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PL-16-2548Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-267371 Permit Number: PL -9-16-2548 Scheduled Inspection Date: December 19, 2016 Inspector: Hernandez, Rafael Owner: Job Address: 525 NW 111 Street Miami Shores, FL 33138-0000 Project: <NONE> Contractor: NELMAR PLUMBING INC Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition/Alteration Phone Number (786)580-8923 Parcel Number 3021360210720 Phone: (305) 261-3942 Building Department Comments PLUMBING FOR 2 BATHROOMS REMODEL AND KITCHEN Infractio Passed Comments 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 17 of 60 Project Address Miami Shores Village 10050 N.E. 2nd Avenue NW Miami Shores, FL 33138-0000 Phone: (305)795-2204 525 NW 111 Street Miami Shores, FL 33138-0000 Owner Information Permit Permit NO. PL -9-16-2548 Permit Type: Plumbing - Residential Work Classification: Addition/Alteration Permit Status: APPROVED Issue Date: 9/2212016 Expiration: 03/21/2017 Parcel Number Applicant Address 3021360210720 Block: Lot: DAVID WILLIAM PROPERTIES L Phone Cell DAVID WILLIAM PROPERTIES LLC 1680 MICHIGAN Avenue MIAMI BEACH FL 33139- (786)580-8923 1680 MICHIGAN Avenue MIAMI BEACH FL 33139- Contractor(s) NELMAR PLUMBING INC Phone CeII Phone (305)261-3942 Type of Work: PLUMBING FOR 2 BATHROOMS REMODEL AN Type of Piping: Additional Info: Bond Return : Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $1.20 $3.38 $3.38 $0.40 $225.00 $3.00 $1.60 $237.96 Pay Date Pay Type Invoice # PL -9-16-61349 09/15/2016 Credit Card 09/22/2016 Credit Card Amt Paid Amt Due $ 50.00 $ 187.96 $ 187.96 $ 0.00 Available Inspections: Inspection Type: Top Out Final Review Plumbing Underground 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 above-named contractor to do the work stated. September 22, 2016 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date September 22, 2016 1 Miami Shores Village 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 BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC ❑ ROOFING REQ D SEP 15 2016 CCM FB(C20f'-10 Master Permit No. ! 6- 2GY Sub Permit NoYL ( 25 1 C7 ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL El PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: City: Folio/Parcel#: Occupancy Type: 52 N � tt�;= `fY S Miami Shores Cou tv: 1- a \-S(Li- 021- 0-72.0 Load: Miami Dade Zip: 33\ (Oa) Is the Building Historically Designated: Yes NO' Construction Type: Flood Zone: BFE: OWNER: Name (Fee Simple Titleholder):�'J ) 1tk11/�f"� ( es Address: I Lo pt7 i l r 1�/*,(V A 1%g f �T E -/3 City: reseit State: 17-- Zip: � �• FFE: Phone#: 14,c4 :fav 1W Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: MEL 1A46 -1Z PL.. iit),5 iSY Sal 7 r Address: City: V I Viov I State: Qualifier Name: —'/(5 P /2 D kI 5 CZ 2Foo x$2.176 Phone#: 3o.r 2—C/-3' ( L State Certification or Registration #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ 2000. u° Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New E'Repair/Replace ❑ Demolition Description of Work: 471) co4/ z 64/kaom{, c ' ��`LI Phone#: Zip: ,3 3 /5)'" Certificate of Competency #: 02dfJv $ t Specify color of color thru tile: • �A Submittal Fee $ Permit Fee $ Scanning Fee $ D • G7 Radon Fee $ Technology Fee $ [ • GC) Training/Education Fee $ 0 • 40 CCF $ I • ZO CO/CC $ • 3a DBPR $ -3.39 Notary $ Double. Fee $ Structural Reviews $ (Revised02/24/2014) Bond $g TOTAL FEE NOW DUE $ 1 �' �� 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 forregoing information is accurate and that all work will be done in compliance with all applicable laws regulating constru' tion an'd piing: "WARNING TO OWNER: YOUR FAILURE TO' RECORD A NOTICE OF' COMMENCEMENT MAltr`: 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 inspectshich occurs seven (7) d • • er the building permit is issud. In the absence of su posted notice, the inspection will not b • • •roved and a reinsp= ion - will be charged. Signature Signature 0 ' NER or AGENT CONTRAC The foregoing instrument was acknowledged before me this The foregoingfoinstrument was acknowle ged before me this , 20 i L , by ( day of 6 Er , 20 1 6 , by <,/ f I 2.1,-014D , who is personally known to Lars r Ro I 5A2 , who is personally known to 2 1 day of til"I me or who has produced fi L 0(-4 identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: as me or who has produced as identification and who did take an oath. NOTARY PUB Commission # FF 124099 Sign: Print: Seal: J RENE 0. TDMA MY COMMISSION t FF 186224 EXPIRES: April 25, 2019 Bonded Thru Notary Pubic Undeneriters *********************************************************************************************************** APPROVED BY q' —ge Plans Examiner Zoning (Revised02/24/2014) Structural Review Clerk Miami Shores Viitage Building Department CONTRACTORS' REGISTRATION IF CONT TOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. cOPY OF QUALIFIERS STATE LICENCES B. 1 COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE* D. / COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 Certificate must specify the description of operations or contractor license number. BUSINESS NAME: Neirot,/ Ainitt;c BUSINESS ADDRESS: '/%.5 7}- CITY /4,1/ STATE P7' ZIP 3.3//1— BUSINESS 3/ff BUSINESS PHONE: ( ) FAX NUMBER () CELL PHONE ( 36) 26/ a64 QUALIFIER'S NAME: La's' LA(14'2. QUALIFIER'S LIC NUMBER: f' 003 6- 2& C 46,„ Vat ,,,.7tion Tracieff, Qualifying Board -ERTIFiC•i;TE OF COMPETFNCY RODRIGU Is certified under the prm;:,oris Chapter 10 of Miami -Dade County VALID FOR CONTRAC l'ING UNTIL 0 9/3012017 kR PI. UMBING INC QUALIFYING TRADE(S) 0001 PLUMBiN( 0022 MEDICA :NSTALLAUON Jtzira H. Saias P.E. Secretary of the Board .11,e;dei-AII' Want -Dade County retains el property c'r - MIAMI-DADE ir arr.dade.govieconcmy STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 RODRIGUEZ, LUIS F NELMAR PLUMBING INC 4954 SW 75TH AVE MIAMI FL 33155-4439 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. 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 www.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about 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, and congratulations on your new license! DETACH HERE RICK SCOTT, GOVERNOR (850) 487-1395 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION RF0038206 18SUED: 08/05/2015 REGISTERED PLUMBING CONTRACTOR RODRIGUEZ, LUIS F NELMAR PLUMBING INC; . (INDIVIDUAL MUST MEETALL.L-OCAL LICENSING REQUIREMENTS -PRIOR TO CONTRACTING IN ANY AREA) HAS REGISTERED under the provisions of Ch.489 FS. Expiration date : AUG 31, 2017 L1508050001208 KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD LICENSE NUMBER The PLUMBING CONTRACTOR Named below HAS REGISTERED - ` ' Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2017 (INDIVIDUAL MUST MEET ALL LOCALLICENSING REQUIREMENTS PRIOR TO COMPACTING IN ANY AREA) - RODRIGUEZ, LUIS F NELMAR PLUMBING INC*''`` 4954 SW 75TH AVE MIAMI FL -331554439 I.SSI JF% nRin5onl A, `~ - ,' e, . -. ; tit "� N ' IIISPI AY AA RFC), IIRFII RY 1 AW SEO # L1508050001208 • 011886 Municipal Contractor's Receip - Miami -Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 265140 BUSINESS NAME/LOCATION NELMAR PLUMBING INC 4954SW75AVE MIAMI FL 33155 OWNER NELMAR PLUMBING INC Category(s) 1 RECEIPT NO. NEW 7488023 EXPIRES SEPTEMBER 30, 2017 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 SEC. TYPE OF BUSINESS MMC PLUMBING CONTRACTOR 000008586 PAYMENT RECEIVED BY TAX COLLECTOR $220.00 07/29/2016 FPPU06-16-020774 ibis Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit ora certification of the bolder s quslificatioes, to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT NO. shove must he displayed on all commercial vehicles - Miami -Dade Code Sec tta-276. For more information, visit www2niemidade.00v/taxcellector 000214 Local Business Tax Receipt Miami -Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 265140 BUSINESS NAME/LOCATION NELMAR PLUMBING INC 4954 SW 75 AVE MIAMI FL 33155 OWNER NELMAR PLUMBING INC Worker(s) 20 RECEIPT NO. RENEWAL 265140 LBT EXPIRES SEPTEMBER 30, 2017 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 SEC. TYPE OF BUSINESS 196 PLUMBING CONTRACTOR 000008586 PAYMENT RECEIVED BY TAX COLLECTOR $125.00 07/29/2016 FPPU06-16-020773 This Local Business Tax Receipt only confutes payment of the Local Business Tax. The Receipt is not a license, permit or certification of the holder's qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT NO. above must be displayed on ell commercial vehicles - Miami -Dade Cods Sec Sa-176. For more information, visit www.miamidade.aov/taxcofector ACORDT, CERTIFICATE OF LIABILITY INSURANCE TE (M DA04/06 016 PRODUCER Serial # 133128 EMMANUEL INSURANCE & ASSOCIATES, INC 2370 E 8TH AVE HIALEAH, FL 33013-4236 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIL# INSURED NELMAR PLUMBING, INC 4954 SW 75 AVE MIAMI, FL 33155 1 INSURER A. PREFERRED CONTRACTORS INC. CO. INSURER B: ASCENDANT COMMERCIAL INSURANCE, INC INSURER C: INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY 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 POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. an TYPE OF INSURANCE POUCY NUMBER PODkIggragg PQLICE MOTION �w LIMITS LTR A X LABILITY ABILITY COMMERCIAL GENERAL LIABILITY PCA86713-05 04/27/2016 04/27/2017 EACH OCCURRENCE $ 1,000,000 RENTED DAMAGE TO RENTED PREMISES Ea occurencel $ 50,000 MED EXP (Airy on. person) $ 5,000 wow MADE X OCCUR PERSONAL & ADV INJURY S 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGC S 2,000,000 GEN'LAGGREGATE ^ 1 LIMIT APPLES PER POLICY 1 ^ 1 I l l LOC AUTOMOBILE — _- _ UABLRY ANY AUTO AU. OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS OMIT (COMB Ea accident) S BODILY INJURY (Per person) S BODILY INJURY (Per accident) S IPFrOPPER DAMAGE S GARAGE I IIBIUTY ANY AUTO AUTO ONLY))- EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LABIUTY OCCUR CLAIMS MADE oEoucneLEs RETENTION $ EACH OCCURRENCE $ AGGREGATE $ S _ $ B WORKER', EMPLOYERS' ANY OFFICER/MEMBER S E6IAL PROPRIETOR/PARTNER/EXECUTIVE PROVISIONS COMPENSATION AND LIABILITY EXCLUDED? NS below WC -66394-1 11/27/2015 11/27/2016 1 TNORY 111.4% 1 X KV EL EACH ACCIDENT S 1,000,000 El. DISEASE - EA EMPLOYEE S 1,000,000 EL DISEASE - POLICY war $ 1,000,000 OTER DESCRIPTION COMMERCIAL OF OPERATIONS/L.00ATIONSNEHICLE8/EXCLU$IOHS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS & RESIDENTIAL PLUMBING CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE BUILDING DEPARTMENT 10050 NE 2 AVE MIAMI SHORES, FL 33138 I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE JS814i INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO TCERTIFICATE ERTIFICATE ER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR UAeIUTY OF ANY KIND UPON THE INSURER. ITS AGENTS OR REPR ENTATIVES. . ,'a . REPRE:., • .r 7f l OB' RTJ.PERES A% ^nem rnODADATIALI 1GRA ACORD 25 (2001/08) CERTPROS.FP5