DEMO-14-445.►
inspection workmlhoet
MIAM1i Shores Vittagei
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: i30 95-2204 For- pospse-a Z
inspection Number: IN$P.2 }85''2 Parmit Number: DEMO -3 -14 4
Scheduled Inspection Date: Apmil 0it,2014 PerM t Type DeMowon
Inspector: Diaz, OsvaWo
tnsp Lion TyOO. FIn41
fir.` FRED 11C PUREN, � PU i Work Cf Ss"qw� Pio.�ing
Job Address* 9179 k SAYSHORE Drive
Miamlfhoces, FL 33138 Phone Number
Parcel Number 100909
Prat
Contractor: R m;RLUMBtNG INC Phone, (405) -618
Settkting D Comments
DEMOLITION FO OLUMBING tM gene
M1t3PECT • , OWM FWW
Inspector Comment
Passed HRS CAN FILE
Failed El
Correction
m
Re4nsplectloo
Pee
No Additional Inspections can be scheduled
m4nspedbn fee is WA
April CfB, 201+i
For inspections please ca11 ' i5)YOZ -4949
Page 12"Of'V
M%4-e� (Y - 44S
DIVISION Of
EMU*Mmfftc HUft
Modda.Health
®,► Miamt Dade County ��
Q� OSTDS/Well D"Mon 0
^- — 11805 SW 261' Street • Miami, FL 33175 O
0 OSTDInspector J ® C' p Date r' 34 j
Address�� 1����/ �a
S # / �I'r U372.7_Z
Comments: '
Signature
AGC R CERTIFICATE OF LIABILITY INSURANCE
M3M3
TIC CERTIFICATE 18 411SUED 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 POLICE
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING =W00). AUTHORIZED
REPRESENTATiYE OR PRODUCER. AND THE CERTIFICATE HOLDER.
IAAPORTANT: N the oeAi. holler ls an Awilo IAI. INSURED. the poUaylies) must be andorsed. If SUBROQAT10N L4 WNVED, 8ubjeot to
the tans and eattditlurs of Bre Polley, certain policies may require an endorsement A statement on this owdricate does flat sorrier rights to flro
09Klfbatahoiderin 11w otsuoh endommmittsl
PAR
Nana Insurance
809 W. Sample Road
Deerfield Beach, FL 33064
Pyle (854) 979 -1110 Fax (854) 582 -5239
NOVUS INSURANCE
(964)M1110- 954 582 -6238
NOVUS INSURANCENHOTMAIL.COM
CUSTOMER
A
NraECe
RSURED
BEAR PLUMBING, INC.ID 344171
PO Box 612255
NORTH MIAMI, FL 33281-
(306) 940.8180
nwipmA: COVINGTON SPECIALTY INSURANCE COMPA
pia e . PROGRESSIVE INSURANCE COMPANY
v4sURERC.
V430M D • FLORIDA CITRUS ASSOCIATION
3 1,000.000
$ 100,000
R UNRF
® CMWERCaL GENERAL LIAetl nY
aWVIKKAQIM CERTIFICATE NUMBER. REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWmiSTANDINt3 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 DESCRY HEREIN IS SUBJECT TO ALL THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMER.
TR
7YPfi OP RSrRMCE
POUCYNUNMER
rJliM
GENERALLIABILIff
EACH -00Ci IRaENCE
3 1,000.000
$ 100,000
® CMWERCaL GENERAL LIAetl nY
A
p p CWM8 MADE &5 OCCUR
❑
Y
N
VBA21569901
12!03!2013
12/0212014
MED EXP one
s 5,000
SAL a AM MURY
S 1000 000
❑
GENERALAGGREGYITE
s 2,004000
P - COMMOPAW
S 1. 000
GEMAGGREOATEUUITAPPLMSPM
El POLY ❑ M p LOG
04448118-3
11123/2013
11@312014
COMSO EO SOMS UWT
CFO accw -Q
E
S 500,000
B
AUT01008 .B LIABILITY
® AWYAUTO
❑ ALL OYYNED AUTOS
❑ SCNEDULEDAUTQ,S
❑ F1 MAUTOS
Y
N
SLY Mere)
S
BODX.YpLNRY(Perecdit
$
PROPEWD
Mefscdd -Q AMAGE
s
❑ NOWNVNEDAUTOS
s
❑
s
❑ SALr48 p OCCUR
EACHOCCURRENCE
S
p EXCESS LM8 CLAtAM MAM
N
AGGRIMM
3
❑ DEDUOMLE
3
3
FErENT10Dl 3
VXNUM COMPENSAT"
W 8 TU• OTN-
0
AND E0PLOYlatS' LIABILITY
'0 "=MWREXCtAM CVTr45YY
(dIyWeau6 r
DESGRIPTIDN OF OPERATX)NS below
NrA
N
106 -52140
04/25/2013
04/2512014
E.LEACHARDENT Is
E.1- EAEMPLOYE
50010w
$ 600000
E.L DISEASE • POLY Lark
f 600,000
DESCRt rw OF OPERATIONS I LOCA1fM 1 vENUX.ES plmah ACOR0101. AdeGtlmral RamrMs Setodula 8 n" epee* la fewhed)
plumbing servios
CFC057720
CERTIFICATE HOLDER CANCELLATION
Miami Shores Village
Building Department
10050 N.E 2nd Ave
Miami Shores, FL, 33138
ACORD 26 (2008108) OF
MOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION D_4R_TH�E�REOF. NOTICE WILL BE DELIVERED IN
ACCORDANCE W1711 THEILOUCY PROVIS IONS.
1
IN. All rfghte reserved.
The ACORD name and logo are ragbitared nu" of ACORD
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
BUILDING
PERMIT APPLICATION
Permit Type: PLUMBING
JOB ADDRESS:
City: �Miami Shores County:
Folio/Parcelk t �' o' // -I . A g� 9N 'q ofy)
Is the Building Historically Designated: Yes
FBC 20
MAR Q,i 20
Permit NoDeln f�-
Master Permit No.4!-�M4
NO x Flood Zone:
OWNER: Name (Fee Simple Titleholder): Fr( (_ 1 r i c + Phone#: - 12-13 -194 2
City:
State:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: CoCommpany Name:
Address: P. U, )( 0�,
— , — r- . u
State Certification or Registration #:
DE3XEl„Plrchitect/Engineer: 6 \a I Phone#:
d� ° °
ue of Work f t�js Permit: $ Square/Linear Footage of Work:
wovo V" °
T oOAdress ❑Alteration ❑New ❑Repair/Replace ®®Demolition
V0 1 11 se�ea�
Submittal Fee 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 $ 2-a a
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 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.
Signature
caner or gent
The fore Ring instrument was acknowledged before me this
day of , by
who rsonally kno me or who has produced =8
As identification and who did taki Drift; _
NOTARY PUBLIC: 1i m
0 ca
Z CD
Sign: 40 3
Print: 8 Q
My Commission Expires: �� l Y, a, m $
MV
APPROVED BY �// /�i Plans Examiner
Signature
&44r—
The foregoing instrument was acknowledged before me this
day of � , 20 �, by 01 �� C� ®1l' ,
who is personally known to me or who has produced
Structural Review
(Revised3 /12/2012)(Revised 07 /10 /07)(Revised 06110/2009)(Revised 3/15/09)
Zoning
Clerk