Loading...
PLC-12-2019Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 (1_ r), Inspection Number: INSP- 180695 Permit Number: PLC -10 -12 -2019 Scheduled Inspection Date: January 02, 2013 Inspector: Hernandez, Rafael Owner: , BARRY UNIVERSITY Job Address: 11300 NE 2 Avenue Renne M. Hall Miami Shores, FL 33138 -0000 Project: BARRY UNIVERSITY Contractor: A -1 QUALITY PLUMBING CORP Permit Type: Plumbing - Commercial Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1121360010160 -18 Phone: (954)912 -4700 Building Department Comments REPLACE TWO TOILETS Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Infractio Passed Comments INSPECTOR COMMENTS , Inspector Comments False December 28, 2012 For Inspections please call: (305)762 -4949 Page 3 of 22 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 OCT 25 atiZI gar; 000mom0000mms� FBC 2014 � i 22QYi I CC2OI Master Permit No. Permit Type: PLUMBING JOB ADDRESS: //.300 /1/.67 02-4)AcI (Ylottreirr) 41- 1 & it City: Miami Shores County: Miami Dade X448 Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleh lder): �L:l`E Phone #: (3)E� -51e5 Address: / /_3� €$ a City: Olicaii Shoos State: (4l Zip: 53t(DI Tenant/Lessee Name: Email: Phone #: CONTRACTOR: Company Name: #9--/ . ' 04,-, Phone #: fi{c'922-- 7°27 Address: : :.- City: U Qualifier Name: State Certification or Registration #: Contact Phone #: DESIGNER: Architect/Engineer: State: Zip: 3-36'j%" Phone #: 9547--'14f``,' %S Certificate of Competency #: �� '%S 7 Email Address: a /'vim /I fy,P /cry 4 4s a n Phone #: Value of Work for this Permit: $ CSO 0 Square/Linear Footage of Work: Type of Work: ❑Address °Alteration New .Repair/Replace Description of Work: (off) �- (a) i °Demolition ******** ** * * *** * * * * * * * * * * * * ***** * ** * * ** Fees************* * * * * *** * * * * * * * * * * ** * *** * * * * * * ** Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ /0 °® CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ 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 MR 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 PROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN NANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE CORDING YOUR NOTICE OF COMMENCEMENT." No ice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must pr mice in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person wh se property is subject to attachment. Also, a certied copy of the recorded notice of commencement must be posted at the job site fo the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the in ection will not be approv , f ' d a reinspection fee will be charged. Sinnature Owner or Agent The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of® Ct6Et, 20 1-E, by PrZAJI qtivtos , day ofteel,, 20/2, by 1.4,��� who is personally kno me or who has produced who is personally known to me or who has produced As identification and who did take an oath. N 0 T PUBLIC: Contractor Sign: P t: M Commission Exp APPROVED BY (R 's as identification and who did take an oath. NOTARY PUBLIC: Print: 01.1A204- a eeee. sass e❑ p969s9 .9867988®9777e6.ee.eee9eS.e My Commission Expire UNDA 1 . SURD `o�Agvpp t; Comm# DD0888376 4. Expires 5/14/2013 // mmmmmeeeeeeeee L ®/ % l 2 —Plans Examiner Zoning Structural Review Clerk 0$14 107 /10 /07)(Revised 06 /10 /2009XRevised 3/15/09) Rightfax N3 -1 10/24/2012 11:30:00 AM PAGE 2/002 Fax Server A °R° CERTIFICATE OF LIABILITY INSURANCE 10/24/2012 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 policypes) must be endorsed. If SUBROGATION is WAIVED, subject to the . terms and conditions d the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in Ileu of such endorsement(s). PRODUCER AUTOMATIC DATA PROC INS AGCY INC 1 ADP BLVD IVS 325 ROSELAND, NJ 07068 (877) 677 -0428 XV770 70A *it ,1 • t'' '. ,, Ex1): (arn 6T/ o42a ��{+ No): tan) srr -oaso ADOFESS: sPelleadrCaraveleis.can IMTS __CUMIEf ID,M 2908x4161 INWIMERAAFFORMIGONERNE NAIC# INSURED A-1 PLUMBING CORPORATION 1055 NW 31ST AVENUE POMPANO BEACH, FL 33069 INSURERA.'tIE TRAVELERS Q COLVANYOFAIfIERCA INSURER B: INSURER : EACH OCCURRENCE INSURER : D D DAMAGE TO F N I tU PRF7WSESiEaomarems) INSURER E: INSURER F: MFDEXP (Any one persm) COVERAGES CERTIFICATE NUMBER: 951535619211892 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 BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT TOALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POUCIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 'ma L TYPE OFII ADDL I 1A� b PdJCYMAHER I MTXYWYY) IP.11141XYVYYY1 IMTS GENERAL LIABIITY COMMERCIAL GENIMAL LIABILITY ❑ OCCUR EACH OCCURRENCE $ DAMAGE TO F N I tU PRF7WSESiEaomarems) $ CLAWS -MADE MFDEXP (Any one persm) $ PERSONAL& ADV INJURY $ GENERAL AGGREGATE $ GHIL AGGREGATE LIMIT APPLES PER —I ICY ri IL PRODUCTS- COMP/OPAGG $ $ AU — _ CRIOB.EUA.ITY ANYAUTO AU.CINNED AUTOS S( EDREDAUTCIS HFEDAUTOS M 4-OMEDAUTOS ; NGLE LffvIT $ BODILY INJURY BODILY INA RY(Per accident) $ Pa IMAGE $ $ $ ' IREFIELLA UAB EXCESS LIAR _ OCCUR CLAWS -MODE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE $ $ $ A WORKERSeRMSAIION AB TY YIN ANY PROPRIETOR/FARMER/EXECUTIVE ❑ • •? EXQ UDED? . -.' 3i. ; —' `7.. belwx WA UB- 3B274100 -12 03/16/2012 03/16/2013 X I TORM I ER EL E CHA00DENT $100,000 EL DISEASE - EA EMPLOYEE $100,000 EL DISEASE - POLICY LMT $ 500,000 DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLESWadi ACORD 101, Additional RenaksSd echAs, R=maws Is required) CANCELLATION MIAMI SHORES VILLAGE BULDING DEPARTMENT 10050 NE 2ND AVE MIAMI SHORES, FL33138 SHDULDANY OF TIE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRDSBITATIVE ACORD 25 (2009/09) ©1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD TOR THIS DOCUMENT HAS .AhCOLORED OACKGROUNI) • M3CROP I TING • "LINEMARKT' PATENTED PAPER { ATE OF.. FLORJQ ARTNENT Off' BtTSINESS AND PROFESSIONAL REGULATION ,CONSTRUCTION: INDUSTRY LICENSING BOARD sEo# L12073102047 LICENS8 NBR: • :K S QVERNOR DISPLAY AS REQUIRED BY LAW KEN LAWSON SECRETARY BROWARD 115 Business Name: Owner Name: Business Location: Business Phone: Rooms COUNTY LOCAL BUSINESS TAX RECEIPT S. Andrews Ave., Rm. A -100, Ft. Lauderdale, FL 33301 -1895 — 954 - 831 -4000 VALID OCTOBER 1, 2012 THROUGH SEPTEMBER 30, 2013 DBA: A 1 QUALITY PLUMBING CORP Receipt #:PLUMBING /LWN Q Business Type: (CERTIFIED PAT WILKINSON LANCE Business Opened :03/07/1988 1055 NW 31 AVE State /County /Cert/Reg:CFCO27526 POMPANO BEACH Exemption Code: 954 -346 -8500 Seats Employees Machines Professionals 1 SPRNKL /CONTR PLUMBING CONTR For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years : ; Collection Cost Total 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 Tax 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. Mailing Address: PAT WILKINSON LANCE Receipt #01A -11- 00010048 1055 NW 31ST AVE Paid 08/15/2012 27.00 POMPANO BEACH, FL 33069 -1107 2012 - 2013 TOR THIS DOCUMENT HAS .AhCOLORED OACKGROUNI) • M3CROP I TING • "LINEMARKT' PATENTED PAPER { ATE OF.. FLORJQ ARTNENT Off' BtTSINESS AND PROFESSIONAL REGULATION ,CONSTRUCTION: INDUSTRY LICENSING BOARD sEo# L12073102047 LICENS8 NBR: • :K S QVERNOR DISPLAY AS REQUIRED BY LAW KEN LAWSON SECRETARY A -1 Quality Plumbing 1055 N.W. 31st Avenue Pompano Beach, Florida 33069 Phone 954- 346 -8500 Fax 954 - 972 -3220 www.a-lqualityplumbing.com Email al qualityplumbing @yahoo.com 10/24/2012 I, Lance Wilkinson, President of A -1 Quality Plumbing authorize Sunday Chamberlain to expedite a permit to the City of North Miami for the following address: Barry University - Mottram Doss Hall, 11300 NE 2nd Ave, Miami Shores, FL 33161. Thank you, Lance Wilkinson, President, A -1 Quality Plumbing From: Gulfshore Insurance, Inc. To: Miami Shores Village Building Department Page: 3/3 Date: 10/24/2012 12:05:10 PM Client#: 66366 Al PLU ACORDTM CERTIFICATE OF LIABILITY INSURANCE - DATE /24/2D/YYYY) 10/24/2012 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 policy(ies) 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 Gulfshore Insurance - Naples 4100 Goodlette Road North Naples, FL 34103 -3303 239 261 -3646 CONTACT Michelle A. Kalicharan (AH/CNE EA, 239 435 -7143 1 (a No): 239 213 -2852 E-MAIL Rss: mkalicharan @gulfshoreinsurance.com INSURER(S) AFFORDING COVERAGE NAIC 3 INSURERA: Scottsdale Insurance Company LIABILrrY COMMERCIAL GENERAL LIABILITY INSURED A -1 Quality Plumbing, Inc. 1055 NW 31st Ave Pompano Beach, FL 33069 INSURERS: FCCI Insurance Company CPS1585379 CA00185122 INSURER c 05/19/2013 05/19/2013 INSURER D $1,000,000 INSURER E : $100,000 $5,000 INSURER F : CLAIMS -MADE X OCCUR • • 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. INSR TYPE OF INSURANCE ADDLSUBR INSR WVD POUCY NUMBER POLICY EFF (MM/DD /YYYY) POUCY EXP (MM/DD /YYYY) UMITS A GENERAL X LIABILrrY COMMERCIAL GENERAL LIABILITY CPS1585379 CA00185122 05/19/2012 05/19/2012 05/19/2013 05/19/2013 EACH OCCURRENCE $1,000,000 DAMAGE (EaEoccun-ence) $100,000 $5,000 CLAIMS -MADE X OCCUR MED EXP (Any one parson) X BI/PD Ded:1,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $ 2,000,000 GENII. AGGREGATE LIMIT APPLIES PER: POLICY n Jr CI' n LOC PRODUCTS - COMP /OP AGO $ 2,000,000 COMBINED (E ident) SINGLE LILimn- $ $ 1 s s 000 000 B AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS AUTOS NON -OWNED BODILY INJURY (Per person) $ BODILY INJURY (Par accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAR EXCESS LIAR _ OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENT ON $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER /PMEMBER�EXXCLUDED?�C�ryEn (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N /A ( WC STATU- TORY LIMITS I I OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, !Imam space a required) PC' wrICV'ATC IJAI nrn CANCELLATION Miami Shores Village Building Department 10050 NE 2nd Avenue Miami, FL 33138 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 .`:Z1414041740. #44 © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S591624/M574474 MAK Rightfax N2 -1 10/24/2012 11:28:45 AM PAGE 2/002 Fax Server At 9J CERTIFICATE OF LIABILITY INSURANCE LI DDNY"") 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 pollcy(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 AUTOMATIC AD BLVD MS 325 INS AGCY INC ROSELAND, NJ 07068 (877) 677 -0428 XV770 70A ti. ' I . , q�( . Ehd): (877) 077 -0428 1 IA/Cy NO): (877) 877 -0430 ADDRESS: apcblcadp@travelers.com PRODUCER CUSTOMER ID#: 2908X4181 INSURERS) AFFORDING COVERAGE NAIC# INA QUALITY PLUMBING CORPORATION 1055 NW 31ST AVENUE POMPANO BEACH, FL 33069 INSURER A: TFETRAVELERSIPDENN7YOdN�ANYOFAMERICA INSURER B: INSURER C: INSURER D: $ INSURER E: $ INSURER F: 1 CLAIMS -MADE THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDMON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT TOALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. SR TYPEOFINSURANCE ADDL INSR SUE VVVD PCUCYNUMBER POLICYEFP ( rypI:Yyyyy) POLICY EXP TIyyYyy) UNITS GENERAL LIABIRY COMMERCIAL GENERAL UABILTIY E OCCUR EACH OCCURRENCE $ LAMALIE 10 HEN! ti) PREMISES (Ea occurrence) $ 1 CLAIMS -MADE MED EXP (AnV one person) $ GENL — PERSONAL & ADV INJURY $ AGGREGATE WAPPUESPER: POUCY TEIFM -El LO GENERAL AGGREGATF $ PRODUCTS -COMP /OPAGG___$ $ AUTOMOBILELIABIJTY — — _ — ANYAUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON- OWPEDAUTOS S (V16a 1 D1SINGLE UMff (Ea $ BODILY IN.IURY (Per persar) $ BODILY INJURY (Per oxidant) $ 7PEeca pAM4GE trtl �J $ $ $ _ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED .0 1B_.E RETBVTION $ _ $ $ A AND ANYPROPRIETOR/PAFRNEWDCECUTNE ST-_ y/N ❑ NIA UB- 36274100 -12 03/16/2012 03/16/2013 �yy�� q X1 IDRY�LlA EMPLOY ABWTY RIM EXCLUDED? ���n� N��) ""' VAS below EL. EACH ACCIDElT $100,000 $100,000 EL DISEASE - EA EMPLOYEE EL. DISEASE- POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (Attach ACOFD 101, Additional Remarks Schedule, If more space is required) CFRTIFICATF I-Int nm2 - - .._ -. - - -. - - - MIAMI SHORES VILLAGE BULDING DEPARTMENT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 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 530 ACORD 25 (2009/09) O 1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD