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PLC-14-1225Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 C — f �,4 -- Inspection Number: INSP-217076 Permit Number: PLC -6-14-1225 Scheduled Inspection Date: August 26, 2014 Permit Type: Plumbing - Commercial Inspector: Diaz, Osvaldo Inspection Type: Final Owner: TANYA DE LA ROSA, OMAR OSMAN Work Classification: Addition/Alteration Job Address: 9101 PARK Drive Miami Shores, FL Phone Number Parcel Number 1132060141370 Project: <NONE> Contractor: SCALTEC USA CORP Phone: (954)439-0359 rsul comments ELIMINATE 1 LAVATORY CAP OFF HOT AND COLD INSPECTOR False WATER AND DRAIN PLUMBING LINE INSPECTOR COMMENTS Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-213996. partial for cap off Failed Correction Needed Re -inspection C' ('4 ►.-�� Fee No Additional Inspections can be scheduled until re -inspection fee is paid. August 25, 2014 For Inspections please call: (305)762-4949 Page 15 of 39 BUILDING PERMIT APPLICATION Miami Shores a Villag Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 LBY' Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC2010 Master Permit No. Sub Permit No. VLC IL_� BUILDING ELECTRIC ❑ ROOFING ❑ REVISION EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL F-IPUBLICWORKS [:]CHANGE CONTRACTOR CANCELLATION ❑ SHOP DRAWINGS JOB ADDRESS: g I o t T"4_ City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): 01,4e% -y L "'?g4V Phone#: Address:y 1 1 >G r� i City: r,"�1 o �� State: " (- Zip: �3 1 Tenant/Lessee Name: �l r> f,-\ 1 \ Phone#: Email• V;y.e __c, 1c; } CONTRACTOR: Company Name: 4-1-j- G e4T-0 , crb&4 Phone#: ®.r?Px Address: J_ V e_4 _'�24 /i City: J _ State: oV Zip: 'A'>0 0' Qualifier Name: State Certification or Registration #: DESIGNER: Architect/Engineer: Iva of Competency #: '%z".rnt Cs� Address: City: State:. Zip: Value of Work for this Permit: $ 350- Square/Linear Footag e of Work: _ Type of Work: F-1Addition❑ Alteration ❑ New Description of Work: 1 t4l` 1 cqn owr- X03- c01 Ct a'4.0(_ k color Submittal Fee Scanning Fee $ ❑ Demolition Permit Fee $ s" - CCF $ CO/CC $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ Technology Fee $ TOTAL FEE NOW DUE $ I � S Q 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 on 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 ane ins tion fee will be charged. �� ilannfiirP / P --� ¢ianotima Owner or Agent The foregoing instrument was acknowledged before me this .- day of J/1 a 20 � by "/— e1Ee22 nV'7 , who is personally known to me or who has produced ,ft Wel 9® As identification and who did take an oath. NOTARY PUBLIC: Sign: f / M COmmISS10t�Twr) Nary Public State of Florida Y Joanna M Feliciano My Commission FF 082753 Expires 01/12/2018 APPROVED BY / -/�/`� Plans Examiner Contractor The foregoing instrument was acknowledged before me thiszo— day of Jt,/Gtlf 20/, byi0V/f4� E�ki wh 'personally know me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: _- TARYPU'BLIU-b FAIEOF FLDRMI Print, w � • . " Patricia Olszewski e mmlSSIOD EE034389 My Commission Expires: ''�.,,„,.:' Expires: OCT.13, 2014 BONDED THRU ATLANTIC BONDING CO., INC. Zoning Structural Review Clerk RevisedO2/24/2014)(Revised 5/2/2012)(Revised 3/12/2012) )(Revised 06/10/2009)(Revised 3/15/09)(Revised 7/10/2007) Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 JUNE 11, 2014 Permit No: PL 14-1225 PLUMBING — OSVALDO DIAZ FBC 107.2 PROVIDE INFO PROVIDE MASTER PERMIT PROVIDE PLANS Plan review Is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, replace them with new revised sheets and place behind the most current page. Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION FORM ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED OR THE VILLAGE MAY MAINTAIN A FILE WITH YOUR INFORMATION FOR A $30.00 FEE PER YEAR. A. '" COPY OF QUALIFIER'S STATE LIC CARD B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE (CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPT) D. .177 COPY OF WORKERS COMPENSATION (EITHER CERTIFICATE OR EXEMPTION) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT C. COPY OF LIABILITY INSURACE (CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKER COMP INSURANCE (EITHER CERTIFICATE OR EXEMPTION) YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 ........................................................................................... BUSINESS NAME: s c ele:x-v BUSINESS ADDRESS: Z,!�L %� ��'r-� /f67 CITY n &cW STATE ZIP CODE �2?dO l -035q BUSINESS PHONE: FAX NUMBER �) �� CELL PHONE () ,��`��' QUALIFIER'S NAME: f��e-/�'%J 1�-- QUALIFIER'S LIC NUMBER: c/�45141a, F7 / E-MAIL ADDRESS OF APPLICABLE): yz-A04eio ww" Lah, Created on 3119109 BY MIM 1 RV 3126109 MWV STATE OF FLORIDA DEPARTMMT OF BUSINESS AND PROFESSIONAL REQUILATXON CONSTRUCTION INDUSTRY LICENSING BOARD 3940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 GROSS, 141CMML SCOTT SCALTEC USA CORP. 4869 KENSINGTON CIRCLE CORAL SPRINGS PL 33076 Congratulations! With this license you become one of the nearly one million Floridians tensed 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. Every stay we work to improve the way we do business In order to serve you better.: For Information about our services, please log onto w+aw.ttt There you can find more information about our divisions and the regulations that Impact you, subscribe to department newsletters and learn 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! DETACH HERE (850) 487-3398 BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954831-4000 VALID OCTOBER 1, 2013 THROUGH SEPTEMBER 30, 2014 DBA:SCALTEC USA, CORP Business Name: Receipt #'PL ING 44N SPMUM/CON Business Type: (CONTRACTOR PLUMBING ) Owner Name: MICHAEL SCOTT GROSS (QUAL) Business Opened:07/13/2012 Business Location:135 E DANIA BEACH BLVD # 2 Ststo/CoUnty/CertfReg:CFC1428701 DANIA BEACH Exemption Code: Business Phone: 954-9 8 41, Z Y Professionals Rooms 8 ff Number of Machines: w qm iypa: Tax Amount Transfer Fee Coulon Cost Total Pak! 27.00 0.0 ;< 0.00 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non -regulatory in nature. You must meet all County and/or Municipality planning WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that It is in compliance with State or local lawns and regulations. Mailing Address: BRADLEY GROSS (OWNER) Receipt #04C-12-00002826 135 E DANIA BEACH BLVD # 2 Paid 07/05/2013 27.00 DANIA BEACH, FL 33004 07/01/2013 Effective Date 2013 -2014 A6.1* CERTIFICATE OF LIABILITY INSURANCE `--' �"��° ' 06n01M4 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($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER IMPORTANT: If the certificate hohler Is an ADDITIONAL INSURED, the poticy(les) must be endorsed. N SUBROGATION IS WAIVED, subject to the term and conditions of the policy, certain polices may require an endoreenent. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsemerrt(s . PRODUCER REEL INSURANCE DBA COVER ALLL INSURANCE 5800 W ATLANTIC BLVD MARGATE FL 33063 OLACT SNE 854- FAXIm 85480555 E -MNL INSURRIWAFFORRING COVERAGE NAICS INSUREMA; MID CONTINENT CASUALTY CO INSURED SCALTEC USA CORP 135 DANIA BEACH BLVD N DANIA BEACH FL 33004 INSURER . NORMANDY HARBOR INS CO 04OL400901240 04126 M4 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 CONTRACTOR OTHER DOCUMENT WITH RESPECTTO 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. TYPE OF UISIRANCE POLICY EFF POLX:Y EXP tuTB A GENERAL LAITY X COMMERCIAL GENERAL RAL LIASIL CLAIMS-MADE-10CCUR 04OL400901240 04126 M4 008!2015 EACH OCCURRENCE $1,00%000 DAMAGE TO RENTE D 1IN i sEXCLUDED NIED Ew ow pmm PERSON&&XWMW 1 000 GENERALAGGREGATE S tQE rL AGGREGATE LUNIT APPLIES PER: X POLICY PRO- LOC PRODUCTS - COMPOP AGO $ AUTOMOBILE LIABILITY ANY AUTO ALL MNEDSCHEDULED AUTOS AUTOS HIRED AUTOS NO COMBINED SMIGLE LIMIT BODILY KRIRY (Per pereafl) 5 BODILY (INJURY (Pm fit) $ PROPERTY DAMAGE $ S UMBRELLA LIAS EXCESS UAB OCCUR CLWAM4r5VMAADEAGGREGATE EACH OCCU EN $ B WORKERS COMPENSATIONv4,STAn1- AND EMPLOYERS' LWBIUrY YIN ANY PROPPJETORIPAffrN1ER1EXECUTlVE[:] OFFICER IB EXCLUDED?N lManaam>y e+� S desvibe under Ow / A NHIC05305 2F8l2014 215 OTH EL EACH ACCIDENT $1 O� E - FA EMPLOYEE1 EL DISEASg - POLICY mr-r s1 OQO DESCRIP I OF OPERATIONS I LOCATXNS IVEHICLES (Akmch ACORO 101, Additional Remarks Schedule, B mom apace lsrwpkw ) REMODELING, PLUMBING, MECHANICAL MIAMI SHORES VILLAGE BUILDING DEPT 10050 NE 2ND AVENUE MIAMI SHORES FL 33138 ACORD 25 (201WW The ACORD name and logo are registered marks of ACORD b_I r, . u1 t=_.-,r--�r