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PL-09-1900Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 C5?7I Inspection Number: INSP- 129440 Permit Number: PL -11 -09 -1900 Scheduled Inspection Date: April 11, 2012 Inspector: Hernandez, Rafael Owner: POLANCO, DEYSI Job Address: 1183 NE 91 Terrace Miami Shores, FL 33138- Project: <NONE> Contractor: ACER PLUMBING INC Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: New Phone Number Parcel Number 1132050010200 Phone: 305 - 935 -4103 Building Department Comments pl Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments April 10, 2012 For Inspections please call: (305)762-4949 Page 3 of 25 BUILDING PERMIT AP FBC 20 Permit Type: PLti Owner's Name (Fee Sin Owner's Address / 1 C. Tenant/Lessee Name Email Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 Poi- 0-4a0 Permit No. (� `-'I Master Permit No.Vl C. 0 f -155 ple Titleholder) 0 3 /V E f°!, Tn CP rC' State 77'.7" i cI '306- Zip Job Address (where the ivork is being done) City Miami Shores Village FOLIO / PARCEL # Is Building Historically Phone # 11- X205 -0 ©l —0200 1183 ,vc q1 Te. County Miami -Dade Zip Designated YES NO Contractor's Company Name P/6-1 d 9 w` g T e' Contractor's Address / E J / N Q- 2-06 7-3-r City y✓1 f r3 M ' State Ft-14 Qualifier Name bs4 v i b 130 ur-1 v 1 State Certificate or RRegis ration No. e F C' 0S .33 2-6 Contact Phone it ' 4 el 0 /�, e cho E -mail Architect/Engineer's Na Phone # Flood Zone - '. `? tip - g - 2 s ss- Zip 33 1'77 Phone # V $ G e-i .g 4. • 2L/ 's Certificate of Competency No. ? c c, 2.2 Z O y,y A ov , e (if applicable) Phone # Value of Work For this (Permit $ Br x . 00 Type of Work: ['Addition ['Alteration Describe Work: N �1 h V (JSQ Squ e / Linear Footage Of Work: ew ❑ Repair/Replace ❑ Demolition * * * * ** Submittal Fee $ Notary $ Scanning $ Double Fee $ Permit Fee $ 2_ )'a Training/Education Fee $ 1' (QQ DPBR $ Violation date: I Total Fee Now Due $ 29V\ Radon $ Structural Review. $ CCF $ ' CO /CC $ Technology Fee $ c• 4) Bond $ See Reverse side -+ 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 # ' er the building permit is issued. In the absence of such posted notice, the inspection will not be approved , a reinspection f 'will beZ`rged. Signature Owner or Agent The foregoing instrument was acknowledged before me this day of (Q' , 20 (l , by who is personally known to me or who has produced 'dentificationand whodid �take an oath. N /� MY COMMISSION ASLAN # OD 891662 EXPIRES: June 20, 2013 Bonded Thu Budget Netry Woes Signature Contractor The foregoing instrument was acknowledged before me this day of ez,tp i , 20 , by L)4 who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: My Commission Expires: Sign: Print: My Co f v Zoning Engineer (Revised 07 /10 /07)(Revised 06/10/2009) Clerk checked • •• DATE •H • E3ATC1-1NU..MBER 07/13/2009 098003691 *61 • The BUSINESS ONGANIEATIO*•:7;,i, • Named below IS QUALIFIED . • • Under the provisions or.is: chapter ..489 113. Map/ration, date: AUG 31, 211 .. (THIS 12 NOT AJ LICENSE TO:..iPBMORK. =WANT TO DO 3l_IMIESS:'.Og2?:IP:IT HAS A Qtr0.1i11!1:120k4.10-.:--V_± AM. PL: wc - .• "La:: ImiG /851 NE 206 TEER MIAMI • • ALEX SMNIC SUM OF FLOPADA CUSP Felat UPARTINSIT MAMMAL Want= mum OF WOMBS' COMPSWATIMI * * =NOM OF 10 FMB RESWA WOWIRIC ISIEWMATUNI LAW CONSTRICTION Belt' E ERWE DS ibis certifies that the Wad Med helm bas elected to be ammapt from Ftt ' EFFECTIVE DATE 09103t EXPIRATION DATE: MUM RONAN DAVID PER* ESOSSNI49 BMW= NAME Aft ADEMEM Meet Toutaca tom num BEACH FL 03179 SCOPES OP RUMNESS OR TRADE t- conrinED FLUNWONI C1314MICTOR ttrunintre tivantot to Motet 440 . e ES„ .o Atm at • catoteidos .to elects atittlPft Itae eds &Wu by a ,,_ a cetiUI sta at ditclItstt toter this =Ham asoy rot wooer tomtits or eorepernatten wen this them memo to catou am aAat, r =. Detrttetee E a?tztica to Lc - -- opoty may lottkto scup ea dte tostoess or tots I Ike faudee e4 sintiaa sa be Pao -ssaae Me= 949.0 F,S., tea et efeettee le ;t., =WI i=d aesaireras e4 llama attar ths+ nun at tie Cot or to tss a of tta coliai as e election t® tier stall E eitdre to rem 0, at str� meta a 'r•eme a? °"'J' Gtae For talttaa at the Q s roma eert t© ee mama the rngotr�rs9s o7 t swam �z a c itism4a. QUESTIONS? 413-11 on Ito te, moat tee r of ads seldom PAC-152=RCM OF TO BE EXEMPT REVISED 09-46 PLEASE CUT OUT THA CARD BELOW AND RETAIS FOR FUTURE REFERENCE STIGEOF MINIMA CEPARMENT FINANCIPI. SERVICES mNl CIF COMPERSATYz iii+ Tts+ a - WY EFFECTIVE 128/08/ 20011 PERM* DAVID RONAN Ff BUSINESS MANE AND ADI7EIESa COMM hest BEAM R. 3 139 MOPE (3P ELISIFESS CM TRADE I- Ct IMPORTANT to 44A�' F.S.. as *Mar of a o trim '` ch4Ona by i a CertifbmEe of ettotion L. tom' trOs =don um ssei ate soofits or ao...�r� meatFa -un wuze r eft ® stater. f /AOg t Pecs t to t 44'AIS112i, F.S. Certificates of doze= t® he *4 - vain the scope of business or ad en € the tta a of elet ti of to ba eaemat R E Pursuant to Unger 44E0b41* F.S. Nati= of etuatian Is be axttt certlitailam al abscOam ta ba e AIR be sabiata (a roaatimm if, at cR1 title after the Mop of the exotics el the hansom of :.. tea, the person named an the 000e or earefkahe ea hew tree the regoiresonnts of thfs section for hems= of a certificate. The dammed theg navdke o certificate at sty thee for fame of the puma lammed on the fit mie ie Onta the nandreneoes of this OUESTUNIS? t- t 4t3-1511: CUT * Carry banana pardon on the job. for your records. DATE BATCH NUMBER 07/26/2008 = y The PLUMBING COMM _`' Named below IS 'Under the prowl. Expiration dat BONAN, DAVID AOER .. PLUI BT1 . 1851 NE 206218 TERR MIAMI MARL= CRtST GOVERNOR %4S REQUIRED BY LA r �@ T 270259 -6 BuiffiVENOtiltie 1851 NE 206 TERR 33179 MIN DADE COUNTY "WAR PLUNDINB INC Geriftell aillifrie CONTRACTOR MS L4 ONLY A LOCAL MOMS TAX REM?. w DONS NOT NNW NE 6 .;:lifircatz zit DDNB IT @uffravr arum P" FROM p ia Of LAID. TOMS me Rouen OVAUFICA- PAY I;' TAX X7/2312009 09010024001 000075.00 SEE OTHER SIDE REAiEWAt. 6407 -9 STAT - 'x3320 FIRS'It-CLASS U.S. POSTAGE PAM FL PERMXTNO. WORKER /S 10 DO NOT FORWARD INC DAVID RONAN�PRESS 1851 NE 206 TERR MIAMI FL 33179 Nov 05 05 04:10p Sep 2509 0325p data boner •■•••••••••••••••11/ •■■• P 1 &WA CERTIFICATE OF LIABILITY INSURANCE am.re1077"" INN carnmeme Issue) ASARIATTERM 02/12109 coax AND DOWERS ND 1110111S UPON IRE CERTIFICNE HOLM. 11,113 ATE DOSS Nur AZION10. WEND OR AUER ThE ceWRRADE AFFoRDED faTTRE Mums —1N# Roebuck Assocs. Xma. amalgams* ESSE S. Vgliversity Drive. 0201 Magela VS 33328 Elgoama954-62.6-1800 aaasSa4-61S-L11841 rErramae• INSuRmas AFFORDING COMRADE oRtMEWk Agserlican Velaolo Moil. Co- lliStMERS: SOURERC: IRSUREROt WORMS COVERAGES THEPOUCIESOP $55UM051151215550$$$$$OESIORUEDIOTIIMSURIO NUM AMONSFORThoPOUCIPERIO0 barCA222.RCOWOUSUROING SEMIEagerr. TutuaRcemmosepAlimangukcrancingestagmagamerregnsmasaraggessavuscagussgassourseaSUEDOR saky paw& damsuRivicedopaudeoarnevaudiesUESMENONEami LIOREUECTIOALLNIEVERM IRCURROM$AUDOODUIROBR or sou POLICES. AmmassasluaTsmovslimargesalaggISSalegaff$MODOMMS. snrci$OPROujnyCE ARNEIRALOSOCUTt ogassleasassa %WIMP ragMillr D3SIMERCURGERERALUARIVIr OARSMAN OCCUR salumegasuir AVIV 411.0504080410500 (12,12/09 52/12 PROOUCO1.051CROPAGG s2,000.000 1001111111MIURT grerstssaa is rwearli.a=liff 8 PROPERIVIONOUitt (Peruteloal MOOOMY4MOCCORAR mrkw;a:r: mums EXCREMOSIGNIALIMIATV accuR 0 $1/41501$1$15 I- s 5 CERTFICATEI1OLDER CANCELLAisOrs Miami Shores Village 10050 N.E. 2 Avenue Miami Shores, Florida 33138 SRIORDARWOPROIDBOURCOSICROADPOLICISS OCCRNCELLEDOOCROThe OlarTIMEROoR3WRORWROULIROCCWORTOIRAR 1.0 osvesanonso agattgielstaamassaa*NOLOSMIEDIDTINFLEP4SEMAISIETSESSOINAgg, mass NOiesuSa1101114311 usuguressamtigag won Tossausgst REPRZIERM105$ ACORD 25 mouse v d 0811 OZZ Cr' 61.Nwnid mew CORPORATIONIESB d:90 60 90 AoN