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RC-14-885 (2)Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-217284 Permit Number: RC -5-14-885 Scheduled Inspection Date: August 07, 2014 Permit Type: Residential Construction Inspector: Rodriguez, Jorge Inspection Type: Final Building Owner: BLANCO, JUAN Work Classification: Alteration Job Address: 146 NW 92 Street Miami Shores, FL 33150- Phone Number Parcel Number 1131010160010 Project: <NONE> Contractor: REGOSA ENGINEERING SERVICES INC Phone: (786)262-2964 comments KITCHEN AND 2 BATHROOM REMODELING ' - -- INSPECTOR COMMENTS False August 06, 2014 For Inspections please call: (305)762-4949 Page 19 of 25 Inspector Comments Passed '�J_m Failed Correction Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. August 06, 2014 For Inspections please call: (305)762-4949 Page 19 of 25 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 R ECEIVED 30 014BY: FBC 2010 BUILDING Master Permit No. c _ I Lj -- PERMIT APPLICATION Sub Permit No.!2) l � -- E-2f-L ❑BUILDING ❑ ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP It C� (' CONTRACTOR DRAWINGS JOB ADDRESS: 4410 NW `2 ?T ✓! City: Miami Shores County: Miami Dade Zia: Ba1co- Folio/Parcel#: 4 _ 2-))l DA O! " A " '10 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee S Address: ' 4 I City: w Tenant/Lessee Name: Email: p: 3 s C eJ u CONTRACTOR: Company Name: —Phone#: TOO /�. • kk % • Qualifier Name: %OV;h V C5 State Certification or Registration #: DESIGNER: Architect/Engineer: Address: Value of Work for this Permit: $ Type of Work: ❑ Additio'n__ oo ❑ Alteration Descriation of Work: o �(�.� 0-f- 0 of Competency #: V - i Specify color of color thru tile: 9 Submittal Fee $ Permit Fee $ TS CCF $ CO/CC $ Scanning Fee $ Technology Fee Structural Reviews (ReAsed02/24/2014) Radon Fee $ DBPR $ Notary _ Training/Education Fee $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ Demolition Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address Zip 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 ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, 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 commen ent must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In th a sence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature OWNER or AGENT The foregoing instrument was acknowledged before me this I day of 0V%k, 20J by U&CA &NO, who is erso y known me or who has produced as The oregoing instrum Kwas acknowledge4bef1re is iday f v�by who isto me or who has produced identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: LUZ EDITH 61RALD0 Commission #EE53278 Sign: Sign: MY Commission Expires Print: Print: GU DO Seal: :+_ ply g�#i1 E108QD Seal: WM AdY 04.2015 as APPROVED BY � Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) STATE OF FLORIDA DEPARTMENT. OF 1317SINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY.LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET y � TALLASASSEE FL 32399-0783 VELEZ, GUSTAVO DANIEL REGOSA ENGINEERING SERVICES INC 15700 NE 2 AVE uE MIAMI FL 33162 002184 Local Business Tax Receipt Miami -Dade County, State of Fldrida -THIS IS NOT A BILL DO NOT PAY 5574117 BUSINESS NAME/LOCATION IP RECET NO. REGOSA ENGINEERING SERVICES INC RENEWAL 1050 SE 5 ST BAY 9 6813960 HIALEAH FL 33010 LBTJ EXPIRES SEPTEMBER 30, 2014 Must be displayed at place of business Pursuant to County Code' Chapter BA - Art. 9 & 10 OWNER SEC. 'BYRE OF BUSINESS PAYMENT RE=CEIVED REGOSA ENGINEERING SERVICES INC 196 GENERAL BUILDING CONTRACTOR BY TAx cct.1 CWE Worker(s) 3 CGC75�952 $45.00 07/10/2013 TXHSI-13-021229 This Legal Bash" Talc Receipt only confirms Payment of the Legal Business Tax. The Rec is not a license, bo w mac„ busiM ss. Holder must comply witb any governmental or parent, ar a certificalloo of the Ider s ocm, to d nongovernmental regulatory[no o and re apply to the business. `the RECEIPT NO. above must be displayed on -an commercial vehicles- Miami -Dade Code Sec 8a-278, For more hdormation, visit wwuv mip!M!pde govRrnccaHectnr STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGMATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH MONROE'STREET .�� TALLARnSSER FL 32399-0783 VELEZ GUSTAVO DANIEL REGOSA ENGINEERING SERVICES INC 15700NE 2 AVENCIE MIAMI FL 33162 Local Business Tax Receipt Miami -Dade County, State of Florida -THIS IS NOT A BILL - 00 NOT PAY 5996336 un ] i BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES REGOSA ENGINEERING SERVICES INC RRA WAL SEPTEMBER 30. 2094 1050 SE 5 ST 9 021$"17' Must be displayed at place of business HKEAH FL 33010 Pursuant to County Code Chapter 8A - Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS PAYMENT RECEIVED REGOSA ENGINEERING SERVICES INC 196 PLUMBING CONTRACTOR BY TAX COLLECTOR CFC1427292 Worker(s) 1 $45.00 07/10/2013 7)(161-13-021229 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is rot a license, permit or a cert�cadon of the holder's qual lostions, to do bustnass. Holder Aust complyvvit6 any goeeramental or nongovernmental'"Watery laves and vegahemoms which apply to the business The RECEIPT N0. ahova most he displayed on all commercial vehicles - Miami-Dado Code Sec lia-M For more iolormellon. visit vwvuv ariamidada gavhexcoltector AC# 6214807 STATE OF FLORIDA �►v.� ia�ua.s svav iara�.uo y az : at�.vmarl�riavv ave+uw SEW L12072200095 . • = a =2012 2012 12.8014507 ,CFC1427.292 LICENSE NBR ,,;, '. .,.:. RICK -SCOTT REN LAWSON- GOVERNOR SECRETARY DISPLAY AS REOUtREQ' BY LAW , - CERTIFICATE OF LIABILITY INSURANCE °A TE 001,6120` 4" 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, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT* Ifthe certificate holder is an ADDITIONAL INSURED, the polley(ies) 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). pR�� ACT Best Rate insurance Agency Inc (866) 616-0065 Not (305) 403.0801 8600 NW 17 St. Suite 170 Doral, FL 33128 Phone (866) 616.0065 Fax (305) 403-.0801 INSURER AFFOROMCOVERAGE 1401CH tNsuRER Brld afield Employers Insurance Company 90701 INSURED Regosa Engineering Services, Inc 1050 SE 5th Street, Bay 9 INSURER B r Preferred Contractors ins Co RRG LLC 12497 SURER C : Progressive American Insurance Company 24252 INSURERD: Hialeah, FL 33010 INSURERS: Phone (786)262-2984 iNS F AUTOMOBILLtIABILRY a sG ®N ULEp HiREDAUTOS ® AUTOS COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE -FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER OOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN iS SUBJECT TO ALL THE TERNIS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CMTS, TYPE OF INSURANCE ADD B u CYNWRER 10 W& &EM Will S B GENERALLIABMY =AltMCiAL GENERAL LIABILITY E] ❑ CMWAADE ® OCCUR F1 GEHL AGGREGATE LILUT APPLIES PER 11 POLICY ® ❑ LOC N I PC83837.03 06/13/2014 06/13/2015 HOCCURRENCE $ 1,000000._00 h GE a ocean S 50,000.00 MED EXP An one psrson S 5,000-00 PERSONAL& ADV 94JURY $ 1,000,000.00 GENERAI.AGGREGATE $ 2,000,000.00 PRODUCTS- COMPiOP AGG $ 1,000,000.00 $ C AUTOMOBILLtIABILRY a sG ®N ULEp HiREDAUTOS ® AUTOS 01873815-0 06113/2014 08/9312015 ani INMELihUr g 300,000,00 BODILY i aMY (Par Tamm) $ BODY KIURY 0e � $ S Comp & COD Ded $ 100,000.00 UNNM.LAUAB ®(OCCUR 0 Excess t 1aB ❑ CLA,At3ME F-ACHOCCURRENCE S AGGREGATE $ 10 DED 0 MEWK)-N$ A 6YORXERSCOt1PENSATION ANLW D ENPLOYERV LIABILnY YIN ANY PROPRiETORIPARTNERIEXECUTNE g&nd8I yh1NM EXCLUDED? a ew yq@ass�� WW"Na NIA 0830-50966 05/22/2014 05=2015 WCSTATU- E.L EACH ACCDENT $ 1,000,000.00 EL DISEASE- EA EMPLOYE $ 1,000 000.00 ELDiSEASE-POLICYLIMIT $ 1,000,000.00 DESCRIPTIM OF OPERATIONS I LOCATIONS /VEHICLES (Attach ACORD t01, AddiNanai Re�narkg 3chedute, (f mora space N �aguired) Miami Shores Village Building Department 10050 NE 2nd Ave Miami Shores FI 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Avr4160-11"_ - ACORD CORPORATION. AO rfahts ACORD 25 (2010105) OF The ACORD name and logo are registered marks of ACORD BUILDING Mi -ami Shores Village Building Department _ MAY ®� %/ r 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 BY: INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20 Master Permit No. _ 1,4 SEE PERMIT APPLICATION Sub Permit No %BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLICWORKS [:]CHANGE CONTRACTOR ❑ CANCELLATION ❑ SHOP DRAWINGS JOB ADDRESS: 146 GVW % til City: Miami Shores County: Miami Dade Zip: 33' S Folio/Parcel#: [I e 301-- CIG_ M18 Is the Building Historically Designated: Yes NO Occupancy Type: OM Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Im `y 1, Phone#: Add City: Miami S � State: Tenant/Lessee Name: Phone#: Email: Og D E LG O al CONTRACTOR: Company Name:q;*tAq;..1kC_PhoneM186 2 4r�'' Address: ��d ✓ S'T !;UM City: State: Zip: 3 7'�� Qualifier Name: V� Phone#: • 242 .Iq &V State Certification or Registration #: �' fSDG��a Certificate of Competency #: DESIGNER: Architect/Engineer: Value of Work for this Permit: State: Zip: Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition Description of Work: K,�c+� AMD 13"0004hr. BF, M0 I'` AA Specify color of color thru tile: Submittal Fee $ 5V `00 Scanning Fee $ Permit Fee $ CCF $ CO/CC $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ Technology Fee $ TOTAL FEE NOW DUE $ ° Bonding Company's Name (if applicable) { Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip 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 broch a will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commence t must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the bs nce of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature k Owner or Agent The foregoing instrument was acknowledged before me this day of u 20 by _3U A 64 cliG o who is p na y kno me or who has produced NOTARY PUBLIC: Sign: Print: W My Commission Ex As identification and who did take an oath. July 04, 2015 The=foregoing instrument was ackowledged bf fore me this day of 0' by ruwmwo who is p so�knowno me or who has produced as identification and who did take an oath. NOTARY PUBLI LUZ EDITH WALDO My COMMISSION # EE53= EXPIRES: March 22, 2015 V PI Notmy DWount Asm Co Sign: Print: My Commission Expires:1VIi r VT 000 Jj1, APPROVED BY Plans Examiner Zoning Structural Review (Revised02/24/2014)(Revised 5/2/2012)(Revised 3/12/2012) )(Revised 06/10/2009)(Revised 3/15/09)(Revised 7/10/2007) Clerk STATE OF FLORIDA DsPARTm=T OF alasnMas AND monssiowm REGULATION CONSTRUCTION -INDUSTRY, -:LICENSING BOARD 1940 NORTH MONROE STREET TALLAH49SM . FL 32399-0783 VEMZj, GUSTAVO DANIEL REGOS ' ENGINEERING SERVICES INC 15700 NE,XVMUE Mimi ,2 *L 33162 0021" Local Business Tax Rebeipt Miami—,Dade County, State of F1 rida THIS IS NOTA BILL- DO NOT PAY 5574117 (850) 487-1395 BUSINESS AIAMEMOCAMON WIMEWF NO. EXPIRES REGOSA ENGINEERING SERVICES INC RENEWAL SEPTEMBER 30, 2014 1050 SE 5 ST BN 9 6813900 Must be displayed at place of business HKEAH FL 33010 Pursuant to CouvytV Code Chdptet8A-Art. 9&10 OWNER SEC. TYPE OF BUSINESS PAYMENTIMEWED REGOSA ENGINEERING SERVICES INC 196 GENERAL BUILDING CONTRACTOR By 'rAx cou.EcIrOR Worker(s) 3 CGC1508952 $45.00 07/10/2013 TXHSI-13-021229 This Local Business Tax Reno only coldirals of he Local Busliess Tax The Receipt Is not a license.I jot permit, or a cerfficellen of the holder's qua=Mne busloom Holder must comply with any govoramental of nongovernmental regulatory laws and requirements which applyto the husiness. Tho RECEIPT NO. above must he dispMW on all commercial vehicles- Miami -Bade Code See 80-27& -for more Information, vbh w mourdeaddideamowcollecto- I STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 VELEZ, GUSTAVO DANIEL REGOSA ENGINEERING SERVICES INC 15700 NE 2 AVENUE MIAMI FL 33162 Local Business Tax Receipt Miami -Dade County, State of Florida -THIS IS NOTA BILL- DO NOT PAY 5996336 BUSINESS N1AMEMOCATION REGOSA ENGINEERING SERVICES INC 1050 SE 5 ST 9 HIALEAH FL 33010 RECEIPT NO. EXPIRES RENEWAL SEPTEMBER 30. 2014 8256317 Must be displayed at place of business Pursuant to County Code Chapter SA - Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS PAYMENT RECEIVED REGOSA ENGINEERING SERVICES INC 196 PLUMBING CONTRACTOR BY TAX COLLECTOR Worker(s) 1 CFC1427292 $45.00 07/10/2013 TXHSI,-13-021229 This Local BusiassTax Receipt only confirms payment of Ute Local Business Tax. The Receipt Is not a license, permit or a certification of the holders qualifications, to do business. Holder most complyv"M any governmental or nongovernmental regulatory leans and requirements which appip to the business. The RECEIPT 1N. ohm must he displayed an all commercial vehicles - Miami -Dade Code Sec 8a47L For more information, visit vuvrw miamidadegovRaxcoilectei 0 AC# 6214807 STATE OF FLORIDA gg �p,�, DEPART NSTRUCTIOONN WUSTSTRYRLICEN$ING BOAI"IIlo" P SEL12072200095 F r - LICENSE NB 07/22/2012 1128014507 CFC1427292 f The PLUMBING CONTRACTOR Named below IS CERTIFIED. Under the provisions of Chapte'r 4s9- Expiration 69Expiration dates AUG 31, 2014 VELEZ, GUSTAVO DANIEL REGOSA ENGINEERING`SERVICES INC 1050 SE STH STREET SUITE 9 Hr; L AH FL 33010 RICK SCOTT KEN LAWSON GOVERNORSECRETARY DISPLAY AS REQUIRED BY LAW