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PL-15-3003 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax:(305)758-8972 Inspection Number: INSP-248622 PermitNu' ber. PL-12-15-3003 Scheduled Inspection Date:August 09,2018 Permit Type Plumbing - Residential Inspector: Hernandez,Rafael Inspection Type: Final Owner. , Work Classification: Addition/Alteration Job Address:1094 NE 91 Terrace Miami Shores,FL 33138- Phone Number (305)338-7100 Parcel Number 1132050010380 Project: <NONE> Contractor. UNIVERSAL PLUMBING CORP Phone: (305)887-3131 Building Department Comments PLUMBING FOR REMODULATION OF 2 BATHROOMS Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction ❑ Needed Re-Inspection a Fee No Additional Inspections can be scheduled until re-inspection fee is paid. 2-4 6-3003 ? sx r g� Miami Shores Village luo Sin -'Ri�!$(dential �S. 10050 N.E.2nd Avenue NE INc�rtc��Sltt(C11? j a iitt �ItEI"tt�rl n Miami Shores,FL 33138-0000 I. WIPR OVED Phone: (305)795-2204 issui :12/7/2015 Expiration: 0 /04/2016 Project Address Parcel Number Applicant 1094 NE 91 Terrace 1132050010380 WATERSEDGE SHORES LLC Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Celt WATERSEDGE SHORES LLC 1094 NE 91 Terrace (305)336-7100 MIAMI SHORES FL 33160-3313 72 GOLDEN BEACH Drive GOLDEN BEACH FL 33160- Contractor(s) Phone Cell Phone Valuation: $ 3,000.00 UNIVERSAL PLUMBING CORP (305)887-3131 Total Sq Feet: p Type of Work:PLUMBING FOR REMODULATION OF 2 BATH Available Inspections: Type of Piping: Inspection Type: Additional Info: Top Out Bond Return: Final Classification:Residential Scanning:1 Review Plumbing Underground �JE Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.80 Invoice# PL-12-15-57917 DBPR Fee $3.38 12/07/2015 Credit Card $239.56 $0.00 DCA Fee $3.38 Education Surcharge $0.60 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 ce tft that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. # authorize the above-named contractor to do the work stated. December 07, 2015 Authorized S ture:Owner / Applicant / Contractor / Agent Date Building Department Copy December 07,2015 1 ' Miami Shores Village Building Department L��c ° 0�5 10050 N.E.2nd Avenue,Miami Shores, Florida 33138 �1 t Tel:(305)795-2204 Fax:(305)756-8972 01 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 201 BUILDING Master Permit Np. -��-�..� � PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ['PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF F-] CANCELLATION ❑ SHOP '"'CC CONTRACTOR DRAWINGS JOB ADDRESS: 1!2 City: Miami Shores County: Miami Dade Zip: 3 '3/ 3 P Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: -Flood Zone: BFE2 FFE: OWNER:Name(Fee Simple Titleholder): ��r ���� /�4 /t/�0 2 Phone#: �0 S 3 3�" �/D Address: / U ti amity: State: / —Zip:- Tenant/Lessee Name: Phone#: Email: G .SL/ CONTRACTOR:Company Name:('/�z,L ell C.-C / L,,L �i`/t� C J(t 1, Phone#: 3/il'� f 8 y Address: City: /Lo G'G t !v State: Zip: 3:.3®/? rA 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. Signature Signature O NER or AGENT k C TRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this _Z S day of /t-- 20 /S by day of 20 fT, by ®ANNE- kCry( P who is personally known to �1I, '�/� ,who is.personally known to me or who has produced �� ��� r ,-ISAIV as me or who has produced J"k i j/-a `� L 1'(p S identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC- Sign: /� Sign:—L Print: nt: wn� r►us•., Seal: •�� r '��. Seal: ��'. 4�-•. �-®�R®Ick MARIN ?o�►a �i'F'aT CAMPBELL MY COMMISSION#FF009167 o =.�, N�ryIiABpe-Stete Of flOritle EXPIRES Apffl 17 2017 Mr COM.E Oct 30,2G'8 '7) •;r (407)398 0153 FloridallotaryServlae.com 2=A1k7k��k'+k'M�k APPROVED BY �' /� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) ---'v 1-7.1I.Ic(UMI) 17865S10156 From:Fr-AnkAOOste CERTIFICATE OF LIABILITY INSURANCE DATE(fAWDD1YYYYI THIS CERTIFICATE 13 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERg No RIOHrs UPON THE CERTIFICATE HL.13*OLD�,015 CERTIFICATE DOES NOT AFFIRMATM/ELY OR NEGATNELY AMEND, EXrENt7 pit ALTER THE COVERAGE AFFORDED �' T;{g Pt1LITMHI CIEg BEI CW THIS CERTIFICATE OF INgt1�NcE DOES NOT CONSTITUTE A CONTRACT sETw THE IgsuING rNsuReR{g)� AUTHORIZED REPRESENTATIVE OR PRODUCER.AND THE CERTIFICATE HOLDER. IMPORTANT: It the Gertific9te holder is an ADDITIONAL INStJREb,the policy(ies}must be endorsed. sUgaOGAT101Y t5 WAIVED,subject to the tonna and eonditlons of the policy,certain pollcias may require an endorsement A statement an th;s CertlfiCate does not confer rights a the certificate holder in lieu of such endorsement(s), F47NO�rth Th* sk Management Group NAME: Barb!* Toledo �yw {786}587.-5550 ECa d AVer+ueL — ad FL 33030 INBUIR E S RUING COVERAGE - NAIL AI ENSURED �HSUF?ERA A6Car�SenC C�exCial IYt912renC9 Univers** Plumbing Corp INSUR B: 141 Beast 60th stvaet I11AUARR10:•• --- --- INSURER 0: B1alCtyh INSURER E: 1rL 33013 ....... .... . ......... ..... fC COVERAGES CER1TFIN URER F ATE NUMBER;cxd g1()22OOgg1 R1=V141UN NUMBER: THIS ISTD CERTIFY THAT THE POLICIES OF LAMENT, TE LISTED LOw yq BEEN ISWED TO THE INSURED NAMED ABOVE Folz THE POI ICP pElzlpp INDICATED, NOTYuITHSTANDING ANY REQUIREMENT, TF.h'ivl O!Z CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESplrGT 70 WH(GH THIS CERTIFICATE MAY BE ISSUED OR l41AY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES OESCRIBEO HEREIN FS SU6JECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.L IPAITS SHoWp(fNgY HgVE gREJd REDUCED t3Y Pglp CLAIMS. g - — TYPEOFIN&URANtE f ..... COMMERCIAL Y U f POLICD EFF P, Y f,MRALLIABILITy may$ IPAS-MADE �� 3 OCCUP f EACH OCCURRENCE ,"11AMZ+E r0 Rq 4 • � + �.P1iCA1fSLS fEeOcwrr_rtoal $ TMs_ j I 1 MED EXP(Anr W o DpaO/II GEM AGGREGATE'LiMlp AppLW PIR: i I PERSONAL A ADV fN.tURY ; POLICY[—I PR 1 rENERk AGGREGATE _ ' ! PRODUCt$-COMPiOPAO@ T AWMMOHILE l _ LIABIuTY i •� ANYAUTOLL r ` tEa c,LE a OD AVTOSULED ( 00DILYIWURY(Pxp�B�; 6 --_ HIRED AUTOS AUTY9E0 I i BODILYIIWURYS --- UMBRELLA LL46 _..... OCCUR 6XC_'-1LIA13 - T CLAIMS-MA0E f BCH OCCURRENCE_ g ED RETEN7I ;AGGREGATE - — - 1A' ORKER3.OMPEAMTiON AND EMPLOYERV UAelu7y ANY M0PR%ETORFARTNERrEX=_CU'IVE YIN A lm FIC VMEm�=LUDED? Y!N I A II—WStr VC�$8D89�0 EL EraCHACC3aEJuT 8 1 000 000 DL I TIpNMC� �� X10/20/2015 IJ2AT1 NS 7 0/24/ 016 EL DISEAS]t.EA E(APLQyC t _1�04o ,00 I I C L.DISEASE-POLICY L INUT S i,000 �C��ON OF QpERArpNe/LOCanOM3!VENIDLE$(ACORD 101,Adr>;lipnal Rcmar4a.90{iOQWn may Iu agav,�RmW. Universal t',luMbirlg Corp. License #CsC3.428421 aPaoelaraaultaC! CERTIFICATE HOLDER CANCELLATION z4iami Shares Villas H.-al SHOULD ANY OF THEAROVE DESCRI9E0 POUC a BE CANC©1FD BEFORE 10050 NE 2nd Ave THE EMRATION DATE THEREOF, NOTICE WILL BE Drc11yEFEp IN Miami Sharer., >:`Y, 333,38 ACCORDANCE WITH THE POLICY PROVISIONS, AVTHpRZeD REPR�ENTAnVG ACORD 25(2014/0l) 198&2014 ACORA CORPORATto INS02S(271401) The ACORD name And logo are registered marks of ACORD All rights raagrved,