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PLC-15-3061 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-249587 Permit Number. PLC-12-15-3061 Scheduled Inspection Date: December 21,2015 Permit Type: Plumbing -Commercial Inspector. Diaz,Osvaldo Inspection Type: Final Owner: ,BARRY UNIVERSITY Work Classification: Repair Job Address:11300 NE 2 Avenue Sage Hall Miami Shores,FL 33138-0000 Phone Number Parcel Number 1121360010160-15 Project <NONE> Contractor. MARLIN PLUMBING OF MIAMI INC Phone:305-652-6108 Building Department Comments REPLACE 180 FT OF 2"SCH8O COLD WATER LINE Infracdo Passed comments FROM METER TO EACH BRANCHE WITH 4 NEW BALL INSPECTOR COMMENTS False VALVES REPLACE 180FT OF 1 112 OF CPVC HOT WATER LINE FROM HEATER TO EACH BRANCH WITH 4 NEW BALL VALVES REPLACE 180 FT OF 314 OF CPVC HOT WATER RETURN LINE FROM HEATER TO END OF EACH BRANCH AND INSULATED BOTH HOT AND COLD LINES Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-249104. OK TO BACK FILL Failed Correction I 21 Needed a Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid. December 18,2015 For Inspections please call:(305)762-4949 Page 27 of 51 permit No. PL,. -12-15-3061:. Miami Shores Village dtTl7?/t Type;Plurltfir# CCfY1lit8tI it 10050 N.E.2nd Avenue NE a�.� IflltN�t ct� �ttanw'RePa'' , Miami Shores,FL 33138-0000 � �e �, t&tt � �?'����(E�} Phone: (305)795-2204 �x ; Issue Oahe l otl Isttsue ; Expiration: 0 0712016 Project Address Parcel Number Applicant 11300 NE 2 Avenue Number: Sage Hall 1121360010160-15 BARFLY UNIVERSI C Y INC Miami Shores, FL 33138-0000 Block: Lot: Owner Information Address Phone Cell BARRY UNIVERSITY INC 11300 NE 2 Avenue MIAMI SHORES FL 33161-6628 e 11300 NE 2 Avenue MIAMI SHORES FL 33161-6628 Contractor(s) Phone Cell Phone Valuation: $ 15,500.00 MARLIN PLUMBING OF MIAMI INC 305-652-6108 _._._. Total Sq Feet: 0 Type of Work:REPLACE 180 FT OF 2"SCH80 COLD WAT Available Inspections: Type of Piping: Inspection Type: Additional Info: Final Classification:Commercial Review Plumbing Scanning:3 it Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $9.60 DBPR Fee $6 98 Invoice# PLC-12-15-58011 DCA Fee $6.98 12/14/2015 Check#:2357 $463.56 $50.00 Education Surcharge $3.20 12/10/2015 Check#:2356 $50.00 $0.00 Permit Fee $465.00 Scanning Fee $9.00 Technology Fee $12.80 Total: $513.56 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compli ince with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the prof ar authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or err.ployec I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL wor<. OWNERS AFFID ce : 0Fthgie- information is accurate and that all work will be done in com)iiancc with all applicable laws regulating construction and zoning. tor bove-named contractor to do the work stated. Decer fiber 14, 2015 o e:Own pplicant / Contractor / Agent date Building epartment Copy December 14,2015 1 Miami Shores Village %c 2015 Building Department 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 9�t BUILDING Master Permit N... (� PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL 70 PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 11300 NE 2ND AVENUE -SAGE HALL City: Miami Shores County: Miami Dade Zip: Folio/Parcel#:11-2136-000-0050 Is the Building Historically Designated:Yes NO X Occupancy Type: Load: Construction Type: PLUMB Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder):BARRY UNIVERSITY Phone#:305-899-3995 Address: 11300 NE 2ND AVENUE City: MIAMI SHORES State: FL Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: MARLIN PLUMBING OF MIAMI, INC Phone#: 305-652-3031 Address: 20145 NE 16TH PLACE City: NORTH MIAMI BEACH State: FL Zip: 33179 Qualifier Name: EDWARD J WALKER Phone#: 305-652-3031 State Certification or Registration#: CFC048292 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address City: State: Zip: Value of Work for this Permit:$15,500.00 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New 0 Repair/Replace ❑ Demolition Description of Work: REPLACE 180FT OF 2"SCH80 COLD WATER LINE FROM METER TO EACH BRANCHE WITH 4 NEW BALL VALVES REPLACE 180FT OF 1 1/2"OF CPVC HOT WATER LINE FROM HEATER TO EACH BRANCH WITH 4 NEW BALL VALVES REPLACE 18OFT OF 3/4"OF CPVC HOT WATER RETURN LINE FROM HEATER TO END OF EACH BRANCH AND INSULATE BOTH HOT&COLD LINES Specify color of color thru tile: s s Submittal Fee$. °� Permit Fee$ a�,�,' CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ 6-3 " (Revised02/24/2014) k 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 reinspection fee will a charged. i Signature Signature 41 wi�v OWNER or AGENT CONT OR The fgregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this Qd�fn• day of Au�115,�I L ,20 1!by 1 (0 day of A1,Q Ue&neZ 20 1,4;- by @Ar-,AN Pb%N AL ,who is personally known to FrJ14046d -"WC,1ke-4 who is personally known to Jrr e 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: Sign: es1.0 ngKA Print: -40 Print: C- Notary Public tate of Florida Seal: Jeffry J YaoSeal: ,•;;�:o",;a•. +� $ My Commission MCCREERYn FF 189481 icy ��y pM Expires 11/12/201e . ? Notary Public-State of Florida o4 My Comm.Expires Dec 6.2017 *x.��******�***���*�***���*****�*�*�**�*�x�x��*�**w****�.**x.x.x.x.*��.* *w'taoR�i�`°apt`.•*�**�� I��.i���*�������** �**�.x��.w* APPROVED BY ��� �U of Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD a ;� a( r 5L'JMBING CONTRACTOR A -ea below IS CERTIFIED Vit`' :er the provisions of Chapter 489 FS _• at:o^ gate AUG 31 2016 0 R1 'VALKER. EDWARD MARLIN PLUMBING OF MIAMI INC � '0'45 NE 16TH PLACE N(`RTH MIAMI BEACH FL 33179 ,,SUF, 0a,�.3�2u1a DISPLAY AS REQUIRED BY LAW SEo>a Ll4osos0oosz9s 000464 Local Business Tax Receipt Miami-Dade County, State of Florida -THIS IS NOTA BILL - DO NOT PAY LBT 2503465 BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES MARLIN PLUMBING OF MIAMI INC RENEWAL SEPTEMBER 30, 2016 20145 NE 16 PL 2627108 Must be displayed at place of business MIAMI FL 33179 Pursuant to County Code Chapter 8A-Art.9&10 OWNER SEC.TYPE OF BUSINESS PAYMENT RECEIVED MARLIN PLUMBING OF MIAMI INC 196 PLUMBING CONTRACTOR BY TAX COLLECTOR Worker(s) 1 CFC048292 $75.00 08/19/2015 CREDITCARD-15-041586 This Local Business Tax Receipt only confirms payment of the Local Business Tax.The Receipt is not a license, permit,or a certification of the holder's qualifications,to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT NO.above must be displayed on ail commercial vehicles-Miami-Dade Code Sec Ba-276. For more information,visit www miamidadg,gov/taxcollector DATE ASR©® CERTIFICATE OF LIABILITY INSURANCE 11/2/2015D 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 CONTACT Lauren Mayer NAME: Keyes Coverage Insurance 5900 Hiatus Road PHONE 954-724-7000 W-C .954-724-7024 Tamarac FL 33321 EMAIL ,Imayer@keyescoverage.com INSURERS AFFORDING COVERAGE NAIC# INSURERA:Wesco Ins Co -25011 INSURED 5937 INSURER B:Brid efield Employers Ins Co 10701 Marlin Plumbing of Miami, Inc. INSURER C: 20145 N.E. 16th Place Miami FL 33179 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1361986687 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. ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDY EFF MMIDD EXP LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y WPP115738601 5/8/2015 5/8/2016 EACH OCCURRENCE $1,000,000 CLAIMS-MADE 5 PREMISES OCCUR DAMAGETO Ea RENoccurrTED ence) $100,000 X Al Per Wrtn Cont MED EXP(Any one person) $5,000 X WOS Per Contract PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY F X]PEa LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINFO—S-1-0 CE1 $ Ea accident ANY AUTO BODILY INJURY(Per person) $ AUTOS SCHEDULED BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAB FOCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION y 830-25781 12/1/2015 12/1/2016 XPER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached H more space Is required) RE: License#cfc048292 CERTIFICATE HOLDER CANCELLATION 30 days except 10 days nonpayment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Village of Miami Shores ACCORDANCE WITH THE POLICY PROVISIONS. 10000 NE 2nd Avenue Miami Shores FL 33138 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD CA f-I T V� \.L.� 1 • • ••. • . • ••. .. .. . . . .. .. . . . . . . . . . . . war,{ 70 Y"C i S ... _ �1 • • • • • • Pie W! i L' !RJ �U L?'Cr'1q/�y- Pi PC' •:• :• •• •:• ••• •:• ••• 6,*,'( A-7 C A<,4-y T ' _ 1'6c►U 1 Sh.cxe� . .L 3 31 0 y /� .. . . . .. ... •• • . 0. DEC 10 2015 rr i w F FL 313171 3o5=(65A- 3031 v �iJa�✓ Meter Y� '� - -JU C. Pun+ I :o°"rP°e%•. THERESAMCCREERY 4 �••� -- C"®LD6KJA •_ SJ�`� e9 I�p�4= A� � -� _ o�r� Be�� ✓R�✓B WI.�7JDfC Notary Public-State of Florida 4 L �A My Comm.Expires Dec 6,2017 _ _ 11_lci_ _Y'.- H ISA f f� °•.;o���q Commission 8 FF 070897 D4- 4 *4-e.� pit f' �A� ti'AT �1 1