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EL-11-1617BUILDING 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 PERMIT APPLICATION Permit Type: Electrical JOB ADDRESS: A -_)t4) I P 1 t�� . FBC 20 Permit No. E ( H ®l 6 Master Permit No. I) - I , j 9 . City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee City: A.1 . State: Tenant/Lessee Name: _ Phone#: Email: cell e's , C&"'_ CONTRACTOR: Company Name: (2 P-�: Phone#: 3L)5- "'5,70 Address: 16o ® A(LJ 29'x; City: 14M/ State: Zip: Qualifier Name: AW &,W Phone#: State Certification or Registration #: EC 13 ® 0 0 ( Certificate of Competency #: Contact Phone#: Email Address: DESIGNER: Architect/Engineer: Value of Work for this Permit: $ a., O Square/Linear Footage of Work Type" Work. OAddress 4=#on ONew LJRepair/Replace ODemoliti6n Description of Wprkz'IL; 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 Mortgage Lender's Dame (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 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 inspectio which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be ap a reinspection fee will be charged. Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this Z+ The foregoing instrument was acknowledged before me this 2.--+ day of _ 20 _*, by (-) A C day of , 20 �, by N4�cr►iae U Biu who 's ersonall own tom r who has produced whq4sperguffa y mown tom r who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My APPROVED BY REYES MAComm. E*MS Oct 11, 2015 Commleslon N EE 106714 BOOM TW* NaWal Marr Assn. . f, / All AAA— Plans Examiner Structural Review (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) NOTARY PUBLIC: Sign: Print: My ,my c . Expir4's Oct 11, 2015 COMMIssiOn N EE 106714 60rM TIS National Notary Assn. Zoning Clerk ' Miami Shores Village 7BYY: Building DepartmentAR 04 201 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 Permit Type: MECHANICAL JOB ADDRESS: FBC 20 Permit No. 1, C t 1 15 ®l �- Master Permit No. ) ] — 1.11S-9 6' City: Miami Shores County: Miami Dade Zip: Foho/Parcel#: 1®— s w% m ®7.1 m® \(0Q Is the Building Historically Designated: Yes NO w Flood Zone: OWNER: Name (Fee W.&IM2.Ta City: ati®��� State: —_o Zip: Tenant/Lessee Name: r Phone#: Email: CONTRACTOR: Company Name: 7AO' 0� Vim/ !j `C Ca- �`,/ tC Phone#: ��®S � 119 Address: L:f %✓� City: State: Zip: �53 /_�'5 Qualifier Name: r Phone#: State Certification or Registration #: ef /4L-- Zef 6 3 C (S Certificate of Competency #: Contact Phone#: _ 30 5 _Z 16 e) yl )-i Email Address: 05X df—) 4k F U0,00 f/k DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ 3av� Square/Linear Footage of Work: Type of Workr'UA-064 ONew ORep*. laee �� - Description o f Worst:'` A—,- C = )fib,ti c4 Submittal Fee Scanning Fee $ Permit Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CCF $ CO/CC $ DBPR $ Bond . Technology Fee $ TOTAL FEE NOW DUE $ WA 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In thy,absence of such potted notice, the inspection will not be approved and a reinspection fee will be charged. / /` 1 Jgy%��— Signature Signature .mss Owner or Agent Contractor The foregoing instrument was acknowledged be re me this 2� The foregoing instrument was acknowledged before me this day o .a , 20 J , by ld f i r L— day of ro , 20 ! , b I who' erso ho has produced persona own me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: My APPROVED BY ;M$Jrf. ExpirestOct 11, 2015 Commission # EE 106714 Bonded Through National Notary Assn. NOTARY PUBLIC: P' Notary l- S t FIM a M �`n ash 4E EE 106 14 // 11' Through NOW Notary Assn. Plans Examiner Zoning Structural Review Clerk (Revised 3/ 12/2012XRevised 07/10/07XRevised 06/10/2009)(Revised 3/15/09) Miami Shores Village Building Department 10050 N. E.2nd Avenue Miami Shores, Florida 33138 Tel (305) 795 2204 AIR CONDITIONING REPLACEMENT DATA Fax: (305) 756.8972 PERMIT NUMBER: MC This form must accompany ALL air conditioning replacement permit applications. Each unit change -out must be on its own data sheet. Multiple units on single sheets are not acceptable. Job Address (where the work is being done): CO- I City: Miami Shores Village County: Miami Dade Zip Code: ALL CONDENSING UNITS MUST BE ON A 4 INCH SOLID CONCRETE SLAB ALL UNITS MUST COMPLY WITH F.E.M.A MINIMUM FLOOD ELEVATION A COPY OF THE CONTRACT IS REQUIRED WITH ALL SUBMITALS ARI (AHRI) DATA SHEET REQUIRED Change Disconnecting means: YES ❑ NO ❑ ARHI Sheet Attached: YES ❑ NO ❑ Contract Attached: YES ❑ 1. 2. 3. 4. Minimum Circuit Ampacity (Aire Size): w e Maximum Overcurrent Protection (Fuse/Breaker Size): K 40 "T, ) Voltage of Circuit (208/240/480): 'Z.. d °— 2- 3 Size Disconnecting Means: 3 eq 4".A—p- Contractor's Company Name: Phone: -Z,-, ®S _ Z ) 8 6 8 State Certificate or Registration N. %45 Certificate of Competency N. Signature Date: Z -/-z 0 (Qualffle afore only) UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER „Q AHU or PKG. UNIT MODEL # E0? 1 COND. UNIT MODEL # KW HEAT NOM TONS 'X, AHU CU PKG 1 M.C.A AHU CU PKG AHU CU PKG 2 M.O.P AHU CU PKG AHU CU PKG 3 VOLTS AHU CU PKG PKG UNIT' / / PKG UNIT 1 / EER/SEER 10 YES NO REPLACING DUCTS YES ✓ NO YES NO REPLACING THERMOSTAT YES °— NO YES NO NEW 4°CONCRETE SLAB YES `+- NO YES NO NEW ROOF STAND YES NO YES NO NEW RETURN PLENUM BOX YES V' NO Minimum Circuit Ampacity (Aire Size): w e Maximum Overcurrent Protection (Fuse/Breaker Size): K 40 "T, ) Voltage of Circuit (208/240/480): 'Z.. d °— 2- 3 Size Disconnecting Means: 3 eq 4".A—p- Contractor's Company Name: Phone: -Z,-, ®S _ Z ) 8 6 8 State Certificate or Registration N. %45 Certificate of Competency N. Signature Date: Z -/-z 0 (Qualffle afore only) 02128/2014 12:06 P.0011001 CERTIFICATE OF LIABILITY INSURANCE L 02128/14 PRODUCER Accurate THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 8300 West F"Ier Suite 114 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Miami, FL 33144 HOLDER. THIS CERTIFICATE DOES NOT AMEND, BRTEND OR ALTER THE E BY THE POLIC IES BELM Phone (305)226.6727 Fax (32284787 INSURERS AFFORDING COVERAGE NAIL 18 INSURED (The) Hunter Air Conditioning Contractor INSURE a Grande Insurance Com ny - — 1790 SW 141 Ave iNsupEg B: Normandy Harbor Insurance Com an Miami, FL 33175- INSURER C: I INSURER 0: COVERAGES INSURER E: TKE ROLICIE3 OF INSURANCE LISTED HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITMTANDING ANY REQUIREMENT. TERM OR CONOMON OF ANY CONTRACT OR OTHER DOCUMENT 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 TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS. INGHADD LM D TYPE OF INSURANCE POLICY NUMBER p�j "TWE2WOKPIRAT01 LIMITS GENERAL LIABILITY EACH OCCURRENCE 1,000.000 10 COMMERCIAL GENERAL LIABILITY 118FL456982 0812212013 0811?J2014 �IaE 6a ED100.00 A 1:1❑❑ CLAMS MADE Q OCCUR MED EXP wyam Paw) 10.0000 ❑ PERSONAL SADVINJURY 110001000 ❑ GENERAL AGGREGATE 2 nnn (IAn GENS. AGGREGATE LIMIT APPLIES PER: _ © POLICY ❑ PROJECT ❑ LOC AUTOMOBILE LIABILITY ❑ ANY AUTO ❑ ALL OWNED AUTOS B ❑ ❑ SCHEDULED AUTOS ❑ HIRED AUTOS ❑ NON OWNED AUTOS 13 ❑ IGARAGE LIABILITY M ANY AUTO EXCESS I UMBRELLA LIABILITY ❑ ❑ OCCUR ❑ CLAIMS MADE ❑ DEDUCTIBLE ❑ RETENTION 3 B lZiA1ORIETOR M PARTNER I HXECUT WG YM OFFICER I MEMBER EXCLUDED? (Mandator► In NH) PRODUCTS - CdAP/0P AGO COMBINED SINGLE LMR 800ILY INJURY BODILY INJURY (Per Mdd" PROPERTY DAMAGE P� AUTO ONLY • EA ACCIOEN OTHERTHAN EAAC AUTO ONLY: AGG EACH OCCURRENCE AGGREGATE 131825 11/26/2013 11/26/2014 Id I JIMa E.L. EACH ACCIDENT E.L. DISEASE. IPA EMPLOYEE E.L. DISEASE - POLICY LBftT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I UO - Replacing Air Conditioning Certificate holder is listed as additional name Insured. CERTIFICATE HOLDER Village of Miami Shores 10050 NE 2nd Ave Miami Shores, FL 33138 305-786-9557 BY ENDORSErtAENTI CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED To THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPOfjTW IIj@UR% ITq AGENTS OR REPREBONTATwes. Lucia ® 9988.1009 ACORO CORPORATION. An rights reserved. The ACORD name and logo are regIdered marks of ACORD t 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 Permit Type: PLUMBING 0 4 20% Permit No;�/,P 1 11, ®- Master Permit No. J I a 1 fq �5— JOB ADDRESS: O b_�) 1 (Q . City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO a/ Flood Zone: OWNER: Name (Fee Simple Titleholder): Phone#:_ 30!�' ~ 13'-0 City: / , A, w_ , State: e 9 zip: Tenant/Ussee Name: Phone#: Email:',L14 r - CONTRACTOR: Company Name: ; .. , �'c�'� i Phone#: 6,`, / —2 - Address: City: Ali PI J Qualifier Name: Zip: L � �.� Jr State Certification or Registration #: r c e Certificate of Competency #: Contact Phone#: Email Address: :;-a' DESIGNER: Architect/Engineer: Phone#: a ^ r A n Value of Type of Wor ©Address !UAlteration . 1 Description o Work,��`u��� _�Kuaa cr rvvy�agc y�_; s,�:vf n. ONew� �$ Submittal Fee $ Permit Fee $ t ,_ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CCF $ CO/CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $,�/��- CEJ Bonding Company's Name (if applicable) Bonding Company's Address City . State Mortgage I,endW&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 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 thea ence of such posted notice, the inspection will not be appro d and a reinspection fee will be charged. Signature Signature Owner or Ag t Contractor The foregoing instrument was ackn wled a me this )4 The foregoing instrument was acknowledged before me this day o , 20 1+by day of g2o by �iACCAV[us - eI er. �1o ispersonally own to meo ho has produced who i personally Dowor who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: Sign: �`O"�,�",, A FNY REYES u �. ■ ru- Print: - MyOct 11, 2015 z, s n My Commissio Eit Naftal Mary Assn APPROVED BY ? -Y- ( q Plans Examiner Structural Review (Revised3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) NOTARY PUBLIC: Zoning Clerk 0010$3 Local Business Tax Receipt Miami -Davie County, State of Florida -THIS IS NOT A BILL -DO NOT PAY 4464889 BUSINESS NAMEILOCATION ISLAND PLUMBING COMPANY 326 CRANDON BLVD 705 VILLAGE OF KEY BISCAYNE FL 33149 RECEIPT NO. EXPIRES RENEWAL SEPTEMBER 30, 2014 4661303 kluge be displayed al placer of business Purru:mt to County Code Chaplet SA - Art 9 & 10 OWNER SEC. TYPE OR BUSINESS nD ISLAND PLUMBING COMPANY 196 PLUMBING CONTRACTOR BYTAPAYMENT LLECRECEOA CFC0574B6 BY rax c®tl.�crolt Worker(s) 10 $45.00 07/10/2013 FPPUII-13-001631 This local Busirmss Tait Receipt only canlirms payment of am local Business Tex. The Receipt is not a license, permit, at a certification of the holder's qualifications, to do business. Holder toast comply with any governmental er nangoveramental regulatory lavas and requirements which apply to the business The RECEIPT No. above must be displayed an all commercial vehicles - Miami -bade Code Sec Ba -276. For more information, visit gai�niaonidade agvllagggllectm •r ,4c R�' CERTIFICATE OF LIABILITYl9LAN-2 OP 10, c INSURANCE °"Trz°M"°°ftyfy) THIS CERT' KATE 15 ISSUED AS A MATTER OF INFORMATION ONLY ARID CONFERS NO RIGHTS UPON TI1B CERTIFICATE H 1111412014 THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, F.=ND OR ALTER THE CQUPON T CERTI ICFFORDED TEBy- THE EFL THIS BELOW. THIS CERTIFICATE E INSURANCE DOES NOT CONSTtFUTE A CONTRACT BETWEEN THE ISSUING INSIlRER(S), AUTHORIZED I PRESENTATNE OR t'ROI)uQi�, AND THE cERTIFICATE HOLDER. IMPORTANT: ff fha ot'rtitieate holder Is art ADDITIONAL IN$IIi�E4r the rns and Conditlormust the ta(s of the polIM certain 111006188etes POUR WS) be endurwd, if SUBROGATION IS WAIVED, subject to t eKfi' tt:ate holder In lieu of SiR:lr enaorsemem(s) "wire an antlorsenlegt A stateDTaraR on th18 CMACafe does not center right to the PROISUCEk Fort Lm...%'UdorsTale, c 33319 valliam F. Dowd III----- PHONE '--.." '-- ---- __ _.....__._ .. -- •-- -, tttBURED I51and PlurnbEng Ctriparsy o _........ _T...._. _�xvgtgtFS,APPORattta aovaawue eeial IHStAtERanNavl atgrsS fns.l;p - ;38056 Ina �ISURER6:7fdYeleTs _ -�r.._ .......... _..- •--- ..._._.�_ ---- P. Q_ Sox 490984 Key Biscayne, FL 33448 . _._._ .. _...._;25658 ar ; i=t'. lnSUrdn �-- ..,__ oe Company .... ;10178 IN5URFJZ COVERAGES CERTIFICATE NUMBER: nimm P.THI IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELgW HALAL-' BEEN ISSUED TO THE INSURE�MEDNABOVF_ FOR THE POLICY PERIOD INDICATED. INDICATED. NOTWITHSTANOINO ANY REOUIt�IT, TERM OR CONDITION OF CERTIFICATE MAY Be ISSUED OR MAY PERTAIN, -INE INSURANCE AFFORDED BY TH$ POLICES DESCRIBED HEREIN IS WITH ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO RESPECT Cl EXCLUSIONS AND CONDITIONS OF SUCH POIJGES. TO ALL WmI WHICH THIS UMITS SHOW_ N MAY HAVE BEEN 1 11lC8D PAID CLAIMS. AbDLSU '... . " ' TERMS. TYPBOFINSURANCE PDLIt:YA((INBCR r UUMERALLUIEILITY Tl" F tiaf0 LWS ,—' _ .. ._. . A X t cor�a,Tr Rewe aENer.A�Ir,�;Lln HO l4CGLt22 6iC Irl (=UR.REN'M S 01110/Z094.04/i012015 efle — 1, S 1,000,00 CLAIASS.RtAIK X: OCCUR :^ .,— MI�oExP(AnaroQasmr. S S _ __ 6CCItld ._.. .._....._..___.....__.... •FEREONALBADV•1NJUP.Y I 1,OoaQa QUXtAGGREGATE LTMIT APPLIES PER i 8,0x0,0 X POUCY PRO LOC PRODIlG7g-COMPfOPAGG ° § : T«'1.000 0 ' AUTOMQBRE LtABRA Y t • 8 X i ANY AUYaI BA-SA320892-14-SEL. 1� FNEO StN6LE LMI (I^8•tnccute(rtl •, , ._.... _ _ :g. 01!0812014 i Diills/3015 BMLVINJURY MOS Au'r0S (Per po-so�j _ HIRED AUTOS N NNEO I .. ; I 80DILY INJt1RY (Per 0ccidentl. S ; fiR F�.RiY'r�iayv'Ct, S � IPE ACCpW*., CCCUR ExCBSS UAB ' DED RfTt=nT10Ns AGG .... REGATE ....._.»_ _._i Y MIS$ COnFEN9A1lON 5........._ ND E ANDEMPLO>ERS L1A91u7r C :ANY vaoalxlrypyTH •WCf8A179 =xQ.uoED+ n /A WC STATU OTl{- t I X 70FiX.U,M!TS _... I ER„ jjjI — + ' 0712312013 07/23/2014 } (Mawdw fin" I E.L. EACH ACCIDEN 1,000,00 1f Des. dQ2w%* under t]ESCRIPnON OP 0PARA,n0NS 1 i j 6.L: DtsBAs� - 6A EArffR.oyEB S »E.L 9,000,00 DLSEuii - POUCY UtdtT i DESCRIPTION GP OP ATIONS I LOCATtONs l VaittlCl g5 (AttaeM ACORD 101. Addmeeat R.Me M SclrcdWe, it mem $Mm Is TeR+�3 Plumbing contractor ' A VIIIB9e of Miarn! Shores 40050 NE 2 Ave. Miami Shares, K 33438 ACORD 25 (2a10105) 10/10 39dd MlAMIS2 SHOULD ANY OF THE ABOVE DEgCRIBED POU=S W CAWCg, _, 130FOM THE EXPIRATION DATE '{HEREOF, N0110E WILL, BE 'DUWERED IN ACCORDANCE'Wk7H TM POLICY PROVISIONS. ALITHORRRMIM {—u�pfp gg(RaT1YE /f The ACORR name and logo are registered marks Of ACORD NOIlonNiSN00 aWiSI 681619650E Ai1 rights reserved. 6Z:01 b10Z/00/E0 farm* Shores Village Building Department =50 NE -2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUAMER: (30P 76ZA949 BUILDING PERMIT APPLICATION Permit Type: BUILDING 1 JUL 2 , cd is FBC 20 Permit No. 15-czS-- Mas W Permit Na ROOFING JOB ADDRESS: 115 &�&_D tQ 1 4. - - Maori Shores Couaty: Miami Daae Foliornarcew: Is the Builft Ektor)WRY Deignate& Yes NO Rood Zai: TeenanL meName: Email: (/RmC,n.Y CPIA l+_S t—.) A& Phone#•.._ Y i��llwd 1 \ 11 1 1 ' � 1 Cloy: State: —Zip: Qualifier Name: �, State Certification or Re0stration #: Contact Phone#: DESIGNER: Archy .. try5��: Value of Work for this Permit: $ L/ / Type of Work: OAddition OAheration Dewrip of Work: C QAA!SA 4 Av 01 Cettificate of Competency #: Address: '"a AL 1252-8- Phone#; 305 X31- t7 70 Color Mm 171: ONew -" r 1ka'.113 Fa fl i s k Submittal Fee $ Perntit Fee $ W *U� J CCF $ MCC $ Senning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ 1'rainln$lEdnartlall Fee $ Technolog Fee $ Double Fe $ Sbwhuw Review$ TOTAL FEE NOW DUE J501 Banding Company's Name (if applicable) _ Bonding Company's Address City r.--. State Mortgage Lender's Name Cif applicable) ✓� Mortgage Lender's Address ---- City State 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 constntction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, FOOLS, FURNACES, BORERS, HEATERS, TANKS and AIR CONDITIONERS, ETC..... OWNER'S AFFIDAVM I certify that all the foregoing information is accurate and that all work will be done in compliance with aU applicable laws regulating construction and zoning. G . 1 `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 UINTM NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeifing $25W. the applicant must promise in'good faith that a copy of the notice of commencement and construction lien taw brochure will be deliverers 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-* ed. }the lzbsenve,bf such _posted notice, the inspection will not be approved and a reinspection fee will be charged Si Signature <� yo Owner or Agent Contractor — Ar— The fore oing instrument was owledgedbefore me this The fo' g t was ackno wkdged day of_.�, day of .20Z34 ac - who is known to or wh has produced who is personally to me who has prodttced As identification and who did take an oath. -- - as Iden ' and who did take an oath, NOTARY PISBLIQ NOTARY PUB Si a t® of Rm ida $1 .Flint: My Comms Aor lila I'Id , B EB dWIS t e+�e�es**rt�tt+txe�ateeaeee���k��x�ea,x+�,spa*eex+txc:�se�ra�++��aea���e�w��s**sae APPROVED BY Plans Examiner. Zoning Structural Review Clerk (Revised 3n212012)tlt 1 mnortrWevised 06nonM)(Revisea 3ASM) r, '*U wlw.,l WA &W"tcm Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR/ ARCHITECT 'Permit N. RC I l - l s :s— Owner's Name (Fee Simple Title Owner's Addre s: _ "S7 City: Job Address (Of where work is being City: Miami Shores Contractor's Company Name: Address: Phone #: 3c S'- 45V-7/34 State: �C Zip Code:. SA_. State:—Florida Zip Code: Phone #: City: State: Qualifier's Name: Lic. Number: Zip Code: rchitect/ ngineer of Record Name: a�Q �� ��: Phone #: 3o -- 'L.31- 1170 Address: -1009 5�6 72 - City: State: :7 Describe Work: Zip Code: _V/ss I hereby certify that the work has been abandoned and/or the contractor/architect is unable or unwilling to complete the contract. I hold the Building Official and the Miami Shores harmless for all legal it SignRU Signature o `rorAgent The foregoing i trument was aknowledged before a The foregoing Z this day Ox 11MA 206%K 1,11A,191 ✓M+��+t. this 2Z.. d� o i persona y kn to me or who as produced person as indentiflcation. 280by 6 `�• to m r who has produced �J as Indents ication. No RMlrli{ �•.•,��'�, . CENY REYES ••••P� V y�� YES Sign Saa Magi Si ota p of a :• •"e My omm, pires Oct 11, 2015 s• + •: Y C Seal. ,c� ComndsilOn +� EE 106714 S ',�� Commission N EE 10$714 '' a u• EMP Bonded �'a a fit+`'•,' wed TIUO11S5 Neti6eal Noti y Aw Thro* N i NaTary Assn. ni a UNITED STATES POSTAL SERVICE First -Class Mail Postage & Fees Paid USPS Permit No. G-10 • Sender: Please print your name, address, and ZIP+4 in this box • ■ Com 1�2, and,3. Also complete Rem livery is -desired. ■ Print your name and address on the reverse so that we can return the card to you. ■ Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addresses to: A Signature X 13Agent ❑ Addressee B. Received by ( Printed Name)7 of Dejlery D. Is delivery address different from item 1? ❑ Yes If YES, enter delivery address below: ❑ No _ .331 ta,5 3. sante Type . 0"bartifled Mail ❑ Evress Mail ❑ Registered ❑ Return Recelptfor Merchandise ❑ Insure Mail ❑ C.a.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes 2. Article Number ��cq71]11 115 0002 01485091 PS Form 3811, February 2004 Domwitic Return Receipt 1-M-tsao WLJ Certified Mail Provides: ■ A mailing receipt ■ Aunique Identifier for your mailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders; ■ Certified Mail may ONLY be combined with First -Class Mail® or Priority Mail& ■ Certified Mail is not available for any class of international mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables, please consider Insured or Registered Mail. ■ For an additional fee, a Return Recelpt may be requested to provide proof of delivery. To obtain Return Receipt service, please complete and attach a Return Receipt (PS Forams 3811) to the article and add applicable postage to cover the a dupe icate retmuriipreceipt a USReceipt So i� kReque on your CeertifiedtlMaireceipt Is required. ■ For an additional fee, delivery may be restricted to the addressee or ' addressee's authorized agent. Advise the clerk or mark the mallpiece with the endorsement Restricted DeffvW. ■ If a postmark on the Certified Mail receipt is desired, please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed, detach and affix label with postage and mail. IMPORTANT. Save this receipt and present it when matting an Inquiry. PS Form 3800, August 2006 (Reverse) PSN 7530-02-000-9047 Er .. . .- C3 ,.n For delivery information visit our website at www1usps.comoC0 Fff F ; Postage $ C3 ti Certified Fee C3 C3 Return Receipt Fee 9, cc Postmark Here 0 (Endorsement Required) rY Restricted Delivery Fee C3 (Endorsement Required) Ln ri Total Postage & Fees $ $6.11 F17/19/2013 r-9 r-aSo rl R0_A1/.LLWB!�---- l� tom- .; or PO Box No. 49 a -- ---- dam :rr --- --- a rr. - -- - ------------------------------------------- -- - -- ---- 33142t� o ---- ..................... Certified Mail Provides: ■ A mailing receipt ■ Aunique Identifier for your mailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders; ■ Certified Mail may ONLY be combined with First -Class Mail® or Priority Mail& ■ Certified Mail is not available for any class of international mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables, please consider Insured or Registered Mail. ■ For an additional fee, a Return Recelpt may be requested to provide proof of delivery. To obtain Return Receipt service, please complete and attach a Return Receipt (PS Forams 3811) to the article and add applicable postage to cover the a dupe icate retmuriipreceipt a USReceipt So i� kReque on your CeertifiedtlMaireceipt Is required. ■ For an additional fee, delivery may be restricted to the addressee or ' addressee's authorized agent. Advise the clerk or mark the mallpiece with the endorsement Restricted DeffvW. ■ If a postmark on the Certified Mail receipt is desired, please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed, detach and affix label with postage and mail. IMPORTANT. Save this receipt and present it when matting an Inquiry. PS Form 3800, August 2006 (Reverse) PSN 7530-02-000-9047 11 1 from the office of REGALANDS PROPERTIES INC. 8650 Biscayne Blvd. El Portal, Florida 33138 tel. 305458-7134 fax 305-756-9557 email: dancenvrevesnaol.com to the office of Orlando Ran�el 9940 SW 37 St. Miami, Florida 33165 July 18, 2013 Re: release and cancellation of your contract as architect for the property located at 175 NW 101 St. in the city of Miami Shores, Florida. (folio # 11-3101-023-0160). Dear Mr. Rangel, Let this letter serve as official notification that you, have been officially released from the job site referenced above as the architect of record. All permits have been re-applied for under another architects name. The permits will not be pulled under your name and or license number. Please sign your acknowledgement below, releasing us and the Village of Miami Shores from any further liability and or responsibility in regards to the permits, work and contract referenced for the above referenced property. D eny e Regalands Properties, Inc. cc: Village of Miami Shores 12/04/13 CC-NGIA Insurance 2 General Liability Insurance Update: CERTIFICATE OF LIABILITY INSURANCE '° 4//12/12/201133 THIS CERTIFICATE 13 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($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(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). PRODUCER cONT Jon Rock The Contractors Choice Agency PHONE(800) 918-3584 FAC W. : (877) 694-9951 PO Box 13645 ADDRESS:Jon@nginsuranceoriliLne.com INSURE S AFFORDING COVERAGE NAIC 8 Chandler AZ 85248 INSURERA-Xatrl Contractors Insurance 12293 INSURED Vista Construction services Inc., DSA: Vista INSURERS: ANY AUTO 2280 SW 23rd Terrace INSURER C: INSURER D: INSURERE: M Miami H'Ir 53145 INSURER F COVERAGES CERTIFICATE NUMBERCL1312219459 ocvlclnkl uu rannco. Inla lb Iv L:tK111-Y 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 CONTRACT OR OTHER DOCUMENT 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 TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE POLICY NUMBER POLICY MOM/DD/YYYY LIMITS GENERAL LIABILITY WVD EACH OCCURRENCE $ 1,000,000 C X COMLAJMSLGENERALLIABILITY PREMISES Eeoccurrence $ 50,000 A LAIMS-0AADE OCCUR LF000014371-01 /11/2013 /11/2014 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJJRY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 ��GE ----AGGREGATE p IT APPLIES PER: PRODUCT S-COMP/OPAGG $ 1,000,000 ----T—Ippn- 1-1 Pan_ I-1 AND EMPLOYERS' LIABILITY WC STATU- �ICER/MEMBEREXCLUDED? �TIVE YIN N/A E.L. EAC�ACCIDE (Mandatory In NH) It yes, describe under E.L. DISE DESCRIPTION OF OPERATIONS below E.L. ❑ISFAA4F _ PA DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) (305)756-8972 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Village Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 10050 ME 2 Avenue Miami Shores, rL 33138 AUTHORIZED REPRESENTATIVE Robert Rock/JDA- ACORD 25 (2010/06) O 1988-2010 ACORD CORPORATION. All rights reserved. INS025 t901nn5tol ThA annRn name and Irwin am rnnIQ#PrArl mmrke of arnRl'1 $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea e.dent ANY AUTO INJURY (Per parson) $ ALL OWNED SCHEDULEDBODILY BODILY INJURY (Per accident) $ AUTOS AUTOS HIREDAUTOS NON -OWNED AUTOS PROPERTY DAMAGE Par. cldent $ UMBRELLA LIAROCCUR EXCESS LIAR ,., A.—.....� EACH OCCURRENCE $ AND EMPLOYERS' LIABILITY WC STATU- �ICER/MEMBEREXCLUDED? �TIVE YIN N/A E.L. EAC�ACCIDE (Mandatory In NH) It yes, describe under E.L. DISE DESCRIPTION OF OPERATIONS below E.L. ❑ISFAA4F _ PA DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) (305)756-8972 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Village Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 10050 ME 2 Avenue Miami Shores, rL 33138 AUTHORIZED REPRESENTATIVE Robert Rock/JDA- ACORD 25 (2010/06) O 1988-2010 ACORD CORPORATION. All rights reserved. INS025 t901nn5tol ThA annRn name and Irwin am rnnIQ#PrArl mmrke of arnRl'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 -, %%\/V BUILDING �\\ PERMIT APPLICATION Permit T e: BUILDING JOB ADDRESS: _ 17S AJ4.) )O 1 �t- FBC 20 P Permit No. PCA Master Permit No. uq�� UI1I1miklull City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 1 k-3101 Is the Building Historically Designated: Yes NO Flood Zone: Tenantlxssee Name: Phone#: Email: v II _ CONTRACTOR: C- ompany Name: �ST(� C)asy C d n �� i J Phone#: �®`� Address: Qo� UU Try r City: C4 ; i ( State: FL- Zip: -�s Qualifier Name: n l Gyyl I n Mem'r) Phone#: �� 3 ��^1 �7T State Certification or. Registration #: C- C7 C i Lf Certificate Certificate of Competency #: Contact Phone#: Email Address: DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit:.$ V cry Square/Linear Footage of Work: Type of Work: ❑Addition Alteration ❑New ❑Repair/Replace Description of Work:C (-) _V.V\ p Ie +,c c iy'4e F t (1 s �' Vk Q in -k C) (L gLU 4F OAA rFL6-r Color thru file.- Submittal ile. Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ av CCF $ CO/CC $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ DBPR $ Bond $ Technology Fee $ ❑Demolition TOTAL FEE NOW DUE $ ti _ 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 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 Owner or Agent The foregoing instrument was acknowledged before me this day of , 20 / , by who is personally known toe or who has produced As identification and who did take an oath. NOTARY A n Signa Contractor The for oinngpinns,, }was ackn ledged befo1rne me -4 day of ! JWY ►, A;, by G�' 1 who is personally known to me or who produced )a— �' entification and who did take an oath. NOTARY PUBLIC: Sign: / Sign: Print: Print: es My Commission Expires:I My C c �detilrilers APPROVED BY ✓ ��� Plans Examiner Structural Review (Revised 5/2/2012)(Revised 3/12/2012) )(Revised 06/10/2009)(Revised 3/15/09)(Revised 7/10/2007) Notary Public - State of Florida Commission # EE 128810 Bonded Through National1otary Assn. Zoning Clerk Miami Shores Villa*ge Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR 1 ARCHITECT Permit N. 5� 5 Owner's Name (Fee Simple Title Owner's Address: V&SO City: le i rAa ne #: 305— 4Slr• State : e!. Zip Job Address (Of where work is being done): / 7 5 0k, /o I *' . City: Miami Shores—woo" State:—Florida ✓ Zip Code: Contractor's Company Name: NA s4* 5yc.4 A Phone#: w —i4ol r Address: -E&W Sw 24 T.rr City: AA4 State: Zip Code: 386W7 Qualifiers Name: Lic. Number: C,4n6 j.204 kms Architect/ Engineer of Record Name: Address: City: State: Describe Work: Phone #: Zip Code: I hereby certify that the work has been abandoned and/or the contractorlarchitect is unable or unwilling to complete the contract. I hold the Building Official and the Mia "Shores harmless for all legal involvement. Signature g Signature 4**o'w.n -r ent C ntractororArchitect The foregoing instrument:was aknowledged before me The foregoing instrument was aknowledged before me this day of AIL ,2o &bY ,tSs this I qday of Gl pJ`:1 20 M C I�Y-S Who is personally known to me or who has produ d who is personally known to me or who has produced as indentification. as indentification. Sign: Seal: ic: qEs; 7 Bonded TAruY PuM_' Notary Publ' Sign: Seal: "%V10",a, OANCENY RMS Notary Public - state of Florida ` my Comm. Eom Oct 11, 2011 Commlealon M EE 106714 Goaded Ttuanob Nohnr Ilam ..e1"Zy. ?Cs , e.i:' - u-•`e.r ittip.p'. - r�,y,�' 1, d �' N .. '�+ � N�✓. dl`h� 1 from the office of REGALANDS PROPERTIES INC. 8650 Biscayne Blvd. El Portal, Florida 33138 tel. 305-458-7134 fax 305-756-9557 email: dancvnyreys(c�aolxoni to the office of: Luke and Sons Construction Inc Aft: Abel Villanueva 15440 SW 68"` Lane Miami, Fl. 33193 April 301h, 2013 Re: release and cancellation of your contract as general contractor for the property located at 175 NW 101 St in the city of Miami Shores, Florida. (folio # 11-3101-023-0160). Dear Mr. Villanueva, Let this letter serve as official notification that your company, Luke & Sons Construction Inc., has been officially released from the job site referenced above. All permits issued to your name have expired and are hereby cancelled. The hermits will not be newed under vour name and or license number. Please sign your acknowledgement below, releasing us and the village of Miami Shores from any further liability and or responsibility in regards to the permits, work and contract referenced for the above referenced property. I, Abel Villanueva, personal representative for Luke and Sons Construction, Inc. hereby release Regalands Properties, Inc. and the Village of El Portal from any liability and or responsibility for the property referenced above. , Mr:16—cen—yReyes Regalands Properties, Inc. cc: Village of Miami Shores -AL 1 Villanueva Luke and Sons Construction Inc. • * Coed, low Ott 11 C • f f0/"4 MNM �' dot 3 VIAo E6.-lmq 10 pfoi , I 1:44 61vwf saw 4fto r c ti 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 20VC-7 Permit Type: PLUMBING OWNER: Name (Fee Simple MAY 0 6 2013 gla�k Permit No. PL- 9 Master Permit NoA cl -11 —15 �-5 City: 33/.9 Tenantdxssee Name: Phone#: Email: JOB ADDRESS: 1774V A)k) 101 6+ City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: !l -3/0I -- 023 "01 &0 Is the Building Historically Designated: Yes CONTRACTOR: Company Name: ON Address: ` j6 City: State: Qualifier Name: " �` Zone: 305-- 3(01--2.92-1 Zip:d 30'd 33.3 - 011 h's- State Certification or Registration #:dYr C 051 Lrgr Certificate of Competency #: Contact Phone#: Email Address: a DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ 1 9 Square/Linear Footage of Work: Type Work : _; Address Al`teraU ❑New ORepair/Replace ODemolition Desc j tipq o Work! C Submittal Fee $ Permit Fee $ 9 CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ Ux- 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. I sence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. # l Signature Owner or Agent The foregoing instrument was acknowledged before me this day of 9'/ 4- , 20 L3by , who is personally known to me or who has roduc ld NOTARY P My Comrdission APPROVED: BY As identification and who did take an oath. (Revised.07/]0/07)(Revised 05/10/2009)(Revised 3/15/09) I Contractor 144 The fore go'ng instrument was acknowledged before me this0? day of by W is personally known to me r who has produc entification and who did take an oath. Structural Review Zoning Clerk :Permit N. Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR / ARCHITECT Owner's Name (Fee Simple Title Owner's Add City: U Phone #:,3,os� Job Address (Of where work is being done): /7,6- A.�6 .' i®/ 5 p City: :!j1ami Shores State:—Florida Zip Code: �?-hone #321--3(P� — 24 2j7 Architect/ Engineer of Record Name: Phone #: Address: City: Describe State: Zip Code: I hereby certify that the work has been abandoned and/or the contractor/architect is unable or unwilling to complete the contract. I hold the Buildin Official and the Mia i Shores harmless for all legal inv eme Signature Signature owner orAgent 'ontraC or orArchito The foregoing instrument was aknowledged bef The foregoing ins nt was aknowled ed before me t 20/ y tris is personally known to or who has produced who is rs ho has produ ARAB jhgpWw as indentiflcation. '"�' �nci$rtiN. } SAW 8 48 No ry Pu x a11AitU► ..+�s�►�,u Tbra Nd Sign: !tom Apr 4% MIS Sign: -1\C41121101111*611on WEE 180848 Seal: Nauaiai NOWY Am Seal: 7 UNrrED STATES POSTAL SERVICE First -Class Mail Postage & Fees Paid USPS Permit No. G-10 • Sender: Please print your name, address, and ZIP+4 in this box • �� mss' F' ■ Complete items 1, 2, and 3. Also complete Item 4 if Restricted Delivery is desired. ■ Print your name and address on the reverse so that we can return the card to you.. ■ Attach this card to the track of the mailpiece, or on the front If space permits. 1. Article Addressed to: A. ❑ Agent B. Reoelved by (Printed Name) kJ 10. D. Is delivery address dt fererd from item 1? ❑ Ye: If YES, enter delivery address below: ❑ No 3. Se ceType CwtivRed Mail ❑ Express Mail ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? Prtra Fee) p Yes 2. Article Number a (Transfer from service Iabso *701/ ,BOO 0001 M-4 Z ! Z 4 Ps Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 41 I .V from the office of REGALANDS PROPERTIES INC. $650 Biscayne Blvd. El Portal, Florida 33138 tel. 305-458-7134 fax 305-756-9557 email: dancenvreves Rg2]--conl to the office of Mp Associates Contractors 12350 SW 132 Ct. Miami, Fl. 33186 Permit: PL -8-11-1596 March 12, 2013 ru Er ru ni ru L ................ -0 ni postage $ Certffied Fee r -q - .4 -* �f I C3 R 2. �Fo .=RsoaqIqFaQ C3 (Endorsement Re red) 0 Reswcted DeWery Fee (Endorsement Required) C- N., A Ln Total postage & Fees M r -I S;QTO — ---------- ----------------------------------------- M ----or ---------- R Re- work stopped and cancellation of your contract as electrical contractor for the property located at 175 NW 101 St. in the city of Miami Shores, Florida. (folio # 11-3101-M3-0160). To whom it may concern, Let this letter serve as official notification that your company, MP Associates Contrabove has expired actors., has been . officially removed from the job site referenced above. Also, take note that the Permit referenced and no further action is needed on your behalf. Unfortunately the general contractor who you were working under has been officially fired for lack of performance and unprofessional behavior. Our new general contractor, Vista Contractors, has hired and retained another electrical company to complete the work needed. Respe"Iy, 4-06*1 Wrr. Dancerr Reyes RqWands Properties, Inc. = Mr. Jorge L. Fors — PA .0 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 Permit Type: Electrical JOB ADDRESS: L _�-5 N '(A) I ()[ Sr FBC 20 APR 3 0 2013 Permit No. tj 11—) j - f_11 Master Permit No. 1)TT City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes OWNER: Name (Fee Simple City: CA 1®0� Tenant/Ussee Name: Email: State: NO V Flood Zone: 7/3 33 X63 j- CONTRACIIT� OR: Company Name: CA's -C c rbc cg ( lz& Phone#: ,Sc)� Address: 1 b do N• o 4V C City: M i 9,±`6 State: Zip: `3 3 Qualifier Name: Phone#: 30S) (a3 1-1 -- S G: 0 State Certification or Registration #: Vy U % l O Z_ 0 Certificate of Competency #: �0y �®d I ra Contact Phone#: Email Address: 0 V S �� e.0 M(C 1-C'' �1 M �c�/� s 0 DESIGNER: Architect/Engineer: Phone#: Value of Work for thi$.Permit: $ ! Z Type of Work:',, ❑Addrttss ,:Z on ❑N w ❑Demolition Submittal Fee $ Permit Fee $ >U'/0,0' CCF $ CO/CC $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ DBPR $ Bond 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 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 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 Owner or Agent The foregoing instrument was acknowledged before me this -3' day o�'tpersonally by ���� �-ci � , who kno a or who has produced As identification and who did take an oath. NOTARY XMMUM AMA ceryl-amoof Fkdo Sign: 116 Print: EE t8081S My Commission Expires: Signature ` Vii✓ Contractor The foregoing instrument was acknowledged b e me this—Lip day of A at 6 , 20 1.3, b L O ouu& 9© who ' ersonall known to me or who has produced as identification and who did take an oath. APPROVED BY - ',' j�a- y Plans Examiner Structural Review (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) NOTARY PUBLIC: Sig, Prin My Zoning Clerk Miami shores V Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR / ARCHITECT Permit N. Owner's Name (Fee Simple Title Holder) ' - fJ ," ; one #:. S' e/ S ° 7(� Owner's Ad ss:. 6-C ?a k__�)9 `� ��r �A > i�s r E-� City:6-''LP`C"qa�State :p- Zip Code3--?1",3 Job Address (Of where work is being done): / ?!S_ A/Lj j o ) S -f— City: Miami Shores State:—Florida Zip Code: Contractor's Company Name: P -S 6�4LL-e_ j =L4Phone #: Address: /(0 Do 1V .._0) City: 07 10,11 State: Zip Code: Qualifiev'i C . Lic. Number: Qco®i 7 3e Architect/ Engineer of Record Name: Address: City: Describe Work: 0 State: Phone #: Zip Code: I hereby certify that the work has been abandoned and/or the contractor/architect is unable or unwilling to complete the contract. I hold the Building Official and the Miami hores harmless for all legal involve m- e�� Signature Signature - " L- �W,63 ownero Agent Contra orArchftect The foregoin ins nt as aknowledged be" me The foregoing instrument was aknowledged before thi _ day of 013,b this day of ,r , 20 13)Yl`�®ti Who is a nown to me or who has produced who i ersonaily1nown to me or who has produced as indentification. as indentifi t. 3130MARA ARAU Notary Public• pdswa - aw® of Nota P til e>� AW 18, 201 Notary li i Sign: g 18081 Sign: Seal: SOMW ThrauoN0tar71 � ; wart � W � Seal: , '� LB UNITED STATES POSTAL SERVICE First -Class Mail Postage & Fees Paid USPS Permit No. G-10 • Sender. Please print your name, address, and ZIP+4 in this box 0 Blue Self Storage 8650131myrie Blvd. El Portal, Fl. 33138 306-764-8864 ■ Complete items 1, 2, and 3. Also complete A. fbVC Item 4 If Restricted Delivery is desired./ _ ❑ Agent ■ Print your name and address on the reverse 0 Ad'ressee so that we can return the card to you. ■ Attach this card to the hack of the mallpiece, B. RweN C. D of Del ery- or on the frartIf space permits. D: ery address nt from item 1? tf YES, enter ery add below: Yes 0 No 1, Article Addressed to: �-•y� • 3. Service 7j)e !(/ ❑ Certified Mail ❑ Express; Mail 13 Registered 0 Return Receipt for Merchandise 0 Insured Mail 17 C.O.D. 4. Restricted Delivery? (Extra Feel 0 Yes 2. Article Number ;- -- - _- _ (1)erWer from service label) 7 011 3500 '0 0 01 7 2 6 2 - 2285 Ps Form 3811, February 2004 Domestic Return Receipt 102686-0&M-1540 U.S. Postal ServIC TM p CERTIFIED MAIL,. RECEIPT. ■ (Domestic Mail Only; No Insurance Coverage Provided) For delivery information visit our website at www.usps.Com® rll .A ru Postage $ r%_ CertifiedFee C7 Retum Receipt Fee E:3 (Endorsement Required) O Restricted Delivery Fee 0 (Endorsement Required) O t.rt Total Postage & Fees L't 3. M - s:' ` rc � �9 G•l p i 3800, August 2006 See Reverse for Instructions Certified Mail Provides: K A mailing receipt ■ A unique identifier for your mailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First -Class Mail® or Priority Maile. r Certified Mail Is not available for any class of International mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables, please consider Insured or Registered Mail. ■ For an additional fee, a Return Receipt may be requested to provide proof of delivery. To obtain Return Receipt service, please complete and attach a Return Receipt (PS Form 3811) to the article and add applicable postage to cover the fee. Endorse mailpiece "Return Receipt Requested". To receive a fee waiver for a duplicate return receipt, a USPS® postmark on your Certified Mail receipt is required. ■ For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent. Advise the clerk or mark the mailpiece with the endorsement "Restricted Delivery". ■ If a postmark on the Certified Mail receipt is desired, please present the arti- cle at the post office. for postmarking. , If a postmark n the Certified Mail receipt is not needed, detach and affix labei'with postage and rhall. IMPORTANT. Save this receipt add prisent it'wh6n=making an Inquiry. PS Form 3800, August 2006 (Reverse) PSN 7630-02-000-9047 ' from the office of REGALANDS PROPERTIES INC. 8650 Biscayne Blvd. El Portal, Florida 33138 tel. 305-458-7134 fax 305-756-9557 email: dgncenyreves(alaoti.coni to the office of Metro Electric Service Inc. Att: Armando 1999 NE 150 St. North Miami, Fl. 33181 Permit: EL — 8-11-1617 March 12, 2013 Re: work stopped and cancellation of your contract as electrical contractor for the property located at 175 NAV 101 St. in the city of Miami Shores, Florida. (folio # 11-3101-023-0160). To whom it may concern, Let this letter serve as official notification that your company, Metro Electric Service Inc., has been officially fired from the job site referenced above. Unfortunately the general contractor who you were working under has been officially fired for lack of performance and unprofessional behavior. Your termination is effective immediately, therefore any further visits to the job site will be considered by our company as trespassing. As per our previous communications with you over the last couple of months, we have forwarded all communications between our companies to our attorney, Mr. Jorge L. Fors, whose address is 1108 Ponce de Leon Blvd., Coral Gables, Florida 33134, with telephone number 305-448-5977. Please be advised that we have instructed our attorney to file suit against your company for all the damages you have caused our firm to incur. Furthermore, our legal counsel will be in touch with corresponding licensing board overseen general contractors to file an official complaint and claim against your firm. Please govern yourself accordingly. Re;Danqceny tfully, yes Regalands Properties, Inc. cc: Mr. Jorge L. Fors — PA NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TISIE.OF "RST.MSPECION PERMIT NO l9 .0 p° 1$ TAX (FOLIO NO. STArt OF FLORIDA: . COUNTY OF MIAMI-DADE: THE UNDERSIGNED hereby gives notice#hat improvements will be made to certain real property, and In accordance with Chapter'713, Florida Statutes, the following information Is provided in this Notice of Commencement. C 1= ilk 2n g 13R O4098 0 OR Bk 28644 Ps 0715; (1P9} RECORDED 05/23/2013 12:35:14 HARVEY RUVINY CLERK OF COURT MIAMI—DADE COUNTYQ FLORIDA LAST PAGE Space above reserved for use of recording office Legal description of property and streettaddress: I P-50 I . 2. Descriptipn of 3.Owner(s) name and address: Z Interest in property: Name and address of fee simple Aftleholier 4. Contractor's. name, address and phone number: a 5. Surety: (Payment bond required by owner from contractor, if any) Name, address and phone number: Amount of bond $ 6. Lender's name and address: . 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may served as provided by Section713.13(1)(a)7., Florida Statutes, Name, address and phone number. 8. In addition to himself, Owners designates the following 713.13(1)(b), Florida Statutes. Name, address and phone number:— 4MA9 _ 9. Expiration date of this Notice of Commencement: receive a copy of the Lienor's Notice as .provided In Section (the WIMUon date Is 1 year fmm the date of rerwrdhV unless a different date is spedffed) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOT IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA' STATUTES, AND IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED M FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WI OR RECORDING YOUR NOTICE OF COMMENCEMENT. " T 1HEREDY CORTOO Signature(s) of kr(s) or Prepared By Print Name x ra STATE OF FLORIDA COUNTY OF MIAMI-DADE uu momouany, or U a$ ❑ Personally known, or v Print 1 acknowledged before me this day �/< S for -7 produced the= -following type. oftic Signature of. Notary Public: Print Name: (SEAL) pNN, °tom° t "'s JAt�QE A RiCMM IDSON VERIFICATION PURSUANT TO SECTION g2.S25 FLORIDA SUMITES -'�° s Under penalties of perjury, I declare that 1 have read the foregoing and MY CoWlS M f DD 889088EXPIRES: Ochftr 1, 2014 that the facts stated in it are true, to the best of my knowledge and belief. ; SmdedThruNotaryPubucurwarw'tens Signature(s) of Owner(s) or er(s)'s Authorized Officer/Director/Partner/Manager who signed above: BY... A—S By 123.01-62 PAGE 3 3/10