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PL-12-1831Inspection Worksheet l Miami Shores Village .1 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-179387 Permit Number: PL -10-12-1831 Scheduled Inspection Date: May 15, 2013 Inspector: Hernandez, Rafael Owner: SUAREZ, ALEJANDRO Job Address: 85 NE 110 Street Miami Shores, FL 33161 - Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition/Alteration Phone Number Parcel Number 954/961-1400 1121360040240 Project: <NONE> Contractor: SANTINACHO ENTERPRISES INC Phone: (786)443-9590 Building Department Comments PLUMBING WORK FOR INTERIOR REMODEL Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction ❑ Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. May 14, 2013 For Inspections please call: (305)762-4949 Page 4 of 45 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shotes, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION FBC 20 OWNER: Name (Fee Simple Titlehold� Address: '. 141S NE 13111^ City: MCM Mlla,M1Ste; F L Tenant/lessee Name: A w Email: OCT Q 21"512 Ya�0000emm�emoo°o Permit No. Master Permit No )2— MINA ��%Phonekjy ZOO "171 S ,Zip: 331 to 1 A JOB ADDRESS: SS N E 11 O 4' City: Miami Shores County: - Miami Dade Zip: Folio/ParceW. Is the Bmllditag 11<Istorically Deslgnateds Yes v� NO Flood Lone: CONTRACTOR: Company Name: Address: 90,61C4 u. s3 t(r City: N m0?0^ ,a�.A State: _ t ° I --Zip: Qualifier Nam © W Phone#: )RCk:> State Certifications d t Registration* *-- Certificate of Conieteacy #: Contact Phone#: Email Address: DESIGNER: Architect/Enemeer Phon&. Value of Work for this Permit: $- Square/Linear Foo tags of Work. Type of Work: OAddress OAlteration ONew ORepair/Replace ODemolition Description of Work: Submittal Fee $ Permit Fee $ ;.L' v CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ No Training/Education Fee $ Technology Fee $ Doable ee $ 14 i C! 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) , C 1'f i-ZAN:1t! : Nuc Mortgage Lender's Address 1000 11Cf I OL10 (11 22- ,-- -.--- city n ` IRku' N1 State N10 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, WORD, 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature 9Signat Owner or Agent Contractor The foregoing instrument was acknowledged. before me this'-)-- day his2 day of , 20 . Lby eLXP1IAC�—�r-- who is n kno a or who has produced As identification and oath. NOTARY PUBLIC: p< w LMY COMMISSSION ON,# #EE108885 , EXPIRES: JUL 05.2015 «°, Bo ided through 1st Slate 'trend"® Sign: The foregoing instrument was acknowledged before me thisL day of CL . 2079 by who is rsonally kno me or who has prod�l as idea c 'ran who fan oa . t�< n MY COMMISSION #EE108885 NOTARY PUBLI EXPREs: JUL 05; 2015 An"drd thrqugh 1st Swe,nsumnce Sign: Print: Print: My Commission Expires: My Commission Expires: +�eeeeeeeeas�eeee��+xeeeeeeseaeae�x+e��x*eeeeet*aa��+����aee*�r<eeee�e+eye$�eaaeee�aa�xerAe�ea��e��a�e�+ee+e�sea�eeaeeeaae�ee APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 07/10/07KRevised 06/10=09)(Revised 3/15/09) r ILI' — 669477-3 HS IS NOT A aLL - LV RUT PAY REWWAL askasomma=Arm FfigWT W 6%778�1 SM11RACHO ENTERPRISES CORP STATE# CFC142UBS 2299 NE 164 Si 34160 NORTH MAW BEACH ONTRACTOR 00 bW FORWM ENTERPRISES CORP ANTONIO LOVARA PRES 2299 HE 164 ST 0 MIAMI BEACH fL 53160 09810029002 000945.00 6 �Jjl Till, : 0. f-WIll rug's.: a: A 07-17-201:: STATE OF FLOMDA DEPARTMIENT. OF SERV-1f."Es DiVISJON OF WORKERS' COVIPleNSATOW aL CERTIFICATE -OF %WTION TO BE. EXEMPT 4100 KORMA WMBn..0DNFE"SATl0NAAW*.* ACONSYRUCTION WOUSTRY-F-YEMPTION.' T:.5 c-pefies !:hitt O??- individual listed -taIL'N h:la S`arrk fi., :­ 9x!1'I1-:t f-.0ii Fl—oride '3 4 JEFFF-CTWE DME: 04J.'251202 EXPIAA 1`�% DA TE -3Z.'23;20'iA PERSON LUVAF.A ANT-D.NiO =Vrt X37 2? 33 BuS.INFSS; -NAME AND AODWSS-. &*el.rrNAa0 PireqpRing CORP - 4156 -sw $8 AvgWE 4L 33196 SCOPES Of RUSNESS 08 TRAM I- Cra4STRUCT2eff 3- PLP3lwW3,.Mc`AW0 DAIVMS CERTIF= -:UbSlhl�- CONTMA71W- 4,,e&P4:4a from' fillw-el ofillwu Ledo Imc ---OxWu tt Lbw 4410 cuc f. to tw. Ar-trift Psle'd-airms -J, u extcrt. 4N -Aar 444 ii:la US wicifou.xv w.'*xkwi aa wtvl=as *f , 2 'ay.O.MW iv. 1.,"Y &b. 1R- t C-p;BM's. 't:4 P"4'Lniv Cc ?b WICO U PA -jailao ai tul FQ'V­ od. c4e.r ft. I 3'n 1eNC-2;j2 CEV!gqCA.*jt )X JLc-,'j0fd -to 3,9 f*li',?T 8E7;SE_`- 01- P P:.EAS= Uu) L-Ul THE CARD BtL)A' *;: rlp.e OF: sisMs OR TR.Ikr;e 1: OR EAWCh K+.'dA itATAQ. 3- 7tl8ralV; 'ric Aho DAMPS A;4C ;ZeTA.'N FOR FUTURE RtfERENCE WPOSTANT Ldt:6(W. wofficar V ccts.rrfrom 'irn ihaPler by i;,ina 4 of ein-dor mavnor --Pier bafqf.ts'er zols;arsavclv w"cer ":s ;,v!tan- to Cuipmr .44QJ5tl21, Ot -dWilet' to to Wgcily rjr-,'y thi tl&.l*. Lsawc Or, E ri, ,soli._- ci *:ection to ba i,cmpt E FL-varl to +.Wtvf h:.,.Kos .0, * r w. . s tia.'rol -TO be txoript SWI *he .4^t=.fQ --ey5uaaW 0. d. Illy J;%t --fte, Tv ti'ma 'fif the notice or ailb muma of tin :he r.-AV;t or ccrl0:= M 1 --VW t:er:BtHt the re4tia-m-.9n... of "s ts-mcr !Or. . :4ya"nit cf.:& coficm. Th.a. aclaruftf- shal revoke a C*jn,fi*3 tg awj lata'to, 4WJars ot ft tv-.MsA-tb M4;J'tM.w4 Of LSIS CUT H9RE u Cargybottom pmilon on iche :ob, k�o_p upper Portion CMAWZ iijr F%ECT,(jW Til 13E ilEMPT�8EVbtJ C_—AKTME'PTOP MINAhMIAL WRIVICES 7, J��T4'CE\1ft3R3tGR`'ta'01�4tffiNSRTiU,W MSTAIL-101. Ti TRS! Mns?_lA-, E,;)F.sj3cr:l0NM 3e EXEMPT FRalA. FL-CMDA, vtioRl ERS 4C;cAvnWTi OR LAW r.=FECTPVS : 412S/2011 WjWZ0N-5P:Ffi: AM= LU%ARA zcUrE -470927= ei)WISS NAME AIM -ADORSS& S,r­iz,c,v zNTEVIM-9.1 ccs " sw to Avegbe Ft. 3310! *;: rlp.e OF: sisMs OR TR.Ikr;e 1: OR EAWCh K+.'dA itATAQ. 3- 7tl8ralV; 'ric Aho DAMPS A;4C ;ZeTA.'N FOR FUTURE RtfERENCE WPOSTANT Ldt:6(W. wofficar V ccts.rrfrom 'irn ihaPler by i;,ina 4 of ein-dor mavnor --Pier bafqf.ts'er zols;arsavclv w"cer ":s ;,v!tan- to Cuipmr .44QJ5tl21, Ot -dWilet' to to Wgcily rjr-,'y thi tl&.l*. Lsawc Or, E ri, ,soli._- ci *:ection to ba i,cmpt E FL-varl to +.Wtvf h:.,.Kos .0, * r w. . s tia.'rol -TO be txoript SWI *he .4^t=.fQ --ey5uaaW 0. d. Illy J;%t --fte, Tv ti'ma 'fif the notice or ailb muma of tin :he r.-AV;t or ccrl0:= M 1 --VW t:er:BtHt the re4tia-m-.9n... of "s ts-mcr !Or. . :4ya"nit cf.:& coficm. Th.a. aclaruftf- shal revoke a C*jn,fi*3 tg awj lata'to, 4WJars ot ft tv-.MsA-tb M4;J'tM.w4 Of LSIS CUT H9RE u Cargybottom pmilon on iche :ob, k�o_p upper Portion CMAWZ iijr F%ECT,(jW Til 13E ilEMPT�8EVbtJ Cct, 2. 2012 11:45AM FLORIDA BANKERS No, ?111 F. 1!1 ' 14 6CERTIFICATE OF LIAEI _ITY INSURANCE 1 DATE 0102D/5^M') '�_ -^"�'- _ _ _ _ i 10/02!12 THIS CERTIFICATE IS ISSUED ASA NATTER OF INFORMATION ONLY AND GC .VFERS 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 CON "RACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED �—REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: M the certificate holder is an ADDITIONAL INGURF , the poflc S) must bee: darsed. If SUBROGATION 18 WAIVED, subjectto the terms and conditions of the policy, cwWn policies may require an endorsement. A stat .meat on this certlficate does not confer rights to the I Certificate holder In lieu of such endorsement(s). 1 ! PRODUCER -- -- �6RTAi" --- — —_� NAME: f�ARTAALONSO Florida Banks Insurance PHONE (3()5)266.6493— —� No): (305)262-0679 —� 7278 SW 8 Street E4MLY marte(�Noddabankersinsurence can — Miami, FL 33144 _ _ INSURER(S) AFFORDING COVERAGE MAIC b� Phone (305)266-6493 Fax (305)262-0679 INSURER A FEDERATED NATIONAL ; INSURED -- -- - -- — — — -- — - _INSURER B _ SANTINACHO ENTERPRISES CORP. ENSURER C —� 4155 SW 96 AVE 0. MIAMI. FL 33165 (305) 956-3855 INSURER E>_----i-----_- L.-_—..•-. INSUREH F' I COVERAGES CERTIFICATE NUMBER: _ _ REVISION NUMBER: THIS IS TO CERTIFYTHAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN IS:. !ED O THE INSURED NAMED ABOVE FOR THE POLICY PEROD _ _ _ v`' I INDICATED. NOTWITHSTANDINGANYREQUIREMENT, TERM OR CONDITION OF AN'YCCN" -ACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BYYHE POLOAL S DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN RE :Eva BY PAID CLAWS.. I INSI - TYPE OF INSURANCE ADDL UB IM NUtoffiEFc C—D YiYS 1 MPOJC IVES — -- LINTS_ -- -` ( NSR WVD _ _ — -- -- — �• f --._ —� - ----T ---- - -- -a GENERAL LIABiLRY1.000,0 I I -BCH CC :�iRP=r.K:E i $ '00.00 1 _- Ci1GWERGALGEnr_4ALLIABILITY I I ?EhtSF; (E86CCufro::C61 $ 100,004_00 - ❑ ❑ CLP!MS-MADE © CCCU? I GL -0504005767-01 ,ECEXP ;Arg')i ;r*rson) > 5,000.00— — N ! M E 24. ?012 : 481242013 ' . — -- _ ^eFSV4AL & ADV INJUR'r s 1,000,000.00 =NERAL AGCPEGATE —is 2 400,004.00 GrEN1 AGGREGP is LIMIT APPLIES PER. �RODJCT^c - C?t1r^.^?= A.G>,4t�4,040.44 _ I✓ _POLII-Y ❑ T ❑ LOC AUTOMOBILE LIABILITY - -- -- - .T— --- - 'J ABINED S 1,1GL = Li M; tr'Ie aacldent - - - A.NY AUTOrr ❑ALL ONNED SCHEDULED AUTOS 17 ALTOS I I CL11_" INJURY (Petetridert? $ ti ❑ HIRNON-OvirED EC AUTOS AL,TOS I I !II =PeCFaEcRct r,d.4h_ ; $ -- --1I --- --- UMBRELLA LIAR ❑ OCCUR I -ADH CCOORPENCE $ EXCESS LIAR -. - - L�I CLAWS -MADE 0._� 2EG.4TE — ❑ GED ❑ RETENTION $ WORKERS COMPENSATION — --� —_— �C 51,0_1­ AND P ❑-� � AND EMPLOYERS'LIABILITY Y 1 N � .�Y! IT' - A.hly PROPRIETORI:I.ARTNERI XECU-IVE OFFICER0EAIBEREXCLUDED7 nNIA I _cL- EACHACCIDE;JT _ $ - - (Mandatory In NH) 7_ i = L_D;SEASE- EA aAPLGYF$ - -- - - - f yes, describe uncle r `—_DESCRIW-13M1 O- OPERATONS belor DESCRIPTION OF OPERAMONS I LOCATIONS 1 VEHICLES (Attach ACORD 101, AddRional Remarks Schedule, If more space is req. Ired) i I I I ! I j CERTIFICATE HOLDERCANCELLATION I SHOULD ANY OF THE ABOVE 0E6L R(BED POLICIES BE CANCELLED BEFORE MIAMISHORES VILLAGE THE EXPRATION DATE THEREOF, !IOTICE KILL BE DELIVERED IN I ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2 AVE MIAMI SHORES, FL 33138— AUTHORIZED REPRESENTATIVE 305-8239741 r i I 01988-2010 ACORD CO?PORATION. All righti reserved. ACORD 25 (2010/05) OF The ACORD name and logo .ire registered Mark _- of ACORD b