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PL-15-1022Inspection 'worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972. Inspection Number: I SP -233652 Permit Number: PL -4-15-1022 Scheduled Inspection Date: May 12, 2015 Permit Type: Plumbing - Residential Inspector: Diaz, Osvaldo Owner: , Job Address: 33 NE 93 Street Miami Shores, FL 33138 - Project: <NONE> Inspection Type: Final Work Classification: Sprinkler System Phone Number Parcel Number 1132060130380 Contractor: AFFORDABLE IRRIGATION, INC Phone: 305-681-6322 uepartment Comments INSTALL NEW IRRIGATION SYSTEM EXISTING WELL INSPECTOR COMMENTS p !L Inspector Comments Passed Failed Correction Needed Re -inspection a Fee No Additional Inspections can be scheduled until re -inspection fee is paid May 11, 2016 For Inspections please call: (305)762-4949 Page 22 of 42 y Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Parcel Number Applicant 33 NE 93 Street 1132060130380 ANUV LLC Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell ANUV LLC 3332 NE 190 Street AVENTURA FL 33180- ............. 3 3332 NE 190 Street AVENTURA FL 33180- Contractor(s) Phone Cell Phone AFFORDABLE IRRIGATION, INC 305-681-6322 Type of Work: INSTALL NEW IRRIGATION SYSTEM EXIST Type of Piping: Additional Info: Bond Return : Classification: Residential Scanning: 3 Fees Due Amount CCF $1.80 DBPR Fee $2.25 DCA Fee $2.25 Education Surcharge $0.80 Permit Fee $150.00 Scanning Fee $9.00 Technology Fee $2.40 Total: $168.30 Valuation: $ 2,300.00 Total Sq Feet: 0 Pay Date Pay Type Amt Paid Amt Due _I Invoice # PL -4-15-55377 05/04/2015 Check* 18578 04/29/2015 Credit Card $ 118.30 $ 50.00 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Final Underground Sprinkler Review Plumbing In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above-nagontractor to do the work stated. May 04, 2016 Authorized Signature: Owner / Applicant Building Department Copy May 04, 2015 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 BUILDING PERMIT APPLICATION FBC 20 Permit Type: PLUMBING OWNER: Name (Fee Simple Titleholder):_,&/I/ u Permit No. - 1022, Master Permit No. Address: City: Od-14ZZC.4� f 's k State:c = Zip: —33 / 6 Tenant/Lessee Name: Phone#: Email: JOB ADDRESS: City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes CONTRACTOR: Company Name: Address: / MA/- Wt /3 NO Flood Zone: Z City: g& i to v State: C . Zip: Qualifier Name: Phone#:07e ;��/ 6 T 1Z State Certification or Registration #: Certificate of Competency #: Contact Phone#:(r3a11 a/Q -k011_ Email Address: 2eG1�`O�r%<s xr ? DESIGNER: Architect/Engineer: zz Phone#: Value of Work for this Permit: $ A_? ®e)< Square/Linear Footage of Work: 101 Type of Work: OAddress Alteration l]New ORepair/Replace Description of Work: e &.j ODemolition az_t_ C/ - / > . Submittal Fee $!Fj'3 • Permit Fee $ 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 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. The foregoing instuI m€nt was acknowledged before me this day of , 2011 , by �°�, -LPT L,> 4 who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: �"— Print: My Co ssi Expires: XME TOLEDO ON * PAY COP MIMION # EE 224678 EAPAES: August 22, 2016 9f p4q�a Bonded Thru N" PublicUnderwiters Signature Contractor The foregoing instrument was acknowledged before me this�7& day of r. , 20/E, by . *-C -• •,%.t J , who is personally known to me or who has produced as identification and who did take an oath. APPROVED BY Plans Examiner Structural Review (Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) NOTARY PUBLIC: Sign: JORQETOLEW pqv r OktpAiSStOtd # EE 224678 F,XOPES: August 22, 2016 Nonded Ika Notary Pt1W Underwriters Zoning Clerk From Nomi Media Center 1.305.356.1241 Tue Apr 28 15:03:43 2015 EDT Page 1 of 4 ANUV, LLC POWER OF ATTORNEY I, URI SEGEV, individually and in my capacity as manager of ANUV LLC, a Florida Limitad Liability company, currently residing at 3332 NE 190th Street, Unit 1010, Aventura, Florida 33180, being of sound mind and body, hereby appoint ODED SHAININ, currently residing at 2001 Biscayne blvd #3202 Miami FL 33137, as my true and lawful attorney-in-fact, to act for me and in my name and on'my behalf to: Represent me construction work matters ralatad to the following property, and axecuta ire my nama any and all city parm3.t applications and construction related documents: 33 NE 93 str®et Miami SIhoras FL 33138 giving and granting unto my said attorney full power and author.i.ty to do and Perform all and every act and thing whatsoever requisite and necessary to be done in and about the premises as fully, to all intents and purposes, as I mLght or could do if personally present, with full power of substitution and revocation, hereby ratifying and confirming all that my said attorney or his substitute shall lawfully do or cause to be done by virtue hereof. IN WITNESS WHEREOF, I have executed this power of attorney on the 26 day of April, 2015. �igned, sealAd and delivered in the presence of: URI E FOR ANUV LLC STATE OF FLORIDA COUNTY OF MIAMI-DADE The foregoing instrument was acknowledged before me on this 25 day of April 2015, by URI SEGEV, who is personally known to me or who has produced lficatlon. ARY PUBLI Stat$ of Florida My Commission Expires. Aiafi % 3'.>Wl -7 From Nomi Media Center 1.305.356.1241 Tue Apr 28 15:03:43 2015 EDT Page 3 of 4 Electronic Articles of OrganizationL12000112905 FILED 8:00 AM For September 04, 2012 Florida Limited Liability Company Sec. Of state noulligan Article I The name of the Limited Liability Company is: AN'UV LLC Article II The street address of the principal office of the Limited Liability Company is: 3332 NE 190TIi ST #{1010 AVENTURA, FL. US 33180 The mailing address of the Limited Liability Company is: 3332 NE 190TH ST #.1010 AVENTURA, FL. US 33180 Article III The purpose for which this Limited Liability Company is organized is: ANY AND ALL LAWFUL BUSINESS, Article IV The name and Florida street address of the registered agent is: URI SEGE V 3332 NE 190TII ST #{1010 AVENv'1-URA, FL. 33180 Having been named as registered agent and to accept service of process for the above stated limited liability company at the place designated in this certificate, I hereby accept the appointment as registered agent and agree to act in this capacity. I further agree to comply with the provisions of all statutes relating to the proper and complete performance of my duties, and I am familiar with and accept the obligations of my position as registered agent. Registered Agent Signature: URI SEGEV From Nomi Media Center 1.305.356.1241 Tue Apr 28 15:03:43 2015 EDT Page 4 of 4 aArticle V L1 20001 1 2905 The name and address of managing members/managers are: FILED 8.00 AM Se temiber 04, 2012 Title: MGRM Se�gOf tate UV GROUP LLC 2183 N POWERLINE RD POMPANO BEACH, FL. 33069 US Title: MORM NES HOLDINGS LLC 1835 NE MIAMI GARDENS DR #264 MIAMI, FL. 33179 US Article VI The effective date for this Limited Liability Company shall be: 09/04/2012 Signature of member or an authorized representative of a member Electronic Signature. URI SEGEV I am the member or authorized representative submitting these Articles of Organization and affirm that the facts stated herein are true. 1 am aware that false information submitted in a document to the Department of State constitutes a third degree felony as provided for in s.817.155, F.S. I understand the requiretnentto file an annual report between January 1 st and May 1 st in the calendar year following formation of the LLC and every year thereafter to maintain "active" status. A� V CERTIFICATE OF LIABILITY INSURANCE TE DA 04/28/2015 ) 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(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT NAME: Automatic Data Processing Insurance Agency, Inc. vcNn o ExtI: A//C No): E-MAADDRESS: 1 Adp Boulevard Roseland, NJ 07068 INSURER(S) AFFORDING COVERAGE NAIC # EACH OCCURRENCE $ INSURER A : Technology Insurance Company, Inc. 42376 INSURED AFFORDABLE IRRIGATION INC INSURER B: INSURER C : Llc# SP2035 INSURER D: 198 NW 139TH ST N. Miami, FL 33168 INSURER E : INSURER F: $ COVERAGES CERTIFICATE NUMBER: 338024 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 TYPE OF INSURANCE ADDLSUBR INSD WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS Miami Shores, FL 33138 COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FIOCCUR EACH OCCURRENCE $ IJAMAUE TO RENTED PREMISES Ea occurrence $ GEN'L MED EXP (Any one person) $ PERSONAL & ADV INJURY $ AGGREGATE LIMIT APPLIES PER: POLICY ❑ JET [:] LOC OTHER: GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO ALLOWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED S NGLE LIMIT $ Ea accident BODILY INJURY (Per person) $ BODILY INJURY (Peraccident) $ PROPERTY DAMAGE $ Per..dent UMBRELLA LIAB EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED J I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOR/PARTNER[EXECUTIVE OFFICER/MEMBER EXCLUDED? FN]N (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below I A N TWC3448882 01/17/2015 01/17/2016 PER OTH- X I STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCFUP71ON OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached K more space is required) Sprinklers System Installation License #9613000219 CERTIFICATE HOLDER CANCELLATION A©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Village ACCORDANCE WITH THE POLICY PROVISIONS. 10050 N.e. 2nd Ave AUTHORIZED REPRESENTATIVE Miami Shores, FL 33138 A©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD ACC)R L'® CERTIFICATE OF LIABILITY INSURANCE 4/282015 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(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 Brown 6 Brown of Florida, Inc. CONTACT NancyMunoz NAME: PHONEAX (305)247-5121 F0.(305)248-8543 EDDRL .nmunoz@bbinsfl.com dba T.R. Jones & Co. INSU S AFFORDING COVERAGE NAIC8 1780 N Krome Ave INSURERA:Scottsdale Insurance Company 41297 Homestead FL 33030 INSURED INSURER B INSURE RC: Affordable Irrigation, Inc. INSURERD: P.O. Box 601743 INSURER E: 9/12/2014 1 INSURER F: No Miami Beach FL 33160-1743 COVERAGES CERTIFICATE NUMBER: 2014 Master 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. TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF MM/DD POLICY EXP MMlDD LIMITS T Jones Jr./NANMUN GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 rA X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR P32028748 9/12/2014 /12/2015 DAMAGES (RE ED PREMISES RENTED $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY PRO -LOC JECT $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident HIRED AUTOS NON -OWNED AUTOS UMBRELLA UAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR DED RETENTION $ $ WORKERS COMPENSATIONWC STATU- OTH- AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? N / A E.L.EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POUCY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Sprinkler System Installation License Number: 96000P219 CERTIFICATE HOLDER CANCELLATION ACORD 25 (2010/05) INS026 (201005).01 ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shore Village 10050 NE 2 Ave AUTHORIZED REPRESENTATIVE Miami Shore, FL 33138 T Jones Jr./NANMUN ACORD 25 (2010/05) INS026 (201005).01 ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ..•. .. • sees a iR: j4�1 3 �*00:00 ••:• .. .:. ease .. . :. ..: see } •cease ••• •• ::a • S E • • • • • }�a• •• •e•• •• •e• • it ••seas • • y }y :sews 11 • • • • ( • • • • •ease: • • s g •• a 5 3 FOLIO: 11-3206-013-0380 ., SUB -DIVISION: MIAM! SHORES SE" ' AMD OWNER: ANJV .._C _ ADDRESS: c3 NE 93 S. :AIA:! SHORES Iv e� CC# 96P000219 } �Je Affordable Irrigation, Inc. s (= 198 NW 139 Street Miami, Fl- 33168 Tel: (306) 681-6322 --- ,,,„,u,N . . cep WMMMISSION EE 224678 f EXPIRE8 August?2,2018 Bonded Tina Notary PubBc llrtderNiteta Ir FLUMB4 l <fi .. k 4 0 PLS,! Approved ,Z_._... Disapproved Da... ;•mss r.��.�:��' i APR 2 9 2015 A UJ�I/ -Z y 6? -M