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RC-12-1917Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 179894 Permit Number: RC -10 -12 -1917 Scheduled Inspection Date: June 07, 2013 Inspector: Rodriguez, Jorge Owner: ORTIZ, DESIREE Job Address: 9210 NE 2 Avenue Miami Shores, FL 33138- Project: <NONE> Contractor: WIKI CONTRACTORS CORP Permit Type: Residential Construction Inspection Type: Final Work Classification: Addition /Alteration Phone Number (786)543 -6707 Parcel Number 1132060133080 Phone: (786)399 -0886 Building Department Comments REMODEL OF THREE BATHROOM. TWO IN SECOND FLOOR AND ONE ON FIRST FLOOR Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. June 07, 2013 For Inspections please call: (305)762-4949 Page 5 of 24 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: o JOB ADDRESS: ICR2 ® City: `Miami Shores County: Folio/Parcel #: \ 2 OS 0(3 3 'SO FBC 206� �01,� Permit No. e- Master Permit No. ROOFING Miami Dade Zip: 33 (3 i Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): ditto 2 6 A �v (- &IT / C- Phone#: 3.� ) e� 53 Address: ,t Z% 0 1J v- 7 & u _ 1 /� City: .( ,A '(AD State: C� L9$Zv- Zip: g�' . O Tenant/Lessee Name: Phone #: Email: s. CONTRACTOR: Company Name: UJ (, 1 L . ' 1' '3, ,s- Phone #: 1, % 3991° Address: `�g(D S OJ S T City: L cklA -t; — Stater 5CQ r Vii# zip: 33 ( 4S Qualifier Name: g (kGT- Q -/t( State Certification or Registration #C 1 C ( 1 665 Certificate of Competency #: Phone #: Contact Phone#: Email Address: DESIGNER: Architect/Engineer: Phone #: l� add Value of Work for this Permit: $ ; "v1 __ Square/Linear Footage of Work: Type of Work: DAddi • . n DAlteration New DRe . air/Replace ODemolitio Description pf Work . 3 A . e _ 4- Color thru tile: ** * * * * * ** x*+ x** **** ************** ******* Fees*******+ x**+ x**+ x******** **************+x******* 1 Submittal Fee $ Permit Fee $ aCCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ No • Training/Education Fee $ Technology Fee $ 80 Structural Review $ TOTAL FEE NOW DUE $ / 12. ti 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 commencem ust be posted at the job site ce of sucjj posted notice, the for the first inspection which occurs seven (7) days after the building permit is issued. In the inspection will not be approved and a reinsp ' tion fee will be charged. Signature Signature Owner or Agent The foregoing ins s ment was acknowledged before me this The foregoing ' s i s ent was ac ." owledged before me this day of (� , 20® , by ie n /e ti b , day of 7C� , 20 „by 55 .hasi de �� ��O. who is personally known to me or who has produced who is personally known to me or who has produced F-4 '° As idp =.'fication and who did take an oath. 614 L/ as identification . who did take an oath. Contr: ctor NOTARY PUBLIC. 1` Commission .,ll DD968088 PUBLIC-STATE OF FLORIDA My Co � �'ssion Expire a`: II* � My Commission E� <^s 1;EDrR ar rtc I Gi' ., . f = ',• Commissiooni #DD 68088 fill l.- C ik. „,.. ` ". "Moires: MAR. 14 2014,:;'..:.,,. NOTARY P 1 LIC: APPROVED BY Zoning Structural Review Clerk (Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) J. ha 1- i7 ?3 OF =TO9: EX71 ES 3E. VI 2213 -rte AT ti:21 _ 682093 -1 BUSINESS NAME l LOCATION WIKI CONTRACTORS CORP -- 3690 SW AA ST 33145• MIAMI =:. • XKI CONTRACTORS CORP SQc o4 auslnes 196 GENERAI s ILDING CONTR*C- • MIS AS -ONLY • A LOCAL - • nu S1AX RECEIPT. IT DOES 'NOT PERMIT THE HOLOLR TO VIOLATE ANY EXISTRG REGULATORY OR - - ZONING LAWS OF THE• COUNTY OR CITES. NOR . DOES 11' EXEMPT ME HOLDER FROM ANY OTHER PmMIT OR LICENSE REWIRED BY LAW. MIS IS •NOT A cERTWICATION OF - THE 9OLOER'S 01jALUiCA- PATRON' RECEIVERY:... MAE -0AM COUNTYTAX anuaCTOR: 09/10/2012 09010524001 000045.00 .. "; SEE OTHER SIDE •TLASS iL% O�STAGE t FL PERMIT NO. 231 RENEWAL STAT * RECEIPT 709454 -3 19665 WORKER /$ =" OR 1 NOT FORWARD i±[IKI :CONTRACTORS CORP: SEBASTIAN TARALLOPRES `3690 SW- ':14 ST 6 141AMr, EL 33145 7 l:J1?Itilulflt, Its! lfttt t t1H11t /lI hIttfitfl *tltII1® or FLORI 4 - AC ; C 22 I 3 }[t+3 x DEPARTMENT OF BUSINESS AND 'PROFESSTOtti REGUIATTCN C 2519665 08/21/12 :120©03937 CERTIFIED GENERAL CONTRACTOR TARAT,LO,:- SE-BASTIAN WYKI :CONTRACTORS, CORP £ERTIFIED ur Cie r: the provfsiosa.bE;C1i:4S9 as srlrati4v. Kac G 3I. 2014 ffi12QS21O22If STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES a4 DIVISION OF WORKERS' COMPENSATION CONSTRUCTION INDUSTRY CERTIFICATE OF ELECTION TO HE IMINIMPT FROM FLORIDA WORKERS' COMPENSATION LAW • EFFECTRia OE /23/2011 EXPIRATION DATE: 05/22/2013 PERSON ...:ASTAN TARAL LO K'^' FEIN X5045E06347I85 ;BUSINESS NAME AND ADDRESS: WIKI CONTRAET.Ol29 -@ORP ..i.' - -' -3690 SW ::14Tt(:STREET 06 MIAMI ,`€1. - 3344.6 SCOPE OF BUSINESS =:OR TRADE I- CEIFFlF1E6 L CONTRACTOR._, z c t-, CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 09/26/12 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(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Florida Bankers Insurance 7278 SW 8 Street Miami, FL 33144 Phone (305)266 -6493 Fax (305)262 -0679 CONTACT MARTAALONSO NAME: FL ): (305)266-6493 NC, No): (305)262 -0679 ADDREESS: marta @flortdabankersInsurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: FEDERATED NATIONAL INSURANCE CO. N INSURED Wiki Contractors Corp 3690 SW 14 St # 6 Miami, FL 33145- (305) 970 -1520 INSURER B : 04/25/2012 INSURER C : EACH OCCURRENCE INSURER D PR PREM RENTED MI ESES S (Ea occurrence) INSURER E : n COMMERCIAL GENERAL LIABILITY INSURER F : MED EXP (Anyone person) COVERAGES CERTIFICATE NUMBER: 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.SUBR INSR WVD POUCY NUMBER POLICY EFF (MM/DD/YYYY) POUCY EXP (MM/DD/YYYY) LIMITS A GENERAL LIABILITY N N GL- 0504007464 -00 04/25/2012 04/25 /2013 EACH OCCURRENCE $ 1,000,000.00 PR PREM RENTED MI ESES S (Ea occurrence) $ 100,000.00 n COMMERCIAL GENERAL LIABILITY • • CLAIMS -MADE M . OCCUR MED EXP (Anyone person) $ 5,000.00 PERSONAL BADVINJURY $ 1,000,000.00 GENERAL AGGREGATE $ 2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: n POLICY II jEa • LOC PRODUCTS - COMP/OP AGG $ 2,000,000.00 $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ • ANY AUTO BODILY INJURY (Per person) $ • A OWNED ■ BEDULED SCHEDULED BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS • AUTOS • • PROPERTY DAMAGE (Per accident) $ $ UMBRELLA UM • OCCUR In EXCESS LIAR II CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ II DED • RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILI Y Y / N AND PROPRIETOR/PARTNER/EXECUTIVE N / A • WC STATU- OTH- TORY LIMITS • W- EL BACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) EL DISEASE - EA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERATIONS below EL DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE 10050 NE 2 AVE 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. AUTHORIZED REPRESENTATIVE ACORD 25 (2010 /05) QF © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NOTICE OF CO ENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO.) 1 1 I j TAX FOLIO NO. 11320%00 30410 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: 2. Descri•., on of i +.