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RC-10-1753Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 156864 Permit Number: RC -10 -10 -1753 Scheduled Inspection Date: March 21, 2011 Inspector: Bruhn, Norman Owner: SANCHEZ, ISRAEL Job Address: 375 GRAND CONCOURSE Project: Miami Shores, FL <NONE> Contractor: HOME OWNER Permit Type: Residential Construction Inspection Type: Final Work Classification: Alteration Phone Number (305)757 -5247 Parcel Number 1132060135940 Building Department Comments REMOVE AND REPLACE NEW KITCHEN AND 2 BATHROOMS. Passed 44,2‘zil Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments March 18, 2011 For Inspections please call: (305)762 -4949 Page 31 of 37 March 6 2011 Miami Shores Building Department c/o Miami Shores Village Hall 10050 NE 2nd Avenue Miami Shores, FL 33138 Re: 375 Grand Concourse, Miami Shores, FL 33138 (the "Property") Dear Sir or Madam: I am a duly certified engineer in the State of Florida. At your request, I inspected the framing, drywall and insulation work (the "Subject Work ") performed at the above referenced Property in connection with the remodeling of the same pursuant to the architectural drawings approved by the Miami Shores Building Department in November 2011 (the "Approved Plans "). I hereby confirm that the Subject Work complies with applicable requirements of the 2007 Florida Building Code (as supplemented) and the Approved Plans. Sincerely, By Name: Gonzalo A. P : PE #60734 Title: Structural Engineer MAR 1 State of Florida County of Miami -Dade The foregoing instrument was acknowledged before me this day of , 2011, by , who is personally known to me or has produced as identification. , Notary Public Name: Commission No.: MIA 181,755,543v13 -8-11 1 1 Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Applicant 375 GRAND CONCOURSE Miami Shores, FL 1132060135940 Block: Lot: ISRAEL SANCHEZ Owner Information Address Phone Cell ISRAEL SANCHEZ 375 GRAND CONCOURSE MIAMI SHORES FL 33138 -2746 (305)757 -5247 (786)253 -6004 Contractor(s) HOME OWNER Phone Cell Phone Valuation: Total Sq Feet: $ 25,000.00 200 1 Approved: In Review Comments: Date Approved: : In Review Date Denied: Type of Construction: KITCHEN AND BATH REMODEL Stories: Front Setback: Left Setback: Bedrooms: Plans Submitted: Yes Certificate Date: _Bond Return : Occupancy: Single Family Exterior: Rear Setback: Right Setback: Bathrooms: Certificate Status: Additional Info: Classification: Residential Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $15.00 $11.25 $11.25 $5.00 $750.00 $30.00 $20.00 $842.50 Pay Date Pay Type Invoice # RC -10 -10 -39061 11/23/2010 Check #: 1755 10/04/2010 Credit Card Amt Paid Amt Due $ 692.50 $ 150.00 $ 150.00 $ 0.00 Available Inspections: Inspection Type: Final PE Certification Shutter Final Window Door Attachment Tie Beam Slab Termite Letter Framing Insulation Drywall Screw Shutter Attachment Window and Door Buck Ceiling Grid Fill Cells Columns Declaration of Use 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 foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated. November 23, 2010 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date November 23, 2010 1 PERMIT # RESUBMITAL DATES: PROJECT TYPE: STRUCTURAL ELECTRICAL FIRE IMPACT FEES HRS /DERM PLUMBING Q`0\6 MECHANICAL 611, D' 6 NOC BLDElv O 1611'6110- rieAcfre -71'10-S13- 027 Miami Shores Village Building Department RZaZIM3B OCT 1 2 2010 BY:. ' ..............a..... 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax; (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING Permit No.120 10 PERMIT APPLICATION Master Permit No. FBC 20 Permit Type: BUILDING OWNER: Name (Fee Simple T itleholder) R A L S ,L H E Phone #: 7 gip- 25 J -6 Address: 375712. 1 J) ( ©NCO()rSF City: /PAM / 549 State: f / Oi � Zip: ,--13 y Tenant/Lessee Name: Phone #: Email: _ S /9NCH Z / /nig f © coy JOB ADDRESS: 375 5 Gf?/9 A,/., CJ/V C'yarzs e City: Miami Shores County: Miami Dade Zip: 33 LI Folio/Parcel #: Is the Building Historically Designated: Yes NO ,( Flood Zone: CONTRACTOR: Company Name: Ozwu & . / &I /deZ, Phone #: Address: City: State: Zip: Qualifier Name: Phone #: State Certification or Registration #: Certificate of Competency #: Contact Phone #: Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ ptiJ) O Square/Linear Footage of Work: Type of Work: OAddress DAlteration New DRepair/Replace ODemolition Description of Work: FOR Y-ef GCe) Ma fr-cL4o'vJ cud loatkrochens. OR THROUGH ROOF TILE IS REQUIRED acknowledged by: *********************************** ****Fees****** * *** ****** ** : ** ******** ******w***** *** Submittal Fee $ 1'1)" Permit Fee $ 2S CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ (09 2" 50 Bonding Company's Name (if applicable) Bonding Company's Address City State j Zip Mortgage Lender's Name (if applicable) (),.1; (v/ Mortgage Lender's Address / g f ' Pao c City L0 :Clamped), ed), State Afit/ Zip / l 1010 4 46. ail cOe 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 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 b approved and a reinspe tion fee will be charged. Sign re %a ' � ° => Signature Owner o Contractor The fo o .wled ed f•re m his 109--J The foregoing instrument was acknowledged before me this day of , by Y�1a 1 1 1 L^' `� , day of , 20 by who is per s nally known t. i. e or who has produced L who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: NOTAR Sign: •�u — �.� /� �� Sign: Print: jy, �'�' Print: tification and who did take an oath. My Commission Expires: APPROVED BY r Aiatio My Commission Expires: Plans Examiner Zoning Structural Review Clerk (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)(rev6 /4/10) Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 OWNER BUILDER DISCLOSURE STATEMENT NAME: --15696 L Sri &di e7 DATE: / ADDRESS: 3 75 £I ? M ) G A ) c o o f f/ M/ 5t10 S, Tt 334 Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, F.S 489.103(7). And I have read and understood the following disclosure statement, which entitles me to work as my own contractor; I further understand that I as the owner must appear in person to complete all applications. State Law requires construction to be done by a licensed contractor. You have applied for a permit under an exception to the law. The exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license: You must supervise the construction yourself. You may build or improve a one - family or two- family residence. You may also build or improve a commercial building at.a cost of $25,000.00 or less (The new form states 75,000). The building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the construction is complete, the law will presume that you built for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as a contractor. It is your 'r responsibility to make sure the people employed by you have licenses required by state law and by county or municipal licensing ordinances. Any person working on your building who is not licensed must work under your supervision and must be employed by you, which means that you must deduct F.I.C.A and with- holdings tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances, buildings codes and zoning regulations. Please read and initial each paragraph. 1. I understand that state law requires construction to be done by a licensed contractor and have applied for an owner - builder permit under an exemption from the law. The exemption specifies that I, as the owner of the property listed, may act as m own contractor with certain restrictions even though I do not have a license. 2. I understand that building permits are not required to be signed by a property owner unless he or she is respons construction and is not hiring a licensed contractor to assume responsibility. the 3. I understand that, as an owner builder, I am the responsible party of record on a permit. I understand that I may protect myself from potential financial risk by hiring a licensed contractor and having the permit filed in his or her name instea. ' u own name. I also understand that the contractor is required by law to be licensed in Florida and to list his on permits and contracts. 4. I understand that I may build or improve a one family or two- family residence or a farm outbuilding. I may also build or improve a commercial building if the costs do not exceed $75,000. The building or residence must be for my use or occupancy. It may not be built or substantially improved for sale or lease. If a building or residence that I have built or substantially improved myself is sold or leased within 1 year after the construction is complete, the law will presume that I b .tan :Ily improved it for sale or lease, which violates the exemption. 5. I understand that, as the owner- builder, I must provide direct, onsite supervision of the construction. 6. I understand that I may not hire an unlicensed person to act as my contractor or to supervise persons working on my building or residence. It is my responsibility to ensure that the persons whom I employ have the license required by law and by county or municipal ordinance. 7. I understand that it is frequent practices of unlicensed persons to have the property owner obtain an owner - builder permit that erroneously implies that the property owner is providing his or her own labor and materials. I, as an owner - builder, may be held liable and subjected to serious financial risk for any injuries sustained by an unlicensed person or his or employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an owner - builder and am aware of the limits of my insurance coverage for injuries to workers on my property. 8. I understand that I may not delegate the responsibility for supervising work to be a licensed contractor who is not licenses to perform the work being done. Any person working on my building who is not licensed must work under my direct supervision and must be employed by me, which means that I must comply with laws requiring the withholding of federal income tax and social security contributions under the Federal Insurance Contributions Act (FICA) and must provide workers compensation for the employee. I understand that my failure to follow these may subject to serious financial risk. 9. I agree that, as the party legally and financially responsible for this proposed Construction activity, I will abide by all applicable laws and requirement that govem owner - builders as well as employers. I also understand that the Construction must comply with all applicable laws, ordinances, building codes, and zoning regulations. niti 10. I understand that I may obtain more information regarding my obligations as an employer from the Internal Revenue Service, the United States Small Business Administration, and the Florida Department of Revenues. I also understand that I may contact the Florida Construction Industry Licensing Board at 850.487.1395 or http ; / /www.myftoridalicense.com /dbpr /pro /cilb /i Ini at c /j 11. I am aware of, and consent to; an owner - builder building permit applied for in my name and understands that I am the party legally and financially responsible for the proposed construction activity at the following address: 12. I agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the inform have provided on this disclosure. Licensed contractors are regulated by laws designed to protect the public. If you contract with a person who does not have a license, the Constr4uction Industry Licensing Board and Department of Business and Professional Regulation may be unable to assist you with any financial loss that you sustain as a result of contractor may be in civil court. It is also important for you to understand that, if an unlicensed contractor or employee of an individual or firm is injured while working on your property, you may be held liable for damages. If you obtain an owner - builder permit and wish to hire a licensed contractor, you will be responsible for verifying whether the contractor is properly licensed and the status of the contractor's workers compensation coverage. Before a building permit can be issued, this disclosure statement must be completed and signed by the property owner and retumed to the local permitting agency responsible for issuing the permit. A copy of the property owners driver license, the notarized signature of the property owner, or other type of verification acceptable to the local permitting agency is required when the permit is issued. Was acknowledged before me this 1 L day of 20) By \SYtJ baUC.i,15who was personally known to me or who has 0(06-1 L'24)* Produced there License or I oe._, as identification. NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO W1O 3 TAX FOUO NO. 11 -3206 -'00 - 59110 STATE I HEREO, original fi STATE OF FLORIDA: COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to cert J property, and in accordance with Chapter 713, Florida Statutes, the following inforiin is provided in this Notice of Commencement. Sy 1. Legal description of property and street/address: 2. Description of improvement: 111110 11111 11111 11111 11111 1111111111 11111111 CFN 2010R0693189 1 693189 IIJR Bk 27452 F's 255 (1.P9) RECORDED 10/13/2010 12.35 :53 HARVEY RUVINn CLERK OF COURT I`1IANI —C'ADE COUNTY? FLORIDA LAST F'AGE FLORIDA, CER FY Ma r o is OUNliYC .is • true r A020 Space above reserved for use of recording office /08 / M77ri1F4' 4AJD MW f F4I /2f'J -- 375 C 9uD CrAieznit9E 3. Owners) name and address: Interest in property: ()h.�,1'W 1 %' ft Name and address of fee simple titleholder. F./._1 •• .99/Lj/'i�e't7 375 4. Contractor's name, address and phone number: �j0A4c, /..Z1.1 5. Surety: (Payment bond required by owner from contractor, if any) Name, address and phone number: V/j Amount of bond $ AJ ffj 6. Lender's name and address: 449 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. 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)(b), Florida Statutes. Name, address and phone number. 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless 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 CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Signature(s) of Owner(s) or Owner(s)' Authorized Prepared By23169 i 309tt /e Print Name- 7SO9Mf.iS►'. Title /Office Q '7eI' STATE OF FLORIDA COUNTY OF AMI -D E The f • •J1. -, i strum NI Individually, ore a ❑ Personally known, or edged before me this 1 au day of (k/11-detri for produced the following type of identificati 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. -2111 Lwroforiavimito 1 ►1'1;'1 /!Ili /111IGJ�i�R[G'R't�a�t?��f a, 4'71' Signatur: Owner(s) o + �' 's Autho • ed Officer/Director/Partner /Manager who signed above Xf 1.1" " `gyp BotiV .3 TiTgo rT By /�`1 > r / _ .1 %. By ofw-gc iU.. Lht.. 123.01 -52 PAGE 3 3710 CFN 2010R0693188 OR f111111l111{ 1111111111113 11111111111111111111 RECORDED 10/13/2010 12 :35:53 HARVEY ROY. b OF CO RTI, MIAMI -DADE COUNTY: FLORIDA This instrument prepared by or under the supervision of .a (and after recording should be returned to): Name: Israel I. Sanchez, Esquire Address: Greenberg, Traurig, P.A. 1221 Brickell Avenue, Miami, Florida 33131 e Reserved for Clerk of Court) NOTICE OF TERMINATION OF NOTICE OF COMMENCEMENT BEFORE ME, the undersigned authority, this day personally appeared ISRAEL I. SANCHEZ, after being duly sworn on oath, deposes and says as follows: THE UNDERSIGNED hereby informs all concerned that the following information is in accordance with Section 713.132, Florida Statutes. 1. Description of Property: LOT 1 and the NORTHEASTERLY 1/2 OF LOT 2, BLOCK 44, AMENDED PLAT OF MIAMI SHORES SECTION NO. 1, according to the Map or Plat thereof, as recorded in Plat Book 10, Page 70, of the Public Records of Miami -Dade County, Florida a /k /a 375 GRAND CONCOURSE, MIAMI SHORES, FLORIDA 33138. 2. General description of improvements:Kitchen and Bathroom Remodel 3. Owners: Information: (a) Owner's Name and Address: Israel I. Sanchez, 375 Grand Concourse Miami Shores, Florida 33138 (b) Owner's Interest in Site of the Improvements: Fee Simple (c) Name and Address of Fee Simple Titleholder (if other than Owner):N /A 4. Contractors' Name and Address [the "Contractor "): Franque & Denis Construction, 13727 SW 152 Street, Suite 369, Miami, Florida 33177 5. Surety: N/A 6. Lender: N/A 7. Name and address of person within the State of Florida designated by the owner as person upon whom notices or other documents may be served as provided by Florida Statute Section 713.13(1)(a)(7): Franque & Denis Construction, 13727 SW 152 Street, Suite 369, Miami, Florida 33177 8. The owner has designated the following person in addition to himself, to receive a copy of the lienor's notice as provided in Section 713.13(1)(b) of the Florida Statutes: None 9. The Notices of Commencement provided: "Expiration date of Notice of Commencement (the expiration date is 1 year from the date of recording unless a different date is specified) ". The expiration date specified was one year from date of recording. 10. The Notice of Commencement was recorded on October 4, 2010; in O.R Book 27441, Page 3928, of the Public Records of Miami -Dade County, Florida. 11. The Notice of Commencement is hereby terminated. 12. This Notice of Termination applies to all the real property subject to the Notice of Commencement. 13. Prior to recording this Notice of Termination, the Contractor BOOK 27452 PAGE 2554 LAST PAGE referenced herein has been given a copy of this Notice of Termination. All lienors have been paid in full. No lienors have given notice to Owner. Witnessed By: STATE OF F7600/1 COUNTY OF -11,9Af j - /)" Israel I. San This instrument was sworn to and acknowl day of October, 2010 by Israel I. Sanchez, who is•er ,..ed„ c Name: (Notary d before me this on lly nown to me or- NOTARYPUBLIC - STATE OF • • DA Jeffrey Tenen Commission #DD636220 ,,;,..•/'' Expires: FEB. 07, 2011 BONI= MAUATIANTICBONDINGCO.,INC. STATE OF FLORIDA, COUN1 OF DADS 1 HEREBY C TIFY That thls is e y of the original fi °d( i iS r `.rr�:'► of AD20 WIVE R' -ty hand and ( e31. HARVEY RUVIN, CLERr, of Cif ; d Courts By / D.C. Permit No: 10 -1753 Job Name: October 18, 2010 Miami Shores Village Building Depart Building Critique Sheet ent 10050 N.E.2nd venue Miami Shores, Florid- 33138 Tel: (305) 7 5.2204 Fax: (305) 7'6.8972 Page 1 of 1 Corrections for electrical and plumbing must be completed. 2) Permit applications for chanical, electrical and roof repair must be submitted. 3) Identify the level of alteration per the FBC Ex. '4j Identify all interior bearing walls in the house. 5) Provide energy calculations. Plan review is not complete, when all items above are corrected, we will do a complete pl - n review. If any sheets are voided, remove them from the plans and replace with new revised shee s and include one set of voided sheets in the re- submittal drawings. Norman Bruhn CBO 305 - 795 -2204 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. Pc /0- (-7s--.) Job Name PLUMBING CRITIQUE SHEET A%€01 i9Lc' /ex — 10/19/2010 10:51 FAX 1 800 685 7530 DATA SCAN FIELD SERVICES IZ 001 * * * * * * * * * * * * * * * * * * * ** * ** TX REPORT * ** * * * * * * * * * * * * * * * * * * * ** TRANSMISSION OK TX /RX NO 0684 RECIPIENT ADDRESS 97865130287 DESTINATION ID ST. TIME 10/19 10:49 TIME USE 01'16 PAGES SENT 4 RESULT OK 41 al Permit No: 10 -1753 Job Name: October 18, 2010 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1: of 1 Building Critique Sheet 1) Corrections for electrical and plumbing must be completed. 