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RC-13-270
Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 193735 Permit Number: RC -2 -13 -270 Scheduled Inspection Date: June 18, 2013 Inspector: Bruhn, Norman Permit Type: Residential Construction Inspection Type: Final Building Owner: HAISCH, CHARLES Work Classification: Addition /Alteration Job Address: 160 NW 92 Street Miami Shores, FL Project: <NONE> Contractor: THE COMBINED GROUP CORP Phone Number 305 - 788 -0416 Parcel Number 1131010000210 Phone: (786)272 -2828 Building Department Comments 2 BATHROOM REMODEL Qualifier to speak with BO prior to any further inspections. NB Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments PassecLXCJ 61bJ1 Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. June 18, 2013 For Inspections please call: (305)762 -4949 Page 20 of 25 PERMIT # TRACTOR: �/� I CON � � +�/ blYad GaGq k) _ SUBMITTAL DATE: � `0 ADDRESS: I I. 0 9,2S- NAME: RESUBMITAL DATES: LAl in1 1311111►dAt hill PROJECT TYPE: ZONING FIRE STRUCTURAL IMPACT FEES " 1, -' ELECTRICAL 2°-'423" `", HRSIDERM „2- '4'0 PLUMB a NOC �1 `-' ' CHA(NICAL� ��tiy BLDG-- DBPR - SOTOLONGO, CARLOS ADRIAN; Doing Business As: (THE) COMBINED G... Page 1 of 1 1:01:44 PM 2/8/2013 Licensee Details Licensee Information Name: Main Address: County: License Mailing: LicenseLocation: License Information License Type: Rank: License Number: Status: Licensure Date: Expires: Special Qualifications Construction Business SOTOLONGO, CARLOS ADRIAN (Primary Name) (THE) COMBINED GROUP CORP (DBA Name) 13660 SW 56TH STREET MIAMI Florida 33175 -4202 DADE Certified General Contractor Cert General CGC1516482 Current,Active 11/25/2008 08/31/2014 Qualification Effective 11/25/2008 View Related License Information View License Complaint 1940 North Mom. = Street, Tallahassee FL 32 99 :: Email: Customer Contact Center :: Customer Contact Center: 850.487.1395 The State of Florida is an AA /EEO employer. Copyright 2007 -2010 State of Florida, Privacy Statement Under Florida law, email addresses are public records. If you do not want your email address released in response to a public - records request, do not send electronic mail to this entity. Instead, contact the office by phone or by traditional mall. If you have any questions, please contact 850.487.1395. *Pursuant to Section 455.275(1), Florida Statutes, effective October 1, 2012, licensees licensed under Chapter 455, F.S. must provide the Department with an email address if they have one. The emalls provided may be used for official communication with the licensee. However email addresses are public record. If you do not wish to supply a personal address, please provide the Department with an email address which can be made available to the public. Please see our Cheater 455 page to determine if you are affected by this change. https:// www. myfloridalicense .com/LicenseDetail. asp? SID= &id= 3FE4D59ECCEF76562627... 2/8/2013 919-1\ ftliami Shores Villa Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 7614949 BUILDING PERMIT APPLICATION Permit Type: BUILDING F:7 0 y� 0 Permit No. M21-- 210 Master Permit No. ROOFING JOB ADDRESS: /(O itle41 90Z 5 City: Miami Shores County: Miami Dade Zip•+/ 573 • Folio/Parcel #: Is the Building Historically Designated: Yes NO OWNER: Name (Fee Simple Titleholder): TeuM 14 443, • Address: i 60 V&o 9014 1,•' • City: If f a'"! i 414,97rA State: /r /0, i amt+, Tenant/Lessee Name: 9,00 Email: Flood Zone: Phone#: Zip: 33 /CO Phone#: CONTRACTOR: Company Name: / Cht Of 'be". '5 le d P . Address: //die S G(A' J 6 / City: /Via ant' State: if c Zip: % !'01.4r* Qualifier Name: t /es ,,,L Phone#: %6l — ?/4 "'pid State Certification or Registration #: d G / S/ 6 yet?, Certificate of Competency #: ,,�� Contact Phone#: .99i— 3/ 6- SON Email Address: e«r /tX i4... e y Gs,..64.0. x� io. y. CV", DESIGNER: Architect/Engineer: 44 Phone#: .�, / Value of Work for this Permit: $ 6/400 I:-. • Square/Linear Footage of Work: Bo Phone#: 966-.).9a-R-0 R-0 a-8 Type of Work: ❑Addition ®Alteration / ®New Description of Work: R.irvt 1ivL/ , t,C � isC p,4.o( Ize ie _ t 40.1.- 4004.4.44-440., b felt Art• .0 1 dolor thru tile. Repair/Replace ®Demolition dhli t%`* /t dC .*** * * * ****** **** **** ****** **** k.*** +x.FaPe** ** *** ***** ***** **** ** *** * *** ***.****** *a C7 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 S4 • 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 A14kIDAV1T: 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 $25 00, 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 no be approved and a reinspection fee will be charged. Signature er or Agent The foregoing instrument was ackno led d before / ,mme this 07/. day of _, 20 11_, by C2 e. got,o) L. , who is ersonall known to me or who has produced entification and who did take an oath. Signature Contractor The foregoing instrument was acknowledged before me this A/ day of AG ,20AL by who is rsonall kno ,.Q me or who has produced lion and who did take an oath. NOTARY PUBL Sign: Print: My Commission Expire * * * ** * *** * * * * * *0 * *0 ** APPROVED BY Plans Examiner Structural Review (Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06/10/2009)(Revised 3115/09) NOTARY Sign: Print My Commission t 1J�* Notary PublIc State of Florida Marta Pulido My Commission EE 174191 ** *** * * ** Zoning Clerk 4' _l� AO K/ BON MONOXIDE -DE AN: ALL CLOTH AN It ULA El. ONPUCT S To Do: 7a Aee pf ce -HI, 0, az.> r t#.44../15- °/ '44 ,-c., WoPX' °►L T'7 ®dr. /q4- 4r *e v►yt., ve jet P_ /4-414'4(/ po4e) Uc%iIt'h'9 it (e..fv ki Fh toe e-ad,--). roiROOM RECEPTACLE ON 20 AMP CKT AND C.F.O PR©? CTED cf /4e _::Repl4ce /rah ►md Rap /a tee. 4//a 1 142•C•i,e- ,-er c40, 1/e.e. "7117 Wok, 1 -1•40S /I Re41-ru t'‘, Al-Ard4 14-4.-d5 L'�c�i`o, -S u-i// be /v ✓.:e,P. BATHROOM RECEPTACLE ON 20 AMP CKT AND G.F I PROTECTED ii• 11111111111111111111 NOTICE OF COMMENCEMENT e: FN 2012R092181.96 A RECORDED COPY MUST BE POSTED ON INE JOB SITE AT T1ME OF FIRST nr. Bk 28411 F'9 2240; (1 ) RECORDED 12/21/2012 10:18 :01 HARVEY Rt1VIHe CLERK OF COURT MIAMI -DADE COUNTY, FLORIDA LAST PAGE 1I1�1 PERMIT NO. TAX FOLIO NO. STATE OF FLORIDA: COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements will be made t property, and in accordance with Chapter 713, Florida Statutes, the followin is provided in this Notice of Commencement. 1. Legal description of property and street / address: 60_ ,uw U s+ L(t'aine Si.arej , F•(. 33cso STATE OF FLOR 0 HEREBY CERT** I'''. a "ptiontpf improve4ent &Pus a+ 3. Owner(s) name and address: y €� Pida41. Id* ,u , Interest in property: art r✓2GC • Name and address of fee simple titleholder. 4. Contractqrs name ansl address: The, C404194q0 o . Cori 5. Surety: (Payment bond required by owner from contractor, if any) Name and Address: Amount of bond $ 6. Lender's name and address: 4.7 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 Ad dress: • 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 : 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) Print Owner's Name Je, n /hid Prepared by •/ £ Sworn to and subscribed before me this t I day 6 • , 20 1)•• . dress: Notary Public: Print Notary's Name: My commission expir 2/26/11, 1 /1 Report Viewer JEFF ATWATER CHIEF FINANCIAL OFRCER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DMSION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * * CONSTRUCTION INDUSTRY EXEMPTION This certifies thatthe individual listed below has elected to be exempt from Florida Workers' Compensation Taw. EFFECTIVE DATE: 1/31/2013 EXPIRATION DATE: 1/312015 PERSON: SOTOLONGO CARLOS A FEIN: 261979379 BUSINESS NAME AND ADDRESS: THE COMBINED GROUP CORP 7344 SW 48 ST UNIT 101 MIAMI FL 33175 SCOPES OF BUSINESS OR TRADE: LICENSED GENERAL CONTRACTOR Ptasum 4�q Bmalardawpae6mwhoei�m ®mmptlonhan9tls chitin by88nnaTe not to Chapter Tel ssection a may ava aaap udxtles to � C ds dy f of thetualnessorendue :ieeonthenoncedelecBm beexempt�� Nfcedetection ote dationtobesump' Mull besubjeetto remotion If, iaaryy&neater Menne dtte Mks cote Issuance dthe certificate, the person rumen ones notice a emanate no longer meets the requlremata deb section for lasuai edacerefcae. Theaepatrnereshall ravakeaceNecatealaytbretartaerreorthe person named onihecertigcoteto meatterequlremaffi ones section, DFS- F2 -DAC -252 CERTIFICATE QF ELECTION TO BE EXEMPT REVISED 07 -12 QUESTIONS? (850)4131809 hops:// apps8. fldfs. com/ crreportviewerheportViewer .aspx? data= kdvpginc9D7Q3gH6TER6eP1KIVE% 2fSz5bXKYfBxkrekeESoPVy1v4NPOPN42XeirDRGXV W... 1/2 THIS IS NOT A BILL — DO NOT PAY RENEWAL RECEIPT NO. 661395-5 STATE* CGC1516482 634667 -0 BUSINESS NAME / LOCATION COMBINED GROUP CORP THE 13660 SW 56 ST 33175 UNIN DADE COUNTY FIRST -CLASS U.S. POSTAGE I PAID MIAMI, FL PERMIT NO. 231 OWNER COMBINED GROUP CORP THE Sec. Type of Business WORKER /S This Is 49Y6A MERAL BUILDING CONTRACTOR 1 BUSINESS TAX RECEIPT. IT DOES NOT PERMIT THE HOLDER TO VIOLATE ANY ZONING LAWS OFR THE DO NOT FORWARD COUNTY OR CODES. NOR DOES IT EXEMPT THE HOLDER FROM ANY OTHER PERMIT OR LICENSE REQUIRED BY LAW. THIS IS NOT A CERTIFICATION OF THE HOLDER'S QUALIFICA- TIONS. PAYMENT RECEIVED MIAMI -DADE COUNTY TAX COLLECTOR: 09/10/2012 60020000152 00.0075.00 COMBINED GROUP CORP THE CARLOS A SOTOLONGO PRES 13660 SW 56 ST • MIAMI FL 33175 4l11lttjl1ttD jjjt tilt jt jtt jltD jjtltstlllltl :t:jlttjlt)tftttl SEE OTHER SIDE Feb. 26. 2013 10:04AM FLORIDA BANKERS INSURANCE No. 2256 P. 1/L as"' CERTIFICATE OF LIABILITY INSURANCE I —"'lam /°`' PRODUCER Florida Bankers ins<rcance 7278 SW 8 Street Miami, FL 33144 Phone (305)266-6493 Fax (305)262 -0879 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. INSURERS AFFORDING COVERAGE NAIC 8 THE COMBINED GROUP CORP. INSURED 13880 SW 58 MIAMI, FL 33175- (305) 382 -4348 INSURER A: FEDERATED NATIONAL INSURANCE POLICY EXPIRATION INSURER B: PROGRESSIVE EXPRESS INS. A INSURER C: GENERAL LIABILITY I J COMMERCIAL GENERAL LIABIIm( ❑ ■ CLAIMS MADE RI OCCUR INSURER D: 03/22/2012 INSURER E: EACH OCCURRENCE COVERAGES THE POLICIES OF INSURANCE USTED HAVE BEEN ISSUED TOTHE INSURED NAMED ABOVE FOR THE POUCYPERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDMONS OF SUCH POLICIES. AGGREGATE LIMITS SHONM MAYHAVE BEEN REDUCED BY PAID CLAIMS. INeR LIR ADDI. IRMO TYPE OF INEAIRANCE POLICY NUMBMR POLICY EFFECTIVE POLICY EXPIRATION LIMITS A • GENERAL LIABILITY I J COMMERCIAL GENERAL LIABIIm( ❑ ■ CLAIMS MADE RI OCCUR GL- 0504008970 -00 03/22/2012 03/22/2013 EACH OCCURRENCE 1,000,000.00 PRDAEATEMENTED ) 100,000.00 NEC OM (Anyone person) 5,000.00 ■ , PERSONAL & ADV INJURY 1,000,000.00 • GENERAL AGGREGATE 2,000,000.00 GEM AGGREGATE LIMITAPPUES PER: ® POLICY 0 PROJECT ❑ LOC PRODUCTS - COMP!OP AGG 2,000,000.00 AUTOMOBILE LIABILITY _ COMBINED SINGLE LIMIT (Ea acciderd) • ANYAUTO ■ ALL OWNED AUTOS BODILY INJURY (Per poison) ■ • SCHEDULED AUTOS • HIRED AUTOS . BODILYINJURY {Peraccideid} Q NON OWNED AUTOS • PROPERTY DAMAGE (Per accident) n • GARAGE LIABILITY • 'AUTO . AUTO ONLY- EA ACCIDENT OTHER THAN EA ACC • AUTO ONLY AGG EXCESS / UHUIRELLA LIAELITY • OCCUR ❑ CLAIMS MADE EACH OCCURRENCE AGGREGATE is ■ DEDUCTIBLE o RETENTION, S WORKERS CONVERSATION NAiD EMPLOYERS* LIABILITY ANY PROPRIETOR / PARTNER! EXECUTIVE YIN OFFICER! MEMBER EXCLUDED? (Mandy In p) If yes, descnbe under SPECIAL PROVISIONS below AR RA pT� ARYLIA 0 ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE El. DISEASE - POLICYUMR OTHER DESCRIPTION OF OPERATIONS ! LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSOMINT / SPECIAL. PROVISIONS CANCELLATION VILLAGE OF MIAMI SHORES BUILDING DEPARMENT 10050 NE 2 AVE MIAMI SHORES, FL. 33138 SHOULD ANY OF THE ABOVE DEED POLIO BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING BMEUREdR WILL EIR EAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE tERTWICATE HOLDER NAMED TO TIM LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON TIE MUM, ITSAGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE : ` ' >:.::- : ' < :: : :: : ::::::::: +B 18$8 -2009 ACORD CORPORATION. AO rights reserved The ACORD name and logo are registered marks of ACORD STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 SOTOLONGO, CARLOS ADRIAN (THE) COMBINED GROUP CORP 13660 SW 56TH STREET MIAMI FL 33175 -4202 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myflorldalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and leam more about the Department's initiatives. Our mission at the Department Is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida „and congratulations on your new license! DETACH HERE (850) 487 -1395 THIS DOCUMENT HAS 'A COLORED.BACKGROUND • MICROPRINTING • LINEMARKT�' PATENTED"PAPER TF'4oF.FLOPIn te•'%L1.Ff "[fly. j' / z, ." R 2t i J�1�r1g PPROFES•SIONi L :IREGULATION I � W ENS G:° BOARD : ':f >• ' 'n' °:q:: SEQ#L120802020 BATCH NUMBER RA Nained4:lie `.IS C' ,CIF . Under the'provisions off•.: Chapt E}axpirati.gn date: AUG1;,,3 1, .2 014 (THE) ;C.OMEIN;Eb G1i.Ot1 13660 SW 56TH STREE MAlI FL., x;3175- RN 0 flI t 'b\ Ac DMrrii IIDr r i Auni KEN LAWSON SECRETARY