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PL-16-832"M e lIY FGORiDP Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795 2204 Permit Parcel Number Permit No. PL-3-16-832 Permit Type: Plumbing - Residential Work Classification: Addition/Alteration Permit Status: APPROVED issue Date: 4/1/2016 1 Expiration: 09/28/2016 Applicant 548 GRAND CONCOURSE 1132060171410 Miami Shores, FL 33138- Block: Lot: ASHLEY M ABESS REVOCABLE Owner Information Address Phone Cell ASHLEY M ABESS REVOCABLE TRUST 548 GRAND CONCOURSE (917)657-0713 MIAMI FL 33138- 548 GRAND CONCOURSE MIAMI FL 33138- Contractor(s) Phone Cell Phone EDDY MARTINEZ PLUMBING SERVICI 305-883-8486 of Work: REMODEL KITCHEN SINK, GAS STOVE, C of Piping: onal Info: Return : ification: Residential Scanning: 1 Fees Due Amount CCF $2.40 DBPR Fee $2.25 DCA Fee $2.25 Education Surcharge $0.80 Permit Fee $150.00 Scanning Fee $3.00 Technology Fee $3.20 Total: $163.90 Valuation: $ 4,000.00 Total Scl Feet: 0 Pay Date Pay Type Amt Paid Amt Due Invoice # PL-3-16-59191 04/01/2016 Credit Card $ 113.90 $ 50.00 03/29/2016 Credit Card $ 50.00 $ 0.00 In consideration of the issuance to me of this permit, I agree to perform the work covere pertaining thereto and in strict conformity with the plans, drawings, statements or specificatio su accepting this permit I assume responsibility for all work done by either myself, my agent, ery required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING an SWI OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all ork will construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated. Avauame inspections: Inspection Type: Top Out 9 ender in compliance with all ordinances and regulations itted to the proper authorities of Miami Shores Village. In s, or employes. I understand that separate permits are IING POOL work. ne in compliance with all applicable laws regulating April 01, 2016 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy April 01, 2016 Miami Shores Village =BY: 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 M45� BUILDING Master Permit No. QC_ %S z� 3 PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL X PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: -t�o qg> bR..WD CO►� CO SH mi Folio/Parcel#: Occupancy Type: Load: Construction Type: _ OWNER: Name (Fee Simple Titleh Address Building Historically Designated: Yes NO Flood Zone: BFE: FFE: slePhohe#: 417 SIL7 ©11� City: VVb,"�' a, jwC State: —T� Zip: Tenant/Lessee Name: Phone#:_ Email: CONTRACTOR: Company Name: Z Oo y moarlyt2 PLUM�;n� 5er-ViCe$ Phone#: 305-33 Address: I ( as-0 S;eJ• l 7 S S/, City: ►`n'0'4 /A / State: Zip: Qualifier Name: F O 9 " f M t) 12 -rl N t'Z-- Phone#: State Certification or Registration #: C rc 0 5 r? 6 5 ( Certificate of Competency #: _ DESIGNER: Architect/Engineer: 1% t�� �, L a"�� qs� S C�ZC'_Phhone#: Address: a mo ,0 G i�=j_City: 1 WO - State: ;F (' Zip: Value of Work for this Permit: $ 4(y) ob —Square/Linear Footage of Work: �— cr-c Type of Work: ❑ Adddiition AM Alterations I I ❑ New t ❑ Repair/Replace ❑ Demolition Description o`fWork: R2modet !�,k^en si�1f� 74g .STCIyII G , W4Sh•-S me-L, Specify color of color thru tile: J Submittal Fee $ 50 1 W Permit Fee $ / �U CCF $ a-, Lf 0 CO/CC $ Scanning Fee $ 3 JQ Radon Fee $ _�Z • C? 5 DBPR $ a. gb Notary $ Technology Fee $ 3 • 0-0 Training/Education Fee $ (9' C"J-D Double Fee $ 0 Structural Reviews $ (Revised02/24/2014) Bond $ TOTAL FEE NOW DUE $ 113,96 Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip 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. Signatur 41&�- "�� OWNER or GENT The foregoing instrument was acknowledged before me this 9,1 