2) Permit applications for Mechanical, electrical and roof repair must be submitted. 3) Identify the level of alteration per the FBC Ex. 4) Identify all interior bearing walls in the house. 5) Provide energy calculations. Plan review is not complete, when all items above are corrected, we will do a complete pl ;n review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Norman Bruhn CBO 305 - 795 -2204 FAX 1X - 513 - b2 7 10/19/2010 14:05 FAX 1 800 685 7530 DATA SCAN FIELD SERVICES * * * * * * * * * * * * * * * * * * * ** * ** TX REPORT * ** * * * * * * * * * * * * * * * * * * * ** TRANSMISSION OK TX /RX NO 0686 RECIPIENT ADDRESS 97865130287 DESTINATION ID ST. TIME 10/19 14:04 TIME USE 01'17 PAGES SENT 4 RESULT OK Permit No: 10 -1753 Job Name: October 18, 2010 Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1of1 Building Critique Sheet 1) Corrections for electrical and plumbing must be completed. 2) Permit applications for Mechanical, electrical and roof repair must be submitted. 3) Identify the level of alteration per the FBC Ex. 4) Identify all interior bearing walls in the house. 5) Provide energy calculations. Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Norman Bruhn CBO 305 - 795 -2204 Aix ; fz g --5I 3- b22 -g-1 l� Permit No: 10 -1753 Job Name: October 18, 2010 Miami Shores Village Building Department Building Critique Sheet 10050 N.E.2nd venue Miami Shores, Florid 33138 Tel: (305) 7 5.2204 Fax: (305) 7 6.8972 Page 1 1) Corrections for electrical and plumbing must be completed. 2) Permit applications for Mechanical, electrical and roof repair must be submitted. 3) Identify the level of alteration per the FBC Ex. 4) Identify all interior bearing walls in the house. 5) Provide energy calculations. of 1 Plan review is not complete, when all items above are corrected, we will do a complete pl n review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Norman Bruhn CBO 305 - 795 -2204 BUILDING.._ PERMIT FBC 20 Perm Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 IN ECTIO 5) 795.2204 Fax: (305) 756.8972 PHONE NUMBER: (305)k/62:4949 ® 4 , _v i W .��IL'PI imple Ti - I older): r t S rem . Phone #:7 %v- 2 G.cWa{ State: OWNER: Nam Address: 375" City: 4 t& PH �herTes B -CTT -0_. 2010 is Permit-No. C° l 0 Master Permit No. Zip: 1-5 L3g Tenant/Lessee Name. Phone #: Email: y iSawCke L. o I JOB ADDRESS: 3 1'S C-br Cie City: Miami Shores County: Miami Dade Zip: '3 S t3 e Folio/Parcel #: it -3206 - 0 r 3- 5 p'4th Is the Building Historically Designated: Yes NO X Flood Zone: CONTRACTOR: Company Name: rah (IC. 4 DeluZ5 4.4a014,571A4Sireid Phone #: 3425-*".N01,3-11344 t Address) 421 14.-p 1 '51-, -r rrarr is 4e' 'et, ¢ig',3 C f City: Amu.; ` State:. P . Qualifier Name: re At IJ . r1,2 it State Certification or Registration #: l- 4 c, ,1f l 7 6 Cif Certificate of Competency #: Contact Phone#: °301.3 -Q 3� Q Email Address: Fir `� S� ®� DESIGNER: Architect/Engineer: 412 *L.", . a `' Zip: Phone#:', 2.,a417341 k 00 Value of Work for ;this Permit:? 5, Square/Linear Type of Work: °Address` '? gAlteration °New Description of -Work: '24.4.....i. ? Row,. Ito COLOR THROUGH ROOF TILE IS REQUIRED a °Demolition ;ie.. idl _) ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** sr `':** * * * * * *,r * * * * * * * * ** Submittal Fee $ IW Permit Fee $ °lie F $ CO /CC $ Pail) 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 kVA - State Zip Mortgage Lender's Name (if applicable) ) /( Mortgage Lender's Address City State ``` Zip i Application is hereby made to obtain a permit to do the work and installationsnasIndicated. 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 hi 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 $25,,00, 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 rec otice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the buildin issued. In the absence o _ -ch posted notice, the inspection will not be approved and a reinspection fee will be charged. Own lirr Agent The foregoing instrument was acknowledged before me day of oG- .,20i0,by who is personally known to me or who has produced As identification and *ho did tak NOTARY PUBLIC: Sign: 1 "` Print: My Commission Expires: ontractor as acknowledged before me this2-% 20 ICS byN , is personally known to me or who has produced 31 as identification and who did take an oath. APPROVED BY ''''V'' ''' MARY E. RUTHERFORD My (ft Notary Pak • State of Florida • g" *Commission Ewe May 10, 2011 „cqmil A DD 672841 Plans Examiner Structural Review (Revised 07 /10 /07XRevised 06 /10 /2009)(Revised 3/15/09Xrev6/4/10) ommission Expires: *********** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Zoning Clerk ONS RUCTION Oetober8,2010 Miami Shores Village Building Department 10050 ME. 2" Avenue Miami Shores, FL 33138 E: Change ftiConttaetor for 375 Grand FE g W3 Et OCT 1 2 2010 , oes, FL 31138 Dear Sir or Madam: Franque & Denis Construotion will no longer be the geneMi etletteeter for the reodeUng w at hIr. Israel Sanchez residence located at 375 Otand Concourse, Miami Shores, FL 331t Mr. Sanchez has elecux1 to act as his own contractor and obtain an owner/builder pemt drawin re ee tba` ateot hardvet41 please transfer andicor oredh Mr. Sanchez with modeli ng prol s Thank you. 'eet , paid in respect of the projet. anY ate on By Nam: Denis Title: President 4 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION FORM ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED OR THE VILLAGE MAY MAINTAIN A FILE WITH YOUR INFORMATION FOR A $30.00 FEE PER YEAR. IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. 1 COPY OF QUALIFIER'S STATE LIC CARD B. ✓ COPY OF LOCAL BUSINESS TAX RECEIPT C. ✓ COPY OF LIABILITY INSURANCE (CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPT) D. VO COPY OF WORKERS COMPENSATION (EITHER CERTIFICATE OR EXCEMPTION) +� IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT C. COPY OF LIABILITY INSURACE (CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKER COMP INSURANCE (EITHER CERTIFICATE OR EXEMPTION) YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 COMPLETE CONTRACTOR'S INFORMATION BUSINESS NAME: i- I U( 4 Die& e o•��ifLUCT cwt BUSINESS ADDRESS: ( 3121 l v 2 1i2 k 1 CITY Lae w.: STATE 1— L- ZIP CODE 3,.J 1- BUSINESS PHONE: (° ) 9c11--72,61 FAX NUMBER ( ) 5 i`b - 6ze CELL PHONE (3o5 ) 32:3 -33'( ( QUALIFIER'S NAME: 1- 121 rot. r kG41. . QUALIFIER'S LIC NUMBER: CGC I iSt 5�i E -MAIL ADDRESS (IF APPLICABLE): ircu► FD cc/0 VT. CCM - Created on 3119/09 BY MLDV I RV 3126109 MLDV CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDJYYYY) OP ID LB FBANQ -1 09/03/10 PRODUCER Atlantic Pacific - Stuart 620 SE Central Parkway Stuart FL 34994 Phone:772- 223 -0400 Fax:772- 223 -1919 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED Franque and Denis Construction DBA rranque and Denis construe 13727 SW-152 St Suite #369 Miami. PL 33177 INSURERA Mid- Continent Casualty Co 23418 INSURER B: INSURER C: INSURER D: INSURER E: COVERAGES 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 Pitt IAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 1 LTR NSRO TYPE OF INS UANCE POLICY NURSER E MM0DIVYYYj POLICY EXPIRATION D(RA0DwyY LIMITS A GENERAL LIABIUN COMMERCIAL GENERAL LIABILITY 04 -GL- 000787454 12/31/09 / 12/31/10 EACH OCCURRENCE $ 1,000,000 X POISES {Rnce) $ 100,000 CLAIMS MADE X OCCUR MED EXP (Any ono person) $ excluded PERSONAL & ADV INJURY $ 1, 000 , 00 0 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMB APPLIES PER: POLICY n P& n LOC PRODUCTS - COMP /OP AGG $2,000,000 n AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCI-EDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS 1 UMBRELLA LIABRRY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ $ WORKERS AND EMPLOYERS' ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER (Mandatory If yes, describe SPECIAL COMPENSATION LIABILITY Y 1 N WC MAW- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ In NH) under PROVISIONS below E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS contractors - executive supervisor CERTIFICATE HOLDER CANCELLATION City of Miami Shores Building & Zoning 10050 NE 2nd Ave Miami Shores 8Z 33132 M AMISH SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER VWI_L ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. RIa�.1 RE ICT A u O� �,� ACORD 25 (2009101) M11988-2009 ACORD CORPORATION. AU rights reserved. The ACORD name and logo are registered marks of ACORD r IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2009101) STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 MUM FRRAA US'& DENIS CONSTRUCTION LLC 144182 SW 172ND LANE MIAMI FL 33177 -6625 Comgratulaiions! 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 fmd more information about our divisions and the regulations that impact you, department newsletters and team more about the Department's inifiatives. Our mission at the Department Is: License Effichently, Regulate Fairly. We Thank �n for doing business anda, and congratulations your new licenser DETACH HERE (850) 487 -1395 04 -26 -2010 ALEX s(RK STATE OF FLORIDA CHEFRNMWMALMRCER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXRIPT. FROM FLORIDA WORKERS' COMPENSATION LAW * * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE 04/26/2010 EXPIRATION DATE 04/25/2012 , PERSON: FRANQUE FRANK FEB* 800513804 BUSINESS NAME AND ADDRESS: FRANC=E & DENIS CONSTRUCTION LLC 14482 Sid 172 LANE MIAMI FL 33177 SCOPES OF BUSINESS OR TRADE 1- GENERAL CONTRACTOR 2- CONSTRUCTION MANAGEMENT IMPORTANT: Pursuant to Chapter 440 . 05114 F.S., an officer of a corporation cafe elects exemption from this chapter by film a certificate at election eater this section may not recover benefits at carupensation eider this chapter. Pursuant to Chapter 440.05(12). F.S., Certificates of Mediae to be exempt.. apply cell within the scope of the business or trade listed an the notice of election to be exempt Pursuant 10 Chaplar 440.05(13} F.S., Notices at election 10 be exert ad certificates et eloet(en to be exempt shall be sahject to revocattoa 1f. at any time after the filing of the oaks er tbe issuance at the certificate, the person named on the notice at certificate as langur seem the requirements af this section for issuance of a certificate. The departmert shall revoke a certificate at any time for failure of the person sated n the certificate to meet the regafrements of this sewn. DWC- 252 CE RTIRCATE OF ELECTION TO BE EXEMPT REVISED 09 -08 QUESTIONS? (850) 413 -1609 ALEX SINK STATE OF FLORIDA cWEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * TE OF BLECTION TO BE EXEMPT FROM FLORIDA WOIIKERW COMPENSATION LAW CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. 04 -26 -2010 EFFECTIVE DATE PERSON: FEIN: 04/28/2010 EXPIRATION DATE 04125/2012 t DENIS MARIO 800513804 BUSINESS NAME AND ADDRESS: FRAM 1JE & DENIS CONSTRUCTION LLC 13727 Sod 452ND ST STE 369 NXAMX FL 33177 SCOPES OF BUSINESS OR TRADE 1- GENERAL CONTRACTOR 2- CONSTRUCTION MANAGEMENT IMPORTANT: Pursuant m Chapter 440 . 05(14). F.S., on officer of a cusporetin eta elects exemption from this chapter by filing a certificate of election coder this section may not recover benefits er compensation ender this chapter. Pursont to Chapter 440.05(12). F.S., Certificates al election to be exempt.. apply Daly WOMB the scope of the basing ar trade listed on the notice of election to be exec. Pursuant to Chapter 440.05(18! F.S.„ Notices 01 election to be exempt and certtficates of Martian to be exempt shall be subject to revocation if, at any lime alter the filing of the nitre ar the issuance of the cert5icate, the person named n the melee or certificate to tenger meets the requirements of this section tar issuance of a certificate. The department sate a revoke a certificate at any time for falba: of the person flamed an the certificate to meet the requirements of this secttoo. QUESTIONS? DISH 413 -1603 14486 Si': MAW -e4 MIAMI DADE COUNTY I TAX COLLECTOR 140 W. FLAGLER ST. 1st FLOOR MIAMI, FL33130 2010 LOCAL BUSINESS TAX RECEIPT 2011 FIRST -CLASS MIAMI -DADE COUNTY - STATE OF FLORIDA U.S. POSTAGE j EXPIRES SEPT. 30, 2011 PAID MUST BE DISPLAYED AT PLACE OF BUSINESS MIAMI, FL PURSUANT TO COUNTY CODE CHAPTER IIA - ART. 9 & 10 PERMIT IIO. 231 663631 -1 BUSINESS NAME / LOCATION FRANQUE AND DENIS CONSTRUCTION 14482 SW 172 LN 33177 UNIN DADE COUNTY THIS IS NOT A BILL — DO NOT PAY RENEWAL RECEIPT No. 690702 -7 STATE* C6C1518504. OWNER FRANQUE & DENIS CONSTRUCTION LLC See. Type of Business WORKER /S This 15 120A igtERAL BUILDING CONTRACTOR 1 TAX A &L E DOES HOT VIOLA E THE HOLDER MMHG TO VIOLATE OR ZONING LAWS OF THE DO NOT FORWARD COMP( OR CITIES. NOR DOES R EXEMPT THE HOLDER POW OR AMY OTHER REQUIRED SY LAW. THIS IS HOT A CERTIFICATM OF FRANQUE AND DENIS CONSTRUCTION __ FRANK FRANQUE 13727 SW 152 ST I A PAYMENT rTAX MIAMI FL 33177 cau. rox 07/20/2010 60020000327 000075.00 SEE OTHER SIDE 1.11.IILI,ML.A.huILAHLAWL huty 1 Frank Franque Frank Franque President Address:13727 SW 152 ST Miami FL, 33177 Suite #369 Off : (786)397.7861. Fax (786)513.0287. Cell (305) 323.834t Web Site: www.fdconst.com frank0,fdconst.com !CONSTRUCTION IZRANQUE &DENIS' Permit No: 10 -1753 Job Name: November 8, 2010 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Building Critique Sheet 2nd Page 1 of 1 1) Permit applications for Mechanical must be submitted. Mechanical permit for the new kitchen exhaust vent is required I called and spoke with the designer and discussed if this is a recirculation exhaust or ducted as per plan. If recirculation style then mark as on plans and no mechanical permit will be required. 2) The plans state that there are no bearing walls in thisstructure but the age of the home indicates interior bearing walls would be required. Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheet and include one set of voided sheets in the re- submittal drawings. Norman Bruhn CBO 305 - 795 -2204 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 -05 Inspection Number: INSP - 152443 Permit Number: EL -10 -10 -1844 Scheduled Inspection Date: February 23, 2011 Inspector: Devaney, Michael Owner: SANCHEZ, ISRAEL Job Address: 375 GRAND CONCOURSE Miami Shores, FL Project <NONE> Contractor: WATTS ELECTRIC INC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number (305)757 -5247 Parcel Number 1132060135940 Phone: 305 -824 -3722 Building Department Comments TRIMS OUTLET Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments fre,/) /// February 22, 2011 For Inspections please call: (305)762 -4949 Page 6 of 29 1 1 Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Applicant 375 GRAND CONCOURSE Miami Shores, FL 1132060135940 Block: Lot: ISRAEL SANCHEZ Owner Information Address Phone Cell ISRAEL SANCHEZ 375 GRAND CONCOURSE MIAMI SHORES FL 33138 -2746 (305)757 -5247 (786)253 -6004 Contractor(s) WATTS ELECTRIC INC Phone 305 -824 -3722 Cell Phone Valuation: Total Sq Feet: $ 2,380.00 0 1 Type of Work: ELECTRICAL Additional Info: OUTLETS Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $1.80 $2.25 $2.25 $0.80 $225.00 $3.00 $2.40 $237.30 Pay Date Pay Type Amt Paid Amt Due Invoice # EL -10 -10 -39198 11/23/2010 Check #: 1755 $ 187.30 $ 50.00 10/19/2010 Credit Card $ 50.00 $ 0.00 Available Inspections: Inspection Type: Final Meter Box Alteration Relocation Fire Alarm Service Change Underground W. W. 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 foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated. November 23, 2010 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date November 23, 2010 1 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 BUILDING PERMIT APPLICATION FBC 20 Permit Type: Electrical OCT 53airnYZ 1 2010 Permit No. Master Permit No. OWNER: Name (Fee Simple Titleholder): 1-si?A2 L SI) /V(/t Phone #: Address: 3 7 55 a/64 wiD e City: /`-(/iiM / -9-w fie. S State: f /Pit/l919 Tenant/Lessee Name: ` /I�ei� e_ / y� Email: ._L_ T .T S / /V eh eZ- /)mN,y //,o' / JOB ADDRESS: 3 75 at/9/VD (D�Cf2(af�s to City: Miami Shores County: '7 t6 ia4� zip: 33/3g Phone #: Miami Dade Zip: .�3/3 ' Folio/Parcel #: Is the Building Historically Designated: Yes NO CONTRACTOR: Company Name:/° ^ t- Address- . 7 t 3 ' Flood Zone: Phone — g.) /.? / City: //9-Z...0;97/ State: ice- Zip: /3 1 /).- Phone#:7 fi�4?J- 69 OS Certificate of Competency #: ' T (e2 e Qualifier Name: State Certification or Regis ation #: Contact Phone# �`'�g e� ' 3 7 Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ .0T c3 ��% Square/Linear Footage of Work: Type of Work: OAddress ❑Alteration ❑New URepair/Replace ❑Demolition Description of Work: ******* ********** ******************** **Fees*x:*** ****** ** * * ** x***** ********x:************ .- 3 � `t -sue' , Submittal Fee $'` '�J Permit Fee $ .% XS, ®e' 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 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 rued. In the absence of suci posted notice, the inspection will not s , approved and a reinspection fee will be charged. Signature I1"" , / Y _?; Signat Owner or !3if Contractor The foree�oinLg, instrument was ac��ledged before me this �� /' The foregoing ins ment was acknowled ed before me this day of lllG 6/ 20 /D, biz C4 EL � day of , 20 /D, by - l�#i who is personally known to me who is personally known to me or who has produced NOTA P , LIC: Sign: Print: My Commis ion Expires: a and who did take an oath. Jeffrey Tenen iT : 0=5131011 °'•..,�:,.o° Expires: FEB. 07,.2011 BONDED THEW A17AN11C BONDING CI8iNCr as identification and who did take an oath. NOTARY PUBLI SSig�n: My co Al PUBLIC -STATE OF ssio Maggi Bar *' ° Commission # DD968088 % „0M,� ".' Expires: MAR. 14, 2014 BONDED THRV ATLAI 1C BorQ CO., INC. /0 APPROVED BY ...40.---4, 22e9 —c7f Plans Examiner Zoning Structural Review Clerk (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) 2010 -10 -19 11:52 1 Watts Electric 3058253373 » 10/18/2010 1300/2241001JA2Z 0018 -0002 Last Seq.# :0002 WI LBTlh3o 4i3978_ Local Business Tax #200.00 OK 5249.50 CHANGE $0.00 MIAMI -DADE COUNTY TAX COLLECTOR LOCAL BUSINESS TAX SECTION 140 W. Flaglsr St. - tort Floor Miami, Florida 33130 TEMPORARY RECEIPT 2010 -2011 MUNICIPAL CONTRACTOR TAX Local Business Tex11:30415978 -6 State /CCA :Cam$ Issued to: WATTS ELECTRIC INC TYPo of Wetness: ELECTRICAL CONTRACTOR SEE BACK OF OFFICIAL, RECEIPT FOR N0IPARTICIPATIN3 MUNICIPALITIES PAYIMMENT Y0I LOCAL AS EVIDENCE OF O MoINESS TAX R PETIT. YOUR OFFICIAL RECEIPT WILL BE MAILED V�ATION DDATE ON�� �T. Pint Received as Certified Above Ni alai -Dads County Tax .Co1 I ector 1 800 685 7530 *X*** * 1 * * * * * 1 1 1 1 * * * MIAMI -DAOE COUNTY TAX COLLECTOR, 140 W. Flaglor stroet Miami. Florida 3.100 Please keep your receipt for future reference. Thank you and have e nice day. 10/18/2010 1300/224/001JAll 0018-0001 Last Seq.# :0002 WI LBT#:00 415978 -S Local Business Tax 349.50 MIAMI -DADE COUNTY TAX COLLECTOR LOCAL BUSINESS TAX SECTION 140 W. Filmier St. - let Floor Miami, Florida 33130 TOYY RECEIPT LOCAL BUSINESS TAX Loo& Business TaX1:00415978 -6 State/CC# :000016608 teemed to; WATTS ELECTRIC INC •. Type of Business: ' ELECTRICAL CONTRACTOR : THIS RECEIPT•IS ISSUED AS EVIDENCE OF PAYMENT FOR YOUR L0CA1. BUSINESS TAN.. OR PERMIT. 14' YOUR OFFICIAL RECEIPT WILL BE MAILED TO YOU WITHIN 10 DAYS FROM THE ' VALIDATION DATE ON THIS RECEIPT. Payment Miami-Dade iCournty Tax Above P 1/3 2010 -10 -19 11:53 Watts Electric 3056253373 » • • 1 800 685 7530 • • a,4r, '.' S `;+�.:•1t If +%ms °L JJ+ ij. J� r li r G,,taFlr:g:,v`s'1:cz :.� �. F , ." . �� a .i.�:': �ifi'. ".,itil •. ' ,v :•t'.'e _ 1 ��'}, [Y 1 1:.' ?il,�'£^'^�il:.Fr,b.�i<v kt�'l I" :NL�'. ' {rw,r`•r'• •'t`•..; .;y.. {irY.rN,u tit; 7.�ry, 'y ..i• • mw� railcar U.B.'tiafAiii • $90.544.', : , • ° YM(..1.0 I tI4 13o IVO.1 PAY • ' •• • • • • TTS,:ELE TRIO':;Np <_.::'M1 ,1 AO a ria • � ' �,�e 6 • tAti `- �p002a608.• : Cint1C;.>r.!N0 rise � 4up 4, .419,4002:0W..: :.O9fl1O29 it0 ::r • "0eo015fir o,, %• .: 1.11111111*Ii1, +1. 111111 ,1,11111111tlaillitithullift115 11 saz aniin ail ELECTRIC E OOKp Z PRES 470 WEST 38 PLACE 1IXALEAH FL 33010 INAWDAUNCOUNTY TAX 011L1.00104 10 FLLOCR ` • MIAMI, PL 98130 BUSINESS =MOM t0= 1• ..;' WA Ketr 6 a .4 ., QONZAL,EZ JUAN 1r Ikd . • 1As a�' :N 10�� tt,`Ja 9.,1312;/.2:61'.1P RECEIPT NO, g U 86 RUSINES9 NAAAE T WATTS ELECTRIC INC 470 W 38 PL OWNER *WATTS ELECTRIC INC • EAPIRESSMPT.W0M6 THIS 18 NOT'A BILK. - 00 NOT PAY CC NO1 '000026608 SEE • BACK OF RECEIPT FOR •A LIST OF NON - PARTICIPATING MUNICIPALITIES moWftWdorimot mciamMittodty whale wak la to be dm*. ftweiTOOtwim IiWlkfA08ctiOmffM 16/27x/2009 '02280011001 000200.00 • PIFIST -CLAS8 POSTACIE 1 .peowr WW1 f *PT WO .&MY D0 ,11081,41MtAkAcottrmSerco • AtilIPL4XPIED HEREON EkECT t'ICAL AONT$AC1'OR OO NOT'FoAWARO WATTS ELECTRIC INC JUAN E GONZALRZ•PRES 470 VEST 38 P ACE HIALEAN FL 33012 1 hi Ill3111 11 111W11iJ1f1 1111W11'11111h” t1 P 2/3 2010 -10 -19 11:53 Watts Electric 3058253373 » 1 800 685 7530 STATE OF FLORIDA DEPARTMENT OF BUTS /NESS AND PROFESSIONAL REGULATION ELECTR =CAL CONTRACTORS LICENSING BOARD (850) 487 -1398 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 P 3/3 GONZALEz, JUAN E WATTS ELECTRIC INC 470 W 38TH PL HIALEAH FL 33012 -4228 Congratulationsi With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals i and businesses range from architects to yacht brokers, from 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,myftorJdalIcense.com. There you can find more information about our divisions and the reguiatLons 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! DETACH HERE • • sTATH aP FLORIDA AG# 5258,661 DOARTDDDIT • OF sus floss AND : pROF•ERsxo TAL ' R.EGULATION • F114066212: :'6212. . /0/04/10 1.0810 ,481 • REO ZALO CS ELELECT/Zan: CONTRACTOR GON r', WA'TT,B� °. LS.cTRLC INC: • `' i('TNDX IDUAL• •MUST' MEET ALL LOCAL, CEI S ZNO REQuIESKINTS PRIOR CONTRACTING IN ANT AREA) RZ4Z8 FRED widow oho provisions of Cn.40g ro�gtitaCSaa'. a#frF'e, AUO 31, . 2012 W.0100401532 • • •^ .r• AC# 5258663 STATE:OF FLORIDA DEPAR � p� " ' T Tilt 1, BATCH NUMBER LATION' SEQ# L10100401532 The ELECTRiCAtLCONTRA. TO Named below•'i:HAS REGIStTE .' D : Under - the prbvis'tone ' "oal* ' Choi` t f Expiration date: AUG 31, 201a,' (INDIVIDUAL, MUST MEET. ALIA 4 REQUIREMENTS. PR1*R Tbi•: •c0N'.t`R* GONZA L.SZ WATTS •ELECTRI INC:, 470 W 38TH ?L • �a.:• HIALEAH FL 33012-'12 8 4:� CHARLIE 'CRIST GOVERNOR • . Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No.' .aCl152° /� 3 Job Name 5 ` r�G c9� CRITIQUE SHEET P A-7• I1 6 9"c ,1A Ke- w,07 f"'eJ e- /4z y 7 "d P/i - /LPG f�(/ 12A ✓�GI�z�� I/o ea- Few goViz .tw,,y 4// ` %e, , aL-A A2 e # / -A -c ,/ `7 f /Y 2P)2 - Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 lo_ r-7s`; Inspection Number: INSP- 152314 Permit Number: PL -10 -10 -1820 Scheduled Inspection Date: March 07, 2011 Inspector: Hernandez, Rafael Owner: SANCHEZ, ISRAEL Job Address: 375 GRAND CONCOURSE Miami Shores, FL Project: <NONE> Contractor: HOME OWNER Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number (305)757 -5247 Parcel Number 1132060135940 Building Department Comments REMODEL BATHROOM AND KITCHEN ADD BAR SINK Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments March 04, 2011 For Inspections please call: (305)762 -4949 Page 4 of 30 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 BUILDING PERMIT APPLICATION FBC 20 Permit Type: PLUMBING Permit No. PLL 0 I3ZD Master Permit No. '2. '` (75 3 Owner's Name (Fee Simple Titleholder) ..L 5W t L 2T 59Ai,/ t erphone # 7 °' 3 - 6610K Owner's Address AL' in o1)y e_ City f1/ / /A,// Z./VMS State cia/f)/ Zip Tenant/Lessee Name /jel Ve Email III .s/gn./l &L.) %1OT%t!/)/L . (p M Job Address (where the work is being done) City Miami Shores Village FOLIO / PARCEL # Phone # 375 609,0 C oviouv'. e County Miami -Dade Zip 3313 (Sr Is Building Historically Designated YES NO X Flood Zone Contractor's Company Name . ?i,..au,i1011-1--Nc Phone # (1 6 /-4.7 / q Co ctor's dress N Ci �'D1� -o State F1. Qualifier Name Zip -333 1 7 Phone # State Certificate or Registration No. r 1 1� 2�' i 1 S Certificate of Competency No. �� Contact Phone is t"'4�" 4105 "3 451 E -mail ar4 2q 0 flasZ.14 cotrrL Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ *3, 06 0 .11 0 Type of Work: Describe Work: 4_ &Ilk' Additi.n AlAo 'TN teration Lm - 1,41.144‘ 1? i. ; wAS it. Square / Linear Footage Of Work: 60111 [New ❑ Repair/Replace ❑ Demolition !N (Zao-m.. i� l�L��7Sr J., It) flit.. vA) k_ ******* b*f * * * * * * * * * * * * * * * * * * * * * * * * * * ** *Fees * * * * * * * * * ** Submittal Fee $ L-/ Permit Fee $ Notary $ Training/Education Fee $ Scanning $ Radon $ DPBR $ Double Fee $ Violation date: Structural Review. $ Total Fee Now Due $ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** CCF $ CO /CC $ Technology Fee $ Bond $ See Reverse side -- 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 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 approved and a reinspection fee will be charged. Signature Owner or The foregoing instrument was acwledgeedobefore me this / v� day of , 20 /O, by.. t' 1, cJ who is personally known to me or-wito-h - pseduced n is of and who did take an oath. NOTARY Sign: Print: My Commission Expires: ' I ' Fl '111 I - I 75Commission #DD636220 Expires: FEB. 07, 2011 BONDED THRU ATLANTIC BONDING CO., INC. * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPROVED BY * Contractor The foregoing instrument was acknowledged before me this I, trA day of who is personally known to me or who has produced -' l as identification and who did take an oath. Plans Examiner Engineer (Revised 07 /10 /07)(Revised 06/10/2009) NOTARY PUBLIC: Sign: Print: My Commission Expires: ser ' 03/06/2011 ' NOYARY p11BL/C ''...0, COmmiss /0 90 ' ryli(116ail0 Zoning Clerk checked 1 Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 375 GRAND CONCOURSE Miami Shores, FL Owner Information Parcel Number Applicant Address 1132060135940 Block: Lot: ISRAEL SANCHEZ Phone Cell ISRAEL SANCHEZ 375 GRAND CONCOURSE MIAMI SHORES FL 33138 -2746 (305)757 -5247 (786)253 -6004 Contractor(s) HOME OWNER Phone CeII Phone DJR PLUMBING INC (954)321 -9719 Valuation: Total Sq Feet: $ 3,000.00 50 1 Type of Work: KITCHEN AND BATH AND BAR SINK Type of Piping: REMODEL Additional Info: PLUMBING Bond Retum : 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 -10 -10 -39165 11/23/2010 Check #: 1755 $ 168.30 $ 0.00 Available Inspections: Inspection Type: Top Out Re Pipe Main Drain Heater Water Service Final Water Main Lavatory 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 foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated. November 23, 2010 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date November 23, 2010 1 11/23/2010 14:23 9545839802 JW INSURANCE PAGE 01/01 1 DATE (MM/DD/YY) �� ® CERTIFICATE OF LIABILITY INSURANCE L 11/23/10 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION PRODUCER JW Insurance Services 100 North State Road 7, # 106 Margate, FL 33063 _ -Phone (964)983 -7213 INSURED DJR Plumbing, Inc. 748 NW 48th Avenue Plantation, FL 33317 (954) 321 -9719 COVERAGES ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES �E�Q11V,,, .... _ •, Fax (934)563 -2045 INSURERS AFFORDING COVERAGE NAIC # r INSUT3 RAIL Seminole Casualty INSURER B: INSURER C: INSURER D: INSURER E: INSURER F: THE POLICIES OF INSURANCE LISTED 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 1S SUBJECT TO ALL THE TERMS. 'EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE EEEN REDUCED BY PAID CLAIMS. INSR ADD'L LIB IN 3Q A TYPE OF INSURANCE I POLICY NUMBER 1K/um' EFFECTIVE POUCY EXPIRATION DATE(MWDDIYY) DATE(pM6a1DDIW).. GENERAL UABILITY E COMMERCIAL GENERAL LIABILITY ;SGT - 000306942 -1 [3:1 CLAIMS MADE ) OCCUR I GEN'L AGGREGATE LIMIT APPLIES PER:' POLICY L ] PROJECT _ 1.0C AUTOMOBILE LIABILITY ^ - -- ] ANY AUTO ] ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON OWNED AUTOS GARAGE LIABILITY I 1 ANY AUTO EXCESS/UMBRELLA LIABILITY 7...1 OCCUR CI CLAIMS MADE 1 DEDUCTIBLE 1 f -: RETENTION S 1NORKE.R3 COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER / MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below OTHER 10/23/10 10/23/11 • LIMITS EACH OCCURRENCE 300,000 TRW= _ ._ ._.. PREMISES (Ea ocatre ..._; - _ -•-- MED MP (Any one pennon) — PERSONAL 8 ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP /OP AGG Fire Damage Liability COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per Person)....... BODILY INJURY (Per accident) • PROPERTY DAMAGE (Per accident) AUTO ONLY • EA ACCIDENT OTHER THAN EA ACC AUTO ONLY AGG EACH OCCURRENCE 5,000 300,000 800,000 600,000 100,000 AGGREGATE W STATU- j OTH- E.L, EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT DE$CRIPTIOIV OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CERTIFICATE HOLDER City of Miami Shores 1050 NE 2 Ave Miami Shores, FL 33138 ACO>`ED 2s (2001/08) QF ___— ..... . CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL • 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY j OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ® ACORD CORPORATION 1988 Nov 2310 02:08p Dale Robinson 9543219719 STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES 1 DIVISION OF WORMERS' COMPENSATION CONSTRUCTION INDUSTRY CERTIFICATE OF ELECTION TO BE EXEMPT PROW FLORIDA WORKERS' CONIPENSATIQN LAW EFFECTIVE 02/02/2009 EXPIRATION DATE: 02/02/2011 PERSON: DALE J ROBINSON FEIN: 283398552 BUSINESS NAME AND ADDRESS: D J R PLUMBING INC 748 N W 48TH AVE PLANTA`ION, 9. 333/7 p.2 I SCOPE OF BUSINESS OR TRADE t- CENTIME) PLUMBING CONTRACTOR STATE OF FLORIDA'". • AC# 14 4'16-2-33- DEPARTMENT OF BUSINESS AND .PROFESSIONAL REGULATION •QB64944 05/27/09 080488941 QUALIFIED BUSINESS ORGANIZATION D J R PLUMBING INC • (NOT A LICENSE TO PERFORM WORK. ALLOWS COMPANY TO DO BUSINESS IF- XT HAS A LICENSED QUALIFIER.) SS QUALIPx u under the provision® o> ch.489 FS 3xpJret-ion date: AVG 31, :2011 -- L090E2700785 RATE a6FLOmDA AC# BUSINESS, AND �OIONAL REGULATION 64944sr 05/27/09 080488941 QUALIFIED BUSINESS ORGANIZATION D J R PLUMBING INC NOT A. LICENSE TO PERFORM Vol ALLOWS CODLIRANY TO DO BUSINESS ;IF IT 1MS A LICENSED QUALIFIE1t. i8 QUALIFIED under the provisions of ch.489 FS szpiteati asee€;AUG 31, 2011 L09052700785 . a .is`Yrsa esoY.ome a11rrV■I ir.. YALE v.` - 4V4 ..r..'r�.�..;.r��.�— ��'�b...te • a -■ ti r 'y • ■ 7s � 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301- 1895 — 954- 831 -4000 VALID OCTOBER 1, 2010 DBA: Business Name: D J R PLUMBING INC Owner Name: ROBINSON DALE JONATHAN Business Location: 748 NW 48 AVE PLANTATION Business Phone: Rooms Seats THROUGH SEPTEMBER 30, 2011 Employees 1 Receipt #:182 -1721 Business Type :PLUMBING /LWN SPRNKL /CO (PLUMBING CONTRACTOR) Business Opened:04 /02/2009 State /County /CerilReg :cFC1427915 Exemption Code:NONEXEMPT Machines Professionals For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00- 000 0.00 0.00.' 0.00 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non- regulatory in nature. You must meet all County and/or Municipality planning WHEN VAUDATED and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. Malting Address: ROBINSON DALE JONATHAN 748 NW 48 AVE PLANTATION, FL 33317 2010 - 20_11 Receipt #15E -09- 00003712 .;. Paid 07/22/2010 27.00 CTOR Miramar, Florida. 2010 -11 -17 MIAMI SHORES VILLAGE Building Department Att. Norman Bruhn Ph. 305 - 795 -2204 Ref: Permit No. 10 -1753 Mr. Bruhn: The following are our responses to your Building critique sheet of November 8-2010: + Item 1: Notes were modified indicating a new recirculating Hood in the kitchen, instead of a ducted exhaust fan. Item 2: To the best of my knowledge and based on the information provided on record drawings obtained from the city archives, the location of the existing bearing walls of the house have been indicated on our remodeling plans. None of the existing bearing walls or any other structural element is intended to be altered, changed or affected by the scope of this remodeling. Thank you, Arq -LINE, inc. Chris Shirar AR. 0094012 • 18731 SW 28 Court. Miramar, Florida 33029 Ph. 954. 701.1599 hmarin @arq- line.com