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PL-15-981 s si YS err �' DRB � �t 3 Miami Shores Village a , 0001t +�� 10050 N.E.2nd Avenue NE ? Miami Shores,FL 33138-0000k y yF� Phone: (305)795-2204 �,...•' u Expiration: 10126/2015 Project Address Parcel Number Applicant 9350 NE 12 Avenue 1132050070150 I R.ANDREW DE PASS WILLIAM Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell R.ANDREW DE PASS WILLIAM J. 5701 N BAYSHORE Drive (305)609-3851 MIAMI SHORES FL 33138- 5701 N BAYSHORE Drive MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 400.00 JZ PLUMBING CORPORATION (305)218-8078 Total Sq Feet: p Type of Work:GAS GENERATOR OF GENERAL 60KW GENER Available Inspections: Type of Piping: Inspection Type: Additional Info: Final Bond Return: Press Test Classification:Residential Scanning: 1 Review Plumbing Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 Invoice# PL-4-15-55318 DBPR Fee $2.25 DCA Fee $2.25 04/29/2015 Credit Card $ 109.10 $50.00 Education Surcharge $0.20 04/23/2015 Credit Card $50.00 $0.00 Permit Fee $150.00 Scanning Fee $3.00 Technology Fee $0.80 Total: $159.10 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 zog. Futhermore, I a orize,the above-named contractor to do the work stated. April 29, 2015 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy April 29,2015 1 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-233285 Permit Number: PL-4-15-981 Scheduled Inspection Date: July 14, 2015 Permit Type: Plumbing - Residential Inspector: Diaz, Osvaldo Inspection Type: Final Owner: WILLIAM J.JURBERG, R.ANDREW DE Work Classification: Gas DACC Job Address:9350 NE 12 Avenue Miami Shores, FL 33138- Phone Number (305)609-3851 Parcel Number 1132050070150 Project: <NONE> Contractor: JZ PLUMBING CORPORATION Phone: (305)218-8078 Building Department Comments GAS GENERATOR OF GENERAL 60KW GENERATOR AS Infractio Passed Comments PER MASTER PERMIT INSPECTOR COMMENTS False GAS FOR GENERATOR PERMIT# EL-15-980 Inspector Comments Passed EJ' o Failed 6 Correction ❑ Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid. July 13,2015 For Inspections please call: (305)762-4949 Page 13 of 41 Y Miami Shores Village ep FzD Building Department APR 2 015 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 f� Tel:(305)795-2204 Fax:(305)756-8972 $Y: I INSPECTION LINE PHONE NUMBER:(305)762-4949 1 FBC 2n i BUILDING Master Permit Nc-,"p i � PERMIT APPLICATION Sub Permit No.'PL— � " -pi ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ]PLUMBING ❑ MECHANICAL ]PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP J/4t IZ CONTRACTOR DRAWINGS JOB ADDRESS:—?.,75b A A,& City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): Phone#: S �O 5! Address: � 12- City: MAAAA State: Zip: f'3� Tenant/Lessee Name: Phone#: Email: // Q Q CONTRACTOR:Company Name: 4" �� •Phone#:�2b , 6� c) Address: City: —State: Zip: Qualifier Name: ��e Phone#: 3S. 13'0 © D State Certification or Registration#: Certificate of Competency M C a- i`1"Z 5J r7(o77 DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ � Square/Linear Footage of Work: Type of Work: ❑ Addition �❑._..Al`teration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: 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$ TnTAI FFV 111n\Ai ni iV�` 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 NER or AGENT f NTRACTOR The foregoing instrument was acknowledged before me this The foregoin nstrument was acknowledged before me this tx_f� day of 20A by clof by l� w o is personally known �t`b wh is personally known t 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: Si "" .��-MCRA?fNPALMER Sign: " ., ARTIN J.PALMER Notary Public-State of Florida ;�'s Notary Public-State of Florida Print: - = omm Print: MyCgppm.i May 23,2916 Seal r Commission#EE t73S42 Seal: "'eoFv°? Commission#EE 173842 Bonded Through National Notary Assn. " Bonded Through National Notary Assn. "vs ss********************************************************************sssss*s***s******s****ss**s*s********* APPROVED BY �`�"L3—/S Plans Examiner Zoning Structural Review Clerk r 7 O n � z T1 a D 1750 SERVICE ITEM ACCESSIBILITY CHART 7 [6B 7/8"3 100 SERVICE ITEM 2 4L TVP [4'] OIL FILL CAP au RlaHr000R (MOUNTING HOLES) CENTER OF OIL DIP STICK THau RIGHT GOGR NOTESGRAVITY au ie i 746(29 1/4"] OIL FILTER TH "woR i)MINIMUM RECOMMENDED CONCRETE ON GUIDE SU(45 ED WIDE X 2255 - _ OIL DRAIN HOSE TIRU RIGHT-OR (BB 7/8')LONG.REFERENCE INSTALLATION GUIDE SUPPLIED WITH UNIT - LOW VOLTAGE FOR CONCRETE PAD GUIDELINES. AREA ONLY RADIATOR DRAIN HOSE THRU LERT 000a 2)ALLOW SUFFICIENT ROOM ON ALL SIDES OF THE GENERATOR FOR MAINTENANCE 822 STUB-UP AREA .AIR CLEANER ELEMENT TRRU—000R AND SERVICING THIS UNIT MUST BE INSTALLED IN ACCORDANCE WITH CURRENT (32 3/8"] / SEE NOTE 4 SPARK PLUGS THRU Ear Goon APPLICABLE NFPA 37 AND NFPA 70 STANDARDS AS WELL AS ANY OTHER FEDERAL. TYP .;�, `� STATE AND LOCAL CODES FOR MINIMUM DISTANCES FROM OTHER STRUCTURES. (MOUNTING "'./ ^ 102 _ MUFFLER SEE noTes HOLES) (49 FAN BELT sEEHOTD 3)SEESCIRCUIT BREAKER SHEET WITHIN 58 BATTERY rHRu LUT DOOR � SEE SPECIFICATION SHEET WITHIN OWNERS MANUAL I 1 [2 1/4"] 4)INSIDE STUB-UP AREA FOR AC LOAD LEAD CONDUIT CONNECTION.NEUTRAL 1 �.. 1 REFERENCE OWNERS MANUAL FOR PERIODIC c') ACCESS BATTERY CHARGER 120 VOLTAC(0.5AMP MAX.)CONNECTION,AND _ - REPLACEMENT PART LISTINGS ACCESS TO TRANSFER SWITCH CONTROL WIRES.REMOVE FRONT COVER FOR ACCESS. BATTERY 12 VOLT 26F p 4A)FIELD CUT HOLE IS ONLY REQUIRED FOR MOUNTING OF GENERATOR ON AN 525 COLD CRANKING AMPS EXISTING PAD. 91.4 _ 5)REFERENCE OWNERS MANUAL FOR LIFTING WARNINGS. 13.5(17/32")DIA.MOUNTING (3 5/8"] 381 195 Ul 6)REMOVE EITHER LEFT OR RIGHT HAND SIDE PANEL TO ACCESS EXHAUST MUFFLER HOLE(4)PLACES (15"] [7 3/4"1 LOCTED ON BO OM VISE ACTION LATCH, OF TOP VIEW y AND FAN BELT GENERATOR MOUNTING FRAME CID -ONE PER DOOR,ONE LIFT-OFF y -- ----- 1950[763!4"] - DOOR PER SIDE OF GENERATOR EXHAUST AND AIR DISCHARGE CONTROL PANEL LOUVERS-FRONT AND SIDES 1139[44 13/161 � � BATTERY CHARGER IS 850[33 1/21 n DOOR TYP ENCLOSED WITHIN 33 '—cc o- E cC ul c a c EXHAUST MUFFLER ?� 1145.5 3 c E ENCLOSED WITHIN, - -+�-. g / (451B"] 3 == E SEE NOTE to 13.5(17/32")DIA.MOUNTING ��—___ 1,- (FRONT COVER - c 884 co HOLE(4)PLACES.12 7(12") SEE NOTE.4 , _ (34 13!16"1 9 mill p DIA.MASONRY ANCHOR i r'y DOOR = BOLTS RECOMMENDED c AIR INLET - >_ EE _ _ 'CIRCUIT BREAKER g 752.5 u>= 1525 E 752.5 152.5 LOUVERS SEE NOTE 3 [j 161 7 C)'1 MIN. rF MIN. MIN. MIN, - 49.5 - AREA LIFTING PROVISION REAR VIEW FRONT VIEW [2] LEFT SIDE VIEW _STUB UP _ cn CONCRETE MOUNTING PAD -� (4)PLACES.SEE NOTE SAND (SEE NOTE 1) NATURAL GAS CONNECTION:1-114"NPT FEMALE. 1000 139 3/81 - — CENTER OF GRAVITY DIMENSIONS N ---- --- LPV CONNECTION:314"NPT FEMALE COUPLING �'�, FIELD CUT HOLE FOR OUTSIDE CONDUIT - LOCATED ON THIS SIDE(LH) CONNECTION ONLY,SEE NOTE 4A n" nn �• c �I T �I m co 41 1�11 .-� Z o 3 3o D 5. n Gu ardiank, Series 11-14-2012 JEFF ATWATER STATE OF FLORIDA CHIEF FINANCIAL OFFICER 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: 11/14/2012 EXPIRATION DATE: 11/14/2014 PERSON: ZEPEDA JOSE N FEIN: 760764201 i BUSINESS NAME AND ADDRESS: JZ PLUMBING CORPORATION DBA JOSE ZEPEDA 17921 NW 82CT HIALEAH FL 33015 SCOPES.OF BUSINESS OR TRADE: 1- PLUMBING NDC AND DRIVERS IMPORTANT: Pursuant to Chapter 440 . 051141, F.S., as officer of a corporation who elects exemption from this chapter by filing a certificate of election ander this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.051121, F.S., Certificates of election to be exempL.. apply only within the scopeof the business or trade listed on the notice of election to be exempt. Perseast to Chapter 440.051131, F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named an the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department skall revoke a certificate at nay time for Failure of the person named on the certificate to meet the requirements of this section. QUESTIONS? (850) 413-1609 DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01-11 006413 Local Business Tax Receipt Miami—Dade County, State of Florida HIS IS NOTA BILL - DO NOT PAY 5433586 T BUSINESS NAMEILOCATION RECEIPT NO. EXPIRES J Z PLUMBING CORP RENEWAL SEPTEMBER 30, 2015 17921 NW 82 CT 5673174 Must be displayed at place of business MIAMI FL 33015 Pursuant to County Code Chapter 8A-Art 9&10 OWNER SEC.TYPE OF BUSINESS J Z PLUMBING CORP 196 PLUMBING CONTRACTOR PAYMENT RECEIVED CFC1426387 BY TAX COLLECTOR Worker(s) 1 $75.00 07/28/2014 CREDITCARD-14-030256 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 govenrm mul or nougovemmetnel regulatory Isms and requirements which apply to the business. The RECEIPT N0.above must be displayed on all cosovemial vehicles-Miaali-0ade Code Sec ea-276. For asme idonandon,visit wwwjohmildailLgiliftwdleclof SNORES �t �t1C. f32 some Miami Shores Village rag Building Department RIDA 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. 1 Signature: Owneii State of Florida County of Miami-Dade / The foregoin s ac w e ge before me thit2 O day of ,20) BY who is per pally known to me or has produced `,SOS�,ItV p`• T identifMAR&M.J.PALMER •�: Notary Public-State of Florida Nota ;e?My Comm.Expires May 23,2016 Notary: °' Commission#EE 173842 Bonded Through National Notary Assn. SEAL: April 21/2015 State of Florida County of Dade Before me this day personally appeared Jose Zapeda who, being duly sworn, deposes and says: That he will be the only person working on the project located at :9350 nel2 Ave, Miami Shores. Sworn to and subscribed before me this 21 day of April, 2015, by Jose Zapeda. Personally known `.;PµY Aver MARTIN J.PALMER Notary Public-State of Florida •« `-My Comm.Expires May 23,2016 Commission#EE 173842 E O � //!uii�•` Through National Notary Assn. Notary Stamp & Signature STATE OF FLORIDA ',_.:�„ IMPI34TAXI DwARTMENT OF RmANciAL SERVICES s ,gy m cl,gber Ram ni:1'F.s.,auabw OtbcorPoratlm DMSION OF WORMERS'COMPENSATION •1 "b ,+ , ram°boidtact ebo,a f CONSTRUCTION I 'F PDUSTRy EX6IAPTION 1 �� 1,O PPe Toru 441105(12),the Fo'Sa;sa�u+afl w�eineaea�1D yL uwdrnthbrndcbarAaeHanm6bwnpl j ` OHHpl�CA1H OPHtEc=lo HE EXHUPTPRd1lPlgepA l + fq'P HNbA1MN PtrbuebmCho=40.081�,F,0..Nd) 'dalmdantobe HFPHClVH DA7: 11!1412014 + O O 1i H.Of tl tln to be� dWl be + PJf►atAT(Y1 DAIS; 11lUI2016 I fl np d the rmdee PHRHON: ZEPEDA JOSE or Mtb wsuw cedthe cwviccwe,the parson m p� + N I E hotly a cwlffateno Imabr eeeto ihs res reneMe dtNb Rink 710784201 1 "Wm kr Isauwm ab cwWkm .The ehdl ramie ' 1R bcartl6uleatbrrytlmeFor lailyeathe fWnWanthe BUSINESS NANO?AND ADDRESS: �E Obrtllakbmeet0eragUnvm of Ns am JZ PLUMBING CORPMmON + ' r + 17021 NW BZ CT ' NIALEM FL 33018 SCOPES OF BUSINESS OR TRA 1 r r _ICENSED PLUMBING 'ONTRACTOR 1