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PL-15-2927 � --tea- Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax (305)755.8972 Inspection Number.INSP-248124 PermItNumber: PL-11-15-2927 Scheduled Inspection Data: March 15,2016 Permit Type: Plumbing -Residential Inspector Hernandez,Rafael Inspection Type: Final Owner. CHrrrY,ROBERT Work Classification: Sprinkler System Job Address:1665 NE 104 Street Miami Shores,FL 33138- Phone Number (305)754740" Parcel Number 1122320320200 Project <NONE> Contraactor. JML IRRIGATION INC Phone:(305)992-7866 Building Department Comments LAWN SPRINKLER INSTALLATION WITH 3 ZONES WITH �N factlo Passed R Cor�anEw'rS False ms 37 HEADS Inspector Comments Passed Failed Correction Needed Re-Inspection Fee No AW t rW In pecWms can be sdWuW una re4nspedlon The Is paid Mamh 14,2016 For Inspections please calk(305)762.4949 page 6 of 30 MIAMI-DADE WATER&SEWER DEPARTMENT METER OPERTATIONS&MAINTENANCE MIS MI- CROSS-CONNECTION CONTROL UNIT 1001 N.W.14Th STREET,MIAMI,FL 33136.2209 Phone(305)547-3046 Fax(786)268-5485 BACKFLOW PREVENTION ASSEMBLY TEST REPORT FORM A0f'RFSSCr_CEVfCE:1665 NE 104 STREE'r MNER CF GEWLE. GANERCCNIACT: FAX. MIAMI SHORES Fl- Zip LOGE NAME OF TESTER (;ERT:F!.'^AT70.'4 j E. Jeff Reamer 0965 305-884-5700 Dixie Landscape Co. 12950 NW. 113 Ct. Miami, A ZIP CCCF 33178 3 MGM-. SER?I At SITE I 0E. TEST YfT�#Av MID WEST 845-5 05151912021UP16 YES /NO TEST PLEASE MARK: R.P. D.C. P.V.B. MW OF ASSEVRM, SEWL SIZE. WILKINS a T272055 ill _L(04TON OF ASSEVM.LEFT SIDE OF THE HOUSE V f I F R NO. 4 X MT[CFIEST: %,E I E R R E A D*Uri INITIAL TEST: ANNUAL TEST: 03102/16 $89T QEF VALVE 41: SHUT OFF VALVE;2 CLOSED TIGHT: CLOSED TIGHT: PRESSURE STABLE:YES-NO LEAKED: LEAKED: LINE PRESSURE.— D.CM.A. R.P.Z.A. u 13M.B. CHECK VALVE 110.1 CHECK VALVE NO.2 DIFFERENTIAL RELIEF VALVE A1111.11LET CHECK VAtV Closed Tight: X Closed Tight: FAILED TO OPEN: LEAKED:. (n ,u—j Leaked: Leaked: OPENED AT: PRESSURE C,FIFERENTMIL ACROSS CHECK PREMRE D.FFERENPALACROSSChSO, HEIDAT; PSI PSI OPENED AT:__–PSf. 2.8 2.0 psi —1 1 PSI 1 IF THE ASSEMBLY FAILS FOR ANY REASON,COMPLETE THIS SECTIO NOTE REPAIRS RE4-.1ARKS I REASON FOR FAILURE(IF APPARENTp I CHECK V,1%1,.E.1.3 2 0111-F LAEUTI-L 11PLIEF IJALV�. CLEANED: CLEANED..._._____ CLEANED:.. CLEANED: REPLACED, REPLACED: REPLACED: REPLACED: iL tit D.C.V.A. R.RZ.A. P.V.B. CHECK VALVE NO.I CHECK VALVE NO.2 f.F1 Iff W-.1;i AQ I%Lff CH ECK VMIE 4 1-- F; ED lqu'Fu LEAKED: Closed Tight: Closed Tight: FAILED TO OPEN: OPENED AT: HELDAT: trt Leaked: Leaked: PSI PSI PRESSURE D.FFERENTIAL ACR0,5S CHECK PRESSURED FFERERVALACROSSCHECK OPENEDAT:—PSI PSI PSI I I CERTIFY THAT I HAVE TESTED THE ABOVE ASSEMBLY INACCORDANCE WITH THE MARVA.CROSS CONNECTiON CONTROL fAANUAL AND THAT ALL THE INFORMATION Is ACCURATE TO THE BEST OF MY ABILITIES. SIGNATURE OF CERTIFIED TESTER: DEVICE PASS DATE:03/02/16 NOTE: TEST FORM MUST BE COMPLETED IN ITS TIRETY. INCOMPLETE TEST FORMS WILL BE RETURNED. Revised: 5/27/2010 o-mail. CCC@mlamIdada.q of: I mml e.govh-iator/cross-cotinection-backflow.asp U ( I�Ilv 'I, Miami Shores Village 10050 N.E.2nd Avenue NE Miami Shores,FL 33138-0000 ` k ` Phone: (305)795-2204 , Expiration: 05/2242016 Project Address Parcel Number Applicant 1665 NE 104 Street 1122320320200 ROBERT CHITTY Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell ROBERT CHITTY (305)754-4000 (786)897-8557 Contractor(s) Phone Cell Phone Valuation: $ 21500.00 JML IRRIGATION INC (305)992-7866 Total Sq Feet: 0 Type of Work:LAWN SPRINKLER INSTALLATION WITH 3 Available Inspections: Type of Piping: Inspection Type: Additional Info: Final Bond Retum: Underground Sprinkler Classification:Residential Scanning:3 Review Plumbing Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.80 Invoice# PL-11.15.57822 DBPR Fee $2.25 11/24/2015 Credit Card $ 118.30 $60.00 DCA Fee $2.25 Education Surcharge $0.80 11/19/2015 Credit Card $50.00 $0.00 Permit Fee $150.00 Scanning Fee $9.00 Technology Fee $2.40 Total: $168.30 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 AFFIDAVI 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 z rmore,I authorize the above-named contractor to do the work stated. November 24,2015 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy November 24,2015 1 Miami Shores Village Building Department NOV 19 2095 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 �Y' INSPECTION LINE PHONE NUMBER:(305)762-4949 ] FBC 20/// BUILDING Master(waster Permit No.0 PERMIT APPLICATION Sub Permit No. ❑BUILDING. ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ;LUMBING ❑ MECHANICAL ❑PUBLIC WORKS [] CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: ip( S Ai.E . 104 zTe_E c-r City: Miami Shores County: Miami Dade Zin: Folio/Parcel#: Is the Building Historically Designated:Yes NO / Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): 906C2,1- k. CK I TTY Phone#: Address: 16(16<S .E. l Ott sr '^ City: AIA,w _SK O E s State: Fe_ Zip: Tenant/Lessee Name: J��A Phone#:,'30C-1!54,'f 0010 Email: _ G 123 w Po sT�„ �.a�. Ctlm CONTRACTOR:Company Name: M,\ Y r IZA ® V\ ,►°1 C Phone#: 30s l 1 Z -ITU Address: m ® .s W AVE uri,i4 is City: K �Yh \ State: o r l � c?r Zip: 33 � O to /' Qualifier Name: ®5 e Go Q V'YC� Phone#: -3®-S 09_.:_"� _C State Certification or Registration#: Certificate of Competency#: (0 P 0 0 0 2—+q DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: 0 Value of Work for this Permit:$ *S Q Square/Unear Footage of Work: Type of Work: ❑ Addition ❑ Alteration New ❑ Repair/Replace ❑ Demolition Description of Work: LG w n S ems'1 v1yAt v 1 v­�S�n'A O Al O V% w f ! � mo rl e.S w14k 3-:� )As,9As Specify color of color thru tile: Submittal Fee$@ Permit Fee$ It CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ Pj (ReWsed02/24/2014) r t 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment Also,a certified copy of the recorded notice of commencement must be posted at the Job site for the fast ' ction which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection ill no be approved and a reinspection ee . Signatu Signature OWNER or AGENT CONTRACTOR The fore oing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of tJ D J 20 by -��F da/y-sof �!2 20 IS .by 9-'Y A � ,who is personally known to ,10 Iyl l )U ��QWho is personally known to TLI� r me or who has produced as me or who has produced UDEN as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: ^� Print• Print: V.LGOLDMAN Seal: MY COMMISSION#FF033M Seal: EXPIRES:August 8,2017 0 P Notary Public State of Florida ga 4••` Bonded Thru Notary Public Unde.vr tiers �y ; My Co Alvarez "A oQ My Commission FF 156750 p�p� Expires 09/03/2018 APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Miami shores- Village Buildino Department 10050 N.E:2nd Avenue Miami$hares, Florida 33138 `f'e1:(305)793.2204 Fax:X345)756,8972OOT O " ' CST TION ��fr�r•lo �rri wry IF CONTRACM IS.A WRIDAESTATE IFIED:COWMCTOR. A. _COPYOF QUALIFIER'S STATE LICENCES a. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE* P. COPY OF WORKERS COMPENSATION INSURANCE*' (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and CD*actorAf lav1tl IF CONTRACTOR HAS A MIAMI DACE CQINTY CERTIFICATE OF COMPETENCY: COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER COPY OF LOCAL BUSINESS TAX RECEIPT C, COPY OF STATE REGISTERED CONTRACTOR LICENSE. OR MIAMI .DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. COPY OF LIABILITY INSURACE* E COPY OF WORKERS.CO IPENSA T R ,ION INSURANCE (Workers Compensation EXEMPTION mud:have NOTICE TO OWNED form&W Conf ttuf:A tlav !Y E COMPANY MUST 1881JE A CERTIFICATEM CERTIFICATEFOL laertlflcate Buller.. MIAMI SHORES YiLLAGE:BLDG DEPT 10060 NE 2ND AVE MIAMI SHORES,Fl.33138 Certificate must specify the description of operations or contractor licensenumber. •sraaaaaasrasmrmewa■aaamsMrrmeers®riaawm rrarrrmwrawrrraaememarras�r�arr'rra�.amarMrrtmwwere BUSINESS'NAME: V' e C7 v� L BUMN 58 ADNESS: 138 0 6 sem,, I LU MZ1, \a m 1_ STATEIL ZIP 33 � BUSINESS°P HONE ( os 99 2 31-C� FAX NUMBER C x1°12 �6 QUALIFIED'NAME: �c�S� �U cY rA IUALIFIEWSVC NUMBER.; 1 0_ ._. Z 4 CTQB ° Construction Trades Qualifying Board R-BUSINESS CERTIFICATE OF COMPETENCY 10P000278 JML IRRIGATION INC D.B.A.: GOER�SE is certified under the provisions of Chapter 10 of Miami-Dade County r U� �r� Local Business Tax Receipt Miami—Dade County, State of Florida —THIS IS NOT ABILL—DO NOT PAY LBT 6652698 BUSINESSNAME/LOCATION RECEIPT NO. -EXPIRES JML IRRIGATION INC RENEWAL SEPTEMBER 30, 2016 13806 SW 142 AVE UNIT 15 6923677 MIAMI,FL 33186 Must be displayed at place of business Pursuant to County Code Chapter 8A—Art.9&10 OWNER SEC.TYPE OF BUSINESS PAYMENT RECEIVED JML IRRIGATION INC 196 SPECIALTY PLUMBING BY TAX COLLECTOR C/O GUERRA JOSE M CONTRACTOR 75.00 09/16/2015 Worker(s) 1 10P000278 0223-15-006474 This Local Business Tax Receipt only confirms payment of the Local Business Tax.The Receipt is not a license, permit,or a certification of the holder's qualifications,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 Sec 8a-276. MDFor more information,visit www.miamidade.govNxcoilector OP ID:DT CERTIFICATE OF LIABILITY INSURANCE 1111212015 THIS 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 CONTACT FILER INSURANCE,INC. PN p� FAX 9440 S.W.77 Avenue Ext): No: Miami,FL 33156 SSS. X Mark Bluh PRICER cuST ERm#:JMLIR01 INSURESINSUREM AFFORDING COVERAGE NAIC# INSURED JML Irrigation,Inc. INSURER A:Depositors Insurance Co. 42587 16390 SW 278 St INSURERS:Allied P&C Insurance Co 42579 Miami,FL 33031 INSURERC: 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, E)(CLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INISR TYPE OF INSURANCE POLICY NUMBER M1D EFF POLICY LIMITS GENERALITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY CP596"98205 05/10/2016 OW1012016 PREMISES Ea ocautence $ 100,00 CLAIMS-MADE 1 OCCUR MED EXP(Any one person) $ 1,00 X Contractual PERSONAL ti ADV INJURY $ 1,000,00 Liability GENERAL AGGREGATE $ 2,000,00 GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,00 17 POLICY PRO LOC $ AUTOMOBILE LIABILITY (CEOMBIBINdED SINGLE LIMIT $ 1,000,00 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ B X SCHEDULED AUTOS ACP5916339781 09/26/2014 09/26/2015 PROPERTY DAMAGE B X HIREDAUTOS (PER ACCIDENT) $ B X NON-OWNEDAUTOS $ $ UMBRELLA LIM OCCUR EACH OCCURRENCE $ EXCESSLU16 CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ WORD COMPENSATION WC STATU- OTH- AND EMPLOYERT LIABILITY Y I NER �UMANY PROPRIETORIPARTNEROCECUTIVE F—� N/A E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ K es,de�ribe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Sdnadule,N more apace Is regtdred) License#1 OP000278 CERTIFICATE HOLDER CANCELLATION MIAMI05 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Village of Miami Shores THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN g ACCORDANCE WITH THE POLICY PROVISIONS. Building Dept 10050 N.E.2 Avenue AUTHORMED REPRESENTATIVE Miami Shores,FL 33138 DARYL TORRES-A21 ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 26(2009109) The ACORD name and logo are registered marks of ACORD Rte® CERTIFICATE OF LIABILITY INSURANCE DATE A;(MMI°u,s 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 CONTACT NAME: Automatic Data Processing Insurance Agency,Inc. PHONE AIC No Ext AIC No 1 Adp Boulevard ADDRESS: Roseland,NJ 07068 INSURER(S)AFFORDING COVERAGE NAIC A INSURER A: NorGUARD Insurance Company 31470 INSURED INSURER B: JML IRRIGATION INC INSURER C: 13806 SW 142ND AVE UNIT 15 Miami,FL 33186 INSURER D INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 413823 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. LTR TYPE OF INSURANCE INSO WVD POLICY NUMBER M MMID LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE D OCCUR PREMISES Ea Ocwrrence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑JE7 LOC PRODUCTS-COMPIOPAGG $ OTHER: $ AUTOMOBILE LIABILITY Ea aWdeM I $ ANY AUTO BODILY INJURY(Per person) $ ALS SSCHEEDDULED BODILY INJURY(Per acddent) $ HIRED AUTOS NAUT ON -OWNEDAUTOS r=denl $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIMB HCLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X AND EMPLOYERS*LIABILITYY YIN TY STATUTE UERTH ANY PROPRIETORIPARTNER/D(ECUTIVE �Y E.L. ACCIDENT $ 100rWo A OFFICERIMEMBER EXCLUDED? N I A N JN WC673399 08/11/2015 08111/2016 (Mandatary in NH) E.L.DISEASE-EA EMPLOYE $ 1 00rNo rc yyeess de lbe undo DESdAPSICION OF OPERATIONS belay E.L.DISEASE-POLICY LIMIT $ .� DESCRIPTION OF OPERATMS I LOC MNS I VEHICLES(ACORD 107,AdMonW Remarks Schedule,maybe attached K more space Is required) Contractor License:10P000278 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Village Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd Avenue Miami,FL 33138 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD M uni ci pal Contractor's Tax %cei pt M iam i-Dade County, State of Florida THIS IS NOTA BILL-DO NOT PAY CC NO: 10P000278 Cw*# BUSINESS NAM E&OCATION RECEIPT NO. EXPIRES JVIL MGATION INC 13806 SW 142 AVE UNIT 15 7476299 SEPTEMBER 30, 2016 MIAMI,FL 33186 Pursuant to County Code Sec 10-24 OWNER TYPE OF BUSINESS PAYMENT RECEIVED JALIMGATION INC SPECIALTY PWMBING CONTR4CTOR BY TAX COLLECTOR C/O GUEFPA JOSE M 37.50 11/19/2015 0243-16-001462 Restricted to City of Miami Shores MIAMI Fbr more ink mation,visit www rriamidade ao dwmaisctor r lam mw NOV,-1 9 20�g BY, we Cum - Y N t rr%4Yk soh Leo�eh ©WCC6 r me-llelr 16 65 w r. 104 SA"A 1 a agc-K FW-j tr:E'14 G+r'tC V,cAV-L4 roved � `if r �p O spray Heads ...... GOh+V-0114 v'$ i annrnv � : • ate+_ • . . . .. ..... ... 1 Ra�h1�1r� C.on}rotltr f- Ra%h . SenSbr 1 .. f N zone 3--► o ( s Zone i 3 �r. JDOmlkl�%C. - N E loq *c) , ewe PROJECT NAME: Gro5 Ry E 104 S HITTY t--'-S SNim e s DATE: SCALE: wM. 13906 SW 142 AVE.UNIT 15 MIAMI,FL 33186 UC OIOPM78 *t 6 0000•• 0000•• • • • • 0000•• assess • a••••• • 609 • • • • 0000 •000• • •e•• • 000• 0• •• • ••see• 0000•• a..:.* ase••• •••••• 0 0 0 •0.00• 0•0000 • • • •