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RC-13-250Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 185437 Scheduled Inspection Date: April 29, 2013 Inspector: Bruhn, Norman Owner: LIAO, CHIA CHING Job Address: 180 NW 111 Street Miami Shores, FL 33138- Project: <NONE> Contractor: PP3 CONSTRUCTION CORP Permit Number: RC -2 -13 -250 Permit Type: Residential Construction Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1121360030470 Phone: (305)389 -0065 Building Department Comments KITCHEN & BATHROOMS REMODEL Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed 4J2 Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. April 26, 2013 For Inspections please call: (305)762 -4949 Page 15 of 50 11111111111 11111 11111 11111 11111 11111 1111 1111 NOTICE OF COMMENCEMENT c F14 2013R01274-04- A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION OR Etc 28492 F4 0445; k 1 } RECORDED 02/15, 2013 13 : 13.07 c�� HARVEY RUVIN? CLERK OF COURT ) 3-Z 5 TAX FOLIO NO. NIANI"DADE COUNTY? FLORIDA PERMIT NC 1121100�47o LAST PAGE STATE OF FLORIDA: COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Legal description of property and street / address: 180 NW 111th Street, Miami Shores, Florida 33188 2. Description of improvement Remodel Kitchen & Bath %,TATE OF FLOVID , =MTV DACE I-tE ROY CZTRITFY fm' F (we cop f"f f 1 5172a13 ...cd 3. Owner(s) name and address: 160 NW 111th Street, Miami Shores, Florida 33168 Interest in property: Name and address of fee simple titleholder. 4. Contractor's name and address: PP3 Construction, Corp. 750 NE 98th Street, Miami Shores, Florida 33138 5. Surety: (Payment bond required by owner from contractor, if any) Name and Address: NA Amount of bond $ 6. Lender's name and address: NA 7. Persons within the state of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes. Name and Address: 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name and Address: 9. Expiration date of this Notice of Commencement (the expiration date is 1 year from the date of recording unless a different date is specified) Signature of • + er Print Owner's Name \C 41,11 Sworn to and subscribed before me this 4441 day of rzaif v?vl Yy , 20 15 . Address: Prepared by Gabriel Rodriguez Notary Public: Print Notary's Name: My commis, ion expires: po Notary Public blic State • Florida Gabriella Rodriguez ' �resn4/2n6 193489 of wo 0�01 ai)-413 I 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 Permit Type: BUILDING JOB ADDRESS: 180 NW 111th Street Permit No. Master Permit No. ROOFING City: Miami Shores Folio/Parcel #: 11211360030470 Is the Building Historically Designated: Yes County: Miami Dade 33168 NO X Flood Zone: X OWNER: Name (Fee Simple Titleholder): CA (41 C'( 1k) SI Li #\(\ Phone#: 3 7 O Address: 180 NW 111th Street City: Miami Shores State: Florida zip: 33168 Tenant/Lessee Name: Phone#: Email: T( c,S K it t I®cjimerir 1 c CONTRACTOR: Company Name: PP3 Construction, Corp. phone#: 305 -389 -0065 Address: 750 NE 96th Street City: Miami Shores State: Florida Zip: 33138 Qualifier Name: Gabriel Rodriguez phone*: 305- 389 -0065 State Certification or Registration #: CGC1516509 Certificate of Competency #: Contact Phone#: 305 - 389 -0065 Email Address: Babe @pp3construction.com DESIGNER: Architect/Engineer: Amulfo Sanchez H. Architect Phone#: 305 - 552 -6943 Value of Work for this Permit: $15,000 Square/Linear Footage of Work: 300 SF Type of Work: OAddition GAlteration ONew URepair/Replace ODemolition Description of Work: Remodel Kitchen & Baths Color thru tile: *****W***d **** ***+ Y*****************t s* *** k***# ***** Qa**+ k*i**** *akR+X***da************ Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ ta Bonding Company's Name (if applicable) NA Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) NA 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Owner o nt C ctor The foregoing instrument was acknowledged before me this The for going instrument w• acknowledged before me this day offarklik4 20 a, by Chiot �' tik UA 0 , day of 4E49 , 20) 3, by who is personally known to me or who has p Riowr►j• As identification and who did take: an oath. NOTARY PUBLIC: Sign: . T tU Print: jlai90 14 My Commission Expires: APPROVED BY otary Public State of Florida ir: Gabriella Rodriguez My Commission EE 193469 or p04 Expires 04/26/2018 who is onally known to iti or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: TI R My Commission Expires ANACRISTINA R. ROQUE MY COMMISSION # EE 181 O€ EXPi;ES ,hav 1;1.2018 1rde-wriv7 ** * * * ** * ** *p . *�x #.. < **************>< �N****$** * * * *** * * * * * * * * * * * * * * * * * * * * * * *** �/ Plans Examiner Zoning Structural Review (Revised 3 /12/2012)(Revised 07 /10/07)(Revised 06 /10/2009)(Revised 3/15/09) Clerk • PREPARED BY AND RETIBRN TO: THOMAS STRUM M CONSUMERS flRST UTLE COMPANY, INC. 1176E W. SAA1oLE ROAD. flit IN CORAL SPR1tOS. FL 33045 PH ENommen CoNSIDERitioN:314gpno,ag 11011111111111111111111111111111111110111 CFN 20 J. 3R00 38 7 06 OR Bit 28445 Pe 10461 ties) RECORDED 01/15/2015 10s37115 DEED OOC TAX 84040 HARVEY RUVIII, CLERK OF COURT AT1I IMC€ COUNTY, FLORIDA PAGE WARRANTY DEED Made this 14th day of December, 2012 by GILENE SYLVAIN AND ELLISON AND WIFE, whose Altus is: CH SOT i�� office iv 160 NW l l ST, MIAMI SHORES, FL 33168, Grantor. to mail Ctemaoe pereinsRercalle:dthe (Whenever used herein the term "Grinner and 'Grantee Include all the patties to this Instrument and the heirs, legal representatives mid assigns of individuals, and the SMCCS$sma and assigns of corporations) Witnesseth, that the pastor, for whereof is hereby ea wl hereby leteby consideration bargains, sells, a aliens, roan roles, ,says unto the chaniee, all that cohain hand situ to in Miami -Dade Canty, Florida . to wit Lot IS, Rink 220, MIAMI SHORES} EXTENSION, according to the Pint thereof,' as recorded In Phu Book 43. at Paage40, MIN: Public Records ofMiemi -Dade Downy, Florida. TLz FolioNumber: II-2136-0034470 Together with all the tenements, heteditamemta and appurtenances thereto belmeging or in anywise appertaining. To Have aid to Hold, the Mme in fee simple forever. • And the Grantor hereby covenants wish MN Grantee that the grantor is lawfully seized of said thud in the simple; that the Grantor has good right and lawful authority to sea and convey said bads that the Grunmr hereby Ddly warrants the title to said land and will defend the acme against the lawful elate* of all parsons whomsoever; and ;tit said land is free of all a euawanees except tans stunting sabseque■f to December 31, 2011, and eovennts, conditions, restrictions and dents recorded in the public records. and mubieipal lens, violations, code eafo vement violations and lien and utilities levied and tinned against the reeled property by Real manidpadtles tented la Mhtmi -Dade County. In Witness Whereof, the sold Cantor has signed and sealed these p ematethe day and year lost above written. Signet oroarpresence: dorMilk .7 SSAINT. mess Printed Name: Pa. ,. e STATE OF FLORIDA. COUNTY OF MIAMI-DADE VINE OP FLORIDA, COUN1Y OF DAM HEREBY thick frattqw 10ii7 MAW ai (144 AD?0 and iiihYtlhfCount The foregoing insotunent was acknowledged before me this 14th day of December, 2012, by ()ILENE SYLVAN A EL.LISON TDUSSAINT, who is/me personally (mown me or who has/have produced # as identification. My commission Expires: Nom Pubhe 1 Book28445/Page1046 CFN#2 0130038706 Page 1 of 1 Td W136T :60 6002 B '100 : '0N Xtid AC CERTIFICATE OF LIABILITY INSURANCE 2 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON TFiE CERTIFICATE HOLDER. THE 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 this certificate holder is an ADDITIONAL INSURED, the policy(Eea} must be endorsed. if SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain Polio may require an endorsement. A statement on Mkt certifies* does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Merchant Insurance - Miami PO Box 173306 Miami INSURED FL 33017 PP3 CONSTRUCTION, CORP 750 NE 96TH STREET MIAMI COVERAGES FL 33138 CONTACT ercharwt (305) 804 2989 FAX ES• rnaA fiecht merchantiMeurancesolutOncONom 4983 INsus A : FUBA tk INIRES C INSURER 0 z _ERE INSURER F • THIS IS TO CERTIFY THAT THE POLICIES INDICATED. NOTWITHSTANDING ANY REQUIREMENT, CERTIFICATE MAY BE ISSUED OR MAY EXCLUSIONS AND CONDITIONS OF SUCH OF INSURANCE PERTAIN, POLICIES; ADM SUBS WA wenn LISTED BELOW HAVE BEEN ISSUED TO THE INSURED TERM OR CONDITION OF ANY CONTRACT OR OTHER THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED LIMITS SHOWN MAY HAVE BEEN REDUCED €IY PAID CLAIMS EFF I FOUL"' EXP POLICtlNUAfIF#FzR ,M OIY ti INiti l9*CYYi NAMED ABOVE FOR THE FOLICY.l RIOD MENT WITH RESPECT To WHICH THIS REIN IS SUBJECT TO,ALL `FHE; TERMS, INSR TYPE OF INSURANCE GENERAL LIABIi TY - COMMEFGIALCLNE LIABILITY ' EACH .E TRREEN N CE ISkA`O R4 } MAIMS -WOE 1 ; OCCUR MED EXP IAn, pewon} . :6.; .. I . ij P�TtSONAL$ALiVtNJIdRY GENERAL AGGREGATE Del AGGR GATE LIMIT APPLIES �R PER PRODUCTS- GQSItDPAGt? k POLICY ; I mo- t % LOC S AUTOIkMOBILE LIABILITY ANY AUTO ALL MANED AUTOS FIRED AUTOS SCHEDULED NON -VAPIE l AUTOS CaMSINED SINGLE uMrr ffi BODILY INJURY ) S ----"` Y INJURY p�Ipitl .IPEr�t DAMAGE , f S. UMBRELLA UAB EXCESS LIAR i OCCUR E i ? , FJKCII.�3CCIfiiRENCE $ I E - - sl�t °rl?E��_ " RETENT N S �DEDf A WORE RS COM LIABILITY AM) ANY PROPRIETORIPARTNERFEXECUTIVE OFFICERMEMBER,EXCLUDED? (Mandatory In NM) If yes de scr€e:e ender DESCRIPTION OF OPERATIONS t N ! # 1 1- j 1J I A � 106 - 49201 ' 3114/2012 y 3/14/2013 STATU : WH- QRi ktMf7fi2 Fiit:. t .. E' EACH ACCIDENT S' F000, I hehnx Ei}; DISEASE -E 4 EA9PI OYES $ 1,OOt2;iID0 I iq DISEASE -POI ICYUNIT DESCRIPTION OF OPERATIONS I LOCATIONS r VEHICLES (Attaofi ACORO 101, AddllloRaf Femarks rye, it mwe spars 4s requlrodl The Village of Miami Shores 10050 NE 2nd Avenue Miami Shores FL 33138 ACOR (2010/05) The ACORD CANCELLATION SHOULD ANY OF THE ABOVE DESI,r"RiBEIT PDLICIES'BE C BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE < IN ACCORDANCE WITH THE POLICY PROVISIONS. ©19118.20 10 A!CORD CORPORATION. All rights d logo are registered marks of ACORD Pro at%i Folio 11- 2136- 003 -0470 Property Address 180 NW 111 ST Owner Name(s) ELLISON TOUSSAINT &W GILENE Mailing Address 180 NW 111 ST MIAMI FL 33168 -4323 Primary Zone 0800 SGL FAMILY - 1701 -1900 SQ Use Code 0001 RESIDENTIAL - SINGLE FAMILY Beds /Baths /Half 4/2/0 Floors 1 Living Units 1 Adj. Sq. Footage 1,894 Lot Size 9,150 SQ FT Year Built 1940 Legal Description Assess MIAMI SHORES EXT PB 43 -40 LOT 15 BLK 220 LOT SIZE 75.000 X 122 OR 19795 -4570 07 2001 1 COC 24166 -3707 01 2006 5 OR 24166 -3707 0106 01 a Current Previous Year 2012 2011 and Value, $44,981 $44,981 Building Value $150,379 $151,338 Market Value $195,360 $196,319 Assessed Value $195,360 $196,319 Current Previous Year 2012 2011 Homestead $0 $0 2nd Homestead $0 $0 Senior $0 $0 Veteran Disability $0 Civilian Disability $0 $0 Widow(er) $0 $0 Disclaimer: MIAMI -DADE COUNTY OFFICE OF THE PROPERTY APPRAISER PROPERTY SEARCH SUMMARY REPORT Carlos Lopez - Cantera Property Appraiser N A Aerial Photography 2012 Current Previous Year 2012 2011 Exemption /Taxable Exemption /Taxable County $0 / $195,360 $0/$196,319 School Board $0 / $195,360 $0/$196,319 City $0 / $195,360 $0 / $196,319 Regional $0 / $195,360 $0 / $196,319 Info -1' Date Amount Recording Book -Page Qualification Code 1/2006 $0 24166 -3707 Sales which are disqualified as a result of examination of the deed 7/2001 $130,000 19795 -4570 Sales which are qualified 1/1998 $90,000 17957 -4717 Sales which are qualified 4/1997 $0 17595 -3251 Sales which are disqualified as a result of examination of the deed 5/1972 $32,000 00000 -0000 Sales which are qualified The Office of the Property Appraiser and Miami -Dade County are continually editing and updating the tax roll and GIS data to reflect the latest property information and GIS positional accuracy. No warranties, expressed or implied, are provided for data and the positional or thematic accuracy of the data herein, its use, or its interpretation. Although this website is periodically updated, this information may not reflect the data currently on file at Miami -Dade County's systems of record. The Property Appraiser and Miami -Dade County assumes no liability either for any errors, omissions, or inaccuracies in the information provided regardless of the cause of such or for any decision made, action taken, or action not taken by the user in reliance upon any information provided herein. See Miami -Dade County full disclaimer and User Agreement at http: / /www.miamidade.gov /info /disclaimer.asp. Property information inquiries, comments, and suggestions email: pawebmail @miamidade.gov GIS inquiries, comments, and suggestions email: gis @miamidade.gov Generated on: Wednesday, February 06, 2013 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No: EL 13-251 Job Name: August 24, 2012 1. Approved Rafael Hernandez Chief Plumbing Inspector 786.290.0800 Plumbing Critique Sheet Electrical Critique Sheet 1. Need load calculation Showing 100 amp. is adequate. Michael Devaney Sr. Chief Electrical Inspector 305.986.7028 Stopped Review Page 1 of 1 Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re-submittal drawings. Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 s Inspection Number: I NSP- 190005 Permit Number: EL -2 -13 -251 Scheduled Inspection Date: April 25, 2013 Inspector: Devaney, Michael Owner: LIAO, CHIA CHING Job Address: 180 NW 111 Street Miami Shores, FL 33138- Project: <NONE> Contractor: MANUEL LINARES ELECTRIC INC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1121360030470 Phone: (954)450 -8430 Building Department Comments ELECTRICAL WORK FOR BATHROOMS AND KITCHEN 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 REINSPECTION FOR INSP- 185467. April 25, 2013 For Inspections please call: (305)762 -4949 Page 46 of 49 BUILDING 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 BAP �. FBC 20 Permit No.' I PERMIT APPLICATION Master Permit No. Permit Type: Electrical JOB ADDRESS: 10 NW 1 t 1 ►i-1 City: Miami Shores Folio/Parcel #: 112t.)toDD6Dk11) County: Miami Dade Zip: 351(11 Is the Building Historically Designated: Yes NO is Flood Zone: X OWNER: Name (Fee Simple Titleholder): (�a Mt t j WI) Address: t L1D ■14 1,11.1-14 1 T i Phone#: 605. °103 • till 22 City: IdtlitPA \ s 1 b es Tenant/Lessee Name: State: Phone#: Email: Piyennonni►a� c�aA;il. wvh CONTRACTOR: Company Name: 411./ ML. _ ! f iJc. Phone #: ?1l9 ' (99r'4,007 Address. D I A F i 5t) / City: ' Ilti F...S r / State: �'le7 r'!7J/9 Qualifier Name: j J t) Aiii.). -Q.ci Phone#: 71 o^-v 41 0 Sr State Certification or Registration #: ea 1.3D0 Z?_.,O, A.6 Certificate of C ompe t ncy #: Contact Phone #:�4 %41 :fo 6 Zip: � iLA,2 7V c.sh Email Address: DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ IC, Q�� . Square/Linear Footage of Work: 4 ° 0 -Pt Type of Work: UAddress ❑Alteration ❑New ❑Repair/Replace ❑Demolition Description of Work: ** * * *** * *** ***x ***wax * **** a** ***** * * * ** Fees*********** *w* ** ***** *********,x**** * **** ** ** o �`�',iorli "1i'�' 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 $ `��'• LJT 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 FT.F,CTRICAL 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. Signature � -r/"' t <oiv Owner or Agent The foregoing instrument was acknowledged before me this day ofgibi�lf/1m, 20 AA by Chug NJ' M Lao who is personally known to me or who has pro uced . i n 1 t IC.YtdW 1 As identification and who did take an oath. NOTARY PUBLIC: Sign: a Print: Contractor The foregoing instrument was acknowledged before me this 1141 day of.R OY1#t Yy , 20 15_, by Halm! L vutvtS who is personally known to me or who has produced, f ifSMM.tty MD IN VI as identification and who did take an oath. NOTARY PUBLIC: My Commission Expires: * * * * * * * * * * * * * * * * * * ** APPROVED BY eoui, Public State of Florida Gabriella Rodriguez if My Commission EE 193469 or aow Expires 0412612016 * Plans Examiner Structural Review (Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Sign: Print: My Commission Expir * * * * * * * * * * * * * * * * ** CIA 111 I. 1 I� A i, -I T','s'i TTt T : Mary Public State of Florida Gabriella Rodriguez oT My Commission EE 193469 Expires 04/2612016 Zoning Clerk 02/07/2013 16:23 FAX 3052071343 RAMALLO ASSURANCE INC 81001 ACOR CERTIFICATE OF LIABILITY INSURANCE i�,sl;�.••'" 02/0711:3 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMA11QN ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AF'FPRRMATIVELY 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. 1M1fiPORTANT: If the certificate !Waite is an ADDITIONAL INSURED. the poitry(ies) must be endorseccirahROGATION IS WIMP, sUbleet to the terms and Condl lone of the policy, certain Policies may require an endorsement, A statement on this certflicate does not confer rights to the ceilM ltte holder In lieu of such ertduraementisl• DATE(MMIDDrmY) PRODUCER Ramaio Assurance Inc. 12955 S.W. 42nd Sheet Miami, FL 33175 Phone (305 `'7.1332 INSURED Manuel Linares Electric Inc Fax (305)207 -1343 NAmeACT Jorge Romano Ex0• (305)207.1332 126* Pleb (306)2074343 Fr{g; ramelloa ltoassurance•com IN$URERIF+) AFFORDING CONS €R •d am• INSURER A : Federated National Ins Co 11710 Taft St Pembroke Pines, FL 33026- 305 COVERAGGES CERTIFICATE NUMBER: INSURERS : INSURER C: INSURER b : ARE: _MINER : • NAM* REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISPED 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, 9X .USR?NS AND CONDITIONS OF SUCH POLICIES. UNITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR ADDLSU9R PO �V_ EFF PO,_ EXP LTR tN$ Yi1(D- POLICY NUMOSS 1M ~ •T�� M LL•)• -,,W LIMITS A TYPE OF IN9uRANGE GENERAL LIABILITY • COMMERCIAL GENERAL UAss.rrr ❑ ❑ CLAIM$ -MADE ❑ OCCUR • GSM. AGGREGATE LIMIT APPLISS PER: ❑ POLICY CI jTT CI LOC AUTOMOBILE LIABILITY ❑ ANY AUTO g�H ❑ALL OWNED rat . UL90 AUTOS CI A TO N•OWtiaD ❑❑ HIRED AUTOS ❑l AUTOS ❑ UMBr:EI L A L NAB '❑ O UR ❑ MEDD LAD I.AIME -MADE DBD ❑ REYLNTION $ GL- 0000013690 09/16/2012 09/1812013 WORf$SRa GOMPEN$ATION AND EMPLOYERS LIABILITY Y / N ANY PROPRIETOR,Pp CLn1VE� NIA OFFICER/MEMBER EX LU (Mandatoryln NH) dyes. describe under DESCRIPTION OR OPERAMONS below 6ACH OCCURRHNICE s 500,00000 Pnem1355..ftaaamrovei S 100,000.00 MED EXP (Any we per= n S 5.000.00 PERSONAL A ADV INJURY S 500,000,00 GENERAL AGGREGATE $ 1.000.050.00 PRODUCTS • COMRioP AGG S 1.000.050 SI BODILY INJURY Per person) BODILY INJURY (Per amide EACH OCCURRENCE AGGREGATE Er.L EACH ACCDENT $ EL DLaEASE • L".A EMPLOYE 1 EL Dismal • POLICY LIMIT S D@SGRIPYIDN OF OPERATIONS r LOCATIONS! VEHICLES Mach ACORD 101, Addieser l Rensants Belavie, If rnely aiaee le mqulraal CERTIFICATE HOLDER CANCELLATION Villages of Miami Shores 10050 NE 2nd Ave Miami Shores, Fl 33138 ACORD 26 (2010105) OF SMoULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED SWORE THE EXPIRATI , ' •ATE THBRBOP, NOTICE W)LL BE DELIVERED IN ACCOR • TH THE PO(JCY PROVISIONS. ®1633.2010 ACORD CORPORATION. All rights reServed. The ACORD name and logo are registered merits of ACORD JEFF ATWATER STATE OF FLORIDA CHIEF FINANCIALOFFiCIEI 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. 01 -09 -2013 EFFECTIVE DATE: 01/09/2013 EXPIRATION DATE: 01/09/2015 PERSON: FEIN: LINARES 364545352 BUSINESS NAME AND ADDRESS: MANUEL LINARES ELECTRIC INC 11710 TAFT ST P PINES FL 33026 SCOPES OF BUSINESS OR TRADE: 1— ELECTRICAL WIRING WITHIN BUIL MANUEL J IMPORTANT: Pursuant to Chapter 440 . 06(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 440.06(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. DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01 -11 QUESTIONS? (850) 413 -1609 • i 1 BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT .1 115 S. Andrews Ave., Rm. A-100, FL Lauderdale. FL 33301-1895 — 954-831-4000 ...1_ VALID OCTOBER 1,2012 THROUGH SEPTEMBER 30,2013 : r ' 1 : I DBA: Business Name; NftNi1e.1, LINARES EL ecrazr INC Owner Name; MAN:JPL. osb ,1,171Ait.MS Business Location: 921 E 23 sr :4I DA DE COUNTY Business Phone: 5'54-450- 843* Rooms Tax Amount Seats Number DI Machines; Transfer Fee NSF Fee O. 30 Emptoyaos Fri/ it ReceIPt livd::ivalLIALARms/m.v.TRAtzsa •:, etti5 ineeS Type: caTLF,LTra/c.AL, coNTRAcTolo Business Opened:08/T2/2004 State/Cotanty/Cert/Reg:ec.300223,1 Exemption Code: No chinos Vomffnu Typo: Yt!hOCS Professionals THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT WHEN VALIDATED Mailing Address: r.;;OST: MARTES I./ 710 TAU'!" Si If3r.T.YWOOD, 1:7. 33076-2:043 This tax is levied for the privilege ot doing business will* aro:lard County and is nen-regtealory en nature. You must meet all County andiur Ittlurutvatily planning and zoning requiroments. This Sirsness Tax Receipt must be transferred when the business is sold, btisiness has changed or you have moved the business location. This receipt does 111:4 ;ndicate that the business is legal or that it is in compliance with Slate or /aws and reguiOtiOnS 2012 - 2013 Receipt #027k-11-00006587 Paid 09/1S/2012 27.00 • !- !; t; li f I I ?.1 • . ! ELOZ /ZZ /Z® 0.1 h•4 CO LUX- LEtV -0U6 3OLUO X3Q3.J Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 189860 Permit Number: PL -2 -13 -252 Scheduled Inspection Date: April 29, 2013 Inspector: Hernandez, Rafael Owner: LIAO, CHIA CHING Job Address: 180 NW 111 Street Miami Shores, FL 33138- Project: <NONE> Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1121360030470 Contractor: XIMENO PLUMBING Phone: 305 - 829 -4050 Building Department Comments PLUMBING WORK FOR BATHROOMS AND KITCHEN 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 REINSPECTIGIKI FOR INSP- 185470. April 26, 2013 For Inspections please call: (305)762 -4949 Page 32 of 50 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 Permit Type: PLUMBING JOB ADDRESS: 1S0 1vYv 11\4 1f► S &&( FBC 20P1)l2 Permit No. Master Permit No. City: Miami Shores County: Folio/Parcel #: 11211311006D/op Is the Building Historically Designated: Yes Miami Dade Zip: &511.0 NO X, Flood Zone: X OWNER: Name (Fee Simple Titleh�oldder): Y' A (Al �q vIAD Phone#: 3D S. °U)3. tl 22 Address: 11 \MI I 144i D j S YMi J 1 City: µtA1M t Shb Y.tS State: Or Zip: 331 O Tenant/Lessee Name: Phone #: Email: f i VIA DV1nr'' a VYAI 1. tbWI CONTRACTOR: Company Name: /l 4 Vwe \ P\w. I, Phone#: �� S)Q Os V ��10 City: '"l 1, oz., ' J v ���)) State: Zip: � � t Qualifier Name: L Q r T eS �,, ,, Phone #: State Certification or Registration #: C EC l�, 2-,c g • Certificate of Competency #: Contact Phone#: 6) a S J kk S (, Email Address: DESIGNER: Architect/Engineer: Phone#: Address: g -1 u /OW \ Value of Work for this Permit: $ 2.10 0 a . 613 Square/Linear Footage of Work: OD Type of Work: DAddress DAlteration New ORepair/Replace ODemolition Description of Work: * *** *** * *** ** •, ** * * *a * **** ****** **x * ** Fees** * ** * ****w* ** * *** * *** *** * * *** * * ** * * *** * *** 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 $ I i 3'10 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 FT FCTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOWERS, 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. Signature Owner or Agent The foregoing instrument was acknowledged before me this 10 day oftknA04, 20 _l5_, by 6141A �, who is personally known to me or who has pro uced�bI,a14 Y. -DWV1 As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Ad ovuttA 1\1 todvi My Commission Expires: * * * * * ** * * * * * * * * * * * * * * * * * ** APPROVED BY Notary Public State of Florida Gabriella Rodriguez Azr d My Commission EE 193469 Expires 04 am 6 Signature Contractor The foregoing instrument was acknowledged before me this LQ day of 2191er ►ry , 20 , by g Ykb V.SfIntS61 , who is personally known to me or who has produced QGY� SDt11 kMDWh as identification and who did take an oath. NOTARY PUBLIC: Plans Examiner Structural Review (Revised3 /12/2012)(Revised 07!10 /07)(Revised 06/10 /2009)(Revised 3/15/09) Sign: Print: 01 ,.1►lii4 , u. My Commission Expires: Notary Public State of Florida Gabriella Rodriguez AY My Commission EE 193489 as aP Expires 04/28/2016 *** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ** * Zoning Clerk A °® CERTIFICATE OF LIABILITY INSURANCE 2A;� VY) 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(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 Eastern Insurance Group, Inc. 9570 SW 107 Avenue Suite 104 Miami FL 33176 CONleir David M. Lopez PONE . (305) 595 -3323 FAX Not (308) 595 -7135 ADDREss,csr @easterninsurance.net INSURER(S) AFFORDING COVERAGE NAIC # INSURER A id- Continent Casualty Company UABIUTY COMMERCIAL GENERAL LIABILITY INSURED Ximeno Plumbing Inc 8210 NW 191 Street Apt H Hialeah FL 33015 INSURER a:CastlePoint Florida Insurance 04 -GL- 000859208 INSURER C : 9/23/2013 INSURER D : $ 1,000,000 INSURER E : 100 000 $ � INSURER F : COVERAGES CERTIFICATE NUMBER�'Iaster 12 -13 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 LTR TYPE OF INSURANCE ADDL INSR SUBR W VD POLICY NUMBER POLICY EFF (MM/DDIYYYY) POLICY EXP (MMIDDIYYYY► LIMITS A GENERAL X UABIUTY COMMERCIAL GENERAL LIABILITY 04 -GL- 000859208 9/23/2012 9/23/2013 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) 100 000 $ � CLAIMS-MADE X OCCUR MED EXP (Any one parson) $ Excluded PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY n PE O- n LOG PRODUCTS - COMP /OP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED NON-OOWNED AUTOS (CEOMBBII COMBINED SINGLE LIMIT $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LEAB _ OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY XE ANY PROPRIETOR/PARTNER/ECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) It yes, describe under DESCRIPTION OF OPERATIONS below YIN N/A I7CP760952401 11/9/2012 11/9/2013 X I WC STATU- I 1 0TH - TORY LIMITS ER E.L EACH ACCIDENT $ 100,000 EL. DISEASE - EA EMPLOYEE $ 100,000 EL DISEASE - POUCY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedu e, If more space Is required) CERTIFICATE HOLDER CANCELLATION (305) 756 -8972 Village of Miami Shores Building Department 10050 NE 2 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 111/11TN THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE David Lopez /ANA ACORD 25 (2010/05) INS025 rsni nsi ni ©1988 -2010 ACORD CORPORATION. All rights reserved. The, Ar:ARi1 name and Innn ara ranictarmd rrrardre of Ar:ARrl 02/13/2013 14 :04 3058204012 XIMENO PLUMBING INC 'HAS IS NOT A BILL - CO NOT PAY505704 -b RENEWAL INC STATErGFCr2S874 2367 W 80 ST 33016 HIALEAH OVER EN0 PLUMBING INC s i ;rl bSTAt$ CONTRACTOR TTgW�S 16 ONLY A LOCAL POAC i i cRmlxh n NOLOER na TO YIOLATC AON EXISTING REGULATORY OR 2CGOMNNTOY =emit, DOER VT T�NB MOLHQI rnOM ANY EY r 11 RE001 NY LAW. TWA 1$ N07 A ONITIRICATION or TTOE HYOLDER'R OUALIPICA• MALO OA NCO A TAX �� 07/11/2012 09UYUU /8001 000045.00 SgE OTHER SIDE WORKER/s 1 DO NOT FORWARD XIMENO PLUMBING INC RICARDO XIMENO PRESIDENT 8210 NW 191 ST H MIAMI FL 33015 i, =ilaTiiT►>,tatii,i, i,tndhillin idluidimga PAGE 02/02 U.S. POSTAGE PAW MAMA PERMIT NO. }T41 528175 -3 Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No: EL 13 -251 Job Name: August 24, 2012 1. Approved Rafael Hernandez Chief Plumbing Inspector 786.290.0800 Plumbing Critique Sheet Electrical Critique Sheet 1. Need load calculation Showing 100 amp. is adequate. Michael Devaney Sr. Chief Electrical Inspector 305.986.7028 Stopped Review Page 1 of 1 Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings.