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PL-16-2715Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 I (.-Zo3o Inspection Number: INSP-269397 Permit Number: PL -10-16-2715 Scheduled Inspection Date: October 24, 2016 Inspector: Hernandez, Rafael Owner: BOEHNE, PATRICIA Job Address: 55 NE 94 Street Miami Shores, FL 33138 - Project: <NONE> Contractor: NORTHWEST PLUMBING INC Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Gas Phone Number (202)262-2500 Parcel Number 1132060130560 Phone: (786)586-5203 Building Department Comments PERMIT REQUEST FOR GAS VENT PER THE INSPECTORS REQUEST Infractio Passed Comments INSPECTOR COMMENTS False Passed 07i Failed Correction Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP-268393. CANCELLED BY ROGER FROM NORTH WEST PLUMBING 10' Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 30 Inspection Number: INSP-269604 Permit Number: PL -10-16-2715 Scheduled Inspection Date: October 25, 2016 Inspector: Hernandez, Rafael Owner: BOEHNE, PATRICIA Job Address: 55 NE 94 Street Miami Shores, FL 33138 - Project <NONE> Contractor: NORTHWEST PLUMBING INC Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Gas Phone Number (202)262-2500 Parcel Number 1132060130560 Phone: (786)586-5203 Building Department Comments PERMIT REQUEST FOR GAS VENT PER THE INSPECTORS REQUEST Infractio Passed Comments INSPECTOR COMMENTS True Passed Failed Correction Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP-269397. CREATED AS REINSPECTION FOR INSP-268393. CANCELLED BY ROGER FROM NORTH WEST PLUMBING Vent only Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit Permit NO. PL -10-16-2715 Permit Type: Plumbing - Residential Work Classification: Gas Permit Status: APPROVED Issue Date: 10/19/2016 Expiration: 04/17/2017 Parcel Number Applicant 55 NE 94 Street Miami Shores, FL 33138- 1132060130560 Block: Lot: PATRICIA BOEHNE Owner Information Address Phone CeII PATRICIA BOEHNE 55 NE 94 Street MIAMI SHORES FL 33138- (202)262-2500 Contractor(s) NORTHWEST PLUMBING INC Phone CeII Phone (786)586-5203 (305)986-1157 Valuation: Total Sq Feet: $ 300.00 0 Type of Work: PERMIT REQUEST FOR GAS VENT PER THE Type of Piping: • Additional Info: PERMIT REQUEST FOR GAS VENT PER THE Bond Return : YES Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $0.60 $2.00 $2.00 $0.20 $100.00 $3.00 $0.80 $108.60 a r` LT- C ? In consideration of th pertaining thereto accepting: this required for E OWNERS construct suance to trict confor sume resp , PLUMBI an in t I a RICA Pay Date Pay Type Invoice # PL -10-16-61565 10/19/2016 Credit Card 10/04/2016 Credit Card Amt Paid Amt Due $ 58.60 $ 50.00 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Final Press Test Review Plumbing thermit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In 11 work done by either myself, my agent, servants, or employes. I understand that separate permits are HANI SAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. FFIrAVIT: certify an zonin;. t -- 4 foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating or e the above-named contractor to do the work stated. Builci,ng Depa Octobl r 19, 2016 October 19, 2016 n , Appli -nt / Contractor / Agent Date ent Copy 1 Miami Shores Village 0\) p Building Department BUILDING PERMIT APPLICATION 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 '5-1-4-1 FBC 2O1( -I �� Master Permit No. �'l• ( (p -2030 Sub Permit No. P 1 ( "ZR- 15 • ❑BUIL 9ING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL OCT 042016 PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP �[ CONTRACTOR DRAWINGS JOB ADDRESS: ��1\1 JE 74th City: Miami Shores County: Miami Dade Zip: 5' 1 •3 1 Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): �/STr i'^ � t'! N i Phone#: Address: —4—C ist I.E. (1.4* 6 -Vo T- aw: 64-16f if 4j State: l ) 06— Tenant/Lessee Name: Phone#: Email: ��/ 'M�INI,� .14‘J Phone#:g CONTRACTOR: Company Name:No-iT Address: City.. .- /y Qualifier Name: :1714-% 4 State:11:0..CPA Zip: 3-5 t PhoneOW 6 42123 State Certification or Registration #:�"-+G 14241-4" Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ Type of Work: ❑ Addition Description of Work: ❑ Alteration Square/Linear Footage of Work: ❑ New ❑ Repair/Replace n Demolition Specify color` f color thr:'u ... A 1 petlgY � 1ry y, y Submittal Fee $ 5e) Permit Fee $ /6 D CCF $ . 00 Scanning Fee $ Radon Fee $ 2 . Technology Fee $ ' O O Training/Education Fee $ s Z CO/CC $ `�— DBPR $ 2 - Notary $ Double Fee $ Structural Reviews $ (Revised02/24/2014) Bond $ TOTAL FEE NOW DUE $ 5S • co 0 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.andcbnstruction 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. Signature64 OWNER or AGENT The foregoing instrument was acknowledged before me this Signature CONTRACTOR The foregoing instrument was acknowledged before me this , by 0/ day of %j , 20 16 , by to {% S/ 7b •j',ag'RJA . , who persornow to js personally known me or who has produced as identification and who did take an oath. NOTARY PU Sign: Print: Seal: 4. 4. sit, �Ar' . Roger A Cabrera My Commission FF 155238 Expires 08/27/2018 APPROVED BY (Revised02/24/2014) me or who has produced as identification and ho did to oath. NOTARY PUBLI �. rl. 3 Print: Seal: to -11-1C Flans Examiner 149+aryPublic State of Fiends . . Rc,,.•,r A Cabrera • ir My C nmm:e::en ff 155. 38 Y • Cr::. ************************************************ Structural Review Zoning Clerk LICENSE CLASS 5.. .OAL 9450 CARIBBEAN BLVD CUTLER BAY. FL 33185-1514 DOB 03-11-1968 SEX Mme, ISSUED 02-01-201' • !EXPB:ES: 83-17- REST 3-17 REST EMDtIRsE- 1 EPLACED- 02 -2: - SAFE DRIVER Operat,nr. •,t a motor vorte is r_.mtrute..-nnsen, to aced sobriety t+..ar •e,,, 009884 Local Business Tax Receipt Miami—Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 6632351 BUSINESS NAME/LOCATION NORTHWEST PLUMBING INC 9450 CARIBEAN BLVD CUTLER BAY FL 33189 OWNER NORTHWEST PLUMBING INC EDUARDO SABINA QUALIFIER Worker(s) 1 RECEIPT NO. RENEWAL 6903125 LBT EXPIRES SEPTEMBER 30, 2017 SEC. TYPE OF BUSINESS 196 PLUMBING CONTRACTOR CFC1428177 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 PAYMENT RECEIVED BY TAX COLLECTOR $45.00 07/21/2016 CHECK21-16-098579 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit, or a certification of the holder's qualifications, to do business. Holder must comp?,. evith any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT NO. above must be displayed on all commercial vehicles - e.: ,:oda Sec 8a-276. For more information, visit www.miamidade.gov/toxcatfe,...,, RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD LICENSE NUMBER CFC1428177 The PLUMBING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2018 SABINA, EDUARDO NORTHWEST PLUMBING INC 9450 CARIBBEAN BLVD CUTLER BAY FL 33189 ISSUED: 07/26/2016 DISPLAY AS REQUIRED BY LAW SEQ # L1607260001151 IiCR 1 IrII.H 1 C Vr LIHDILI 1 T IIIIOU1'CHIV oC 07/26/2016 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(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 this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Emmanuel Insurance & Associates, Inc. 2370 E 8TH AVE HIALEAH FL 330134236 CONTACT Sarai Medina NAME: PONN), (305) 693-0003 FAX, No): (305) 691-4381 E-MAIL )oel emmanuelinsurance.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Wesco Insurance Company A INSURED NORTHWEST PLUMBING, INC. EDUARDO SABINA 9450 Caribbean Blvd Cutler Bay FL 33189-1514 INSURER B : Associated Industries Insurance Company, Inc. INSURER C : WPP1480891-00 INSURER D : 07/22/2017 INSURER E : $ 1,000,000.00 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY WPP1480891-00 07/22/2016 07/22/2017 EACH OCCURRENCE $ 1,000,000.00 CLAMS -MADE X OCCUR PNTED REM SES EaGE TO Eoccurrence) $ 50,000.00 MED EXP (Any one person) $ 5,000.00 PERSONAL &ADV INJURY $ 1,000,000.00 GENERAL AGGREGATE $ 2,000,000.00 GEN'L X AGGREGATE POLICY OTHER: LIMIT APPLIES JECT PRO PER: LOC PRODUCTS - COMP/OP AGG $ 2,000,000.00 $ AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY _ SCHEDULED AUTOS NON -OWNED AUTOS ONLY COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS UAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N Y N/A AWC1065582 05/10/2016 05/10/2017 PER STATUTE OTH- ER E.L. EACH ACCIDENT $ 1,000,000.00 E.L. DISEASE - EA EMPLOYEE $ 1,000,000.00 E.L. DISEASE - POLICY LIMIT $ 1,000,000.00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) COMMERCIAL 10% & RESIDENTIAL 90% Plumbing New, service or Repair. CERTIFICATE HOLDER Miami Shores Village 10050 NE 2nd Avenue Miami Shores, FL 33138 Te1:305 795-2204 Fax 305 756-8972 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved.