PL-10-1584MOVE EXISTING WASHER AND DRYER TO NEW
LOCATION
Passed
Inspector Comments
/
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
nspection Number: INSP - 153273
Permit Number: PL -9 -10 -1584
Inspection Date: November 12, 2010
Inspector: Hernandez, Rafael
Owner: MARTINON, JULIAN
Job Address: 145 NE 94 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: POMPANO PLUMBING INC
Building Department Comments
November 12, 2010
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
For Inspections please call: (305)762 -4949
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1132060132920
Phone: (954)785 -8010
Page 1 of 1
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: PLUMBING
Miami Shores Village
Building Department
Job Address (where the work is being done)
Owner's Name (Fee Simple Titleholder) / /t' Ajj,Q y Phone # _305 r p o L i 7 7 7c
Owner's Address !45 4/ 94 Sr
City / c rh ■ State F.Z.
Tenant/Lessee Name
Email
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
/ '/6 /vg
City Miami Shores Village County Miami -Dade
FOLIO / PARCEL #
Is Building Historically Designated YES NO
Contractor's Company Name ' t a.n6 .. \L . Phone # 1 4 I$ ' 80th)
Contractor's Address 25 ; i ,i .
L
City fJ' 4, PFLASQ Yjt - s. State $ L,
Qualifier Name i \fig >.4`:CLit , Phone # •
State Certificate or Registration No.. Certificate of Competency No.
Contact Phone
Architect /Engineer's Name (if applicable)
Value of Work For this Permit $ 75i' 6.°
Type of Work:
Describe Work:
1 E'A 776
Notary $
Scanning $
Double Fee $
Structural Review. $
Addition
Radon $
[Alteration
fitr
Submittal ttal Fee $ �/ • co- Permit Fee $
E -mail
** * ** * * *: * *: * * ** **** * * **** * *** * * * ** F * * * ** * * ** ** ** * ** * * * * * * * * * * * * * * * * ** * * * * * * **
loo
Training /Education Fee $
Violation date:
DPBR $
Permit No I
0 H554
Master Permit No.
Zip
Phone #
Zip
#
Square / Linear Footage Of Work:
❑New ❑ Repair /Replace
CCF $ CO /CC $
Total Fee Now Due $
Zip
Flood Zone
Technology Fee $
Bond $
See Reverse side -*
❑ Demolition
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable) - ex) 766 7
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 ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 approved and a reinspection fee will be charged.
N /1
Owner or Agent
The foregoing instrument was acknowledged before me this 3
day of �[0 T , 2 0 / , by /(/t R /e 1,4, 4
w o is personally known to me r who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
APPROVED BY
Print: L,ZLLAAL ,/ Siti J
My Commission Expires:
(Revised 07/1 0/07)( Revised 06/10/2009)
Yr ' MYCOMMISSSiO( K C .::99
EXPIRES:No:e":: •:J10
Bonded Thru Notary Put, c Underwriters
******** * * * * * * * * * * * * * * * * * * * ** * * * * * * * * **
Plans Examiner
Engineer
Signature
Sign:
Print:
Contractor
The foregoing instrument was acknowledged before me this i'/
r
day of A t. s 20 /(.. by dam et (,/ /` 3,-;-(=e),
who is personally known to me or who has produced
as, dentification and who did take an oath.
,,r
NOTARY P �)(C:
C / l/1A
My Commission Expires: i" 4,,, HORSTMOLLER
* MY COMMISSION # DD 897258
EXPIRES: October 6, 2013
• „ Bonded Thru Notary Public Underwriters
************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Zoning
Clerk checked
THE POLICIES
ANY REQUIREMENT,
MAY PERTAIN,
POLICIES. A
OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
GREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
,; " IDDIYYYY)
10/21/09
NFORMATION
EXTEND OR
BELOW.
r " '
PRODUCER
Brown &
5900 N.
P.O. Box
Ft. Lauderdale
Phone:554-
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MMIDDIYY)
POLICY�Xp�RAT�pN
DATE (AHAHIDDIYY)
LIMITS
Pompano Plumbing Inc.
925 SE tat Street
Pompano Beach FL 33060
INSURER A: *Fr.% Mutual Fnsurance Co.+
=
XI
RAL LIABIuTY
COMMERCIAL GENERAL LIABILITY
MPG84093
10/12/09
10/12/10
EACH OCCURRENCE
$ 1 000 000
PREMI : occu
$ 500 000
III
■ CLAIMS MADE I X I OCCUR
MEO EXP (Any one person)
$ 10 000
■
PERSONAL & ADV INJURY
$ 1 000 000
III
GENERAL AGGREGATE
$2,000,000
I:- Nit AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$2 000 000
1
POLICY IT 781: F LOC
■ I
X
X
OMOBILE LIABIUTY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
MPG84093
10/12/09
10/12/10
COMBINED SINGLE LIMIT
(Est acddent)
$ 1,000 , 0 00
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
G
RAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
AUTO ONLY: AGO
$
B
EX
X
SSIUMBRELLALIABILITY
CUG84093
10/12/09
10/12/10
EACH OCCURRENCE
$ 1 000 000
I OCCUR
I CLAIMS MADE
AGGREGATE
$1 000 000
DEDUCTIBLE
$
$
X
RETENTION $10 000
$
A
WORKERS COMPENSATION AND
EMPLOYERS LIABILITY
ANY PROFRIETORIPARTNEWEXECUTIVE
OFFICERIMEMBEREXCLUDED?
U eess d g under
SP
WC8400018114
10/12/09
10/12/10
+ TH-
TORY LIMITS ER
E.LEACHACCIDENT
$ 500000
E.L. DISEASE - EAEMPLO _
$ 500000
E.L. DISEASE- POLICY LIMIT
$ 500000
OTHER
DESCRIPTION
Residential
. F OPERATIONS 1 LOCATIONS /VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS
Plumbing Contractor
AC
CERTIFICATE OF LIABILITY INSURANCE OP ID C6
POMPA07
,; " IDDIYYYY)
10/21/09
NFORMATION
EXTEND OR
BELOW.
PRODUCER
Brown &
5900 N.
P.O. Box
Ft. Lauderdale
Phone:554-
Brown of Florida, Inc .
Andrews Ave. #300
5727
FL 33310 -5727
776 -2222 Fax:954- 776 -4446
THIS CERTIFICATE IS ISSUED AS A MATTER OF
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND,
ALTER THE COVERAGE AFFORDED BY THE POLICIES
INSURERS AFFORDING COVERAGE
NAIC#
INSURED
Pompano Plumbing Inc.
925 SE tat Street
Pompano Beach FL 33060
INSURER A: *Fr.% Mutual Fnsurance Co.+
10385
INSURERS: *Old Dominion Ins. Co.+
40231
INSURER C:
INSURER D:
INSURER E:
COVERAGES
CERTIFICATE HOLDER
FOR INFORMATION ONLY
FORINFO
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHOR TIVE
ACORD 25 {2001108)
CANCELLATION
0 ACORD CORPORATION 1988