PL-15-2112 • ; t. ��
Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
nspection Number: INSP-241751 Permit Number: PL-8-15-2112
Inspection Date: June 07,2016 Permit Type: Plumbing - Residential
Inspector: Hernandez, Rafael Inspection Type: Final
Owner: TOVAR,JONATHAN$ANDREA Work Classification: Addition/Alteration
Job Address:464 NE 92 Street
Miami Shores, FL
Phone Number (786)375-5533
Parcel Number 1132060140030
Project: <NONE>
Contractor: DEL RIO&SON PLUMBING CORP Phone: (786)295-0098
Building Department Comments
REMODELING KITCHEN SINK AND BATHROOM AND Infractto Passed Comments
GAS. INSPECTOR COMMENTS False
Inspector Comments
Passed KI
Failed El
Correction ❑
Needed
Re-Inspection
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid
For Inspections please call: (305)762-4949
June 07,2016 Page 1 of 1
Miami Shores Village
10050 N.E.2nd Avenue NE f
Miami Shores,FL 33138-0000
Phone. (305)795-2204 M t<
Expiration: 02/17/2016
u2
Project Address Parcel Number Applicant
464 NE 92 Street 1132060140030
JONATHAN&ANDREA TOVAR
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
JONATHAN&ANDREA TOVAR 464 NE 92 Street (786)375-5533 (305)610-0914
Miami Shores FL 33138-
464 NE 92 Street
Miami Shores FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 10,000.00
DEL RIO&SON PLUMBING CORP (786)295-0098 Total Sq Feet: 0
Type of Work:REMODELING KITCHEN SINK AND BATHROO Available Inspections:
Type of Piping: Inspection Type:
Additional Info: Top Out
Bond Return: Final
Classification:Residential Scanning:1 Review Plumbing
Underground
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $6.00 Invoice# PL-8-1666777
DBPR Fee $5.25 08/21/2015 Credit Card $379.50 $0.00
DCA Fee $5.25
Education Surcharge $2.00
Permit Fee $350.00
Scanning Fee $3.00
Technology Fee $8.00
Total: $379.60
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, 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 zonin . Futhermor , u o. the above-named contractor to do the work stated.
August 21,2016
Autho Signa / Appli nt / Contractor / Agent Date
Building Departme y
August 21,2015 1
Miami Shores Village
Building Department i AUG 2015
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. tom= \ S -\'25
PERMIT APPLICATION Sub Permit No-f US" 2-1 t 2-
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING F-1MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
i /b n CONTRACTOR DRAWINGS
JOB ADDRESS: A(0L` 0 �:-, ``'►2 S�
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
f ame(Fee Simple Titleholder): Pwy-JiY 9Ec ! "TC)Jc'S�Y- -;P.hone#:--:qho "7��:�
Address; 4GLA NE ! na 5i
'City: 5)(lare�p State: L Zip: 3:i13f�,
Tenant/Lessee Name: Phone#:
_r Emai: - mcS,V'c-:m-y!1\Yea tit 12 !�Ynp&A + Qyn_
CONTRACTOR:Company Name:_ Y, SY`^ P�_I"j Phone#:C786 J2qS009 W
Address: 84q(D S L.-) 9-4
�� zip: 33 1 h37
City: State: p:
Qualifier Name: c�.�-�-� �-- Phone#:C'7 86 ?-q5 00 Cl
State Certification or Registration M e r-C t 49.115 2 b Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:! 0 0 Square/Linear Footage of Work:
Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace El Demolition
Description of Work: \ --�
Specify color of color thru tile: s��
Submittal Fee$ 41 Permit Fee$ '� CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ ;i�9 •50
(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.
Si Signature
r�
OWNER A CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument'was acknowledged before me this
��day of-/ J C;C�St ,20 a � .by �day of J�Q(Sk)C—T ,20 ,�5 .by
kme-�-A —r0VA9— ,who is personally known to -PE31-Ag,who is personally known to
me or who has produced as me or who has produced -rt—:C221 UC3EnAs
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: Print:
Seal: Seal: Q%:ry Public Stats of Florida
goEqtawof dia Alvarez
Commission FF 158750
pf pAres 08(03/2018
*************** **************** * * * *************
APPROVED BY E'�'`� Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
Sep 2315 04:22pp _ ?L • (S_ 2 C (Z- 7863625426 p.1
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A Rv CERTIFICATE OF LIABILITY INSURANCE 09!23!2015
THIS CERTIFICATE 1S 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 policyges)must be endorsed. E SUBROGATION 1S WAIVED,subject to
the terms and conditions of the pocky,certain policies may require an endorsement A statement on this certificate does not confer rights to the
certificate holder In lieu of such endorsement(s).
