Loading...
PL-14-136 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone:(305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-208059 Permit Number: PL-1-14-136 Scheduled Inspection Date: March 04,2014 Permit Type: Plumbing - Residential Inspector: Diaz,Osvaldo Inspection Typ oofmVit Owner: LAMAZARES,MANUEL Work Classification: Addition/Alteration Job Address:230 NE 101 Street / C Miami Shores,FL 33138-2423 Phone Number (305)401-3012 Project: <NONE> Parcel Number 1132060134640 Contractor: WESTLAND PLUMBING CORP Phone:(305)863-6223 Building Department Comments INSTALL BATH FIXTURES Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Ell' 6)<- Failed lcFailed ❑ —`N Correction Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid. March 03,2014 For Inspections please call:(305)762-4949 Page 25 of 34 Miarm' Shores Village Pe&_"NJ Building Department p v p f, i 90050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel: (305)795.2.204 Fax: (305)756.8972 INSPECTION'S PHONE NUMBER.(305)762.4949 r+'BC 2�1.� I "" BUILDING Permit No. PERMIT APPLICATION Master Permit No. V'C' Permit Type: PLUMBING JOB ADDRESS: '_�2 30 AV 5. /o/ SS- u / City: Miami Shores County: Miami Dade Zip:'4/3 7 Folio/Parcel#: Is the Building Historically Designated:Yes NO Flood Zone: ti U OWNER:Name(Fee Simple Titleholder): U-Z / z,1 .-)-A?-A/VA Phone#: , ���`N/ �J J Z Address: U U% lw'e'-1 City: . fio/-L,' Jn.e 5 State: Zip: Tenant/Lessee Name: Phone#: Email: 1���`h/9� A � t�� /d'I �.� ✓.� (CONTRACTOR:Company Name: U/d4VAuo NUN'61 hjq mPhone#: 3v?" 3 e 62 Address:_1��� (A/GC `� rte d City: km ea� State: ' Zip: 3 S®)t Qualifier Name: (�6 CMGs IM Phone#:"7 f4 Z5(9 (�l State CertificationorRegistration#: �k(rytL��� l(® Certificate of Competency#: Contact Phone#: _/g�o ' 13& GJ a Email Address: DESIGNER:Architect/Engineer: Phone#: Value of Work for this Permit: Square/Linear Footage of Work: Type of Work: ®Address ❑Alteraltion ®New_ / oRepair/Replace/ ® emolition Description of Work: iv , 7 k7` qr �����=k*�k� aa�k�z�k#�s#k�s���c�€�c:xe�ca�a�a�#k.-��FeeSxkxx:Rxx��xac,��•x,a��s�•x, k�k�kx��c�xxxkk�a�a���a��ek���a� Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ `�`� 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 ELECTRICAL WORK,PLUMBING,SIGNS, WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS and 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature. Signature Owner or Agent Contractor The fore oin/instrument was acknowledged before me this 7 The foregoing instrument was acknowledged before me this 2 3 day o �i' 20 f ,by A>KI�G��� G�I�CS, day of SA+1v r 20 14,by C"s s _> who is personally own to me or who has produced who is personally known to me or who has produced V—OL who identification and who did take an oath. as identification and who did take an oath. NOTARY LIC: NOTARY PUBLIC: Sign: IVA� �y ` Sign:_ * L�rd- Print: ec— f f Print: My Commission Xpires: NERyCEUARW*o�►;;:; E PEREDA * * MICOO MtS$IN 1 MY COMMISSION#DD973729 s EXPIRES:August 11 2016 '; EXPIRES April 30,2014 r'���o�`Or Bandedj�� �=k��%k�aaok:k k�H+m=;M :ed%#�=k%k s,ce:msnikkz�kur,.e�g;ci�� -�s=;,h�skw�9a:k:k>tiues,=x�ae••: �ggo�tp�q:aF.g-x:.e- >k>g�-x, a:yF=kxevex-ea4 kRE=k>k APPROVED BY r.-D/-L18 Plans Examiner Zoning Structural Review Clerk (Revised3/12/2012)(Revised 07/10107)(Revised 06/1012009)(Revised 3/15/09) A CERTIFICATE OF LIABILITY INSURANCE DATE Z�01/14 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 BYTHE 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 endorsement(s). PRODUCER CONTACT Risk Transfer Programs,LLC NO 219 East Livingston Street PHONE 866-481-9363 FAXC No: Orlando,FL 32801 Wo- ADDRESS: INSURERS AFFORDING COVERAGE NAIC S INSURER A:Technology Insurance Company,Inc. 42376 INSURED INSURER B: Engage PEO Labor Contractor for leased workers to:Westland Plumbing Corp#131011 3001 Executive Drive INSURER C: Suite 340 St.Petersburg,FL 33762 INSURER 0: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:X3GYY5A7 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. INSR TYPE OF INSURANCE D UBR POLICY NUMBER MMND E� MMND YY LIMITS LTR GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISE31 11 E1 S Ea occurrence $ CLAIMS-MADE �OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GE N'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED S G LI IT Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident UMBRELLALU4B OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTIONS $ A WORKERS COMPENSATION TWC3384730 11/01/2013 11/01/2014 X OC STATU---770TH ER AND EMPLOYERS'LIABILITY YIN ANY PROPRIEfOR/PARTNER/EXECUTIVEEl N/A E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ Use describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,I more apace is required) Coverage is extended to the leased employees of alternate employer in all states except in monopolistic states(ND,OH,WA,WY): Westland Plumbing Corp#131011 (Effective 12/27/12) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores Village AUTHORIZED REPRESENTATIVE 10050 NE 2nd Avenue Miami Shores,FL 33138 Page 1 of 1 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD WESTPLU-01 DGOLDEN CERTIFICATE OF LIABILITY INSURANCE DATE(M5/13/1201201YY1� 3 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 Ileu of such endorsement(s). PRODUCER CONTACT NAME: RSI Insurance Brokers of Florida,LLC -FL Lic#L061315 PHONE ggg g30-4396 FAX 3111 N.University Drive,Suite 402 AIC No Ext:( ) Arc No):(800)505-7306 Coral Springs,FL 33065 pppA ; INSURER(S)AFFORDING COVERAGE NAIC INSURER A:Mt.Vernon Ins.Co. 26522 INSURED INSURERB: Westland Plumbing Corp INSURER C: 101 W 24 Street INSURER D: Hialeah,FL 33010 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. ILS TYPE OF INSURANCE D U R POLICY NUMBER MMO/LIDD EFF POLICY EXPLIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CL2571980C 5/9/2013 5/9/2014 PREMISES Ea occurrence $ 300,000 CLAIMS-MADE FX-1 OCCUR MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GE N'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X I POLICY PRO- LOC $ JECT AUTOMOBILE LIABILITY C.OWBINED SINGLE LIMIT(Ea accident) $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS AUTOS PER ACCIDENT UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATIONWC STATU- OTH- AND EMPLOYERS'LIABILITY YINER ANY PROPRIETOR/PARTNER/EXECUTIVENIA E.L EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L DISEASE-EA EMPLOYE $ It �,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,K more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Village ACCORDANCE WITH THE POLICY PROVISIONS. 10050 Northeast 2nd Ave Miami,FL 33138 AUTHORIZED REPRESENTATIVE �9_ � ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET we+°''� TALLAHASSEE FL 32399-0783 COBOS, CARLOS M WESTLAND PLUMBING CORP 101 WEST 24TH STREET HIALEAH FL 33010 Congratulations! With this license you become one of the nearly one million — STATE Of FLORIDA _ AC#_P- 29 L,9 0[ Floridians licensed by the Department of Business and Professional Regulation. DEPARTMENT OF BUSINESS AND Our professionals and businesses range from architects to yacht brokers,from PROFESS,I REGULATION boxers to barbeque restaurants,and they keep Florida's ecnomy strong. CFC037110 128049289 Every day we work to improve the way we do business in order to serve you better I r ; For information about our services,please log onto www.myfloridaiicense.corn CERTIFIED TRACTOR There you can find more information about our divisions and the regulations that COBOS, �� s impact you,subscribe to department newsletters and learn more about the WESTLAND ,( Department's initiatives. Our mission at the Department is: License Efficiently,Regulate Fairly.We ;. constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida,and congratulations on your new license! I IS CERTIFIED under the provisions of ch.489 Fs Exyiratioa dates AUG 31, 2014 L12082202345 ------ DETACH DETACH HERE \C#6291900 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD SEQ#L12082202345 1 • LICENSE NBR 08/2V2012 128049289 CFC037110 ,; , The PLUMBING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapte"#:' Expiration date: AUG 31, 2014 LOBOS, CARLOS Md, &w WESTLAND PLUMBING CORP `r 101 WEST 24TH STREET HIALEAH FL 33010 RICK SCOTT REN LAWSON GOVERNOR SECRETARY DISPLAY AS REQUIRED BY LAW i Of B►��E�g City of Hialeah a.. Business Tax Receipt 2013-14 ycOBFUM1���O Mayor Carlos Hernandez No: 238220-68 (OLD-1711-12) Amount: $ 150.00 The person,firm or corp.listed here has paid the business tax required to engage in or operate the business specified subject to the regulations and restrictions of the City of Hialeah,Florida Owner: CARLOS M COBOS Type of Business:Plumbing, Heating, and Air-Conditioning Contractors WESTLAND PLUMBING CORP 101 W 24 ST Business Location: HIALEAH, FL 33010 101 W 24 ST Validating No.: 324835 Expires September 30, 2014 THIS IS NOT A BILL 14XMLt:Wf1[VVt,ILANUI-LUM13IN000RP-Ta)Sys-Miami-DadeCountyTaxCdlecW Tax Collector Home Search Reports Shopping Cart 2014 Details — Business Tax Account WESTLAND PLUMBING CORP Business Tax Acac,unt#1562538 D Account details r- Account history 2014 2013 2012 2011 2010 Paid Paid Paid Paid Paid Account number: 1562538 Ow ner(s): WESTLAND PLUMBING CORP Business start date: 08/24/1988 101 W 24 ST Business address: WESTLAND PLUMBING CORP HIALEAH,FL 33010 101 W 24 ST Mailing address: WESTLAND PLUMBING CORP HIALEAH,FL 33010 101 W 24 ST Physical business location: HIALEAH HIALEAH,FL 33010 0] Print account application (PDF) Receipts Aid Occupations Receipt 1562538 Paid 2013-09-05$45.00 Contracting 10/01/2013— NAICS code:23822 Receipt#ECHECK-13-006896Print this PLUMBING 09/30/2014 Units: 10 bill CONTRACTOR Additional documentation required:CFC037110 State/County License or Certificate httpsJMmwwmiamidade.camt)t m.c onYpublic/business Wprint bt applicaation 1/1