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PL-12-31 ti Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 168352 Permit Number: PL- 1 -12 -3 Scheduled Inspection Date: January 20, 2012 Inspector: Hernandez, Rafael Owner: NUGEN, JOHN Job Address: 375 NE 99 Street Miami Shores, FL 33138 -2436 Project <NONE> Contractor: ALEX SPRINKLERS INC Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132060135530 Phone: (786)229 -7345 Building Department Comments IRRIGATION SYSTEM Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments January 19, 2012 For Inspections please call: (305)762 -4949 Page 7 of 10 05 -19 -2011 JEFF ATWATER STATE OF FLORIDA CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO RE 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 taw. EFFECTIVE DATE PERSON: FEIN: 05/19/2011 CANALS 770610212 BUSINESS NAME AND ADDRESS: ALEX SPRINKLERS INC 10465 SW 200 STREET MIAMI FL 33157 SCOPES OF BUSINESS OR TRADE: 1- IRRIGATION EXPIRATION DATE 05/1812013 ALEJANDRO IMPORTANT: Pursuant to Chapter 440 . 05114), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election nadar this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05112), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on tile notice of election to be exempt. Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate. the Berson named on the notice er certfficate no longer meets the requirements of tbis section for issuance of a certificate. The department shall revoke a certificate et any time for failure of the person named on the certificate to meet the requirements of this section. QUESTIONS? (850) 413-1609 DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01 -11 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKS' COMPENSATION CONSTRUCTION IteXISTRY CERTIFICATE OF ELECTION TO BE EMMET FROM FLORIDA WORKERS COMPENSATION LAW EFFECTIVE 05/19/2011 EXPIRATION DATE: 05/18/2013 PERSON ALEJANDRO CANALS FEIN 770310212 BUSINESS NAME AND ADDRESS: ALEX SPRINKLERS INC 10485 SW 200 STREET MIAMI. P1. 33157 SCOPE OF BUSINESS OR TRADE 1- 00410AT1ON IMPORTANT FO Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exehtption from this chapter by filing a certificate of election L tinder this section may not recover benefits or won under this D chapter. Pursuant to Chapter 440.05(12L F.S., Certificates of election to be H exempt- apply only within the scope of the business or trade listed on E the notice of election to be exempt E Pursuant to Chapter 440.05(13), F.S, Notices of election to be exempt and Certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issimtce of the certificate. the person named an the notice 'or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. QUESTIONS? (850) 413 -1609 CUT HERE * Carry bottom portion on the job, keep upper portion for your records. DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01 -11 2012 -01 -03 10:48 Eguino & Associates 3052671197 » 1 800 685 7530 P 1/1 ik,..i" CERTIFICATE OF LIABILITY INSURANCE 01/03/12 FlTHIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATI6N ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. TA'S endorsement. A statement on IND certificate does not cantor rights to tho 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 cortiflcato Holder to an ADDIliONAL INSURED, the policy(I08) must be endorsed. If SUBROGATION 1E WAIVED, subject to terms and condltiona of tho policy, certain poilcios may require an certificate holder In Ilou of such ondorsomont(s). PRODUCER Egulno & Associates 7229 Coral Way Miami, Fl- 33155 Phone (306)266 -1700 Fax (305) 267-1197 INSURED ALEX SPRINKLERS INC. 10465 SW 200th Street Miami, FL 33157- (786) 229.734$ DATE (MMIoD/TYYY) CONTACT" „NAME.I. PNONE (30 266.1700 „(AIC,,r(o.I:�Ip: -,,,• y7 Rs). (305) 267.1 DRkS$: marihmac6uino.com INSURERS) AFFORD, It o CONPRACE . NM, INSURERA: GRANADA INSURANCE COMPANY INSURER ¢: KINGSWAYAMIGO INS, COMPANY INSURER C; INSURIER IMSURE. EI,t . COVERAGES INSURER F i CERTIFICATE NUMBER: REVISION NUMBER: THIS 1S TO CERTIFY "`HAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO'fHE IN SURED NAMED ABOVE FOR THE POLICY PEW T------ T- -- -"'-"- INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED Olt 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 87 PAID CLAIMS, 1�7R, TYPt? OF INSURANCE $ _ BR POLICY_ _ EfF _ POLCY LiP 0 NERAL UAaarry °^ • ADD RI coma:Rm. commit, LAWN ❑❑ ❑ CtAINISMADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER ❑ POLICY ❑ JCOT ®LOC AUTOMOBILE uASILITY ❑ ANY AUTO q ❑ AAULTOS NED Af �ULBO N A Q HIRED AUTOS LJ AUTOSWNED OUMBRELLA LI" ❑ OCCUR ^ ••• ❑ excess me (� CLAIMS -MACS RE1 @WTIONS WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECI.MvE N OFFICER/NEMBER IOICLUDED9 N IA D. orrcr luu!88S (M le!M(?Diy_maY.! 0188FL00023926 CA- 99226.05 02/07/2011 08/08/2011 02/07/2012 LIMITS „EACH OccURRBNCIE $ 1,000 000.00 DAM EY0- RENTI;O — 2BEM.I$88.(Eequu .,. , $ 100,000,00 IUD X+ (A:ry one Parana) s 5,000.00 PERSONAL & ADV INJURY $ 1,000,000,00 GENERAL ACGRE YE s 2 000 000.00. PRODUCTS • COMP /0P AOG $ 2,000,000.00 08/08/2012 (Mandatory In NH) U as. describe debar D S IMItON OF OPERATIONS Delawr DESCRIPTION OP OPERATIONS 1 LOCATIONS I vENICLDS (Attach ACORD let, Additional Remarks Schedule, It more apace le required) P LUM B I NG.RES IDENT'IAL CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE 10050 NE 2 AVE MIAMI SHORES, FL 33138 ACORD 25 (2010/05) QF (E � INGI.E' LMMIT BODILY INJURY (Par Paw) 10,000.00 BODILY INJURY (Per accident $ 20,000.00 OPrrRTY G $ 10,000.00 leocGi�nt PIP- $10,000 BASIC. $ EACH OCCURRENCC A©OREt3ATt; $ tq� SYATU- ATM= E.L. DACH ACCIDENT E ! . DISEASE + EA EMPLOY E $ E.L DISEASE - POLICY UMW' $ SHOULD ANY OF THE ABOVE ^ SCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THE . , OF, NOTICE WILL BE DEUVERED IN ACCORDANCE WITH/ CY PROVISIONS. AUTNQRIZEDRt3 ° • �!'.A i1 MARITZA INC 1888 -2010 ACORD CORPORATION. All rights reserved. Th : ACORD name and logo are rogtstorod marks Of ACORD Miami Shores Village RECEIVED 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): Address: //__ City: (' , OI /\:. / Sld v'5 State: Tenant/Les - - Name: Email: JAN 0 3 2011 Permit No. Master Permit No. 6 o te' Phone #: ■60 Phone#• Zip: —7 -7 f ?v JOB ADDRESS: 3-3 e (I/ City: Miami Shores County: Folio/Parcel #: Is the Building Historically Designated: Yes CONTRACTOR: Company Name: A) tgi Address: la (0S- S • 4.00 City: M: 40// Qualifier Name: A(Ci j/.a► A, n/I/iJ State Certification or Registration #: Contact Phone #: Miami Dade Zip: 33) 3e, NO 57 1 a■ Neit 5 State: T CAniAlS Flood Zone: Phone#: "7 °? 7 9 " 7 Email Address: Zip:: 3 4..) -7 Phone#: 2c9 Certificate of Competency #: l ?S ?®©w% 4/3 L14 9 ,ps1,,/le /®ram° &Mee, 60-- DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: i" oQ Type of Work: DAddress ❑Alteration Description of Work: / 6 Square/Linear Footage of Work: Cew ❑Repair/Replace ❑Demolition ************ * * ** ** *******w+x************ Fees ** ** x*********** * * * * ** * * *******+x*w*****x *** Submittal Fee $ . OO Permit Fee $ IC1) J CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding. Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature Owner or Agent The foregoing instrument was acknowledged_ b7 fore( � e this day of a\/CN s , 20 1 (, by �+��' N �'''" who is personally known to me or who has produced As identification and who did take an oath. Sign: Print: My Commission Exp Contractor The foreg i t was acknowledged before me this _. day of (O , 20 t � , by who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: .0011111111i, \ \ ' `itlS Sr Print: NOT4 v 2012 My Commission Exigrcli' Comm.'," N «C i' %,, .• ,, y .aD9a" i0 31 y Fi7sImr►er •a1\� . -\.(a 'f'/11S111111\\\;�" APPROVED BY (Revised 07 /10 /07)(Revised 06/10 /2009)(Revised 3/15/09) Review Zoning Clerk Alex Sprinklers inc Company address 10485 SW 200 ST MIAMI ,FL33157 Company address 3 Phone Number: 788- 229.7345 E mail: alexaprinklers@aof.com NUCitN f-<tWUCIVC:t 375 NE 99 TH STREET MIAMI SHORES,FL 33138 3/4" 1 1/2" 1" 3/4" Irrigation Legend R Rain Sensor Mini Clip • Existing Irrigation Pump 1 1/2 Hp Q Rain bird control timer ESP4 ® Rain Bird control Valve 1 1/2" PEB • Rain Bird 1804 Pop up 15-H 2 GPM O Rain Bird 1804 Pop up 15-Q 1 GPM 1 (11 GPM) .Pump and Timer Zone 2 (24 GPM) 4 1 1/2" 1 1/2" 4 (1111 X 91 8. � 7 W-1 \7, ,'::tJ0 1 2011 4 1 1/2" � PI I ("L ..� # f' V ` - M ami Shores Village APPROVED BY DATE ZONING DEPT BLDG DEPT SUBJECT 10 CCMPIJANCE WTfri ALL FEDERAL STATE AND CC UN 1Y MULES AND REGULATIONS S;IS:NOT A BILL — DO NOT PAY. IIECEIPT;N0. 579654 CC :05P000437 555617 -1 BUSINESS NAME / LOCATION ALEX SPRINKLERS INC' 10465 SW 200 ST 33157 CUTLER BAY OWNER ALEX ...SPRINKLERS INC ec. udne This IS ijo AS IALTY PLUMBIAI6 :CONTRACTOR BIB TAX RE�Pf IT DOES NOT PERmlr THE H=LDEt TO VIOLATE ANY EXISTING REGULATORY OR ZONING LAWS OF THE coUNrY OR OWES. NIA DIES FT EXEMPT THE HOLDER FROM ANY OTHER PEA IT OR LICENSE REQUIRED BY LAW. THIS 15 Nor A CERTIFICATION OF THE MILDEWS aususCA- PAYMENT RECEIVED MIAIGLIATIE .COUNTY TAX COLLECTOR: 09/29/2011 60000000301 000045.00 SEE OTHER SIDE -KEW'S DO NOT FORWARD ALEX SPRINKLERS INC ALEJANDRO L CANALS PRES 10465 SW 200 ST MIAMI FL 33157 111111 „L11.1r,111111111rRL1111r111311 1111111131311111111 Town Qf Ctt1er 1.4720 CARIBBEAN.BLVD CUTLER Local Business Tax ALEX SPRINKLERS INC 10465 Slit/ 200 ST CUTLER BAY, FL 33157 Receipt ik BL -000164 Business: Specialty Plumb Contractor . ALEX SPRINKLERS IMF Business �Address: + 1 SY@ FINANCE DIRECT'QRR NON-TRANSFERABLE • POST IN A CONSPICUOUS PLACE * NON TRANSFERABf; .