PL-12-2232 Miami Shores Village °v 2 g 012
Building Department
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795.2204 Fax:(305)756.8972
INSPECTION'S PHONE NUMBER;(305)761.4949
BUILDING Permit No.
PERMIT APPLICATION
ABC zo Master Permit No._(Z
h
OWNER;Name(Fee Sim ple Titleho der): 4 � 14 1
one#:
• Address: � .. _ .,
City: State: Zip:
Tenant/Ussee Name:A a
Phone#• � ��,
Email:
�.
JOB ADDRESS: , V�
Miami Shores
City: County:. Miami Dade gip;
Folio/Parcelt
ie the BuPldngtorlcUy lY�e Yes NO
Flood lone:
CONTRACTOR:Company Name: ��- � b 91 4>W Phone#: '•`d'�:1 .���
Address: • U)• �� o 1)
City: a ! foe State:
Qualifier Name: N4S pbfD C �;p..
� Phone#: L• ( °
State Certification oAWstration 000(Rk4 4 C1 iffc�te ot 61npfthdyl �Q
Contact Phone#: Email Address:
DESIGNE1te ArchitectlEngmeer Phone#:
0 or '•. SquarelLinear F000f ork:
Tyke of Work: OAddress OAlteration ONe ,
air/Replace ODemolition
Submittal Fee Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ ,
DBPR$ Bond$
Notary$ Training/Education Fee$_________Technology Fee$
Double Fee$ Structural Review$
TOTAL FEE NOW DUE$ •
Bonding Company's Name(if applicable)
Bonding Company's Address
City State zap
Mortgage Lender's Name(if applicable)
Mortgage Lender's Address n
City State �1?
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 F.I ECMCA WOR, PLUW;N,P,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
DWROVEMENTS 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$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure.will be delrvered to the person
whose properly is subject to attachment. Also, a certified copy of the recorded notice of conui nentement mint be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
ti
Signature Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this The fore 17a' g instrument was ackrftand d before n�thiepq
day of C� .20�2 by Fl 0v (.1 Lam" CM UCH , day of t�• .20. ,by
who is personally known to me or who has produced�l C who is known to me or produced
As identification and who did take an oath. as identificatioho did take oath.
NOTARYPUBLIC: - NO$fAR C:
fill
Sip: �� 0 ,.:.. , T Sign; _
6, rulAca,ma OF rimme..
Print: as o«� Print:
My Commission Expires: = i.'�l�g�d��b'`p� _ My Commis n UTME.M osrs,r2a,e
'�. ✓ ' dxS.•�'
"'Mill I1N0�\`
APPROVED BY Aw,
' ®�� �� Plans Examiner Zoning
Structural Review Clerk
(Revised 07/10/07XRevised 06110/20ogXRevised 3/15/09)
t
ACOW. CERTIFICATE OF LIABILI IN URAL4CE V 9 �oa2 '
(305)512-5880 SAX: (305)512-5891 THIS CERT(P(CATE IS UNWED? AS A I ATTFR OF DWO)iMATM
Torres Ineurancm Agency Inc. ONLY AND CONFERS T M�T9 DOES NOWT# � 0 OR
6135 NW 1167 STREET S E25 ALTER THE COVERAGE BY THE BELOW
Miami Lakes FL 33015 INSURERS CflVERAtiE 0
m D WWKRA.NAPM TXSURAb= C010ANY
Big Plumbing Corporation MISURLR&Caatle Paint Florida
9190 NW 119th Street say 10 INSURL`RC:
aaleah Gardens SL 33018 a�sUaXR
i
THE POLICIES OF INSuRANM LISTED BELow HAVE BEEN HUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICKUU NOTWITHSTANDIN11 ANY
REOWREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIRCATE MAY BE ISSUED OR RAY PERTAIN,
THE INSURANCE AFFORDED BY THE POLWA DESCRIBED NOON IS SUBJECT TO ALL THE TIBIM. SICLUSIONS AND CONDITIONS OF SUCH POLICIES.
rim OF AN POLICYAOMM t P�ItCY C1iV8 Y
OENERALLMMTY 1,000,000
x UASKM 6L{8 DEIUaEO s .�100,000
A CLAM pccim CP0323606 3/30/2012 3/30/2013 Mg0EvtMvww20W s 5,000
1,000,000
S 2,000,000
GEWLAGWQATeUWTAKW8PER: 2,000,000
x FMICY ED Y& M Lao
AUTOUDBlLE LUUMMY
ANYAM ;ft—MM) NCILELEt4T 6 300,000
A ALLOWCOAVTOS CA120330065 3/30/2012 3/30/2013 Y Y
7C BCHEDmomnos (par PWWN $
NAWMT09 BOIILY INSM
NON oaYNI:OAUTOS (FW daiftm s
X PIP $10,000 PROPERTYOAMAGE
X I COWCOLt 01,000 Dad IP O*Mdw* $
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"040YERS'LIABILITY
ANYPROPFt C 100 000
0E-FtCM M k0FREXCLU0E0? KCP761068600 3/30/2012 3/30/2013 I.F ..EAIMPA 100,000
gym oecue www : $00.000
00
LURT Is A OTtmR Small To01S 080323606 3/30/2012 3/30/2013 $sos nod 02,500 Mv
(Unscheduled)
09=411TION OF OPHRATIONSILOCA IINON81 ADMW 13VENDORNMEN is
P'Umbing Contsaotos 1048t0d at: 9190 8W 119th 9tr06t Day 10 Hialeah Gardens, S1 33018
Co»sratal Auto. vahLWea: 2007 rord P280 Vin(...)4470 6 2006 Surd 5280 Pia (...)6723. Comprehensive 8 Collision: ACV
minus $1,000 AOP Ded. UM Rejected.
CSKTWMTE CAN
WMW ANY OF THE ASM MWJVM PQU= W CAfiUUM 88PW TW
MIAMI SIRAMS VILLAGE ®TIIRATIWI VAT@ TNMtWF. THE ISNIM MfiWR WILL F.IPAVOR TO MAIL
10050 NE 2ND AVS 10 DAYS LxlTr,t6EN MUM TOW CER MATE MUM ROOM THE LEFT,BUr
MIAMI SHORES, FL 33139 FAQ TO 00 90 SMALL OPM ND OUMTM 09 LWIUW OF ANY IONO UPOR TM
80111M ffS NOW—M OR A s. A ✓
AWHOMMARPSIRSENTATM
ACBRD 29(200148) i2f3i1)!9�
INS0261OSOSIAge Pnpo I ot4
a, l STATE OF FLORIDA
DEPARTM STRUCTIO I1 USTRY LICENSING BOAR �'gt��
♦ . ♦ YWCENSE WR
0� 18 2011 00O000000 IRFOO66479
The PLUMBING CONTRACTOR
Named below HAS REGISTERED
Under the provisions of Chapter 489 FS
Expiration date: AUG 31, 2013
(INDIVIDUAL MUST MEET ALL LOCAL LICENSING
REQUIREMENTS PRIOR TO CONTRACTING IN ANY AREA)
GOONZ.ALEZ , ARMANDO
BIG PLUMBING CORPORATION
654 E 51ST ST
HIALEAH FL 33013
RICK SCOTT KEN LAWSON
SECRETARY
GOVERNOR SECRETARY
AS REQM, ED BY LAW
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sr. lglf T4', a':x ,. " >x smk _ _ .�,,,+y, >✓bY � q$Z`R c �t PEN"
RECEIPT NO. 30-4392221 CC NO: 97P000310 �����DO
BUSINESS NAME 1 LOCATION i 3060 SS AS A'COWRACTOR
BIG PLUMBING CORP ASSPECtflEt3kt 0
9190 NW '119 ST
OWNER :BIG PLUMBING CORP
SEE BACK OF RECEIPT FOR PLUMBING CONTRACTOR '
A LIST OF NON-PART°ICIPATING
MUNICIPALITIES
Receipt holder must DO NOT FORWARD
rester in the city
wherewo*istobe BIG PLUMBING CORP
done. ABRAHAM LATRAS PRES
9190 NW 119 ST BAY 10
HIALEAH GARDENS FL 33018
PAYN84T RECEWW
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l.UMBIN CORPORATION
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