PL-15-1298 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-235727 Permit Number: PL-5-15-1298
Scheduled Inspection Date: August 10,2015 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo
Inspection Type: T
Owner: ALVAREZ,JUAN A Work Classification: Add itio Aeration
Job Address:735 NE 91 Street 1-E 6��"
Miami Shores, FL Phone Number (305)632-3928
Parcel Number 1132060440130
Project: <NONE>
Contractor: QUICK PLUMBING REPAIRS INC Phone: (305)380-9888
Building Department Comments
INSTALL SINK Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
August 07,2015 For Inspections please call: (305)762-4949 Page 8 of 29
's..
RVillagealt T P �m r R� ltiit
Miami Shores
t 77,
10050 N.E.2nd Avenue NEdit�lAit6ration,PeV '
W Ctaadc�f
Miami Shores,FL 33138-0000 � �;,
••�� � Phone: (305)795-2204 " POO �tus
,.: fate 711215 Expiration: 12l2l21
Project Address Parcel Number Applicant
735 NE 91 Street Number: 1-E 1132060440130
JUAN A ALVAREZ
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
JUAN A ALVAREZ 735 NE 91 Street (305)632-3928 (305)331-0812
MIAMI SHORES FL 33138-
830 NE 212 Terrace
MIAMI FL 33179-
Contractor(s) Phone Cell Phone Valuation: $ 150.00
QUICK PLUMBING REPAIRS INC (305)380-9888 Total Sq Feet: 0
Type of Work:INSTALL SINK Available Inspections:
Type of Piping: Inspection Type:
Additional Info: Top Out
Bond Return: Final
Classification:Residential Scanning:1 Review Plumbing
Underground
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60 Invoice# PL-5-15-55764
DBPR Fee $2.00 07/01/2015 Credit Card $58.60 $50.00
DCA Fee $2.00
Education Surcharge $0.20 05/29/2015 Credit Card $50.00 $0.00
Permit Fee $100.00
Scanning Fee $3.00
Technology Fee $0.80
Total: $108.60
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify tha the o going information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhemt re,louthgfze the above-named contractor to do the work stated.
July 01, 2015
Authorized Sig ature: Applicant / Contractor / Agent Date
Building D rtme t Copy
July 01,2015 1
Miami Shares Village
Building Department MAY 29 2015
10050 N.E.2nd Avenue, Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
�/
FBC 20
BUILDING Master Permit No. y- q-
PERMIT APPLICATION Sub Permit No. Vu S-1
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL [:]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: r7 3 5- 4' ( S T tp t—E
City: Miami Shores County: Miami Dade Zip: J,71 3$
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: / FFE:
OWNER: Name(Fee Simple Titleholder): J JAS 4 L,-)-'4, e Z Phone#: Os 6 2'3 Cr z"3
Address: B36 rJ c 2 ( 2 ?°f 7�O, --b `t/
City: bUl A a.4 [ State: FL-ti K-I t.�p A Zip: 3 `79
Tenant/Lessee Name: n/ Phone#:
Email: �-v �`� Z Z8 /o _ O�u-�fit! L • G-E)mL,--
CONTRACTOR:Company Name: V<<� 1 LVw� �/� ��5 �t�G' Phone#:
Address: '-7 SJ t / lb S
City: y'� �"� State: 1 �L Zip: t
Qualifier Name: C(/}�. ��AI�t)� l •'t)/Agr7�L C� Phone#:
State Certification or Registration#: 0-4 C c14Z'7r? C 7 Certificate of Competency#:
DESIGNER:Architect/Engineer: Lam' />t Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ CJ Square/Linear,FF,000ttage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New 5d Repair/Replace ❑ Demolition
Description of Work: -FA(-L-i t_J f") A 3 coJ K
Specify color of color thru tile:
Submittal Fee$ '�� Permit Fee$ 00- CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ � 'G d
(Revised02/24/2014)
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 rei ection fee will be charged.
Signature Signature
O R or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of M 20 by day of 20 /� by
T—
wAN —twho is personally known to _ £ �a r.�/P who i personally known to
me or who has produced T �iO�I IMS I--'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: Sign:
Print: Print: o✓ �*�tt ax
�4001P
�� Note P ,t�ri�, LUIS A.Seal: ry ublic state of Florida Seal:S ,2015
irtdia AlvarezMY COMMISSION#EE 096242
° ` My Commission FF 166750 .. EXPIRES:June"' tsExpires 09103/12018 �°r Bonded Thru Notary Public Underwrflers
"4f�t'•
4*•k•k�>k#*ffi�k•k+k******kik*ffi*�k*+k&*>K�*#*�*****#�k+k&&*ffi*&*****ffiffi***&+kN�#&M�****#*��*�k+k+k�k�****+k&**********&�k+k***�k+k*****#
APPROVED BY 45r 2T--f 57 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
CFC1427799
n `
The PLUMBING CONTRACTOR
Named below IS CERTIFIED
Under the provisions of Chapter 489 FS.
Expiration date: AUG 31,2016
QUINT'ERO, GERARDO I3
QUICK PLUMBING REPAIRS INC k
17710 SW 176TH STREET
MIAMI FL 33187
{
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ISSUED: 07/01/2014 DISPLAY AS REQUIRED BY LAW SEO# L1407010001255
i
o cal Miness Tax Receipt
Mlami,-Dade County, State of Florida
-THIS IS NOTA BILL - DO NOT PAY
E
6291405 LBT
BUSINESS N4dtEiLCSCITtGtN RAPT NA.
QUICK PLUMBING REPAIRS INC RIENFEWAL
SEPTEMBER 30, 2016,'
a 17710 SW 176 ST EI 1
s Must be displayed at place,of business
MtA14i1C PL 33187 Pursuant to Coupty 0040
' Chapter 8A-Art.9&10
}
OWNER SEC.TYPE OF BUSINESS PAtt# I
QUICK PLUMBPAYMENTfiEG6
PLUMBING REPAIRS INC 196 PLUMBING CONTRACTOR PA Tax CORa GIVA
Worket(s) I CFC1427799 $75.00 07/18/2014
CHECK21-14--025748
This Local Business Tax Receipt only confirms payment of the local Business Tax.The Receipt is not a llneaso,
permit ora certification of the holster'squalifications,to do business.Holder must comply with any goventommal
0r400110VOrnmental regulatory Iowa anti requirements which apply to the lnslrtass.
The RECEIPT NO.above must be displayed on OR commercial vehicles Miami-gods Code Sec 98-27j.
For mora information,VWftynWAHhMjdsde, codec
`d P
�oca1 ss `fax Receipt
�fiV iami-[fade County, Stag of Florida'-
-THIS IS NOTA SILL - CSC}NOTPAY
1206
I . ........
BUSINESS RtAME/LOCA"IOr4 RECEIPT NO.
EXPIRES
QUICK PLUMBING REPAIRS INC MNEWAL SEPTEMBER 30, 2015
17710 SIN 176 ST 7151433
Must tis(fis0ayed at gram of business
MIAMI R 33187
Pursuant to Cognty''
Charter BA-Art.9&10'
OWNER, SEC.TYPO OF BUSINESS
}UICK PWMBING REPAIRS INC 205 LPG INSTALLER By TMAX ENT t.OLLECTOR
LPG29027
$100.00 08/07/2014
CHECK21-14--04 055
I
This Isom Business Tax Receipt only confirms payment of the Local Business Tex.The Receipt is not a liven"
Permit,are cortifientieb of the holdor'eqqupalifications,todobusiness.Hotdermostco*yWith any governmental
or menNteagpiatory tads a4d tequirmasms which apply to the business,
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CONTRACTORPLUMBING AND GAS
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MIAMI SHORES VILLAGE 2
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BUILDING-DEPARTMENT00 �.
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IMPORTANT
STATE OF FLORIDA Pursuant to Chapter 440.05(14),F.S.,an officer of a corporation
DEPARTMENT OF FINANCIAL SERVICES who elects exemption from this chapter by ming a certificate of
DIVISION OF WORKERS'COMPENSATION election under this section may not recover benefits or
a F compensation under this chapter.
CONSTRUCTION INDUSTRY EXEMPTION O
CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA L Pursuant to Chapter 440.05(12),F.S.,Certificates of election t0
WORKERS'COMPENSATION LAW D be exempt..,apply only within the scope of the business or trade
EFFECTIVE DATE: 10/812014 EXPIRATION DATE: Icnr20le listed on the notice of election to be exempt.
PERSON: OUINTERO GERARDG g
FEIN. 202013723 N Pursuant to Chapter 440.05(13).F.S.,Notices 01 e1BCtlOn to be
E exempt and certificates of election to be exempt shall be
BUSINESS NAME AND ADDRESS: R subject to revocation if,at any time after the filing of the notice
QUICK PLUMBING REPAIRS INC E or the issuance of the cenlficate,the person named on the.
notice or certificate no longer rneets the requirements of this
17710 SW 176 STREET UNIT B section for issuance of a certificate.The department shall revoke
a certificate at any time for failure of the person named on the
MIAMI FL 33187 certificate to meet the requirements of this section.
SCOPES OF BUSINESS OR TRA
LICENSED PLUMBING PLUMBING NOC AND GAS MAIN OR
CONTRACTOR DRIVERS
CONNECTION?CONST CQNST
- _ _ .
STATE CERTIFIED PLUMBING AND GAS CONTRACTOR
QUICK PLUMBING REPAIRS INC.
17710 SW 176 STUNIT B
MIAMI FL 33187
305-380-9888
DATE:05-20-2015
STATE OF FLORIDA
MIAMI DADE COUNTY
BEFORE ME THIS DAY PERSONALLY APPEARED WHO,
BEING DULY SWORN,DEPOSES AND SAYS THAT HE WILL BE THE ONLY PERSON WORKING PLUMBING ON
THE PROJECT LOCATED AT: 'T3 S 14 E Q I s--i A-rm /-E
SWORN TO (OR AFFIRMED)AND SUBSCRIBED BEFORE ME THIS S DAY OF 5 20�L
p�_
BY lA 4n O
PERSONALLY KNOW
PRODUCED I.D.
TYPE OF I.D.
Ply LUIS A QARCIA
COI MISSION#AE 096242
t9 ati XPIF Jun 2015
nvriters
PRINT,TYPE OR
yHORES
�, �SiC• 93z `r�
*+ V" Miami shores Village
logo
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Building Department
�bfRIUA
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-rime 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:
er
State of Florida
County of Miami-Dade G
The foregoing was acknowledge before me this l day of 1 2CJ 20
Bwho is personally known to me or has produced
. Lit. \��000nu11/1iii
1 j �' ntification.
Notary:
El d 33 .
SEAL: �l]9fid a V10N
'• 9d el9n