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DEMO-12-2160Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 181567 Permit Number: DEMO -11 -12 -2160 Scheduled Inspection Date: December 13, 2012 Inspector: Bruhn, Norman Owner: Job Address: 9230 NE 2 Avenue Miami Shores, FL 33138 -2805 Project: <NONE> Contractor: FAB INTERIOR & EXTERIOR INC. Permit Type: Demolition Inspection Type: Final Work Classification: Building Phone Number Parcel Number 1132060133050 Phone: (305)751 -4447 Building Department Comments DEMOLITION OF GARAGE PARTITION WALLS AND SOFFITS. BRING SPACE BACK TO ITS ORIGINAL USE Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments A1-41- Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. December 12, 2012 For Inspections please call: (305)762 -4949 Page 7 of 24 14(1112—IAA BUILDING PERMIT APPLICATION 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 Permit Type: BUILDING JOB ADDRESS: C,/� 0 iC 9-14 Permit No. NOV 1 4 fl .5 q 1 Master Permit No. ROOFING City: Miami Shores County: FoliolParcel #: 1 ` ' 39,14 — O` 3 - 3t5 Miami Dade zip: 3 3 vg Is the Building Historically Designated: Yes NO Flood Zone: 1e sck ex41- .N 1 rfol • QWNER; Na a ee tim e Titleholder): ♦; ►.. ,� IL, N u I�± ► ' ta.�. Phone#: Address: ► '�'".� t t.1... 11 i I� State: e.A City: Sbiy, 1:51-63 Tenant/Lessee Name: Finail• CONTRACTOR: Company Name: r k ()v. ( Phone#: Address: EIS Ot, 0% City: Kale[ `` SrOV15 State: / Zip: g Qualifier Name: #. (_) S } i n0 State Certification or Registration #: ("Ye 0 j (6-4.5 Contact Phone#: � 0 -2.51 �(3kAp Email Address: DESIGNER: Architect/Engineer: Phone #: I p, Certificate of Co . . petency #: } Q A;�.:L c • 1..i# F�2fid3k?s in %;' 9Fer . r•' Fa L1146W ®Rep Value of Work for this Permit: $ 000 Type of Work: DAddition DAlteration D p 'on of Work: (AAci3r5 kh Phone#: Color thru tile: ******** * * * * *** * * * * * * * * * * * * * * * * * * * * * * ** Fees * * * * * * * *** * * * * * * *, * *** * *** * * * * * * * * * * * * * * * * ** 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 Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip 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. 64.1114, aft& Owner or Agent The foregping instrument was acknowledged before me this of NOd , 20 0 -, by 1I c'.iern AKIRAL St611 , who is personally known to me or who has produced El- t As identification and who did take an oath. I% NOTARY PUBLIC: Signa Sign: Print: The foregoin day of 0:41 /.' who i Contractor instrument was acknowledged befor- me thi ,20 9a, by to me or who has produced as identificati PUBLIC: 0 �. ,4pqY Pt% i BRANDON MANASA ='_� �'� °'s Notary Public - State of Florida r. �, My Comm. Expires Apr 17, 2015 .�F ;; • 85048 .F.et�j,.iNa • Notary Public State of Florida Desiree Ramos My Commission 00877402 Expires 04/05/2013 My Commission Expires: My Commission Expires: 04 tc (2013 ***************************** *****+ x**************** ** ****lic**+x****+x**** *************** **** *+x **** ******+x*+x**** APPROVED BY Plans Examiner Structural Review (Revised 32/ 1241 evi 07110 /07)(Revised 06 /10/2009)(Revised 3/15/09) Zoning Clerk State of California County of Sfin. OTE ACKNOWLEDGMENT On ocTu3E2. 23, zo rz before me, aeo/En...r owl Ngauc y - moTnity rate r . (insert name and title of the officer) personally appeared SWAniNVN c...e.re..4.1 PEL . who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is /are subscribed to the within instrument and acknowledged to me that he /she /they executed the same in his /her /their authorized capacity(ies), and that by his /her /their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature -4`-,r (Seal) ROBERT OWEN HARVEY Commission # 1968299 Notary Public - California San Diego County Comm. Expires Feb 2, 2016 Deb as T` ,1`ti Tit e: Vice President ` a perao i to be the person who she exec: d the eine or the entity City upon foregoz mess my OF P e Y und of California t the Pursuant to by and arno Mutual- Secu Agreements. EXHIBIT A Servicing Agreements belt A z *' auk, N.A., as successor is interest Mortgage Company,: as Se. r, and Lang Beach. LONG BEACH MORTGAGE LOAN TRUST 2002 -5 November 1, LONG BEACH MORTGAGE LOT TRUST 2003 -1 February I, 2003 LONG BEACH MORTGAGE LOAN TRUST 2003-2 April 1, 2003 LONG BEACH MORTGAGE LOAN TRUST 2003 -3 Junel, 2003 LONG 13EACH :MORGAGE LOAN TRUST 2003 -4 July 1, 2003 LONG BEACH MORTGAGE LOAN TRUST 2004-1 February 1, 2004° LONG BEACH MORTGAGE LOAN TRUST 2004-2 May 1, 2004 LONG BEACH MORTGAGE LOAN TRUST 2004 -3 June I, 2004 LONG BEACH MORTGAGE LOAN TRUST 2004 -5 August , 2004 LONG B ;CH'MORTGAGE LOAN TRUST 2004 -4 September 1, 2004 LONG BEACH,M ORTGAGE LOAN TRUST 2004 -6 October 1, 2004 LONG BEACH MORTGAGE LOAN TRUST 2005 -1 January 1, 2005 LONG BEACH MORTGAGE LOAN TRUST 2005-2 April 1, 2005 LONG BEACH MORTGAGE LOAN TRUST 2005 -WL1 July 1, 20+5. LONG B ACH: MORTGAGE LOAN TRUST 2005 -i L2 August 1, 2005 LONG BEACH MORTGAGE LOAN TRUST 2005-3 September 1, 2005` LONG BEACH 1 MORTGAGE LOAN TRUST 2005 ' ;3 Nov bcr 1, 2005 LONG BEACH MORTGAGE LOAN TRUST 2006- L2: Jan < 1, 2006 LONG BEACH MORTGAGE LOAN TRUST 2006 -WL3 3anu , 20 LONG BEACH MORTGAGE LOAN TRUST 2406 -WLI January 1, 2006 LONG BEACH: MORTGAGE LOAN TRUST 2006 -1 Feb ' I, 2006 LONG BEACH MORTGAGE LOAN TRUST 2006 -2 Marini 1, 2006 LONG 'BEACH MORTGAGE LOAN TRUST 2006 -3 Apr111, 2006 LOFSJG BEACH! MORTGAGE LOAN TRUST 2006 -A May I, 2006 LONG BEACH MORTGAGE LOAN TRUST 2006 -4 May 1, 2006 LONG BEACH MORTGAGE LOAN TRUST 2006 -5 J 1, 2006 LONG B EACH MORTGAGE LOAN TRUST 2006 -6 July 1, 2006 LONG BEACH MORTGAGE LOAN TRUST 2006 -7 August 1, 2006 .ONG. BEACH MORTGAGE LOAN TRUST. 2006-g September 1, 2006 LONG BEACH MORTGAGE LOAN TRUST 2006-9 October 1, 2006 LONG BEACH MORTGAGE LOAN TRUST 2006 -10 November 1, 2006 LONG BEACH MORTGAGE LOAN TRUST 2006-11 December 1:, 2006 E Egan t 7 fit. , : C 9270 Chit # the c A � � is amo T . 0rmei #n C r a ; moo C N.A Nom. sxed, t� ` A : fl e e t :; ...... 1 , 201 tree FA : d shin n. .. . ; . S riles com, hereby ad "th t the T ?s tt and : mil. -ix Tre s PIS d for the T by rthe1 � hc ruste r el y and p is fit" any : of the mo . : s da of " 'ra sa" ctively) and o notes s acting as Txustee . #r vet# POWER 1 ebelceet; l which C e Note tment shall or in the Agreement shal 1. The modification c modification or re- recording is so or Deed of Trust to corer trcet tleors discovered aid aodiiction or re -recd the hen o" e or of T to the provisions Q t Age= The subordination of tract lie. of a Mortgage or Deed of Trust to an easemea favor of a public utility company of government agency eminent domain; this section shall include, without limitation, partial satisfactions/releases, partial reconveyauces or the elution or rues to trtistees to accomplish same, veyance ofthe properties to t mortgage' yL Pert! to be acquired as real estate owned, or cox completion of loan assumption agreetnen upo n pa and discharge ol limitation, cancellation,ofthe r e clom eyance of title o y Mortgage or D of Trust epurchase of tae Mort' St Mortgage 'ote, loan secured and evidenced a Mortgage or Deed of Trust upon.paynre by in con unction r the refitment ortgage Note of of and preservati i Deeds of Trust, and including but not hmt ted to, foreclosure, 1 foreclosure„ or the coanxpletiou of jud%cial or.nonjug termination, eanccllation or rescission of any such formcl osecution and completion of eviction actions or proceedings ings respect to, or on, cancellation or rescission of any such eviction actions or proceedings, and the purmit of title insurance, hazard insurance and clams in bankruptcy proceedings, ineluding; r ithout lintitatior , any and all ofthe following acts: in the Mortgage by way of, Seta of or the itiatier. er a: Deed of Trust, rtcct tiro the preparation and issuance of statements of breach or rid filing of notices of `default and/or notices o of notices of effult and/or notices the cane e. the taking of deed in lieu of foreclosure-, 10. the T ru prosecutiort,and defense y cases of on and service ofnoti+ at4, prosecute and e d.df u Elvis; t other: cp may i s Fac€ full pater : and < : s to and evicry t e y or idea thi y does 4, 2012. a ed as heri is flO we of attorney. city to t Aeem Bau Natii to delegate its h :car obligati a delegate the antharfty given to it hY >b ie ,under this Limited Power of Attorney, for purposes . r obligations by emu g additional h. ` veers of attorney in favor of its attorneys -in -fact as are necessary for such pulp° greater authority than that held by the Servicer. No ng coma ned. herein trustee e Agr Trustee under the Agreeme defend any suit, litigation or The Servicer's attorneys - n-fact sib ve vided to the ri htts protections afforded the itiatet or e of Deutsche. Bail. National Trust Company except as specifically provided for :herein. Tfthe -Sery cer receives any no tice :of t; litigation tax proceeding in the name of Deutsche Bank National Trust Company, then the ur r r .sue promptly forward a. copy ofsaxne to the Trustee. is not intended to extend the powe take any action with to Agreement by agrees Fold the Trustee any an .. . Servi s l or in - fast, of the powers granted to i Lion of this Limited Power of Atte to Trustee under the Agreement . rn or of any d or ader. The foregoing indemnity ey and the Agreement or the earlier td shall be governed by the 1 t law principles of such state. of t ac notice ". aTi y rely upon the ex ercise. of the power granted tinder this of Attorney; and may be satisfied that this Ural Power of Attorney shall force and effect and his not been revoked unless aai °instrument of revo±tion has wdting by the undersigned. FOUND 1/2" IRON PIPE (NO ID.) 5'WALIC N.E. 93RD STREET (75' R/W) • .„.• 1V:r2)AVEb). • WOOD - FENCE LOT 6 BLOCK 23 FOUND 1/2" IRON ROD (NO ID.) 15' R/W (PLAT) . 4 ,•• '.18.5' 105.06 35.9' r V/ 24'01;s' CONC., , DECK ' 15 •-4.14 119' 0\ filtYk 18S RY RESIDENCE :,;',111111 3 • P.C. FOUND 1/2" IRON PIPE (NO ID,) (0.04'N, 0.02'W) P.I. FOUND DRILL HOLE (0,34'N) P.T. FOUND 1/2" IRON ROD (NO ID.) 40.00' rioye vq�. 30Yatle. aoolf5 . LOT 1 BLOCK 23 POOL 35.9' C.B.S. WALL (FENCE ON TOP) WOOD FENCE 43.0' •5' r't CONC. • DRIVE • ."'•• .,•• 51.1' ,„•„., 02.X2' 1:]3'X4' 02.5'X2.5' P.E. NC CONC. II I N89°51'06"W 130.00' 4.5 CI? LOT 3 BLOCK 23 C 1RVE TABLE APPROVED ZONING DEPT BLDG DEPT ‘711 SUBJECT TO COMPLIANCE WITH ALL FEDERAL STATE AND C UNTY RULES AND RFGUIATinms LATE 43.0' LOT 2 BLOCK 23 • 46-40' 0 FOUND 1/2" IRON ROD (NO ID.) RADIUS DELTA ANGLE 89'51'06" ARC LENGTH 39.20' S00 °0000 E (8.R.) CHORD BEARING S44'55'52"E 35.31' /7/19Z. ,e E• CERTIFIED TO: East Coast Affiliates, LLC - PROPERTY ADDRESS: 9230 NE 2nd Ave., Miami Shores, FL t- FLOOD ZONE: X (FIRM 120652 - 0302L 9/11/2009). DESCRIPTION: Lots 1, and 2, Block an Amended Plat of fvfiami Shores Section No. it, according to the PlatAT n Plat .Book 10, Page 70, of the Public Records ‘..lof Miami-Dade Cott ' F o a. SURVEY NOTES: `.5 1.) Area = 0.319 acre 2.) Lands shown hereo instruments of rec 3.) No underground i 3 4.) All bearings and 5.) This firm's "Ce' 3138 LEGEND: eon ar office for easements, right-of-ways, or other t and measured unless otherwise noted. •zatio number is 1.B.#6838". REVISIONS: BOUNDARY SURVEY This survey is invalid without embossed surveyor's seal and/or an authenticated electronic signature and authenticated electronic, seat RegistepdLand Surveyor, Florida Certificate No. ./f-MICHAEL J. MILLER #4034 CALC. C.B.S. CONC. MON.= CONC. D.E. U.E. P.E F,F.EL. EL. (1' 1'.) (0) (M) CALCULATED CONCRETE BLOCK STRUCTURE CONCRETE MONUMENT CONCRETE DRAINAGE EASEMENT UTILITY EASEMENT POOL EQUIPMENT FIFI/SHED FLOOR ELEVATION ELEVATION BEARING REFERENCE DEED MEASURED (P) A CH.B. • = N.G.V.D. O.R.B. P.R. P.C. = P.T. = P.R.C. P.C.C. PLAT RADIUS CENTRAL "DELTA" ANGLE ARC LENGTH CHORD BEARING NATIONAL GEODETIC VERTICAL DATUM OFFICIAL RECORD BOOK PLAT BOOK POINT OF CURVATURE POINT OF TANGENCY POINT OF REVERSE CURVATURE POINT OF COMPOUND CURVATURE P = POINT OF INTERSECTION P.O.C. POINT OF COMMENCEMENT P.O.B. = POINT OF BEGINNING RAN = RIGHT OF WAY y — = CHAIN LIFIK FENCE - WOOD FENCE o o METAL FENCE CEFITERLINE EASEMENT COVER OVERHEAD LINES LOT TIE ASPHALT PAVEMENT CONCRETE PLATVVORK PAVER BRICK PLATWORK WOOD POWER POLE WATER my, ER FIRE HYDRANT CATCH BASIN SANITARY MANHOLE SCALE: 1" 30' DRAWN BY: PICARD FIELD WK: M.M. 1 B.M. DATE: 10/08/2012 MILLER LAND SURVEYING 1121 LAKE AVENUE LAKE WORTH, FLORIDA 33460 PHONE: (561) 586-2669 - FAX: (561) 582-0151 www.millersurveying.com e-mail: millersurveying@aol.com REFERENCES: 877/29 PREV. JOB NO'S. JOB NO. Y120872 - 46,303 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 DEMO- l2-2_1(,20 Inspection Number: INSP- 182829 Permit Number: DEMO -12 -12 -2299 Scheduled Inspection Date: December 12, 2012 Inspector: Devaney, Michael Owner: Job Address: 9230 NE 2 Avenue Miami Shores, FL 33138 -2805 Project: <NONE> Contractor: AMERICAN POWER ELECTRIC CORP Permit Type: Demolition Inspection Type: Final Work Classification: Electric Phone Number Parcel Number 1132060133050 Phone: (305)216 -7491 Building Department Comments REMOVE WIRES AND J -BOXES 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 December 11, 2012 For Inspections please call: (305)762 -4949 Page 36 of 41 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: Electrical JOB ADDRESS: f c3D /\\) c7T*1 City: Miami Shores County: Folio/Parcel #: '� \ 32-0 ,,,,,,-c-z___27-z--- D i v ( : : : : C 0 w 2012 j j 11: BY _ Master Permit No. 0 �- I I - 12 —21(00 Miami Dade Zip: Is the Building Historically Designated: Yes NO Flood Zone: (Fee S. 1e Titlehol ) Tenant/Lessee Name: Email: e. 5NI 0 t— Phone#: r6 State: C CONTRACTOR: Company Name: Address: City: Zip: / 21 2 - Phone#: ?)M7Lhone#: d Vif -- State: Zip: 3t® Qualifier Name: 72.Y? �'✓) Phone#: 2r 6-77`7 State Certification or Registration #: ____� /3�t3/®i� Certificate of Competency #: Contact Phone#: o '�%l _ 7y 9 J Email A. +� ess: Cte� /Pe /-~/ e - DESIGNER: Architect/Engineer: Phone#: (J0 Value of Work for this Permit: $ 50u, Square/Linear Footage of Work: Type of Work: OAddre OAlteration ONew URepair/Replace Description of Work: ��. CaP h0�-e� ODemolition ***************************************F ***** ********* *** * **** ** * ****** **** *mix ****** Submittal Fee $ Permit Fee $ / ®'6> ' 4® CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ / TOTAL FEE NOW DUE $ 10 & l/0 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 Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me t 's day of , 20 _, by day of O , 20 e!.-by who is personally known to me or who has produced who ' . - _ a m . o' II $ me or who has produced As identification and who did take an oath. as identificati . n .111 SO , NOTARY PUBLIC: NOTARY PUBLI Sign: Sign: Print: Print: 67 2 P My Commission Expires: gel- 4ter OSCAR PEREZ = MY COMMISSION 8 DD 928715 EXPIRES: October 4, 2013 "�'i,, . Bonded Thru Notny Pubftc Underwriters My Commission Expires: ******************* ************ ***: i<*********= t:> r•**** *** *>k*** ** ********* *** * * ** * * ******** ** *+> * *** **** *** * **** lZ APPROVED BY -fiz 6---4;2"PG Plans Examiner Zoning Structural Review (Revised 3 /12/2012)(Revised 07 /10107)(Revised 06/10/2009)(Revised 3/15/09) Clerk Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 `DE O - 12 21 too Inspection Number: INSP- 182476 Permit Number: DEMO -12 -12 -2298 Scheduled Inspection Date: December 10, 2012 Inspector: Hernandez, Rafael Owner: Job Address: 9230 NE 2 Avenue Miami Shores, FL 33138 -2805 Project: <NONE> Contractor: METROPOLITAN PLUMBING INC Permit Type: Demolition Inspection Type: Final Work Classification: Plumbing Phone Number Parcel Number 1132060133050 Building Department Comments CAP OFF EXISTING WATER PIPES 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 / December 07, 2012 For Inspections please call: (305)762 -4949 Page 20 of 41 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: 99 0 2j\ ► 1 U� City: Miami Shores County: Folio/Parcel #: FBC 2 PVC/ Permit No. G ` Master Permit No. Demo -- (I - c -2 i60 Y i.7C, 0 2012 as_ Miami Dade Is the Building Historically Designated: Yes Tenant/Lessee Name: Email: JAS NO Flood Zone: tl eld 1 er): ' t ��i ' .1 �' it a it , Phone#: State: C-ik gz12-- Phone#: CONTRACTOR: Company Name: ®v Address: �,1 0 QC 1 5 City: i�.C),\( . 0,V\ State: `. Qualifier Name: NV `■.)2\ C-n�. Q vt\ State Certification or Registration #: Contact Phone# :. ..YS°g -a" -yao Ema Address: DESIGNER: Architect/Engineer: Phone#:339g Do Zip: X010 Phone#: •7 2-Q-1.00 Certificate of Competency #: Phone#: Value of Work for this Permit $ 6 00. 00 Square/Linear Footage of Work: Type of Work: DAddress DAlter tion UNlew ClRepair/Replace Description of Work; I \ - & DDemolition ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Perm ft Fee $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ 1 O& ( TOTAL FEE NOW DUE $ aO w Bondta Company's Name (if applicable) lionding 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 CONDMONERS, 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 Signature SW! III Talk Iiimmmt Owner or Agent -, acr The foregoing instrument was acknowledged before me this The foregoing instrum: t was acknowledged before me this day of , 20 , by , day of _, 20Q; by cgL'\ GV }_Q rd, cllj who is personally known to me or who has produced who is ersonally known to a or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: S Print: My Commission Expires: Print:' k® c `G�,.�`'� „«,, ;•�, j. ito MMISSION#EE 117934 My Commission Expi ^�. R./ �; EXPIRES: AUG. 01, 2015 wwW.AARONNOTARY.com ***** **** **** ********* ******* *********************************************** * *** *** * *** ** *** ***** ****** **** APPROVED BY C a2 si Plans Examiner Zoning Structural Review Clerk (Revised3 /12r2012)(Revised 07110/07)(Revised 06/10 /2009)(Revised 3/15/09) METRO -1 OP ID: MG A. .- CERTIFICATE OF LIABILITY INSURANCE �' 112 ' 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 305- 223 -2533 !Sure Insurance Brokers 2700 SW 137 AVE 305 - 220 -0765 Miami, FL 33175 Javier A. Fernandez coNracI E' N • . Ext): ice, No): L AIL INSURER(S) AFFORDING COVERAGE NAIC 0 INSURER A: Scottsdale Ins. 41297 INSURED Metropolitan Plumbing, Inc. 1020E 14 St Hialeah, FL 33010 INSURER a : Bridyefleid Casualty ills. Co. 10335 INSURER c 03131/13 INSURER D : $ 1,000,000 INSURER E : $ 50,000 INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POUCIES 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. UMITS SHOWN MAY HAVE BEEN REpDUUCCYED BY PAID CLAIMS. RR TYPE OF INSURANCE INNSSRL SUBR POLICY NUMBER (MMJDD1YYYY) (MEAD 1YY)fY) UMITS A GENERAL X UABIUTY COMMERCIAL GENERAL LIABILITY CP $1561878 03/31/12 03131/13 EACH OCCURRENCE $ 1,000,000 DA IM sEs (Ea occur) $ 50,000 CLAIMS -MADE X OCCUR MED EXP Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE POLICY X LIMIT APPLIES Er, PER LOC PRODUCTS - COMP /OP AGG $ 1,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED I— At ITDS HIRED AUTOS SCHEDULED At ITaS NON-OWNED OS COMBINED SINGLE UMIT (Ea accident) BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ R ((Per a DAMAGE $ $ UMBRELLA UAB EXCESS UAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENT ON $ $ WORKERS COMPENSATION AND EMPLOYERS' UABIUTY AND ANY PROPRIETORIPARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y 1 N N 1 A 830-23430 05/07/12 05/077/13 X STATU- TWC ORY LIMITS OTH- - °R E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLIGY UMIT $ 1,000,000 DESCRIPTION OF OKRATIONS 1 LOCATION 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) plumbing residential & commercial CERTIFICATE HOLDER CANCELLATIO I MIAMI S Miami Shores Village Building Department 10050 NE 2 Ave. Miami Shores, FL 33138 -2304 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POUCY PROVISIONS. AUTHORIZED REPRESENTATIVE hi� erg ACORD 25 (2010/05) 01988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ' • : • - • • - DATE • • . . . " .:; .1: • 1.7 60'1.- • i. .31T. • e•41S.:ite•:::".. el . • ‘4t - ..bltPAY AS FOJIWYB: • ‘0) FSC SEMI:Busses PRINTED WM Pass.51341116110M City of Hialeah Business Tax Receipt ENFVUIMENDIXMENTAUXINKS "sw;11:". Mayor Carlos Hernandez - - ' , No 21182210,421 . (OLD-1711-981) . Mnount$ 150.00. 2012-13 .. : `,"..__ . ,.. : , ,... . • , , - .. .. . „. . .. „ The veioip..,,_ firm •ot.ttlp,••• ,:1..t.4-80$ottas paid the business tax tequiteti to engage in ot.00efai...tho*i*s voi.fistilitoot td the:1 ' • ' • * :ofthe:city of:Hialeall,, owner: , -M1GUE1. 61J1::;.; , .. . 44i4--.i.r.isi :...Heatang-, and ,Air-Concitic9414 Contractors ,.. ':.. ., : .....: •:: ....• , ;. . •••.: : . ,• : • ' ,'• ::. ...:*:::-.- • . . .• ' • • • . - •. ..• . SL NOT A BILL • ires :Sept*mber 30 2013 • • • • • • • THIS IS NOT A BILL.— DO NOT PAY 398677-6 RENEWAL 416043-4 BUTERNIMIKUMBI NO INC STATirM7152 1020 E 14 ST 33010 HIALEAH • "NrROPOLITAN PLUMBING INC secire Illintfrfile CONTRACTOR TM IS ONLY A LOCAL BUSINESS TAX RECEIPT. IT DOSS NOT Mau THE HOLD TO VIOLATE ANY MEM REGULATORY OR MENG LAWS OF THE COWRY OR MIS. NOR DOES IT EXEMPT THE 'HOLDER FROM ANY OTHER PERMIT OR MEM REQUIRED BY LAW. THIS IS NOT A CERIVICATION OF THE HOLDER'S CAIALIRCA- TIOM • WORKER/S 5 DO NOT FORWARD METROPOLITAN PLUMBING INC MIGUEL OUIARDINU PRES 1020 E 14 ST UT Al CAU Ct 27tr1 n