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PL-16-2827
Inspection Worksheet Miami Shores Village 0— 10050 N.E.2nd Avenue Miami Shores, FL C 28z Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-269172 PermitNumber: PL-10-16-2827 Scheduled Inspection Date: December 19,2016 Permit Type: Plumbing - Residential Inspector: Hernandez, Rafael Inspection Type: Final Owner: PIERRINE LEONEL AND ALFRED Work Classification: Addition/Alteration 1 Ve%KICI CDAAV`IMIC DICDDC 1 AMC Job Address:20 NE 104 Street Miami Shores, FL Phone Number Parcel Number 1121360130910 Project: <NONE> Contractor: JOSEPH A. MARCELIN CONSTRUCTION Phone: (305)562-7926 Building Department Comments REPLACE FIXTURES Infractio Passed Comments REPLACING PL14-23 INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid December 16,2016 For Inspections please call: (305)762-4949 Page 18 of 60 s+; Miami Shores Village f'�trt Tyjrte PI-Jur,W 1011,", � R 10050 N.E.2nd Avenue NE Wo � catlii I Miami Shores,FL 33138-0000 1 mastaiwo" hF � Phone: (305)795-2204 Expiration: 04/29/2017 Project Address Parcel Number Applicant 20 NE 104 Street 1121360130910 Miami Shores, FL Block: Lot: FRANCINE PIERRE LOUIS PIERI Owner Information Address Phone Cell FRANCINE PIERRE LOUIS PIERRINE 20 NE 104 Street -- - - ---- - - MIAMI SHORES FL 33138-2027 Contractor(s) Phone Cell Phone Valuation: $ 750.00 JOSEPH A MARCELIN CONSTRUCTU (305)562-7926 Total Sq Feet: 0 Type of Work:REPLACE FIXTURES Available Inspections: Type of Piping: Inspection Type: Additional Info:REPLACE FIXTURES Top Out Bond Return: Final Classification:Residential Scanning:1 Review Plumbing Underground Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 Invoice# PL-10-16-61694 DBPR Fee $2.25 DCA Fee $2.25 10/31/2016 Credit Card $109.10 $50.00 Education Surcharge $0.20 10/18/2016 Credit Card $50.00 $0.00 Permit Fee $150.00 Scanning Fee $3.00 Technology Fee $0.80 Total: $159.10 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 zon' 7uthermore,I authorize the above-named contractor to do the work stated. October 31,2016 Authorize ignature:Owner / Applicant / Contractor / Agent Date Building Department Copy October 31,2016 1 Miami Shores Village OCT 1 2016 Building Department 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 201q BUILDING Master Permit No. A C f ? ZG PERMIT APPLICATION Sub Permit No. P 19(0 - Zfs 2 ❑BBUILDING ❑ ELECTRIC ❑ ROOFING F-1 REVISION ❑ EXTENSION ❑RENEWAL ['PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS r , CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: ). ® AI,C 10�6-Al - City: Miami Shores County: Miami Dade Zip: 3.313 Folio/Parcel#: //-02-13,r-,-0/3-04910 Is the Building Historically Designated:Yes NO c/ Occupancy Type: Load: Construction Type: Flood Zone: A,-a BFE: FFE: OWNER:Name(Fee Simple Titleholder): Phone#: ?.P,4 306 f 9 31 M Address: R-0 N r P d V-* - -7A6 37,F 78'27 City: t'4H l Si6g�LS State: H Zip: 3 3/3.P Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: �OJ410w 114 s�41 PlaOnc#: Address: city:.6 '1 ! State: Zip: A / Qualifier Name: �l ��Y//�� Phone#: State Certification or Rgistration#: t: G /yt�� ]7 AS Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ 1,c)QA to Square/LinearrFF000ttage of Work: Type of Work: ❑ Addition ❑ Alteration EJ �ReNew Lpair/Replace ❑ Demolition Description of Work: VI-0, 0-b,� e'p � Specify color of color thru tile: .. Submittal Fee$ � Permit Fee$ �.� CCF$ ' CO/CG$ Scanning Fee$ Radon Fee$ 2 . 2'S DBPR$ 2 Notary$ Technology Fee$ ' 215® Training/Education Fee$_ Z 0 Double Fee$ Structural Reviews$ Bond$ 1 TOTAL FEE NOW DUE$ I O q • (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 be approved and a reinspection fee will be charged. Signature J Sigj'% e IT OWNER or AGENT VRA 0 The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this (�1 *0 day of ®�OQ-Y ,20 1 C by 1,j�2 day of 201,by __,who is personally known to who is personally known to me or who has produced t` 1.��1 ��c 9 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: Sign: Print Print: Seal: JIMNd�AD1 Seal: W BION i#FF8B M a MOiVDELINE F.DUBE 4� F M1ay11.21101 �` �PIR� $,�ONl #FFle AD B* *w** ** x** **x* APPROVED BY � IV 11flAp Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) STATE OF FLORIDA fi DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 PERDOMO, MANUEL MANNY'S PLUMBING SERVICE INC 9850 NW 27TH STREET DORAL FL 33172 Congratulations! With this license you become one of the nearly __ one mil Floridians licensed by the Department of Business and STATE OF FLORIDA Professional Regulation. Our professionals and businesses range DEPARTMENT-OF BUSINESS AND from architects to yacht brokers,from boxers to barbeque restaurants, 06'. PROFESSIONAL REGULATION and they keep Florida's economy strong. - CFC1428796 IS�UEI -.03/19/2013 Every day we work to improve the way we do business in order to serve you better. For information about our services,please log onto CERTIFIED PW MBINGCONFR�R www.myfloridalicense.com. There you can find more information PERDOMO,MANUEL =— about our divisions and the regulations that impact you,subscribe to department newsletters and learn more about the Departments NANNY'S PLUMBIIiICT SEI2VICEIN ! initiatives. _. Our mission at the Department is:License Efficiently,Regulate Fairly. We constantly strive to serve you better so that you cpn serve your i IS CERTIFIED under the provisions of C-h:489 customers. Thank you for doing business in Florida, F�cpirariondete:AUG 31 2014 u3CMSM00489 and congratulations on your new license! =-- -- -- - - The Department of State is leading the commemoration of Florida's 500th anniversary in 2013. For more information, please go to www.VivaFlorida.org. MA RNPA500 DETACH HERE STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD CFC1428796 �• The PLUMBING CONTRACTOR Named below IS CERTIFIED- 0.-. Unde the provisions-of Chapter 489 FS. Expiration date: AUG-31;2014 P " :PERDAMO,=MANUEL - - :MANNY'S PLUM91NG SERVICE .. WEST 3 -P.LACE BAY.-1502A k `HIALEAF# Fl_33D12 - y VIVA FIODIDA 500. RICK SCOTT ISSUED: 03/19/2013 SEO# L130319W00489 KEN LAWSON GOVERNOR DISPLAY AS REQUIRED BY LAW SECRETARY Local Business Tax Receipt Miami-Dade County, State of Florida -THIS IS NOTA BILL-DO NOT PAY LBT 3359791 BUSINESS NAMEnACAT1ON RECEIPT NO. EXPIRES M ANNYS PLUMBING SEWCE INC RENEWAL SEPTEMBER 30, 2014 1631 W 38 PL 1502A 3502161 HIALEAh1 FL 3301 2 Must be displayed at place of business r Pursuant to County Code Chapter 8A-Art.9&10 OWNER SEC.TYPE OF BUSINESS PAYMENT RECEIVED MANNYS PLUMBING SERVICE INC 196 PLUMBING CONTRACTOR BY TAX COLLECTOR 49.50 10/01/2013 Worker(s) 1 CFC1428796 0228-14.000007 This Local Subsea Tax Receipt only tonfitms payment of the Local Business Tax.The Receipt In net a licesse, permit,or a eertiticados of the belder's qualigcatiens,to de business.!older mast camply witb any governmental at neagovernmentai regulatory laws and requirements width apply to the business. The RECEIPT N 0.above must be displayed on an commercial vebieles-Miami4ade Cede See 8a-276. Puma® Fer mere isfarmatiou,visittvww miamidade gevlgxeellsetor a ---"MON OP ID:MIAC .44c"NLY DATE(MWDWYYY) �, CERTIFICATE OF LIABILITY INSURANCE 12/12/13 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 pollcy(ies)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). CONTACT PRODUCER 305-262-55244 NAME: Allsafe Insurance Group dba 786-368-7244 PHONE FAX ASI Florida AIC No A/C No): 7171 Coral Way 8209 E MAIL Miami,FL 33155 ADDRESS: PRODUCER MANNY-1 Jackie Pena,PIAM CPIA cuuSTO MERIDA: INSURER(S)AFFORDING COVERAGE NAIC tt INSURED Manny's Plumbing Service Inc INSURERA:Capacity Insurance Company 32930 Manny Perdoma INSURERB:Technolo Insurance Company, 42376 1631 W 38 PI #1502 A Hialeah,FL 33012 INSURER C: INSURER D: 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. INSR AWL SUIBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCEMAL mfp– POLICY NUMBER MM/D MM/D LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY CLM01001559B-2 11/06/13 11/06/14 PREMISES Ea occurrence $ 100,00 CLAIMS-MADE OCCUR MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,0 GENERAL AGGREGATE $ 2,000,00 GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 1,000,00 X POUCYFI PRO 1-1 LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS (Per accident) $ NON-OWNED AUTOS $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS Y/ LUU31UTY TORY LIMIT ER B ANY PROPRIETOR(PARTNER/EXECUTIVE❑N NIA TWC3379359 11/06/13 11/06/14 E.L 'EACH $ 1,000,0 OFMCERIMEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,0 DESCRIPTION F OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) ercia1 Plumbing 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 FAX#:305-756$972 ACCORDANCE WITH THE POLICY PROVISIONS. BUILDING DEPARTMENT 10050 NE 2 AVE AUTHORIZED REPRESENTATIVE MIAMI SHORES VILLAGE,FL 33138 ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD