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PL-15-1662 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-240113 Permit Number: PL-7-15-1662 Scheduled Inspection Date: September 03, 2015 Permit Type: Plumbing - Residential Inspector: Diaz, Osvaldo Inspection Type: Final Owner: SMITH, PATRICE AND SCOTT Work Classification: Addition/Alteration Job Address:358 NE 101 Street Miami Shores, FL 33138- Phone Number Parcel Number 1132060135280 Project: <NONE> Contractor: DEL MAR PLUMBING Phone: (305)271-2800 Building Department Comments RE ROUTE SANITARY LINE TO NEW SEPTIC TANK Infractio Passed Comments LOCATED IN FRONT OF HOUSE INSPECTOR COMMENTS False PERMIT AFFILIATES WITH PL-6-15-1436 Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-239848. CREATED AS REINSPECTION FOR INSP-238312. NO ANSWER NONE HOME SECOND INSPECTION NO ONE HOME NO ANSWER AT CONTRACTOR NUMBER 305-271-2800 Failed PAY RE FEE 75.00 Correction Needed ❑ Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. September 02,2015 For Inspections please call: (305)762-4949 Page 13 of 35 Permit NO. PL-7-15-1662 Miami Shores VillagePermit 1 yp ,Plumbing-R$Sidential: ; 10050 N.E.2nd Avenue NE Work Classification:Addition/Alteration ' Miami Shores,FL 33138-0000 Per, 0 Phone: (305)7952204 ,,, f $% I Permit Status:APPROVEDA,, issue Date:7114/2015 Expiration: 01/10/2016 Project Address Parcel Number Applicant 358 NE 101 Street 1132060135280 Miami Shores, FL 33138- Block: Lot: PATRICE AND SCOTT SMITH Owner Information Address Phone Cell PATRICE AND SCOTT SMITH 358 101 Street MIAMI SHORES FL 33138- 358 101 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 1,800.00 DEL MAR PLUMBING (305)271-2800 ()= Total Sq Feet: 00 Type of Work:RE ROUTE SANITARY LINE TO NEW SEPTI Available Inspections: Type of Piping: Inspection Type: Additional Info: Top Out Bond Return: Final Classification:Residential Scanning:3 Review Plumbing Underground Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 Invoice# PL-7-15-56205 DBPR Fee $2.25 DCA Fee $2.25 07/06/2015 Credit Card $50.00 $116.70 Education Surcharge $0.40 07/14/2015 Credit Card $ 116.70 $0.00 Permit Fee $150.00 Scanning Fee $9.00 Technology Fee $1.60 Total: $16610 In consideration of the issuance to me of this permit, I 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 accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the ove-named contractor to do the work stated. July 14,2015 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy July 14,2015 1 Miami Shores Village .� ✓�� (� g Department JUL 0 6 X015 n De artment � C� 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION UNE PHONE NUMBER(3oS)762-4949 FBC 20 BUILDING Master Permit No.RZZ5—_.j PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ELECTRIC ❑ ROOFING ❑ REVISION ❑EXTENSION ❑RENEWAL %PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: reg--- �Sg J V L� 0 '�" st- _ CY' Miami Shores County Miami Dade Z 3 ( 3 8 Folio/Parcel#: D the Building Historically mated;Yes NO Occupancy Type' Load: - Construction Type• Flood Zone- BFE• FFE• OWNER:Name(Fee Simple Titleholder): Phone#, Address:�y-� E ) C. State. Zip: 93 Tenant/Lessee Name: Phone#. Email: For V--v.^ Ie� f Corl�� 03 CONTRACTOR:Company Name: /J�- Phone#: -90. 7/Z�es� Address: ®/3 1<i.,l /3 let5 A- d City- 4?a I / Tap:_ 3.3/4� Qualifier Name: e_ „� �-, 8,j 04 ti J Phone#: 3©S 2 7/ 725 u State Certification or Registration `>;Z Certificate of Competency#: DESIGNER:Architect/Engineer. Phone#- Address: W. State. Zp. Value of Work for this Permit Square/Unear Footage of Work Type of Work ❑ Addition ❑ Alteration ❑ New EN Repair/Replace ❑ Demolition Description of Work_ I R D f e SA-W; f A& •" If C9 alF �'/ 7-4-kl r c',rl ed i, Fr., �J� JGlm11 Specify color of color thru We: Submittal Fee$ Q®Q Permit Fee$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ wry$ Technology Fee$ Train1ndEducation Fee$ Double Fee$ Structural Reviews$ Bond$ :L 1 h—(� G (RevCsed02/24/2014) TOTAL FEE NOW DUE$ 0 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 cert 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 ap laws regulating construction in this jurisdiction. 1 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$250,the applicant must promise in good faith that a copy of the notice of commencement and construction lien low brochure will be dern ed to the person whose property is subject to attachment Aiso,a cerbf'red 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 inspection will not be approved and a reins ection of such Pied notice, the P fee will be chorged_ Signat a ( ��C�' Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing Instrument was acknowledged before me this XV"'—day of rx�1 20 1 .by Aday of U/141 20_J!,by who is personally known to who' Ily�knowno me or who has producedF! S X30 Ivb� ��,00 p as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBUG NOTARY PUBLIC: Sign: Print: Print: �- Seal: ►Ar o µ►Y p� sssssss3sssss*s°� :�`�s,sl�ER��gR ssssssssssssssssssSsesasl:sssssss:,firs..a,w�r�,s*:ry4s��MMGIS1MCRNI'a�gFFsR 16 °MYCOL6ISSIQCF1I �11 EXPIRESd. F 014ESJuly 222018� ,� &1Wr* y s *sssssssssssssss APPROVED BY '}' f s Plans Examiner Zoning Structural Review Clerk (Revised02/24J2014) Jun 261510;57a Microsoft 305-253-4003 P.1 011870 Local Business Tax Receipt Miami-Bade County, State of Mond 7MS is NMA BILL - DEI NOT PAY 5980165 BvsrNr�ss prAa��r_ocnrTaN DFL MAR PLUMBING INC REce`�' NO' EXPIRES 9013SW138STA EW lNt,SEPTEMBER.30, 2845 MIAIW R 33176 sc be dWsptayed at place of buses Pursuant to County Cod® . Chapter 8A-ArL9&IQ OWNER Sr:C-TYPE OF BUSINESS DEL MR PLUAWNG INC 196 PLUMBING CONTRACTOR PAYMEW RECEMED Worker(s) t CFC1427248 BY TAR COUjICTOR . 875.00 07/16/2014 CHECK21-14-020946 ka�ra ��tGo� ettlmlocalBaslnsyslax The isaata ffcmsa � ' R'�saod� �dubasiaess.Affidar°°steatapi�►vrdbanYSoor " ThORECEIPrUMalm aP�+lyEoZbeb sisem amatbe dlsplaye�oo alleo�el�rehicles—Alii-,�8 .�c8ir27Gc Farmma irdo¢mqti RICK SCOTT; GOVERNOR KEN LAIM ON,SECRETARY STATE OF iFLOMDA DIEPA'RTMENT OF SUSNESS AND PROFESSIONAL REGULATM WDUSTRY LICENSM BOARD CFC1427248 The PLUMBING CONTRACTE3R !Named below IS CERTIF, UrKler Me F- Pi tion d8fee. AUG39? 69 x489 FS ROLOAN,GERLjAN E - .^ DEL MAR PLUMBIr4G INC - ILI SSW 138 STS#A . FL 33176, -•• X14 D1SPLAYAS REQUIRED BY LAW SEQ# L1 110a Aca CERTIFICATE OF LIABILITY INSURANCE THIS CERTIF"TE IS ISD AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS Uri THE t33tTIFICATE HOLDER.THUS CERTIFICATE IDES NOT AFFIRIEATrAH-Y OR NEGATIVELY AMEND. EXTEND OR ALTER THE COVERAGE AFFORD BY TUE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER131 AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERnRCATE HOLDER IMPORTANT: If the cordficaft holder is an ADDITIONAL INSURED,the policy(r�rte be N SUCTION IS WANED.sit to the forms and contiffions ofthe policy,certain poftles may racpfus an ondowerneaL A shitement of tk1s cordlicale does met confer milts to the cera firato holder In Uau of such e PRODUC REddy Gana ff"WIEGaza Insurance Allen y,LLC 785,35&550D Fax _786-35&5066 PO BOX 562829 gest,FL 33255 QbuImw1QQM s MDMA. AwMW lmmna tca Company 11573 uwuRw Dal Mar PdanbutU,hw etre. 9013 SIN 138 ST#A LuTmk FL33176-7158 Itlster�c: 9D• AssociatedInlfs limmance Co,Inc 23740 DISURERE: F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POUCI6S OF INSURANCE LiS EU BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLY PERIOD INDICATED. NOTWITHS DING ANY REBURENENT,TERRA OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO VuHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONSAND CONDITIONS OF SUCH POI.iC1ER LIMTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLANS. TMOF01SURFACE AWL SLM POLICY PCNJCYEXP p .OBIS A eEIa»u.uABLIM EDENOtt s 1,000,000 CONUEFUML tit trAlt LRY CPP 0013398-1 041i4P2815 0411412MS a 100,000 ::1 CLA804MDE ®OCCUR uEsFw("Gw s 5>000 IPERSCM&ADVKRW a 1,000,000 c AGGRIMATE s 2,000,000 GEN.AGGREGArE Lahr APPLIES PEft PRODUCTS-COMP20PAGG S 2,00,000 POL.ILY pEJtor, s Colummomwtuar AUTONOBILELIAMLITY fEaMWkIM6 ANYAITO - YRWRY074ffe ) a � SCHEDULED YOLKWto� a MS AUTOS HIRED AUTOS AUTOS a a w�tAlYtBHamAc%mVkUADE EACH a EXCMUMANTE S R> rd$ s D Rale- 1 1oTRR &M uram ANY MADUMUTI& Y❑ erA AINC1025323 lotli.0% 1a1l=5 ELLEA to T aOFRCERNAEMBER 100,000 t ,r1nK" EL -rAH9q.OVM $ 10,000 'c ERAr�raSt E.Lo -pc;Lr-Yttar Is 100,000 IEWWWOR OFOHMMMS1LOCATBB/BJI Ina�-ft WORD st,A S&eoftIr es+ Phmt iq Contractor CERTIFICATE HOLDER CANCELLATION MIaInI Shores VBap SHOULD ANY OF THE ASE 1DESCRIBIED POLES BE CANCELLED BARE 10050 NE 2nd Ave 7w EXpM7 Hi DATE THEREOF, I . BE DELIVERED IN MIar1I Shom Vim,FL 33138 ACCORDANCE=IN WE POLR.9f TttE 019BB-2(T10 ACORO CORPORATION. All rigids reserved ACORD 25(2MOM) The ACORD name and logo are regislered marks of ACORD