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PL-14-1429
Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax: (305)756.8972 Inspection Number. INSP-215318 Permit Number: PL-7-14-1429 Scheduled Inspection Date: March 23,2016 Permit Type: Plumbing -Residential Inspector. Hernandez, Rafael Inspection Type: Final Owner: COHEN,DEDE Work Classification: Addition/Alteration Job Address:571 NW 112 Street Miami Shores,FL 33138- Phone Number (305104646 Parcel Number 3021360210940 Project <NONE> Contractor: LUIS QUALITY PLUMBING INC Phone: (786)256-2210 Building Department Comments ALL INTERIOR REMODEL KITCHEN BATHROOMS AND Infracdo Passed merits LAUNDRY ROOM INSPECTOR COMMENTS False Inspector Comments Passed Failed El Correction Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspectlon The Is paid March 22,2016 For Inspections please call:(305)762-4949 Page 1 of 34 Miami Shores Village JUL 0 2 20% Building Department BY: WM NX.2nd Avenue,Miami Sha,Mojift 33138 Td:(305)795.2204 Fa=(305)MOM INSPECTION'S PHONE NUMBER:(305)762,4949 60*4-, -*- nC 2010 BUHMING Pew No. y PERMIT APPLICATION M Pew Nu S� ' /� Pexmit Type:PLUMBING JOB ADDRESS• -// 2 Mr. NOW Show County: ?*C=W Daft FoliotParcd#: Is Me M&tng Mstwicaft Dfti atse&Yes NO Zone: OWNER:Name(Fee Side `.�.1n Pho •� 6� Address: --&COA()t a W & ' City: On( ka�-/ State:_ ziP= Tenandlxssee Name: 1 : Email CONTRACTOR;Cony Nates: v�u z v� •. > : 7� a�� ZZ/�' Aadwress: S �Lrr c 7- (3ty. /��/" �a State• lr 1 ✓/2. L Quali�a Name• v• 40/1 Nb )�•y-- Phone: �� = C G L� State Certification or Regisuadoia 41:XE6 40 3 C,ertirwate of Cody CoMa Pho : 36 d"—2k k C, 2."' Ac cess: DESIGNER:ArcMw . Wee of Work for Ob Peru:$ np? �' "' _Squ=WLbww Foetape of Work: Type of Work: DAadrew NZAlteration (]Ncw CMApaiiddReplac vueaso'' Dww4dm at Werk: dJ�'t,��-6.d /.0 &o 11/ is"Ap- T OLU tic' l Fee$ Peroft Fee$ 360. CCF$, CO/CC$ S Fee$ Radon Fee$ DBPR$ Bo"$ Notary$. TcabloWEdu Fee$ TedmekW Fee$ Double Fee$ Straw Review$ TOTAL FW,NOW DIM Ii ��` 2-0 Boading.Company's Name(if applicable) Bonding Cody's Address City State zip Mertgage Lender's Name(if applicable) Mortgage Lender's Address City stage lap Application is hereby made to obtain a permit to do the work area installations as indicated. I certify that no work or installation has commenced prior to the ince of a permit and do all work will be performs to meet the standards of all laws regulating contra don in this jurisdiction. I end that a separate permit must be secured for ECECI'RiCAL WORK,PLUMBM,SIGNS, WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS and AIR COMMONERS,ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing iufannutwn is accurate and drat all work will be done in compliance with all applicable laws regulating cmMuctim 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 WITS YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMA MCEMENT." Notice to Appftww As a condidon to the issuance of a building permit with aro estimated value erwedaeg$2500,the applicant must promise in good faith that a copy of dw Mice of conunencement and contraction lien law brochure wall be delivered to the person whose property a sd*ect to anachmemt Also,a cert+jied copy of the recorded notice of commencement must be posted at the job site for the fust inspection which occurs severe (7)days after the building permit is issued In the ab of such posted notice, the kwection will be approved a rdnwcdon fee will be charged Signaum. Owner or Agent Contractor 1 The foregoing instrament was acknowledged before r 9e this� The foregoing instrument was acl�wledged before me this 3 day of J V M 2d—'-L by P ' t V--', day of 2 by L u g s lc c no who is personally known to who is personauy known to me or who has i Rake an AtOT ,,'Y Puer�- tare to of 16 alt oath NEtDY�� Expires Oct 3,2016 State of Florida •'a MY Comm• #EE 840251 .* Notary Public plres oct 3,2016 Commis `.; = MY comm #EE 840251 ,'rrF pc o Sign: Print- T (nprint: y My Commission E)q*w. My Commission Expires: ------------- APPROVED BY ��' t-ty Plans Examiner Zoning Structural Review Clerk 0twwedsn2lto12XReviwd 07n0WXRcvjwd 06n0V2009hRev=A 3n5ro9) CTQB Construction Trades Qualifying Board BUSINESS CERTIFICATE OF COMPETENCY 04P000065 LUIS QUALITY PLUMBING INC D.B.A.: �p"` DOMINGO H FtN_ EZ LUIS DOM Is certified under the provisions of Chapter 10 of Miami-Dade County 1M : f .00WRACTING UNTIL 09130/2046 a _ C ,� ! Mi�m� 13County, # # off�rida 19:NOT A 0)LLPIbT 1;AY "r ^.3�!► CGNO tJ4POg65 'e.'��f Y'h� � �; isUt3�tM NANtl3!a•k,Q�►TIbN Q�tM7' U ALtCY 1�l U(1991NG 1NC ,..: � ' IPA W c L.I$RU ' " � w ; ;,i k :,�� •N 7d3'i!S>�0'. Must ba�ia`pti'�Mane of b ` ,`�,� n MlAf�,.FL 3�126 t�uri3uant�o Caui►ty�g-: Ch r BA Art s3 10' ITI C t °Aiy� Vt C i• 4 t .. Ov f 'i1 t TYF�B pF,taustwN1es�eCTOR BY T LUIS QUALITY PLUMBING INC PLIMA�iINC A�( LLlCTOR 7 C/O LUIS HERNANDtt: 200.00: 09/20/2013 .. 0223-13-001.465 r i r a W tdx Grit. (�Qr I110r8 idi0relRtibn.vleit _.....« .. rnp _.,._....,......................... 14 ._ ............. ._.. 7 Art, t ° 1 � 88ct r� , g � � ism"d-4-Did-0-0614nty► lorida I$* A BILL NOT'PAY" � :.503179_' gt�#I NAMRX00A'iiON i q�eli►� NCl� � 4 Jr7 .l s� , `LU15 Q11AL1tY pLUM9ING INC �IyI�L .; 245*NUY�s Ct-: � °�`�,� �� A�iAhAI�,FL a31 Z6 Muff!i9 dl�play�at 1#la�e of btu :.�ureuarrctaCountyOssBe r Clittptir'8ay►+-Att 9 8t 70 � owN,Btti' sec #°YPe oR Bi�sttuaes ; O, roe a LUIS(jUAU IY PLUMBING INC 196 YM PLUMBtlVG C�I�;, W TT tso4LeCrt� f 1 CSD LUIS HERNANDt ;45.00 09/20/2013 t► Wrker(s) lb 04P00006 " '0223-1'S_-001463 a' • 11de tonal Htifne�Tex Reaalpt oaly nonnpplpi�yhioht:M the tonal Btahares Tax. Recolpt 1$not a Iloaiatr. r.' paret� a oertlRoegon of lbeltoide�'e qna ailonA ka bnsineRe Holder I..** Iy vW**pvernmenW arnongmr MUM regit(adlrir'tavreandrelahappit+liltabl The RECD f b0,6*9 tauet be displayed on aR boaoaemial ttmlilol�e•R latnf-ti tde Code$ea 9u Z76. For mom tnianaetion,Weh wn I ..................._, ........... ._. ....... Local a .s -Tei Reca p# Mian-Dade County,State of Florida --MS I NOTA WL-DO NOT PAY 503178 [LBT Bt t38tYAMGtLpCAT iN REt fPTNQt E"IR nS LL"QVWTYMUMMo JNC. SEPTEMBER 30,2©16 -246 WV 69 OT 5ti 1178 Mud io dbo"ed ptme of huahtew WN,Pl. U126 Peesua tOCOUBW�Cgde fhepfter ffia—out.she�o OWNER SEC TYPE!QFsusmSS PAIMMM WSMIVND uns ouA rrY P1_uMBING INc 196 P.MONG BY TAX COULOMOR cio!4AS HE€NANDEZ CONTRACTOR 45.00 0 1012014 Warker(s) 10 04P000005 0229-14-UOSM Tbb Lead aw&ws Tax note*.*Mdhft P"Weidde-wa BudowT—Tbaloco l;eat&amwe. pmftwaCauuatindo"Umor's t-de .HOMO Mod am*t a" ar mgafate�yhaad aPPtpis�-ham. The REWff N0.ahm mw he did-a®samat=W - Cede 3-e80-M Cerl�ed-rm�ioa.+uak n pal on attar`s Tarr Receipt Mfarnt-Dade County,State of Florida TMSFS NOTA ELL-D6 NOT PAY' CCNO:04FOOM65. d1 BU SS MAMEROCATON EST MO 07 ES.: LLAS�� Nl .e ..$BFT1E 30,204.0 .. . 245 R s9:CT 74$4.M.. �# 331 Augtbsd aRPJ eotbasLaeAa: ` .. F�tasc�nt toovrtSr Code Cbgler -Rtt 9&74 CrAMM TYPE OF Bi7St;116SS PAVaMW wis QI3riLITY PLLUBM WC FWMBING COtitTRACfOR NV TAX ca +� C/O 1W_HEF.1\MM 200.00 09/10/2014 0229-14-006649 ismForam bjmwd-avis& CERTIFICATE OF LIABILITY INSURANCE VASSWNW aArr " 01=5 nn TE IS ISSIJED AS A MA FFR OF INFORMATM ONLY AND CONFER NO ROM UICN THi CERTIFICATE HOLOiR-THIS CERTIWATE DOLS Not AFFMMTNEI.Y OR NEGATMMy ABIEND,EXTEND OR ALTER THE COVERS AFFORDW BY THE POLICES MOW. THIS CP.RiIFICAM OF INSURANCE DOES NOT CONSI TUTS A CONTRACT SEN THE ISSUING WSURER(Sh AUTHORIZED REP RESTINTATWE OR PRS,AND THE ATE HOLDER. _..... PANT-Bemf bsnA L 00PODOP*mwtbeat .U`SUBROSATWNISTI D,subjectiO - thate Mmd ottile pofty,coMIS pooda wayrmpftaa mbmmonLA oA aOoesA A etA� Fast Fno�r�e _ Cim Ire l —C 1 ----..• — {3e1b�441-8443 4101 NW BIA Shad thuamaoum — HIBRAt.FL 33128 JUSUMBINAFFOR00180014SlAGE MRS (305)441-2997 I= 141443 Aroma• WESTERN WORLD N0URANCE COMAPNY LUIS CAIALITY PLuh0 NG MC 245 NW 50 COURT a- _ LIAM 33128awgi ��. _._-•-- _ _ F: E$ CERTIFMATE NUMBER: REVISION : THIS ISTO CERTiPYTHRTYHE POLICIESOF=0VlNCEL HAVE BEIM OSUED701M DMURED NAMMABMMRTHE POLICPERIOD NWAIM NOT INSTAHMANY REARMtBAENT.TERM OtCQ 1OFANYCONTRI TOROTHER DDC=NrVifFHR YT0 VMCH 7H@8 CEI TE MAYBE ISSUED ORMAYPERTMTHEBNSURMWEA EDBYTH E POMESO HSI IS SUlUECrlOALLTHE7ERMS. _EXMMONSANDCONWIONS OF SUCH POUMM LaM SHOWMMAY HAVE BEEN REDUCED BYF*D CLANS. _.._.. ul TWOOFOUNWANG9 PoLmumma Jpwm asm Lam atLIASUrtr EACH 1 ® OMWERMALOWERALMMITY i $ 1O0,M00 ❑ A ® O=lR NPP11018/Z0t4 10/1808 oA»� ase ixeon 5.0•o POISMAL&AMMMM 1,000m.00 ❑ _ GENERALAGGREGATE s 2.CW.00&00 (MMAi QATELUT'APPLESPEt FR0DtLiS-t A8G s 1,Qi�.00000 ❑Foiww ❑ M ❑ Loc $ W.E AUTONOL�IiY Lear ANYAUTO vWAIRYOWP0=4 S ❑ Aoi88 ❑ B&YvLgwow8 ❑ ADAUToB ❑ AUTOS — 8 S ❑ I LS ❑ocom EACHOCCURROM 0 — L37WMLMB ❑ _ ow 0 $ 1Sft: ANDEMPLOVENFLffinam YIN ELEACHACCIMM $ w DIY MIA dwrialso p E.L.DWENE-POLLCYt.ib97 8 �OPIHtA7lracCA•l /V (AMaehA�'!a£ Aitma�apmeb _._.... PUMING RESIDENTIAL OR DOMESTIC LUIS HERNANDEZ LTCEN8E 0 CERTIFICATE HOLDER CANCELLATION.--.-- SHOULD D ANYOF THE ABOVE DESCRIBED POLTIIES LE CANCELLED BLUE NLAM SHORES VKJAM BUMNG DEPT' UffMPMAR-MOATETH .bio7I VVMLBE IN THEPOLMYPAONS. 100M NE 2 AVE !~IASL.FL 33136 O998B-2010Atm CORPORATION. AlIdgIVISISSWUS& ACM 26{2@1MQ fF THAB ACORD nwm mW Wgo are togistored waft of ACORD JEFF ATWATER CHIEF FINANCIAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS'COMPENSATION **CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS'COMPENSATION LAW CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers'Compensation law. EFFECTIVE DATE: 9/18/2013 EXPIRATION DATE: 9/18/2015 PERSON: HERNANDEZ LUIS FEIN: 200422434 BUSINESS NAME AND ADDRESS: LUIS QUALITY PLUMBING INC 245 NW 59 CT MIAMI FL 33126 SCOPES OF BUSINESS OR TRADE: PLUMBING NOC AND DRIVERS Pursuant to Chapter 440.0.5(14).F.S..an officer of a cmpom*jn who elects eocmription from this chapter by filing a centiRcate of election under this section may not recover benefits or compeneadon ureter Oft chapter.Pursuant to Chapter 440.05(12)F.S.,Certificates of erector to be exempt..apply only within the scope of the business or trade Bated on the nodoe of election to be mwipt.Pursuant to Chapter 440.05(13),F.S.,Notion of election to be exempt and certificates of election to be axwnpt stag be aubisct to revocation if,at arty thne after the Ming of the notice or to Issuance of to certificate,to person narned on the notice or certificate no longer meeIs to requirements of cls section for Issuance of a cartiflicate.The deparbnent shag revoke a ow i icate at airy time for falure of the person rained on to certificate to rnest to requirements of this section. DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 07-12 QUESTIONS?(850)413-1609 II mass 0=1111 Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner - Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. §440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers'Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees, including the owner, must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if: I. The officer owns at least 10 percent of the stock of the corporation,or in the case of an LLC,a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State,Division of Corporations;and 3. The corporation is registered and listed as active with the Florida Department of State,Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers'compensation exemption.In these circumstances,Miami Shores Village does not require verification of workers'compensation insurance coverage from the contractor's company. Therefore,you may be personally liable for the worker compensation injuries of my Rerson allowed to work under this permit. Please check with your insurance carrier since most property insurance policies DO NOT cover this type of liability. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. erCointra7% Nam 4 Print Name: Print Nam Signature: 1 aw Signature: V/Iss State of Florida State of Florida County of Miami-Dade) County of Miami-Dade ed before this sworn to L—2 Sworn to Sw t=1 day of ZU3 day of HEID 2 CERTA CERTAIN No B 0 lic- rida Of Florida B ec ituct 3 20 ommiss, (S 25l (SEAL) LT of T of Identifica#on produced LUIS QUALITY PLUMBING INC. 245 NW 59T" CT M[ AMI FLORIDA 33126-4749 LIC # 04000065 COM LENTS: THE CONTRACTOR HAS PROVIDED AN AFFIDAVIT STATING THAT HE OR SHE WILL BE THE ONLY PERSON ALLOWED TO WORK ON YOUR PROJECT. CONTRACTOR Signature: ;�L State of Florida County of Miami-Dade The foregoing was acknowledge bee me this�,� day ofiva✓ —, 20 / 5 . By LV / r who is personally known eo me or has produced 2�. YP4e`c�'s HEIDY CERTAIN as identifi n. _ * Notary Public-State of Flo, •'S My Comm.Expires Oct 3, 7 OF Commission#EE 84024" n�.