PLC-10-801Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 142711 Permit Number: PLC -5 -10 -801
Scheduled Inspection Date: April 13, 2011
Inspector: Hernandez, Rafael
Owner: SYLVAIN, FRED
Job Address: 9100 NE 2 Avenue
Miami Shores, FL 33138-
Project: <NONE>
Contractor: A & C PORTELA PLUMBING
Permit Type: Plumbing - Commercial
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number (305)759 -6235
Parcel Number 1132060133200
Phone: 305/343 -2115
Building Department Comments
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
April 12, 2011
For Inspections please call: (305)762 -4949
Page 3 of 21
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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
Permit No.
AUG 1 7 2010
L0 `phi
Master Permit No. CC- IC) — t t3
Permit Type: PLUMBING
OWNER: Name (Fee Simple Titleholder): AM/ g % •� � 1 S t% one #:
Address: / >
40 /`E )J �7 &
City:
fr) rimy' 317a r?
State:
531 57)
Tenant/Lessee Name: Phone #:
Email:
JOB ADDRESS: e 100 Nt
City: Miami Shores County:
Folio/Parcel #:
Miami Dade
Zip: , 31 s !
Ls the Building Historically Designated: Yes
NO Flood Zone:
CONTRACTOR: Company Name: A `� Mr-4ebt r
Pu.5,
Address: c9(#55- 33 414 '� i 11'e-
City: f ram I e State: •
Qualifier Name:
Phone #:
Zip: ,95)3s
Phone #: 3(/ — °J/
State Certification or Registration #: Certificate of Competency #:
Contact Phone #: Email Address:
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: ❑Address ❑Alterattion ❑New
Description of Work: VC VLSz- ri, 10411. tQtc/ol7'/
URepair/Replace
❑Demolition
************ * * * * * * * * * * * * * * * * *********** Fees****. x* ********** ***.x+x***** :* ****:x***********
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 $
a
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 AFF'IDAVIT: 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 a ' nspection fee will be charged.
The foregoing instrume °" as acknowledged before me this
day of
who is person
20 ID, by 44.4414:,,
own to me or who has produced
1q-
Signature
Co ' actor
The foreg ing instrument was acknowledged bef re this f �'
day of
di 20 e_, by kkeMdd P' ,
' who is personally known to me or who has produced 7/
as identification and who did take an oath.
ntification and who did take an oath.
NOTAR
Sign:
Print:
My Commission Expires:
APPROVED BY
Witrit
IC
NOTARY PUBLI
Sign
Pri
My Co
********************** *** * ***** ***** *** * ** *** ***** *** ********* **
( Plans Examiner
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
(08//6
Zoning
Structural Review Clerk
Miami Shores Village
Building Department
10050 N E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
PERMIT APPLICATION
FBC 2004
1-_TIRUNR
cP 72010
Permit No. ? L-C I D -SO 1
Master Permit No. C C- O — 13
Permit Type: , Plumbing
Owner's Name (Fee Simple Titleholder) ' I j
�' ( ■, Phone # 30C--70 -62_3 5
Owner's A s CU 00 /06— ; f .
City fr( State f. Zip / .- G ,
Phone #
Tenant/Lessee Name
E -MAIL:
Job Address (where the work is being done)
City Miami Shores Village
FOLIO / PARCEL #
County Miami Dade
Zip
Is Building Historically Designated YES NO
Contractor's Company Name
6 4
Contractor's Address q--- W 3F4
City tifc / State` ° Zip
Qualifier Name Ade, pp 4 Phone #
State Certificate or Registration No. 0 CA ,0®®t9®/ 0 Certificate of Competency No.
E -MAIL:
one # , °2f (74. —,CI
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $
0 D-0 Square / Linear Footage Of Work:
Type of Work: ❑Addition Alte�f
r�ation ['New -
Describe Work: e � ptovi 1 k
sifGLoli41- i W V
El Repair/Replace ❑ Demolition
f' 5.
**** *****a********** rearsass**** ******* *F ********************* aft seas** ***fr***********
Submittal Fee $
Training/Education Fee $ 1 ) , OV Technology Fee $ 12- 00
" oo • Radon $
P Permit Fee $ 57, �CCF $ q.00 CO /CC
Notary $
Scanning $ 3
Bond $
Structural Review. $ Total Fee Now Due $ 531 . ck_D
See Reverse side -+
DPBR $ & on
Zoning $
Code Enforcement $ Double Fee $
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the
inspection will not be approved a reinspection fee will be charged
Signature °�'/ ���
�3'asa
Signature
The forego instnun cknowledged . - n e this 0,k The fore
day of 20 by`� t day of
who is personally kno , o _ :� who is
an oath.
NOTARY P
Sign:
Print:
My Co . u i . ion Expires: ez,--t. 2
***** * * * * * * * * * * * * * * * * * * * * * * * * ** * * ***
APPLICATION APPROVED BY:
(Revised 02/08/06)
12----1)
Contractor ,�f
ent was acknow .• , fore me this Z<�`"
20(0, by 4 J
me or h z p • duced
as identification and who did take an oath.
NOT
Si
C:
PUBLIC -STATE OF FLORIDA
�I Commission # DD839079
My Commission E " J Expires: DEC.10, 2012
y TARU Arum BONDING al, ING
kirk** Watt{ MrirRSltaieik **trick** irk sirr #ices**********e *** *4*,s********** ft*
Plans Examiner
Engineer
Zoning
4
ACORD, CERTIFICATE ()F: LIABILITY INSURANCE OATS IMM/oDNYYY)
05/11/2010
30$ O60 2003 EXT 205 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIQN
ONLY AND CONFERS NO RIGHTS UPON THE CERTIPICA7Ei
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
.RODUCER
MUTUAL INTEREST 4SSURANCEX
CERTIFICATE - 8/01 EDITION
IAQEVEQQAL 06/05/2009 305
860 2003 EXT 205 MUTUAL INTEREST
/AIRED
AC PORTELA PLUMBING INC
2655 SW 33 AVE
MIAMI, FL 33133
OVERAGES
THE POLICIES OF INSURANCE. LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THt: 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 TCRMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHAWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
N • DQ... 1 POLICYBPPGCTI E I POLICYE 1 Le
kV •LICYNU HINDER
I = � r,n•�♦ F „u ,:
INSURERS AFFORDINQ COVERAGE I NAIC #
INSUIRERA! GRANADA INSURANCE COMPANY
INSURER e: ASCENDANT COMMERCIAL INSURANCE
INSURER C:
INSURER D
I
I INSURER E: I
A
GENERAL LIABILITY
X 1 COMMERCIAL GENERAL LIABILITY 1 GL- 018SFL6034
CLAIMS MADE I OCCUR
GEN'LACGREG_ ATE LIMIT APPLIES PER:
I POLICY 1 1 JFOY 1 LOC
AUTOMOBlLe LIABIUTY
ANY AUTO
ALL OWNED AUTOS
I SCHEDULED AUTOS
HIREDAUTOS
I NON+OWNEDAUYOS
I ..
GARADE LIABILITY
I ANY AUTO
I 1
EXCE$SJUMBRELLA L AI ILITI
I OCCUR i CLAIMS MADE
I DEDUCTIBLE
1 1 RETENTION $
1 WORKERS COMPENSATION AND
B l wI.ove,RB' LIABIUTY
IAN,
PFICERIMHMBER EXCLUDED? @CUTIVE
I {ryes,describe under
SPECIAL PROVISIONS below
OTHER
WC- 60262 -1
N
LIMITS
EACH OCCURRENCE S 1,000,000
01/20/2010 01/20 /2011 D'App��AGE TO RENTED "
DAMACES,(Eaaypuranrx) I8 50,000
MEO EXP (Any ens pa11T► Is 1,000
I PERSONAL AADVINJURY I E 1,000,000
I C}ENERALACGREGAYE , I ffi 1,000,000
I PRODUCTS s0OMPIOPAOC? I,S 1,000,000
I
COMBINED BINDLE LIMIT 1 d
1
01/13/2010
I (Ea accident)
BODILY INJURY
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(Per!CClder,q
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1 AUTO ONLY +EAACCIPL'NT 1$
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I$
01/13/2011
DESCRIPTION 0P OPERATIONS 1 LOCATIONS 1 VEHICLESIEXCLut'rIoNS ADDED HY ENDORsEmENT1 SPECIAL PROVISIONS
PLUMBING CONTRACT
CERTJFICATE HOLDER
CITY OF MIAMI $HORS
305/397 -2277
ACORD 26 (2001108)
TO /TO 29dd
1S3i•131NI10111f1w
(AGGREGATE
I$
$
TWO,RY (MITE : I ER )
I E.L. EACH ACCIDENT 14
1 E.L .DISEASE s EA EMPLOYEE I S
1 E, . DISEASE+ POLICY LIMIT i E
CANCELLATION
100,000
500,000
100,000
SHOULD ANY OP THE ABOVE DUSCRIBeD POUDI .S BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURE* WILL ENDEAVOR TO MAIL 3Q ^ DAYS WRITTEN
T. BUT FAILURE TO DO SO SHALL
Y KIND UPON THE INSURER, ITS AGENTS OR
NOTIce TO THE CERTPICATE MOLDER NAMED
IMPOSE NO OBLIGATION O = 1'k
FPRP.SENTATIVES.
AU'rHORaso REPRESENTATIVE
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L }o L abed ZL6899LS0£ :ol
6/2/2010 1:25 PM FROM: Plumbing A _C Portela Plumbing. TO: 3057568972 PAGE: 001 OF 001
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To: +1-3057568972 Page 1 of 1
2010-05-12 15:27:40 (GMT) 13053972277 From: dayniel del Ilano
b/12/2010 101b AM FROM Plumbing A _C Portela Plumbing. TO: 3053972271 PAGE: 001 OF UUI
MIAN1143ADE-couttri
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MIAMI; PL 82150:
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MIAMI,DADE. COUNTY STATE9F FLCARIDA
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1
To: +1- 3057568972 Page 1 of 1
2010 -05-12 15:31:44 (GMT) 13053972277 From: dayniel del Plano
b /12/ZU10 1U:19 AM FROM: Plumbing A _C Portela Plumbing. TO: 30b39122T4 PAGE: 001 OF UU1
6641
.STATE Of FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REG[.JLATT:ON
CONSTRUCTION INDUSTRY LICENSING BOARD SEC
LICENSE Ni3R
08/20/200.9 200:9. 096000182 R 11.05:, x.90
The PLYING CONTRACTOR
Named be3.w HAS REGISTERED
Under the povivions of ChaPtez 48:9 FS.
Expiration data :: AUG 31., 20.11
(INDIVIDUAL MUST MEET ALL LOCAL LICENSING
REQUIREMENTS PRIOR TO CONTRACTING IN NY AREA)
FIGTJE RO it FRANK P
A & C PQRTEZ.aA nOvil5TITG INC
2-6.55 S.11, , 3 3RD AVENUE
MIAMI. FL 33133