PL-13-986 it
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores,FL
Phone:(305)795-2204 Fax:(305)756-8972
Inspection Number. INSP-190999 Permit Number: PL-5-13-986
Scheduled Inspection Date:September 24,2013 Permit Type: Plumbing - Residential
Inspector: Diaz,Osvaldo Inspection Type: Final
Owner: NEWBY, BENNY Work Classification: Addition/Alteration
Job Address:10525 NE 2 Court
Miami Shores,FL Phone Number (305)336-0676
Parcel Number 1122310130610
Project: <NONE>
Contractor: APA PLUMBING CORP Phone:(305)992-4614
Building Department Comments
PLUMBING FOR KITCHEN AND 2 BATH RELOCATE INfrach° Passed comments
INSPECTOR COMMENTS False
PLUMBING LINES.
Inspector Comments
Passed PL-u t-"' D
Failed
Correction ❑
Needed
Re-Inspection. ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid. ,
September 23,2013 For Inspections please call: (305)762-4949 Page 7 of 29
C IV .
' Miami Shores village MAY 0 8 2013
Ht.ild:ing Department :
40050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795.2204 Fax:(305)756.8972
INSPECTION'S PHONE NUMBER:(305)762.4949
FBC 20 t C5
BUILDING Permit No.F 1--- 1 .3 — 9 �r(°
PERMIT APPLICATION Master Permit No. f2N C°15
Permit Type:PLUMBING
JOB ADDRESS: 1 Z a3 C'F
City: Miami Shores County: Miami Dade Zip: 3 313 Y
Folio/Parcel#: — n3 1 0( 10
Is the Building Historically Designated:Yes NO Flood Zone:
OWNER:Name(Fee Simple Titleholder): T>1&4:J j L L),F_�S Phone#: 30 S 3 5 6- QG I G
Address:_ ®`a'i,1 a 0 C r.
city: Vl i tca m i S Ho-teo State: '04 C 1.0 a zip: 3 3 1_i s
Tenant/Lessee Name: 0 Phone#:
Email: le1�i k
2 CONTRACTOR:Company Name: � Phone#.
Address:
city: �n State: Oa- Zip:
Qualifier Name: K uf"S. A= ` Phone#:
State Certification r Registration# C K CA*a / � �Certificate of Competency#:
Contact Phone#: Email Address: V%'A Ce, LV(/ _"C q,4
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit:$ $quarelLinear Footage of Work:
Type of Work: ❑Address ❑Alteration ONew _Peepair/Replace ODemolition
Description of Work: Q r,,r' Vll
S'. .,J-L
Submittal Fee$ � Permit Fee$ C CF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$
TAT�T Z.ITTT 1TASf/T*TT d.
Bonding Company's Name(if applicable)
Bonding Company's Address
City. State Zip
Mortgage Lender's Name(if applicable) a t {O�L
Mortgage Lender's Address 00 0. a F-
City Mir, State 1�,M40TN Zip T� V
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
inspectum will not be proved and a reinspecdon fee will be charged.
Signature Signature
Owner or Agent o tractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me
day of ,20 a,by �� p day of 201,1 ,by
who is personally known tome or who has produced ® - ID who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: ``\\\%ttilt1ittllstoio,® NOT PUBLIC:
'�.,
Sign: 4. C'. SignAn E
Print = z•=�: -® _ Print !dI Bevy
My Commission Empires: �� :����a My �
Am
I
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
ro•,,:°•aan�nm�,rua,a°�n�nnfm�roaa..�n�nnvinn<»roo,„ ma anvnm
' ♦5t1 RES pi
�:.,. p...� Miami shores Village
4 �° Building Department
RtD� 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 LICENCES AND INSURANCES EACH TIME A PERMIT IS
SUBMITTED OR THE VILLAGE MAY MAINTAIN A FILE WITH YOUR INFORMATION FOR A$30.00 FEE PER YEAR.
IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR:
A C PY OF QUALIFIER'S STATE LIC CARD
B. COPY OF LOCAL BUSINESS TAX RECEIPT
C. COPY OF LIABILITY INSURANCE(CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPT)
D. COPY OF WORKERS COMPENSATION (EITHER CERTIFICATE OR EXEMPTION)
IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY:
A COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER
B. COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT
C. COPY OF LIABILITY INSURACE(CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPT)
D. COPY OF WORKER COMP INSURANCE(EITHER CERTIFICATE OR EXEMPTION)
YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW:
MIAMI SHORES VILLAGE BLDG DEPT
10050 NE 2ND AVE
MIAMI SHORES,FL 33138
COMPLETE CONTRACTOR'S INFORMATION
BUSINESS NAME:
BUSINESS ADDRESS: � 1160+ CITY
STATE ZIP CODE
BUSINESS PHONE:( �l) � SI-0&k FAX NUMBER(� ) 0
CELL PHONE QUALIFIER'S NAME:
QUALIFIER'S UC NUMBER:
F c ?
E-MAIL ADDRESS(IF APPLICABLE): q bq Xt k Cr r?b
Cn on 3/19109 BY lLOV/KV 312M MWV
9
_
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395
1940 NORTH MONROE STREET
TALLAHASSEE FL 32399-4783
GARCIA LUIS ALBER.TO
A P A k5aING CORPORATION
8741 SW 49TH STREET
MIAMI FL 33165-6701
Fi n. AC#�*r AL -br?
Congratatailonsl With this license you become one of the nearly one mWon - P TWNT 'OF BIISI SS `
Floridians licer t by the Department of Business and Professional Replaiion. E. sBIOML RSGII A"CIOBit:
Our pofessionals and businesm age from wd*ecis to yadd brokers,from. -
box=io tarbeque rte:itnd they keep Florida's economy Wong.
- '�iCErC14�7`I'`8$,� . 1 118192616 ,
Every day we work to improve the way we in order
arthlioom ;.� L'STIB' P7t DRSINt3 CO>�CTOR 'serve you bener.
For information about our .r�y�
There you can tktd more it rrration about our and the reguleffons that ,v C1 1A VMS �A�.B8RT0
impacy+ou,subscribe to department newsletters and[earn more about the A P�tGoR8oa1
0ep8ffhnE W,S tnitiatives. =
Our mis»sian at the Department Is:License tHidently,Regulate Fa&ty.We
consiar*strive to serve you better so that you can serve your customers'
Thank you for doing busing in Florida,and congrob fisdons on your new ftensei ?20sa9ooaba
.�_
L
DETACH HERE
kC# 61431-17 STAW OF I-ORIIIA.
DLPART F REGULATION
.7 PRO
x... .., 5 SEt#L12052900909
:05-,29. 2012: 118192616' GI?414�lT83
Thy PItDN�2NG CONTRACTOR
W 3med 3>>e10�t - S C:ERTIF?��} <- ,
Undis 't).e .grovisiaiYis oi. 3saptH'ar;.489 FS.
EXpf.rattio_ m date: AUG 31 d 2 t31A 311 3
..: 'BERT- 0-`
""OARCd�i/ LUI S AL7 .:.' •k `r S,' .t�
';A P A:PLUMBING CORPQltATION ;
8741 SW••49. H,:;:SiB..Iib&I
MIAMI FL -33165=4-0-k -_
RICK SCOTT. KEN LAWSON
4 SECRETARY
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MIAMI, FL
PERMIT NO. 231
628168-7 RENEUAL
BU INESS ME I LOCATION REIPT NO. 654736-9
P A 'LUMBIMG CORP STATE ,,EC_ CF'C:1427783
7075 SCI 46 ST
33155 UNIN DADE COUNTY
MINE I A PLUMBING CORP
Se � "� LNORG CONTRACTOR O E�ss
THIS IS ONLY A LOCAL
SUSINESS TAX RECEIPT,IT
DOES NOT PERMIT THE
HOLDER TO VIOLATE ANY
EXISTING REGULATORY OR
ZONING LAWS OF THE DO NOT FORWARD
COUNTY OR CITIES. NOR
DOES IT EXEMPT THE
HOLDER A P A PLUMBING CORP
mom OTWER •
PERMIT OR LICENSE
REQUIRED BY LAW.THIS IS LUIS GARCIA PRES
THE HO CERTIFICATION UIRCA- 7075 sal 46 ST
T1ON� MIAMI FL 33155
PAYMENT RECEIVED
MIAMI-DADE COUNTY TAX
COLLECTORb8/31/2012
60030000276 � 1111 000075 . 00 a � � �� >< �a � �� sitsI illith 'i ilililm-144
SEE OTHER SIDE
PoffCy Number. CL 2638341 Dote Entered: 04/0212013
CERTIFICATE OF LIABILITY INSURANCE I 4/2/2023---
THIS CER1*1CATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ZERnFICATE HOLDER.'THIS
cawimi E DOES NOT AmmAmELY OR NIeATIVELY A9IAENiiR. EXTEmD OR ALTER THE GAGE AFFORDED 8Y THE PMxMS
BELOW. THIS CERTF CATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INS1RE3qS), AUTHORIZED
WIW:SENI-ATMORPRODLKZKANDTMCERoF=TEIiOLDEIL
01PORTANT; It'#n oorMcate holder is=ADDrrK)NAi.NSURED,the pagcy tm)r7I he errdo7sed. If SUBROGATION IS WAIVED,SUI>jea to
the town and ins of the pd&W,caTtain paUdes any re*dm an onforsement. A statemeat an aft caroficate does rmt mftr rights to the
cwdftdo haiderin lieu ofsud7 s n
FROMOM Pablo A, NatL233.a
Your Options Insurance pyXXS F
882 SW 70th Ave (888)40.6-0997 (866)394-4923
"fo@ ins.com
Miami, FL. 33144
AFFD123
Tt....:MDuNT mm mm 7rIRE INS CO
/sm A.P.A Plumbing Corporation s: -
7075 Sw 46th St ttro-
Miami, FL 33155 DISU E;
war F:
COW ERAGES CERIN'ICATENUMSM RE4ASION NUMBER:
THIS G TO CEIrm THAT THE POLICIES OF INSURAHCE LISTED BELOW HAW BEEN ISSUED TO THE INSWIED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. N09=11STAHDIN6 ANY RMUREAMAIT TE W OR COMMON OF ANY CONTRACr OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRWED HEREIN IS SUIMECT TO ALL THE TERM,
OCCLUSIONS AND CONDITKM OF SUCH POLICIES.Ltll MS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LN IMOF P IH r3 F3� LIM
GENOMLMORM EACH 01NMOVEMM $1,000,0000
A IAL.mmm"►S>ay X CL 2638341 /25/2433 3/25/2034 a ES Ea�ar $100,000
CWMMAM oos MWEW6Ajwcw I $5,000
&AMO $1,000,000
a GE,ERAL ABATE s2,000,000
GEML AGGRECAM UVgTAPPLgSP0 PR0M=-C06IP/I MM $1,000,000
M= L= $
AVAXWOKSLIARLITY Law $
AWYA F0 otTD�9Cgd3U13Y�erperson) $
AL TS BODll3ftll�1?RY�+erao ) $
N
N1138I I UFOS �4A1113�idE0
$
$
rffisam ALIAS OCAM, EAC!l 9t $
0WML" CLAMIG-i AGONS pTE $
� t�3l�id7fJAt$ g
rgpIMM" "M ANC Si A�i9
AND B
LIABLOY Alf R
Vin/NYC MIA ELEAMArCW897' $
bowl ELDHWASE-EAEA OYEE $
� l�etom ELDt -7�1.IL'YL�1'd' $
OF lL9CA7�18/018/ (A�ACD 1��97,A17SIgrtoa�espaas7sn )
PLUNBING RESIDENTIAL, (98483) PLUMING COUMERCIAL (98482)
as per information with underwriter policy covers installation LPG equipment- `
Certificate holder is also additional insured
CER I NFICATE HOLOM CANCELLATION
Miami Shores Village Building-Department SHOULD AMY OF THE ABOVE DESCR13M POLICIES BE CAMCELtlM OEM
THE 9DIPIRATION DATE 7HIERr", MOTILE' WILL BE 013.110ED IN
10050 N.E.2 av nCCORIMUCE IM THE POLICY Pte.
Miami Shores,Florida 33138
pwaam cawao
0 9988-2010 ACORD CORPORATION. M rigs reserved.
ACORD 26(2010 00 The ACORD amm and Igo are registered nm*s of ACORD
nvdumt using Forma Bm P1w soitwm vrm Fmmssowmn;hVressive Pubftft 800-MB-IO 7
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SIATI
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2739 U.S.Hxjhway 19 N. --HoNday,FL 34691(727}938-5562 9 ' NAIC#
South East Personnel Leasing,lnm& tton t 2739 U S.Highway 19 K
Holiday.FL 34691
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10050 N.E.2 av eadt40° '
Miami Shores,Florida 33138 d• �