Loading...
RC-15-2685 r ' Inspection Worksheet , Miami Shores Village q 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-246257 Permit Number: PL-10-15-2685 Scheduled Inspection Date: September 28, 2016 I Permit Type: Plumbing - Residential Inspector: Hernandez, Rafael Inspection Type: Final Owner: URRUTIA, MONICA Work Classification: Addition/Alteration Job Address:361 NE 101 Street Miami Shores, FL 33138-2424 I Phone Number (786)356-3445 Parcel Number 1132060135220 Project: <NONE> Contractor: UNIVERSAL PLUMBING CORP Phone: (305)887-3131 Building Department Comments PLUMBING REMODELING Infractio Passed Comments INSPECTOR COMMENTS False i. t t 1 t t 1 Inspector Comments Passed 1 Failed 4 1, Correction ❑ Needed Re-Inspection Fee 1 1 No Additional Inspections can be scheduled until re-inspection fee is paid. i September 27, 2016 For Inspections please call: (305)762-4949 Page 3 of 39 Permit No. PL-10-15-2685 `SuoaFs yr 10050 N.E.2nd Avenue NE Miami Shores VillagePen 1 Permit Type:Plumbing-Residential Work Classification:Addition/Alteration " Miami Shores,FL 33138-0000 Permit Status:APPROVED N Phone: (305)795-2204 fiCORIDP Issue Date: 10/27/2015 FixP1 ration: 04/24/2016 Project Address Parcel Number Applicant 361 NE 101 Street 1132060135220 Miami Shores, FL 33138-2424 Block: Lot: MONICA URRUTIA Owner Information Address Phone Cell MONICA URRUTIA 361 NE 101 Street (786)356-3445 MIAMI FL-33138- 361 NE 101 Street MIAMI FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 3,500.00 UNIVERSAL PLUMBING CORP (305)887-3131 Total Sq Feet: 0 Type of Work:PLUMBING REMODELING Available Inspections: Type of Piping: Inspection Type: Additional Info: Bond Return: Top OutFinal Classification:Residential Scanning: 1 Review Plumbing Underground Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $2.40 DBPR Fee Invoice# PL-10-15-57505 $3.38 10/27/2015 Check#:400 $ 191.16 $50.00 DCA Fee $3.38 Education Surcharge $0.80 10/21/2015 Credit Card $50.00 $0.00 Permit Fee $225.00 Scanning Fee $3.00 Technology Fee $3.20 Total: $241.16 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. i OWNERS AFFIDAVIT: I certify-!bat all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zo re,I authorize the above-named contractor to do the work stated. -' October 27, 2015 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy October 27,2015 1 L* , Miami Shores Village RECEYVED Building Department oc,T z zo,5 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel:(305)795-2204 Fax: (305)756-8972 $Y; �. INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 BUILDING Master Permit No. ` cs- 221 PERMIT APPLICATION Sub Permit No.Fk_ ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ©PLUMBING ❑ MECHANICAL QPUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 361 KE i I s' 1 ee-+ City: Miami Shores County: Miami Dade Zip: 3 3 1 3 Folio/ParcelM Is the Building Historically Designated:Yes NO .Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder): '-`� '� V'��J I " 1 Phone#: Address: 4boo ,p� W c��c�e , �`� � 6 1 City: ��u�� �'``� , State: —� L"r " Zip: �� � 3� Tenant/Lessee Name: ? ? Phone#: Email: CONTRACTOR:Company Name: 6�Arli f/iGm Otl ?hone#: Address: city./l`/4 le,21v' ti State: 4ualifier Phone#;3i oee SC/ State Certification or Registration M:a-c6gg By I Certificate of Competency#: DESIGNER:Architect/Engineer: '* Phone#: Address: City: State: Zip: Value of Work for this Permit:$ Sika Square/Linear Footage of Work: Type of Work: ❑ Addition erapieji *ew gRepair/Replace ❑ Demolition Description of Work: . f p i_ Specify colori,of color thru tiler (x,,� �) ref Y ►. r� `a Submittal Fee$' Permit Fee$, '`` CCF$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ - Double Fee$ I Structural Reviews$ Bond TOTAL FEE NOW DUE (Re,vised02/24/2014) j: 4" y '1) Bonding Company's Name(if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) Mortgage Lender's Address ' I City State ' Zip + i I ti 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. t "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 issbancer of d 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 cpyofhe recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. `'J Signature -""" Signature r' OWNER or AGE ' CONTRACTOR ..ti 1 The foregoing instrument was acknowledged before me this "' The foregoing instrument was acknowledged before me this` day of MAW-eIVy„ 20� y da, b t,L`._ L of" �; ,'B� � , 20 Y�� . b '12nll 41 who is personally known to �i,� ��:�ii, who is personally known to me or who has produced rL'- 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: Print: Print: Sea :4M public State of Florida Seal: LOURDES MARIN tary tiA.. oa•• c=�:' 4�; �` enna M Feliciano yCommission FF 082753MY COMMISSION#FF009167 • °a. p y, :9 v;' o111212018 !FoPEXPIRES Aprll 17,2017 * # *####*####****#**###**###*##**########*#* 4 1 Foi o e **###******#*# APPROVED BY Cd-2I-I r Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Ac CERTIFICATE OF LIABILITY INSURANCE DATE(MWPD/YYYY) 10121/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT:If the certificate holder is an ADDI71ONAL INSURED,the policy(las)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain Policie8 may require an endorsement A statement on this certificate does not coMer rights to the certificate holder in lieu of such endorsement(s), PRODUCER WNTAUT NAME: Automatic Data Processing Insurance Agency,Inc. P DNE 1 Adp Boulevard F-MAJLs: Roseland,NJ 07468 ADDRESINWRERM AFFDRDING GOVENAGE NAIC a INSURED INSURERA_ NorGUARD Insurance Company 31470 UNIVERSAL PLUMBING CORP INSURERS: 141 EAST 80TH STREET INSURER c: Hialeah,FL 33013 INSURER D' INSURER!; INSURER F: COVERAGES CERTIFICATE NUMBER: 404392 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 SUI3JECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IK*K A00POLICY EFF p LTR TYPE OF INSURANCE IVSD= POLICYNUMBERUf613 COMMERCIAL 49NERAL LIABILITY EACH OCCURRENCE CLAIMS MAOE OCCUR PREMISES Ea i MEG EXP(Anyone seq i PERSONAL&ADV INJURY i N L AGGREGATE LIMI- [--E5 PER GENERAL AOOREQATE S POLICY 1:1 JEC LOC PRODUCTS,COMPIOPAGG a OT+IER; i Au7OMOBRE LIABILrIY LIMIT = ANY AUNO ALL OWNED SCHEDULED BODILY INJURY(Rte pft m) i AUT08 AUTOS BODILY INJURY(Per sodden:) f HIREDAUTOS = PR TY DAMAGE Per a�dCerN = UNO W-LLA LIAR = OCCUR EACH OCCUkRENCE f E�(GR�!Lag HCLAIMPp#AADE- AGGREGATE i DED RETENTION f WORKERS COMPENSATION i AND EMPLOYERS'LIABILITY Y/N X STATUTE ER TF. ANY PROPRIETOR/PARTNER�7tECUmrE f 100,000 OFFICER/MEME:ER EXCLUDED? N/A N UNWC50883911/2W2014 11/25!2015 EL EACH ACCIDENT (MSMalay M NH) IfyyQy Ov.Wbam� E.L.DISEASE-EAEMPLO i 100,000 9MRIPT10N OF OPERATIONS bebw E.L.DISEASE-POLICY LIMIT S 500,000 DESCRIPTION OF OPERATIONS/LOCAT10N8I VEM1.68 IACORD 101,AQdwonat Rem vM S¢hWwle,,,,,IY Iso attadua a more spies k red) Contractor License:CFC1428421 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CARMLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City Of Miami Shores ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NO 2nd Ave. Miami Shores,FL 93138 AUTHOMM MpREBENTATWE 4 IV 1888-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD � f RICK SCOTT,GOVERNOR KEN LAWSON, SECRETARY STATE^OF`FLORIDA "` •�" ^---DEPARTMENT.OF=BUSINESS AND PROFESSIONALREGULATION:,„ �'` I ".,, ✓"" '""" '"h�i''""`~ `-"r v _CONSTRUCTIONINDUSTRY•LICENSING BOARD��*,'*,;+,,; , , - d + s ,p r..�_ ..-firer- .x«,:-+,,- .,._ •*t,� —"�+w�. 1� 'l ,-'..awy,'y+.., 'a. '�,. '�"1 1y- 'ha.."'»�. •L"'�� : s� .!'I rr�CMC125014fi.,+*, ,r•- a """r*- i "" r `,a _`" .`R..' ^a. aN '��"yy° 4.� w The MECHANICAL-CONTRACTOR �IVamed,below I5 CERTIFIED ` �- O. . Under,theaprovisio`ns of=Chapter,489 FS' , - ■, .,�; - � 'WE Ex iration"date.AUG,3172018----' GARCIA, MtCHEL. .�> '^- UNIVERSAL,f?LUMBING,.CORP- mF+�330 ��.�'""'►...^�+��.;����""'s ISSUED 910fs° D SPLAY A�S'R EDRE '�L'A 1- SE # L36090 00038 ��� RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY ,STATE OFORiDA .,, ,, -. DEPARTME TOF`BUSINESS�AND PROFESSIONAL REGULATION,;,,,+ a CONSTRUCTION lNDUSTRYL'ICENSING'BOARD 4� C 6428421,,;,, ;. .-`A r--.The:PLUMBING:CONT.RACTOR ---- ,d' -•�»�.. ^*, •,.. �•:�--�„ -� y may-. .� ',. Named.below,IS CERTIFIED„ .."", '" -.'''`� °° `", *. ,,�``` ..°`` , ""�` .,°` Under,thedprovisions of:Chapter 4 Expirat on. We: A J. 312018 ---' GARCIA,,MICHEL ""'��" UNIVERSAL"PL� UMS#IYG; 1ALI AH 3 - HIAL'EH F -,33013. * -�- IssuEo'�-os/oirzo DI'' PLAY`AS°REQUIf2E©BY-LAW -~ I SEQ# L16090 1