The URL can be used to link to this page

PL-15-692 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-235973 Permit Number: PL-3-15-692 Scheduled Inspection Date: June 04, 2015 Permit Type: Plumbing - Residential Inspector: Diaz, Osvaldo Inspection Type: Final Owner: MOLINA,ADRIANA Work Classification: Addition/Alteration Job Address: 1059 NE 98 Street Miami Shores, FL 33138-2505 Phone Number (305)213-5070 Parcel Number 1132050180230 Project: <NONE> Contractor: BEST PLUMBING SERVICES COMPANY Phone: (305)558-8544 Building Department Comments PLUMBING IN KITCHEN AND 1 BATHROOM Infractio Passed Comments INSPECTOR COMMENTS False nspector Comments Passed CREATED AS REINSPECTION FOR INSP-231141. Failed Correction Needed 6 y Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. June 03, 2015 For Inspections please call: (305)762-4949 Page 15 of 28 Miami Shores Village Building Department MAR 27 2015 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel:(305)795-2204 Fax:(305)756-89724nrt G, INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 /0 BUILDING Master Permit No. ? _ S ._ gg- PERMIT APPLICATION sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP A� }} CONTRACTOR DRAWINGS JOB ADDRESS: -�> City: Miami Shores County: Miami Dade Zip: 'Z 3) 5 JS Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder): i h/ �,��n/P Phone#:7,p< 7� �o o Address: aAg City: SlL�6a; f_ o lS� State: L Zip: 33 13 9 Tenant/Lessee Name: Phone#: Email: G CONTRACTOR:Company Name: �CS7 i�1`/��^ �� ( ,L'(J ('`-a. Phone#: 3a v.5S9!_Z,L1 Address: 05 c S f� aa City: r � J state: / �-� Zip: 3 a 1 3 04 Qualifier Name: DS /�Lr Z Phone#: State Certification or Registration#: - �� 1��G c3� Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ �p O Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New 1 p ❑ Repair/Replace ❑ Demolition Description of Work: FI�(�� b i y" � bc-kl it L, LIJLA d �� 100 Specify color of color —thru tile: Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ 1 (Revised02/24/2014) f ' 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. 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$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 Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this T YV1 day of M"f 20 s by day of /`��f� ,20 16— by cls f c-I(1 n H c; + n`' who is personally known to Zwho is personally known to me or who has produced f L PL kySZ)_E)c (4i 16 as me or who has produced ke4S4QAq�/(y 1,<tia g1A) as identification identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: "� Sign: Print: tv 1 S`�c, '2 ^x Print: S/ e— qac:P J.DOYLE Seal: A MEUSUR.ILM Seal: = ' . _,: r- MY COMMISSION#EE 151729 o P�° Notary Public,State of F]2015 •. EXPIRES:December 27;2015 .... ` Bonded Thru Notary Public Underwriters 11 Commission#EE 107RSA" My avmm,expiree June 2 ************ **************************************************************** APPROVED BY �� s Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD 1 CFC1426732 The PLUMBING CONTRACTOR Named below IS CERTIFIEDg c's° Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 RODRIGUEZ, JOSEPH r BEST PLUMBING SERVICES COMPANY 251 E 44TH ST HIALEAH FL 33013 ISSUED. 07/15/2014 DISPLAY AS REQUIRED BY LAW SEO# L1407150000913 007658 Local Business Tax Receipt Miami-Dade County, State of Florida —THIS IS NOT BILL — DO NOT PRY \1LBT 3920056 �/ �g �a BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES BEST PLUMBING SERVICES CO RENEWAL SEPTEMBER 30 2015 251 E 44 ST 4092946 Must be displayed at place of business HIALEAH EL 33013 Pursuant to County Code Chapter 8A—Art.9&10 OWNER SEC.TYPE OF BUSINESS BEST PLUMBING SERVICES CO 196 PLUMBING CONTRACTOR PAYMENT RECEIVED CFC1426732 BY TAX COLLECTOR Worker(s) 3 $45.00 07/18/2014 CREDITCARD-14-028590 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, 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 business. The RECEIPT N0,above must be displayed on all commercial vehicles—Miami—Dade Code Sec 8a-276, For more information,visit www miamidade govhaxcoHector -4 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 1 03/17/2015 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(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 CONTACT MARIA A RAMOS _ Proper Insurance Agency NAME: PHONE FAX - 471E 49Th St A/C No,Ext) 305-681-1645 A/c No): 305-688 9362 - - E-MAIL erins mail.com Hialeah FL 33013 -ADDRESS: proP_ @9 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:ARCH INSURANCE COMPANY INSURED BEST PLUMBING SERVICES CORP INSURERS: 251 EAST 44TH STREET INSURER C: HIALEAH FL 33013 INSURER D: 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 I. _.�ADDL'SUBR�' Y_.-._- POL LTR I TYPE OF INSURANCE POLICY NUMBER MM DID/YYYY 'r MM DD//YYYY LIMITS COMMERCIAL GENERAL LIABILITYI. EACH OCCURRENCE $ 1,_0.00.000 CLAIMS-MADE v OCCUR DAMAGE TO RENTED 1 -- -- -- _PREMISES(Ea occurrence) $ 100,000 — — AGL0020033-00 '12/07/2014 12/07/20151 M ED EXP(Any one person) $ 10,000- PERSONAL&ADV INJU RY 0,000PERSONAL&ADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,0_00 PRO- '' ___....-__...-..-- --_- -:--- — POLICY JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: 1 $ COMBINED SINGLE LIMIT $ AUTOMOBILE LIABILITY (Ea accident) _- _ _ ANY AUTO BODILY INJURY(Per person) $ _- - ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ _ HIRED AUTOS NON-0WNED PROPERTY DAMAGE $ --- AUTOS ISI Per acadent)---- UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE!, AGGREGATE $ -----__ _ _._.— - - - - ----_ - _ -- DED RETENTION$dwo'KERS ! $ AND EMPLOYERS'LIABILITY PER OTH- STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N — — rt - -- -- -- ( ry COMPENSATION .. E.L.EACH ACCIDENT $ Mandato in I __-...__ -_. --- -- —_ --.. _-- OFFICER/MEMBER EXCLUDED? � N/A III If es,describe under --_ --_- -_-T$ -- li Y E.L.DISEASE- A EMPLOYEE DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ F ilF—1 III DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RESIDENTIAL/COMMERCIAL PLUMBER CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE BUILDING DEPARTMENT THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 NE 2ND AVE ACCORDANCE WITH THE POLICY PROVISIONS. MIAMI SHORES,FL 33138 AUTHORIZED REPRESENTATIVE /J ?�� ,,-Z�,-.e-' @ 1988-2014 ACORD COR ORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Produced using Forms Boss Web software.www.FormsBoss.com;?Impressive Publishing 800-208-1977 F� JEFF ATWATER CHIEF FINANCIAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS'COMPENSATION **CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS'COMPENSATION LAW CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers'Compensation law. EFFECTIVE DATE: 8/30/2014 EXPIRATION DATE: 8/29/2016 PERSON: RODRIGUEZ JOSEPH FEIN: 650811170 BUSINESS NAME AND ADDRESS: BEST PLUMBING SERVICES C 251 EAST 44TH STREET HIALEAH FL 33013 SCOPES OF BUSINESS OR TRADE: LICENSED PLUMBING CONTRACTOR Pursuant to Chapter 440.05(14),F.S.,an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter.Pursuant to Chapter 440.05(12),F.S.,Certificates of election to be exempt..apply only within the scope of the business or trade listed on the notice of election to be exempt.Pursuant to Chapter 440.05(13),F.S.,Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation ff.at any time after the filing of the notice or the issuance of the certificate,the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate.The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 07-12 QUESTIONS?(850)413-1609 ORE'S '(14C 1932 1,,,, ,,,,,M Miami shores Village Building Department �l0RiDp' 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner - Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees,including the owner,must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if: 1. The officer owns at least 10 percent of the stock of the corporation, or in the case of an LLC,a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State,Division of Corporations;and 3. The corporation is registered and listed as active with the Florida Department of State,Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers'compensation exemption and has acknowledge that he or she will not use day labor,part-time employees or subcontractors for your project.The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project. In these circumstances,Miami Shores Village does not require verification of workers'compensation insurance coverage from the contractor's company for day labor,part-time employees or subcontractors. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: Owner State of Florida County of Miami-Dade The foregoing was acknowledge before me this day of I ��y ,20 1, By A A 1 Ci Y) at b' i-()CN who is personally known to me or has produced V L r'1 �D _�)60-' 4 136as identification. �A ,� MELISSA R.LAX Notary: _ o Notary Public,State of Florida Commission#EE 107488 SEAL: spaMy comm.expires June 28,2015 (305) 558-8544 FAX: (866) 229-8550 t >tpiunbna r.i---_s ��niatl,��ml CFC1426732 Date: 3/2512015 State of Florida County of Miami-Dade Before me this day personally appeared Joseph Rodriguez who. being duly sworn, deposes and says: That he will be the only person working on the project located at: 1059 NE 98"" STREET MIAMI SHORES. FL 33138 Sworn to (or affirmed) and subscrib d fore me this 25`h day of March. 2015, By Joseph Rodriguez Personally know OR Produced Identification -� •�.L 2 �._ Lp Type of Identification Produced L— \\11111// ROCIO zAMBRANo Notary` •�, y Public- State of Florida MY Comm.Expires Oct 27,2017 ) Commission #FF 34822 "1Ir1Tlt, Type Or Stamp Of Ota.ry BondeRP d through National Notary Assn. Miami Shores Village Per�T �� 10050 N.E.2nd Avenue NE GJ*CI�S fI A�lidtrtllA ion • �""'i�' Miami Shores, FL 33138-0000 PermittR":AP Phone: (305)795-2204 .,... Fta�,tiA al Expiration: 09/29/2015 Project Address Parcel Number Applicant 1059 NE 98 Street 1132050180230 Miami Shores, FL 33138-2505 Block: Lot: ADRIANA MOLINA Owner Information Address Phone Cell ADRIANA MOLINA 1059 NE 98 Street (305)213-5070 MIAMI SHORES FL 33138- 1059 NE 98 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Ltion: $ 1,600.00BEST PLUMBING SERVICES COMPAP (305)558-8544 Sq Feet: 00 Type of Work: PLUMBING IN KITCHEN AND 1 BATHROOM 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-3-15-54959 DBPR Fee $2.25 04/02/2015 Credit Card $ 116.70 $50.00 DCA Fee $2.25 Education Surcharge $0.40 03/27/2015 Credit Card $50.00 $0.00 Permit Fee $150.00 Scanning Fee $9.00 Technology Fee $1.60 Total: $166.70 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 tW all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zonin ,F I authorize the above-named contractor to do the work stated. April 02, 2015 Authorized Sin ure:Owner / Applicant / Contractor / Agent Date Building Department Copy April 02, 2015 1