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PL-15-2012 . o Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-241075 Permit Number: PL-8-15-2012 Scheduled Inspection Date: February 09,2016 Permit Type: Plumbing- Residential Inspector: Hernandez,Rafael Inspection Type: Final Owner: NEWBAUER,JEFFREY Work Classification: Addition/Alteration Job Address:70 NE 92 Street Miami Shores, FL Phone Number (305)799-0885 Parcel Number 1132060130020 Project: <NONE> Contractor. SHARK PLUMBING INC Phone: (305)384-5595 Building Department Comments PLUMBING WORK FOR INTERIOR REMODELING Infractlo Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed a� Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid February 08,2016 For Inspections please call: (305)762-4949 Page 4 of 31 Miami Shores Village ' 10050 N.E.2nd Avenue NE Miami Shores,FL 33138-0000 Phone: (305)795-2204 , Expiration: 2117101 Project Address Parcel Number Applicant 70 NE 92 Street 1132060130020 JEFFREY NEWBAUER Miami Shores, FL Block: Lot: Owner Information Address Phone Cell JEFFREY NEWBAUER 70 NE 92 Street (305)799-0885 MIAMI SHORES FL 33138- 70 NE 92 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 8,000.00 SHARK PLUMBING INC (305)3845595 Total Sq Feet: 0 Type of Work:PLUMBING WORK FOR INTERIOR REMODELI 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 $4•S0 Invoice# PL-8-15-56666 DBPR Fee $4.20 08/21/2015 Check#:2999 $304.20 $0.00 DCA Fee $4.20 Education Surcharge $1.60 Permit Fee $280.00 Scanning Fee $3.00 Technology Fee $8.40 Total: $304.20 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 and ni . uthermore,I authorize the above-named contractor to do the work stated. August 21,2015 Authoriz S gnature:Owner / Applicant / Contractor / Agent Date Building Department Copy August 21,2015 1 Miami Shores Village Building Department `'- AUG 1 12095 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(30S)762-4949 ` FBC 20i`4 5 BUILDING Master Permit No. PERMIT APPLICATION Sub Permit No. �' - 20 Iz, ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL [PLUMBING ❑ MECHANICAL [__j PUBLIC WORKS [-] CHANGE OF [:] CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: jQ /jSG !.:E 2 S 7 City: Miami Shores County: !�� Miami Dade Zio: 3 -3> Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: 1 OWNER:Name(Fee Simple Titleholder):JE F TILEY e M4 Le;A) 4- r Phone#: Sbste�"?11 "0 Address: 26, N E 42A'0 S rC City: M t h 1 5"a" State: fr4t'' Zip: 13/3 g Tenant/Lessee Name: Phone#: Email: JEFF. C-O^ CONTRACTOR:Company Name: 012Ae t-11, 0 ..i k,>7:a ,Ajc. P -y7hone#: 30,1--,38yd J y Address: /3oo 97- /- oy City: fo," State: bL Zip: Qualifier Name: S )6tet J- 5 Phone#: 30 State Certification or Registration M CA"L. Certificate of Competency M DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ gow Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: i`t� ( T U 9 OR1KP��2 [ j��"ice. L�Q' Q a A bb gLLfL.k1q Specify color of color thru the: a Submittal Fee$ Permit Fee$4ZIN !"_ CCF$. CO/CC$- Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ ®%4- 29 (Rewsed02/24/2014) • 7 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. 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•�NOTI1Cf OF COMMENCEM�11lTI' • , o. F 1 ..1 Notice to Applicant: As a condition to the issuance of a building permit with an estimated value edlneUbo, the applicant must promise in g fsdtl�-thbt a copy of the notice of commencement; construction lien law r ill be deliv, t�}~hh person whose propertys subJecf to attachment Also,a certified copy of therecordednotice of commencement� Mutt 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 bi y�qa ®d�`.a a �. *, )�* -Signatur Signature A---od4 OWNER or AGENT O RACTOR The foregoing in rument was acknowledged before me this The foregoing in rum t was ledged before me this _�_day of tS%AA J .20 1 S .by day of 20 ��,by tAV-QJRAP-&t who is personally known to OTho is personally known to me a or who hasroduced as iden0ma0cmand who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: de�Sign: Sign: Print: C17M Print: ELOISE[FF Seal: •�'" ` ' KURT A BIRCHENOUGH Seal: g: MY COMMISSIO884 EXPIRES:Jt8MY COMMISSION#FF051900 ft"ThruNo" EXPIRES September 8,2017 APPROVED BY �� ��S Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) � 1 z � ' r R QBwtffikA1914R� <..,r. �to argr 1'� ttylei. Local Business Tax Receipt Miami—Dade County, $tote u€Fiorid -THIS:115NOTA BILL-8OVOTPA'F 6754320 Lamm, T BUSINESS NAME/LOCATi'ON RECEWT NO, EXPIRES SHARK PLUMBING INC REAt° (1�L 1300 SW 92 AVESEPTEMBER 30, 2015 MIAMI,FL 33174 7027733 Must be displayed at place of business Pursuant to COunty Cods Chapter 8A-Art.9&10 OWNER SEC.TYPE OF BUSINESS SHARK PLUMBING INC 196 PLUMBING PAYMENT RECEIVED BY TAX COLLECTOR CONTRACTOR 75.00 07/14!2014 Worker(s) 1 CFC1428368 CHECK21-14-017879 This Local Business Tax Receipt only confirms payment of the Local business Tax:Tile Receipt is not a license, permit,ora certification of the bolder s qualifications,to do business.Holder must comply.with any gmrnmental or nongovernmental regulatory laws and requirements which apply to the busionss. The RECEIPT N0.above trust be displayed on all commercial vehiciss-Miami-Deft Code Sac 8e-ft MIAMF amore Information,y1sh RICK SCOTT, GOVERNOR _._. KEN I-AWSON, SE RC ETAI STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD CFC1428368 The PLUMBING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 WE YANES, JOSE LUIS SHARK PLUMBING INC 1300 SW 92ND AVE MIAMI FL 33174 ti ate,-� • ISSUED: 05/29/2014 DISPLAYAS REQUIRED BY LAW SEQ# L1405290001823 �;;.:...,..; ,.,:,... .................. .. ......................... ., . D� °"��`" CERTIFICATE OF LIABILITY INSURANCE �"`�"'"" 07120116 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. __........_..._..........._.__.....__._.._......_---..._....._._.__...__.—_-N'-A*........................................._...---..._.._._._-. ._.............. .........,....... ...-...............-___---_,.__,_..,,,-.---_._.._._...__............_........,........ ...... ( JfdPORTAN7: If ttre certSlcete holder�an ADDt7tONAL INSURED,ttfe pogcy(hes)must be endorsed._d SUBRO(311TI0N IS WAIVED,subject o ! the terms and conditions of the pollM certain policles may require an endorsement. A stetwent an this cert icate dans not corder rights to the I certifksato holder in lieu of such endorsemern(s). n PRODUCER COktACT _ Mada Almoide 11A4s _.......,__...._...,...__..................................._.._...._.............._..__.... ..._........... ......................_.. Blanco insurance Associated Inc. PtiiV,Ext) 8$8-0624 272.0044 ? 1462 E.4th Ave. ..........nmeasbisncolnsurance.com .....__......................... Hialeah,FL 33010INSURERIs)AE oRaura,92vi gnciE NPt��, _................... Phone (3t)5)888-0524 - Fax X305)883-6218„ - _........INSURER a b...__Granada Insurance co. k INStgtt ASCENDANT ...... Shark Plumbing Inc. INS ___............ ........... ..... s ! . .......... r: 1300 Sw 92 ave BtauRER D: _.. Miami A.33174 (305)384-5596 INSURER E: _._ COVERAGES __ C_ERTiFICA_TE NUMBER: REVISION NUMBER: THIS IS TO CFJ2TJFY 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 TEFWS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I � ADDt SUIMp�1y .....TYPE OF INSURANCE---. _._._INSR _...,_..._...._..POLICY t�Jj�@R.__ ���_f04ffitA��1 .___... ....._._.__....—— LIkUTS.._._.. ... ..........__..._....._ :: GENERAL LIABILITY 1004 000.00 ❑/ COMMERCIAL GENERAL LIABII.rrY OAUWE TO 1104TED s $.._..100,000.44............. ❑ © R1 OCCUR 0185FL00031020 MED�'JA++Y_M $s�000.00•--.......... i A N I 11/0212014 11/02/2015 - I .04 0 4.4 ,00 ElPERSOAlltL&ADVO�Jt1RY $ 100 - —._..._�. .__._._....... j ❑ .._-........___.—__.�__.__.__..._.._...,.. GENERALAGGREGATE $ 2w000,000,OQ GEML AGGREGATE LIWT APPLIES PER: PRODUCTS-comptoP AGG $ 2,000,000.00 —®POLICY.D. T..... hoc _.._...._... _$_......... --._._........... I AUTOMOBILE LIABILITY —_................_....._........ ...__...._..........___..._..__ .....-- r Cog p INGLE LIbBT i❑ ._._. -----�4.......................................... ANY AUTO { ...... ALL OWNED SCHEDULED BODILY INJURY(Par Persen) $ B ❑ AUTOS ❑ Nq pwHED BODILY INJURY(Per aaldent $ ❑ HIREDAUTOS ❑ AUTOS cd $ �.__. $ ❑ UMBRELLA LIAR ❑occuR EACH OCCURRENCE._._._.__$--..__....,.....__------... ' � EXClaBS UAB El CtlUMS-0NAOE AGGREGATE _ $ WORKERSCOMPENISATION — ----..................._._.. -- .. —WC3TATW — _.. ....._.._......................._......._. � AND EMPLOYERS`LIABILITY YIN _._._.__...._._......................... ANY PROPRIETORIPORVEXECUTIVE03/20/2015 03/20/2016 $ OFFICERIMEA/BEREXCLUDED? — N 1 A We-61 1010 E.L. .EACH ACCIDENT ._._� $._ _._........... [ Y [Y]-] E.L.DISEASE-EA EMPLOYEEIf er $ .540,004.04 t 1 DESCRIPTION OOFF OPEPA11016 b tow _..w_...E.L.DISEASE-POUCYLIMIT $ 100,000.04 DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES(Attach ACORD 101,AddWor Remral<s 8aheduin E emre apace Ie regWred) Plumbing Work.LICENCE#IS CFC1428368 z CERTIFICATE HOLDER CANCELLATION j SHOULD ANY OF THE ABOVE DESCRIBED POLICIES Be CANCELLED BEFORE MIAMI SHORES VILLAGE BLDG DEPT THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 10050 NE 2ND AVE ACCORDANCE WITH THE POLICY PROVISIONS. MIAMI SHORES,FL.33138 AUTHORIZED REPRESENTATIVE M Fax:305-756-8972 ..................... _.._....---__.___.._._.. - hMIAALMOL .�._ 201 AGO D CORP(> ATION. All rights resrved. e ACORD 25(2010105)QF ---," w ACORD name and logo are registered marks of ACORD