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DEMO-15-741Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 inspection Number: INSP-231431 Permit Number: DEMO -4-15-741 Inspection Date: June 04, 2015 Permit Type: Demolition Inspector: Diaz, Osvaldo Inspection Type: Final Owner: KESSLER, NOAH & AUBREY Work Classification: Plumbing Job Address: 1002 NE 105 Street Miami Shores, FL 33138 - Phone Number (917)579-8541 Parcel Number 1122320280010 Project: <NONE> Contractor: BIG PLUMBING CORP Phone: (305)821-2880 Buildina Deaartment Comments DEMOLITION FOR PLUMBING Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed C, Correction Needed l� 6 Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. For Inspections please call: (305)762-4949 June 04, 2015 Page 1 of 1 ts,orss g Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Parcel Number Applicant 1002 NE 105 Street 1122320280010 NOAH 8 AUBREY KESSLER Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell NOAH & AUBREY KESSLER 1002 NE 105 Street (917)579-8541 MIAMI SHORES FL 33138- 1002 NE 105 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone BIG PLUMBING CORP (305)821-2880 0= of Demo: Plumbing onal Info: DEMOLITION FOR PLUMBING kation: Residential nine: 3 Fees Due Amount CCF $0.60 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.20 Permit Fee $100.00 Scanning Fee $9.00 Technology Fee $0.80 Total: $1 MA Valuation: $ 1,000.00 Total Sq Feet: 00 Pay Date Pay Type Amt Paid Amt Due Invoice # DEMO -4-15-55019 04/02/2015 Credit Card $ 64.60 $ 50.00 04/01/2015 Credit Card $ 50.00 $ 0.00 Available Inspections: Inspection Type: Final In consideration of the issuance to me of this permit, 1 agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accur d-ttrai aff1vork will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above-named c '- April 02, 2015 Authorized Signature: Owner / Applica Contractor / Agent Date Building Department Copy April 02, 2015 1 9 Miami Shores Village' �01a Building Department APR 8 1 10050 N.E.2nd Avenue, Miami Shores, Florida 33138dc+/l�t� Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20 d BUILDING Master Permit No. DEMO -3-15-550 PERMIT APPLICATION Sub Permit No.Dmd I-, ❑BUILDING ❑ ELECTRIC ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑■ PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 1002 NE 105th Street City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 11 -2232-028-0010 Is the Building Historically Designated: Yes NO X Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Aubrey & Noah Kessler Phone#: (917) 579-8541 Address: 1002 NE 105th Street City. Miami Shores State: FL Zip: 33138 Tenant/Lessee Name: NONE Phone#: N/A Email: ladybreezy@gmail.com CONTRACTOR: Company Name: 2.1'C' F.Q m B" 6 CO r% Phone#: Address: 9 ! T 0 Mvi S -r 0� 10 4 ( iAa,'eA-10 Gl1) City: /State: �f Zip: � =� Qualifier Name: �%� A,AJ.b0 eZ;;PJ `Z Phone#: 30A—S Z, � State Certification or Registration #: -[ �-('—]'I Certificate of Competency #: P 60® 'moi , DESIGNER: Architect/Engineer: Donald Hodgetts, P.E. Phone#: (305) 663-8885 Address: 5901 SW 74th Street, Suite 405 City. South Miami State: FL Zip: 33143 e of Work for this Permit: $ ®OD- Square/Linear Footage of Work: a Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace Q Demolition Description of Work: Sub Permit to Demolition Plan Specify color of color thru tile: Submittal Fee $ Permit Fee $ ° �� CCF $ CO/CC $ Scanning Fee $ Technology Fee $ Structural Reviews $ (Revised02/24/2014) Radon Fee $ Training/Education Fee $ DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ h BoncOng Company's Name (if applicable) ' Bonding Company's Address N/A None City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address 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 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 occurs seven (7) days after the building permit is issued. in the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature �� OWNER or AGENT The foregoing instrument was acknowledged before me this I'-1 day of W1 ` i \ 20 15 by Kl'ty^ I ' . who is personally known to me or who has produced D-,-`t(/vw b c Si as identification and who did take an oath. NOTARY PUBLIC: Sign: --�14y Print: Seal: M:�-Oi�' CONTRACTOR The foregoing instrument was acknowledged before me this _ day of M br . 20 by who is personally known to me or who His produced as identification and who did take an oath. NOTARY Sign:_ Print: Seal: Notary Public State of Florida Alexis Sanchez My Commission EE1308ae Expires o9N512o15 *��*B�RR�68�Rla��R�R�k�k5t��6#�lc�kB�Bt&&/y�B�R�k�B�c�R�Rli�l�k�k+ka&s�k�k�k�Btl�Y�W&�k&tk APPROVED BY - /'/5 Plans Examiner Structural Review (Revised02/24/2014) Zoning Clerk Mar, 30. 2015 6:51AM No. 1982 P. 1/1 AC -08-D.7 AC -08-D. CERTIFICATE OF LIABILITY INSURANCE 3 2 2M8 5 ) PRODUCER (305)512-5800 FAX: (305)512-5861 Torres Insurance Agency Inc. 61.35 NW 167 STREET # E25 Miami Lakes rL 33015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED 13Y THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSUREO Big Plumbing Corporation 9190 NW 119th Street Hay 10 Hialeah Gardens FL 33018 r•nvFoer-ee INSURERA:MAPFRE INSURANCE COMPANY INsuremAssoaiated Industries Ins INSURER C. ENSURER 0: INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTIMTHSTANDING 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 1S SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADp'(, TYPE OF INSURANCE POLICY NUMBER PQLCY EFFEG DATE Nltb POLICY £7[P RATE N DATE M61ZD LIMITS GENERALIIAEILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PR Mls�s E encs S 100,000 MED EXP one son $ 5,000 A X 71 CI•ANSMADE ❑X OCCUR CP0323606 3/30/2015 3/30/2016 X $500 PI3 bed PERSONAL & ADV INJURY g 1,000,000 Per Claim GENERAL AGGREGATE $ 2,000,000 $ 2,000,000 GEN'LAOGREGATE LIMIT APPLIES PER: X POLICY 6CT LOC AUTOMOBILE LIABILITY ANYAUTO COMBINED SINGLE LIMIT (Eaeoddant) $ 1,000,000 A X ALL OWNED AUTOS 4150120005642 3/30/2015 3/30/2016 BQDILYINJURY X SCHEDULED AUTOS (Perpereon) $ HIREO AUTOS BODILY (NJURY NON•OWNEDAVTOS (PeraWdenl) S X PIP $10,000 X PROPERTYDAMAGE (PeracclGenl) $ COMP CoLL1 DQQ I10Q OARADE LIA$IL17Y AUTO ONLY - EA ACCIDENT IS ANY AUTO OTHER111" EAACC $ AUTO ONLY: rr E)(OESS/UMBRELLA LIABILITY OCCUR FICLAIMS MADH $ AGGREGATE $ OEOUCTIBLE $ STATU-z OTH- $ WORKERS COMPENSATION ANDWC EMPLOYERS' UABIL17Y X ,q E.L EACH ACCIDENT $ 100,000 ANY PRQPRIETOR/PARTNERIGXF-CUTIVE: OFFsCER/MEMSER EXCLUDED? E,L.OISEASI;-EAE,MPLOYEE$ 100 000 Myes,descnbeurlder eunder AWC10434'71 3/30/2015 3/30/201.6 AOTHER SPECIALPROMSIONSbelow ls E.LDISEASE-POLICYLIMIT S 500,000 Cp0323606 3/30/2015 3/30/2016 $900 Dad $2,500 Max (Unsc (Unschedueduled) DESCRIPTION OF OPERATIONSILOCATIONSfVERICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS P1Umbirlg Contra0't" 1OCated at: 9190 NW 119th Street Bay 10 Hialeah Gardena, F1 33018. Blanket Additional Insured - CG2033 with respect to General Liability policy. commeroi*1 Auto' Vehicles: 2007 Ford F250 Vin( ... 4470) & 2006 Ford P150 Vin G., . 6723). Comprehensive & Collision! ACV -$1,000 Dad, UX Ttejeoted. CERTIFICATE HOLDER CANCELLATION (305) 7568972 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE MIAMI SHORES VILLAGE 10050 NE 2ND AVE EXPIRATION DATE THEREOF, THE ISSUING INSURER WELL ENDEAVOR 70 MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 80 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE —INSURERAT"GENT&eR•REPRO ENT TIV . AUTHORIZED REPRESENTATIVE A 8025 (?,oepa41(pllj .__• _ _ 0 ACM0 CORPORATION 1008 Page 1 cf2