PL-13-963 08-07-'13 06:47 FROM- T-641 P0003/0010 F-834
Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone:(305)795-2204 Fax: (305)758-8972 pp ci^
Inspection Number: INSP-190840 Kermit Number: PL-5-13963
Scheduled Inspection Date:August 06,2013 Permit Type: Plumbing- Residential
Inspector: Diaz, Osvaldo
Inspection Type: Final
Owner: TIBBITI',DANIEL AND SEI2ENA Work Classification: Addition/Alteration
Job Address:11 NE 110 Street
Miami Shores,FL 33161-7043
Phone Number
Project <NONE>
Parcel Number 1121360040300
Contractor: UNIVERSAL PLUMBING CORP Phone:(305)887-3131
Building Department Comments
CHANGE FIXTURES IN BATH AND KITCHEN Infractio Passed Comn ants
INSPECTOR COMMENTS False
Inspector Comments
Passed Failed
Correction
Correction,
Needed
Re-Inspection
Fee
No Additional Inspections can be scheduled until
re-inspection fee Is paid
August 05,2013 For Inspections please call:(305)762-4949
Page 10 of 37
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DIVISION OF WORKERW COMPENSATION
••CERTIFICATE OF ELECTION TO at EXEMPT FROM FLORIDA WORKERS'COMPENSATION LAW..
CONSTRUCTION INDUSTRY EXEMPTION
'This certifiea that ttts lndMdusl listed below has elected to he exempt from FlOrlda Workers'Compensation law.
EFFECTIVE DATE; 6/0/2018 EXPIRATION DATE: 502016
PERSON; GARCIA MICHEL
FEIN: 284039076
BUSINESS NAME AND ADDRESS:
UNIVERSAL PLUMBING CORP
141 E 60 ST
HIALEAH FL 33013
SCOPES OF BUSINESS OR TRADE:
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From:CM0 Engineering 305 917 17 05/1512013 15:35 #880 P.0021004
STATE OF FLORIDA
DEPART 01? atisImSS P.= prc0pp.SS:E0ML p3GUIATIOX
CONSTRUCTION INDUS�'Ry 7-%ICM;SXNC- 130 (85 0) 497-139S
TMMO THEMONItom PL 38399-0'783
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boxers to barque Mutant$,End tft�y Iwp t=tarida'a economy strorig, i
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Et�ety dayy We work to ImProvs time Way we do ouslftess In order to serve you better.
FOr Ihfb ratlon about our=,Aces,please tog onto o:aeyf9ottde =6S2.r�rn. CERSIFIBD 3=Z = .0O3mRAcToR
There you can fend more WoMMV06 t our distorts east the reguta�IOrts GdREtIA >lXCB=
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Oepartrement's InWa9ves. 1 MiE#R*.AE PLYING•;;•' CORP
Our brialan at the Department is:Lkense EfcfsnW,Regulate,Faio,y,We
coP.stsPUy strive to serve you better so that you can serve yaw customers. =s � ati?a �� � ero+�s�souo ce �a.4ea �s
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From:CN0 Engineering 305 917 4517 05115/2013 15:35 0880 P.003/004
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s�EMM9 LING CORP STATN'S"k8421 7 08228-2
37k 35 ST
33012 IALKAH
QwMVEltSAL PLUMBING CORP
' i 6® CONTRACTOR IaORKE3lS ,
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UNIVERSAL PLUMBING CORP
s WWI,. MICHEL GARCIA QUALIFIER
$7:4 W 35 ST
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374 V 35 ST
.33012 HIALEAH
O'MVERSAL PLUMBING CORP
11�. �scmAN2CA$ c¢IN'1"R=olt 4�OJ�ICEI
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UNIVERSAL PLUNRIN$ CORP
4 E 374EW 35 LLON PRES
ST
HIAL9AH FL 53012
Im 8/SQ/2012 �
02270820002
8808499.60 PS8I�1&Di9EtfIDDDED �7DiSDE�iE1+8��iEE8� E6EElliEEiE�EE��P$EE��
BEE OTHM 86DB ,
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Miami Shores Village CE I 1_f -, I
CF
MAY 0 7 013
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Building Department
10050 N.8.2nd Avenue,Miami Shores,Florida 33138 T'Y:
Tel:(305)795.2204 Fax:(305)756.8972
INSPECTION'S PHONE NUMBER; (3fl5)762A949
FBC 20
BUILDING Permit No. 1 ':3 (o
PERMIT APPLICATION Master Permit No.V'C')�5_ 2,
Permit'fype: PLUMBING
JOB ADDRESS:
City: Miami Shores County: Mimi Dude Zip; 3316ol
Foliat?arcel#: // – gl 3 to U d q 67-Jolo
Is the Building Historically Designated: Yes NO >e- Mood Zone:
OWNER:Name(Fee Simple'fitleholder): _2),an1d 74ilt Phona: 3
Address: It E //0
City;M-04-vi State:
Tenant/Lessee. Name:, Aj/A Phone#-.
Email: rllq xrp ev�
CONTRACTOR:Company Nam:
a/lfho
Address:
city; State-. Zip: lZ
Qualifier Name-,e,�Oe2W &,�P-O'A Phone#-
State Certification Or/KRe-listration Certificate of Competency
Contact Phone :
1� W —Email Address: P W
DESIGNER itect/Engmeer:
------
—Phone#:
Value of Work for this Permit:$ Idol O-D Square/Linear Footage of Work:
Type of Work: LIAddress LJAlteration LINew )1kepair/Replace LIDemolition
Description of Work: Pkne- A*Y- Nti�j 7"
TV '2 n"(3/
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
lof 2
W lco)
UA6
L \�
Bonding Company's Name(if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender"s Name(if applicable)
.Mortgage lender's Addireass
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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. 1 understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,SIGNS,
WELLS,POOLS,FURNACES,BOILERS,IIEA 1'ERS,'1'ANKS and Alit CONDI'T'IONERS,ksllv.....
OWNER'S AFFIDAVIT: 1 cxxtify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and;coning.
"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 ALw,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 pasted notice, the
inspection will not be approved and a►inspection fee will be charged.
Signature �— Signature
Owner or Agent Contractor
The foreping instrument was w�dd before me this The fore in ent was acknowledged befo "SAO a
day of e[��/20L'20 13 by /VL& 7/6-f 17' day of 2013 by �,(.o,
who is personally known to me or who ha&pwd ad who is lly known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTAR UBLI .,�o,`k"t' YODALY LOPEZ NOTARY P
MY CtTMI3S10N#EE217378 a 'MARYLIN TORANO
•. EXPIRES July 17,20113 a Slo1Q s EM2630
Sign: sigmi
Print: ].�P_A104f Prim 1 . n
My Camrnissio l ^� my Commission Aires:j fir)e, �r �1.,
6 OTC/
APPROVED BY �� Plans-Examiner 'Zoning
Structural Review Clerk
(RevimWl2r2Ol2XRery 107/lOM7XRevised O6fl M9XRevised 3/ISR19)
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