PL-15-340 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-234384 Permit Number: PL-2-15-340
Scheduled Inspection Date: May 12, 2015 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo
Inspection Type: Final
Owner: EIRA ROJAS, BENOIT V WIRZ Work Classification: Addition/Alteration
Job Address.893 NE 96 Street
Miami Shores, FL 33138- Phone Number
Parcel Number 1132060142690
Project: <NONE>
Contractor: H. BETO'S PLUMBING INC Phone: (786)368-1902
Building Department Comments
Intractio Passed Comments
REMODELING OF MASTER BEDROOM BATHROOM
CABANA BATHROOM REPLACE SEWER LINE FROM 0010,INS ACTOR COMMENTS False
CABANA BATHROOM TO SEPTIC TANK
i
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-228328. NO PLANS NO
PERMIT
Failed
Correction a
Needed
Re-Inspection
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
Mav 11, 2015 For Inspections please call: (305)762-4949 Page 28 of 42
� FSB � 7 2415
Miami Shores Village
Building Department
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 2010
BUILDING Master Permit No.
PERMIT APPLICATION Sub Permit No. P I.Ste-- 3 e
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
�LUIVIBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
p� �{ �jJ QI' n CONTRACTOR DRAWINGS
JOB ADDRESS: 0 q,3 k r / 1� 7i K��
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): Z-1v C Phone#: ?
Address:
City:��['�'c� �:� 5 State: —71
/, Zip: l 3 d
Tenant/Lessee Name: Phone#:
Email:
�
CONTRACTOR:Company Name: Y Phone#: %d'6 J�O
Address:
City: r✓1 State: Zip: 22��
Qualifier Name: Q nn f)(fin Phone#: Ue `J�'-
State Certification or Registration#: L � d0"/J Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
C n6
Value of Work for this Permit:$ � S Square/Linear Footage of Work:
Type of Work: ❑ Alt eAlteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: �� ( 0
Specify color of color thru tile:
Submittal Fee$ �J Permit Fee$ 5• CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ O
(Revised02/24/2014)
Bonding Company's Name(if applicable)
Bonding Company's Address
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.
SignatureSignature
OWNER VENT ebWTOR
The foregoinginstrument pwas acknowledged before me this The foregoing instrument was acknowledged before me this
1 C1 day of X'Cgi
.Y�(c�C�L-fZ �,20 C by �� day of orui; 20 by
l �\Q�S who is personally known to ,C�l ���1fD�j�e� who is personally known to
me or who has produced t-V-A-7tye.►y(,k►(Jb�'as me or who has produced[ C�11-06NV's IJICA1 '�-as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: ` ��'� Sign:
Print:, Print:.
Seal: o JENIFERLLONGA Seal:
MY COMMISSION 0 FF 015798
INI
W. r EXPIRES:July 29,2017 Et ti I NIFER L LONGA
Bonded ThN Notary Public Undenxliters :+ MY COMMISSION/FF 015798
EXPIRE 29,2017
APPROVED BY .7S Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
SNORES G'
�t
soonun�Pl
J " Miami shores Village
Building Department
ORiDp'
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305)756.8972
CONTRACTORS' REGISTRATION
IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR:
A. ✓ COPY OF QUALIFIER'S STATE LICENCES
B.�COPY OF LOCAL BUSINESS TAX RECEIPT
C. COPY OF LIABILITY INSURANCE*
D.---7 COPY OF WORKERS COMPENSATION INSURANCE*
(Workers Compensation EXEMPTION must have NOTICE TO OWNER Affidavit)
IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY:
A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER
B. COPY OF LOCAL BUSINESS TAX RECEIPT
C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL
CONTRACTOR'S TAX RECEIPT.
D. COPY OF LIABILITY INSURACE*
E. COPY OF WORKERS COMPENSATION INSURANCE*
(Workers Compensation EXEMPTION must have NOTICE TO OWNER Affidavit)
*YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW:
Certificate Holder:
MIAMI SHORES VILLAGE BLDG DEPT
10050 NE 2ND AVE
MIAMI SHORES, FL 33138
Certificate must specify the description of operations or contractor license number.
■........................■ ..�.............................MEN...........................■■
BUSINESS NAME: ei�O S �(l� n
BUSINESS ADDRESS: 945 OU) 9C !iA CITY 141tr)I' STATE FLS ZIR33✓47�
BUSINESS PHONE: 5(08 '19 D a' FAX NUMBER
CELL PHONE(Y6 QUALIFIER'S NAME: F�GI !.(�, f—��t'�'Jct►'Jt�°2
QUALIFIER'S LIC NUMBER: � (�LAq'S 93 7
3
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395
1940 NORTH MONROE STREET
TALLAHASSEE FL 32399-0783
HERNANDEZ,SAYDA WALESKA
H. BETO'S PLUMBING INC
8454 NW 24TH PLACE
MIAMI FL 33147
Congratulations! With this license you become one of the nearly
one million Floridians licensed by the Department of Business and
Professional Regulation. Our professionals and businesses range STATE OF FLORIDA
from architects to yacht brokers,from boxers to barbeque restaurants, DEPARTMENT OF BUSINESS AND
and they keep Florida's economy strong. PROFESSIONAL REGULATION
Every day we work to improve the way we do business in order to CFC1428937 ISSUED: 06/26/2014
serve you better. For information about our services,please log onto
www.myfloridalicense,com. There you can find more information CERTIFIED PLUMBING CONTRACTOR
about our divisions and the regulations that impact you,subscribe HERNANDEZ,SAYDA WALESKA
to department newsletters and learn more about the Department's H.BETO'S PLUMBING INC' -
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, IS CERTIFIED under the provisions of Ch"488 FS,
and congratulations on your new license! Expiration date AUG 31,2016 L1406260000763
DETACH HERE
RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD
CFC1428937 .
The,PLUMBING CONTRACTOR"
Named-below IS CERTIFIED WE
Under the provisions6f Ctiapter 489 FS.
Expiration date: AUG-31,2016
NERNANDE� �,YDAWA, a• y.
-r ,H-tETVS,PiL-t ING-IN a
a5g NW�dtTfi C
MIAMI3q
ISSUED: 06/2612014 DISPLAY AS REQUIRED BY LAW SE4# L1406260000763
002039
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Y
NMI; g r
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i•3.��� .�a1� '�rt'ffitrf�►aa��busin & !
OW
am 30,
44,
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f 8pfesr 1#A Art 9&1U'
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OWNER",
SEC.TYft tV BUSINESS
H.BETOOLUMBING INC 196 PLUMOING CCINTRA6T4 PAYMENT RECEIVED
Worker(s) 1 CFC142M7 BY TAX COLLECTOR i
$75.00 07/15/2014
ECHECK-14-139797
This)soet BusinessTax Receipt only confirms payRentof the Local Business Tax.The Receipt is not a licerr9e
permit.are certification of the hohlei sualifications,to do business. Holder must comply with any goveratmuftl
mgoogovernmental teguistory laws eelrequirements which apply to the business.
The RECEIPT NI).above most be displayed oa off comelercial vehicles—Miami—Bade Code Sec 8a-276.
For more iafermation,visit si"NW miamidede.
1
ACC> CERTIFICATE OF LIABILITY INSURANCE F
DATE(MM/DD/YYYY)
`� 02/112015
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 policy(ies)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 NAME cT JOHNNY TUNON
ROYAL CARIBBEAN INSURANCE AGENCY II PHONE E,.305-642-4541 FAX--- 95-642-1087
-
1772 WEST FLAGLER STREET EMAIL LTUNONROYAL112_RGMAIL.COM
ADDRESS:
MIAMI. FL 33135 INSURER(S)AFFORDING COVERAGE NAIC a
INSURER A:CAPACITY INSURANCE COMPANY
INSURED INSURER B:ASSOCIATED INDUSTRIES INS.CO.
H. BETO'S PLUMBING. INC. INSURER C:
8454 NIP/ 24 PLACE INSURER D.
MIAMI. FL 33147 INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 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 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.
INSR _..----- ADOL SUBR
POLICY EXP
LTR POLICY NUMBER MM/LDDrYYYY JMM/DD/YYYY LIMITS
TYPE OF INSURANCE
A GENERAL LIABILITY X CLM01009525A 04%15/2014 04/15/2015 EACH OCCURRENCE S1,000,000
XCOMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED -- -_-"—
� 1 _PREMISES(Ea occurrence) S 100.000
CLAIMS-MADE I X]OCCUR MED EXP(Any one person) S _ 5,000
PERSONAL&ADV INJURY S 1.000.000
GENERAL AGGREGATE S _ 2.000.000
FGEN'L AGGREGATE LIMIT APPLIES PERS PRODUCTS-COMPVOP AGG S_ 1.000,000
POLICY PE 0 LOC _- - S -- --- _
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
Ea„accident) _ S _
ANY AUTO BODILY INJURY(Per person) S
ALL OWNED SCHEDULED BODILY INJURY(Per accident) S
AUTOS AUTOS ( )
_.
NONOWNED PROPERTY DAMAGE
(Per accident) .. S
LHIREDAUTOS
S
UMBRELLA UAB OCCUR EACHOCCURRENCE S _
EXCESS LIAB CLAIMS-MADE AGGREGATE _ S _
DED I I RETENTIONS S
B WORKERS COMPENSATIONAV(/C 1032823 04r15r2014 04!1512015 WC STATU- OTH-
ANDEMPLOYERS'LIABILITY YIN _TORYIIMIT
ANY PROPRIETORiPARTNER;EXECUTIVE _E.L.EACH ACCIDENT S 1,000,000
OFFICER;MEMBER EXCLUDED? a N/A --
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S 1'000
,000.000
II yes,describe under - - — --- -
DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT S 1.000.000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101.Additional Remarks Schedule.I more space is required)
PLUMBING CONTRACTOR
PLUMBING STATE CONTRACTOR LICENSE#CFC 1428937
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
MIAMI SHORES VILLAGE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
BUILDING DEPARTMENT
10050 NE 2 AVENUE AUTHORIZE REPRE NTATIV
MIAMI SHORES, FLORIDA 33138
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ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD