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PL-16-2594Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-267621 Permit Number: PL -9-16-2594 Scheduled Inspection Date: December 21, 2016 Inspector: Hernandez, Rafael Owner: COBAS, SEBASTIAN & BARBARA Job Address: 821 NE 99 Street Miami Shores, FL 33138 - Project: <NONE> Contractor: BEST PLUMBING SERVICES COMPANY Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition/Alteration Phone Number (305)814-8808 Parcel Number 1132060340110 Phone: (305)558-8544 Building Department Comments REPLACEMENT OF KITCHEN SINK ,DISHWASHER AND ICE LINE BOX Infractio Passed Comments INSPECTOR COMMENTS False Passed [xf Failed Correction Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. Inspector Comments Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE ' Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit Parcel Number Permit NO. PL -9-16-2594 Permit Type: Plumbing - Residential Work Classification: Addition/Alteration Permit Status: APPROVED Issue Date. 9/23/2016 Expiration: 03/22!2017 Applicant 821 NE 99 Street Miami Shores, FL 33138- 1132060340110 Block: Lot: SEBASTIAN & BARBARA COBA Owner Information Address Phone Cell SEBASTIAN & BARBARA COBAS 821 NE 99 Street MIAMI SHORES FL 33138-2566 (305)814-8808 821 NE 99 Street MIAMI SHORES FL 33138-2566 Contractor(s) Phone CeII Phone BEST PLUMBING SERVICES COMPAP (305)558-8544 Valuation: Total Sq Feet: $ 700.00 0 Type of Work: REPLACEMENT OF KITCHEN SINK ,DISHWA Type of Piping: Additional Info: REPLACEMENT OF KITCHEN SINK ,DISHWA Bond Return : Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee s Technology Fee Total: Amount $0.60 $2.00 $2.00 $0.20 $100.00 $3.00 $0.80 $108.60 Pay Date Pay Type Invoice # PL -9-16-61406 09/20/2016 Credit Card $ 50.00 $ 58.60 09/23/2016 Credit Card $ 58.60 $ 0.00 Amt Paid Amt Due 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 - i that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating constru e, I authorize the above-named_c_ ntractor to do the work stated. er / Applicant /( Contractor / J Agent Building Department Copy September 23, 2016 Date September 23, 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 .PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS JOB ADDRESS: 821 NE 99TH STREET City: Master Permit No. Sub Permit No. SEP 2 0016 aue. FBC 20i`t4-11" t (0 -1444 PL -9-u6 -2-594 ❑ REVISION ❑ EXTENSION ❑ CHANGE OF CONTRACTOR ❑ RENEWAL ❑ CANCELLATION ❑ SHOP DRAWINGS Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes Occupancy Type: RES Load: Construction Type: Flood Zone: NO BFE: OWNER: Name (Fee Simple Titleholder): BARBARA & SEBASTIAN COBAS Address:821 NE 99TH STREET NO X FFE: Phone#:7864691003 City: MIAMI SHORES State: FL Zip: 33138 Tenant/Lessee Name: N/A Email: BARBARACOBASI@GMAIL.COM Phone#: N/A CONTRACTOR: Company Name: /5 eS4 ! (� %3'► L /4 cast' f eS C9 Address: ZS `� ( City: / / ` GGI Stale: r(... • Qualifier Name: Lf45�P % �/ , if eZ. State Certification or Registration #: C/Cc/ c/ /'.3 z_., Certificate of Competency #: Phone#:305' 551-85* Zip: 3,3/3 Phone#: .3oK —55 0-esq 1 DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ -7 0° •JTh Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration Description of Work: kepA 09`11, elA Ratko' /lir 4°)(' ❑ New Repair/Replace ❑ Demolition a( /C%ytcieGl �i' k/ is4.t/e,5A e.r h ) Specify color of color thru_tile: Q Submittal Fee $ '3O Uel + Permit Fee $ /Dt5 ' CCF $ C) , 60 Scanning Fee $'- _ Radon Fee $ 2 • CA DBPR $ 2 - 00 Technology Fee $ 0 SO Training/Education Fee $ 0 • ZV Structural Reviews $ (Revised02/24/2014) CO/CC $ Notary $ 0 Double Fee $ 5 Bond $ 9 TOTAL FEE NOW DUE $ 58 '6 0 Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) QUICKEN LOANS Mortgage Lender's Address 1050 WOODWARD AVE City DETROIT State MI 448226 Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature OWNER or AGENT The foregoing instru ent was acknowledged before me this 3v day of �U$t , 20 ) ll' , by JR4 (.bcIs , who ' ersonally known o me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign Print: —Sea!: I Q,lG il�.c, J O , * APPROVED BY (Revised02/24/2014) AOMANA NUNO Notary Public - State of Florida Commission r FF 9B51118 *°�4N Notary Assn. ovum Signature CONTRACTOR The foregoing instrument was acknowledgedwlbefore me this day of `jC!4"00/�b2-i ,20 1 (r ,by YOSQ�h Pod i 1 �l who is personally known to me or who has produced lN- L. R 36c) identification and who did take an oath. NOTARY PUBLIC: Sign: /n1 Print J-4 1' yCt J.. — 1un�,. Seal: ,•,`�'";'"MARIA VIN, z. ;�� ' My Comm. Expires May 17. 2020 � '' ''' Bonded through National Notary Assn ******************** *************** Notary Public - State of Florida Commission #t FF 958005 Plans Examiner Zoning Structural Review Clerk DEC/19/2016/MON 02:38 PM FAX No, 3056889362 P, 001/001 t;ifticogitr CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDiYYYY) 12/19/2016 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 pollcy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on Ms certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Proper Insurance Agency 471 E 49th St Hialeah FL 33013 CACT MA NAME; RIA A RAMOS PHONE WC, No, EMI. 305-681.1645 FAX No; 305-688-9362 E-MAILoSS• eroj3erinscgmail.com INSURER(S) AFFORDING COVERAGE NAIL 0 INSURER A: WESCO INSURANCE COMPANY 01913 INSURED BEST PLUMBING SERVICES CORP 251 EAST 44TH STREET HIALEAH FL 33013 rnVKUnr_cc ......�..................__ INSURER B INSURER C: INSURERD: INSURER E : INSURER F : REVISION NUMBER; 1THE INDICATED. NOTWITHSTANDING ANY IREQUIREMENT, TERM OR CONDNtLI ITION OF ANY CONTRACT OR OTHER DOCUMENT VVITH REHAV t I ED TO THE INSURED NAMED ABOVEOR SPECT TOLICY IOD VVHICH RTHIIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDFTIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUER EXP POLICY EFF LTR TYPE OF INSURANCE POLICY NUMBER (MM/DDIYY ) (MM/DD A 1 COMMERCIAL GENERAL LIARIUTY 1 CLAIMS -MADE .. . OCCUR H GEN'L AGGREGATE LIMIT APPLIES PER: POLICY f jE O. 0 LOC OTHER: AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY_ AUTOS HIRED NON -OWNED AUTOS ONLY — AUTOS ONLY UMBRELLA LIAR EXCESS Las OCCUR CLAIMS -MADE DED 1 1 RETENT ON $ WORKERS COMPENSATION AND EMPLOYERS'UAOIUTY ANYPROPRIE TOR/PARTNER/EXECUTIVE OfFICERmaDARER EXCLUDED? (Mandatory In NH) If yea describe under DESCRIPTION OF OPERATIONS below u u LJ WPP1425853.01 POLICY) 12/07/2016 12/07/2017 LIMITS EACH OCCURRENCE PESESOaEc RMI(Eoc nog $ 1,000,000 $ 100,000 MED EXP (Any one person) $ 10,000 PERSONAL. & ADV INJURY )1.000,000 GENERAL AGGREGATE PRODUCTS - COMP/OP AGO $ 2,000,000 $ 2,000,000 COMbINEL7 SINGLE LIMIT (Ea accldant) E sODiLY INJURY (Per person) f BODILY INJURY (Per accident) PROPERTY DAMAGE (Par socldAnt) $ 0 1� EACH OCCURRENCE S AGGREGATE 0 N/A ISTATUTE I a E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE S U U EL. DISEASE -POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule. may be attached if more space Is required) PLUMBING SERVICES. RESIDENTIAL AND COMMERCIAL. LICENSE# CFC 1426732 CERTIFICATE HOLDER s CANCELLATION MIAMI SHORES VILLAGE BUILDING DEPARTMENT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 ACORD 25 (2016/03) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTNQRIZED REPRESENTATIVE ORATION All rights ACORD CO res erved. The ACORD name and logo are registered marks of ACORD Produced using Forms Boss Web Software, www.FormeSoee.com (c) Impressive Publishing 900.208.1877