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PL-14-1649 (2) 1+ I` Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-216871 Permit Number: PL-7-14-1649 Scheduled Inspection Date: April 28, 2015 Permit Type: Plumbing - Residential Inspector: Diaz, Osvaldo Inspection Type: Final Owner: Work Classification: Addition/Alteration Job Address:9400 NW 2 Avenue Miami Shores, FL 33138- Phone Number Parcel Number 1131010150290 Project: <NONE> Contractor: ECO-TECH PLUMBING CORP Phone: (305)969-5486 Building Department Comments WORK TO BE DONE AS PER MASTER PERMIT Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed CJ Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. April 27, 2015 For Inspections please call: (305)762-4949 Page 3 of 29 FRECIPJ�7F'I ' i Miami Shores Village LBY-.741114 �uBuilding Department — 1 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 20 LO BUILDING Master Permit No.RC14-1224 PERMIT APPLICATION sub Permit No ) q— LG Lq ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION F-] EXTENSION []RENEWAL ❑■ PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 9400 NW 2 AVE City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO X Occupancy Type: R-1 Load: Construction Type: CBS Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): ELITE HOME PARTNERS Phone#:305-905-6913 Address:2300 WEST 84 ST#602 City: HIALEAH State: FL Zip: 33016 Tenant/Lessee Name: Phone#: Email: JDELAFE@TEAMDELAFE.COM CONTRACTOR:Company Name: J---C 7 ASI A_UV,61;V4 CSP Phone#: -'?6`t—Sy&6 Address: /4Sf NNS SS' C,1AZCAy P[�4CC City: IWI. "4/ State: �'L Zip: 7 Qualifier Name: MASA" A ?7lu/l�o s Phone#: State Certification or Registration#: CAC A429 621/ Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ 1 Jr _60 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑■ Alteration ❑ New ❑ /Re lace Re air p p El Demolition Description of Work: WORK TO BE DONE AS PER MASTER PERMIT Specify color of color thru tile: Submittal Fee$ Permit Fee$ 'F� CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (Revised02/24/2014) r 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. Signature46a-t-.. r>�- Signature _( OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before Imre this The foregoing instrument was acknowledged before me this 22 day of 20 N'T , by -L'T day of NM6 Y 20 y by (a]DIC1,16 t4 tei personally kno to -N-44,44f Q- M /A*10S ,who i personally knowA to 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: 6tn( Sign: Wa so RAA f P n Print: Jnr S .° Notary Public-State of Florida Seal: ,� * M`iCOM141SSION0EE024272 My Comm Expires Oct 24,2017 EXPIRES:October S,2014 Commission N ff 066091 �eo�`ON •��.9;,t,:,,•. APPROVED BY } �cr-� Y Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) AC40 CERTIFICATE OF LIABILITY INSURANCE DA3/,' ,`4YY' 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 NAME: WILLIAMS SACKS PHC No 866.266.6101 No: 972.421.1776 1730 ELM AVE E-MAIL morgandean@sbcglobal.net NORTHBROOK IL 60062 INSURERS AFFORDING COVERAGE NAIL ff License#: INSURERA: ASCENDANT 38261 INSURED INSURERS: HARTFORD INS.COJRAMSGATE 38261 ECO-TECH PLUMBING CORP. INSURERC: 19507 NW 55 CIRCLE PL INSURER D: _ MIAMI,FL 33055 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. ---- — -INS --- ---TYPE OF INSURANCE .-__.._. ADDL SUER ------ ------ POLICY EFF_._-POLK:Y EXP LIMITS LTR POLICY NUMBER MMID MM/D GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PRREEMISEg EaE�,°�ence $ 100,000 CLAIMS-MADE a OCCUR MED EXP("one person) $ 5,000 A X GL42725 082713 082714 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 17 POLICYF-1 JECT PRO- LOC $ AUTOMOBILE LIABILITY COEa acddenlMBINED SINGLE LIMIT $ 1,000,000 X ANY AUTO BODILY INJURY(Per person $ B ALLOWNEDX SCHEDULED ATIIOI13-1 110113 110114 BODILYINJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per a s X UMBRELLA UAB OCCUR EACH OCCURRENCE $ 1,000,000 B EXCESS LIAB X CLAIMS-MADE UL110113-1 110113 110114 AGGREGATE $ 1,000,000 DED I I RETENTION$ $ WORKERS COMPENSATION X STATU- OTH- AND EMPLOYERS'LIABILITY YIN NY-UMI?$ -Ef3-------- ANY PROPRIETOR/PARTNER/EIIECUTIVE E.L..L.EEACH ACCIDENT $ 500,000 A OFFICERMEMBER EXCLUDED? ❑N N/A WCCO04557300 021114 021115 ------- ------------ (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) UC#CFC1428624 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN MIAMI SHORES VILLAGE ACCORDANCE WITH THE POLICY PROVISIONS. BUILDING DEPARTMENT 40050 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 Aug 28 14 02:49p p 1 A CERTIFICATE OF LIABILITY INSURANCE °Ao811 , Y") 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 riot confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: NellySardina Flamingo Insurance Agency,Inc PHONE (305)828 847 FFAX 305 556 51 (IVC,Nol: ) 21896 West 60 Sb ee%Sulte 202 ADDRE E40%R' nsardina min Nt ESS: �� 90 SuranCO.COiTI __ INSURER(S)AFFORDING COVERAGE NAIL R Hialeah FL 33016 INSURERA: UNITED SPECIALITY INSURANCE COMPANY 12537 INSURED INSURER S: Eco-Tech Plumbing Corp. INSURER C: 19507 NW 55th Circle Place INSURER 0: INSURER E: Opa Locka FL 33055 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. LTR POLICY E AID S FF POY EXP LIC TYPE OF INSURANCE � POLICY NUMBER IWO p1YYY LIMITS GENERAL LIABIL-ITY EACH OCCURRENCE S 1 G00000 X COMMERCLALGENERAL LIABILITY DAMAGt`1-45RENTEO SOOOO PREMSES 4p.000umo p $ CLAMS-MADE a OCCUR MED EXP(A-y orra pesos) $ SOOD A - - CGDOOD04700-01 06/17/2014 08/1712015 PERSONAL&ADV INJURY i 7000000 — GENERALAGGREGATE S _2000000 GEN'LAGGREGATE UNITAPPLIES PER: PRODUCTS-COMPIOPGG S POLICY • F71 $X POT LOC 1000000 AUTOMOUlLe LIABILITY COMBINED SINGLE OMIT ; ac Wont ANYAUTO BODILY 11 $ ALLOWNED SCHEDULED - ---- AUTOS AUTOS BODILYIOMRY(Peraadder;Q S HIRED AUTOS MON-OWAUTOS NEO PROPERTY DAMAGE1. S per dong i - s UMBRELLA LlA6OCCUR EACH OCCURRENCE _ $ EXCESS LIAB HCLAIMB-MADE OED ETAGGREGATE $ R $ WORKERS COMPENSATION �/ WC STATU- O rH- AND EMPLOYERS'LIABILITY YIN I_/� TORY LIMB B EL OFRCEPJRMEEM R EXCLUDE NIA WCC 0045573 02/f 1/2014 0211112015 E-L EACH ACCIDENT $ 500000 — (Mandatory In and �E.L WEASE.EAEMPLOY S 5500000 �If��aa deacbs ander _ DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LSAT .S 500000 DESCRIPTION OF OPERATIONS I LOCATIONS,,VEHICLES(Atlach ACORD 101,Additional Remarks Schedule,N more-para is required) Self Insured Relantion:$2,500 Per Claim CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Village ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd Ave AUTHORIZED REPRESENTATNE Miami Shores FL 33138 0 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD