PLC-15-2343 M � �� C�d4j
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-243516 Permit Number: PLC-9-15-2343
Scheduled Inspection Date: October 21, 2015 Permit Type: Plumbing - Commercial
Inspector: Diaz, Osvaldo
Inspection Type: Final
Owner: Work Classification: Addition/Alteration
Job Address:9055 BISCAYNE Boulevard
Miami Shores, FL 33138- Phone Number
Parcel Number 1132060110051-55
Project: <NONE>
Contractor: SUNCOAST PLUMBING & ELECTRIC INC Phone: (352)628-6608
Building Department Comments
PLUMBING WORK FOR INTERIOR RENOVATION Infractio Passed Comments
DOLLAR TREE INSPECTOR COMMENTS False
Inspector Comments
Passed EZ/ 616 H rc
Failed �XE
CK C
Correction
Needed G P r
Re-Inspection
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
October 20,2015 For Inspections please call: (305)762-4949 Page 12 of 50
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Miami Shores Village 3 Pel 7#l* y 'plum�tll£�•�Qtltlti�l���),
10050 N.E.2nd Avenue
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Miami Shores,FL 3313&0000 � � �ionfAi>verat c n
tie , Pormit Status:APPROVED
Phone: (305)795-2204
�0RIDA
I$Ws Date.107 1'* . Expiration: 04/04/2016
Project Address Parcel Number Applicant
9055 BISCAYNE Boulevard 1132060110051-55
SHORE SQUARE PROPERTIES 1
Miami Shores, FL 33138- Block: Lot:
Owner Information Address Phone cell
SHORE SQUARE PROPERTIES LLC 9055 BISCAYNE BLVD. '
fi
Contractor(s) Phone Cell Phone
Valuation: $ $,400.00
(352)302-2178
SUNCOAST PLUMBING&ELECTRIC 1 (352)628-6608
_.. Total Sq Feet: 12477
Type of Work:PLUMBING WORK FOR INTERIOR RENOVATI Available Inspections:
Type of Piping: Inspection Type:
Additional Info: Top Out
Classification:Commercial Re Pipe
Scanning:3 Main Drain
Heater
Water Service
Final
Water Main
Lavatory
Rough
Rough
Review Plumbing
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Underground
CCF $5.40
DBPR Fee Invoice# PLC-9-15-57090
$5.63 09/15/2015 Check*2174 $50.00 $359.66
DCA Fee $5.63
Education Surcharge $1.80 10/07/2015 Check#:3367 $359.66 $0.00
Permit Fee $375.00
Scanning Fee $9.00
Technology Fee $7.20
Total: $409.66
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 informal* is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore,I authorize the above-n d c tra t do the work stated.
October 07, 2015
Authorized Signature:Owner / ApplicantCo ra o Ag t ate
Building Department Copy
October 07,2015 1
SEP 2015 Y
Miami Shores Village
Building Department J
10050 N.E.2nd Avenue, Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC20/�/ -
BUILDING Master Permit No.('() /S— 2/
PERMIT APPLICATION sub Permit No.)21e- /S 2 -�
BUILDING ❑ ELECTRIC ROOFING REVISION EXTENSION ORENEWAL
0■ PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 9055 Biscayne Blvd.
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO X
Occupancy Type: M Load: 345 Construction Type: 11 Flood Zone: BFE: FFE:
OWNER:Name(Fee simple Titleholder): IMC Property Management& Maintenance Phone#:305-893-9955 EXT-107
Address:696 ME 125 Street North
City: Miami State: Florida Zip: 33161
Tenant/Lessee Name: Dollar Tree Stores Phone#:757-321-5218
Email: cgomez@dollartree.com
CONTRACTOR:Company Name: Suncoast Plumbing & Electric Phone#: 352-628-6608
Address: PO Box 2290
City: Homosassa State: Florida Zip: 34447
Qualifier Name: Todd Workman Phone#: 352-628-6608
State Certification or Registration#: CFC058041 Certificate of Competency M
DESIGNER:Architect/Engineer: RRMM Architects Phone#: 757-622-2828
Address: 1317 Executive Blvd. Suite 200 `` City: Chesapeak State: VA Zip: 23320
Value of Work for this Permit: S*0 �-`� Square/Linear Footage of Work: 12,477
Type of Work: ❑ Addition ❑■ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: h)s1017 ", 7)n
Specify color of color thru tile: - s
Submittal Fee$ !�__O •-C2 Permit Fee$ 3 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)
Bonding Company's Name(if applicable) N/A
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. the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
15
Signature Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The�foregoing instrument was acknowledged before me this
��—day of �t'�M81+ ,20 16 by _C. day of l P� i�'� e� ,20 f by
UD4-k -'a4l-kIL ,.who is personuay k��w�to �0 �✓`��rr�lGcA ,who is personally known;o
mfr 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 Sign: pp
Print: tJ G L l.._['0 Print: 2V
Seal: �Y•PbB, LUCY CICILIO Seal: a Notary Public State of Flo�da
MY COMMISSION#EE 164923 Duc Phan
EXPIRES:April 19,2016 �� My Commission FF 232517
P Expires 0 511 8/2 0 1 9
Bonded Thru Budget Notary.Services
APPROVED BY 15 Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
•
• RICK 6C:t.71 I, LioVt~KNUR nr_ry r�vvJUrv, Jc4Mr-Itkm r
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION k
CONSTRUCTION INDUSTRY LICENSING BOARD £
CFC058041 � z
The PLUMBING CONTRACTORK-.`
Named below IS CERTIFIED
Under the provisions of Chapter 489 FS.
Expiration date: AUG 31, 2016
01
WORKMAN,TODD MURRAY °
SUNCOAST PLUMBING &ELECTRIC INC
6970 W GROVER CLEVELAND BLVD �,•
HOMOSASSA FL 34446
ISSUED: 07/28/2014 DISPLAY AS REQUIRED BY LAW SI Q# L1407280000921
ei
201512016
CITRUS TY BUSINESS TAX RECEIPT
State of Florida
210 N Apopka Ave, Suite 100, Inverness, Florida 3445084298
352-341-6500
EXPIRES SEPTEMBER 30, 2016
ACCOUNT# 19449 RECEIPT ,# 171.102.54026
Business Name. SUNCOAST PLUMBING &ELECTRIC INC Lotal:ion: 6970 W GROVER CLEVELAND
Owner Name: TODD WORKMAN - PRES/QUAL, TENNI WORKMAN -•SEC/TR, ROBERT RICHARD/EI BLVD
Mailing Address: PO BOX 2290 HOMOSASSA, FI_ 34446HOMOSASSA SPGS, FL 34447
Business Phone: 352-628-6608 Exemption:
Business Type: R100 CST-CERTIFIED PLUMBING CONTRACTOR
R120 CST-LP GAS INSTALLER
For-Vending Machine Business Only
Number of Vending Machines: Vending Machine TYpe.
Tax Amount Transfer Fee HazMat' Sub-Total Penalty Prior Years lCollection Costj Total Paid
so.00 o.oc�
_i0_'0_0=- 70.00 0.00 q.go o.on lo.ci0
THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS
THIS BUSINESS TAX RECEIPT DOES NOT CONFIRM THAT REGULATORY OR ZONING REQUIREMENTS HAVE BEEN MET.
IT IS THE OWNER'S RESPONSIBILITY TO ENSURE COMPLIANCE.
This section to be completed by the owner of the above named business.
Business has been sold to:
x
-._.
Signatu__r$ ---.._-_receipt .-_holder..___-.. r- . .......-_or awo—w-.ri.._._. ..-c-h-ang-e-------
of current upon Transferership chDate
Date Business Closed:.,__�.�— T - Signature:
Paid 010-14-00003496 69/18/2015 70.00