PL-11-1811Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 165067 Permit Number: PL -10 -11 -1811
Scheduled Inspection Date: January 13, 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
PLUMBING FOR GARAGE ENCLOSURE 1 BATHROOM
AND LAUDRYROOM
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
January 13, 2012
For Inspections please call: (305)762 -4949
Page 1 of 9
•
.16
Miami Shores Village
Building Department
al50 Nl.2id A‘enue. NI111111 Show, 114.rida 3113S
id: 0.41■51 795.22014 Env: i 7.56.S972
INSPECTION'S PHONE NUMBER: 03051762.39P
Permit No.
Master Permit No. RC - 11— 1 37
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: PLUMBING
"Jifrc-• ner4).# )11e4F:
OWNER: Name4Fee Simple Titlehualuler (Ice er
19-Lveum.t..) 3 )'
Tenantil_ev-ce
Enidil Jawi1/41A21_ n Phk trio&
JOB ADDRESS: 20 (1•31.) ( o3 S:(---4
CR. Miami Shore,
FoliuulPiovelb'
Is the Building Historivally Designated: 1' en, NO
Dade
CONTRACTOR: Cuumparru Naliae. 6favrtheRG
A,,,,„,.
A-me
VtlIi'cr Name. ottierica Phume#1' 40s" cif 3/91
r_Fc (037-H> Cc r Ili.cdte ( ‘05s we-WM #
Coluau:t Phone: "426- 416 7 hr. o I Aulune.us. 7-144aerrePAP
DESIGNER: ArclotectiFoguneer.
Moro; 304• /PG f
Po gt•J P-a- Ta- 3P/ VS-
Slate: Ft 3 3/K
Site Ceraileation s Bet:stratum
Value of Work for th6 Permit: $
,941"0-
Squareil ittear Footage of Work:
Type of %%urk: aNddreu:, JAI:mut:um URepast/Repla,:e aDemolinum
Description n$' Work:
,tAtct xi, 47 6r44r
Submittal Fee $ Permit Fee $_ (11 S
Scanning Fce $ Radon Fee $ 11113PR 5 Bond $
Notary 5 Training/Education Fee $ Technology Fee
Double Fee % Structural Re‘ieu
COICC S
TOTAL FEE NOW DUE S
dr • 4
Bonding Company's Name tit applicable!
Bonding Company's Address
City State Zip
Atortgttge Lender's Name t 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_ 1 certify that no work or installation has
commenced prior to the issuance of a permit and that all work will Iv performed to meet the standards of all laws regulating
construction in this jurisdiction t understand that a separate permit must he secured for ELECTRICAL WORK. PLUMBING. SIGNS,
\ FI.<ES. POOLS, FURNACES. BOILERS. HEATERS. TANKS arid AIR. CONDITIONERS, ETC.....
OWNER'S AFFIDAVIT: I certify that all the foregoing intiarmation is accurate and that ail work will he done in compliance with all
applicable laws regulating construction and ;.oning,
"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 OBTAI.N
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT."
\otiee arc .pplic•aau: .4n o coat/ham to the Lssreu►u r 0/ 0 budding / ^c rmia 'vita ou ec ►anacatcd r ►clue- r seceaink S25rttI the applicant must
pro►►tise i ►► .reamed faith than a eopy of the nonce of commencement eanel tumor-gulags /ie -n law brc.adeurc• gill be clr(ia Bred to the fSe►:s0►a
whose pr iprrrs s su ire attachment, .41so. u r eru /ied e ropy OI the recrerrlr I atelier ell r °rauune nr r f ►re ►►t noose! be prste•d eel the jccl? .site
%rcr the J a'et in .:-:Honcrejtich cac e7►rs seven t71 r alter lle budding in rota is issued, In the absence et) sorb posted notice. the
iuspertira a a l iralt'e approved and a reinspc ton tee a i ' ?r c hrartred.
Owner or Agent
The forego ng instrument was acknowledged before me this
day ccf' ( ' . by
who is per. " malty known to are or who h: aQgAUlf14' ' CUD
\` \ \s��l hyl
As identif`icaki40�l14)l,Qii�, .,anoath.
tr
'SAr i6Z ,. \ t Z QL 2 ,
NOTARY PUBLIC:
Sign:
Print:
Vista Commission Expires:
10659LOa''
# UO SIWWO j
•
d> CN
89 r1 .•''
nannntt`sss\
:�>;:E�rj E: k: y ;: K. rl rar3.Y Gfr.:seKYE: F,�3sai.3 f� r�sfi:: g. ��srer;::;< az, HS �ar:�a8n++7o3s�fi¢�srtliE"u88a+:3 rtz a: faglH:g 7F: ac
APPROy'El� E3Y L�
wRto .I It7Tfru07i4Re% ed ,Ow!tF,2Itro#Rc 3 /t5fH'Jy
Contractor
The foregoing instrument was acknowledged
dos of g' r lQainh s iL. he hi,m
who is personally know,
Plans Examiner
Structural Review
.tore me this
4 letre3),
to me or who has produced
as identification and who dial take an oath.
NOTARY PUBLIC:
Sign:
Print:
•
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WIRD RODRIGUiZ
tate of Florida
1151/151
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Zoning
Clerk
Oct 131103:18p Twin Brother
3052003022
p.1
A RD CERTIFICATE OF LIABILITY INSURANCE
1 mo o„
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON 7HE CERTIFICATE HOLDER THIS
CERTIFICATE DOES MOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED ST THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERS), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT; It tic certificate holder ban ADDITIONAL INSURED, the poRcy(les) must be endorsed. If SUBROGATION IS WAIVED, oubjest to the
terms and oortddiwna of tile policy, Pilate policies may require en eiLdmsemenL A statement on Ws cett facet does not Wafer NOM 10 the
curlt1Jcalo holder in Rau of such ondorawnanas).
PRODUCER
VP lebt(r8n®
3942 Davie eivri
Fort Nniderdala,FL 33312
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INSURED
Twin Brothels Purring Contractors CITP
2930 sw 22 ten
Miami.FL 33145
INSURERS:
PREMISEStEnac sr)
INSURER
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INSURr7R S. :
PEIMOWILAARYINJURY
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THIS 13 TO CERTIFY THAT THE POLICIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONG YIDN OP ANY CONTRACT OR OTHER DOCUMENT 1NOTH RESPECT TO WHICH THIS
CERTIFICATE MAY IIE. ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT 70 ALL THE TERMS.
EXCLUSIONS AND CONDITIONS OP SUCH POLICIES. UNITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
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DEBC RUMOR CIF O PERATDNB'LOCATIONS,VEHICLES r$ldoh ACORD 15 ASS sumo goon.rra5*imute.rawrarp,..uususree
CERTIFICATE HOLDER
CANCELLATION
Building
10050 NE
Miami Shales.
Deportment
2rd Ave
FL 33130
$I(OULD ANY OF THE AIIOVE DESCRIEIED POUCHES BE CANCELLED BEFORE
THE ERPIRATION DATE THEREOF, NOTICE WILL BE DELNEREO IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUM D REFRE J1TATWE
.a. • Ma 0 -enMM AenRD eeRPeIUTION. All rights reserved.
ACORD 25 (2010105)
The ACORD name and logo are registered marks of ACORD
Oct 1311 02:49p
Twin Brother
T
IM AMI•DADE COUNTY
TAX COLLECTOR
140141. FLAGLER ST.
1st FLOOR
MIAMI, FL 33130
635548-1
TW NAME ROTHERS PLUMBING
CONTRACTORS CORP
2930 SW 22 TERR
33145 MIAMI
OWNER •
TWIN BROTHERS PLUMBING CONTRACTO WORKER /S
1 P�G CONTRACTOR 1
3052003022 p.1
2011 LOCAL BUSINESS TAX RECEPT 2012
MIMU -DARE COUNTY - STATE OF FLORIDA
EXPIRES SEPT. 30.2012
MUST BE DISPLAYED AT PLACE OF BUSINESS
PURSUANT TO COUNTY CODE CHAPTER SA - ART. 9 & 10
THIS IS MOT A BILL - DO i lOT PAY p RENEWAL
R>_c No. 662291 -5
STATE* CFc037112
FIRST - CLASS
U.S. POSTAGE
PAID
MIAI41, FL.
PERMIT NO. 231
7X18 IS WET A LOCAL
B ORERS TAX REFEPT. IT
DOES NOT PERIN TEE
H OLDER TO MATE SAW
EXISTING REGULATORY OR
ZOIEDE LAWS OF THE
COUNTY OR crtES. DDR
D OES IT EWER TIE
HOLDER FROM ANY OTHER
PERMIT OR =ERE
. REQUIRED BY LAYI. THE IS
NOT A CEIWIRGTION CF
THE HOLDERS COAIIRIA•
QOM
PAYMENT RECEIVED
BXALO DADS COUNTY TAX
O OLIEO7OR:
07/13/2011
60030000422
000045.00
•
i SEE OTHER SIDE
t_ .
DO NOT FORWARD
TWIN BROTHERS PLUMBING
CONTRACTORS CORP
2930 SW 22 TERR
MIAMI FL 33145
1► It111ril.,I1111111IS 11111111111111, /1111II111111iI4191 11