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Pl-13-1066Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 7952204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION Permit Type: PLUMBING JOB ADDRESS: /25' NE /a( 5 i City: Miami Shores Folio/Parcel #: Is the Building Historically Designated: Yes MAY 15 2013 FBC20L0 Permit No. ?L.i3 --loL 7 Master Permit No..'2: County: MiamiDade Zip: NO v/ Flood Zone: Phone#: OWNER: Name (Fee Simple Titleholder): f -I UPI q L rr© Q(%Saas Address: 126- NE. 049 S T City: MIAMI S1,1 D t S Tenant/Lessee Name: Pfrr Rmail• State: FL- zip: 33/ 3 Phone#: CONTRACTOR: Company Name: tit a p ►s b (R:3 Inc Phone#: (. Address: tot -SSS Ave Sss).-te 494 59 -5-i i1 City: L12 arv� State: C L Zip: .R ,i Sfo Qualifier Name: -Sash.) q cm an Phone#: 005).2'54 - S-7 t I State Certification or Registration #: CrsiCiGpS Certificate of Competency #: Contact Phone#: �-i e) k3 g2 6 2 Email Address: 6 er U i cz Q214::■ i P �� tin b . e orr) DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ SoxD Square/Linear Footage of Work: Type of Work: ❑Address 6l'Alteration ONew ORepair/Replace Demolition tiz 1 Work: / / /owe_ LU4/ir 1 /ht6. and (/r41/1 / /MeS 5- ****** ** *******e********** ***** **** ***Fees7 * *** �********** ***ex�,a�a�a *�ax�******** *****e Submittal Fee $ SO ' u-° Permit Fee $ .2"--)57 ° C ' CCF $ CO /CC $ Sunning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ )4311 2. 11 pending Company's Name (if applicable) N P' Bonding Company's Address City State LP 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 pertained 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven days after the building permit is issued In the absence of such posted notice, the inspection will not < . approved , ° tnspec fee will be charged. Owner or Agent The foregoing instrument was acknowledged before me this day of �? , 20a, by /7f/ ,in err8 &W 5 i Signature Contractor ,� The foregoing instrument was acknowledged before me this 13° Cdr , day of �i 't 20 by (7 0.3 1 /t lc/%�t✓, s personally known to mitt who has produced to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOT Sign: My Commission Expires: *** ***** *** ********** APPROVED BY posPF "t9i.� JUUA A. TAQUECHEL MY COMMISSION #00887882 EXPIRES: August 8, 2013 ild ************* *** *** **** *********a *,* * ******** * ****es*eeeeb NOTARY PUBLIC: Sign: Print US'A a. A ,tit MY COMMISSION # CE 11b744 My Commission Expires: �, p$ 'n �� Nu Budget Maly s Plans Examiner Zoning Structural Review Clerk (Revised3/1212012)(Revised 07 /10/07XRevised 06/lOt2009XRevised 3/15/09) No Drip Plumbing Inc. 7862427634 p.1 ACORD,® CERTIFICATE OF LIABILITY INSURANCE PRODUCER BEACON INSURANCE GROUP INC 8567 Coral Wag #301 Miami., FL 33155 (305)266 -9706 NSURED NO DRIP PLUMBING, INC 12855 SW 136TH AVE, STZ 204 MI. MI, FL 33186 DATEIMMODlY'YYY) 5/29/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INFRA SCOTT SDALE INSURANCE CO. NAIC# INSURERS SCOTTSDALE INSURANCE CO. INSURER C: SCOTTSDALE INSURANCE CO. INSURER C: INSURER E: :OVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. iFIR Ili iDDL NORD TYPE CF INSURANCE POLICY NUMBER GENERAL. LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MACE ® OCCUR GEM. AGGREGATE LIM T APPLES PER: POLICY El JEL'F n AUTOMOBILE UAW YY ANYAUTO ALL OWNED AUTOS SCFEGULED AUTOS HIRIM AUTOS NON -OYVN DAUTOS LOC GARAGE LLABILITY ANY AUTO EXCESS/UMBRELLA LIABILITY OCCUR U CLAIMS MADE RDEDUCTIBLE RETENTION WORKERS COMPENSATION AND EMPLOYERS' I..IABIL I tY ANY 2ROPRIETOVPARTNERfEXECUTIVE OFFICERNIBIBER E EU.CED7 Wpm, claerfbe under SPECIN. sPROVISIONS beEw OTHER GL- 54672 -1 )ATECMI4D "}E 09/23/12 POLICYEXPIRATFON DATE [MMDDM ) 09/23/13 LIMITS EACH OCCURRENCE DAMAL,h ID HEN [ti) PREMISES Es oafrenceT MED EKE' (Any one perszny PERSONAL &ADV INJURY GENERAL AGGREGATE PRODUCTS - CCMP/OP AUG COMBINED SINGLE LIMIT (Ea ecoicert( BOD'LY INJURY (Per person) BODILY INJURY ;.Per acciderl) PROPERTY DAMAGE (Peraocidert) AUTO ONLY- EA ACCIDENT OTFER THAN AUTO ON_ ": EAACC EACH OCCJRRENCE AGGREGATE AGO I I TORY LIMITS l I °ER ESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY UNIT $ ERTIFICATE HOLDER CITY OF MIAMI SHORES 10050 NE 2ND AVE NMANM SHORES, FL 33138 :0RD2512001108) CANCELLATION SHOULD ANY OF TI-E ABOVE DESCRIBED POLICIES BE CANCELLED EE =ORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHAL.. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON 1-E INSURER, RS AGENTS OR REPRE$ENTAT:VES. AUTHOR C REP ATIVE O ACORD CORPORATION 1988 No Drip Plumbing Inc. 7862427634 p2 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 KAUFMAN, JOSFLUIL ALEXANDER NO DRIP PLUMBING INC 12855 SW 136 AVE SUITE 204 MIAMI FL 33186 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. ' CFC056965 ' 07/19/12 120031654 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.myfloridalicense.corn. : - CERTIF/ED- -PLUMBING: CONTRACTOR There you can find more Information about our divisions and the regulations that ' • - KAUFMAN, •_ JOSHUA- ALEXANDER .• Impact you, subscribe to department newsletters and team more about the Departments initiatives. - - - NO DRIP PLTRCRING- INC Our mission at the Department is: License Efficiently, Regulate Fairly. We • • constantly strive to save you better so that you can serve your customers. • - Thank you for doing business in Florida, and congratulations on your new licenset.; -. , • _ " • is • CEETXFZED under the provisiore of CU 489 , exps..sezion data : AUG 3.1 r 2014 : 1,12071901.43.2 (850) 487-1395 MATE CO: FI+01210A • • • AC# sge 2 1 380 iiEPARTiIENT.; OP .80SINESS '...'PR0FE1391.011.1Alis .REGULATxCIN ••• • DETACH HERE AC# 6213804 STATE.OF FLORIDA DEPARTMENT OF BUSINESS:AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD • SEQ# L12071901011 07/19/2012 120031654 CFC056965 The PLUMBING CONTRACTOR • . - : Named below IS CERTIFIED. Under the provisions of Chapter 489FS,• Expiration date: AUG 31, 2014. XAUFMAN, JOSHUA. ALEXANDER NO DRIP.PLUMBING-.INC 12855.SW 136-AVE SUITE 204 MIA/ FL 33186 • . „. No Drip Plumbing Inc. 7862427634 p.3 • MIAMI-DADE COUNTY: TAX-COLLECTOR 140 W. FEADLER. ST..:.. I L.3313D 502343 -7 "AITMEIMige INC 12855 SW 136 AVE 33186 UNIN DADE COUNTY i r%k1r:.ELLSINES$TAX; ECEiPE':e lies. O'01ME'G(WNI4Y: _ spVt0 0 FLORI. EXF!�tT:'3O 2013 lUtijS ii:L1I :AI"EOnT:PI;A `r l46;3II URSI ANT: `Cfl U Y O(Di~;* AJ YER $iq M THIS IS NOT A BILL - DO NOT PAY OWNER PLUMBING INC s196PLB ING CONTRACTOR THIS IS ONLY A LOCAL DUST SS TAN REC®PT. IT DOES DDT PERMIT THE HOLDER TO VIOLATE ANY EXISTING REGULATORY OR ZONING LADS OP THE COUNTY OR CRIES NOR IT DOOEDS FROII NO THHR RERAN' OR LICENSE REMISED PM LAW. THIS IS HOT A CERTIFICATION OP THE HOLDER'S OVALIPICA• TONS. PAYNIEtT RECEIVED IEALIFDACE COUNTY TAX COUECTORt 08/14/2012 60020000330 000075.00 SEE OTHER SIDE 204 ��pTRENEWAL STATE #�o FCe56965 WORKER'S 1 DO NOT FORWARD NO DRIP PLUMBING INC JOSHUA KOUFMAN PRES 12855 SW 136 AVE * 204 MIAMI FL 33186 h I 11 I I11It uj'!1111I Il31I eI II 1 I 111111411 T1II11111TUI 11 FIRST -CLASS U.S. POSTAGE PAID MIAMI, FL :j PERMIT NO. 231 524545-1 No Drip Plumbing Inc. JEFF ATWATER CHIEF FINANCIAL OFFICER 7862427634 p.4 STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the Individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 6/16/2013 EXPIRATION DATE: 6/16/2015 PERSON: KAUFMAN JOSHUA FEIN: 900002666 BUSINESS NAME AND ADDRESS: NO DRIP PLUMBING INC 12855 SW 136 AVENUE MIAMI FL 33186 SCOPES OF BUSINESS OR TRADE: PLUMBING NOC AND DRIVERS Pursuant to Chapter 44a05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05(12), F.S.. Certificates of election to be exempt.. apply only within the scope of the business or trade listed on the notice of elect ion to be exempt. Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt and certificates of election to ba exempt shalt be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for Issuance of a certificate. The department shad revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. DFS- F2 -DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 07 -12 QUESTIONS? (850)413 -1609 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 207839 Permit Number PL -5 -13 -1066 Scheduled Inspection Date: February 27, 2014 Inspector. Diaz, Osvaldo Owner: QUESADA, HUMBERTO Job Address: 125 NE 106 Street Miami Shores, FL 33138 -2036 Project <NONE> Contractor: NO DRIP PLUMBING Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1121360060350 Phone: (305)259 -5711 Building Department Comments REPALCE WATER LINES AND DRAINLINES 2 TOILETS, 2 SHOWERS AND 3 SINKS. Infractio 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- 207506. SEAL PENATRATIONS AROUND CABINET SECURE SHOWER HEAD TRIM FOR WASHING MACHINE GAS PERMIT IS STILL OPEN 1- 1 Ihi O L, cj?2 tfir February 27, 2014 For Inspections please call: (305)762 -4949 Page 27 of 43