PRODUCER ��Pablo M Conde
A&A Underwriters,Inc. PHONE 305-220-7447 ac No:305-220-4621
8778 SW 8 St ; m aaunderwriters.com
Miami,FI 33174 INSU APFORDINSCOVERAGE NAME
elswzERA:BRI3GEFIEL.D EMPLOYERS INSUR CO. 012158
INstrRED INSURER 8:
Dei Rio Son Plumbing Corp. "L%RERC:
8851 SIN 4 Terr INSD: --
Miami FI 3:3174 PERIRERE
IIISURF.R 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,
EXCLUSION AND CONDITIONS OF SUCH POLICIES.LIMITS SHOVYN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
TIM
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LUOItI'S
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CLAIM04AME 0 OCCUR f �1�T�I YE' $
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ANY AUTO BODILY INJURY(Per peason) $
ALA.OWNED SCHEDULED
AUTOS AUTOS BODILY INJURY(Pr eWdenq $
HIRF_DAUTOS NONANNED
AUTOS PROPERTY DAMAGE $
IAABRE1lA LUIH OCCUR EACH OCCURRENCE 1$
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A AND PROPRIIErO$uAsam OwAAR E vsxECUnvE Y J N 083045983 09-03-15 09-03-16
OFPICERIMEMSM EXCLUDED? a MIA El.EACH ACCIDENT $ 11000,000
IMi�Osrafatoryr)n NH) E.L.DISEASE-EA EMPLOY $ 1,QOO,000
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LICENSE # CFC 1427828
CERTIFICATE HOLDER CANCELLATION
Miami Shores
Buildin De Ifinent SHOULD ANY OF THE ABOVE DEsCRtBED POLICIES ag CANCELLED 9EFORE
.� I THE SWIRATION DATE THEREOF, NOTICE WILL BE DELPMRED IN
10050 NE 2 AVE A=ORDANceWrrNTwPOLICYPRovisioNs.
Miami Shores Village , FL , 33138
019W4013 ACORD CORPORATION, All rights reserved.
ACORD 26(2013104) The ACORD name and logo are reglsteed marks of ACORD
.a►co v` CERTIFICATE OF LIABILITY INSURANCE
09123=15
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 policWles)must be endorsed. If SUBROGA N IS WAIVED,subject to
the terms and conditions of the policy,certain policies may require an endonsement. A statement on this eerUth ate does not confer rights to the
certificate holder in Rau of such endorsements
0Et ACT
amwi. Pablo M Conde
A&A Underwriters. Inc. 305-220-7447 ac �.305-220-4821
8778 SW 8 St H me eaunderwriters.com
Mimi,FI 33174 INSURER AFFORDIIIGCOVERAGE "AIC#
(NSURFRA:BRIDGEFIELD EMPLOYERS INSUR CO. 912158
Ileum INSURER u:
Del Ria Son Plumbing Corp. wSUIRC:
INSURER D:
8851 SW 4 Tarr IusuRSRer
Miami R 33174 Ir ERy:
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 CON01TION 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.
ILTRfth TYPE ONr MURANCE sue
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AUTOMOBILE LIAHILnY TIMIT $
ANY AUTO B0L1a.Y WMRY(Perperson) $
ALLAUTO AUTOS�� BODILY INJURY(Per a ldeM S
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DEBCRWMN OP OPERATiORs JtACAiwm iveMCI (ACORDIM.AddMonWRmmftSdm&&o=ybgottnhodifmmaflpeceismWboM
LICENSE#CFC 1427828
CERTIFICATE HOLDER CANCELLATION
Miami Shores SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Building Department THE EMRAMIJ DATE THEREON=, NOTICE WLL BE DELIVERED BI
10050 NE 2 AVE ACCORDANCE WITH THE POLICY PROVISIONS.
Miami Shores Village , FL , 33138 AUr11D�Res�IrATnrE
®ISW2013 ACORD CORPORATION. All rights reserved.
ACORD 25(2013104) The ACORD name and logo are registered marks of ACORD
L'd 9ZV9Z9£99L d9Z:ti0 91,£Z deS