1 49 Mpg/re-MD SSai.0. Phone State iteog5 /S Municipal # / 7g Competency # / 7 7 Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL)LUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION P00/ <' Square Ft. Estimated Cost(value) WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAX RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. • 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 construct n and zoning.. Furthermore, I authorize the above -named contractor to do the work stated. /h< Signature of owneV' and /or Condo President Date: Notary as to My Commission E ** *' PEES: PERMIT I/64 APPROVED: - • NICOL State of Florida My Comm. Exp. Feb. 21, 1994 COMM !A 739492 - and /or e d RADON President Mechanical Plumbing Signature g4 Contractor or Owner-Builder Date: Notary as t ' ntractor r • per- Builder My Commiss'-on -Expir * * * C.C.P. Fire Other d. COMM; rA 7 NOTARY TOTAL DUE Zoning Building Electrical V ** 1 �1� Engineering ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WINO) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN MPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUND TANKS LAVATORY OVEN ABOVE GROUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS SHOWER MOTORS OVER 1- 3 HP HOT WATER BOILERS SINK, POT /3 COMP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP COOLING TOWERS WATER CLOSET MOTORS OVER 100 HP VIOLATION INDIRECT WASTES A/C WINDOW REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER- REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL 1 OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTURES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS DRAINFIELD, 4' TILE/RES. VIOLATION PUMP 8 ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. CATCH BASIN DISCHARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) . GAS PIPING ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL • NOTICE OF COMMEN6EMENT PERMIT NO. TAX FOLIO NO. STATE OF FLORIDA: COUNTY OF DADE: 93R575815 1993 NOV 22 13 :24 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. Legal description of property and street address: 3 0 /(A.. / 0 / S % 2. Description of improvement: p00 1 'eV 11 Q Qk 3. Owner(s) name and address: !? /1l .,1i)) knv) Y .6k /ZS Interest in property: Name and address of fee simple titleholder: 4. Contractor's name and address: Pj/YYi 4� /00 /s g„1.13 OA 9- E. CIO t y , (/ 3/ 6 16 5. Surety:(Payment bond required by owner from contractor, if any) Name and address: Amount of bond $ 6. Lender's name and address: 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., Florida Statutes. Name and address: 8. In addition to himself „Owner designates the following person(s) to receive 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 m the da of rec a different date is specified) ��� �K': `'� di 5 A F �_ j CA�`q src. I HEREW CER1 frofFy`p�� ��U VTR D.= DADS / r� f , ' p Q lino; C i e �' this i s a Prue coat' of ording thunless o K- 1/1 �t r >.- - — d oY of Q® 3 Signature Of Owner Print Owners Name TNESS my h .n �flzi C A� ?VE � - 3c6ct spas. n9 �� 1 '2 k _ � .�' e L1Rr ed � iQ / t►) �D/ %� _o Y _ , ,� . ,, tea., Sworn to and subscribed before me his /V day of �`..` _. _ 19 9 : - . -- -- = _ - � ,_ 9—r/ 2VL o Notary Public Print Notary's Name My Commission Expires: ANN NICOL N/A ru State of Florida I4 ' ,mm Fvr Fah 91 1994 COMM ••' A 739492 Address: g ? [3 Nut/ 7 9 ' In€Dtrei / A 33/ ( (j) "Commercial peel /spa contractor' means a con- tractor whose scope of work involves, but is not Limited to, the construction. repair, water treatment, and aervic ing of any 4wimmin pool, of hot tub a spa, whether public, private, or otherwise; regardless of use. The scope of such work includes layout, excavation, opera- tion of construction pumps for dewatering purposes. steelwork, trsstalletion of light niches, construction of floors. gunitlpg, fiberglassing, installation of tile and cop• ing, Installation otalt perimeter end filter piping. installa- tion of aH filer equipment and chemical feeders of any type. ptastenpg of the interior. construction of decks, construction of equipment rooms or housing for pool equipment, and installation of package pool heaters. However. the scope of such work does not include di- rect connections to a sanitary sewer system or to pole. isle waterlines. (k) 'Res dential pool /spa contractor" means a con- tractor who a scope of work involves. but is not limited ns to. the ca ruction, repair, water treatment, and servic- ing of any residential swimming pool or hot tub or spa. regardless 41 use, The *cope of such work includes Lay- out. excavation. operaticn of construction pumps for de. watering purposes, steelwork, instettation of light nich- es, construction of floors, gunit;ng, fiberglassing, Instal• Iation of tile,and coping, insta Nation of ail perimeter and filter piping,: installation of all filter equipment and chemi• cal feeders of any type, plastering of the interior, con- struction of decks, installation of housing for pool equip- ment. and instaHation of package pool heaters. Howev- er, the scope of such work does not include direct con- nections to a sanitary sewer system or to potable water fines. (I) "Sw coming pool /spa servicing contractor` means a contractor whose scope of work involves the servicing, repair, water treatment, Including, but not lim- ited to, the direct infusion of chlorine gas, and mainte- nance of any swimming pool or hot tub or spa. whether public or private. The scope of such work may include any necessary piping and repairs, replacement and re- pair of existing equipment, or Installation of new addl. Clonal equipment as necessary. The scope of such work includes t14 reinstallation of tile and coping, repair and replacement of all piping, filter equipment, and chemical feeders of any type. replastertng, reconstruction of decks, and reinstallation or addition of pool heaters. %m) 'Plumbing contractor' means a contractor whose contracting buzinors consists of the execution of con. tracts requi {ing the experience. financial means, knowl- edge, and skill to install, maintain, repair, alter, extend, Of, when