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PL-14-1664Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-218200 Scheduled Inspection Date: August 21, 2014 Inspector: Diaz, Osvaldo Owner: GONZALEZ, RICARDO Job Address: 150 NW 101 Street Miami Shores, FL 33138 - Project: <NONE> Permit Number: PL -7-14-1664 Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition/Alteration Phone Number Parcel Number 1131010230210 Contractor: AFFORDABLE IRRIGATION, INC Phone: 305-681-6322 liunamg uepartment comments REPLACE EXISTING SPRINKLERS SYSTEM Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction ❑ Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. August 20, 2014 For Inspections please call: (305)762-4949 Page 22 of 27 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 FBC 20 Permit Type: PLUMBING --------- - f T*fi''fi'._Tl JUL 3 0 2014 FY Permit No. Master Permit No. OWNER: Name (Fee Simple Titleholder): 4W 11/'60R A CDyw ZSyle f Phone#: Address: ��.• ( 2�-46rze, vfie,"5X-g j ozogin,' rG. 3-1131 P City: � � �/Ld �• state: L -zip: �3 13/ Tenant/Lessee Name: Phone#: Email: JOB ADDRESS:. / S -a /o / tg / -7 City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: /1— 3101 — 0 23— Da2/6) Is the Building Historically Designated: Yes CONTRACTOR: Company Name: Address: / 17A AV &) / NO Flood Zone: M City: &_V 1% O State: ir—,L • Zip: Qualifier Name: �&.0jiGO �o.r/fS Phone#: �Of 4P 0 State Certification or Registration #: Certificate of Competency #: Contact Phone#:0 ®,Jl3/O-?/D/2 Email Address:�1_ 4ec24W DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ ,I, • Square/Linear Footage of Work: Type of Work: ❑Address O,Alteration ❑New ORepair/Replace Description of Work: e <.! Cc Sf ,b r r �J' .%/ _ • �i �( v 4 Submittal Fee $ Permit Fee $ �� ' �``� CCF $ CO/CC $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ DBPR $ Bond Technology Fee $ TOTAL FEE NOW DUE $ I ❑Demolition 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 "prov3�tnd a reinspection fee will be charged. Owner or Agent The foregoing instrument was acknowledged before me this�� day of 20/k, by who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Signature— C� — -;2�4 W fp� Contractor The foregoing instrument was acknowledged before me this dZ day of M , 20/ by oZrC� .l�` who is rsonally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Structural Review (Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) Clerk 08/05/2014 09:43 3054610121 ClienIM 1682973 04AFFORIRR PAGE 01 1FICATE OF LIABILITY INSURANCE is e'1aA Ire �abIank.ineEI R IV. DATE (MfiAIPCIYTYh I 2!1112014 THIS CERTIFICATE IS ISSUED ASA 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 13Y THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOSS NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, IMPORTANT: if She certificate holder is an ADDITIONAL INSURED, the pollay(iss) muse 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 don not confer rights to the certificate holder in Hsu of such endorsement(s). BB&T Insurance Services, Inc. 414 Gallimore Dairy Road .Shiite F Greensboro, NC 27408 WF -FT PHON,E 888 74S 2217=.N.,,8888278861 RDDR IN6U3Tq&j AFFORDING COVERAGE NAIL 0 INSURER A. Technology Insurance Company 42376 INSURED Affordable irrigation Inc 198 NW 139th St. Miami, 1=L 33168 INSURER 61 INGURRR 0: INSURER D 1 INSURER E: INSURER F 1 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: ISSUEo OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIE=S. LIMITS SHOWN MAY HAVE BEEN REDUCED BYPAIDCLAIMS. O TYPE OF INSURANCE ADD L RR q yD POLiCY NUMBER D NllDo LIMITS GENERAL LIABILITY EACH OCCURRENCE S 00VAIMCIAL GENERAL LIABILITY CLAIMS4 AADE F-1 OCCUR E NTTA nGB $ MED E%P one poison) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS. COMPJOP AGG S GERL AGGREGATE LIMIT APPLIES PER: POLICY TE LOC $ AUTOMOBILE LIASIUTY � Ba�IN�eEDSIN IT S ANY AUTO BODILY INJURY (Porpw2 nt) 5 FOOD W�µ�yjU., D ED HIREO AUTOS NAUTM BODILY lwuRY ewacwwo $ Pur ndd YEDAMAOE $ _ S EACH OCCURRENCE $ UMBRELLA LFAB occult IJmm LIAR OLAIMS-MADL AGGREGATE $ DED I I RETENTION S $ A wARKERSCOMIPENSATION AND Ee1PLOVERS' LIABILITY ANY PROPR qR/ q�NERlEXECUTNE Y/ N CFP CORK I EXOLU0 NIA TWC3396567 1/17/2014 01/17/201 • X WCSTATU oTH+ E.L. EACH ARDENT 51000.000 E.L. DISEASE- FAEMPLQYEiE $1000,000 (Msn0d2= In NH) er : 6FUPPTIONN OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 111.000,000 T1 wn yr vrr,va, •vim+, LQQWRwn t V=niuLG5 (AiWen As vKA 747, ^udinooal Ken101$6 3G1 W&p R InOW spam Im mquin:d) Village of Miami shores Bldg & SHOULD ANY OF THE AIJOVS DESCRIBED POLICIES eE CANCELLED BEFORE THE EXPIRATION PATE THEREOF, NOTICE WILL BE DELIVERED IN Zoning Dept ACCORDANCE WITH THE POLICY PROVI3EONS. 10050 NE 2nd Ave Miami, FL 33138 A,WHORM90 REPRESENTATIVE v�+�ii�+ IIS, 44AKO ®190$-201 O ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are regisWed marks of ACORD #S11846527/M11789805 CMLA JUL 3 0 2014