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PLC-16-2778 Inspection Worksheet Miami Shores Village C C 10050 N.E.2nd Avenue Miami Shores,FL l C� Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number. INSP-268891 Permit Number: PLC-10-16-2778 Scheduled Inspection Date: October 24,2016 Permit Type: Plumbing -Commercials' Inspector. Hernandez,Rafael Inspection Type: st Owner: LLC, MSVC Work Classification: Addition/Alteration Job Address:9488 NE 2 Avenue Miami Shores,FL 33138- Phone Number Parcel Number 1132060132780-88 Project: <NONE> Contractor: ROYAL PLUMBING CORP Phone. (305)6941964 Building Department Comments PLUMBING INTERIOR REMODEL InfracUo Passed Comments RUN PVC PIPE FOR BUILDING DRAIN AND VENT PIPE INSPECTOR COMMENTS False Inspector Comments Passed Failed I�� Correction ❑ Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid. Elio , enet y Miami Shores Village " 10050 N.E.2nd Avenue NEh tl y "' Miami Shores,FL 33138-0000 ;212, � Y `yy Phone: (305)795-2204 14111- F Expiration: 04/17/2017 last }�i0119l2016 Project Address Parcel Number Applicant 9488 NE 2 Avenue 1132060132780-88 Miami Shores, FL 33138- Block: Lot: MSVC LLC Owner Information Address Phone Cell MSVC LLC 2310 HOLLYWOOD Boulevard HOLLYWOOD FL 33020- Contractor(s) Phone Cell Phone $ 15,000.00 Valuation: ROYAL PLUMBING CORP (305)694-1964 Total Sq Feet: 0 Type of Work:PLUMBING INTERIOR REMODEL. Available Inspections: Type of Piping: Inspection Type: Additional Info: Top Out Classification:Commercial Re Pipe Scanning:1 Main Drain Heater Water Service Final Water Main Lavatory Underground Review Plumbing Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $9.00 Invoice# PLC-10-16-61639 DBPR Fee $7.88 10/14/2016 Check#:2727 $50.00 $517.76 DCA Fee $7.88 Education Surcharge $3.00 10/19/2016 Check#:2739 $517.76 $0.00 Permit Fee $525.00 Scanning Fee $3.00 Technology Fee $12.00 Total: $567.76 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 zoning. Futhermore,I authorize the abov ameg contracto to d thework stated. o October 19,2016 Authorized Signature:Owner / Applicant / Contractor / Age ate Building Department Copy October 19,2016 1 Miami Shores Village REPEIVED Building Department OCT 14 1016 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 201'-1�� BUILDING Master Permit No.CC-8-16-2167 PERMIT APPLICATION Sub Permit No. ��� ..dew� ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑EXTENSION ❑RENEWAL FE_jPLUMBING ❑ MECHANICAL [—]PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 9488 NE 2 Avenue City Miami Shores County: Miami Dade Zip: Folio/Parcel#:1132060132780-88 Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder):MSVC LLC. Phone#: Address:2310 Hollywood Boulevard City: Hollywood State: Florida Zip: 33020 Tenant/Lessee Name: Starbucks Coffee Co. Phone#: Email: CONTRACTOR:Company Name: Royal Plumbing Corp. Phone#: 305-694-1964 Address: 3525 NW 79 Street City Miami State: Florida Zip. 33147 Qualifier Name: Joel Gonzalez Phone#: 305-694-1964 State Certification or Registration#: CFC1425760 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$� �� �� Square/Linear Footage of Work: Type of Work: ❑ Addition M Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: Plumbing Interior Remodel ( Run PVC pipe for building drain and vent pipe. Run water distribution in copper pipe. Insulate the hot water line. Set the plumbing Mures) Specify color o color thru tile: Submittal Fee 5 � Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$_ - _ DBPR$ Notary$ Technology Fee$_(2. 60 Training/Education Fee$ �' Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ 5 (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 b appro and a reinspection fee will be charged. Signature Signature ` ER or AGENO TRACTOR Th foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of 0 CI-V 0 b . ,20 ,by 10th day of October 120 16 by OSC(Br SKI aK who is ersonally known t Joel Gonzalez who is personally known to me r 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 PUBLI 14, Sign:— �/ Sign Print 7 1 Print: Sul uinffi �400? t_39MI63 MY COMMISSION#FF998479 Seal: _ " Commission It F ;'+;267 Seal:• :++r:;' IUfaGil flj '�QQQ EXPIRES June 02,2020 F eNofaryServ+cecom tmlUGe 144,AwUll 140" �ianll�a wsxr*�>�>��*fx�x��*rwr+rr**sw�***+e***x*xffrcc�+�+ r//*waw�+r****sire***+xx*r*waw***��w��wrrrsrxwwr*+*.rerrr+r�*xx��*r�*wry• APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) ROYAL03 OP ID:AD ✓� CERTIFICATE OF LIABILITY INSURANCE DAM(MMiDDlYYM04105/2016 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((es)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 Kahn-Carlin&Company,Inc. PHONEFAX 3350 S.Dixie Highway a Ext 305-446-2271 AIC.NII:305-448-3127 Miami,FL 33133-9984 DRESS,processing@kahn-carlin.com INSURE S)AFFORDING COVERAGE NAIC# INSURER A:Travelers Casualty Ins Co Amer 19046 INSURED Royal Plumbing Corporation INSURER B:FCCI Insurance Company 10178 3525 NW 79 Street INSURER c:Berkley.,Assurance Company 39462 Miami,FL 33147 INSURER D:Commerce&Industry Ins Co 19410 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. ILTR TYPE OF INSURANCE POLICY NUMBER MM/D EFF MMIDD FSP LIMITS C X COMMERCIAL GENERAL LIABILnY EACH OCCURRENCE $ 1,000,00 DAMAGE TO RFINITED CLAIMS-MADE T OCCUR VUMC0023663 12/14/2015 .12!14/2016 PREMISES Ea occurrence) $ 100,00 MED EXP(Any one person) $ 5,00 X Per Proj Agg$3M PERSONAL&ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY a JPE LOC PRODUCTS-COMP/OP AGG $ 2,000,00 OTHER: $ AUTOMOBILE LIABILITY COMBINED IN LE LI IT $ 500,00 (Ea acxident A X ANY AUTO BA3F746741 12114/2015 12114/2016 BODILY INJURY(Per person) $ AALLOOWNED SACOEDULED BODILY INJURY(Per accident) $ UT NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS AUTOS I accident) X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000.00 D EXCESS UAB CLAIMS-MADE EBU012051175 12/14/2015 12/14/2016 AGGREGATE $ 5,000,00 DED I I RETENTION$ $ WORKERS COMPENSATION X PER OT STATUTE EMPLOYERS'LIABILITY STATUTE ER B ANY PROPRIETOR/PARTNER/EXECUTIVE YNIA 001WC14A62982 12/14/2015 12/14/2016 E.L.EACH ACCIDENT $ 1.000,00 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,00 It s,descibe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS i VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached N more space Is required) State License No: CFC1425760 CERTIFICATE HOLDER CANCELLATION MIAMI84 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. Building Department 10050 NE 2 Avenue AUTHORIZED REPRESENTATIVE Miami Shores,FL 33138 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD 005578 .Local.Business Tax Receipt Miami-Dade County, State of Florida THIS IS NOT A BILL-DO NOT PAY 4751351 LBA- T__,� BUSINESS NAME/LOCATION RECEIPT NO. EXP ROYAL PLUMBING CORP - RENEWAL SEPT R 30, 2017 MUNICIPALITIES LOC 4960762 Must splayed at-place of business COMMERCIAL LESSORS FL 33888 Pursuant to County Code Chapter 8A—Art.9&10 OWNER SEC.TYPE O BUSINESS PAYMENT RECEIVED ROYAL PLUMBING CORP 192 COM RCL/INDUST/OFFICE SPACE BY TAX COLLECTOR Aggregate sq.ft.3950 $75.00 07/2272016 CREDITCARD-16-043114' This Local Business Tax Receipt ool 'onfirms payment of the Local Business Tax The Receipt is not a license, permit,ora certification ofthe hol r s qualifications,to do business.Holder must comply with any governmental or nongovernmental regulatory and requirements which apply to the business. The RECEIPT N bove must be displayed on all commercial vehicles—Miami—Dade Code Sec 8a-276. For more information,visit www miamidade.gov/taxcollector 008229 Local Business Tax Receipt Miami-Dade County, State of Florida -THIS IS NOT A BILL—DO NOT PAY 5959631 LBT BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES ROYAL PLUMBING CORP RENEWAL SEPTEMBER 30, 2017 3525 NW 79 ST 6217087 Must be displayed at place of business MIAMI FL 33147 Pursuant to County Code Chapter 8A—Art.9&10 OWNER SEC.TYPE OF BUSINESS ROYAL PLUMBING CORP 196 PLUMBING CONTRACTOR PAYMENT RECEIVED CFC1425760 BY TAX COLLECTOR Worker(s) 5 $75.00 07/22/2016 CREDITCARD-16-043114 This Local Business Tax Receipt only confirm payment of the Local Business Tax The Receipt is not a license, permit,er a cer ificationafthe holders qualifications,to do business.Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT N0.above must be displayed on all commercial vehicles—Miami—Dade Code Sec Ila-276. For more information,visit www.miamidade.govRaxcallecto STATE OF FLORIDA b r °° DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ` CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399-0783 GONZALEZ, JOEL ROYAL PLUMBING CORP 3525 NW 79 ST MIAMI FL 33147 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and = ti, STATE OF FLORIDA Professional Regulation. Our professionals and businesses range from architects to yacht brokers,from boxers to barbeque DEPARTMENT OF BUSINESS AND restaurants,and they keep Florida's economy strong. .,p'' PROFESSIQNAL REGULATION Every day we work to improve the way we do business in order CFC1425760 ISSUED: 08/07/2016 to serve you better. For information about our services, please log onto www.myflofidalicense.com. There you can find more CERTIFIED PLUMBING CONTRACTOR information about our divisions and the regulations that impact GONZALEZ,JOEL you, subscribe to department newsletters and learn more about ROYAL PLUMBING the 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, Ex CERTIFIED under the provisions of Ch0807 023 and congratulations on your new license! F�piondate AUG 31.2018 L1608070002356 DETACH HERE RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD CFC1425760 e The PLUMBING CONTRACTOR - Named below IS CERTIFIED WF. Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2018 Ell GONZALEZ, JOEL ROYAL PLUMBING CORP' 3525 NW 79 ST MIAMI FL 331:47 ISSUED: 08/07/2016 DISPLAY AS REQUIRED BY LAW SEQ# L1608070002356