PL-11-1270Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
I 14 ce
Inspection Number: INSP- 162027 Permit Number: PL -7 -11 -1270
Scheduled Inspection Date: January 11, 2012
Inspector: Hernandez, Rafael
Owner:
Job Address: 180 NW 103 Street
Miami Shores, FL 33150-
Project <NONE>
Contractor: TWIN BROTHER
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number (305)825 -7080
Parcel Number 1131010230020
Phone: (305)332 -1969
Building Department Comments
KITCHEN REMODEL
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
January 10, 2012
For Inspections please call: (305)762 -4949
Page 6 of 37
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 15
Permit No. 17(--- 1 t�
Master Permit No. ,fie - `/ ° //*
Permit Type: PLUMBING
OWNER: Name (Fee Simple Titleholder): 44 /04/ /? /16,,e77 T / L C Phone#.��(�%�rf'al./ 211°
Address: Age Cduapr v- gef D �®
City: ,22 ,,'/v/ J- /2 /c- €'.I
State: /4-:'
L
Tenant/Lessee Name: " //4'
Email: x91/ / VA- Z e .. t3 64,-- _I e,r/1,'lE7
Zip: &0/V
Phone #:
JOB ADDRESS: l gv N (,J 11) 3 S-1-,
City:
Miami Shores County: Miami Dade Zip:
Folio/Parcel #:
NO c‘/' Flood Zone:
Is the Building Historically Designated: Yes
CONTRACTOR: Company Name: /C.L // ie-oT ieC (9/ 0 mi'( `04 Phone #: '30g 3 a / `l 4-7
Address: -9-93 to -a-a- 7--e-
City: , -p-(% State: TL Zip: 33 t LiC
7"7) Z Phone #: ®• 9/ 7- 3 V7
State Certification or Registration #: C--e- (9 ' 7",/ 2- Certificate of
Competen y #:
Contact Phone #: - m S 3 3 a- ( 9 (e y Email Address: 7 &J.7 °" d> 0'
a( � -` C - _/L C4-47° .
DESIGNER: Architect/Engineer: Phone#:
Qualifier Name:
Value of Work for this Permit: $ �s Square/Linear Footage of Work:
Type of Work: ❑Address UAlteration ❑New ❑Repair/Replace
Description of Work:
g71-cit
❑Demolition
***+r****** *********** * * * ** ************* Fees****** *+ x+ x*+ x**** *+ x** ************** ***********
Submittal Fee $ Permit Fee $ .- CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $ Q (�
TOTAL FEE NOW DUE $ �` ` d )
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 FT.ECTRICAL 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 be a ', � :owed and a reinsp, ron ee w l be charged.
Owner or Agent
The forego i instrument was acknowledged before me this
day of , 201/ , by .7406' 1-- • (/4ZGC€e4
/—LI
h i1" s erson • 1 known to me . who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign: NI A ®yk tau-
Print: et-A /1",i9 fr 4 ,C 77it/' V
My Commission Expire
** * ***** ** * ** * * ****
APPROVED BY
Pv4p Notary Public State of Florida
Clara Martinez
My Commission DD784687
* *:''I#°*** �+rxe n� �x�xmx�mm �xm
Signature
ontractor
r
The foregoing instrume was acknowledged before me this
day of , 20 lL , by
who is personal y known to me or who has produced Fire -1 a
'br/ rer hA .Gr+ as identification and who did take an oath.
NOTARY PUBLIC:
7:` If Plans Examiner
Structural Review
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Sign:
Print:
My Commission Expires: `` s NOTARY PJ011C
STATE OF FLORIDA
. Cann* EEQ90B82
Zoning
Clerk
08 -24 -2010
ALEX sillg( STATE OF FLORIDA
CHIEF FINANCIAL OFFWER DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS' COMPENSATION
* * CIMTIFICATE OF ®.ECTION TO BE EXIMPT FROM . FLOM iISATION LAW *
CONSTRUCTION INDUSTRY EXEMPTION
This certifies that the indiviAtal listed below has elected to be exempt from Florida Wolters' Compensation law.
EFFECTIVE DATE
PERSON:
FEIN:
08/24/2010 EXPIRATION DATE 08/23/2012 -
•ALVAREZ BENITO
500326797
BUSINESS NAME AND ADDRESS:
TWIN BROTHERS PLUMBING CONTRACTORS CORP
2020 SW 22 TERRACE
MIAMI F1. 2314S
SCOPES OF BUSINESS OR TRADE
1- PLUMING ammo=
RACTOR
*
0aF0RTA ITI Porelient to Chapter 440. 05(1 F.S., an officer al a corporation mho dials °Nefaoa tram aft cbapter by mfng a cmtNkao of etetdm under Ibis
.aecdon may ma reeovm benefits or coneenieNon ender tots dmpam Poraoaot to Cheraw 440.05(12). F.S., Certificates of elation to be exert.. may only within the
scope of the bon' er trade asted on the coffee of election to be exempt. Pmt to Chapter 440.i 5(1). F.L. Nadas of eledim to be exempt nil certifidates of
election to be exempt draa be sebjont to reeecatoa IL et any time after the filing of the entice or the fssaesse of the cnttleate, the mono monad on the ■atiee or
tmtittate on limner meets the regratemeats at this Minn for ire of a certificate. The department shalt rarebe a cmafirade at any time he hNma of the pmson
named on the certificate to name the requirements of ems sedlon
• Q(ffSi(ONS7 1860) 413 -1669
- OWC -262 SITE OF ELECTION TO IE EXEMPT REVISED 09 -06
PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE
STATE OP FLORIDA
DEPARTMENT OF FINANCSAL SERVICES
DM$ION OF COMPENSATION
CORTOHCATE OF ELECT= TO BE IMEMPT FROM PUMA
woRKER, coMPENBATIoN LAW
EFFECTIVE 08/24/2010 EXPIRATION DATE: 08/23/2012
PERSO{1l BENITO ALVARiZ
FE01t 300325797
BUSINESS NAME AND ADDRESS:
Tank BROTHERS MIRO o CONTRACTORS CORP
2930 SW 22 TERRACE
MAAn4, FL 33145
SCOPE OF BUSINESS OR TRADE
1- PURfBING CONTRACTOR
IMPORTANT
F Pursuant to Chapter 440.05114. F.S., an officer of a corporation who
O elects exemption from this chapter by filing a certificate of election
I- tinder this section may not recover benefits ar conmensation mater this
D tier.
Por amt to. ChRner 441105(121, F.S., Certificates of election to be
exempt_ imply only within the Scope of the btu or trade listed on
the notice of election to be exempt.
Pinson( to Ciopter 440.05113). F.S, Notless of election to-be exempt
and certificates of election to be tit shaU be subject to revocation
at a y time after the filing of the notice or the i ce of the •
certificate, the person nand on the notice or iertifitate no longer meets
the requirtm>oras of this septian for bonanza of a cortifltate. The
department shall revoke a certificate at any thoe for failure of tine
perspn named on the certificate to meet the rephionents of this.
section
H
E
R
E
QUESTIONS? (8501 413 -1609
CUT HERE
* Carry bottom portion on the job, keep upper portion for your records.
0WC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED -O9 -O6
STATE OF FLORIDA
DEPARTaNT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487 -1395
1940 NORTH MONROE STREET
TALLAHASSEE FL 32399 -0783
ALVAREZ BENITO A
TWIN BR6THERS PLUNBING CONTRACTORS CORP
2930 SW 22 TERRACE
MIAMI FL 33145
b you Mme one of the nearly one mire*
Fi by Department of ashram and Professional Ramon.
Our professionals and businesses range from archftecis to yacht goers, from
boxers to barbeque restaurants, and they keep Flow's economy strong.
Every day we work to improve the way we do business in order to serve you better:
For information about our services, please log onto wane
There you can And more Womatton about our divfons and the regulations that
impact you, to department and team. more about the
Our mission at the De a rimed 1 License Efficiently, Regulate Fairly. We
constantly strive to serve you better so that you can serve you customers.
Thank you for.doing business In Florida, and congratulations or your new Stens&
DETACH HERE
MIAMI-DADECOUNTY
TAX COLLECTOR
140. W. FLAMER ST.
1st. -FLOOR
MIAMI, FL 33130
635548-1
BUSINESS NAME / LOCATION
TWIN BROTHERS PLUMBING
CONTRACTORS CORP
2930 SW 22 TERR
33145 MIAMI
OWNER
TWIN BROTHERS PLUMBING CONTRACTO
Sec. Type of Business
6APMBIAIG CONTRACTOR
BUSINESS TAX RECEIPT. IT
DOES NOT PERMIT THE
HOLDER TO VIOLATE ANY
UNITING ZONING LAWS REGULATORY R
!COUNT' OR COLES. NOR
DOES : tf mew- . THE
HOLDEOR ANY 01WER
REQUIRED SY LAW. 111M IS
NOT THE HOL
MOM.
2010 LOCAL TAX RECEIPT
MIAMI-DADE COUNTY -STATE OF FLORIDA
EXPIRES SEPT. 30, 2011
PMUST BE DISPLAYED AT PLACE OF BUSINErot(
URSUANT TO COUNTY. CODE CHAPTER 8A - 1.
THIS IS NOT A BILL - DO NOT PAY
FIRST- CLASS
U.S. POSTAGE
PAID
MIAMI, FL
PERMIT
F40. 231
,PAYMENT IAW ADECOUNTYTAX
COLLECTOR:
09/22/2010
60000000432
00444544-
OTHER SIDE
RENEWAL
NO. 662291 -5
STATE* CFC037112
DO NOT FORWARD
TWIN BROTHERS PLUMBING
CONTRACTORS CORP
2930 SW 22 TERR
MIAMI FL 33145
111111. 11111111111111111111111111S IIf111111i 11111111I1„>„ i
CERTIFICATE OF LIABILITY INSURANCE
PRODUCER
VP Inman=
3442 Date WA
Fort tam FL 38312
Twin entauns Riming Cantactow Cop
296D8W22Two-
Mat Fl 33145
COVERAgEs
L woo patemattnti
,1I1
TIM «T1 dCTERISASAIRATTBROP !N lTION
ONLY AND 110 RIGHTS UP= THE I FsCATI
Imo. TINS ATE DOES IOTA . EXTEND OR
ALTER THE C AOEA BY TIIE POLICES BELOW_
NAM*
=summit Aaoaalw�tUn LLc
SISUREn
WIRER
INSWER
e
THE POLICIES OF I UST mow taw MN IB UEDTOTHE BAD NAM/ ABOVE FOX THE POL,CY PERIODBIDICATED. NOTWITIe'ANO1N 1
ANY TOM OR COMMON WNW CONMACTOR OTHER 4TW1TH RESPECT TO WHICH THLRC COWMAN BED 4:61 MAY
PERTAIN, THE �AF BY7HEPf HERMITS MIUECTTOAU.TIIETE�AQ�ANQ OF SUCH
POLICES. AGGREGATE ATELMWS MMAYHAVE BEEN BYPAR) CLAM
LTR DIN R3E03 P�/N
wunnwitffilluw GL-344 48-i p O I'll
Reny
GIAIloowe ®OCCUR
INNLAGGREOWE tRrn APPUESPut
AUTON0813 uaaAmr
1
ANY AUTO
AU. OTMDAU OS
SCIEDULEOAUTOS
NUiEQA ao5
NOENWOIEDAITTO$
swift mourn'
ANY AVM
,R
EifI:H $
9
MINTED
MOE P(Anyens pwsoa) $
S
rSOlmtdAIMIRY $
A6 6RTE $
Pre D t&*
1.003
1,003,0110
1,p10
IRMO
SITIOUELIMIT
s
WOW UMW
(Per PW3113
s
LatlErf
s
s
excEesuAaturf
p
IMMNPSIMMm"
nRY
3m, dams dw. Wow
ANrooNIY- EAAQ�ENr .S
EAAGG $
A81,
MOM
$
Sant s
s
s
AMA •I
ELENA TT $
ets.E►onE s
E - ONEA$E- ROUCYLMAT 1
oEoway, toravenanows.lacn,
cE nF A,TO MOLDER
VAN ARON
Miami Shores Village
Building Deparment
10050 N.E.2nd Avenue,
Miami Shores,Florida 33138
ACORD 2S (MUM
OW= NNW THB MORE MIMES es cANC3Lino Mona THE EXPIRAVON
RATE nowtsW.THEWSionninswwn wat. mums To MW. 39 wens vaimen
MIME le WE conalteM100133311110139 TOTTEIST,BiR MUM TOMBOMiAU.
MOSE ebusucomou on INUITUTYOrARY +:r THE UMITEK M3AIENTOC H
ITSPREMIDZITUIER
AU1R
Darabeys Perez
AAA PfeRfaktATION 1333