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PL-15-1454 Miami Shores Village�S g RE��T Building Department J 52015 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY: Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(30S)762-4949 FBC 2010 BUILDING Master Permit No. R41A `1; 01 PERMIT APPLICATION Sub Permit No. � 5- `1 %4 ✓ ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CA `' CONTRACTOR DRAWINGS JOB ADDRESS: ` l o� l�• `Q' City Miami Shores County: Miami Dade Zip: Folio/Parcel#: ` ;�'� C)(P C) "k 17110 Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: G`,, Flood Zone: �_BFE: FFE: OWNER:Name(Fee Simple Titleholder): k. J 0.t-1 r5 Nia 0 Phone#: v 30 _l `(P V Address: 01 ?_'.)4� g; • ' �0 yT- City: i v l ~ State: a- Zip: ` 3 Tenant/Lessee Name: Phone#: Email: &1 e(t J d � OU�(�• N Q '� CONTRACTOR:Company Name: 1p���13e�� co tilpp Phone#::3 Address: lD • City: A .4-r=.f1¢_,"Z State:.'�, Zip:X30/3 Qualifier Name: ZE '09-F4. S S" Phone#: State Certification or Registration##Sf,( �3 Q©�� Certificate of competency#:Q F p� DESIGNER:Architect/Engineer: Fl �klo 7 ��� Phone#:7)�� Z7.52 Z [15z; Address: l"LZ��' r • �� City: State: Zip: Value of Work for this Permit:$ Square/Linear Footage of Work: Type of Work: tA Addition ❑ Alteration ❑ New ❑ Repair/Replace El Demolition Description of Work: '-W V l<0Lk9� 10�-on &N a-ene, � �-� Specify color of color thru the: l�A Submittal Fee$ ba Permit'Fee ` Z8 ^ Q� n CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ t ' TOTAL FEE NOW DUE$ �^5 •g (Revised02/24/2014) Bonding Company's Name(if applicable) QC) P&- Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) �s Q.r>� Mortgage Lender's Address _217,11- 13 cc— f)e City CC) kk1- G-1k`�(�°j State , \G'- Zi \ p 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 qpprovepFand a reinspection fee will be charged. Signature Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this �s day of J .20 .by day of JUM .20 �by Iry ' N o ,who is personally known to '=lylA1BQMKP►S ,who is personally known to me or who has produced as me or who has produced FA.. %)MkJeI0 IA.CCP^S identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: Print- 40 ilai,al+LOURDES SAAITElROI' o Seal' [L?IP4�-& .�Sincdis Notary P'' i -te of FlOtide My COMMISSION 0 88840895 o -•tn-n akTW 6x MM:lrowamba 16 2016a^• +��FF 158750 r 20'4 ����*��xs�x��a�*****�sr*•a�•e�*•��**����**��+r*�e�ww��x+��xm*w*�x�aa�a�**ww�x***�sw�xs�s�***a���xa�x��a�x�s����a��e�s�*+���s�***�s�**���e�x*r APPROVED BY �6'� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Feb. 22 . 2016 02 : 01 PM 3058221118 3058229377 PAGE. 1/ 1 t nnp is • 00aea1 yY•.4v;:... 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J.'`:'.�f., �4..:�.v�'', f,-y��.i� _ ..y �,�i n �y�{ 1 i���by S+NP.•A ,•;�' Y�'IA,"1C,. (v�r� _,1'•:7.. :•3:. ".7+.. .L� �M�IF'1V� ,�1,..QRn"_•it. ��..'. �( ,t}Q.., !:Y:•. i'd':`� ,:!i'''h •i�%'�1.`)':1:4,t`gir.n � �`� �y����� �l� �y a:r... r." ..t 1i k a'!•:• !:': Stu stEC-TAT!G PAvMl OF �:4►si'a11� itt!fwRECullg4� ;. ;;;;�•-', OW •• •• LL�C�C4 N@. 196 PLU eING 'SA CORP `'1:'CFC037b 10 s•< - ''�HECKr:1�15--082162 " 'a!I gusinesa 1sx Tila fl� a Isnot f )teael t tl,.,,.oflunapa � Ia111K 1 I?. ld I aaYt;ave dmelrtsl'• suslnocif;, '�`�fC n e. Ho flt Wt.s !I! This: dqy R lifloetida< 98 1 n carliilon ,01 the o f Ylaa p A V6hit li;A to the he '' la a iaf ragvirertiHs I :. ? ��';t;•x:., "� pp�f b�.rnmantaftA((liletory )NtY.41 �ml r : 'A:'Wtla-278. I1;� don allo,' cialVdlilClaa �IrOj4 �'"lrlie''p�C��T H0.ebd4kmua\h0 df �! mer F,pCll►ofd'{�q�QrmatlonrY��O�,,, ?:r•t•:e.s ,.. . Feb.22.2016 01:58 PM 3058221118 3058229377 PAGE. 1/ 1 CA8AS-2 OP ID:XM CERTIFICATE OF LIABILITY INSURANCE D 08(2812015 08/Z8/Z016 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 pollay(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). PRODUCUR Xlomara Martinez South Florida Insurance Und. AIa ,305-699-6788 D/B/A Trimart LLC a L 306-688-8888 Ax 7850 NW 83rd Street Sulte 213 AogkEgO� Doral,FL 33165 Xiomers Martinez IN RE s AFFORa o rjP NAIC a INSUPMA:Granada Insurance Company 16870 INsulu3o Cases Plumbing Corp. I lil3(.._.....� 40 East 42 St INsuReR c: Hialeah, FL 33013 ., .....__._ INBURBR C 1 INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS 13 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 CERTIFIOATE 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 599N REDUCED BY PAID CLAIMS. _............. ......._---,'-- A=m 80 TR TYPE OF INBtIRANCE POUOYNUMDRIt UM178 A X CommENCIAL OENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 08/23/201 CLAIMS-MADE M OCCUR DISOPL00020361 5 08/23=16 PREMISESE ooe $ _ 100,00 MED EXP Arw one Person $ 5410 ERSONAL d ADV INJURY $ 1,000,00 GZEN'L AGGREGATE LIMIT APPLIES PER: POLICY U GEN@RAL A(4C3RE TE $ 2,000,00 X jec�T LLOC PRODUCTS-COMP/OP A02 2,000,00 OTHER, 8 AUTOMOS"UAMIJTY a ol$[NOME'0191—T $ n ANY AUTO BODILY INJURY(Per Peraotl) $ AALL UTOS SCHEDULEDUDB SSBODILY INJURY(Ppr Ilaidont) $ HIRED AUTOS NON-OWNEDp Por R ERTY - $ UFAHRG1.I A LIAROCCUR EXCESS UAB CLAIMS-MADE OCCURRENCE $ EACH ACH GATE $ RETENTION $ YUORRERB COMPENSATION AND EMPLOYERS'IJAMILITY Y!N a u E NY PROPRIETOR/PARTNERMXEOUTNE I—i R VFFlOER/MEMBER EXCLUDED? U N/A E.L. H ACCIDENT $ (Mandatory in NH) H yea.deso lbe undat E.L.DISEASE-EA EMPLOYPOCEE $ RIPTION OF O? RATIONS comwE.L.DISEASE-POLICY LIMIT $ DHBCUMON OF OPERATIONS/LOOATIONe I V5WLE8(AOORD 101.Additional Rentarlw 8otledale,may be aunhod If mora aria in required, Plumbing Contractors Licenee CFC037083 CERTIFICATE HOLDER CANCELLATION THEEXPIRATIONDATE THEREOF, NOTICE WILL B ULD ANY OF HEPOLICIESID CEDELIVEREDNOELLED rI Miami Shores Village looso NE 2nd Ave ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores Village,FL 33138 A��RIjSRNTArnE 1988-2014 D CORPORATION. All rights reserved, ACORIR 25(2014/01) The ACORD name and 1090 are registered marks of ACORD a Miami Shores Village 10050 N.E.2nd Avenue NE '' Miami Shores,FL 33138-0000 ' r' y Phone: (305)795-2204 R ri Project Address Parcel Number Applicant 9105 NE 5 Avenue 1132060141210 ALEJANDRO PINO Miami Shores, FL 33138- Block: Lot: Owner IMormatlon Address Phone Cell ALEJANDRO PINO 9105 NE 5 Avenue (305)302-5770 MIAMI SHORES FL 33138- 9105 NE 5 Avenue MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone $ 8,000.00 CASAS PLUMBING CORP (786)303-7960 Valuation: Total Sq Feet: 0 Type of Work:NEW KITCHEN,NEW GARAGE,NEW BEDROO Available Inspections: Type of Piping: Inspection Type: Additional Info: Top Out Bond Retum: Final Classification:Residential Scanning:1 Review Plumbing Underground Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $4•S0 Invoice# PL4;-15-55964 DBPR Fee $4'20 06/15/2015 Check*7457 $50.00 $254.20 DCA Fee $4.20 Education Surcharge $1.60 06/23/2015 Check#:7458 $254.20 $0.00 Permit Fee $280.00 Scanning Fee $3.00 Technology Fee $6.40 Total: $304.20 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 cerly that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction an r= ore,I authorize the above-named contractor to do the work stated. June 23,2015 Authorized ignature:Owner / Applicant / Contractor / Agent ate Building Department Copy June 23,2015 1 - -=A --a----- ---- - ---- R1C#�SCOTT,GOVERNOR KEN LAWSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD CFC037083 The PLUMBING CONTRACTOR Narhed below IS CERTIFIED Under the provisions of Chapter 489 FS. A Expiration date: -AUG 31,.2018 _ CASAS-ISMAEL 1CASASS PLUS iikA COIF • .s 4t?E 42ND.ST - Y / H#AI�EAtI` r R 3+3 2242 s ISSUED: 07/08!2014 DISPLAY AS REQUIRED BY LAW SEQ# L1407080000823 CM087 > �� I�aW# xx� , NRS Cs� �ct>1 1E,�1 , MV z� AAustl� 'attpia eofl 1 ; t - Cfii�W#:ir OYYN SEC.Ty #d BUSINESS PAYME ttECE11 GASAS_IBING CORP 396 PU 1111 11G COIdTRAC R BY rax t iu Ecrol let 10FC037{ i''= ..:$45.00 flrr/15J1-4 y: HEa2t:14-019226 71 Buslsakfmpsuf a al anineasuL no&me is oat s 77-7,77-7 IV-4 aq ry whkNspplytoUre f �tioe, Jun. 8. 2015 4:54PM South Fla Ins Und No. 2535w2P. 1 op it):xM CERTIFICATE OF LIABILITY INSURANCE VA=fflWMVffM 06/08/2016 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 DMOW. 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 polhcoes)must be endorsed- If SUBROGATION IS WAIVED,Subject to the tarrm and conditions of the policy,certain policies map require an endorsement A stdement on this o&"dffcate dose not confer rights to the certifies holder In lieu of such s. Pryxiomara Martlnex South Florida Insurance Und. 306.588.8888 ft 305-09.8788 D/B/A Trirralrt LLC 71160 NW 53rd Street Suite 213 Doral,FL 33168 Momam Martlnez "FF011DINB MOMA: insurance Company 78870 INSURM Cassts plumbing Corp. Ids: 40 East 42 St moo: Hialeah,FL 33013 man"G: Il�URER F S COVERAGES CERTIFICATE IFICATE MJMSER: REVISION NUMBER- THIS BER:THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTBD BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREWNT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERnFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HERON IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED SY PAID CLAIMS. TrPB OF otsuWANdB NOW pjam SOMMMau9eTs A X cowwQALemEtALLuoury EACH OCCURRENCE $ cLA 04AADE ❑OCCLIR IOBFL00029361 08123x2014 08123x201$ S MW8XP(Any aft P $ PERSONAL&ADV INJURY S GHMLAGGREGATELINTAPPLIESPER! GENERALA(i0R61$AM 3 POLICY 0 JECT 7 LOC PRODUCTS.COMPIOP AGO S AU7006011.11 UAVLnY 'Comm S ANYAUTO BODILY INJURY(per PWIM) S �� SCHEDULED BODILY INJURY(PW aodd" 8 HM AUTOS AUTOS 8 UMMI raOCCUR EACH OCCURRENCE 8 EXCISS LAL HOLAINISMADE AGGREGATE ATE S 8 Nam TION AND WrPLOYXIW UA8LrIY A ANY PROMtETOWARTNEVE)CECUYN61MIA ILL EACH ACCIDENT S EXCLUDED? pwida vu,NN) E.LDISEASE-EA EMPLOYES $ d s.d MWeunowP M OFEL ILL DISEASE-POLICY LIMIT S TIONOFOPBRATIONBILOCATMMIV (A lot Ibaratrrm8oneade, YasstealsHna»easesrsroQtUraN Plumbing Contractors License CFCO37083 CERTIFICATE HOLDER CANCELLATION OM LD ANY OF THS ARM 001SCRWED POLICIES BE CANCEUM 8EORE Miami Shores ViNage THE EXPIRATION DATE F, NOTICE WILL BE DELNERED IN � ACCOROJWGE THE YPRovr3wNs. 10050 NE 2nd Ave Miami Shores Village,FL 33138 AvrNo�o A Xiomaem mlartinez 01880 2014 ORD76HPORATIOPL All rights mserved. ACORD 25(x094109) The ACORD name and logo are registered marks of A b Jun. 8. 2015 4: 19PM South Fla Ins Und No. 2534As..•P. 2/2 op in:xM A �Rl7r CERTIFICATE OF LIABILITY INSURANCE 77m-Is 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 INSURLR(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the poitay(im)must be endorsed. If SUBROGATION IS WAIVED,.subject to the Berms and conditions of the policy,cerl+tin poilCi t may requfre an endoMmea A afternent on this certificate doss not confer rights to the certificate holder In lieu of such andorseme a Aa0° Xiomara Martinez South Florida Insurance Und. 11181A Trimart LLC 305-899.8989 308.5998788 7960 NW 63rd Sheet suite 213 Doral,FL 33186 Xiomara Martinez 040110POWAffgaMCOVERAGE MAIC e RetailFirst Insurance r9surance Com a OURI o Casae plumbing Corp. 40 Eget 42 St Hialeah FL 33013 mac: RISURER BS Ft COVERAGES C 11 ICATE NUMBS • REVISION NUMBER: THIS IS TO COF;MFY THAT THE POLICIES OF INSURANCE LISTED FLOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDM 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 SUBJ90T TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAD. TYPE OF etStlRAUM PJML SUM POLICY NUMBER LATS COMMERCIAL GENaM UA 9%ff IFACII OCCURRENCE 8 _ MJUV 4MOS 7 OCCUR 102AMI&M $ MdEO E7Q'A one 8f80R � PERSONAL&ADV INJURY S OWL A136REQATE LUT APPUE8 PER; GBNMIAL AGGREGATE S POLICY LOC PRODUCTS-COMPWAGG S S ANYAUTO SOOILYINJURY(Parpvr=) S � ULED SODILYINJURY(For eaole3m) 8 OWNSD wNGD HMO AUTOS A S ffi UM INK"A u" EACH OCCURRENCE: i BXCRSRUAR ACOREOATME b DiD KTWS ffi 1woomm COMAPMINSA71011 III AND yme UAIXUTY A OE)CC1�"' Ya NIA 211$ 0�071Z016 06/07!2018 EL EACH ACCIDENT ffi ("we",In NHI E.L.DISEASE-EA I LOY6E $ undw WE= tlentnl� 6 L UMfC 9 R OF OPURATIONS I LOCATIONS I VOM (R01=149.AddWhaW Rmaaks$vfte o.PW be akseAed if mine spino N IvsNdroAj Plumbing contracators Ucense CFC037083 CERTIFICATEER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCH IS CANCELLED BEFORE h Village THE EXPIRATION DATE OF, NOTICB WILL INR DELIVERED IN Miami S oree I age ACCORDANCE Wnw Testa PO PROVISIONS. 10050 NE 2nd Ave Miami Shores Village,FL 33138 AUT OAXIM R11PIMNrATIVg xiomara Martinez 1888-2014 ORD TION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marlin of ACdRD