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PLC-15-1805 (2) Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone:(305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-241188 Permit Number: PLC-7-15-1805 Scheduled Inspection Date:August 25,2015 Permit Type: Plumbing-Commercial Inspector: Diaz,Osvaldo Inspection Type: Final Owner: , BARRY UNIVERSITY Work Classification: Addition/Alteration Job Address:11300 NE 2 Avenue Landon Student Miami Shores,FL 33138-0000 Phone Number Parcel Number 1121360010160-32 Project: BARRY UNIVERSITY Contractor: MANNY&LOU PLUMBING CONTRACTORS INC Phone: (305)666-7811 Building Department Comments INTERIOR RENOVATION/ALTERATION OF FOOD Infractio Passed comments SERVING LINE INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-239414. provide a vented EU/ access panel for aav and remove insulation Failed Correction U Needed �t❑ t49 I� Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid August 24,2016 For Inspections please call: (305)762-4949 Page 15 of 33 WW" �� Miami Shores Village j/ Ph;mtkr Zipft IIIt�# 10050 N.E.2nd Avenue NEAQ r Will' �' 3�= 3 Miami Shores,FL 33138-0000 Phone: (305)795-2204 ww issue I� ?"I21l20'f Expiration: 01/17/2016 Project Address Parcel Number Applicant 11300 NE 2 Avenue Number: Landon Studen 1121360010160-32 Miami Shores, FL 33138-0000 Block: Lot: BARRY UNIVERSITY INC Owner Information Address Phone Cell BARRY UNIVERSITY INC 11300 NE 2 Avenue MIAMI SHORES FL 33161-6628 11300 NE 2 Avenue MIAMI SHORES FL 33161-6628 Contractor(s) Phone Cell Phone Valuation: $ 5,700.00 MANNY&LOU PLUMBING CONTRAC (305)666-7511 Total Sq Feet: 0 Type of Work:INTERIOR RENOVATION/ALTERATION OF F Available Inspections: Type of Piping: Inspection Type: Additional Info: Top Out Classification:Commercial Re Pipe Scanning:1 Main Drain Heater Water Service Final Water Main Lavatory Review Plumbing Underground Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $3.80 DBPR Fee Invoice# PLC-7-15-56392 $3.38 07/20/2015 Credit Card $50.00 $194.36 DCA Fee $3.38 Education§urcharge $1.20 07/21/2015 Credit Card $ 194.36 $0.00 Permit F(WI $225.00 Scanningtte $3.00 TechnoloWFee $4.80 Total: $244.36 M1� M1•7 M1J S'7 O In considion of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining reto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting AMs permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required fqr-ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. s OWNERSFIDAVIT: I certify that all the foregoing informati is accurate and that all work will be done in compliance with all applicable laws regulating constructiNand zoning. Futhermore,I authorize the above-na ed contractor t do the wor tated. July 21, 2015 Aorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy July 21,2015 1 RECEIVE- Miami ECEIV -Miami Shores Village JUL 2015 Building Department BY: --_= 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 TV INSPECTION LINE PHONE NUMBER:(MS)762-4949 S FBC 201 BUILDING MasterPermit No.CC-3-15-522 PERMIT APPLICATION Sub Permit No.�;to �! LcyD []BUILDING []ELECTRIC ROOFING REVISION ❑EXTENSION []RENEWAL PLUMBING [:]MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS 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): &,(t'f 11111 VP TS& Phone#: W— "1-31000 Address: )1150 !Lc 9 &Z City: M t a wi d Sl%orPS State: Zip: 33! to I Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: Manny&Lou Plbg Phone#: 3056667511 Address: 7125 SW 47 St.#307 cit ,. Miami State: FI. ZIp. 33155 Qualifier Name: Manuel Fuentes J. Phone#: 3056667511 State Certification or Registration#: CFC 1426706 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$5,700.00 Square/Linear Footage of Work: Type of Work: ❑ Addition [K Alteration `` ❑ New t ❑ Repair/Replace ❑ Demolition Description of Work: Sy%+@.vyd r d� foej Sd ryiyta L%y,.e- Specify color of color thru We: Submittal Fee$ Permit Fee$ iffi CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (kMseW2/24/2014) , g Bonding Company's Name Of 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$2SW,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. L'J� Signature Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The f egoing Instrument was acknowledged before me this _ .1__day of 20 I'S day of Ua4 .20 1 .by Si�:50 in �Co 5 P U� r l .who is ersonally kno to �G?1 who is personally known to llbki"y me or who has produced as me or who has produced as Identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign:—IA Print: d .ehV1 l S 0164& Print: r Seal: r Seal: ' •P"�o YYONNE E94 w p�ic gUM d Fish * MY COMMISSION Ii EE 8491i� rig gmitA EXPIRES:November 11,2016 yComvbsbnEESUMn,+iilt �lFi1k APPROVED BY d®� Plans Examiner Zoning Structural Review Clerk IReylseM/24/20141 I , 1 .... ami Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305)795.2204 Fax: (305)756.8972 CONTRACTORS' REGISTRATION IF CONTIjACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LICENCES B. COPY OF LOCAL_ BUSINESS TAX RECEIPT COPY OF LIABILITY INSURANCE* D COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor 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 form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder. `J MIAMI SHORES VILLAGE BLDG DEPT 'X 10050 NE 2ND AVE U MIAMI SHORES,FL 33138 Certificate must specify the description of operations or contractor license num ........... SON ■./............1..■.............................. BUSINESS NAME: BUSINESS ADDRESS: CITY STATE ZIP BUSINESS PHONE: FAX FAX NUMBER(� CELL PHONE( QUALIFIER'S NAME: QUALIFIER'S LIC NUMBER: f I � i I STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850)487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 FUENTES,MANUELAJR MANNY&LOU PLUMBING CONTRACTORS INC 7125 SW 47TH ST BAY 307 MIAMI FL 33155 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,iron bogs 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 CFC1426706 LSSUED: 07/03/2014 serve you better. For intornlation about our services,please log onto www.myflorldalicerme.com. There you can find more Information CERTIFIED PLUMBING CO about our divisions and the regulations that impact you,subscribe CONTRACTOR to department newsletters and learn more about the Department's FUENTES,MANUELA JR initiatives. MANNY&LOU PLUMBING_CONTR6CTORS I Our mission at the Department is:License Efficiently,Regulate Fairly. 1Ne 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.499 FS. and congratulations on your new Iicensel Expkahm dM 7 AUG 31,MI5 ua 103MOS 7 DETACH HERE RICK SCOTT,GOVERNOR KEN LAWSON.SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD CFC1426706 The PLUMBING CONTRACTOR + i Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG.31 2016 FUENTES;MANUELAJRaSol D MANNY&LOU'PLUMBING CON CTORS IX 7.125_SW 47TH ST :;u BAY 307. .MIAMI FL 3311 n r ISSUED: 07103=4 DISPLAYAS REQUIRED BY LAW SEQ# L1407MOD00957 000967 Local Business Tax Receipt Miami—Dade County, State of Florida -THIS IS NOTA BILL - DO NOT PAY 966441 LBT7--1 BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES MANNY&LOU PLUMBING CONTRACTORS INC RENEWAL SEPTEMBER 30, 2015 7125 SW 47 ST 307 966441 Must be displayed at place of business MIAMI FL 33155 Pursuant to County Code Chapter 8A-Art 9&10 OWNER SEC.TYPE OF BUSINESS PAYMENT RECEIVED MANNY&LOU PLUMBING CONTR INC 196 PLUMBING CONTRACTOR BY TAX COLLECTOR Worker(s) 10 CFC1426706 $75.00 07/23/2014 CHECK21-14-032055 This Local Business Tau Receipt only confirms payment of the Local Business Tax.The Receipt is not a Hcense, permit,or a certification of the holder's qualifications,to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the busing. The RECEIPT N0.above must be displayed on all commercial vehicles-Miami-Dade Code Sec ea-V6. For more information,visit www.miamidade.govAoxcollector ,1t �--,MON MANNY-3 OP ID: FI DATE(MWDDIYYYY) �.,. CERTIFICATE OF LIABILITY INSURANCE 07/17/2015 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(les)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 CONTACT Brown&Brown of Florida,Inc. PHONE Fax 1201 W Cypress Creek Rd#130 a/c No Exti: AC No): P.O.BOX 5727 E-MAIL Ft.Lauderdale,FL 33310-5727 ADDRESS: Andrew Noye,CIC,CRIS INSURERS)AFFORDING COVERAGE NAIC fl INSURER A:Nat'l Fire Ins Co of Hartford 20478 INSURED Manny&Lou Plumbing INSURER B:Transportation Insurance Co. 20494 Contractors,Inc. INSURER C:Brid Employers Ins.Co. 10701 efield 7125 SW 47 St.Bay 307 9 Miami,FL 33155 INSURER D:WestchesterSurpl Lines InsCo 10172 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MM/DD MM/DD LIMITS GENERAL LIABILITY MN ACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY 5099257931 02/07/2015 02/07/2016 PREMISES Ea occurrence $ 500,000 CLAIMS-MADE �OCCUR MED EXP(Any one person) $ 15,00 PERSONAL&ADV INJURY $ 1,000,000 D X Pollution Liabili G27596782001-SEE NOTES 05/11/2015 07/31/2015 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY X j,CTPRO LOC Poll Liab $ $1M/$1M AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 A X ANY AUTO 5099257959 02/07/2015 02/07/2016 BODI LY I NJURY(Per person) $ ALL OWNED SCHEDULED (BODILY INJURY Per accident AUTOS AUTOS ) $ X HIRED AUTOS Lx NON-OWNED PROPERTY DAMAGE $ AUTOS PER ACCIDENT X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 B EXCESS LIAR CLAIMS-MADE 5099257945 02/07/2015 02/07/2016 AGGREGATE $ 5,000,000 DED I X I RETENTION$ 10,000 $ WORKERS COMPENSATION X WC STATU- X OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER C ANY PROPRIETOR/PARTNER/EXECUTIVE83052078 01/01/2015 01/01/2016 E.L.EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? a N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 A Equipment Floater 5099257931 02/07/2015 02/07/2016 Scheduled 536,34 Leased/Re 25,00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) Contractors License# CFC 1426706 CERTIFICATE HOLDER CANCELLATION MIAMISH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Village of Miami Shores THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Building Dept. 10050 NE 2nd Avenue AUTHORIZED REPRESENTATIVE Miami Shores,FL 33138 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD FG27596-7782001 MANNY-3 PAGE 2 INSURED'S NAME Manny 8�Lou Plumbing OP ID:FI nate 07/17/2015 ld Liability: m: Occurrence ims Made Limit: $1,000,000 General Aggregate $1,000,000 Contractor's Pollution Liability - Each Pollution Condition Deductible: $2,500 Contractor's Pollution Liability - Each Pollution Condition Project Specific Only: Job# /Project : UM C-724