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PLC-15-1986 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-240865 Permit Number: PLC-8-15-1986 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 Browne Hall Miami Shores, FL 33138-0000 Phone Number Parcel Number 1121360010160-14 Project: BARRY UNIVERSITY Contractor: THE PLUMBING EXPERTS INC Phone: (561)368-5111 Building Department Comments REPLACE TOILET, LAV SINK, LAV FAUCET, SHOWER Infractio Passed Comments VALVE, ALL IN SAME LOCATION. INSPECTOR COMMENTS False Inspector Comments Passed Failed F7 1� Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. August 24,2015 For Inspections please call: (305)762-4949 Page 14 of 33 _ t Miami Shores Village l0lu toll 10050 N.E.2nd Avenue NE u ' Miami Shores,FL 33138-0000 a k,AP PROVED # Phone: (305)795-2204 toR"* 0 Expiration: 02l07/2016 Project Address Parcel Number Applicant 11300 NE 2 Avenue Number: Browne Hall 1121360010160-14 BARRY UNIVERSITY INC Miami Shores, FL 33138-0000 Block: Lot: Owner Information Address Phone Cell [B�ARRY: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: $ 3,225.95 THE PLUMBING EXPERTS INC (561)368-5111 Total Sq Feet: p Type of Work:REPLACE TOILET,LAV SINK, LAV FAUCE 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 $2.40 Invoice# PLC-8-15-56635 DBPR Fee $2.25 DCA Fee $2.25 08/11/2015 Credit Card $ 113.90 $50.00 Education Surcharge $0.80 08/07/2015 Check#:006976 $50.00 $0.00 Permit Fee $150.00 Scanning Fee $3.00 Technology Fee $3.20 Total: $163.90 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 AFFI T: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction an zo ng. uthermore,I authorize the above-named contractor to do the work stated. August 11, 2015 uthoriz d Signature:Own / Applicant / Contractor / Agent Date Buil Department Copy August 11,2015 1 Miami Shores Village Building Department 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 BUILDING Master Permit No.CC 0-16- PERMIT APPLICATION Sub Permit No. :2f,IS- �GB(o QBUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP p CONTRACTOR DRAWINGS JOB ADDRESS: .2n,4 f City: Miami Shores County: Miami Dade Zip: 33/4 1 Folio/Parcel#://–a?/, -p 0 d • O Q,j-O Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): jQ�A u2,rsr Phone#: Address://-?d o E zkj. ,4j�-c City: 42,a S a t 1., State: FL Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name:Pl4.rn bi u d � 'I't 7,5.1 n c• Phone#:J'4 �2-7 V647 Address:,�dSs^ 5'�o�,oreSS v� State: JrL Zip: 3 Qualifier Name:16170 2 �.-� t h ke Phone#:3Z/• 2 79- 1 cf 6 0 State Certification or Registration#:C 2Certificate of Competency#: DESIGNER:Architect/Engineer:--Al Phone#: Address: City: State: — Zip: 9 Value of Work for this Permit: —, ^ Square/Linear Footage of Work: 0 Type of Work: ❑ Addition ❑ Alteration ❑ New 91 Repair/Replace ❑ Demolition Description of Work: /1�FWL C E TD/L /,, L /I(/ S/NX., L l9 U F/f 4 cc T , S11-00'F-'z V.dLVC ALX ,tom6 G0 CA 1ioN Specify color of color thru tile: A/o Nc" Submittal Fee$ Permit Fee$ /J"� CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ f TOTAL FEE NOW DUE$ (Revised02/24/2014) Bonding Company's Name(if applicable Bonding Company's Address _ City Z State Zip Mortgage Lender's Name(if applicabl ) 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 w71 be charged. Signature Lval 12�z'w Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before�?X this The foregoing instrument was acknowledged before me this da ofr/? 20 by �fti day of //_ j-�,7- 20/5 by / who is personally known to h k� who is personally known to me or who has produced as ,MgxLpwho has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: • \P1S TAgo/F Vi* NOTARY PUBLIC: 1JSSk w •.. /� a�'�p 28,�o`��0�•• y • ''° z Sign: xw Print: _.2!;7/ JQOFF20337 Print: e7r" q�. d�N ;•�` Notary Public state of Florlds Seal: l-•• •••.• \��� Seal: d Gregory F Eispol;tlto Jr S7A ��\ i�' Q phi oiaOt6 17003e 1111111111 *sr*sssss**ss***r*rs*r�**r**ss**srs►s**sss*st*srt**rs*s*s*****s��*+e*ssss**s***s*r+�r*r�ssr**ssss*ss*s*sssss APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 �«. 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 WINKE, JOSEPH C THE PLUMBING EXPERTS INC 21198 HAMLIN DRIVE C/O JOSEPH WINKE BOCA RATON FL 33433 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 STAT -Ffi31� --- - from architects to yacht brokers,from boxers to barbeque restaurants, _. SS-AND, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to g serve you better. For information about our services, please log onto - _ _- www.myftoridalicense.com. There you can find more information r CsER, about IFtfli our divisions and the regulations that impact you,subscribe - .- KE1© to department newsletters and learn more about the De artmenfs P p initiatives. Our mission at the Department is:License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, is GeRst��€��ua'de- pwv�sL�,ns and congratulations on your new license! '. tvip�`rya:ite ,m�csrw� DETACH HERE RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY r I� -� �- �• .��:. -. M,, - 5 ��PSK; t �R�AlIEN1F®F B' . . P RE�G<! TION IlES9fblY19� 1-A. _ 1 .ate"+-""�•..r✓"�1'�..�'`�'�„ ..- �^�L`�.'ti �.. o _ Pye, �..�r' , , .✓ �„' ` S ANNEM. G A N N O NP,O,Box 3363 West palm Beach,FL 33402-3353 "LOCATED AT" "'CON8TITUTIONAL.TAX COLLECTOR www.pbctax.com Tel:(561)355.2264 NOW Serving Palm Beach County 2055 South CONGRESS AVE Serving you. DELRAY BEACH,FL 33445 TYPE OF BUSINESS 29.0069 PLUMBING CONTRACTOR CERTIFICATION Y RECEIPT NDATE PAID AMT PAIp ;BILLY 1MNKEJOSEPH C CFC142= U14.730664-OWOW14 This document is valid only when reCeipted by tfie Tax Collectors Office, s90 so eaot z STATE OF FLORIDA PALM BEACH COUNTY 201412015 LOCAL BUSINESS TAX RECEIPT PLUMBING EXPERTS INC THE LBTR Number: 201103593 PLUMBING EXPERTS INC THE 2056 S CONGRESS AVE EXPIRES: SEPTEMBER 30, 2015 DELRAY BEACH,FL 33445 This receipt grants the privilege of engaging in or milli 1II1uIrtills III fill managing any business profession oro0cupa6on within its jurisdiction and MUST be conspicuously displayed at the place of business and in such a. manner as to be open to the view of the public. DATE MMID CERTIFICATE OF LIABILITY INSURANCE 8/6;2'015DIYYYY) 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: Karen Nold Keyes Coverage Insurance PHONE FAX 5900 Hiatus Road AIc No Ext:9S4-724-7000A/C,No: Tamarac FL 33321 ADD ESS: knoldQke escovera e.com PRODUCER CUSTOMER ID#:12 2 8 9 INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A:Hanover Insurance Company 22292 The Plumbing Experts, Inc. and INSURER B:Philadelphia Indemnit Ins CO -23850 The Remodeling Experts, Inc. Master Rooter of Florida INSURERC: _ 2055 South Congress Ave INSURER D: Delray Beach FL 33445 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:348803456 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 VVITH 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 TYPE OF INSURANCE ADDL UBR POLICY EFF POLICY EXP LIMITS LTR I POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A GENERAL LIABILITY Y Y LZJ A001779-02 5/13/2015 5/13/2016 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $100 CLAIMS-MADE 1XI OCCUR MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $2,000,000 POLICY RO ECfPLOC $ B AUTOMOBILE LIABILITY Y PHPK1336367 5/13/2015 5/13/2016 COMBINED SINGLE LIMIT $1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ X HIREDAUTOS (Per accident) X NON-OWNED AUTOS HIRED COMP/ COLL DED $1,000 X HIRED PHYSICAL DAMAGE ACV $ UMBRELLA LIAB H OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATIONWC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1 $ A INLAND MARINE RHJ A001772-02 5/13/2015 5/13/2016 Contractors Equip $73,500 ALL RISK ACV Rented/Leased Equip $25,000 Ded: $1,000 7 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) *Except 10 days notice of cancellation due to non-payment of premium. Plumbing License CFC 1427238 CERTIFICATE HOLDER CANCELLATION 30 Days* SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Village of Miami Shores 10050 NE 2nd Ave Miami Shores FL 33138 AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE DATE/6/2015 A8/6/20155 DD/Y 8/6/ 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 WANED,subject to the tens 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 NON AMrTHolly Buzen Frank H. Furman, Inc. PHONE_(fila N2 END. (954)943-5050 FAX No:(950942-6310 1314 East Atlantic Blvd. MIL .holly@f+++maninsurance.com P. O. BOY 1927 INSURER(S)AFFORDING COVERAGE NAIC 9 Pompano Beach FL 33061 INSURERANOrmandy Harbor Insurance Co. 1. 3.012 INSURED INSURER B: Plumbing Experts, Inc. INSURER C: 2055 South Congress Avenue INSURERD: INSURER E Delray Beach FL 33445 INSURER F: COVERAGES CERTIFICATE NUMBER:15-16 WC only 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 TYPE OF INSURANCE POLICY NUMBER MM/LID�EFF' PO CY EI(P LIMITS LTR COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE ­ CLAIMS-MADE �OCCURPREMISESP -Me o trance $ MED EXP(Any one person) $ PERSONAL-&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑jRE- LOC PRODUCTS-COMP�PAGG $ $ OTHER: COUVWED TIRUCE LIMIT $ AUTOMOBILE LIABILITY Me accident) BODILY INJURY(Per person) $ ANY AUTO ALL OOWNED SSCCHT�LED BODILY INJURY(Per acdderlt) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Peraocident $ UMBRELLA LUUB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ $ DED RETENTION WORKERS COMPENSATION. R S M ERH AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/E7(ECUTIVE E.L.EACH ACCIDENT $ 500000 OFFICERIMEMBER EXCLUDED? N I A A (Mandatory In NH) NHFi+0038702015 6/30/2015 6/30/2016 EL DISEASE-EA EMPLOYE $ 500 000 Hyes,desa0>eunder E.LDISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101 Addidonal Remarks Schedule,may be attached K more apace is required) Plumbing License CFC 1427238 s CANCELLATION CERTIFICATE HOLDER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE a Of Miami Shores THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Village ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd Ave Miami Shores, FL 33161 AUTHOREMD REPRESENTATIVE Dirk DeJong/HB 01988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS029rm+ann