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PL-15-2096 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-246748 Permit Number: PL-8-15-2096 Scheduled Inspection Date: October 29, 2015 Permit Type: Plumbing - Residential Inspector: Diaz, Osvaldo Inspection Type: Final Owner: CARRON,JEFF& MALACHY Work Classification: Addition/Alteration Job Address:94 NE 99 Street Miami Shores, FL 33138- Phone Number (917)655-5400 Parcel Number 1132060131040 Project: <NONE> Contractor: DSD PLUMBING CORP Phone: (305)979-0516 Building Department Comments ROUGH AND FINISH OF 1 TOILET, 1 LAVATORY, 1 Infractio Passed Comments SHOWER INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-241670. MISSING HOSE CLAMP SEP SHUT OFF CHECK PRESSURE AT SHOWER VALVE Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. October 28,2015 For Inspections please call: (305)762-4949 Page 26 of 33 Miami Shores Village �J7T?il � )>t� in � INorfc Claffica#ars Addle fl/Ailitic>�n: 10050 N.E.2nd Avenue NE E 3 Miami Shores,FL 33138-0000 f�errtr 5a1u V yFg Phone: (305)795-2204 r f Issue 0 tot,81 " Expiration: /201 Project Address Parcel Number Applicant 94 NE 99 Street 1132060131040 JEFF S MALACHY CARRON Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell JEFF&MALACHY CARRON 94 NE 99 Street (917)655-5400 (917)749-0242 MIAMI SHORES FL 33138- 94 NE 99 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 1,250.00 D&D PLUMBING CORP (305)979-0516 Total Sq Feet: 0 (; Type of Work:ROUGH AND FINISH OF 1 TOILET,1 LAV Available Inspections: Type of Piping: Inspection Type: Additional Info: Top Out Bond Return: Final Classification:Residential Scanning: 1 Review Plumbing Underground Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 Invoice# PL-8-15-56761 DBPR Fee $2'25 08/28/2015 Credit Card $ 110.70 $50.00 DCA Fee $2.25 Education Surcharge $0.40 08/19/2015 Credit Card $50.00 $0.00 Permit Fee $150.00 Scanning Fee $3.00 Technology Fee $1.60 Total: $160.70 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 bXca either myself my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing informati that al ork will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the above-n o ork stated. August 28, 2015 Authorized Signature:Owner / Applicant / C r / Agent Date Building Department Copy August 28,2015 1 i Miami Shores Village �.T Buildin g Dep artment Aug r 201 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY:_ Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC20( BUILDING Master Permit No. AC — 7 PERMIT APPLICATION sub Permit No. pL (`r --Mq6 ❑BUILDING ❑ELECTRIC ❑ ROOFING ❑ REVISION ❑EXTENSION F-1 RENEWAL ]PLUMBING ❑MECHANICAL F-1 PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP Of q CONTRACTOR DRAWINGS JOB ADDRESS. ` � ( � S J Cia Miami Shores County;_ Miami Dade Zip: Folio/Parcel#• ^ O 'Z --r Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: //�� Flood Zone: BFE: FFFEE:: OWNER:Name(Fee Simple Titleholder): �%'n rlro IJ Phone#: Address: VLA Jq5 4) 9 City: 101✓W1 ahw-e- State: t!i Zip: sa I s Tenant/Lessee Name: Phone#:G,(LIf7 Email: � ° CONTRACTOR:Company Name: Phone#: "�D�j ? ��r'!�� Address: 3) 4C City: U) `'I 1 state: �t Zip: Qualifier Name• ��Lo V L Phone#• �°'S�� State Certification or Registration#: C��- I N Z )�� Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State Zip: Value of Work for this Permit:$ i Z�� Square/Linear Footage of Work: Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace El Demolition Descri nofWork: �S-"L •- �V` 'Ibi �r-r/ / CA"/ , / �-4"_,v) --� V-1 4 Soo Specify color of color thru tile: Submittal Fee$ Permit Fee$ . - CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ L 10. qCD (Revised02/24/2014) 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 ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES,BOILERS,HEATERS,TANKS,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 m be ed at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absent h posted notice, the inspection will not be approved and a reinspection fee will be charged. -' ) Signature Signature OW N ER or AG ENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of Af,40�� 20 5 by day of /��JJ 20 ,by U1*M 4LU2yi ,who i ersonall to J 3 DO Z who Is personally kno me or who has produced as me or who has produced as Identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: ii v✓/ �G L/v Sign: � Sign: Print: YA Print: MY COMMISSION#FF127992 -�s a COMMISSION #F ' Seal: =�;�.. !_� Seal: °*; ':_: MY COMMISSION#FF 028557 '''.'�'oiop EXPIRES June 1, 2018 pQ� EXPIRES:October 18,2017 " " %R1�• Bonded Thm notary Publo Ur�demritera (447)39"153 FloadaNctaryservice.com ffiffiffiffiffiffiffi►ffiffiffiffiffiRffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiRkeRMiMffi#tffiRffiAeffiffiffiffiffi#itrffilrffiffiffiffiffiffiffiffiffiakffiffiiffiffiffiffiffiMffiffiffiffiR ffiffiffiffiffiklffiffiffiffikffiNffiffiffi4kffiffi+affikffi4ffi APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) D01428 Local Business Tax Receipt Miami—Dade County, State of Florida -THIS IS NOTA BILL - DO NOT PAY �ILBTIJ 5268586 BUSINESS NAME/LOCATION RECEIPT NO.. EXPIRES D&D PLUMBING CORP RENEWAL SEPTEMBER 30, 2016 3145 SW 19 ST 5505483 Must be displayed at place of business MIAMI FL 33145 Pursuant to County Code Chapter 9A—Art.9&10 SEC.TYPE OF BUSINESS OWNER 196 PLUMBING CONTRACTOR PAYMENT RECEIVED D&D PLUMBING CORP CFC7426173 BY TAX COLLECTOR Worker(s) 1 $45.00 07/27/2015 CHECK21-15-105518 This local Business Tax Receipt only confirms payment of the Local Business Tax.The Receipt is not a license, perm%ora certification of the holder squalifications,to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT N0.above must be displayed on all commercial vehicles—Miami—Dade Code Sac Be-276. For more information,visit www.miamidede.govitaxcollector _. RICK SCOTT, GOVERNOR ^- KEN LAWSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD CFC1426173 _°� The PLUMBING CONTRACTOR o Named below IS CERTIFIED Under the provisions of Chapter 489 FS. a Cos WY y Expiration date: AUG 31, 2016 �a DIAZ, DAVID Q • ■❑ D& D PLUMBING CORP 3145 SW 19TH STREET MIAMI FL 33145-1927 �g ISSUED: 08/11/2014 DISPLAY AS REQUIRED BY LAW SEQ# L1408110001168 CERTIFICATE OF LIABILITY INSURANCE `� '`"'` 12/02!14 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:Il'the certificate holder Is an ADDITIONAL INSURED.the pogcy(tas)must be endorsed.N SUBROGATION IS WAIVED,subject to the terns 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 endorsenmengs). PRODUCER =MY Lucia E,State Accurate ME edk (305)226-8727 (305)226-8767 8300 West Flagler Suite 114 Iuelaesmamobeasa+ih-r et Miami,FL 33144 INSU AFFORDING COVERAGE N=# Phone 305)226-8727 Fax (305)226-8767 INSURER A: United States Uabilay Insurance Comp INSURED INBURER a. Association Insurance Co. D&D Plumbing Corp INSURER C: 3880 NW 2 Terrace NSUREftD. Miami,FL 33126 (305)979-0516 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. TYPE OF HNSURAmCE KISR POLICY NUMBER UNITS GENERAL LIAGUM EACH OCC RRENCE S 1,-000000.W ® COMMERCIAL GENERAL LIABILITY TMe O RENTED S 5,000.OD A ❑ ❑ CLAIwwwE ® Y 11126/2014 11/26/2015 OCCUR CL-2633197A MED Exp( are pesar S 100,000.00 El PERSONAL PERSONAL a AM INJURY s 1,000,000.00 ElGENERALAGL� 00 GATE $ 1,0 ,000.00 OWL AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGO $ 1,000.000.00 ❑POLICY 1:1P O- 1:1 Lac $ AUTOMOBILE UABRRY COMBIVEOrSIRGLE LUT ❑ M,AUTO BODILY MARY(par Pte+) $ ❑ ALL A OWNED ❑ SCHEDULED BODILY Knw(Pe7 S ❑ HUED AUTOS 11 AUTOS �EO P PERTY ❑ $ ❑ UMBRELLA LIAR ❑OCCUR EACH OCCURRENCE S ❑ EXCESS LIAR El CLAWSWADE AGGREGATE S El DED 0 RETENTioms S WORKERSCOMPENSA11011 WCSTATU- OTH- AND EMPLOYERS UABRM YIN E]ER 1,000,OQD.QO B ANY PROPRIETORIPARTNERIEXECUTNE EL EACH ACCIDENT 1,000,000.00 OFRCERAIEMBER EXCLUDED? 0 Y Y WCV818M510A 1IJ262014 11/2612015 (Mandawy in MR) ELMSFASE-EAEMPLOYE S 1,000.000.00 Mas EoactRie a SCRIN OF OPERATIONS W. EL DISEASE-POLICY LWT a ONION OF OPERATIONS/LOCATIONS 11 t ACORD 101,AddtUons1 Pernaft Schedule It more epaee Is regXdroOl State Plumbing Contractor CFC1426173 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THMOF,NOTICE WILL BE DELIVER£O IN Miami Shares Village Dept. ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd Avenue Miami Shares,FL.33138 AUTHORIZED Luria Estrella ACORD 25(2010108)QF vA 9 and5/ 1 CORPORATION.are registered gisi�a 1 ks of reserved. ACORD nerve and 1 are 4 �lyi I �•�° Miami Shores Village �c�1�'F� JUL ® 8 ���� Building Department �Y: �o 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 ' Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 _ FBC 2W zv ' � BUILDING (waster Permit No.a_!L PERMIT APPLICATION sub Permit No. ew BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL F-]PLUMBING ❑ MECHANICAL E]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION [:] SHOP �j CONTRACTOR DRAWINGS JOB ADDRESS: [9 �� City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Con struction 11Type: Flood Zone: /� BFE: FFE: �7NER:Naq a Fee Simple Titleholder): ^t" fAffAone#: e ' I ' UG- Address: 7 City k�WState: Zip: Tenant/Lessee Name: Phone#: Email: ^� CONTRACTOR:Company Name: /�, l 1'FTLU6NOfJ SZ5641 C'S Phone#: 794 —4&2 Address: 40- SW 4 (01 �-3 (4S City: � I/i/1 ( State: �� Zip: Qualifier Name: C�NRJ-L � ALL UAJJ T_EZ__ Phone#: W'� State Certification or Registration#: CC� (�-cI M Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ 10.000 Square/Unear Footage of Work: Type of Work: F-1Addition [:1Alteration [-INew q Repair/Replace ❑ Demolition Description of Work: � a� � I��tJ14, "K 1 'onOAkb t V1 Specify color of color thru tile: Submittal Fee$ J �� Permit Fee$ _4D, C CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (Revised02/24/2014) 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 ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS,HEATERS,TANKS,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. MWV Signature. Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this /�—day of LYLO ,�, •by 0 day of U,1 C 20 / . by lh E��/,�P�1 ,who is personally known to � ��r �6Z�,ui7 L.who i ersonally kno-to me or who has produced FOC-1-1 as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Si n- sign:- Gam-- Z72 Print- Print' MABELIS E FERNANDE2. Seal: +o Notary Pudic State of Florida Seal: _; Joanna M Feliciano ': MY COMMISSION#FF127s92 'A My Commission FF 082753 �y @ EXPIRES June 1, 2018 �,,,i Expiresolnwo18 (407)398-0153 FloridallotaryService.com >Kae*ere>Ax�>9�aa*�xe�we�**sw+a�sse*e• res *.e *>�x��ex��xswx�waex�*�s�+sx��s�aaea�*��*ss rssse��*�w�a�ssa APPROVED BY flans Examiner Zoning Structural Review Clerk (Revised02/24/2014) r S�,OREs a,,, 11111M Miami shores Village Building Department R`lpA 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305)756.8972 Notice to Owner — Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees,including the owner,must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if: 1. The officer owns at least 10 percent of the stock of the corporation,or in the case of an LLC,a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State,Division of Corporations;and 3. The corporation is registered and listed as active with the Florida Department of State,Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers'compensation exemption and has acknowledge that he or she will not use day labor,part-time employees or subcontractors for your project.The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project.In these circumstances,Miami Shores Village does not require verification of workers'compensation insurance coverage from the contractor's company for day labor,part-time employees or subcontractors. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: Owner State of Florida County of Miami-Dade The foregoing was acknowledge before me this day of C vl ren 2,V ByrJ Oa/lc�yl_) who is personally known to me or has produced as identification. Notary: _�,, N=StateedaJoanna M SEAL: c ,< Manna��,o E OZ Construction Services 3642 SW 14 St,Miami FL 33145 ( s' i ' CONSTRUCTION Phone:786-467-7200 Fax:305-461-6816SERVICES INC. Lic#CGC1520184 www.MIAMIOZ.com GENERAL AFFIDAVIT State of Flo d County of (--I" BEFORE ME,the undersigned Notary, W'14'it on is 2 ti day of 20_Lj personally appeared kno to me to be a credible person and of lawful age,who being by me first duly sworn,on 6'd 1o�rtth,deposes and says: That he or she ad1l be the only person working on the project1"ated a6 - t 4� �L" 9- I g�— Personally know OR Produced Identification Type of identification produced ABELIS E FERNAND ' MY COMMISSION#F 127 2 3',oc" PIR S 1, 2 7) 153 Flo rvice. / Print,Type or Stamp me of Notary DATE(MM1DD/YYYY) `4 CERTIFICATE OF LIABILITY INSURANCE 4/27/2015 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. I 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 ic ONTACI NAME,J ANDYS ASSURANCE AGENCIES PHONE.._ — _ _—_ ' A1C No Ext1 (305) 642-8407 - -...._._... j�AIC yah j305) 643-5969 1441 W Flagler St E MAlL Miami, FL 33135 iDURks< Inret @anCi rsasstiranc. cOm _ _ ............... INSURER(S) AFFORDING COVERAGE NAICb INSURERA MAXUM INDEMNITY COMPANY --- ! _ . _. ...... _____..___... __ INSURED 02 CONSTRUCTION SERVICES GROUP,INC. INsuREr,s 3642 SW 14 ST INSURER C. MIAMI , FL 33145 1 INSUREr D N URER E INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED 1'0 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 THf: POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS GENERAL LIABILITY '--t-- T—� INSR tM/D _ NOL i'-t�F PCL(;lIXP — -- ........ _.�.__... _ __ iTRR: TYPE OF INSURANCE POLICY NUMBER N N.1 TDt r'I';YS :h1Nf+DD YYYYI 1 LIMITS �ADDL' UBR EACH OCCURRENCE s 1,000 000__.. X COMMERCIAL GENERAL LIABILITY { l5A?TAGETO RE(dTED-- -- PREMISES tEa occunencej ;$ ____1_0_0__f 000 I CLAIMS-MADE �x OCCUR j MED EXP(Any ono person) $ 1,000 A' ;�._....� BDG0074501-03 CJ4/23/15,:04/23/16PERSONAL&ADVINIURY S 1,000,000 _ ...._...__.. ....� GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PF ODUCrs COMPio ACG 1 S2,000,000 X 1 POLICY PRO- LOC S AUTOMOBILE LIABILITY � _ COMBINED SINGLE LIMITI � ,...tEa accident}. _.^._..._... $_-.........._ ........_� ANYAUTO BODILY INJURY(Per per,.,I 5 j ALL OWNEO SCHEDULED — __ . —_ AUTOS AUTOS - BODILY INJURY(Per acuaen 1 5 NON-OWNED a '^PPOPERT�DAMAGE .._ HIRED AUT6S I AUTOS j fPer cc ^) $ I .._... _._...... ...__. ._........... _ _.... � I ( S i UMBRELLA LIAB OCCUR ` EACH OCCURRENCE S _.._._ EXCESS UAB f �CLAIM5•MADE AGGREGATE S _.. -.._ _ OED i RETENTION$ WORKERS COMPENSATIONS i /CSTANU OTH- ANDEMPLOYERS'LIABILITY YIN ''N A 70R1'_L,IMI7S _ R __ y ANY PROPR1ETORIPARTNERIEXECUTIVE a I { FN t aCH ACCIOEN7 j $ v OFFICEWMEMBER EXCLUDED9 ! _._-. .......... rI` ...... _...... ! (Mandatory in NMI L D j E DISEASE EA EMPLOYE..5 ..__ .. _..__. ........ _......_t i if es,describe under - !DESCRIPTION OF OPERATIONS below E L DISEASE POLICY LIMIT S j f DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if:none sure;}rr+quired) ;GENERAL CONTRACTOR-REMODELING i CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE BUILDING SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE DEPARTMENT THE EXPIRATION DATE THEREOF, NOTICE: WILL BE DELIVERED IN 10050 NE 2 AVE ACCORDANCE WITH THE POLICY PROVISIONS. MIAMI SHORES,FL. 33138 AUTHORIZED REPRESENTATIVE C)1988-2010 ACORD CO PORATION All rights reserved. ACORD25(2010/05) The ACORD name and logo are registered marks,Ii ACORD 000 c , moa O O D W• ► ��- I v Dl JUL 0 8 2m D W- EX G J W I EN KITC N00 ; { NS P ; m c 15 D�Zr �kIIAMI SHORES VILLAGE LINTER TO BE Mint ;hH OTECTED RECEPTACLE. BY ; DATE BATH WOM RECEPTACLE ON 20 (T ^ D, a s;; ;�-OTACLE UNDER SIN,,'. Alllklo m , AND G.FI PROTECTED AIL OED AF r W,1' P ONI G ADD SMOKE/CARBON MONOXIDE DETECTORS ANY AND ALL CLOTH AND RUBBER DINING $ U URAL DINING INSULATED CONDUCTORS TO BE REPLACED ROOM I ROOM EVCTOCAL gyp, i 00 • •• INS NO POINT ALONG COUNTER TO BE MORE THAN •• ••• •• •• 2 FEET FROM G.EI PROTECTED RECEPTACLE PUT DIWRECEPTACLE UNDER SINK. ••• •;• ••• ••• ••• MiECH�NiCAL ALL FIXED APPLIANCES ON DEDICATED CKTS. 0.0 • D • • • :—� • • • • • • • NCE WITH ALL FEsutsi i�LE:A3- STATE AN C®11NTy RULES AND RErIyLAIICI-I:. � I _ APP rov ed �,z Disap roved - I I P �.� to ?icy 6'cco ! edf I I I ec® Ew �G Rev, -V HATHHoOM RECEPTACLE •• ••• •• ON 20 AMP CKT . . . . . . . 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IT SHALL BETHE RESPONSIBILITY OF THE CONTRACTOR TO LOCATE ALL EXISTING UTILITIES WHETHER SHOWN HEREON OR / NOT AND TO PROTECT THEM AND OTHER EXISTING PHYSICAL PROPERTY FROM DAMAGE. CONTRACTOR SHALL VERIFY ALL DIMENSIONS AT SITE BEFORE COMMENCING THE WORK IF ANY DISCREPANCIES EXIST,THE N ARCHITECT OR ENGINEER SHALL BE NOTIFIED(IN WRITING) BEFORE PROCEEDING WITH THE WORK. ui CONTRACTOR SHALL BE RESPONSIBLE FOR DAILY REMOVAL AND ! ,� 000 DISPOSAL OF DEBRIS FROM INTERIOR AND EXTERIOR AREAS. `J FDW- ----- (q�/ CONTRACTOR SHALL BE RESPONSIBLE FOR PREPARING AN w - - 71' AS-BUILT SET OF DRAWINGS UPON SUBSTANTIAL COMPLETION. /�/ MT 6.10.1. O1CONTRACTOR SHALL PROTECT ALL COMMON AREAS AGAINST LL QQ J D ODAMAGE.AND IS RESPONSIBLE FOR THE REPAIR ORI"-_ REPLACEMENT OF ANY DAMAGE AREA REGARDLESS WHICH w0 TRADE CAUSED SUCH DAMAGE. CONTRACTOR SHALL HOLD HOME OWNER HARMLESS FOR V) DAMAGES TO THE PROPERTY.ADJACENT COMMON AREAS 6ADJACENT PRIVATE PROPERTIES. ,L,119"-- -----119"w -- — Qo Ln EXISTIN77 A __ NEWUKITCHE --- _ KITCHEN KEYNOTES: ulrI �7 EXISTING REFRIGERATOR fTl { I G. 1. I TO BE REMOVED AND RESET N �^ I G I �� I Iii I G Z --72"----- I. A - ---64 ----- I A EXISTING KITCHEN CABINETS&COUNTERS O 14� Np O A �J AR TO BE REPLACED Ocli N ' � -,� - !�� I G STOVE TO RE REMOVED AND RESET 0 I 41 `\ I , /J % E DISHWASHER TO BE REMOVED AND RESET G. G.6. SINK TO BE SELECTED BY OWNER Z : �. •••.• 1 ••Ck� •• •I COUNTERS TO BE SELECTED BY OWNER 4 •'•••. •. • go z ••. • • I W rn ••�•e• •�•••• p t1 H " •• • I X: • • W r o G g ••'•�• • ••• w Q cam+ • • DINING ROOM DINING ROOM i LEGEND W z .• WALL SWITCH 15A.125V Lu •• : • YS 5-WAY WALL SWITCH 15A.InVLLJ N I� DUPLEX RECEPTACLE OUTLET 15A.125V iIm. SWITCHED DUPLEX RECEP.WTLET 15A.125V Q Q DUPLEX FLOOR RECEPTACLE.15A.125V Z I� SIMPLEX RECEPTACLE OUTLET 15A.125V SPECIAL RECEPTACLE WTLET i —"---- 1-0 WALL MWNTED LIGHTING FIXTURE • ---' — _�_+ CEILING LIGHTING FIXTURE JUNCTION BOX ® RECESSED CEILING LIGHTING TELEPHONE JACK 0 TELEVISION WTLET FUSE OR DISCONNECT SWITCH SCALE' AS SHOWN ❑c CHIME DATE: O CARBON-MONOXIDE SMOKE DETECTOR Om SMOKE DETECTOR JOB NO. ••' EXHAUST FAN [7—] ELECTRICAL METER—N SHEET NO.: O ELECTRICAL PANEL �--o-� A— UJDER-COTER LIGHTING UN STATE OF FLORIDA REVISIONS 1 FIBER-CEMENT IN V4E'AREA,FIBER-MAT REINFORCED CEMENT.G-ASS MAT GYPSUM BACKERS AND FIBER-REINFORCEC GYPSUM ON I X PT o%000 FURRING CER TILE ON MTL LATH VI/LEVELING COAT DF CEMENT PLe57ER � LINE OF WA_L SEA ANT CERAMIC TILE W I-----------------------58----------------------- _ I 6D MIL MIN REE INF � ----------25 TT________I PL45TIC SHOWER PAN / M MORTAR.SLOFE FROM I'O A- M T I PERIMETER TO 0'6'DRAIN Q OPEN SHOWER u Z o LINEN SHOWER PAN DETAIL LL CLOSET O 1 1 U t�" KEYNOTES: D F� Ln BATHROOM RESET =:o Lf) v� ,— j TILE TO CEILING z 3v w TILE TO BE SELECTED BY OWNER O N UCli i SHOWER FAUCET&RAINSHOWER HEAD TO REMAIN M N TOILET&SINK TO BE REPLACED O I I` TILE BACKER BOARD(DUROCK) I 1 CERAMIC TILE WALL COVERING Z •• ••••• TILE TO BE SELECTED BY OWNER C) •• •••• STANDARD NICHES } 00.00. •0• • • GYPBOARD �� ! z v ••••• • CO © pR1­0 d • • :004. 14' -------- W •• ---- --34"----- GF4" o� Luo a®v LIGHT FIXTURE @ 88" Q- a P W • T O v= ••• i•••• LEGEND W Z •• ••• k WALL SWITCH IS,I- I- Lu ••• • • �� i� i i �� �� ✓•I- ��C V SWAY WALL SWITCH 15A.125VLu • 1$ DUPLEX RECEPTACLE OUTLET ISA.I25V IX I� SWITCHED DUPLEX RECEP.OUTLET 15A.I25V Q DUPLEX FLOOR RECEPTACLE.15A.125VZ � SIMPLEX RECEPTACLE OUTLET 15A.175V EXIST. B SPECIAL RECEPTACLE OUTLET b WALL MOUNTED LIGHTING FIXTURE y CEILING LIGHTING FIXTURE C Q JUNCTION SOX Q RECESSED CEILING LIGHTING� TELEPHONE JACK • 0 TELEVISION OUTLET Q FUSE OR DISCONNECT SWITCH SCALE: AS SHOWN Q CHIME GATE: O CARBON-MONOXIDE SMOKE DETECTOR 0 SMOKE DETECTOR JOB NO. All' EXHAUST FAN ELECTRICAL METER/MAIN SHEET NO.: C� ELECTRICAL PANEL B-1 UNDER-COUNTER LIGHTING STALE DF FLORIDA