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PL-12-1590r Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 177710 Permit Number: PL -8 -12 -1590 Scheduled Inspection Date: October 31, 2012 Inspector: Hernandez, Rafael Owner: PACHECO, MANUEL Job Address: 9080 NE 2 Avenue Miami Shores, FL Project: <NONE> Contractor: ACER PLUMBING INC Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number (305)336 -4908 Parcel Number 1131010190090 Phone: 305 - 935 -4103 Building Department Comments REPLACE FIXTURES IN KITCHEN AND BATHROOMS Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Com ents October 30, 2012 For Inspections please call: (305)762 -4949 Page 11 of 44 I BUILDING PERMIT AP FBC 20 Permit Typ r, j OWNER: Nam - i e older): �/�/ liV1/'V G1/ .P/take--CO City: g • tM L //�1 i� -r7 State: AIL 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 TION PLUMBING Permit No. Pi 2--' 15 Master Permit No120 Address: Zip: Tenant/Lessee Name: Phone#: Email: JOB ADDRESS: /0 60 /VC' 5,.t.° City: Miami Shores County: Miami Dade Zip: Folio/Parcel #: Is the Building Historically Designated: Yes CONTRACTOR: Company Name: , Address: 1 / / ��� City: Qualifier Name: State Certification or Registration #: C NO Flood Zone: Phone #: 93®5 35 ( zip: Contact Phone #: C Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ Type of Work: ❑Address ❑Alteration Description of Work: Square/Linear Footage of Work: ❑New epair/Replace ***************************************Fees*****. ***** x ** *************4 u * * * ** *** Submittal Fee $ Permit Fee $ /66 s� tOiCa Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $- 621.e0 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 accuiaie 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection hich occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not b, app1oved and a reinspection fee will be charged. Signature Si wner or Agent / Contractor The foregoing instrument was acknowledged before me this I41 The foregoing instrument was acknowledged before me this dl day of Ib)1 ,20 i2, by M'�D)b P4((6 , day of _tiki, 20 /2,by .P,440'-‘) J , who is personally known to me or who has produced who is personally known to me or who has produced$L As identification and who did take an oath. _ - identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: (�9 Sign: Print: I. JA (ti -(,z My Commission APPROVED BY B. SALVER r. Notary Public - State of Florida My Comm. Expires Dec 3, 2014 Sign: Print: IJ•; a My Commission E,\ *72720/3 s, 44.0F F10P° -tARAENTERSI * MY COMMISSION # DD 892205 EXPIRES: Sep4 mbar 22, 2013 Bonded Thru Budget Notary 5ervict° *************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Zoning Clerk Aug 21 12 12:09p david bonan 3059360013 p,1 AC #.6184536 THES DOCUMENT HAS A COLORED BACKGROUND • MICROPRINTING • LINEMARK "' PATENTED PAPER STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD SEQ# L1207040032 DATE BATCH NUMBER LICENSE NBR 07/04/2012 118205674 CFC053320 The PLUMBING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2014 BOMAN, DAVID ACER PLUMBING INC 1851 NE 206 TERR MIAMI RICK SCOTT • GOVERNOR 1 MIAMI -DADE COUNTY TAX COLLECTOR 140 W. FLAGLER ST. 1st FLOOR MIAMI, FL 33130 FL 33179 DISPLAY AS REQUIRED BY LAW KEN LAWSON SECRETARY 2011 LOCAL BUSINESS TAX RECEIPT : 2012 FIRST -CLASS MIAMI -DADE COUNTY - STATE OF FLORIDA US. POSTAGE EXPIRES SEPT. 30, 2012 PAID MUST BE DISPLAYED AT PLACE OF BUSINESS MIAMI, FL PURSUANT TO COUNTY CODE CHAPTER 8A - ART. 9 & 10 PERMIT NO. 231 270259 -6 -1i.;; 1 ;3 NCT r BILL - i,C? FJC PAY RENEWAL +e BUSINESS NAME /LOCATION RECEIPT NO. 256407-9 ACER PLUMBING INC STATE* CFC053320 1851 NE 206 TERR 33179 UNIN DADE COUNTY OWNER ACER PLUMBING INC Sec. T e of Business WORKER /S 196 PLUMBING CONTRACTOR 10 THUS IS ONLY A LOCAL BUSINESS TAX RECEIPT. IT DOES NOY PERMIT THE HOLDER TO VIOLATE AMY EXISTING REGULATORY OR ZONING LAWS OF THE COUNTY ON CMES. NOR DOES IT EXEMPT THE HOLDER FROM ANY OTHER PERM.. OR LICENSE REQUIRED BY LAW. THIS IS NOT A CERTIFICATION OF THE HOLDER'S QUAUFICA. PAYMENT RECEIVED MIAMt•DAOE COUNTY TAX COLLECTOR: 09010029001 000075.00 SEE OTHER SIDE DO NOT FORWARD ACER PLUMBING INC DAVID SONAR PRES 1851 NE 206 TERR MIAMI FL 33179 Aug 21 12 12:10p david bonan 3059360013 p.2 08-17-2011 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 f> CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: PERSON: FEIN: 08/17/2011 BONAN 650953849 BUSINESS NAME AND ADDRESS: ACER PLUMBING INC 1651 NE 206TH TERRACE NORTH MIAMI BEACH FL 33179 SCOPES OF BUSINESS OR TRADE 1- CERTIFIED PLUMBING CONTRACTOR EXPIRATION DATE: 08/16/2013 DAVID IMPORTANT: Pursuant to Chapter 440 . 05(14), F.S.. so officer of a cerperetioo who elects exemption from this chapter by Filing a certificate of election under Ibis section may not recover benefits or compensation wader this chapter. Fermat to Chapter 440.05(121, F.S.. Certificates al election to be exempt.., apply only within the scope of the heehaws or trade listed on the notice of election to be exempt. Parsuaal to Chapter 440.05(13), F.S., Notices of election to be exempt and cerlificoles of election to be exempt shall be subject to revocation 1f, at any time after the filing al the notice or the issuance el the certificate, the person named en the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shell revoke a certificate at any time for failure of the person named on the certificate to men die requirements al Ibis sestina. QUESTIONS? (850) 413 -1E 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 WORKERS' COMPENSATION CONSTRUCTION INDUSTRY CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW EFFECTIVE: 08/17/2011 PERSON: DAVID BONAN FEIN: 650953848 BUSINESS NAME AND ADDRESS: ACER PLUMBING INC 1851 NE ECM TERRACE NORTH MIAMI BEACH, FL 33179 EXPIRATION DATE: 011/16/2013 SCOPE OF BUSINESS OR TRADE 1- CERTIFIED PLUMBING CONTRACTOR OPursuant to Chapter 440.05(141, 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. H 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 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 meet 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. IMPORTANT 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 Aug 21 12 12:10p david bonan AWR/O® 3059360013 p3 CERTIFICATE OF LIABILITY INSURANCE DATE IMMIDDIYYVY] 2/9(2012 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 pollcy(les) 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 Presidential insurance Services, LLC 2665 South Bayshore Drive #220 -16 Miami, FL. 33133, INSURED Acer Plumbing, Inc. 1851 NE 206 Terr. Miami, FL. 33179 NA NTACT NA Jeff Lampert _ lwla No, Ext] , 305-423-0350 _ ... ..... ( . NY 305 -423 -0351 AD" IBS: jefffinsurancequotelive.com INSURER] AFFORDING COVERAGE HAICI INSURER A: Preferred Contractors Insurance Company INSURER C: INSURER D : INSURER E : INSURER F : 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. • _. -. LIR : TYPE OF INSURANCE ' MISR WW(D- POLICY NUMBER POLICY EFF i POLICY E7Cp UAINDO/YYYY) , MIND LIMIT$ S GENERAL UABIUTY : ,..._� X `COMMERCIAL GENERAL .. LIABILITY .. _■ CLAIMSMADE X OCCUR . • PC105043- PCA80297 1 .. 2/9/2012 i 2/9/2013 , EACH OCCURRENCE i $ 1,000,000 D,raT€�- - -- -�.. PR ES (Ea gg}1{ ee 50 C100 __ - MED EXP (Any Or Gerson) -. $ _._ 5,060 PERSONAL S ADV IN,:URY . $ _ 1,000,000 GENERAL AGGREGATE A : $ 2,000,000 GEN_ AGGREGATE UMRAPPL [ES PER. PR• X ; POL'CY : SECOT i LOC PRODUCTS -COMP/OP AGG $ 1,000,000 $ AUTOMOBILE LIABILITY _ ' ANY AUTO ALL °MED SCHEDULED AUTOS i AUTOS NON -0LMIED i _ : HIREOAUTOS ;_J AUTOS I COMBINED SINS/ a LIMIT Eeno:41 INJURY(Perperson) $ «BODILY BODILY INJURY (Per =Went) 5 PROPERTY OADAAGE (PPreagden,] -._ __ $ s UMBRELLA LIAB OCCUR I CLAMS-MADE EXCESS GAB (_ I I EACH OCCURRENCE $ AGGREGATE $ C C • RETENTIONS - $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y r N N. 1 . WC TATU CTH- ' TOR LIMITS I . FR, E'_L EACHACCIDENT S _ -- E.L DISEASE - EA EMPLOYEE S E L DISEASE - POLICY LIMIT S ANY PROPRIETOR/PARTNERIEXECUTVE OFRCER. MEMBER EXCLUDED? N / A. (Mandatary In NH) 1 If yes. tesaibe ender I DESCRIPTION OF OPERATIONS below I I . I DESCRIPTION OF OPERATIONS / LCCATIONSi VEHICLES (Attach ACORD 101. Additional Remeties Schedule, B more spate Is requIred] CERTIFICATE HOLDER Miami Shores Village 1 00'550 NE 2nd Ave. Miami Shores, FL. 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE ACCORDANCE WIT H THE �THEYEPROVI$OONSS. WILL BE DELNERED IN AUTHORIZED ED %� A7N� ACORD 25 (2010/05) «/ 988- 010 ACORD CORPORATION. AV rights reserved, The ACORD name and logo are registered `(Ttarks of ACORD