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PL-14-476e - Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 208791 Permit Number: PL- 3- 14-476 Scheduled Inspection Date: March 19, 2014 Inspector: Diaz, Osvaldo Owner: SCHAEFER, NORAH & PAUL Job Address: 47 NE 93 Street Miami Shores, FL 33138- Project: <NONE> Contractor: MARLIN PLUMBING OF MIAMI INC Isunamg uepartment comments PLUMBING WORK AS PER PLANS Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number INSPECTOR COMMENTS False Inspector Comments Passed r", Failed J Correction Needed�� 3 Re- inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. 1132060130390 Phone: 305 - 652 -6108 March 18, 2014 For Inspections please call: (305)762 -4949 Page 29 of 51 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 MAR 12 2014 FBC 20 Permit No. Master Permit NoA� 1 — Z JOB ADDRESS: I-)'-? nE City: Miami Shores County: Miami Dade Zip: 331P'J$ Folio/Parcel #: ► 13 ;kV '�0_61110 Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): ®Q (C 11 IC. Sii lfe�r_ Phone .: 3p .rte 8 ee Address: City: M i CLM i State: Zip: Tenant(Lessee Name: Phone #: Email: 1--)�; k S 0 Ugh - V-)� CONTRACTOR: Company Name: M t • ( �! Phone; Address: �201q_5 Al City: Vi e4: A State, / Qualifier Name: �e4: � � PO . �GS PP— Phone: C Zip: 3 State Certification or Registration #: Certificate of Copetency #: Contact Phone #: fL 6 ®J/ Email Addresc s: DESIGNER: Architect/Engineer: Ct�f:; Phone #• 2k ^ A) T< - k1 Value of Work for this Permit: $ Square/Linear Footage of Work: Noe, e, � Type of Work: ❑Address1lterdhon= ;. ONew ORepair/Replace _ DDemolition Description of Work: �.t�-c Jrser� C` j:n� =ti tS'c �,c�,Q�v.¢�• ,�, g� G:�t crrA' L,�,� Submittal Fee $ AEO • Permit Fee $ Scanning Fee $ Radon Fee $ Nota Training/Education Fee $ Double Fe $ Structural Review $ CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ 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 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature �` Owner or Agent The foregoing instrument was acknowledged before me this 10 day of , 20 ! 4 by A) O,-a h ,�GAae&C , who is personally known to me or who has produced 5 /6 6,3 1 3.59 o As identification and who did take an oath. NOTARY PUBLIC: Sign: ,goanna M Feticiano My Commission FF 082753 Expires 01/1212018 Signature V/ o ctor The foregoing instrument was acknowledged before me this day of QIC 204, by _J�d - (lj& /ceY SN who is personally known to me or who has produced% a2, �s� 3, /j}as identification and who did take an oath. NOTARY PUBLIC: Sign: T No�rY puWte State mission FF W4 1i=018 �a ~; APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised3 /12/2012)(Revised 07 /10 /07XRevised 06 /10 /2009)(Revised 3/15/09) - 10/24/2013 11:34 3 056523135 AC# 8310780 - MARLIN PLUMBING STATE OF FLORIDA .•1 fl 829.2ti°* 0B 28 20 FG _ SING CONTRACTOR � •my; The PL IS C$R lamed below p cf rQvisiona or 'Under the date : AUG 31 E EDWAR2? MARLIN PL RING OF MIAMI NORTH M MT BEACH FL 33779 SE R'BTARX AL W � •—� RGOVERNOR 0043 rlRur- U1/ Ui t. SEQ# L120828o1972 , ;;ft aFart.. .1V�1B�Ctf.ti 2503455 er�ocar�ota ,IjENEWAL , ,APrRI -W PLU.Milt OF'NA ' WC sa tV1k;fI.33t79 . �. SBO. TYPE OF BUSINESS' PAWLI�EYiENEO ova" 195 PL1} RING CONTRACTOR BY TAx l,�LLECro� MARLIN PLUMBING OF MIAMI INC CFC0401t $75.00 S7'F%11/20T•3 WusRer(s) l `TXmsJ -- 13423314 al 8asiocss TWL The Reoipt is Dot a licens& Business Tare AecOipt u�Y coMlrma yfthB`LoC th any gWj*mnmmal or Ttirslacai pl.dutess Ho40!' permit or a certificnaon Of the f *WW'seq°nriem 'to the bwt ': .• aapgovar mortal ragnlatory lewsem4 q cede See 81►116 a eaun all ca ''q icial vebi TheRECEIFTNO.abevasmstb9 l Y ,;�•r...;. . Fp► mweiDfe�tion:llfSN www,�iamidfll�~ DATE (MM/DDNYYY) CERTIFICATE OF LIABILITY INSURANCE 11/22/2013 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 endorsements) PRODUCER (eyes Coverage Insurance 5900 Hiatus Road Famarac FL 33321 INSURED Marlin Plumbing of Miami, Inc. 20145 N.E. 16th Place Miami FL 33179 5937 E: RFVISIAN NUMBER: COVERAGES I L!'tV r I vvv _fH_1S HE IS TO OR CONDITION OF ANY CONTERACTT OR OTHER DOCUMENT WITH RESPECT TOLIWHICH THIS INDICATED.CNOTWITHSTANDING ANYIREQUIREME TN TERM THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. A DL R POLICY EFF POLICY EXP LIMITS INSR • LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MM/DD MM/DD A 1 GENERAL LIABILITY Y Y 2589416 /812013 /812014 EACH OCCURRENCE $1,000,000 DAMA E TO RENTED PREMISES Ea occurrence $100,000 I^ COMMERCIAL GENERAL LIABILITY — -1 X MED EXP (Any one person) $5,000 J CLAIMS -MADE OCCUR PERSONAL 8 ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OPAGG $2,000,000 r_1 l POLICY X PRO LOC $ UUMI AUTOMOBILE LIABILITY Ea accident $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ AUTOS AUTOS NON -OWNED 9 I Per accident HIRED AUTOS AUTOS $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ $ B DED I I RETENTION $ WORKERS COMPENSATION Y 30 -25781 1211/2013 21112014 X WCSTATU OTH- E.L. EACH ACCIDENT $1,000,000 AND EMPLOYERS' LIABILITY YIN ANY PROPRIEfOR/PARTNER/EXECUTIVE [ N L A OFFICER/MEMBER EXCLUDED? LJ E.L. DISEASE - EA EMPLOYE $1,000,000 (Mandatory in NH) onbe undeOF r IDEf yesSC, E.L. DISEASE - POLICY LIMIT $1,000,000 RdesIPTION OPERATIONS below ' I DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) PLUMBING CONTRACTOR u- TOWN OF MIAMI LAKES 6601 MAIN STREET MIAMI LAKES FL 33014 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE HE EXPIRATION DATE HEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 2 r_. woes nnwn Arnon r+noor%0ATInM All rinhfa rmarvFa[i_ ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD