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DEMO-14-2209Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-222557 Scheduled Inspection Date: November 04, 2014 Inspector: Diaz, Osvaldo Owner: ATASH, KARIM & METIS CORINA Job Address: 1195 NE 100 Street Miami Shores, FL Project: <NONE> Permit Number: DEMO -10-14-2209 Permit Type: Demolition Inspection Type: Final Work Classification: Plumbing Phone Number (305)790-5551 Parcel Number 1132050190360 Contractor: A&C PORTELA PLUMBING INC Phone: (786)547-4611 Building Department Comments DEMO AS PER PLANS INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-221245. no access and stop ��r work posted by building official Failed LA -6 Correction ❑ Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. November 03, 2014 For Inspections please call: (305)762-4949 Page 25 of 33 Miami Shores Village Building Department OCT ®s 2014 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 By- Tel: LINE PHONE NUMBER: (305) 762-4949 FBC 20 /0 I �j BUILDING Master Permit No. -Demo PERMIT APPLICATION Sub Permit NoDd6w/ ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL 'PLUMBING F -]MECHANICAL ❑PUBLIC WORKS F -]CHANGE OF E]CANCELLATION ❑ SHOP p�- CONTRACTOR DRAWINGS JOB ADDRESS: ( lAl L < 0 0 l— �a 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): )`t hi k.L n` 4-1 SH Phone#: 5- `7 ! o - 5 7 5 / Address: L(2 5 Z if'- 100 S- City: &z Ani .T S "N c) RES State: 1" Zip: -3 '3 ( 1 Tenant/Lessee Name: Phone#: Email: ��� (�7./x ia-� A-5-44 la-�) 6,4iA: -1 -004A 51`� c` �! VM �1 j /) L CONTRACTOR: Company Name: h Phone#: Address: avSW 33 "Yyt City: mi lei State: i:t zip: 33 i 3 3 Qualifier Name: ��U� �I fid Wi� Phone#: State Certification or Registration #: C 0 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: t Zip: Value of Work for this Permit: $ rj o 0 i Square/Linear Footage of Work: � `•I co a Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace 14KDemolition Description of Work: "V> r4 _ o t X T J-- 0 ,�/ S ��� �� -p6t �1S R V t Specify color of color thru tile: Submittal Fee $ Permit Fee $ ldo = CCF $ CO/CC $ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ (Revised02/24/2014) DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ C . 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 L � v 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 ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, 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 oc s seven (7) days after the building permitf�ssued. in the absence of such posted notice, the inspection will not be ap rove and a reinspection fee will be charged. ' a Li'�— Signature Signature OWNER or AGENT The foregoing instrument was acknowledged before me this �®) day of ®cf o belf> 20 by .,who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: Print CAA :: NATALIA LARA Seal: ;� _ My COMMISSION # EE124,530 -�:?, �,.•' EXPIRES September $0, 2015 APPROVED BY (Revised02/24/2014) as CONTRACTOR The foregoing instrument was acknowledged before me this 106 day of 06 0 62 , 20 14 � , by , who is personallyknown to me or who has produced ?;54– 1by – S o–�?T((,, - y • as identification and who did take an oath. NOTARY PUBLIC: Sign: LA– DL LV LLQ Print: C _ E;: TALIIA LARA -- Seal: My COMMISSION # EE124530 '' ,•.' EXPIRES September 30, 2015 Plans Examiner Zoning Structural Review Clerk ,d#61 i ® CERTIFICATE OF LIABILITY INSURANCE �...� ° 01/05/2014 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 pol(cy(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 CONTACT NAME: ESTHER VIDAL MUTUAL INTEREST ASSURANCE PHONE305 860-2003 FAXCAm. ti, m,1:305-860-0907 9295 CORAL WAYE-MAIL �,MUTUALA OI—COM SUITE 3 MIAMI, FL 33145 INSURERS AFFORDING COVERAGE MAIC# INSURER A: GRANADA INSURANCE CO. INSURED A & C PORTELA PLUMBING, INC 2655 SW 33 AVENUE INSURER INSURER 6: INSURANCE PERSONAL & ADV INJURY $ 1,000,000 INSURER D: INSURER E: MIAMI, FL 33133 S INSURER F • ""VY ftmI [=FK [ [F[[:Ll [ F N[ [MKFK• WF Ml"w WE [MKFw- 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. LLTRR TYPE OF INSURANCE AIM SUERPOLICY NUMBER -- POLICY EFF POLICY EXP A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE E OCCUR GL -113937-3 1/20/2014 1/20/2015 EACH OCCURRENCE S 1,000,000 DAMAGE a 0 Eaaaamenoe) S 50,000 PREMISESS (Ea MED EXP (Arty one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE S UK' 000 GEML AGGREGATE LIMIT APPLIES PER: POLICY 7 PRO- JECLOC PRODUCTS - COMP/OP AGG S 2,000,000 S AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS AUTOSED Ee accid�Dit I GL IT S BODILY INJURY (Per person) S BODILY INJURY (Per accidenri) $ PROPa DAMAGE S ' S UMBRELLA UAB EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE S AGGREGATE S DED I I RETENTIONS S C WORKERS C°nRS LIABILITY An°R AND EAWLOYERS' LI ANY PROPRIETOR/PARTNEP.CUTNE YIN OFFICERIMEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, desvibe under DESCRIPTION OF OPERATIONS below N/A WC-60262-3 1/13/2014 1/13/2015 T RV LIh11T5 ER_ E.L. EACH ACCIDENT $ 1,0w,000 E.L. DISEASE -EA EMPLOYEE S 1,000,000 E.L. DISEASE - POLICY LIMIT S 1,000,000 oEscmPT10N OF OPERATIONS I LOCATIONS I VEHICLES (ANaeh ACORD 101, Additional Remarlm Satredub, If more apace Is required) PLUMBING CONTRACTOR CITY OF MIAMI SHORES VILLAGE 10050 NE 2ND AVE BUILDING DEPARTMENT MIAMI SHORES, FL. 33138 SHOULD ANY OF THE ABOVE THE EXPIRATION DATE M ACCORDANCE WITH THE ROIL D POLICIES BE CANCELLED BEFORE NOTICE WILL BE DELIVERED IN ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (20101051 The ACORD name and loao are realstered marks of ACORD RICK SCOTT, GOVERNOR LICENSE NUMBER KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD The PLUMBING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 PORTELA, DAVID A&C PORTELA PLUMBING, INC. 2655 SW 33 AVE MIAMI FL 33133 • ISSUED: 06/04/2014 DISPLAY AS REQUIRED BY LAW Al SEQ # L1406040001604