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PL-15-1720 3 3 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-252776 Permit Number: PL-7-15-1720 Scheduled Inspection Date: February 16,2016 Permit Type: Plumbing - Residential Inspector: Hernandez, Rafael Inspection Type: Final Owner: TATE, BRANTLEY&CLAUDINE Work Classification: Addition/Alteration Job Address:874 NE 99 Street Miami Shores,FL Phone Number (786)420-5950 Parcel Number 1132060142410 Project: <NONE> Contractor: MAR-B PLUMBING CORP Phone: (305)324-0909 Building Department Comments ROUGH AND INSTALL 1 SHOWER 2 LAVATORY 1 Infractlo Passed Comments WATER CLOSET AND 1 BATH TUB INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-252676. CREATED AS REINSPECTION FOR INSP-238712. no access 2:20pm Contact info: ❑ Brantly-Property Owner/GC Failed 786-518-5042 Correction Needed ❑ ✓ � c Re-Inspection Fee No Additional Inspections can be scheduled until re-Inspection fee is paid February 12,2016 For Inspections please call:(305)762-4949 Page 28 of 38 Miami Shores Village 10050 N.E.2nd Avenue NE Miami Shores,FL 33138-0000 � � y Phone: (305)795-2204 7• Expiration: 01/17/2016 Project Address Parcel Number Applicant 874 NE 99 Street 1132060142410 BRANTLEY 8:CLAUDINE TATE Miami Shores, FL Block: Lot: Owner Information Address Phone cell BRANTLEY&CLAUDINE TATE 874 NE 99 Street (786)420-5950 (786)518-5042 MIAMI SHORES FL 33138- 874 NE 99 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 2,500.00 MAR-B PLUMBING CORP (305)3240909 .�...:..�.�..:.. Total Sq Feet: 75 Type of Work:ROUGH AND INSTALL 1 SHOWER 2 LAVATO Available Inspections: Type of Piping: Inspection Type: Additional Info: Top Out Bond Retum: Final Classification:Residential Scanning:1 Review Plumbing Underground Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.80 Invoice# PL-7-15-56288 DBPR Fee $3.38 07/10/2015 Credit Card $50.00 $189.56 DCA Fee $3.38 Education Surcharge $0.60 07/21/2015 Credit Card $189.56 $0.00 Permit Fee $225.00 Scanning Fee $3.00 Technology Fee $2.40 Total: $239.56 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 foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction an zoning. P th I authorize the above-named contractor to do the work stated. July 21,2015 XtWbrized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy July 21,2015 1 Miami Shores Village 1.- Building Department JUL,1 U �5 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY: Tel:(305)795-2204 Fax:(305)756-8972 --- INSPECTION LINE PHONE NUMBER:(305)762-4949 F BC 2010(J BUILDING Master Permit No.a R..` ��•� l-1 -2P3.3 PERMIT APPLICATION sub Permit No.2. 15 --p zo ❑BUILDING F-1 ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL kLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP Q' �J, CONTRACTOR DRAWINGS JOB ADDRESS: O ! �� Ve City: Miami Shores County: Miami Dade Zip: 3,71.?e Folio/Parcel#: j` Is the Building Historically Designated:Yes NO Occupancy Type: Lotatd: Construction Type: Flood Zone: BFE: FFE: Brant l OWNER:Name(Fee Simple TIMI Ider): �"1 -0ffy PhonW )5�_ e (O Addr dr City: State _ FLZip: Tenant/Lessee Name: Phone#: Email: CONTRALTO :Com an ame: I 1 Phone# 3�q op6gog Address: City: I I LA4 � State: _ Zi Qualifier Name: Phone#: 'VvJ 1 State Certification or Registration#: Certificate of Competency#: DESIGNER:Architect/Engjneer: P one#: iN7 Address City: • State 'p: Value of Work for this Permit-$ a ��`� Square/Linear Footage of Work: S SF Type of Work: N Addition ❑ Alteration ❑ New ❑ Repair/Re lace 1 p ❑ Demolition Description of Work: .lug i9 lw�dz.l� 5� '�L�,�a fi n,c„�/ � 1 & � �S Specify color of color thru tile: Submittal Fee$ Permit Fee$ • dF$ 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) � t 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. 1 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. 1 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 the applicant must promise in good faith that a copy of the notice of commencement and construction lien law ochur 1 be ivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of com ence must be osted the job site for the first inspection which occurs seven (7) days after the building permit is issued. In a ence of suc p e notice, the inspection will not be approved and a reinspection fee will be charged. Signature SignatureX O AER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of 20 .by O day of a `.0 ,20 S by Zot ` 4 who is personal) known to ho is personally known to SF (�li`Ci1'h � y me or who has producedas mg or who has produced as Identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: SigQ4 Sign: Print: 05 F Notary Public Stele orida �awgy Seal: ef Joanna M Fel 10 Seal: ,.•;�•Poe••, OSCAR SU My Commission FF 082783 �e�po Explrea oalt2l2ote Notary Public-State of Florida My Comm.Expires Mar 6„2018 Commission#r FF 069626 APPROVED BY `� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) i a 7/2/2015 10:32 AM FROM: Fax Mar-B Plumbing Corp. TO: 3057568972 PAGE: 002 OF 005 It: mass �'3ec ams` Miami shores Village `n, � Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305)795.2204 CONTRACTORS' REGISTRATION Fax:(305)756.8972 IF CO RACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: PY OF QUALIFIER'S STATE LICENCES COPY OF LOCAL BUSINESS TAX RECEIPT #. OPY 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. ■w u•w•ww•••www••ww••••••ww•ww■ • ■■•u•■••w•w•••w••••■••••ww•w••••v•w•••■w••■ww•ww•ww•ww•ww BUSINESS NAME: . Ir BUSINESS ADDRESS: l �J 1 V ti`V STATE 9 1 P �CJ BUSINESS PHONE: Z�1-' C FAX NUMBER�-S- CELL PHONE 3LIS---�Z3LI QUALIFIER'S NAME: �l i U� ��i 1�'�clV1 tc->7— QUALIFIER'S LIC NUMBER:OEC. 06 y t 7/2/2015 10:32 AM FROM: Fax Mar-B Plumbing Corp. TO: 3057568972 PAGE: 003 OF 005 STATE OF FLORIDA I DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION .� CONSTRUCTION INDUSTRY LICENSING BOARD (850}487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 MARTINEZ, SILVIO MAR B PLUMBING CORP 131 NW SOUTH RIVER DRIVE MIAMI FL 33128 ' Congratulationsi Wfth this!i-oen'se y-ofl"become one of*the•nearly_-. one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range STATE OF FLORIDA from architects to yacht brokers,from boxers to barbeque restaurants, DEPARTMENT Of BUSINESS AND and they keep Florida's economy strong. PROFESSIONAL REGULATION Every day we work to improve the way we do business In order to CFC057729 ISSUED: 07/16/2014 serve you better, For Information about our services,please log onto www.myflaridalicanse.com. There you can find more information CERTIFIED PLUMBING CONTRACTOR about our divisions and the regulations that impact you,subscribe Ito department newsletters and team more about the Department's MARTINEZ,SILVIO MAR B PLUM61Nf3 CORP Our mission at the Department is:License Efficiently,Regulate Fairly. We constant)y strive to serve you better so that you can serve your Customers. Thank you for doing business In Florida, IS CERTIFIED under the provlsfons of Ch.488 F8. and congratulations on your new licensel s bndaft:AUa 31.2016 040716=1282 DETACH HERE RICK SCOTT.GOVERNOR KEN LAW-SON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD CF0477n The PLUMBING CONTRACTOR Named below 1S CERTIFIED a Under the provisions of Chapter 489 FS. Expiration date: AUG 31,2016 MARTINEZ, SILVIO i Q MAR B PLUMBING CORP r 131 NW SOUTH RIVER DRIVE MIAMI FL 33128. , ,r Q ISSUED: 07/18/2014 DISPLAYAS REQUIRED BY LAW SEC# L14071WW1282 7/2/2015 10:32 AM FROM: Fax Mar-B Plumbing Corp. TO: 3057568972 PAGE: 004 OF 005 o ' L L-P ."N r exCty'ifti„f;j",$y�y+,w�y','.•aRt. ,y '':'JPY'`F'i,:�'k••�7`i�q•:.^ :4 'F y, � •''a.'.t:r �. "c7'"1 ,`�' a: ,F•'<':k•^ •r {. •.r:o✓;.r fi.r�.:rF."•§:•:`'.e.,ec'�.' !��;�+"'�'$� � �r .� q4 v,:r,. :i?,r' N..1•.n,,;'-''•� ':uZL^ ..;F,t,4•, �,; k:,;•,T•a.C:;Yi;.yt^;1�'�•+'�`J,'Y',�+s^,r;` ;<�. ,eM°i '. ,+9y.•. � a %••` � „.: ,sw•j�p �i:u•< ..g �i, z 1..� '.t::-a'.;?"�':1�"� �' �H '` •t�• al.' .t2:}^" .Y?u,. :+: 3'ey:T��r,.:.`;t: y..•. ri- '..;�-i .,•'+,'�9_!?J SEC.-V KA r G 198 ;�,s r ��=PAYhQsror BY TAX C T• ,<... . TOR i:��t"��(S i ''' '�� Vii::}?�x`�+` ;t� k.,-.p.'r•'.;:.:::..!:%: ?„ ti.;`?Ti6sLoc Tart •' � -':•.'.+h;={sSsS:,:,:•',t •.;_ a"owmk• t cause ?' f-2Mw. ly ►� n r��;!r Tb. » 1JYws and♦ r ' wbkA ap/htii ds�QstQeas. 5.r:.� �0„„ ,'1j1*.•�x., n�"+r M0. r •: ”. W1 d 1Q QM9NIc3a!Ya sIrn ��' . ;.ti F• .. ;'Y 4'� a ACORIO' DATE(MMIDWYM CERTIFICATE OF LIABILITY INSURANCE 4n12015 THIS CERTIFICATE IS ISSUED AS A HATTER 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: N the certificate holder Is an ADDITIONAL INSURED,the pol"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 certifica3Ke does not confer rights to the certificate holder In lieu of such endo s. PRODUCER MAOT Nuria Fletes Coastal Insurance Group PNONE 305-887-5999 Fax 305-887-7809 150 Westward Drive Miami Springs FL 33166-1660 Auums.nfletesocoastalinsgroup.com AFFORDING COVEMSE M=# INSURERA:Association Insurance Co 11240 INSURED MARBP-1 DISURERB:Brid eteld Employers Ins.Co 31267 Mar B Plumbing Corp INsuRBRc:Scottsdale insurance Company 15580 Silvio Martinez 131 NW South River Drive INSURER°' Miami FL 33128 INSURER E: INSURERF: COVERAGES CERTIFICATE NUMBER-441198720 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. LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y GLP0144946 02 41112016 4IM2016 EACH OCCURRENCE $1,000,000 CLAIAl18 AAADE OCCURPREMISES oCcurrenoo) $100,000 AHED EXP WW one poison) $5,000 PERSONAL&ADV INJURY $11000,000 GEN'L AGGREGATE LIMIT APPLIES PEP: GENERAL AGGREGATE $2,000,000 POLICY❑JPERC F]LOC PRODUCTS-COMPIOP AM $2,000,000 OTHER: $ AUTOMOBILE LIABILITYaBINE $ ANY AUTO BODILY INJURY(Par poison) $ ZrEO rUSULED BODILY INJURY(Per*ocid" $ HIRED AUTOS gN�01�® S C UMBRELLA LIAR X OCCUR XB 908 112015 1/2018 EACH OCCURRENCE $3,000,000 EXCESS UAB CUUMSMADE AGGREGATE $3,000,000 DED RETENTION$ $ B ANDY OCOMPENSSA� Y 83023337 /2015 112018 —FSMTA TH ANY PROPRIETORIPARTNERIEXECUTNE Y� MIA EL EACH ACCIDENT $1,000,000 EXCLUDED? under B�s, In E.L.DISEASE-EAEMPLO $1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$1,000,000 DESCRIPTION OF OPERATIONS I LOCATKM I VMGCLE8(ACOnD 101,Adel Romnaft Schedule,main be allochod N more apace M requiroM CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Village Building Department ACCORDANCE VATN THE POLICY PROVISION& 10050 NE 2nd Avenue Miami FL 33138 AUTHoRAM REPRESENTATM ®1988-2014 ACORD CORPORATION. All rights reserved. 07/10/2013 09:40 3053240919 MAR-B PLUMBING #1123 P. 001/001 AC<>R,' CERTIFICATE OF,LIABILITY INSURANCE 4/7/2Q1b"°"Y'^'' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMAM014 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMAEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CON'T'RACT BETWEEN THE ISSUING INSURER(S), AUTHORW-ED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT. If the CK"Ifkate holder Is an ADDITIONAL INSURE%the poliey(Ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and Condltions of the policy,certain policies may require an endorsemenL A statemad on this certificate does not confer rtghl$to the oetOfWa holder III lieu of such endo IL:. CRInsurance Group —•• � Nuria Flates 160.Westward Drive 305.887.5998 EM -305.887-7809 Miami Springs FL 33166-1660 292im,n�tW$@Coastalinsgroup.com .. INSUt0:SMAFPDRDWC39aVMtAGS – _ NA900 NSURERA-Association Insurance Co 11240. DISURIM MARBP-1 B:6ridgelleid Emplovets ins.Co 31267 Mar S Plumbing Corp Silvio Martinez jNsuRmc:Sc_ott a&le Insurance Company 1558A _ 131 NW South River Drive IN$UREx D I Miami FL 33128 SURERE- "- • INSURER V I .. ... vERAGFA C TIFICATE NUMBER:441198720 REVISION EMBER- "w<S F CERTIFY THAT THEPOLICIES OF IN URANCE LISTED BELOW HAVE BEEN ISSUED 70 THE INS URSD NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITNSTANDIN(3 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, W(CLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE W 48MRANf3e POLICY NueverxL MM AM A X OOMM WAL GENERAL LIAMUTY Y Y QLP01"W 02 12015 /1/2016 EACs t oEN( a1 a�,Lhop CLAMSMADE OCCUR ?RMIe: s Ee 8100,000 $$.000 PERMNAL&ADV INJURY $1,000.Mn AG'C4REL3gTF_uthtr naPUEs PER; cErERnL ACtfiRECiATF_ La 000.000 POLICY E] 7, PRODucr8_COb1PIOP a 000 000 OTHM. FE! LIMU rYO AAO I� 800LYINJURY(PetNON-0WDED SO04Y INJwW(Per L WWO S UrCB AUTO$ S Ci UR�HIALMG X ... –...._ $ UM �R X8�036�8 1/2016 L 0 � R� s3,000.000 AGCT3ATTc 53,000,000 WAAMEI DLD S .._. COMPENS B AND&erPtOiuB/ r f N Y 1/2015 1/2018 — $ ANY In Em OLU F N/A aL.EACHACf2D6rrr E.L.DISEASE-EA Enr— ' $1.000.000 oPLlLrnrlpNs a�ov/ ru, -POIOYUMIT 51,000,000 hhFSG�Tlp11�OF8tA7JON8/LOCATIONS/YBUCI.E$(ACORp tot,A0 SorleGWe,oklyCo dtlaoHeA 9f ntaae sRtce is*a9++�1 PLUMB)TG/CFC005729 CERTIFICATE ROWER CANCELLATION SHO LD ANY OF THE AWW DESCIRMW POLICIES BE CANCELLED ED HEFORE Miami Shores VII a BuildingTHE I�IRATIOIII DATE TNMMOF, NOTICE WILL BE DELIVERED IN 10050 NE 2nd Avenue Department ACCORDANCE VM THE POLICY PROVISIONS. Miami FL 33138 AUTHOR03) 'ATNF ACORD 26(2014/01) ®198$-2014 ACORD CORPORATION. Ail r,ghts reserved.The ACORD nm*and 1090 are M91st0red marks of ACORD