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PLC-15-587 2-0- 2.0 3�1 Inspection Worksheet `ems Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-230502 Permit Number: PLC-3-15-587 Scheduled Inspection Date: September 09, 2015 Permit Type: Plumbing - Commercial Inspector: Diaz, Osvaldo Inspection Type: Final Owner: , BARRY UNIVERSITY Work Classification: Addition/Alteration Job Address: 11300 NE 2 Avenue Weber Hall Miami Shores, FL 33138-0000 Phone Number Parcel Number 1121360010160-13 Project: <NONE> Contractor: AL HILL ENTERPRISES CORPORATION Phone: (305)687-9963 Building Department Comments WEBER HALL PLUMBING RENOVATIONS Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed E00�� Failed Correction Needed ® 1 Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. September 08,2015 For Inspections please call: (305)762-4949 Page 4 of 44 Miami Shores Village Building Department 10050 N.E.2nd Avenue,Miami Shores, Florida 33138 MA 7 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20t 6 BUILDING Master Permit No. C� 0 PERMIT APPLICATION Sub Permit No. ?Lf- 6- u� ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP q CONTRACTOR / DRAWINGS JOB ADDRESS: /�/1" � City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: f�Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder): .6a1 i-� ni� Q��i Phone#: Address: 11?0 �� o-r"e �"�— Le City: 4^( State: Zip: ® Tenant/Lessee Name: Phone#: Email: p rPrt S e Phone#: CONTRACTOR:Company Name: Address: q-o /V - City: �1 ( State: Zip: 3 Qualifier Name: Phone#: 3 0 3 State Certification or Registration#: Cr(2454?AL®) Certificate of Competency#: c Coo( (10T 3�® DESIGNER:Architect/Engineer: l��y Phone#: Address: ®/)® ) �/ler ��� ,sup -0D City: State: Zip: Value of Work for this Permit:$ 6-01 0,90. Square/Linear Footage of Work: Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: nk � �� e -10 Lj ®� Specify color of color thru tile: Submittal Fee$ '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$ �,6 W (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 on 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 foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of A&(U`� ,20 l by a day of P(Cw" by SI'CIAt� QXEM hU ,who is personallyknown to Aioevj 1-hi I ,who is p rsonally kno to me or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sig . Pri Print: ry p6mle suit of FWM Seal: ter Pio Js"J Yeo r°,•••.,Go VER1+UliWAiEAL Se My Catan�ia�FF 166481 * * MY COMMISSION i FF 146M ar Exptestv12 016 of EXPIRES:44 3,201Y qoF iig 60*0 1Mn 6 d N017)n APPROVED BY / Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY _............ . STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION,INDUSTRYLICENSING BOARD CFCA58101..: . The PLUMBINGCONTRACTOR Named below IS CERTIFIED: . ; Underthe provisions.of Chapter 489 FS Expiration date::AUG:31;20:16 HILL ALBERT AL HILL ENTERPRISE CORPCSRATIQN 13740 NW 19TH AVENUE UNIT 12. OPA LOCKS FL 33054 ISSUED: 07/28/2014 DISPLAY AS REQUIRED BY LAW SEQ# L1407280000905 Local Business Tax Rem Miami-Dade County, State of Florida -THIS IS NOT A Btll-DO NOT PAY LBT-1 635301 BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES AL HILL ENTERPRISE CORP RENEWAL 13740 NW 19 AVE BAY 12 635301 SEPTEMBER 30, 2015 OPA LOCKA, FL 33054 Must be displayed at place of business Pursuant to County Code Chapter BA AR.9&10 OWNER SEC.TYPE OF BUSINESS AL HILL ENTERPRISE CORP 196 PLUMBING PAYMENT RECEIVED BY TAX COLLECTOR CONTRACTOR 4b.00 0911612014 Worker(s) 10 000016132 CREDITCARD-14-037617 This Local Bosiaess Tax Receipt only confirnm payment of the local Business Tax.The Receipt is not a license, permit ora cOdWAtion of the holder's qualifications,to do business.Holder must comply wjM any governmental Of aoagovOmOM al regulatory laws and requirements which apply to the business. The RECEIPT N0.above mast be displayed on all commercial vehicles-Miami-Dade Code Sec Ia-M MIAMIADEM For more informatiou,visit .miamidalllg: xoallecmr • s A ACR lw�_ "� CERTIFICATE OF LIABILITY INSURANCE DAT 03/1103/11D/YYYY) /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 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 CONT A N ME:CT Lucia Estrella Accurate PHONE , (305)226-8727 A/c No: (305)226-8767 8300 West Flagler Suite 114E-MAIL Iuciaestrella@beilsouth.net Miami,FL 33144 INSURER(S) AFFORDING COVERAGE NAIC# Phone (305)226-8727 Fax (305)226-8767 INSURER A: Arch Specialty insurance Company INSURED INSURER B: Progressive Express Insurance At Hill Plumbing Corp.