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WS-15-520 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-229816 Permit Number: WS-3-15-520 Scheduled Inspection Date: September 11, 2015 Permit Type: Windows/Shutters Inspector: Rodriguez,Jorge Inspection Type: Final Owner: OMENACA, CARLOS Work Classification: Window/Door Replacement Job Address:9300 N BAYSHORE Drive Miami Shores, FL 33138- Phone Number 305/756-0839 Parcel Number 1132050270130 Project: <NONE> Contractor: PENINSULA PLUMBING INC Phone: (305)310-3676 Building Department Comments REPLACE IMPACT WINDOWS 13 Infractio Passed Comments RENEWAL OF EXPIRED PERMIT WS12-908 INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. For Inspections please call: (305)762-4949 September 10, 2015 Page 6 of 31 Permit N©. WS-3-15-52 �sKO1 s L,� Miami Shores Village Permit Type.'WindoWsiShU q� 10050 N.E.2nd Avenue N orkCtassification:Window/Door Replac Miami Shores, FL 33138-0000 , er PennitStatus:'APPR Phone: (305)795-2204 'FCORLDAv ,. Issue Date: 3/1912415 Expiration: 11 015 Project Address Parcel Number Applicant 9300 N BAYSHORE Drive 1132050270130 Miami Shores, FL 33138- Block. Lot: CNiiLus GMENA�A Owns-ir..ormation Address Phone Cell CARLOS OMENACA 9300 N BAYSHORE DR 305/756-08:39 MIAMI SHORES FL 33138-2951 Contractor(s) Phone Cell Phone Valuation: $ 12,000.00 PENINSULA PLUMBING INC (305)310-3676 Total Scl Feat: 0 Type c,Work: REPLACE IMPACT WINDOWS 13 i„ Ava;lable Inspec ions: No of openings: 13 Inspection Type: Additirral Info: Window Door Attachment Classification: Residential Final Scanning: 3 Review Building Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $7.20 Invoice# WS-3-15-54738 DBFR Fee $3.45 DCA Fee $3.45 03/19/2015 Credit Card $ 290.10 $0.00 Education Surcharge $2.40 Lost Plans Fee $25.00 Perm,:gee $230.00 Scanning Fee $9.00 Technology Fee $9.60 Total: $290.10 In core Heration of the issuance to me of this perry t, I agree to perform the work covered hereunder in comp) ince with all ordinances and regulations pertair ,tg thereto and in strict conformity with the play s,drawings, statements or specifications submitted to the pro; er authorities of Miami Shores Village. In accepi,, g lri5 permit I assume responsibility for all +.✓ork 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 wor OWNERS AFFIDAVIT: I certify that all the foregoinc information is accurate and that all work will be done in corn diance with all applicable laws regulating construction and zoning. F thermore, I authorize the z,bove-named contractor to do the work stated. �? Mar ;h 19, 2015 Aut d ature:Owner / Applica it / Contractor / Agent Date Bu!!de m eDepartment Copy Marc 19, 2015 1 _ Miami Shores Village IgF BuildingDepartment MAR 10 zo,5 p � Pw 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 i oN Tel:(305)795-2204 Fax: (305)756-8972 -- -"-- ' INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 l BUILDING Master Permit No. +1.�'j PERMIT APPLICATION sub Permit No. 41 BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL F-]PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP q y� B CONTRACTOR DRAWINGS JOB ADDRESS: X300 A)• J/�S�SN®� � 2 City: Miami Shores County: Miami Dade Zip: -3313P Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: o G OWNER: Name(Fee Simple Titleholder): (24X0'5 DM€AjReo9 Phone#: 30f 7,F6 Address: '7306 A) . 8 4'rjS5 O2C' D2. City: HIR"/ /Z 6,5 State: rZ Zip: .331.3ff Tenant/Lessee Name: Phone#: Email: Q - jCONTRACTOR: Company Name: X14 Jct fir/ / ►�> Phonep f ✓� �✓ --Address: �� ��iL� G �-- Y✓ --City: �/1�+ �`„ State:: rZip: ,_.Qualifier Name: Phone#: --state Certification or Registration#: r� G s La ��/ Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: MM o p --Value of Work for this Permit:$ /2 Ci O Square/Linear Footage of Work: _Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work �J!N&A )o.1 rp� e� S _mom Qf rN-j jj_ S ( 2- - `o� Specify color of color thru tile: /�'1,`` Submittal Fee$_ W Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ _ TOTAL FEE NOW DUE$ (Revised02/24/2014) 1 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 a posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absenc such posted notice, the inspection will not be a proved and a r inspection fee will be charged. Signature Signature OWNER or AGENT TRACTOR The foregoing instrument ,,was acknowledged before me this The foregoing instrum n as acknowledged before me this ^ day of ,'t NAl 120 is by day of r 20 by R6scc who is aersonall��kno���n t� �1 �COA �/�n/ems , who is personally known to me or who has produced as me or who has produced i !91 meoj as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: U1jPrint: Print: Ge Notary Public State of Florida Seal: Seal: A LISSETT NODARSE ?YoF �; Joanna M Feliciano � Notary Public,State of Florida, �m a9a My Commission FF 082753 Commission#FF 110001 o@ Expires 01/12/2018 My comm.expires May 30,2018 APPROVED BY / Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Mar 0515 03:11 p WILVER ALMARALES 305-382-6777 p.1 - CERTIFICATE OF LIABILITY INSURANCE DATE(MWDD1YY) -- -- — --- . _—. _03/05/15 . PRODUCER WAM Insurance Agency THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 10637 SW 88th St.Ste 7-1 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Miami,FL 33176 HOLDER_THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFOR-DEI3BY TIE POLICIE BELOW.__ Phone (305)274-4353 Fax (305)274-9994 INSURERS AFFORDING COVERAGE NAIC -. . - -- - _ �INSURED Peninsula Plumbing, Inc tNsuRERA SCOTTSDALE INSURANCE CO. 206 SW 22 Road ;INSURER-B: ASCENDANT COMMERCIAL INSURAN Miami, FL 33129- INSURER c: TECHNOLOGY INSURANCE COMPAN INSURER D: -- -. INSURER E: -- COVERAGES -- --._—_-_— _ _ INSURER F THE POLICIES OF INSURANCE USTED 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 F POLICIES.AGGREGATE LIMTTS SNO O SUCH ' _.WN MAY HAVE BEEN REDUCED BY R _.. ---... ... AID CLAIMS. INSR�ADD'L --- - ----- -- LTR, IN.$gp- TYPE OF INSURANCE POLICY NUMBER IPOLICYEFFECTIVE POLICY EXPIRATION ..- . ..-.... _ MIDO.IYYY� DA7E�NAlraprYyJ -- LIMITS _ LI-- NUMBER .DATE�M GENERAL LIABILITY -----_— _ EACH OCCURRENCE 1'O00,000I L COMhERCIALGENERALLIA81UTy ICPS2O37285 07/28/14 DAirIA(Y,ETORENTED _ 07/28/1 5 PREMISES a ocauren 100,000 CLAIMS MADE OCCUR — -- ) - - -- — A � L ED EXP(Any ore person) 5,OD0 — .--- PERSONAL&ADV INJURY 1'000,000 --.... -- -- - GENERAL AGGREGATE 2 000 000. GEN'L AGGREGATE LIMIT APPLIES PER: -- PRODUCTS COMPlOPAGG - - 2000,000 POLICY I_j PROJECT I_I LOC --- _-- AUTOMOBLE LIABILITY - - ANY AUTO CA31438-3COMBINED SINGLE LIMIT 10/20!14 1020115 301000.00 ALL OWNED AUTOS ' (�accfdenty B E SCHEDULED AUTOS BODILY INJURY IJ_ HIRED AUTOS (Per person) _. NON OWNED AUTOS BODILY INJURY (Per accident) PROPERTY DAMAGE GARAGE LIABILITY ----- —.` _ _ _ ...._----__,1P_er accident) AUTO ONLY-EA ACCIDENT C G ANYAUTo OTHER THAN EAACC AUTO ON LY: EXCESS/UIYBRELLA LIABILITY EACH OCCURRENCE G OCCUR —] CLAIMS MADE _--._------ AGGREGATE DEDUCTIBLE R£YEN710N $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY TWC3425375 —. .. 06/30/14 Og/3p/1, C; we sFATv- C' ANY PROPRIETOR!PARTNER/EXECUTIVE I._ DR./I INUTS-___=ER -- . OFFICER/MEMBER EXCLUDED? E-L EACH ACCIDENT 1,000,000 If fres,deaenbe under -- .... -- —. __.. E L DISEASE-EA EMPLOYEE 1 ODO,000. SPECIAL PROVISIONS_!slow - _ _.. --— EL DISEASE-POLICY UfmArr 1,000,000 OTHER --- --__ --_ _ 1 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES r EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS GC1509221 -CFC 1425878 CERTIFICATE HOLDER - CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE I EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR-9 IIIAAIL MIAMI SHORE VILLAGE 3O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO BUILDING DEPARTMENT THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY i 10050 NE 2 AVENUE OFANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. M1AM1 SHORE, FL 33138 AUTHORIZED REPRESENTATIVE _ I305-756-8972 -- - ---- WILVER ALMARALES - ACORD 25(2009/08)QF ®ACORD CORPORATION 1988 _91r 42,77 J77 p � 7j,7 7711� x �y r aa- STATE OF FLOFUDA CONSTRUCTION INDUSTRY LICENSING BOARD 7-1395 1940 NORTH MONROE STREET TALLAHASSEE F. PEMNSULA PLLOWNG INC SW22ND ROAD FL 33129 aft MAIWA ftOtt of , ° CSL STATE Of FLORDA DEPF.WSIW-SS AW aid th"kftp ecowumw 0"I PROF;=T 4"LXT" day W* CFC1425878, For �q m, Mo you "'o"NSULAOW Our miWon at Me Uepewt rwK is:Ummie E a.ReouWe' WWIyou fir doing FkOftt Wo gmds,T 9 of 0*440AS of thAlfs, DETACH HERE FUCK;,�...... TTs GSECRETARY STA'M FLORWA PAME AND IONAL REGULATION C T LICENSING BOARD `ht PLISG CONTRACTOR . CERTIFIFED Jay ip# s n v z. W L.. AL 41 k P� V s ti 1& ISSUED 0"14414 DISPLAY AS REWRED 8Y e � } (' Local Buslnelssk Tax Receipt State of Florida N9 IS No T A O&L T PAY pmawer too,PENINSULA PLUMBING INC RENDVAL SEPTEMBER EXPIRES 2,06SW 22 RD 1 MIAMI. 2it, hotuAm to c4utov Cod* We, T 111,96 . . ' TAXI 1 Work4Oml 14-001196 ll 60