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RC-10-189Project Address Owner Information Contractor(s) COLTRAIN CONSTRUCTION CO Phone (305)285 -6723 CeII Phone Fees Due CCF DBPR Surcharge Education Surcharge Permit Fee - Additions/Alterations Radon Surcharge Scanning Fee Technology Fee Total: Amount $2.40 $0.60 $0.80 $300.00 $0.60 $9.00 $3.20 $316.60 Building Department Copy March 02, 2010 Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Address Parcel Number Phone Approved: In Review Comments: Date Approved: : In Review Date Denied: Type of Construction: KITCHEN REMODEL Stones: Front Setback: Left Setback: Bedrooms: Plans Submitted: Certificate Date: Bond Retum : Occupancy: Single Family Exterior. Rear Setback: Right Setback: Bathrooms: Certificate Status: Additional Info: Classification: Residential Invoice # RC -2 -10 -36998 Invoice Total Amt Paid Amt Due $316.60 $316.60 $0.00 Expiration: 08/23/2010 Applicant 58 104 Street Miami Shores, FL 33150- 1121360131060 Block: Lot: CAV HOLDINGS, LLC CeII . §:MMMOIUMMTKOMENEMMEMMIEME' 41: CAV HOLDINGS, LLC 91 64 Street HIALEAH FL 33012 -2663 Valuation: Total Sq Feet: $ 4,000.00 120 For Inspections please call: (305)762 -4949 Available Inspections: Inspection Type: Drywall Final Framing Insulation 2 BUILDING PERMIT APPLICATION FBC 20 Permit Type: BUILDING O FIN g Owners Name (Fee Simple Titleholder) h (� �d L Phone # City l / f�� Tenant/Lessee Name Owner's Address YHA/i U 6-41 CLL Emile k co Job Address (where the work is being done) 4.67f /D 1 /- 5 /74-a City Miami Shores-Villaee County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES NO, Contractor's Company Name Ca 7_ Contractor's Address Zf' f 'Contact Phone ?:05— ' TX' - Miami Shores Village Building I) ep artment 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 Zip City j /, 4 / State Qualifier Name / 2,,,y1/( 6.91.T/N State Certificate or Registration No. 4� 2. E -mail Notary $ Trainin ducation Fee $ Scanning $9' 00 Radon $ (p1 DPBR $ Double Fee $ , Violation date: Permit No. I 10 e I n Master Permit No. Phone # Flood Zone itacr//(g hone # .—V(..) -2- Z. Zip Phone # C ° Z97 Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ �(F.-- Square / Linear Footage Of Work: Type of Work: Addition DAlteration DNew e air/Re lace /1/6/C6 p p ❑ Ddmolition Describe Work: ,, —1 /wine/04 ?� C cj,/iV1fl � 7 �/ 5/710 /04C/ `/ C� Co U V.yl S \ �' (ANN) t . \ � t�(� I l Q4A9 l \� 5 \ 1� 9 `4oW €� N.10 * * * * ** Fees ************* * * * * * * * *f * * * * * * * * * * * * * * ** * * * * ** Submittal Fee $ Permit Fee $ ?QQ CCF $ CO /CC . $ Technology Fee $ 5' Bond $ Structural Review. $ Total Fee Now Due $ ?)1 (DO See Reverse side -> � I�GE3III�I3� FEB 0 8 2010 BY: .. Bonding Company's Name (if applicable) Bonding Company's Address City State OC „, Mortgage Lender's Name (if applicable) Mortgage Lender's Address OGE7i City State Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence o such posted notice, the inspection will not b ap r ed and a reinspection fee will be charged. f Owner or Agent The for in instrument was ac -so, ledg before day of ,20 �� . 6by 9 /JL NOT ' UBLIC: APPROVED BY sonally own t e or who has produced (Revised 07 /10 /07)(Revised 06/10/2009) tion and who did take an oath. 41" N I l ARY PUBLIC: Sign: �.� �. 11 ��' G $■ti Si Print: 04" c" � Print: My Commission Expires: Signatur Contractor trument was acknowle 20 . 