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PL-11-292Inspection Number: INSP - 156221 Scheduled Inspection Date: March 02, 2011 Inspector: Hernandez, Rafael Owner: RANDLE, MARTIN Job Address: 150 NE 103 Street Project: <NONE> Miami Shores, FL 33138- Contractor: MIAMI PLUMBING & SOLAR HEATING Building Department Comments March 01, 2011 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 Number: PL -2 -11 -292 Permit Type: Plumbing - Re Inspection T Work Classifica io Phone Number Parcel Number 1132060131740 ' Phone: (305)835 -8008 INSTALLATION OF NEW TANKLESS WATER HEATER Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments de Page 30 of 44 BUILDING PERMIT APPLICATION FBC 20 Permit Type: PLUMBING Address: SS A), E IC 3 StLAe1 City: TA/ fr/'l 1 s5 State: / Tenant/Lessee Name: JOB ADDRESS: `S tA /03a 5 /- City: Miami Shores County: Folio/Parcel #: State Certification or Re 's atio n #: Miami Shores Village Building Department BY: 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 OWNER: Name (Fee Simple Titleholder): MR +/N PL. Miami Dade Permit No. Is the Building Historically Designated: Yes NO � X CONTRACTOR: Company Name: � 791/4 � 2 1 - 14 - 1148, 00& Address: . / 2, NV/ cz.cesT City: /' 7 i,?,7 ' State: lr Qualifier Name: fO - vt t� / " > �A/Ji1 ` f%' 1 / M©MTC7M`� it FEB2220 y 1 Master Master Permit No. Email: Phone #: 30E ` y ^ SS3/ Zip: 3 3 (3g Phone#: 30S - 7S S 3/ Zip: 3 3 /3g Flood Zone: /.)0 "31 ePVIr Zip: .7� Phone#: � Certificate of Competency #: Contact Phone #: & C' O � Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ Ci CgT VG/ Square/Linear Footage of Work: Type of Work: ❑Address ❑Alteration -�} New ❑Repair/Replace ❑Demolition Description of Work: T a U.) 0- x-2.1. /Y ***** *** * * * * ** **** * * ***+ +x*******+ ****** F *********** ****** ******+x********** * * ***** Submittal Fee $ Permit Fee $ i t 6 0— CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ tL\ , ID 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. Signature w o 's perso Owner or Agent nstrument was ackn , 20 , by known to me who has produced stion and who did take an oath. NOTARY ') BLIC: ell # I ' Sign: ��� Ll L A L 1 Print: My Commission Expires: c * \O' 0 � My Commission Expires:, e IF y;,,, amis `s 'p4 of (Revised 07 /10 /07)(Revised 06/10/2009)(Revised 3/15/09) 4V G���aA APPROVED BY // Plans Examiner Structural Review Signatur J e/ / 4' ,� Co actor The fore¢oin ) instrument was ackn ► ed ed before me r s , 201 / , by A n.i nally kno o me or who has pro ► uced ntification and who did take an oath. N Sign: Print: .. _ PUBLIC: fw AAA- ell 1 it Zoning Clerk 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR ADO I INSRD TYPE OF INSURANCE POLICY NUMBER . VE DATE (MM /D e/YY) POLICY EXPIRATION DATE (MM /DD/YY) LIMITS A GENERAL LIABILITY NZ COMMERCIAL GENERAL LIABILITY CLAIMS MADE � 'v l OCCUR GL 141147 -3 05/07/10 05/07/1 EACH OCCURRENCE $ 100,000 DAMAGE TO RENTED PREMISES (Ea occurence) $ 50,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 100,000 J GENERAL AGGREGATE $ 100,000 GEN'L AGGREGATE LIMIT APPLIES PER: 7 POLICY n PROJECT n LOC PRODUCTS - COMP /OP AGG $ 100,000 AUTOMOBILE LIABILITY ANY AUTO 7 ALL OWNED AUTOS D SCHEDULED AUTOS 7 HIRED AUTOS NON -OWNED AUTOS t ( a cci d en t SINGLE LIMIT $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO • AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS /UMBRELLA LIABILITY 7 OCCUR CLAIMS MADE DEDUCTIBLE 7 RETENTION $ EACH OCCURRENCE $ AGGREGATE $ $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below WC S i Ai U- U rH- I TORY LIMITS n ER E.L. EACH ACCIDENT $ E.L. DISEASE • EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS? LOCATIONS7VERIMES FIEXCEIISIONS ADDED BY ENDORSEMENT / SPECIAL PR IJS A CORL PRODUCER McTaggart Insurance Agency, Inc 9900 Stirling Road Cooper City, FL 30024 INSURED Miami Plumbing &Solar Heating 2170 NW 95th Street Miami, FI. 33147 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND 9R ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURER A: National INSURER B: INSURER C: INSURER D: INSURER E: DATE (MM/DD/YYYY) 04/28/2010 NAIC COVERAGES ACORD 25 (2001/08) City of Miami Shores 10050 NE 2ND ave. Miami Shores, FI. 33138 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED P.OLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 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 REPRESENTA ES. AUTHORIZED R PRESENTATIVE © ACORD CORPORATION 1988 1 40 0 4 0.1 0 00 0075.; :0 SEE OTHER SIDE STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CONSTRUCTION INDUSTRY CERTIFICATE OF ELECTION TO 8E EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW EFFECTIVE: 08/05/2009 EXPIRATION DATE: 08/05/2011 PERSON: GEORGE KITZMILLER FEIN: 352219643 BUSINESS NAME AND ADDRESS: MIAMI PLUMBING & SOLAR HEATING INC 2170 N W 95TH ST MIAMI, FL 33147 SCOPE OF BUSINESS OR TRADE: 1- SOLAR ENERGY SERVICE 2- CERTIFIED SPECIALTY CONTRACTOR 3- CERTIFIED PLUMBING CONTRACTOR IMPORTANT i Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election I under this section may not recover benefits or compensation under this D chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt.. apply only within the scope of the business or trade listed on the notice of election to be exempt. R E Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. QUESTIONS? (850) 413 -1609 -CLAW A GE tl FL SIT NO. 231 DO NOT FORWARD MIAMI PLUMBING & SOLAR HEATING GEORGE KITZMILLER 2170 NW 95 ST MIAMI FL 33147 39