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PL-15-1887 7 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (306)796-2204 Fax: (305)756-8972 Inspection Number: INSP-240041 Permit Number: PL-7-15-1887 Scheduled Inspection Date: September 02,2015 Permit Type: Plumbing - Residential Inspector: Diaz, Osvaldo Inspection Type: Final Owner: CAICEDO,JUAN Work Classification: Addition/Alteration Job Address: 162 NW 106 Street Miami Shores, FL 33150-1248 Phone Number (561)340-4300 Parcel Number 1121360080060 Project: <NONE> Contractor: BIONIC PLUMBING CORP. Phone: 305-498-9100 Building Department Comments NEW GAS VENT SYSTEM FROM HEATER TO CEILING Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction Needed ❑ Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. September 01,2016 For Inspections please call: (305)762-4949 Page 18 of 47 � max' r� Miami Shores Village say I 10050 N.E.2nd Avenue NW � [ Miami Shores,FL 33138-0000 . Phone: (305)795-22043 a W Expiration: 16/2016 Project Address Parcel Number Applicant 162 NW 106 Street 1121360080060 JUAN CAICEDO Miami Shores, FL 33150-1248 Block: Lot: Owner Information Address Phone Cell JUAN CAICEDO 162 NW 106 Street (561)340-4300 MIAMI SHORES FL 33138- 162 NW 106 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 400.00 BIONIC PLUMBING CORP. 305-498-9100 ..:u ....,... � Total Sq Feet: 00 Type of Work:NEW GAS VENT SYSTEM FROM HEATER TO Available Inspections: Type of Piping: Inspection Type: Additional Info: Top Out Bond Retum: Final Classification:Residential Scanning:3 Review Plumbing Underground Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 DBPR Fee Invoice# PL-7-75-56491 $2.00 07/28/2015 Credit Card $50.00 $64.60 DCA Fee $2.00 Education Surcharge $0.20 08/20/2015 Credit Card $64.60 $0.00 Permit Fee $100.00 Scanning Fee $9.00 Technology Fee $0.80 Total: $114.60 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the above-named contractor to do the work stated. August 20,2015 Author "ed Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy August 20,2015 1 i Miami Shores Village CEIVED Building Department 1 JUL ti 8 2095 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 BY: eJ INSPECTION'S PHONE NUMBER:(305)762.4949 FBC 201'/ BUILDING Permit No.� 1 ®��w / Rif? PERMIT APPLICATION Master Permit No. Permit Type: P LUAMING JOB ADDRESS: 4jr•W• ��� City: Miami Shores County: Miami Dade Zip: e-7 40 Folio/Parcel#: Is the Building Historically Designated:Yes NO Flood Zone: OWNER:Name(Fee Simple Titleholder);�w"'lr �dZ&_ J Phone#:ss /6 `4 46 7'' Address N •W - /O`pZ� City: '.aerg 5 State: Zip: Tenanftzssee Name: Phone#: Email: CONTRACTOR:Company Name: a'—'. PhonA4Te2_ Address: J k) e!f1bU474— City• State: Qualifier Name: D bG Phone#: State Certification or Registrati n# 74 0Certificate of Competency#:61 we Contact Phone#: Email Address:&W dg, 1� •G�� DESIGNER:Architect/Engineer: Phone#: Valve of Work for this Permit:$ 6Square/Linear Fooe of WorkType of Work: ❑ bAddress &Iteration ONew epair/Replace ODemolition Description of W$rk: 'V w Ci/9-S 1/ /I SN S r gol Submittal Fee$ Peru Fee$ ®�. 1CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ L01 , c 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 L 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement roust be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me day of ZO/ ���11.1 /� � day of .20 b , y � T� who' rsonally known to or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: C V Y ReBIiLOCK NQTARY PUBLIC: . •n r�unh Slate of fl0tldi ' m =xDires Nov 8,201$ m an EE 1446 Sign: S1 Print: is iuun► c My Commission Expires: w corm >e a a s My C w' da COMbOm 0 ME 144M Joanna M Feliciano w My CorF,mission FF 082753 sk�k8a�k�ksk�ksksk�ksR�ksknk�k�ksk�kae3�sR3s:kskskskskSaa2�k�ksi�sk�Ia�IaskskskSwl��F�F��4aakaksR�R�ksR�sk�ksRoRakaksk�A�kKwxsk�akBa:I��k�A ak ��g r � 018 aR �ksksia APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) a )2382 U6,A] Business Tax"R c-t apt Mia4.-Dade County, State of Florida" -THIS IS NOT A BILL - DO NOT PAY 4107025 BUSINEt`s8 NAME/LOCATION PIECEIPT 1110: �`���',�*+ti7: ": . BIONIC PL.UMBO G CORP REN uuAl. S PTEI IiB�R�}34, 20, I 80111 Sw 99 Gi , a 4 000 Mae; 15al 4i4plaxed a�pi o#1uainaas 1>r111lIMt"Fl, T3 PursuarxtttY'CiaurCq�]e Chaptar BA-;,l�rt.9 8i`1A OWNER SEC.TYPE OF BUSINESS PAYMENT RECEIVED BIONIC PLUMBING CORP 196 PLUMBING CONTRACTOR BY TAX 6OLLECTOR Worker(s) 1 000012646 $75.00 07/09/2015 CHECK21=15-085103 This Local Business?ax Receipt only confirms paymeot of the Local Business Tarr.The Receipt is not a license, permit,or a certification of the holders qualHlcatiolm,to dabosiness.Holder mug comply with any gaverltmental or nongovernmental regulatory lawe.and requirementswtiich apply to the business. The RECEIPT N0.above must be displayed on all commercial vehicles-Miami-Dads Code Secea-276. For more information,visitwww•miamidede.aovhazbolloctor IOS001 Loca[ Business Tax RaCeipt Miami—Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY LBT 6212286 BUSINESS NAMB/LOCATION RECEiPT NO. E"XP�RG"s Bioivtc PLUMBING coRIuuac SEPTEMBER 3p, 2016 $011_SVIf 99 Cr6Aa $9® Must ba disp1, a iplace of 660nass MIAMI 1 73 Pu rsuatit to Gstux►�y Code Chaitar.BA Art 981,T0. OWNER SEC.TYPE OF BUSINESS PAYMENT RECEIVED' BIONIC PLUMBING CORP 196 PLUMBING CONTRACTOR BY TAX COLLECTOR Worker(s) 2 CFC1427452 $75.00 07/09/2015 CHECK21-15-085183 This Local Business Tax Receipt only confirms payment of ft-Local Business Tax.The Receipt Is not a license, permit,are certification of the holders qquelHlcations to do business.Holder most comply with any governmental ocnoogovernmemai regulatory laws and requiremitats which apply to the business. The RECEIPT N0.above must be displayed on all commercial vehicles-Miami-Dade Codo is*Be-276. For more information,visitwvuw.miemidede.aovhezcollactor Jan 30 2015 10:49AM HP LRSERJET FRX p. 1 CERTIFICATE OMTE,MWDWYYY_Y► F CATE OF LIABILITY INSURANCE o,r3ons THIS CERTIFICATE IS ISSUED ASA 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 ISSILING INBURER(S).AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT: 8 the ced f kde holder is an ADDITIONAL INSURED,the pollcylkm)must be endorsed. ff SUBR00ATION IS WAIVED,subject to the terms a d sand itions of the policy,certain policies may require an endorsement. A statement on this rite does rM confer rights to the certificate holder In Oeu of shich endorsement(s), PRODUCER CONTAM YOANYS ARMIES US-1 UISY wce PHONE M5)WO-1422 (305)970-0013 9806 S.aw Hwy. uslmsurenoeS808@01.nel Mierni,FL 33156 INS AFFORDING COVERAGE NAICS Phone (305)070-1422 Fax 0-0013 INSURERA: GRANADA INSURANCE COMPANY INSURED INSURERS: Bonk: Plumbing Corp INSURER C: 8011 SW 9D Ct INSURER O: MIAMI,FL 33173• =5)2899741 NSNRER E. INSURERF: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS E 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 Sw"MAY HAVE BEEN REDUCED BY PAIDCLAIMS. LNT R TYPEOF INIANIANCE ADOL KER POLICY NUMBERAffin POKY EXP LIMITS GMERALLIABIIITY EACHOCCLRRBNCE s 1,0000M.00 ® CA ZERCIAL GENERAL.LIABILITY P X00 f 100.01M.00 ❑ ® CLAWS-MADE F] OCCUR 0185FL0001�8 rffiDEIP(Any wre!>8� s 5.000.OD A ❑ N N =23=141 09/23/2015 PERSONAL a ADV INJURY S 1.000.000.00 ❑ GENERAL AGGREGATE s 2.000.OIOO.00 GENT-AGGREGATE LMR APPLES PER: PRODLIcrs•COMPmP AGO s 2,000,000.00 L1 POLICY ❑ ❑ Loc S AUTOMOBILELUMLRYB e SINGLEumff ❑ ANYAUTO SODILYpWJUt RY(Perpersen) S ❑ AUTOS OWNED ❑ SCHEDULED BODILY INJURY(Per�tder�$ S ALffOS ❑ HIREDAums ❑ ANUCTNO SNNED P S ❑ S ❑ UMBRELLA LIAR ❑OCCUR EACHOCCURRENCE s ❑ EXCESS UAB ❑CLAIMS-MADE AGGREGATE S DED ❑ RETENTION S S WORKERS COMPS SAnON Elam ❑OT1 AND EMPLOYERS'LIABIUTY YIN ANYPROPRWTOWPARRNERtEJQ3aITiVE EL,EACH ACCIDENT $ OFRCER#AEMSER O(CLUOED? N I A "mu,lct In NHdewrbe ) L.01SEASE-EA EMPLOYES pESCR TION OF OPERATION bokm EL DISEASE-POLICY LILMR S s DESCRIPTION OF OPE RAT10NS$LOCATIONS r VEMIQES(AnaOh ACORD 101.AddItIeW RmwkB BOMWI9,N mora SM9 to mQuIred) COMMERCIAL1 RESIDENTIAL PLUMBING--- BIONIC PLUMBING CORP. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVEDESO CIES 13E CANCELLED BEFORE MIAMI SHORES VILLAGE THE EXPIRATION DATE THEREO OTI Bte DELIVERED IN I 0050 NE 2NO AVENUE ACCORDANCE VM THE MIAMI SHORES,FL 33138 AUTHORMOi MPRESPJNTATIVE ®1886 201 A PORATION. I res ed ACORD 26(2010106)OF The ACO and logo ere register r wksof ACCMI LK CERTIFICATE OF LIABILITY INSURANCE17/27/201527( 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 M URER(S), AUTHORED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the cerdflcete holder Is an ADDITIONAL INSURED, the policypes) must be endorsed. H SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement Aatertett on this certificate does not colder rights to the certificate holder In Rer of such eedorcement(e} PRODUCER CONTACT InterPay Solutions, Inc PPHHONE FAX 639 Cindy Lane � ,NO'Extr wy West Seneca, NY 14224 ADDRESS: l NSURER(S7 AFFORDING COVERAGE NAICS INSURER A: AssodaW Industries Insurance INSURED INSURER B: BIONIC PLUMBING CORPORATION INSURER C: 8011 SW 99 CT INSURER D: MIAMI, FL 33173 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. ffm LTRTYPE OF INSURANPOLICY W-1- POLICY I-" CE IVSm LYVD POLICY NUMBER (MMlDDNYYY) (MWOD/YY YY) LIMITS GENERAL. LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES(Ea oa�) $ CLAIMS-MADE 1:1 OCCUR MED EXP(Anyonepmon) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEML AGGREGATE LIMIT APPLIES PER PRODUCTS-COM PLOP AGG $ POLICY Ej JJpm LOC $ AUTOMOBILE LIABWTY $ ANYAUTO BODILY INJURY(Per pinion) $ ALLOWNED SCHEDULED BODILY INJURY(Peracciderd) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOSH $ AUTOS (Per accident) UMBRELLA A LIAB SUR EACH OCCURRENCE $ EXCESS LJAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION IN STATU AND EMPLOYERS LIABILITY YIN TORY L MITS 1 ANY PROMETORPARTNERIE7(ECUTIVE E 1_EACH ACCIDENT® $ 50MOO A In N" NSA AWC1046628 5/15/201 05/15/2016 F-I DISEASE-EAEMPLOYEE $ 50 Ryes,describe under 5000( DESCRIPTION OF OPERATIONS bakm E I DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Addiftnal RerroftSchedule,if fforespaw s required) License#CC12646 CERTIFICATE HOLDER CANCELLATION Miami Shores Village 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. 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