day of {mCll'C 11 20 16 by i AWL45 S , who is personally known to me or who has(!roduce f'L Dl. /�OOi 3d 34*3-92 identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal 0. Citrin VSS:� — tE829921 :ES: 'JG. 23, 2016 VtNV,.r1Ar0NN0TARY.com Signature CONTRACTOR The foregoing instrument was acknowledged before me this -� r0 day off) HP l`L� 20 ) (o by s r11 �i IJ�2 , who is personally known to me or who has oduce ,-i&3e- ar-1 b<tg(090) as identification and who did take an oath. NOTARY PUB Sign: Print: av """,,,,, Seal: oo,Pav ARICELIS RODRIGUE Public - State of Florida Notary My Comm. Expires Jan 13, 2017 Commission # EE 864899 ************************************************************** APPROVED BY Plans Examiner ************ Zoning Structural Review (Revised02/24/2014) Clerk 03/31/16 12:17PH HP LASERJET FAX P.01 DATE(MMICONYYY) ,.)RE) CERTIFICATE OF LIABILITY INSURANCE 03131112016 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 SU8R0CATION IS WANED, Subject to the terms and conditions of the policy, Certain policies may require an endorsement. A otatemont on this certificate does not confer rights to the certificate holder In lieu of such endoraement(s). _ _ _ Avet� Insurance tIN4l3sr. )tt1: {305) i94 4691 ___.__._.._M,----•- I -Fad..,: 30-5 894-4694 PRODUCER NAMN1.1 —18.4.__aSti -.._.—_......_—__..,,.,.,..._.__I.t N.o�'._ �.—_._J...,......._ rnONE E-MAILavelloinsurSnCsl att net 8051 NW 36st Suite 612:._.........— _ _ ._. u ..,......—. _— RFORDINtl GDVERAGE I NAIC A floral FL 33166 EDDY MARTINEZ PLUMING SERVICES INC 11250 SW 175 ST MIAMI FL 33157 INSURERS A ....-.....,...._.,,,--....__.--- WESCO INSURANCE COMPANY THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOWATHSTANDtNG 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 REDUCEO BY PAID CLAIMS. __ . ...... - ...— 7C6DL'S17R_..-...._-_.... -----..._, _....._T...•RbL(4Y1fIrk Ppj;1"Y11IT^ i9R TYPO OF {N$UftANC! POLICY NUMBER 'O (MMrOD 1 UWTS X COMMORCIAL GENBRAL LIABILITY I i FAI:Ii OCCURRf NCI: 3 1000000 r--� F'bA�FiCE-TGAENtEIS~...-----•----..�,w,.,..--- --._ CLAIMS MADE 1 J OCCUR SAS Lik... 100000 ' G.Bi__... - I - .i..._ WPP1429806 01104/201fi ov04raa17PERSONAEaA011INJURY 5 1000000 A..._....... i _W,.-----._.W.. J ........__..... _�__- I i I - f;C1tFRAl. AC.t41FIF.(SAT£ i 3 2000000� GEN'L AGGRrGATE LIMIT APPLIES PER. POLICY i jFr �_j 10C OTHE4t: __ AUTOMOBILFL LIABILITY —1 ANY AUTO ALL 01NNE0 5CHELIULED _..j AUTOS �._� AUTOS HIRED AUTOS WNED NON-O AUTOS UMBRELLA LIAR 1 occuft EXCESSUAS CtAIMSMAOE, 0 I RETENr10N3 WO MRSCOMP£NSATION l AND EMPLOYERS' LIABILITY Y) N ANY PRrjDRIE70"ARTNER✓exC-CUTNE N 1 A OF:ICER/MEMSER EXCLUDW-) (vaodatory In NI4) If ves. cwwibe urMer ... ... _ .. _ PRODUCTS : COMP)OP AGG ; S?000000 CQMBINfD 5IN .+ . LWIT$ BODILY INJURY (Par Faison) i $ 00DILY INJURY (Por auiTerl)' S 'Pp2iFeriTv-67a4TA'0'�"`-_. : s S DESCRIP — N OP OPERATIONS) LOCATIONS I VENICLI90 (ACORD 101. AddlHo"I Remar%e Bchedufe, play pp attechotl 1T MOM space to requiraGj CFC057691 VILLAGE OF MIAMI SHORES BUILDING DEPARMF.NT 10050 NE 2 ND AVENUE: MIAMI FL 33138 ACORD 25 (2014101) S L EAI;N ACCIDENT _ S L. OISEASE - EA EMPLOYE 3 ANCI LLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POI My PROVISIONS. AUTHORIZED O MPRESENTATTVE ISBEL BASULTO ._....... 01088-2014 AC The ACORD name and logo are registered Marks of ACORD All rights reserved. 1<curDate><curTime>Work Comp Associates lac.Elissa A Lucchese 7 tCoi l " CERTIFICATE OF LIABILITY INSURANCE DATE (MMlDD/YYYY) DA0>3/31/2016 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: B the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. It SUBROGATION IS WAIVED, subject to the terns 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 endomement(s). PRODUCER Work Comp Associates, Inc. P.O. Box 33297 Palm Beach Gardens, FL 33420.3297 CWTACT Michael D. Holleman Sara (561) 863-9581 (561) 881-9745 E4'"a mail@WorkCompAssoc.com INWRERs) AifORONG COYOUWE NAlce INSURER A: BusinessFirst Insurance Company INSURED Eddy Martinez Plumbing Services Inc 11250 S.W. 175th Street Miami, FL 33157-3946 INSURER 9: DEER C: INSURER D: INSURER E: 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 CLAMS. INSR AD SUBI POLICY EFF POLICY EXP GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑ OC.CUR ❑ ❑ EACH OCCURRENCE $ $ MED EXP (Any one n $ PERSONAL 8 ADV INHIRY t GENL AGGREGATE LIMIT APPLES PER: 71 POLICY F 1 PRO LOG GENERAL AGGREGATE $ PRODUCTS - 0DW10P AGG $ $ ' AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED HIRED AUTOS NON -OWNED ❑ ❑ $ BODILY HA RY (Per Pelson) $ BODILY IN."Y (Per eccidert) $ $ S UMBRELLA lJA6 EXCESS LIAR OCCUR CLAMS -MA ❑ EACH OCCURRENCE $ AGGREGATE y DED RETENTION $ 1 $ A WORKERS COMPENSATION r r ANY PROPRETORVPARrNEFGEXECUTIV Y (Mandatory In NH) If yes, describe underEL. N ❑ N 0521131500000 8l14J2015 8l14/2016 X EL EACH ACCIDENT $ 100,0 DISEASE - EA $ 100,00 EL DISEASE - POLICY LIMB 500,00 ❑ ❑ DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, It mom specs Is required) According to DBPR, Eddy A Martinez holds the license #CFC057691 for Eddy Martinez Plumbing Service Inc CERTIFICATE HOLDER CANCELLATION City of Miami Shores Building Department 10050 N E 2nd Avenue Miami Shores Village, FL 33138-2382 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED W ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE. m 19811a2010 ACORD CORPORATION. All rights reserved. AOOFID 25 (2010/05) The ACORD name and logo are registered marks of ACORD i +IVIi i•71 'L,�J 1�3a 3' AA 71.+t� ti s�Vd',- .�{L Y �{�14�! .: *4 � �Bi%$Ih1E,�„S NA1111F/!_OCit�L�f7ON �, � ,a. R�CEIP,..1�'-'tAl��� �R y � r: •=2��y�,ii i'I��"�7 ! D y"1UI 2 n q , , RTIN (T�{�yt[� ca s c + VI ER""3@" iQ airy '1'� qYt/ § S ,p y .p'TO �Q iip ` ,• + F t � ���.. i� �}�[ �/p� S � /{�. ��.�/ .t1u• N EII9 1 1+ I�y.W.al. i.+ ��; _•...i <��ti4tt•Titi3Ei157,� � +w �3 �Fi�,it'Gl4ea ; :t'.a`�� ^3��,,""•e,'� ,� t�1��tck � a^,�5, ',+-�p�c.`a �•i�`FSUant`i�Y �„N UI�e t,G }' a,.. Jli 4,q: t i ASL 8� 0 Z �'..+^•-�',w„.,��'�� 4 -a;, SEC E OF 'Ii96 'L (11181NG 1'fi�CtOli t?AYM 'RECEt „a �MARIINEZ PLUMB[ iY VICES `, , �4 `' r TAX " LLEt: jiSllE . CFC05769 "' 4', g _`.�.a� rt Wortiirt '1 y+` - tj75.00 a /16/ D15M �! ,� si r,,,,' ." •' REDITARD-1 1119 f` t Bust ;aecetpt d 11lnepfirmsBusine Tex The R 1 is not a s nse a ttiar certtidafron fthelto et alificatx6ns,to d65sui' Nold widieny aleml �ogt►v rementetreg�latory Is�r srequireme�ts'`iti�iicfi apj► � to the 6a�itteas. t.�,, ��. The �iECEII NO. e6o must be diiaplayed an all r�q ttarcie! vihTcles — Mlgtiii d.� otle Sii. 8e—M 1<curDate><curTime>Work Comp Associates Inc.Elissa A Lucchese Work Comp Associates, Inc. Florida's Premier Source for Workers' Compensation Coverage & Information March 31, 2016 City of Miami Shores Building Department sent via: Fax 10050 N E 2nd Avenue Miami Shores Village, FL 33138-2382 RE: Eddy Martinez Plumbing Services Inc Certificate of Insurance Dear City of Miami Shores Building Department: As you requested, we have issued a certificate of insurance for the above insured with your company listed as the certificate holder. If you have any questions or if you wish for the certificate of insurance to be modified in any way, please call us at 1-800-258-9581. Thank you for your attention to this matter. Respectfully, Elissa A. Lucchese Customer Service Manager EAL:cg Attachment: Certificate of Insurance (See attached file: COI.pdf) Mailing Address: P.O. Box 33297, Palm Beach Gardens, FL 33420-3297 Tel. #561-863-9581 Physical Address: 9250 Alternate AlA, Suite A, Lake Park, FL 33403 Fax. #561-881-9745 Miami Shores Village .. .. _ • •_ r R E P:-. , B�uilding-Department S�� -dIvc- 10650 N.E.2nd Avenue, Miami Shores, Florida 33138 FEB 11 ZOi9 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 BUILDING PERMIT APPLICATION [:]BUILDING; ❑ ELECTRIC ❑ ROOFING FBC 20,1-4 - - Master Permit No.-_2 C �' 2 Sub Permit No. ❑ REVISION ❑ EXTENSION ❑ RENEWAL PLUMBING PUBLIC WORKS ❑MECHANICAL ❑ ❑CHNGE OF ❑CANCELLATION ❑SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 548 Grand Concourse rCity: Miami Shores. + �� r {.• County:, -Miami Dade Zip " a t # .11-3206-017-14,10 Folio/Parcel#:; , r a .1 'is the Building Historically Desigriafid: Yes NO,; Occupancy Type:: Load:, , i Construction Type: '-± Flood Zone k a BFE OWNER: Name (Fee Simple Titleholder): Grand Concourse Trust Phone#: 305-299-'5311 Address:. - 548 Grand Concourse city: Miami Shores State: ' FL 33138 ' Zip: Tenant/Lessee Name: ' r, Phone#: Email: ttorres@t2-group.com CONTRACTOR: Company Name: HOD-1 M,147/yEZ )0b,,n6,•44 Serv�cc Phone#: Address: City: Mi ti m, State: f-41 Zi p 3 3 /S 9 Qualifier Name: Ep y r11 *4T/-✓t•Z. " � Phone#: i oSi-3J.S- Ka / �f State ^Certification or Registrati6n #: C fC O % if _7 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: _ Address: City: State: Zi Value of Work for this Permit: $ D0 6 r Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace El Demolition Description of Work: A . , , ,`�(b Ize ,10 a �� � �� 2 � k. Y- �+�G a :... •n1'Y. ,_t' ,; ,•Yt'` ``.t`'L+e�.i y''ywy 0.v.HA r',.xnM, Specify color of color thru tile:_ Submittal Fee $ Permit Fee $ . CCF $ CO/CG$' Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ - Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ 1 G r �� (Revised02/24/2014) Bonding Company's Name (if applicable) Bonding Company's Address -F City ' State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Addres's w 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'sfandards 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_,— r , 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. IiF 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 $2506, 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. SignaiturU Signature M r - - OWNER or AGEN _ CONTRACTOR The fgr. going instrument was acknowledged before -me this The foregoing instrument was acknowledged before me this � day of i' � 20 by' l _ day1of - : � C L+ 20 f A5�n*n Pss - who s personally known t �Jr dr "� T7� who is personally known f me or who has produced ` ` as me or who has produced , identification and who did take an oath. _ identification and'who did take an oath. NOTARY PUBLIC: - `i' J NOTARY PUBLIC: A I / Ino. �•1�1��i���W�Ir" 1M APPROVED BY �g Plans Examiner Zoning . Structural Review Clerk (Revised02/24/2014) i Licensed OVER 35 YEARS OF EXPERIENCE Insured Precis!-�"�n Gee Service, Inc. Installation and Service of LP and Natural Gas Equipment Industrial - Commercial - Residential 786-205-3558 2160 S.W.143 Place, Miami, Florida 33175 305-297-0943 This letter is to certify that on, ..'- i- % i a drop test was performed with a manometer. All appliance connections and house lines were drop tested. Results were as follows: Lock Up Pressure Line: _ 7 Lock Up pressure Equipment: � 7 At 'address: 331.38 , P.residf`nt anal -Owner, Roberto Garcia, %' n /-/- License# 21151 01 " ''�S X � "; /'-) 'M�T. PEREZ MY COMMISSION # GG 127202 �'Fo,o" EXPIRES. July 23, 2021 j