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PL-15-1726Inspection Worksheet 02C Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-238768 PermitNumber: PL-7-15-1726 Scheduled Inspection Date: March 28, 2016 Permit Type: Plumbing - Residential Inspector: Hernandez, Rafael Inspection Type: Final Owner: SMITH, PATRICE AND SCOTT Work Classification: Addition/Alteration Job Address: 358 NE 101 Street Miami Shores, FL 33138- Phone Number Parcel Number 1132060135280 Project: <NONE> Contractor: DALE PLUMBING Phone: (786)663-1804 Building Department Comments CONVERSION OF COVERED TERRACE PLUMBING Infractlo Passed Comments ADDITION AS PER PLANS I INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. �yt!°Res Miami Shores Village 10050 N.E. 2nd Avenue NE r _ IIJ_ ... Miami Shores, FL 33138-0000 Phone: (305)795-2204 F�oni'D Permit NO. PL-7-15-1726 Permit Type: Plumbing - Residential Pen Work Classification: Addition/Alteration Permit Status: APPROVED Issue Date: 12/23/2015 1 Expiration: 06/20/2016 Project Address Parcel Number Applicant 358 NE 101 Street 1132060135280 Miami Shores, FL 33138- Block: Lot: PATRICE AND SCOTT SMITH Owner Information Address Phone Cell PATRICE AND SCOTT SMITH 358 101 Street MIAMI SHORES FL 33138- 358 101 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone DALE PLUMBING (786)663-1804 Type of Work: CONVERSION OF COVERED TERRACE PLUMB Type of Piping: Additional Info: Bond Return : Classification: Residential Scanning: 1 Fees Due Amount CCF $1.80 DBPR Fee $3.38 DCA Fee $3.38 Education Surcharge $0.60 Permit FQei $225.00 Scanning'-T-�ee $3.00 Technolrgy Fee $2.40 Total $239.56 Valuation: $ 2,600.00 Total Sq Feet: 0 Pay Date Pay Type Amt Paid Amt Due Invoice # PL-7-15-56294 12/23/2015 Credit Card $ 189.56 $ 50.00 07/10/2015 Credit Card $ 50.00 $ 0.00 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 pertain ingWereto 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 assum responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for: ELECTRICAL, PY JMBING, MECI�PICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWN EWAFF A IT: I c y he foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction an zc in( mo , authorize the above -named contractor to do the work stated. December 23. 2015 Authdr 6d Si ur13;.0: er / Applicant / Contractor / Agent Building Department Copy December 23, 2015 BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC PLUMBING JOB ADDRESS: ❑ MECHANICAL J4!5" Miami Shores Village i Building Department JUL 1 2015 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 -- INSPECTION LINE PHONE NUMBER: (305) 762-4949 �- FBC 2019 Master Permit No.P24-) Sub Permit No.� (� R ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL [:]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP � o CONTRACTOR DRAWINGS of City: Miami Shores Countv: Miami Dade zip: _3!�3 ( _�,_ Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): �D�tf Phone#: Address: �F� r'-(o 1S City: �I i u/1 I �VL 0� State: �� Zip: T� Tenant/Lessee Name: Phone#: Email CONTRACTOR: Company Name: P P(C)A4>rt4!7 "o J Phone#: Address: / J-q 04-1 7 < �_ l- 78� % '0: IE-oy City: =Y. az idJrrl ( Gi b State: r Zip: , Qualifier Name:l�[ a4bjo Dj�zuz )C-/ f'l -� Phone#: t' '7 State Certification or Registration #: Certificate of Competency #: Crl^C /7 ` DESIGNER: Architect/Engineer: one#: Address: City: State: Zip: Value of Work for this Permit: $ 4/ � O Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: ectf %c/S%Oyu- p C ou-t-v4" r�P1a J -4 Specify color of'color thru tile: Submittal Fee $ � —�V - W Permit Fee $ Scanning Fee $ Technology Fee $ Structural Reviews $ Radon Fee $ Training/Education Fee $ CCF $ DBPR $ CO/CC $ - Notary $ Double Fee $ _ Bond $ (Revised02/24/2014) TOTAL FEE NOW DUE $ 1 �j - i • 5'('o Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) _ Mortgage Lender's Address City State Zip 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 apAoved and a reinspection fee will be charged. OWNER or AGENT The foregoing instru ent was acknowledged before me this 'Z a day of k^20 l y , by �O who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign. 'I Print: C--C,# N CONTRACTOR The foregoing instru ent was acknowledged before me this day of v w L 20 N by ho is personally known to as me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: v Print: L GlC%---k as Seal: �►RY'we� LAURAFARLEY ap�'Pr'�k 188027 ...,. Seal: MY COMMISSION # MY COMMISSION # FF 18W * * EXPIRES: March 16, 2019 � � EXPIRES: March 16, 2019 s� P` Bonded Thru BudO Notary 47 nTl Bonded Thru Budget Notary Servim 'F W OF F�� APPROVED BY c. �� s �S Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) 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: r�cr Owne State of Florida County of Miami -Dade The foregoing was acknowledge before me this day of 20(� By�7j o � whgis per -so nally khowr)to me or has produced as identification. Notary: uulu FAMEY SEAL: �•� My ...,, COMMISSION t FF 188M * * EXPIRES: March 16, 2019 Bonded Thru Budget Notary SerVkee Dale Plumbing Inc. 154 NW 97 Street Miami Shores, Fl. 33150 7/10/2015 State of Florida County of Dade Before me this day personally appeared Mr. Linton Dawkins who \being duly sworn, deposes and says , that he will be the on7a-Qt rson Working on the project located at S,5'? 14 (o 1 5 t' 1 5� &A-9, ( �r ► 3 Sworn to and subscribed before me this -=�� - day of --` -12015 Personally known Print name - Laura Farley I �'�µ;•'u�i� (AURA FARLEY MY COMMISSION II FF 18W * EXPIRES: March 16. 2019 �jv�tor r4 ftwed Thru Buod Notary Services MIA�MFGADE 5835617 DBA/BUSINESS NAME: DALE PLUMBING INC BUSINESS LOCATION: 154NW97ST MIAMI SHORES, FL 33150 OWNER/CORP. DALE PLUMBING INC PHONE # 786-663-1804 154 NW 97 ST MIAMI SHORES, FL 33150 NAICS CODE: 23822 MIAMI-DADE COUNTY - STATE OF FLORIDA LOCAL BUSINESS TAX 2015 - 2016 APPLICATION If no longer in business, please notify us in writing. Review and correct the information shown on this application. A 25% penalty will be assessed to anyone found operating without a paid local business tax, in addition to any other penalty provided by law or ordinance (Sec 8A-176(2)). A Certificate of Use and/or City Business Tax Receipt may also be required. MIAMI-DADE COUNTY - STATE OF FLORIDA LOCAL BUSINESS TAX 2015 - 2016 APPLICATION 5835617 BUSINESS LOCATION: 154 NW 97 ST MIAMI SHORES, FL 33150 OWNER/CORP. DALE PLUMBING INC DALE PLUMBING INC LINTON H DAWKINS PRIES 154 NW 97 ST MIAMI SHORES, FL 33150 BUS. COMMENCEMENT DATE: 07/01/2006 SEC TYPE OF BUSINESS PLUM PLUMBING CONTRACTOR 1 N/A October 05, 2015 RENEWAL RECEIPT. 6084388 STATE # CFC1427087 APPLICATION DETAILS FEE AMOUNT Receipt Fee 30.00 UMSA Fee 0.00 Beacon Council Fee 15.00 Bingo Permit Fee 0.00 Nightclub Permit Fee 0.00 Multi -Municipal Contractor Fee 0.00 Restricted Contractor Fee 0.00 Library Fee 0.00 Transfer Fee 0.00 Doing Business without a License Penalty 0.00 Late Penalty 0.00 Collection Cost 0.00 NSF Fee 0.00 Prior Years Due 0.00 Amount Recently Paid - 45.00 TOTAL AMOUNT DUE: 0.00 To pay online go to www.m!amidade.gov/taxcollector To pay by mail, make check payable to: Miami -Dade County Tax Collector Business Tax 200 NW 2nd Avenue Miami FL 33128 To pay in person go to: 200 NW 2nd Avenue (305) 270-4949, fax (305) 372-6368 A service fee of not less than $25.00 up to a minimum of 5% will be charged for all returned checks. t RETAIN FOR YOUR RECORDS t ................................................................................................................................ 1 DETACH HERE AND RETURN THIS PORTION WITH YOUR PAYMENT + N/A October 05, 2015 RENEWAL RECEIPT. 6084388 STATE #CFC1427087 BUS. COMMENCEMENT DATE: 07/01/2006 SEC TYPE OF BUSINESS PLUM PLUMBING CONTRACTOR APPLICATION IS HEREBY MADE FOR A LOCAL BUSINESS TAX RECEIPT OR PERMIT FOR THE BUSINESS PROFESSION OR OCCUPATION DESCRIBED HEREON. I HAVE BEEN INFORMED OF ALL ZONING RESTRICTIONS IMPOSED ON THIS RECEIPT. I SWEAR THAT THE INFORMATION IS TRUE AND CORRECT. SIGNATURE REQUIRED SEE INSTRUCTIONS ABOVE Please pay only one amount. The amounts due after Sept 30th include penalties per FS 206.053. If Received By Oct 31, 2015 Nov 30, 2015 Dec 31, 2015 Jan 31, 2016 Please Pay $0.00 $0.00 $0.00 $0.00 7000000000000000000000006084388201600000004500000000000002