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PL-14-428Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-217261 Permit Number: PL -3-14-428 Scheduled Inspection Date: August 07, 2014 Permit Type: Plumbing - Residential Inspector: Diaz, Osvaldo Owner: FRONTAL, RAUL Job Address: 585 NE 93 Street Miami Shores, FL 33138 - Project: <NONE> Contractor: CASTELLON PLUMBING CORP Building Department Comments Inspection Type: Final Work Classification: Addition/Alteration Phone Number (305)609-6700 Parcel Number 1132060141030 Phone: 305-553-1490 KITCHEN REMODEL Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-213501. CREATED AS REINSPECTION FOR INSP-208483. NO ONE AT SITE Failed Correction ZY❑ Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. August 06, 2014 For Inspections please call: (305)762-4949 Page 17 of 26 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: PILUMBING FBC 20 Permit No. Master Permit No. aC Cl JOB ADDRESS: .-ems City: Miami Shores County: Miami Dade Zip: Foho/Parcel#: Is the Building Historically Designated: Yes OWNER: Name (Fee Simple NO Z____ Flood Zone: Address: 6-7- gP i 3 S -,. e, 0 City: f9/��/�� /1On,P_5 State: Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: zrs- 9'.r Address: �%lQ� C/ City: T� Z;! � y �e �i State: ,eF� _ Zip: 00 Qualifier Name: / � �� ►, j' ;�e Phone#: State Certification or Registration #:7 4r Certificate of Competency #: Contact Phone#: Email Address: �� y` �� ~ DESIGNER: Architect/Engineer: _ Phone##: 00 Value of Work for this Permit: $ Square/Linear Footage of Wojrk; :. •.. Type of Work: ❑Address ❑Alteration Ll s ' ' ,J �pair/Replace ` ❑Demolition a Description of Work; ,X,e- A lAe,e 'e veke.� e'e Submittal Fee $�i ` �� Permit Fee $ �-Sa ° ® CCF $ CO/CC $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ DBPR $ Bond Technology Fee $ TOTAL FEE NOW DUE $ I I Y,- 10 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 ilk 1 be apprave4and-a-retedonfee will be charged. _ Signature Signature yr^�sr Owner or Agent Contractor The foreg oing ��instrument was acknowledged before me this The foregoing instrument was acknowledged before me this-4— day his day of ' _, 20) y by 1�1 J aL / 4 , day of 20 / , by �o t . Aw who is personally known to me or who has producedE AS 7 a who is ersonally known to In or who has produced 6 As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: L _ Sign: A C.^ 4 a4 rY Pustwe Of fZ P* Joanna Print:. Ibe-1'� tz /ix u eent:- 3 y Commission Ex E" ou1um18 osarsa My Commission Expires -1P.!":-.'-`, BEATRIZA. Bum * MY COMMISSION 4 EE 052014 0001B0*d EXPIRES: APriI 7,2015 0 ihru Budget Notary SaIM APPROVED BY Plans Examiner Structural Review (Revised3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) Zoning Clerk w STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD 1940 TALLAHASSEE ONR08 STREET TALLAHASSEE CASTELLON, GIRALDO CASTELLON PLUMBING 9841 NW 130 ST. HIALEAH GARDENS CORP FL 33018 (850) 487-1395 s�r�, oFia AC# D$$A1�Ti8SNT F BUSINSSS AND Congratulations! With this license you become one of the nearly one megiUion IsRO $BgIOLA REGULATION Floridians licensed by the Department of Business and Professional R ulation. ; bOuroxprofessionals rs to barbeque restaurants, they from kee aFlhitects to arida's economy strongacht . from _ p CFC019039 05/30/12 110404692 Every day we work to improve the way we do business in order to serve you better. I CONTgACTOR For information about our services, please log onto www.myfloridalicense.com _ANTgLO` There you can find more information about our divisions and the regulations that`CAp . ING CORP impact you, subscribe to department newsletters and loam more about the 33'NLLD>` DepartmenYs initiatives. ; Our mission at the Department is: License Efficiently, Regulate Fairly. We IS CERTIFY>;D unser the provisions of. Et►.489 Fs that you can serve your customers. constantly strive to serve you better So t .. a +sr.esoa ��_ AIIa 31, 2019 L120 ,1001066 Thank you for doing business in Florida, and congratulations on your new license! DETACH HERE STATE OF FLORIDA AC# 6 14 4 91 8 DEPARTMECONSTRUCTION INDUSTRYPRO LICENSING BOARD�ATIO SEW L12053001066 05/30/2012110404692 ICFC019059 The PLUMBING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2014 CASTELLON, GIRALDO CASTELLON PLUMBING 9841 NW 130 ST. HIALEAH GARDENS RICK SCOTT GOVERNOR CORP FL 33018 nISPLAY AS REQUIRED BY LAW KEN LAWSON SECRETARY CERTIFICATE OF LIABILITY INSURANCE DATE U/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: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terns 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 CONTACT First Class Insurance Market PMONt (305)441-2997 1 1W `c. Nor. (305)441-644_3 4101 NW 9th Street aooREss _ fcimc@aol.com_ ' 10/29/2014 Miami, FL 33126 _ _ INSURER(S) AFFORDING COVERAGE j_ NAIC # Phone (305)441-2997 _-- Fax (305)441-6443 INSURER A: WILSHIRE INSURANCE COMAPNY 1,000,000.00 INSURED INSURER B: CASTELLON PLUMBING CORP INSURER C: 2,000,000.00 GEN L AGGREGATE LIMIT APPLIES PER. 9841 NW 130 ST 1_ INSURER D: �� ROD -COM G PRODUCTS P/OP AG $ HIALEAH GARDENS,FL 33018— -- -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 POLICY EFF j POLICY EXP LIMITS TYPE OF INSURANCE -- I POLICY _ (MMS /DD/YYYY) I (MM/DD/YYYY)I INSR 1} 1 ADDL�SU BR 1 GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000.0_0 0 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTEDPREMISES (Ea occurrence) i$ 100,000.00 ❑ ❑CLAIMS -MADE ❑d OCCUR 01028513 A N ' 10/29/2014 MED EXP (Any one person) $ —� 5,000.00 - - ❑ _ 110/29/2013 PERSONAL BADV INJURY $ 1,000,000.00 ❑ - - j GENERAL AGGREGATE $ 2,000,000.00 GEN L AGGREGATE LIMIT APPLIES PER. � �� ROD -COM G PRODUCTS P/OP AG $ 2,000,000.00 PRO- ElSPENT ❑ LOC $ _�---___.-- _—_---_--_-- + —-�--^ AUTOMOBILE - COMBINED SINGLE LIMIT (Ea arxident) _ _-1$ F] ANY AUTO BODILY INJURY (Per person) $ - - - ALL OWNED SCHEDULED ❑ AUTOS ❑ AUTOS N ;BODILY INJURY (Per accident $ — ❑HIRED AUTOS NON -OWNED ❑ AUTOS PRROPERTY DAMAGE $ (Peraccident) --,-- — _-_-- -__ �$ ❑ UMBRELLA LIAB ❑ OCCUR EACH OCCURRENCE r $F_� _ EXCESS UAB AGS_-GREGATE - _ ❑ DED ElRETENTIOagCLAIMS-MADE $ - --- WORKERS COMPENSATION ❑ ❑ q AND EMPLOYERS' LIABILITY Y / N TORYTLIMITS ANY PROPRIETORIPARTNER/EXECUTiVE OFFICER/MEMBER EXCLUDED? • (Mandatory in NH) 1 E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYE $ $ Nes, describe under Dyy OPERATIONS ESCRIPTION un OPERATIONS below �- E.L. DISEASE -POLICY LIMIT I $ - -- DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more apace Is required) PLUMBING CONTRACTOR CERTIFICATE HOLDER VILLAGE OF MIAMI SHORES 10050 NE 2 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. - 19 8-2010 ACORD CORPORATION. Ali rights reserved. ACORD 26 (2010/05) OF T e ACORD name and logo are registered marks of ACORD 11/6/13 Report Viewer • / t 100% JEFF ATWAIER STATE OF FLOWDA CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION • - CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA W ORIMW COMPENSATION LAW CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 11/22/2013 EXPIRATION DATE 1122/2015 PERSON: CASTELLON GIRALDO FEN: 591676886 BUSINESS NAME AND ADDRESS: CASTELLON PLUMBING CORP 9841 NW 130 ST. HIALEAH GARDENS FL 33018 SCOPES OF BUSINESS OR TRADE: LICENSED PLUMBING CONTRACTOR palm nwwd cit 0cwNcew to watft re9druneM dUs DFS -F2 -DWG -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 07-12 QUESTIONS? (850)113-1609 httpsJ/apps8.fldfs.c orWcrrgmrW wer/rewffi wer.asp Odalff--kt pginc9D7Q3gH6TER6ePlOAZ*kZSz5bXKyi)keIEESoPVov'4NIPOPN42XeirDRGXVWbcH... 12 3 000797 Local Business Tax Receipt Miami -Dade County, State of Florida THIS IS NOT A BILL — DO NOT PAY 4W748 BUSINESS NAME/L.00ATION CASTELLON PLUMBING CORP 9841 NW 130 ST HtA W GARDENS FL 3A18 RECEIPT NO. EXPIRES MNEWA- SEPTEMBER 30, 2014 Must be displayed at place of business Pursuant to County Code Chapter 8A — Art. 9 & 10 OWNER SEC, TYPE OF BUSINESS PAYMENT RECEIVED CAMLLON PLUMBING CORP 196 PLUMBING CONTRACTOR BY TAX COLLECTOR Worker(s) 10 CF69059 $45.00 07/02/2013 FPPU07-13-001200 This Local Business Tax Receipt only confirmsent of the Local Business Tax. The Receipt is not a license, pesmiL or a certification of the holder's qualific�.to do business. Holder must comply with any governmental or nongovmnmemal regtdatory laws and requirements which apply to the business. The RECEIPT N0. above muadtfie displayed on all commercial vehicles — for now information. visit.. www.miamidade.aa qty. • ; t -�: �' � �