PL-11-1259t
r
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 161984 Permit Number: PL -7 -11 -1259
Scheduled Inspection Date: September 02, 2011
Inspector: Hernandez, Rafael
Owner: CASTRO, JULIANNA
Job Address: 1020 NE 99 Street
Miami Shores, FL
Project: <NONE>
Contractor: CASTELLON PLUMBING CORP
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number (305)978 -0977
Parcel Number 1132050320020
Phone: 305 -553 -1490
Building Department Comments
CAP OFF SOLAR PANEL EXISTING
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
September 01, 2011
For Inspections please call: (305)762 -4949
Page 2of7
U'1
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
BUILDING
PERMIT APPLICATION
FBC 20
JUL 1 2011
Permit No10 11.—i
•■••■
Master Permit No _
Permit Type: PLUMBING
OWNER: Name (Fee Simple Titleholder): Ve//4„..44 A
Phone#( ? ®.f) 9704- Y/2 f
Address: /02 t /,k 77. .9 je, ioe
city: ,44z i S/'/ 0'c P 3 state: �Asi • zip: '131,, r
Tenant/Lessee Name: Phone #:
Email:
JOB ADDRESS: /D 2 a /v 9 f �/x te e
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #:
Is the Building Historically Designated: Yes
NO Flood Zone:
CONTRACTOR: Company Name: C7 S° /'f /41/1 Ng/ 114 k I Phone#(741)
Address:
City:
Qualifier Name:
Certification or Registration #:
Contact Phone #: 6 4' J
DESIGNER: Architect/Engineer:
State: Zip: -31 OAP
A C4 S
71efe -SL, Phone #: C:4:194.) 2 STS-- S ;%i
r f —r 0/ 9D5
Certificate of Competency #:
Email Address:
Phone#:
Vhie of W ' f $— 0� ®e Square/Linear Footage of Work:
Type of Work: Address UAlteration ❑New ARepair/Replace ❑Demolition
Ca / o1,71 ?Ail /4& 4.--/.5 V /
Description of Work:
************** *+ x********** **+ x**+ x******* Fees*** ******* **** *************** ** u+x******** ***
Submittal Fee $ Permit Fee $ /0
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 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
The foregoing instrument was acknowledged before me this
day ofd, 20 I S , by J U.11(n,n ck CtZS ,
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY •PUBLIC;
Sign:
Print:
Signature
ontractor
The foregoing instrument was acknowledged before me this
day of E c , 20 �•�, by &7i 0-64-4�
who is personally known to me or who has produced
as identification and who did take an oath.
=N 'fARY PUBLIC: \\�omtiuiuiu,,,
•, — NI ®I�iOy °�.
�,�pr vpe.�� J. BOVELL ' ��� ° s
I it ro• Notary Public - State of Florida V ;',
.1 s Jul 11i h '
OF 0 �.o Commission # EE 7930 rin
of
My Commission Expires:
* * ** * ** * ** * * *** * * ** ** **
APPROVED BY
g
w ' Z ''4;4')
m ®� /g
My Commission Expires: %� y'
******** * ** ** **+x+ + x***x: ***** **************** **•x*****************/* /*VM=**********
Plans Examiner Zoning
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Structural Review Clerk
FROM :CASTELLON PLUMBING CORP
ALEX SINK
CHIEF FINANCIAL OFFICER
FAX NO. :305 558 1617
Jul. 19 2011 10:32PM P1
.STATE OF FLORIDA
DEPARTMENT .OF FINANCIAL SERVICES
DIVISION' OF WORKERS' COMPENSATION •
* * CERTIFICATE OF ELECTION TO RE EXEMPT FROM FLORIDA WORKERS' CORMMNISATa .LAW 1F 1E
CONSTRUCTION INDUSTRY EXEMPTION
This certifies that the individual listed below hes elected to be exempt from Florida Workers' Compensation law.
09 -30 -2009
EFFECTIVE DATE:
PERSON: CASTELLON GIRALDO
FEIN: 591676886,
BUSINESS NAME AND ADDRESS:
CASTELLON PLUMBING CORP
2830 S W 115 AVE
MIAMI FL 33163
11/23/2009 EXPIRATION DATE: 11/23/2011
SCOPES OF BUSINESS OR TRADE:
1- REGISTERED PLUMBING CONTRACTOR 2- CERTIFIED PLUMBING CONTRACTOR
IMPONTANT. Porsaeru lo Chapter 440. 061141, f.s.. ab officer of a cerporetieo who Worn exemplioa from this cbapter by filing t eerlllcete of election Met refs
sation may for lacovef beaglils 01 compeneetion ender this chimer. Pursuant to Chapter 440.011121, P.S.. Williams 01 election to be swept- apply only Within Me
scoot el the business 01 11148 ,fated oa IDe notice of election to he exempt. Puree101 to Cbe81u 440.061131, f.$., Notices 01 election 10 1e 0amapt and tenlllcatex el
election to 00 aaempl ioell be aebiecl to lev006IIoP 11, a1 any time after the 111104 61 the Police Or (DB 14444068 61 the CorNficete. 133 p06606 .111060 OP 1114 "lice of
temli0810 Po Ienger meets the requirements of thls section for Insane of a certifkrlo. The department shall revoke e certtlfaale a1 any lime tar latlere 01 1118 p610611
e6ma4 o.1 toe eenilieete to meet the requirements v1 this section. aUESTIONS? (850! 4 13-1
OWC-152 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06
PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE
STATE OF FLORIDA
DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS• COMPENSATION •
CONSTRUCTION INDUSTRY
CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA
WORKERS' COMPENSATION L AW
•
EFFECTIVE:' 11/23/2009 EXPIRATION DATE:
PERSON: GIRALDO CAST ELLON
EIN; 581876886
rduSINESS NAME AND ADDRESS:
••, •tot Minted CORP
. o. n se . 15 Ave
M;AM, •I 33166
11/23/2011
SCOPE OF BUSINESS OR TRADE
: H6GISt6RSp PLUMBING CONTRACTOR 2 • CERTIFIED PLUMBING CONTRACTOR
IMPORTANT
Pursuant to Chapter 440.05(14)a F.S., an officer of a corporation who
elects exemption from this chapter by filing e certificate of election
L 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
t1 exempt... apply only within the scope of the business or trade listed un
E the notice of election to be exempt.
R •
E Pursuant to Chapter 440.05(13), F.5., Notices of election to be exempt
and certificates of election to be exempt shall be subject to revocation
1.. 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 mee
the requirements of this Section for issuance of 6 certificate. The
department shelf revoke a certificate al any time for failure of 1110
person named on ttie certificate to meet the requirements of this
section.
QUESTIONS? (850) 413-1609
CUT HERE
Iti Carry bottom portion on the job, keep upper portion for your records*
•
UWC• 251 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06
FROM :CASTELLON PLUMBING CORP FAX NO. :305 558 1617 Jul. 19 2011 10:33PM P2
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD
1940 NORTE MONROE;STREET.
TALLAHASSEE 'FL-32399- 0783
CASTELLON, GIRALDO
CASTELLON PLVDIBING CORP
9841 NW 130 ST.
HIALEAH GARDENS FL 33018
Congratutationst ' With this license you become one of the nearly one mitffon
Flondfans licensed by the Department of Business and' Professional Regulafion.
Our professionals and businesses range from architects'to yacht brokers, frorri
boxers to barbeque restaurants, and they keep Florida's economy strong. '
Every day we work to im
• my Y prpva the way we do business lit order to serve you. better ��L�
For information about our services, please log onto www.myttorldalicense.com. " ;.!
There you can find more information about our divisions and the regulations that
impact you. subscribe to department newsletters and team more about the
• Departments initiatives.
•
' Our mission at the Department•is• License Efficiently, Regulate Fairly. We
constantly strive to serve you better so that you can serve your customers.
Thank you for doing business in Florida, and' congratulations on your new license!:
DETACH HERE
1850) 487 -1395
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