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PL-15-218Ap Inspection Worksheet _001 Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-227447 Permit Number. PL -1-15-218 Scheduled Inspection Date: February 17, 2015 Permit Type: Plumbing - Residential Inspector: Rodriguez, Jorge Owner: NICHOLS, ALLAN Job Address: 113 NW 106 Street Miami Shores, FL 33150 - Project: <NONE> Inspection Type: Final Work Classification: Repair Phone Number (305)758-9630 Parcel Number 1121360080310 Contractor: BIONIC PLUMBING CORP. Phone: 305-498-9100 Liu Comments INSPECT EXISTING HOT WATER VENT PIPE BASED ONI mTmcuo Passed comments PERMIT RF 15- 63 INSPECTOR COMMENTS False Inspector Comments Passed Failed 131 Correction C Needed F7 Re -Inspection Z. Fee No Additional Inspections can be scheduled until re -inspection fee is paid. February 13, 2016 For Inspections please call: (305)762-4949 Page 8 of 30 D 0 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: (3057 762.4949 BUILDING PERMIT APPLICATION Permit Type: PLUMBING JOIN 2� 1 FBC 20 ►6 Permit No.�� Master Permit N 0� ®� 30B 1ADDRESS• City:Miami Shores ,A County: Miami Dade Folio/Parcel#: 4 / 0 / l� %_ Is the Building Historically Designated: Yes OWNER: Name (Fee Simple Titlehol Address: � ( � d?) City:'Q1Z"q PI't / '5 Tenarift,essee Name: A / G NO Flood Zone: State: S Zip: -:? .--3 / _� M Email: 11 / !� 1 CONTRACTOR: Company Name:��9 At C_�� !iJ Phone#: �� `�� '�p / 0 Address: - /® _s' �(.� `9 C t— City: Qualifier Name: Phone#: 0 ,�)6' State Certification or Registrati n #: eFf j e9r �s Certificate of Competency #: �7 l7y Z� /vim Contact Phone#: Email Address: C e, live ®I J Cor Cir DESIGNER: Architect/Engineer:Phone#: Value of Work for this Permit: $ 06 A ® Square/Linear Footage of Work: Type of Work: OAddress OAlteration ONew . 04air/Replace ODemolition Submittal Fee $,-510 Permit Fee $ Scanning Fee $ Radon Fee $ UU , t-> CCF Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CO/CC $ DBPR $ Bond Technology Fee $ TOTAL FEE NOW DUE $ 0 4 • Go 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 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 CONDMONERS, 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 harged Signature Mcz"'- Owner or Agent The foregoing instrument was acknowledged before me this day ofa , 20/, by ` who iscpersonally known to me r who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign:°�C Print: My Commission Signature '(� ConZZ r The foregoing instrument was acknowledged before me this day of /e , 20/ by ///�� who ooyis personally Lown to me or who has produced .aZ VVIaA identification and who did take an oath. NOTARY PUBLIC: Sign: Print: 0WRWAOCK ^piiw - My Co iffla'Expi m ?Y Public anO Florida Notary Pobue M "� •State of FkrlOrr My Comm. Expires Now 8. M'S $o�n Joanna FF n82753 4,1y CnmmlaalOn • EE 144693 . �y�Commiss� 12 ' � -f n ire, 01!12(2018 Tls'' APPROVED BY S Plans Examiner Structural Review (Revised3/12/2012)(Revised 07/10/07)(Revised 06110/2009)(Revised 3/15/09) Zoning Clerk Jan 301510:14a Bionic Plumbing Corp 3055980211 p.1 1111111IRT 1i111r11 Itotlttintia,i. 001 prittaaidoilitils and huaine w,ls 114111,110l)f NA41ME=N 'Cif=' pt);3INI=;36 AND h om 11111111001110 y1whi blakinti, irt,in hoiturn to hnrbticIiia ronlatirtulln, 111101ES$10NAL RVAJI ATION and ilwy koop I'loridn's ocunomy strong. 1*1'1L)ti113,.� ISSUED; (i?I1'7P.-()13 Every day we work to improve the way we do business in order to serve you better, For information about our services, please log onto www.myfluridalleense.com. There you can find more information about cur divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department is: License. Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida. and congratulations on your new licensel RL-'.GISTERED PLUMBING GONTRACi ()it ROBULOCK. GARY W BIONIC PLUMBING CORP (INDIVIDUAL MUST MEET ALL -LOCAL LICENSING REQUIREMENTS PRIOR TO CONTRACTING IN ANY AREA) HAS REGISTERED under the provisions of Ch.Afli, FS Ezora bn drft -. AUG 39.2015 t IM11700101 It, r The Department of State is leading the commemoration of Florida's 500th anniversary in 2013. . For more information, please go to www VivaFlorida.org. DETACH HERE STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD Named below HAS REGISTERED Under the provisions of Chapter 489 FS. Expiration date: A1UG 31, 2115 (INDIVIDUAL MUST MEET ALL LOCAL LICENSING REQUIREMENTS PRIOR TO CONTRACTING IN ANY AREA) ROBULOCK, GARY W BIONIC PLUMBING CORP 8011 SW 99TH CT MIAMI FL 33173 'a VIVA ROMA RICK SCOTT ISSUED: 071'7/2013 SEQr# L1307170000516 KEN LAWSON GOVERNOR DISPLAY AS REQUIRED BY LAW SECRETARY Jan 30 1510:08a UUM2 Bionic Plumbing Corp Local Business Tax Receipt Miami—Dade County, State of Fto6da THIS IS NOTA BILL - DO NOTPAY 6212286 BUSINESS NAfiAFll.001►TION BIONIC PLUMBING CORP Sol I SW 99 Cr MIAMI FL 33173 3055980211 p.1 L - BT RECEIPT No. EXPIRES 9 SEPTEMBER 30, 2075 6476MMust be displayed at place of business Pursuant to County Corse Chapter 8A- Art 9 & 10 OWNER SEC. TYPE OF BUSINESS BIONIC PLUMBING CORP 186 PLUMBING CONTRACTOR PAYNtEidTRECERIEO Worker(s) 2 CFC1427452 BY TAX COLLECTOR $75-00 07/30/2014 CH ECK21-14-038465 This Loeal Business Tax Recerrpptt easy conRrws paymeet attbe LocalBmiaess las Tina Rntaipt is not a Iicertse, pareftaraearMicutientHtbeh Idw-s eado mtodohesiaess Roldermastcmeplywi3haaygovemmeatal orwagovaramea&1 regukkry laws and requitemeuftwhitb apply to the bnsiaes. The RECEIPT N0. ebwe must he dispin yed an all cortmeraial gehides- IIBamI-DadaCade Sea ea -276. For afore it"nazday. aisitwwwmiartoidadassovhaxoollet�tur aats7s Local Business Tax Receipt Miami -Dade County, State of Florida =THIS IS NOTA BPL . - DO NOTPAY 4107025 BUSUYESS NAIVlF'WCATION_ BIONIC PLUMBING CORP No 8a11 Sw 99 CT HEN AL MIAMI FL 33173 4289005 LBT EXPIRES SEPTEMBER 30; 2075 Must be d+splayed at place of business Pursuant to County Code ChapteraA-Art.9 & 10 OWNF_R SEC TYPE OF BUSOMESS 8I0MC PLUMBING CORP 196 PLUMBING CONTRACTOR PAYd®tIT RIECEn M �00126d•.- BY TAX COLLECTOR Worker(s)1 $75AO 07/3D/2014 CHEM I-14. 038462 T6isLoraiBusimrssraxRacerPQmdycoatimsspaymea[off6eLsralBta:in�Tex. The Racaipt��ta1'ire�a, . ap��l anaftdabordea-sq ee;wdabusieess, HalQarmratmmptpwitltae erremmeoml re9alaoaryWwsaa�t�r ircnlea>rwfiicltaPPlYteihebusbt� V9 The RECENT KIM above nws! be distdeyed an an canaaaroia! rehides-11diemi-WC n Cede Sec aa --m For moreiatoa�tiut►.*isit�nwreroaaiidade.om/�bs ue � 0 Jan 28 2015 3:59PM HP LRSERJET FAX P.1 p '?V' CERTIFICATE OF LIABILITY INSURANCE °"�01JOBAS ""' THIS CERTIFICATE LR 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 INSURED6 the pol"les) must be emtoraed. h SUBROGATION IS WAIVED, subject to the terms and eonditiatmofthe policy, CaWn policies may require an endorsement A statement on this certiticate does not confer rights tothe certficate holder In Neu of such endorsement(4 PRODUCER US -1 insurance 9W8 S. Dbde Hwy. Miami, FL 33156 Phom X70-1422 Fax (30.5)570-M13 TACT YOANYS ARMS iN. EM (3t}5}570-1422 D.WI3 IffnIhm,uslinsumn .net Iu AFFORDING COVERAGE NAIL o INSURER A: aRANADAINSURAINGECOMPANY INSURED BHonic Plumbing Corp 0011 SW 90 Ct MIAMI. FL 33173- (305) 2WO741 INSURER 8: INSURER C: INSURER 0: INSURER E: INSURER F: COVURAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDM ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLIS DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN" TYPE OF INSURANCE ADM SUBRI POLICY NUMBER Y 119d UCY OMITS A GENERAL LIABILITY ® COMMERCIAL GENERAL LIABILITY El ®cLAims-NADE Elo=R ❑ N N 0185FLOMWON �23/m14 09/23/2015 EACH OCCURRIZNCE 1,000,000.00 DAMAGE TO RENTED pyl S 100,DDO.00 MED EXP eperson $ 5,000.00 eaPERSONAL a ADV ah URY s 1,000.000.00 ❑ GENERALAGGREGATE s 2,000,000.00 GEN'LAGGREGATELIMIT APPLIESPER: L1 POLICYC1 PRO- ❑ LOC PRODUCTS-COMP/IpAGG s 2,W0,000.00 S AUTOMOBILE LIABILITY ❑ ANYAUTO ❑ AUTOS OWNEDALL ❑ �OSUL® ❑ HIRED AUTOS ❑ AUr65 MED OIINNSINCRLE LWgT SLWgT S BODILYNf.IURYOWpamn) S BODILY INJURYBODILY INJURY (Pa��} SS O GE S a ❑ UMBRELLA LIAB ❑ OCCUR ❑ EXCESS UAB ❑ CLANS -MADE EACH OCCURRENCE S AGGFU93ATE S ❑ Dw ❑ RE(EMnoNS s WORKERS COMPENSATION ANDEMPLOYERS'L[ABILITY YIN ANY PRCPRIETC"ARTNERII9(ECUTIVE OFFICER AEMBER EXCLUDED? Hy��d� Ube M DESCRIPTION OF OPERATIONS below N I A f T WC sTa71 oTH El E.L. EACH ACCIDENT S EL - EA EMPLOYE S E.L. DISEASE - POLICY LIMIT s DESCRIPTION OF OPERATIONS 1 LOCATIONSI VENICLES (Attach ACORD 101. AdWftnal Remarks Schedule, A moue apace b required) COMMERCIAL I RESIDENTIAL PLUMBING -- CERTIFICATE )FOLDER CANCELLATION ACORD 25 (2010!06) OF M: I . 01986-2010 ACORD CORPORATION. AR rights reserved The ACORD name arid logo are registered marks of ACORD SHOULD ANY OF THEABOVE DESCRIBED POLICIES BE CANCELLEDBEFORE MIAMI SHORES VILLAGE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 NE 2ND AVENUE ACCORDANCE WITH THE POLICY PROVISION& MIAMI SHORES, FL 33138 AUTHOR¢EDREPRESENTATIVE ACORD 25 (2010!06) OF M: I . 01986-2010 ACORD CORPORATION. AR rights reserved The ACORD name arid logo are registered marks of ACORD Jan 301511:46a Bionic Plumbing Corp 3055980211 p.1 CERTIFICATE OFI LIABILITY INSURANCE DATE QVMDMVM, 1113012015 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 IMSURERCS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certlflcdte holder is an ADDITIONAL INSURED, the pollcy(ies) must be endorsed. It SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, cartain Policies may require an endorsement. Astatement on this cerdfkete does not cartfer rights to the certificate holder In Ileu of such endorsement{e} PRODUCER InterPay Solutions, Inc 639 Cindy Lane' West Seneca, NY 14224 NAM N°' �" C. No> ADDS 1NSURER(Sj AFFORDING COVERAGE rfacR INSURER A: INSURED BIONIC PLUMBING CORPORATION INSURER B: IKSURER C: 8011 SW 99 CT INSURER D: INSURER E. MIAMI, FL 33173 INSURER Fc COVERAGES CERTIFICATENUMBER. 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 CONTRACT OR OTHER DOCdIMENT WITH RESPECT TO WFBCH 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_ LIR TYPEOFINSURANCE NSR EM YAM POUCYNUMSER (M @AM/DDJYYYY) LIMITS GENERAL LIABILITY $ EACH OCCURRENCE13— PREMISES (Ea cocrnrence) $ a)MMERCIAL GENERAL LIABILITY LI CLAIMS—MME Ej OCCUR Mm EXP (AnYom) $ PERSONAL. &ADV INJURY S GENERAL. AGGREGATE $ GEN'L AGGREGATE LIMITAPPUESPER: PRODUM- COMPIOPAGG $ POLICY nPRO- LOC $ AUTOMOBILE LIABILITY tram =45INSLE LIMIT $ BODILY INJURY (Per person) $ ANYAUTO ALLOUMMED SSQi� LED AUTS BODILY INJURY (Peroodderd) S { o 1D S NON -DINNED HIRED AUTOS S UMBRELLA UAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CAWS -MADE DED I I RETENTION S $ AANY WCRKERS COMPENSATIDN AND EMPLOYERS LIABILITY YIN OFFM �r EW �tI E M (Mandatory In NFn NIA AWC1032730 5/15/201 0&15/2015 I TORY LIAI-ITS OER E1 EACH ACpDENi S —ffM O E.L. DISEASE- EAEMPLOYEE $ -5 000 [ryes, desuase unser DESCRIPTION OF OPERATIONS helow 1 E.L. DISEASE- POLICY LIMIT S 500 000 i i I CESCRIPTION OF OPERATIONS r LCCATTONS i VEHICLES (A IaM ACORD 101, Addifia I Remarks S3redUe.a rn°reapace is required) I Plumbing Contractor License Number: 000012646 CERTIFICATE HOLDER CANCELLATION Miami Shores Building Department SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 10050 N. E. 2nd Avenue THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores, FL 33138 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORRED REPRESENTATIVE 8 1988-2010 ACORD CORPORATION. Ail rights reserved. ACORD25 (2010105) The ACORD name and Logo are registered marks of ACORD