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PLC-10-860Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 143428 Permit Number: PLC -5 -10 -860 Scheduled Inspection Date: June 21, 2010 Inspector: Rodriguez, Jorge Permit Type: Plumbing - Commercial Inspection Type: Final Owner: , BARRY UNIVERSITY Work Classification: Addition /Alteration Job Address: 11300 NE 2 Avenue Benincasa Hall Miami Shores, FL 33138 -0000 Project: <NONE> Contractor: RIGHT WAY PLUMBING CO INC Phone Number Parcel Number 1121360010160 -34 Phone: (954)423 -0000 Building Department Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can bescheduled until re- inspection fee is paid. Inspector Comments June 18, 2010 For Inspections please call: (305)762 -4949 Page 17 of 31 BUILDING PERMIT APPL FBC 20 Permit Type: PLUMI 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 CATION ING Permit No. §TOT*, At MAY 1 42 0 BY: 'Q LGtp Master Permit No. l ®-4 8 (p Owner's Name (Fee Simple Titleholder) ► ) n+ Ve rs, � Phone # 3oS - S1. • 3°TZ Owner's Address Moo N . Z'O Nettde, City tk:arni Shore State Tenant/Lessee Name Email Zip Job Address (where the work is being done) I40 pytl \Ir'"` 6-netror City Miami Shores Village County Miami -Dade FOLIO / PARCEL # 2)31, —1700 -004o 3316( Phone # Zip 3316' Is Building Historically Designated YES NO X Contractor's Company Name V.; 04-rwM l�L)gt Contractor's Address t ?3. A Stn ZJ 6L- City SLAIA r1 5 e ( Stat �Pkw 1�Q Phone # Flood Zone 41s`f /c 3 bZ O Zip 3s3 Qualifier Name \ -C .0%A (16, e Phone # /S^ �'�� PID State Certificate or Registration No. CFC €4.5 f a , Certificate of Competency No. Contact Phone e-/--" E -mail Ci, Y l b ‘ Architect/Engineer's Name (i applicable) Phone # Value of Work For this 'Per mit $ 414 v 0 0 Square / Linear Footage Of Work: 1 \.. n Type of Work: ❑Addition ❑Alteration ❑New Repair/Replace ❑ Demolition Describe Work: 6o4Fikrt .pu, fi-qMeta> C m-4ms krr, tvfarrtb wvnK__ tiascau.Ea everAC -11 ?f.P- gfirwRwl5 4CE9, wogAA AefAr t- ,q Q4 T OA1 .0orT * * * * * * * * * * * ** ************************* Feess************* * * * * * * * * * * * * ** * * * * * * * * * * * * * * * ** Submittal Fee Permit Fee $ 660 , CCF $ CO /CC $ • � /� Notary $ J Training/Education Fee $ 4'Q() Technology Fee $ 1(Q•0(7 Scanning $ (500 Radon $ 55 •QJ DPBR $ M`00 Bond $ Double Free $ Violation date: (Oak • 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 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 a. ; . -d and a reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this l L day of AAY , 20 lb who is personally known to m9 or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission,Expires: Contractor The foregoing instrument was acknowledged before me this' 2 day of YAC ,20 ,by Dlart. , who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commis ° a a restXPIRES January 06, 2012 (097)398 -D153 Fbrid8Nole Ccvic_..c ^m *9c*9nk******ir** ** **4r9edr*4r*A ** *4ro4**** ** **irihie**** ** ****** *ir*** kaYir9r******* *aY**** * ***okat**** * * ******4r*** *** * *** *** APPROVED BY Plans Examiner Engineer (Revised 07 /10 /07)(Revised 06/10/2009) Zoning Clerk checked BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A -100, Ft. Lauderdale, FL 33301-1895 - 954 - 831 -4000 VALID OCTOBER 1, 2009 THROUGH SEPTEMBER 30, 2010 DBA: Business Name: Owner Name: Business Location: Business Phone: RI R 1 S (9 Rooms HT WAY PLUMBING CO URKE DANIEL JOSEPH 29 SHOTGUN RD NRISE 33326 4)423 -0000 Receipt # Business Type: PLUMBING Business Opened: State/County /Cert/Reg: Exemption Code: Seats Employees 10 UNITS Machines 182- 0000844 CONTRACTOR 06/21/00 CFC 045182 NON EXEMPT Professionals For Vending Business Only Vending Tvne: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid $ 27.00 $ 27.00 0000000000 0000002700 0000001820000844 1001 6 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS TAX RECEIPT D THIS BECOMES WHEN VALIDATE Mailing Address: RIGHT WAY PLU BING CO ROURKE DANIE JOSEPH 1329 SHOTGUN OAD SUNRISE FL 33326 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 and zoning requirements. This Business Tax Receipt mu&be- transferred when the business is sold, business name has changed o` &ail;, have moved the business location. This receipt does not indicate that ttf business is legal or that It is in compliance with State or local Taws -gnd regulations. 2009 - 2010 :C NAL REGIIIJATION SEQ# Lo806190065S7 ASPNFAX 5/13/2010 10:03 AM PAGE 2/003 Fax Server Cert ID 22869 ACRD.. CERTIFICATE OF LIABILITY INSURANCE I DATE(MM/DD/YYYY) 5/13/2010 • . .. PRODUCER Seitlin 6700 North Andrews Avenue #300 Ft. Lauderdale FL 33309 (954) 938 -8788 (954) 938 -8566 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 Right Way Plumbing Company, Inc. 1329 Shotgun Rd Sunrise FL 33326 I INSURER A: American Guarantee & Liability 26247 INSURER 8: New Hampshire Insurance Co. 23841 INSURER C: Discover Property & Casualty 36463 INSURER D: National Union Fire Ins. Co. 19445 INSURER E: AMAGE TO RENTED PREM SES Ea occurence) COVERAGES THE POLICIES OF INSURANCE LISTE BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONbITION 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 LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR c ADM i. -o. • . .. POUCY NUMBER POLICY EFFECTIVE 1,,,, ..AAA POLICY EXPIRATION ,„ .. Ah LIMITS D GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY 4025792 7/1/2009 7/1/2010 EACH OCCURRENCE $ 1.000. 000 X AMAGE TO RENTED PREM SES Ea occurence) $ 500, 000 CLAIMS MADE X OCCUR MED EXP (Any one person) $ 10,000 X XCU,BFPD PERSONAL &ADV INJURY $ 1,000,000 X CONTRACTUAL LIAR GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 7 POLICY n IF (.T ILOC D AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 6049031 7/1/2009 7/1/2010 COMBINED SINGLE LIMIT (Ea accident) $ 1, 000,000 X BODILY INJURY (Per person) X BODILY INJURY (Per acddent) X PROPERTY DAMAGE (Per acddenl) GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGO $ A EXCESS/UMBRELLA UABIUTY AUC5914498 -04 7/1/2009 7/1/2010 EACH OCCURRENCE $ 10, 000, 000 � X l OCCUR CLAIMS MADE AGGREGATE $ 10, 000, 000 DEDUCTIBLE RETENTION $ 8 $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? It yes, escribe under SPECIAL PROVISIONS below 7582380 7/1/2009 7/1/2010 X I TORY LIIMITS I IOER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 C OTHER Excess Auto Liab D228Y00192 7/1/2009 7/1/2010 $1,000,000 in excess of underlying $1,000,000 DESCRIPTION OF OPERATIONS! LOCATIONS! VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS *10 DAYS NOTICE OF CANCELLATION IN THE EVENT OF NON - PAYMENT OF PREMIUM. Certificate Holder as Designated Organization is Additional Insured as respects to General Liability when required by written contract and subject to the policy terms, conditions and exclusions. Miami Shores Village Building Department 10050 NE 2nd Ave Miami Shores FL 33138 I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR NOTICE TO THE CERTIFICATE HOLDER NAMED TO IMPOSE NO OBUGATION OR LIABILITY OF ANY KIND REPRESENTATIVES. BE CANCELLED BEFORE THE EXPIRATION TO MAIL 30 DAYS WRITTEN THE LEFT, BUT FAILURE TO DO SO SHALL UPON THE INSURER, ITS AGENTS OR AUTHORIZED REPRESENTATIVE ;� _. —_yf; s `. P"ti -tie p /`? .0 .�s......y:.s C J ACORD 25 (2001/08) Page 1 of 1 05/13/2010 THU 13: 13 [ JOB NO. 8353] 0002