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PL-16-872 .& 1-6 #-XV Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shore,FL Phone: (305795-2204 Fax:(305)756.8972 Inspection Number INSP-259439 Permit Number. 131-4-16-872 Scheduled inspection Date: May 23,2016 Permit Type: Plumbing -Residential Inspector. Hernandez,Rafael Inspection T Final P� YPe� Owner. GABRIELA SABATE,GUILLERMO Work Classification:Addition/Alteration 'M 14-1111 WK A Job Address:89 NW 106 Street Miami Shores,FL 33150- Phone Number Parcel Number 1121380060170 Project <NONE> Contractor. ARKEST LLC Phone:(904)355-9001 BuIWhV Department Comments REPLACEMENT OF EXISTING FIXTURES I - Ome nts TO REPLACE PL-14759 INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-256064. not ready Failed Correction ❑ Needed Re-Inspection a Fee No Additlonai Inspections can be scheduled until re-inspec don fee is pald. P4.11D4 Miami Shores Village10050 N.E.2nd Avenue NWMiami Shores,FL 33138-0000 Phone: (305)795-2204 ' 3 '£ " Expiration': 10/12/2016 Project Address Parcel Number Applicant 89 NW 106 Street 1121360060170 Miami Shores, FL 33150- Block: Lot: GUILLERMO ALMADA GABRIEL Owner Information Address Phone Cell GUILLERMO ALMADA GABRIELA 3966 PARK Avenue - - -- MIAMI FL 33133- 3966 PARK Avenue MIAMI FL 33133- Contractor(s) Phone Cell Phone $ 2,300.00 ARKEST LLC (904)355-9001 Valuation: Total Sq Feet: 0 Type of Work:REPLACEMENT OF EXISTING FIXTURES 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 $1.80 Invoice# PL-3-16-59240 DBPR Fee $2.25 04/15/2016 Check#:1297006E $112.30 $50.00 DCA Fee $2.25 Education Surcharge $0.60 03/31/2016 Check#:1888 $50.00 $0.00 Permit Fee $150.00 Scanning Fee $3.00 Technology Fee $2.40 Total: $162.30 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 ither myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDO , OORS,RO ING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing informal is cc at all work will be done in compliance with all applicable taws regulating construction and zoning. Futhermore,I authorize the above-nai he work stated. April 15,2016 Authorized Signature:Owner / Applicant Ng6nt Date Building Department Copy April 15,2016 1 Miami Shores Village Building Department MAR a 12 O 10050 N.E.2nd Avenue,Miami Shores, Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 BY: INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20l`'l BUILDING Master Permit No. RCA(.( , ';- PERMIT APPLICATION Sub Permit No.,'?C,I(a-- 3`Z2.-. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL [:]PUBLIC WORKS [] CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 89 NW 106 Street City Miami Shores County: Miami Dade Zia: Folio/Parcel#:1121360060170 Is the Building Historically Designated:Yes NO X Occupancy Type: R Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder):Guillermo Almada Phone#:786-586-4489 Address:89 NW 106 Street City: Miami Shores State: Florida Zip: 33150 Tenant/Lessee Name: Phone#: Email: bilantarconstructions@gmail.com CONTRACTOR:Company Name: Arkest LLC Phone#: 904-355-9001 Address: 533 E Chruch Street City: Jacksonville State: FL Zip: 32202 Qualifier Name: Rafael E Caldera Phone#: 904-355-9001 State Certification or Registration#: CFC1426714 Certificate of Competency#: DESIGNER:Architect/Engineer: N/A Phone#: Address: City: State: Zip: Value of Work for this Permit:$2,300 Square/Linear Footage of Work: Type of Work: ❑ Addition El Alteration ❑ New ❑■ Repair/Replace ❑ Demolition Description of Work: Replacement of Existing Fixtures Specify color of color thru tile: Submittal Fee$ %33 , Q Permit Fee$ 14-0 .owl CCF$ CO/CC$ Scanning Fee$ -3 ° CO Radon Fee$ �` � DBPR$ a' � Notary$ Technology Fee$ o Training/Education Fee$ 0 -A90 Double Fee$ Structural Reviews$ Bond$ 5� TOTAL FEE NOW DUE$ 112-, J® (Revised02/24/2014) 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 Signatu �AER or AGENT CONTRACTOR The foregoing instrum nt was acknowledged before me this The foregoing instrument was acknowledged before me this day of 20 ,by day of r 20 ,by ffh�is personally known to r�' who is personally known to me or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: • i Sign• _ Sign: Print: Dlogo" I Print: i Seal: _ comma" f139 Seal: #W3791 pll? Atm B* V. �t f AWS 27,2019 1:, y ,A11N4tAaY ► , WYWy,A01ARY.M ############ ############################################################################################## APPROVED BY 3-3 1 — Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) RE& Miami shores Village P BuildingDepartment y o�� R 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 n jJ CHANGE OF CONTRACTOR/ ARCHITECT Permit N. –1+ qv� Owner's Name(Fee Sim ^lerr�^ide older)6 (i6 » Phone# Owner's Address: vll (v City: 11'YYl l State: Zip Code: Job Address (Of where work is being done): � W l()(06hDff.2L City: Miami Shores State:—Florida Zip Code: Contractor's Company Name: G Phone#: Address: City: M I State: Zip Code: Qualifier's Name: IIZWfV 711HT1 Lic. Number: (. Architect/Engineer of Record Name: Phone#: Address: City: State: Zip Code: Describe Work:y9mmlUAM Ud/ PJWn 1 hereby certify that the work has been abandoned and/or the contractor/architect is unable or unwilling to complete the contract. 1 hold the Building Official and the iami Shores harmless of all legal involvement. Signature Signature V- er o Ag t Contractor or Architect The foregoing in men was aknow dged before&4J& The foregoing instrum nt was owledged b fore me � �thiV�day of f 20�(by this day of r""M ,20y Who is personally knownt e or who has produced who is p rsonally kno me or who has produced as indentification. A as indentification. Notary 1 : Notary u lic: Sign: Sign: 4— Seal: `y Seal: AN,, . Nohemy Caldera NOhemy Caldera w ... �i commissloN # FF190254 ;�. COMMISSfON # FF190254 = EXPIRES:January 15,2019 ay, EXPIRES:January 15,2019 ��.�°� wWW AARONNOTARY.COM WWW.AARONNOTARY.COM 40 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 we 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 CALDERA, RAFAEL EDGARDO ARKEST LLC 533 EAST CHURCH STREET JACKSONVILLE FL 32202 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range STATE OF FLORIDA from architects to yacht brokers,from boxers to barbeque restaurants, DEPARTMENT OF BUSINESS AND and they keep Florida's economy strong. ULATION Every day we work to improve the way we do business in order to CFC1426714 UEb 08/27/2014 serve you better. For information about our services,please log onto s www.myfloridalicense.com. There you can find more information CERTIFIED PLUMBING CONTRACTOR about our divisions and the regulations that impact you,subscribe CALDERA RAFAI EiRDO to department newsletters and learn more about the Department's AR9{EST LLC initiatives. Our mission at the Department is:License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business iii Florida, 11tid.er,th®**i� Y§fiot sof Ch.489 FS. and congratulations on your new license! ExpWoh dato:AUG`si• oT6 l iao z7000sz1s DETACH HERE RICK SGOTT,GOVERNOR KEN LAWSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION.INDUSTRY LICENSING BOARD a CFC1426714 Thi PLItMBINO CONTRACTOR a " Na*reed below IS OI:RTIFIED Under the provisions,of Cha�ppter 9 fS: Expiration date: AUG 31, 2016 k� CALDERA,.RAFAEL EDGARQ.Q• r ARKEST LLC 533.EAST CHURCH STR i JACK5UNVIILI* X02 .. r Y Y a ISSUED: 08/27/2014 DISPLAY AS REQUIRED BY LAW SEQ# L1408270003219 2015-2016 BUSINESS TAX RECEIPT MICHAEL CORRIGAN,DUVAL COUNTY TAX COLLECTOR 231 E.FORSYTH STREET,SUITE130,JACKSONVILLE,FL 32202-3370 Phone:(9D4):630-1916,option 3; Fax(904)630-1432 Website:www.coj.net/tc;Email:taxoollector@coj.net Note-A penalty is imposed for failure to keep this receipt exhibited conspicuously at your place of business. This business tax receipt is furnished pursuant to Municipal Ordinance Code, Chapters 770-772,for the period October 1, 2015 through September.30 2016. ARKEST LLC CALDERA, RAFAEL EDGARDO 533 E CHURCH STREET JACKSONVILLE, FL 32202 ACCOUNT NUMBER: 156645 LOCATION ADDRESS: 533 E CHURCH STREET JACKSONVILLE, FL 32202 DESCRIPTION: CONTRACTOR-ALL TYPES COUNTY RECEIPT DESC: CONTRACTOR-ALL TYPES COUNTY'TAX: 12.38 MUNICIPAL RECEIPT DESC: MC 772.309 MUNICIPAL TAX: 34.38 TOTAL TAX PAID: 46.76 VALID UNTIL September 30,_2016 'ATTENTION' THIS RECEIPT IS FOR BUSINESS TAX RECEIPT ONLY. CERTAIN BUSINESSES MAY REQUIRE ADDITIONAL STATE LICENSING. This is a business tax receipt only. It does not permit the receipt holder to violate any existing regulatory or zoning laws of the County or City. it does not exempt the receipt holder from any other license or permit required by law. This is not a certification of the receipt holder's qualifications. TAX COLLECTOR THIS BECOMES:A RECEIPT AFTER VALIDATION. PAID-729801 .0001-0001 A20 10/30/2015 46.76 3/'31/2016 Image-1 jpg CERTIFICATE OF LIABILITY INSURANCE DATE(MKOWYYYV) 3'HIS CERTIFICATE IS ISSUED AS a MATTER OF INFORMA7'tON 03/23/2016 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLCiER.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: IOTtTANT i!the certiticate holder�ati ADDrrIONAL IPiSlItiED,the _ ---�--.. ,_.... pollcy(I )tnuat be anc+oef. n sU6{tOt3ATIOPt lS aVAIVEt);sulijecto the terms and conditions of tlne policy,certain policies MOV require an endorsemerrL A statsment 6athl certificate does not confer rights to the cerRcate holder In UN of such endorsemetr4s). .._..._. __..__ ........__............ ... ... PRODUCER _...._.. _ ._. All Alliances Insurance PHONE'— Grag' _. ....... .......... F 1076 W.Sample Rd. a.� 9{}725-0235 ts64}725 0237 dvdCslH(�aW c onI Pompano Beach.FL 33064 Phone (954}725-0235 ... 3N8URER(3)AFFORpG COVERAGE Fax..(..954}725-0237 Nac a INSURED INSURERA COVington Speciality ins.Co ARKEST LLC LNsuRER B; Torus National Insurance Co iusc; in First Insurance Company _._ 533 E CHURCH STREET INSURER D; ..._..._ ........ ...._.. Jacksonville FL 322022723 ls `s Ct'sVERAGte"�S GBRTli=!GATE NUMBER 3 INsuRRF � -IREVISION NUMBER INDICATED, 'THIS TOCERTIFY THAT THE POLICIES OF tdSURANC (.ISTEO BELOW HAVE Ey SUED TO THE INSURED NAMd6ABOVE FOR THE POLICY PERIOD NOTWITHSTANDING ANY REAU�EMENtT,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 1$SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, L TYPE OF IIURANtCE ADOI,�SUiNt INSBiSfD_........._ POuCY NUMBER_ {Ip1P0 EFF! { Y}: .. LIMITS CLIRSIAERCIALGENERAL LIABILITY CLA;FAS-MADE iV' OCCUR E.ACHQCCURRENCE._ 3 1,000,000.00 DAMAGE TO RENTED PREMISES.IEasCgw.rqr, S :.S 100,000.00 A N N VBA365581-01 03/03l2015 03/0312016' MED EXP I"orre Person) $ 5,000 00 GEN L AGGREGATE LiNtiT APPLIES PER: PERSONALBADVINJURY S 1,000,000.00 POLICY V' LOC GENERALALiGREGATE $ 2000,000.QQ OTHER PR9PK!§-POMPW AGG $ 1,000,000.00 AUTOMOBILE LIABILITY...... ...... ..,.....__.... ........ $ OMB��iNGLE LIai1T $ ANY AUTO ALL OV4NE077 SCHEDULED BODILY INJURY(Per person) $ AUTOS AUTOS _ NON-OWNED BODILY INJURY(Per emkieng S HIRED AUTOS AUTOS - POP .. UMBRELLA Luke $ OCCUR .,........ b EXCESS LIARcl AIMs.naar»._. N N 71561 N15DAU EACH OCCURRENCE $ 2,000,000.00 05115!2015 05/15/2016 AGGREGATE >s gR.4TENttoNS $ 2.000.0D0.00 WORx£RSCOMPENSATION y AND EMPi OVERS'LIABILITY YIN. J STA'(11TE OTH- ANY PROPRIETOMPARTNERIMCUTIvE...._.. _ER C OMmmkoly in FFICERlRPIEMBEREXCLUDED? NJA N 521-08825 E(.EACHACCIDENT $ 500,000.00 { kHi o6n5/aa15 06/25r2016 ES � 'N undel E.L.DISEASE-EA EMPLOYEE 3 500,000.00 DESCRIPTION OF OPERATIONS below m-•-, ---..->.- E.L.DISEASE-POLICY LUT _._.......... _._.___ CIESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attaoh ACORD 161,AddlBonal Remarks Schedule,ifmore a pace Is required) GFC1428714 GMC1249896 CERTIFICATE HOLDER _. CANCELLATION SHOULD ANY OF:THE ABOVE DESCRIBED POLICIES BE Miami Shores VlHage THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN BEFORE Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE and Avenue _..._-...__ .. ._...., .-. AUTHORIZED REPRESENTATIVE Miami Shares,Ft.33138 i ACORD 266 4}OF 0,1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and I090 are registered marks of ACORD W4sd/meil.googie.com/mail/LdMntmc/153cd3574e357d6f?projector=1 1/1 From:Israel Wended Fax:(306)690-6986 To:Miami Shotes Village Bi Fax: +1(306)766-8972 Page I of 1 041011201611:2.1 AM CERTIFICATE OF LIABILITY INSURANCE DATE Wn-nj 0312312016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS No RIGHTS UPON 4 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),AUTHOR17-ED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. ................................... I T: If the cGfdftab hOkisr Is an ADDITIONAL INSURED,the PORCY(les)mast be endorsed. N SuiwooAmON IS WAIVED,subjeato the term and condMone Of the P0111cY,Certain POKC!"malt MQuire an endorsement A statsfftnt an this certificate does not confer a"to the cerMIcAde hoklerinlieu ofsuchendomeni6ni0s). 7 00 .............Greg Beyer - 'r Ail Alliance Insurance PH Noy....1964)725-1}237 1076 W.Sample Rd. AQ 0 Waj�. %.V4 C 8 t I I a01.0 Pompano Beach,FL 33064 L_Ehope.... 9S4 ...... INSURED Torus National Insurance Co. ARKEST,LLC .ustnes�Firstney!.�n�qTn a ................. _p_qy 533 E CHURCH STREET ..I_ER R_i........ 3acksonvilileWSURERIE: FL 322022723 COVEk4G—ES CE_RT__1'F*_1CATE_NUM ............................... BER: REVISION NUMBER: 1 THIS IS TO CER nr-Y AT THE POLICIES Or INSURANCE LISTED BELOW HAVE BEEN ISWE._tjTO THE—INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDIING ANY REQUIREMENT,TERM OR CONDITION OFAN Y CONTRACTOR OTHER DOCUMENT WITH RESPECT To WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED By THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED By PAID CLAIMS DOC TYPE OF INSURANCE ---UWTS �ENCI COMMERCIAL GENERAL LIABILITY E3 CLAIMS-MADE W OCCUR Itt 0 TWIRENTED 100,000, I N VBA366681-01 MED EXP An ow parsw 5.000.{X} i 03103r" j PERSONAL& ons $ I nm-00 GEWL AGGREGATE LIMIT APPLIES PER: ......... ';y ............ A 03(0312017 2,OW,000.00 POLICY ❑0 LOC MP ODD,000 OTHER 7 COWMP�/OPP ZOG S OD ....... ... AUTOMOBILE LIABIRM _._.._.._....L—..i- FtN-6LF—wiff L R.M. ANY AUTO ....... BODILY WURY*�Person) AtLJLTWNED SCW-MLED ODI r_1 ..... ....LAI ...... i HiREDAUMN"T BLY INJURY(Per S D AUTOS A LJ I f UMBRELLA LIAB OCCUR $ 2 000.00 f ............ L-9:6�L N N 716SINISDAU 10511-512015 1 05/45/20161.2AGGREGATE $ *'*,000.000.00 WORKERS 00UPENSATION AND ZWPL YOW LL4881W YIN ANY PROPR01 IETOPJPARTN ___11NIA N '521-M25 C OFFICERWEM13ER=LURE""! EACHACCIDENT is 500,WO.00 obnd"v in NH) owanm (w2wole P�i. ..........nn:0 E#s 500,000.00 -Y ffy".desaft urgw 1 E.L.DISEASE-EA qjk?�I�_OF OPERATIONS below I E-L.DISEASE-POLICY LIWi $ 500.000.00 T ................... DESCRIPTION OF OPERAT100181 LOCATIONS/VEHICLES(AftfthACOR0101,Ad"*ndRemarks Sthedule,If more%VMS is required} CFC1426714 CMC1249696 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 Bujldft Department ACCORDANCE WITH THE POLICY PROVISIONS. 10060 NE 2nd Avenue AUTHORMWREPRESIDITATIVE Miami Shores,FL 33138 ACORD 25(2014f01)OF ®1988.2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 41; L;}17R ja QN14 �5 Ng� Ov, of I INM VW ij HL�-A77it, Wl,-Ill- A"A IR t,7 Ks: Nk F4 W MI