PL-13-2185In
Inspection Worksheet
Miami'Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-199940
Scheduled Inspection Date: February 03, 2015
Inspector: Diaz, Osvaldo
Owner: KILPATRICK, JOHN
Job Address: 621 NE 92 Street 3-A
Miami Shores, FL
Project: <NONE>
Contractor:
PRO -BOWL PLUMBING INC
lsuuamg uepanment comments
KITCHEN AND BATH RENOVATION
Passed
Failed
Correction ❑
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
w� 11107
vZ
Permit Number: PL -9-13-2185
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Addition/Alteration
Phone Number (305)910-1581
Parcel Number 1132060430090
INSPECTOR COMMENTS False
Inspector Comments
2°
Phone: (954)520-0000
February 02, 2015 For Inspections please call: (305)7624949 Page 1 of 41
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BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT
115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000
VALID OCTOBER 1, 2013 THROUGH SEPTEMBER 30, 2014
DBA: Receipt #:PL INN/Lata SPRNKLL1C
Business Name:
PRO—BOWL PLUMBING INC Business Type: YP (PLtrMaznic corrrRACrTOR)
Owner Name: SCOTT S mcr.ARY Business Opened:08/12/1997
Business Location: 12134 WILES RD State/County/Cert/Reg:CFC054102
CORAL SPRINGS Exemption Code:
Business Phone: 954-346-9873
Rooms Seats Employees Machines Professionals
3
For Vending Business Only
Wumberof Machines; Vending Type:
Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid
27.00 0.00 0.00 ff:V0 0.00 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 laws and regulations.
Mailing Address:
SCOTT S MCGARY Receipt 6034-12-00003305
12134 WILES RD Paid 07/17/2013 27.00
CORAL SPRINGS, FL 33076
2013 .2014
Miami Shores village
Building Department
117(}.5() N.E.2nd Avenue, ]Miami .giores, l=k_,rida 3 l3$ qjp�'
Tei: (305) 795.2-204 Fax: (305) 756.8972 wW9�
INSPECTION'S PHONE NUMBER: (3041 ?62.44�i9 `w SEP 66 5
tbFBC 2410 t--------- -m
U
em
LDING Permit No. )15 -'o`nnI �
PERMIT APPLICATION plaster Permit No.��l
Permit Type: PLUMBING
JOB ADDRESS: (0 11 Ne 4'Z AFI W k
City: Miami Shores County: f" Miami Mde lip:
N)liotpa wel*
Is the Building Historically Designated: Yc:s NO � F (W Zone:
OWNER: Name (Fee SimpleTiticlx)kler): If --1 ped, l- Phone#:
Ackire s' (A ci Z 41
t
City: ice, t P State: 1 Zip:
Tenant/Lessee Name: l'laone#:
CONTRACTOR: Company Name: kra buwL In c _PlU)ne#:
Acklress• 1 2_l till
City: C6'', -4,L- S Q4 --Lf+ 4s P1 State: le, Zip: '3307
Oualifier Name: w -C- C -.r Plume;#:
State Ceitific:ation or Regisa-aii,.xn #: C CC c1 o t alt Certificate of Caampetency #:
COntak:t Phone#: ( S�k $ Z0 , 0 o a o Ismail Address:
DF. -SIGNER: Arehitect/l•:ngincer: Phonek
Value of Work for this Penult: 9 � 0. 0_Square/Linear Footage of Work:
Type of Work: LIAddress UAlteration UNew ORepa it/Replace
Description of Work:
❑DetmMition
r"Out OL, 1 r2n (a 6
$ U - l '3 w►a iG \rh d� 5t lk
Qt��f�i$J3i$�Si.:+Ri )j'ii&i(Si�f t�fi 4h fj D'j i$I$�t(2 ia'iSt82s 3p ijiYg3$:ji tit4l'�ib)�$23}i �ii'4eSK`iY iSiii$.i Fjii�t3{2 'N� �l�d (i Y`^r i(f 3�ifi�`iitjl ii.��3'T. ih. YjYo-iS; Fii�i�)Ti Si$Ijt$i 4'-iiFk'T $i�iFii6
Submittal Fee $ Permit Fee $ /56, CCF $ CO/CC
Scamning Fee $
Radon Fee $
DBPR $ Bond
Notary $ Trainhig/Education Fee $ Technology Fee $
Double Fee $ Structural Review
TOTAL FEE NOW DUE $_ „__, __._ •
Bonding Company's Name (if anilicabie)
13tording Company's Address
City
State
1Rtollgage Lender's Name (if applicable)
Morigage Lender's Address
City
State
Zip
Zip
Application is hereby made to obtain a permit to do the work and aistallaitions as indicated. I certify that no work or installation hos
commenced prior to the issuance of a permit and that all work will be perk)rmed to meet the standards of all laws regulating
construction in this juriuiiction. .1 underst►Dnd that a scpaarate Nrmit must be secured liar ELECTRICAL WORK. PLUMBING, SIGNS.
WELLS, POOLS, 'FURNACES. BOILERS. HEATERS, TANKS areid AIR CONDITIONERS, ETC.....
OW'NER'S AFFIDAVIT: I certify that all the fioregtoing information is accurate ivid that all work will he clone in compliance with all
applicable laws regulating constructkui avid 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 building permit with an estimated value exceeding $2500, rhe applicant trust
promise in good faith flirt a copy of the notice of commencement and construction lien last, brochure will be deGsered to t1w person
whc-.se pmperty is subject to attachment. Also, a cerrified copy of the recorded notice of cotmnenceDne t inust be posted at the poli site
for the first inspection which occurs seven (7) days after the building permit is issued. 1 t lie a ence of such posted notice. the
inspection will not heCv7da reins per ion fee will be charged.
Signature Signature
(h ier or Agent
'rise fioregoing instru enl was acknowledged belore me this Z 7
daffy sof I V Qi' 20 _. bywho is personally known to me or who has prt:sduced 1k1 --y
As identification and wlxt did take an oath.
NOTARY PUBLIC:
Sign: W
1�THOMAS STEPHEN HART
Print:*TnS ;•i OMMISSION #
My Commist^o D"
Contractor
The foregoing instrument was wknowledged herore Doc; this
day of fftf I20 /3 . by 0%4 6e<S
whta is personally k►xown to me or whcD has produce -d t."ux
as identification and who did take an oath.
NOTARY PUBLIC:
Sign p'HOMAES STFPHEN HA,_-`'
Prins: Y COMMISSION # EE14X
ELPI.RFtNo ntkr06, 20':-i
My CX) ►timis. •o�a►o 3 53 PtorideNota com
sans5<$s$ss��$s>Fsy�.HsCadsds�sksbs��chda8�>isA'+�shhsks�hta 3r<xs�W>Csssskt:P,R.fisFssks�gsgseFs�+��fi��sk�kisk ks>ysg�skEdks�darZsMssk+i*�sdsfaaYst+>ks�>kskrsdsdl�ls�kAcsitAs*s�ksa���KaHsdsdar?<AaR`+�r��ss�ka&#*s:.bsFxsks�s2:
APPROVED BY Plans Examiner laming
Structural Review
llZe�i d3/1?!2(Di21(Rrvicixio711a(o71(Revit'dt:Ml1(A,2t.?[D31EReviuxi3/i5Rri3i
Clerk
Miami shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
CONTRACTORS' REGISTRATION FORD(
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.
IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR:
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. 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
■■eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeseeeseeeesYeeseee■seeeeeeeeseeseeat
COMPLETE CONTRACTOR'S INFORMATION
BUSINESS NAME: Prn &WZe._ ar•�, �T ( c
BUSINESS ADDRESS: 11,es RJ CITY
STATE 11-11 ZIP CODE 170 " L
BUSINESS PHONE: SW ) 5-7-)- 2rl o j FAX NUMBER (f h) Sll- 2 9 CS
CELL PHONE (_—)
QUALIFIER'S LIC NUMBER: c
E-MAIL ADDRESS OF APPLICABLE):
Created on 3119M BY MLDV d RV 3?26f09 fALDV
QUALIFIER'S NAME: tv%(6-4
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SEWL12071300057
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SLAWSON
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CERTIFICATE OF LIABILITY rNSc.r NCE
QFIIH {1MMIU(M'WVj
6/21/2013
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON TM CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER Timet COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CER1 KATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: it the certificate holder is an ADDITIONAL INSURED, the poiiaylies) must be etvefot"d. It 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 enldiorssment s .
