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PL-14-1725 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-217457 Permit Number: PL-8-14-1725 Scheduled Inspection Date: September 10,2014 Permit Type: Plumbing - Residential Inspector: Diaz,Osvaldo Inspection Type: Final Owner: GREEN, MATTHEW&AMANDA Work Classification: Gas Job Address:930 NE 95 Street Miami Shores, FL Phone Number Parcel Number 1132050070070 Project: <NONE> Contractor: R&I PLUMBING SERVICES Phone: (305)823-6911 Building Department Comments NEW GAS LINE FROM THE GAS METER TO THE Infractto Passed Comments KITCHEN RANGE INSPECTOR COMMENTS False Inspector Comments Passed ff Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. September 09,2014 For Inspections please call: (305)762-4949 Page 21 of 44 • , R & I PLUMBING SERVICE INC. 7898 NW 174 TER HIALEAH, FL.33015 786 2517552 CC # 03P000074 DROP TEST This tag to state this installation has been inspected and approved to code and in conjunction with F.B.C. & N.F.P.A. —58. Min W.C.D P.S.I. JOB ADDRESS ��'I ��e Technician Date 00 f STATE OF FLOR DA COUNTRY OF MIAMI DADE Before me a Notary Public authorized in the state and County set forth above, personally appeared known to me and known by me the person(s)who executed the foregoing DROP TEST. IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official seal, in the State and County aforesaid,the /0 day of _2 Nota Stamn IYONNE PALOMO MY COMMISSION #EES28M Nota P blic State of Florida EXPIRES August 21.2015 4c0; ae 153 Floaa.Na�rYB.nw ov. �1 Miami Shores VillageT7� Building Department AUG o7 20% 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 B Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20LO BUILDING Master Permit No. RC - 10 - IS " 232-8 PERMIT APPLICATION sub Permit No. d q--.0z5 ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP /-IN CONTRACTOR DRAWINGS JOB ADDRESS: 6120 I4� -(� 5-1 Cl7t2C-6= City: Miami Shores County: Miami Dade Zip: IZ— Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): 6. Phone#: Address: pp . !�� W- City: t V L d "&U,0 CXA State: R Zip: :1 j Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: iq 09b t6 Phone#:10 Address y7 f 7 /.� C_Q_ City: T/C JSt � State: Zip: 7�; Qualifier Name: C.A.P— (13 1)Z F-C Phone#: State Certification or Registration#: Certificate of Competency#: (2 DESIGNER:Architect)j ngineer)- Cf Phone#:3gC4'q _q_1&6 Address: Clio/ S6 sr' City: l e' State: Zi[):-;3/C9=- Value ip:?3/C9=-Value of Work for this Permit:$ 4p g° Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration p ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: M 0-� ( &--:z, l t+A;U rl® - ,6 t Specify color of color>hru tile: Submittal Fee$ g Permit.Fee$ , /�®, °�' 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) 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." III 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 will be charged. Signature Signature ER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoi g instrument was acknowledged before me this — day of G 5 20 by .� day of ' S 20 /`' , by Ha* Awe) ,whois�perso'nally kn w�to �9-0e— (L)r—k L � ,who' personally know me or 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. G ( / g p Print:—`A el 11) I/e Z Print: I/A N 1 G` r7 - �7P I/e Z-- Seal: Seal: MMIAD.PEREZ �atiea "° MMIAD PEIZ ?.: MY COMMIMN @ EE 1VM .r. MY COMMISSION EE 1271st o EXPIRES:September 7,2015 Banded EXPIRES'Septerl'b@r 7,2015 •L;'•''�° Balled Thra ��• Nfty PubhC U APPROVED BY T Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) CTQB ConntrucWn Trades Qualifying Board BUSINESS CERTIFICATE Of COMPETENCY 03PO00074 &I PLUMBING SERVICE CORP. D.B.A.: G ZMAN RENE Is certified ure+.the provisions of Chapter 10 of Miami-Dade County VALID FQR CONTRACTING UNTIL 09- 2015 A w.. DRfVM:ii.��s,E.CRSS E G256-720-57-368-0 „ N 78"mw 174 7m Fes^ tlitlRtN1,i�1. Ai01 s OW to48lw tae dna+ ��scat ea ae els a+mitt a ey aeea aopy�rr�bg fit' STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 GUZMAN RENE INDIVIDUAL 7898 NW. 174TH TERR. MIAMI LAKES FL 33015 Congratulations( With this license you become one of the nearly - -- - one million Floridians licensed by the Department of Business and STATE OF FLORIDA Professional Regulation. Our professionals and businesses range DEPARTMENT OF BUSINESS AND from architects to yacht brokers,from boxers to barbeque restaurants, n PROFESSIONAL.REGULATION and they keep Florida's economy strong. RF0057119 - ISSUED: 09/08/2013 Every day we work toimprove the way we do business in order to serve you better. For information about our services,please log onto REGISTERED PLUMBING CONTRACTOR www.myfloridalicense.com. There you can find more information GUZMAN, RENE_ about our divisions and the regulations that impact you,subscribe INDIVIDUAL to department newsletters and learn more about the Department's initiatives. (INDIVIDUAL MUST MEETALL LOCAL LICENSING REQUIREIfAENTS-PRIOR Our mission at the Department is:license Efficiently, Regulate Fairly. TO CONTRACTING IN ANY-AREA) We constantly strive to serve you better so that you can serve your HAS REGISTERED under the provisions of Ch.489 FS. customers. Thank you for doing business in Florida, sxpbstim date:AUG 31,2015 1.130 688 and congratulations on your new license! The Department of State is leading the commemoration of Florida's 500th anniversary in 2013. For more information, please go to www.VivaFlorida.org. MA 11010A 0r DETACH HERE STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION '' a CONSTRUCTION INDUSTRY LICENSING BOARD RFOO67119 The PLUMBING CONTRACTOR - • Named below HAS REGISTERED Under the provisions of Chapter 489 FS. Expiration date: AUG 31,2015 (INDIVIDUAL MUST MEET ALL LOCAL LICENSING REQUIREMENTS PRIOR TO CONTRACTING IN ANY AREA) GUZMAN, RENE INDIVIDUAL 7898 NW 174TH TERR. MIAMI LAKES. FL 33015 VIVA FLOW N RICK SCOTT ISSUED: 09108/2013 SEQ# L1309080002688 KEN LAWSON GOVERNOR DISPLAY AS REQUIRED BY LAW SECRETARY Local Business Tax Receipt Miami-Dade County, State of Florida -THIS ISNOTA BILL-DO NOT PAY �LBT 50076537� BUSINESS NAME/LOCATION RECEWT NO. EXPIRES R&1 PLUMBING SERVICES CORP RENEWAL SEPTEMBER 30, 2014 7898 MN 174 TERR 5228945 MIAMI,R. 33015 Must be displayed at place of business Pursuant to County Code Chapter 8A-Art.9&10 OWNER SEC.TYPE OF BUSINESS PAYMENT RECENED R&I PLUMBING SERVICES CORP 196 PLUMBWG CONTRACTOR BY TAX COLLECTOR 82.50 10/10/2013 Worker(s) 1 03P000074 0221-14000170 This Local Business Tax Recelpt only confimts payment of the local Business Tax.The Receipt is not a license. permit or a certification of the holder's qualifications.to do basins.Holder mast comply with any governmental or nongovernmental regalatery laws and requirements which apply to the basiuess. The RECEIPT N0.above mast be displayed on alleemmorciai vehicles-aAiami-Dade Code Seaga-2x ® For move faformation.vwww wjoiamida oolloctor Municipal Contractorps Tax Receipt Miami-Dade County, State of Florida -TMS IS NOT BILL-Do NOT PAY CC NO:03P;D0O()74 M C BUSINESS NAME/LOCATION RECEn9T NO. R&I PLUMBING SERVICES CORP EXPIRES 7898 NW 174TERR NEvuBUSINESS SEPTEMBER 30, 2014 MIAMI,FL 33015 7438622 Must be displayed at place of business Pursuant to County Code Chapter 8A-Art.9&10 OWNER TYPE OF BUSWESS R&I PWMB1NG SERVICES CORP PLUMBING CONTRACTOR PAYMENT RECEMED BY TAX COLLECTOR 200.00 10/10/2013 0221-14-OW 170 ® For more informatia®.visitawvw miamidade gov/taaoolisetor Aug 071410:52a World of insurarancec.7 �j �} 3052310711 p.1 �4�®�A`�? DATE(e+uuDnrvY,rv) CERTIFICATE OF LIABILITY INSURANCE _ 081_0.7/14 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICAT�H { OLDER.THIS ' CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATNELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES ' BELOW. THIS CERTIFICATE OF JNSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING WSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. I IMPORTANT: If the certlllcate*twider is an ADDITIONAL INSURED,the pollcy(Fesy must be endorsed if SUBROGATION IS INAIV®,subject te; the terms and conditlons of the policy,certain Policies may require an endorsement A statement an this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER -- CONTACT _ . NAME JORGE CAST7LL0 World Of Insurance Agency aC Noypin): (305')231-1111 _ _ FAX .__ Arc Ivul;_ (305)231-0711 18600 NW 67 Ave Unit 113 Mme- workiofinsuran{dJatt.net _.. iami.Lakes,FL 33015 INSURER(S)AFFDROINGCOVERAGE _ NAICif Phone (305)231-1111 Fax 305 231-0711 -- ..?—T....._ ._ _ { ) _ ,_ QJSURER A:,_.STARR INDENDNTYAND LIABILITY INSURANCE COM _. INSURED ..._— WSURER 6: R A I PLUMBING SERVICE CORP --__--.- .. - .•-_ _INSURER C: 7898 NW 174 TARPACE atSURER D: Miami Lakes,F1 33015 305 aJSURERE__ COVERAGES — _ INSUReRF: _ __ GERTIFICATE_NUMBER _ REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE IST LED BELOW HAVEEN BEISSUE TO THE INSURED NAMED;%66N E FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WH(CH THIS I CERTIFICATE MAY BESSU IED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALL THE TERMS, 111 _ EXCLUSIONS AND CONDITIONS OF SUCH P_OLtCI_ES,LWITS SHCIVM MAY HAVE BEEN REDUCED BY PAID CLAIMS. --- —ADO tIa -- INSR LTIj__ TYPE OP INSURANCE PO GEUCY EFF i 'EXP I WVD ._ I�OIIC, YNUMBER MUDD/YYYY)�IIfiytpDlYYW11 _ LIMITS NERAI.UABIUTY .— EACH OCCURRENCE COMMERCIAL GENERAL LIABILITY DAMAGE 7p RENTED 1 QOO OQO.QO CUstMS-MADE R OCCUR PREMISES(E2 qrc' @nC6) I S A J•I 1000051665131 MED EXP(An�areQerson) I $ 1,000,000.00 0810712014 0$/07/2015 __... .._ 0 .----._-- • � PERSONAL&ADV INJURY ffi 5,000.00 "1 _• - ... _ ._.._._.—1 EG •NERALAGGREGATE I $ 1,QOO,Q00.00 GERL AGGREGATE LIK%TAPPLIES PER -IPRO ODUCTS-cowtoPAGG' $ 2,00.000.00 y i_ _U POLICY U JECL�LOC AUTO (COrkgINEDSINGLElRJI1T _ ---- AUTOMOBILE $ _.. _ ... _ E I_ ANYAUTO I c .1940 - ._ _ . .. ... - - I ALL OYJNIDSCHEDULED I _EMILY INJURY(Per pars=) S AUTOS I� AUTOS HIREDAUTOSII��II NON-OWNEDBROpDILYINJURY(Peracdda $ - -- AUTOS Peen .S•- F1 i i EI UMBRELI_AUAS 1� 1 f- occuR ----- ---- -- - El EXCESS UA13 I_!CLAIMS-MADE ..EACii OCCURRENCE $ LJ DED L: RETENrioN$ AGGREGATE-- s -- -- WORKERS COMPENSATION _ AND EMPLOYERS,LIABILITY Y J N I�I WC STATU- I-7 07H-i ANY PROPMETORIPARTNERIEXECUTIVE t .I TORYLIMITc .I_ I .T..... OFFICERIMEMBER EXCLUDED? NIA E.L.EACH ACCIDENT S (Mandatory in NFL) des cribe under i DESCRa'TIONt OF OPE.L DISEASE-EA EMPLOY ERATKIN3 below - —._._ ....—_.-..-..— L - - ._. E.L DISEASE-POL�Y LllatlT�S I DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES{Anacb ACORO t01,Addt)oasl Remi Schedule,if more spaae is fired) PLUMBING CONTRACTOR CER77FICATEHOLDER-- CANCELLATION_ _..... MIAMI SHORES VILLAGE SHOULD ANY OF THE A13OVE DESCRIBED POLICIES 13E CANCELLED BEFORE I THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN i 10050 NE 2ND ACCORDANCE WITH THE POLICY PROVISIONS. MIAMI SHORES FLORIDA 33138 - ---•- --• - AUTRORIZ®REPRESENTATIVE - -- i.•. _._L_ - _ — JORGE CASTILLO ACORD 25(201 DIOS)OF ©1988-2010 ACORD CORPORATION. All rights reserved.- The ACORD flame and logo are registered marks of ACORD 6 jEFF ATwATER vt CHIEF FIVANCtAL OFFICER STATE OF FLORID DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS'COMPENSATION "CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS-COMPENSATION LAW'• :ONSTRUCTION INDUSTRY EXEMPTION This cardfies that the individual listed below has elected to be exempt from Florida Workers'Compensation taw. EFFECTIVE DATE 3J2812013 EXPIRATION DATE: 3/28/2015 PERSON: GUZMAN RENE FEIN: 611433275 BUSINESS NAME AND ADDRESS: , R&1 PLUMBING SERVICE COI 7898 NW 174 TERRACE HIALEAH FL 33015 SCOPES OF BUSINESS OR TRADE: PLUMBING NOC AND DRIVERS P—mdto Cfi 4 f49.F.S.,an atti are cmpmwmr wird a tiau� of edectian rssder arta. a matt._ _ . rm1fQcmmbmftcr=up=1msfti underttds dmptm Pursrmnt to ChWw440.os(12),F.S.,Cogtates of eiedtan to be:exmnpt...apply only wM b me scope .. of"buda"aruate It w mt the rtot?ce of eteebcn to be emmpL Pia=Mtt to Omptar44MW14 F.S.,Notices of ededton to boom amicoaft9tesar eft to be mof»npt stmD be subs in rer If at arrytirr�aftertite ti[irt0 afore rhe or ftsumm atom certkate,to pemm rt8m 4 on the nosomar cmmcate no mWmeemihe c1vft sedton far issue of a eertift.'m mm I I fswmuwwa asr a at arty timet�faArue attire pmsoa mt tits t0 rrmat tim r cf tiro secftL DFS-F2-DV Vr-M CERTIFICATE OF ELECTION TO BE EXEMFrr REVISED 07_12 QUESTIONS?(850)413-1609 P