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RC-11-2302 (2)Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 167707 Permit Number: RC -12 -11 -2302 Scheduled Inspection Date: February 28, 2013 Inspector: Bruhn, Norman Owner: LEBOWITZ, MARIA Job Address: 1285 NE 102 Street Miami Shores, FL Project <NONE> Contractor: JOHN DALTON LLC Permit Type: Residential Construction Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132050250120 Phone: (561)394 -2619 Building Department Comments BATHROOM REMODEL (MASTER BATH) AND NEW FLITCH PLATE REMOVAL OF STEEL 4X4 COLUMN IN KITCHEN JOIST REPAIR. 3/14/2012 - LETTER ON FILE TO PLACE PERMIT ON HOLD. INSPECTION REQUESTWED ONLY BY JOHN CUNNIFF QUALIFIER. CHANPF (1F C(INTRACTOR X4/94/2(119 Inspector Comments Passed r y Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. February 27, 2013 For Inspections please call: (305)762 -4949 Page 1 of 35 r Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 ii -ate Inspection Number: INSP - 184610 Permit Number: PL -1 -12 -118 Scheduled Inspection Date: February 14, 2013 Inspector: Hernandez, Rafael Owner: LEBOWITZ, MARIA Job Address: 1285 NE 102 Street Miami Shores, FL Project: <NONE> Contractor: MARLIN PLUMBING OF MIAMI INC Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: New Phone Number Parcel Number 1132050250120 Phone: 305 -652 -6108 Building Department Comments PLUMBING WORK FOR NEW BATHROOM REMODEL Infractio Passed Comments INSPECTOR COMMENTS False Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSP. TION FOR INSP- 169128. not ready February 13, 2013 For Inspections please call: (305)762 -4949 Page 10 of 22 DQ ao / AZ- 'fie 10)- sr 1 3 ortei tztn- 30S-- 737 (i)111A ■•":. 7;1 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 BUI DING PERMIT APPLICATION FBC 20 ,1E011(7cil JUN 21 2J•i, Permit No. PL." I" j Z" 11$ Master Permit No.4 11%-2b09-• Permit Type: PLUMBING OWNER: Name (Fee Simple Titleholder): R G.11/1 a- L2.60 (L) 1"L Phone #: 3 6,5-757- Address: /2$5 ,V E /Q Z Si-reef City: M i am; 5ho--e5, P2 State: FL Zip: 33/ 38 Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: S� trig- City: Miami Shores County: Folio/Parcel #: Is the Building Historically Designated: Yes NO Miami Dade Zip: Flood Zone: CONTRACTOR: Company Name: Iv I 0-4.1 i rt P IV m b i ni 6a' M i a. M,g1 Trw- ,Phone #: 345-452 3d 3/ Address: v� /4/.5. /l%6 /19 #2/4.4,__ �! City: A%. AtrkM.l &a C`y State: FL. Qualifier Name: Ed ia? cl. ;1 Walktry- State Certification or Reg hon #: FC 0 4,?.2. o. Certificate of Competency #: Contact Phone #: u" t' Email Address:160A 4 pJvrri6e.ha�t9_C4aLr Crl -i') DESIGNER: Aclfitect/Engineer \1 Phone #: Zip: 33`7 Phone #: 306 -452---303 / Value Vork for ti ,Permit: $ �` a ! 5, CJ 5. Footage of Work: Ty of Work: GiAddress 5rAlteration UNew ❑Repair/Replace UDemolition on ork: M 0 Ue.G1 i 62, A442369-4- t i ova- ate- (- Al ee J ge. Vi S du» s '45 T /11;71' ******** * * * * * * * * * * * * * * * * * * * * * ** * * * * ** ** Fees* * ** *** * * ** * **** **** Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ * * * * * * * * * * * * * * * * * * * * ** tS-� r CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ 7�"` 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 certed 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 Owner or Agent • la. e foregoing instrument was acknowledged befor me this 3'' • day of,' Noveto., 2011 ' , by 1'130,0% \Scu K tiaenwt3 who is personally known to me or who has produced La+s. Jew 4.1. tx..' • . dentification and wh did take an oath. NOTAR S. Print: My Commissi n Expires: * * * * * * * * * * * * * * * * * * * * * * * * ** APPROVED BY SAIYED SHABBAR JAWAID Notary Public, State of Florida Commle ierr* SE 10701 My oomm, expires Jun@ IS, Signature ' �gntractor The foregoing instrument was acknowledged before me thisO 'day of Surto,, , 0 `, by ��u9a,lcl � 'ka ' who is perso. own to me or who has produced TIERESA MCCREERY NOTARY PUB Ex `N MY COMMISSION mDD9431306 EXPIRES: December H, 2015 Bonded Thor Ploy Public Underwriters Sign: Print: -ES N My Commission Expires: I2 °(o _�1� * ******************************************************************************* —L./ Plans Examiner Structural Review (Revised 07 /10 /07XRevised 06/10/2009XRevised 3/15/09) Zoning Clerk Miami Shores Village Building De p artment 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 �,, ��1 , t-,,:... ------- - - - - -- ®INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING Permit No. Ph 2-71 K PERMIT APPLICATION Master Permit No. RC-42.-1 t VOL FBC 20 Permit Type: PLUMBING / OWNER: Name (Fee Simple Titleholder): Gi awn' �� D LEI ts. i -z. Phone #:365 -75'2 ' 12-55 Address: 12.8S A t k72_ Sjrejf City: M d AAA; 5 h.are. S State: FL. Zip: 33/38 Tenant/Lessee Name: Phone #: 2a-6,62-303 Email: JOB ADDRESS: 9 2...2:5 /4E /6 2 5/reed- City: Miami Shores County: Miami Dade Zip: 33 / 3i Folio/Parcel #: 1 -32b5-025-- 0/ 2 Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: Ma r h r► Q(Um b fi 25 w si nrt � �r C._ Phone #: ,36S- S2 -,30 3( Address:o2O LIS J E /(o 09/a d . City: M '1444; 4.; 13 e d,1 . State: F Zip: 3-3 179 Qualifier Name: EcICao4-4r 3 MI Q 1 k e-/C Phone#: SOS -662 303/ State Certification or Registration #: C, F�C�O(kg. a 9 Certificate of Competency #: Contact Phone #: 36S - GS 2,- 303/ Email Address: Max h n fei yin Loi QciL e 6FYI DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ Jf a 90, n C3 Square/Linear Footage of Work: Type of Work: UAddress DlActeration ONew ORepair/Replace ODemolition Description of Work: aa __� 0�A� (040 * *** * *********** *a:**** ***************** Fees** ***** * ***************** * * ** x ************** Submittal Fee $ Permit Fee $ P5 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. Signat The foregoing instrument was acknowledged before me this 1 day of , 20 f by Mcl,ur , e. Le.bnu] i , who is personally known to me or who has produced Fl-r'. bril/80 tleaxriSelis identification and who did take an oath. NOTARY PUBLIC: Signature Contractor The foregoing instrument was acknowledged before me this day of H 01 , 2012_, by cL T ; Ja , who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: * * * ******* ***** * ****** **** *** * ****** **** * * ********* . APPROVED BY G� ''� plans Examiner (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Structural Review Zoning Clerk r Fed Shiprrtent on natu Trite Std Sign Sarvi Your t[ :i r ( aturtf rr.i e Detailed Results 111111111111,1 Trap Lod bons Le,am FectSx, Offiok 0 Printer-f ready Eater tearing number Set Link 3 ra: 8000346042 Seed time format 121'11 C)E-rriail notificalicie Delivered Delivered Signed for by KVALLI Axixdiet; Shbinerit Dates Destination .. .... _....._,_ Ship date e May5, 2012 Signature Proof of DeDoery 0 ! DefiVery date e May 7, 2012 10:12M .. ShOment Options 0 Han Hold at FetlEx Location Hold at FedEit Location service is not available for this shipment. Shipment Farts &mice type Pit ority Envelope - Direct Signature Delivered to Residence Required (S) t Shipment Travel History e Hein Select time zone: Local Scan The All shipment travel activity is daplayed n local tityte far the locafion flteffit s7 Activity Location flay 212 10:12 AD Delivered 71, 2012756 Ala On Fyffe vehicle fur deiivery BOCA RAM, FL lday 7,2012714AM At bee fetEx faddy SOCA RA1DN, FL 20124:56 AN At destination sort foelly FORT LAUDERDALE, FL INey 5, 20121012AM Picked op leAlttir FL Tendered at fedfx Office Betas I.-Won't be around for delivery? 11favens..iii]lit.tito shipment for ntil tradicin0 . - 1...nonve.et:prkup. Learn tif.tire Wat11% detito ExAdvanced Tracking: :ed Package Express US Airbill Pros Phase Rad hat Sandots Foda 0013 3460 4208 limier% /21 t "A,'& t Yaw 'Offal eilikag Waren= sposraumr 31'0 nanpasta Puling lamina •amelbxem FolEx Rrat Nino " 1171/fil EE alma Xi:Whim-117ra= r*" wabg' Priba* 0 FeillItStsollard Crommight mad& pakiwootaft. o Expop.m. 0 r 41=;.+Vattr C3 BMW dirty WO^ II Packaging quarto irsatassa Mix Envelopes 0 Fattil# Par Special 0 WPM: CS. 0 ant Delivsly Signature Option Tubet Othcr 1.1fr Addles /6 5--7- Alto ea P.11 banal Kt /*Mu (p . .. *' ...! .., .'•::. ; 1::;'',;.1 ':..% 0 • 1: 9.1 ;.. '... i.,.:) C.4...1.ATA.!;:sr:.,..., ",..3"i":1;.:.-.', 1:'.',.......... i.,,22. L,., I . . , • ' , ° • :.'• ; -I :I.., • - ' '.1. ,';. '' 1 . . .. Maggio, 0 itz=zoistosotkatiodligulZipekaabl parser!" .1,1?. MUM= 0 Carp Aiwa Et r---- Eserhdb And. *maga cambia& 0 Reeving aThird Party ilemalit Card Dcw�eck Tutailliettt MINIDaluedVedud Q5 to. tilistR.NiartbdiMpinzistenazel===alc. 140.61== Br, 111114.Pong1317%. 0123K3101%ft• PENTON USA. lif PIFF4 Maurice D. Lebowitz, M.D. 1285 NE 102nd Street Miami Shores, Florida 33138 Reno's Plumbing and Pool Inc. 1057 NW 6th Drive Boca Raton, Florida 33486 Sir: May 4,2012 This letter is notice of my election to terminate and that I am dismissing Reno's Plumbing and Pool Inc, that you and/or your agents are no longer permitted to access to our property or seek to gain access to our home. Your agreement was with Atlantic Development (which is terminated) and is not nor never was with me. Maurice Lebowi PROPOSAL MARLIN PLUMBING OF MIAMI, INC. 20145 N.E.16th PLACE, NORTH MIAMI BEACH, FL 33179 (305) 652 -3031 fax (305) 652 -3135 License CFC048292 PROPOSAL SUBMITTED TO Name: Dr Maurice Lebowitz Street: 1285 NE 102 Ave Miami Shores, FL 33138 Phone: 305- 757 -1255 Cell: 305- 298 -9222 Email: cellarddr @bellsouth.net Wayne Hasher: 954- 708 -0849 Fax: 954- 327 -8510 WORK TO BE PERFORMED AT Name: Dr. Maurice Lebowitz Street: 1285 NE 102 Ave Miami Shores, FL 33138 Phone: Fax: We hereby propose to furnish the materials and perform the labor necessary for the completion of: MASTER BATHROOM Marlin Plumbing to install shower mixer valve with total of 3- body sprays, 1- Shower Head, 1- Rain Shower and 1- Hand held shower. Also will install 8'X5' pan and bench wrap. Marlin Plumbing to rough and water pipe for 1- Shower, 1- Tub and vent system. Materials to be used will be PVC pipe and fittings on drain line and copper pipe and fittings on water supply lines. All to be strapped and hung as per code. Marlin Plumbing to re- install Jacuzzi tub with new drain and 3A" water service (Owner to supply all faucets, valves and fixtures) NOTE: Any deviations from scope of work mentioned above will be extra to contract and done at time and material, Marlin Plumbing not responsible for any wall, floor or tile patching. Permit fees are extra to contract if needed. ($1,963.34 Deposit) ($1,963.34 Upon Commencement of work) ($1,96332 Upon Completion of Work) All Material and Workmanship is Guaranteed for One (1) Year starting from Completion date. Note: Marlin Plumbing will not be responsible for any underground water pipes, sprinkler lines, gas or electric lines while doing any trenching. If needed, Marlin will call for location services to mark services. All materials and workmanship is guaranteed for one (1) year from the completion date of the contract to be as specified, and the above work to be performed in accordance with the drawings and specifications submitted for the above work and completed in a workmanlike manner for the sum of. $5,890.00 *In the event that the customer fails to make any payments to Marlin Plumbing in accordance with the terms and conditions of this agreement, Marlin Plumbing shall be entitled to all reasonable attorney's fees on collection and/or litigation or other court proceeding including attorney's fees on appeal. Respectfully submitted: Marlin Plumbing of Miami, Inc. By : Raul Bringas Date: 5/2/12 ACCEPTANCE OF PROPOSAL marlinpropdoc /form 1 / 1998 1. PROPOSAL MARLIN PLUMBING OF MIAMI, INC. 20145 N.E.16th PLACE, NORTH MIAMI BEACH, FL 33179 (305) 652 -3031 fax (305) 652 -3135 License CFC048292 PROPOSAL SUBMITTED TO Name: Dr Maurice Lebowitz Street: 1285 NE 102 Ave Miami, FL 33138 Phone: 305- 757 -1255 Cell: 305- 298 -9222 Email: cellarddr@bellsouth.net Wayne Hasher: 954- 708 -0849 Fax: 954- 327 -8510 WORK TO BE PERFORMED AT Name: Dr. Maurice Lebowitz Street: 1285 NE 102 Ave Miami, FL 33138 Phone: Fax: The above price, specifications, and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payments will be made as outlined above. Any alteration or deviation from above specifications involving extra costs will be executed only upon written order and will become an extra charge over and above the estimate. All agreements are contingent upon strikes, accidents or delays j yond our control. Date: S -7" /Z Signature: ei Date: Signature: marlinpropdoc /form 1 / 1998 DATE IMMIDDlYYYY) AC,Rcio CERTIFICATE OF LIABILITY INSURANCE _ 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 INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pofcy(Ies) must be endorsed. if SUBROGATION 15 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 IIeu of such endorsement(s). PRODUCER Keyes Coverage Insurance 5900 Hiatus Road Tamarac FL 33321 mSURED Marlin Plumbing of Miami, Inc. 20146 N.E. 16th Place Miami FL 33179 5937 CONTACT NAME Sandra Jones PHONE Et:954- 724 -7000 ADDREss:sjones{rkeyescoverage corn INSURER(S) AFFORDING COVERAGE rA10. Nok954- 724-7024 NAIC $ suuERA:Hartford Fire Insurance Co iwsuRERD:Brldgefteid Frnployersins Co INSURER C : INSURER D: - NNSURBRE4 INSURER F: 19682 10701 COVERAGES CERTIFICATE NUMBER: 2063183359 ISSUED TNDICATTEDD. CERTIFY TWITTHAT ANDING AN IREQUI INSURANCE REMENT, TERUM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH mIS 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. POIAC POLIO ECP LTR TYPE OF INSURANCE INSR wve, POLICY NUMBER RB9IDD�MMlD LIMITS A GENERAL LIABILITY Y 21UUNIT922S 618/2012 51812013 EACHOCcuR ENCE $1,000,000 DAMAGE TO RENTED PREMISES (Ea oourrencel $300,000 MED EXP (Any one person) $10,000 REVISION NUMBER: X COMMERCIAL GENERAL UABILITY { CiAIMS -MADE n OCCUR B UMBRELLA LIAR OAR EXCESSLIAB ■ CLAIMS -MADE DED ■ RETENTION$ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTNE FFICEFUM In MBER EXCLUDED? H desaibe under !PITON OF OPERATIONS below YIN N IA Y PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE $2000,000 PRODUCTS -COMPIOPAGG $2,000,000 (▪ SNGLE UNrr BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ I 1• DAMAGE EACH OCCURRENCE AGGREGATE $ 830 -25781 1211/2011 1211/2012 T• ORORYTL.IMITs i I ER EL EACH ACCIDENT $ EL. DISEASE - EA EMPLOYEE S1,000,000 81,000,000 E.1.. DISEASE - POLICY L82T $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 901, AddlMnal Remarks Schedule, If more specs Is required) CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE BUILDING DEPARTMENT 10050 NE 2ND AVENUE 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. AXD REPRESENTATIVE ACORD 25 (2010105) ©1888 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD u >i:s4; 4 I MCI -DADS COUNTY TAX COLLECTOR 140 W. -FLAGLER ST. 1st;FLOOR' MIAMI, FL- 333130 250346 -5 BUSINESS NAME / LOCATION MARLIN PLUMBING OF MIAMI 20145 NE 16 PL 33179 UNIN DADE COUNTY 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. OWNER MARLIN PLUMBING OF MIAMI Sec. Type of Business 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 CITIES. NOR DOES IT EXEMPT THE HOLDER FROM ANY OTHER PERMIT OR LICENSE NOT REQUIRED R CCER'RFICATION�OF THE HOLDER'S QUALIFICA- TIONS. 19 PLUMBING CONTRACTOR PAYMENT RECEIVED MIAMI -DADE COUNTY TAX COLLECTOR: 09010336001 000075.00 SEE OTHER SIDE RENEWAL RECEIPT NO. 262710-8 INC STATE* CFC048292 FIRST -CLASS U.S. POSTAGE PAID MIAMI, FL PERMIT NO. 231 INC WORKER /S 1 DO NOT FORWARD MARLIN PLUMBING OF MIAMI INC EDWARD WALKER 20145 NE 16 PL MIAMI FL 33179 tfllMiiMl}tf F'1hltnflltn hil Mill Alllh u MIlflfa all Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR / ARCHITECT Permit N. PL" 1'12.- i l Owner's Name (Fee Simple Title Holder): Ma tit rl & D 1a loo w -1-z- Phone #: 3 5 -7S7 - /ASS Owner's Address: /a(5 we- /02- Si- City: /dl i 4 nti i 6/14-Yes, State : Zip Code: 3/3i Job Address (Of where work is being done): 1 aes E /c City: Miami Shores State: Florida Zip Code: 33 /.3? Contractor's Company Name: Ma-di n i l u rn.(ini t1 Phone #:3�S 6s"a �'3/ Address: OD ! qS AJ City: f1%44i Mi4ivtd State: FL Zip Code:33 /79 Qualifier's Name : E%,va rd k ..Y Lic. Number: FCd q ea ?„2, Architect/ Engineer of Record Name: Phone #: Address: City: State: Zip Code: Describe Work: spi t) 10-1 11' RC) C o I hereby certify that the work has been abandoned and /or the contractor /architect is unable or unwilling to complete the contract. I hold the Building Official and the Miami Shores harmless for all legal involvement. Signature The foregoing instrum •ed before me this '7 day of Mal ,201a,by Mau n e2. LA2,60u 4 . Who is personally known to me or who has produced F1 oY i arm Dri Vet 1, i esbn z , as indentification. Notary Public: Sign: Seal: Signature Contractor br'Architect The foregoing instrument was aknowledged before me this '7 day of , 2012by EdWcucl TVAIatker who is personally known to me or who has produced as indentification. Notary Public: Sign: Seal: f' Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 7952204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 JAN2 BY: _______mo__o__m a oeme BUILDING Permit No. P N-7-1)g PERMIT APPLICATION FBC 20 Master Permit No. 0'C 11—W02– Permit Type: PLUMBING .� OWNER: Name (Fee Simple Titleholder): tr' A+I" le—e, Lam, Co 1 l Phone#: 305--4291?-22;r2, Address: 425° jt' £r l b Zoud S 1 City: A P m r S r�5 state: ci Zip: 3318 sir Tenant/Lessee Name: Phone#: JOB ADDRESS: 5144n City: Miami Shores Folio/Parcel #: Is the Building Historically Designated: Yes County: Miami Dade Zip: NO ?( Flood Zone: CONTRACTOR: Company Name: k.]S P( O zr eio,_;, Phone#: " 33 Address: 13 (4 SG 3 a- State: Qualifier Name: "T,ir LTO State Certification or Registration #: Zip: • ,(1, Phone#: go i ° Certificate of Com tency #(Fe,c 07? . - Contact Phone#: —&.01-3- ' Rmai1 Address: D k) S y .. 2U4 D E S I G N E R : Architect/Engineer: 3 3 3 Phone#? Value of Work for this Permit: $ $V 629" Square/Linear F Type of Work: ❑Address UAlteration ONew Description of Work: _Lk Ica % nri , Q,e Wen e of Work: 32. 95 Repair/Replace ODemolition Wis p-,2 4, 'NIA. *********** * * * * ********* ********** * * * ** ga**** * *********** *a *** ** ** ***** * ** a*** ***** ** Submittal Fee $ Permit Fee $ bie 'd' CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Educatiion Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL li'I E NOW DUE $ 1 (DO ' tf 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 Lion fee will be charged 0.,0.0dgent The foregoing instrument was acknowledged before me this 24 day ofjt CI .20 l by who is(personally known_ _o ine or who has produced As identification and who did take an NOTARY PUBLIC: Sign: ,0''o ' lStar' o (LA Print: k7 Sus .4A) My Co Signature Contractor The foregoing instrument was acknowledged before me this 33 day of-Qt , 2012 by Kk own to me or who has produced as identification and who did take an oath. PUBLIC: 11 11 M MANS MY COMMISSION # BE 158312 EXPIRES: February 3, 2018 Banded Thor Notary Public Underwriters a - .��� Sign: - Print: MoD Gkr i s ? (0-0 t•J My Co * * * * * * ** * * * * * * * ** 4 Y P NMa Pti* §tiE§ Bi FIdRHti IRgi@R §8R ®HIBilfifl6fl € @3 ** *jb#19(1i�ri * * * * * * ** APPROVED BY (1" i -,3r- / Zjplan.s Examiner (Revised 07 /10/07XRevised 06/10/2009)(Revised 3/15/09) Structural Review ** Zoning Clerk RENO'S PLUMBING &POOLS This fl prepa e by: LIAISON CONSULTING GROUP wvw Iiaisonine.00m RENO'S PLUMBING. & POOL, INC. 134 SE 3rd Court Suite #2 Deerfield Beach FL 33441 Office: 561.368.3308 Fax: 561.361.8073 Email: info @renosplumbing.com Lic.# CFC- 056782 Jan 24 12 08:57a Kathy Valli P.O. Box 3353, West Palm Beach, FL 33402-3363 CIS-PISIMITIO NAL VAX Cat MOTOR wwwlextvilectorpbc.com Tel: (561) 355-2272 Sercingrahn D'eadt County 561-361-8073 p.1 "LOCATED AT 1057 NW 6TH DRIVE BOCA RATON, FL 33486-3437 TYPE OF BUSINESS OWNER CERTIFICATION # RECEIPT fl/CATE PAID AMT PAID BSI • 23-0089 PLUMiStNG CONTRACTOR VAW RENATO JAMES CFCOSEPS2 011.622435 09,30111 $27.50 840084285 This document is valid only when receipted by the Tax Collector's Office. RENO'S PLUMBING& POOL INC RENO'S PLUMBING & POOL INC 1057 NW 6TH DR BOCA RATON, FL 33486-3437 STATE OF FLORIDA PALM BEACH COUNTY 2011/2012 LOCAL BUSINESS TAX RECEIPT LBTR Number: 200306261, EXPIRES: SEPTEMBER 30, 2012 This receipt does not constitde a franchise, agreement, permission of authority to perform the services or operate the business described herein when a franchise, agreement or other county commission, state or federal permission of authority is required by county, state of federal law. • • ArA ''''.•"%ST,TE OF FLORIDA :••• •• * -*: • 'IN'.1"' — . . z . A ---g 1 44 UT • • . • • • ,--.•!-..,5, svacR' .i.4 F__ ' itottst,XcO*Z.;048GtriaiTZON . '.' ••:.• .*:.•'. • •.;:•.'!... -,:,. i;s•si .:4•••%•',,..,•,,,,,.!..riir.I.,1;i:: ••;.:""!,.. ••• — • • s„::••`,.!.."..- ......-1-.... ,), ..: • ' C 0 ntt:I."02...:•:;.r. '''.' ' • ± ,,:•:.• ••, ' : :CERT/Fit 1:i.';', * ::..A.r.; ."..,:...,1......... • under 024 pr oyd sinus of Ch. 489 ya • . 561 -361 -8073 Jan 24 12 09:01a JEFF ATWATER CHIEF FINANCIAL OFFICER * * CERTIFICATE Of ELECTION 111 BE EXEMPT CONSTRUCTION INDUSTRY EXEMPTION This certifies that the Indivr uel listed below has elected STATE 00 ,FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS` COMPENSATION FROM FLORIDA WORKERS' COMPINSATION LAW * * EFFECTIVE DATE: /17/2011 PERSON: Ai U FEIN: 50189836 BUSINESS NAME AND ?ADDRESS: RENO'S PLUMBING & POOLtINC 134 SE 3 COURT DEERFIELD BCH FL 33441 I SCOPES OF BUSINESS., OR TRADE: 1- CERTIFIED PLUMBING CONTRACTOR 06 -03 -2011 to be exempt from Florida Workers' Compensation law EXPIRATION DATE: 05/16/2013 RENATO . • I- PLUMBING IMPDATANT: Purauenl to Chapter 440' . 061141, F.S., ea officer of a corporation who ateCts aaemption from IMO chapter by lluing a certlflcaie o1 election under Uils section may eat recover benefits ar compensation under This chapter. Pursuant to Chapter 440.06(12), F.S., Ceilleatoa et Woollen to be ehsompt.,. apply only within the scope of the bsstness or trade listed OR the notice of election to be exempt. Pursuant to tbapter 440.051131, F.S., Notices of election to .be exempt and certitlaates of election to tie exempt obeli be snbject to mention ill at any time efter the 11II4 of the notice or the laseanre of the certificate, the person named as the notice ar certificate 00 longer meets the requirements of This sestina far Isananca of a certificate. The department shall revoke a certif icate at any time for failure of the persaa named on the certificate to meet the requirements of this section. OWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01 -11 QUESTIONS? (850) 413-1809 rom:nr-ii a btone teaxID: Date:1 /24/2012 09:23 AM Page: 2 of 2 OP ID: ES '`'�,..` - CERTIFICATE OF LIABILITY INSURANCE DAB ( 01/24/12 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- 395 -1435 The Plastridge Agency -BRO 2100 N. Dixie Hwy. 561-395-4755 Boca Raton, FL 33431 CONTACT NAME: AX (Pine. Extr (A/C ' No): E-MAIL ADDRESS: PRODUCER RENDS -1 CUSTOMER ID*: INSURER(S) AFFORDING COVERAGE NAIC i INSURED Reno's Plumbing & Pool, Inc. 1057 NW 6th Drive Boca Raton, FL 33486 ri I DAr_oc __-- -- •- --- ---- - - - -- INSURERA: North Pointe Insurance Co. INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : REVISION 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 SUER LTR TYPE OF INSURANCE VINO GENERAL LIABILITY ADDL INSR POLICY NUMBER A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I X I OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS UMBRELLA LIAB EXCESS LIAB 3093002662 POLICY EFF (MM/DD/YYYY) 09/26/11 POLICY EXP (MM/DD/YYYY) 09/26/12 LIMITS EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES (Ea occurrence) $ 1,000,000 100,000 MED EXP (My one person) 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ 2,000,000 COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) OCCUR CLAIMS -MADE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below EACH OCCURRENCE AGGREGATE Y/N N/A WC STATU- TORY LIMITS OTH- ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE Plumbing IN Residential or CombinedwCLRes ldentlal /Commerlal Remarks Schedule, IF more space le required) CERTIFICATE HOLDER E.L. DISEASE - POLICY LIMIT $ MIAMS -1 Miami Shores Village Building Department 10050 NE 2nd Avenue Miami Shores, FL 38138 CANCELLATION 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 O 1988 -2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD DBPR - VALLI, RENATO J; Doing Business As: RENO'S PLUMBING & POOL INC, ... Page 1 of 1 12:26:17 PM 2/6/2012 Licensee Details Licensee Information Name: Main Address: County: License Mailing: LicenseLocation: License Information License Type: Rank: License Number: Status: Licensure Date: Expires: Special Qualifications Construction Business VALLI, RENATO 3 (Primary Name) RENO'S PLUMBING & POOL INC (DBA Name) 1057 N.W. 6TH DR. BOCA RATON Florida 33486 PALM BEACH Certified Plumbing Contractor Cert Plumbing CFC056782 Current,Active 08/26/1994 08/31/2012 Qualification Effective 02/20/2004 View Related License Information View License Complains~ Contact Us :: 1940 North Monroe Street, Tallahassee FL 32399 :: Call.Center(rpdbpr.state.fl.us :: Customer Contact Center: 850,487.1395 The State of Florida Is an AA/EEO employer. Coovriaht 2007 -2010 State of Florida. Privacy Statement Under Florida law, a -mall addresses are public records. If you do not want your e-mail address released In response to a public- records request, do not send electronic mall to thls entity. Instead, contact the office by phone or by traditional mail. If you have any questions regarding DBPR's ADA web accessibility, please contact our Web Master at webmaster8 dbor.stata.fl us. https:// www. myfloridalicense .com/LicenseDetail. asp? SID= &id= 1F22E7134A85B9382B4E... 2/6/2012