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PL-13-192Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 185044 Permit Number: PL -2 -13 -192 Scheduled Inspection Date: June 12, 2013 Inspector: Hernandez, Rafael Owner: SCHAFER, KATHERINE Job Address: 912 NE 95 Street Miami Shores, FL Project: <NONE> Contractor: EPOCA CORP Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number (305)778 -5103 Parcel Number 1132060010010 Phone: (305)778 -5103 Building Department Comments REPLACE MAIN DRAIN WATER SERVICE FROM METER TO THE HOUSE AND COTTAGE Passed Failed Infractio Passed Comments INSPECTOR COMMENTS False Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments June 11, 2013 For Inspections please call: (305)762 -4949 Page 6 of 38 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 185044 Permit Number: PL -2 -13 -192 Scheduled Inspection Date: June 13, 2013 Inspector: Hernandez, Rafael Owner: SCHAFER, KATHERINE Job Address: 912 NE 95 Street Miami Shores, FL Project <NONE> Contractor: EPOCA CORP Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number (305)778 -5103 Parcel Number 1132060010010 Phone: (305)778 -5103 Building Department Comments REPLACE MAIN DRAIN WATER SERVICE FROM METER TO THE HOUSE AND COTTAGE Infractio Passed Comments INSPECTOR COMMENTS True Inspector Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. June 12, 2013 For Inspections please call: (305)762 -4949 Page 6 of 36 0 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 iyl° PERMIT APPLICATION Permit Type: PLUMBING JOB ADDRESS: 90 N 96 fti S,free. 7L Permit No. Master Permit No. City: Miami Shores County: Miami Dade Zip: -a31 -J-6 Folio/Parcel #: /I '33 ®Co- ®0! - 0010 Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): VaAhe. tvka c YAdekr Phone#: 305_4 (4_' I Address: 12- N E ci 5 +h Skree* City: NWAr Ai SIIoteb State: I Zip: 3S%3' Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: acot Grp Phone#: 306-118 - 5103 Address: e00 t' /95-* 5/Yee.--/- City: N M f`cw.4; State: P Zip: 3 31 tot Qualifier Name: Dowi d 5 eraci 1a Phone#: 306 - 71$ -5103 State Certification or Registration #: CFCl 10'2$5 QS Certificate of Competency #: Contact Phone#: 306 --77E3- 5 (03 Email Address: DESIGNER: Architect/Engineer: ,N®/fie- Phone#: Value of Work for this Permit: $ 4440 Square/Linear Fooe of Work: a `¥O Type of Work: OAddress OAlteration ©Ne /Replace CIDemolition Descrl t%n of Work: j r�'J�RG e »/ /ii Waiee Sew' ✓ic e _in o f ee r tio-u S e c 0 wee G Submittal Fee $ Permit Fee $ JI®® CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ ' TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip r 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 t2 The foregoing instrument was acknowledged before me this a8 The foregoing instrument was acknowledged before me this tp- day of Giv^ , 20/3, by euf`levirie . cba , day of , 20 13, by Da.v,d S &ad/ who i personally known me or who has produced who ierrsonally known)me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLI Signature Contractor NOTARY PUBLIC: Sign: Print: Oretsfe :1471,1 oc. 11 My Commission Expires: ** * * * * * * * * * * ** * * * * * * * * * * * * * ** Sign: Print: a- es-71e My Commission Expires: * * * * * * * * * * * * * * * * * * * * * * * * * * ** * APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised3 /12/2012XRevised 07 /10 /07)(Revised 06/10/2009)(Revised 3/15/09) This Document Prepared By and Return to: Clear Title Group, LLC Jay Phillip Parker, P.A. 1691 Michigan Avenue, Suite 320 Miami Beach, Fhrida 33139 Parcel ID Number: 11 -3206- 001 -0010 Warranty Ded 111111111 1 1111111 1111111111111111111111111111 CFN 2013R0016252 OR Bk 28433 Pss 1751 - 1755# t5pss) RECORDED 01/08/2013 13:24:46 DEED DOC TAX 2,352.00 HARVEY RUVIN, CLERK OF COURT MIAMI[ -DARE COUNTY, FLORIDA This Indenture, Made this day of December, 2012 A.D., Between Claudia R. Tharp, a married woman and Wayne K. Richardson, a single man and Rosiiyn J. Richardson, a married woman and Robert R. Richardson, a single man, each as to a 25% interest in the property of the Cotmty of Miami -Dade, She of Florida, grantors, sod Katherine Schafer, a single woman whose address is 912 NE 95th Street, Miami Shores, FL 33138 of the Cotmty of Miami -Dade, State of Florida, grantee Witnesseth that the GRANTORS, for and in consideration of the sum of --�- ---TEN DOLLARS ($10) DOLLARS, and other good and valuable consideration to GRANTORS hi hand paid by GRANTEE, the receipt whereof b hereby acknowledged, have granted, bargained and sold to the said GRANTEE and GRANTEE'S heirs, successors and assigns forever, the following described land, situate, lying and being hi the County of Miami -Dade State of Florida 10 wit Lot 1, Marilyn Heights, according to the map or plat thereof, as recorded in Plat Book 41, Page(s) 8, of the Public Records of Miami -Dade County, Florida. The property herein conveyed DOES NOT constitute the HOMESTEAD property of The Grantor CLAUDIA R. THARP. The Grantot"s HOMESTEAD address is 9290 SW 104 STREET MIAMI, FLORIDA 33176. The property herein conveyed DOES NOT constitute the HOMESTEAD property of the Grantor ROSILYN RICHARDSON. The Grantor's HOMESTEAD address is 107 STONBBRIDGE DRIVE SAVANNAH, GA 31410. SUBJECf'1'O TAXES AND ASSESSMENTS FOR 2012 AND SUBSEQUENT YEARS. CONDITIONS, RESTRICTIONS, EASEMENTS AND LIMITATIONS OF RECORD, W ANY; PROVIDED THIS PROVISION SHALL NOT BE DEEMED TO IMPOSE SAME; ZONING AND OTHER GOVERNMENTAL REGULATIONS. and the grantors do hereby fully warrant the title to said land, and will defend the same against Iawlid claims dell persons whomsoever. ***SIGNATURE PAGES TO FOLLOW SC1A121312 Dook28433 /Page1751 CFN #20130016252 Page 1 of 5 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS REGISTRATION FORM ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED OR THE VILLAGE MAY MAINTAIN A FILE WITH YOUR INFORMATION FOR A $30.00 FEE PER YEAR. IF CONT CTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LIC CARD B. OPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE (CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKERS COMPENSATION (EITHER CERTIFICATE OR EXCEMPTOON) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT C. COPY OF LIABILITY INSURACE (CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPT] D. COPY OF WORKER COMP INSURANCE (EITHER CERTIFICATE OR EXEMPTION) YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 COMPLETE CONTRACTOR'S INFORMATION BUSINESS NAME: Porn. Co BUSINESS ADDRESS: `60O j1 lay -. sit-reek CITY N A 6.4\ STATE r:i ZIP CODE 33ibi BUSINESS PHONE: ( 305 ) fl $- 31 0 3 FAX NUMBER ( ) CELL PHONE ( ) QUALIFIER'S NAME: Dakti 8- QUALIFIER'S LIC NUMBER: C? C - IS 5q E -MAIL ADDRESS (IF APPLICABLE): oomao t'p c® Created on 3119109 BY MLDV 1 RV 3126109 MLDV N aTH City of North Miami 776N.E,125 Street • North Miami, FL Wei + 305 -893 -6511 Business Tax Receipt/Certificate cif Use NNW Date: 101112012 aspiration Date: 0/30/2013__ Elueltxtee Tic Receipt*: BTU EPOCA CORP BOO NE 125 ST NORTH WAN, Ft_ 33161 -8712 OFFICE; ADM$Nt9TRA11VE OFF FOR f COMPANY Business Name f Address: EPOCA CORP SOO NE 125 ST NORTH MIAMI, FL 33161-5712 UCTION • rJ()T f;'E: s";JS i ESS 1 • IRAN 5r = R: D `VG'HsF MUST BE. I`. MOVER E + POST tN A CQNSPICUOUS PLACE STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487 -1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 BRADLEY, DAVID SCOTT EPOCA CORP 800 NE 125 STREET MIAMI FL 33161 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. STATE OF FLORIDA AC# is 3 5 5 3 5 3 DEPARTMENT OF BUSINESS AND PROFESSIONALa REGULATION CFC1428595 09/11/12 128076613 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. CERTIFIED. PLUMBING CONTRACTOR There you can find more information about our divisions and the regulations that BRADLEY, DAVID SCOTT impact you, subscribe to department newsletters and leam more about the EPOCA CORP 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 IS CERTIFIED under the provisions of ch,489 Fs sspization date, AVG 31, 2014 L12091102140 THIS DOCUMENT HAS A- COLORED BACKGROUND MICROPRINiING! LINEMARKT' PAMEENTEO PAPER AC# 6355353 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD $EQ# L12091102148 LICENSE NBR 128076613; CF142595 BA`I-CH NUMBER The PLUMBING CONTRACTOR Named below IS CERTIFIED Under the provisions of- Cha ter 4 Expiration date:-AUG 31, 20141 BRADLEY, DAVID SCOTT EPOCA CORP 800 NE 125 STREET FL 33161 RICK SCOTT GOVERNOR DISPLAY AS REQUIRED BY LAW CERTIFICATE OF LIABILITY INSURANCE producer; bon Insurance Company 2739 U.S. Highway 19 N. Holiday, FL 34691 (727) 938 -5562 'insured: South East Personnel Leasing, Inc. & Subsidiaries 2739 U.S. Highway 19 N. Holiday, FL 34691 I Dee 1/30/2013 Tim Castigate Is IIs Waal as a matter of Information enly and conly and confers no rights upon the Certificate Holden. Tide Cattgcate does not amend: extend or alter the coverage afforded by the polities below. Item Afford4ng Coverage Insurer A: Lint Insurance Company Insurer 3: Insurer C: Iuer 0: Insurer E NAIC # 11075 Coverages Tie paces al Rename { m a d teltw t e been iced ire hared rented ebwe for the poky pet Indicate," Not+dhstandltg ary requf>e mart, fcnn or rditfan or any centred or otter &tuned with respect to reduoed by paid ma bels�sdormazyp eeksuum worded by the poBalosdeserlbedteeelntosub+ dott bad the terms ,emAatons,andaurdltlomoree Pollalea %gfFeyeze Mae staxrereyheeebeen its LTR ADDL NSW) Type of Insurance NERAL LIABILITY Commercial General Liability Claims Made Occur Policy Number Policy Effective Dale (MM)DDm) • `7 Expiration Date (MMJDD/YY) Umita ner: l aggregate hmit applies Per Petty 0 Proleot 0LOC Each Cootnenoe Damage to ratted premises (EA led Ebp Personal Adv injury General Aggregate P -oc+aIOP Aug Cambtred &rale Urrdt (EA Accident) amity v (Per Penton) Bed* interY (Par Property Damage (Per Ambled) EXCESSIUMBREUA LIABILITY axes (3 Cane Made Deductible EtrobCootirenas A Workers Compensation and Any propfistoripannerlencuilve at cndnenber No If Yea, under sperm below. WC 71949 _ 01/01/20 }SI/01 Q14) X tort' Limits 1 I ER E.L. Each Accident • $1,000,000 E.L. Disease - Ea Employee 81,000,000 E.L Disease - Fifty L Lion ittinganaa Company Is A.M. east Cenpeny rated A- ( Expelient). AN Dseordptiun* of OO por Wan nen .00eWoneNantorsaEreoruelooa eddod by End ova sag ant/Spool et I�povasioea: Cie only apples to Wive ) 01South Emu Employee (.easy Services, Inc, that are leased to the Mowing "{Beret Company". IIPOCA-04-0; .. Coverage only apps to injuries ironed by South East Personnel thug, Inc. & .__ active employee(s) , ve in Florida, Coverage does not app* to statutory ) or Independent amtractor(s) of the tint Company or any other fir. A IS of the active ) leased to he Cthant Company an be obtained by foxing a request to (727) 937 -2138 or by naWng (727) 938 -5552. Project Nance ISSUE 01-30-13 (JN) t1,0QO,0oo CtentID: 81- 55-788 I 3 0tNtti l ARTI N T 10050 NE 2ND AVENUE WAN SNORES VILLAGE, FL 33138 Bean Dube wiaciz .tt Simr#dany abarna ditscdted yanks be CATICebdtettIM the esterrondtte thereat tie issuing hewer will erefeavarto man 30 days written rake to the owlet :ate holder rnmed to te telt, brtreasetoeosmshell Wilma re oblgaton or Debt* dory Nnd upon the tr er,itsagerts or representatives. + CERTIFICATE OF LIABILITY INSURANCE 'A'E NCIIYV "'' u" '" "��� 01/3003 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EmTEND OR J .TER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRAC BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESIDGATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER YAI : (tt11p heider t$ an ADOMONAL INSURED, the pope) meths endorsed. if SUBROGATION US WAIVED, the tense and donations ones policy, ear lain popsies may wore an endorsement. A statement en this certificate does not center rights to the certificate holder h Oats of each Xs). PROD Fltst Insurance Group 10%740St • Miami, FL33165 Phone (305)221 -7878 Fax (305)554 -7080 ENSURED EPoCA_ZORP- —i 80014E 125 St NORTH MIAMI,. FL 33181- 30g COVERAGES CERTIFICATE NUMBER: Tats IS TO CERTIFY TtiAT TIE POLiCiES t]F INSURANCE LISTED BELOW HAVE IWEN ISSUED TO THE INSURED NAMEliABOVE FOR: THE POUCY PERIOD INDICATED. NOTVINTHSTANINNO ANY RECIARE }ENT, TERM OR CONDITION OFAtYY C0t4TRACT OR OTHER DOCUMENT W1Th RESPECT TO WHICH THIS CERTIFICATE MAY RE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE PQUCIES DESCRIBED HEREIN /8 SUBJECT TO ALL THE Tom, EXCLUSIONS ANDeOI N$OF SUCH P IE& LMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLANS.. IMIM4 MESA i3O5)22t4878 .c7, A> 1iEFILIBLIC VAIVGIJ Rp ! WHOA RAF: (305)5554 -7090 REVISE IMAM D =muses Q occuR ri + % AOGREOWE MT APPLIES P R .1..f. Automontn UARIUTY 0 Atimfro 0 tuseosuros U Alyros MORELIA 1.04$ 0 occol FoucY WAN* PGL 12 C... ENOE - $ 1,000,000.00 BONO I a ; $ t 1 ! t30 MED EXP IAt !a eporsen) ' s 50130 .00 0W11212012 (Nil e/20131 .. i r &ADIf MAT $ 1,000,0M.00 gip! .E . $ 2:fiX .000.00 . _ $ 2,000,000•00 LINT = > $ .YI$JUl Y (Per person) 6 Y !Rimy wet ' $ EACH =M ROE s noigazoonom :S iat AcORD'1D1, Poldritored Remarks 8dw ItmaeegpassIs GENERAL. CONTRACTOR UUABIUTY CERTIFICATE N0 DER MIAMI SHORES BUILDING DEPARTMENT 10050 NE 2nd AVE MIAMI SHORES VILLAGE FL 33138 ACORO 28 (S CIF CANCELLATION _ ... $.[. EACBt o $ L.L - EA Et4PLOYEE 8 e.L mom •POLICY LAW $ L 40'00 AGENT. Sa'L ; SWUM ANY OF TIM ABOve oEsemitED POUCIES BE t,.ANt U. IHE EXPfttAllON DATE MAIM, NOTICE ASIDE ACDONOANCE VIM THE POLICY AflvE 198&2410 Aeon covipom The AGORD rye and logo are