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PL-15-1524Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 c2,c n-903 Inspection Number: INSP-237306 Permit Number: PL -6-15-1524 Scheduled Inspection Date: August 31, 2016 Inspector: Hernandez, Rafael Owner: Job Address: 500 NE 92 Street Miami Shores, FL Project: <NONE> Contractor. GMP CONTRACTORS Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition/Alteration Phone Number Parcel Number 1132060141200 Phone: (786)443-3548 Building Department Comments 3 SINK INSTALLATION, 2 BATHROOM VALVE INSTALLATION Infractio Passed Comments INSPECTOR COMMENTS False Passed Failed Correction Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. Inspector Comments Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address 500 NE 92 Street Miami Shores, FL Permit Permit No. PL -6-15-1524 Permit Type: Plumbing - Residential Work Classification: Addition/Alteration Permit Status: APPROVED Issue Date: 4/29/2016 Expiration: 10/26/2016 Parcel Number 1132060141200 Block: Lot: Applicant PORTO CABRAL LLC Owner Information Address Phone Cell PORTO CABRAL LLC 500 NE 92 Street MIAMI SHORES FL 33138-3157 500 NE 92 Street MIAMI SHORES FL 33138-3157 Contractor(s) GMP CONTRACTORS Phone (786)443-3548 CeII Phone Valuation: Total Sq Feet: $ 4,800.00 0 Type of Work: 3 SINK INSTALLATION, 2 BATHROOM VAL Type of Piping: Additional Info: Bond Return : Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $3.00 $3.38 $3.38 $1.00 $225.00 $3.00 $4.00 $242.76 Pay Date Pay Type Invoice # PL -6-15-56044 04/29/2016 Credit Card $ 192.76 $ 50.00 06/22/2015 Check #: 1096 $ 50.00 $ 0.00 Amt Paid Amt Due Available Inspections: Inspection Type: Top Out Final Review Plumbing Underground In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that 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. icant / Contractor / Agent Building Department Copy April 29, 2016 Date April 29, 2016 1 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 7624949 BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC ❑ ROOFING %PLUMBING ❑ MECHANICAL ['PUBLIC WORKS JOB ADDRESS: •-",e10 s City: Miami Shores County: FBC 20 t� �j Master Permit No. act 0 3 Sub Permit No. I 5-1 S2-1 ❑ REVISION ❑ EXTENSION EJ CHANGE OF CONTRACTOR ❑ CANCELLATION Miami Dade Zip: ❑ RENEWAL ❑ SHOP DRAWINGS Folio/Parcel#: 1 r 0 - o' 1 3--00 Is the Building Historically Designated: Yes NO DC Occupancy Type: Load: Construction Type: rr� p c Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): >O\<;$ C\J ` U --c.... Phone#: Address: � +1-•+ (\ oo� ) C 9c)- 5 p 1'—,- City:Y- City: y V�.\A --,,` q. -- - State: Zip: Tenant/Lessee Name: Phone#: Email: r��/n1p j(� [ ijV CONTRACTOR: Company Name: � N'k- COW 1� `zY� Phone#: 0V . I 1 -.?1‘.1 r Addres :3 S 3 p)-5 City: e1/4":( State: C Zip: Qualifier Name: �S -strC- C ( A (•�p� Phone#: A V . ( 4 3-- l&` (rState Certification or Registration #: GFt✓ prP1 y a_ rCertificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: Value of Work for this Permit: $"'-C •) O 00 1 CI Type of Work: Addition ® Alteration New Description of Work: S 4-u - ---v 0 rJ e `cost? • State: Zip: Square/Linear Footage of Work: Repair/Replace ❑ Demolition Specify color of color thru tile: Submittal Fee $ SO -6-3 itO Permit Fee $ a25 CCF $ 3 . 03 Co/CC $ IQ Scanning Fee $ 33 - VJ Radon Fee $ "- 3 e DBPR $ 3 - 39 Notary $ 10 Technology Fee $ 4 , GJ Training/Education Fee $ . OZ Double Fee $ 0 Structural Reviews $ p Bond $ TOTAL FEE NOW DUE $ ( 1 Q 2 - G 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 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 he abs • • - • uch posted notice, the inspection will not be approved and a reinspection fee will be charged. g _At Signature '► —�� . Signature - OWNER or AGENT The foregoing instrume t was acknowledged before me this day of /J 20 /5— • by �f cA, v l/ , who is personally known to me or who has produced Pt • Y/ V" 7 L. Cea4tas identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: HAROLD LOPEZ NOTARY PUBLIC ci STATE OF FLORIDA Comm# EE138198 Expires 11/25/2015 CONTRACTOR The foregoing instrument was acknowledged before me this day of �3u(� n�,,. , 20 15 C� 4 - ,thy S� iG C(#- Aho is personally known to me or who has produced rimit(1 Ppue-A' as identification a did take an oath. NOTARY PUB Sign: Print: �p.v. ��)g� `•••; ELVIRAL _Z Seal: * • * MYCOMMISSIONiFF072394 EXPIRES: March 21, 2018 Bonded Inn Budget Notary Services *******i******iii************** ****Mkt**** ******************tit****#********************** *******iii#*ski*** APPROVED BY Ile 4 - Plans Examiner Zoning Structural Review Clerk Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner — Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees, including the owner, must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if: 1. The officer owns at least 10 percent of the stock of the corporation, or in the case of an LLC, a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State, Division of Corporations; and 3. The corporation is registered and listed as active with the Florida Department of State, Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption and has acknowledge that he or she will not use day labor, part-time employees or subcontractors for your project. The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project. In these circumstances, Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company for day labor, part-time employees or subcontractors. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: State of Florida County of Miami -Dade The foregoing was acknowledge before me this day of By C 371 ,koffilt4iiiinibxersonally known to me or has produced �� p\•,••.... .• c7 w •(vG= A� OV. i � • to Sam i [[� :• _ iP' • invoO�*•• * �� eiit8vt1 ,20 l (5) SEAL: GMP CONTRACTORS 13500 SW 250 th Homestead , FL 33092 04/11/16 State of Florida County Dade Before me this day personally appeared Isaac Caballeros who being duly sworn , deposes and says : That he or she will be the only person working on the project located 500 NE 92 street - Miami Shores , FL. Sworn to (or affirmed) and subscribed before this 11 day of April , 2016 By ?61:-•'6°(% ELVIRA LOPEZ * c_: * MY COMMISSION # FF 072394 111' EXPIRES: March 21, 2018 Typ n_Produced Nr'TFaFoe. Bonded Thru Budget Notary Services Personally Know Or p :. uced Identification Matt IdL/t., Nota