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PL-10-135Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 162281 Permit Number: PL -1 -10 -135 Scheduled Inspection Date: March 07, 2012 Inspector: Hernandez, Rafael Owner: Job Address: 637 NE 92 Street 12 -C Miami Shores, FL Project: <NONE> Contractor: FULL PLUMBING INC Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132060430140 Phone: (305)303 -2157 Building Department Comments PLUMBING WORK FOR KITCHEN AND BATHROOM REMODEL 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- 134320. no access 2:OOpm March 06, 2012 For Inspections please call: (305)762 -4949 Page 3 of 27 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's Name (Fee Simple Titleholder) Owner' Address 1/5 City Klan Tenant/Lessee Name Email State wisoisnwsiN JAN 2 7 2010 tYl BY: . . .. . ...°.. Permit No. 9' 10 Hb5 Master Permit No. 120 )0"" ___ CMod:ana G Phone # ST Zip 33 13 i3 Job Address (where the work is being done) City Miami Shores Village County Miami -Dade FOLIO / PARCEL # ! f '30.-0 -Q43 0 Phone # ctorharP -C c:W1-4 s-r (tct Zip ."Sa.I Is Building Historically Designated YES NO Flood Zone Contractor's Company Name l ?C U C Phone # SO ' �O3 ,c9-15-1 Contrac or's Address 1 330 uJ 4, IS City aC.e c AeN State_TE_ 330 Zip 0 Qualifier Name ego 4r (6 i eu Phone # 3cc - j0 2-t E*7 State Certificate or Registration No. q Sg Certificate of Competency No. Contact Phone Architect/Engineer's Name (if applicable) Type of Work: ❑Addition E -mail 'COD ['Alteration Phone # Square / Linear Footage Of Work: ['New ERepair/Replace [' Demolition E. Submittal Fe Q�i/ Notary $ Training /Education Fee $ �J • Technology Fee $ ' 'COO Scanning $ 3- Radon $ a 10 DPBR $ ark-) Bond $ Double Fee $ Structural Review. $ Total Fee Now Due $ Qt..,2 x(00 Violation date: See Reverse side —* 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 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 r 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 a for the first inspectio inspection will not ment. Also, a certified copy of the recorded notice of commencement must be posted at the job site rs seven (7) days after the building permit is issued. In the absence of such posted notice, the a reinspection fee will be charged. The foregoing instrument was ac day of 120 I O, by _ who is rsonally known to me or who has _produced 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. Signature 3 tractor The fore oing instrument was acknowled ed before me this day of , 20 a, by �r t.O t) NOTARY Sign: Prin C: My Commission Expire APPROVED BY dis CRISMARY PASCARELLA Notary Public - State of Florida My Comm. Expires May 26, 2013 NOTAR UB IC: Sign: Pri My I * * * * * * * * * ** 69`Plans Examiner Engineer (Revised 07 /10 /07)(Revised 06/10/2009) ExIANSMARY PASCAREL .A F. s Notary Public State of Florida T My Comm. Expires May 26, 2013 Commission #E 00 893337 ****** * * * * * * * ** Zoning Clerk checked Miami Shores Village Building Department ' :1 (7 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 L FEB 2 1011 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BY.. 6-135 ■0_q BUILDING PERMIT APPLICATION FBC 20 Permit Type: PLUMBING n Owner's Name (Fee Simple Titleholder) 0.---30S4K-V-e*-A Pho ne # S_) — 19 H Owner's Address RZ1 0:a 19` sT City h nn State L, Permit No. Master Permit No. Tenant/Lessee Name Email Zip 33I -8 Job Address (where the work is being done) Phone # City Miami Shores Village County FOLIO / PARCEL # Is Building Historically Designated YES Miami -Dade Zip NO Contractor's Company Name y` FU /1 PA/ IA/ L/htl- /y L Phone # Contractor's Address. / 3 3 0 W 41 4 / - J S City 11/ 4 /e4.1•1 State IG Qualifier Name ,4410 hi 0 14 A ter State Certificate or Registration No. .1. Pc /V Z 49 3 y Flood Zone 3e25-- 363 2 /s'? Zip 3 3 e/2, Phone # 05`, 3 P3 2/5-- Certificate of Competency No. Contact Phone E -mail f ' (L p! a Jai a j„, is 6 Co y q hi-0 te) 1 � Architect /Engineer's Name (if applicable) Value of Work For this Permit $ Type of Work: ❑Addition ['Alteration ❑New ❑.epair/Replace ❑ Demolition Describe Work: 6-0 j,� • L -1 -10- 13S Phone # Square / Linear Footage Of Work: .01.. ., »4- *p, * * * * * * * * * * * * ** *,*fir * * * ** ************Fees*********** * * * ** *. * * * *. �. * � �`�� `� Sub ittal Fee $ Notary $ Scanning $ Radon $ Double Fee $ Training/Education Fee $ DPBR $ Violation date: Technology Fee $ Bond $ Structural Review. $ Total Fee Now Due $ See Reverse side - 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 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 atta h . ent. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection wh r�e rs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be '4.;'I n * 1 i reinspection fee will be charged. Signature ((t(i , Signaturz ..6 ■. -1.1 t Contractor The foregoing instrument was a`IT wledged before me this 20 The foregoing instrument was acknowled ed before mee this day of �, 20 , by cc 1 _ , day of At , 20 t 3 , by �F� i-0 4C\Q -e,_ who is personally known to me or who has produced 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 P IC: NOTARY PUBLIC: .41A0/1110 ,i4t1/& 0I 1 �• • Sign: Print: GAPS My Commis * * * * * * * * * * APPROVED BY CRISMARY PASCARELLA Notary Public - State of Florida *My Comm. Expires Mayjt Sign: Print: My Comm. * * * * * * * * * * * * * * * * * * * * * * **. * ** Plans Examiner Engineer (Revised 07 /10 /07)(Revised 06/10/2009) CRISMARY PASCARELLA Notary Public • State of F orida My Comm. Expires May 26 2013 Commission # DD 89337 Zoning Clerk checked CERTIFICATE OF INSURANCE ISSUE DATE 6/10/2010 PRODUCER Estrella Insurance, Inc 106 1140 W 68th St Hialeah, FL 33014 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. COMPANIES AFFORDING COVERAGE COMPANY A Lloyd's of London LETTER INSURED Full Plumbing 1330 West 46th Street #15 Hialeah, FL 33015 COMPANY B N/A LETTER COMPANY LETTER C N/A COMPANY D N/A LETTER COMPANY E N/A LETTER COVERAGES THIS IS TO CERTIFY THAT 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, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE POLICY EXPIRATION DATE LIMITS A GENERAL LIABILITY AMTE002741 5/7/2010 5/7/2011 GENERAL AGGREGATE 2,000,000 1,000,000 1,000,000 1,000,000 50,000 5,000 PRODUCTS- COM /OP AGG. PERSONAL & ADV. INJURY EACH OCCURRENCE DAMAGE PREM RENTED TO YOU MED EXPENSE (Any one person) B PERSONAL LIABILITY COMBINDED SINGLE LIMIT MEDICAL PAYMENTS TO OTHERS C EXCESS LIABILITY EACH OCCURRENCE AGGREGATE D E PROPERTY BUILDING CONTENTS LOSS OF USE DESCRIPTION OF OPERATIONS / VEHICLES / SPECIALTY ITEMS Plumbing commercial & industrial, Plumbing residential or domestic THIS INSURANCE IS ISSUED PURSUANT TO THE FLORIDA SURPLUS LINES LAW. PERSONS INSURED BY SURPLUS LINES CARRIERS DO NOT HAVE THE PROTECTION OF THE FLORIDA GUARANTY ACT TO THE EXTENT OF ANY RIGHT OF RECOVERY FOR THE OBLIGATION OF AN INSOLVENT UNLICENSED INSURER. SURPLUS LINES INSURERS' POLICY RATES AND FORMS ARE NOT APPROVED BY ANY FLORIDA REGULATORY AGENCY. SURPLUS LINES AGENT VIRGINIA C. PHILLIPS LICENSE# A206695 13577 FEATHERSOUND DRIVE PO BOX 17069 CLEARWATER, FLORIDA 33762 CERTIFICATE HOLDER CITY OF MIAMI SHORES 10050 N.E. 2 AVE Miami, FL 33179 Should any of the above described policies be cancelled before the expiration date, the company shall endeavor to mail 30 days written notice to the certificate holder named to the left, but failure to mail such notice shall impose no obligation or liability of any kind upon the company, its agents, or representatives. AUTHORIZED SIGNATURE Dec 17 10 10:48p User MIAMi-L7ADE COUNTY TAX COLLECTOR 140 W. FLAGLER ST. 1st FLOOR MIAMI. FL 33130 3058208925 21' LOCAL BUSINESS TAX RECEIPT 2G':', FIRST-CLASS MIAMI-DADE COUNTY- STATE OF FLORIDA U.S. POSTAGE I EXPIRES SEPT. 30, 2111 PAIO MUST BE DISPLAYED AT PLACE OF BUSINESS MAW F... PURSUANT TO COUNTY CODE CHAPTER SA • ART. 9 & 10 PERMIT NO. 231 p • 1 THIS :S NOT A BILL - 0,:) NOT pAy 639574-3 RENEWAL BUSINESS NAM / LOCA11C4 RECEiPT NO. 666364-6 FULL PLUMBING INC STATE* CFC1427934 1530 W 46 ST 15 33012 HIALEAH OWNER FULL PLUMBING INC See. Type cl. Business WORKER/5 196 SgECIALTY BUILDING CONTRACTOR 1 Tr1:5 IS CRLY A L. AL IRISSESS TAX RECPT. rl. OCIS C/OT FERMI? TIM HOLDIT4 TO VIOLATE ANY :71114C LAWS OF /NE 00 NOT FORWARD DIVING REGULATORY OR OOL•HT/ OR criEs. MGR COE S IT EARLIPT INE SOLDER PROM ANY OTKER PERNIT OR 6.r..ENSE A ROT A ezpvricknoN OF FULL PLUMBING INC RSOO177SO RV !...4v. rt A es Tmi KOLDERII OUALTICA. ANTONIO ABREO PRES nor4s, 1330 W 46 ST 15 PAVIVoTRE:F:VEM HIALEAH FL 33012 glAIV.i•OACE ccgmr, coLacion: 07/27/2010 60020000525 000045.00 SEE OTHER SIPE 11 V11111.1,1‘ t 11111'llis tk. !I°11 t Nnw 113 OS 1235p 3058i.".1113ti;e_t1 03-26-200S P • `I ALEX 5 INK STATE OF FLORIDA piwANciAL er44:cEe, DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS COMPEUSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW CONSTRUCTION INDUSTRY EXEMPTION Thi ceet,ties that the individue fisted Wow has elected to be exempt from Florida Workers' Compensation L. EFFECTIVE DATE: 03126/208g EXPIRATION DATE: 031 26/ 2011 PERSON: ABREU ANTONIO FEIN: 263597171 BUSINESS NAME AND ADDRESS: FULL PLUMBING INC 33O W 4TH STREET APT 15 NtALEAM FL 33012 SCOPES OF 8USINESS OR TRADE: 1- CERTIFIED PLUMING CONTRACTOR ?ursuatt thaw- 45 . flb4 alroraffoo Witt agools eoamoCeo iron this CaAafer firiog 4 ,:41tilii;44? oi ellOtto3 afloat this stotioo Itta;- reCeve' bettefits or csoppeasatios tower shor oosate.,, ParIcirat ret (.31103: O40,0602/. F.S., Cartiffs•tat otactiaa so be ezetcat... apply oat), tsithtn t.14 ;epee of 11,i, business OF toa+Ct an the sotto. j ttottot t, Os exempt. att,soatit to ettaxet 44t.351131, f.S., Kokes d aloolios to at Csetoof see cer.11ientes Ue alt 36 steteot to r0OrrreffOO if, Cr aly eta; ie tj1 G ,.6f netioe tr.1 tostiaose of the certificate, the 4310,4% ;Isom! 0: tee OirtiCe ttortiliosta tooger rt9211 tat requirententt o■. this secs fOr 7rSIMOCe Of 0 Certificate. Y1 OeU'ortatetts a4 reYehe cerfinsitfo . m ffrO0 lOr 10nOIL at fhO P0gfal na,rtal ori t ?Art:tit:ate to rneot rtio r Q i.IEST!ONS? i55;.1} 4 :3-10C;f:i teit-7-2:52 CEBT/FICATE f./F LECVON TT 8F iXF.PdfF1 11£11,SE0 03-OE 10# STATE OF FLORIDA ADEPARTMW OF BUSINECS AND PROFESSIONAL REGULATION vsi —ONSTRUCTION INDUSTRY LICENSING BOARD • SEQ#L09031900150 0 * 0 0 02/19/2009 080271716 CFC1427934 The PLUMBING CONTRACTOR Named below IS CERTIFIED Under the provisione of Chapter 485 FS. Expiratioa date: AUG 31, 2010 ABREU, ANTONIO FULL PLUMBING INC 1330 WEST 46TH STREET APT#15 HIALEAH FL 33012-3256 CHARLIE CRIST GOVERNOR CHARLES W. DRAGO SECRETARY D1SPLAYASREQUIREUBYLAW •