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PL-14-2197 ' T_ (, Q �� _ ... 1 !��4 C/ Inspection Worksheet Miami Shores Tillage 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-221104 Permit Number: PL-10-14-2197 Scheduled Inspection Date: May 20,2015 Permit Type: Plumbing - Residential Inspector: Diaz, Osvaldo Inspection Type: Final Owner: NARDECCHIA,VALERIA Work Classification: Addition/Alteration Job Address:1226 NE 93 Street Miami Shores, FL 33138- Phone Number (305)494-6888 Project: <NONE> Parcel Number 1132050270170 Contractor: RJ QUALITY PLUMBING CORP Phone: (954)919-8382 Building Department Comments KITCHEN REMODELING Infractio Passed Comments INSPECTOR COMMENTS False ®W � el� LVI �O� � Inspector Commentsel—y "L> i Passed Failed Correction ❑ Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid. May 19,2015 For Inspections please call: (305)762-4949 Page 1 of 40 Miami Shores Village OCT 7 N14 Building Depa-rtment 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 �� Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(30S)762-4949 FBC 20 BUILDING Master Permit Nolo- PERMIT APPLICATION Sub Permit No.'P�—' - kT-4 ❑BUILDIN ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL E]PUBLIC WORKS ❑ CHANGE OF [] CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: !zz,6 —94f je.;3 City: Miami Shores County Miami Dade Zip• iai5l gs_ Folio/Parcel#: /'l•O LO6- ®zl- 4/740 Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: ��t�S► 4. t ockf- 4991A OWNER:Name(Fee Simple Titleholder): 1-01-AA.-=9 Phone#: Address:_ '''' z2� /lSil49 '9��• 5r City: A&; State: ;5q& &9:: Zip: %�3 Tenant/Lessee Name: A6A Phone#: Email: I CONTRACTOR:Company Name: �!!?y Phone#: � Address: � � /lrG(� / � �®vim City: 8LS! State: Zip: Qualifier Name: - Z G Phone#: /� State Certification or Registration__#: &Z 7,V1021—Certificate of Competency# (�, DESIGNER:Architect/Engineer: -7//64 A2r A=l[e rALGf M5 Phone#:! W-s A50/- /709 Address: Z657 Wz4"firkR. L, •,rte Ci�� ¢:�C 2ip: Value of Work for this Permit:$ 00 Square/Linear Footage of Work: Type of Work: ❑ AdditionAlteration El New22--Re-pair/Replace Demolition ❑ Description of Work: l✓1 ;/,,;7 Specify color of color thru tile: Submittal Fee$ .0� Permit Fee$ 22-S CCF$ CO/CC$ 0 _ Scanning Fee$ .- 03 Radon Fee$ DBPR$ Notary$ 69 Technology Fee$ ` ( ®• Training/Education Fee$ c) Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ '�I (Revised02/24/2014) Bonding Company's Name(if applicable) MIA Bonding Company's Address City State AMA Zip Mortgage Lender's Name(if applicable) A 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 on,estimated value exceeding$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien low 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. 1n 'the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature "0-7 OW-N-E'R or AGENT CONT CTOR The foregping instru ent was ackno ledged befor a this The foregoing instrument was acknowledged before me this day of [ 20T by , day of �� '� .20 1�1 by )ey-) w` who is personally known to �."k Y k t who is personally known to me or who has prokced as me or who has produced as identification and who did take an oat identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC- 7/ Sign: Print: ER Print: �(V I tom' MMION 178755 ��,�"t,,•,, VIRt�I&MIRANDA Seal' Seal: �" _ 3.2018rt1AQPdIS3i(Nf 1 EE 031732 • �• EXPIRES:October 3,2014 Wn 53 ;RE Fye' ?1M-d Tnn,Notary Pubik Ufte4rW items APPROVED BY ��e"��fT Plans Examiner Zoning Structural Review Clerk (Revisedo2/24/2014) RICK SCOTT, GOVERNOR KEN LAWSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION'INDUSTRY LICENSING BOARD CFC1.427987 x' The PLUMBING CONTRACTOR Named below IS CERTIFIEDb Under the provisions.of Chapter 489 Expiration date: AUG 31, 201.6 JACAS, RAYVEL 'RJ QUALITY PLUMBING CORP 8416-NW 103RD ST_ #405' HIALEAH,GARDENS FL 3 01 ISSUED: 05/18/2014 DISPLAY AS REQUIRED BY LAW SEQ# L1405180001231 Local Business Tait Receipt Miami-Dade County, State of Florida -THIS IS NOT ABILL -DO NOT PAY L Ir 688886 BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES RJ QUALITY PLUMBING CORP RENEWAL SEPTEMBER 30, 2015 6170 NW 173 ST 434 6758818 Must b MIAMI, FL 33015 e displayed at plat®of business Pursuant to County Code Chapter 8A-An. 9&10 OWNER SEC.TYPE OF BUSINESS RJ DUALITY PLUMBING CORPPAYMENT RECEIVED 196 PLUMBING BY TAX COLLECTOR ' CONTRACTOR 75.00 0911612014 Wtxkor(s) 7 CFC'I42Z987 CREDITCARD 14037590 This Local Business Tax R"ecsipt1only confirms payment'of the Local Business Tax.The Receipt is not a license. permit'of a certification of 1likholder's qualfications.to dd.business,Nolder must comply with any governmental 'or nougo# rnmental regulatory lows and requirements which apply to"the business. The RECEIFT N0.above must be displayed on all commercial vehicles-Miami-Dade Code Sec 8a-276. n®i _ Formorsinfo roaation,visit www.miamidadegovItUcollectar c ; DATE ,4 CERTIFICATE OF LIABILITY INSURANCE F1010212014(MM/DD)YM) 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 CONTA NAME:CT SOUTH FL COMMERCIAL INSURANCE PHONE 305 819-8618 FAX NO; 305 819-2543 15165 NW 77 AVENUE#1004 E-MAIL MIAMI LAKES FL 33014 INSURER(S) AFFORDING COVERAGE NAIC# INSURERA:SCOTTSDALE INSURANCE COMPANY 41297 INSURED INSURER B: RJ QUALITY PLUMBING CORP INSURER C: 6170 NW 173RD STREET,#434 INSURER 0: HIALEAH FL 33015 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 SUB TYPE OF INSURANCE ADDL POLICY NUMBER MMIDDPOLICYIYYYY MM/DD/YYYY EFF POLICY EXP LIMITS LTR GENERAL LIABILITY EACH OCCURRENCE $1,000,000 A X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $100,000 CLAIMS-MADE ®OCCUR CPS1879907 1010112014 10/01/2015 MED EXP(Any oneperson) $5,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 X POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ HIJREDSAUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS (Per accident) UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ WORKERS COMPENSATIONWC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETORIPARTNER/EXECUTIVE❑ E.L.EACH ACCIDENT $ OFFICERlMEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) COMMERCIAL AND RESIDENTIAL PLUMBING CONTRACTORS State License Number:CFC1427987 CERTIFICATE HOLDER CANCELLATION Miami Shores Village BLDG DEPT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 NE 2ND AVE ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores,FL 33138 AUTHORIZED REPRESENTATIVE <OV> MACNEILL GROUP INC ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD A�® CERTIFICATE OF LIABILITY INSURANCE D"1�OOti D0114' 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 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: Sara!Medina Emmanuel Insurance&Associates,Inc. a"/c°NN Ell: (305)693-0003 IFAX No): (305)691-4381 2370 E 8TH AVE E-MAIL ADDRESS: sarai@emmanuelinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# HIALEAH FL 33013-4236 INSURERA: Retail First Insurance Company 10700 INSURED INSURERS: RJ QUALITY PLUMBING,CORP INSURERC: RAYVEL JACAS INSURER D: 8416 NW 103 St#105 INSURER E: Hialeah Gardens FI 33016. INSURER F: COVERAGES CERTIFICATE NUMBER: 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. INR TYPE OF INSURANCEADDLISUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD GENERAL LIABILITY EACH OCCURRENCE $ NLNI COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS-MADE 1-1 OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO- F T LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTYDAMAGE $ AUTOS Per accident UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X I WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000.00 A OFFICERIMEMBER EXCLUDED? N/A Y 0520-45605 09/09/2014 09/09/2015 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEd$ 1,000,000.00 If yes,describe under 1,000,000.00 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,K more space is required) Plumbing Contractor. Any Changes or alterations Done to this document after being issued shall constitute it null and void. CERTIFICATE HOLDER CANCELLATION Miami Shores Village Building De atment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE g p THE EXPIRATION DATE THEREOF, NOTICE ALL BE DELIVERED IN 10050 NE 2nd Avenue ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores,Fl 33138 AUTHORIZED REPRESENTATIVE Sarai,MaA� ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD