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PL-15-2408 (2) Inspection Worksheet Miami Shores Village �� l 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax: (305)756-8972 inspection Number. INSP-243990 Permit Number: PL-9-15-2408 Scheduled Inspection Date: March 28,2016 Permit Type: Plumbing - Residential Inspector. Hernandez,Rafael Inspection Type: Final Owner. NUNZIATA,MICHAEL JOSPEH Work Classification: Addition/Alteration Job Address:1201 NE 101 Street Miami Shores,FL 33138-2608 Phone Number (352)682-8303 Parcel Number 1132060171470 Project <NONE> Contractor. INTEGRITY PLUMBING CORP Phone: (954)472-5767 Building Department Comments NEW ADDITION&NEW PLUMBING. Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction ❑ Needed Re-Inspection Fee No Additional Inspections can be scheduled until reinspection fee is paid. Miami Shores Village Building Department ! SEP 2A2015 10050 N.E.2nd Avenue, Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 L1 INSPECTION LINE PHONE NUMBER:(305)762-4949 STt FBC 20 1`- BUILDING Master Permit No. P, — t (S' 1,16 PERMIT APPLICATION Sub Permit No.-PL0 ` 24 Qw ❑BUILDING ❑ ELECTRIC ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS [:] CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 10104 41,C— &—Z 5 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: OWNER:Name(Fee Simple Titleholder): /'nchAel /rJ aAei— Phone#: Address: 5)-,o4% 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 roved and a reinspection fee will be charged. Signatur Signature i ✓ OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of Z d�* 20 , ,by l 0 day of 1I77 20 ,by Ift I1 who is personally known to 1 l WA.hhho is ersonally known o me or who has produced as me or who has produced ____-- _ as identification and who did take an oath. identification and who did take � ERIKA ETCHISON NOTARY PUBLIC: NOTARY PUB _. _ MY COMMISSION#FF 074271 •, a: EXPIRES:March 17,2018 ' ....` Bon Thm Notary Pebl's Undenwiters Sign: Sign: p�p Print: ' 1 Print: JANET L.TRUMP p;�:'2;, ERIKAETC Seal: Seal: � , w= myco MISSION#FF NOTARY PUBLIC EXPIRES.Meech 17 STATE OF FLORIDAIQ�'' BondedThruNotarvPuh' Comm#EES46915 - APPROVED BY �/-2�"0� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Sep 18 2015 03:05PM HP Fax page 1 �,g11{oAES ISBN ""'M Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 CONTRACTORS' REGISTRATION Fax: (305) 756.8972 IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A.__COPY OF QUALIFIER'S STATE LICENCES B• "'� COPY OF LOCAL BUSINESS TAX RECEIPT C._COPY OF LIABILITY INSURANCE" D. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A• COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE' E. COPY OF WORKERS COMPENSATION INSURANCE- (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS LLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES,FL 33138 Certificate must specify the description of operatlons or contractor license number. ■r��a��i��a�ta��r��a■ ■��a��aa��r��rrr�a��a�r��■ BUSINESS NAME: BUSINESS ADDRESS.-i_ 7 S> ��t( �T . CIN '� STATE �t BUSINESS PHONE:( )yr-��, 51L0 FAX NUMBER CELL PHONE -71 QUALIFIER'S NAME: �P Ti l _ QUALIFIER'S LIC NUMBER: (a �{ Sep 18 2015 03:05PM HP Fax page 3 RICK SCOTT,GOVERNOR _._...__..�. ....�.. .. .. .-.__...._....__..___...__. . ...., _. . .......KEN LAWSON S _ _._ _.... . .. ......_ �._.ECRETARY STATE OF.FLO..RIDA- DEPARTMENT OF BLCSIgESS,AND PROFESSIONAL REGULATION CONSTRU.CTi boSTRY LidtNSIMG#0AJRD 1"t'FC1425594 The PLUMBING CONTRAG 1`OI3 .. Named below IS 40ERTIFI Under the.p ovislons of ChaDpt� 9'. ;: f 4$ Fes^: Expiration date: AUG'31 2016'. .. „. ..�... .. ... .. ._ Vis;.�, MIJRA,.JAMES':MIEHAF, .ter a�.. �,„,�. ti 4. ■ ■ INTEGRITY'.P! 1 y Yw4•.: :.. - _ � , , ~ ., '1 ❑ ❑ L`1J#IRl•N � ..,, LW ♦� , .f}yy ex:F�..f. '. ,•y �l t ■ 13925..S1N 24T- ss ;' r�w�'.4 �,�•L's, 4 4 ■ DAME411. ' n �.. Q,. ,n,v-. ttfi ' tit 4b• '4 - .,.�,}i..- , '�< 't mk: •,y ISSUED: 0629/2014 DISPLAY AS REQUIRED BY LAW SEQ 0. 1.14062900012oB Sep 18 2015 03:05PM HP Fax page 2 �� ':::;.'.'---.;..,;.;,..'..•*:•.�.r..,;i;:1'ncjr'_°"�i � �� itw.int'^STi:`#tXT'�'i eha�`S�. •��C.. l BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895—954-831-4000 VALID OCTOBER 1,2015 THROUGH SEPTEMBER 30, 2016 DBA: Reicelipt#:PLUMBING/LWN SPRNKL/CONTRA.'R Business Name:INTEGRITY PLUMBING CORP Buslness Type: (MAST3R, PLUMBER CONTRACTOR}:; Owner Name:JAMES x MURA / QUAL Business Opened:o5/15/1997 Business Location:13925 SW 24 ST State/Count'y/Cort/Reg:CFC1425594 DAVIE Exemption Code: 3 Business Phone:954-447-6177 Room seats Employees Machines Professionals =r: 2 For Vending Stalneas Only "' Number of Machines: Vending Type: f' Tax Arnount Transfer Fee NSF Fee Penalty Prior Years Colleefian Cost Total Paid . 27.00 0.00 0.00 o.oa o.o0 0.00 27.00 • ' rS+ THiS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax Is levied for the privilege of doing business within Broward County and is non-regulatory in nature.You must meet all County and/or Municipality planning ; WirfEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the ; business location.This receipt does not indicate that the business is legal or that r, it is in compliance with State or local laws and regulations. Mailing Address: JAMES M MURA / QUAL Receipt #ICP-14-00017334 13925 SW 24 ST Paid D7/22/2015 27.00 DAVIE, FL 33325-5028 ,4 2015 - 2016 Sep 18 2015 03:05PM HP Fax page 4 CERTIFICATE OF LIABILITY' Y INSURANCE °ATE'"'""'°°^YM THIS CERTIFICATE I$ ISSUAED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE GOES NOTA' 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($), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the pol(eyp9s)must be endorsed. If SUBROGATION IS WAIVED,subject to the ifleat and conditions of the policy,certain Policles may require an endorsement. A statoment on this certificate does not confer rights to the ceHiflcate holder!n Ileu of such e110101`8ement(s). PRODUCER Gil, Garden, Avetrani Insurance Group Co E: Yamile Corral 10689 N. Rendall Drive (305)630-4777 (305)279-3022 Suite 208 AnIRE .YCorral@ggaig.ccm Klami FL 33176 INSURE—S) AFFORDINGCOVERAeE NAtCp INSUREDINSUR ERA:Gell]ni Insurance CO an 10833 integrity Plumbing Corp IN8URERS:FPVA Mutual Insurance CO 10385 13925 SW 24th Stxeet INSURaRC:Weaco =nsvrance C an 25011 INSURER D: Fort Lauderdale FL 33325 INSURER E: COVERAGESI SURER F. C11 E11 RTIFICATE NUMBERCL1581807320 THIS 13—.0 CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED REVISION NAMED ABOVE EOR 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. wa Tt'PEOFINSURANCE Pb 1 YEFF X COMMERCIALGENERAL LIABIUTy POLI NUMBER POLICY P uMlrs A CLAIMS-MADE D OCCUR EACHOCcURRENC6 S 11000,000 VNG2001163 P MI a .urr a $ 100,000 8/20/2015 8120J2016 MEDEX(Anyone pereon $ Bxclnded GEN1 AGGREGATE LIMIT APPLIES PER: PERSONAL&ADV IRI URV $ 1,000,000 POLICY�JEC 7 LOC I GENERAL AGGREGATE $ 2,000,000 OTHER PRODUCTS-COMPlOPAGG $ 2,000,000 C AUTOM ISILELIABI.ITy X ANY AUTO I 8/20/2015 8/20/2016 31 anal I IT $ 1 000,000 AUTOS OWNED WRp1397Sa5-00 ' , T�UL ED BODIL Y INJURY(Pet Person) $ X HIRED AUTOS X ASO O WNED I BODILY tNJLRi"(Per accident) $ — ———' UMBRELLA U PROPERIY�OAMAGE $ AS $ EXCESS LIAS OCCUR CLAIMS-MADE EACH OCCURRENCE $ IN _ RETE ION I AGGREGATE $ AND EMPLOYERa.U ILITY ANY PWiIETOR/PARTNE ECU YIN X STAT E T - $ $ OFFICER/MEM BEREXCLUDED7 n INy�NfAJ Iy�ee d Ieun�r WC84000247952015A ig/2012013 � EL��ENT1 000DESCRIPTION OF O 8/20/2016 E.L.DISEASE,EA EMPLOYE $ noNs beloY, 1 000 000 E.L DISEASE•POLICY LIMIT $ 1 0.000 DESCR Plumbing OF OPEtrae 8/LOCATIONS/VEHICLES (ACORD t01,AddMonal Rem&**Schedule,�Y be aaaehed it more e Plumbing Contractor zicenso CFC1425594 Pee:e b reywredJ CERTIFICATE HOLDER CANCELLATION Miami Shores VIllage Bldg Dept SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 10050 NL 2nd Ave THE EXPIRATION DATE THEREOF, NOTICE WILL BE 0 K'aati Shore,6, Fla. 33138 ACCORDANCE WITH THE POLICY PROVISIONS. ELIVERED IN AUTH___RHPRFSENrAT1VE Joe Avetrani/TM - ACORD 28(2014101) INS026(Wtam j reThe ACORD name and(ago are rsglsted marks of ACORD RD CORPORATION. All rights reserved.