PL-14-1094Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-213181 Permit Number: PL -5-14-1094
Scheduled Inspection Date: April 30, 2015 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo Inspection Type: Final
Owner: MAINADE, FRANK & KELARA Work Classification: Addition/Alteration
Job Address: 925 NE 92 Street
Miami Shores, FL 33138- Phone Number
Parcel Number 1132060060070
Project: <NONE>
Contractor: UNIVERSAL PLUMBING CORP Phone: (305)887-3131
Building Department Comments
PLUMBING WORK AS PER PLANS
INSPECTOR COMMENTS False
April 29, 2015 For Inspections please call: (305)762-4949 Page 1 of 29
spector Comments
Passed
Failed
,3��
Correction
❑
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
April 29, 2015 For Inspections please call: (305)762-4949 Page 1 of 29
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:
xJOB ADDRESS:
X
X
BUILDING
9V 3 0 F094
BY: ---
FBC 20 �0
Permit No. � C) I (A - 1®9 I
Master Permit No. m
City: Miami Shores County: Miami Dade Zip:
Foho/Parcel#: ,
Is the Building Historically Designated: Yes
NO 1/ Flood Zone:
OWNER: Name (Fee Simple
CONTRACTOR: Company Name: 64/ 6 J%V�rYJ flt ey/,>?Phone#_7a
Address: i
City: 6 State: �%C Zip:
Qualifier Name: Phone#:0�(K.�/,,&
State Certification or Registration #jr4/OzCertificate of Competency #:
Contact Phone#: Email Address: zo-r k!wzS v
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: Square/Linear Footage of Work:
_�AAType of Work: ❑Addition / L3 Alteration New ❑Repair/Replace
Description of W6r $ Ul %
Submittal Fee
Scanning Fee $
Notary $
Color thru We:
Permit Fee $ CCF $ CO/CC $
Radon Fee $ DBPR $ Bond $
Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $
❑Demolition
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lende 's Address
City
State
Zip
zip.
Application is hereby spade 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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the abse of such posted notice, the
inspectio 'll not be a oved and a reinspectio ee will be charged.
Signature Signature
Owner or Agent ' Contractor
The foregoing instrument was acknowledged before me this
day of b�-'x,120 ,by -Fr ANle- "prr r l A,DC.
who (personally known me or who has produced
As identification'and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: c� � W"NS� 0-�1GAb Z)
My Commission E' pij>;s. ANNEYANSI DEL®ADO
MY COMMISSION # EE145476
EXPIRES November 09, 2015
Or
The foregoing instrument was acknowledged before me thi�
day of i/ 204)(,, by ,
who is personally known t Qr ced
S►8'y
aside d wMWd;llN
MY COMMISSION #FF009187
NOTARYP L � .1Of .' EXPIRES April 17, 2017
(aOn 398.0153 FloridaNOtWy ,@M
Print: r��r•wn
APPROVED BY<y ��v ®� Plans Examiner
Structural Review
My Commission Expires:
•evised 5/2/2012)(Revised 3/12/2012) XRevised 06/10/2009)(Revised 3/15/09)(Revised 7/10/2007)
zoning
Clerk
Miami sVilag-e
Building Department
10050 N.E.ZW Amue
Mimi Simres. Florida 33138-
Tel: (305) 795.2'104
ft= (305) 756.8972
Notice to Owner - Workers' Compensation Insurance Exemption
Florida Law requims Wa&we Compmmdian insurnuce
o$cow
a 440 of Florida Ste, Fla. Stat §440.05
llows date cers in the construction ' to =1Cmpt 111hemseives fmm this
mcclwaulgilt for pier to obWning a building] Pito The Flonda Division ofWadcers' Employer
1� wa mon p ix
An employer in the mon hKhMfty who employs one or m+ore
employees. the o � or fir l atee
w� must obtain workers' ami coverage. Corporat
officers or exempt of a limited liab�, comfy (moi Indw mon may may
elect to be
1. Tim officer owns at leap 10 percent of the stock of the c ogKn icm, or in the case
Of an LLC, a statesment attesting to the minimm 10 Percent ownalb p;
2. Ile officer is listed as an officer of the corporation in the records of the Florida
DeParbncnt of State, Division ofCons; and
3. 11te coqxnation is registered and listed as active with the FloridaDepartment
of
State, Division OfCaporation,
No more than three corporate officers per c orpastion orhanted hWb&W
cony mems
are'Mowed to be exempt Construction exemptions are valid for a pedml of two years or UDM
a voluntary revocation is filed or the exemption is revoked by the Division.
Your conractar is requesbag a perad under this wrldws' compensabon exemption. In these ,1& Shores Vr'Dage
does not reslnire verification ofw s' inscnanc c coverzige fiarn the hr's company_ paref"e- ym my be
liable Eton the worker' " of alio work under Plea check with your
insurance crier since most Property nism=ce P0ncK3 DO NOT cover this type of liability,
BCOYNTSIGT)�f'S.NIING BELOW YOU ACffiVOVLEDGE THAT YOU HAVE READ THIS NOTICE AND UN DE mAND IT3
oil ;I
State of Florida )
County ofA+ffinni-Dade)
Sworn to and befome no
day of ® Q(-D!V� .20
By
MAP
Comity of1 Imide) .
Swan to In- me
day of , 20
My COMMISSION # EE145475
EXPIRES November 09, 2015 ww�°EXPIRES April 17, 2017
,__: 'T 3.x.1-t11g3 Flor�aw.�.m__.__ fC�91398.ot53 FlertrlwNntarvRn.virtu nnn
STATE OF FLORIDA
DEPARTMENT OF BUSINESS ARID PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD
CFC1428421
The PLUMBING CONTRACTOR
Noned bebw IS CERTIFIED
Under6■ P of 489 FS
Expiletan AUG 31, 2019
GARCIA, MICHEI.
UNIVERSAL PLUMBING, CORP
141 E BO ST
HIALEAH FL 33013
MUMD, 09M=4 DISPLAY AS REQUIRED BY LAW SEG N L140991OW3M3
Local Business Tax Receipt
Miami-Dade County, State of Florida
T n15!5..W3T A 3tt_ - aG NG; PAY LBT
6603779
UNwnem RGMErEOC^TwN Re°Em*"'°- EXPIRES
IVERSAL PLUMBING CORP RENEWAL SEPTEMBER 30, 2015
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