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RC-15-1904 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-259367 PermitNumber: RC-7-15-1904 Scheduled Inspection Date: May 23,2016 Permit Type: Residential Construction Inspector. Mesa,Michael Inspection Type:. Final I� � Owner: CAUCHI, PAUL&MAGDALENA Work Classification: Alteration Job Address:131 NE 96 Street Miami Shores,FL Phone Number Parcel Number 1132060132590 Project <NONE> Contractor: DECON ENVIRONMENTAL&ENGINEERING Phone: (954)485-8800 Building Department Comments REMOVE AND REPLACE KITCHEN CABINETS Infractio Passed Comments REINSTALL COUNTER TOPS INSPECTOR COMMENTS False Inspector Comments Passed r _ Failed El Correction Needed F-1 Re-Inspection Fee No Additional Inspections can be scheduled until re-Inspection tee is paid. May 20,2016 For Inspections please call: (305)762-4949 Page 28 of 36 Miami Shores Village 10050 N.E.2nd Avenue NE •• � Miami Shores,FL 33138-0000 Phone: (305)795-2204 t f � Expiration: 04126!2016 Project Address Parcel Number Applicant 131 NE 96 Street 1132060132590 PAUL&MAGDALENA CAUCHI Miami Shores, FL Block: Lot: Owner Information Address Phone Cell PAUL iii MAGDALENA CAUCHI 131 96 Street MIAMI SHORES FL 33138- 131 96 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 6,414.87 DECON ENVIRONMENTAL&ENGINEI (954)485-8800F M F � rr TT pµ T� Total Sq Feet: 00 Approved:In Review Available Inspections: Comments: Inspection Type: Date Approved::In Review Fill Cells Columns Date Denied: Final PE Certification Type of Construction:REMOVE AND REPLACE KITCHEN Occupancy:Single Family Window Door Attachment Stories:1 Exterior. Framing Front Setback: Rear Setback: Insulation Left Setback: Right Setback: Drywall Screw Bedrooms:3 Bathrooms:2 Window and Door Buck Plans Submitted:Yes Certificate Status: Review Planning Certificate Date: Additional Info: Review Structural Review Mechanical Bond Retum: Classification:Residential Review Electrical Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Review Electrical Review Electrical CCF $4.20 Invoice# RC-7-15-56513 DBPR Fee $2.89 Review Plumbing DCA Fee $2.89 07/29/2015 Check#:1701 $50.00 $171.43 Review Plumbing Education Surcharge $1.40 1029/2015 Credit Card $171.43 $0.00 Review Building Permit Fee $192.45 Review Building Scanning Fee $12.00 Review Building Technology Fee $5.60 Total: $221.43 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,RO ING d SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is a rat d t all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the above-named r he work stated. October 29,2015 Authorized Signature:Owner / Applicant ! CrontractoF / Agent ate Building Department Copy October 29,2015 1 ' Miami Shores Village =BY:)2q4Q;;�M- INSPECTION Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 LINE PHONE NUMBER:{305}762-4949 FBc 201 s'Iti Z-c�z BUILDING Master Permit No. 15— jq�// PERMIT APPLICATION Sub Permit No. AUILDING ❑ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑CANCELLATION SHOP /� CONTRACTOR DRAWINGS JOB ADDRESS:y J I .f�i 9� "►�oS�C rej��L City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: lt-?>2 !�AO'0 11'XS91 D Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): Akoj&" #: ay' -3 1.6- Address: I'M N �t 010� -5rep--U City: �.1A.tti `v�fe—S State: E(. . Zip: 3 13$ Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: bqX- K3 "jN V�CO^.M q_t,.j' -AtL- Phone#: q y S- cb�bO� Address: a1� � ts� k`f-.- City: 1FL LAu4.eA 4A — State: F U Zip: Qualifier Name: SA 5Ae. 1N Q Phone#: qSq-L(%S"%mc) State Certification or Registration#: C C D LAq'18 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ (A »7 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition Description of Work: KCwrAMC-%d B.. O►,P1 C� �t'���►�c�1e.(�} �� C� _ 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$171 ' 3 (Revised02/24/2014) t s • � 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. Signature CPU Signature OWNER or AGENT CONTRACTOR The foregoing instrurgnt was acknowledged before me this The foregoing instrument was acknowledged before me this day of J JO _ - 20 tt by day of 3"Is 20 X5 by �,^wwhho�is�pejrsona/llly;k�nown to J��d� 8���C,r ,who is personally known to me or who has produced � VK1 Iy— unig me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUB NOTARY PUBLIC: Sign: Sign: Print: Print: j( � g .,,w N�arY u n: Seal: ' Sindia Alvarez Seal: My Cornmiseion FF 158750 ;io'•�a`� •. DANA POTGIETER porta© X16 ?�.' : Notary Public-State of Florida My Comm.Expires Nov 11,2017 ******************************* *s*.► ***s****•tsrs*e**s*ss*s**r**rsss: i '.tl *e*04 i"06 vesm 1. s*ss* APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) n lossp�•s' Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. X COPY OF QUALIFIER'S STATE LICENCES B. X COPY OF LOCAL BUSINESS TAX RECEIPT C. X COPY OF LIABILITY INSURANCE* D. X COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES,FL 33138 Certificate must specify the description of operations or contractor license number. BUSINESS NAME: Decon Environmental & Engineering Inc. BUSINESS ADDRESS. 2652 NW 31 Avenue CI Ft Lauderdale STATEFL Zip 33311 BUSINESS PHONE: 9( 54 ) 485-8800 FAX NUMBER(954 1485-8809 CELL PHONE( ) QUALIFIER'S NAME: Jay Saelinger QUALIFIER'S LIC NUMBER: CGCO44418 111�If\tJV W 6 f f V V O LI♦t�yf♦ /6Cir Lt4YYb'9vn,a?CVRC 1AM t t`a NOes: a 511 Issues: 06113rM4 DISPLAYAB REQUIRED BY LAW SEO t1408130001M BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm.A-100, Ft. Lauderdale, FL 33301-1895—954-831-4000 VALID OCTOBER 1,2014 THROUGH SEPTEMBER 30,2015 DBA:DECON ENVIROMENTAL & ENGINEERING Receipt#:GENES CONTRACTOR (G g.. Business Name:INC Business Type: COR) �. Owner Name:JAY D SAELINGER Business Opened:il/03/2008 Business Location:2652 NW 31 AVE State(County/CortfReg:CGC044418 FT LAUDERDALE Exemption Code: Business Phone: �Fb .. U#l Rooms fro. <.` Professionals For Vending Business Only, Number of Machines: Tax Amount Transfer Fed 7 Collection Cost Total Paid 54.00 0. R '.. ... :.,; 0.00 54.00 r t i THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS 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 it is in compliance with State or local laws and regulations. Mailing Address: JAY D SAELINGER Receipt #OlA-13-00006377 2652 NW 31 AVE Paid 08/28/2014 54.00 FT LAUDERDALE, FL 33311 Y_ 2014 - 2015 HIM .. _. ... gland Jul. 8. 2015 2:38PM No. 7435 P. 1 A�® CERTIFICATE OF LIABILITY INSURANCE /6/20 3 "' THIS CERTIFICATE 13 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 ADD TIONAL INSURED,the poilcy(les)must be endorsed. It SUBROGATION 15 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 endormemant(s). PRODUCER CONTACT Carly Underwood Grayling insurance Brokerage aOM, (710)552-4225 P t866)Sso-aoe� 3780 Mansell Road aarly.undaxwoadOgroyling.aom Suite 370 INSUREM AFFORDING of NAIL 41 -A Alpharetta GA 30032 IN URPAA INr S eci.alt Insur ae 11 INSURED URBRB ch inaurance Comany 1 0 DECOY Environmental & Engineering, Inc. INSURERC DECOY Worldwide, Inc. INSu D: 2652 NN 31st Avenue INSURER E Ft. Lauderdale FL 33311 1 MURERFs COVERAGES CERTIFICATE NUMBER:14-15 (Main one) 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.LIMIT'S SHOWN MAY HAVE BEEN REDUCED BY PAID CUuMS. UL leg TYPE OF INSURANCE UAM a POIJOY NUMBER P UMITB GENERAL LIABILITY EACH OCCURRENCE 4 1,000,000 X COMMEROML GENERAL LIABILITY DPREMIS 98 f Fs $ 50,000 A CLAIMS-MADE ®OCCUR 120072104 02 0/20/2014 0/20/2016 MED D0,(Any ass nu,n g 3,000 X Centractoria Poli, Limb. PERSONAL&ADV INJURY S 1,000,000 X J Profosaional ]viability GENERALAGGREGATE $ 2,000,000 GENLAGGRWAYELIMITAPPUESPER! PRODUCY$-COMPIOPASS S 2,000,000 POLICY FxOIPMLOC S AUTOMOBILE LIABR.ITY Nfi 91 ANY AUTO BODILY INJURY(Perpsman) S L'DSCHMULSD BODILY INJURY(Aar aumeM S AUTOS HIRED AUT09 V008"ED WUKGE S 4 IJi18RELLA Luh X AOR EACH OCCURRENCE $ 5,000,000 A X EI(ONSLIAB CLAIMS-MADS AGGREGATE 6,000,000 DED I X 0.0c 12211a$12034 02 0/20/2014 O/20/2015 S $ WORKERS OOMPHURATION g 1 0 AND EMPLOYERS'LIA91LRY ANY PROPRIEfOR/rqRTHMID(EcunvE Y)A E.4.EACH ACCIDENT & 11000,000 OFFICE OMEIER EkCLUDEW N NIA BWCCOOOSO 02 ( 0/20/2014 0/20/2015 endalwy In NN) R.L.DISEASE-EA EMPLOYEE 4 11000,00 d�s.deauibe under QFSSCRIPTIO OPERATI below ML DISEAS -POLICY LIMIT 4 120000 DESCRIPTION OF OPERATIONS I LOCATIONS r VEHICL�(Alfeell ACORD 1016 Additional Remelt Sehadale.if aero spikes Is ra4ulreA Re: Jay Baelinger CGC license 094018. Excess Liability includes Contractor Ia Pollut3-on Liabllity e Brofeenional Liability, Professional Liability in primary & excess liability policies is claims-made. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE E"IRATION DATE THEREOF, NOTICE WALL BE DELIVERED IN Miami Shores Village building Department ACCORDANCE WITH THE POLICY PROVISIONS. 1001SO HE 2nd Avenue Miami Shores, FL 33138 AUTNORIYeoREPRUENTATIVB David Collings/CURLY ���� ACORD 26(2010/015) ®1988.2010 ACORD CORPORATION. All rights reserved. INRftVI%m nn-o n4 Tha Ar`nprl nanw anti fern era~tiasatarl,rtarfr@ ref annon :.. .. _� :7 MMGW ate ......... BROVVARD COUNTY LOCAL BUSINESS fiAX RECEIPT 115 S.Andrews Ave., Rm.A-100. Ft. Lauderdale, FL 33301-1885—954-831-4000 ,a VALID OCTOBER 1,2015 THROUGH SEPTEMBER 30,2016 DBA: Receipt#:180-8 622s Business(tiaiite'DECON ENVTROMENTAL & ENGINEERING BtTSitF@ffiS T GENERAL CONTRACTOR (GENERAL YI CONTRACTOR) Owner Nance:JAY D sAELZNGER Business,Opened:11/03/2 00 8 Business Location:2652 NW 31 AVE t00C0tnty1Ce tfReg•OGC044418 FT LAUDERDALE Exemption Code: Business Phone: ; i. Rooms Seats Employees Machines Professional 20 For VQim Bust""only Number of Mach: Vending Type: Tax Amount Transfer Fee fdSF Fde Penalty Prior Years Collection Cost Total Paid 54.00 0.00 .0.00 0.00 0.00 0.00 54.00 x .. r gffi;. THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS 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 it is in compliance with State or local laws and regulations. Matting Address: .' JAY D SAELINGER Racept01A-18-0o0081d7 2652 NW 31 AVE Paid 07/17/2015 54.00 FT LAUDERDALE, FL 33311 1511 2015 - 2016 } �p Client#:25238 DECOENVI ACORD. CERTIFICATE OF LIABILITY INSURANCEDATE(MMIDDIYYYY) 10/1912015 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 Carly Underwood Greyling Ins.Brokerage/EPIC a8�o Et):770.562.4225 FAX ac No: 866.550.4082 3780 Mansell Road,Suite 370 E-MAIL Alpharetta,GA 30022 : carly.underwood rey gIln .com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Arch Specialty Insurance Co. 21199 INSURED DECON Environmental&Engineering,Inc. INSURER B:Arch Insurance Company 11150 INSURERC: DECON Worldwide,Inc. INSURER D: 2652 NW 31st Avenue Fort Lauderdale,FL 33311 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 15-16 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 CONTRACTOR 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. LIf TYPE OF INSURANCE ASL WVD POLICY NUMBER A�MIDD FF MMNDY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY 12EMP7210403 0/20/2015 10/20/201 EACH OCCURRENCE $1,000,000 CLAIMS-MADE I ^]OCCUR PREMISES EaErrence $50OOO X Contract Poll.Liab MED EXP(Any one person) $6,000 X Professional Llab. PERSONAL&ADV INJURY $1,000,000 GEMLAGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $2,000,000 PRO- POLICY II JECT F LOC PRODUCTS-COMP/OPAGG $2,000,000 OTHER: $ AUTOMOBILE LIABILITY Ea COMBINED SINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS per.Ment $ A UMBRELLA LIAB X OCCUR 12EMX9285403 1012012016 10120/2016 EACH OCCURRENCE $6,000,000 X1 EXCESS LIAR CLAIMS-MADE AGGREGATE $5,000,000 DED I X I RETENTION$0 $ B WORKERS COMPENSATION EBWCC0008003 1012012015 10/20/201 X PER SER EMPLOYERS•LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? a N l A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 "Ps describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached K more space is required) Re:Jay Saelinger CGC license#044418.Excess Liability includes Contractor's Pollution Liability& Professional Liability.Professional Liability in primary&excess liability policies is claims-made. CERTIFICATE HOLDER CANCELLATION Miami Shores Village Building SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Department ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd Avenue Miami Shores,FL 33138 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014101) 1 of 1 The ACORD name and logo are registered marks of ACORD #3412968/M412689 CUND1 ip DECON ENVIRONMENTAL&ENGINEERING Insured: CAUCHI,PAUL Home: (305)766-8206 Property: 131 NE 96TH ST Cellular: (305)332-1109 MIAMI SHORES,FL 33138 Home: 131 NE 96TH ST MIAMI SHORES,FL 33138 Claim Rep.: Alesia Richardson Business: (561)994-8366 Company: FL Peninsula E-mail: alesia richardson@floridapeninsula. com Estimator: Nelson Ramirez Business: (954)655-7239 Company: DECON E-mail: nelson@decon corn Contractor: Nelson Ramirez Business: (954)655-7239 Company: Decon Environmental&Engineering Inc. E-mail: nelson@decon.com Business: 2652 Nw 31 St Ave Fort Lauderdale,FL 33311 Claim Number: FPI049741 Policy Number: FPH1127793-02 Type of Loss: Water Coverage Deductible Policy Limit Coverage A $1,000.00 $220,000.00 Date Contacted: 6/12/2015 Date of Loss: 5/6/2015 Date Received: 6/12/2015 3:08 PM Date Inspected: 6/16/2015 Date Entered: 6/12/2015 3:54 PM Date Est.Completed: 6/17/2015 3:03 PM Price List: FLMI7X JUN15 Depreciate Material: Yes Depreciate O&P: No Restoration/Service/Remodel Depreciate Non-material: Yes Depreciate Taxes: Yes Estimate: CAUCHI PAUL Depreciate Removal: No DECON ENVIRONMENTAL&ENGINEERING CAUCHI PAUL CAUCHI PAUL CAT SEL ACT DESCRIPTION CALL QNTY REMOVE REPLACE TOTAL L CLN AV Clean the surface area 1 1.00 SF [*N] 0.00+ 6414.87= 6,414.87 In agreement with adjusters estimate.We will supplement for permit costs and professional fees. Supplement needed for new cabinets. Total: CAUCHI PAUL 6,414.87 Line Item Totals:CAUCFH PAUL 6,414.87 CAUCHI PAUL 6/17/2015 Page:2 DECON ENVIRONMENTAL&ENGINEERING Summary for Coverage A Line Item Total 6,414.87 Replacement Cost Value $6,414.87 Less Deductible (1,000.00) Net Claim $5,414.87 Nelson Ramirez CAUCHI PAUL 6/17/2015 Page:3 DECON ENVIRONMENTAL&ENGINEERING Recap by Room Estimate:CAUCIH PAUL 6,414.87 100.00% Subtotal of Areas 6,414.87 100.00% Total 6,414.87 100.00% CAUCHI PAUL 6/17/2015 Page:4 DECON ENVIRONMENTAL&ENGINEERING Recap by Category Items Total % CLEANING 6,414.87 100.00% Subtotal 6,414.87 100.00% CAUCHIPAUL 6/17/2015 Page:5 • ••. • • w • ••• • • • • • ••• •• • • • 0 JUL Z 9 2015 • . . . Cauchi Kitchen Restoration UP. y I 0 0 Z Refinish exisitng cabinets NO POINT ALONG COUNTER TO BE MORE THAN o 2 FEET FROM G.F.I PROTECTED RECEPTACLE o —!- PUT D/W RECEPTACLE UNDER SINK. ALL FIXED APPLIANCES ON DEDICATED CKTS. Paul Cauchi . :a -- 131 NE 96th st ADD SMOKE/CARBON MONOXIDE DETECTORS. i B24R MR MR U Miami Shores, FL 33183 __ �____ ___ ._4.. ANY AND ALL CLOTH AND RUBBER Y INSULATED CONDUCTORS TO BE REPLACED, N Scope of Work Building > Remove and Install new bottom cabinets fn 1- Remove and install new bottom cabinets where indicated. 2- Refinish exisitng top and bottom cabinets. N stn 3- Paint interior walls in kitchen. m 4 Reinstall counterto . Remove existing countertop p Reinstall countertop and reconnect plumbing p trap U w 2 - supply lines and drainage. o z Scope of Work << Plumbi e4a I B24R 1 9R1 M e: +� E 1- Reinstall all appliances. 2- Reinstall sink and faucet. 3- Install new P trap, supply lines and drainage. 4240HO 4 Install new angle stops. �o Scope of Work � � Refinish exisitng cabinet No Work Electrical . 1- No electrical work needed. LU _ 2- Fixtures, outlets and switches to remain. o 0 w ° Q� F-- e w �� 1 w o 1st Floor ® �W m a LU V W ATE: UO- /1/2015 a., V QLU GtI O Hm Z Z w w a O ca f' 1 <W IL o a 'Q N CL J d W U) � SHEET: `� `U Lal,- 1 F L.cc-t4 8 .. .. . . . .. .. . OFFICE . . . . . . . . . . . . ... . . . . ... .. . . . . . .. . . . . • . . •• • .goo .• • . • . . • • . . • Ca :7e0 _4,77 t... 0 00 _ a 7: a ..r;, „ v,'i.,#y�.. ° ' fl _ L,' n.. .. '°J'i:�iY. :_ o,,„• ^� m S o OPY 00 co Master Bedroom ° Living Room z Den o 13 0 . ..y 2668 .E-�� ,� _,,..._m �; n � .._� 5968 B21R � i B24R ; B24R Bathro _IE co Hallwaco CID -:, 00 do M 2668fn ~ u = u 2668 to IT �- I t0 CA N CD I' m I U N 0 CID o J Kitchen { . a Bedroom Inn + c Dining Room I + So Bedroom 2 t B48 B24R ® 91Ri o N o E O 2040H0 5068 4240H0 _ ( - ((� u Mi 3mi Shores Village O APPROVED BY DATE ZONING DEPT bX OCT 0 201 BLDG DEPT Its `� SCALE: i :>I1ftJECT TO COMPLIANCE WITH ALL FEDERAL Existing Smoke Detectors _ -- _ AND CC)UNTY RULES AND REGULATIONS SHEET: Pc,A6 rd- <>s A- 1