1013 o is pe .o The foregoing day of ly known ed b ®fore m who has produced ion and who did take an oath. C� s: „A1;"a� h - al ,il My Commission l� . ac I 4 N c l t�Y4kBeirYe9ededetksk�Y�i' tkdetk9t4e 'kA'*** *de$'tk3e4nk4t�k� led:::""' 9ttk4rk�te4e9*** *� *** tYsFieik9e9ktk4t** **tktkst*** * *k9t4eit•+edrk ° • *9tsktktktYBe*9tdtitdr*** OS2 19,4) Bow Plans Examiner Zoning Engineer 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.JI- /2 -OM - - lam 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. Legal description of property and street/address: 5 N - fi/4001 -Jklierot - pc, 2. Description of improvement: L Irl() 1#J7 -itan giotati.c. 4 fiiwv-7 3. Owner(s) name and address: 0/ -Fig L/ t1. / Interest in property: _OGC)AI!K Name and address of fee simple titleholder: 4. Contractor's name and address" /45 amisi fl /c ed..' CC1 rAticr pt N€ no 5. Surety: (Payment bond required by owner from contractor,,W _ ptc,,m,7 cr4 r ) , E 9C° o- Nr1 u r s-.1' � ' 8 , il Name and address: Amount of bond $ 6. Lender's name and address: 7. Persons within the state of Florida designated by Owner u provided by Section 713.13(1)(a)7., Florida Statutes, Name and address: Notary Public Print Notary's Name My commission expires: 123.01 -52 PAGE 4 5105 • ew`';43 a:s 4 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lie 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) ®j L f U/ Ail Signature of OwneCto-VA Print Owner's Name r • Sworn to and subscribed before me this /ea_ day of p , 20 C/4-AI (MA Prepared by Aitie �4-,IU tDDI EXPIRES: January 18, 2014 s) tw Bated Um Budge Nobly Sta 11111111 11111111 CFN 2010R0137359 OR Bk 27198 Pa 4411; ( ins ) RECORDED 03/02/201') 05:18:40 HARVEY RUVINr CLERK OF COURT MIAMI -DADE COUHTYr FLORIDA LAST PAGE , Lstmido AA- pr 1 zat whom notices or other documents may a s s " otice as provided Address:_4(4 A/4 3r- // 3115899 -6 THIS IS 13T A Bfli - DO NOT PAY BUSINESS NAME /LOCATION RENEWAL 320687_7 3 TRUCT.ION C(1 3 R6 53'5` SW -8-41 1 110 S TATE* 00558 8 331 MIAMI st LERR St i= 331 30 OWNER COLTRAIN CONSTRUCTION CO SeC m 9 ON BU ILDING ` CONTRACT rIGEBritirAL ss lux a rr I lia THE r ZONING Guupre�s tf9 CmEs. _Ham FROM ANY w DIM roxillT OA is REQUIEM BY LAW _A cammanott OP T� P ATMEprREC4YED COLIAIATOR ; 02280 200 001 R . 00 ilia f!►/ iiii tl �Itljtimiii /�illfiihrit!`lllltsisi t SEE OTHER SIDE iI[t1 DO NOT FORWARD COLTRAIN CONSTRUCTION CO MARK COLTRAIN 441 NE 53 ST MIAMI FL 33137 - -CLASS POSTAGE PAID ldt, RI: NO.231 1 FEB Y: 8 Ape e j _•O• ••••• '•O•• NO • • • • • • • • • • • • • • • • • • • • • !I • •• • • • • • • • G.t.:(us‘ 4 - 9 1. 1 . • .. • • . • • • ,. • • •• • • . . . • • • • • P r • • • • • • ... • • • • • •••• • • • • .. • .. • • • • • • .. • • • • .... • . • . •••• • • • • • .. • • • • • • • •••• • . • . d4 • • • • • 11 0 D❑ 000 000 .. • • .... • • • • • • • . • .. • • • .... • • .. • • • • .. • • • • • • • • • • .... • • .. .. • • • • •. • • •.• • • •• ••.•• • • . • .. • • • • • • • • .• ••I..1 •.=• ••• • •••• • • • • • • •• • •• • •••• • • • • • •••• ri I (ID I (ID (1) D .„1 8 I (1) .1 i 11 • • • • •• •• .. • .. • • • • .. • •••• • • •••• • • • • • .. • • •• •• • • •••• • • • • • .. • • • • • • • • .• • • • • • • • • • •• •• • • • • • .•• Inspection Number: INSP - 138347 Scheduled Inspection Date: March 22, 2010 Inspector: Devaney, Michael Owner: , CAV HOLDINGS, LLC Job Address: 58 NW 104 Street Miami Shores, FL 33150- Project: <NONE> Contractor: COLTRAIN CONSTRUCTION CO Building Department Comments March 19, 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 Phone Number Permit Number: EL -1 -10 -136 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Parcel Number 1121360131060 Phone: (305)285 -6723 SERVICE UPGRADE REMOVAL OF CLOTH WIRING NEW RECEPTALCE 4 SMOKE DETECTORS Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments 14', 94 2 A/ VP— /9-P(4 jLvt `a r `,z ,LX'7 /- PPTco6o 2Q a/2, a tit i,vs reit /Z- 0 Page 15 of 26 Owner Information JACQUELINE PINERO Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 58 104 Street Miami Shores, FL 33150- 1121360131060 Block: Lot: JACQUELINE PINERO Contractor(s) MOODY ELECTRIC INC Phone Cell Phone (305)758 -2000 Type of Work: SERIVCE UPGRADE Additional Info: ELECTRICAL Classification: Residential Fees Due CCF Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Submittal Fee Submittal Reversal Fee Technology Fee Total: Amount $4.80 $1.60 $262.50 $3.00 $50.00 ($50.00) $6.40 $278.30 Building Department Copy Address 91 64 Street HIALEAH FL 33012 -2663 Authorized Signature: Owner / Applicant / Contractor / Agent Phone Valuation: Total Sq Feet: Invoice # EL -1 -10 -36918 Check #: 18062 Total Amt Paid Amt Due $ 278.30 $ 278.30 $ 0.00 January 28, 2010 Date Cell $ 7,500.00 0 For Inspections please call: (305)762 -4949 Available Inspections: Inspection Type: 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. January 28, 2010 1 FROM: Michael -,A, Devaney Sr. DATE: . ,y 4-/a• 1 TO: F.P.& L. N.E. service ctr. RE: Work with inspection O :K. MESSAGE: • rlr� A ss .:5_� 4 - ' I - /4 1 l® - l3�' HAVE A NICE DAY BUILDING' AND ZONING DEPARTMENT OC {O, N.C. SECOND AVENUE MIAMI SHORES. FLORIOA 33136.2322 TELC?HOSC 13031 793.220.4 FAX 0051 736 6972 * * * * * * * * * * * * ** FACSIMILE TRANSMITTAL * * * * * * * * * * * * * * * ** - NUMBER OF PAGES: (INCLUDING THIS PAGE) 1 ORIGINAL DOCUMENT(S) TO FOLLOW VIA: ( ) REGULAR MAIL (. ) EXPRESS MAIL (X ) ORIGINAL DOCUMENT WILL. NOT FOLLOW (ONLY IF REQUESTED) PLEASE CONTACT OUR OFFICE IF ALL PAGES ARE NOT RECEIVED. 11111 PHONE # CELL 1305.986a028 FAX # 30 5 - 7707996 /c .?\ /t - MOODY - MOODY# ELECTRIC, INC. www moodyelectric.com 669 N.W. 90 Street • Miami, FL 33150 -2166 Tel: (305) 758 -2000 Fax: (305) 754 -1333 H1;e &4Q/2,-0 - 4a.a412 (,)P RA Cc.aoott 15 • �•�4P V6. i • 1 MARY PAT BRIGGS s Notary Public State of Florida • Ny Commission Expires May 11, 2010 8 Commission 11 DD 511936 n 'Bonded By Pali °a Nr..tary Assn. q MOODY ELECTRIC, INC. www. moodyelectric.com 669 N.W. 90 Street • Miami, FL 33150 -2166 Tel: (305) 758 -2000 Fax (305) 754 -1333 RESIDENTIAL DEMAND LOAD CALCULATIONS W / SQ. FT REFRIGERATOR APPLIANCES DISHWASHER GARBAGE DISPOSAL MICROWAVE CLOTHES WASHER DRYER RANGE WATER HEATER OVEN FREEZER TRASH COMPACTOR GARAGE DOOR MOTOR JACUZZI JACUZZI BOOSTER HTR. IRONING BOARD POOL EQUIPMENT SPRINKLER PUMP LANDSCAPE LIGHTS STEAM SHOWER A/C WALL UNIT SPARE CAPACITY SPARE CAPACITY TOTAL CONNECTED LOAD FIRST 10 K.W. @ 100% REST @ 40% A/C @ 65% / HEAT @ 100% c&, 4 5 e .0 /14 A nJ she / ,Lora /,boo 7g K.W. /_ 5 K.W. 3,6 K.W. /'�• -� K.W. K.W. /5 K.W. K.W. K.W. / /,D K.W. g,5 K.W. - K.W. - K.W. K.W. K.W. K. K 39 x.w. 3` 10.0 K.W. & K.W. Otto /b K.W. ,.„„ MARY PAT BRIGGS �°� °B( Notary Public - State of Florida •Uly Commission Expires May 11, 2010 K. ' : ",; Commission # DD 531936 . . Bonded By National Notary Assn. K.W. 4 K.W. K.W. K.W. K. K. TOTAL DEMAND LOAD 3f 9v ` � K.W. /g5 "f 9 K.W. / 240 VOLT = /33 AMPS aODa -4^p c� C 1/C4' BUILDING PERMIT APPLICATION FBC 2004 Permit Type: Electrical Owner's Name (Fee Simpj Titlehoider) Owne J fl //,q4 f I, Address (/ / City i' State Tenant/Lessee Name E -MAIL: Job Address (where the work is being done) Describe Work: Radon $ Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. ti —/O ° /36' Master Permit No. 1101.-Pfits 1-1-C., Phone # Zip 3 fi3 Phone # City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES NO t/ Contractor's Company Name l & iQjt_ /Ak:.- Contractor's Address b6? /� ® S r City MA1111 State 'IL-- Zip /5 Qualifier Name -/- l tti IT/WO Phone # State Certificate or Registration No. GC' 0 / iel Certificate of Competency No. E -MAIL: Phone # � 7cg - 2(0 1 6 (� Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ - 7 • Square / Linear Footage Of Work: CM IC JAN 2 7 201 BY: •g Type of Work: ❑Addition ['Alteration s ['New Re - pair/Replace Demolition ❑ oP412m £ & &, ie>z F 6zrt log//* **** **$ e**xxxxxxx******* **************** F *x ok************x t �Y � *****x�Y* *** * * *****Bc****** Submittal Fee $ Permit Fee $ �� �'J CCF $ - 1 • YO CO /CC Notary $. Training /Education Fee $ 1 .k-t 0 . Technology. Fee $ 'to.- G •� DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ See Reverse side -› Bonding Company's Name (if applicable) Bonding Company's Address City Mortgage Lender's Name (if applicable) Mortgage Lender's Address City 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 apprQv � an,d a reins pection fee will be charged Signature The for day of who is p Sign: Print: Owne b ent ing instrument was acknowledged before me this Zjo 20 j � �, by Cha irit< Il' As identification and who did take an oath. NOTARY PUBLIC: I � sonally known to me or who has produced (Revised 02/08/06) My Commission Expires:" r. **** ** * ****** ** * ** ** APPLICATION APPRO State St AM. JO, All, NIldb•Odi MARY PAT BRIGGS *NetaryiPubNta*State t f ** • MY Commission Expires May 11, 2010 Commission # DD 531936 Bonded By National Notary Assn. Zip I Zip Contractor The foreg9Mg instrument was acknowl before me this'" day of ,20 /� by ® % /'1,.1 - who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Com�►isso MARY PAT BRIGGS • ,�'' • !' My Commission Expires May 11, 2010 9, ,, Commission.# DD 531936 ra* Bonded Byi National Notary Assn. Z3 1B n Engineer Zoning 'ner A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. 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. /9"r4.4i 069■ 4 79 1. Legal description of property and street/address: 2. Description of improvement: 9. Expiration date of this Notice of Comn ncement: 1210142 PAGE 3 10/09 NOTICE OF COMMENCEMENT TAX FOLIO NO. 5g 10 Space above reserved for use of recording office /7,f9 / �l 3. Owner(s) name and address: at Interest in property: (- Name and address of fee simple titleholder 4. Contractor's name, address and phone number f D� / - (9er.7(> �� /moo-G Ti�� 4 s�' 5. Surety: (Payment bond required by owner from contractor, if any) f Name, address and phone number. Amount of f bond $ 6. Lender's name and address: 7. Persons within the State of Florida designated by ►ner upon whom notices or other documents may be served as provided. by Section 713.13(1)(a)7., Florida Statutes, Name, address and phone number: 51 8. In addition to himself, Owners designates the following person(s) to receive a copy of. the Uenor's Notice as provided in Section 713.13(1)(4 Florida Statutes. Name, address and phone number. (the expiration date is 1 year from the date of recording unless a different date is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Signature(s) of • ', '_ s • Own ' K prized Officer /Director/Partner/Manager Prepared By !� Prepared By Title/Office CAU Print Name etipats IIA Print Name 414 r r� >�A i �fe /(� STATE OF FLORIDA COUI9Y OF MIAMI-DADE . of -J U Individually, or fa as for ❑ Personally known, or la produced the following type of iden Signature of Notary Public: Print Name: (SEAL) VERIFICATION PURSUANT TO SECTION 92.525. FLORIDA STATUTES Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true, to the best of my knowledge and belief. CIA} M I i..:: on: MN& _ OPOPOP 1111111111111 1111111111111111111 1111111111111 4 'r �"+ ; ° ° MARY PAT BR10Yi5 _ . ) -• t Notary Pubs - State of Florida g. _ " • +Ccn mission May 11.2310 4. -:; " �m ¢ .°a Commission # 130 531936 • ��` Bonded By National Notary/ Assn. CVN ? i1110- Rorer16.x. OR Bk 27162 Ps 08731 (APO RECORDED 01/27/2010 12:26:42 HARVEY RUVIN, CLERK OF COURT tIANI -DACE COUNTYr FLORIDA LAST PAGE Signatur f Owner(s) or - - " - Ks ) Qwn �s Authorized Officer/Director/partner/Manager who signed above: B U STATE OF FLORIDA, COUNTY OF DADE BI/ F at his is of the day of re ESS my hand and • HARVEY RUVIN, ; Circwf and County Courts By D.C. Scheduled Inspection Date: May 12, 2010 Inspector: Devaney, Michael Owner: , CAV HOLDINGS, LLC Job Address: 58 NW 104 Street Miami Shores, FL 33150- Project: <NONE> Contractor: COLTRAIN CONSTRUCTION CO Building Department Comments May 12, 2010 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 For Inspections please call: (305)762 -4949 RC -2 -10 -tgq Inspection Number: INSP- 143041 Permit Number: EL -1 -10 -136 CI- Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1121360131060 Phone: (305)285 -6723 SERVICE UPGRADE REMOVAL OF CLOTH WIRING NEW RECEPTALCE 4 SMOKE DETECTORS Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments ) 7 HzIK Page 22 of 25 PLUMBING WORK FOR BATHROOM AND KITCHEN REMODEL. WATER HEATER INSTALLATION Passed Inspector Comments CREATED AS REINSPECTION FOR INSP- 135026. missing wm hook up Approved by Rafael Hernandez, he did the inspection at time of permit final 10 -721 NB 5 -27 -10 /). Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection Number: INSP - 144611 Permit Number: PL -2 -10 -190 Inspection Date: May 27, 2010 Inspector: Hernandez, Rafael Owner: , CAV HOLDINGS, LLC Job Address: 58 NW 104 Street Miami Shores, FL 33150- Project: <NONE> Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Contractor: JUPITER FARMS PLUMBING & IRRIGATION INC II in Department Comments May 28, 2010 For Inspections please call: (305)762 -4949 RC- 2. -to- 189 CL Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition/Alteration Phone Number Parcel Number 1121360131060 Phone: (305)662 -7979 Page 1 of 1 Inspection Number: INSP - 135026 Scheduled Inspection Date: March 19, 2010 Inspector: Hernandez, Rafael Owner: , CAV HOLDINGS, LLC Job Address: 58 NW 104 Street Project: <NONE> Miami Shores, FL 33150- Contractor: JUPITER FARMS PLUMBING & IRRIGATION INC Building Department Comments Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL ° P'` Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Number :, L -2 -10 -190 Permit Type: Fantbing - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1121360131060 Phone: (305)662 -7979 PLUMBING WORK FOR BATHROOM AND KITCHEN REMODEL. WATER HEATER INSTALLATION Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments March 18, 2010 For Inspections please call: (305)762 -4949 Page 4 of 7 Project Address Owner Information Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795 -2204 58 104 Street Miami Shores, FL 33150- 1121360131060 Block: Lot: CAV HOLDINGS, LLC Contractor(s) Phone JUPITER FARMS PLUMBING & IRRIGI (305)662 -7979 CeII Phone Fees Due CCF Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $1.20 $0.40 $150.00 $3.00 $1.60 $156.20 Building Department Copy March 02, 2010 Address Parcel Number Phone CAV HOLDINGS, LLC 91 64 Street HIALEAH FL 33012 -2663 Valuation: Total Sq Feet: Type of Work: PLUMBING Type of Piping: KITCHEN REMODEL Additional Info: Bond Retum : Classification: Residential Invoice # PL -2 -10 -36999 Invoice Total Amt Paid Amt Due $156.20 $156.20 $0.00 Expiration: 08/23/2010 Applicant Cell For Inspections please call: (305)762 -4949 Available Inspections: Inspection Type: Top Out Re Pipe Main Drain Heater Water Service Final Water Main Lavatory Underground 2 BUILDING PERMIT APPLICATION FBC 20 Permit Type: PLUMBING e' Owner's Name (Fee Simple Titleholder) Owner's Address City Tenant/Lessee Name Email C J c ) (/ ® v - Job Address (where the work is being done) , o &" City Miami Shores Village FOLIO / PARCEL # Is Building Historically Designated YES 17 3 e0,81, State Certificate or Registration No C (Y 2 6517— Contact Phone • n 2i - 74,e 3 - 3 °j 0 3 Architect/Engineer's Name (if applicable) Type of Work: Describe Work: Submittal Fee $ Permit Fee $ Miami Shores Village panyzi Building Department FEB 0 8 2010 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 County Miami -Dade Violation date: NO Permit No. Master Permit No. LL( Phone # 0 • 7 C 3 . 3 3 1� � Phone # � - l 2-2_ -✓ _G 1 Contractor's Company Name l 0,- `S 64. V . 1 .0 1 t nifond Contractor's Address City ( kit 7'G✓ State ''t- Zip 33 `-t Z V' Qualifier Name P/(-t zk`' `C A^- t B ale/ 7 Phone # _S P I -' - j ° / 3 ' 7 Certificate of Competency No. E -mail Li fe) s - e `l s®a f4. n e- f Phone # Value of Work For this Permit $ 1 1 SOO 'OD Square / Linear Footage Of Work: ['Addition ['Alteration ['New Repair/Replace 4 CIS, bi � � &CI k - tom � '1 JL� w_d Sri Zip Flood Zone r L (44"., k, ") J•2 ,ruv , -O de f [' Demolition ******** * * * * * * * * ** * * * * * * * * * * * * * * * * * * * ** Fees************* * * * * * * * * * * * * * * * ** * * * * ** * * * * * * ** CCF $ CO /CC $ 1. Notary $ Training/Education Fee $ _ Technology Fee $ Scanning $ Radpn $ DPBR $ ,Bond $ Double Fee $ Structural Review. $ Total Fee Now Duet 15 - �© See Reverse side Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (i€ applicable) Mortgage Fender's Address • City ,; <1 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 absj e of such posted notice, the inspection will not be approves'/ and a reinspection fee will be charged. Sign: Print: Owner or Agent The f e e g instrument was a • ledg . • befor �jjyy t day of , 2 010 , by o is ersonally . -sown to ' e • who has produced . tion and who did take an oath. NOT My Commission Expires: * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPROVED BY (Revised 07 /10 /07)(Revised 06/10/2009) Engineer Signature Contractor The foregoing instrument was ackno4edged before me this j � day of CEN4revir42o to by lefeitatd ii'l AlI der , who is personally known to me or who has produced a: f, . ?. as iae11tification and who did take an oath. NOTARY PUBLIC: Sign: r14c, Print: ' , w �c��t► °c � My Coi 1 �, y , , pS�ley Coney G � �°�'� Commission #DD933319 P/ 't , Expires: OCT. 15, 2013 P / t t BONDED THRU ATLANTIC BONDING CO., INC. ********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 4/ ° Plans Examiner Zoning Clerk checked T` IFICA7 ' ' .. u c " 3 #I JO 1201 PRODUCER Work Comp Associates, Inc. p P.O. Box 33297 Palm Beach Gardens, FL 33420 - 3297 USA THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. COMPANIES AFFORDING COVERAGE COMPANY A Florida Citrus, Business & Ind. INSURED Jupiter Farms Plumbing & irrigation, Inc. 17392 Mellen Lane Jupiter, FL 33478-5205 COMPANY B COMPANY COMPANY D COVERAGES = THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. u. J TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMIDDNY) POLICY EXPIRATION DATE (MMIDDIYY) LIMITS GENERAL LIABILITY COMMERCIAL GENERAL UABIUTY • GENERAL AGGREGATE PRODUCTS - COMP/OP AGE $ CLAIMS MADE [] OCCUR PERSONAL & ADV INJURY $ $ — OWNERS & CONTRACTOR'S PROT EACH OCCURRENCE FIRE DAMAGE (My one lire) $ MED EXP (Any one person) $ AUTOMOBILE — — — LIABILITY ANY AUTO AU. OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE UMIT $ BODILY INJURY (Per Person) $ ^ BODILY INJURY (Per Accident) $ PROPERTY DAMAGE $ GARAGE — UABIUTY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS R UMBRELLA LIABILITY FORM OTHER THAN UMBRELLA FORM EACH OCCURRENCE $ AGGREGATE $ $ A WORMERS COMPENSATION EMPLOYERS' LIABILITY PARTN ROPERS/ E EECUTIVE OFFICERS ARE: AND — f0( INCL EXCL 10639841 4/1/2009 4 /1/2010 )a I E ATU I 1 ER EL EACH ACCIDENT $ 500 000 EL DISEASE - POLICY UMIT $ 500 000 EL DISEASE -EA EMPLOYEE $ 500,000 OTHER DESCRIPTION OF OPERATIONS /LOCATIONSNEHICLESISPECIAL ITEMS mil`# TIFICAT E OLD .. " CA ±I ti„A Miami Shores Village Building Department 10050 N.E. 2nd Avenue Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 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 KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORED REPRESENTATIVE /' • / / X1--------_- G % L'i7 PEAL) - *CORD, - 53° 0- - RI:t P IOW: , ; . FS. NG I INC FLT 33478 AC# tikkOf O BUB Xt +STRUCTIO - LI 07/25/2008 080002369 CF147 The PLUMBING'CONTRACTD - Named below IS CERTIFI Under the provisions o f=C Expiration date: AUG 31, VICKER, RICHARD JUPITER FARMS PLUMB 17392 MELLEN LANE JUPITER CHARLIE CRIST GOVERNOR ACA _ 449161 9 3 CENSF I+TB 05/29/2009 080497293 QB7752 The BUSINESS ORGANIZATIO Named below IS QUALIFIED Under the provisions of = Chapter 489 FS. Expiration date: AUG 31, 2011 (THIS IS NOT A LICENSE TO PERFORM WORK. THIS ALLOWS :_; COMPANY TO DO BUSINESS ONIF Y IF:, IT HAS A QUALIFIER JUPITER FARMS PLUMBING c IRtIGATION INC 17 392 MELLEN LANE JUPITER FL 38478 CHARLIE CRIST GOVERNOR 2005 -13909 JUPITER FARMS PLUMBING & IRRIGATION INC VICKER RICHARD M STATE OF FLORIDA,. S 'BINS AND PRO SSIONAL REGULATION STRUCTSON- Wit 1ICEN$ING - BGARD: S EQ# LO9052901164 ANNE M. GANNON TAX COLLECTOR, PALM BEACH COUNTY 42 SPLAY AS REQUIRED BY LAW A, STATE OF FLORIDA PALM BEACH COUNTY LOCAL BUSINESS TAX RECEIPT EXPIRES: SEPTEMBER - 30 - 2010 LOCATED 17392 MELLEN LANE JUPITER FL 33478 This receipt is hereby valid for the above address for the period beginning on the first day of October and ending on the thirtieth day of September to engage in the business, profession or occupation of. PLUMBING CONTRACTOR CFC1426572 SIGNAL REGULATX SING BOARD - SgQ# Ldsa7 ho'0 :CHUCK DRAG '. HRIM SECRE v. .... .a•.• w.. ..... .. CNTY TOTAL CHARLES W. DRAGO SECRETARY OC -032 CLASSIFICATION 27.50 27.50 THIS IS NOT A BILL - DO NOT PAY PAID. PBC TAX COLLECTOR 27.50 BTR 049 01671451 07/20/2009 THIS DOCUMENT IS VALID ONLY WHEN RECEIPTED BY TAX COLLECTOR 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 POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OFSUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR ADM. TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YYYY) POLICY EXPIRATION DATE (MMIDDIYYYY) LETS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY 074682 - 72723786 - 09 12/13/2009 12/13/2010 EACH OCCURRENCE $ 1 000 , 000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 300 , 000 CLAIMS MADE X I OCCUR MED EXP (Any one person) $ 10, 000 $ 1, 000 , 000 GEN'L PERSONAL 8, ADV INJURY GENERAL AGGREGATE $ 2,000,000 $ 2,000,000 AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG POLICY X j LOC B AUTOMOBILE X LIABILJTY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 4742473100 10/23/2009 10/23/2010 COMBINED SINGLE LIMIT (Ea accident) $ 1, 000,000 BODILY INJURY (Per person) BODILY INJURY (Per acddent) $ PROPERTY DAMAGE (Per accident) GARAGE LUUNUTY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ C EXCESS X X I UMBRELLA LIABILnY 47 424 - 731 - 01 12/13/2009 12/13/2010 EACH OCCURRENCE $ 2,000,000 OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ 5,000 AGGREGATE $ 2,000,000 $ $ $ WORKERS AND EMPLOYERS' ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER (Mandatory If yes, describe SPECIAL COMPENSATION LIABILITY Y/ N WC STATU- OTH- TORY LIMITS ER EL EACH ACCIDENT $ r I EXCLUDED? E.L DISEASE - EA EMPLOYEE $ In NH) under PROVISIONS below E.L DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS ACCORD CERTIFICATE OF LIABILITY INSURANCE PRODUCER (561) 746 -4546 FAX: (561) 746 -9599 Tequesta Agency, Inc. 218 S. US Highway One Suite 300 Tequesta FL 33469 INSURED Jupiter Farms Plumbing & Irrigation, Inc. 17392 Mellen Lane Jupiter FL 33478 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURER k Southern Owners Insurance Co INSURER B: Owners Insurance Company INSURER c Owners Insurance INSURER D: INSURER E: DATE (MM/DDIYYYY) 2/5/2010 NAIC # 10190 32700 18988 COVERAGES CERTIFICATE HOLDER CANCELLATION (305)756 -8972 Miami Shores Village Bldg Dept 10050 NE 2nd Ave Miami Shores, 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 OBUGATION OR LUIBIUTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORED REPRESENTATIVE vl Mark Kasten /DEBBIE ACORD 25 (2009/01) INS025 (200901) © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD