PL-13-1200Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 192520 Permit Number: PL -5 -13 -1200
Scheduled Inspection Date: February 19, 2014 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo
Owner: PEDRO DE MELLO, CYNTHIA DA
rrne-rw
Job Address: 1208 NE 95 Street
Miami Shores, FL
Project: <NONE>
Contractor: NOVO & SONS, INC
Bull
comments
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1132060144100
Phone: (305)444 -7177
PLUMBING WORK FOR INTERIOR REMODEL ..... -__ __......_.._
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
February 18, 2014 For Inspections please call: (305)762 -4949 Page 2 of 63
BUILDING
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
PERMIT APPLICATION
Permit Type: PLUMBING
MAY 312013
FBC 20 1
Permit No. 1
Master Permit No I
JOB ADDRESS: ( � GA !�
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #: 11 -32-0-6
Is the Building Historically Designated: Yes
OWNER: Name (Fee Simple
NO Y.- Flood Zone:
Address: A 12,0'6 NF-- 46 —
City: f "l A W 510 S- State: L zip:
Tenant/I.essee Name: Phone #:
Email:
CONTRACTOR: Company Name: Novt 4 SU125 WC, Phone #: _a06— 444— -7'7
Address: A il aO e-yj 9-F
City: &. ( I' State: 4
Qualifier Name: D 6a Oayo Phone #: 50T, 2 02) ° IS i ,
State Certification or Registration #: _ � 8 � �9 _'t Certificate of Competency #:
Contact Phone #: `305® 4 4 4 -`(''�° Email Address:
DESIGNER: Architect/Engineer. Phone#:
Value of Work for this Permit: $ 1400, 00 Square/Linear Footage of Work:
Type of Work: ❑Address
Des'eriptiou of. Work:.
t:
❑Alteration
❑New
gRepair/Replace
❑Demolition
Submittal Fee $ Permit Fee $ CCF $ �® CO /CC $
Scanning Fee $ C� - Radon Fee $ - � DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $ l =
Double Fee $ Structural 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
zip
City State zip
Application-is, eieby 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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Owner or Agent
The foregoing instrument was acknowledged before me this A
day of 20 by GV/�& DE [4Z4
who is personally known to me o who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign: C�
Print: 5L✓ A ZAi
i _-;�& /3.
wry Pdk - 81041 no"
MICoaaMEOUOata n"
APPROVED BY
Signature ,.:A & &yli��
Contractor
The foregoing instrument was acknowledged before me this
day of , 20aby
All-
who is personally known to me or who has produced
as identification and who did take an oath.
Plans Examiner
Structural Review
(Revised3 /12/2012 )(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)
NOTARY PUBLIC:
Print - Y r
v0 Notary Public State of Florida
My Commissio �; Josephine FeWel
3` My Commission EE 884829
or woe Expires 08/1S/2017
Zoning
Clerk
CERTIFICATE OF
PRODUCER Morgan Insuranoe Group
13155 SW 42nd St S 107
Miami, FL 33175
Phone (305) 222 -9001 Fax (305) 222 -900r;
INSURED NOVO & SONS INC
4470 SW 2 St
Miami FL 33134-
LIABILITY INSURANCE DATE ;� 13""r)
_ f THIS CERTIFICATE I$ ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
aL7Egl 7HE• C_ SZ� %�R!►.SzE.LIF.Ei�R.�ItiS2.I;sY 7�.P_S�4iC.Ll�B �1,01N.
INSURERS AFFORDING COVERAGE NAIC 0
INSURERA: AMERICAN VEHICLE_IN3URANCE
I.INSURER 8:
'INSURER C:
305 444 -7144 IN_SURER,D: ,• ,•
_ .. . - ......_.: .....
- I INSURER E.
COVERAGES
HE
TPOLICIE8 OF INSURANCE LISTED 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 C9RTIFICAT9 MAY BE ISSUED OR
MAY PERTAIN. THE INSURANCE AFFORDED SY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO
ALL THE TERMS,
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
EXCLUSIONS AND CONDITIONS OF SUCH
SRI ny. Immi TYPE OF INSURANCE
I POLICY NUMBER lRITLICY eFFECTIVE IPOUCY EXPIRATION
f E�MMllounYY!f,jLO�ATE.CaLM!t9?! LIMITS
GENERAL LIABILITY I
J COMMERCIAL GENERAL LIABILITY
.
EACH OCCURRENCE
DAMAGE YO lkE�1M .. �
300,000
GLO5004000701 03/03/2013: 03/03/2014
I ❑ ❑ CLAIMS MADE W
PREMISES (Ea q= rrer4e) -
MED EXP
60,000
OCCUR
!
(Any One Person)
I
5,000
_ -I : ❑
PERSONAL S ADV INJURY I
100,000
❑
i
I GENERAL AGGREGATE
100,000
' GEN'L AGGREGATE LIMIT APPLIES PER !
PRODUCTS - COMP /OP AGG
100,000_
❑ POLICY ❑ PROJECT ❑ LOC
AUTOMOBILE LIABILITY
❑ ANY AUTO
COMBINED SINGLE LIMIT
(a accident)
_ [-I ALL OWNED AUTOS !
] SCHEDULED I
I
L AUTOS
L] HIRED
Ter pr rsoINJURY
(Per pen)
j
I AUTOS
NON OWNEO AUTOS
BODILY )NNJURY
(Per SpCideny !
!
❑.... ..... _.......
..
i
PROPERTY DAMAGE
� (Per eaadent). { ...
�
LIABILITY I
.. •.._.._ . — �
- m
f AUTO ONLY - EA ACCIDENT {
I
��••GARAGE
❑ L _{ ANY AUTO
I
I OTHER THAN EA ACC
I[] —
- ^—
-�
I AUTO ONLY: AGO
EXCESS / UMBRELLA LIABILITY
EACH OCCURRENCE
i
❑ OCCUR ❑CLAIMS MADE
AGGREGATE
I
❑ DEDUCTIBLE
I
'❑ RETENTION $
{
w
WORKER5COMPF_PISATiUNAND _ .. _... i .. _.__. —
-.•• -
❑ W STATU- ❑ 0TH-
TO LIMIT; ER �
! EMPLOYERS' LIABILITY Y/N i
!
Y
I
ANY PROPRIETOR/ PARTNER /'EXECUTIVE
I
E.L. EACH ACCIDENT
I OFFICER/ MEMBER EXCLUDED?
i
i (Mandatory In NH) ;
E.L. DISEASE - EA EMPLOYEE
- • --•
11 yea, describe under
19.L. DISEASE -POLICY LIMIT
OTHER I !
IESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED ISY ENDORSEMENT I SPECIAL PROVISIONS
'LUMBING CONTRACTER I
CERTIFICATE HOLDER
MIAMI SHORES VILLAGE
BUILDING & ZONING DEPT
10050 NE 2ND AVE
MIAMI SHORES, FL 33138
ACORD 26 (2008!01) OF
TO 39Vd
_CANCELLATION
SHOULD ANY OF THE ABOVE D98CRIBF -0 POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO
THE LEFT, BUT FAILURE TO DO SO SMALL IMPOSE NO OBLIGATION OR LIABILITY . !
(
OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES -
AUTHORIZED REPRESENTATIVE
"' "' 1858.2009 ACORD 41,
The ACORD name end IOV marks of ACORD
Ttfi :ZT ETOZ /E0 /01
10/03/2013 12:41 1
'I--I ... -
JEFF ATWATER
CHIEF P'otA emL OFFICER
I
W.
STATE OF FINANCIAL SERVICES
DIVISION OF WORKERS' COMPEjy a,. ION
09 -24 -2012
PAGE 02
* * CERTIFICATE OF 13E 18N To 13E EXEMPT FROI1d FLORIDA WORKERS' COMPISNSATION LAW � e
CONSTRUCTION INDUSTRY EXEMPTION
This certifies that the individual listed below has elected to be exempt from Florida Workers, coittpensation law.
EFFECTIVE DATE: 09124/2py2
PERSON: NOVO EXPIRATION DATE: 09/24121D14
FEIN: S9'1 ROBERTO
70f8$0
BUSINESS NAME AND ADDRESS:
NOVO AND SUM INCORPORATtD
4470 SW 2No ST
MIAMI FL 33134
SCOPES OF BUSINESS OR TRADE;
1- PLUMBING Ia10C AND DRIVERS
IMPOWANT' Po►seapt 10 Chapter 440 . 15110, F.S., ao offtcet e1 o corporatloa who elem9 es
secttee may not mess o Dtrad7ta or aampensaOne aedor tats c exemption from tbla cbapter by filing a Cere11409 el election ender
SCOpa of me business or fade listed an iba aotfce of elactton rot be pursuant to Chapter 440.0iW123, F.S., Ceniffcatee of ela tan to bo apply o I
exempt. PaIN"I to Chattier 440.15(131, F.S., notices of efactfaa is bePettempa d cernficates�91
4lect1o0 ro De exempt Skeff ba soblecl to rerooteioa N, et any time after the filing of Ike notice at the ismiabcs of the certificate, the paean rrsme4 on the notice or
certificate no e logger ate to m rathe raebir of tbl8 section for issaaaee of a certificate. The doparmteor shalt revoke a eertitiene. s1 any time for tenors of tae Person
acme. ea the Certificate to weer the rapairotgoNtg of this section.
IWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT NVISEO Ot ^11 nUEMONSt !8501 413 -1609
PLEASE CUT OUT TfIF CARO BELOW AND RETAIN FOR FUTURE REFERENCE
01AIr- Or FLQKWA
DWARTi 11011T 01= FINANQkL SEKvIcES
DIVISION OP V4ORK9RW COKV9M iATkW
CONSTRUCTION rNPUSTRY
CERTIFICATE of ELECTION TO BE Ex60 T FROM FLORIDA
WORKMW CATION LAW
EFFECTIVE 08/24/2012 EXPIRATION DATE
PERSON ROBERTO NOVO
FEIN: 381701880
BUSINESS NAME AND ADDRESS.
ROVb ANO SONS RIC000RATIM '
4476 SW ZKD ST
MIAMI, Ft 33134
SCOPE OF BUSINESS OR TRADE
1. PLUBMING NOC AND DRIVERS
IMPORTANT
PurSuetlt to Chapter 44(1.05{14), F.8„ an officer of a corporation wire
D elects exemption from this chapter by filing a certificate of election
under this section meY not recover benefits or cmYW ONtion under this
09/24/2014 H Porsumn to
Chapter 440.05!121, F.S., Certificates of eteckian'b :jm
Rexempt„ apply on1Y within the scope of the business or trade fh ttld an
the notice of election to be exempt
E Pw5te11t to Chapter 440.05 {13), F.S., Notiaes of election to be exempt
mid certificates of election to W exempt shall be Subiect to revttG don
it, Qt MY time after the filing of die notice or the issuance of the
certificate. tiff: person named on the notice or certificate no Imlgw nets
the requirements of this Section for lssumtne of a certifiixam The
depertMnt shall revoke a certificate at arty time for foikire of the
person named On the certificate to most the re umirmnents of this
Section.
O.IJESTiONsf f850) 413 -1609
CUT HERE
• Carry bottom portion on the Job, keep upper portion ifor your records.
i
NC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01-11
10/03/2013 12:41 1
STATE Of FLOMDA
OF BUSIMSS am PROFS
CON MUCTION nWUBMY LICENSING
• x.94 NOUTH MONROR STRMU
TALLAEUBRE FL 32399-07
NOVO, ROBRRTO
NOVO & SONS INCORPORATED
4470 SW 2 ST
MI FL 33134
AC# 61 SO 6 4 2 WrA*M CW
ILI
1-07102/203.21220084267.
The
.NaMed below 14 XFX
Under the provisican of,cbapt,
Expiration dates KUG 31# 20
5111T
NOVO,
NOVO R &18 T-M RPORN'Tw
4470 SW T
TA= 2 S YL 33134
- I
RNMUTION
PAGE 03
(OSO) 497-1395
AC# 9 ABE) rm Ac 2
ARTMOT, OF
CFC142 6337 120002967
le
R
& :9
NOVO
WO 13t. 20,14 =20"2#000
GEQNL3L2*7020"28
m L&WWx
r
-6 SY• 'LAW
10/03/2013 12:41 1
q . ,
%W74
W74
Local Business Tax Recer"
Mlarnl -Dads County. %ts of Florida ..
.t" 18 NOT IM- PC Nflr MY
E
S=ff E
NW a sty Prot:
44470 SW 2 Sr
MIAMI FL 33134 "
LBT
EXPIRES
MUM 00 dI4W ��pW" Of bVilinm
lour~ wn to County too
CMPNP &A - Ass. S i to
OWNti1 BEG. rfm p' mY*wG=
NOVO A SONS INC Ise PLUMI NN4 CONTRACTOR PAYMINT ORNPAd
Waft ft 10 CFC.14MV By TAN OOLLIGM
845 7/I 6/1013 OW
aMawkvm Ig q TXHS I•-t ��#M Wgissmalimm
The Realm No, ebb" Oft Na dilrWW ossu ser s"W "WIN -Mbobb Cods Ida %.a&
PAGE 04