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PL-16-2370Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 23 uimbin sidentl;; ion Sp>rihk ar Sym" Parcel Number APPROV Expiration: 02/22/2017 Applicant Owner Information Address Phone Cell ROBERT AND NANCY FREHLING 421 E SAN MARINO Drive MIAMI BEACH FL 33139- 421 E SAN MARINO Drive MIAMI BEACH FL 33139- Contractor(s) DESMAR PC INC Phone (305)876-6761 Cell Phone Valuation: Total Sq Feet: $ 2,200.00 800 Type of Work: NEW SPRINKLER SYSTEM Type of Piping: Additional Info: Bond Return : Classification: Residential Scanning: 3 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $1.80 $2.25 $2.25 $0.60 $150.00 $9.00 $2.40 $168.30 Pay Date Pay Type Amt Paid Amt Due Invoice # PL -8-16-61089 08/23/2016 Check #: 1117 $ 50.00 $ 118.30 08/26/2016 Check #: 1105 $ 118.30 $ 0.00 Available Inspections: Inspection Type: Final Underground Sprinkler Review Plumbing 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 as responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRIC �MBING, M ' HANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT rtify th- all a foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and z• r .; Futhe ' ore, uthorize the above-named contractor to do the work stated. 4 —r August 26, 2016 Authorized Signature: 0 'ner / Applicant / C Building Depa ent Copy / Agent Date August 26, 2016 1 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 -5(oLf Inspection Number: INSP-265960 Permit Number: PL -8-16-2370 Scheduled Inspection Date: December 21, 2016 Inspector: Hernandez, Rafael Owner: FREHLING, ROBERT AND NANCY Job Address: 1285 NE 95 Street Miami Shores, FL Project: <NONE> Contractor: DESMAR PC INC Permit Type: Plumbing - Residential Inspection Type: Underground Sprinkler Work Classification: Sprinkler System Phone Number Parcel Number 1132060144020 Phone: (305)876-6761 Building Department Comments NEW SPRINKLER SYSTEM Passed Failed Correction Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. Inspector Com Infractlo Passed Comments INSPECTOR COMMENTS False 's (6F Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 201'r BUILDING Master Permit No. 'PUG PERMIT APPLICATION Sub Permit No. RC 1 c-P-Sb(f El BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL BY \UG 2 " A16 [PLUMBING ❑ MECHANICAL El PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: City: 1� Ar6 96 51 Miami Shores fcr)- l35? County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes Occupancy Type: Load: OWNER: Name (Fee Simple Titleholder)):: Address: /e _1 ,I E / S .''- City: MAAA., O v Construction Type: Flood Zone: BFE: NO FFE: one#: -34e7 g State: Zip: 33/3g Tenant/Lessee Name: Phone#: ev/e tz_-4 CG, Erb . Email: CONTRACTT/OO�R: Company Name: 11 tme_ '1 t (MG • Phone#: 3 - 87440- (vTta' Addres s: �UlCAvS- N (l/ 4 s� iZ9 City: (/l/w I/V4//11 , ),^,,� ,n State: ''1-- • Qualifier Name: L✓ [� 41Rbo ��F��,�- A(-12-41-1k4�7 State Certification or Registration #: CPC-- I 2- Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ - g , o0 Square/Linear Footage of Work: ' ,�+� r Type of Work: ❑ Addition ❑ Alteration / ��EN- New ❑ Repair/Replace ❑ Demolition Description of Work: Ai F 5177/7/k1 (L i,-. >)c1P"--- Phone#: Zip: 33 1 3- Specify color of color thru tile: Submittal Fee $ 0 • 1C) Permit Fee $ /5-6 CCF $ 1 2/0 CO/CC $ P Scanning Fee $ 9 . cj Radon Fee $ "212,__G___ DBPR $ 2-- 2.g Notary $ Technology Fee $ 2 ° ''"-i0 Training/Education Fee $ 0 .6 0 Double Fee $ 0 - Structural Reviews $ Bond $ 30 TOTAL FEE NOW DUE $ Ie (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. OWNER or AGENT Signature CONT CTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 2if day of i , 20 16 , by daily of a„t , 20 4b , by L_" , who is personally known to -Z• , who is ersonally kno v3to me or who has produced as me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: identification and who did take an oath. NOTARY PUBLIC: Seal: 2aoa;Y• • ;enu% RAMON O. CEBALLOS � ' ' Seal: ot°'��° :l.:?: RAMONO. CEBALLOS* MY COMMISSION 6 FF 060760 * MY COMMISSION 9 FF 060780 EXPIRES: October 7, 2017 s ; !an . EXPIRES: October 7, 2017 .- .P.,r^'!M 99 Bonded ThruBudd tN Notary Services ''rk. F 00 Bonded Thru Budget Notary Services ****************4M42******* ** *********************************.************************************* APPROVED BY (Revised02/24/2014) Plans Examiner Zoning Structural Review Clerk RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD LICENSE NUMBER CFC1427442 The PLUMBING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 20-18 ANGEL, -EDUARDO F.:. DESMAR PC=INE 6405 NW 36 "ST-SUFTE "- MIAMI.'<�_y ISSUED: 08/08/2016 ` . STATE OF FLORIDA DEPARTMENT OF. BUSINESS AND PROFESSSIe REGULATION CFC1427442 '"x:08/08/2016 CERTIFIED PLU 'I F Q�00 ANGEL, EDUA . DESMAR PC I IS C-ERTIFIED under- the provisions -of Ch.489 FS. • Expiration date; r AUG 31, 2018 L1608080001113 DISPLAY AS REQUIRED BY LAW 008455 SEQ # L1608080001113 Local Business Tax Receipt Miami—Dade County, State of Florida -THIS IS NOT A BILL -DO NOT PAY 6076483 BUSINESS NAME/LOCATION DESMAR PC INC 6405NW36ST 124 VIRGINIA GARDENS FL 33166 OWNER DESMAR PC INC C/0 ANGEL E FRANK QUALIFIER Worker(s) 2 RECEIPT NO. RENEWAL 6338768 LBT SEC. TYPE OF BUSINESS 196 PLUMBING CONTRACTOR CFC1427442 EXPIRES SEPTEMBER 30, 2017 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 PAYMENT RECEIVED BY TAX COLLECTOR $45.00 07/19/2016 CREDITCARD-16-042282 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit, or a certification of the holder's qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT NO. above must be displayed on aII commercial vehicles - Miami -Dade Coda Sec 8a-276. For more information, visit www.miamidade.nemtavemi...n.. ACORD CERTIFICATE OF LIABILITY INSURANCE `'r----- DATE(MM/DD/YYYY) 8/18/2016 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 policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certaln 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 Pan Am Assurance Agency CONTACT Carlos Allen Sr. (acNNo Ext): (305) 270-1424 (a/c, No): (305)270-8997 9100 Sunset Drive Miami FL 33173-3433 ADD RIEss:carlos@panamassurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER AMasco Insurance Company 25011 INSURED Desmar PC, Inc 6405 NW 36 Street STE 124 Suite #124 Miami FL 33166 INSURER B:Ascendant Commercial Insurance, Inc 13683 INSURERC:BusinessFjrst Insurance Company 11697 INSURERD: INSURERS: CLAIMS -MADE INSURERF: OCCUR CL1681801308 • 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 LTR TYPE OF INSURANCE ADDL _MAD SUBR WVD POLICY NUMBER POLICY EFF IMM/DD/YYYYI POLICY EXP (MM/DD/YYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY WPP1222391 01 01/05/2016 01/05/2017 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES PREMISES (Ea occurrence) $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GE X 'L AGGREGATE POLICY OTHER: LIMIT APPLIES PRO- JECT PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO ALL OWNEDX AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS CA -90186-0 01/29/2016 01/29/2017 (EOMBIINIEeDtSINGLE LIMIT $ 300,000 BODILY INJURY (Per person) $ BODILY INJURY (Per ( ) $ PROPERTY DAMAGE (Per accident) $ Uninsured motorist BI split limit $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below y/ N N / A 521-03296 08/16/2016 08/16/2017 PER STATUTE OTH- ER E.L. EACH ACCIDENT $ 500 000 r E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more apace Is required) Plumbing Contractors. CERTIFICATE HOLDER (305) 756-8972 Miami Shores Village 10050 NE 2 Avenue Miami Shores, FL 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. AUTHORIZED REPRESENTATIVE Carlos Allen Sr. /DS /�a.� ACORD 25 (2014/01) INS025 (2n14n1I © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD