PL-10-842Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
DA-0
Inspection Number: INSP - 143193
Scheduled Inspection Date: October 14, 2011
Inspector: Hernandez, Rafael
Owner: SNOW, TIMOTHY AND DAVID
Job Address: 12 NE 101 Street
Miami Shores, FL
Project: <NONE>
Contractor: MARK E STIRRUP PLUMBING, INC
Permit Number: PL -5 -10 -842
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1132060131380
Phone: (954)965 -6200
Building Department Comments
RE PIPE ALL PLUMBING SERVICE IN THE HOUSE
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
October 13, 2011
For Inspections please call: (305)762.4949
Page 1 of 5
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 No
MAY 1 21U'�Q
.010-ea
PERMIT APPLICATION Master Permit No
FBC 20
Permit Type: PLUMBING
Owner's Name (Fee Simple Titleholder) boAV t t/10 (.,ti Phone # 2. ^ -j3O — 913
Owner's Address /0/ S
City pi,atrrl; Sko./Crj State FL
Tenant/Lessee Name
Email
Jv /A
Zip Sz7i j g
Phone #
tAa wth t,
Job Address (where the work is being done)
City
FOLIO / PARCEL #
Miami Shores Village
Cowl
County
/.2 iV 101 sT
Miami -Dade Zip .3/3
Is Building Historically Designated YES NO y
Flood Zone
Contractor's Company Name /v"V t�� hone #K- °iG GJ - C,,2 QCI
Contractor's Address BB t) ?ev10 ,i -oke ?-,eit•
City 1.40,11Cnv\e/(n, (e. IgCeiG(n State Ft-
Qualifier Name /tilatrk p
State Certificate or Registration No. C �[ �t.� 2(, C,C�
Contact Phone "30G " (°f Cj 4(7 7 7 E -mail
Architect /Engineer's Name (if applicable)
N�,4
Value of Work For this Permit $ S� 0C90
Type of Work: ❑ Addition ['Alteration
Describe Work: K..4 4tn.
Zip '330ooi
Phone #
Certificate of Competency No.
1.\ -V0@s- 1JJ iP1U M'o:n,.CovH
Phone #
Square / Linear Footage Of Work:
fNew �, f ❑ Repair /Replace
D
❑ Demolition
*********** * ** *' *� * * * * * * * * * * * * * * * * ** * * * * ** Fees************* * * * * * * ** * * ** * * * * * * * * * * * * * * * * * **
Submittal Fee $ �" W Permit Fee $ vozS CCF $ ( CO/CC $
Notary $ 5• C:4=' Training/Education Fee $ 1.00
C
Scanning $ 3. co Radon $ V - / 5 DPBR $ 0 .� S
Double Fee $ Violation date:
Structural Review. $
Technology Fee $ 400
Bond $
Total Fee Now Due $
150
See Reverse side -�
Bonding Company's Name (if applicable) NA
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable) A /t-
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 . e cyi prov and a reinspection fee will be charged.
Signature
Owner or Agent
The foregoing instrument was ac owledg bere me this /2
day of May ,20 /0,byi ?IA l
who persona y n to me or who has produced 7
01?'0
As identification and who did take an oath.
NO AR PUBLIC:
Sign:
Print:
My Commission Expires:
Contractor
The foregoing instrument was acknowledged before me this 21
day of rn ,2010, by frs. (W „WI 2„ttJ('
ho is personally known to me or who has produced
s
°es"
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
1
tirt�rrrrrr, *�,
Print: =rt—
(-) 'bb`.'
\
/ / / / /��rl f!I! 1*1111�����
v;************ ** * ** ** * ** * * ** * ** * ** * * ** ** * * **� :t *** * * * **� *** ** * ** * * * **
My Commission Expires:
APPROVED BY &t—/'
Plans Examiner
(Revised 07 /10 /07)(Revised 06/10/2009)
Engineer
Zoning
Clerk checked
MAY -28 -2010 18:15 From:
To:13057568972 Page:1 /1
ACORQ CERTIFICATE
PRODUCER
Ace Underwriting Group
5305 W. Broward BlVd.
Plantation, FL 33317
954 - 581 -0202
MARK E STIRRUP PLUMBING,
INSURED
OF LIABILITY INSURANCE
PO BOX 61146
MIAMI, FL 33261
954-965-2800
COVERAGES
DATE (MMIDO!YY)
Q5/28/2010
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
INC.
INSURERA. GMAC INSURANCE CO
INSURER R• SEMINOLE CASUALTY INSURANCE
INSURER 0:
INSURER D:
INSURER E:
INSURER LETTER:
CITY OP MIAMI SHORES VILLAS
10050 NE 2ND AVE
MIAMI SHORES, FL 33138
305 - 795 -2205
305 - 756 -8972 Fax
ACORD 25-S (7/97)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES OE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS w triEN
NOTICE TO THE CERTII'ICA HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
t
� \1
IMPOSE NO OBLIGATION OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
BII-ITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR
—`1110.11�� o ACORD CORPORATION 1988
THE
ANY
MAY
POLICIES.
POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE
REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH
PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT
AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
FOR THE POLICY
RESPECT TO WHICH
TO ALL THE TERMS,
POUCCY EXPO I��l N—
10/18/10
PERIOD INDICATED. NOTWITHSTANDING
THIS CERTIFICATE MAY BE ISSUED OR
EXCLUSIONS AND CONDITIONS OF SUCH
INSR
LTR
TYPE Of INSURANCE
POLICY NUMBER
DATE EFFE IYYIE
10/18/09
UM179
EACH OCCURRENCE
$1,000,000
B
GENERAL LIABILITY
SCL- 000306882 -0
X
COMMFRCIAI. GENERAL LIABILITY
FIRE DAMAGE (Any c iv fim)
S100,000
1 CLAIMS MADE OccIJ
NCO EXP (Any one person)
s 5 , 0 0 0
„
PERSONAL &ADVNJURY
s1,000,000
GENERAL AGGREGATE
S 2 , O O O , O O O
GCL AGGREGATE UM17' APPLIES PER.
PRODUCTS - COMP /OP AGG
$ 2 , 000, 000
3 1 I`� ^ JE�CT LOC
A
AUTOMOBILE
LWDIEITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIREDAUIOS
NON -OWNED AUTOS
PIP— $10,000
FLC9564542
07/12/09
07/12/10
COMBINED SINGLE LIMIT
(Ea aixident)
5 750,000
BODILY INJURY
(Fee person)
$
X
X
BODILY INJURY
(Pa accltlonl)
X
X
PRoPCRTY DAMAGE
(Per accident)
$
$ 0 —DED
GARAGE
LIABILITY
ANY AUTO
AUTO ONLY - FA ACCIDENT
$
OTHER THAN EA ACC
$
AUTO ONLY: AGG
8
EXCESS
LIABILITY
EACH OCCURRENCE
S
OCCUR I I CLAIMS MADE
AGGREGATE
8
UEDUC I IBLE
RCTCNTION $
S
$
I 1. •
T RY MITS . ER
E.L t ALi i ACCIDENT
S
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
$
E.L DISEASE EA FMPIQYEE
$
E.L DISEASE - POLICY LIMIT
$
DESCRIPTION
OTHER
OF OPERAT ONS/LOCATIONswE JCLEs/EXCLUSIONsADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CERTIFICATE HALt!ER 1 I _ _ _ • _ __
INSURER LETTER:
CITY OP MIAMI SHORES VILLAS
10050 NE 2ND AVE
MIAMI SHORES, FL 33138
305 - 795 -2205
305 - 756 -8972 Fax
ACORD 25-S (7/97)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES OE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS w triEN
NOTICE TO THE CERTII'ICA HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
t
� \1
IMPOSE NO OBLIGATION OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
BII-ITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR
—`1110.11�� o ACORD CORPORATION 1988
BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT
115 S. Andrews Ave., Rm. A -100, Ft. Lauderdale, FL 33301 -1895 — 954 - 831 -4000
VALID OCTOBER 1, 2009 THROUGH SEPTEMBER 30, 2010
DBA:
Business Name: MARK
Owner Name: NAP;
Business Location: 3140
1-1741,1
Business Phone: 9E:4 -
E STIRRUP PLUMBING INC
ERIC STIRRUP
4 PEMBROKE RD J14 Business Opened:
NDALE State /County /Cert/Reg:
65-6200 Exemption Code:
Receipt #:
Business Type:
Rooms Seats
Employees
1
Machines
182 -1334
PLUMBING /LWN SPRNKL /CONT
(CERTIFIED PLUMBING CONT
01/26/2005
CFC1426501
NONEXEMPT
Professionals
Nurnher of Machines:
Transfpr
0.00
Tax Amount
27.00
For Vending Business Only
Vending Type:
NSF Fee
0.00
Penalty
2.70
Prior Years
Collection Cost
Total Paid
0.00
0.00
29.70
THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS
THIS BECOMES A TAX RECEIPT
WHEN VALIDATED
Mailing Address:
MARK E STIRRUP LU 13ING INC
P 0 BOX 611146
MIAMI, FL 3361-1146
This tax is levied for the privilege of doing business within Broward County and is
non- regulatory in nature. You must meet all County and /or Municipality planning
and zoning requirements. This Business Tax Receipt must be transferred when
the business is sold, business name has changed or you have moved the
business location. This receipt does not indicate that the business is legal or that
it is in compliance with State or local laws and regulations.
Receipt #52B -09- 00000377
Paid 10/09/2009 29.70
STATE OF FLORIDA AC# 4
;iDEPARTMENT OF BUSINESS AND
PROFESSIONAL REGULATION
CFC1426501 08/20/08 086001108
CERTIFIED PLUMBING CONTRACTOR
STIRRUP, MARK ERIC
MARK E STIRRUP PLUMBING INC
IS CERTIFIED under the provisions of Ch.489 Fs
Expiration date: AUG 31, 2010 L08082001425
CTC
CTC
ALEX SINK
CHIEF FINANCIAL OFFICER
40.
STATE OF FLORIDA
DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS' COMPENSATION
* * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW
08 -31 -2009
CONSTRUCTION INDUSTRY EXEMPTION
This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law.
EFFECTIVE DATE:
PERSON:
FEIN:
08/31/2009 EXPIRATION DATE: 08/31/2011
STIRRUP MARK E
562480712
BUSINESS NAME AND ADDRESS:
MARK E STIRRUP PLUMBING INC.
PO BOX 611146
MIAMI FL 33261
SCOPES OF BUSINESS OR TRADE:
1- CERTIFIED PLUMBING CONTRACTOR
* *
IMPORTANT: Pursuant to Chapter 440 . 05(14), F.S., an officer of a corporals
section may not recover benefits or compensation under This chapter. Pursuant
scope of the business or trade listed on the notice of election to be exempt.
election to be exempt shall be subject to revocation s1, at any time alter the
certificate no longer meets the requirements of this section for issuance of a
named on the certificate to meet the requirements of this section.
DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06
on who elects exemption from this chapter by filing a certificate of election under this
to Chapter 440.05112), F.S., Certificates of election to be exempt... apply only within the
Pursuant to Chapter 440.05113), F.S., Notices of election to be exempt and certificates of
filing of the notice or the issuance of the certificate, the person named on the notice or
certificate. The department shall revoke a certificate at any time for failure of the person
QUESTIONS? (850) 413 -1609
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 LAW
08/31/2009 EXPIRATION DATE: 08/31/2011
PERSON: MARK E STIRRUP
FEIN: 552480712
BUSINESS NAME AND ADDRESS:
MARK E STIRRUP PLUMBING INC.
PO BOX 611146
MIAMI, FL 33261
SCOPE OF BUSINESS OR TRADE:
1- CERTIFIED PLUMBING CONTRACTOR
IMPORTANT
OPursuant to Chapter 440.05(14), F.S., an officer of a corporation who
elects exemption from this chapter by filing a 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
H exempt... apply only within the scope of the business or trade listed on
E the notice of election to be exempt.
E Pursuant to Chapter 440.05(13), 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 named 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 meet the requirements of this
section.
QUESTIONS? (850) 413-1609
CUT HERE
* Carry bottom portion on the job, keep upper portion for your records.
DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06