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PL-12-2217Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-229258 Permit Number: PL -11-12-2217 Scheduled Inspection Date: March 03, 2015 Permit Type: Plumbing - Residential Inspector: Diaz, Osvaldo Inspection Type: Final Owner: PERKINS, GERTRUDE & HARRY Job Address: 96 NW 92 Street Miami Shores, FL 33150 - Project: <NONE> Contractor: ALL 4 ONE SERVICES INC Building Department Comments Work Classification: Addition/Alteration Phone Number Parcel Number 1131010160070 Phone: (954)990-7666 INSTALL NEW FIXTURES IN BATH AND KITCHEN - ,----- __........_ INSPECTOR COMMENTS False Inspector Comments CREATED AS REINSPECTION FOR INSP-227995. CREATED AS Passed El, REINSPECTION FOR INSP-181952. relief line shall be 3/4 inch d/w requires separate angle stop and proper drain connection for kitchen sink waste Failed Correction Needed ❑ �� t Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. March 02, 2015 For Inspections please call: (305)762-4949 Page 27 of 29 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 MAR 19 2014 Permit N11" j � -01914 Master Permit No. 1-3C Id JOB ADDRESS: �t7 Al tl 7sP !�,T City: Miami Shores i County: Miami Dade Zip: Folio/Parcel#: //-9 La —a z 0Z, 70 Is the Building Historically Designated: Yes NO OWNER: Name (Fee Simple City: State: _ Fz— TenantlLessee Name - Email: r Corn - Zone: 7;P' 7�" CONTRACTOR: Company Name: �rkk f V LC -S Ih- C Phone#: 2S - Address: Q9. 9 S N W Cry Y d Q 1 City: <rU r i S'y State: 1fL _ ZiD: Qualifier Name: State Certificatic Contact Phone#: DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑Address ❑Alteration ❑New ❑Repair/Replace ❑Demolition Description of Work: ��� Gg-/1�C Submittal Fee $ Permit Fee $. S CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ I Bonding Company's Name (if applicable) _ Bonding Company's -Address, cityState Mortgage Lender's Name (if applicable) _ Mortgage Lender's Address City State Zip Zip Ir 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 appro an a reinspection fee will be charged. Signature Signature Owner or Agent ontractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this-13— day hisday of , 201 q, by day ofa , 20 �, by J CL n k �f � who is personally known to me or who has produced Cl P&10l— who is personally l own to me or who has produced As identification and who did take an oath. NOTARY PUB C: Sign: avian tiantana. Print: •NARY PUBLIC -STATE OF FLORIDA My Commission Expires: VMan Santana i•, Commission # EE008318 %,,,,,,,•• Expires: JULY 12, 2014 RONDO THRQ ATLA.', nC B O,NlDiG CO-. nvr APPROVED BY e.- 3 T7 -1Y Plans Examiner Structural Review (Revised3/12/2012)(Revised 07110/07)(Revised 06110/2009)(Revised 3/15/09) as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: ,,,, Efrain Butanuouit My Commission Expires.- -ci COMMISSION#EE861281 EXPIRES: DEC. 27,2016 WWW.AARONNOTARXCam Zoning Clerk I, r. STATE OF FLORIDA AC# 6296133 DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CFC1426751 08/23/12 128042180 CERTIFIED PLUMBING CONTRACTOR HANLEY, JOHN LANE ALL 4 ONE SERVICES INC IS CERTIFIED under the provisions of Ch.489 Fs. Expiration date: AUG 31, 2014 L12082302089 rir b -w '4`CUPRO'CERTIFICATE OF LIABILITY INSURANCE �� TE (MMMONYYY) °" 0 03/13/143113114 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: If the certificate holder Is an ADDITIONAL INSURED, the policy(res) 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 JW Insurance Services 100 Nath State Road 7, # 106 Margate, FL 33063 Phone 954) 583-7213 Fax (954) 583-2045 CONTACT PHONE 954) 583-7213 FAC : 954 No 583'2045 DnR info@jMnsurance.net INSURERS) AFFORDING COVERAGE NAIL # INSURER A: Capital Specialty INSURED All 4 One Services, Inc 10795 NW 53rd Street #201 Sunrise, FL 33351 (305) 775-1552 INSURERS: FCB & I INSURER C: INSURER D: INSURER E: INSURER F: 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 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. ILTR NSR TYPE OF INSURANCE ADD B POLICY NUMBER MMMD EFF MPS EXP LIMITS A GENERAL LIABILITY Q COMMERCIAL GENERAL LIABILITY ❑ ❑ CLAIMS -MADE © OCCUR F-111/04/2013 CS02304517MED 11/04/2014 EACH OCCURRENCE $ 1,000,000.00 P EMG ET EaRENTED $ 100,000.00 EXP (Any one person $ 5,000.00 PERSONAL &ADV INJURY $ 1,000,000.00 ❑ GENERAL AGGREGATE $ 2 000 OW.00 GEWL AGGREGATE LIMIT APPLIES PER: 1 W1 POLICY ❑PRO- [:]LOC PRODUCTS - COMP/OP AGG $ 1,000,000.00 $ AUTOMOBILE LABILITY ❑ AN AUTO ❑ AALLOOWNED ❑ SACOEDULED ❑ HIRED AUTOS ❑ AUTOS ED Elree O gd nt SINGLE LIMIT Ea a .I BODILY INJURY (Per person) $ BODILY INJURY (Per accident $ P�20PER DAMAGE $ $ ❑ UMBRELLA LIAR ❑ OCCUR ❑ EXCESS LAB ❑ CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ ❑ DED RETENTION $ B WORKED COMPENSATION AND EMPLOYERS' LABILITY Y / N ANY PROPRIETORIPARTNER/EXECUTIVE OFFICERIMEMBEREXCLUDED?NIA (Mandatory in NH) ❑ If yes describe under DESCRIPTION OF OPERATIONS below 10653480 11/05/2013 11/05/2014 ❑ WC STATU-, ❑ OTH OMn E.L. EACH ACCIDENT $ 100,000.00 E.L. DISEASE - EA EMPLOYE $ 100,000.00 E.L. DISEASE - POLICY umrr $ 500,000.00 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Renun ius Schedule, H more space Is required) *** PLUMBING *** CERTIFICATE HOLDER CANCELLATION ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 26 (2010/05) OF The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village 10050 NE 2nd Avenue THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores, FL 33138 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 26 (2010/05) OF The ACORD name and logo are registered marks of ACORD MAR/19/2014AED 04:07 PM 911 FAX No,9546345150 P,002 vnvYYHity WiLilm II T' i;.10VA- .. 'I:11.11w Vt55 'fAX MVGE1F-•__ ... . 115 S. Andrews Ave., Rm. A-100, Ft Lauderdale, FL 33301-1895 — 954.831.4000 VALID OCTOBER 1, 2033 THROUGH SEPTEmsER 30, 2.014 Receipt #,182-236529 Beminess NatrtB:ALL 4 On S13 t'V'ICES 11W gel Type sym lwasOwnerNanw. w .Ex iotas a/QuAL 8usinesgOpened:l2/16/2011 easiness Location:10795 t 63 ST UNIT 2016tate►00urRy1CerI1Rag:CVC1426191 SUNRISE Exemption Cods: Ew"em Phone:305 607-0545 Rooms Seats employees reaahlmes Proteseionak 2 k Tax Amatau Transfer Fes j NSF Fes I penalty prior Ysa.s I oorm*n Cos 7alak Paid 27.001, 3.001 0.001 2.701 0.00 1 0.001 32.70 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business "hln Broward County and Is non-requistwy in nature. You rust meat a0 County and/or Municipality planning WHEN VALIDATED and zonhng fequmements. This Business Tax Recaipt must be trannsferred when tits businOss is sold. business name bas changed cr you have moved the business locatlon. Thle receipt does not Wkwo that the busine9s Is legal or that R is in Compliance with State or local h ws and MWulallons, Mailing Address; ALL 4 ONE SERVICES INC 10195 NX 53 ST UNIT 201 Receipt $30A-3.3-00000613. SIMM9E, FL 33361 $aid 10/10/2013 32.10 Mfi-v"6,4� CbA-- IYliami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tei: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR t ARCHITECT Permit N. ! jt l -i 2- 2915 001nees Name _(Fee. pmpie Title Owner's Address: —a41 c. Job Address (Of where work is being done):_ City: Miami Shores Contractor's Company Name: Address: 1079S M u ) Phone #: 2oS- 1'rl2• 53-D,4 State: =L -Zip Code: 67!> L°1`?� amort State:—Florida_ Tip Code: S3ISO Phone#95�.9--WXa& City: -4 t State: F: -L- Zip Code:� Qualifier's Name: A0 t hL et IJ 1- Lic. Number. CP -0- 14 2(o-7 5'1 Architect/ Engineer of Record Name: Phone#: Address: City: State: Zip Code: Describe Work: 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 re— The Miami Shores harmless for all legal Involvement. 9Si nature foregoing Instrument was aknowiedged before me this 13 day of AWa 20/0,b Apeksh-gvi Who is Nrsonaliv k wn tome or who has produced as indentiflcation. Signature The foregoing instrument was4knowiedged before me this day ofre. I- -201 Y - J ity who is �rsonal- I� to me or who has produced f] as indentification. Public: tAP'RES: DEC. 27, 2016 WwW.AAR0N{N0TARVxM Jan 13, 2014 Re: 96 NW 92 ST Miami Springs, FL 33150 Ezzard C Matute, Lic: CFC1427616 6686 TRAVELER RD W Palm Beach, FL 33411 We, Property Consultant Group, Corp, are writing to inform you that we will no longer be having you as Plumbing Contractor for the repairs/remodel of our above referenced property. As per current building code policy/procedure, your reception of this letter shall initiate what is the 10 day period necessary to have you removed as current qualifier. Carlos Cienfuegos Property Consultant Group, Corp 9415 SW 72 ST Miami, FL 33173 ® 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 back of the mailpiece, or on the front if space permits. 1. Article Addressed to: j G ���V le 4 le t - r eAc4 j 3qz�/ I gpuro ❑ Agent 0 Addressee Received by ( Printed Name) C. Date of Delivery B. R � D. Is dress different from item 17 . 0 No If YES, enter delivery address below: Service Type Certified Mali Ia Express Mail E3 Registered 1:3 Return Repeipt for Merchandise ❑ Insured Mail 4. Restricted Delivery? (Ext►a Fee) ❑Yes 2. Article Number 7013 1710 0001 7 621 4157 (Transfer from service taW 10255-02-M-1mo PS Form 3811, February 2004 Domestic Return Receipt awl v? U, NITED STATES POSTAL SERVICE First -Class Mail Postage & Fees Paid USPS Permit No. G-10 •Sender: Please you, name, address and ZIP+4 in thiiss�box • -ep 'Y , con -5 V /7� 9y� 5 sW fa>m, FZ 9..;;? 7"