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PL-11-1060 (2)Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 161532 Permit Number: PL -6 -11 -1060 Scheduled Inspection Date: July 01, 2011 Inspector: Hernandez, Rafael Owner: CUMING, RICHARD Job Address: 436 NE 94 Street Miami Shores, FL 33138- Project: <NONE> Contractor: Y&M PLUMBING, INC Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Sprinkler System Phone Number Parcel Number 1132060140340 Phone: (305)267 -1676 Building Department Comments INSTALLATION OF NEW SPRINKLER SYSTEM TO AN EXISTING WELL Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP- 160821. June 30, 2011 For Inspections please call: (305)762 -4949 Page 10 of 11 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 Permit No. BUILDING PERMIT APPLICATION FBC 20 Permit Type: PLUMBING JUN 0 2011 BY: •091700a041D-00Q011,10,./9 I I NO Master Permit No. OWNER: Name (Fee Simple Titleholder): R � � t' 1Ci rCCt GorOv) Cl t o_ I n Phone #? � l - l ( ©a 3 a5 Address:4 a( 1\,,F• £ , I ' cc+. • City: is V `Ia I (Sh3reS State: Tenant/Lessee Name: Phone#: Email: JOB ADDRESS: City: Folio/Parcel #: cif1 Miami Shores 0 Is the Building Historically Designated: Yes County: Miami Dade Zip: 331i(e) NO V Flood Zone: CONTRACTOR: Company Name: Y' 4 P1Uimk M Phone #: 9T6269 6 t �ry Address: 71 1 .(1-1A1. 14, TER It— City: 1014 v✓i. Qualifier Name: Phone #: State Certification or Registration #: C FC 1 t/26 6 8' I Certificate of Competency #: Contact Phone #: /78`36 96 /S'' 96 Email Address: State: FL_ Zip: 33 15 S DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ / 500 .ca Square/Linear Footage of Work: Type of Work: °Address ❑Alteration UNew °Repair/Replace °Demolition Description of Work: �111,k Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CCF $ Co /cc $ , DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ ` 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 inspectio hich occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not b ap ' roved and a reinspection fee will be charged. Signature Owner or Agent CSC' The forgoing instrument was a j �owledged before me this o C' �L, by V( `l .1 L a %a C who is to me or who has produced NOTARY PUBLIC: Sign'. Print: My Commission Expires:5 I I (.0 1 2,0 APPROVED BY (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Signature Contractor The foregoing instrument was acknowlec ed before day of .\Calms , 20 u, by wore or who has produced as identi Plans Examiner Structural Review NOTAR, P Sig Print: IC• I1100ALIA MARTIN Notary Pt - State of Florida *Comm. Expins Dec 17.2013 Commlasion • EE 96341 11 M i•� atail: My Commission xpires: (� t. Zoning Clerk IRRIGATION PLANS SPRINKLER HEAD KEY SYMBOL TYPE AREA 0 R -Bird or equal gear driver roaters Turf R -Bird or Equal (4" high pop) Sprinkler Head Turf & Ground Cover VALVE SCHEDULE ZONE VALVE SCHEDULE GPM AREA 1 Fimco Indexing Valve 28 Turf & Shrub 2 Fimco Indexing Valve 28 Shrub 3 Fimco Indexing Valve 28 Turf 436 NE 94 Street, Miami Shores NOTES 4 RAINBIRD OR EQUAL GEAR DRIVEN ROATERS 36 RAINBIRD OR EQUAL (4"" HIGH POP) SPRINKLER HEADS WITH NOZZLES SPECIFIED ON PLANS Hunter Mini Click Rain Sensor install in an open area where rain sensor is exposed to unobstructed rainfall and is clear of irrigation spray AC R ®� CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 06/09/11 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 pollcy(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 lieu of such endorsement(s). PRODUCER Lopez Insurance Agency 5755 W. Flagler Street #204 Miami, FL 33144 Phone (305)264-3636 Fax (305)264-3357 INSURED Y & M Plumbing, Inc. 7115 SW 16 Terr Miami, FL 33155- COVERAGES CERTIFICATE NUMBER: NAME: Egglis Cepero PHONE 305 264-3636 - A/C. No. EA): ( ) DRESS: PRODUCER CUSTOMER ID #: FAX . No): (305) 264-3357 INSURERS) AFFORDING COVERAGE NAIC # INSURERA: ASCENDANT COMMERCIAL INSURANCE INC INSURER B : SUA INSURANCE COMPANY INSURER C : INSURER D : INSURER E : INSURER F : REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MMIDD/YYYY) 04/15/2011 POLICY EXP (MM/DD/YYYY) 04/15/2012 LIMITS EACH OCCURRENCE $ 1,000,000 A GENERAL LIABILITY GL- 34693 -1 PR (RENTED PREMISES I DAMAGE (Ea occurrence) $ 100,000 b/ COMMERCIAL GENERAL LIABILITY ,/ ❑ ❑ CLAIMS -MADE ❑ OCCUR ❑ MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 ❑ GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $ 1,000,000 ❑ POLICY • JEC : ❑ LOC $ AUTOMOBILE LIABILITY ❑ ANY AUTO ❑ ALL OWNED AUTOS ❑ SCHEDULED AUTOS ❑ HIRED AUTOS NON-OWNED AUTOS ❑ COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ ❑ UMBRELLA LIAB ❑ OCCUR ❑ EXCESS LIAR ❑ CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ ❑ DEDUCTIBLE ❑ RETENTION $ $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEY�N f OFFICER/MEMBER EXCLUDED? Y N I A _ WSAUIEC1214480 11/10/2010 11/10/2011 WC STATU- OTH- ❑ TORY LIMITS ❑ ER E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 100,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space Is required) CERTIFICATE HOLDER CANCELLATION Miami Shores Village Building Department 10050 N.E. 2nd Avenue Miami Shores, Fl 33138 305 - 762 -4949 ACORD 25 (2009109) QF 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 © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD