The URL can be used to link to this page

PL-16-1234 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax: (305)756.8972 Inspection Number: INSP-258393 Permit Number: PL-5-16-1234 Scheduled Inspection Date:June 02,2016 Permit Type: Plumbing -Residential Inspector: Hernandez,Rafael Inspection Type: Final Owner: LEVER,DANIEL&KATIE Work Classification: Addition/Alteration Job Address:501 NE 96 Street Miami Shores,FL 33138-2736 Phone Number (305)632-9829 Parcel Number 1132060171560 Project: <NONE> Contractor: EMPIRE PLUMBING COMPANY Phone:(305)531-7017 Building Department Comment REPLACE ENTIRE HORIZONTAL BLDG DRAIN UNDER me fft HOME AS PER EXISTING FIXTURE LAYOUT TO INSPECTOR COMMENTS False INCLUDE HOME SEWER TO SEPTIC TANK CONNECTION IN YARD. Inspector Comments Passed Failed Correction D Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid June 01,2016 For Inspections please calk(305)762.4949 Page 12 of 34 Miami Shores Villages f+ 10050 N.E.2nd Avenue NE Miami Shores,FL 33138-0000 f "€ Phone: (305)795-2204 s'��t 3 f � � ,� � , , �, x=��s� h,�f_ . � �u.. �;••�,. �•, x (�, 4 Expiratlon: l U 201 Project Address Parcel Number Applicant 501 NE 96 Street 1132060171550 DANIEL 8 KATIE LEVER Miami Shores, FL 33138-2735 Block: Lot: Owner Information Address Phone Cell DANIEL&KATIE LEVER 501 NE 96 Street (305)632-9829 MIAMI SHORES FL 33138-2735 501 NE 96 Street MIAMI SHORES FL 33138-2735 Contractor(s) Phone Cell Phone $ 10,840.00 Valuation: EMPIRE PLUMBING COMPANY (305)531-7017 Total Sq Feet: 80 Type of Work:REPLACE ENTIRE HORIZONTAL BLDG DRAI Available Inspections: Type of Piping: Inspection Type: Additional Info: Top Out Bond Retum: Final Classification:Residential Scanning:3 Review Plumbing Underground Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Bond Type-Contractors Bond $500.00 Invoice# PL-5-16-59699 CCF $6.60 05/06/2016 Check#:7902 $50.00 $785.60 DBPR Fee $4.50 DCA Fee $4.50 05/10/2016 Check#:7887 $785.60 $0.00 Education Surcharge $2.20 Bond#:3080 Permit Fee $300.00 Scanning Fee $9.00 Technology Fee $8.80 Total: $835.60 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, servan , r employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIM POOL work. 1 OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate that al rk�II ne in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the above-named contractor t _ May 10,2016 Authorized Signature:Owner / Applicant / Contractor / Agent ate Building Department Copy May 10,2016 1 Miami Shores Village Building DepartmentYA95�s�=10050 N.E.2nd Avenue,Miami Shores,Florida 33138Tel:(305)795-2204 Fax:(305)756-8972 BY•INSPECTION LINE PHONE NUMBER:(305)762-4949 . FBC 20 ! BUILDING Master Permit No. v PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑EXTENSION ❑RENEWAL OPLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF [:]CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 501 NE 96 Street City: Miami Shores County: Miami Dade Zip: Folio/Parcel#:11-3206-017-1550 Is the Building Historically Designated:Yes NO x Occupancy Type: Residential Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder):Daniel R Lever& Katie Lever Phone#:305-632-9829 Address:501 NE 96 Street City: Miami Shores State: FL Zip: 33138-2735 Tenant/Lessee Name: Phone#: Email: lever@tdflaw.com CONTRACTOR:Company Name: Empire Plumbing Company Phone#: 305-531-7017 Address: 1754 Bay Road city: Miami Beach State: FL zip: 33139 Qualifier Name: Albert V Elbaz Phone#: 305-531-7017 State Certification or Registration#: CFCO27516 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: -- 00( � Value of Work for this Permit:$ 10 O �'[® ® � Square/L near Footage of Work: �� 4-9 Type of Work: ❑ Addition ❑ Alteration ❑ New M Repair/Replace ❑ Demolition Description of Work: Replace entire horizontal bldg drain under home as per existing fixture layout to include home sewer to septic tank connection in yard. Specify color ol color tthru tile:or Submittal Fee$ r-� Permit Fee$ CCF$ 60 CO/CC$ Scanning Fee$ cz) Radon Fee$ DBPR$ Y • Notary$ Technology Fee$ Training/Education Fee$ Q _ ® Double Fee$ ,,TT Structural Reviews$ Bond$ S CI() • 03 TOTAL FEE NOW DUE$ t�• W (Revlsed02/24/2014) -=I as /so 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$250, 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. 2q Signatu Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this '-`,day of 0-A ( ,20 by day of 20 by Hary r 1 L vt_ who is personally known to - G L ,who is personally known to as ma nr who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Print: � � 2 !�, Ot`Gs O Print: +ol V¢) So Seal: MEMNON Seal: NN,"•. U1gAD. 01% MYCOMMf ISS ONYAAM#FF 055390 MY COMM OctOobeW24.2017 ONTO UM 174 P<= EXPIRES:December 21,2017 ' 24,2017 �� eon!nw Dbtary Pubnc Underwrkers APPROVED BY 04 Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) ...x - Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33131 Tel: (305)796.220# Fax: {305)756::8972 CONTRACTORS"REGI AT[Q}[d IF CONTRACTOR ISA FLORIDA' T,ATE „ ERTI CC►NTRACTOR: A. " COPY OF QUALIFIER'S STATE LICENCES 8, X COPY OF LOCAL BUSINESS TAX RECEIPT G.--!--COPY OF LIABILITY INSURANCE* D. X COPY OF WORKERS COMPENSATION![DURANCE* (Workers Compensation EXEMPTION musthaw NOTICE TO OWNER fbtM and CwtractorAf davit) IF CONTRACTOI ., A L,IAMI DADE CQUNTY CERTIFICATE OF C��I�PETEt"�CY, A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B.-COPY OFLOCAL:B.USINESS TAXRECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE* E. COPY OF WORIERS COMPF ATIONANSUI ANCE* (Workers Compensatim EXEMP1 ION:must have NOTICE TO OWNER form and CootrwW Affidavit) *YOUR P ` MUST ISSUE A CERTIFICATE.AS FOLLOK- Ceftftdo Holder: MIAMI SH0REtVlLLACE BLDG DEPT 10050 Nl 2ND AVE MIAN SHOD$, 33438 000090 must specify the description of operations oroorittactor license number. rrarr:r:xr,�lrlleer,:iRarsrr.ri�:w.ria:rrr��•�•rrr■rrr■■rrrrar,rrr�!_r�s�.�F•Mir�rar.rrsc�r�r��rrisrrr■��■arrrr BUSINE .NAE}. Empire Plumbing Company BUSIN SS AD0W : 1754 Bay Road CITVF Miami Beach STATE FL ZIP 33139 BUSINESS PHONE: 3( 0 5 531-7017 FAXNUMBER 3� 0 n 531-7044 CELLPHONE 3305 218-4727 QUALIFIER:$NAME. Albert Elbaz QUALIFIER'S LIC NUMBER: CFCO27516 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850)487-1395 1941 ORM*..MONROE STREET. i" �E. FL 32399-0783 ELSAZ;ALBERT V EMPIRE PWM81NG COMPANY 1754.BAY OAD MIAMI BEACH FL 33VW G; tgratviatiorrsl. With this license yyoo trecome one of°.tom nearly one miiiic�rr 1 rswl fans wed by tht Department of Susrrness and Professional Regulation. Our prolboslonalix and businesses nwqe STATE OF i LO from it .to yactt brokers l9` M.box to barbeque.res"urants,. ES NeStA 1l and they keep Florida's ii i0 strong. PRS y, 1.A1` 1N Every day we work Improve theF �7 ��14 tnray we do business.in ord+sr`tcr k4 wrote YOU better: For inWriationabout-our sen ess,please log onto WWW. mEyft©rl rl r *64m. Thate you can find more information about our dl that irttpad you,sub�ant�e Ply to d�artrrrerit l rrrbre:abcut the t'�eparfteWs E A� . TA inibfatt=s l� our mission at ithe .- .. edt`ls License Efficiently,Regulate:Fairly; W� We constantly strive td Aerve,you better so that you can serve your � customers: atticou fora Y y drrrng business rn Florida. t..oRts ura+tt rise povrsrons oc.cs-h 4ss FIs and congratulations on your neW 1106riset �x __......__. DETACH.MERE .. RICK SCOTT,GOVERNORKEN t AWSOAI,SECRETARY Sl "M .4 t �1., The u�11 N '.' ub Z .SAZ*ALT V $ '�11Fxji1'JE,PLURk[[[�� a MIN5 ISSUED: 0528/2014 DISPLAY AS (SQUIRED BY LAW 51 3# L140529 til 41 f -- • 004834 10, lolm Yh ` s S � � � � `"�t.r� orf r Utz t a�i 3 �; �, t �'-. ,Y'�•s x y h kx i fi 1; R r s�� PLgr}#ONO Aft 7 -, OWN 1 ' ' , EMPIR-3 OP ID:AD [�►W CERTIFICATE OF LIABILITY INSURANCE DATE o5ros I s 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(les)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 endomement(s). PRODUCER REACT Kahn-Carlin S Company,Inc. PHONE 305446_2271 FAX Ne;305-448-3127 3350 S.Dbde HI hway N ErR Miami,FL 33138984 ADDRESS:procnslng@kahn-carlin.com INSURE S)AFFORDING COVERAGE NAIC# INSURER A:Hanover American Insurance Co. 36064 INSURED Empire Plumbing Company INSUR:ERB:Assoclated Industries Ins Co 23140 1754 Bay Road Miami Beach,FL 33138 '"&'tet: INSURER D INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 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. ILSR TYPE OF INSURANCE POLICY NUMBER WD EFF POLICY EXP LaArrB A X COMMERCIAL GENERAL uAwLITY EACH OCCURRENCE $ 1,000,0001 CLAIMS MADE TOCCUR LZJ930628204 08/23/2015 08/23/2016 DAMAGE TO RENTED PREMISES Ea occurrence) $ 300,00 MED EXP(Any one Parson) $ 5,00 X PER PROJECT AGGRE PERSONAL&ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 2,000,00 POLICY a JEEl LOC PRODUCTS-COMP/OPAGG $ 2,000,00 OTHER: $ AUTOMOBILE LIABILITY M ED IN E LIMIT $ Ea aa9dent ANY AUTO BODILY INJURY(Per person) $ ALS ED SSCHHEEDDULED BODILY INJURY(Per accident) $ AUT NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LJAB CLAIMS MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION X ERS AND EMPLOYERS,LIABILITY STA UTE Y/N B ANY PROPRIETOR/PARTNER/EXECUT IVE FN]NIA A WC1051659 08/23/2015 08/2312016 E.L.EACH ACCIDENT $ 1,000,00 OFFICER/AAEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEA$ 1,000,00 If yes,describe under DESCRIPTION OF OPERATIONS below I I I I E.L.DISEASE-POLICY LIMIT 1$ 1,000,00 DESCRIPTION OF OPERATIONS 1 LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,nay be aAacmad if more space Is,required) Contractors License Number: CFCO27516 CERTIFICATE HOLDER CANCELLATION MIAMS-2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Building 8c Zoning ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd Ave Miami Shores,FL 33138 AUTHORED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD