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DEMO-10-1973
f(ih7423j1D 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 FBC 20 Permit No.020O iO Master Permit No. Permit Type: BUILDING �j OWNER: Name (Fee Simple Titleholder): em & gal E Ye V. I V LL( Phone #: 3/ 7q ' 11-101' Address: 1 1 S NUJ c17-h2 3 +r -d City: M fel. m 3h ores State: Fl Zip: 31 d�l�l Phone #: ii !/-f Tenant/Lessee Name: Email: JOB ADDRESS: 1 1 B Nu) 97-4' Sfee+ City: Folio/Parcel #: Miami Shores County: Miami Dade 11 — 31 1 _ 02 5 - po Zip: 33 150 Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: Alf San Ch eZ Lc.. Phone #: 7 /55/y - /e35 Address: /3'14'j Mai -5-.14 e_ < p City: i4 State: Zip: / & !J Qualifier Name: V 1 L 1� rz ApoLvia ig., a vi 7- Phone #: 7 (I5/ =i J 935 V Lf� State Certification or Re 'stration #: C. 6e. '15 / 7 2 Certificate of Competency #: 0 rk� Contact Phone #:70 /574 ° /0 .35 Email Addr s: FFii``�� Phone #: ESIGNER: Architect/Engineer: `'W Value of Work for this Permit: 1 Square/Linear Footage of Work: .Sep pi-- Type Descri UNew ia COLOR THROUGH ROOF TILE IS REQUIRED acknowledged by: e v 1 Submittal Fee $ Permit Fee $ CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ Technology Fee $ TOTAL FEE NOW DUE $ ( J .1/49 • 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, BOl.FRS, 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 g6t5 111 or Agent The foregoing instrument was acknowledged before me this c2 day of 20 (0 by `1" e n `9 (-1l t1 , who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Co Signature Contracto The foregoing instrument was acknowledged before me this ,a7 day of t) iir)641') , 20 /0, by d,e- not who is personally known to me or who has produced as identification and who did to oath. NOTARY PUBLIC: Sign: Print: My C ********************************************* * ** * * * * * * * * * * * * * * * * * * * * * * * ** * ** APPROVED BY ;C l//0 ao Plans Examiner * * * * * * * * *,* * * * * * * * * * * * * * * ** �d Zoning Structural Review Clerk (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)(rev6/4/10) 1 Project Address Miami Shores Village 10050 N.E. 2nd Avenue NW Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Applicant 118 NW 97 Street Miami Shores, FL 33150- 1131010250070 Block: Lot: 1 Owner information Address Phone Cell 118 NW 97 Street Contractor(s) Phone Cell Phone MR. SANCHEZ CARPENTRY INC (786)355 -0212 Valuation: Total Sq Feet: $ 1,500.00 200 1 Type of Demo: Building Additional Info: DEMOLITION OF (LEGAL BATHROOM ... Classification: Residential Scanning: 2 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $1.20 $2.00 $2.00 $0.40 $100.00 $6.00 $1.60 $113.20 Pay Date Pay Type Amt Paid Amt Due Invoice # DEMO -11 -10 -39369 11/24/2010 Credit Card $ 63.20 $ 50.00 11/09/2010 Credit Card $ 50.00 $ 0.00 Available Inspections: Inspection Type: Final In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. November 24, 2010 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date November 24, 2010 1 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 SANCHEZ, VICTOR APOLINAR M R SANCHEZ CARPENTRY INC 13460 NW 5TH AVE NORTH MIAMI FL 33168 Congratulations! With thiq iicense you become one 0: the nearly one million Floridians licensed by the Department of Business an 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.myflorldalicensccom. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and earn 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 starve your customers Thank you for doing business in Florida. and congratulations on your new license! 0-1901 3 (850) 467-1395 DETACH HERE STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 M R SANCHEZ CARPENTRY INC 13460 NW 5 TH AVE NORTH MIAMI FL 33168 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_i For information about our services, piease log onto www.mytioridalicenSe„COM. There you can find more information about our divisions and the regulations that mpact you. subscribe to department newsletters and learn 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 STATEOFFLORIDA AC# 4403576 DAVARTME10.(0BUS/NESS AND PROFESSIONAL REGULATION 665S1: 080282095 QUALIFIED. BUS nmsS ORGANIZATION R SANCHEZ CARPENTRY INC • (NOT A LICENSE TO PERFORM WORK. ALLOWS COMPANY TO DO BUSINESS IF IT HAS A LICENSED QUALIFIER ) iS .,01:11.ALIFIED under the provisions of ch.489 ATI 31, 7()11 L090s1209140 • 07 -10 -2009 ALEX SINK 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: 07/10/2009 EXPIRATION DATE: 071101201:1 PERSON: SANCHEZ MERXIADES FEIN: 571205691 BUSINESS NAME AND ADDRESS: M R SANCHEZ CARPENTRY INC 13460 NW 5TH AVENUE NORTH MIAMI FL 33168 SCOPES OF BUSINESS OR TRADE: 1— CARPENTRY IMPORTANT: Pursuant to Chapter 440 05flM1f, F.S., an officer of a corporation who elects exemption from this chapter by +Wing a certificate of eject ion under this section may not recover benefits or compensation trader this chapter. Pursuant iu Chapter 440.05112}, F.S. , Certificates at election to be exempt_.. apply only Within the scope of the business or trade listed on the notice at election to he exempt. Pursuant to Chapter 440.0F413t. F.S., Notices at election to be exempt an,i certificates of election to be exempt shelf be subject to reification 0, at any time after the filing of the notice Of the issuance of the certificate, the person nomad eft the notice fir certificate no linger meets the requirements of this section fat issuance of a certificate. The department shall revoke 3 certificate at aoy time for failure of the poison named an the certificate to meet the requirements of this secrian. OWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 11UESTIONS7 i85O) 413 -1a09 City of North Miami NORTWMIAMI 775 N E 125 Street • North Miami, FL 33161 • 305-893-6511 Business Tax Receipts issued Date: 10/1/2010 Expiration Date: 9/30/2011 Business Tax Receipt #: 6T-000721 M.R. SANCHEZ CARPENTRY INC 13460 NW 5 AVE NORTH MIAM,, FL 3,.1168 CARPENTRY/general contractor AT CUSTOMER LOCATIONS (OFFICE ONLY) SPECIAL RESIDENCE CITY CODE SEC 29-22 Business Name / Address: M.R. SANCHEZ CARPENTRY INC 13460 NW 5 AVE NORTH MIAMI, FL 33168 City Clerk NOTICE; BUSINESS TAX RECEIPT MUST BE TRANSFERED WHEN I3USINESS IS MOVED OR SOLD. NON-TRANSFERABLE • POST IN A CONSPICUOUS PLACE • NON-TRANSFERABLE CERTIFICATE OF LIABILITY INS1JRANCE 11/1610 cm. ilanilonro PRODUCER Exceilv murance 3101 SW 1C7 Avenue Fl., 3.31b$ Priome SO5)22b-Sa00 Fax (30 )220-1.9$7 INSuRSO M $anchet. Carpontly , 1 $480 N. W. 6th Avenue Ncrtli Miami, FL 33168 (306) 668-7P14 COVERAGES: T14-1E POLICIES OF 'INCiJIMINCE UMW HAVE SEEN ISSUED TC 1.075: NAMED ABOVE FOR TN 2 POLICY PERIODINLICA rEn. um wormSTANDiNG . 1 ANY RECUiP.ZNIENT, TERM OP. OOMDMIN OP ANY CONTRACT DR OTHER DOCuMINT %PATH RE8RE:7 TO WHICH THIS CERT,FICATE MAY 3E. ISSuE0 OR MAY PERINI. THE INSURANCE AFFORDED BY THE PCLICIES CSSORISED HEREIN tS SUSSOT TO A _L T4E TERMS. EXCLUSIONS AND OCNNTioNS OF SUCH .,, paL.0.;;IE$ AGGRE,.34.232 HOWN Mkt' HAVE Bat RE00)E0 BY PAID CLAIMS. ; POLICY NUMBER iretp,1142M1 "'Iwo Egglago__;"11"14114T !INS* JUXTL i TYPE oF INSURANCIn 1 '`'Ir114.3117i32"-- PI LtALI 1 s ,000! , DENBRAL BITY !EACH OCOURRENC E IRS CENTIFII:ATE IS $SUED AG A MATTER bF IWORMATION ONLY AND CONFERS NO kOHT$ UPON THE CERTIFICATE Hazel% THIII C@RTIFIGATE DOE$ NOT AMEND ro(TEND OR ALTER THE a g a s c r - h r P Q R E Y THE POUCIES DELOW,_ INSURERS AFFO R...noto COVERAGE . NAIC # INSURER A: UNITED SPECIALTY INSURANCE CO. INSURERS: INSURER C: IMIRERD INSURER E INSURER F: LIMIT Mc 1'0 FIg1M6- 0/19/11 eqs Ma ccaztnr..) 2 1GO ,000 s MED EXP (Any one per5G IV 5,000.00 PaRsoNAL & ADVIINJURY 1- I ,CCO,OCC I ' ; GENERAL AGBIREGATE 1.°00,000! 1PRODUCTE ., COMP/OP AC,0 I ,000,0001; 17-i" COMMERCIAL GENEPAL LIASILTTY , i 245 ' ! 05/1S/10 , , != CLAN* MADE rk OCCUR i A r--, [ c 7, L....; '4 r•-: GEN'L AGGREGATE LiVrT Apt!ttES FIP.'„ POUCY rjj PROJECT ! . LOC VIIIX.10.600/10 AUTOMOBILE LIABILITY ANY AUTO I L: ALL OWNED AUTOS nD SCHEDULED AUTJS HIRED AUTOS NON OWNED AUTOS COMEi NEC a'LE LIMit I (Ea accident I BODILY INJURY 1 2trir-sron) BCOILY INJURY (Per am,lOent 1 GARAGE LIADIUT9 ANY A6TO EXCESS/UMBRELLA LtASILITY COCJR r7 CLAIM MAIS FOUCTIBLE p•-! RETENTION s 1—.170.—RINERS COMPENSATION MID 1 EMPLOYERS' LiABILAY !AN" PROF RIETOR PARTN EP. ! OFFICER ; MEMBER EXOLLIDED? ti Yek dEarmbie otlet SPE., VI. PROVISIONS` beIouT °THEN PROPERTY DAMAGE ooidont) ALTO ONLT", EA AOC"DENT IPer o 1, OTHER T-AN E. ACC AtjTC MCURJC CURRE • • sTA111- TC.titY Li:AT E t.. EROM ACCIDE!,7 E. L. DISEASE - EA EMPLOYEE !"!SEASE POLtCY OTT DESCRIPTION OF OPeRAnON$ (AI koNs vF_Hutes itxtA.I4SIONS ADDED BY ENDORSEMENT, SPECIAL PROVIsIoNs CERTIF1GATE, HOLD 4R Miemi Shares Viliaoe 10030 Nortneast grid Avenue Want, FL 33120 AGORD 2 (2001771-r-- GANCELLATIOII SHOULD ANY cf CORATIoN I?to FOLIMEs E ANELLW SUCRE F, T. He INSURER WILL ENDEAVOR TO NM& TO Tilt CERTMCAIs, HOLDER NAMED TC 0 SO SMALL WPM NO CAUSATION OR LIABILkTY SURER, ITS AGENTS OR RNPRESINTATIVES. NT q-; ACO.-------4POPLAllON 19U NORA GALMGO, Esq. Galege Law Group 232 Andalusia Avenue Suite 202 Coral Gables, FL 33134 305- 444 -9000 File Number: 101402 Will Call No.: 111111111111111111111111111111111111111111111 CFN 2010# 05999925 OR Bk 27409 Pes 3160 - 3161; (2ass) RECORDED 09/03/2010 1059:16 DEED DOC TAX 732.40 HARVEY RUVINr CLERK OF COURT MIAMI -DADE COUNTY, FLORIDA (Span Above This Line For Remedies pate) Special Warranty Deed This Special Warranty Deed made this 31 day of August, 2010 between REF Broward LLC, a Florida limited liability company whose post office address is Two NE 40th Street., Suite 204, Mtamt, FL 33137, grantor, and BE MA REAL ESTATE INVESTMENTS IV LLC, a Florida Limited Lability Company whose pat office address is 13200 Coronado Drive, Miami, FL 33181, grantee: (Whenever used herein the tarns crane, and grantee include all the parties w this instrument and the helm legal,eptesentnives, cad aselps of individuals, and the saamso4s and assigns ofaorporatiom, austt and trustees) Witnesseth, that said grantor, for and fin, consideration of the sum TEN AND NO/100 DOLLARS (010.00) and other good and valuable cansideratitsns to mid grantor in land paid by said grantee, the receipt whereof is hereby acknowledged, has granted, bargained, and sold to the aid grantee, and grantee's heirs and assigns forever, the following described land, situate, lying and being in Miami -Dade County, Florida, to-wit Lot 7, Block 3, ResubdtvWon Of Block 3 Bomar Park, according to the plat thereof as recorded to PLt Book 42, Page(e) 60, Public Records of Miami -Dime County, Florida. Parcel Identllcatton Number: 11-3101-0254070 Subject to: Taxes for 2010 and subsequent years, Zoning restrictions, prohibitions and other requirements imposed by governmental authority; Restrictions, limitations, and easements of record, without intent of reimposing sane; Matters appearing on the Plat or otherwise common to the subdivision; Public utility easements of record, if any. Together with all the tenements, hereditasmento 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 grandee that the grantor is Iaavfrily seized of said land in fee simple; that the grantor has good right and awful authority to sell and convey said land; that the grantor hereby hilly warrants the title to said land and will defend the same against the lawful claims eau persons cleiaumg by, through or under grantors. hi Witness Whereof, grantor las hereunto set grantor's band and seal the day and year first above written. V(6.;?7 DoubloTkInte Book274091Page3160 CFN #20100599925 Page 1 of 2 Project Address Miami Shores Village 10050 N.E. 2nd Avenue NW Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Applicant 118 NW 97 Street Miami Shores, FL 33150- 1131010250070 Block: Lot: BEMA REAL ESTATE INVESTME Owner Information Address Phone CeII 118 NW 97 Street 1 Contractor(s) Phone Cell Phone PIPELINE PLUMBING SERVICES INC (305)978 -4715 Valuation: Total Sq Feet: $ 400.00 0 1 Type of Demo: Plumbing Additional Info: Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $0.60 $2.00 $2.00 $0.20 $100.00 $3.00 $0.80 $108.60 Pay Date Pay Type Amt Paid Amt Due Invoice # DEMO -11 -10 -39392 11/24/2010 Credit Card $ 58.60 $ 50.00 11/09/2010 Check #: 1617 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Final In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. November 24, 2010 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date November 24, 2010 1 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 w'-- Permit NoTE ' w 10— r BUILDING PERMIT APPLICATION FBC 20 Permit Type: PLUMBING Owner's Name (Fee Simple Titleholder) }�Q k cal Err j' L(2hone # Owner's Address 1 T N l ` S y j e- Master Permit No. City 1 i am (py€S State p Tenant/Lessee Name Email 30s17gq- 1167 Zip -331 50 Phone # Job Address (where the work is being done) City Miami Shores Village 113 NIn 93-444- Zip SO County Miami -Dade FOLIO / PARCEL # , % ° ) 01 - 0 -2-5 -op 9-0 Is Building Historically Designated YES NO Contractor's Company Name Al L j $/E P/' Pluvfri Contractor's Address 205(= sc,t✓ S .A./ € City M1411 State rl if - Qualifier Name Flood Zone Phone # JOS 1 -9g LI 9l5 C 355 ca2X-itt„,�z Zip 33/5-5- ? l7) 9-96- Phone # State Certificate or Registration No. (l Z P coo g'/4/ 30S17y9' 7)— Contact Phone E -mail Certificate of Competency No. Architect/Engineer's Name (if applicable) /' /A Phone # Value of Work For this Permit $ 460 - V v Type of Work: ❑Addition DAlteration Square / Linear Foota ONew Describe Work: p((ivvi fe.)R E/k 0 Li tra,t, 2 P1 e Of Work: Repair/fteplace ,,j #2- diftg/cibm_. 644 R4 kir * * * * * * * * * * * * * * * * * *** Fees**********,** * * * * * * * * * *** * * * * * * ** * * * ** * * * * ** Submittal Fee $ Permit Fee $ /®O — Notary $ Scanning $ Radon $ DPBR $ Double Fee $ Training/Education Fee $ CCF$ CO /CC$ Structural Review. $ Violation date: Technology Fee $ Bond $ Total Fee Now Due $ See Reverse side - 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature A44, Owner or Agent The foregoing instrument was acknowledged before me this day of ®C , 20 l0 , by / who is personally known to me or who has produced As identification and who did take an oath. NOT Sign: Print: pg� :AIRIS PUENTE Notary i'ub1iC • State of Fielids MI Comm. Expires Jan 1$, 201 My Commission Expir APPROVED BY l Signature Contractor The foregoing instrument was acknowledged before me this 1/ day of JUOV6 4e, , 20 /0 , by / tJ( 4 , who is personally known to me or who has produced as identification and who did take an oath. /A169 /C2* Plans Examiner Engineer (Revised 07 /I0 /07)(Revised 06/10/2009) NOTARY PUBLIC: Sign: Print: My C Zoning Clerk checked 05/28/2017 01:13 FAX 11/09/2010 15:46 CERTIFICATE OF LIABILITY INSURANCE IZ 001/001 #7565 P.001 /001 1 DATE (wismatfrelf) 1 11/09110 THIS CERTIFICATE 18 ISSUED AS A MATE OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIRCATE HOLDER. THIS CEPMFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED STINE POLICIES RELOVV. THIS CERTWICATE OF INSURANCE DOES NOT CONSUME A CONTRACT BETWEEN THE ISSUING INSURERS), AU1HORRED REPRESENTATIVE OR PRODUCER, AND T4lE CERTIFICATE HOWER, UNPONTAIM !Me certificate holder le an ADM se tame and condition of the po5cy, cartitin Certificate holder le Ben of sunk endoraretner40)- IF —AtODUCCR Professional Insurance Group, Inc 11865 SW 25 St Ste 041 Ratak FL 33176 Phone (305) 554-1212 INSURED Piperuke Plumbing Services, Inc. 2050 SW 64 Ave Miami, FL 33156- (306) 26S-7322 COVERAGES A INSURED, the soieeies) least be endorsee. E SUBROGATION IS WAIVED, subJectto envy require an anaorantitent. A etatement on ege certificate does not confer rights*, the • Fax (3O)554.1312 CERTIFI NURIBER: THIS IS TO c Eit-T—IFY" hiAT THE POLICIES OF' . Ramie* NUMBER INDICATED, NOTWITHSTANDING ANY REQU CE LisTED sacw HAVE SEEN ISSUED TO THE INSURED NAtilWABOVE FOR 11-1E FOE= PERIOD • TERN OR COMMON OF ANY CONTRACT oR OTHER DOCUMENT wing RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, INSURANcE AFFORDED SY'THE ForiCIES DEscRisED HEREIN IS SUISJEcT To ALL THETERMS. EXCLusioNSAND common OP SUCH - • :19• Wars snoww MIRY HAvE BEEN REDUCED SY PAID =Ans. ...egLomegg_. ALLAILALAi _fat/luau COSERAss National Group Ifteurarice INSUNEN - 111suRgit SgSURER DI a : TYPE OP SiCURANCE OCHER& LAWN CONESENCiAL GENERAL UABILRY 0 cLAseeme 21 °cam L I lulaReiiArg LW AMES Flit ! FoucY Rot_ 0 Lac SUMMAR LAWRY • AuT Arno • /al. OWNED AVM • sCreDurso Avros Li HIRED AMC NON-ONINEC AUTOs U UNIINsuA Me 0 occuR a WOW UAD D CLAMS-MADE O aeDuanaLE wratialtita arnagetaaTiON AND ENIPLOWERW MUM ACP 14141PEXCLUDED? N /A WAG-0000303332 clascawerar 0FOPENATIONS/ wairataeS/ VINSCLES Plumbing Services EiffirilvATE HOWER Wand Shores Village Building Dept 10050 NE 2 Ave Nardi