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PL-17-160
Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit Permit NO. PL -1-17-160 Permit Type: Plumbing - Residential Work Classification: Addition/Atteratlon Permit Status: APPROVED Issue Date: 1/3012017 Expiration: 07/29/2017 Parcel Number Applicant 61 NE 108 Street Miami Shores, FL 33161- 1121360110460 Block: Lot: JOSEPH FULTON Owner Information Address Phone Cell JOSEPH FULTON 61 N 108 Street MIAMI SHORES FL 33161- (305)905-7188 61 N 108 Street MIAMI SHORES FL 33161- Contractor(s) Phone CeII Phone P & P SERVICES AND REPAIRS INC (305)970-2312 Valuation: Total Sq Feet: $ 750.00 0 Type of Work: REPLACE EXISTING GAS WATER HEATHER Type of Piping: Additional Info: REPLACE EXISTING GAS WATER HEATHER Bond Return : Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Amount $0.60 $2.00 $2.00 $0.20 $100.00 $3.00 $0.80 Total: $108.60 Pay Date Pay Type Invoice # PL -1-17-62677 01/30/2017 Check #: 631 01/20/2017 Check #: 631 Amt Paid Amt Due $ 58.60 $ 50.00 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Top Out Final Review Plumbing Underground 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 certify that all the forego. construction and zoning. Futhermore, the a o ation e-na curate and that all work will be done in compliance with all applicable laws regulating contractor to do the work stated. January 30, 2017 Authorized Signature: Owner / Applicant / ctor Building Departm - t Copy January 30, 2017 / Agent Date 1 BUILDING Miami Shores Village Building Department CEIVED 20 2017 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 LJ FBC 2011 Master Permit No. QL t - 11- 1 PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION El RENEWAL BING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS b C l o& T JOB ADDRESS: City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Occupancy Type: Load: Is the Building Historically Designated: Yes NO Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): - '-c...)L: , Phone#: 305. 3oi $2 (C. Address: Lol tic 1 tb S`( mos' 9 W City: tk, 4.+•-1 % State: F-4-- Zip: 3 5(lol Tenant/Lessee Name: Phone#: 305 3o! 924(0 Email: t-1A41tkSPs1L..Sbb e L;,1�P<<`,. co—.130S gas ' -I 88 CONTRACTOR: �Company Name: 'A ii CM) )01 Cj t i(% Phonett: 33 r -c)-\043 (3-- V' Address: .f4 . ( 4 1,,)\f 1 PG City: Al 4A State: PL. Zip: Qualifier Name:JPd uS OBitIOS Phone#: State Certification or Registration #: (b 'r Fe_ 1 ),0 $F Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $?-fa '00 Type of Work: ❑ Addition ❑ Alteration /� ❑ New 1� •air/Replace n Demolition Description of Work: % � i 9 i (x/17 al- 4)//72a 14) Square/Linear Footage of Work: Specify color of color thru tile: Submittal Fee $ Permit Fee $ I!/(J / CCF $ ' COO CO/CC $ Scanning Fee $ Radon Fee $ Z DBPR $ 2 Notary $ Technology Fee $ ' 80 Training/Education Fee $ ' 20 Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ (Revised02/24/2014) 4G0 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 OWNER or AGENT The foregoing instrument was acknowledged before me this day of --)G`" , 20 n by )c e) h CuL\A-ern , who is personally known to me or who has produced -TAk C..e.,ns identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: as tpf 41. 116, �•s Notary Public - State of Florida •c My Comm. Expires Aug 10. 2018 F P' Commission # FF 113494 Bonded Through National Notary Assn. ******************************** * APPROVED BY (Revised02/24/2014) , _244-) Signature CONTRACTOR The foregong instrument was acknowledged before me this ( g' day of .4 40 , 20 / 9 't€a,&s 040 me or who has produced 2 identification and who did take an oath. NOTARY PUBLIC. , by , who is personally known to Sign: Print: Seal: /ri as ,71 • Notary Public - State of Florida •- Commission #FF96487 r: My Commission Expires April 30. 201. **************************************************************** Plans Examiner Structural Review Zoning Clerk STATE OF FLORIDA 4" DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD .9' 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399-0783 COBOS, JESUS LAZARO P & P SERVICES AND REPAIRS INC 19341 NW 10TH ST PEMBROKE PINES FL 33029 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.myfIoridaticense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn 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! RICK SCOTT. GOVERNOR (850) 487-1395 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CFC 1426058 ISSUED: 09/04/2016 CERTIFIED PLUMBING CONTRACTOR COBOS, JESUS LAZARO P & P SERVICES AND REPAIRS INC IS CERTIFIED under the provisions of Ch 489 FS Expiration date AUG 31 2018 11609040001763 DETACH HERE KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD LICENSE NUMBER CFC 1426058 The PLUMBING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS Expiration date' AUG 31, 2018 COBOS, JESUS LAZARO P & P SERVICES AND REPAIRS INC 444 WEST 43 PLACE HIALEAH FL 33012 ISSUED 09/04/2016 DISPLAY AS REQUIRED BY LAW SEQ # L1609040001763 City of H ALEAH 010292 City of Hialeah Business Tax Receipt or Carlos Hernandez No: 238220-171 Amount: $ 300.00 The person. firm or corp. listed here has paid the hu:ine>. Ia.\ required to engage in or operate the business specified subject to the rcuulation and restrictions of the Cite or 1lialcah_ Florida ONvnrr- JESL S COBOS - P k P SERVICES A\D REPAIRS. INC. TypeofB1/oo cc:Plumbing, Heating, and Air -Conditioning Contractors 2016-17 P & P SERVICES AND REPAIRS, INC. 444 W 43 PL HIALEAH, FL 33012 Validating Ao.: 0000 THIS IS.\OT.1 BILL Local Business Tax Receipt Miami -Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 8284 BUSINESS NAME/LOCATION P & P SERVICES AND REPAIRS INC 444 W 43 PL HIALEAH FL 33012 OWNER P & P SERVICES & REPAIRS INC 70 JUAN PABLO REYES, PRESIDENT .Jorker(s) 9 RECEIPT NO. RENEWAL 7446900 Business Location: 444 W 43 PL Expires September .30.2017 SEC. TYPE OF BUSINESS 196 PLUMBING CONTRACTOR CFC1426058 EXPIRES SEPTEMBER 30, 2017 Must be dissplayec at place of business Pursuant to County. Code Chapter SA - Art. 9 & 10 PAYMENT RECEIVED BY TAX COLLECTOR 545.00 07/26/2016 CHECK21-16-101415 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 holders 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 all commercial vehicles — Miami—Dade Code Sec 8a-276. For more information, visit www.miamidade.g,ov/taxcollector ACCPRO D' CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 01/18/17 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 CONTACT Beatriz Bruno NAME: Excellence Insurance Agency 3801 SW 107 Avenue Miami, FL 33165 Phone (305)226-3900 Fax (305)226-3997 INSURED P & P Services and Repairs, Inc. 444 West 43 Place Hialeah, FL 33012 COVERAGES 'ac�Jo,Ext):._(305)226=3900 L(NC No).(305)226_3997 A DRESS: bbrunO@Excellenceinsurance.net INSURERS) AFFORDING COVERAGE NAIL # INSURER A : Granada Insurance Company INSURER B : Associated Industries Insurance Company INSURER C : Wesco Insurance Company INSURER D : (305) 270-6442 ENSURER E__—�_ INSURER 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 TYPE OF INSURANCE ADDLSUBR POLICY EFF POLICY EXP LTR INSR WVp POLICY NUMBER (MM/DD/YYYY)JMM/DDIYYYY) LIMITS GENERAL. LIABILITY EACH OCCURRENCE $ 1,000,000.00 DAMAGE TO RENTED _P_1 C• OMMERCIAL GENERAL LIABILITY PREMISES_(Ea occurrence) $,_ 100,000 00_ ❑ ❑ • CLAIMS -MADE LJ OCCUR 0185FL00081067 MED EXP (Any one person) $ 5,000.00 A C B GEN'L AGGREGATE LIMIT APPLIES PER: LJ POLICY-❑_JEC_T__Fl LOC.. AUTOMOBILE LIABILITY ❑ ANY AUTO f l ALL OWNED ,t SCHEDULED U AUTOS LI AUTOS ❑ H• IRED AUTOS ❑ AUTOS ❑ PIP - 0 DED Y Y ❑ UMBRELLA LIAB ❑ OCCUR ❑ E• XCESS LIAB ❑ CLAIMS -MADE N ❑ D• ED ❑ RETENTION$ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below LN N/A Y N Y WPP1120970-02 03/29/2016 -r- 10/07/2016 03/29/2017 10/07/2017 PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) BODILY INJURY (Per accident PROPERTY DAMAGE (Per accident Uninsured Motorists EACH OCCURRENCE AGGREGATE $ 1,000,000.00 $ 2,000,000.00 ^_ $ 2,000,000.00 $ �vv,vvv.v $ $ $ 20,000.00 $ $ $ A W C 1060769 03/04/2016 03/04/2017 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) PLUMBING CONTRACTOR CERTIFICATE HOLDER MIAMI SHORES VILLAGE BUILDING DEPT 10050 NE 2 nd AVE MIAMI SHORES , FL 33138 CANCELLATION Lel ORYLMTS ❑ ERH- EL. EACH ACCIDENT E.L. DISEASE - EA EMPLOYE E.L. DISEASE - POLICY LIMIT $ 1,000,000.00 $ 1,000,000.00 $ 1,000,000.00 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOR RESENTATIV,�/-��- ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) QF The ACORD name and logo are registered marks of ACORD