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PL-13-2534Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 208765 Permit Number: PL -11 -13 -2534 Scheduled Inspection Date: March 26, 2014 Inspector: Diaz, Osvaldo Owner: HARRIS, BRETT Job Address: 1173 NE 103 Street Miami Shores, FL 33138 -2651 Project <NONE> Contractor: BIONIC PLUMBING CORP. Permit Type: Plumbing - Residential Inspection Typh Work Classification: New Phone Number (305)764 -9401 Parcel Number 1122320310070 Phone: 305 -498 -9100 Building Department Comments SET 2 TOILETS 2 LAB 1 KITCHEN SINK 1 HOT WATER HEATER 2 BATHROOMS Infractlo Passed Comments INSPECTOR COMMENTS False Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP- 208652. GAS W/H SHALL BE PLACED ON AN 18 INCH STAND P -TRAPS AT ALL LAVATORIES SHALL NOT HAVE S -TRAPS Pt(k) 64"),j-- March 25, 2014 For Inspections please call: (305)762 -4949 Page 16 of 40 Miami a Shores � o es 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: I ` ska t 1 63 rc_c S '� :w \-TED NOV 0 8 2013 FBC 20 Permit No. P 1 1 3 -,25-3e/ Master Permit No.2(1 ? '4,95 33 City: Miami Shores Coun PAPE Miami Dade Zip: ?-3/ ? Folio/Parcel#: 2. 3 2, rU 0 0 U Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): '�'��'� S Phone#: Address: \ \� 3 �. t ��• -� Sir City: `1'1. c 4,1% ' L1 e_s State: '- L--- zip: -3 3 13 Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: f ( `) 1 k(- ?(Ur"-ti? + r, ( CO3--1) Phone#: J2' 5-- Y % ,R— 3 `-/ i 7 Address: S°t ( SW l Gi rt. c-1-- ,-- T City: 'lL. I State: �� L zip: ? -?1-1-:? Qualifier Name: Cn / 7 � ' i-vL (c Phone#: 3'5".--4- 7 ti - 9i t C.) ti, S t a t e C e r t i fi c a t i o n o r R e g i s t r a t i o n #: `2 (l OK a- 13 - Certificate of Competency #• l 2 L LI t' Contact Phone#: -3 0S' ,k- — el( v 0 Email Address: CIA-fir). ‘.cc) ./� ? C , ✓r 6 C !, L 6 ,.).---. DESIGNER: ' eer. j- -fC Cam► rt (C C ( Phone#: ';J S"--r1 j f - 23 te Value of Work for this Permit: $ ii Square/Linear Footage of Work: Type of Work: °Address DAlteration ONew ORepair/Replace ODemolition Description of Work: 5ef Z 1-01 ! e ��--,� s e r 2 ' (....4) / lei ler ift -t-e s'i yr ' .1-e rr c-,. ertZ EACE- +t******* **** *i r,rtr* ** *,ter* ** ,rrkr p * *saint *** *,t+ irk*** ,k**** * * *,k,ir**,k *** **, **** Submittal Fee $ D O.0 0 Permit Fee $ '.Z.-5 CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State a 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 • A ,Tr--ri which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspec will not be , 'proved and a r • i ection fee will be charged. Signature Owner Signature Agent Contractor The foregoing instrument was acknowledged before me this 22- The foregoing instrument was acknowledged before me this day of 1:1-2'17-15 , 20 13 , by j2FyC C , day of l (D , 2015 by (,AQ ' ( ?-).0),? UC CF''L who is personally known to me or who has produced who is personally known to me or who ha% produced l --t As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: ��,,,,,,, Sign: ,, ::: Sign: Print: Print $ ca : ®%° 4 • My Commission Expii ; i ele . L'�� ©y�,' wo - , its •••••....•• °'' A********** �r**** w****ar *******ar i **** *a�,r,�ar�x ****,xa********* ** * ******* z******* reset *,x tdraat*** ***** .."*.. * ii1tt►na►tl' APPROVED BY /' -ft Plans Examiner Zoning 1 t, It I Structural Review Clerk ;bUiock "107, E 144693 NOTARY PUBLIC: My Commission Expires: (Revised3 /12/2012)(Revised 07 /10 /07)Revised 06 /10/2009XRevised 3/15/09) litit lob_ 000012646 BIONIC PLUMBING CORP D.B.A.: CTQB Construction Trades Qualifying Board BUSINESS CERTIFICATE OF COMPETENCY ROBULCSCK GARY W Is certified under the provisions of Chapter 10 of Miami -Dade County I201 5 tot Ptototitllowil tot julullow Our prafee[sIOInif €ind businesses ratify) trorn architects to yacht brokers, from boxers to barboquo restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridelleense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and team more about the 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. Thank you for doing business In Florida, and congratulations on your new license! it r" 0"1,' • UIVA HORN UEPAk M PRO RF11067135." s. A' DUSINLNt ANL) GULA'ON Ei 07/17/2013 Ci1st'CA :r ®R REGISTEREQ P IM8IN�(a, c ROBULOCK, GARY VItli BIONIC PLUMBING CORD (INDIVIDUAL MUST ,.EE' AL 1 LOCAL LICENSING REQUIRE. MEETS PRIOR TO CONTRACTING IN ANY AREA) HAS REGISTERED under the provisions of Ch.480 FS Expiration date : AUG 31, 2015 L13071/0000510 • The Department of State is leading the commemoration of Florida's 500th anniversary in 2013. For more Information, please go to www.VivaFlorida.org. • LICENSE NUMBER DETACH HERE STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD The PLUMBING CONTRACTOR Named below HAS REGISTERED Under the provisions of Chapter 489 FS. Expiration date: AUG 31 2015 (INDIVIDUAL MUST MEET ALL LOCAL LICENSING REQUIREMENTS PRIOR TO CONTRACTING IN ANY AREA) ROBULOCK, GARY W BIONIC PLUMBING CORP 8011 SW 99TH CT MIAMI FL 33173 VIVA MBA l9[1 RICK SCOTT ISSUED: 07/17/2013 SEQ# L1307170000518 KEN LAWSON SECRETARY GOVERNOR DISPLAY AS REQUIRED BY LAW 090262 Local Business tax Receipt Miami -Dade County, State of Florida -THIS iS NOT A BILL DO NOT PAY 6212286 BUSINESS SIAMEII.00ATION BIONIC PLUMBING CORP 8011S99CT • RECEIPT NO. EXPIRES RENEWAL SEPTEMBER 30, 2014 8479 Must be displayed at 0100 of business Pursuant to County Cede Chapter BA -Art. 9& 10 OWNER BIONIC PLUMBING CORD Workers) 2 SEC. TYPE OP SLIMNESS 196 PLUMBING CONTRACTOR PAYMENT RECEIVED NY TAX COLLECTOR $7500 07/11/2013 CREDITcARD- 13- 002456 1Ttis1aoa1 Balinese Tie* Rece only aosemre entolthe Local Basta Tax. tiro Baaslpt la note to e, rah, or a t}Beatton of the holders ora,todo business. Holder must comply any governmental or rolfflei talregulatorylawsand reinkame vrhla aptly to the business. The RECEIPT NO. sleeve malt IN dbpleyed;on all commercial vehicles »lldia il-le Code Bea Ss. -215. for more intonation, vie@erww.,miamidade aovReiccolfecto` A CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 10/24/13 ,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: tithe certificate holder Is an ADDITIONAL INSURED, the policy(ies) 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 endorsement(s). PRODUCER US -1 Insurance 9808 S. Dixie Hwy. Miami, FL 33156 Phone (305)670 -1422 Fax (305)670 -0013 INSURED Bionic Plumbing Corp. 8011 SW 99 Ct MIAMI, FL 33173- (305) 299 -9741 CONTACT NAME: YOANYS ARMAS PHONE (305)670 -1422 (N (NC, No, Eat): , No): (305)670 -0013 ADDRESS: uslinsurance9808 @att.net INSURER(S) AFFORDING COVERAGE NAIC B GRANADA INSURANCE COMPANY INSURER A : INSURER B : INSURER C : INSURER!) : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS ISTO CERTIFY INDICATED. NOTWITHSTANDING NG ANYIE REQUIREMENT, TERM OR CONDITION VOFB ANY CONTRACT OR OTHER DOCCUMENT WITH RESPECT TOLI WHICH TIHIS 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 MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY EFF POLICY EXP ILTR TYPE OF INSURANCE .INSR WVD, POLICY NUMBER (MM/DDIYYYY) (MMIDD/YYYY) , UMITS SR GENERAL LIABILITY EACH OCCURRENCE $ 1.000,000.00 DAMAGE TO RENTED Q COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ $ 5,000.00 MED EXP (Any one person) [1 El CLAIMS•MADE ]OCCUR Y Y 0185FL00040776 11/09/2012 11/09/2013 A ❑ $500 PERSONAL F. ADV INJURY $ 1,000,000.00 GENERAL AGGREGATE $ 2,000,000.00 ID GENERAL - COMP /OP AGG - $ 2,000,000.00 GEM_ AGGREGATE LIMIT APPLIES PER $ El POLICY ❑ jECT CI LOC COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accrdent) $ PROPERTY DAMAGE $ 1 (Per accident) AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED ❑ AUTOS r 11 NON -OWNED ❑ HIRED AUTOS ❑ AUTOS ❑ UMBRELLA UAB ❑ ❑ EXCESS LIAB ❑ CLAIMS -MADE - ❑ DEO ❑ RETENTIONS WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROOPRIET OFFICER/MEMBER NER E ECUTIVE (Mandatory In NH) If yes, deeonbe unde DESCRIPTION OF OPERATIONS below OCCUR NIA $ EACH OCCURRENCE $ AGGREGATE S $ WC STATU- 0TH- ❑ TORY LIMITS II ER E L EACH ACCIDENT S E.L DISEASE - EA EMPLOYEE $ E.L DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) GL PLUMBING CERTIFICATE HOLDER MIAMI SHORES VILLAGE 10050 NE 2ND AVE MIAMI SHORES , FL 33138 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988 -2010 ACORD CORPORIyi`ION. All rights reserved. ACORD 25 (2010105) CIF The ACORD name and logo-are Ialistered marks of ACORD d INSURANCE 110124/2013 .�- CERTIFICATE OF LIABILITY THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERfIPCATE 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 cestllaato holder Is an ADDITIONAL INSURED, the per) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain polls may require an endorsement A esteemed on Ibis certificate does not confer Hghts to the certificate holder In lieu of such endorsement(s). PRODUCER InterPay Solutions, Inc 639 Cindy Lane West Seneca, NY 14224 WN IAt.I NAM PHONE FAX No, Ex* I , Nor. ADDRESS: DISURERM) AFFORDING COVERAGE NAGS INSURER A: Guarantee Insurance Company INSURED BIONIC PLUMBING CORPORATION 8011 SW 99 CT MIAMI, FL 33173 INSURER B: INSURER C: EACH OCCURRENCE INSURER D: UAMAGe 10 ntn I eu PREMISES (Ea oe urrem e) INSURER E: MED EXP (Any oneper on) INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE POLICY NUMBER _ ti s _ _ _ LIMITS GENERAL — LIABILITY COMMERCIAL GENERAL. LIABILITY EACH OCCURRENCE $ UAMAGe 10 ntn I eu PREMISES (Ea oe urrem e) $ MED EXP (Any oneper on) $ CLANSMADE OCCUR PERSONAL &ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ GEN. AGGREGATE LIMIT APPLIES PER POLICY f JECT • LOC $ _ -- AUTOMOBILE — — — UABIL IY ANYAUTO ALLOWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON-OWNED AUTOS COMSINtD SINGLE-1241 I (Ea accident) BODILY INJURY (Per person) $ BODILY INJURY (Per =Went) $ PROPERTY ( )D $ $ — UMBRELLA LIAR EXCESS UAB OCCUR Ca A MS MADE EACH OCCURRENCE $ AGGREGATE $ BED I J RETENTION $ $ /qX WORKERS COMPENSATION AND EMPLOYERS' UABILLTY YIN N/A E GWGC602001221 -113 35/15/2013 05/15/2014 �i� �T!r•-= - EL EACH ACCIDENT $ 500000 EXCLUDED? (ANrldatayhtrBl) If yes, det gibe under DESCRIPTION OF OPERATIONS belair El. DISEASE- EA EMPLOYEE $ 500000 EL DISEASE- POUCY LIMIT $ 500 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101,Addfiaml RemarksSehhedule,tf maespace Is tegiked) CERTIFICATE HOLDER CANCELLATION Miami Shore Village 10050 NE 2 Ave Miami, FL 33138 I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE "i2j(L R64419. ACORD25 (2010/05) m 1988 -2010 ACORD CORPORATION.AII rights reserved. The ACORD name and logo are registered marks of ACORD