PLC-15-168 co /
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
nspection Number: INSP-227092 Permit Number: PLC-1-15-168
Inspection Date: January 28, 2015 Permit Type: Plumbing - Commercial
Inspector: Diaz, Osvaldo Inspection Type: Final
Owner: PROPERTIES LLC, SHORE SQUARE Work Classification: Addition/Alteration
Job Address:9099 BISCAYNE Boulevard BURGER
visir_
Miami Shores, FL 33138- Phone Number (305)779-8040
Parcel Number 1132060110040
Project: <NONE>
t,;.,ntractor: ROYAL PLUMBING CORP Phone: (305)694-1964
Building Department Comments
PAY FEES FOR EXISTING FLUE PIPE THROUGH ROOF. Infractio Passed Comments
INSPECTOR COMMENTS False
L
Inspector Comments
Passed 12f
Failed El
Correction
Needed
--low
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
For Inspections please call: (305)762-4949
January 27, 2015 Page 1 of 1
Miami Shores Village
CE!
RE
Building Department JAN 2.6 2015
10050 N.E.2nd Avenue, Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972 t`T BY:
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 2016
BUILDING Master Permit No. r,-o-- I'4 - 3
PERMIT APPLICATION Sub Permit No.PQ Q -6- Iro�}
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
QPLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 9099 Biscayne Blvd
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 1132060110040 Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder):Shore Square Properties LLC Phone#:305-779-8040
Address:696 NE 125 Street
city: Miami State: Florida Zip: 33161
Tenant/Lessee Name: Phone#:
Email:
X 30 5 213- 62 fit?
CONTRACTOR:Company Name: Royal Plumbing Corp. Phone#: 305-694-1964
Address: 3525 NW 79 Street
City: Miami State: Florida Zip: 33147
Qualifier Name: Joel Gonzalez Phone#: 305-694-1964
State Certification or Registration#: CFC1425760 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ 100.00 Square/Linear Footage of Work:
Type of Work: ❑ Addition 0 Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: Pay fees for existing flue pipe through roof
Specify color of color thru tile:
Submittal Fee$ 'Q�Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$ C'
TOTAL FEE NOW DUET
(Revised02/24/2014)
BonxN.g Company's Name(if applicable)
r '
Bonding Company's Address
City State Zip
Mortgage Lender's Name(if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES,BOILERS,HEATERS,TANKS,AIR CONDITIONERS, ETC.....
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING
YOUR NOTICE OF COMMENCEMENT."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. in the absence of such posted notice, the
inspection will not be approv d a a ret. ction fee will be charged.
Signature Signature %eL7-� Qe0/Afi-?/-
R or AGENT CONT4GR-)
The foregoing instrume was acknowledged before me this The foregoing instrument was acknowledged before me this
Z-(a day of / // c� 20 /' by 18th day of December 20 14 by
4df&-+" �7_CLaIS_who is personally known to Joel Gonzalez ,who is personally known to
me or who has produced as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: Y IrEZ Print:
4. :w_ commission#FF 032722r ti st, ROUWDO R.RIVERA
Seal: a. � . :,i Jul 2 2017 Seal: r
Q, P' Y � ` MY COMMISSION#EE 865103
<,NuTMyFain MUM=800-M-701B EXPIRES;March 30,2017
Bonded Thrd Notary Public Underwriters
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
Jan. 26 2015 11 : 12AM p. 1
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSI "-INAL 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
Congratulations! With this license you become one of the nearly
one miilion Floridians licensed by the Department of Business and
Professional Regulation. Our professionals and businesses range StAtI .0FF FkORI( A
from architects to yacht brokers,from boxers to bsrbeque restaurants,
and they keep Florida's economy strong. - AEFAfT , $t3SINES'S AIdl7
? LAT10N
Every day we work to improve the way we do business In order toC.I4� 760� �13r2014
serve you better. For information about our services,please log onto k -
www.myforidalleense.eom. There you can find more information "
about our divisions and the regulations that impact you,subscribeC1rF1`GIirIE&P
to department newsletters and learn more about the Department'sOr
initiatives. tyLLt�
Our mission at the Department is:License Efficiently, Regulate Fairly,
We constantly strive to serve you better so that you can serve your
customers. Thank you for doing business in Florida,
and congratulations on your new license! ! +++ac:xrte Btorra^aF 4�s f:S� '
DETACH HERE
RICK SCOTT, GOVERNOR _ .... . .
KEN LAWSON, SECRETARY
t r. 7ATfi OF FLORI��4
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ROYAL03 OP ID:AD
....�- CERTIFICATE OF LIABILITY NIISURANCE DATE(MM/DDIYYYY)
THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFI R.3 NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTR,,CT BETWEEN THE ISSUING INSURER($), AUTHORIZED
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IMPORTANT: H the certiNcate holder Is an ADDITIONAL INSURED,the policy les) ml st be endorsed. If SUBROGATION IS WAIVED, subject to
the teens and conditions of the policy,certain policies may require an endorsement Statement on this cerllFlCa
certificate holder In lieu of such endomorrient s . to does not confer tights to the
IPaoou c!R 305-446-2271
Kahn-Carlin$Company,Inc. NA AEA
3350 i, L xie33 3 99,E 305-448-3127 PHONE 31 5-446-2271 NII: 3p5�48-3127
Miami,FL E313898ii __
AODRss: roe:ssln ahn-carlin.com
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CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUE'�TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM A CONDITION OF ANY CONTI-ACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAYO ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE PO JCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCE ;SY PAID CLAIMS.
TYPl OFINSURANCE POLICY NUMBERP
GENERAL LIABILITY MMID MMID UMTS
C X COMMERCIAL GENF_RAL LIABILITY BINDER#10016 EACH OCCURRENCE S 0001
12114'I4 1?J7411a PREMIE Eao utrence S 100,00
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GENL AGGREGATE LIMIT APPUES PEFt GENERAL AGGREGATE S 2,000,00
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DESCRIPTION Of OPERATIONS/LOCATIONS VEHICLES (Aftch ACORD101onz&jaz ,Additional Remarks Sahsdule,rnwm sp+.:a Is wqulne!)
State LicensaoNo:01 GCFC1425760
CERTIFICATE HOLDER
CANCELLATII°IN
MIA71AUTHORIZZED
MlamI Shores Village THE SHOULD ANY
DATE THEREOF,DESCRIBED
POLICIES WILL BE CDELIVERED RN
10050 Northeast 2 Ave ACCORDANCE WITH THE POLICY PROVISIONS.
Miami Shores„ FL 33138
REPR:!3ENTATIVE
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ACORD 25(2(110/05) The ACORD name and logo are registered mar is of ACORD RD CORPORATION. All rights reserved.