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PL-13-2169 ' Miami Shores Village '`"ILE � . Building Department I ,q 10050 N.E2nd Avenue,Miami Shores,Florida 33138 EP 2 Tel:(305)7952204 Fax:(305)756.8972 ' ( e r INSPECTION'S PHONE NUMBER:(305)762.4949 BUIFBC 20 Permit No. �1 LDING ry PERMIT APPLICATION Master Permit No.R�A ' L(®V Permit Type: PLUMBING JOB ADDRESS: // I &O City: Miami Shores County: Miami Dade Zip:_ .� Folio/Parcel#: Is the Building Historically Designated:Yes NO Flood Zone: OWNER:Name(Fee S' le Titleholder): 9A9 C Its, Address: � rw� yl Z Phone#:l d/� City: 1 state: F/ zi : Te nantlL,essee N e: — Phone#: Emai3: a ct k c CONTRACTOR:Company Name: /y Phone#•_ 'G Address: 11J16, Ski l sa City: /tel00-3- State:_ �G QualifierName: Phone#: ` ft •G G�3•ya 3l State Certification or Registration#• CFC I JAZ Sof Z_7 , — _Certificate of Competency#• t Contact Phone#• -lA I Email Address: oma, , ,�►,. f/12r,.� oo•CO AV DESIGNER:Architect/Engineer. Phone#• fi m Value of Work for this Permit:$_ J{d�" SquarenLJnear Footage of Work: of Work: OAddress Type of O1Jew ORepair/Replace ODemolition Description of Work: .. .. k-i��-►tee_,-� 'St n1� Lim� it111rlr******�*fir,kir*,kak+hktk*,r*,kir�r,R�k***,t�ktk,r*,ktkF�ir**�k4r*tk,k*fk,kkakkanklrfrt,k*«,1Hate�r*lair#nk*,k,ktr*,ktra�ktk* Submittal Fee$ 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 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 st be secured for ELECTRICAL WORK,PLUMBING,SIGNS, WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS and CONDTTIONERS,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 1WROVEMENTS 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 o the notice ofcq inencement and construction lien law brochure will be delivered to the person whose property is subjec o attac ent. Also, a c fi copy of the recorded notice of commencement must be posted at the job site for the first inspection ich rs seven (7) s a er the building permit is issued. In the absence of such posted notice, the inspection will not be rov a a reinspe fee 'll be charged. Si tore L Signature gna rt Own or A�ent Contractor The foregging ins ent was acknowledged before me this The foregoing instrument was acknowledged before me this 0 day,(Mi r 20L by�c�5 ?C`feGet-AD�, day of 20 ,by` rlgTu �eeia who is personally known to me or who has produced \/ 0,'a who is personally known to or who hat produced P-w;yg& aaEraZ-I,' A&identification and who did-take an oath. as identification and who did take an oath NOTARY 07QBLIC: NOTARY PUBLIC: Sign: " Sign: Print: A '.l C. C �z' Print: My Commission Exp e�►�``°"Bo Notary Public State o1 Florida My Commission Expires: �' Maria C Castells' �g My Commission EE 191533 .., OF a°a Expires 08/08/2018 ., 'etyg�: MYLAI HERNANDEZ MY COMMISSION#K 221249 tx*,�**,xa�arart� ararterr,r�rxra�e*xar**,x ,,x,k�nx *,garu*,r **a�*,kt ,r�rarxir,x,tr,kirarx�a+rer,ut,r�*,r,x lr*rr o m�s* APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised3/1212012)(Revised 07/10/07)(Revised 06/1042009XRevised 3/15/09) STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 GARCIA, RODRIGO ROCKET PLUMBING CORP 11310 SW 46 STREET MIAMI FL 33165-5546 Cengratbl�ional one million Floridians licensed by the Department of Business and STATE OF FLORIDA Professional Regulation. Our professionals and businesses range DEPARTMENT OF BUSINESS.AND from architects to yacht brokers,from boxers to barbeque restaurants, PROFESS10"A-L R2EGULATION and they keep Florida's economy strong. - CFC1428827LlEOx_05/14/2013 Every day we work to improve the way we do business in order to t - serve you better. For information about our services,please log onto CERTIFIED R wwrw.myfloridalicense.com. There you can find more information GARCIA,RODt LIQ about our divisions and the regulations that impact you,subscribe ROCKET PLUii/I$ tG ` to department newsletters and learn more about the Department's initiatives. , Our mission at the Department is:Ucense Efficiently,Regulate Fairly. We constantly strive to serve you better so that you can serve your is CERTIFIED under the provisions of ChA89 FS. customers. Thank you for doing business in Florida, Expbn4on date AUG 31,2014 L13MI40OW43 and congratulations on your new license! _ If —A. The Department of State is leading the commemoration of Florida's 500th anniversary in 2013. For more information, please go to www.VwaFlorida.org. i VIVAHUII�I�DD. DETACH HERE _ AQP PLO A DEPARTMENT Of'BUSfNESS AND PROF S$IONAL,REGULATION a' CONSTRUGTI04INDUSTRY.LICEf I ING BOARD . ` Cf C14ass27 ' TIae,Ptl1M0JING CON, RAGTOR i latno ti below iS CERTIFIED Q Und�rthe provisions;of Chapter%4$9 FS. { .' cprtioft da#e� AUG 31,2014 Vit,y t w ODRIGQ � RCt R - A A sCnnXaT R`�pP{ U a* 0 R11 '1131Y 7�1/Y 4�fTIIE ;T'"yac°"y,n"u��e,�,•?M�,, ,µJ.n `✓�"'.�.�e. , �t „qw� - VIVA FLORIDA 500. a RICK SCOTT ISSUED: 05/14/2013 SEQ# L1305140000743 KEN LAWSON GOVERNOR DISPLAY AS REQUIRED BY LAW SECRETARY Itoport Viewer Page 1 of 1 JEFFAMAUR CHW FINANCIAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL.SERVICES DIVISION OF WORKERS'COMPENSATION ••CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS'COMPENSATION LAW•• CONSTRUCTION INDUSTRY EXEMPTION 7tds mMa that Me individual Ilded below has elSCW tO be exinpt from Ficuida Workers'CoTMwastim law EFFECTIVE DATE: 6MM13 EXPIRATION DATE: WWI PERSON: GARCIA RODRIGO FEIN: 300745108 BUSINESS NAME AND ADDRESS: ROCKET PLUMBING CORP 11310 SW 46 STREET MIAMI FL 33168 SCOPES OF BUSINESS OR TRADE: PLUMBING NOC AND ORtVERS PursueChepterMd05(74},F.&.aao�erafaoonwtw etaGae5mi 6ts b�f�ngeomdl�eoldecHanmdertbkaecBon aay adtet:aVBib orC ml labbpfhb eha Pu �Cb ar410.�tIJ,FB., N M6em -ap�r�Nv o9ia soopa dam bushesareadebmWCanounofdeeomtobeemmpl.PWWmmttoC�r4WL9l F=omenofe taCea aodcei68ratesof deWmtobo=m4t�abea�atto[e [(etagfmae�ti+e�m alB�a��eemimha aTme ,"m peamn na=dmrAnm%WW amlIDcaRa ao Wogaraffime+a9aPoum asetbp farlssmave ola iM depabaB cawfreaoeditiam deAyfEem fortaA�oi� .lam eameA on the fo a�ilre off4bt a DF8F2-DVYRG252 CERTIFICATE OF ELECTION TO BE EXMWr REVISED 07-12 QUESTIONS?(8 W13.1609 httpsJ/apps8.Rd&.cmWcrreporMewer/repofViewer wpx?dataFkdvpginc9D7Q3gH6TER6e... 6/5/2013 i Pte : 5g ti FIRST-CLASS U.S.POSTAGE ' PAID r MIAMI,FL y x PERMIT NO.231 THIS IS NOT A BILL-DO NOT PAY NEW BUSIN7 1 RECEIPT NO. 743076-2 ESS S5 NAME/LOCATION ROCKET PLUMBING CORP STATE# CFC1428827 11310 SW 46 ST 33165 UNIN DADE COUNTY - OWNER ROCKET PLUMBING CORP WORKER/S Sso.Type of Business 1 196 PLUMBING CONTRACTOR THIB Is ONLY A LOCAL susuiM TAX RECEIPT.IT HOD= NOT PWTHE LDER TO VIILATE ANY MWTING REGULATORY OR DO NOT FORWARD ZONING LAWS OF THE OM T E1�PT TOR HE HOLDER FROM ANY OTHER RERUIT OR LICENSE REQUIRED BY LAW.THINSSIS ROCKET PLUMBING CORP s NOT o c nAOF u°NRcL, RODRIGO GERCIA PRES TIONS. 11310 SW 46 ST P TRECEE�TAX MIAMI FL 33165 CON.I.ECTOR. 02280008001 #f # jjjif}fFflr€r # r#rr#f# #f7fffif3lf ' fl#r '1 000075.00 SEE OTHER SIDE CERTIFICATE OF LIABILITY INSURANCE DATE 9;09,1'3 -- - 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 CONTRA&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 CONTACT NAME: MIRIAM First Insurance Group DREs ) 305 221-788878 (A/C No)_ (305)554-7090 �a11&0 Ext _ ( ) FAX 10967 SW 40 St ADD E midammesa@aol.com Miami, FL 33165 INSURER(S)AFFORDING COVERAGE NAIC# Phone (305)221_7878 Fax (305)554-7090 INSURERA: SCOTTTSDALE INSURANCE INSURED -- _-- — INSURER B ROCKET PLUMBING CORP INSURER C: 11310 SW 46 St INSURER D: Miami, FL 33165- 305 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 MAYBE 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 PUB POLICY EFF POLICY EXP INS -- - ADDL - - - -- _-_ D POLICY NUMBER MM/DD MM/DDrYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE I $ 1,000,000.00 DAMAGE TO RENTED 0 COMMERCIAL GENERAL LIABILITY 100,000 00 A ❑ ❑ CLAIMS-MADE ❑ OCCUR CPS1809986 06JOC/2013 06/06/2014 MED EXP(Anyon persooccurren�j $ 5 000.00 INJURYPERSONAL&ADV El _ GENERAL AGGREGATE $ 2,000,000.00 ❑ P -_AGGREGATE LIMITAPPL❑IE PER: PRODUCTS-COMP/OP AGG;r$ 1,000,000.00 i - LOC - - -- - - JECT- --- - --- - - -$ - -- AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ❑ ANY AUTO BODILY INJURY(Per person) j $ ALL OWNED SCHEDULED BODILY INJURY(Pid ❑ AUTOS ❑ (Per accent AUTOS $ NON-OWNED I P PERT) DAMAGE ❑ HIRED AUTOS ❑ AUTOS er accident-_- $ - ❑ — ❑ ❑ UMBRELLA LIAB ❑OCCUREACH OCCURRENCE $ - - ❑ EXCESS LIAB ElCLAIMS-MADE = _ AGGREGATE _ $ ❑ DED ❑ RETENTION$ $ WORKERS COMPENSATIONElTORYTLIMITS ❑ EORH AND EMPLOYERS'LIABILITY YIN - -.- -__ ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT - $ OFFICER/MEMBER EXCLUDED? N/A -- ----- ---- - (Mandatory in NH) L E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) PLUMBING PLUMBING OPERATIONS I ; I CERTIFICATE HOLDER CANCELLATION —"--— - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE MIAMI SHORES VILLAGE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN BUILDING DEPARTMENT AUTHORIZED REPRESENTATIVE °�ACCORDANCE WITH THE POLICY PROVISION V. j 10050 NE 2ND AVENUE, — "" —- --— MIAMI SHORES„FLORIDA 33138 ©1988-2010 ACORD C ION. All rights reserved. ACORD 25(2010/05)QF The ACORD name and to registered marks of ACORD