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PL-13-1512Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number. INSP-194775 Scheduled Inspection Date: January 23, 2014 Inspector: Diaz, Osvaldo Owner: BIANCOSPINO, MONICA Job Address: 8821 NE 4 Avenue Road Miami Shores, FL Project: <NONE> Contractor: BAY PLUMBING COMPANY Permit Number: PL -7-13-1512 Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition/Alteration Phone Number Parcel Number 1132060460550 suiming uepartment comments PLUMBING WORK FOR KITCHEN REMODEL Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments PassedE WORK WAS ALREADY DONE WITHOUT A PERMIT BY PREVIOUS OWNER — L:s -i, Failed Correction ❑ Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. January 22, 2014 For Inspections please call: (305)762-4949 Page 3 of 22 Jan 21 2014 12:54PM HP Faxbay Plumbing Co 3054462248 page 2 COLORTI I IS DOCUMENT HASA ED e . PAP Ell 6 31.6 19- 0 STATE OF FLORIDA DEpARTD+lEr1T: pV BII INESg AND PROI¢$ NLATION i Como.... CTION 2:1rTDIISTRY �I+10ENNWB j SEQ# LX20829024 0 29 .20 1:2806x9'8 CP'C05700.7.,::.. .�..:.,,.: TheP�I,tlM13X:NG CONTRACTOR Named 1pelow. S`S CERTIFIED Under the -provisions of ' Chaptei Ex .piratLon date: AUG.31, . `BEANS,. ROiB$RT-: L�YNC9 HAY PLLUM=G: COMPA y > :A 3029 9 W 2 $Til STREET FL 33133. �RICR .SCOTT KEN LAWSON G�OVERNOR DISPLAY AS REQUIRED BY LAW SECRETARY 00120 Local .Business Tax Receipt Miami -Dade County, State of Florida THIS IS NOT A BILL — DO NOT PAY +4519709 SWUM" NAMr =ATION BAY PLUMBING COMPANY 3029 SUV 28 ST MIAMI FL 33133 MCEPT 11O• EXPIRES RENEWAL. SEPTEMBER 30, 2014 4718525 Must be displayed at place of busklees Pursuant to County Code Chapter HA — Art. S & 10 OVMER 9MCL7YP6 OF BUSINESS pAYM$tirr fffit:aBVeO RAY PWMBING COMPANY 196 fiUMBING CONTRACTOR PA MGNr13Y TAX ELCE sa Worker(s) 1 CFt�t67007 $45.00 09/17/2013 TXHS1-13-067396 This Local BaaL►asatiTmt Recut a� aaalFrsle meet of � lace! Bas6mse leu. the B ie oct a p�Iae. permp, a celtlRoes at the hetdn�e �a1�c ala, b do tiaalmse Holder mast eoa►ply eery Osverameat� ar w"Ove mnsatel replatery Isms ad roquirsaumts aTldob appi�to the twataeaa The 9ECEIPT W. aboae melbe displayed on all aoamarolelvahid es — Iftod—pada lade Bao ge-271L For alae iafprntatiop visit Jan 21 2014 12:54PM HP Faxbay Plumbing Co 3054462248 page 1 Client#: 129708 BAYPLUMB �a4C®RDTM CERTIFICATE OF LIABILITY INSURANCE DATE THIS CERTIFICATE 18 ISSUED AS A MATTER OF INFORMATION ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE HOL12f2Q/�S3 CERTIFlCATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGEAFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOE S NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: Ifthe c6l"ITICate holder Is an ADQRIONAL WSURE the term® and conditionsitionsof the polirse Q, the policy(fes) must tw endod. if SUVROGATION 13 WAIVED, subject to t cy, certain policies may require an endorsement. A lStat®ntent on this certificate does not confer rights to the certificate holder In lieu Of such andorsement(s). PRODUCER USI Insurance 139 vices, LLC/CL P.O. Box 141916 P e; 305 Bt39-�O0 1� , 30S tiBg.Sp30 Cora! Gables, FL 33114.1916 305669-6000 1 AFFORDINGCOVERAAE Nace INsu1ow INSURERA: Admiral Insurance Company 24855 Bay Plumbing Company INSuRERe : Brldgetield Employers Insurance 10701 3029 SW 28 St INSURER c Miami, FL 33133.3505 awRERD: THIS IS TO CERTIFY REVISION NUM13ER: THAT THE F'OUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOORTHE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT VYITH 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, ��ggEXCLUSIONS AND CONDITIONS OF SUCH POUCIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TRR TYPE OF INSURAMM EFF P A OENERAL LIABILITY POUCYNUNNER LwrrS X COMMERCIAL GENERAL LIAauTy CA0000172580 1!01/2014 01/01/201 NCE S CIAIMSMADEj OCCUR �ENTED $ MED EXP Ary Qna person) $ PERSONAL B ADV (NAIRY $ GEN'LAGGREGATEUMITAPPLES PER: GENERAL AGGREGATE $. X POLICY FMLOC PRODUCM-COW10PAGG S; AUTOMOBILE LIA any $ ANY AUTO COMB S LIM � IT AUTOS OWNED SC NEDULED OWLY INJURY (par person) S AUTOS HIRED AUTOS NO -OWNED AUTOPEPer BODLYINJURY (Pereoddent) S R E $ UMBRELLALLOB OCCUR $ EXCESS LIAS SMS -MADE EACH OCCURRENOE $ DED PZTENTION111 AGGREGATE $ B t ORKERB CuNg%NSpTtM ANOEMPLOYERV LIABILITY 083028220 =,,FE RIETOWP�ARTNpiIEyF�yErI yVC STA OTH 1/01/2014 01/01/201 X $ (14"C tart In JIM) CLLUUbbEEDD??�' N NIA F1 EACH ACCIDENT $1 'Ir1f Yyee. UPTI N under SON OF CpERaTrvua . e E.L. DISEASE- Fa cues Hurt QM DESCRIPTION OF OPERATIONS 1 LOCATION81! VEMCLM (Aitwh ACORD 101, Add[tlorpt Plumber. R--Iw ed+edtde, amore epaca N ravmreel Miami Shore Village SHOUL.DANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Buliding and Zoning Department THE EW'RATlON DATE THERQOF, NOTICE WILL BE DELIVERF IN 10050 NE 2 Ave ACCORDANCE WR'H THE pOLloy PROVISIONS. Miami, FL 33139-2302 "THORMWREPRE8l9I1'1'AWM ACORD 25 (2010105) 1 of 1 Tire ACORD RaflTe end i 011968.2014 ACORD CORPORATION. All rights reserved. 9S11450282IM11449293 090 are registered maltcs of ACORD CBPZP 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: PLUMBING d; '��,� 43 FBc Zo 151 � Permit No. 13 �' Master Permit Nofl--c I 257Li5la JOB ADDRESS: 9 L Z- I Ave 603 City: Miami Shores County: Miami Dade Zip: -3-3 13 e Folio/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): Address: City: State Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: �/P�/�l� W Phone#:C✓ Address a C Sb S City: 16A C l State: itlL Zip: -3 /�/� Qualifier Name: R0-'- 1F-Vt (3 15i vti ` Phone#: ac , % Y W- % �T- State Certification or Registration #: c G' 04 L' ') Certificate of Competency #:. G Contact Phone#: Email Address: DESIGNER: Architect/Engineer: Phone#: acv Value of Work for this Permit: $ —,*(Square/Linear Footage of Work: Type of Work: ❑Address ❑Alteration ❑New ❑Repair/Replace ❑Demolition Description of Work: ,� � _2 4t) C Submittal Fee $ Permit Fee $ l'111-9 CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ Technology Fee $ TOTAL FEE NOW DUE $ n Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address zip 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 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of c mencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issue In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature caner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this � day of .—, 20 1�_, by 14 o A 4 icA1 � 1 �i G®5 i !� , day of .2013.bv 0 / 16�2 % L &A(A, who is personally known to me or who has produced 'V=- 1Vt;.e- w s p oers Wally kno�wnto who has produced L + CQ. Inv, As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: )rVQPc-- My Commission Expires: f % nnN RERNAN DAR10 OLWM My COUMSSION # EE1949M -40. 4 � EXPIRES: J* 08, 2016 APPROVED BY Plans Examiner Structural Review (Revised3/12/2012)(Revised 07/10/07XRevised 06/10/2009)(Revised 3/15/09) NOTARY PUBLIC: Sign: Print: My Commission GEORGE FELICIANO JR. MY COMMISSION # EE084486 i —PIRES May 31, 2015 Zoning .DAR � 7.07/10jTlU,Q8Ttb6,'l6-0152-59.-. =CFCO- I The P?�OMG Namedbelow1'C,4'it urider t egr;;i0.n`tCsl 01 Expiration date:' AUG 3-1, 2010'- BEAN; it38ERT�'. SAX P16M"�h 3029' S ::28H STREP MIAMI F:L ,4 �f CS =�E CRi fj ` �QF_ L!;?�IDA � �rssrc TION SEO# LOS 671.0006-10 _ (� .� L [MV A > f r Ci�C]R DRAGO / IN'iE11M SECRETARY ti_ L�sz�AUIRE68rY LAV�I 02/25/2010 14:36 3054462248 BAY PLUMBING PAGE 01/01 :.:.... "—; . MASINkIalAddlhD14t9� OQ •,g; u. �:' ::' •.,•T.:�, • l�i CO 5t TAX 2a'o` r M `AT11t' C ; :.:..-.--.^^-� 4 140 ':l�!11+m! �.r i �Itm. ,�, PWV7'Ok�%�• r" •� W F , lot$itFT. X11, �Oi1i.. • ,'• , :. • AFLOOR YWAT PM' Fb�BCl�NE88; . � � Ptll�l�••�II;;WTY.Ck]CtE�P1�AP.'('Eit SA�'.AFkT•. 9:�'i0•• I I": : �: •. `` "' - � �.Q41Ud'1II3!• ` � � • '. •45X9•i' ' ��J�i1S�13t+i�1;f:A„'BEl.G� eK)•Np7'••P,�Y`:(:� ` • NWA Ahs'_ ',,.,,', , ~ . .. •::• :.BRY•PL`�FM�I,N©�:>COII�.��: 51"AT.ERB�3U'Oy`�` 531$3 pt A I •AMT `P•11lhIBEI��'�:fi�ti�t�14T�'^` �`` . I RUN ftomm DO NOT FORWARD W. tnUa BAY PLUMBING COMPANY �w ROBERT L BEAMS •. wnmoa. 3024 SW 28 ST ,. MIAMI FL 33133 �'aavu�r.•r�covm• •. �O'0045.a00 . 20 see OTHFR siDe -.. _.-------------------------------•-- Client* 129709 BAYPLUMB ACOR0. CERTIFICATE OF LIABILITY INSURANCE ATE (MMIDD/YYY1f) D12/27/2012 THIS ERTIFICATE 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 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 USI Insurance Services, LLC/CLPHpN CT N ME: E 305 669-6000 305 669-6030 AIC o Ext : NAIC No P.O. Box 141916 Coral Gables, FL 33114-1916 305 669-6000 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE MAIC 0 INSURER A.- Admiral Insurance Company 24856 INSURED INSURER 13: Bridgefield Employers Insurance 10701 Bay Plumbing Company 3029 SW 28 St Miami, FL 33133-3505 INSURERC: INSURER D INSURER E 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 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. LTR TYPE OF INSURANCE INDRL SSU D POLICY NUMBER Map �F M POLICY EXP LIMITS A GENERAL LABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Fx-] OCCUR CA0000172580 D110112013 0110112014 EACHOCCURRENCE $1,000,000 PREMISES EaEMo Eccufrence s300000 MED EXP (Any one person) $10 000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEMLAGGREGATELIMIT APPLIES PER: 7X POLICY jRa LOC PRODUCTS-COMP/OPAGG $2,000,000 $ AUTOMOBILE LABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS NUTOS ON-OWNEDPROPERTY HIREDAUTOS AUTOS COMBINED SINGLE LIMIT Es acadent BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ DAMAGE $ PeracddeM 4EXCESS UMBRELLA LIAB LAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYED' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? FNI (Mandatory in NH) IDESunder CRIPTIO�N OF OPERATIONS below N I A 083028220 1/01/2013 01/01/201 X wC STL MIT DTH - E.L. EACH ACCIDENT $1 000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE- POLICY LIMIT 1$1.000.000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Plumber. Miami Shore Village Building and Zoning Department 10050 NE 2 Ave Miami, FL 33138-2382 ACORD 25 (2010/05) 1 of 1 #S9167290/M9148893 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 CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ABVZP