PLC-11-2197Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 167086
Scheduled Inspection Date: December 14, 2011
Inspector: Hernandez, Rafael
Owner: , BARRY UNIVERSITY
Job Address: 11300 NE 2 Avenue Weber Hall
Miami Shores, FL 33138 -0000
Project: BARRY UNIVERSITY
Contractor: MARLIN PLUMBING OF MIAMI INC
Permit Number: PLC -11 -11 -2197
Permit Type: Plumbing - Commercial
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1121360010160 -13
Phone: 305 -652 -6108
Building Department Comments
RUN HOT & COLD WATER LINES FROM KITCHEN SINK
TO LAUNDRY AREA. ALSO VENT WITH STADER VENT
Inspector Comments
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
December 13, 2011
For Inspections please call: (305)762 -4949
Page 24 of 53
1.2-\* , 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
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: PLUMBING
OWNER: Name (Fee Simple Titleholder): f.3a/Y1(•� U N j v 0
Address: 1300 &,q_� �'✓�
City: MI a 44 Siwye$ State: FL
Tenant/Lessee Name:
Email:
NOV 282011
BY: -_ -_-
�No�l I126fl
Master Permit No.
� ! .1-1°
Phone #: 3o 5.-114 - 37%
Zip: 33 /4 /
Phone#: 305 - 899 - 3 7 5 5
JOB ADDRESS: 113 0 o N 6 o2,-J 4-Ye- We 60-✓ 131 d gr •
City: Miami Shores County: Miami Dade
Folio/Parcel #: , I •* 2131o.00o . 43 4 So
Is the Building Historically Designated: Yes
Zip:
NO Flood Zone:
CONTRACTOR: Company Name: 1.4 0.411 n PtUFnkiktj o lwi tki,i mac.. Phone#:3a5- rsa"3o31
Address: aOl q.S IJ a /G to Cy__
City: 44 PtiI6au.; Peadk State: r-7L Zip: 714214 83/79
Qualifier Name: ed L e 4iJ, S 11JA.(kaAr Phone #: 305 - 45.2 -3•63)
State Certification or Registration #: C. Fe O cf 8a9a.. Certificate of Competency #:
Contact Phone #: 30$ -4, 5a-3o 3 / Email Address: ,fh4.1 Idn Phrrnl0pD €e01. 0/I'I
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $ a 9 'la AD Square/Linear Footage of Work:
Type of Work: DAddress OAlteration ONew ORepair/Replace DDemolition
Description of Work: (r n hh64- & Cold. vJa4er r 11 ALS •Qrom ki 3: n k 46 lal.f.�.cf P -
A 1 St, 0414- iN f.1-k SJ•e�daj Ve -n.4- a
**** ***+ x*+x**** *** * * ************* ** *****Fees******* ******** x * ************ ** * *** **+x******
Submittal Fee $ Permit Fee $ /J CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ 11 2 � V
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 o curs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be appro . ed a reinspection fee will be charged.
Signature �°� "°� Signature ,G
Owner or Agent
/Ved/deJ/L----*
Contractor
The foregoing instrument was acknowledged before me this IR" The foregoing instrument was acknowledged before me this Ib
day of jVO\i , 20 _, by gc Ce (j c sOctrots ,
who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: .vi,S Alent,an `r
My Commission Expires:
51 Gpo' a.
APPROVED BY
day of ___ I id: 20 IL, by txvfcL TAPciticeiv
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Plans Examiner
Structural Review
Sign:
Print: e..sA Meer- eef%Ac�
My Commission Expires: 1z -47 -.049J3
Zoning
Clerk
DEC -2 -2011 11:28 FROM:
TO:3057568972 P.1/1
AC° • D CERTIFICATE OF LIABILITY INSURANCE DATE`MMIDDNYYY)
11 18 2011
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, 71118
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S). AUTHORIZED
• REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an D ONAL INS RED, the•paticy(les) must be ondorsed, If SUBROGATION 13 WAIVED, Subject to
tho terms and conditions of tho policy, certain pallclos may roqulro an ondorsomont A statement on this certificate does not confer rights to the
corttflcate holder In Ilou of such endomement(s).
PRODUCER
Keyee Coverage Inrluranee
5900 Hiatu8 Road
Tamarac PL 33321
INSURED
5;337
Marlin Plumbing of Miami, Inc.
70146 N. t. 16th Plane
Miami FL 33179
NAME: Saruira Tones ��
PNCt Fe954-724-'�Q,0.0 1AIG.No):954 .L1d4i024
r� -etAU.
AI2ttIt:SS:sj one nrekeyassQyo age aem
INauRERI81 API?ORDINO DOI/ERASE
NAIL 0
Remus :Hartford are
iNsuMERel$Yidge field )riilplt)yP.ra TnS Co
MISUML°R C
bu$URER D
INSURER E:
INSURER P r
10741
COVERAGES
CERTIFICATE NUMBER;
REVISION NUMBER:
THIS IS TO CERTIF=Y THAT 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 8Y THE PQLlt;tkS DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAIL) CLAIMS
I TR
TYPE OF INSURANCE
AI D.
�F
..... POLICY NUM�'R
POLICY EfP
•
POLICY aI XP
LW IYS
A
SIENERALLIABIUTY
21tEINTTS2,lII
5/A /2011
5/8/2012
EACH OCCURRENCE
$$.000,004
R -
--
COMMERCIAL GENERAL UADIUTY
j CLAIMS MADE PE OCCUR
PREMEW$E EESECU
83004"
310,000
MEO GIP (Any am Ee 1100)
$1 L000,000
PERSONAL A ACV INJURY
32,4100 eon
GPMFRAIA Atx:RENATS
OENI L AQOREQATE LIMIT APPLIES PEI.
�
I PCII UiY x RR ■ II-31
PRODUCTS - COMP1OP AG
33 Don 0110
$ .
sureueen.s LIABH,rm
ti
IFA a rmdantl
,$
$
____
ANY AUTO
BODILY INJURY (Per parson)
LLIOWNED
HIRED AUTOS
—"
—
SOKEEOOULEO
ED
�
I1p ItjYINJURY(Peraeeidens
� Z IMAM--
S
$
$
F _
UMBRELLA UAB
EXCESS LIAR
OCCUR
CLAIMS -IUR AOE
EACH OCCURRENCE
AGGREGATE
$
9
3 —
DP-13 1 J RETENT ON $
B
WORKERS COMPENSATION
AND EMPLOYERS LIABILITY
ANY PROPRIOTOR/PARTNERtG!0CUTIVC YIN
OFFICERNMEM:1ER EXCLUDED? ❑
Mandatory In NH)
It 0y0e0� CASEIN 1.1'
DESCRIPTION OF OPERATIONS ?way,/
N!A
870 75701
12/1/7051,
12/1/5012
yy� $fps(}
ITORYL.IJ I 10TH-
FR
$ L EACH ACCIDENT
$1.000,000
$1 .000,000
EL DISEASE - OA Shako=
E L DISEASE- POLICY LIMIT
$L. two 000
DESCRIPTION OP OPERATIONS 1 LOCATIONS 1 V3HICI,E6 (AKaah ACQRD 101, AddiOanat Remarks SEtladula,11 mom slum Ia required)
CERTIFICATE HOLDER
MIAMI SNORES VILLAGE BUILDING DEPARTMENT
10050 ND 2ND AVENUE
MTAMT SPOPEA FL 33138
ACORD 25 (2010/05)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES 8E CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
®19804010 ACORD CORPORATION, All rights reserved.
The ACORD name and logo are registered marks of ACORD
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. TAX FOLIO 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.
111111111111111111111111111111111111111111111
CFN 201.1R0794755
DR I.k 27906 Ps 2890; (1s)
RECORDED 11/28/2011 11 :2204
HARVEY RUVII.1, CLERK. OF COURT
MIAMI-DADE COUNTY► FLORIDA
LAST PAGE
Space above reserved for use of recording office
1. Legal description of property and street/address: 4 136 D N 6 gna IWe- A4kw14.4 (Merest FL 33/40!
wP.1OGY
2. Description of impr
ement: (an WAY I,'ru z' d r wd sh��► Mach; (,,Je19e4, B0,-1Lri
3. Owner(s) name and address: f x . . . r r l j a } t treaC,111 i t iota N E 2214d Ave_ Ma'am 5114Nzz, FL 9 3/41
Interest in property:
Name and address of fee simple titleholder.
4 Contractor's name, address and phone number: 1V1.9.4 rn i Jmr�y/ _ 20 /e!5 NE /4' Asap-. or* A i40,4
1 eechf R_ 33174 305-452- 30 31
5. Surety: (Payment bond required by owner from contractor, if any)
Name, address and phone number. IV/ A
Amount of bond $ , •�, , N/A
6. Lender's name and address: ST R D . COUNTY O
7. Persons within the State of Florida designated by STATE �SWEJT is may rovided by
4 .
Section 713.13(1)(a)7., Florida Statutes,
Name, address and phone number:
original filed in This office o n day of
8. In addition to himself, Owners designates the following
713.13(1)(b), Florida Statutes.
Name, address and phone number:
Section
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)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER Al- I ER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED
IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, 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 Owner(s) or �-y!= - thorized Officer/Director/Partner /Manager
Prepared By �� Prepared By Mt' -i-CO
Print Name 110.E PWAIZPS Print Name '1 ife'' M(1-Ltiireell
Title/Office N,(tC.0 re.i- Siorzil l Z 1 1.6114 SS A- FIr.VJCifItle /Office +-r` o- Marna 72.( .
STATE OF FLORIDA
COUNTY OF MIAMI -DADE
The fore oing instrument was acknowledged before me this 1 day of (JO 2w
v.l C
By . ' 1)C-f- e'Lj ' f
k ndividually, or Ig.as �� for •
ersonally known, or ❑produced the following type of ident
r Signature of Notary Public:
Print Name: .�.r . C it Le. nrn>Q Y1
(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.
..s
'Madit n PCiiaii3ira
2.ot I
Signature(s) of Owner(s) or Owner(s)'s Authorized Officer/Director/Partner/Manager who signed abov.
By By
123.01 -52 PAGE 3 5110
UNIVIRSITY
11300 N.E. 2ND AVENUE
MIAMI SHORES, fl 331014695
PHONE (305) 899-4910
DATE
V
E
N
0
R
Marlin Plumbing of MItsuni, inc
20145 NE 16th Place
North IC ml Beach FL 33179
Nov 14,2011
ITEM QUANTITY
NO. N L NIT
PURCHASE ORDER
No.
P0143681
i.,1,11-)7,c3i:irC,1
P' pf,k1S ..L. ORDER NUMBER MUST
Iz 1.-
AVC)1CFS t AL3ELS, PACKPC,Fc, AND
SHIPPING PAPERS.
SHIP et BBL TO
SAME AS PURCHASER UNLESS INDICATED BELOW
DELIVER: Barry University
11300 NE 2nd Ave.
MARK Miami Shores FL 33161
PKG FOR:
INVOICE: PURCHASING DEPARTMENT
This order Is subject to the Terms and Conditions on the revrse We.
DATE REQUIRED
Dec 04, 2011
REQUISITION NO
SHIPPED VIA
STOCK
NUMBER
DESCRIPTION
UNIT PRICE
TERMS
Net 30 Days
DISC.
EXTENDED
PRE
1 1 EA
Weber Hall - Rtn 205 -To
run hot and cold water
lines from kitchen sink
to laundry area - hang
and strap as per code,
Must cut out ceiling in
rence m
2,940.0000
ORIGINAL
BY
1.4bNadlelniit E2R.
Director of Putr-hasing
ITY
TOTAL.
AMOUNT
TAX EXEMPT NO. 85-1301262,764C-7
2,940.00
2,940.00
PROPOSAL
MARLIN PLUMBING OF MIAMI, INC.
20145 N.E.16tb PLACE, NORTH MIAMI BEACH, FL 33179
(305) 652 -3031 fax (305) 652 -3135
PROPOSAL SUBMITTED TO
Name: Barry University
Street: 11300 N.E. 2 Avenue
Miami Shores, FL
Phone: 786 -402 -7726- Chick Fax: 305- 899 -3508
Attention: Jeff
WORK TO BE PERFORMED AT
Name: Barry University
Street: Weber Building Number: 205
Miami Shores, FL
Phone: Fax:
We hereby propose to furnish the materials and perform the labor necessary for the completion of:
Marlin Plumbing to cut out ceiling in conference room under unit 205.
Marlin Plumbing to core drill and rough drain line for washing machine, will vent with studer vent
Marlin Plumbing to run approximately 10' cold and hot water line from kitchen sink to laundry area, will hang
and strap as per code.
Materials $727.60
Core Drilling $262.40
Labor $1,800.00 Plumber rate $90.00x 12hrs Helper $60.00x 12hrs
Permit Fees $150.00
(Allowance fees are not to exceed $150.00 if so owner to pay the difference)
NOTE: Any deviations from scope of work mentioned above will be extra to contract and done at time
and material. Note Marlin Plumbing not responsible for any tile patching.
All Material and Workmanship is Guaranteed for One (1) Year starting from Completion date.
Note: Marlin Plumbing will not be responsible for any underground water pipes, sprinkler lines, gas or electric lines
while doing any trenching. If needed, Marlin will call for location services to mark services.
All materials and workmanship is guaranteed for one (1) year from the completion date of the contract to be as
specified, and the above work to be performed in accordance with the drawings and specifications submitted for the
above work and completed in a workmanlike manner for the sum of $ 2,940.00
*In the event that the customer fails to make any payments to Marlin Plumbing in accordance with the terms and conditions of this agreement,
Marlin Plumbing shall be entitled to all reasonable attorneys fees on collection and/or litigation or other court proceeding including attorney's
fees on appeal.
Respectfully submitted: Marlin Plumbing of Miami, Inc.
By:
Raul Bringas Date: REVISED 11/11/11
ACCEPTANCE OF PROPOSAL
The above price, specifications, and conditions are satisfactory and are hereby accepted. You are authorized to do
the work as specified. Payments will be made as outlined above.
Any alteration or deviation from above specifications involving extra costs will be executed only upon written order and will become an extra
charge over and above the estimate. All agreements are contingent upon strikes, accidents or delays beyond our control.
Date: Signature:
Date: Signature:
marl inpropdoc /form 1 / 1998
ACO D®
CERTIFICATE OF LIABILITY INSURANCE
PRODUCER (954) 724 -7000 FAX: (954) 724 -7024
Keyes Coverage, Inc.
5900 Hiatus Road
Tamarac FL 33323.
INSURED Pax # 305 652 3135
Marlin Plumbing of Miami, Inc.
20145 N.E. 16th Place
Miami
FL 33179
IDATE (MMIDDIYYYY)
4/29/2011
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. 11118 CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC #
INSURER A Hartford Fire Insurance Co
19692
glsuRER B:Bridgefield Employers Ins Co
10701x
INSURER C
INSURER D:
INSURER E
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSRADDL
BE CANCELLED BEFORE THE EXPIRATION
TO MAIL 10 DAYS WRITTEN
POLICY NUMBER
PO Wszpo
5/8/2011
Building Department
} a
LMTS
A
GENSRALLIABUJTY
COMMERCIAL GENERAL LIABILITY
211RINIT9228
5/8/2012
EACH OCCURRENCE
$ 1,000,000
$ 300.000
S 10.000
X
PR DAMAGE
EMISES TIOER0 occur/um)
I CLAIMS MADE X OCCUR
MEDEXP(WromsPimmn)
PERSONAL a ADV INJURY
$ 1,000.000
$ 2, 000, 000
GENERA. AGGREGATE
GEML AGGREGATE LIMIT APPUES PER:
PRODUCTS • COMPIOPAGG
$ 2,000,000
1 ouc ICI nLOC
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
COMBINED
(Ea eedQen1) GLE LIMIT
$
BODILY INJURY
(Per parson)
$
_
_
GODLY INJURY
(Par =Went)
S
—
PROPERTY DAMAGE
(Per ecddBnq)
S
GARAGE LIABILITY
n ANY AUTO
AUTO ONLY - EA ACCIDENT
$
0THER niAN EA ACC
$
AUTO ONLY: AGE/
S
EXCESS
I UMBRELLA UABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
•
EACH OCCURRENCE
$
AGGREGATE
$
$
$
$
8
WORKERS
AND EMPLOYERS'UABiLITY
OFFIC�IBER
(Mandatory
iIy dasednaunder
>: PROVSIONS
COMPENSATION
YIN'
930 -25751
12/1/2010
12/1/2011
OOO�TTTR���I
- -V I -"_
"
EL EACH ACCIDENT
$ 1,000,000
$ 1,000,000
EXCLUDED? N
E.L. DISEASE -EA EMPLOYEE
In NH)
blow
E.L. DISEASE -POUDY LIMIT
$ 1,000,000
OTHER
DESCRIPTION OF OPERATION! LOCATION /VEHICLES I EXCLUSION ADDED BY ENDORSEMENT /SPECIAL PROVISIONS
HOLDER
INS025 (1).01
®1988-2009 ACORD CORPORATION. All rights reserved.
The ACORD name and Togo are registered marks of ACORD
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR
BE CANCELLED BEFORE THE EXPIRATION
TO MAIL 10 DAYS WRITTEN
Village of Miami Shores
NOTICE TO THE CERTIFICATE HOLDER NAMED TOME
LEFT, BUT FAILURE TO DO SO SHALL
Building Department
IMPOSE NO OBLIGATION OR UABILRY OF ANY KIND UPON THE INSURER, 115 AGENTS OR
10000 NE 2nd Avenue
REPRESENTARVES.
Miami Shores, FL 33138
AUTHORIZED REPRESENTATIVE
-••
Carey Reyes/MS
INS025 (1).01
®1988-2009 ACORD CORPORATION. All rights reserved.
The ACORD name and Togo are registered marks of ACORD
250346 -5
BUSINESS NAME ! LOCATION
MARLIN PLUMBING OF MIAMI INC
20145 NE 16 PL
33179 UNIN DADE COUNTY
IHtSi_;INS@ ALILL
FIRST -CLASS
U.S. POSTAGE
PAID
MIAMI, FL
PERMIT NO. 231
DO NOT PAY RENEWAL
RECEIPT NO. 262710-8
STATE# CFC048292
OWNER
MARLIN PLUMBING OF MIAMI INC
Sec. Type of Business WORKER /S
196 PLUMBING CONTRACTOR 1
THIS IS ONLY A LOCAL
BUSINESS TAX RECEIPT. IT
DOES NOT PERMIT THE
HOLDER TO VIOLATE ANY
EXISTING REGULATORY OR
ZONING LAWS OF THE
COUNTY OR CITIES. NOR
DOES IT EXEMPT THE
HOLDER FROM ANY OTHER
PERMIT OR UCENSE
REQUIRED BY LAW. THIS IS
NOT A CERTIFICATION OP
THE HOLDER'S QUALIFICA-
TIONS.
PAYMENT RECEIVED
COLLECTOR:
MIAMI-DADE COUNTY TAX
09010336001
000075.00
SEE OTHER SIDE
DO NOT FORWARD
MARLIN PLUMBING OF MIAMI INC
EDWARD WALKER
20145 NE 16 PL
MIAMI FL 33179
IIIIIID IIID$ DDIIILIILI, tt tl► IInLIILIDIIiLL ,DiLLiDaatl