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PLC-11-955ZiviA/F- Cod/s771-41e;av, 744,(c_ E.Ha!bwcidk 6e4e4 Wmod yzc 4"k(fi'I4k lSea&X � Ft_ 3 300 q eLva: 30s --WI- `f `Pt `( Also*/ , (f1_Q_- ChvelA Petic PLC-5-I/-qss Pot- 114- LQa a✓ 4%Aiir NO Pf"m !3 /N6 Wa rk was JAM. 0#4*%kr-t-k 0/4)--td 1//z1 24212- Miami Shores Village Building Department NAY 2 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 -95S Permit No. - Master Permit No. C—C-- BUILDING PERMIT APPLICATION FBC 20 Permit Type: PLUMBING OWNER: Name (Fee Simple Titlehold r): Address: / l .16 Z'' Phone #: sec- ee9-:� , City: i' Z/ f Skeyrec State: Zip: 3 3) Tenant/Lessee Name: Phone#: Email: JOB ADDRESS: /4141VC 451(441. , City: Miami Shores County: Miami Dade Zip: Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: Phone #: R SiOl /�01� Zip: i�'C9c Y Phone#: 9sys)o yd-4-0.0 Certificate of Competency #: 8:11. Fwd weA Beer Pia-A. �• • r E r CONTRACTOR: Company Name: A ile - e!- 42--;** L Address: cio(O i \) G4 e t 41-44-7 City: Or . t-v Ae.4 State: /J / Qualifier Name: L(/�` ! �. .+� ✓/ t State Certification or Registration #: % F C O $.70/01.3 Contact Phone#: Email Address: DESIGNER: Architect/Engineer: f Phone#: Value of Work for this Permit: $ 1 Lki'IJ • QA Square/Linear Footage of Work: Type of Work: DAddress Alteration Description of Work: atom. 1N 6' ONew ❑Repair/Replace &A? f if e ODemolition **** ***x.**** * ** .**+xx•*+ * ** ** ***mm m **** Fees ** ** **** ***** *****.x******** ***** *** * * ***** Ae Submittal Fee $ '. n Permit Fee $ /5oA Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ 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 approvey i a reinspection fee will be charged. Signature Owner or Agent % r The foregoing instrument was acknowledged before me this day of 20 by Rai& 1G ov Ln , is personallv known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: iAA My Commission Exp. J. YAO ON 6 EE36829 : November 12, 2014 PL Notary Dimwit Apra Ca Signature ` L Contractor The foregoing instrument was acknowledged before me this /276.. day of , 20 // , by /4414'4n, A4 W , who is p o own to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: ************** 3t** *sN***sk****+ k+ l• ****skgs* ******* *+ U+ k**Ns** ****+ Mh*****+k**sk**:k #+ksN******** *****+)•**** *+N+)'*+k****+k+R**+k**** APPROVED BY 7' 2 -1/ Plans Examiner Zoning Structural Review Clerk (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 FUSCO, WILLIAM B A BETTER INC 4061 N FEDERAL HWY POMPANO BEACH FL 33064 Congratulations! With this license you become one of the nearly one million Flo_ mmans licensed by the Department o "` 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 or information about our services, please log onto www.myfloridalicensc,com. here 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 �A FE ©F r oRNA DEPARTMENT ' OF -13i3S MESS ` Ai4'D PaOF .\L. RE TATIO 317 233 xs. =rii�i m,Y , - p-r0;,.5-a0s Qi .465 F, sxn a :vn ststc :�1i1 - 31. 2 0 r2 poi c'7: ,7r ;, DATE BATCH NUMBER 0707 06/071'2010 1098-17.2393 CFC11572 The PLUMBING CONTRACTOR - Named below IS CERTIF3 -P 'J lder the provi:3io of attapt Ex si.ruticz dciLCr .:.r3iTe 31, 2012' FUSCO,.WILLIAM-_H A BETTER -, INC. ' 4 0 61 N FEDERALiZ'_ -_ POMPANO BEACH' DISPLAY AS REQURED°RY 115 S. Andrews Ave., Rm. A -100, Ft. Lauderdale, FL 33301 -1895 -954- 831 -4004 VALID OCTOBER 1, 2010 THROUGH SEPTEMBER 30, 2011 DBA: Business Name: A BETTER INC Owner Name: WILLIAM P. F USCO /0W\L Business Location: 4061 N FEDERAL HWY POMPANO LEACH Business Phone: 954 - 592.4000 Rooms Geceipt e C.m r /Lw i SPPrit:z„ °C0 3�a1F vC OR Business Type= (PLUMBING COMPACTOR) 1OR) Business Opened :05 / 131'1. ©99 StateICountytCertlReg CPC057223 Exemption Code 11°NEXEMPT Professionals Tax Amount Transfer Fee NSF Fee Petralty Prior Years Collection Cost Total Paid 27.00 0.00 C?.tltt 4 5,., , `i.fl0 0.00< 11.0 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non- regulatory in nature. You must meet all County andlor Municipality planning WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in compliance with State or loci laws and regulations. Mailing Address: WILLIAM B FUSCO /QUAL 4061 N FEDERAL HWY POMPANO BEACH, FL 33064 Receipt #O1A -10- 00001419 Paid 11/09 /2010 31.05 2010 - 2011 DESR ACORD.. CERTIFICATE OF LIABILITY INSURANCE DATE D/YYYY) 5/9/2 5/9/2011 TYPE OF INSURANCE PRODUCER Automatic Data Processing Insurance Agency, Inc 1 ADP Boulevard Roseland, NJ 07068 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 NAIC # INSURED A BETTER INC 4061 N FEDERAL HIGHWAY Pompano Beach, FL 33064- INSURER a Twin City Fire Insurance Company 29459 INSURER B: LIABILITY COMMERCIAL GENERAL UABIUTY INSURER C: $ INSURER D: CLAIMS MADE OCCUR INSURER E: $ VERAGES 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. INSR LTR ADD'L INSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMIDD/YYI POLICY EXPIRATION DATE (MMIDDIYYI LIMITS EACH OCCURRENCE $ GENERAL LIABILITY COMMERCIAL GENERAL UABIUTY DAMAGE TO RENTED PREMISES (Ea occurence) $ CLAIMS MADE OCCUR MED EXP (Any one person) $ GEN'L PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ AGGREGATE UMIT APPUES PER: POLICY PRO- JECT LOC PRODUCTS - COMP/OP AGG $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE UMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA 7 LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes describe under SPECIAL PROVISIONS below 76WEGNG3324 1/1/2010 6/14/2011 "( TORY MT WC UMIT ER U- ER E.LEACH ACCIDENT $ 1,000,00Q E.L DISEASE - EA EMPLOYEE $ 1,000,000 E.L DISEASE - POUCY UMIT $ 1,000,000 OTHER DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CERTIFICATE HOLDER Miami Shores Village Building Department 10050 NE 2nd Ave Miami Shores, FL 33138- SHOULD ANY OF THE ABOVE DESCRIBED DATE THEREOF, THE ISSUING INSURER NOTICE TO THE CERTIFICATE HOLDER IMPOSE NO OBLIGATION OR LIABILITY REPRESENTATIVES. POLICIES BE CANCELLED BEFORE THE EXPIRATION WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTHORED REPRESENTATIVE' ACORD 25 (2001/08) © ACORD CORPORATION 1988 OP ID: M5 '4 R °ry CERTIFICATE OF LIABILITY INSURANCE DATE 05 /09DfYYYY) 05109111 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 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 ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the .certificate holder in lieu of such endorsement(s). PRODUCER 561- 622 -2550 Celedinas Insurance Group -PBG 561- 721 -0540 4283 Northlake Blvd. Palm Beach Gardens, FL 33410 William Hamilton CONTACT E PHONE FAX wc, No, Ext): (AIC, Nor E-MAIL ADDRESS: PRODUCER ABETT -1 CUSTOMER ID e: INSURER(S) AFFORDING COVERAGE NAIC 5 INSURED A Better Inc 4061 N Federal Hwy Pompano Beach, FL 33064 INSURER A:Allied P 8,C Insurance 42579 INSURER B: Nationwide Mutual Ins Co INSURER C: ACP5903744935 INSURER D : 01/15111 INSURER E : EACH OCCURRENCE INSURER F : 1,000,000 COVERAGES CERTIFICATE NUMBER: • THIS IS TO CERTIFY 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 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. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR MID POLICY NUMBER POLICY EFF (MM/DDIVYYY) POLICY EXP (MMIDDmYYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY OCCUR ACP5903744935 01/15111 01/15/12 EACH OCCURRENCE $ 1,000,000 PREMIS S ( RENTED PREMISES (Ea occurrence) $ 100 000 , CLAIMS -MADE X MED EXP (Any one person) $ 5,000 X GEN'L —1 Waiver of Subro. PERSONAL &ADV NJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 AGGREGATE LIMIT POLICY X PRO JECT APPLIES PER: PRODUCTS- COMPIOP AGO $ 2,000,000 LOC $ A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS ACP5903744935 01/15/11 01/15/12 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY NJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ $ B UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS-MADE 77CU8611123001 01115/11 01/15112 EACH OCCURRENCE $ 3,000,000 AGGREGATE $ 3,000,000 DEDUCTIBLE RETENTION $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y 1 N ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERA4EMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N I A WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE- POLICY LIMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more apace la required) CERTIFICATE HOLDER I Maimi Shores Village Building Department 10500 NE 2nd Ave Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE William Hamilton , ACORD 25 (2009109) O 1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD