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PL-13-1725 08-14-'13 06:49 FROM- T-659 P0004/0013 F-877 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax:(305)750-8972 Inspection Number: INSP-197043 Kermit Number: PL-7-13-1725 Scheduled Inspection Date:August 13,2013 Permit Type: Plumbing -Residential Inspector: Diaz, Osvaldo Inspection Type: Press Test Owner: MICHELLE CANERO, PENN DAVIS Work Classification: Gas Job Address:384 NE 94 Street . Miami Shores,FL Phone Number Parcel Number 1132060138140 Project: <NONE> Contractor: THE NEW MIAMI SHORES PLUMBING• e me-.006)7611 2446 ■ w �r.r Building Department Comments INSTALL GAS TANKLESS WATER HEATER InfracNo POS64d Comments INSPECTOR COMMENTS f=alse Inspector Comments Passed LZ Failed Correction Needed Re-Inspection Pee No Additional inspections can be scheduled until re-inspection fee is paid August 12,2013 For Inspections please call:(305)762.4949 Page 38 of 51 m 0o I N W ROM co ® MUMI SHORES PIAIMBIRC TELEPHONE. 9"?LW. 144th Stmet Co (30S)751-2446 1►inw,R 39168 FAX ql eel OPCO1920 (305)754-3402 p Lf WaalCaidhuUmd 3 Drop Test Job Name Permit# 2- �:3 Address 3 9 z1 Nr 9 city r`avn; 4h d e's Operating Pressure Lock up Pressure Test Pressure Minutes Performed By to b m m Ln m m N w co r A r Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-196265 Permit Number: PL-7-13-1725 Scheduled Inspection Date:August 14,2013 Permit Type: Plumbing - Residential Inspector: Diaz,Osvaldo Inspection Type: Final Owner: MICHELLE CANERO, PENN DAVIS Work Classification: Gas Job Address:384 NE 94 Street Miami Shores, FL Phone Number Parcel Number 1132060136140 Project: <NONE> Contractor: THE NEW MIAMI SHORES PLUMBING Phone: (305)751-2446 Building Department Comments INSTALL GAS TANKLESS WATER HEATER Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comm_ents Passed Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. August 13,2013 For Inspections please call: (305)762-4949 Page 14 of 36 Miami Shores Village Building Department JUL �a g De art p L 3 1 L0 10050 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 BUILDING Permit No. l PERMIT APPLICATION Master Permit No.p I f l 3 - Permit Type: BII.DING -� JOB ADDRESS: 3 O� NE q# City: Miami Shores County: Miami Dade Zip: 33/3 0 Folio/Parcel#: Is the Building Historically Designated:Yes NO kz Flood Zone: OWNER:Name(Fee Simple Titleholder): ��?/) Jaws Phone#: Address: '30 V /W I A City: 0: 4Ut, o f State: IFS— Zip: 33/13$ Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: ;%I V*4; 16'tt64U 4. %Wf &U Phone ���� Address: '100 AJ W City: UA444% State: zip: 331 $ Qualifier Name: Amnij Ile 144 /h Phone#: 305- -75-1 Wk State Certification or Registration#:�/0F,/C 0l.9 P-0 Certificate of Competency#: Contact Phone#: �� ��3' J T z°I" Email Address: DESIGNER:Architect/Engineer: Phone#: er% Value of Work for this Permit:$ lG Square/Linear Footage of Work: Type of Work: ❑Addition ❑Alteration ❑New ��❑Repair/Replace emolition Description of Work: '_f.,lL !.�� Color thru tile: nx�xx�xx��x��xx��x�x�x���x��n�x�x�xx��nxFees���xu���x�xx��x��xxxx�x�xx�x+xx�xx��x�nx�xxxx Submittal Fee$ Permit Fee$ 7 I S& CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology'Fee$ Double Fee$ Structural Review$ _ TOTAL FEE NOW DUE$_ A i .. �J'.."t.. � r -... � s t:•�� ..�..—N � } ...... 4.1' i a�. SI ..� t �a.ka. .aPe ay.'f.+.a. i e 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_o4pCoved and a reinspection fee will be charged. Signature Signature Owner or Agent Contractor The forego!�p instrument was acknowledged befo a me this The foregoin //instrument was acknowledged befo is e me th day of ✓t! ,20.t—),by IMM IF- 040-1 day of 9, ,20./Y-,by iw G d� , who is personally known to me or who has produced o'ke J who is personally known to me or who has produced yU �G.tcS P� As identification and who did take an oath. kii*f t as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: /W�� Print 16 a L Print: My Commission Expire! KENNETH 6 KOTAUK My Commissio L KENNETH B KOTAUK d- MY COMMISSM 0 EEO!MMW MY COMMISStCq!I S PED"M EXPIRES May 02,2015 EXPIRES Main 02,2015 APPROVED BY Plans Examiner zoning Structural Review Clerk (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) CERTIFICATE OF LIABILITY INSURANCE DA DD/YYYY) 8/9//201201 3 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(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 endomement(s). PRODUCER NAME: Suzie B. Keyes Coverage Insurance PHONE 5900 Hiatus Road A/c No Ed:954-724-7000 AIC No:954-724-702 4 Tamarac FL 33321 ADDRESS: suzieb@keyescoveracre.com PRODUCER CUSTOMERID : 8658 INSURED INSURER(S)AFFORDING COVERAGE NAICS INSURER A:Hanover Amer Iris Co New Miami Shores Plumbing, Inc. [The] Miami Shores Plumbing INSURER B:Hanover Insurance Company 22292 900 NW 144th Street INSURER C:Bridcle field Employers Ins Co 10701 Miami .FL 33168 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:2029891327 REVISION NUMBER: THIS IS TO CERTIFY THATTHE 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 POLICY EFF POLICY EXP LTR TYPE OF INSURANCE S POLICY NUMBER POLICY OLIC LIMITS A GENERAL LIABILITY Y Y RZJ394105005 8/23/2012 8/23/2013 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES a oawn $100,000 CLAIMS-MADE OCCUR MED EXP(Any one person) $5,000 PERSONAL 8 ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GENt AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG $2,000,000 POLICY 17 PRO LOC Ded: PD $2,000 B AUTOMOBILE LIABILITY Y AWJ A04214900 7/1/2013 7/1/2014 COMBINED SINGLE LIMIT $l,000,000 X ANY AUTO (Ea accident) ALL OWNED AUT03 BODILY INJURY(Per person) $ SCHEDULED AUTOS BODILY INJURY(Per accident) $ X PROPERTY DAMAGE HIRED AUTOS (Per accident) $ X NON-OWNEDAUTOS $ $ B X UMBRELLA LIAB X OCCUR UHJ384105304 8/23/2012 8/23/2013 EACH OCCURRENCE $5,000,000 EXCESS UAB CLAIMS-MADE AGGREGATE $5,000,000 DEDUCTIBLE $ X RETENTION $0 $ C WORKERS COMPENSATION Y 83034950 �YTATIITJS O - AND EMPLOYERS'LIABILITY YIN 8/23/2012 6/23/2013 X A ER ANY PROPRIETORIPARTNER/EXECUTIVE OFRCER/MEMBER EXCLUDED? N/A E.L.EACH ACCIDENT $100,000 (Mandatory In NH) If yea,describe order E.L.DISEASE-EA EMPLOYE $100,000 DESCRIPTIONOFOPERAnoNSbelow E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS i LOCATIONS/VEHICLES (Aftach ACORD 101,Additional Remarks Schedule,if more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED Miami Shores Village IN ACCORDANCE WITH THE POLICY PROVISIONS. 10050 Northeast 2nd Avenue Miami Shores FL 33138 AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD Miami shores Village �5� .1 Building Department 1111 atilt" 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 jpRlp�► Fax: (305) 756.8972 Date: 'q - :5 1 1 Permit No: L Plumbing Critique V- �� 8 . 1 c, � 0 Pic L I�1 � � C C- c, _ p Osvaldo "Ozzie" Diaz Chief Plumbing Inspector Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re-submittal drawings. CITY COPY E 94i Tin 1`7 Miami Sf o Village APPROVED BY DATE ZONING DEPT - BLDG DEFT � SUBJECT t'O CCPPl.1�MCE WI f-I ALL FEUER,4L STATE AN,)CC,UN f HUL_S AP1D RE.GI)LArlO'IS t�bcoa ,� r� S,4-X„L9 24 Hour s Service Z r MIAMI SHORES PLUMBING i 900 NW 144 St. Tel;305/751-2 446 Fax:305/754-5402 North Miami,FL 33168 License No.:CFC 019205