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PLC-12-136
BUILDIG PERMIT APPLICATION FBC2007 Miami Shores Village �.y a 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 Department Permit Type: PLUMBING OWNER: Name (Fee Simple Titleholder): Phone #: Address:_ City:`R.ra Tenant/Lessee Name: Phone #: Email: r State: P7 Zip: JOB ADDRESS: nee' !114) //6-7457- City: Miami Shores County: Miami Dade Zip: Folio/Parcel #: / / Z/3 6 a e c 7 6 y1---e9 Is the Building Historically Designated: Yes NO Flood Zone: 7g6a61Soil- CONTRACTOR: Company Name: "7i, /7 7 -e, Reole Ste Phone #: 70...1-" 6 3 C !' %ad Address: 3 Zoe A/ _3 reel g7— City: ,C%si+r� i State: Zip: 3 3 f 5G Z° Qualifier Name: 7004 e/ ? '%v //' Phone #: 3,5-- 4-934-‘0,69/ State Certification or Registration #: ,1 1' ®/ Certificate of Competency #: Contact Phone #: 3 °S` v� ® 1.. � 1 Address: ��v // e 7 f�-a -•c "-7 J DESIGNER: �; r.x', „�� Phone#: Value of or.. ' t ; ' e mit: $ Z4000. Square/Linear Footage of Work: Type of Wo % Address Alteration ❑New DRepair/Replace ODemolition Description of Work: i/z e S ®W-®Nf «x.50 ** ****** ***a:+ x************ * * ************ Fees** ************+x*************** ************** Submittal Fee $ Permit Fee $ 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 AI}'r'IDAVIT: 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 before me this day of , 20 _, by who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: Contractor The foregoing instrument was acknowledged before me this, / day of , 20 L2, by _11_46'// who is pe rsonally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: `3 L y. ***************************** �xx�+ x�x�x* �x�x�x**** �x�x�xx��x�x**** �x�x�x�x�x�n�rm a��x******** �x�a�x* �x�x+ x�n�x• x• x�nx��n�x• x�x�x�x�x�xx�x��x�x *x�+x�xa��x�x�x **** APPROVED BY / 2- ( V I Plans Examiner Zoning Structural Review (Revised 07 /10/07)(Revised 06 /10/2009)(Revised 3 /15/09) Clerk k\33\a- vocC� BUILDING P 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 LICATION LUMBING RECEIVED JAN 2 2012 BY: Permit No. PL Master Permit No. CC/1/0 - 4-86 l3WNERriNim_ . e ee Simple Titleholder): WO( O( ' Phone#: Address: l0 y) me .rcd 4 City: M l PA I R p c' (('C1 L- State: (,, Zip: 3,i6 Tenant/Lessee Name: Phone#: este Email. JOB ADDRESS: /54° /vci/ /if/4_5r - N.--,N tNvA -A - Gkirea o n A c City: Miami Shores County. Miami Dale Zip: 3 3/6/ Folio/Parcel# Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: /✓%v / /"- A.:,(1 P'2474 6 �'"/ /mac Phone#: 30 tr- 654 ^! ? c Address: 3 2- /Y 441 3 s s City: 1/41;)=1-7^-1 State: P 3 3 / Qualifier Name: Woe. Phone#: State Certification or Registration #: Certificate of Competency #: -5 / 2 -5-67 ®® Contact Phone#: 3G- - 4/95' 6 2-0/ Email Address: r 06// /mac- . 47//e'r /Mo //eee ®®7 e /kL.0 W/ DESIGNER: Architect/Engineer: Phone#: 4 viip of vprkSir ° Type of Work: DAddre.ss 4.1^> rIptioit Of err /g670 Square/Linear Footage of Work: % ®a OAlteration ONew ORepair/Replace ODemolition �Mi��hABB�P+b �b************* b ********** Fees************* *****�ki��F�k********d� *i�l�S�+ ******** Submittal Fee $�Aur_4 f1•, Permit Fee $ /®e" CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 6 �� 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 properly 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 ap ' and a reinspection fee will be charged Signature O'er er Age The foregoing instrument was acknowledged before me this day of AAA i rt', 20 lt' by 66AA ' eporia 5' , who is personally known to me or who has produced As identification and who did take an oath. NARY PUBIC: Sign: Print My Commission JEFFRY J. YAO MY COMMISSION # EE36829 mil` EXPIRES: November 12, 2014 swift 444.6444.A401kOCI N: OVA ' A Contractor The forg�oing instrument was acknowledged before me this ac day o ctel lit, jj , 20 i2..; by (/2® 1rr_'d Itd' who is personally known to me or who has producedVCI iOterc 141414-e.. as i. W'00 w'ar MELISSA J. 6ARCI Notary Public - State of Florida .a My Comm. Expires May 15, 2015 Commission # EE 58647 Through National Notary Assn. Structural Review (Revised 07 /10/07)(Revised 05/10/2009)(Revised 3/15/09) Print My Commission Expires: es--1 ,SI Zoning Clerk i STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF STATE FIRE MARSHAL TALLAHASSEE, FLORIDA CERTIFICATE OF COMPETENCY THIS CERTIFIES THAT: ROGELIO S MULLER 3200NW 38TH STREET MIAMI, FL 33142 - BUSINESS ORGANIZATION: MULLER FIRE PROTECTION CONTRACTOR II IS LIMITED. TO THE EXECUTION OF CONTRACTS REQUIRING THE ABILITY TO LAYOUT, FABRICATE, INSTALL, INSPECT, ALTER, OR SERVICE WATER SPRINKLER SYSTEMS, WATER SPRAY SYSTEMS, FOAM -WATER SPRINKLER SYSTEMS, FOAM -WATER SPRAY SYSTEMS, STANDPIPES, COMBINATION STANDPIPES AND SPRINKLER RISERS, ALL PIPING THAT IS AN INTEGRAL PART OF THE SYSTEM BEGINNING AT THE POINT OF SERVICE, SPRINKLER TANK HEATERS, AIR LINES, THERMAL SYSTEMS USED IN CONNECTION WITH SPRINKLERS, AND TANKS AND PUMPS. CONNECTED THERETO,,EXCLUWi PRE - ENGINEERED SYSTEMS. aA, 07 01 2010 07 16 Dade 51256100011995 1921240001 150.00 06 30 2012 Issue Date Type Class County License/Pem►it Number Application # Taxes & Fees Expire Date 332085 -0 BUSINESS NAME /'LOCATION MULLER FIRE PROTECTION INC 3200 NW 38 ST 33142 UNIN DADE COUNTY THIS IS NOT A BILL - DO NOT PAY RENEWAL RECEIPT NO. 345959 -1 CC 0 512561000 OWNER MULLER FIRE PROTECTION INC Sec. Type of Business 8S 1S 12•¢ Agsr'' USINESS TAX RECEIPT. IT DES NOT PERMIT, THE OLDER TO VIOLATE ANY IUSfINO REGULATORY OR MNING LAWS OF THE RUNTY OR CRIES. NOR DES IT EXEMPT THE OLDER FROM ANY OTHER ERMR OR LICENSE EGUUUa BY LAW. THIS IS DT A CERTIFICATION OF •E HOLDER'S OUALIFICA- ONS. 4YILENT RECEIVED WIB -DADE COUNTY TAX DU.ECTOR: 09/29/2011 02280033001 000075.00 SEE OTHER SIDE MECHANICAL CONTRACTOR MIAMI -DADE COUNTY TAX COLLECTOR 140 W. FLAGLER ST. 1st FLOOR MIAMI, FL 33130 PAID MIAMI, FL PERMIT NO. 231 WORKER /S 4 DO NOT FORWARD MULLER FIRE PROTECTION INC ROGELIO MULLER PRES 3200 NW 38 ST MIAMI FL 33142 I:Llli tills itintiitittlikii ilititttlin olltilfllltti(.110 2011 MUNICIPAL CONTRACTOR'S 2012 TAX RECEIPT MIAMI -DADE COUNTY - STATE OF FLORIDA PURSUANT TO COUNTY CODE SEC. 10 -24 EXPIRES SEPT. 30, 2012 THIS IS NOT A BILL — DO NOT PAY RECEIPT NO. 30- 3459591 'CC NO: 512561000 BUSINESS NAME / LOCATION MULLER FIRE PROTECTION INC 3200 NW 38 ST OWNER :MULLER FIRE PROTECTION INC SEE BACK OF RECEIPT FOR A LIST OF NON- PARTICIPATING MUNICIPALITIES Receipt holder must register in the city where work is to be done. PAYMENT RECEIVED MNMI -PARE COUNTY TAX 'L1 730 /2011 02270035001 000175.00 FIRST -CLASS U.S. POSTAGE I PAID MIAMI, FL PERMIT NO. 231 RECEIPT HOLDER MAY DO BUSINESS AS A CONTRACTOR AS SPECIFIED HEREON. SPEC MECHANICAL CONTRACTOR DO NOT FORWARD MULLER FIRE PROTECTION INC ROGELIO MULLER PRES 3200 NW 38 ST MIAMI FL 33142 ILL JIuIII1IIIIIIIIIIIIIIIIIII $II,1111l1►t1111111IIlltloi °••t THIS IS NOT A BILL - DO NOT PAY RECEIPT NO fA W O J z W C.) 0 z Z H 1-4 O 1-- O N Z 1.1 0 0 0 W 0 W W O AeO N QO Et � Cl. 0 ,» W 0I- - M 1-1-1 1 Ce ! G--1 Z 1 Z O 4M€ Lfl O N W Z ▪ g0rZ g7 h O. O♦ J ..p utJNr- l QJ lenn a gqg 3F c i M▪ o c a53 ga m §E i M Let o ° fooaC 0 m O c2 o U z H Z 0 1-4 V W WIY I— 0 o I— Z a-w1 —N7' • O M J N r4 D 0 Z m eo M W 1—IZN± Z L J IYN ZLL N O jWoZ o Z Z M i otz z z N 0 N C.) war .-n N r40 rl0 OM O \o LT1 ONO o No) N �'N© w ae 0O SEE OTHER SIDE ACCM," PA I RENDp)yyyy) CERTIFICATE OF LIABILITY INSURANCE ./192012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING :INSURER(3), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATIION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement, A statement on this certificate dues not confer rlghte to the certificate holder In lieu of such endorsentent(s). peceue@R Frank H. Furman, Inc. 1314 East Atlantic Blvd. P. 0. Box 1927 Pompano Beach FL 33061 INSURED Mulie,r Fire Protection Inc 3200 N W 38th Street Miami FL 33142 9D ncborah Dingle ADORlPHONE ( 954) 943 --5050 F Not. (554) 942-6310 a13 @£+•"" °n$.nS71ranoe3,cum _ INSURER(S1 APFORINNG gOVERAGS NAIL 6 INSU A:GOtham Insurance C ar,x_ 25569 DmuReRS.Aspociated Industries Ins Co 23140 INSURER C t INSURER D; INSURER E : INS COVERAGES CERTIFICATE NUMBER•MASTER #2 F REVISION Nu>I�aaIER: THIS I5 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY FERIOODD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WPI'H RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE APPORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, E XCLusioNS AND CONDITIONS OF SUCH POLICIES. LIMITS INSR r� POLIO, NUMBER p p• mIxrpm 4i) nnu TYPE OF INSURANCE AM GENERA` LIAelLrry t�OMMERCIAI, GENERAL LIABIIJ7 CLAIMS MADl; y OCCUR x x GRN1. AOOREGATE LIMIT APPLIES P @R: nP n AUTOMOIAII.E L1AlirLrrr ANY AUTO PAUTOS Sb HIRED AUTOS UTOEgULED AUUTTOSVlNED II WORKERS ANY O€MER1MEMSER (Mandatory !he% DESCRIPTION UMBREW A i.t s sxcss UA9 1 OOCUR CLAIM9 -MADE I A rim m R r_l ON1 EPO9 LIABILITY PROPMETOR/pARTNEIVEXECUTIVIE Y / N EXCLUDE? ern In NN) clamte ender OF OPEMTIONB below D CERTIFICATE HOLDER 012 SC00165 1/19/2012 1/19/x013 1008643 LIMITS EACH OCCURREN��E $ 11000 ,000 DAfulAG 1U RENT'(• _EIVallEgassaid lzenee) i00 , 000 MED EXP (Any one msani $ 5, 000 PERSONAL SADVIQURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS .COMp/OPAss $ 2,000,000 O del+0 NL LIMIT $ BODILY INJURY (Pair person) $ BODILY INJURY (Pew ant) $ UPERTYnt) DAAMI S $ CITY OF MIAMI SHORES BUILDING DEPARTMENT 10050 Ng 2N11 AVER mum= r >+ 33138 ACORD 25(2010/04 7/31/2011 7/31/2012 EACH 0000RRENC E AGGREGATE $ S x OTH- $ E.LEADkACOIDENT S 1,000,000 E.L, DISEASE . EA EMPLOYEE S 1,000,000 El. DISEASE - $'OLI;YLIMIT $ 1 000 000 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED P0LIC18S BE CANCELLEp BEFORE THE EXPIRATION DATE THEREOF, NOTICE !NILE BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 01988.2010 ACORD CORPORATION. Alt rights reserved, Tiro AMilian en,,,q and Ls ,., was rontg/,wrad rnarkc of Atefinh NOTE: ALL SHEETS MUST BE REVIEWED MIAMI -DADE COUNTY BUILDING DEPARTMENT Herbert S. Saffir Permitting and Inspection Center 11805 SW 26th Street (Coral Way), • Miami, Florida 33175 -2474 • (786) 315 -2100 APPLICATION FOR MUNICIPAL PERMIT APPLICANTS THAT REQUIRE PLAN REVIEW FROM MIAMI -DADE FIRE RESCUE AND /OR DEPARTMENT OF ENVIRONMENTAL RESOURCES, MANAGEMENT I PROVIDE MUNICIPAL PROCESS NUMBER HERE C. C- / g 1 LOCATION OF IMPROVEMENTS Job Address / Vo '/ /S 7 r /i61.51-A021 n. 33 /0 CONTRACTOR INFORMATION Contractor No. Z ..5-6/ T)C) ) 947 Last four (4) digits of Qualifier No. 7Z-9 Folio Contractor Name solu/`eot 7e Pad: %V es Lot Block Qualifier Name e,/ �4 ® �d /lam Subdivision PBP9 Address I Z4-20 Ale,) 3 840 .5 7 - Metes and bounds City , State /-:-/--. -. Zip Y7/ $‘ - TYPE OF IMPROVEMENTS [ ] New Construction on I 1 Demolish Vacant Land [ ] Shell Only Alteration Interior [ ] Addition Attached [" ]Alteration Exterior [ ] Addition Detached [ ] Relocation of Structure [ ] Re -Roof [ ] Enclosure [ 1 Foundation Only [ ] Repair [ ]Repair Due to Fire Current use of property 46 • Description of Work �2€ 57�� -'tea Sq. Ft. Value /De) Units % Floors 0") t 3 ti'' of Work '75-220. °® PERMIT TYPE [ 1 MBLD * Category REVIEW STATUS [ ] Chg. Contractor [ ] Re -Issue [ ] Re -stamp [ ] Revision [ ] Not Applicable for Fire OWNER'S NAME I Owner Address [ ] MELE City State Zip [ 1 MLPG Phone [ ] MMEC Last four (4) digits of Owner's Social Security No. FIRE 3 7.-- PERSON TO PICK UP PLANS Name / % /Q/L ARCHITECT / ENGINEER Name Address 326 D "4.1 3871 37 - Address City / ;// State ZIp 3T/ City State Zip Phone 3 d 5`— C 3 6 F7 0 Phone FIRE SPECIAL REQUEST PLAN REVIEW (SRI) I am requesting a Special Request Plan Review (SRI) to be scheduled as soon as possible at the rate of $190 for the first hour and $65 per each addition hour in addition to the review fees. Minimum charge one -hour. P 1st Request: Date: 2nd Request: Date: - 3`d Request: Date: GERM OPTIONAL PLAN • REVIEW (OPR) 1 am requesting Optional Plan Review (OPR) to be scheduled as soon as possible at the rate of $75 for each discipline. Additional review fees may apply. 1' Request: Date: 2nd Request: Date: 3'd Request: Date: YAForma 0102 - Municipal Permit ApplicaHOu.doc BUILDING PERMIT CATEGORIES CATEGORY DESCRIPTION PERMIT TYPE BUILDING 01 GENERAL BUILDING — COMMERCIAL MBLD 02 SUB — GENERAL BUILDING — RESIDENTIAL MBLD 08 CANVAS AWNING MBLD 10 COMMUNICATION TOWER MBLD 15 DEMOLITION MBLD 29 METAL AWNING & STORM SHUTTER MBLD 48 SCREEN ENCLOSURES MBLD 55 SWIMMING POOL MBLD 56 TENNIS COURTS (SURFACE PAVING) MBLD 86 TRAILER TIE DOWN MBLD 88 WALK —IN COOLER MBLD 91 MARINAS MBLD 92 LOW SLOPE APPLICATIONS (GRAVEL, SMOOTH MODIFIED, SINGLE PLY) MBLD 95 SHINGLES (ASPHALT, FIBERGLASS) MBLD 96 a SHINGLES (METAL ROOFS/WOOD SHINGLES & SHAKE) MBLD 97 STAGE 2 VAPOR RECOVERY SYSTEM MBLD 99 SOIL IMPROVEMENT MBLD 0100 BULK STORAGE PROPANE TANK MBLD 0101 REMOVABLE STORM PANELS MBLD 0107 TILE ROOF MBLD 0110 WATER MAIN MBLD 0111 SITE PLAN MBLD 0112 INDOOR EVENT /EXHIBIT MBLD ELECTRICAL 04 FIRE ALARM SPECIALTY MELE 16 SPECIALTY WIRING MELE 38 GENERATORS MELE LPGX 01 LIQUEFIED PETROLEUM GAS MLPG 02 MISCELLANEOUS MLPG 04 LIQUEFIED PETROL. GAS /STATE MLPG MECHANICAL 09 ABOVE/BELOW GROUND TANKS / PUMPS & POLLUTANT STORAGE SYSTEM MMEC 38 COMMERCIAL HOODS MMEC 43 n FIRE CHEMICAL MMEC 46 SPRAY B OOTHS MMEC 48 SMOKE CONTROL MMEC 52 RESIDENTIAL ELEVATOR MMEC FIRE 32 FIRE SPRINKLER FIRE YAFotmsY180102- MuWapal Pamit Applic tion.doc