not prohibited by law. design plumbing A plumbing contractor may install; maintain. repair, alter, extend, or, ,'when not prohibited by law, design the for• lowing without obtaining any additional focal regulatory license, certificate, or registration: sanitary drainage or storm drainage faci venting systems; pub&e or pri' vete .rater supply systems: i3eptie %Me: drainage and supply wells: swimming pool piping: irrigation systems: or solar heating water systems and all appurtenances, apparatus, or equipment used in connection therewith, Including boilers and pressure process piping and in- cluding the, installation of water. natural gas (excluding, liquid petroleum gases), and storm and sanitary sewer • r.S. 1989 ALEti r_ESNETT ST THOMAS. pp27J55552 I I", L�,1 A I 1 VV...•-J TV 11 ti/ A+1T u I .�r• .. CONTRACT1Nfl 619 • • 1 • ' @3 • •.•I)'; M • 1�'t'. •1i •. • I Ch. 489 lines; and water and sewer plants and substetlons. The scope of work of the pturnb(ng contractor also includes the design, when not prohibited by law, and installation, maintenance. repair, alteration, or extension of air - piping, vacuum line piping, oxygen tine piping, nitrous oxide piping, and all'related roedioal gas systems: tire tine standpipes and fire sprinklers to the extent author- ized by law; ink and chemical tines; fuel oil and gasoline piping and tank and pump installation, except bulk stor- age plants: and pneumatic control piping systems, all In such a manner as to comply with all plans. specifica- tions, codes, laws, end reguletlona eppllcabla• The scope of work of the plumbing contractor shell apply to private property and public property. shall it'ciude any excavation work Incidental thereto, and shalt tnolude the work of the specialty plumbing contractor. Such con- tractor shalt subcontract, with a qualified contractor in the field concerned, all other work lnotdenlal to the work but which is specified herein as being the work of a trade other than that of a plumbing contractor, Nothing in this definition shalt be OOnstrued to limit the scope of work of any specialty contractor certified pursuant to a. 489.118(6). Nothing in this definition shell be construed to require certification or registration under this part of any authorized employee of a public natural gas .utility or of a private natural gas utility regulated by the Public Service Commission when disconnecting and reconnec. Ling water tines In the servicing or replacement of an ex- isting water heater. (n) 'Underground utility contractor means a con- tractor whale services are limited to the construction, ' tnstattation. and repair, on public or private Property, of main sanitary sewer collection systems, main water dis- tribution systems, and storm sewer collection systems, and the continuation of utility lines from the •maul sys- tams to a point of termination tip to end including the meter location for the Individual occupancy, sewer col lection systems at property line on residential or single- occupancy commercial properties, or on muitioccupan• cy properties at menhote or wye lateral extended to an invert elevation as engineered to accommodate future building sewers, water distribution systemo, or storm sewer collection systems at storm sewer structures. An underground utiilty contractor shall not instait any piping that is an integral part of a fire protection system es de• fined in s: 633.021( beginning at the point where the piping is used exclusively for such system. (4) "Primary qualifying agent` means a person who possesses the requisite skull, knowledge, and expee- ence, and has the responsibility, to supervise, direct, manage, end control the contracting acthities of the business organization with which he is. connected; who has the responsibility to supervise, direct manage, and control construction activities on a lob for welch he has obtained the building permit; and whose technical and personal pvalificatla to have been determined by invest• gation and examination es provided ke We part, Fe at. tested by the department. (5) 'Secondary qualifying agent' means a person who possesses the requisite skill, knowledge, and expe• rience, and has the responsibility to supervise, direct, manage, and control construction activities on a lob for which he has obtained a permit, and whose technical • IbU4 t.0 Ui g 44 { ir11 %i iJ'LlrJ►K (t1E; V J,1J NW 1ST STRE =Tr t1I.AMi Fl. 3312$ \ SUI tE . 1010 3 TAIL' CO lTRAC74RS CE12' LE1 ' f;GT7TFcATtuN ISSUE* SEPTE f).O, I914 THXS LS TO CtwR7.ta Y THAT .PALM 3AY PAUL /writ . v IH u /8 /A; C•C.N LGC 4455' TRAM: AU;t1.UIN4 UU ila bADE HAYING Aik•Y THE RE TRAT1oN - EQUAREt%I t4TS Ut t1 . rRUPoL.i rAM oAUL catlttY, IS HERESY REGIl1EREI' AS. A COPiTRALIOR IN THE f t P.Aui• LAI EGCRY (S) as yC t Rkt (STATi ) ► , s filiti ALL 1PRt. TU 81~ 00C tliiUt'i� TKw 4.1AL:LFY LN$ ACE tr T U' 1Att JtJtfN egui tiAY Pi ULS /k1R 1 :ATUR!iS 16 •; 8 KIRd'Y' AVt. N•E• ' �PALA RAY FL 32401, .914 .ftgIttr JaDUi A 3TA T1` BVtE.1i AA 710tNING DEi`NP,1he..Ni 111 N4 1ST STl2>_►;It s'1IAiii, FL J3146 . O'LRel.T SUetiRYISXOU AND CONTROL 14 26)-0 1 -31KT tilts 0:4131RAT100 IS VALID UNTIL • 40 TLt1BER 30, 1/95 by AUTNCJRI.ZATSUN OF CARLOS F. BUN..( S1,: :CRalARY, LONST MANS QUAL BCAuc ALTERAT19N• RE=PRODuLTI OR rRANSfF R {J tH i5 C6RC.IF)CA1 t: 1.S PROH .TTia. • FEE FOR TW15 CS:RT1t ICAfir i,AS PACO O.ti PA►JCFS:t NG 1441246 a7.4. St r� LONtRACTORS CERTft( cATE OF REGISTRATioN t.SUl,:i: Ath. JJ 1 7 his Ia re ,CZRT1PPY 1HAT PAO LiAY Pu +0L:; + 4 R t ..C•11 CPtU32'.337 7 fi:A!)t Buit4I i:; . P ; ;LIALTY 1'wT i�Ht .mg1STRA(iJi1 Rli4UIRg;It.N7. UP .'1:.'1RUP.LIlA1t 0:I1) -.. C.W1TY, .TS rt 4iLSTErt .b AS A L't3c•tTF.ALTQR IN T, fiaLLJoINt. TRA;4. 4:AT440411(S) •• • ao • 1 • — . ' • ,. ,.1 H ALL .w0.74 1l? F.•. ..r4 •t. .•i.R•. TM .. 011.1-„C, • 4iJPEATtiI.:d4 0 U% • ;iav►L . i:4 _{ I H " '• _ i . J•�tt► a► �� ;;,• . K . ' , • S , 1 . m. 390- 3M,407$ • — • ' .':'•:,,,, i'e -. . •• ? • ' * ";., r • •:. m! . • '•t: I g 1. Ft e Y• A Yi: f r_ .. .. A . . °ALM DAY FL 31.701.; • f ilia Lw1 r . AM. L.1 :VALID :Atli. ' 414Firit Al I'M by AU!►IUR.,.Af told ut cAgt..js p. 401.4?.:'" , Si :CROAT, Ct,�ii r Es, gUAL 613AR9 i )IV `1c l_mAi1tu � t:i'xutiuLTVJU tab. iamisi4 :k OF PtfX� CERtti•ICArcV` :• 'J0011YtfO. ..,!LP t'(A THIS C LCATrr ' A.o : A1U AN Mg.! Sa NU• T')33:3$03 ?V'•%:.. • . . CERTIFICATE O� INS ' E b:i D � M � t ' J� I. A rte•.' .., -._. . _... — .w ...�. .. , n t • :�.i • :a8>a RA` 'AC Eft X' •• • ;•• Ag2O, :. FLAt;T,ER AMA ?'1t, FT: 331.14• -• • 1 1, . ..:cif : e;:�;•V. F:LEC`f3 1: r • • • 11/22/93 16:27 ''305 633 5530 AZrTOMODILE LIARK,TY ANY AU Tr ALL OWN AJT•$ SC} H;iEO AUTO$ • NON -OWNED AUTOS • GAOAGE LIABILITY • A AND EMPLOYVer .I AB1l.r rY I IJTMEA CERTIFICATE HOLDER r;nYffaAGE I • EXCESS LIABILI7Y " gTHER TnA.N J? LA f,NM WOAKEA'S COMPENSATION ELECTRICAL W0F.:K , • )r OU.: EnC: t..Ge!c_aAL. • • : CI . A I(y 6 MJ<i)€ • � 0.000P C f - 1 3 0 3 169 .3 wC- 135318992 CESCRIPTtON DP OPERRTIONS4ODAT10NgrvENICLF SISRECIAL ITEMS _:r. ._ ... --:•.-- -•••••• ....L- 4';: :: •• ISSUS•DATO. IhvDAnr {IF ca§ . , f is OEb" � ER OF I FIRrAtRMT45N'L AND ONFERS UPON THE CERTIFICATE HOLDER•.THl3 pgRTIFICATE I OES NOT AMEND,- EXTENO.OR ALTER AFFORDED GY THE a OLICIES BELOW; ... - • .. ,to-•,r:. - t ` .i: °mac.•... . w_ �• • • . : CONIPANI,F,M AFFORQI!`,• cOVF!.lrtf;r. ' • • i 1 C RANCE • .. COMPANY C : • LETTER . COMPANY _..._. : A _ FIRST : ,. ALL I`AN•C :'iINSUTtANC.F: • C0t{PA �• • LETTER, • . '•• • +r it .,.. r O:..4∎P • I .1. • CUMPANY .LETTER . 4/7;93 .2/7/34 3/17/93 3/17/94 CANCELLATION AUTHORIZED • EPREiENTATIV[ () • I 1 ,, T MI$ It :TC) CPRTIF•Y riot f -ri poi )C:I . (.1; INclifANiii rLr;TED BELOW AV{: OW I � CCN J5Butu I u 11- INJRED NAMED Atic)VE FUR THE POL)GY P i •INDICATE ANY REOUIREMENT, TERM OR CONDITION OP ANY CONT'?,CCT OR OTHER DOCUMENT WITH RESAEC TO WHICK740$ ' CERTIFICATE MAY BE )SSUEQ.CR MAY PEPTA ;N, THg INSURANCE AFFORDED SYTHE POLICIES OESCRIEI€O °HEREIN IS SUBJECT MALL THE TERM 'S, " • I EXCLUSIONS AND CONDITIONS OF S.CI1 POLICIES, LJMITS S MAY H Pr.:FN -ft- L)CEO B,Y /'AID CLAIMS. A• .. T..E OF IN,7RAmOd . ; UUCV i _ ? L Gi'FOuty ; RAT • • k 14. •. % D Te .:GT Ilrt ldr0�lY IV3• R ATE ; /oYY )0 . .. L11dtTS . t. • . �•,ti --. - .. ... • ... Lla 9luri _ •. .. .. .. . -. .. ...,.� �_. _• • • • r' 1rpOOIJC;o •;• r_r'. ^A:). PERSONALS A.V. INJI:Ir? , EAi rt qL%:uNr FIRO GAMAGIS , •••^tT CPO fee) MED. EXPENSE iA.. Ono n.(> S . 5,000 , COMBINE•° SINGLE 1 IIJIT * 30011.4 INJJhv /PM ?mtsor . - • BODILY INJURY (Per LCC:.oni) • oonP -, ., •.. EACH vci: ACCr.EGA t r - 5TATLTORY LIMITS FAC:ti ACCIDENT D POLICT LIMIT S rFj 003 •1300;0QC:' ' : 't :000.`, 000 .' . . 3C0;O06.. s . 50, 000.. • 3 .1vv,O ru0. '!00,000• DISEA5E —E4CH EMPLO•'4E i QQ,s, os -• SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLEC BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAvOR TO MAIL 3 V DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LABILITY OF ANY K1NO UPON THE COMPANY, ITS AGENTS ON REPRESENTATIVES. ACORO 25 -S (7/90) eAC6RO CORPORATION 1 990 1 DEPARTMENi OrFR O F E §SIGNAL REGULATION; DATE 7 L AWTON CHILES OQVLRNOR ELECTRICAL CIi1STt2ACTORS LICFNSING BOARD 42206 06/13/5.2 ' + OU0851 5 fHE igT NI v CLE.CTI!Ic.AL CONTR &CTOR NAME• � LOW IIAS lirf;ii.pThD UNDER THE PROVISIONS OF CHAPTER 489 F.,n,., 1OR THE YEAR EXPIr-IINU AUG J1* 19=)4 {MUST MELT ALL LOCAL COMPCT!'4CY uo.ulvfmENTS '•,: TMR TO CONTRACTING IN ANY 'kFA) MOkENGi • ANTf)Ni0 439 NW £ 2 C s r INC MIAMI FL. 331 ?6 DISPLAY IN A CONSPICUOUS PLACE LICENSE NO. 00- 1068477 bU 3INF53 NAME /LOCATION V ti V E cC TR ICAL INC LI WNLN ' :V & VT EL,ECIR.I NCI VALLU IN: 1ALEAN ILLAGE; Uf= KEY iISCAYNE UCeetaeo must +e0tor In the any Whore work 4e to be done. PAYMENT RECLt • caw cur( TAX JIM! CC NC: CAL INC (4E0 STI; SiCRSTARY ELECTRICAL rA Nor FOfrivntTO V 4 V ELECTRICAL INC MIAMI F T L � 33125 19 . . , .NI1,1NIAL CONTRACTOR' • = STATE Or FLORIDA DE COUNTY.•bR0NANCE 66.2 9 T,, 0;,1$94;. • a002 r',n$; CLASS 115 PQ3 AGE ?ADD i ,•t um OOOU144i 13 Heft BY LILtNSED TO DO BUSINESS AS A CONTRACTOR AS SPECIFIED HEREON 407 I 05/06/92 AUDIT CONTROL NO. 1749392 UCENSE NO. BATCH NO. AMOUNT PAID CP;CO32537 C7093 314C_CC CONSTRUCTION INDUSTRY LICENSING PCST ,OFFICE BOX 2 JACK' ONVILLE. EL 32201 UCEN r WALLET C FOLD HERE l STATE OF FLORIDA DEPARTMENT OF PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY, LICENSING BOARD 'CERT.CON.POOL /SPA CONTRACTOR JOHNSON. ROBERT LEE PALM BAY PIS/WATER FEATURE IKC HAS PAID. THE FEE REQUIRED BY CHAPTER : 4E9 F.S., FOR Tt YEAR EXPIRING AUG 1 19 ' 4 O. LAWTON CHILES GOVERNOR GEO GE STU SECRETAR T. JR. P.N. r PALM BAY POOLS • . is 05/06/92 LAW ON CH GOVERNOR LAW CHILES 041 24192 • • Ac, 17 4 9 8 9 2 STATE OF FLORIDA DEPARTMENT OF PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSIYE BOARD DATE LICENSE NO. FiATCH NO. CP CO32537 THE CERT . CON : POOL/SP A:••CONTRAtTOR NAMED BELOW IS CERTIFIED UNDER THE PROVISIONS OF CHAPTER 489 EXPIRING AUG 31. :1994 JOHNSON. ROBERT LEE PALL SAY .PIS /WATER FEATURE INC 505 8AHAPA• OR INDIALANTIC FL 32903 DISPLAY IN A CONSPICUOUS PLACE C6 CO54455 THE CERTIFIED ;SERERAL °CONTRACTOR NAMED BELOW I S C ERTI'f I E Q UNDER THE PROVISIONS OF CHAPTER 4 EXPIRING AUG 34.:1994 lIISIA>IE. :JOHN ROC'ER - PALlI BAY POQLS/VTA FEATURES LEI 2375 X1&H .AVENUE N E! PALI!.HA! IL .32905 DISPLAY IN A CONSPICUOUS PLACE 4077290214 P.01 07093 F.S.. FOR THE YEAR • Aci 17 4 3 4 0 3 STATE OF FLORIDA DEPARTMENT OF PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING @CARD DATE LICENSE NO. BATCH NO. 41558 E.S., FOR THE YEAR • 47. • 2 J In consideration of the sum of 7331 Northwest 74th St. Medley Florida 33168 Date: No. C -94 -660 ( 1) Full Year's License ( ) One -half Year's License with the following restrictions: 08/24/93 The Perfect Location for Industrial Development" OCCUPATIONAL LICENSE Must be displayed at place of business ONE HUNDRED & NO /100 PALM BAY POOLS & WATER FEATURES. INC. Business Address: 8211 N.W. i 4 AVE. MEDLEY. FL 33166 Mailing Address: SAME is hereby licensed to engage in the occupations:If GENERAL CONTRACTOR s 100.00 v0 LIVING ON THE PREMISES OR IN MOTOR HOMES PARKED AT ABOVE LOCATION. NO `IECH.SICAL REPAIRS OR BODY WORK. NO STORAGE OF CHEMICALS. NO HAZARDOUS 'MATERIALS. NO OUTSIDE STORAGE OF EQUIPMENT OR MATERIALS. r ) 4 "S! florn OCTOBER 1 19 93 'D SEPTEMBER 30 1914 subject to tre provisions of Town of M edley Ordinances and state and caurdy Tegutations now in force. Note: THIS LICENSE DOES NOT CONSTITUTE A CERTIFICATION THAT THE LICENSEE IS QUALIFIED TO ENGAGE IN THE BUSINESS OR OCQJPAT1ON SPECIFIED +iERE N. By I DWW Of WEEDLEI.CLOCUDA dr own Clerk t Telephone: (305) 887-9541 C Dollars le TJ r E''• 11 c ' Til I j- I's' it r le Jr! _.1 'LI `Tr . .t a► 11/16/93 CORD c kt: 'A' 1. 1; C A T CI N ANCE ISSUE DATE 11/1G/%3 PRODUCER • THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS INSURANCE BY KEN BROWN INC . NO RIGHTS UPON.THE CERTIFICATE HOLDER,-THIS CERTIFICATE DOES NOT AMEND, P 0 BOX 540569 EXTEND OR ALTER THE COVERApE AFFOWD BY THE POLICIES mow, 1339 ARLINGTON STREET COMPANIES AFFORDING COVEIRAGE OILANDO EL 3254-o569 COMPANY INSURE!) SEE BELOW FOR ENTIRE NAMED INSURED 2875 KIRBY AVENUE N.E. PALM BAY FL 32905 ===COVERAGES = IHI!J IS TO CERTIFY THA THD POLICIES PERIOD INDICATED. NOTWITHSTANDING AN THIS CERTIFICATE MAY BE ISSUED OR MAY TERMS EXCLUSIONS AND CUNVIIPS Ut CO 1 UR! TYPE OF INSURANCE GENERAL LIABILITY EX1 Commercial General Liability A [ 3 Claims Made al Occur. C 3 Oumer's t Contctor's Prot. EX] BROAD FORM PD . E 1 AUTOMOBILE LIABILIIY EX] Any Auto L 3 All Owned Auto:s A 1 t 3 Scheduled Autoi EXI Hired AutnF (X1 Non-Owned Auto t ) Garw LI I EXCESS LIABILITY UMBRELLA FORM .t 1 Other Than Um6ella Form B WORKER'S COMYENSATION ANH . ttlYINTAKIARRY... LEflEi B_ COMPANY LETTER C COPIPANY . . ... conrAwy LETTER F OF INSURANCE LISTED I}L.UW HAVE HUH ISSUED I1 INSURED NAMED ABOVE FOR THE POLICY Y REQUIREMENT, TERM OP CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBITECT TO ALL THE SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED NT PAID CLAIMS, POLICY EPP. POLICY MEd POLICY NUMBER ocr DATE LIMITS 1 GENERAL AGGREGATE 1 $ 119.091000 LPRODUCTFTOMPMP AGGREGATE _1 $ i m456754 05t15/93 .05/15/94 PERSONAL 8 ADV. INJURY . .1_$ soo • 1 EACH OCCURRENCE _Lt 5oo 1.1 ,I EXPENSE (Agy_one_msbn)i $ 5,000 CO B E 1 5 1000,000 1 LIMIT 1 BODILY INJURY $ BA555080 05/15/93 05/15/94 L(Ieupron) 89001305 bRkiipilkb6iiiiiiivklidia2k6iii ITEMS' NAMED INSURED: PALM BAY POOLS & WATER FEATURES, .INC DBA AQUA MEDIC INC =CERTIFICAiE HOLDER= MIAMI SHORES VILLAGE 10050 N.E. 2ND AVENUE MIAMI SHOES FLORIDA 33138 15:18 INSURANCE BY KEN BROWN 001 LETTER A COMPANY GULF IttSURANCE COMPANY 1 BODILY INJURY 1 $ l_aer accident) 1 1 PROPERTY DAMAGE 1 $ 1 1,EACH OCCURENCE 1 $ LAOGREGATE .. 3 STATUIORY LIMITS I-- 01/01/93 01/01/94 1 EACH Acclogg _ unsE6E-P0tIci Emir s" -- "soo l Ooo 1 $ loi isoo" C ANCELLAT/ ON====================. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED, BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY. WILL ENDEAPOR TO MAIL _10, DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDERINAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO (*LIGATION DR LIABILITY OF ANY KIND UPON THE COMPANY ITS AGENT§ OR "PRESENTATIVES. AUTHORIZED REPRESENTAAVE