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PL-10-568 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 139685 Permit Number: PL -4 -10 -568 Scheduled Inspection Date: May 21, 2010 Permit Type: Plumbing - Residential Inspector: Rodriguez, Jorge Inspection Type: Final Owner: LEVINSON, GARY Work Classification: Sprinkler System Job Address: 186 NE 108 Street Miami Shores, FL 33161- Phone Number Parcel Number 1121360090010 Project: <NONE> Contractor: UNLIMITED LAWN IRRIGATION Phone: (305)827 -9648 Building Department Comments Inspector Comments Passed Failed Correction G Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. May 21, 2010 For Inspections please call: (305)762 -4949 Page 4 of 12 Miami Shores Village t 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 kpti Phone: (305)795 -2204 y, 3 �s A nsr Expiration: 10 /03/201 Project A ddre ss Parcel Number Applicant 186 108 Street � 1121360090010 .... �.�..__.��..w...._...__....... MSHORES LLC Miami Shores, FL 33161 Block: Lot: Owner Inf ormation Address Phone Ce ll MSHORES LLC 1451 OCEAN Drive (305)984 -1099 MIAMI BEACH FL 33139 - Contractor(s) Phone Cell Phone Valuation: $ 1,650.00 UNLIMITED LAWN IRRIGATION (305)827 -9648 Total Sq Feet: 0 Type of Work: SPRINKLER SYSTEMS Available Inspections: Type of Piping: PLUMBING Inspection Type: Additional Info: SPRINKLER Final Bond Return Underground Sprinkler Classification: Commercial Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 Invoice # PL -4 - - 37496 Education Surcharge $0.40 04/02/2010 Credit Card $ 50.00 $ 106.20 Permit Fee - Additions /Alterations $150.00 Scanning Fee $3.00 04/12/2010 Check #: 4870 $ 106.20 $ 0.00 Submittal Fee $50.00 Submittal Reversal Fee ($50.00) Technology Fee $1.60 Total: $156.20 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated. April 12, 2010 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy April 12, 2010 1 Mia iii Shore ' s Village Building Department o 30 2 10050 N.E.lMd Avenue, Miami Shores, Florida 33138 APLj2 201 Tel: (05) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 ....... . BUILDING Permit No. ;A-1 - PERMIT APPLICATION Master Permit No FBC 20 Permit Type PLUMBING Owner's Name (Fee Simple Titleholder) Phone # i, Owner's Address City V State Zip Tenant/Lessee Name Phone Email / Job Address (where the work is being done) lam' City / Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES F NO Flood Zone Contractor's Company Name VWZ 11Y11 7�'.� � dyti Xe R1 -1i hone # :9 ' 8 Z 7- 9 G Contractor's Address 1691 1 0 /f° f 79 City ✓''g h'! State �C Zip, 3 30 1I Qualifier Name CA's Phone# 7 S State Certificate or Registration No i' Certificate of Competency No. Contact Phone 704- ZS /- 1-% E -mail U/V,- /IV � T�.� //P1e 1 fo'/Q'j/� /f3ECC S ®G�7`�' � N/-e �` I C Architect /Engineer's Name (if applicable) Phone # Value of Work For this Permit $ �`� �! Square / Linear Footage Of Work: Type of Work: ❑Addition ❑Alteration R�ew ❑ Repair/Replace ❑Demolition Describe Work: /N X T 4 L L QA- ' ;s &� FG 7VE t e C® / t. � G IL--o c-S7 - i Submittal Fee $ Permit Fee CCF $ , 'fiU CO /CC $ Notary $ Training /Educotion Fee $ - ' Technology Fee $ 1 y. Scanning $ Radon $ DPBR $ Bond $ Double Fee $ Violation date: Structural Review. $ Total Fee Now Due $ See Reverse side Bondin W applicable) Bonding ompany's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage L&der'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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a cert copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seve, days after the building permit is is d. n the absence of such posted notice, the inspection will not be approved and on fee will be charged. Signature Signature er or Agent Contractor The foregoing i ent was acknowledged before me this' The foregoing instrument was acknowledged before me this day of �, 20 by day of L , 20 — by s��1 who is pers ally known to me o�(vM %ftwpuced who is personally known to me or who has produce As idc$i\ and.wl�4��Q 1 take an oath. as identification and who did take an oath. C. NOTARY PUB LIC• '� a NOTARY PUBLIC: Sign: �� .-- .., r : Sign: Print: �i�� .9 .. ' $ ```h. Print: My Commission Expires: My Commission E4ires: 1 �.DD a /on n►rluuli�� APPROVED BY f0 Plans1xaminer Zoning Engineer Clerk checked (Revised 07 /10 /07)(Revised 06110/2009) 08-04 -2009 'r ALEX SINI( STATE OF FLORIDA CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual Listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 08/0412009 EXPIRATION DATE: 08104/2011 PERSON: SANCHEZ JUAN J FEIN: 651106390 BUSINESS NAME AND ADDRESS: UNLIMITED LAWN IRRIGATION INC 8940 NW 178 ST N 203 MIAMI FL 33015 SCOPES OF BUSINESS OR TRADE: I- IRRIGATION 2- SPRINKLER INSTALLATION IMPORTANT: Pursuant to Chapter 440 . 05414), F.S., to officer of a corporation who @facts asemption from this chapter by filing a cartitlesto or alectlan under tkti section oily not recover benefits or compensation under this chapter. Personal to Ckapter 440.06112), Vs., Certificates of afeciloo to as exempt... apply only with!# the scope of the business or trade limed 04 the Notice Of 11160108 to be ax6mpt. Porsasnl to Chapter 440.061191, F.S., Nonce# of election to Its exempt end Certttlestan of election to be exempt skalt be subject to revscallon It, at any time after the filing of Iha Notice or the faseenct of tko eertnicsts, the person nomad an the notice or Certificate no fa #gar meets the requirements of this section for fsmance of a certificate. The department shall revoke a certificate at any time for fetters of the person named on the certificate to meet the requirements of this section. aUESTIONS? 18501 413 -1609 OWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -66 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA IMPORTANT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATtON Pursuant to Chapter 4411051141. F.S.. an officer of a corporation who CONSTRUCTION INDUSTRY O elects exemption from this chapter by filing a certificate of election CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA L under this section may not recover benefits Or Compensation under this WORKERS' COMPENSATION LAW 40 D chapter. EFFECTIVE 08/04/2009 EXPIRATION DATE: 09/04 /2011 Pursuant to Chapter 440.051121, F.S., Certificates of election to be PERSON: JUAN J SANCHEZ H exempt... apply only within the scope of the business or trade listed on FEIN: 851108390 E the notice of election to be exempt. BUSINESS NAME AND ADDRESS: E Pursuant to Chapter 44Q 051131, F.5.. Notices of ejection to be exempt UNLIMITED LAWN IRRIGATION INC and certificates of election to be exempt shelf be subject to revocation 6940 NW 179 ST if, at any time after the filing of the notice or the issuance of the d 202 certificate, the person named on the notice or certificate no longer meets WAM{ FL 33015 the requirements of this section for issuance of a certificate. The department shall revoke a certificate at arty time for failure of the SCOPE OF BUSINESS OR TRADE: person named as the certificate to meet the requirements of this 1- IRRIGATION 2- SPRINKLER INSTALLATION section. CLUESTIONS7 (850) 413 -1609 CUT HERE ++ Carry bottom portion an the job, keep upper portion for your records. DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVtStED 0'9 -06 MIAMWADE COUNTY 2009 MUNICIPAL CONTRACTOR'S 2010 FIRST- CLASS TAX COLLECTOR TAX RECEIPT U.S. POSTAGE f 140 W. FLAGLER ST. MIAMI -DARE COUNTY - STATE OF FLORIDA PAID Ist MIAMI, FL 33130 PURSUANT TO COUNTY CODE SEC. 10-24 MIAMI, FL EXPIRES SEPT. 30.2070 PERMIT NO. 231 I HIS IS NOT A BILL — DO NOT PAY RECEIPT NO. 30- 4813441 CC NO: OIPODO545 BUSINESS NAME/ LOCATION RECEIPT HOLDER MAY DO UNLIMITED LAWN IRRIGATION INC BUSINESS AS A CONTRACTOR AS SPECIFIED: HEREON. 6940 NW 179 ST OWNER :UNLIMITED'' LAWN IRRIGATION INC bhh AtA UI_�RECEIPT — FOR SPECIALTY PLUMBING` CONTRACTOR A LIST OF NON - PARTICIPATING MUNICIPALITIES Receipt holder must DO NOT FORWARD register in the city UNLIMITED LAWN IRRIGATION INC where work is to be done. JUAN J SANCHEZ PRES 6940 NW 179 ST 202 PAYMENT Rte MIAMI FL 33015 coLL 02250034002 j( } I I I$ i 66 000175.00 i i I lia $ 1 111 11 11ii11 I 1 sit 1111 11 11 111 1 1} i} a"I.1 1}i j t116A. f t t MIAMI -OADE COUNTY 2M LOCAL BUSWESS TAX RECEIPT 2010 FIRST-CLASS TAX COLLECTOR MIAMWADE COUNTY - ST OF FLORIDA U.S. POSTAGE 140 W. FLAGLER Si'. EXPIRES SEPT. 30, 2010 PAID MIAMI, FL 1 st FLOOR MUST BE DISPLAYED AT PLACE OF SUSHMSR MIAMI, FL 33130 PURSUANT TO COUNTY CODE CHAPTER SA - ART. 9 & 10 PERMIT NO. 231 461052 -4 " RENEWAL ss1N��It OOccAA��Ipp Q 481344 -1 BU uNff1�6 L i.AWN N IRRIGATION INC CC i EVOgf1545 6940 NW 179 ST 202 33015 UNIN DADE COUNTY C UNLIMITED LAWN IRRIGATION INC . T t Busi WORKERlS sec I�PECTALTY PLUMBING CONTRACTOR 1 rms IS ONLY A LOCAL 8U S TAX RECEIPT. IT ODES HOT PERMIT THE HOLDER TO VIOLATE ANY EXLSTM REGULATORY OR DO NOT FORWARD ZOOM LAWS OF THE COUNTY OR CmM NOR OM R EXElmr THE HOLUM FROM ANY OTHM EQUMWs THK ISS UNLIMITED LAWN IRRIGATION INC Nof A TAI of THE TIONI ouAUpcA JUAN J SANCHEZ PRES :=== TAX NW 179 ST 202 � �TMTAX MIAMI FL 33015 LLECTM 09!29!2009 02250034001 t { f { { q i sit j rr��jA� 000075.00 {}} 11113} } 3}F 111S 1 J 1 ii 1}1t i 11 {1111 1 1 411 T {11 t111 t1F Eff I {}I i SEE OTHER SIDE — CTQB Cons#ucb m Trades Quatliying Board BUSINESS CERTIFICATE OF COMPETENCY 01 P000545 UNLIMITED LAWN IRRIGATION INC D.B.A.: SANCHEZ J UAN J. CTQB Construction Trades Qualifying Board BUSINESS CERTIFICATE OF COMPETENCY _ 0 1P000545 UNLIMITED LAWN IRRIGATION INC SAN U J. AN , Is certified under the provisions of Chapter 10 of Miami -Dade County QUALIFYING TRADE(S) 0003 LAWN SPRINKLER Z rminio Gonzalez P.E. Secrets;,. -,;,, M� ry of the Board Maori- pade,COWMy retaIns afl Property rights:herein. w ww_mianedade. 9ovftildingcode Ron c 04/12/2010 13:13 3055584385 FRASES &FRASES INSURE PAGE 01 DATE (MMIDD/YY) CERTI L IABILI TY INSURAN 04/12/10 PRODUCER Frases & Frases Insurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 5900 West 16th Ave. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Hialeah„ FL 33012 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Phone (3 05)558-1333 Fax (305 -4385 INSURER AFFORDING COVERAGE NAIL 0 INSURED Unlimited Lawn Irrigation Inc INS URERA �Soottsdale Insurance Company _ 6949 N W 179 Th St # 202 INSURER 8: INSURE C : Hialeah, FL 33015- IN SURER D INSU E: COVER INSURER F: THE POLICIES OF INSURANCE, LISTED 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, A GGREGATE LI MIT S SHOW_ N MAY HAVE BEEN REDUCED BY PAID CLA INSR ADD'L - POLICYEFFECTNE POLICYEXPO TYPE OF INS URANCE POLICY NUMBER LIMITS _ _ DA T�MMlDDlYY} DATH MMJDDlYY _ _ GENERAL LIABILITY EACH OCCURRENCE 1,0_00,000 ❑/ COMMERCIAL GENERAL LIABILITY GE TOTED 50,000 CPS1086491 08/10/09 08/10/10 PREMISES �Ee occurence ❑❑ CLAIMS MADE ® OCCUR MED EXP (Anyone person) 5,000 A [] ❑ PERSONAL & ADV INJURY 1,000,000 ❑ — GENERAL AGGREGATE 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODU - COMP /OP AOG 2,000,000 ❑ PO LICY 56 PROJEC ❑ LOC AUTOMOBILE LIABILITY _ COMBINED SINGLE LIMIT Q ANY AUTO a eooiden ❑ ALL OWNED AUTOS BODILY INJURY ❑ ❑ SCHEDULED AUTOS (Per person) ❑ HIRED AUTOS ❑ BODILY INJURY NON OWNED AUTOS (Per accident) ❑ - PROPERTY DAMAGE per acci GARAGE LIABILITY AUTO ONLY - EA ACCIDENT U ❑ ANY AUTO OTHER THAN EA ACC ❑ AUTO ONLY: AGO EXCESS/UMBRELLA LIABILITY _ EACH OCCURRENCE ❑ OCCUR [ J CLAIMS MADE AGGREGATE ❑ DEDUCTIBLE _ ❑ RETENTION $ WORKERS COMPENSATION AND —' ❑ WC STA u- ❑ OTH- EMPLOYERS' LIABILITY T2 ER ANY PROPRIETOR / PARTNER I EXECUTIVE E.L. EACH ACCIDENT OFFICER / MEMBER EXCLUDED? E.L. DISEA - EA EMPLOY If yea, describe under _ SPECIAL PROVISIONS b elo w E.L. DISEASE - POLICY LIMIT OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS _ CERTIFICA HOLDER CANCEL SHOULD ANY OF THE ABOVE DESCRIBE POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUI C ANSURER WILL EN VOR TO MAIL Miami Shores Village, Building & Zonning Dept. 30 DAYS WRITTEN NOTICE TO c ERTIFICATE HO ER NAMED TO 1 0050 NE 2nd Ave. T1tE LEFT, BUT FAI TO O SO sHA IMPOSE NO OBL ATION OR Ll�iiLITY Miami Shores, FL 33138 OF ANY KIND W-O TH IN RE ITS ENTS OR REPRE ENTATIV l AUTHORIZED REPRE N IV L3 75&6972 X7//7/ -_j ACORD 26 (2001/08' QF m ORATION 1988