PL-13-2623r
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Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 203325 Permit Number: PL-11 -13 -2623
Scheduled Inspection Date: December 30, 2013 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo
Owner: KOHEN, MARCELO
Job Address: 1177 NE 100 Street
Project
Miami Shores, FL 33138-
<NONE>
Inspection Type. Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1132050190350
Contractor: JOE COLE PLUMBING Phone: (954)472 -2242
Building Department Comments
ADD PLUMBING LINE FOR NEW TOILET AND NEW SINK I rassea toommencs
AND NEW POWEDER ROOM. INSPECTOR COMMENTS False
December 27, 2013 For Inspections please call: (305)7624949 Page 7 of 28
Inspector Comments
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
December 27, 2013 For Inspections please call: (305)7624949 Page 7 of 28
Miami Shores Village
Building Department HU 112013
10050 N.Elnd Avenue, Miami Shores, Florida 33138 Q
Tel: (305) 795.2204 Fag: (305) 756.8972
INSPECTION'S PHONE NUMBER (305) 762.4949
BUILDING
PERAUT APPLICATION
Permit Type:TLL BING
FBC 20 AP 3 ' ��
Permit No. A6
Master Permit No. 3 -'o-13 I
JOB ADDRESS: 11 *7 fl N F 1 ® '5F
city. Miami Shores County: Miami Dade Zip; 3Ls j 3
Folio/Pa=W. 11- 3z*05 - n I q - O 5�
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): G I: =-lam' K-C, f 1 � Phone #:
Address: I I rl 9 K F- 1®-0 Sr
city. 1A I R M I S HO mi state. FL- ° Zip; I o3 s
Tenant/Lessee Name: /A Phone #:
Eman: narCe- 1006) fYlio&ore L. Corn
CONTRACTOR Company Name: L CO i L M n -51 M G Phone#: `� 72 e? ��
Address: 10591 W . �&J 04-. S'u 4v,- 10,
city. Va Y o@ state:
Qualifier Name: TO d &P %@
State certification or Registration #: �_ C �%'� � Certificate of Co - -- #: r
Contact Phone#: �S4, +72' 224 Z. � � '
Email Address: � ®� � � � I � P . ina m
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $ 21 ® ®D Square/Linear Footage of work:
Type of Work: DAddress *'Uteration ONew URepair/Replace ODemolition
Description of Work: AD D PWAA b(�1 U KEA f:C, & Q eV TOILEL dW b SAE A
FbE RF a POWDF41. f200M
Submittal Fee $� • Permit Fee $
Scanning Fee $ Radon Fee $
2-5, � CCF $ CO /CC S
DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Stmctural Review $
TOTAL FEE NOW DUE $
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
s•
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 certifced 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 b appro ed nd a einspection fee will be charged.
Si Signature ► e�
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this i Q The fop4ding instrument was acknowledged before me this,
day of GaDeiC , 20 "5 by c.. day of a Y 20 by loe. 691
who is personally known to me or who has produced who is personally known to me or who hag produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
N P EE 1,55991 y
` O? Gnber 27, 2015
L ;Votary Public Underwriters
Ds: NICHOLAS ROSE
PAY COMMISSION # EE078180
EXPIRES March 27, 2015
APPROVED BY JV-/.3 Plans Examiner Zoning
Structural Review Clerk
(Rmised3 /12/2012)(Revised 07 /10 /07XRe4ised 06/10)2009XRevised 3/15/09)
M
Miami shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
CONTRACTORS' REGISTRATION
ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED.
IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR:
A. COPY OF QUALIFIER'S STATE LICENCES
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 JE1THER CERTIFICATE OR EXCEMPTOON)
IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY:
A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER
B. COPY OF LOCAL BUSINESS TAX RECEIPT
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 WORKERS 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
■■ rrrrrrr�Yrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr�
COMPLETE CONTRACTOR'S INFORMATION
BUSINESS NAME: 00t COLE
BUSINESS ADDRESS: 1201 W , Mt 42V %A CITY
STATE ZIP CODE
BUSINESS PHONE: tom)O FAX NUMBER(_)
CELL PHONE (I_) QUALIFIER'S NAME: JOE: )
QUALIFIER'S LIC NUMBER: 2- ( �
E -MAIL ADDRESS (IF APPLICABLE): i ®
a
Created on 3119109 BY MLDV I RV 3;AM MLDV I RV 6127111 AS
j s 62': .1 9 STATE OF" FLORIDA .
tiSS 1R N L �Cii`""_ ION SEQ#L12071300823
1
C Tier the provisions o
Expiration date: AT30 .31, 2
COLS
l aog 31051 c t
I DAVIB ILL 33328
SCOTT EC ECRETARYN
i;Ir3i0 FOR
DISPLAY_AS REQUIRED BY LAW ___
115 S. Andrews Ave., Rm. A -100, Ft. Lailderdale, FL 33301 -1885 — 954 -831 -4000
VAUD OCTOBER 1, 2013 THROUGH SEPTEMBER 30, 2014
DBA:JOE COLE PLUMBING CORP
Business Name:
Owner Name: JOSEPH L COLE JR
Business Location :10392 W STATE RD 84 1Q8
DAVIE
1 Business Phone:
jRooms
i Number of Machines.
9 Tax Amount Transfer Fee
54.00 O.00a
ReC6110 :pLUMSING / /LWN SPRNKL/
Business Type :(CERT PLUMBING CONTR
Business Opened:12 / 12 / 2 0 0 7
State /CoUntyICertlReq:CFC019211
Exemption Code:
lMatmines Professionals
ears _ Coliealon Cost I Total Paid
0.00 1 54.00
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-reguistory in nature. You must meet all County and/or Municipality planning
and zoning requirements. This Business Tax Receipt must be transferred when
WHEN VALIDATED 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. Receipt #05A -12- 00014252
JOSEPH L COLTS JR 4 STE 108 Paid 09/25/2013 54.00
10392 W STATE RD
DAVIE, FL 3
2013 -2014
JOECO -C OP ID: AX
� • � • • ., r
�1C-C7R0" CERTIFICATE OF LIABILITY INSURANCE
�...��
DATE [MMUDDNYYY)
1011512013
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 policypes) 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 Ileu of such endorsement s}.
PRODUCER Phone: 561-3914661
Sena & Whitney Corp Office Fax: 561 - 3384551
Sena & Whitney LLC
190 Glades Rd Slulte C
Boca Raton, FL 33432
CNAME
M N No):
ADDRESS:
INSURER(S) AFFORDING COVERAGE
NAIL 11
IasURERA:Allled P&C Ins co
42579
$ 1,000,0
INSURED Joe Cole Plumbing Corp.
INSURER 8: Associated Ind. Ins. Svcs
23140
INSURER C:
PERSONAL & ADV INJURY
C & F Holdings of Broward, Inc
10392 State Road 84 Su Ite 108
Davie, FL 33324
INSURER °
GENERAL AGGREGATE
$ 2,000,0
GEN'L AGGREGATE LIMIT APPLIES PER:
fiPOLICY FXI %&T LOC
ALrrOMDBILE LIABILITY
ANY AUTO
ALL OWNED X SCHEDULED
AUTOS NON OWNED
X HIRED AUTOS X AUTOS
NISURER E :
$ 2,0001000
INSURER F:
$
$ 1,000,0
BODILY INJURY (Per person)
.- rsTw�wr� ullaaevo. RFVINION NIlM6EF[_
HV V r- 1%^%W G17
THIS IS TO CERTIFY THAT THE 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS.
LTRR
TYPE OF INSURANCE
ADM
IN
SUN
-
POLICY NUMBER
MM(D
MMIDDNYYY
LIMtT3
A
A
GENERALLUIBILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE FV-1 OCCUR
CPGLP05915392710
CPBAPC5915392710
03/0712013
0310712013
03/07/2014
03/07/2014
EACH OCCURRENCE
$ 1,000,0
DAMAG I: TO RENTE
PREMISES Ea occurrence
$ 100,0
MED EXP (Any one person)
$ 5,000
PERSONAL & ADV INJURY
$ 1,000,0
GENERAL AGGREGATE
$ 2,000,0
GEN'L AGGREGATE LIMIT APPLIES PER:
fiPOLICY FXI %&T LOC
ALrrOMDBILE LIABILITY
ANY AUTO
ALL OWNED X SCHEDULED
AUTOS NON OWNED
X HIRED AUTOS X AUTOS
PRODUCTS- COMPiOP AGG
$ 2,0001000
EeMBI tlED SINGLE LIMIT
$
$ 1,000,0
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
A
UMBRELLA uAs
EXCESS LIAS
X
OCCUR
CLAIMS -MADE
ALCP5915392710
03/07/2013
03/0712014
EACH OCCURRENCE
$ 1,000,0
X
AGGREGATE
$ 1,000,0
DED I X I RETENTION$ 10,000
1GEN LIAR
$ ONL
B
WORKERS COMPENSATION
AND EMPLOYERS' UA13MM
ANY PROPRIETOMPARTNERIDECUTIVE YIN
OFFICERINEMBER EXCLUDED?
(Mandatory In NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA A
WC1011870
0310712013
03/07/2014
X WCSTATUT OTH-
TWO LI
E.L. EACH ACCIDENT
$ 1,000,0
E.L. DISEASE - EA EMPLOYEE
1 000 0
$ s r
E.L. DISEASE - POLICY LIMIT
$ 1,000,0
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required)
PLUMBING CONTRACTOR.
MIAMIS6
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
VILLAGE OF MIAMI SHORES
10050 NE 2ND AVENUE AUTHORIZED REPRESENTATIVE
MIAMI SHORES, FL 33138
lJ 1988 -2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010103) The ACORD name and logo are registered marks of ACORD