Loading...
PL-11-2208Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 167130 Permit Number: PL -11 -11 -2208 Scheduled Inspection Date: April 30,2012 Inspector: Hernandez, Rafael Owner: HIRN, WOLFGANG & NATALIA Job Address: 102 NW 106 Street Miami Shores, FL 33150 -1248 Project: <NONE> Contractor: JB WATERWORKS CORP Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number (786)566 -9669 Parcel Number 1121360080010 Phone: (305)766 -4306 Building Department Comments KITCHEN REMODEL AN CONNECT APPLIANCES Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments April 27, 2012 For Inspections please call: (305)762 -4949 Page 3 of 38 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 gp_E TIMM' MI NOV 292011 BY®om�_ooa°aoa0000a4a� Permit No. 1 111 —t Master Permit No. '�•�- ` 1l - ii d jo8- Permit Type: PLUMBING OWNER: Name (Fee Simple Titleholder): (4rj .� �� `` �� Phone#. �'�� " 3 i-S -06 4'2_ Address: t0"- KO (06 +1 c5'. v City: SA. r- % State: I Tenant/Lessee Name: Email: 11•►'Fo ( udesAbesokirt, JOB ADDRESS: 1O1 wt.) ko4.4' 5-1-. Zip: 3 t5 Phone#: City: Miami Shores County: Folio/Parcel#: d 4 - 2-13 d _ oo g - as / o Is the Building Historically Designate& Yes NO Miami. Dade zip: 33150 Flood Zone: Phone#: '7�! y36; CONTRACTOR: Company Name: .7: 13 • / 78 (oak 5 Address: (p g I E a 42/ S./- City: iv. /v1/ A /5 State• Qualifier Name: Axe I36 P State Certification or Registration it "' D9'6, Certificate Contact Phone#: 3 d r- 7 6 b Zip: 3 /�%i. Phone#: 3 o s= 76 6 - y34, of Competency #: 4/364 Email Address: %j w �g f2, w d/2 k3 p_ DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ 30 Square/Linear Footage of Work: t 3Z- 5.F. Type of Work: (]Address ANteration C3New )Repair/Replace C]Demolition Description of Work: k`a%1oea.) a — NIA 1— / (e..° ca,JNe+. a-rPE' Aar-Ls ******** *** ****** *** ***** * ***** * *** **** Fees************* ***** * * * * *** *** *** *** * ** *** * * ** Submittal Fee $ Permit Fee $ / CCF $ Scanning Fee $ , Radon Fee $ DBPR $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ CO /CC $ Bond $ TOTAL FEE NOW DUE $ , OQ 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged Signature Owner or Agent The foregoing instrument was acknowledged before 1me this .34-n day of 13010-'m !Dev2p I( , by WO who is personally known to me or who has produced ` As identification and who did take an oath. NOTARY PUBLIC: SHARON L. WILBANKS , Commission # EE 12882 ''' ''',•' 43 Bonded Through National Notary Assn. * * *** * * * * ***** *** *** APPROVED BY Signature ✓/ I %�� Contracto. The fore oing instrument was ackno ledged before me this day of O 20 t 1 , b ;� 010S, who is personally known to me or who has produced i°' L as identification and who did take an oath. NOTARY PUBLIC: Si ******* **** * * * * * * ******* ********* * * * ** 4-1 Plans Examiner Structural Review (Revised 07 /10/07)(Revised 06 /10/2009)(Revised 3/15109) 4 °$ :•,r �w r . " Comm `c: ti EE 12882 National Notary A sn. Fla.° gone,.• *** *** wkses**a* ***ew *****ete *s*sssss* Zoning Clerk Al �g CERTIFICATE OF LIABILITY INSURANCE DA 2/ �"' PRODUCER Acceptance Insurance Services 6887 S 40th Miami, FL 33155 Phone (305)740 -0515 Fax (305)740-0518 THIS CERTIFICATE 1S 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 POUCIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED J.B. WATERWORKS CORP. 668 NE 161 ST MIAMI, FL 33162 I INSURER A: AMERICAN VEHICLE INS. CO. 10790 INSURER e. INSURER a INSURER D: INSURER E COVERAGES INSURER F: THE POLICIES OF INSURANCE LISTED 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 OF 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. MR uR t ADM TYPE OF INSURANCE POLICY NUMBER pp TES LIMITS A • GENERAL. LIABILITY COMMERCIAL GENERAL UABIUTY ❑❑ CLAIMS MADE © OCCUR I GL-0521012774 03/23111 • 03/23/12 EACH OCCURRENCE 1,000,000 DAMAGE auu (a rre ) 100,000 MED EXP (My one perm) 5,000 PERSONAL & ADV INJURY 1,000,000 GENERAL AGGREGATE 2,000,000 ❑ PRODUCTS - COMP /OP AGG 2,000,000 GEN'L AGGREGATE LIMIT APPUES PER: 0 POUCY Iii PROJECT I♦ LOC AUTOMOBILE I♦ • ❑ V III ❑ LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON OWNED AUTOS 11 „1 P 1 COMBINED SINGLE OMIT BODILY INJURY (Per person) BODILY INJURY (Per PROPERTY DAMAGE (Per ff �v AUTO ONLY - EA ACCIDENT ❑ _ GARAGE UABILfY • ANY AUTO • OTHER THAN EA ACC AUTO ONLY: AGG D0CESSAIMBRELLA LIABILITY • OCCUR ❑ CLAIMS MADE II DEDUCTIBLE N RETENTION $ --______ ' _ EACH OCCURRENCE ❑ AGGREGATE WORKERS ON EMPLOYERS' LIABILITY AND ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER / MEMBER EXCLUDED? If yes, P be under SPECIAL PROVISIONS below ❑ TORY LINES Il OER EL EACH ACCIDENT EL DISEASE - EA EMPLOYEE EL DISEASE - POLICY OMIT OTHER DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENTt SPECIAL PROVISIONS PLUMBING CONTRACTOR CERTIFICATE HOLDER CANCELLATION Miami Shores Village Building Department 10050 NE 2 Ave Miami Shores, FL 33138 305 - 756 -8972 SRO= ANY OF THE ABOVE DESCRIBED POLICIES BE CAI3PEL ED 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 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE �— - ACORD 25 (2001/08) QF m ACORD CORPORATION 1988 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CONSTRUCTION INDUSTRY CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW EFFECTIVE: 09/09/2010 EXPIRATION DATE: 09/08/2012 PERSON: MAKE A ROADWAY FEIN: 204641735 BUSINESS NAME AND ADDRESS: J.B. WATERWORKS CORP 688 NE 161ST ST MIAMI, FL 33162 SCOPE OF BUSINESS OR TRADE: 1- CERTIFIED PLUMBING CONTRACTOR IMPORTANT ri Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this I] chapter. Pursuant to Chapter 440.05(121, F.S., Certificates of election to be exempt.. apply only within the scope of the business or trade listed an the notice of election to be exempt Pursuant to Chapter 440.05113), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this Section. QUESTIONS? (850) 413-1609 Congratulations) With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com. There you can find more Information about our divisions and the regulations that Impact you, subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! 1.17 ? i "''g5$�." (31' BOA MIA LOCATION JB WATERWORKS CORP 668 NE 161 ST 33162 UNIN DADE COUNTY OWNER THIS 1S NOT A BILL — DO NOT PAY rimo 'r NEWAL STATE* CFC1427090611068,5 Sec.4!prpe WORKS CORP THIS is 41964 PUEIJNBIN6 CONTRACTOR BUSINESS DOES NOT P M r T E EXISTING REGU TORY. O ZONING LAWS OF COUNTY DOES ROR CITIES. � HOLDER FRO EXEMPT M OTHER PERMHT OR LICENSE NOT REQUIRED Ca BY ERh1RCA ION OF THE HOLDER'S 0UALIPICA. TINS. PAYMENT RECEIVED MIAMI -DADE COUNTY TAX COLLECTOR: 10/03/2011 09010195001 000075.00 SEE OTHER SIDE FIRST- CLASS U.S. POSTAGE PAID MIAMI, FL PERMIT NO.231 WORKER /S 1 DO NOT FORWARD JB WATERWORKS CORP JAKE BROADWAY PRES 668 NE 161 ST N MIAMI FL 33162 1 I1111I1111111)11)111111111411 ll; 411111