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PL-11-250 Date: September 1, 2012 From: Jacqueline Butler,Homeowner 1461 N.E. 102 Street Miami Shores,FL 33138 To: The New Miami Shores Plumbing 900 N.W. 144 Street Miami,FL 33168 This letter serves to confirm that the New Miami Shores Plumbing will no longer be the plumbing contractor at 1461 N.E. 102nd Street, Miami Shores, FL 33138. Sincerely, Jacqueline Butler Miami Shores Village g Building Department 10050 NX-2nd Avenue,Miami Shores,Florida 33138 • Tel:(305)795.2204 Fax:(305)756.8972 INSPECTION'S PHONE NUMBER:(305)76L4949 BUILDING Permit No. 11-Z50 PERMIT APPLICATIONMaster Permit No. �--°`� Zvc�� "C 20 Permit PLUM OWNER:Name(Fee Simple Titleholder);_ Address: ILL b l rvf-- %(1--,? S7`- • Phones: City. • re., t � 5:�6'L. State: zip. i 39 ----•- Tenantn.esseeme Na : �...r p� Email: .�.: Phone#: JOB ADDRESS: k r-- City: Miami Shores County: Miami Dade Mp: 3 I?, Folio/ParceW. Is the B forlcally Des ghated;Yes -NO Flood"`Lone. CONTRACTOR:Company Name: LA. fin" I,Al Phone#:_ -3 Address: a,30 O city: d oCLyt oo t7 Qualifier Name• s A M v / J1A 0t J 1AC,b Phone*3©S" O- State Cemtification'ortegisttation'# Certificate of Comtency`#i Contact Phone#: - Address: U C S/t V I A tJIY) n/� m rh DESIGNEIti ArchitectlEn Phone#i Value of Work for $ Footage of Work: Type of Work: OAddress teration OReP air/Replace ODemolition -. - �Deseriptfo�itf work:` ' n/ Avib GA 11i o/yt S: .F • :�*********�****+�***�*****�.e�******e***geese+�**ese+�saee�se****eo******************** 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 perfonrmd to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for UECIN 7 4L WORD,P%UNSING,SIGNS, WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS and AIR CONDITIONERS,ET .. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be dorm 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 TWIG 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 lie posted at the job site for the first inspection which occurs seven (7) days toer 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. Signature $ice amrn ��?/'✓�LP��L�d �.e Owner or Agent Contractor The foregoing instrument was acknowledged before me this o11 The foregoing instrument was acknowledged befor me this day of ew*20 JZ,by in o oC day of�:r ,20�by�v� who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLI %g "`• t s.�INGM ' MYCOMMISSION#MOM UNRMS:Juw 22.2015 ��'••,�: eamedt�ullas Sign: a^n� Sign. Print: oS Print: v O!UG U — L My Commission Exp' W COMMISSION999542 My Commission Expires: WIRES:July 30,2014 Bonded Ttw t�tary P�dc UndawriF�s APPROVED BY ' ✓/� Plans Examiner Zoning Structural Review Clerk (Revised 07/10/07)(Revised 06/10/2009)(Revised 3115109) Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone:(305)795-2204 Fax:(305)756-8972 Inspection Number: INSP-156006 Permit Number. PL-2-11-250 Scheduled Inspection Date:September 08,2015 Permit Type: Plumbing-Residential Inspector Diaz,Osvaldo Inspection Type: Final Owner: BUTLER,JACQUELINE Work Classification: Addition/Alteration Job Address:1461 NE 102 Street Miami Shores,FL 33138-2621 Phone Number Project <NONE> Parcel Number 1132050240140 Contractor: SKYLA PLUMBING INC Phone:(954)773-5323 Building Department Comments HOUSE REMODEL nspector Comments Passed Failed Correction Needed Re-Inspection Fee No Additional Inspecdons can be scheduled until reinspection fee is paid September 04,2015 For Inspections please call:(305)762-4949 Page 1 of 33 U.S. Postal Service ,, CERTIFIF,D MAILTM RECEIPT' . ... (Dome tic Mail Only;No Insurance Coverage Provided) or delivery information vici four website at www.usps.com rImmoff;*elm .t r n PS f-onn 3600.Auuust 2006 See Revorse(or Insiructior Certified Mail Provides: r A mailing receipt ,R ■ A unique identifier for your mailpiece ■ A record of delivery kept by the Postai i$ervice for two years Important Reminders: i { ■ Certified Mail may ONLY be combined with First-Class Mail®or Priority Mail®. n. Certified Mail is not Available for any class ofintemational mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured-or Registered Mail. ■ For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the a tido and add applicable postage to cover the fee.Endorse maiipiece Return Receipt Requestedp.To receive a fee waiver for a duplicate return receipt,a USI,?S9.postmark omyour Certified Mail receipt Is required. ■ For an additional fee, delivery may be restricted to the addressee or addressee's,authorizedwagent.2dvise the clerk or mark the mailpiece with the endorsement"Restricted-Delivery". ■ If a postmark on the Certified Mail receipt is desired,please present the ard- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT.Save this receipt and present It when making an inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-1047 SNORi v " Miami shores ';.V ge "" Building Depaeftt- - � •� 10050 N.E.2nd Avenue �lpR,eCpp► Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR I ARCHITECT Permit N. 'Zl_o Owner's Name(Fee Simple Title Holder): Phone#: Owner's Address: to(-1 tif- �aLsr City: Y'^+p + -;koZr-S State Zip Code:SW Job Address(Of where work is being done): t t k-K-- r-- City: Miami Shores State:—Florida Zip Code: ';,1 -;(3Z1 Contractor's Company Name: A, `rte u M3i(VP4 )j►c, Phone#:qS V4;;E3-S3c23 Address: as SO ` QQ%z- S1. City: �DGGyw006 State: L. Zip Code: 2302'0 Qualifier's Name : 5A1A-U 6(- Ktb o N h C.�s Lic. Number: r Ee M2-20 9-1 Architect/Engineer of Record Name: S+Q' Li--A- P-05 Phone#: Address: City: 01 + r State: Zip Code: Describe Work: KA-`'`' I hereby certify that the work has been abandoned and/or the contractor/architect is unable or unwilling to complete the contract. I hold the Building Official and the Miami Shores harmless for all legal involvement. Signature Signatur`fin ,epi/i' owneVorAgent Contractor orArchttect The foregoing instrument was aknowledged before me The foregoing instrument was aknowledged before me this allday of ,2012,by 9 1per this 6 day of s ,20/).by Who is personally known to me or who has produced who is personally known to me or who has produced as indentification. as indentification. Notaryblic 0 Notary c: Sign: ,;A Sign: � u� Seal: UASPORW Mr�M99" Seal: MARA&RODWM EXpRM 30,2014 MyQ N#EE 068873 Balled TMu traQeap Und�rti�ra EXPIRES:Jwre 22,2015 8aaled Thru Nolm(P tk�vaBere s ' of s rsM ss CFC14270T]+ , , :9 f a6J2 128072339 CTRT�F�� TN�s GON�'PRIKCTO�t I8 RTIFIM undor+ $rovistona'o€ Ch`489 Fs ;ssasa aace: AIIG 31:,: 2014 y3ZA9fl647744 A CERTIFICATE OF LIABILITY INSURANCE PRODUCER Annette Willis Insurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 4759 N.W.183rd St HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR � Miami.FL 33055 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Phone (305)625-8131 Fax (305)625-3694 INSURERS AFFORDING COVERAGE MAIC III INSURER A: GRANADA INSURANCE INSURED SKYLA PLUMBING INC INSURER W. 3315NW 213 TERRACE INSURER C: MIAMI FL 33M INSURER Or INSURER E: COVERAGES INSURER F: THE POLICIES OF INSURANCE LISTED 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. aDWL POLICY EFFECTIVE POLICY EXPIRATION LIMITS IM TYPE OF INSURANCE POLICY NUMBER pAn Imp 96MIMIM AN-W— `— EACH OCCURRENCE � 1000 000 GENERAL LIABILITY ©COMMERCIAL GENERAL LIABILITY DAMAGEREN-TED 100,000 0185fl00028013 07!22/12 07/22!13 PREMISES Ea occxlrence El El CLAIMS MADE ❑ OCCUR MED EXP(Any one person) 5,000 ❑ ❑ PERSONAL&ADV INJURY 1,000,000 GENERAL AGGREGATE 2,000,000 PRODUCTS-COMP/OP AGG 2,000,000 GEWL AGGREGATE LIMIT APPLIES PER: ❑ POLICY ❑PROJECT ❑-LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ❑ ANY AUTO (Ea acddent) ❑ ALL OWNED AUTOS BODILY INJURY B ❑ SCHEDULED AUTOS (per ❑ HIRED AUTOS BODILY INJURY ❑ *NON OWNED AUTOS (Per accident) ❑ PROPERTY DAMAGE (Per GARAGE LIABILITY AUTO ONLY-EA ACCIDENT 1 C ❑ ❑ ANY AUTO OTHER THAN EA ACG ❑ AUTO ONLY' AGG EXCESStUMBRELLA LIABILITY EACH OCCURRENCE ❑ OCCUR ❑ CLAIMS MADE AGGREGATE �D ❑ --- — ❑ DEDUCTIBLE ❑ RETENTION $ — WORKERS COMPENSATION AND ❑ W STATU- ❑ OTH- EMPLOYERS'LIABILITY E ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT OFFICER I MEMBER EXCLUDED? E.L DISEASE-EA EMPLOYEE It yes,desmibe under _ SPECIAL PROVISIONS bebw _ E L DISEASE-POLICY LIMIT _ F DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL.PROVISIONS PLUMBING CONTRACTOR i —1 CERTIFICATE HOLDER CANCELLATION 7 SHOULD ANY OF E AB DESC I CIES BE CANCELLED BEFORE THE Miami Shores Village EXPIRATION D OF, G WILL ENDEAVOR TO MAIL 10 D NO TO CATE HOLDER NAMED TO Building Department THE LEFT, UT F RE TO SO E NO OBLIGATION OR LIABILITY 10050 N. E.2"d Avenue OF A D UP THE I A OR REPRESENTATIVES. Miami Shores,Fl.33138 ACORD 25(2001/08)OF 0 ACORD CORPORATION 1988 �o� �_ C � �, �� `=� a BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S.Andrews Ave., Rm.A-100, Ft. Lauderdale, FL 33301-1895—954831-4000 VALID OCTOBER 1,2012 THROUGH SEPTEMBER 30,2013 DBA: Receipt#:PLUMBING/LWN SPRNKL/CO R Business Name:SKYLA PLUMBING INC Business Type: PLUMBING CONTRACTO Owner Name:sAMQEL McDoNALD Business Opened:io/23/2007 Business Location:2230 POLK ST 20 St8te1CoUnty1CertJReg:CFC1427071 HOLLYWOOD Exemption Code: Business Phone:954-773-5323 l Rooms Seats Employees Machines Professionals 1 For Vending Btsinew Only Number of Machines: Vending Type: Tax Amount Transfer Fee I NSF Fee Penalty Prior Years Collection Cast Total Pail 27.00 0.00 0.00 0.00 0.00 0.00 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS ! i THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non-regulatory in nature.You must meet all County and/or Municipality planning WHEN VALIDATED and zoning requirements.This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location.This receipt does not indicate that the business Is legal or that i it Is in compliance with State or local laws and regulations. i Mailing Address: SAMUEL MCDONALD Receipt #02A-11-00007188 2230 POLK ST #20 Paid 09/26/2012 27.00 r HOLLYWOOD, FL 33020 11 � I 2012 - 2013 Miami Shores Village FEB 1 5 2011 Building Department BY: 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 No. 0 PERMIT APPLICATION Master Permit Notc r FBC 20 Permit Type: PLUMBING OWNER:Name(Fee Simple Titleholder): 7%L& ALkk Phone#: Address: ILtut we, 1OZ S� City: rn►amt S L40c" State: VL Zip: 3303 3 TenandUssee Name: Phone#: Email: JOB ADDRESS: lutal Nie- 1 City: Miami Shores County: Miami Dade Zip: 7 Folio/Parcel#: Is the Building Historically Designated:Yes NO Flood Zone: CONTRACTOR:Company Name: JkL �� .5�r►t°5 Pluthinq Phone#: t S1'Jv74 Address: gmN�.J '� City: "['am/ State Zip: �/1(a ff Qualifier Name:Avms M Phone#: S (� State Certification or Registration#: (IFU®N O05- Certificate of Competency#: Contact Phone# �S : ''�`►`tCU Email Address: DESIGNER:Architect/Engineer: Phone#: Value of Work for this permit:$ 1 SI G6 t) Square/Linear Footage of Work: Type of Work: OAddress DAlteration -L1New-. 0124pair/Replace ODemolition Description of Work: Row ho, WV, m Submittal Fee$ Permit Fee$ ✓r-2 . CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ —I 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 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. C Signatufe\ Signatu /____�/ Owner or Agent Contractor The foregoing instrument was acknowledged before me this The fbrgooipg instrument was acknowledged before me this day of ,20 J—I ,by day of 7 C.ur ' ,20� ,by 1 who is personally known to me or who has produced who is personally known to me or who has produced As identi as identification and who did take an oath. WSPORW NOTARY PUBLIC: (YIY $DDNOMY PUBLIC: , EWRE8:July 30,2014 BalladTftNa4yP�lbM va s Sign: ow► Si Print: Lu 6 rOARA S Print J ': ERA VAP(MEN A. �'� My Commission Expires: JAI Z0 t zo ty My Co (407) s pir&XPIRES March 16,2012 --Floridallota ervtae.com xx�xxax��x+xxaaxaax��xxxa�+a� xx�xxxxxx��xee�xx+xx�x��x��xx+x�aax��x�x+x+xxxaa�xa�x�+x�+xxxsx�a�xx�e�emx�+amxxax APPROVED BY >!�"1 Plans Examiner Zoning Structural Review Clerk (Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)