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PL-13-2750 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-204135 Permit Number: PL-12-13-2750 Scheduled Inspection Date: July 10, 2014 Permit Type: Plumbing - Residential Inspector: Diaz,Osvaldo Inspection Type: Final Owner: HALPERN, MARK Work Classification: Addition/Alteration Job Address:9377 NE 9 Place Miami Shores, FL 33138- Phone Number (305)610-6688 Parcel Number 1132050070100 Project: <NONE> Contractor: DO YOU NEED A GOOD PLUMBER INC Phone: (305)758-9215 Building Department Comments INTERIOR REMODEL Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed CST Failed Correction ❑ Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid. July 09,2014 For Inspections please call: (305)762-4949 Page 5 of 44 1 Miami Shores Village Building Department DEC 0 9 2013 10050 N.E.2nd Avenue,Miami Shores,Florida 33138BY • Tel:(305)795.2204 Fax:(305)756.8972 INSPECTION'S PHONE NUMBER:(305)762.4949 FBC 20 _ BUILDING Permit No. 12�' PERMIT APPLICATION Master Permit No.}�J /�� -�a'77-S^� Permit Type: PLUMBING JOB ADDRESS: ,L& 7 C? /�� E r Z21,4 City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Flood Zone: OWNER:Name(Fee Simple Ti f Jr. Phone#. Address: `kit City: State Tenant/Lessee Name: Phone#: Email: 4&gV ]7 &O'Y wl'corn /CONTRACTOR:Company Name: V0 �dac/Pl��s ane#:J OS- 7,7/ Address 's-r sw. 3 p �� City: � State: �` ► Zi 41 Qualifier Name: Phone#: State Certification or egistration // Certificate of Competency*: ® Contact Phone#: Email Address�AItfJ � c�c�i 1���61d®h 104* l_ �/ @ C40 DESIGNER:Architect/Engineer: Phone#: Value of Work for this Permit:$ Mri-0/-) Square/Linear Footage of Work: Type of Work: DAddress OAlteration ONew URepair/Replace ODemolition Description of Work: , ft% mac) Submittal Fee$ 00 Permit Fee$ ®�• CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ ''double Fee$ Structural Review$ Q Z oft TOTAL FEE NOW DUE$ ' Bonding Company's Name(if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) �� PP Mortgage Lender's Address City State Zip i 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 ELECTRICAL WORK,PLUMBING,SIGNS, WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS and 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is s ject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspec on which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the inspection will not a approved and a reinspection fee will be charged. Signature Signature Owner or Agent Contractor The foreg ' i trument was acknowledged before me this dA- The fore ' g instrument was acknowledged before me this I- day of —� ,20 4,by a I C44&aV ��1)��, day of b>e4�-, Z X20&,by �dry= 41424&-- who -who is personally known to me or who has produced 1 ) who° personally Gown to m or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: �� i +��,, NOTARY PUBLIC: Ar�61)��� Sign: ; d F� Sign: Print: `^°`�°� �' �: = Print: _ �. My Commission Expires: '.°s°�o E WPM— Z! My Commission Exp * . ,. COMMISSION#FFbt1535 < �'• �.�� ° EXPIRES April 24,2017' 0, EXPIRES �`\\\`e\����� 39&Ots3 Ftw�a �yservrce.ewn �HwksAsH ok pAffi+�+&aBskeA � �asAskHa :ARsAs��+ 1HssR ��k ks8 � �+ ��+sk& sBsA sasa ��H,�+aIaakffi$a 9saP��aRsAsIadeakk AadaIs APPROVED BY �/t �- J Plans Examiner Zoning Structural Review Clerk (RcAsed3/1212012XRevised 07/10WXRevised 06/10/2M9)(Revised 3/15/09) � OR�y t a n Room e,..� Miami Shores Village Building Department R 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION FORM ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED OR THE VILLAGE MAY MAINTAIN A FILE WITH YOUR INFORMATION FOR A$30.00 FEE PER YEAR. IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LIC CARD B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE(CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKERS COMPENSATION (EITHER CERTIFICATE OR EXCEMPTION) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT C. COPY OF LIABILITY INSURACE(CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKER COMP INSURANCE(EITHER CERTIFICATE OR EXEMPTION) YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES,FL 33138 COMPLETE CONTRACTOR'S INFORMATION / BUSINESS NAME: V,v /4 � ®� �'� - BUSINESS ADDRESS: `7S-,o / A/ 3 7 e-J. CITY Vayc T STATE ZIP CODE 75-51 BUSINESS PHONE: ( ) TJ124 FAX NUMBER f� �® ` CELL PHONE(_) QUALIFIER'S NAME: kl,�Le- a QUALIFIER'S LIC NUMBER: E-MAIL ADDRESS(IF APPLICABLE): Created on 3H910.9 BY MLDV I RV 31209 MLDV II /'tiff b L b G 6 l L STAI E OF rLUKIUA DEPARTMENT OF SUSINE3g A PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING HOARD SEWL12081100640 �^ LICENSE NHR 108/11/20121118185416 ICFC1428296 The PLUMBING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2014 I HARWEEN, KYLE J J DO YOU NEED A GOOD PLUMBER, INC. 310 NW 189 TERRACE i MIAMI FL 33169 I RICK SCOTT KEN LAWSON GOVERNOR SECRETARY DISPLAY AS REQUIRED BY LAW 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895—954-831-4000 VALID OCTOBER 1,2013 THROUGH SEPTEMBER 30,2014 DBA: Receipt#:p82-256856 SPRNKL/CON Business Name:DU YOU NEED A GOOD PLUMBER INC Business Type: (p ,umH j N;; CON'IVRACTOk) Owner Name;KYLE J HARWFFN Business Opened:0'//26/2013 Business Location:VbOl SW 37 CT State/County/Cert/Reg:CFC1428296 DAVIE Exemption Code; Business Phone: 3C5-758-9215 Rooms Seats Employees Machines Professionals 1 For Vending Business Only ( Number of Machines: Vending Type: i Penalty Prior Years+Collection CostTotal Paid Tax Amount Transfer Fee NSF Fee Pea y0.00 0. O.CC 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non-regulatory in nature. You must meet all County and/or Municipality planning WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. Mailing Address: DC YCU ::lrEI GOOD PLUMBER INC Receipt #05A-12-00011797 sill 31r 011' Paid 07/26/2013 27.00 DAViE, FL 33314 2013 - 2014 TOWN OF DAVIE First-Class Mail BUSINESS TAX RECEIPT PRSRT U S Postage Paid 6591 SW 45t"St PDS Davie,FL 33314 Name and Location of Business Tax Receipt DO YOU NEED A GOOD PLUMBER INC 7501 SW 37 CT DAVIE, FL 33314 License Type: Contractor Plumbing Licensed For& Quantity: Contractor Plumbing 1 License#: 6 Phone#: 3057589215 Effective Date: 10/1/2013 Expiration Date: 9/30/2014 REFERENCE: MAILING ADDRESS: TO: DO YOU NEED A GOOD PLUMBER INC 7501 SW 37 CT Restrictions: HOME BUSINESS PHONE AND DAVIE FL,33314 MAIL ONLY 0 f , .eco CERTIFICATE OF LIABILITY INSURANCE °1„�°13"' `.�- 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 ALTERTHE 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 pollcy(les)must be endorsed. H 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 cerdficate holder in lieu of such endorsement(s). PRODUCER MVICT Risk Transfer Programs,LLC PHONE888-181-9363 Fax No): 219 East Livingston Street N Orlando,FL 32801 ADDRESS: INS! AFFORDING COVERAGE NAIC 0 INSURER A:CastiePoInt National Insurance Company 40134 INmSAdva�Dntage Corporation INSURER a:Tower Insurance Com 00 of New York 443 3350 Buschwood Park Drive INSURER C: Suite 200 Tampa,FL 33818 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:7JTQJA4E 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. L TR TYPE OF INSURANCE POLICY NUMBER D EPF POLI C EXP UNITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL.LIABILITY PREMISES Ea occunww $ CLAIMS-MADE 0 OCCUR MED EXP one ) $ PERSONAL$ADN INJURY $ GENERAL AGGREGATE $ GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ POLICY PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIRT— accident ANY AUTO BODILY INJURY(Per person) $ ALL OSWNED CHEESDULED BODILY INJURY(Per accident)AUTO $ NON-OWNED WP — HIRED AUTOS AUTOS DAMAGE $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ A WoRTIERscoMPENSA tom WSL 208 01/01/2013 01/01/2014 X WC ATI- OTH B AND EMPLOYERS'LIABILITY YIN WSLTHPE000300M _UMtM ANY PROPRIETOR/PARTNERMXECUTIVEQ NIA E.L.EACH ACCIDENT $ 11000,000 OFFICERIMEMBER EXCLUDED? 1,000,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ ff�a describe under 1,�.� DESG�RIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ $ DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLE-(Atlaeh ACORD 101,Additional Remarks Schedule,If more space to required) Coverage Is extended to the leased employees of alternate employer in all states except in monopolistic smites(NO,OH,WA,WY): Do You Need A Good Plumber,Inc. (Effective 10/4/10) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores Building Department AUTHORIZED REPRESENTATIVE 10050 NE 2 Ave Miami Shores Village,FL 33138 Page 1 of 1 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD Dec. 9. 2013 10: 55AM No. 0127 P. 1/1 CERTIFICATE OF LIABILITY INSURANCE DATE(MNUDO/YYY1� - 12/09/13 THIP 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 policypes)must be endorsed. If SUBROGATION IS WANED,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 Get Smart Insurance Inc. PNI ONE Gregg Ditzlan F 20286 NW 2 Ave E�Lo Exti: (305)653-7977- A/c No; (305)654-0293 Miami,FL 33169 PRooucER info insure-smart.com CUSTOMER ID# Phone (305)653-7977 Fax (305)654-0293 INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: Canal Indemnity Insurance Do You Need A Good Plumber Inc INSURER B: Progressive Insurance 7501 SW 37th Ct. INSURER C Davie,FI.33314 INSURER D 305-758 9215 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFYTHAT 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 ANYCONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS. IT TYPE OF INSURANCE sm POLICY EFF - INSR VIVO POLICY NUMBER MMIDD ( MIDD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 ® COMMERCIAL GENERAL LIABILITY 7I E17— PREMISES Ea occurrence $ 100,000 ❑ ❑ CLAIMS-MADE © OCCUR GL105215 MED EXP(Any one person) $ 5,000 A ElN N 09292013 09292014 PERSONAL&ADV INJURY $ 1,000,000 ❑ GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 1,000,000 © POLICY ❑ JECT ❑ LOC PD Deductible $ 500 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ❑ ANY AUTO (Ea accident) F-1 ALL OWNED AUTOS 07736931-1 BODILY INJURY(Per person) $ 10,000 B SCHEDULED AUTOS N N 11292012 11292013 BODILY INJURY(Per accident) $ 20,000 PROPERTY DAMAGE HIRED AUTOS (Per accident) $ 10,000 El® NON-OWNED Auros PIP $ 10,000 ❑ UMBRELLA UAB ❑ OCCUR EACH OCCURRENCE $ ❑ EXCESS LIAR ❑ CLAIMS-MADE AGGREGATE $ ❑ DEDUCTIBLE RETENTION $ WORKERS COMPENSATION $ AND EMPLOYERS'LIABILITY WC ST LIMITSOTH ANY PROPRIETORIPARTNEPJEXECUTIVE YIN TORY LIMITS ER OFFICERIMEMBER EXCLUDED? NIA E.L.EACH ACCIDENT $ (Mandatory In NH) If yes,descriOFbe undo E.L.DISEASE-EA EMPLOYE $ DESCRIPTION OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES (Attach ACORD 101,Additional Remarks Schedule,U more space Is required) Plumber CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Building Department THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 10050 NE 2nd Ave. ACCORDANCE WITH THE POLICY PROVISIONS. Miami shores,Fl.33138 AUTHORIZED REPRESENTATIVE _ ACORD 25(2009/09)QF ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD