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PL-18-2132Inspection Worksheet Miami Shores Village 10050 N.E. 2ndAve, Miami Shores, Florida 33138 Tel: 305-795-2204 Fax: 305-756-8972 Inspection Number: INSP-000712-2018 Permit Number: PL-8-18-2132 Scheduled Inspection Date: October 17, 2018 Inspector: Massanet, Maykel Owner: JOHN BALDWIN Address: 160 NE 104 ST Miami Shores , FL 331382029 Project: <NONE> Contractor: AAA PRO PLUMBING LLC GEORGE L CANCIO Permit Type: Plumbing - Residential Inspection Type: Plumbing Finals Work Classification: Addition/Alteration Phone Number: Parcel Number: 1121360130760 Phone Number: 3056398972 Building Department Comments REPLACEMENT OF WATER LINE Checklist Item General Comments Passed False Comments Inspector Comments Passed Failed Correction Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. October 16, 2018 For Inspections please call: 305-762-4949 Page 2 of 30 Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Permit Peen N©. PL--18-2132 Permit Type: Plumbing -Residential orkCiassiffcation: AdditionlAlteration Permit Status: APPROVED Date: 8712018 Expiration: 03/06/2019 Parcel Number Applicant 160 NE 104 Street Miami Shores, FL 33138-2029 1121360130760 Block: Lot: JOHN BALDWIN Owner Information Address Phone Cell JOHN BALDWIN 160 NE 104 Street MIAMI SHORES FL 33138-2029 Contractor(s) AAA PRO PLUMBING LLC Phone (305)639-8972 CeII Phone Valuation: Total Sq Feet: $ 2,450.00 0 Type of Work: REPLACEMENT OF WATER LINE Type of Piping: Additional Info: Bond Return : Classification: Residential Scanning: 3 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Amount $1.80 $2.63 $2.00 $0.60 $175.00 $9.00 $2.40 Total: $193.43 Pay Date Invoice # 08/09/2018 09/07/2018 Pay Type PL-8-18-68504 Credit Card Credit Card Amt Paid Amt Due $ 50.00 $ 143.43 $ 143.43 $ 0.00 Available Inspections: Inspection Type: Top Out Final Review Plumbing 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 AFFID : 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 • ing. Futhermrr thorize the above -named contractor to do the work stated. ayle2 6 . )G crn i n nic ►' ) er / Applicant / Contractor / Agent Author zedSature: September 07, 2018 Date Building Department Copy September 07, 2018 1 BUILDING PERMIT APPLICATION BUILDING ELECTRIC PLUMBING ❑ MECHANICAL JOB ADDRESS: 160 NE 104 St Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION UNE.PHONE NUMBER: (305) 762=4949 ❑ ROOFING ❑PUBLIC WORKS FBC 20 l'16� Master Permit No:PU Ff--2 3 Z Sub Permit No. REVISION ❑ EXTENSION RENEWAL ❑ CHANGE OF ❑ CANCELLATION .D SHOP CONTRACTOR DRAWINGS City: Miami Shores Foito/Parcel#:11-2136-013-0760 Occupancy Type: Load: Construction Type: OWNER: Name (Fee Simple Titleholder):JOHN BALDWIN County: Address:160 NE 104 ST City: MIAMI SHORES State: FL Miami Dade Zip: Is the Building Historically Designated: Yes NO Flood Zone: BFE: FFE: Tenant/Lessee Name: Email: niwdlab'@bellsouth.riet CONTRACTOR: Company Name: AAA PRO PLUMBING Address:11550 NW 64th ST Phone#: 754-224-0034 Zip: 33138-2029 Phone#: Phone#: 305-639-8972 City: Miami State: FL Zip: 33166 Qualifier Name: George Cando Phone#: 305-639-8972 State;Certification or Registration #: CFC1428813 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: vain ue o Work for this Permit: $ � Cl.) Type of Work: LL ❑ Addition ❑ Alteration Square/Linear Footage of Work:. ❑ New ❑ Repair/Replace Demolition Description of Work: Fee kl_eerref )"1" Coc UJQ;{t°X Nor Specifycolor of color thru Submittal Fee $ Scanning Fee $ Tech logy Fee $ Structural Reviews $ tile: Permit Fee $ Radon Fee $ 2 ' �7 CCF $ CO/CC $ DBPR $ 2 • (0 Notary $ Training/Education Fee $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ ( _` 3 . (1 3 (Revised02/24/2014) Bonding Company's Name (if applicable) Bonding Company's Address City i 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 andoning. "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 valve exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for, the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be a •'roved and a r nspection fee will b charged. �Ard Signature ""r AGENT Signature CONTRACTOR The f. '. ing instrument�was acknowledged before me this The foregoing instrument was acknowledged before me this day C./[-I(.C,Q TI 20 l by 1 St day of August � F$/who is George Cancio �Lf -C personal' known to ,2018 ,by , who is personally known to ___me.sr who has produced as me or who has produced as identification and who did take an oath. NOTARY PUBUC: identification and who did take an oath. NOTARY PUBLIC: Sign". L1�_/', if ••d. ` ��= Notary Public - State of Florida Commission # GG 212638 My Comm. Expires May 28, 2022 Bonded through National Notary Assn. ign: Print: eal: APPROVED BY IXCA, Plans Examiner SMINE gonte,,, Jasmine M. Aaron Commission # FF969025 evg Expires: March 8, 2020 »*.@nn,iCtillIAIM9 ILV****.*. Zoning Structural Review Clerk (Revised02/24/2014) 001757 Local BusinessTax Receipt Miami—DadeCounty, State of Florida -THIS IS NOT A BILL - DO NOT PAY 7170807 BUSINESS NAME/COCATION AAA PRO PLUMBING LLC 8550 NW 64TH SP MIAMI FL 33166 OWNER RECEIPT NO. -E%LPfR s J RENEWAL sEPTEMBER 30, 201,9 74404 Musst be displayed: at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 1 j SEC. TYPE OF BUSINESS \ MA PRO PLUMBING LLC J 196 PLUMBING CONTRACTOR /O EDWIN N M GUERRA MGR r"CFC1428813ax 3 i . Work y I I PAYMENT,RECEIVED 'I BY TAX COLLECTOR * .00•-a7/o2/ial CREDITCARD-18-046146 � `y t I \M Tins Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license; - R` permit, or a certification. of the holder's qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory lawsend requirements which apply to the business. S _ The RECEIPT NO. above must be displayed on all commercial vehicles-Miami-Dad4Code Sec 8a-276. i For more.information, visit www.miamidade.aov/taxoollector rl4► +RI'I CERTIFICATE OF LIABILITY INSURANCE 8/9/(201r78YYYYI 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(ies) 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). PRODUCER South Florida Casualty, Inc. 415 North 4th Street Lantana, FL 33462 CONTACT PHONE 561-533-6144 IA 40)561-533-6170 X" MAIL .ADDRESS:elaine@sfcins. net INSURER(S) AFFORDING COVERAGE NAICR INSURER A. Scottsdale Insurance Company 41297 INSURED AAA Pro Plumbing, LLC 8550 NW 64th Street Miami, FL 33166 305-639-8972 INSURER B: INSURERC: INSURER D. INSURER F. 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 TYPE. OF INSURANCE AWL INSo SUBH- wvo . POLICY NI IM,nrR POLICY EFF (MMiDD-YYYY) POLICY EXP IMMYDD-YYYY; LIMITS A X COMMERCIAL GENERAL LIABILITY CPS2776404 1/16/181/16/19 EACH OCCURRENCE S 1,000,000 CLAIMS -MADE X OCCUR PRrEtt SES;Ea oI HEc'urrencel $ 100,000 MED EXP (Anyone person) $ 5,000 PERSONAL &ADVINJORY $ 1,000,000 GEN9.. AGGREGATE POLICY OTHER- LIMIT APPLIES PER: X PFCOT- Jj LOC GENERA!. AGGREGATE. $ 2,000,000 PRODUCTS - COMPIOP AGG $ 2,000,000 $ AUTOMOBILE LABILITY ANYAUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULEL' AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) S BODILY INJURY (Per person) S BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per: Accident) — UMBRELLA(..LAB EXCESS LAB 1 OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE S $ DED I , RETENTION $ WORKERS COMPENSATION AND EMPLOYERS LIABILITY Y: ANY `.PROPRIE TOH;PAHTNERIEXECUTiVEE.L. OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes. describe under DESCRIPTION OF OPERATIONS below N!A PER STATUTE I I O"=H- FH EACH ACCIDENT 5 E.L. DISEASE - EA EMPLOYEE .. E.L. DISEASE - POLICY LIMIT S — DESCRIPTION OF OPERATIONS I LOCATIONS ;VEHICLES (ACORD 101 Additional Remarks Schedule, may be attached if more space is required) Plumbing Operations CFC1428813 Miami Shores Village BuildingDepartment p SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN 10050 NE 2 Ave ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores Village FL 33138 305-795-2204 AUTHORIZED REPRESS E 7)' Fax 305-756-8972 i © 1988-2013 ACORD'CORPORATION. All rights reserved. AGORD 25 (2013/04) The AGORD name and logo are registered marks of ACORD ���3 c--.: CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 8J9/2018 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(ies) must have ADDITIONAL INSURED provisions or 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), PRODUCER GIGA Solutions Inc 315 SE Mizner Blvd Suite 213 Boca Raton FL 33432 CONTACT NAME PHONE FAX (ACC NExt) (888) 581 0807 I (Atc No) (954) 252-4426 E-MAIL ADDRESS: carts@gicasolves oam INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Technology Insurance Company, 42376 INSURED Integrity Employee Leasing II, Inc. L/C/F AAA Pro Plumbing LLC 128 W. Charlotte Avenue Punta Gorda FL 33950 INSURER B : INSURERC: INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:Cert ID 25912 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 : iADDUSUBR : POLICY EFF LTR TYPE OF INSURANCE INSII WUCL POLICY NUMBER ! (MMiDO/YYW) POLICY EX? 1 (MMrDDtYWY} 1 LIMITS COMMERCIAL GENERAL CLAIM S-MADE: LIABILITY I OCCUR I EACH OCCURRENCE DAMAGE. TO RENTED PREMISES ,Ea occurrence) : MED EXP (Any one person) $ PERSONAL & ADM INJURY $ GEN'1. AGGREGATE P ?.ICY OTHER: LIMIT APPLIES PRO_ FCT PER: LOC l GENERAL AGGREGATE. $ !PRODUCTS - COMFFJP AGG S AUTOMOBILE LIABILITY ANY AUTO i OWNED ED AUTOS ONLY II HIRED AUTOS ONLY SCHEDULED ALTOS NON -OWNED ALTOS ONLY . cOM51NE D SINGLE LIMIT I 13ODILY INJURY (Per person` _ BODILY INJURY (Per accede nt i PROPERTY DAMAGE I (Per accident) UMBRELLA LIAB EXCESS LIAB DEG ' I RETENTION $ O OCCUR '', CLAIMS -MADE: I•. EACH OCCURRENCE ... AGGREGATE WORKERS COMPENSATION A 'AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNERIEXECUTIVE :OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes. describe under c1, DESCRIPTION OF OPERATIONS below Y 1 N 1 TWC3696694 2/12/2018 N I A : PER : 3TH- 2/12/2019 _X _STATUTE .._...........1._E_.._._....______.........._—_..__......._._._......_....._.. E.L. EACH ACCIDENT P.L. DISEASE - EA EMPLOYEE E.L.LDISEASE POLICY LIMIT 3 1_000 ,000 ; 1,000 ,000 000 , 000 5 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Coverage provided for all leased employees but not subcontractors of: AAA Pro Plumbing LLC. Location coverage effective 2/12/2018 CFC1428813 CERTIFICATE HOLDER CANCELLATION Miami Shores Village Hall 10050 NE 2nd Ave Miami FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE R t `DMO�.G ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ac,e :1 o5 :1 • • ••• • • • ••• • •• •• • • •• •• • • • • • • • • • • • • • • ,•• • • • • • • • • • • • • • • ••• • • • • ••• • • • • • • • •*• • • • • • • • • • • • • • • • • ••• • • • • • • •• • •• • •• • • • • • • • ••• • •• • • , •• ••• •• • • • • • • • Miarn Shores Village APPROVED BY DATE ZONING DEPT BLDG DEPT ",I 111,11 (:T 0) COMPI 1 All Am) Cot IN lY ANCE WITH ALL FEDERAL NJ[ FS AND RFGULATIONS /_ PLUMBING PIA Lo v ° a Approved t, bo lut sr Uisapp o' d _ Au % _5L (AN, (4:6\ State of Florida Certified Plumbing Contractor George L. Cancio 6907 NW 51 ST Miami, FL 331-- CFC-1428813 C9M.noro12_ i/1-21) f\AfR Viva P W01067 MtpM%, 1'L 33166 a 0