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PL-13-2614 (2)Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 2 Ae Inspection Number: INSP- 213504 Scheduled Inspection Date: June 05, 2014 Inspector: Diaz, Osvaldo Permit Number: PL -11 -13 -2614 Owner: MARCELO BORODOWSKI, AAM IMI eT1UeWTeIir Job Address: 10659 NE 11 Avenue Miami Shores, FL 33138- Project: <NONE> Contractor: HMF CONSTRUCTION CO Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number (305)466 -4243 Parcel Number 1122320280320 Phone: (954)931 -9886 Building Department Comments REPLACE KITCHEN AND 2 BATHROOMS Infractlo 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- 203289. CAULK FIXTURES AND MAKE MV ACCESSIBLE FOR REMOVAL June 04, 2014 For Inspections please call: (305)762 -4949 Page 12 of 18 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 FBC 20 BUILDING Permit No. A "-0-6 I 1 PERMIT APPLICATION Master Permit No. l— 12- RECEIVED NOV l 9 2013 Permit Type: PLUMBING JOB ADDRESS: 10("Sct PE 'V kJ. City: Miami Shores County: Miami Dade Zip: 3 J «8 Folio/Parcel#: - — 028 °- Off' Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder):. /A/G'e4e7v75 Li C Phone#: 466 4243 ). 202 Address: 2C 9 iUz-- 3c 31? City: 073 State: �f - Zip: 331 Tenant/Lessee Name: Email: Us "i idr0 G erfEYVO FNt LO Q-E fZS. Phone#: C.0 Al CONTRACTOR: Company Name: 14F caucvi-Rocnom co. Phone#: Address: I 01 (O - 1%. ,3Z 2l O Ft— 3344 City: �— t�.�4� State: fi L zip: Qualifier Name: LET--A_ 1 C "t' 1-212 t EL. Phone#: *q3 /-9886 State Certification or Registration #: pC -C. Cif 2_9' $ 0f Certificate of Competency #: Contact Phone#: 954 " t3I / Re 6 Email Address: DESIGNER: Architect/Engineer: Nifias- Phone#: mo Value of Work for this Permit: $ 2 10001— Square/Linear Footage of Work: Type of Work: Address UAlteration ONew Repair/Replace ODemolition Description of Work: 1 ,4@..tc 14 ( .t 2 P r1 P-ecNr -ts \)CTu(LE5 . ************ *** ************** * * *** * * *** Fees** * * **** x** *+ x** **** **** * * * ** ** * *** **w**** *** Submittal Fee $ Permit Fee $ 1$ 7.a.S. ",%'" 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 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 FT.RCTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S A}'1 IDAVIT: 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. o, a certified copy of the recorded notice of commencement must be .osted at the job site for the first inspection which occurs seve (7) days after the building permit is issued. In the of , �'. osted notice, the inspection will not b' approved and a reins ' ction fee will be charged. Owner or Agent Contrac r The foregoing instrument was acknowledged before me this 1 The foregoing instrument was acknowledged before me this l day of J1kgclit /2, 20 , by C`#F0.4. 0 beve, Dove jai , day of r tQ,ci2 , 20 13 , by LeSLAE (I- who is personally known to me or who has produced who is personally known to me or who has produced a - As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Print: t '7 7 t k , FLORIDA t,BLit•5 A My Commission Expires: rIOT�?,: ri usta o Gvt:eZ My Commission Expires: A °' ssian # EE018480 Y P Cotr 15 :2014 NOTARY PLBLIC STA 0 z ti5r? ExPis: AUG. ,,,,,.,. GuSta '•••"••••� L ATLA" :C Bo,WtNG CO.,t , �': Commission # EE018480 18 2014 ******************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *' "'pry: �1 *x*, * * ** BONDEDTHRL AT.L ,TIC$ APPROVED BY Zoning Print: ,;771-14. C �Z Plans Examiner Structural Review (Revised 3 /1212012)(Revised 07 /10 /07)(Revised 06/10/2009)(Revised 3/15/09) Clerk IVI lami 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 CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. 1 / COPY OF QUALIFIER'S STATE LIC CARD B. / COPY 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 EXCEMPTION) 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: *HT Cokonauonopo Ca BUSINESS ADDRESS: 401 60 A Da- O STATE L- ZIP CODE 3 3 44b BUSINESS PHONE: ( 30.S ) 44e•- 424 3 FAX NUMBER ( 305) ti‘ C -C / 35 CELL PHONE ( ) QUALIFIER'S LIC NUMBER: QUALIFIER'S NAME: (�1,E�I�) �--� CFC 2_ 9 4. E -MAIL ADDRESS (IF APPLICABLE): 057 -4vo C DV1 496 -JE L ' )2S ° COl" Created on 3119109 BY MLDV / RV 3126109 MLDV STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487 -1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 TERRIEL, LESLIE S BMF CONSTRUCTION CO 10160 AVENIDA DEL RIO DELRAY BEACH FL 33446 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.myiioridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department is: Ucense 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 THIS DOCUMENT f-- 2 A COLORED BACKGROUND - i 1'CRCPR ?NTING • l INEMARK PATENTED PAPER 0 ANNE M. GANNON coNSTrtintoNAL TEX COLLECTOR Serving Paula Heath County Serving you. P.O. Box 3353, West Palm Beach, FL 33402 -3353 "'LOCATED AT'* 10160 AVENIDA DEL RIO DELRAY BEACH, FL 33444.2422 www.pbctax.com Tel: (551) 355 -2264 TYPE. OF BUSINESS 234051 GENERAL CONTRACTOR OWNER TERNUEL LESLIE FtE CE1P7. MIOATE PAID 513.1 0910813 This document Is vaild only when receipted by the Tax Collector's Office. HMF CONSTRUCTION CO HMF CONSTRUCTION CO 10160 AVENIDA DEL RIO DELRAY BEACH, FL 33446 -2422 uQntllulrrir�nlcllurtlrltlnlrtl�Irtlrl ANNE M. GANNON coarrnsrn6BAL TAX OOLECTOR Serviv Eotm Beacf County Serving you. B1 -201 P.O. Box 3353. West Palm Beach, FL 334 www.pbctax.cxum Tel: (561) 365-2264 BE.L S STATE OF FLORIDA PALM BEACH COUNTY 2013/2014 LOCAL BUSINESS TAX RECEIPT LBTR Number 200021628 EXPIRES: SEPTEMBER 30, 2014 This receipt grants She privilege of engaging in or managing any business profession or occupation within its Jurisdiction and MUST be conspicuously displayed atihe place of business and in such a BMW as to be open to the view of the public. -3353 ""'LOCATED AT`• 10160 AVENIDA DEL RIO DELRAY BEACH, FL 33446-2422 • TYPE OF BUSINESS OWNER:::_ 23.089 PLUMBING CONTRACTOR 1 IERNIEL I FRI -IF I CERTIFICATION 0 I CGC937383 RECEIPTURDATEPAID B13:1S8S - 09158(13:. AMT PAID - BPI 521.80 I 860128268. This documentis valid only when recelpted by the Tax Collector's Office. B2 - 201 HMF CONSTRUCTION CO HMF CONSTRUCTION CO 10160 AVENIDA DEL RIO DELRAY BEACH, FL 33446 -2422 ullutllltl *ILI /tlrl6tt,Itltlt,hlIII;.III STATE OF FLORIDA PALM BEACH COUNTY 2013/2014 LOCAL BUSINESS TAX RECEIPT LBTR Number: 200112575 EXPIRES: SEPTEMBER 30, 2014 This receipt g the privilege of engaging In or managing any business its jurisdiction � MUST conspicuously displayed at the place of business and. In such a manner as to be open bathe view of the public. Report Viewer 2 JEFF AMISH CHOP EINANCOU,OPPMER STATE OF FLOI DEPARTMENT OF FINANCIAL. SERVICES DIVISION OF WORM*" COMPENSATION i °CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA COMPENSATION LAW** CONSTRUCTION INDUSTRY EXEMPTION This o gmeesthat file Individual Ilstatihelaw hasendtobe esompt from Rods bVorl st Compersation Wm. EFFECTIVE DATE: 1/23=13 EXPIRATION DATE lt2312015 PERSON: TERIOEL LESLIE FEIN: 581SE1683 BUSINESS NAME AND ADDRESS: HmF CONSTRUCTION. COMPANY 10110 AVENIDA DEL RIO DELRAYBEACH FL 33446 SCOPES OF BUSINESS OR TRADE LICENSED GENERAL PLUMBING NOC AND CONTRACTOR DRIVERS PID9teatN 4LPa ma1Dmat6 sta „11 6a .17.0. 04.40 .4"' ..62' Stair dim eg d a shat mX'NS matzo daaamman. DP34,2- CMG282. TSCA EMS. ,13AMM TO1EBORER REVISED 07-12 QUESTiONS? (8603412.1€09 https:// apps8.# irifs. eom/ crreportviewerfreportViewer.aspx ?data= kdvpginc fl7Q3gH6 R6... 2/20/20