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PLC-14-1000 i Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 PIC 7 Inspection Number: INSP-217249 Permit Number: Scheduled Inspection Date: August 06, 2014 Permit Type: Commercial Construction Inspector: Diaz, Osvaldo Inspection Type: Final Owner: PROPERTIES LLC, SHORE SQUARE Work Classification: Alteration Job Address: 9099 BISCAYNE Boulevard BURGER Vikir_ Miami Shores, FL 33138- Phone Number (305)779-8040 Parcel Number 1132060110040 Project: <NONE> Contractor: BRV CONSTRUCTION SERVICES INC Phone: (305)238-7953 Building Department Comments INTERIOR & EXTERIOR RENOVATION OF EXISTING Infractio Passed Comments BURGER KING RESTAURANT INSPECTOR COMMENTS False Inspector Comments Passed d-, Failed b �� Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. August 05, 2014 For Inspections please call: (305)762-4949 Page 29 of 37 Miami Shores Village 7BY'. CEIVED ' Building Department AY 15 2914 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel: (305)795.2204 Fax: (305)756.8972 _ INSPECTION'S PHONE NUMBER: (305)762.4949 FBC 2N�l ^ 'OL-)BUILDING Permit No. `--�1 PERMIT APPLICATION Master Permit No.cC 1 V -3 88 Permit Type: PLUMBING JOB ADDRESS: 9099 Biscayne Boulevard City: Miami Shores County: Miami Dade Zip: 33138 Folio/Parcel#: II - 'y21 .2,V p - 0 1( - 00+0 Is the Building Historically Designated: Yes NO X Flood Zone: OWNER:Name(Fee Simple Titleholder): li(Vff Cr6 phw#; Address: tpel1G Uf' I Ze7 yt City: �A 4 64-A 1 State: "L Zip: Tenant/Lessee Name: Phone#: ` Email: CONTRACTOR:Company Name: Royal Plumbing Corp. Phone#: 305-694-1964 Address: 3525 NW 79th Street City: Miami State: Florida Zip; 33147 Qualifier Name: Joel Gonzalez Phone#: State Certification or Registration t CFC1425760 Certificate of Competency#: Contact Phone#: 305-694-1964 Email Address: yairis@royalplumbingcorp.com DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit:$7,500.00 Square/Linear Footage of Work: Type of Work: ❑Address 4AIteration ❑New ❑Repair/Replace ❑Demolition Description of Work: Plumbing rior Remodel Submittal Fee$ / 1 Permit Fee$ 3C)dv x`f 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) y` Bong 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 s en (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be ap roved a a reinspection fee will be charged. Signature Signature Wner or Agent (y Contractor The foregoing instrument was acknowledged before me t is The foregoing instrument was acknowledged before me this 12th day of 120 ,by day of MaY ,20 (�,by Joel Gonzalez who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLI NOTARY PUBLIC: Sign. Sign: Print: Print: R goo Q. Rivera ......... LANDO R.RIVE My Commission Expir � KATYA GONZALEZ My Com �cp RO RA - Commission#FF 032722 1 OMMISSION#F.F 365103 W. A Expires July 2,2017 �od��°; 9ond�PIKES:March 30,2017 �•' hru Notary public Underwriters R„F,`, Bonded TNp Twy Fain Ineunos9003BS.7019RM APPROVED BY C�J-?�/ I`"( Plans.Examiner Zoning Structural Review Clerk (Revised3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) ROYAL03 OP ID: LL ACORO' DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 05/13/14 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,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). CONTAPRODUCER 305-446-2271 NAME:CT Kahn-Carlin&Company,Inc. 305-448-3127 PHONE 305-446-2271 A/C No: 305-448-3127 3350 S.Dixie Highway A/C No Ext Miami,FL 33133-9984 AADDARESS,processing@kahn-carlin.com INSURER(S)AFFORDING COVERAGE NAIC N INSURER A:Berkley Assurance Company 39462 INSURED Royal Plumbing Corporation INSURER B:FCCI Commercial Insurance Co 33472 3525 NW 79 Street INSURER C:Commerce&Industry Ins Co 19410 Miami,FL 33147 INSURER D:FCCI Insurance Company 10178 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 CLAIMS. INSR U R POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MMIDD/YYYY /Y MMIDDYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 AMAGE TO RENTED A X COMMERCIAL GENERAL LIABILITY VUM0023661 12/14/13 12/14/14 PREMISES Ea occurrence) $ 100,00 CLAIMS-MADE FKOCCUR MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 X Per Proj Agg$3M GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 17 POLICY PRO- Loc Emp Ben. $ 1,000,00 AUTOMOBILE LIABILITY EOa a.,dentSINGLE LIMIT $ 100,00 B X ANY AUTO CA00148955 12/14/13 12/14/14 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident —d -___ 1 $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,00 C EXCESS LIAB CLAIMS-MADE EBU035415495 12/14/13 12/14/14 AGGREGATE $ 2,000,00 DED I X I RETENTION$ $ WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'LIABILITY TCRY R MI IN D ANY PROPRIETOR/PARTNER/EXECUTIVE YN/A 001 WC13A62982 12/14/13 12/14/14 E.L.EACH ACCIDENT $ 1,000,00 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,00 If yes,describe under 1 000,00 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ , DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Qualifier : Joel Gonzalez State License No: CFC1425760 CERTIFICATE HOLDER CANCELLATION MIAM184 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN g ACCORDANCE WITH THE POLICY PROVISIONS. 