Pcl90UCER
nes Po1om _
The icon Group, Inc.
PAM gxtk (561)994-9994 x �>geal4sa-7W
6001 Brokers Sound Pkwy.,N.W.
apolom@beacongro irto.am
WOUM§l AFFORDING COVMAGJ WX*
Suite 300
�Eiatidsnwid�s...�na 3443
Boca. Raton BL 33497-2730
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NEDEV LAM One g_...
jWMMIwsuRfiO BCCI Teas Cdr 3472
if
Pro Bowl lltb3mg Inc
12134 Wiles Road
Ie tie .o _ __.
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C®ral = BL 33076
F,
rrrvcvsaracc rcvatcrr-nrc ser •nevcv:s-r.i Raz til Ha % "rVmz m wus�r_rc:
THIS IS TO CERTIFY THAT THE PMICIES CIF' INSURANCE LISTED B£LCM HAVE [SEN ISSUED TO THE ,NSURFL) NAMED Aa --VE FOR PHE P(. -A- I(:Y
INDICATED NCTfVWTHSTANDING ANY REQUIREMENT TCRM OR CONDITION OF ANY CONTRACT QR CITHkf?
WCUMENT WITH RESPECT TO'AtHCH
THIS
CERTFICATE MAY BE ISSUED OR MAY PERTAIN Ti -Ii INSURANCE AFFORDFI) BY THE POLICIES CESCRSEED
! ERVIN S StJEUEti I TCS ALL
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TIME OF INSURA=ADMxP
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A CI.AWSMADE ®OCCUR P 6X09 5906193799 /23/2013 /2312014
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GONERAL AGORMATE s
:. 020, as
AML A"IIEMTE LWIT APPLIES PER _ ( '
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MOCRIPTLON OF OMATHM d LOCATIONS i VEw-Les (Attach ACORD 101, Ad4iikotsI Reamits Schedv6% If more OPWA is ree 1840dl
Miami Shwe Village
10050 ne 2nd Ave.
Miami Shore, F133138
ACORD 25 (201046) OF
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wnn score rowdetarsA markt of anon
BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT
115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000
VALID OCTOBER 1, 2012 THROUGH SEPTEMBER 30, 2013
DBA: Receipt #:182-142$
PRO BOWL PLUMBING INC PLUMBING/LWN SPRNKL/C
Businelm Name: Business TWO* (P umB rw coxTRAmR)
Owner Name- scoTT s mcGARY BUSIneSS OpOnOd:08/12/1997
8491ness Location: 12134 WILES RD State/County/Cert/Reg:CFCO 542 02
CORAL SPRINGS Exemption Code:
Bust nm Phone: 954 - 346 -9873
Rooms Sea" Emptoyeas Njachkm Professionals
3
#Aumhnr of Markintm, FW Vanding 8;;i �Sss 04* Vandinn Tvaw.
THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS
THIS BE0011110116S A TAX RECEtPT This tax is levied for the privilege of doing business within Broward Courity and is
non -regulatory In nature, You must meet all County and/or MunietWity planning
WHENVAUDATED and zoning requirements. This Business Tax Receipt must be transtaned when
the business is sold, business name has changed or you have moved the
business Wation. This recalpt does not Indicate that the business is 11agal or that
it is in compliance with State or local laws and regulations.
Malfing Address-,
SCOTT S MCGARY Receipt #01C-21-00011108
12134 WILES RD Paid 0$/15/2012 27.00
CORAL SPRINGS, FL 33076
2012 -2013
. . .. .. .. ..... - . .. . ...... ..
Tax Amount
Transfer
NSF Fee
PrIoryears
C*11ection Cost
Total Paw
27.00
0.00
t-,
00-1
L
27.00
THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS
THIS BE0011110116S A TAX RECEtPT This tax is levied for the privilege of doing business within Broward Courity and is
non -regulatory In nature, You must meet all County and/or MunietWity planning
WHENVAUDATED and zoning requirements. This Business Tax Receipt must be transtaned when
the business is sold, business name has changed or you have moved the
business Wation. This recalpt does not Indicate that the business is 11agal or that
it is in compliance with State or local laws and regulations.
Malfing Address-,
SCOTT S MCGARY Receipt #01C-21-00011108
12134 WILES RD Paid 0$/15/2012 27.00
CORAL SPRINGS, FL 33076
2012 -2013
. . .. .. .. ..... - . .. . ...... ..
10-02-'14 14:07 FROM- Southwest Ranches
••�KL! CERTIFICATE OF LI/
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ON
I! CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEN]
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITI
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT. If the certificate holder is an ADDITIONAL INSURED -5h,
the terms and conditions of the policy, certain policies may require an
Certificate holder in lieu of such endorsement($).
PRODUCER 4
The Beacon Group, Inc.
6001 Broken Sound Pkwy,,N.W.
Suite 500
.Boca Raton FL 33487-2730
9544341490 T-614 P0002/0004 F-953
MILITY INSURANCE IDME �YY)
.Y AND CONFERS NO RIGHTS UPON THE! CERTIFICATE: HOLDER. THIS
1, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
ITE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
policyties) must he endolseel If SUBROGATION IS WAIVED, subject to
mdorsement. A statement on this certificate does not confer rights to the
NE victoria Stavart
PHONE (561)994-9999
EMAIL a No: (561)997-7087
Ann Ess: vstewartebeacongroupine.eom
INWAERIS) AFFORDING COVERAGE NAIC y
INSURURA.-D ositOrs Ins. Co,
pro Bowl Plumbing Inc INSURER B A1136t( Pro rt and Casua9 t
12134 Wiles Road wsURER02enith Insurance 11^mpa IV
INS RSR D
Coral Springy FL 33076
COVERAGES uasuRr•R P
CERTIFICATE NUME3ER:CL1462303664 REVISION NUMBER
THIS IS TO i;ERTIFY THAT Tu
INDICATED. E POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO YHE INSURED—
NAMED ABOVE FOR THE POLICY PERIOD
NOiIMTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT
CERTIFICATE
OR OTHER DOCUMENT WITH RESPECT TO VMICH THIS
MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL
EXCLUSION$ AND CONDITIONS OF SUCH POLICIES,
LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
SR
THE TERMS,
TYPE OF INSURANCE�MmPOLICY NUme R M LIME bO Cp
GENERAL LWsirITY LNITS
x COMA601ALGENERALUARWY EACHOCCLIRMNCE S
1;000,001
PREmiA 6N EDnra $
A OLAIMS-MADE � OCCUR 906198799 6/23/2014 6/23/2015
100,001
MED ExP (Any cm oi6rsoe) s
5, 00(
PERSONAL ADV 5
1,OD0,0O(
GGIZE(`,A7E UMR APPLIES PER GENERAL AGGREGATE S
2 t 000 , 00(
LICY P LOC PRODUCTS-OOMPIOP AW $
2, 000, OO(
o51LE LIABILITY E
SING ! I
Y 4M acadg
1,000,000
A "' 'D SCHEDULEo n1Ly 1MURy fP...1 $
H2LP0 s9°6195799 6/23/2o1a /23/2015
JU&MORELLA
aODILY1hUURY(Paracddenn s
EDAUTOS OO$WNED
Perw DA
LIAR OCCUR MBGC81rJ00ESS
I
LIAR ..CCU-...__ EACHOCCURRENcL- It
AND
ANY
DESCRIPTION 017.0
RL : >ricranse
ACORD 25 (;01
INS02F, nMtmsi m
v/N
N1
MvWYE s a 000 000
E.L It ,!nnn nnn
VEHICLES (Anvan ACORD 109. Adddeonol R®I .V_ Seheduto, (t mpig gpyee Ic rcryuTnhn
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVEI7ED IN
Shores Village ACCORDANCE WITH THE POLICY PROVISIONS.
-ng Department
NE 2nd Avenue AUTHORIZED REPREgeNTAME
Shores Villag, FL 33138
Johl An */C54 06*-� P -e
D/OS �.2ae9s2 ,
It
Thor Ar`.i1Rn normo Anti I nn arc r mWprp,I m rice B# ernpn CORPORATION. All rights'resero6d.