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PL-11-134Inspection Number: INSP- 155283 Permit Number: PL -1 -11 -134 Scheduled Inspection Date: March 18, 2011 Inspector: Hernandez, Rafael Owner: ORQUERA GIRALDO, MARCOS & CI I7AQCTu Job Address: 9801 N MIAMI Avenue Miami Shores, FL 33150- Project: <NONE> Contractor: A&L PLUMBING SPECIALISTS LLC Building Department Comments REMOVE WASHER AND DRYER MACHINE INSIDE AND RELOCATE WATER HEATER. Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments March 17, 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 Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132060131110 Phone: (954)274 -8915 Page 2 of 3 A --tkv, 9 (Azs..aorx, Bel ISI I l —l.`I BUILDING Permit No. PERMIT APPLICATION Master Permit No. FBC 20 Permit Type: PLUMBING ' A � �,,�/ Owner's Name (Fee Simple Titleholder) f �2� L � Phone # �� 3 4 ' 1 c#4 q . Owner's Address q B I• Ai- l l ArV -Ave. city Ta , shizte.. State 7"L. Tenant/Lessee Name Phone # Email Job Address (where the work is being done) 4 B0i N i44114; Af/e City Miami Shores Village County Miami -Dade FOLIO / PARCEL # (1 3 2 06/01A/1(0 Is Building Historically Designated YES Contact Phone Value of Work For this Permit $ 1, Ape Type of Work: ❑Addition Describe Work: tZ emo'.er t `- alit ' G`ebC. '. .SQ'dt Radon $ Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 Training/Education Fee $ NO E -mail Violation date: DPBR $ Zip 33/50 Zip .33 i SO ❑Alteration l,[i.&hQo /.D D . (are. Tew ❑ Repair/Replace 044 rn t D cti-°f c_ (1/-4-4 Uo_ 410 paLTEwzn JAN 2 6 1011 See Reverse side -+ Y o • ••• 0000000000 0•001 Flood Zone Contractor's Company Name A L FA,ph,, i 7 j� - 9'/.5 / T (W. -f�D � Phone # 9/2 e Contractor's Address ®'�P City *A /O4 State r/ Zip 3 6 / 2. Qualifier Name ele ®!' ig ita des Phone # Q/7 y - g y /,S" State Certificate or Registration No. C FG 1 2 00 243 Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # Square / Linear Footage Of Work: ❑ Demolition r g o imaki— 4,4=4: **9e**4cdedrsY*4r3:3* ** 3r9r9i9r3e9r* zY3e�Ir3eaY�r�r�e�Y�Y**** �r�Y�r�e�k�r�ear�e�e :Y�e�e�i�Y�Y�r:Y:YsY ** Fees Submittal Fee $ ' .0 Permit Fee $ C" CCF $ CO /CC $ Notary $ Scanning $ Double Fee $ Structural Review. $ Total Fee Now Due $ ( ' 2..-Z 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. Signature tQ LCA UQ"Q• Owner or A ent The foregoing instrument was acknowledged before me this day of , 201 , by YY\ c 0 y of Z' .f , 20 /L, by who is personally known to me or who has produced_] Q As identification and who did take an oath. NOTARY PUBLIC: Sign: • ' / /m Print: ? • �, p� p i �a� My Commission Expires: - ' cn c C 0 . % II) E E (Revised 07 /10 /07)(Revised 06/10/2009) o APPROVED BY l( Plans Examiner Engineer Contractor The foregoing instrument was acknowledged before me this '�2. who is personally known to me or who has produced ,9/1. JZ Vi -3 2/164 )1 -0 as identification and who did take an oath. NOTARY PUBLIC: 4 4 , p �6 � *** * * *** *next * * * * * * * * * * * ** p 6 aiZ****************************** *********** * * *** *****dc************ Zoning Clerk checked THEPOLICIESOFINSURANCE :LISTEDBELOW HAVEBEENISSUEDTOTHEINSUREDNAMEDABOVE FORTHEPOLICYPERIODINDICATED. 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 INSURANCEAFFORDEDBYTHE POLICIES DESCRIBED HEREIN ISSUBJECTTOALLTHETERMS, EXCLUSIONSANDCONDITIONSOFSUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN R A ADD%L GENERAL X • . UABIUTY COMMERCLAL GENE ': j POLICY NUMBER GFL- 1012284 , POLICY EFFECTIVE 05 -10 -2010 POLICY EXP `RATION 05 -10 -2011 LIMITS EACH OCCURRENCE g 1.000,000 DAMAGE TO RT 100,000 $ 53000 $ 1.000.000 1 CLAIMS MADE X OccuR PRFMIRFR(F,.nr n' MED EXP (Any one Pelson) PERSONAL& ADV INJU GENERAL AGGREGATE 2,000,000 GEHL AGGREGATE LBW APPUES PER iI POLICY El PrKr�Y n LOO PRODUCTS - COMP /OP AGO $ $ 2,000,000 AUTOMOBILE _ _ LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS COMBINED SINGLE UVAIT (Ea accident) S BODILY INJURY (Pe Pte) $ ( II P ODIL nM U ) RY $ (P deAl °AllW�3E $ AAttace LIABILnY _ ANY AUTO AUTO ONLY -EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY AGO EXCESS / UMBRELLA LIABILITY OCCUR ❑ CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ — DEDUCTIBLE RETENTION $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N ANY PRIETORIPARTNE OFFICE EMBER EXCLUD B �� NH) RPK4`JAU PROV IOt4$ Below WC STATU OTH- TnAV I n„ina FR E.L. EAC (DENT $ E.L DISEASE -EA EMPLOYEE E.L DISEASE - POLICY LIMIT 5 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS IVEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION City of Miami Shores 10050 NE 2nd Ave. Miami Shores, 33138 Phone: (305)796-2204 I Fax; (305)760.0972 AnnIn In Mnno /n4, SHOULD ANYOF 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. AUTHORIZED REPRESENTATIVE <DA> GES Feb, 7. 2011 10:48AM No, 2558 PRODUCER A,B,S. Insurance Consultants 11402 N W 41st Street Suite 213 Miami FL 33176 INSURED Tampa FL 33612 CERTIFICATE OF LIABILITY INSURANCE A & L Plumping Specialists, LLC 1712 West Fore Drive THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE JNSIIRERA: Cypress Property & Casualty INSURER a: INSUREFI C: INSURER O• INSURER E DATE IMWDDIYYYY) 02/07/2011 NAIC # ©1988 -2009 ACOR CORM ION. All rights reserved. The ACORD name and Togo are registered marks of ACORD © 630 ( kJ. ` ®Art : ,�U F. ��~^ a 1 33 c ` ear A 3 /5 eo®pa' '' (NI re cot Offer � 4� - A cie rt -h Nni SUBJECT TO COMPLIANCE 114 ALL FEDERAL STATE AND COUNTY RULES AND REGULATIONS 1 92 , e490 prt2 104.e 1 1 10 dttrks as la ti MEMEn JANE 6 201