10050 Northeast 2 Ave Miami Shores„ FL 33138 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD STATE OF FLORIDA _� - DEPARTMENT OF ,BUSINESS AND PROFESSION REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 GONZALEZ, JOEL ROYAL PLUMBING CORP 3525 NW 79 ST MIAMI FL 33147 ,STATE O,F4�ORl0, i, ACs#Gj 2'4 D 2.6,9 Congratulations! With this license you become one of the nearly one million P"TkkxV bF',SU3TTES.S ANI)= Floridians licensed by the Department of Business and Professional Regulation. P$OFE55IC r� REGULATIou & Our professionals and businesses range from architects to yacht brokers,from boxers to barbeque restaurants,and they keep Florida's economy strong. Y' '`' CFC 14 118193618 Every day we work to improve the way we do business in order to serve you better For information about our services,please log onto www.myfloridalicense.com. 'CLRTIF;,E]dea �RAC,TOR. ' There you can find more information about our divisions and the regulations that >f� �'GONZAItEZ;�� "# r impact you,subscribe to department newsletters and learn more about the ROYAL PLUMB, Y Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly.We �••.•..,,.,<•, constantly strive to serve you better so that you can serve your customers. s Thank you for doing business in Florida,and congratulations on your new license! =s;CERTxFTEb under the pzoveio�s■ Or ct, 489 F$ y �txgfization aat■, AUG 31,`2014y. X+120801021*17 I let, DETACH HERE THIS DOCUMENT HAS A COLORED BACKGROUND-MICROPRINTING LINEMARK"'PATENTED PAPER AC#,6,2 4 0 2 6 9 v. STATE OF FLORIDA DEPARTMENT •OF B(TS,T jESS AND PkOFES IONAL REGULATION Zl T f ,CO1QaTRIICTIAO INDUSTRY LICE SING BOARD SEQ#L12080102117 LICENSE NBRWlo "' V rl�. 08 01` 2b12- �.- he PLUM$INQ• CONTRACTOR 'Named`below It CER'TIFIEDr Under the provisibiis of''Chap Expiration date: AUG 31, 2014 _ ,Wn , gr_ ;i.i i :8: t.f. • .:p f( , Mfr .y/,•5}�. i� A „,•• FQONZAZEZ�, .JOEL' : k r r ROYAL. PLUMBING CORP,�' .. h f 3525 NW 79 3T �' MIAMI ' i FL-. 33147 o•: f Vl t`( a \ ..KEN. LAWSON AICD ?SCOTT" ,a' =.. GOVERNOR f f... SECRETARY' DISPLAY AS REQUIRED BY LAI .. rR al Bu� rea Tax Rees t . 4 Y. . i Miami-Daft County, State of Florida. THIS 15 NOT A;BILt-DO NOT PlY. Y i• � 475135i-', _ tlUBINE96 NAME/LOCATION ;RSCelPi.NO. +xpin.",S ROYAL PLUMBING CORP' RIE NEW4L. SEPT�`rV be h.30, 2014 MUNICIPALME5 LOC, 4980762 i at be di'spl`ayed;ai piece of business, COM EROALIESSORS F03888 Pursuant to County Code^� Chapter OA-Art.9&10 t i SEC.TYPE 01=BU INES$' OWNEit i PAYMENT iICE1VD 1 i f•' 192 CC3M�I��UIIVI UST/Ow.,±SPACE•''l�BY TAX COLLECTOR � r IQ A0LUMBiNG CORP - re ate s ft 3950 t-� tI $75.00 08/21/2013 1 A$$ :.g q1.1. ✓ `ECHEck 13--006678 } Iis Lo l Busin Teir Receipt only co arms 0601WIt of.ths lo."cal Business Tax.The Becdlpt is not license, p[m1t or a certrfialloir of theholder it quahficoaft to do 6oflbom Holdef hi31st fdomply'vvtth anygovernmemal or r nipilovoinmental regulatory lave;entragwrembfita which epll�tto the busine$t_ w _». _ 4 r ! * � t �_ i. f Tiis RECEIPT'N0.ebovgmv9,#:,displavel#knoll commercial vehWef.-Mi6mi»Qatle"sCode Sac ge-2T&P l , t _ Forinbre antormetiori,v ift www miamideye.govAaxcotiebtoc i � � f Loral Busin. 'ss Tax Reft i mismi-Dade County,,State of Fi&Wer " W -THIS IS NOT A BILL-,DO NOT PAY 5959631 BU9INBt38 NAME/LOCi►TION ReGeEXi?IR�$ 1PT NO. , ROYAL PLunn606 CORP RONEWA�. S� �MBER 30;, 2014 3525 N1N''79 ST 6217067 Must tie displayed ert,.plewof tiyginess MIAMI FL 33147 Pursuant to County Cosa; Chapter SA Arte 9.&10 SEC CYPE OR'BUSfNESS OWNERS. �PAYM A WSCEIVEp -w R0 1 P.J�IMBING CORD 196 P1"UN181W CONTRACT QR y'`t3Y TAX COGLECTi�7l 4 4 $75.00;08/21/201.3 a l �' CFC14257fi0 I $ECHEC ,'13--0E]6fi 78 I I � i. This local Buslnsos Tax Receipptt:only lonfirms oaymeptof the local Business Tax.The Receipt is note license, Aperinit of a certification of thehalder"a qualiificukoita,116 da busipeaa Hotti 'fiGuiCtfoniPty hh eery governmental or j nongovernmental1agulatory laws and requirements whiehrapoly to the bdoingss, Tile RECEIPT ND.above'fnaat b e dispiayeV on all comnfotmal vehidief-ANami-I ode Sec°ga-276 a,l "Few..more hNormadonr,vi itwww miemideda �I^"te+-. t I I