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PL-15-1672 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-238366 Permit Number: PL-7-15-1672 Scheduled Inspection Date: November 18,2015 Permit Type: Plumbing - Residential Inspector: Diaz, Osvaldo Inspection Type: Final Owner: RANDOLPH,ALAN Work Classification: Addition/Alteration Job Address:325 NE 95 Street Miami Shores, FL Phone Number (305)613-2605 Parcel Number 1132060136020 Project: <NONE> Contractor: JMD PLUMBING CORP Phone: (786)222-1466 Building Department Comments REMOVE& REPLACE 2 BATH SINKS, TOILET AND Infractio Passed Comments SHOWER TRIM INSPECTOR COMMENTS False Inspector Comments Passed `� Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid November 17,2015 For Inspections please call: (305)762-4949 Page 4 of 33 Penrc�. L-7- 5-1672 `snmoRs Miami Shores Village Perm}t Ty Plumbing-Residential 10050 N.E.2nd Avenue NE � �.„ Wyk C}asS}l�>rafidll:Addition/Alteration ft Miami Shores,FL 3313&0000Perm}t Status.-APPROVED Phone: (305)795-2204 �`Of : Issue �ata:11t212015 FExpiration: 04/30/2016 Project Address Parcel Number Applicant 325 NE 95 Street 1132060136020 Miami Shores, FL Block: Lot: ALAN RANDOLPH Owner Information Address Phone Cell 325 NE 95 Street ALAN RANDOLPH (305)613-2605 MIAMI SHORES FL 33138- 325 NE 95 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 1,650.00 JMD PLUMBING CORP (786)222-1466 Total Sq Feet: 0 Type of Work:REMOVE&REPLACE 2 BATH SINKS,TOIL Available Inspections: Type of Piping: Inspection Type: Additional Info: Final Bond Return: Top Out Classification:Residential Scanning: 1 Underground Review Plumbing Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 DBPR Fee Invoice# PL-7-15-56223 $2.25 11/02/2015 Credit Card $ 110.70 $50.00 DCA Fee $2.25 Education Surcharge $0.40 07/06/2015 Credit Card $50.00 $0.00 Permit Fee $150.00 Scanning Fee $3.00 Technology Fee $1.60 Total: $160.70 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 foregoin in ation is curate and that ork will a done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize t ab a ame ontractor to a work state . Novemer 02, 2015 Authorized Signature:Owner / Applicanf / C ntractor / Agent Date Building Department Copy November 02,2015 1 Miami Shores Village 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 BUILDING Master Permit No.12-C-,15' ^I l c18 PERMIT APPLICATION Sub Permit No.TT--�<!�; -I (Q-7 Z-• BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL VLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: �A) ( �`� °57 City: Miami Shores County: Miami Dade Zia: S3167P JB Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): ALA"�� RA0yO l�1PA Phone#: '-3• ���J ' ��� Address: NE� 15- o City: hA(A-AiI *t+DE-5 State:, Zip: --38 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: �J It OC N�>R°r Phone#: G Address: l 1`7/ a) 7® /''L /L City: 11h If State: Qualifier Name: -TyAJ 0 Jute Phone#: ?x 'a-�- /y(® G State Certification or Registration#: Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: / e� Value of Work for this Permit:$I t 44 . Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition Description of Work: \Av _y 06P to� 7 'Gjx) Specify color of color thru tile: Submittal Fee$S—(:)' Permit Fee$ /5�` '`7 CCF$ CO/CC$ Scanning Fee$ Radon Fee$ _ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ O (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." 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. °rte V Signature a^ Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 2 A day of ` h!!L% 20 15— by day of 20 1, by Il =who' persona�know�no `✓yA*� who is personally known to 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: �`�a�►19i011oiltlFe d Vol / • •�` 5, {/ Sign: Print: •''s 7n� Q,' y' afRf�§:�� 9° W°ta�'Pu6EfCU°ee"vrfters Seal: � •. �: •�� GIG,S fi,� a®��"d60esiilt���A i APPROVED BY 9S Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Miamiones u...1" shores Village Building Department rem 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LICENCES B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE* D. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 Certificate must specify the description of operations or contractor license number. BUSINESS NAME: 119ZZ n2 C BUSINESS ADDRESS: »71 ?/11ez- CITY /-`i,d /e, STATE Ft ZIP 3-? BUSINESS PHONE: 2 2 z 7 6 FAX NUMBER O CELL PHONE QUALIFIER'S NAME: J ✓G�� f]��'e QUALIFIER'S LIC NUMBER: , F G, \ au�,p rf a 3 � 33 Y �1¢ \::: v IRA, STATE OF FLoFd0A o pROFESSIONAL WARTNEW OF BUSINESS AN3 CONSTRUCTION INDUSTRY, (860)487-1395 STREET TALLAHASSEE ROE 940 NORTH � .323 783 JUAN MANUEL No �PLUMBING, CORP LACE HIALEAH FL 33414 of y oronud wsuslam, STATE Of FLORIDA SESS AND mkw% PR box"to barbm* ' an LIII t C1 . v 14 osy evoy ' pro r� sem yW , - d I ^ �L to bow ym on as"-vw xx b #AB'B P'8 ��qq �',gyE Ri § E2N a RaK;$dHA� . g�}pp ��yy viommemornm< p� �rw,.68TY"6Y arVaMO 9 DETACH HERE M m STATE OF FUndeLOWDA _ . r �� M 9: N aexwu ca.<rh s4�d+t8b+Rf39 A r68i Dov i sI t BdRd ` C 702015 Licensing Portal-License Search 1:34:08 PM 71212015 Data Contained In Search Results Is Current As Of 07/02/2015 01:33 PM. Search Results Please see our glossary of terms for an explanation of the license status shown in these search results. For additional information, including any complaints or discipline, click on the name. Name License License Type Name Type Number/ Status/Expires Rank Certified Plumbing DIEZ, JUANL Primary CFC1428262 Current, Active Contractor Cert Plumbing 08/31/2016 Main Address*: 1171 WEST 70TH PLACE HIALEAH, FL 33014 Certified Plumbing JMD PLUMBING' CORP DBA CFC1428262 Current, Active Contractor Cert Plumbing 08/31/2016 Main Address*: 1171 WEST 70TH PLACE HIALEAH, FL 33014 MEN `iii-,;y �,;,,. *denotes Main Address -This address is the Primary Address on file. Mailing Address - This is the address where the mail associated with a particular license will be sent (if different from the Main or License Location addresses). License Location Address - This is the address where the place of business is physically located. 1940 North Monroe Street.Tallahassee FL 32399 :: Email:Customer Contact Center :: Customer Contact Center: 850.487.1395 The State of Florida is an AA/EEO employer.Copyright 2007-2010 State of Florida.Privacy Statement Under Florida law,email addresses are public records.If you do not want your email address released in response to a public-records request,do not send electronic mail to this entity.Instead,contact the office by phone or by traditional mail.If you have any questions, please contact 850.487.1395.*Pursuant to Section 455.275(1),Florida Statutes,effective October 1,2012, licensees licensed under Chapter 455,F.S.must provide the Department with an email address if they have one.The emails provided may be used for official communication with the licensee.However email addresses are public record.If you do not wish to supply a personal address,please provide the Department with an email address which can be made available to the public.Please see our Chapter 455 page to determine if you are affected by this change. tdtpsJM+ww.myfloridalicerue.com/wi l l.asp?mode=2&search=LicNbr&SID=&brd=&typ= 1/1 7/2/2015 2016 details-Business Tax Account JMD PLUMBING CORP-TaxSys-Miami-DadeCounty Tax Collector HaMdade.GOV Tax Collector Haute Search Reports Shopping Cart Please do not include any special characters in the name,address,and e-mail field such as#,&, hyphens,comma, dashes. We have moved.Our new address is: 200 NW 2nd Ave,Miami,FL 33128 The information contained herein does not constitute a title search or property ownership. 2015 1st Quarter Tax Bills are Payable on June 1,2015 2016 ®Mails — Business Tax Account JIVID PLUMBING CORP Business Tax Account#6653902 L�-�Account details Account history 2016 2015 2014 2013 ... 2010 $45.00 due PAID PAID PAID PAID Account number: 6653902 Owner(s): JMD PLUMBING CORP Business start date: 07/01/2010 1171 W70 PL Business address: JMD PLUMBING CORP HIALEAH, FL 33014 1171 W70 PL Mailing address: JMD PLUMBING CORP HIALEAH, FL 33014 JUAN MANUEL DIEZ PRES Physical business location: HIALEAH 1171 W70 PL HIALEAH,FL 33014 Flags: JP Home Business l Print account application (PDF) Receipts And Occupations Receipt 6924972 Pay all: Contracting 10/01/2015-09/30/2016 NAICS code:23822 Print this bill PLUMBING CONTRACTOR Units: 1 Pay this bili: $45.00 Additional documentation required:CFC 1428262 State/County License or Certificate httpsJM,ww.miamidade.cwty-taxes.con/publicibminess taxtaccoarnts/6oM2 1/1 Co DA•'E;Nla' �rr� rI �� . . CERTIFICATE OF LIABILITY INSURANCE -THIS(-;RTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.TH13 CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES. BCLO'd6'. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHOF%!ED RE=PRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holler Is an ADDITIONAL INSURED,the pollcy(les)must be endorsed. If SUVROGATION IS WAIVED,subject tothe terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate doer not confer rights to the certificale holder In lieu of such endorsements) SRO?fCITR CONTACTNAME -- FAX Mar en Insurance Arca. (305)824-9841 370 A tl'.+est 49th Street L Marier>®mariarunsuranim.com _- ------- HiEdaa:,FL 33012 INSURE-RjS)AFFOItDIIIOCOVrRAGE -- Phone (:3106)824-9841 Fax (305)824-0004 INSURERA: Ascendant Commercial Insurance Inc -- - -- NSUF E,)--- INSURER S: Techonology insrnar ce cmparry -- - -- _--- JPhEI Plumbing Corp INSURER C: ---- -- ------------_-------.' 1171 V1/70 PL INSURER D: FL 33014 t (305)231-9271 INSURER E: —__--•----_.--------..- i INSURER F: ----------- .. COV EFI A ES CERTIFICATE NUMBER: REVISION DIUMBER: THIS k.;--O CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLIC't'PI:FJCD INC 1-;:, =D NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DO:UMENT WITH=.ES'IcCT TO WHIC I-I'rlil:i Cl i'7FICA?E MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 1:3 SUBJECT TO ALL THE TETO Ic. DIOL US ONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. . IiJ - - B ppUCY EFF POLICY EXP - UNITS_ TYPE OF INSURANCE POLICY NUMBER M/DD/YYYY D!Y- YYY)._ GENE:aALLIABILITY _ EIkCHOCCUFRENCE $ 1.300,070.0G j O RENTED COMMERCIAL GENERAL LIABILITY P EMISES(Ea occcjnnen'�.) $ 1;i1),000.OG _-; ocuR � $. 5,30_0.09 -,J cwMs MADE - -N N 024/2015 06124Z16 PERSONAL&AM INJURY $ 1,�fIU>p70.00 l GIENERALAG3RE-3ATE $ 2.�p0,0Jp.{1U GC:'LAGGREGATEUMITAPPUESPER: PRODUCTS-COMP/l;AGG $ 1,JCIp.pJplJ'J — + ----- ---- - j FOUCY G PRO El Loc $ --------- { AUTOMOBILE LIABILITY C(1MBINE:D SINGLE OMIT 1 PPIYAUTO BODILY INJUF"r(Per x-mn) $ -- --- -_ 13 _� ALL 4OS NED ❑ SCHEDULED CH�DB UBODILY INJUF:Y(Per awdenq: $ALF --- --- NON-OWNED PROPERTY DAMAGE $— _] HIREDAUTOS ❑ AUTOS 'ParacddenA UMBRELLA LIAR ❑OCCUR EACH OCCUFRENCE. $ EXCESS LIAB ❑CLAIMS-MADE AGGREGATE $ j ❑ RETENTION — WC STATIJ r-07H• --- - -- tIP.tP:1 R9 COMPENSATION ��TORYUMI],��_�T)_ CIE;E MPLOYERV LIABILITY YIN — --- ---- - ; AN' /PFOPRIETORIPARTNERID(ECUTNE TWC3436100 I- ' EAcHACCIDENI• $ 130,00D.00 13 ')FF ICE RIMEMBER EXCLUDED? NIA N 10!15/2014 1011512'015 f— -- MandatorylnNH) � E.-DISEASE-EAEAIPLOYE $ 1:10.000.00 j _ �r•CRIPTION OF OPERATIONS below -_ �-DISEASE-POLICY UMI'• $ 530 00D.pp J I DESCRIPTIQN OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,H mare space to requ(mtq Plumbing CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DE&MBED POLICIES BE CANCELLED bSEFOF(E Miami Shores Village THE FXPIRATiON DATE THEREOF,NOTICEVfiLL BE DELIVERED IN ding DepatUTTt31t ACCORDANCE MOTH THE POLICY PROVISIONS. Buil10050 NE 2nd Ave AUTHORIZED REPRESENTATItlE Miami Shores,FL 33138 K23 - ------ ©1.368-201®ACORD CORPORATION. All rights reserved. &CORD 26(2010105)QF The ACORD nanw and logo are registered marks of ACORD