Loading...
PL-12-1897 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-179762 Permit Number: PL-10-12-1897 Scheduled Inspection Date:June 10,2013 Permit Type: Plumbing - Residential Inspector: Hernandez, Rafael Inspection Type: Final Owner: CHIARELLA,ANTONIO Work Classification: Addition/Alteration Job Address: 10666 NE 10 Place Miami Shores, FL Phone Number Parcel Number 1122320280890 Project: <NONE> Contractor: CASTELLAR C ONSTRUCTION INC Phone: (786)286-0694 Building Department Comments NEW PLUMBING FOR GARAGE CONVERSION Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid. June 10,2013 For Inspections please call: (305)762-4949 Page 4 of 25 EV Miami Shores Villa g e T ` - 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 No. —� j PERMIT APPLICAT`'ION Mauer Permit No. !- �2..,`9 �� FBC 20,10 G OWNER:Name(Fee Simple Titleholder): C k/'t'SS t C _�.+i p r'e I 1 phone#; 3d Address.'- (00(0 G rl 1 L 0 PL ace r %6L City. � 5 4t, ore s �•- , �_s— state: F C. . Zip:3313 8 Tenant/L,essee "- hone# Email• Q e C1 1 !@ 2 ' D v'}� . h I JOB ADDRESS: l O la co b NC (0. City: Miami Shores County: Miami Dade Zip: 3 3) 3 '� Folio/Parcel#; 1 I .?23.2^,01.$- Is the Buildfr >iistoricnllyesiguateds Yes Nb Plow`Lone:_X CONTRACTOR:Company Nme: St P_ t9- Phorie#c Address: ®.. AE- city:- 4a1 State: Bp:—,3 Qualifier Name: phone#: State Certii`ication�r. }. 'stration# G.;,'J ` Certificate o Competency#: Contact Phone#? °vb Email Address: DESIGN91i:Arch tect/Lngineer Phone#: Value of Work for this Permit:$ Squarel inear Footage of Work: Type of Work: OAddress OAlteratio ONew ORepak/Replace ODemolition Description of Work: � a®r Flo,6 ,u_. �o. ILI -t 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 F.LECTR CAIN WORK,PI:,UMBJNG-t 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 wily be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO, OWNER: YOUR FAILURE TO RECORD A NOTICE OF t COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE '- FOR MPROVEMENTS_ TO YOUR x 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 a dig$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law broc ur . l be delipv red to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of co ` ust be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the a e of such posted notice, the inspection will not be approved and a reinspection fee will be charged.: Signature Signature Owner or Agent Motor The foregoing instrument was acknowledged before me this The foregoing,instrument was acknowled , before me this - day of LC 20 r,by day of o et 20 by who is personall to me w has produced who is personal l known me or ho h aced �-/ d who did take an oath. as i dsn,% N liC Stab of Florida NOTARY PUBLIC °•¢ Nc ublic State of Flora NOTARY PUB I eira . Mai ;.pliveira mission EED46216 G �o� rh �ot too 1 U2a/2014 or n y 11/28/�E404�218 Sign: - Sign: - Print: yl Off—t 16 C WA Print: U My Commission Expires: - �-°t° My Commission Expires: APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 07/10/07)(Revised 06/10/2004)(Revised 3/15/04) f o-:�'-RO�g��IO �3GUI�TI=O GrGC151 5812 1 10423 fCT ::. C .A$ the LLAR s C88TIgr n trae3on datai 1�IIti 313 Pso�tl# cups t�F.,CE!to g �8 a 06-20-2012 W � JEFF ATWATER STATE OF FLORIDA CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 07/20/2012 EXPIRATION DATE: 07/20/2014 PERSON: DIAZ RAFAEL G FEIN: 010669246 BUSINESS NAME AND ADDRESS: CASTELLAR CONSTRUCTION INC 5775 SW 149TH PL MIAMI FL 33193 SCOPES OF BUSINESS OR TRADE: 1- CERTIFIED PLUMBING CONTRACTOR 2- CERTIFIED GENERAL CONTRACTOR IMPORTANT. Pursuant to Chapter 440 . 0504), 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 chapter. Pursuant to Chapter 440.05112), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05(13), 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 DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01-11 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA IMPORTANT DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS'COMPENSATION Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who CONSTRUCTION INDUSTRY elects exemption from this chapter by filing a certificate of election CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA L under this section may not recover benefits or compensation under this WORKERS'COMPENSATION LAW D chapter. EFFECTIVE 07/20/2012 EXPIRATION DATE: 07/20/2014 Pursuant to Chapter 440.05(12), F.S., Certificates of election to be PERSON: RAFAEL G DIAZ H exempt.. apply only within the scope of the business or trade listed on FEIN: 010669246 E the notice of election to be exempt BUSINESS NAME AND ADDRESS: E Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt CASTELLAR CONSTRUCTION INC and certificates of election to be exempt shall be subject to revocation 5775 SW 149TH PL if, at any time after the filing of the notice or the issuance of the MIAMI, FL 33193 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 SCOPE OF BUSINESS OR TRADE: person named on the certificate to meet the requirements of this 1- CERTIFIED PLUMBING CONTRACTOR 2- CERTIFIED GENERAL CONTRACTOR section. QUESTIONS? (850) 413-1609 CUT HERE Carry bottom portion on the job, keep upper portion for your records. DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01-11 I rr. # # # r a 8 r M x k x # R # A' .w s Ai Q® CERTIFICATE OF LIABILITY INSURANCE DATE�7/(MM/DD/YY) PRODUCER Florida Bankers Insurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 7278 SW 8 Street ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,E)ITEND OR Miami,FL 33144 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, Phone(305)266-6493 Fax (305)262-0679 INSURERS AFFORDING COVERAGE NAIC# INSURED CASTELLAR CONSTRUCTION INC INSURER A: ESSEX INSURANCE COMPANY 5775 SW 149 PI INSURER B: INSURER C: MIAMI, FL 33193- INSURER D: (786)286-0694 INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIRBAENT,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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADIM POUCY EFFECTIVE POLICY EXPIRATION LTR II RD TYPE OF INSURANCE POLICY NUMBER DATE MMDMW DATE LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000.00 ® COMMERCIAL GENERAL LABILITY GL-3470198 08/02/2012 0810212013 DPRA AAIS SQ�o�u erne $100,000.00 ❑❑ CLAIMS MADE ® OCCUR MED EXP(Any one Pew) $5,000.00 A ❑ ❑ PERSONAL&ADV INJURY $1,000,000.00 ❑ GENERAL AGGREGATE $1,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $1,000,000.00 ® POLICY ❑PROJECT ❑ LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ❑ ANY AUTO (Ea accident) ❑ ALL OWNED AUTOS BODILY INJURY ❑ ❑ SCHEDULED AUTOS (Per person) ❑ HIRED AUTOS BODILY INJURY ❑ NON OWNED AUTOS (P-acciderd) ❑ PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT ❑ ❑ ANY AUTO OTHER THAN EA ACC ❑ AUTO ONLY: AGG EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE ❑ OCCUR ❑ CLAD MADE AGGREGATE Ll ❑ DEDUCTIBLE ❑ RETENTION $ WORKERS COMPENSATION AND ❑ WC STATU- ❑ OTH- EMPLOYERS'LIABILITY TORY S ER ANY PROPRIETOR/PARTNER/EXECUTIVE YAV E.L.EACH ACCIDENT OFFICER/MEMBER EXCLUDED? (Mandatory In NM E.L.DISEASE-EA EMPLOYEE Kyes describe under E.L DISEASE-POLICY LIMIT SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAO_ MIAMI SHORES VILLAGE 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO 10050 NE 2 AVE THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY MIAMI SHORES, FL 33138 OF ANY IUD UPON THE INSURER,ITS AGENTS OR REPRESEMATIVES. AUTHORQED REPRESENTATIVE ACORD 25(2009!01)QF ©1988-200.9 ACORD CORPORATION.All rights raswved. The ACORD name and logo are regh tared marks of ACORD