Loading...
PL-10-1310Tenant/Lessee Name Email miatni Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: ($05) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION Master Permit No. FBC 20 Permit Type: PLUMBING Owner's Name (Fee Simple Titleholder) Owner's Address L2- RAG 3"1 City 7 L i(.e S State ( Zip _33 /3 er tJz- Job Address (where the work is being done) City Miami Shores Village County Miami-Dade FOLIO / PARCEL # 41 I h Is Building Historically Designated YES NO Flood Zone A Contractor's Company Name 2et /w/j/0/1Dheir Phone # por- cfer-g7+1 0 Contractor's Address /020 -6 M4 , Sarre' Cit 1/141e4A Zip 350/0 Qualifier Name Mlaii6Z-- ‘4,4r7■4;74 Phone # APT' Pir-gt)0 State Certificate or Registration No. emosvisn Certificate of Competency No. Contact Phone E-mail Architect/Engineer's Name (if applicable) Phone # imarzarsamia Type of Work: 0Addition 0Alteration 7 lt Re air/Replace 0 Demolition iirgb-W%.-040,......., El , h„ . hth. 4(rh'Phh:qrg■Ohh ' ' - h h' ;) , [ Submittal Fee $ 50,60 ? Prig' Notary $ Scanning $ Double Fee $ Structural Review. $ Permit F $ Training/Education Fee $ Radon $ DPBR $ *Blisirtrt cuv: Phone # CCF $ Zip 1 ,7 JUL 1 : w 11 L1Y: Permit No. VI-10 Violation date: Total Fee Now Due $ VAC See Reverse side —› Phone # 7r ”o7 3 3 / k ****** CO/CC $ Technology Fee $ Bond $ 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 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: caner or . The foregoing instrument was acknowledged before me this Y day of Jt4 , 20 , b Se lya L 6i9d l's who is personally known to me or who has produced Ft- et As identification and who did take an oath. NOTARY PUBLIC: My Commission Expires: APPROVED BY (Revised 07 /10 /07)(Revised 06/10/2009) • � �.•+ ra, MARY A. ROBBINS s., Notary Public - State of Florida Si g n: _ .2014 Commission • DD 972518 Print: Bonded Through National 'r t. Assn. — My Commission Plans Examiner Engineer Signature The foregoin day of / who is NOTARY Contr tor ment was acknowledged before me this ,20 OP by wn to me or who has produced as identification and who did take an oath. • ea/ zt, LUIS FERNANP Z s • MY COMMISSION li DO 832441 EXPIRES: November 7, 2012 Bonded Thor Budget Notary Services Zoning Clerk checked Inspection Number: INSP- 148780 Permit Number: PL -7 -10 -1310 Scheduled Inspection Date: September 20, 2010 Inspector: Hernandez, Rafael Owner: CANNATA, SEBASTIAN Job Address: 622 NE 98 Street Miami Shores, FL 33138- Project: <NONE> Contractor: LONGA CONSTRUCTION Building Department Comments KITCHEN REMODEL Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments September 17, 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 1132060171830 Phone: (954)254 -0491 Page 8 of 26 THIS IS TO CERTIFY THAT THE POLICIES.OF INSURANCE INDICATED. NOTWITHSTANDING ANY REQUIREMENT, CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. TERM INSURANCE OMITS IN R LISTED OR SHOWN MD BELOW HAVE BEEN ISSUED TO THE INSURED CONDITION OF ANY CONTRACT OR OTHER AFFORDED BY THE POLICIES DESCRIBED MAY HAVE BEEN REDUCED BY PAID POLICY NUMBER NAMED DOCUMENT HEREIN IS CLAIMS. (MN DDD ) ABOVE FOR THE WITH RESPECT SUBJECT TO ALL (MMM/UDD�) POUCY PERIOD TO WHICH THIS THE TERMS, LIMITS I LT TR R TYPE OF INSURANCE A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY X OCCUR CPS1150320 03/31/10 03/31/11 EACH OCCURRENCE $ 1,000,000 UAMAUU I HUN ItU PREMISES (Ea occurrence) $ 50,000 CLAIMS -MADE MED FRCP (Any one person) $ 5,000 PERSONAL &ADVINJURY $ 1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE UMIT POLICY II JET APPLIES PER: LOC PRODUCTS - COMP/OP AGG $ 1,000,000 $ AUTOMOBILE UABILI Y ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE OMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ $ UMBRELLA LIAR EXCESS UAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ B WORKERS COMPENSATION AND EMPLOYERS' UABIUTY ANY PROPRIETOR/PARTNER/EXECUTIV OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS N / A 830 -23430 05/07/10 05/07/11 X WCSTATU- OTH- TORY LIMITS ER E.L EACH ACCIDENT $ 100,000 E.L DISEASE - EA EMPLOYEE $ 100,000 below E.L. DISEASE POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, K more space Is required) PLUMBING RESIDENTIAL & COMMERCIAL Miami Shores Village 1 0 0 3 -256 - 72 Ave. hes FL 33138 Miami ami Shores VILLAMS 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 G z coRif CERTIFICATE OF LIABILITY INSURANCE OP ID MA DATE(MMIDD/YYYY) „� 07/01/10 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(les) 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 Iieu of such endorsement(s). PRODUCER iSure Insurance Brokers 2700 SW 137 AVE Miami FL 33175 Phone:305- 223 -2533 Fax:305- 220 -0765 INSURED Metr opolitan Plumbing, Inc. Hi F 33010 (.UN I AL. 1 NAME: PHONE AIC, No, Ext): MAIL ADDRESS: FAX (AIC, No): PRODUCER CUSTOMER ID #: METRO- 1 INSURER(S) AFFORDING COVERAGE INSURERA: Scottsdale Ins. INSURER B: Bridgefield Casualty Ins. Co. INSURER C : INSURER D : INSURER E : INSURER F : NAIC # 41297 10335 COVERAGES CATE HOLDER ACORD 25 (2009/09) CERTIFICATE NUMBER: CANCELLATION The ACORD name and logo are registered marks of ACORD REVISION NUMBER: © 198 -2009 ACORD CORPORATION. All rights reserved.