PL-11-1353Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, F
Phone: (305)795 -2204 Fax: (305)756 -897
Inspection Number: INSP - 165807
Scheduled Inspection Date: October 26, 2011
Inspector: Hernandez, Rafael
I I M
Permit Number: PL -7 -11 -1353
Owner: NIETO - WINZEY, TANYA & JAMES
Job Address: 9777 NE 5 Avenue Road
Miami Shores, FL 33138-
Project: <NONE>
Contractor: BEST PLUMBING SERVICES, CO.
Permit Type: Plumbing - Residential
Inspection Type: Top Out
Work Classification: Addition /Alteration
Phone Number (305)606 -2897
Parcel Number 1132060180010
Phone: 305/556 -2641
Building Department Comments
PL REMODEL BATHROOM
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- 162537. need to verify shower
pan
October 25, 2011
For Inspections please call: (305)762 -4949
Page 23 of 33
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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 Type: PLUMBING
OWNER: Name (Fee Simple Titleholder
Address: ,�
City: 4p, ne.. eST State:
Tenant/Lessee Name: Phone #:
Email:
Permit No.
Master Permit No''
575,7 7.7
L JUL z 6 2,01i
(\idWof1
Phone#:
Zip: 3 -1 5 ,
JoB ADDRESS: ° 1 °1`� N fir, -Ave
City: Miami Shores
Folio/Parcel #:
Is the Building Historically Designated: Yes
County: Miami Dade
Zip: 3 I J O
NO Flood Zone:
CONTRACTOR: Company Name: RAT thin Semi m c es
Address: 25
City:
Qualifier Name:
runlet 305
tate: F(.,-
og o f lQ Phone #: 5oS=- -.557. *
State Certification or Registration #: C FC it/Z.47 3 Z Certificate of Competency #:
Contact Phone#: 305— S5-3 - FS-el Li Email Address:
DESIGNER: Architect /Engineer: Phone #:
Zip: 330/3
Value of Work for this Permit:$ a e/ Square/Linear Footage of Work:
Type of Work: ❑Address
❑Alteration
❑New ❑Repair/Replace
SFr
ODemolition
Description of Work:
********* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *F * * * * * ** * ** * * * * * * * ** * * * * *** * * * * * * * * * * * * ****
Submittal Fee $ Permit Fee $ f5 (. CCF $
Scanning Fee $ Radon Fee $ DBPR $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW -DUE $ 101 < J
CO /CC $
Bond $
Bonding Comfi'any's Name (if applicable)
Bonding Company's Address
City State Zip
N (P�
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
NCR
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 Fi FCTRICAL 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
Owner or Agent
The fore _oing instrument was acknowledged before me this
day of
who is personall
M 5Z --(S'o
NOTARY PUBLIC:
Sign:
Print: .)51°•+-3 V-V—L -P
My Commission Expires: Z.)1,-.1 Z\ 1 2013
NO
o who has or duceil 'F L- 3L
The foregoing instrument was acknowled : ed be
day of
h
personally kno
by
me or who ' as produced
identification and who did take an oath. as identification and who did take an oath.
„ „ ∎171 Susan Herrera
•' �•'• COMMISSION #DD909258
EXPIRES: JULY 21, 2013
u C a,°,A � ..�'WWW.AARONNOTAR'Ccom
NOTARY PUBLIC:
Sign: /Acta AEG
Print: S4.0J Ike 1Z£. Jar
My Commission Expires: 21,20%3
��oiYp�•.,,, Susan Herrera
4 .. =COMMISSION #DD909258
•'!�•�F EXPIRES: JULY 21,2013
� w WW. MRONNO TAR Y..com
*************************************************** * * * ** **+k**** ***** *+k***+ ****#+k***+k**** *****+h*****R**** ****
APPROVED BY 2 a 1/ A.667 Plans Examiner
Structural Review
(Revised 07 /l0/07XRevised 06/10/2009)(Revised 3/15/09)
Zoning
Clerk
ACRD
CERTIFICATE OF LIABILITY INSURANCE
I DATE (MMIDDIYYYY}
07/25/2011
PRODUCER
PROPER INSURANCE AGENCY
471 E 49TH ST
HIALEAH. FL 33013
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
NAIL 13
INSURED
BEST PLUMBING SERVICES CORP
251 EAST 44T14 STREET
• HIALEAH, FL 33013
muREFut ASCENDANT COMMERCIAL INS COMPANY
INSURER 6:
INSURER C:
INSURER D
INSURER E:
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 CLAIIMOS..�q
iLTR
INSRD
TYPE OF INSURANCE
POLICY NUMBER
DATE
DAiEr
LIMITS
A
GENERAL LIABILITY
COMMERCIAL GENERAL 1ABILITY
❑ CLAIMS MADE e OCCUR
GL- 34896 -1
10/1412010
EACH OCCURRENCE
$
1,000,000
PREMISES ceI
$
100,000
10/14/2011
MED EXP (My one f)
$
5,000
PERSONAL & ADV INJURY
$
1,000,000
GENERAL AGGREGATE
$
1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER
—I POLICY n PROJECT n LOC
PRODUCTS - COMP/OP AGG
$
1,000,000
.
AUTOMOBILE URIMJRY
ANY AUTO
ALL OWNED AUTOS
D SCHEDULED MIMS
HIRED AUTOS
NON -OWI� AUTOS
D
COMBINED SINGLE LIMIT
$
Y nY
(Per
•
BODILY INJURY
(Per )
$
PROPERTY
(Per acciden DAMAGE
$
—I
GARAGE LWMLITY
D ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
AUTO OM_Y: AGG
$
CIA LIABILITY
D OCCUR ❑ CLAIMS MADE
DEDucrILE
RETENTION $
EACH OCCURRENCE
$
AGGREGATE
$
$
$
$
EI LOY ETU WTYT°I AND
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFFFI�ICERMEMBER EXCLUDED'?
SPECIAL PROVISIONS below
-
TWO Y LIM S noiTRH-
EL. EACH ROCK/ENT
$
EL 1 .E EMPLOYEE
$
E.L DISEASE - POLICY LIMIT
$
OTHER
DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES I EXCLUSIONS ADDEDMYENDLIRSEMENITSPECIAL PROVISIONS
PLUMBING SERVICES $500 DEDU ON PROPERTY DAMAGE.
a.crc I IFn.r7I c rw.....cn
CITY OF MIAMI SHORES
9777 NE 6 AVE
MIAMI FL
1
-- ---- -- ° - ---
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED ED BEFORE THE EXPIRATION
DATE THEREOF. THE ISSUING INSURER WILL. ENDEAVOR TO MAN. 30 DAYS MUTTER
NOTICE TO THE CERTIFICATE MOLDER NAMED TO THE LEFT, BIIT FAIURRE TO DO SO SHALL
IMPOSE NO OBLIGATION OR MAMMY OF ANY IOND UPON THE INSURE ITS AGENTS OR
REPRESENTATIVES.
2
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! seam wr\DnAe ATIn6I 4100
ACORD 25 (2001108)
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SERVICES :REST 011410. • • • 33013 HIALEAH
•
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TCLASS 4
PoerAGE
JAMffL
IT NO.
BEST pLumoitta $ERvtcts co
Sec. Type or littieltiiie
196 PLUMBING C0f4TRACTOR
$ ONLY A LOCAL
SS TAX RXCPT. IT
NOT PERMIT 11M
LDER TO WOLATX ANY
e eeeuLAToray OR
I.AW$ OF THE
O ft cress. NO
IT EXEMPT Th2
FROM ANY OTIOR
OR LICENSE
EX EY LAW. THIS IX
A cnfi1rFIcA1IoN AT
Haase, ollAUFICA.
NECOANTO
COUNTY TAX
08/30/2010
! .09010212001
000045,00
SEE OTHER SIDE
N91,...em,
• •
WORKtR,
3
DO NOT FORWARD
BEST PLUMBING SERVICES CO
JOSEPH RODRIGUEZ PRES
251 E 44 ST
HIALEAH FL 33013
26
r-
STATE OF FLORIDA
DEPARTNENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION. INDUSTRY LICENSING BOARD
1940 .ROW= MONROE STREET
TALLABASSEE FL 32399 -0783
RODRIGUEZ, JOSEPH
BEST' PLUMBING SERVICES .COMPANY
251 E44TEST
HIALEAH FL 33013
Congratulations! Wit this license you become one of the nearly one million
1~loridiansiicensed.# by the Department of Business and Professional Regulation.
Our pmfessionals and businesses range from architects to yacht brokers, from
b o x e r s t o barbeQue restaurants. and. they keep Florida's economy strong.
Every day we work to improve the way we do business in order to serve you better.
FIX information about our services, please log onto www.mytloridalicense.com.
There you can find more information about our divisions and the regulations that
impact you subs r4 a to department newsletters and learn more about the
Department's:
Obr mission atthe Department is: License Efficiently. Regulate Fairly. We
- nstantiy give to serve you befter so that you can serve your customers.
Thank you for doing business in Florida, .and congratulations on your new license!
DETACH HERE
(850) 487 -1395
DATE EATc f1Lfr''S
41008300176:
•RODRI E.Z.. . `OSEPR
• ,:BEST PLYJXN•G SERVICES 'CO
2.51 E:: 44' -. S'T .
HIALEAH : :, . FL 330r
ALEX SINK
' CHJEF FINANcIAL OFWCER
STATE OF FLORIDA
DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS' COMPENSATION
* * CERTIFICATE OF ELF TO BE EXEMPT FROM FLORIDA WORKERS' COIiPELIISATIOIIN LAW *
CONSTRUCTION INDUSTRY EXEMPTION
This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law.
08 -31 -2010
EFFECTIVE DATE:
PERSOit
FEIN:
08/31/2010
RODRIGUEZ -
680811170
BUSIPESS NAME AND ADDRESS:
BEST PLUMBING SERVICES COMPANY
2S1 E 44TH STREET
HIALEAH FL 33013
EXPiRATI[NV DATE 08/30/2012
JOSEPH
SCOPES OF BUSINESS OR TRADE:
1- CERTIFIED PLUMBING CONTRACTOR 2- PLURMBING
Pummel 10 Chapter 440. 05114 F_S., se officer of a corporation who elects exemption from this Pty; Y a .
eaic Wettest Wier i settles may net recent is or ender Ibis eh �er. fa Chapter 440.05021, F.S., Certificates of t � be exempt... apply n ty yyifhn the
o
scope of the business at trade dated cm the entice el election to he exempt. Posseent to Chapter 440,051131 F_5. tdc@s oi' cUN to be exempt end certificates of
etecttoa to be exec shat be subject to revocation if, at any tiara after the filing of the make or the issuance of the the
certificate ea f y t moot so of notice or
1ae�t meets � requirements o} this sechtoo for issuance of a certificate. The dopatteeat sbail revue a e>:riif`eatii at coy time for failure of the pets
named on the certificate to meet the requirements of this section.
DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09-06
PLEASE CUT OUT THE CARD BELOW AND RETAIN
QUESTIONS? 1850) 413 -180!
FOR FUTURE REFERENCE
STATE OF FLORU A
DEPARTMENT OF MAMMAL SERVICES
DRHSICN+i OF WORKERS' COMPENsATKIN
CONSTRUCTION IPWUSTRY
CERTWICATE OF B.ECTION TO BE EXEMPT FROM FLORIDA
WORKERS TAI LAW
EFFECTIVE 98/31/2010 EXPIRATION DATE:
PERM* JOSEPH RODRIGJEZ
FEiN 650811170
BUSINESS NAVE AND ADDRESS:
BEST PUOM00IG SERVICES COWART
251 5 44TH STREET
HiALEAH, Ft 33013
SCOPE OF BUSfNESS OR TRADE
cERTWIED PUaamaG CONTRACTOR 2- PHNOM
08/30/2012
IMPORTANT
UPursuant to Chapter 440.05(14), F.S., art officer of a corporatism who
elects exemption from this chapter by filing a certificate of election
L under this section may not recover benefits or compensation harder this
D chapter.
H
E
R
E
Pursuant to Chlter 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
Pursuant to Chapter 440.06413), 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 noned 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 rneet the requirements of this
section.
QUESTIONS? (850) 413 -1609
CUT HERE
1+ Carry bottom portion on the job. keep upper portion for your records.
lA�tfaTMIT:
OWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06