•vemel 3. Owner(s) name and add Interest in property: Name and address of fee simple titleholder: 4. Contractor's nanta, addressAnd phone number. 111111111II(NI1II1Il 11I111OIII11lIII1 CF= t+1 2011.2R0753074 OR Bk 25323 Ps 1957r Upsa RECORDED 110,x22/2012 13 :5423 HARVEY RUVIHe CLERK OF COURT MIAMI -DADE COUNTY? FLORIDA LAST PAGE Space - E -o Ali above reserved for use 92) 0 Y recording office o,- ClokUMACT1)/L, O 5. Surety: (Payment bond required by owner from contractor, if any) Name, address and phone number Amount of bond 6. Lender's name and address' 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, address and phone number 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, address and phone number. 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) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT iN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPENIY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Signature(s) of • ,,ls.) or Prepared B) Print Name,r Title /Office STATE OF FLORIDA COUNTY OF MIAMI -DADE The foregoing instrument wa By ❑ Individually, or ❑ as for Personally known, or DI 'produced the following type of Identifi Signature of Notary Public: Print Name: (SEAL) razed Officer/Director/Partner /Manager Prepared By Print Name Title /Office !Y' before me this day of a`- tom'', VERIPCATiON PURSUANT TO SECTION 92.525. FLORIDA STA S , , ; Commission #DDS 968088 Under penalties of perjury, 1 declare that I have read the foregoing and Expires: MAR. 14, 2014 that the facts stated In It are true, to the best of my knowledge and belief. Bo,,renBDTSRU ATLANTIC BONDINGC Signature(s) of Owner(s) or Owner(s)'s Authorized Officer /Director/Partner /Manager who signed above: By By 129,01.62 PAGE 3 3/10 STATE OF FLORIDA, COUNTY OF DADE original alt file in this ogice I HEREBY CERTIFY .that is f er' >ft; irui °a fii;F4 c,0 y of ft D 20 HARVEY RIPON, Clerk of Ciactilii bid CuTI.IByty Coti ie Deputy Clerk 55 THIS INSTRUMENT PREPARED BY STEVEN L. JONES, ESQ. 9999 NORTHEAST 2nd AVENUE MIAMI SHORES, FLORIDA 33138 FOLIO NO. 11- 3208 - 013 -3080 WARRANTY DEED THIS INDENTURE made and executed the 3 day of A.-..A Li "F 20 t Ziy AMSK, LLC, a Florida limited liability company existing under the laws of Florida and whose post office address is 19141 North Bay Road, Sunny Isles Beach, FL 33160, hereinafter called the grantor, to JUAN R. SUTIL and YAEL E. LANIADO, husband and wife, whose post office address is 9210 NE 2nd Avenue, Miami Shores, FL 33138, hereinafter called the grantee: WITNESSETH: That the grantor, for and in consideration of the sum of $10.00 and other valuable considerations, receipt whereof is hereby acknowledged, by these presents does grant, bargain, sell, alien, remise release, convey and confirm unto the grantee, ail that certain land situate in Miami -Dade County, Florida, viz: The South 1/2 of Lot 4 and all of Lot 5, Block 23, AMENDED PALT OF MIAMI SHORES SECTION NO. 1, according to the Plat thereof as recorded in Plat Book 10, Page 70, Public Records of Miami -Dade County, Florida. SUBJECT TO (1) land use designation, zoning restrictions, prohibitions and other requirements imposed by governmental authorites; (2) restrictions, easements and other matters apearing on the plat and/or common to the subdivision; (3) public utility easements of record which are located contiguous to the property lines; and (4) taxes for the year 2012 and subsequent years. TOGETHER with all the tenements hereditaments and appurtenances thereto belonging or in anywise appertaining, to have and to hold the same in fee simple forever. AND the grantor hereby covenants with said grantee that it is lawfully seized of said land in fee simple and that it has good right and lawful authority to sell and convey said land, and will fully warrant title to said land and defend the claims of all persons whomsoever. IN WITNESS WHEREOF the grantor has caused these presents to be executed in its name and its corporate seal to be hereunto affixed, by its proper officers thereunto duly authorized the day and year first above written. Signe Name: Name: le del' e r in • fi �4 `4 <• II „ iAiiii e STATE OF FLORIDA COUNTY OF MIAMI -DADE AMSK, LLC BY: „cc- t art1is” SABRINA SAIEJ4 Office: Executive Manager I HEREBY CERTIFY that on this day, before me, an officer duly authorized in the State and County aforesaid to take acknowledgments, personally appeared SABRINA SAIEH, as Executive Manager of AMSK, LLC, a Florida limited liability company, who is psrsonally known qr who produced as identification, and that she acknowledged executing the same in the presence of two subscribing witnesses freely and voluntarily under authority duly vested in her by said company and that the seal affixed thereto in the corporate seal of said company. WITNESS my hard and official seal in the County and State last aforesaid this day of ;_; , 20 My commission expires: STEVEN L. JONES i Notary Public • State of Florida w My Comm. Expires Dec 5, 2012 „oP,. Commission # DD 838578 Bonded Through National Notary Assn. Vie Vair 4 z5R 2-1°11-1 0, 34.1 011 SUBJECT TO COMPLIANCE WITH ALL FEDERAL TATE AND COUNTY RULES AND REGULATIONS isif-ez-zzor-4_ IMO Pa-0.,11 yeaglpil* w Tu P,1%) R 6 Lill L tik 41' 612t0 204 Ave 11 MAI 60.a, PL 33A38 GA ft Re Y‘Ace. E x‘s-c kci \-\owsf2- Tok Lel' v140 ;TY ciA-r ckoort its9314,Fers=iglellij&Poiitsw4Elockeitle AL' t DAME Crr'17,7" A farariVO Crt it?";47d7 I PfrC 000 2g A:c1/L*7 rc■A LU <-0 LAJ 1_0 QJ o :27 Qj 41) 0) (C4 Q.) CD J▪ L Q.3 Lr) 0 (13 30'2" pwiLy Room (f4) Cirti r A Ce KIT OE 0,0 circ4 5 L. 'v146 g ADD SMOKE/CARBON MONOXIDE DETECTORS ANY AND ALL CLOTH AND RUBBER INSULATED CONDUCTORS TO BE REPLACED. CM Ng AGE. .0800401, *RM. .2.491on ■10..1001s, 1.001.14. o r cit. et- Dpk1' . s ©t2lO (QE 2 f i t14;MA 560 rfjt 33133` St.o9w 1,1420 OA A; t\ltw 5mo kt 'be'tec -or w d rewire a CFI circ . wiHn 4Z Cd Ayer wire UL ADD SMOKE/CARBON MONOXIDE DETECTORS. ANY AND ALL CLOTH AND RUBBER INSULATED CONDUCTORS TO BE REPLACED. 1" Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 189572 Permit Number: EL -10 -12 -1920 Scheduled Inspection Date: April 18, 2013 Inspector: Devaney, Michael Owner: SUTIL, JUAN Job Address: 9210 NE 2 Avenue Miami Shores, FL 33138- Project: <NONE> Contractor: GLEISY ELECTRIC INC Permit Type: Electrical - Residential Inspection Type: Ro Work Classification:ition /Alteration //� d/1-- Phone Number (786)543 -6707 Parcel Number 1132060133080 Phone: (305) 970 -2796 Building Department Comments ELECTRICAL WORK FOR 3 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 REINSPECTION FOR INSP- 187873. CREATED AS REINSPECTION FOR INSP- 187460. CREATED AS REINSPECTION FOR INSP- 187334. lB G ay— 7/L 7)- ze2 April 17, 2013 For Inspections please call: (305)762 -4949 Page 30 of 34 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 No. 12- /2-^...e • Master Permit No! 2.--rt fl BUILDING PERMIT APPLICATION FBC 20 Permit Type: Electrical TE, ___`I OCT I ._ L:,_, OWNER: Name (Fee Simple Titleholder): 'D 0 ad-f—k L j �� L. Phone #: V 9 Address: 'q �2 `` k°,O'� ,, Yom+ E 2 *C"� g City: Al -4-'U - . State: V td tl. zip: ( 3 c3 Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: 60- 10 ►" ® A0 City: Miami Shores County: Folio/Parcel #: 132- C72, o `3c3 Miami Dade S'31 3 g Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: % 's ec-' '° , C °� C Phone #: 3‘) /?-4)--f-1:7-41‘ Address: iN Z l S L✓ 0-? City: Cre�itd' i3' State: F( Qualifier Name: State Certification or Registration #: Certificate of Competency #: Contact Phone #: 34) ¶7) °— q Email Address: 64 (& , p e 6 DESIGNER rchitect/Engineer: Phone#: Zip: 33(Y7 Phone#: 3J .5-- 9 ?-,-) "2 7 st e 7 Value of Work for this Permit: $ 1 Q+2.0 Square/Linear Footage of Work: Type of Work: OAddress Alteration �^ UNew ORepair/Replace ODemolition Description of Work: //� € wlP'<, C, r- 2J /4/ « / '7 ) 7/..// --1 e-✓ Submittal Fee $ Scanning Fee $ Notary $ s* * * * * * * * * * * * *** * * * * * * * * * ** Fees * *** * * * -4=* *a4 * 44 4. ** .x a 4. *** :**** ***i Permit Fee $ CF $ CO /CC $ Radon Fee $ DBPR $ Bond $ Training/Education Fee $ Technology Fee $ Structural Review $ TOTAL FEE NOW DUE $ 1 ► 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 Owner or Agent _ The foregoing i strument was acknowledged before me this '5 The foregoing i strument was acknowledged before me this / r S r day of 0 , 20 / y J V k 5 t� , day of ® , 20 / 6 cAtZ,a a(� Contractor who is personally known to me or who has produced who is personally known to me or who has produced As ide cation and who did take an oath. as identificatio ; d who did take an oath. NOTARY PUBLIC• Sign: Print: My Co NOTARY PUBLIC-STATE OF FLORIDA Tres: Maggi Bar Commission #Dt1968088 '•,,;,.1 Expires: MAR. 14, 2014 NOTARY ' UBLIC. Expires: NOTARY PUBLIC•STATE OP FLORIDA • Maggi Bar Corn #ssion #DD968088 >joxn xttxc ATT.A..-n BONDING A MAR. 14, 2014 APPROVED BY f 44-2,--C-7-- Plans Examiner Zoning Structural Review Clerk (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) 04 -09 -2012 JEFF ATWATER STATE OF FLORIDA CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 04/09/2012 EXPIRATION DATE: 04/09/2014 PERSON: CARDENTEY PEDRO J FEIN: 590705979 BUSINESS NAME AND ADDRESS: GLEISY ELECTRIC INC 8031 SW 197TH TER CUTLER BAY FL 33189 -2109 SCOPES OF BUSINESS OR TRADE: 1— ELECTRICAL/ ELECTRICIAN 2— CERTIFIED ELECTRICAL CONTRACTO IMPORTANT: Pursuant to Chapter 440. 05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election ander this section may not recover benefits or compensation ender 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 fisted 011 the notice of election to be exempt. Pursuant to Chapter 440.01511 3), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation it 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. QUESTIONS? (850) 413 -1809 DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01-11 Scan Log E -mail Sent Date: Monday, 2012 -10 -08 11:48 To: ASheets @ces- us.net,CByars @ces - us.net From: MiamiDowntown0190 @ces - us.net Subject: Message Attachments: image2012- 10- 08- 114807.pdf THIS f S Ell #_ -- 00 NOT PAY 435509 -5 RENEWAL BUSINESS NAME /LOCATION RECEIPTNQ: 454554 -8 GLEISY ELECTRIC INC STATE* EC0002401 8031 SW 197 TERR 33189 CUTLER BAY FIRST -CLASS U.B. POSTAGE PAID MIAMI, FL PERMIT NO. 231 OWNER GLEISY ELECTRIC INC: See. Type of Business 196 ELECTRICAL CONTRACTOR THIS IS ONLY A LOCAL • BUSINESS TAX NEOEIPT. tr. DOES NOT POSIT THE ROWER T4 VIOLATE EXISTING REGULATORY ZONING • LAWS OP 'ME COUNTY OR CITIES:. NOR DOES EXPLOIT. Pan MV W REQUIRED env LAW. THE 15 NOT A COMPICATION OP HOLDERS °UAL RM- now III MaacOUJNTYTAX COLLECTOR: -09/24/2012 02260041001 000045.00 SEE OTHER SIDE WORKERS /S DO NOT FORWARD GLEISY ELECTRIC INC ORLANDO P GARCIA PRES 8031 SW 197 TERR MIAMI FL 33189 111IJT 1Nl iIl llJilN Fl 111 61111111 IflIlllidINIIi1lt111l.il141 BATCH NUMBER r cO °? CERTIFICATE OF LIABILITY INSURANCE 1 to /lo/ 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 POUCIES 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 polh y(Ies) must be endorsed. If SUBROGATION 10 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 Rick Gibbs, P.A. Insurance Agency 1000 S. State Road 7 Plantation FL 33317 CT Joseph Delano NAme PIMIL Fin. (954)581 -7740 I 0 Not 1954) 504 --9975 ADDRIDgk joe @rickgibbspa.com AL B) AFFORDIX3COVERACX NAIL9 msummatailANKERS INSURANCE 33162 INSURED Gleisy Electric, Inc. +-- 8031 S.W. 197th Terrace • Miami FL 33189 POURER 6: mac: MUREX D: INSURER E: ROMER F: COVERAGES CERTIFICATE NUMBER.'OL1182600704 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY 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. AEXCEWEIR POi=NEMEER 010100 f1Y1 nvaR I.TR TYPE OF INSURANCE MURAL UABQITY X COMMERCIAL GENERA. LW&UTY I CLAIMS-MADE OCCUR �GENT. AGGREGATE UMIT APPLIES PER: % I POLICY 1-1 n LOC X X 09 0005330727 5 05 1/21/2012 1/21/2013 uMrrs EACH OCCURRENCE $ 1,000,000 PREMISES ma IMELVI ee). $ MED DcP (My ono Pin) PERSONAL &AO/ INJURY GENERAL AGGREGATE 100,000 $ 5,000 $ 1,000,000 $ 2,000,000 PRODUCTS - COMPAQ AGG $ 1,000,000 $ AUTOMOMAE INABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS 0OMEINED SING OMIT BODILY INJURY (Per person) 0 $ BODILY INJURY (Per act/Mord) PROPERTY DAMAGE EA H S $ $ UNXRELLA EXCESS LM CLAIMS-MADE DED I I RETENTONt; OCCURRENCE AGGREGATE $ $ 1 IMMIX COMPENSATION ���ri g as h NH) EXCLUDED? OD PTI under OF NIA I�UAM sI I E°1t"`R ELL EACH ACCIDENT E.L DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLCY LIMIT S DESCRNMON OF OPERATIONS / LOCA1WIS / VEHICLES (Attach ACORD 101, AthRionad Remarks Schedule, ff more space It ►armed) CERTIFICATE HOLDER CANCELLATION Miami Shores bldg department 10050 NE 2dn Ave Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BED THE EVPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE PODGY PROVISIONS. AEITNORQED REPRESENTAVVE Rick Gibbs /CARJAR ACORD 25 (2010105) INS025 nmrrrn m ®19811-2010 ACORD CORPORATION. AU rights reserved. rota A .f1Rn sworn* And Ines mo ranieb ra el mark sd Amon Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 179929 Permit Number: PL -10 -12 -1919 Scheduled Inspection Date: March 14, 2013 Inspector: Hernandez, Rafael Owner: SUTIL, JUAN Job Address: 9210 NE 2 Avenue Miami Shores, FL 33138- Project: <NONE> Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number (786)543 -6707 Parcel Number 1132060133080 Contractor: EDDIE ROJAS PLUMBING INC Phone: 305 -944 -6788 Building Department Comments INSTALL 3 SHOWER PAN NEW TUB AND REPLACE 3 W/C AND ADD 3 HAND SINK Infractio Passed Comments INSPECTOR COMMENTS Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comme False March 13, 2013 For Inspections please call: (305)762 -4949 Page 5 of 37 Miami Shores Village Buildin g De partment oc T 1 5 ii12 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 7624949 BUILDING PERMIT APPLICATION FBC 20 Permit Type: PLUMBING Permit No. P1 )2 Ictn Master Permit WOK/ 12.161n OWNER: Name (Fee Simple Titleholder); ® � �� .� t i 1 Phone#: Address. 2■O J State: city: Tenalit/i essee Name: . n Pha Email: • zip: 3 131g JOB ADDRESS: City: Miami Shores County: Folio/Parcel #: 1 , 2 8. 013 30 I O- Miami Dade Zip: 3 3 Is the Building 1 istoricxxlly Desigiaated: Yes NO Flood one CONTRACTOR:-Company Name: 10.4 , 4 one #: Address. * cc- 0 IU 1 t t • 7_ City: State: Pt= --Zip: 3 WW Qualifier Name C WOO ' 0 f2 5' . . Phone #: 3,t2). 9`l y State Certification `tsr'Itegistration "#: Cate Ott rop tency'# Contact Phone#: 305- gyti f 7 ." Email Address: ecs DESIGNER: Archi ngineer: ' Phone#: Value of Work for this Permit: $ 1 i? P yes'"' o Square/Linear Foo a of Work: Type of Work: OAddressAlteration ONew epair/Replace. ODemolition Description of Work: �%r ST-4 /1 3 -show p%N AJu ' ,******** ** ******0154** *+k+Mtk #**Ml7 ************, 44 ** ** * * * * *** ******** ******* *** Submittal Fee $ Permit Fee $ /37 CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ J a ° Structural Review $ TOTAL FEE NOW DUE $ WC) 110 4 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 commence nt must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In t sencd such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature Owner or Agent Con The foregoing instrument was acknowledged before me thi The foregoing ' strument was acknowledg: • before me this Z- day of I2 �I�Pmi e ° thi day of ®e 201..; b 20 �,,, by _ y ,:. � by who is personally known to or who has produced who is personally known to me or who has prodice4 As identification and who did take an oath. as identificatio d who did take an oath. NOTARY PUBLIC• NOTARY PUBLIC: Sign: My Co sion Expires: A Maggl Bar Commission # DD968088 a Expires: MAR. 14, 2014 My Co e ssion Expi Ya au..,, PUBUC4TATE OF FL RRJA Maggj Bar f y; ,. Conuflission #DD968088 • BONDED Tall ATLANTIC BOND1 G ea, INC. 9,,,,,,,•` Expires: MAR. 14, 2014 * * * * * * * * * ** * * * * * * * * * * * * ** ** *+ ********** * * #+ MAC +R*** *** ****** ***** ** * **** *1 *** **114* *MMairilsOMERSOUNNi ** APPROVED BY /-- /7-- Plans Examiner (Revised 07 /10/07)(Revised 06 /10/2009)(Revised 3/15/09) Zoning Structural Review Clerk ACC Rn CERTIFICATE OF LIABILITY INSURANCE DATE (i/1fYYY) 09/27/12 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.. WANED, subject to does not confer rights to the certificate hoiden in lieu of such endorsement( IMPORTANT: If the certificate holder la an ADDITIONAL INSURED, the policy(es) must be endorsed, If SUBROGATION I8 the terms and conditions of the pol icy, certain petioles may require an endorsement. A statement on this certificate s). PRODUCER Accurate 8300 West Fiagler Suite 114 Miami, FL 33144 I Phone (305)228-8727 INSURED 'Edward Rojas Plumbing Corp 880 NE 111 St Biscayne Park, FL 33161- Fax (305)228 -8767 COVERAGES CERTIFICATE NUMBER: I NAME: AcT Lucia Estrella I I Extt (305)226 -8727 L ' (tdl: No): (305)226-8767 ADDRESS. INSURERS) AFFORDING COVERAGE IINSURER A : ACtxdent insolence Co. BARER S : iINSURER C : INSURER D: NAIL # INSURER E : 1 INSURERF: nu ranrsFV• 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 BE EN REDUCED BY PAID CLAIMS. SALIM A TYPE OF INSURANCE AO POLICY NUMBER 012487857 POLICY EFF L,.u.,, tak/ 08106/2012 • . . EXP I...�.L._.mAA, / 08106/2013 LIMITS GENERAL. LIABILITY COMMERCIAL GENERAL LIABB nY ❑ ❑ CIA MADE -ki OCCUR ❑ EACH OCCURRENCE $ 500,000.00 , p ISES occurrence) S 100,000.00 $ 5,000.00 $ 100,000.00 MED EXP (Any on e pe son) PERSONAL s ADV NdJURY ❑ — — GENERAL AGGREGATE $ 500,000.00 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG s 500,000.00 k POLICY 1 JECOT 0 LOC $ AUTOMOBILE UABILTY ❑ ANY AUTO ❑ AUTOS OWNED ❑ A$CCTOEDULE0 0 HIRED AUTOS 0 AU 'OS ED li f�OMBIN SINGLE LIMIT [BODILY INJURY (Per pet) $ BODILY INJURY (Pe accident SS P�tj G)PER: AGE ��� $ ❑ UMBRELLA UM 0 OCCUR ❑ EXCESS MB t_.1 CLMMS_MADE N / A EACH OCCURRENCE $ AGGREGATE El DED ❑ RETENTION$ 1 $ WORKERS COMPENSATION AND EMPLOYERS' UABILITY Y/ N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? WC STATU OTH- ❑ TORY LIFTS ❑ ER E L EACH ACCIDENT (Mandatory M NH) ( If describe EL DISEASE - EA EMPLOYER $ yes under DESCRIPTION OF OPERATIONS b ide E DISEASE - POLICY OMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (AIlach ACORD 101, Additlottal Remarks Schedule, Elmore space is required) Certificate holder is listed as additional name insured. nrsrr.n 4 TV. 11 Me. w..a N Miami Shores Village 10050 NE 2nd Ave Miami Shores, FL 33138 acunaleoo@yahoo.com 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 Lucia Estrella ACORD 25 (2010105) QF CORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD UOCU € S tt uuL ; /:. A. INU isY,'3ev'ui Lk l- - iiL 4sL. ° LIP t u A aik.. er.37,1 AT BATCH irm MBE THIS IS NOT A BILL — DO NOT PAY 517565 -8 BUSINESS.NAME / LOCATION EDWARD ROJAS.PLU.MBING CORP 880 NE 111 ST 33161 BISCAYNE PARK OWNER EDWARD ROJAS PLUMBING CORP Sec. Time of Business 196 PLUMBING CONTRACTOR IS IS ONLY A LOCAL SINESS TAX RECEIPT. IT DES NOT PERMIT THE ■LDER TO VIOLATE ANY (STING REGULATORY OR NINO LAWS OF THE ,UNTY OR CITIES. NOR IES IT EXEMPT THE ILDER FROM ANY OTHER RMIT OR LICENSE QUIRED BY LAW. THIS IS IT A CERTIFICATION OF E HOLDER'S OUAUFICA- lrls. YMENT RECEIVED .MI -DARE COUNTY TAX ILLECiOR: 09/10/2012 02230014001 000045.00 SEE OTHER SIDE RENEWAL RECEIPT NO. 237125-0 STATE# CFC049431 * * ** FIRST-GLASS U.S. sPOSTAGE 1 PAID MIAMI, FL PERMIT NO. 231 WORKER /S 1 DO NOT FORWARD EDWARD ROJAS PLUMBING CORP EDWARDO ROJAS PRES 880 NE 111 ST BISCAYNE PARK FL 33161 111111I1 111 I1I II11I1 1111IIfI111111111111111111111 1111111111 •