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PL-11-527
Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 tA Inspection Number: I NSP- 157622 _, S25 Permit Number: PL -3 -11 -527 Scheduled Inspection Date: January 20, 2012 Inspector: Hernandez, Rafael Owner: LONGMAN, JOHN Job Address: 333 NE 92 Street Miami Shores, FL 33138- Project <NONE> Contractor: NELMAR PLUMBING INC Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number ()_ Parcel Number 1132060136370 Phone: (305) 261 -3942 Building Department Comments MOVING W & D INTO GARAGE AND RELOCATE EXISTING BATHROOM Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments January 19, 2012 For Inspections please call: (305)762 -4949 Page 1 of 10 Miami Shores Village Building Department MAY 2. 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 2004 Permit Type: Plumbing Owner's Name (Fee Simple Titleholder) Owner's Address Permit No.' (1 `" 21 Master Permit No. 1 1'"595 (c qtr Phone # 13 — (0 611 City State �� Zip tieg, ILYA-- Tenant /Lessee Name E -MAIL: Phone # Job Address (where the work is being done) City Miami Shores Village County Miami -Dade FOLIO / PARCEL # l (' ` ?c • 01% _ k'N Is Building Historically Designated YES NO Contractor's Company Name Contractor's Address PL S u' -75- t = City r1/1 r ) »14/11 State Zip 3 3 f r Qualifier Name 2.-ctt S f k Q))4.‘'J tfL Phone# 3of'- Zc'/ 3 %V2, State Certificate or Registration No. /2 Fad 3 g Z b 6 Certificate of Competency No. 6' 00 a' 5 6 E -MAIL: Phone# 90.j 67-35.7(2_ Architect /Engineer's Name (if applicable) Phone # Zip Value of Work For this Permit $ 12.1 Square / Linear Footage Of Work: Type of Work: ❑Addition ❑Alteration ❑New ❑ Repair /Replace ❑ Demolition Describe Work: OV. 5�t (' A f (Z_ IN-10 * * * * ** * * **** * * * * * * * * * * * * * * * * *xxxxx* *Fees * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ 2 , 2-5 CCF $ CO /CC Notary $ Training /Education Fee $ Technology Fee $ Scanning $ Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ See Reverse side Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City Zip 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. 1 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 . ur: seven (7) d s after the building permit is issued the absence of such posted notice, the inspection will not be appr. .ed . d a ref coon "e will be charged. Signature Owner • nt Co tractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 2S day of , 20 , by day of r44,4,1 20 f( by who is personally known to me or who has roduced p who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PU : IC: Signature NOTARY PUBLIC: elthIS mss, w ,t°►:�.; ,, A , _.; , i loco,; My Comm :,','f' expires: Sign: Print: * xxxx "rye xxx* x*** x** x******* x******** xxxxxx xx * * ** * * * * * ** *x* * * * * * * * * ** Sign: Print: My Co ++,,,,;t',•• Jx ires: RENETUMA pMY COMMISSION # EE 051463 * * *EXPIFESxAipfi62b tY0 * *x + i f'''''' Bonded Thru Notary Public Underwriters APPLICATION APPROVED BY: (Revised 02/08/06) -// Plans Examiner Engineer Zoning Jun 07 11 02:OGp MIAMI -DADE COUNTY TAX COLLECTOR 140 W. FLAGLER ST. 1st FLOOR MIAMI, FL 33130 p.1 2010 LOCAL BUSINESS TAX RECEIPT 2011 FIRST -CLASS MIAMI -DADE COUNTY - STATE OF FLORIDA U.S. POSTAGE EXPIRES SEPT. 30, 2011 PAID MUST BE DISPLAYED AT PLACE OF BUSINESS MIAMI, FL PURSUANT TO COUNTY CODE CHAPTER 8A - ART. 9 & 10 PERMIT NO. 231 026514 -0 THIS IS NOT A BILL — DO NOT PAY BUSINESS NAME /LOCATION RENEWAL RECEIPT NO. 026514-0 NELMAR PLUMBING INC CC * 000008586 4954 SW 75 AVE 33155 UNIN DADE COUNTY )WNER NELMAR PLUMBING INC lee. Type of Business WORKER /S stWAPII5cyrBING CONTRACTOR 20 ?SS TAX RECEIPT. R NOT PERMIT THE A TO VIOLATE ANY 4G REGULATORY OR LAWS OF THE Y OR CRIES. NOR IT EXEMPT THE R FROM ANY OTHER • OR LICENSE tED BY LAW. THIS Is cERnFICATION OF )LDER'S OUALIFICA- NT RECEIVED )ADE COUNTY TAX :TOR: 08/26/2010 60020000223 000125.00 SEE OTHER SIDE DO NOT FORWARD NELMAR PLUMBING INC MARLON TUMA PRES 4954 SW 75 AVE MIAMI FL 33155 66 Jun 07 11 02:08p MIAMI -DADE COUNTY TAX COLLECTOR 140 W. FLAGLER ST. 1st FLOOR MIAMI, FL 33130 2010 MUNICIPAL CONTRACTOR'S 2011 FIRST-CLASS TAX RECEIPT U.S. POSTAGE MIAMI -DADE COUNTY - STATE OF FLORIDA PAID PURSUANT TO COUNTY CODE SEC. 10 -24 MIAMI, FL EXPIRES SEPT. 30, 2011 PERMIT NO. 231 THIS IS NOT A BILL — DO NOT PAY :CEIPTNO. 30- 0265140 CC NOt 000008586 JSINESS NAME / LOCATION IELMAR PLUMBING INC 4954 SW 75 AVE ]WNER :NELMAR PLUMBING INC iEE BACK OF RECEIPT FOR % LIST OF NON- PARTICIPATING 4UNICIPALITIES :eipt holder must later in the city are work is to be le. MENT RECEIVED ill�-DApDE COUNTY TAX ` 5 g C6 /2010 0020000224 100200.00 RECEIPT HOLDER MAY DO BUSINESS AS A CONTRACTOR AS SPECIFIED HEREON. PLUMBING CONTRACTOR DO NOT FORWARD NELMAR PLUMBING INC MARLON TUMA PRES 4954 SW 75 AVE MIAMI FL 33155 1111171Ii161i1 p.2 Jun 07 11 02:O6p C Trades Construction Qualifying Board BUSINESS CERTIFICATE OF COMPETENCY 000008586 NEL MAR PLUMBING INC D.BA.: RODRIG ' UIS F Is wed under the provisions of Chapter 10 of Miami -Dade County VALID FOR CONTRACTING UNTIL 09/30/2011 p.3 QUALIFYING TRADE(S) 0001 PLUMBING 0022 MEDICAL GAS INSTALLATION STATE OF FLORIDA DEPARTMENT OF PROFESSIONAL RF0036206 07/2 AC# 4478953 BUSINESS AND REGULATION 1/09 090042272 REGISTERED PLUMBING CONTRACTOR RODRIGUEZ, LUIS F NELMAR PLUMBING INC (INDIVIDUAL MUST MEET ALL • LOCAL LICENSING REQUIREMENTS PRIOR TO CONTRACTING IN ANY AREA) HAS REGISTERED under the provisions of Cb. 489 expiration date: AUG 31, 2011. L09072100488 l Jun 07 11 02:07p p. 4 ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID 19 NELMA -1 DATE(MM/DDIYYYY) 04/25/11 • TYPE OF INSURANCE POLICY NUMBER DATE MUD • PRODUCER Emmanuel Insurance Agency Sarai Medina 2370 E 8 Ave Hialeah FL 33013 Phone: 305 - 693 -0003 Fax: 305 - 691 -4381 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 NAIC S INSURED Nelms Plumbing ,Inc 4954 '.sF3 L�3155 INSURER A: ASaendant Ins. Co. 13683 INSURER B: COMMERCIAL GENERAL LIABILITY INSURER C: PR" MISES(Eac INSURER D INSURER E 1 THE POUCIES 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 POUCIES. AGGREGATE UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. • ,: • TYPE OF INSURANCE POLICY NUMBER DATE MUD • •A MM1OD • LIMITS A GENERAL X UABILITY 04/27/12 EACH OCCURRENCE S 1000000 COMMERCIAL GENERAL LIABILITY 201100164 04/27/11 PR" MISES(Eac $100000 CLAIMS MADE X OCCUR rence) MED EXP (Any one person) PERSONAL &ADVINJURY $ 5000 $ 1, 000, 000 GENERAL AGGREGATE $ 2,000,000 GENIAGGREGATE X LIMIT APPLIES PER: POLICY ^ JECT LOC PRODUCTS - COMP/0P AGG 51, 000 , 000 AUTOMOBILE ■ LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS COMBINED LIMIT $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY • EA ACCIDENT 5 EA OTHER THAN ACC $ AUTO ONLY: AGG 5 EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE S OCCUR CLAIMS WADE . AGGREGATE $ DEDUCTIBLE $ $ RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' UABIUTY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER TORY LIMITS 1 ER E.L EACH ACCIDENT S EXCLUDED? IP yes, describe under E.L DISEASE - EA EMPLOYEE S SPECIAL PROVISIONS below E.L DISEASE • POUCY LIMIT S OTHER DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT? SPECIAL PROVISIONS Commercial plumbing, residential plumbing. f2CC•ICrr•Are unI nen CELLATION MIAMI SHORES VILLAGE 10050 NE 2 AVE MIAMI SHORES FL ACORD 25 (2001/08) SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 50 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Sarai Medina © ACORD CORPORATION 1988 Jun 07 11 02:07p P.5 ACORD. CERTIFICATE OF LIABILITY INSURANCE I DATE 9i 0111 PRODUCER (305)556 -1488 FAX: (305)556 -3680 NSI Insurance Group 8181 Northwest 154th Suite 230 Miami Lakes FL 33016 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 NAIC # INSURED Nelmar Plumbing Inc 4954 SW 75 Avenue Miami FL 33155 INSURER A:CaStlePOint Florida 13599 INSURER B: INSURER C: INSURER O: INSURER E: COVERAGES THE POLICIES REQUIREMENT. THE INSURANCE AGGREGATE OF INSURANCE LISTED BELOW TERM OR CONDITION OF ANY AFFORDED BY THE POL LIMITS SHOWN MAY HAVE BEE HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN CIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES V REDUCED BY PAID CLAIMS. INSR IN -RD TYPE OF INSURANCE POLICY NUMBER A (TE MM/00P EFFECTIVE POLICY I LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABWTY EACH OCCURRENCE S DAMAGE TO RENTED PREMISES (Ea occurrence) $ I CLAIMS MADE OCCUR MED EXP (Mv one cerson) PERSONAL $ $ & MW INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG $ $ GEM AGGRE-G'AT�E LIMIT APP —LIES PER: GE I POLICY I (JJEE8T- I 1 LOC AUTOMOBILE — — _ _ LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Pet ardent) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY -EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGO $ EXCESS/UMBRELLA LIABILITY OCCUR CLAIMS MADE EACH OCCURRENCE $ AGGREGATE DEDUCTIBLE RETENTION $ S $ A EMPLOYERS' LIABILITY AND ANY PROPRIETOR/PARTNER/EXECUTIVE OFFIcERJMEMBEREXCLUDED? If yes, describe under SPECIAL PROVISIONS below WCP760735400 2/10/2011 2/10/2012 yWy�� 7(� 4 TORTTLIMI'i'S 1 ITN- E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYEE $ 100,000 E.L DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OTHER OF OPERAT(ONS(LOCATIONSIVEH(Ci ES/EX CLUSIONS ADDED BY EN[�ottSEMENT(SPECIAL PROVISIONS 30 day notice of cancellation except 10 days for nonpayment of premium. CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE 10050 NE 2 AVE MIAMI SHORES, FL AGORD 25 (2001108) INS025 (0108).08a SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE E7(PIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL IMPOSE NO OBLIGATION OR LIABIUTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE G Nenezian /ADRIAN ACORD CORPORATION 198/ Page 1 a: