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RC-12-417Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 170921 Permit Number: RC- 3- 12-417 Scheduled Inspection Date: March 28, 2012 Inspector: Rodriguez, Jorge Owner: MONTERO, CARLOS Job Address: 1245 NE 92 Street Miami Shores, FL 33138- Project: <NONE> Contractor: CONINMAQ LLC Permit Type: Residential Construction Inspection Type: Final Work Classification: Kitchen Cabinets Phone Number (786)282 -4809 Parcel Number 1132050270280 Phone: (786)285 -3073 Building Department Comments KITCHEN REMODEL PERMIT TO LEGALIZE WORK DONE PREVIOUSLY Inspector Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. March 27, 2012 For Inspections please call: (305)762 -4949 Page 8 of 21 �/ Ii )-?-2-- -i r , ' NTiafrOS Hones Vi I lag e APPRON/5D. 7 r-----H3Y- - ,- • DATE : 1 ZONING DERT ; : BLDG DEPT ‘piKee SUBJECT 10, CC M pliANCE Mill •-•—s-T-4,..F Ittol,QtplifilkatiLl.,AND ALL FEDERAL 1 REGULATION ! ... RECE1 MAR, _C 8 • P vx re:07s- • .,.• '• ' tp ZO 3019,d trs MI • • • • 00 00• • •0 0•0 • 00 • • • •• ▪ *•• • •• •• O 0 thee • • • • • • • • • • • NO POINT ALONG COUNTEiTO BE MORE THAN 2 FEET FROM G.F. PROTECTED RECEPTACLE. PUT DM RECEPTACLE UNDER SINK. ALL FIXED APPLIANCES ON DEDICATED CKTS. ADD SMOKE CARBON MONOXIDE DEECTORS. INsuALANTEY ikoNeD0ANtuaCLOTHoRsANT0DBREUFT6R 69v9906 fl • • 4g .61 .. • • .1... • .• E i • S • •• • x :•f••: • • • 1 • • •• 0• • • • • •0 • • • • • • • • • • • • • • 0 v. 0 ,%VVVVVV ....1.*aNNNNeIN -4c.m c% hta 4-, er' OMQ:i0 • !*°5•4746011....mm go :t 900Z LO /90 a:$ w 0_ 11, 4- 3055459808 • # Unit Name 1 Ta II Filler 2 StiiTfl 3 Tall Filler 06/07/2006 32 32.1f-t za .1 . 70. # 2 Refrigerator - 32 — 64- 33 12 - ••• ••• • • • • • •• 99 vz • • • • OOOOO • • • •• ••• •• • • • •• Wid th Height Depth L.SCR R.SCR t_hiD -7330757468@CS - - _ 1112 70 27 3/4 114 ••• ••• • ••• ••• • 32 70 24 1/4 0 • • • • • • • • • • • • •• • Job • • • 1 1/2 70 27 1/4 3/4 • • • • • • • • • • • • • • • • • • • Aena • • • • • . • • . Aetna * Room # 1 (Room 1) - Wall #2 of -3 • • e• • a- • • • • • • • • • • • • • • • • • • • • • • ---•-T-11-11i- • • • • • • • • • FtterM-PV- • • • • • Page 1 011_1 • •• •• • • • • • • • • • EO 39 d • r'1 u. • rr lfIve•=2"Ararzeusel 80869b950E 00:ET 900Z/L0/90 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 No C/ 12--411 Master Permit No. Permit Type: BUILDING ROOFING OWNER: Name (Fee Simple Titleholder): J \ e 6��. Phone #: �� 6 Address: �� c �_ C Sd �� City: ����� � � ��� � � State: Tenant/Lessee Name: Email: ' a ° .C.: JOB ADDRESS: City: Miami Shores Folio/Parcel #: County: ,._ C- Zip: �' Phone#: Miami Dade Zip: Is the Building Historically Designated: Yes CONTRACTOR: omp Name: t Address: 4, 1� City: L 'U Ccu fi 6 _ Qualifier Name: ( �-' (2 State Certification or Registration #: �..�`� C- iC5 1 Contact Phone #: Email Address: C_0(110 1 �' )CL t ` - C V CU I ' "'.-l) �, DESIGNER: Architect/Engineer: Zip: ? �. L. NO Zone: 'L bC'i r LL( Phone #: State: i I Phone #: �" Certificate of Competency Phone #: 'Value of Work for this Permit: $ Type of Work: ❑Addition Description of Work , eY DAlteration Square/Linear Footage of Work: °New DRepair/Replace DDemolition Submittal Fee $ Scanning Fee $ Notary $ Double Fee $ ***!o a** ****** * *** **** x****** Feesxxa xx *xxx****** * *xx**** * *** **** x **** * ***x*** Permit Fee $ /sa O a CCF $ CO /CC $ Radon Fee $ DBPR $ Bond $ Training/Education Fee $ Technology Fee $ Structural Review $ TOTAL FEE NOW DUE $_L1' L' 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 osted notice, the inspection will not be approved and a r'inspection fee will be charged. Signature The forego day of and who did take an oath. Signature \*(- e-6-( Contractor The forego day of NOT Sign: Print: My Commission Ex * * * * * * * * * * * * * * * * * ** APPROVED BY ins ment wajacknowi - s ged be rsona}ly , 20 y • -melisv 1' own me or who has produced and who did take an oath. My Commissio **************** ***** * * ********* **** * ** * ** ***** ?fe(-a Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) 0.100 "' s1 Ake ''1 3 2015 G u'" PC, 2 • " � • •E VW Co rss'o N� A Notary As • •iZ ZF o `d;;.- gore * * * * * * * * * * * * * * * * * * * * * ** Zoning Clerk ,44C-Cosco-, .,Mar. 8. 2012 9:07AM THE FIRST INS. GROUP CORP Nn 2089-5A:.P.: 1 =fro UhKI-IFIcA I k 01- LIABILITY INSURANCE : 03/08/12 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 Tilg.POVERA.gF AFFoRD_ED_DY j INSURERS AFFORDING COVERAGE NAIC # PRODUCER Firsi Insurance Group 10967 SW 40 St Miami, FL 33165 Phone (305)221-7878 INSURED Coninmau LIc 18741 Royal Poinciana Weston, FL 33326- COVERAGES Fax (305)554-7090 •• • •,.. I.INSURER A: UNITED SPECIALTY INSURANCE CO ; INSURER 8; . . INSURER F: THE POLICIES OF INSURANCE LISTEDHAVEBiEu FOR THE PERIOD INDICATED. NOTWIThSTANDINO • 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. •INSR; AMYL ; LTR NERD • TYPE OF INSURANCE POLICY NUMBER I DATE (MLI/Darnj DATE.mminory_yL_I___ LIMITS POLICY EFFECTIVE • POLICY EXPIRATION' . ..._... . . • . - • • •••• ••• •• • GENERAL, LiAssay EACH OCCURRENCE ._ :. _ _1,000,000 . R COMMERCIAL GENERAL LIABILITY i NS1211636 01/30/12 TIATA-a*TORENTED-*---- - - 6. 01/31/13 2RE_Imisgsig_a_racs..yrencE9... ..:.: _ . ... .5....!909:. MED EXP (Any one person) ! •5000 • :A i n • 00 CLAIMS MADE 0 OCCUR 0 • . GEM_ AGGREGATE UMIT APPLIES PER: 0 POLICY PROJECT 0 LOC : AUTOMOBILE LIABILITY ; 0 ANY AUTO • . ALL OWNED AUTOS • B . n SCHEDULED AUTOS . , C] HIRED AUTOS • 0 NON OWNED AUTOS GARAGE LIABILITY • C ; 0 ANY AUTO •-•-•-••••,. ..... ••-• ^ •• ..•.• EXCESS/UMBRELLA LIABILITY 0 OCCUR CLAIMS MADE D DEDUCTIBLE • RETENTION $ WORKERS dOi/IPENSiTIOVAD EMPLOYERS' LIABILITY E I ANY PROPRIETOR / PARTNER / EXECurivE ,• OFFICER MEMBER EXCLUDED? . If yes, describe under • • . . !.§P.gP110- . OTHER F • DESCRIPTION OF GENERAL CONTRACTOR LIABILITY FLOORING AND PAINTING • ••• ..•••_. • HOLDER MIAMI SHORES VILLAGE BUILDING DEPT 10050 NORTHEAST 2ND AVENUE MIAMI SHORES, FL 33138 Adokbii iitibirttird0. PERSONAL & ADV INJURY. GENERAL AGGREGATE I PRODUCTS COMP/OP AGG • 1,000,000. .1,000,000. 1 000 000. COMBINED SINGLE LIMIT • (Ea accident)._ BODILY INJURY BODILY INJURY (Per accident) PROPERTY DAMAGE (Par accident) AUTO ONLY - EA ACCIDENT OTHER THAN „gA6.9.9...: • . Aq4 1 EACH OCCURRENCE AGGREGATE . . . . • .ER E.L. EACH ACCIDENT * • • E.L, DISEASE - EA EMPLOYEE: E.L. DISEASE - POLICY LIMIT BY ENDORSEMENT / SPECIAL PROVISIffla FIRST-INSURANCE GROUP CORP 10967 Bird Rd MIamI, FL 33105 305.221,7870 CANCELLATION 1•, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING IN R WILL E DEAVOR TO !VIAL ' • AT HO ER NAMED TO PION OR LIA TY TATIVES. 30 DAYS WRITTEN NOTICE TO THE C THE COT, BUT FAILURE TO DO SO SHALL IMP OF ANY KIND UPON THE INSURER, ITS AGENT AUTHORIZED REPRESENTATIVE 02 -14 -2012 JEFF ATWATER 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: PERSON: FEIN: 02/14/2012 EXPIRATION DATE: 02/13/2014 GUTIERREZ ANA 651013600 BUSINESS NAME AND ADDRESS: CONINMAQ LLC 18741 ROYAL POINCIANA DR WESTON FL 33328 SCOPES OF BUSINESS OR TRADE: 1- GENERAL CONTRACTOR IMPORTANT: Pursuant to Chapter 440 . 05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt and certificates of election 10 be exempt shall be subject to revocation 11, a1 any time alter the filing of the notice or the issuance of the certificate, the person named on 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. DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01-11 QUESTIONS? (850) 413 -1609 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CONSTRUCTION INDUSTRY CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW EFFECTIVE: 02/14/2012 EXPIRATION DATE: 02/13/2014 PERSON: ANA GUTIERREZ FEIN: 851013600 BUSINESS NAME AND ADDRESS: CONINMAQ LLC 16741 ROYAL POINCIANA DR WESTON, FL 33326 SCOPE OF BUSINESS OR TRADE: 1- GENERAL CONTRACTOR IMPORTANT 0 Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election L under this section may not recover benefits or compensation under this D chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be H exempt.. apply only within the scope of the business or trade listed on Rthe 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 issuance of the certificate, the person named on 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. OWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01 -11 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 GUTIERREZ, ANA BEATRIZ CONINMAQ LLC 16741 ROYAL POINCIANA DRIVE FORT LAUDERDALE FL 33326 -1542 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! DETACH HERE (850) 487 -1395 STATE &F FLORIDA AC# 514 7 5 4 3 DEPARTMENT OF BUSINESS AND PROFESSIONAL:.; EEGULATION CGC151471.60' O o;,T CERTIFIED rz ` GUTIERRE CONINMAQ 1 107012601 ute IS CERTIFIED under the" 'Provisions of ch.489 s3 s+ipiracicn daces AUG 31., 2012 L10b83103623 CTOR AC# 5147543 STATE OF FLORIDA- DEPARTMENT OF BUSINESS .AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD SE(Loos31os62a LICENSE NBR The GENERAL CONTRACTOR Named below IS CERTIFIED i ! Under the provisions of Chaptel` Expiration date: AUG 31, 2012 .: GUTIERREZ, ANA BEATRIZ CONINMAQ LLC 16741 ROYAL POINCIANA DRIVE t� FORT LAUDERDALE FL 33326=25 Wa CHARLIE CRIST GOVERNOR �xxe :+aa DISPLAY AS REQUIRED BY LAW CHARLIE 'LIEM SECRETARY MIAMI-DADE COUNTY TAX COLLECTOR 140 W. FLAGLER ST. 1st FLOOR MIAMI, FL 33130 617746 -3 BUSINESS NAME / LOCATION CONINMAQ LLC DOING BUS IN DADE CO 2011 LOCAL BUSINESS TAX RECEIPT 2012 MIAMI -DADE COUNTY - STATE OF FLORIDA EXPIRES SEPT. 30, 2012 MUST BE DISPLAYED AT PLACE OF BUSINESS PURSUANT TO COUNTY, CODE CHAPTER 8A - ART. 9 & 10 • THIS IS NOT A BILL - DO NOT PAY RENEWAL RECEIPrNO. 644187-7 STATEt CGC1514716 OWNER CONINMAQ LLC Sec. Type of Business 196 GENERAL BUILDING CONTRACTOR 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 CRIES. NOR DOES IT EXEMPT THE HOLDER FROM ANY OTHER PERMIT OR LICENSE REQUIRED BY LAW. THIS IS NOT A CERTIFICATION OF THE HOLDER'S QUALIFICA- TIONS. PAYMENT RECEIVED MIAMI-DADE COUNTY TAX COLLECTOR: 09/30/2011 02280030001 000075.00 SEE OTHER SIDE FIRST -CLASS U.S. POSTAGE PAID MIAMI, FL PERMIT NO. 231 WORKER /S 2 DO NOT FORWARD CONINMAQ LLC CLARA GUTIERREZ 16741 ROYAL POINCIANA DR WESTON FL 33326 I1i)h 1th 111111I�$1111ir1IiHI lIIlIIIlliIilrill)rfll1J� bll CUMULATIVE SUBSTANTIAL IMPROVEMENT VERIFICATION WORK SHEET In accordance with FEMA regulation and Miami Shores Village Flood Damage Prevention Ordinance the costs of all improvements must be monitored. The costs of any improvements in the past 12 months and the costs of any proposed improvements must be shown on the worksheet. The cost of improvements must include demolition, raw and finished materials (include those donated), labor (including volunteer and self- performed), construction supervision and management, and overhead and profit. A list of items the costs of which are to be included as well as those excluded is attached for your reference. (A Copy of the Contract must be attached) PROPERTY OWNER: PERMIT # ADDRESS: \ - -3 k. FOLIO NUMBER: FLOOD ZONE: BASE FLOOD ELEVATION: FREEBOARD: EAST OF FL.CCCL: COST OF PAST IMPROVEMENTS (12 MONTHS): COST OF PROPOSED IMPROVEMENTS: (ATTACH COPY OF CONTRACT) 5-666 3.f0 0 TOTAL CUMULATIVE COST OF IMPROVEMENTS (past and proposed): VALUE OF PRINCIPAL STRUCTLJRE (attach appraisal): • OWNERS SIGNATURE: r . ` "' z °� DATE: PLANREVIEWER: // PLAN REVIEWER SIGNATURE: Created on June 2009 Axod /fi'l�/ /OOH/