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PL-15-2704 Miami Shores Village ? "it," )0w P ifllt ill ) Etki ,: 10050 N.E.2nd Avenue NE 'a p assrtl for 1 Ad�nlAltei itoc Miami Shores,FL 33138-0000 yfi ti— �tus'Al� Cf R�� Phone: (305)7952204 �{ X21 Expiration: 0712016 Project Address Parcel Number Applicant 802 NE 99 Street 1132060142460 Miami Shores, FL 33138- Block: Lot: DONISI HOMES LLC Owner Information Address Phone Cell DONISI HOMES LLC 802 NE 99 Street (561)414-9203 MIAMI SHORES FL 3313-8 Contractor(s) Phone Cell Phone Valuation: $ 1,000.00 WIND CHILL LLC (954)454-9398 Total Sq Feet: 00 Type of Work:REPLACING 2 TOILETS AND 2 VANITIES Available Inspections: Type of Piping: Inspection Type: Additional Info: Bond Return: Top OutFinal Classification:Residential Scanning:3 Review Plumbing Underground Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 DBPR Fee Invoice# PL-10-15-57530 $3.38 02/09/2016 Check#:1263 $ 186.36 $50.00 DCA Fee $3.38 Education Surcharge $0.20 10/22/2015 Check#:1041 $50.00 $0.00 Permit Fee $225.00 Scanning Fee $3.00 Technology Fee $0.80 Total: $236.36 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, ify t t e foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Fu e o uthorize the above-named contractor to do the work stated. February 09,2016 Authorized ig tur .Owner / Applicant / Contractor / Agent Date Building Department Copy February 09, 2016 1 f Miami Shores Village c � Building Department OCT 9 2 2015 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 13Y' Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 BUILDING Master Permit No�J� 270 PERMIT APPLICATION Sub Permit No [._ /,�:' 27 ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL OPLUMBING ❑ MECHANICAL F-1 PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 802 NE 99 STREET City Miami Shores County Miami Dade Zip: Folio/Parcel#:11-3206-014-2460 Is the Building Historically Designated:Yes NO X Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder):DONISI HOMES LLC Phone#:754-423-1989 Address:802 NE 99 STREET City: MIAMI SHORES State: FL Zip: 33138 Tenant/Lessee Name: N/A Phone#: Email: rlopez.ies@hotmail.com CONTRACTOR:Company Name: Wind chill LLC Phone#: 954-454-9398 Address: 723 NW 2 St city: Hallandale Beach State: FL Zip: 33009 qualifier Name: Glen Karamath Phone#: 954-454-9398 State Certification or Registration#: CFC1427552 Certificate of Competency#: DESIGNER:Architect/Engineer: N/A Phone#: Address: City: State: Zip: Value of Work for this Permit:$ 1 0 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition Description of Work: Replacing 2 -Toilets & 2 -Vanities Specify color of color thru tile: C a,aiaee) Submittal Fee Permit Fee$ 2,25 '�� CCF$ ° A CO/CC$ Scanning Fee$ j' Radon Fee$ 3 a? DBPR$ 3- 3 Notary$ Technology Fee$ Q Training/Education Fee$ ' -2-0 Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ /0® 36 (Revised02/24/2014) s Bonding Company's Name(if applicable) N/A Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) N/A 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 nce of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature Cq) OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 13 day of October 20 15 by 13 day of October 20 15 by Charles Donisi who is personally known to Glen Karamath who is personally known to me or who has produced Fl- Da 1k9l S 1 Let C me or who has produced uPiS f lle<&St as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: -11- ' Print: Edwin Silver Print: Edwin Silver Seal: ;�>QY.aUe�n: IE®b91bN S1lL9i9ER Seal: o•� ` �Dlr�l L�BLVf � nay(- MISSION#EE867375 My COMMISSION#EE✓g67375 =�, vk �,e. EXPIRES Ja'uary 22,2017 A110T, EXPIRES January 22.2017 07 39&0's3 For tlaMotarySeervice cam ***� **�x APPROVED BY 'L 7/ Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0753 KARAMATH, GLEN IMRAN WIND CHILL LLC 10700 SW 46TH COURT DAVIE FL 33328 Congratulations! With this license you become one of the nearly one mid Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range QP6 STATE OF FLORIDA from architects to yacht brokers.from boxers to berbeque restaurants, and they keep Florida's economy strong. DEPARTMNO ONAL REGULATION Every day we work to improve the way we do business in order to CFC1427552 ISSUED: 08t12/2014 serve you better. For information about our services,please tog onto www.myftridaticeme.cam, There you can find more information CERTIFIED PLUMBING CONTRACTOR about our divisions and the regulations that impact you,subscribe CERTIFIED GLEN PLUMBING C to department newsletters and learn more about the Department's initiatives. WIND CHILI_LLQ' Our mission at the Department is:License Efficiently.Regulate Fairly We constantly strive to serve you better so that you can serveYW r Customers. Thank you for doing business in Florida, IS CERTIFIED unoer the provisions of Ch 489 FS and congratulations on your new license! Exp==dm AUG 3v.tote 04(0112=1961 DETACH HERE RICK SCOTT.GOVERNOR KEPI LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD Estal r CFC1427552 The PLUMBING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 f• •rte KARAMATH, GLEN IMRAN. .. : - .. WIND CHILL LLC 10700 SW 46TH CT DAVIE FL 33328 • a$ ICClrr:n natilMn" MICMI AV AC+ ncr%l tinr-n nNe 4 nth. «.« .. -- __.. 4( CITY OF HALLANDALE BEACH "`'`'rJtibn ' BUSINESS TAX RECEIPT 400 S.FEDERAL HIGHWAY HALLANDALE BRAC,FL 33009 Hallandale Beach TELEPHONE—(954)457-1341 PRO AE%INNOUdl10N.OPP0210NIFY. September 22,2025 WIND CHILL LLC 723 N.W.2 STREET HALLANDALE BEACH FL 33009 THIS IS YOUR BUSINESS TAX RECEIPT.PLEASE DETACH AND POST IN A CONSPICUOUS PLACE AT THE BUSINESS LOCATION. PLEASE DO NOT REMIT ANY PAYMENT. THIS IS NOT A BILK PENALTIES IF PAID OCTOBER--10% NOVEMBER-15% DECEMBER-20% AFTERDECE4BER31,-25% LICE ' y �' � . . �. OF It J A"ALE BEACH y. ' .: a4l;...... a's , FLORIDA '$USINESS TAX RECE LICENSR 16-00007257 License se issue dated>, ;:, ei 1,2015 ` License ex iratioi `� `' ` 2016 P �� -A r,.'t 7s•�I eul': 0005970 i,,; M !t•r.a t Sh��::•I'kr.:p}'l,.jr.� tZt,�tigi�ir cl.i:>{J���+V'k,`F..:,. ,''Lt7`'9:t. Classification: Classification Des:diP „..•, tf0+a�. ::_';. ar: 't... �vn..is�t��.;�.-:..if:.5�3i'',dri".•:'_ ',.Y.x:.y RUSE i• tiny '� �fi•ei.�D':•�d�yt':ti •'�-C� �"i5 ���Tye.. .f.'y� k.. .. Business Name: WIND CHILI,LLC Business Location: :,, 723&725 NW�ST z N y' HALLANDAI„E BEACIFL 33009 4� It wne�'�Oi`fiC ': f C"�•” f v+ 7' y �1 Q:, :9: ^�y; SIS Jt'F z'H 4d r elsiitess�'Ite 9 4-45 -998 ; ! xemiti ns.- license`Fee�.9.$ad: 118.00 �. • " tiu... `t*+� '�1 .*,r,,,%� �•'1+*„ ti.:.• a&1' ktn .� '�Ii• ni. .. ''.?I ... tT7Liv'+ Sa.;:a•r• ..M97; q •s:,S'x.+ ... ,w (Comments:' PLUMBING& COND)k`J�'IONI�TCr`CONT"CTOIRI. N Restrictions:' NOTICE — In the event business for which this license was issued changes hands, said license may be transferred within 10 days of such change or will become null and void. This license is receipt for payment of tal dile. Issuance of license shall not be evidence that the business is lawful nor that it complies with laws and regulations. DATE IMMIDD/YYYY) A�RIDO CERTIFICATE OF LIABILITY INSURANCE 10/22/2015 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(iss) 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). PRODUCERCONECT Gregg DMan Get Smart Insurance Inc. PHONE(IM No . (305)653-7977 Fax NJ-. (305)654-0293 20286 NW 2 Ave ADDRESS: info@insure-smarLeom INSURER(S)AFFORDING COVERAGE NAIC# Miami FL 33169 INSURERA: SOUTHERN CROSS INSURANCE INSURED INSURER B: ASCENDANT INSURANCE COMPANY,INC. Wind Chill LLC INSURER C: GRANADA INSURANCE 723 NW 2 St INSURER D: INSURER E Hallandale Beach FL 33009 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ADDTYPE OF INSURANCE D BR POLICY NUMBER POLICY EFF POLICYLTR EXP LIMITS X COMMERCIAL GENERAL UABILITY EACH OCCURRENCE $ 1,000,000 F��—q DAMAGE TO RERT� CLAIMS-MADE OCCUR PREMISES occurrence $ 50,000 MED EXP(Any one Penson) $ 5,000 A FLGLN02052AX 10/18/2015 10/18/2016 PERSONAL&ADV INJURY $ 1,000,000 GEM-AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY❑jECT F-1 LOC PRODUCTS-COMP/OP AGG $ 1,000,000 OTHER: $ AUTOMOBILE LIABILITY acckknTY CSINGLE LIMITT $ 1000000 ame ANY AUTO BODILY INJURY(Per person) $ B ALL OWNED SCHEDULED CA-35329-1 01/28/2015 01/28/2016 BODILY INJURY(Per accident) $ AUTOSHIRED AUTOS /� NON-OWNED AWNED PR ERTY DAMAGE $ Per aot�dmrt UMBRELLA A[JAB OCCUR EACH OCCURRENCE $ F�EXCESS U" CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ W01110M RRS COMPENSATION PERTUTEIXI ER OTH AND EMPLOYERS'LIABILITYANY PROPRIETORIPARTNERIEXECUTIVE YIN N E.L.EACH ACCIDENT $ 1000000 C OFFICER/MEMBER EXCLUDED? ❑N N/A WIWC634608 05/03/2015 05/03/2016 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1000000 H yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$ 1000000 DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES(ACORD 101.Additional Remarks Schedule,may be attacfled H more space Is required) Plumbing contractor LICt/CFC1427552 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF MIAMI SHORES ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2ND AVE. AUTHORIZED REPRESENTATIVE MIAMI SHORES FL 33138 k3reg� itzian 069236 ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD ACAORE® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 07/15/2016 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 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 pollcy(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 NTACT NAME; Gregg Ditzian Get Smart Insurance Inc. PHONEtAIC,No. ; (305)653-7977 FA(AIC No): (305)654-0293 20286 NW 2 Ave -ADDRESS: info@insure-smart.com ADDRE INSURER(S)AFFORDING COVERAGE NAIC N Miami FL 33169 INSURER A: Axis Surplus Insurance Company 26620 INSURED INSURER B: Wind Chill LLC INSURER C: Berkshire Hathaway Insurance 20087 723 NW 2 St INSURER D: INSURER E: Hallandale Beach FL 33009 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR LTR TYPE OF INSURANCE POLICY NUMBER POM/DOY EFF PMfDDY EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 �/ DAMAGE TOR D CLAIMS-MADE /� OCCUR PREMISES Ea occurrence $ 50,000 MED EXP(Any one person) $ 5,000 A N N FLGLN02052AX 10/16/2015 10/16/2016 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑JE a F—] LOC PRODUCTS-COMP/OP AGO $ 1,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS AUTOS ( ) NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION I PER OTH- AND EMPLOYERS'LUABILnY y/N STATUTE X ER ANY PROPRIETOR/PARTNER/EXECUTIVEE.L.EACH ACCIDENT $ 1000000 C OFFICER/MEMBEREXCLUDED? ❑N N/A N WIWC634608-1 05/03/2016 05/03/2017 (Mandatory In NH)IffE.L.DISEASE-EA EMPLOYEE $ 1000000 Dyes,describe under E.L.DISEASE-POLICY LIMIT $ 1000000 DESCRIPTION n OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Plumbing License#CFC1427552 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 ACCORDANCE WITH THE POLICY PROVISIONS. Building Dpt AUTHORIZED REPRESENTATIVE 10050 NE 2nd Ave. _ _ Miami Shores FI 33138 C.iTe.£:-- i2ix�cx t3G5�24Cy @ 1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD �(zC l S - a�C�2