The URL can be used to link to this page

PL-12-440Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Rc- 12439 Inspection Number. INSP- 174175 Permit Number: PL- 3- 12-440 Scheduled Inspection Date: June 04, 2012 Inspector: Hernandez, Rafael Owner: HOWARD, DAVID Job Address: 55 NE 97 Street Miami Shores, FL 33138- Project: <NONE> Contractor: PRESTIGE SOLAR Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: New Phone Number (305)968 -2445 Parcel Number 1132060130990 Phone: (305)827 -1935 Building Department Comments WATER HEATER Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION OR INSP- 173962. CREATED AS REINSPECTION FOR INSP -17 •85. need to connect relief valve June 01, 2012 For Inspections please call: (305)762 -4949 Page 14 of 22 From: Cilent#:1464202 05/02/2012 08:38 #338 P.001/002 132PRESTSOLI ACORD,. CERTIFICATE OF LIABILITY INSURANCE 1 DATE(MN/OD/YYYY) 5/02/2012 THIS POUCIES THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER BB&T- Oswald TNppe and Company 9200 S. Dadeland Blvd, Ste 314 Miami, FL 33156 305 670-0083 ateCT Ansa Josephs fa 305 670 -0083 1 Da �): 866 802 -8668 Ems' ° E"a' moms; ajosephs(c, bbandtcom � URER($)AFFORDINGCOVERAGE NMI/ INSURERA : United Specialty insurance Comp 12537 INSURED Prestige Solar Products Inc. RJS Consultants, Inc. 6157 NW 167 St #F3 Hialeah, FL 33015 r.AVFRAISFC ..�s�._......._ ........__. INSURER 8: Twin City Fire Insurance Compan 29459 ,Travelers ravelers Property Casualty Co 25674 IN ° SURER INSURER s DEACHOCCpURREENCE PREfs1ISES /Es ) INSURER F : MED EXP (My one person) REVISION NUMBER: INDICATED. CERTIFICATE �gE�XCLUSIONS NOTWITHSTANDING ANY 41CREQUIREMENT. TERM I OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT ETO WHICH THIS MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I TYPE OF INSURANCE ADM (NSR SUBR ' V0 POLICY NUMB POU H IMMiTI POLICY IOCP (MMEKWYTYY) LIMITS A GENERAL X LIAB1LrrY COMMERCIAL GENERAL. UABLU V (MAIMS MADE 1 X1 OCCUR 0S106757 06/02/2011 06/02/2012 $1,000,000 DEACHOCCpURREENCE PREfs1ISES /Es ) $100,000 $5,000 MED EXP (My one person) X PD Ded:1,000 PERSONAL $ADVINJURY $1,000,000 s2,000,000 $2,000,000 $ GENERAL AGGREGATE —1 GEN L AGGREGATE LIMIT APPLIES PER: POLICY J I ( LOC PRODUCTS • COMPIOP AGG C AUTOMOBILE X X LIABILITY BA4B54941112SEL 03/01/2012 03/01/2013 IOMBINEnDSIIJ,LELIMIT $500,000 $ ANY AUTO AUTOS HIRED AUTOS SCHEDULED AUTOS BODILY INJURY (Par person) BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident/ $ UMBRELLA UAB EXCESS UAB 1 1 — OCCUR CI-AIMS-MADE EACH OCCURRENCE S AGGREGATE $ DEO 1 RETENTION $ WORKERS $ B COMPENSATION AND EMPLOYERS' LIABILITY Y/ N `�� CICEFPERRRIP UDED9 E1 y 1 D(Myyaeenss,dabry lnNH) ESCRIPN CF ORATIONS helm N / A 21 WECP04411 03/31 /2012 03/31/2013 I WC STATU- I IRTH. TORY IJMIT'3 PR E.L. EACH ACCIDENT $100,000 $100,000 E.L. DISEASE- EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (Attach ACORD 101, Addktonal Remarks Schedule, It more space N required) *fr Workers Comp Information ** Propriet ors / Partners /Executive Officers/Members Excluded: ROBERT SCAVUZZO, ELECOFC CHRISTINA SCAVUZZO, ELECOFC (See Attached Descriptions) CERTIFICATE HOLDER Village of Miami Shores Building Dept 10050 NE 2nd Ave. Miami Shores, FL 33138 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05)) 1 of 2 #S8565966/M8555172 644 ;m. Aar AP CD 1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ALJO From: 05/02/2012 08:39 #338 P.002/002 DESCRIPTIONS (Continued from Page 1) "* Supplemental Name " First Supplemental Name applies to all policies - Prestige Solar Products Inc. First Supplemental Name applies to all policies - RJS Consultants Corporation First Supplemental Name applies to all policies - d/b /a Prestige Solar Policy# OS108757 - Doing Business As Prestige Window & Solar Prestige Solar SAGI7TA 25.3 (2010/05) 2 of 2 #S8471510/M8408721 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 PE ' AP ' ICATION FBC REtEOVED MAR 1 3 2 Permit No. L ( 2- Master Permit No. 12--C 12- -439 Permit Type: PLUMBING OWNER: Name (Fee Simple Titleholder): bvt.VICI, Phone #: Address: .5•5 City: V'(1 \'cii State: Zip: 3318 Tenant/Lessee Name: Phone#: Email: JOB ADDRESS: &5 T1 '51- • City: Miami Shores County: Miami Dade Zip: 33►3ee, Folio/Parcel #: (i `3aer:x °01-0479® Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: i"S' ltT ScAou: Phone#: (c) Sal -1935 Address: taV5 % Nom) V4.71 *t' - City: M State: F1 Zip: 3�y -915 Qualifier Name: C.c'N GJCP ..'J �ZZ� Phone#: C°Z7 /4.3 5 State Certification or Registration #: C k i 5(ii (cFj Certificate of Competency #: Contact Phone#: 6 7-i / Gi Y-3 Email Address: CSCGt v 14 Z'-o() es-" gesotar . r\z+- DESIGNER: Architect/Engineer: (Le4A 6 eZe ( rna r Phone #: a/ 3 (p ST) 12 t/ 4, Value of Work for this Permit: $ Type of Work: Address SiAlteration 51)° Square/Linear Footage of Work: 4() S�= New ❑Repair/Replace ODemolition Description of Work: �P1cc• }r 4:::`c % Submittal Fee $ o-5. 11.4,( 9 Permit Fee $ r ad CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ . '" .) tr • 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 Zp 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 etion which oc rs seven (7) days after the building permit is issued. In the absence of posted notice, the inspection will be approved t, a reinspection fee will be charged. Signatur <•Z er or Agent The foregoing instrument was acknowledged before me this 21' day of Fe L2 , 20 12', by -7xt v IG( N9s�c,ro0 , who is zonally knov iuo me or who has produced who is personally known to me or who has As identificaticn anti wno did-take an oath. VANESSA GOMQ as identification and MY COMMISSION #EE149808 NOTARY PUBLIC: EXPIRES: NOV 28, 2015 Bonded th ough l st State Insurance Signature Contractor The foregoing instrument was acknowledged before day of C''619 ,20 2, by NOTARY PUBLIC: Sign: Print: My Commission Expires: Sign: 1' 24' 4-ram. . Print: My Commission Expires: ******** *41*.) *• ***** * *.mo 2do,Ie:344** :1**** iG4t'.: **o*or9QH+S .:** *o GSM: *01.40+140•* * **** **0* ************* ******oo*Mni, APPROVED BY 44' ) fr 1-2' Plans Examiner Zoning tfevised ant0Af7)(Revised O6Ii0!2009)(Itevised 3115/09) Structural Review Clerk • 1 ACORD. CERTIFICATE OF LIABILITY INSURANCE 1 Ds;08o�;Y"Y) THIS CERTIFICATE IS ISSUED AS A`MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the poilcy(les) must be endorsed. if SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER BBST -Oswald Trlppe and Company 9200 S. Dadeland Blvd, Ste 314 Miami, FL 33156 305 670 -0083 � ACT Alisa Josephs PR N . 305 670 -0083 1 rim, No): 866 802 -8668 SS: ajosephs@bbandt.com PRODUCER CUSTOMER ID* INSURER(S) AFFORDING COVERAGE NAIL It INSURED Prestige Solar 21113 Johnson St. #118 Pembroke Pines, FL 33029 INSURERA: United Specialty Insurance Comp 12537 INSURER B : Hartford Casualty Insurance Com 29424 INSURER C : EACH OCCURRENCE INSURER o . AGE RENI ED PR ISSES Ee occurrence) INSURER E : INSURER F : X • REVISION NUMBER: 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 DESCR BED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. MISR TYPE OF INSURANCE ADDL i, - SUER „• - POUCY NUMBER ' • CY EFF L /D • •►uu ' • CY EXP (1 . • • Iiiii LIMITS A GENERAL X LABIUM COMMERCIAL GENERAL LIABILITY JCLAIMS-MADE X OCCUR PD Ded:1,000 05106757 06/0212011 06/02/2012 EACH OCCURRENCE $1,000,000 AGE RENI ED PR ISSES Ee occurrence) $100,000 $5,000 MED EXP (My one person) X PERSONAL SADVINJURY $1,000,000 GENERAL AGGREGATE 82,000,000 GEN1. AGGREGATE LIMIT APPLIES PER: —1 POLICY JJECT n LOC PRODUCTS - COMP/OP AGG $2,000,000 $ AUTOMOBILE — — — _ UABLITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ $ UMBRELLA UAB EXCESS UAB occuR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ g WOFIKERS COMPENSATION AND EMPLOYERS LIABIUTY ANY PROPRIETOR/PARTNER/EXECU11 Y! N (Mandatory In NH) EXCLUDED? �Y (Mandatory In NH) If yea, desaIbe under DESCRIPTION OF OPERATIONS below NA 21WECPO4411 03/31/2011 03/31/2012 IWCSTAMRS 1 EH- E.L. EACH ACCIDENT $100,000 EJ_ DISEASE - EA EMPLOYEE $100,000 EL. DISEASE -POLICY OMIT $500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additlonal Remarks Schedule, If more space Is required) " Workers Comp Information*" Other States Coverage (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION Miami Shores Village Hall 10050 Northeast 2nd Ave Miami, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Peer 94Protr 91988 -2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) 1 of 2 The ACORD name and logo are registered marks of ACORD #S69517231M6951513 ALJO F g6�47700811q -9 BU$(Q(ESS NA�(IE / % N 1'6611557 1NNWW 167 ST 33015 UNIN DADE COUNTY THIS IS NOT A BILL — DO NOT PAY RENEWAL STATE / gt769 "N51 CONSULTANTS INC F3 secIWW PLUMBING CONTRACTOR WORKER /S THIS IS ONLY A LOCAL • 1 DOSWINE= TAX RECEIPT. ff ES NOT PERMIT THE HOLDER TO VIOLATE ANY EXI OF j OR CoUN Y OR anew. NOR DO NOT FORWARD DOES IT EXEMPT THE Houma PERMIT FOR ° uc N REQUIRED NOT C ;,ON a, PRESTIGE SOLAR THE OLDIOI1 QUAUwcA- ROBERT SCAVUZZO PRES 6157 NW 167 ST F3 PAYMENT RECEIVED MIAMI FL 33015 COMEl�DADDE COUNTY TAX 10/05/2011 02280020001 000082.50 SEE OTHER SIDE 81 FIRST -CLASS U.S. POSTAGE PAID MIAMI, FL PERMIT NO. 231 673995 -8 ANA