&AI Hill Enterprise Corp INSURER C: Rockhill Insurance Insurance Company 13740 NW 19th Ave Unit 12 INSURER D: United Specialty Insurance Company Opa-Locka,FL 33054 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. LTR TYPE OF INSURANCE ADOL UBR POLICY EFF POLICY EXP POLICY NUMBER (MMMDIYYYYI IMMIDDIYYroLIMITS GENERAL LIABILITY EACH OCCURRENCE S 1,000,000.00 ❑6 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 100,000.00 PR ISES Ea ac urrence $ A ❑ ❑ CLAIMS-MADE Q OCCUR AGLOO5640-00 MED EXP(Any one person) $ 10,000.00 ❑ Y Y 10/23/2014 10/2312015 PERSONAL&ADV INJURY S 1,000,000.00 ❑ GENE RAL AGGREGATE s 2,000,000.00 GEWL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000.00 2 POLICY El PRO- ❑ COC $ AUTOMOBILE LIABILITY O N�EDtSINGLE LIMIT $ 1,000,000.00 ❑ ANY AUTO BODILY INJURY(Per person) $ ALL OWNEDSCHEDULED 02460092-0 BODILY INJURY(Per accident) $ B ❑ AUTOS © AUTOS Y Y 10/22/2014 10/22/2015 ❑ HIRED AUTOS ❑ AUT SEED P 0aca entPERIe DAMAGE $ El ❑ er S ❑ UMBRELLA LIAR ©OCCUR EACH OCCURRENCE $ 3,000,000.00 EXCESS LIAR RXSLWGR000849-00 C © ❑cLAIMs-MADE 01/07/2015 01/07/2016 AGGREGATE $ 3,000,000.00 ❑ DED ❑ RETENTION$ $ WORKERS COMPENSATION WC STATU- E]OTH- AND EMPLOYERS'LIABILITY YIN ❑ ISS, ANY PROPRIETORlPARTNEWEXECUTIVE E.L.EACH ACCIDENT S OFFICERIMEMBER EXCLUDED? NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ "go f yyes describe under DESG�RIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ D Contractor Pollution USSA4024592 01/21/2015 01/21/2016 $1,000,000.00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) Contractor's License#CFCA58101 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Building Department ACCORDANCE WITH TH O ICY PROVISIONS. 10050 NE 2nd Ave AUTHORIZED REPRESEN A Miami Shores,FL 33138 Lucia Estrella ©1988-2010 hCORD CORPORATION. All rights reserved. ACORD 26(2010/05)QF The ACORD name and logo are registered marks of ACORD yyi 'AiCAORU CERTIFICATE OF LIABILITY INSURANCE [3116'110 5 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; It the Carl ate holder Is an ADDITIONAL INSURED,the pollcy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and condition 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). I? C�tJGt"tf KLA�M� AKN�DVREWV OGRINAN BENDELL INSURANCE GROUP INC PHO 1E Anic 2 5057 X-— I 4 9 PO Box 164235 ro @ " bellsouth.net ............. Miami, FL 33116-4235 INS CaRv N ASSOCIATED INDUSTRIES ............................. . .......... ...............I............ WSURED AL HILL PLUMBING CORPORATION INSURER 8 ....................... AL HILL ENTERPRISE CORPORATION I INSURFR C 13740 NW 19TH AVE BAY#12 INSURER 0 .......... ................ OPA LOCKA, FL 33054 INSURER E 305-687-9963 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. ............................. pR LIMITS If 0 POLICY NUMBER D TYPE OF INSURANCE i COMMERCIAL GEI.MRAL LIABILITY EACH OCCURRENCE CLAflkAS-IIUE OCCUR PREMISES Ea eco frrr� ............... .......... MED EXP JA° wo pair1 S son; ..._. NA PERSONAL ADV INJURY GENERAL AGGREGATE i$ -UN't A('C�RFGATF.LIMIT APPLIES PER F—!PRO- POLICY LOC PRODUCTS-COMP0AGG 1 ...........- OIHER AU I OM01.144,LIABILITYOMBINED SINME r.10 sacc dant}..___...................... BODILY INJURY iPor pw*OM ANYAUTO At.I..OWNED SCHEDULED BODILY INJURY{Por amdar--V;S AUTOS !AUTOS ......................... ........... NA NON,OVVNED $ HtRED AUIOS AUTOS ............... ...................... UMiIRFIALA HAD ?OCCIJR EACH OCCURRENCE O EXCESS CLAIMSVAnE AGGREGATE $ ........................... NA I Uu) RLTLNTICNS %NOR9(ER3 COMPENSATION f PER X I GTfi- _STAfUTE ............................... AND EMPLOVERS'LIAB(t ITY YIN EACH ACCIDENT i$ 1,000,000 AVY A WA '1/29/151/29/16,L.L.ol,EAst~-EAEMPLOYEi$ 1 000,000 (Mand*aq i.NMI i EL DISEASE POLICY LIMIT S 1) SCRIPT ION OF OPERATIONS lnmw 1,000,000 'NA DF SCR WT ION OF OPERAT04 LOCATIONS VE MCI.ES tACORD'101.Aftt,ona'Remarks Scheawia may t;e aftwned:fmolp spaoa,s tdqirredj PLUMBING CONTRACTOR LICENSE if CFCA58101 WAIVER OF SUBROGATION IS AS RESPECT TO WORKERS COMPENSATION APPLIES FOR ALL PARTIES AS PE WRITTEN CONTRACT. CERTIFICATE HOLDER CANCELLATION MIAMI SHORES SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NO , WILL BE DELIVERED IN BUILDING DEPARTMENT ACCORDANCE-WITH THE POLICY PI 10050 NE 2ND AVE MIAMI SHORES, FLORIDA 33138 AUTNORIZED RVIPRESENTATIVL 0 1988-2014 A�ORD q6RPORATION. All rights reserved. ACORD25(2014/01) The ACORD name and logo are registered marks of ACORD r1 0