Mores, FL 33138 ACORD 26(2009(06) Or 11/0612010 11/06/201i ACORN 101, Atinianna Renislo Sclnatian, ancore sewn icnninties) CANCELLATION EACH OCCURRENCE 1,000 100.000 5,000 i 000,000 2.000,000 11)00,000 • f-Aar'-AgIL .LIRD.ELene PENSoNAL ACV INJURY OMER& AOGRECATE ipccjigr$ -COMP/OP AGG COMM= SNOW LatIT arcisenti BODILY iNniNY (Per wan) * $ 3 3 MOLY euultY (Far FR0PER7Y DAMAGN (Pr ac) EAGN occuaNENCE AGO:4E0M _Offiraks', fl .t.. EACH ACcamrt: EL DISEASE -EA EL _ acMASE -PotlOr Lear SHOInD ANY OP THE mous PIESCOUNIX) PoucstE 98 CANCELLED BEFoRE THE ExpIRAT1oN DATE THDREoP, NoTIcE YELL aE DELIVERED IN A Ail wow THE POLICY Movie:KM, 0198S.2009 A The ACORD TION. Ail eights reserved. am nagialsred mans of ACORD M(UNTKLHC, dUlLUINU l.Ullt, 1.U1"!t'LLH1Vl.ti Ur r ll.r, OLV441•141V1 09/08/2009 MOD CONTRACTOR R8763 11:55:51 CCN NO. 02P0008 �ROV ISSUE DATE 11/05/2002 TEMPORARY LIC (Y /N) N EXAM OR BOARD A AL DATE 10/08/2002 COMPANY NAME PIPELINE PLUMBING SERVICES INC D /B /A NAME INSURANCE EXPIRATION DATE 11/03/2009 STATUS A LAST RENEWAL 09/08/2009 CONTRACTOR TYPE D DADE BUSINESS TYPE C CORPORATION ADDRESS 2050 SW -64 AVE PHONE: FAX: CITY MIAMI STATE !'L =LASS EXP DATE 07770/2011 ZIP 33155 PHONE 305 "266 -7322 WORK COMP DATE 11/18/2009 EMAIL: WORK COMP EXEMPT (Y /N) N -QUALIFIER-- SKILL CAT ST REG NUMBER EXP DATE TRDS 199600467 CLASS PLUM LEVEL M 0001 RF11067161 NAME LOZANO FRANK CLASS STATUS A ONLINE EXP DATE 09/30/2011 PRINT(Y /N) _ SSN 000005059 PF1 = UPDATE PF2 = ADD MORE QUA PF6 = PRINT CERTIF NEXT SCREEN NEXT KEY OVERTYPE FIELDS TO BE MODIFIED...AND DE-MISS PF1 tcJno) DEST= TCPP877S •DADE COUNTY 2010 . LOCAL BUSIN_E tt TOR MIAMI -DADEt lUNT'V ER ST EXP... MUST BE DI_ PURSUA NT'TO THIS IS NOT A BILL — DO NOT PAY 493959 -2 RENEWAL BUSINESS NAME / LOCATION . RECEIPT NO. 515733 -4 PIPELINE PLUMBING SERVICES INC CC B 02P000814 2050 SW 64 AVE 33155 WEST MIAMI FIRST-GUS: U.S. POSTAG PAID MIAMI, FL PERMIT NO. 2 OWNER PIPELINE PLUMBING SERVICES INC Sec. Type of Business WORKER /S 196 PLUMBING CONTRACTOR 1 2446ONLY R LOCAT Blest$ T/UC RECEIPT, R DOES NOT PERMIT THE HOWER. TO VIOLATE ANY EXISTING REGULATORY PEND LAMS OF THE DO NOT FORWARD S IT MEW HER En FROM ANY OTHER On LICENSE ....lT Ras is w ACERRTIV1IC � HOLDERS QUALIFICA- TIONS'. PLUMBING SERVICES INC FRANK LOZANO MGRM 2050 SW 64 AVE WEST MIAMI FL 33155 PAYMENT RECEIVED IRAMI�DADE COUNTY TAX COLLECTOR: 09/14/2010 60030.000026 000045.00 t1 tyy yy tt l tt`` tt {{ 11 {{ `{tt 160 yy SEE OTHER SIDE �tl�hnil.. 11, 1A. IA�e.A11,1.1ttm11tiFt�:lh.ikflA RECEIPT NO. 30 515iS34 CC ND~ BUSINESS NAME / LOCATION PIPELINE PLUMBING SERVICES INC 2050 SW 64 AVE OWNER :PIPELINE PLUMBING SERVICES INC 02P000814 SEE BACK OF RECEIPT FOR A LIST OF NON - PARTICIPATING MUNICIPALITIES Receipt holder must inter to tithe RECEIPT HOLDER MAY DO BUSINESS AS A CONTRACTOR AS SPECIFIED HEREON. PLUMBING CONTRACTOR DO NOT FORWARD PIPELINE PLUMBING SERVICES INC FRANK LOZANO MGRM 2050 SW 64 AVE WEST MIAMI FL 33155 CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE FICATE DOES NOT AFFIRMATIVELY EOR NEGATIVELY AMEND, rEXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES S BELOW. INSURANCE AUTHORIZ REPRESENTIATNE OR PRODUCER, AND THE COERTIF CATS HOLDER. IMPORTANT: A CONTRACT BETWEEN THE ISSUING INSURER(S), IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pofcy(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). IDATE(MMIDDNYYY) 11/09/10 PRODUCER Eguino & Associates 7229 Coral Way Miami, FL 33155 Phone (305) 266 -1700 INSURED Pipeline Plumbing 2050 SW 64 Ave m(ami, FL 33155 (305) 216 -4525 ax (305) 267 -1197 CONTACT NAME: marilyn I perez PHONE I A)t No (ANC. No. Est): E-MAIL ADDRESS: PRODUCER ntivroMFR In 0' INSURER(S) AFFORDING COVERAGE NAIL # COVERAGES CERTIFICATE NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD THIS INDICATED. CERTIFICATE MAY BE ISSUED OR MAY REQUIREMENT, AI , THE INSURANCE N CONDMON OF ANY AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECRESPECT THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDjmOOUCYY J CLAIMS. INSURER A : INSURER B : sump INSURER C: INSURER D : INSURER E : INSURER F : REVISION NUMBER: LTh TYPE OF INSURANCE A GENERAL LIABILITY G COMMERCIAL GENERAL LIABILITY ❑ ❑ CLAIMS -MADE ❑ OCCUR 0 ❑ GEN'L AGGREGATE UM IT APPLIES PER ❑ POLICY ❑ ECT ❑ LOC AUTOMOBILE LIABILITY ❑ ANY AUTO ❑ ALL OWNED AUTOS ❑ SCHEDULED AUTOS ❑ HIRED AUTOS ❑ NON -OWNED AUTOS ❑ ❑ UMBRELLA UAB ❑ OCCUR ❑ EXCESS UM ❑ CLAIMS-MADE B ADDL SUER JNSR WVD ❑ DEDUCTIBLE ❑ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS LIABILITY Y, N ANY PROPRIETOR/PARTNER/EXECUTIVE' OFFICE /MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA POUCY NUMBER 6168700mv 08/03/2010 UNITS EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) 08/03/2011 DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) RESIDENTIAL PLUMBING CERTIFICATE HOLDER Miami Shores Village Building Department 10050 Ne 2 Ave Miami Shores, FL 33138 fax 305- 269 -9442 ACORD 25 (2009 /09) QF CANCELLATION MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGO fire damage limit COMBINED �SINGLE UMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) EACH OCCURRENCE AGGREGATE $ $ $ $ $ $ $ $ ❑ ORY UMIT ❑ EER E.L. EACH ACCIDENT $ $ E.L. DISEASE- EA EMPLOYE E.L. DISEASE- POLICY MST $ 100,000 $ 500,000 $ 100,000 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION WI BE DELIVERED IN WITH THE POUCY PROVISIONS. ACCORDANCE AUTHORIZED REPRESENTATIVE MARILYN L. PEREZ 1999-2009 ACO The ACORD name and All rights reserved. rks of ACORD STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487 -1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 LOZANO -" FRANK PIPELINE PLUMBING SERVICES INC 2050 SW 64TH AVE MIAMI FL 33155 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.myfloridalicense.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 STATE OF FLORIDA DEPARTMENT OF B PROFESSIONAL B 1 1 Project Address Miami Shores Village 10050 N.E. 2nd Avenue NW Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Applicant 118 NW 97 Street Miami Shores, FL 33150- 1131010250070 Block: Lot: Owner information Address Phone Cell 118 NW 97 Street Contractor(s) Phone F JIMENEZ ELECTRICAL CONTRACT( 305/556 -5759 Cell Phone Valuation: Total Sq Feet: $ 400.00 0 1 Type of Demo: Electric Additional Info: ILEGAL CONSTRUCTION Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $0.60 $2.00 $2.00 $0.20 $100.00 $3.00 $0.80 $108.60 Pay Date Pay Type Amt Paid Amt Due Invoice # DEMO -11 -10 -39399 11/24/2010 Credit Card $ 108.60 $ 0.00 Available Inspections: Inspection Type: Final In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. November 24, 2010 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date November 24, 2010 1 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 FBC 20 Permit No. 101 1 0 7..U16 6!i Om° I 0-4111) Master Permit No.f. Qt O tO Permit Type: Electrical OWNER: Name (Fee Simple Titleholder). �� RPCI &+-k 1►% . W Li- Q- Phone #: 3 / 7.71- ' Address: la r 1 N Ul.� � i1 ` City: 4 ictinq oreS State: FL Zip: 33150 Tenant/Lessee Name: Phone #: F! A Email: JOB ADDRESS: 1 I QS N uJ CH" v-v! � ° City: Folio/Parcel #: Miami Shores County: Miami Dade (I ® 3101- 09.5 - (�® Zip: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: P ° i t i e I l t ' Z 6 l c e g, l C,ta ( cop7r. Phone #:.3 0 5— 676.— iv 5? 5-9 Address: L2 q ©l (i►1e57 0 Ke cil ()Bee t44- '4(9 City: H N.Le 4h 6I -..d t/r5 State: FC0 e-i L4 zip: 33o ( 7 Qualifier Name: Fle.A4A.V.C1 S Co I ,n e ffe z Phone #: `7 q6 5 21 '0 State Certification or Registration #: EC- 1300 2.i `71 Certificate of Competency #: Contact Phone #: � g6 29 C 2 ( go Email Address: Ville W e Z 3cjci S Bell d vTil rfe l" DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ L-160. 0 0 Square/Linear Footage of Work: Type of Work: Address OAlteration ONew Description of Work: 67e ' • r k 0 • : +air/Re pie OUR lit ow?. 1:i!1ts9� �7sa 9'0 4C $ d��, g yy. ale MO iv Oa f`4.17,37 srxia ** *** ** ** k***>k>k=x*****>k*** ******a *** ****Fees *m** ****>x****** ** > k> x> k>k>k**x:>k******* * **** ***** Submittal Fee. $ Permit Fee $ /6 te94) 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 1\*) A 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 o Owner or Agent The foregoing instrument was acknowledged before me this 2% day of .3 , 20 JO , by -6d111 cA who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: DURIS PUSS n - Stole d Nova AIM vivokosa goy Sign My * * * * * * * * * * * * * * * * ** APPROVED BY Signature ' Contractor The foreg ing ins was ac ledged before me is (J 010 , bytYltlia SC.0 At t rsonallA known ''to��me or who has produced 1- ~ n �entification and who did take an oath. NOTAR ' UBLIC: day of A41A/.. Hi4 G,aS c,0,e�;. $Otis My Commission Expires: ********:************************************** ****** ** **** * ** *** *** ** ** *** * ** Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) Zoning Clerk Ar\tivn1 °I) srtG1'V1tG r — _ 1,0-)11(it, -c I ik,os) ....' t e-S°jr 4 fa eve - /f V4xi4- - 02AYloa0n 0C Cemodru YOran telyMifQ 1C06-- Of .41(4/ kag,' 0 a 010 OP a \ODOM 1rUdP) j0101Cfe, e)8t.. t-o_ge AFTER_ Demp L(r/ok 000i^ • Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 157771 \t-\6\'t Permit Number: DEMO -11 -10 -2000 Scheduled Inspection Date: May 11, 2011 Inspector: Devaney, Michael Owner: Job Address: 118 NW 97 Street Miami Shores, FL 33150- Project: <NONE> Contractor: F JIMENEZ ELECTRICAL CONTRACTOR, INC Permit Type: Demolition Inspection Type: Final Work Classification: Electric Phone Number Parcel Number 1131010250070 Phone: 305/556 -5759 Building Department Comments ELECTRIC WORK ON DEMOLITION OF THE GARAGE BATHROOM AND THE LAUNDRY ROOM 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- 157659. CREATED AS REINSPECTION FOR INSP- 153237. Add smoke/carbon monoxide detectors. ADD BATHROOM & KITCHEN RECEPTACLES. change garage receptacle to G.f.I.. cHANGE RANGE RECEPTACLE TO 4 WIRE. sEAL ALL UNUSED OPENINGS IN PANEL. Smoke detector wiring started. May 10, 2011 For Inspections please call: (305)762 -4949 Page 10 of 25