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PL-10-2098Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 \L) Inspection Number: I NS P- 153713 Permit Number: PL -11 -10 -2098 Scheduled Inspection Date: July 08, 2011 Inspector: Hernandez, Rafael Owner: DURU, CLEMENT Job Address: 139 NW 102 Street Miami Shores, FL 33150- Project: <NONE> Contractor: INFINITY PLUMBING Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1131010220080 Phone: 954- 979 -6067 Building Department Comments TWO BATHROOMS ADDITION AND RELOCATION OF KITCHEN Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments July 07, 2011 For Inspections please call: (305)762 -4949 Page 1 of 7 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: Name (Fee Simple Titleholder): G t-e vw.rti Phone #: ' O .. S ZS — - 4 *-4? Address: 1.50( • M) OZ�r City: ICd, M, k .�'' t"..° State: l Zip :3 3 5 Tenant/Lessee Name: Phone #: Email: i, X553 771 Nov 2 4 L.'. " 131:V`-... Permit No PUO O°Ig Master Permit No. O -- 8-©2. JOB ADDRESS: \' C1 N`% J4 J City: Folio/Parcel #: Miami Shores County: Miami Dade zip: 5 5 1 , 4 . 0 Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: 0 Phone #: Address: 3 ® > iLsic-1 , J tree City: 1 tft— s-1— State: FL p Q7ra Zip: 7 3 °to ?5-q. C/; .(( 7 Qualifier Name: t -.*A- 6 t Phone#: p,AL m7 ?A -"1/ State Certification or Registration #: \L, .0 -31. Certificate of Competency #: Contact Phone*: Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ Square/Linear Footage of Work: Z S 0 o Type of Work: DAddress Description of Work: UAlteration UNew ORepair/Replace 2- ' ' a.` 91%. ,.o w -Z \e+c r4A r 0.S 't).- tom 4.-b �.�...� e & ► �u.�� ODemolition **** ** ****** ********* ****************** Fees*** * *** ** x�xx: �x�x�x�x�n�x+ xa��x **** *�xx�****** **�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 $ TOTAL FEE NOW DUE $ 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 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 will not be approved and a reinspection fee will be charged. Signature Signature Owner or Agent 1 Contractor The foregoing i trument was acknowledged before me this The foregoing instrument was acknowledged before me this day of 12.-. v , 20 AL, by , day of ZS, 0✓ , 20 I `) , by who is , y known to me or who has produced who eizrersonall own to me or who has produced As identification and who did take an oath. ' as identification and who did take an oath. NOTARY1 UBLIC; Sign: Print: L., F.c <-1 "' ` r"t/■ l ` p0eli ° LAURA . My Commission E,�; ta33'41111 f * MY COMM # DD 646761 * ^ _ EXPIRES: March 16, 2011 Bonded Tin Budget Notary Services APPROVED BY // Plans Examiner Sign: Print: c—G4..uo r4)1 "" .kaav p0 [AURA FARLEY - My Commission E ' MY COMMISSION 9 DD 646761 EXPIRES: March 16, 2011 w'9r ' ` F� ,s, Bonded That Budget Notary Services FOF Zoning Structural Review Clerk (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS° REGISTRATION FORM ALL CONTRACTORS MUST PROVIDE COPIES OF UCENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED OR THE VILLAGE MAY MAINTAIN A FILE WITH YOUR INFORMATION FOR A $30.00 FEE PER YEAR. IF CONTRACTOR IS Af. latIDA STATE CERTIFIED CONTRACTQB A. COPY OF QUALIFIERS STATE UC CARD B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE D. COPY OF WORKERS COMPENSATION (EINIKORTIFICATE9R EXCEMPTION1 �.►.���.`' R IU x!..:71 ! G IF CONTRACTOR HA$ A MIAMI D , E C 4 A - _3 . CY A. - COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT C. �,. COPY OF LIABILITY INSURACE C - . .. y 1 H e _' ST . . D..,,_. COPY OF WORKER COMP INSURANCE jJHER CERTIFICATE OR EXEMPTION) INS CE MI S S ERTI . _ A M ± __ MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 VI AS OW- COMPLETE CONTRACTOR'S INFORMA BUSINESS NAME: BUSINESS ADDRESS: 1 ADDRESS: Pap 5 f ' _ CITY g ' u STATE ZIP CODE 3064( _ BUSINESS PHONE: (45/ - ) 4174- (a)L0 l FAX NUMBER ( ) 77 9 IA 12s p CELL PHONE ( ) 15.675"11. QUALIFIER'S NAME: FPM sa.5 T QUALIFIER'S UC NUMBER: Cf • '41.42 -. „ E -MAIL ADDRESS (IF APPLICABLE): creed on 311099 aY MLDV tRV 31 92 /IG 39.10d 9NISIf11d A.I.INI.HI 6ZT96L6096 65 :N @I0Z /CZ/ TT 11/23/2010 12:59 9549796129 INFINITY PLUMBING PAGE 05/05 STATEOFFLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION TRIAIBTION unary LICENSING BOARD (850) 487-1395 SEE PL 32399-0783 STANLEX/_ ERNEST RONALD INFINITY PLUMBIlLiggx ' 1630 E.N. 64TR NORTE LAUDERDALE PL 33068 =Monet Wkh license you beixime one of the needy one inifilon a1 licensed by the (*parboiled of Business end Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to berbeque restaurants, and they keep Florida's economy strong. Even, day we work to improve the way we do buskress in order to serve you better. For information about our services, please log onto wenv.asynoricialloense.ocus, There you can find more Information about our divisions and the regulations that knpact you, subscribe to department newsletters and learn more about the Department's initlegves. Our mission at the Department Is: license EiWcfently, Regulate Fairly. We constantly *lye to UM you better so that you can same your customers. Thank you for doing business in Florida, aril congratulations on your new kens& DETACH HERE rd;..• oI4., • „ 11/23/2010 12:59 9549796129 INFINITY PLUMBING 115 S. Andrews Ave., Rm. A -100, Ft. Lauderdale, FL 33301 -1895 — 954- 831 -4000 VALID OCTOBER 1, 2010 THROUGH SEPTEMBER 30, 2011 PAGE 04/05 DBA: Receipt *182-1201 Business Name: XNFINITY PLt MB NG INC Business Type :VLtiml3 G1/LIPN apRNKL/C (PLt3>IBING CONTRACTOR? Owner Nance: ERNEST R STANLEY Business Location: 1830 SW 64 TER NORTH LAUDERDALE Business Phone: 954-979-6067 Rooms Seats Number of Machines: Business Opened:06/16/2004 StatelCou nty/CertIRog: CFC 14 2 67 3 2 Exemption Code:NONEXEMPT Emplaces 4 Pot Vandloa 1noee Only Machines Professionals Vending Type: Tax Amount Transfer Fee NSF Fee Penaty 11==.10::=11 Totni Paid 27.00 0.00 0.00 0.00 0.00 0.00 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and Is non - regulatory In nature. You must meet all County and/or Municipality planning WHEN VALIDATED and zoning requirements. This Business Tex Receipt must be transferred when the business Is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business Is legal or that It is In compliance with State or local laws and regulations. Malting Address: ERNEST R STANLEY 1830 8R 64 TER NORTH LAUDERDALE, FL 33068 Receipt 652E -09- 00008608 Paid 09/13/2010 27.00 cTOR 11/,2010 14:28 9640639882 JW XtJRANCE PACE 01!01 CERTIFICATE OF LIABILITY INSURANCE QA 11JT3110 PRODUCER JW Insurance Services 100 Ne th State I4t d 7, / 105 Wares, FL 330!51 Peace (264)6B3 -7213 INeUREb Infinity Plumbing, Ina 1830 SW 64th Terrace Ft Lauderdale, PL 33068. (964) 775 -7611 COVERAGES F T15$ CERTi1 1A �i¢5UED AB A MATTE% OF GIFORMAMN ONLY AND CONFERS NO AR NO'S UPON TFiil t3ERflFICATU HOLDER, Thie QILRTIFICA1I DOES NOT AIv1END, Elf1ND OR ammo AFINIMING cOVERAGS FtLB &t 1R a Minn o: lamas ANY REDLAREMENT, TERM OR CONDITION OP ANY CONTRACT OR OTHER DO ULIB IY WITH MISPUCT TO WHICH THIS CERTPFICAiE MAYBE ISSUED OR MAY PERTAIN. THS INSURANCE AFFORDED By THE POLICING DEBORESID HEREIN le SUBJECT TO ALL THE Tom. IONS AND CONISTION8 CP SUCH PCUCIEs. A00RE0ATE L ayrs a 1O V N etAl__!hwEBN REINXIID ST PAD OLAItim AgeN ApD L TYPR of SUMO= POLICY NUMBER GENERAL LIABILITY d COMMERCIAL. MORAL Liowzrry ❑ ❑ cLAIMS mum ❑ 00DUR ❑1 0 ONN'L AccoREIOATO L1Ad1' APPLIES PER: ❑ POLICY ❑ PROJECT 0 Loo CBILB LIABILITY ANY AUTO ALL OWNED AUTOS aceimeApeb Amos HIRED AUTOS NON OWNED AUTOS R CJARACIE LIABILITY ❑ © ANY AUTO t!.!;. ■Ali PERSONAL A AOV INJURY Q PROPERTY a AUTO ONLY • EA ACCAXINT MOMS I UMBRELLA WIELDY © OCCUR ❑ MAIMS Mac ❑ DEDUCTIBLE ❑ RETENTION ` MBr LIABILITY yfiii 10836678 A ANY PROPRIETOR I PARTNER / EXECUTIVE Mandebcry In 101 04/0112010 0410112011 100,010 GP OMBRATIQI ! Lu *haNB Itli1 J ADDED BYE t FICATE HOLDER Miami Shores lH 10050 NE 2nd Avenue Miami Shores, FL 33139 80/E0 add 9NIBIffld ALINI4NI CitISCELLATICIN SHOU$.D ANY Cr 1101A BECA (cELL5D MTFoRE T!1$ assmonstis wow fisoteas, THE ISSUING INSURER WILL IEAYOR To GAL DAYS WRITTEN WES ID THIS ine011401011 HOLDER NAMED TO TRIES% uttr PALLtm YO 00 so SMALL WPM so=AR ON OR LIABILITY OPANY KING UPON THE swum. ITffi men OR REPRIMENTATIVES. A'TNi r r ved. The AC0f110 nano ell loos ant rivistared mares WTACQR6 63t96L60S6 65IZI OIOZ!£Zftt • Hou 23 2818 12 :58159 MT FEW 121/1.7581492886 11 79177881-887-1 ME 883 OF SST DArn eAmlearrf m CERTIFICATE OF LIABILITY INSURANCE RC" (11 -23 -2010 THIS CERTIFICATE IS ISSUED AB 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 IBSUING INBURERIS), AUTHORIZED REPRESENTATIVE ON PRODUCES, AND THE CERTIFICATE HOLbER. IMPORTANT! If the Mertiriaat! holder Is en ADDITIONALINSUREO, thy pallayllaal must be endorsed. It SUSROOATIQNIS WAIVED, WNW t to the terms and oondtIons of the po*. Derteln palm may require an endowment, A etatementen this artiste does not Donfar rights to the cart Manta holder In MAW NORTHEAST AGENCIES INC /PH 210204 P:(866)467 -8730 F:(800)308..8459 301 WOODS PARK DRIVE CLINTON NY 13323 IMMO INFINITY PLUMBING 1230 W. 64TH TEL N. LAUDERDALE FL 33068 0 Rh THIS IS TO OBATIPY THAT B PAS *MS 0 1`7 •' 117`1 r.:Yvjrr 1, T...,_ ISSLBD TO 9- i BD B PO INDICATED. NOTWITHSTANDING ANY REDLRRBMENT, TERM OR CONDITION oil ANY CONTRACT DR CTHMI =WANT WITH R/sPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE ARMAN'D BY THE POIJCIES DESCRIBED HEREIN IS eua lECT TO AU. THE 'TERMS. BNOWSIONC AND DDNDn90NE OP SUMM PDUDIBs. OMITS SHOWN MAY HAVE BEEN REDUCED BY PAID MAIMS amunea R I REVISION SIR nee 41 0110Win QaAe4tAt fda•VrY aommowIAL SUOMI LUASA.ITY DLAIMB•MAIM ODOUR starraJ..Lab 01 S M AN3648 02 /16 /2010 02 /11002.1 �. L1 L a i} • a Q Q 71.1141��, II TI ',vv. -1 2 000 000 1L P ANYaUTM ALL MIND umo HMNa0IAA7 AUTOS MNMO AUTOS 14014-0Wefib AUTOS DEOUGnew porraeree ONKNORTONCIF=tonswaylassuonomagaSOwscepoOffiTSISI=eNeNisigtkitallily NiMitii wIVMOwy Thorne ul6ua1 to the itzau.rad I S Operations. CERTIFICATE HO N Miami Shores% Village Building Departman 10050 NE 2ND AVE MIAMI SNORES, EL a3z35 I SHOULD ANY Or THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE DELIVERED NN ACCORDANCE WITH �THEFPOUCYPRO PROVISIONS. . ummanammme d7�' ACORA 25 12009100) 50/20 39 d 1888-2005 CORPORATION. All riphta reserved. The ACORO name and logo ere Ieplate►ed marks at ACORD 9NIEDATIci AJ.INI4NI 6ZI96L6P56 6S :Zti OtOZ /EZ /Tt •