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PL-15-1595Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit Permit NO. PL -6-15-1595 Permit Type: Plumbing - Residential Work Classification:>Addition/Alteration Permit Status: APPROVED Issue Date. Not Issued Expiration: 01/01/2999 Parcel Number Applicant 1263 NE 94 Street Miami Shores, FL 1132050100070 Block: Lot: NUHOUSE INVESTMENTS INC Owner Information Address Phone Cell NUHOUSE INVESTMENTS INC 15751 SHERIDAN Street FORT LAUDERDALE FL 33331- Contractor(s) Phone FIAT PLUMBING & GENERAL CONTR, (305)446-6366 Cell Phone (954)288-7886 Valuation: Total Sq Feet: $ 7,000.00 00 Type of Work: REPLACE FIXTURES REMODEL MASTER AND 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 $4.20 $3.68 $3.68 $1.40 $245.00 $9.00 $5.60 $272.56 Pay Date Pay Type Invoice # PL -6-15-56130 06/26/2015 Cash 09/10/2015 Credit Card Amt Paid Amt Due $ 50.00 $ 222.56 $ 222.56 $ 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 al. he foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zone•. Fauthorize the above-named contractor to do the work stated. September 10, 2015 Autho ature: Owner / Applicant / Contractor / Agent Building De • artment Copy Date September 10, 2015 1 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-237759 Permit Number: PL -6-15-1595 Scheduled Inspection Date: October 03, 2016 Inspector: Hernandez, Rafael Owner: Job Address: 1263 NE 94 Street Miami Shores, FL Project: <NONE> Contractor: FIAT PLUMBING & GENERAL CONTRACTORS INC Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition/Alteration Phone Number (954)288-7886 Parcel Number 1132050100070 Phone: (305)446-6366 Building Department Comments REPLACE FIXTURES REMODEL MASTER AND HALF BATH ROUGH & SET 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 BUILDING PERMIT APPLICATION ❑BUILDING APLUMBING JOB ADDRESS: 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 ❑ ELECTRIC ❑ ROOFING ❑ MECHANICAL ❑ PUBLIC WORKS 1263 E t4 5T RECEIVED JUN 26 2015 FBC 20 Master Permit No. SC- 6.15-11S3 Sub Permit No.P //5--• ❑ REVISION ❑ EXTENSION ❑ RENEWAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS City: Miami Shores Folio/Parcel#: t �' 3w5 '"O10 " W1 O County: Miami Dade Occupancy Type: Load: Construction Type: Zip: 33( 38 Is the cft Building Historically Designated:AYes NO k. G g / Flood Zone: a BFE: 9 `co FFE: OWNER: Name (Fee Simple Titleholder): NUttOUSe. 11J1ICA-r1 t5T , Address: 151 51 S it r t D h IJ st # (LI.'5 Phone#: l 7-b8* '192C. City: 4r LitUDE(Z-u kct. State: ft - Tenant/Lessee Name: Email: Phone#: Zip: 5333 CONTRACTOR: Company Name: HA -7— T P‘,v Al pt, Address: r)-7 7 5 L� 3 6 City: 1--t I ,�-/`tel 1 State: Zip: 33 13 3 Qualifier Name: VF A 4-7" State Certification or Registration #: ()Fe._ 0 3 / / 7 7 Certificate of Competency #: DESIGNER: Architect/Engineer: CUBEZ AOCiit'( 11)tdicstwo Phone#: 78(x' V35 L110 Address: Z7b0 til' MIk 4i SOt1 gd8 City: !chew State: ft, Zip: 3312"1 Value of Work for this Permit: $ t 7t)(:10-.3-0 , Square/Linear Footage of Work: Type of Work: ❑ Addition ErAlteration ❑ New Q Repair/Replace ❑ Mc Demolition Description of Work: l t-A(t F Otor0 Z- 3 / 1Za;McT1n i�( V11C EIL. i , our Citi l� i IzzuGrt 4 SF.T' Phone#: 3O5 W i36y Phone#: 30)-54-7'66 3 6 iy Specify color of color; thru,.tile::f Submittal Fee $ Permit Fee $ L i a- ',` CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ % TOTAL FEE NOW DUE $ 222.. 5CD (Revised02/24/2014) ! " f 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 O 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 corn►nencement 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 \G\ day of 40 ,20\S ,by ‘zJ V( , who is personally known to • me or who has R -s produced '' \... * ... 081-0 as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: SA"NK \ \ ) F, it SANDRA LUGO MY COMMISSION #FF065861 EXPIRES: OCT 24, 2017 Signature CONTRACTOR The foregoing instrument was acknowledged before me this Z; R) day of V c) &) f , 20 / S , by ��G i✓f"t `�—/% who is personally known to me or who haslproduced. identification and who did take an oath. NOTARY PUBLI Sign: Print: Seal: as Notary Public State of Florida • Jessica C Nasib • My Commission FF 140139 Expires 07/09/2018 ************************************************************************************************************ APPROVED BY (Revised02/24/2014) Plans Examiner Zoning Structural Review Clerk Miami Shores Villa Building Departme CONTRACTORS' REGISTRATION 10050 N.E.2nd Ave Miami Shores, Florida 33 Tel: (305) 795.2 Fax: (305) 756.8 IF CONTRACTOR IS A FLORIDA STATECERTIFIED CONTRACTOR: A. (/ COPY OF QUALIFIER'S STATE LICENCES B. g/ COPY OF LOCAL BUSINESS TAX RECEIPT C. j/ COPY OF LIABILITY INSURANCE* D. / COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OFCOMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICI CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 Certificate must specify the description of operations or contractor license number. BUSINESS NAME: /A- 1.4 ay 8;4/6 ‘ er/Jest (-- tO /CW4c7 g . BUSINESS ADDRESS: ,27))S Gc) 3 L '4)E CITY H / /1-1/ / STATEPG ZIP 3�3 BUSINESS PHONE: ( O ) VY6 ,36‘0 FAX NUMBER (3 0y) 77V 7o 33 RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD LICENSE NUMBER The PLUMBING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 FIAT, JORGE A FIAT PLUMBING & GENERAL CONTRACTORS INC 2727 S.W. 36 AVE. MIAMI FL 33133 ISSUED: 06/09/2014 DISPLAY AS REQUIRED BY LAW SEQ # L1406090000837 002145 Local Business Tax Receipt Miami—Dade County, State of Florida —THIS IS NOTA BILL — DO NOT PAY 5858957 BUSINESS NAME/LOCATION FIAT PLUMBING & GENERAL CONTRACTORS INC 2727 SW 36 AVE MIAMI FL 33133 OWNER FIAT PLUMBING & GENERAL CONT INC Worker(s) 1 RECEIPT NO. RENEWAL 6110340 LBT SEC. TYPE OF BUSINESS 196 PLUMBING CONTRACTOR CFC039977 EXPIRES SEPTEMBER 30, 2015 Must be displayed at place of business Pursuant to County Code Chapter 8A — Art. 9 & 10 PAYMENT RECEIVED BY TAX COLLECTOR $45.00 07/18/2014 CREDITCARD-14-028400 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit, or a certification of the holder's qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT N0. above must be displayed on all commercial vehicles — Miami—Dade Code Sec 8a-276. For more information, visit www.miamidadegov/taxcollector ACUR/J CERTIFIC:' 'E OF LIABILITY INSURA . EDATE(MIMGVYYM THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON 6/25/2D15 CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THEEPOUCIES BELOW. THIS CERT1RCATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: N the certificate holder Is an ADDITIONAL INSURED, the poltcyges) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER OCG & ASSOCIATES INC 7480 Bird Rd Ste 610 Miami, FL 33155 INSURED Fiat Plumbing & General. Contractor, Inc. 2727 SW 36th Avenue Miami, FL. 33133 OSCAR CARTAGENA No.Exrk (305) 447-9577 j mpt(305)447-957$ ADDREssomc@ocginsurance. com INBURER(a) APFop. J(e COVERAGE INSURER A : Scottsdale Insurance Co. INSURERS:RetailFirst Insurance Co INSURER C : INSURER 0 : INSURER E INSURER F : NAICI 41297 10700 COVERAGES CERTIFICATE NUMBER N THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED BOVEMFOR RTHE 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 POUCIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE edea AMR. INBR GENERAL UABILRY SVC POLICY NUMBER (WFEXP X COMMERCIAL GENERAL. LAABIUTY CLAIMS -MADE n OCCUR X DED: Per claimant $500 GENT. AGGREGATE min-APPUES PER: POLICY I I JEfl LOC AUTOMOBILE LIABILITY A X ANYAUTO ALL OWI4E0 AUTOS HIRED AUTOS UMBRELLA UAB EXCESS UAB CPS2169386 3/3/15 IMM CDM'YYTI 3/3/16 LIMITS EACH OCCURRENCE $ 1,000,000 DAMALikIPREMISES Ea occurrence s 100,000 MD EXP (Any one person) S 5,000 PERSONALS AIN INJURY $ 1, 000 ,000 GENERAL AGGREGATE S 2 , 000,000 PRODUCTS - COMP/OP AGG $ 2 000,000 s SCCHHOEOULED AUT NON-OWNED AUTOS X (EC aH161�) INGLE LIMIT BODILY INJURY (Par person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ B DED 1 1 RETENTIONS OCCUR CLAIMS -MADE WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTHEFVEXECMIVE OFFICER,MEMuER EXCWITED7 ;Mandatory In NH3 If OF OPERATIONS below X980048476 3/3/15 3/3/16 EACH OCCURRENCE AGGREGATE YIN NIA 0520-50066 3/9/15 3/9/16 X TORYTLIIMIITTS 1 I ER $ s 1,000,000 s 1,000,000 S E.L EACH ACCIDENT EL. DISEASE - EA EMPLOY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES Mach ACORD 101, AddRional Remarks Schedule If more space b require() RESIDENTIAL & COMMERCIAL PLUMSING LICENSE NUMBER: CFC039977 JORGE FIAT, OWNER, IS EXEMPT UNTIL MARCH 12, 2016 ,IERTIFICATE HOLDER E.L. DISEASE - POLICY LIMIT $ 100,000 $ 100,000, s 500,000 CANCELLATION MIAMI SHORES VILLAGE 10050 N.E. 2ND AVENUE MIAMI SHORES, FLORIDA 33138 1CORD25(2010/05) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POUCY PROVISIONS. AUTHORRED REPRESENTATIVE SD 1988-2010 ACORD c •r );1 . �- , All rights reserved. The ACORD name and logo are registered marks of ACORD