PL-13-1527i
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
OW I
Inspection Number: INSP- 194861 Permit Number: PL -7 -13 -1627
Scheduled Inspection Date: October 29, 2013 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo
Owner: CARROLL, JAMES
Job Address: 1269 NE 98 Street
Miami Shores, FL
Project: <NONE>
Inspection Type. Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1132050090260
Contractor: ALL COUNTY PLUMBING Phone: 305 - 796 -6124
comments
REMOVE AND REPLACE BATH FIXTURES
INSPECTOR COMMENTS False
Inspector Comments
Passed (�
Failed
Correction ❑
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
October 28, 2013 For Inspections please call: (305)762 -4949 Page 8 of 46
Miami Shores Village - - —
Building Department JUL 0
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 t `�
BUILDING
PERMIT APPLICATION
Permit Type: PLUMBING
Permit No. FL— 13 ®I J Z-74—
Master Permit No2,gY -3 ° 15? �
JOB ADDRESS: I ( g rc
City: Miami Shores County: Miami Dade
Folio/Parcelt 1 l ". WD S 1909 0 0
Is the Building Historically Designated: Yes
NO _^,� Flood Zone:
OWNER: Name (Fee Simple Titleholder): eif.l CA Rj C- Phone #: 305 • LV j ®• ,-7 7
Address: 1°2 LQ -q 1,� S q do -- •
City: 1 cj State:
Tenant lessee Name: Phone #: 3 C % (®
Email:
CONTRACTOR: Company Name: R1.1 LO O 'Y f� I L 1� I I�G, Phone #: g5Lt • ��� � � t��
Address: 001 0 lU E 9-0q-01 -
City: D� �g fAA ` State:
Qualifier Name: AI�Wtc m_�� Phone #: • ��� ° t ��✓
State Certification or Registration #: M00 q,Q Certificate of Competency #:
Contact Phone #: - ZaS, 9 f %a, Email Address:
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: S • '� quare/Linear Footage of Work:
Type of Work: ❑Address DAlteration
Description of Work:
UNew ORepair/Replace ODemolition
Submittal Fee $ c 9 Permit Fee $ CCF $ CO /CC $
Scanning Fee $
Radon Fee $ DBPR $ Bond $,
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
Technology Fee $
TOTAL FEE NOW DUE $ 109. V
Bonding Company's Name (if applicable)
Bonding Company's Address
City State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
zip
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 commen ement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. I e sent such posted notice, the
inspection will not be apprye,a reinspection fee will be charged.
Signature , 1 U �/"
c/ r Owner or Agent � ,_Contr rc of
The foregoing was acknowledged b rem this � The foregoing instrument was acknowledged before m�i, this � �� �
day o t% , 20 , by ��' ��° �' @ �, day of , 201 , by �� UJ 'e^ &-�
who is personally known to me or who has produced Ft 0. . o is personally known to m, or who has produced
�--� As identification and who did take an oath. � as identification and who did take an oath.
NOT
Sign:
Print:
My Commiss it
FAIJ 711TOYJ03I-M
`(2----l' 3Plans Examiner
Structural Review
(Revised3 /12/2012XRevised 07 /10 /07XRevised 06 /10/2009)(Revised 3/15/09)
Sign:
Print:
My
imiulan EE009819
07/1 N2014
r
Zoning
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487 -1395
1940 NORTH
• TALLAHASSEE�ONROE STREET FL WS 32399 -0783
WOESSNER, WILLIAM W
ALL COUNTY PLUMBING CONTRACTORS INC
PO BOX 13098
PORT EVERGLADES FL 33316
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SPATE of FLORIDA AC 2 �`9 S
Congratulations! With this license you become one of the nearly one million DEP_i�iRTMENT. tag AUSINESS AM.*
Floridians licensed by the Department of Business and Arofessional Regulation. i ptggSSIONAL REGULATION
Our professionals and businesses range from architects to yacht brokers, from 1
boxers to barbeque restaurants, and they keep Florida's economy strong.
CO3,9 515 t Ef8¢2 -V 12 128048757.
Every day we work to improve the way we do business in order to serve you better - y}
For information about our services, please log -onto www.myfloridalicense.com CERTIFIED1G' CO`R�iGTOR '
There you can find more information about our divisions and the regulations that T�10$SNER,�II;L1Alr3 W r
impact you, subscribe to department newsletters and learn more about the ALt* COUNT ?s NT CTORS
Department's initiatives.
Our mission at the Department is: License Efficiently,'Regulate Fairly. We >:
constantly strive to serve you better so that you can serve your customers. xs:TF=sn timer e>ie �trooeiona of �n:4.89 as
Thank you for doing business in Florida, and congratulations on your new licerisel f
i .Ssp3 ioa dares AZrCs 31 `'2014 Ll'd0821b1$Z1
DETACH HERE
115 S. Andrews Ave., Rm. A -100, Ft. Lauderdale, FL 33301 -1895 — 954 -831 -4000
VAUD OCTOBER 1, 2012 THROUGH SEPTEMBER 30, 2013
DBA: Receipt #:18, — 127 :Z WN SPRNKL /t
Business Name:N� COUNTY PLUMBING CONTRACTORS Business Type: (PLUMBING CONTRACTOR)
Owner Name: WILLIAM W WOESSNER Business Opened:ll /19/1991
Business Location: 701 N E 1 AVENUE State/County /CertiReg:CFC039956
POMPANO BEACH Exemption Code:
Business Phone: 954-796-6124
T Rooms seats Employees Machines Professionals
1
� For Vending Business Only
Number of Machines: Vendino Tvoe:
Tax Amount
Transfer Fee
NSF Fee
Penalty
Prior Years
I Collection Cost
Total Paid
27.00
1 0.00
1 0.00
0.00
0.00
1 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:
WILLIAM W WOESSNER
PO BOX 13098
PORT EVERGLADES, FL
33316
i
2612 .2013
Receipt: #03C -11- 00000414
Paid 09/28/2012 27.00
r.
R
* * 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: 4/25/2013 EXPIRATION DATE: 4/25/2015
PERSON: WOESSNER WILLIAM
FEIN: 651117368
BUSINESS NAME AND ADDRESS:
ALL COUNTY PLUMBING CONTRACTORS INC
PO BOX 13098
PORT EVERGLADES FL 33316
SCOPES OF BUSINESS OR TRADE:
PLUMBING NOC•AND
DRIVERS
Pursuant to Chapter 440.05(14), 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 440.05(12), 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 ofthe 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.
DFS- F2 -DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 07 -12 QUESTIONS? (850)413 -1609
01/08/2013 01:31
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90718 P.001 /001
CERTIFICATE OF LIABILITY
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THIS CERTIFICATE IS ISSUED AS A MATTER F INFORMATN ONLY AND CONFERS NO RIGHTS UPON THE CERTMATE HOER. THIS
COMICATE DOES NOT AFFIRMATIVELY OR NEGATMLY AIIIEND, EXTUM Olt ALTER THE COVERAGE AFFORDIED BY THE POCK ES
BELOW.' TEAS CERTMATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUiAICa iNSURER(Sh AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERT>FICATE HOLDER.
IMPORTANT- K iiw cctWvea io hMckr it e n ADD INMMEO, the poPa3 *q) must be endorwd. N SUBROGATION LS WAMW. suhiLo m
the un m amt owwoon of the polity, cwtaM poWk ks may mqulm an endomomeld. A chdomwA an,Oft aullfiaals door not colaw rigMS M the
QHWItNe balder U Ilea of such eedotserlrent(s}.
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1344 N. Stm Road 7
Matte. 8.33063
Phone 977-0047 FOR 954 977 -5225
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TM IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED WIRED NAMEQ ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY RFQUIREdENT, TEIOA OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY Be 138UED OR MAY PERTAIN, THE *9K~CE AFFORDED BY THE POLICIES DESCRBED HEREIN IS SUBJECT TO ALL TnE TERMS.
EXCLUSIONS AND CON091M OF SUCH POLICIES. LIMB$ SHOWN MAY WAVE BEEN REDUCED BY PAID CLAIMS.
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CERTIFICATE MOLDER CANCELLATION
CITY OF MIAMI SHORES
BUILDING DEPAt2TMENT
10050 NE 2ND AVE
MIAMI SFIORES. FL 33138
ACORD 25 {mIUM OF
SHOULD ANY OF TM ADM D6SCRIBIBT POUCH BECWFJ I.E'D Btu
TWiEXPSiATIGN DATE THEREOF, NOTICE WILL EA DELMEREO IN
ACCORD9i1{C_F�pMRI WE PGL= PRDVRIOW
1885 X010 ACOM CORPIMTION.-A
ACORD name Nord logo are registered