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PL-13-108Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 185320 Scheduled Inspection Date: February 07, 2013 Inspector: Hernandez, Rafael Owner: WEAVER, DARYL Permit Number: PL -1 -13 -108 Job Address: 34 NW 96 Street Miami Shores, FL 33150- Project: <NONE> Contr LO _ • TRACTORS INC Building Department Comments REPLACE SANITARY FOR TOILET, HANDSINK SHOWER LAUNDRY AND KITCHEN. Permit Type: Plumbing - Residential Inspection Type: Water Service Work Classification: Addition /Alteration Phone Number Parcel Number 1131010330480 Phone: 305 -383 -9259 Infractio Passed Comments INSPECTOR COMMENTS False Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP- 185115. February 06, 2013 For Inspections please call: (305)762.4949 Page 23 of 27 NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TiME OF FIRST INSPECTION PERMIT NO. TAX FOLIO NO. /I 0,— '000. STATE OF FLORIDA: COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that Improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. • 1. Legal description of rty and street/address: Kt g t3t Lot 1120 4 k 143 Oil. 434/ p3rSg -6 2660 111111111111111111111111111111111111111111111 CFN 2013R0087722 OR Bk 28471 Pa 1163•, (1pa) RECORDED 02/01/2013 14°02 :57 HARVEY RUVIN, CLERK OF COURT MIAMI—DADE COUNTY, FLORIDA LAST PAGE Space abov reserved for use of recording office bq3 r orb Q8 3 -' ` p.ct - to tz- ®i 3. Owner(s) name and address: Interest in property: Name and address of fee simple titleholder. 4. Contractor's name add Egi p • '..number u) b 5. Surety: (Payment bond required by owner from contractor, if any) Name, address and phone number. Amount of bond $ 6. Lender's name and address: 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes, Name, address and phone number. r_ 'Csr' /Z. •22 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(6), Florida Statutes. Name, address and phone number. iv/ 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unieas a different date Is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER C ' 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROP' . ,NOTICE OF CQMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU I D 0 c.: AIN FINANCING, CONSULT WITH YOUR LENDER OR AN A • • NEY BEFORE COMMENCING WORK OR RECORDING YOUR NO11C OF OM ENCEMENT. Signature(s) f Owner(s) )' rued Prepared By 0 Print Name Title/Office STATE OF COUNTY O The •regoi =f .. day of BY itIndividually, or ❑ as for Personally known, or ❑ produced the following type of identification: Signature of Notary Public: Print Name: (SEAL) VERIFICATION PURSUANT TO SECTION 92.525. FLORIDA STATUTES Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true, to the best of my knowledge and belief. Signature(s) of Owner(s) or Owner(s)'s Authorized Officer/DIrector/Partner/Manager who signed above: cer/Director/Partner/Manag Prepared By Print Name Title/Ofce o o • �> s o •" / /% %A% FLORID By FM •.�E ng in fr -nt acknowled • ed ore me 0 CA 01 r %:- ; .Jfo Jifir;f,�/ /1 ■!..• ._•n 11d`.• RAY COMMON 1 DD 884827 yi EXPIRES' Aptp 22, 2014 .�1� - iC,i ^!•LLJ.i ::lid, „1 :;u.+ By 123.01 -82 PAGE 3 3/10 By j�J "u yg% 4 A QI�.,► WITNESS ' hand end Mai Sea! , CLERK, of anCounty Courts D.C. 44( Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 as 13- B IL ING PERMIT APPLICATION Permit Type: PLUMBING JOB ADDRESS: 3I A 1 JAN 2 9 2013 FBC 20 ID Permit No. Master Permit No. t L l'3 -10Y City: Miami Shores County: Miami Dade Zip: 33 15© Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): 4/0160.._ A AM 1 iU ® Phone#: 305 T Z Z,k, Address: 3 q6 /Cc'1t� Zip: City: �% ®�/ sl -�C7i� State: �% ZiS� �4p Co Tenant/Lessee Name: JO a (Q� 4 ' /1 Al' "A.1-0 Phone #: ag g 4 t Z3 Z fo Email: ?1 tj® i"' 4.1'0 4-v CA9 r M e.4)-c`lA • 0-004--r CONTRACTO ' : Co i s . s y Name: Address: City: Qualifier Name: State Certification or Registration : /�', 6 certificate of Competency Contact Phone f 3 l (2) Email Address: % T C f #% (-own DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit $a0 Type of Work: °Address °Alte ration Description of Work: At ' / _n J i har, i Sf 1'1 qrd r _i {chtn . Chance tft iron For PVC (onl ni-jelr `i Square /Linear-Footage of Wo :; New Repair/Replace . °Demolition S * * * ** * * * * * * * * *, * * * *** ******** * *** * * * * ** Fees * * ***** * * * **** **** , * *, * *********** **** * **•x* Submittal Fee $ ). ` t ® Permit Fee $ /K r 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 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 s bject to attachment. Also, a certified copy of the recorded notice of commencementust be posted at the job site for the first inspec ''n which occurs seven (7) days after the building permit is issued. In the abse ce of such posted notice, the inspection will not e approved and a reinspection fee will be charged. The foreg ' g instrument was acknowledged before me this day of % %ZL 20 by .76,e_ / r wo is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLI cLr-d, Sign: Print: . Notary Public State of Florida Karenia Dieguez My commission EE069786 Expires 03/02/2015 My Commission Expires: V3 APPROVED BY Signature i C ntractor The foregoing instrument was cknowledged befor me this day of / / -42920 by t22_ r)74 t- OgZ, who is personally known to me or who has produced as identification and who did take an oath. —13 Plans Examiner Structural Review (Revised3 /12/2012XRevised 07 /10 /07XRevised 06 /10/2009XRevised 3/15/09) NOT Sign: Print: ublic State of Florida Dieguez mission EE089786 My Commission Expires: 0 Zoning Clerk A c .4110.4110.0---- ,�-�B ' lJ� CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 01/18/2013 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(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). PRODUCER A&A Underwriters, Inc. 8796 SW 8 St Miami, FI 33174 AcT Pablo M Conde Np); 305- 220 -7447 �c.No): 305- 2204821 =E-MAIL pmc @aaunderwriters.com INSURER(S) AFFORDING COVERAGE NAIC tie INSURERA: Scotsdale Insurance Company 003292 INSURED Loncus Plumbing Contractor Inc. 1300 SW 70 Ave Miami FL 33184 1NSURERB: BusinessFirst Insurance Company 012629 INSURER C: 11/16/13 INSURER D : $ 1,000,000 INSURER E : $ 100,E INSURER F $ 5,000 COVERAGES CERTIFICATE NUMBER: ION 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 IN LTR TYPE OF INSURANCE p �g � POUCY NUMBER POLICY EFF J M/ Y POLICY EP LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY CPS1502088 11/16/12 11/16/13 EACH OCCURRENCE $ 1,000,000 PREMISES (Eaaxxurance) $ 100,E MED EXP (Any one parson) $ 5,000 CLAIMS -MADE X OCCUR PERSONAL BADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGO $ 1,000,000 GEN'L AGGREGATE UMIT APPLIES PER: -Y I POLICY PRO- F1 LOC $ AUTOMOBILE LIABILITY ANY AUTO ALL AUTOS OVVNED D HIREAIJTOS _ SCHE LED AUTOS NON-OWNED COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ (AMAGE $ $ UMBRELLA LIAR EXCESS WLB OCCUR CLAIMS-MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) K yes describe under DESCRIPTION OF OPERATIONS below Y/ N N N / A 521 -01010 08/13/12 08/13/13 X TORY STATU- T ER EL EACH ACCIDENT $ 1,000,000 EL DISEASE -EA EMPLOYEE $ 1,000,000 EL DISEASE - POUCY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, It more space 1s requhed) Plumbing Contractor CERTIFICATE HOLDER CANCELLATION I Miami Shores Village Department 10050 NE 2nd Avenue p Miami Shores FI 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORED REPRESENTATIVE ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD PDF created with pdfFactory Pro trial version www.pdffactorv.com STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487 -1395 1940 NORTH MONROE STREET T� TALLAHASSEE FL 32399 -0783 BELLO, REMBERTO LONCUS PLUMBING CONTRACTOR INC 1300 SW 70 AVENUE MIAMI FL 33144 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 from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and team more about the Department's 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 in Florida, and congratulations on your new license! 6121951 DETACH HERE tic E.-f4 t162g O'd & ! STATE OF FLORIDA AC# 6 l 2 1 ci 5: DEPARTMENT OF BUSINESS AND „ , PROFESSIONAL REGULATION CFC1428066 05/08/12 118182572 CERTIFIED PLUMBING CONTRACTOR BELLO, REMBERTO LONCUS PLUMBING CONTRACTOR INC IS CERTIFIED under the provisions of ch.489 FS mq,iratiaa date: AUG 31, 2014 L12050800865 OVA 41046KOW]iigm STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD SEQ#L12050800865 DATE BATCHNUMBER The PLUMBING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2014 BELLO, REMBERTO LONCUS PLUMBING CONTRACTOR INC 1300 S.W. 70 AVENUE MIAMI FL 33144 RICK SCOTT GOVERNOR DISPLAY AS REQUIRED BY LAW KEN LAWSON SECRETARY MST-CLASS U.S. POSTAGE PAID MIAMI, FL PERMIT NO. 231 591873-6 THIS IS NOT A BILL - DO NOT PAY RENEWAL BUSINESS NAME / LOCATION RECEIPT NO. 617415 -5 LONCUS PLUMBING CONTRACTOR INC STATES CFC1428066 1331 SW 84 CT 33144 UNIN DADE COUNTY DWNER LONCUS PLUMBING CONTRACTOR INC Sec. Type of Business WORKER /S 196 PLUMBING CONTRACTOR 3 • THIS IS ONLY A LOCAL BUSINESS TAX RECEIPT. IT DOES NOT PERMIT THE HOLDER TO VIOLATE ANY EXISTING REGULATORY OR MO ANG LAWS OF THE COUNTY OR CRIES. NOR DOES IT EYEUPT THE HOLDER FROM ANY OTHER PERk9T OR LICENSE REQUIRED BY LAW. THIS IS NOT A CERTIFICATION OF THE HOLOER•S OUAUFR:A- noNs 'Anew RECEiV® 1.55141•DADE COUNTY TAX LECTOR 07/16/2012 09010551001 000075.00 SEE OTHER SIDE DO NOT FORWARD LONCUS PLUMBING CONTRACTOR INC REMBERTO BELLO PRES 1331 SW 84 CT MIAMI FL 33144 11111 11}111111111111 111111 14111711111,11111111111!}1 ID Id 3ELLO MAW, _ '3t*44144 - dikfe C.3? o.d'9 veetfS em x=1°2 . ^