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RC-14-361 (2)
Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 t Inspection Number: INSP-207873 Permit Number: PL -2-14-362 Scheduled Inspection Date: August 26, 2014 Permit Type: Plumbing - Residential Inspector: Diaz, Osvaldo Inspection Type: Final Owner: GARBER, DOUGLAS Work Classification: Addition/Alteration Job Address: 53 NE 107 Street Miami Shores, FL Project: <NONE> Contractor: SOLAR QUEST USA INC Phone Number Parcel Number 1121360070370 Bunning uepartment comments REPLACE KTICHEN CABINET/REMODELING IPassed Comments INSPECTOR CTOR COMMENTS False Passed Inspector Comments Failed Correction Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. August 25, 2014 For Inspections please call: (305)762-4949 Page 5 of 39 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 <` �p BUILDING PERMIT APPLICATION Permit Type: PLUMBING JOB ADDRESS: Ne 10-7 54 - FBC 20( v Permit No. � W � L _ Master Permit Nol:�C1 .—I City: Miami Shores County: Miami Dade Zip: D J 1 ► Folio/Parcel#: 1 �, (x.. C . 7). 7,4' Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): �Z)nuyG 16.6 G- YtJ fit/ Phone#: S �0�' OL Address: 15?z, ) ) 3-7 S -V City: _M; Gil►') i V-) r.4t L, State: Y Zip: `C Tenant/Lessee Name: Email CONTRACTOR: Company Name: Ks c& `i�,.,e_ t u_,A _Phone#: q 5Lf qyo Address: I 1 1 C� 56�h 6'04AJ-C City: A-\CA%►1.LjCCCA A State: Zip: 7640 Qualifier Name! f ak oy\ +LA') �tl Phone#: S�1 ci ,� -5, - -Sc c State Certification or Registration #: C F G G \ C, Ci' q � Certificate of Competency #: Contact Phone#: '` �� } ') '`' Email Address: DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ 1 t- ` % Square/Linear Footage of Work:> Type of Work: ❑Address Alteration ❑New ❑Repair/Replace ❑Demolition Description of Work: Submittal Fee $ Permit Fee $ ! / 6, ' CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ Technology Fee $ _ TOTAL FEE NOW DUE $ _ r. 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 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 approy4d and a reinspection fee will be charged. Signature— , or Agent UThe foregoing instrument was acknowledged before me this't day of , ' - 20 �, by t who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign:#, Prin . EAMON TONER ' • ` Notary Public'. State of FlOrlud My Commission Expire: E My Commission Expires Mar 5, 2017 Commission # EE 880934 Signature ' Contractor The foregoing instrument was acknowledged before me this day of 20KIby who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: APPROVED BY •2-6 -r Plans Examiner Structural Review (Revised3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) My Commissi — Zoning Clerk STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD LICENSE NUMBER The PLUMBING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS: Expiration date: AUG 31, 2014 ARES, RALPH A SOLAR QUEST USA INC 1121A SOUTH 21 AVENUE HOLLYWOOD FL 33020 RICK SCOTT GOVERNOR ISSUED: 08/04/2013 SEQ # L1308040002456 DISPLAY AS REQUIRED BY LAW ff]M] CITY OF HOLLYWOOD LOCAL BUSINESS TAX RECEIPT PRINT DATE: 10/14/13 THIS IS YOUR LOCAL BUSINESS TAX RECEIPT. PLEASE DETACH AND POST IN A CONSPICUOUS PLACE AT THE BUSINESS LOCATION. PLEASE DO NOT REMIT ANY PAYMENT. THIS ISJAOT A I31L _ B1 Si sSJVar__e° SOLARQUEST USA NC BALsinesf�_Location' 1119 S 21 AVE Business Class: CONTRACTOR/PLUMBING Tax Basis: 5 - 25 WORKERS Receipt Number: 14 00052559 Receipt Year: 10/01/13 Expiration Date: 09/30/14 N CHARGES: (Itemized Below) 341.00 Comments: Base Fee 316.00 Additional Charges: APPLICATION FEE 25.00 TOTAL _NFW CHARGES• 341.00 Penalty Amount: .00 Previous Balance Due: .00 TOT U__A QOJNT PAID• 341.00 PURSUANT TO STATE LAW, THE LOCAL BUSINESS TAX IS LEVIED ON THE PRIVILEGE OF DOING BUSINESS WITHIN A CITY'S LIMITS, AND IS NON -REGULATORY IN NATURE. ISSUANCE OF A LOCAL BUSINESS TAX RECEIPT BY THE CITY OF HOLLYWOOD DOES NOT MEAN THAT THE CITY HAS DFTFPMINFn THAT TWI= IFYIQTIAlr r10 DDnDnQCn 1100 nc A EXCE&SIUPIDRELLA LIABILITY OCCUR 1 CLA114S MADE DEDUCTIBLE RETENTIOrI 7 WORKERS COMPEI,I9ATIOp1 AND EMPLOYER&' LIABILITY ANl' PRQPRIETORIPARTI`IERIEXEDUTIVE Of-FICFRINICMBGR EXCLUDED? It I" doac(Ihe Undar sLF�jUJ P OVIF(OIJ; holm! O'ri IER %IiIPTIDIJ OF OPERA110N5 (LbCATIOIISIVHHICLE9 I EICOLU910N9 ADDED BY ENDOR6EM214T 1 SPECIAL.PRO_ V1910PIS GENERAL CONTRACTOR AND PLUMBING CONTRACTOR k I l L HULUL'R MIAMI SHORES VILLAGE 10050 NE 2ND AVENUE MIAMI SHORES, FLORIDA 33138 RD 25 (2001108) 1GG $ 5 E.L. EACH ACC fl. 019EA9E- E.L DISE ASE- •-r•uvi.��r.h I lulu SHOULD ANY OFTIAE ABOVP DE6CRIBED POLICIES BE OANCELLED 6EFORe THE CXPIRATIDIJ DATE THEREOF, THE 16601/,113 1 -R WILL ENDEAVOR TO Il 10' DAYS. WRITTEN NOTICETO THE G�RTIFICATL H LDE 11 ED TO TIIE LEFT, U AILURE TO DO SO SHALL IMPOSE NO OBLIGATION DR LIA, ITY Op ANY KIND. UPOI lN9(1RER, ITS AGENT6 OR REPRESENTATIVES. 1 AUTHORIZED REPR28ENT TIVE f 4 l Cs1 ACO0 CORPORATION 1908 ;=. CER11FICAT LN r ITY' NStr ;y�� I� n A p DATE (MIdl00/1 YYYI N :ODUCER //��11 6 1210912013 COVCR ALL INSURANCE THIS CERTIFICATE f5 ISSUED AS A MATTER OF INFORMATION 5000 W. ATLANTIC BLVD, ONLY .AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, E-XT[ND OR MARGATE,FL, 330113 ALTER TFIE COVERAGE AFFORDED BY THE POLICIES BELOW, PH (9.54) 95G•000G (X (95 I) 95G 0555 uusunED INSURERS AFFORDING COVERAGE NAIC P LIVING EARTH REkiODELER'S' INC DBA S'0'Lq'RQUESTUSA 1IdsURCR n: :FEDERATED NATIONAL. INSURANCE COMI' '1121A SOUTH2-ISTAVENOE 114SURERB: HOLLYWOOD FL 33020 1115RER — II19UREft D; D: �OVEIZAGC-S IPI9URER L: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE ANY REgUIREMENT, INSURED NAMED ABOVE TCP.M DR CONDITION OF ANY CONTRACT OR OTHER MAY PERTAIN, THE 11�15URANCE AFFORDED BY THE POLICIES DESCRIBED FOR THE POLICY PERIOD INDICATED, rIpTWITHSTANDING DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR POLICIES. AGGREGATE LIMITS sHoWN MAY HAVE BEEN REDUCED By PAID CLAIMS, ISR 00'L HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH I ��'DF lln�l•I!'F POI..ICY NUMBER PDLIdY EFFECT V9 BOLIcY EMXMPI GEIJ2RAL LIABILITY IDDfIYI LIMITS X COMMERCIAL GENERALI,IABII,ITY GL -050 1ODD�OD-02 1211612013 92I18�20'14 EACH OCCURREI'ICF. 1,000,000 I AMAGETD RENTED CLFlIh49 MADE OCCUR � E •IISFILEx- Ur_Q nl 4 100,000 HIED FXP Wj-_q_nAporaonI s 5,000 PERSONAL IN ADV IIJAI Y 1 1,QQD 000 ' GEI•I'LAGGREGATFLIIrAIT nPPl,lEs PERI GENfFL\LAGGREGATE s 21090 000 X POLIr,Y PRD' LOC PRODUCTS - COMPIOP AGG S 21DOD DDD AUTDpAODILE LIAEILITY AHY AUro COMBINED SINGLE LIMIT ALL OWNEDAUTOS (Fa ...Idoni) - SCHEDULED AUTOS BODILY INJURY 5 IIRFD AUTOS ftrporson) NON -OWNED AUT06 BODILY INJURY _ (Per Aacclde0l) — PROPERTY DAMAGE s GARAGE LIABILITY (Per Pccidnnl) nNY nUTO AI: ED ONLY- EA ACCIDEI IT s — OTHERTI-IAN EA ACC S AUTO ONLY; EXCE&SIUPIDRELLA LIABILITY OCCUR 1 CLA114S MADE DEDUCTIBLE RETENTIOrI 7 WORKERS COMPEI,I9ATIOp1 AND EMPLOYER&' LIABILITY ANl' PRQPRIETORIPARTI`IERIEXEDUTIVE Of-FICFRINICMBGR EXCLUDED? It I" doac(Ihe Undar sLF�jUJ P OVIF(OIJ; holm! O'ri IER %IiIPTIDIJ OF OPERA110N5 (LbCATIOIISIVHHICLE9 I EICOLU910N9 ADDED BY ENDOR6EM214T 1 SPECIAL.PRO_ V1910PIS GENERAL CONTRACTOR AND PLUMBING CONTRACTOR k I l L HULUL'R MIAMI SHORES VILLAGE 10050 NE 2ND AVENUE MIAMI SHORES, FLORIDA 33138 RD 25 (2001108) 1GG $ 5 E.L. EACH ACC fl. 019EA9E- E.L DISE ASE- •-r•uvi.��r.h I lulu SHOULD ANY OFTIAE ABOVP DE6CRIBED POLICIES BE OANCELLED 6EFORe THE CXPIRATIDIJ DATE THEREOF, THE 16601/,113 1 -R WILL ENDEAVOR TO Il 10' DAYS. WRITTEN NOTICETO THE G�RTIFICATL H LDE 11 ED TO TIIE LEFT, U AILURE TO DO SO SHALL IMPOSE NO OBLIGATION DR LIA, ITY Op ANY KIND. UPOI lN9(1RER, ITS AGENT6 OR REPRESENTATIVES. 1 AUTHORIZED REPR28ENT TIVE f 4 l Cs1 ACO0 CORPORATION 1908 TE OFLIABILITY INSURANCE DATEE(MMIDDIYYYY)IFIC THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFI11113/2013 CATE 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: If the certificate holder is an ADDITIONAL INSUREb, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may requi re an endorsement: A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s)- PRODUCER Alliance Insurance Solutions LLC 7405 N Tamiami Trail CONTACT NAME: PHONE JAIc. No t FAX IAIC. Nu Sarasota, FL 34243 E-MAIL ADDRESS: ADDL SUBR LTR TYPE OF INSURANCE POLICY NUMBER INSURER S) AFFORDING COVERAGE NAIC 4 : INSURERA: SUNZ IDaur nce Company INSURER 8: Aspen Re - London - Best li ' -34762 INSURED Essential HR, Inc. dba First Star HR 251 O'Connor Ridge Blvd Suite 370 INSURER C: Callin Syndicate- Lloyds- BEIst Ra'n �"A" CLAIMS INSURER D : Brit Syndicale - Lloyds - Best Rating "A" — -MADE OCCUR Irving TX 75038 INSURER E: PERSONAL & ADV INJURY $ INSURER F: GEIJ'L AGGREGATE LIMIT APPLIES PER: ('.n\/FRA rr-e THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW REVISION NUMBER: HAVE INDICATED. NOTVVITHSTA14DING ANY REQUIREMENT, TERM OR CONDITION BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD OF CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE IIJSR BEEN REDUCED BY PAID CLAIMS. ADDL SUBR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP LIMITS MM/DDfPI'YY MMIDDIYYYY GENERAL LIABILITY : EACH OCCURRENCE $ _ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED CLAIMS PREMISES Es occurrence) $ — -MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEIJ'L AGGREGATE LIMIT APPLIES PER: PRO- - PRODUCTS - COMP/OP AGG $ POLICY FILOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accldenl $ ANY AUTO A AUTOS OTOSS e SCHEDULED AUTOS BODILY INJURY (Per person) $ BODILY INJURY (Per accident) y HIRED AUTOS AUTOS VNED AUTOS PROPERTY DAMAGE (Per accident) $ $.. UMBRELLA LIAR OCCUR - EACH OCCURRENCE F EXCESS LIAR CLAIMS -MADE AGGREGATE b DED RETENTIONS $ $ A WORKEAND EMRs YERS' asnnoN ADIU EPAPLOYERS' LIABILITY WCPE00000184 01 10/112013 10/1/2014 wC STATU- O77i- TORY LIMITS Eii YIN AIJY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED9 ❑ N/A E.L..EACH ACCIDENT $ -1,000.00 0 (Mandatory in NH) If yes, describe under E.L. DISEASE - EA EMPLOYEE $ ' 1,000,000 E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000 DESCRIPTION OF OPERATIONS below B Workers Compensation This is for informational purposes C Excess Coverageand nothing shall create any right D under such reinsurance. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Addilional Remarks Schedule, if more space is required) Coverage provided for all leased employees but not subcontractors of: LIVING EARTH REMODELERS INC DBA SOLAR QUEST USA IN Effective date: 1011/2013 CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 NE 2 AVE ACCORDANCE WITH THE POLICY PROVISIONS. MIAMI SHORES, FL 33138 AUTHORIZED REPRESENTATIVE Glen.1 Distefano © 1988-2010 ACORD CORPORATION" All rights reserved. ACORD 25 (2010/05) The ACORD. name and logo are registered marks of ACORD CERT PC.: 10395192 Todd Trowbridge 11/13/2013 6:39:02 All Page 1 of 1