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PLC-15-1461q-)qq? Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-236831 Permit Number: PLC -6-15-1461 Scheduled Inspection Date: August 20, 2015 Inspector: Diaz, Osvaldo Owner: , BARRY UNIVERSITY Job Address: 11300 NE 2 Avenue Wiegand & Annex Miami Shores, FL 33138-0000 Project: BARRY UNIVERSITY Permit Type: Plumbing - Commercial Inspection Type: Final Work Classification: Addition/Alteration Contractor: HORIZON PLUMBING & MECHANICAL CONTRACTORS INC Phone Number Parcel Number 1121360010160-09 Phone: (305)592-6389 Building Department Comments BATHROOM AND CLASSROOM RENOVATION Infractio Passed Comments INSPECTOR COMMENTS False Passed /Inspector Comments Failed Correction Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. August 19, 2015 For Inspections please call: (305)762-4949 Page 10 of 41 t Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit Issue Date: 61 Permit NO. PLC -6-15-1461 Permit Type: Plumbing - Commercial Work Classification: Addition/Alteration Permit Status: APPROVED /2015 Expiration: 12115/2015 Parcel Number Applicant 11300 NE 2 Avenue Number: Wiegand & Ant 1121360010160-09 Miami Shores, FL 33138-0000 Block: Lot: BARRY UNIVERSITY INC Owner Information Address 11300 NE 2 Avenue MIAMI SHORES FL 33161-6628 11300 NE 2 Avenue MIAMI SHORES FL 33161-6628 Phone Cell Contractor(s) Phone HORIZON PLUMBING & MECHANICAL (305)592-6389 Cell Phone Valuation: Total Sq Feet: $ 64,000.00 1010 Type of Work: BATHROOM AND CLASSROOM RENOVATION Type of Piping: Additional Info: Classification: Residential Scanning: 3 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $38.40 $28.80 $28.80 $12.80 $1,920.00 $9.00 $51.20 $2,089.00 Pay Date Invoice # 06/15/2015 06/18/2015 Pay Type PLC -6-15-55973 Check #: 58965 Check #: 59058 Amt Paid Amt Due $ 50.00 $ 2,039.00 $ 2,039.00 $ 0.00 Available Inspections: Inspection Type: Top Out Re Pipe Main Drain Heater Water Service Final Water Main Lavatory 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 t e for goi . i f•' mation is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,huJ th a • •��-namedcontractorto do the work stated. June 18,2015 Authorized Signature: Owne Building Department Copy Contractor / Agent Date June 18, 2015 1 BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC PLUMBING El MECHANICAL 0PUBLIC WORKS JOB ADDRES 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 RECEIVED JUN, T 5 2015 FBC 20/0 C C( Master Permit No. - -f i �►/Gq2- Sub Permit No. fie /5 / %'d/ ❑ ROOFING ❑ REVISION ❑ EXTENSION 0RENEWAL City: ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS N SAO 4/ Miami Dade Zip: Miami Shores County: Folio/Parcel#: Is the Building Historically Designated: Yes Occupancy Type: Load: Construction Type: Flood Zone: D y� 1/ Phone#: OWNER: Name (Fee Simple Titleholder): �tYr(� , 11� �1 S� lt BFE: NO FFE: Address: 1 W 1.)-e City: 11 r i S 0 et • State: V L Tenant/Lessee Name: Phone#: Email: Zip: Zi(() 1 1 M tcrICAn t ca 1 � CONTRACTOR: {C�ompany Name:-\-1O1�-i�ON �Unnbin JO f URtrQctars,I crone#\305-592 c q Address: 'O 8�-i ax) ibg+h e+ Un tt Zip: <33/5-• Phone#: 365- 592- (038G City: p► i s iiv i State: FL - Qualifier L Qualifier Name:'.ob-ert L. Chaplin State Certification or Registration #: /Cc lav (p 'IQ Z DESIGNER: Architect/Engineer: /ft nXII Address: i� • i / Value of Work for this Permit: $ Type of Work: ❑ Addition Description of Work:- / ZA8,89/1/ IX Alteration ,4J1a�/.9,�J Certificate of Competency #: Phone#7� )417 •�� 65 . State: L Zip: Vi33 iG City: /ifht /' 1 OD • 00 Square/Linear Footage of Work: /,'/D Er El Re aid/Replace [Demolition Specify color of color thru tile: Submittal Fee $ 50,6 QI Scanning Fee $ Technology Fee $ Structural Reviews $ (Revised02/24/2014) Permit Fee $ J Ci 20• 14* CCF $ CO/CC $ Radon Fee $ DBPR $ Notary $ Training/Education Fee $ Double Fee $ Bond $ TOTAL FEE NOW DUE$ 2,O3 1 00 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 LosaavAaoluSto() OWNER or AGENT The foregoing instrument was acknowledged before mg this / �9 day of a , 20 ik26-00-"a, w Is personally known o me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Signature The foregoing instrument was acknowledged before me this , by / 9 day of 770.1 Q' , 20 / , by (RO p fT (v� 1, who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: ��� ‘N \R\I STARD/t zom'R,. to • ▪ • x ...• :#_ ▪ • St,� �1FFn0337 ,a $ Q ******************************** i_''DRi 1s- ;\***********s*******.********s*************sr****s*****ss** iiiiii11111110 APPROVED BY i6 /(°%_ Plans Examiner Zoning Sign: Print: Seal: Johanna f f tela as Y ".Vef Notary Public State of Florida • .,o anna idalgo '� • My Commission EE 836660 "4'or . Expires 7iNU6/2016 (Revised02/24/2014) Structural Review Clerk • Local Business Tax Receipt Miami—Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 1519389 BUSINESS NAME/LOCATION RECEIPT NO. HORIZON PLUMBING & MECHANICAL CONTRACTO®NEWAL .10871 SW 188 ST 1 1519389 MIAMI FL 33157 LBT EXPIRES SEPTEMBER 30, 2015 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS HORIZON PLUMBING & MECH CNTR INC 196 PLUMBING CONTRACTOR Worker(s) 10 CFC056992 PAYMENT RECEIVED BY TAX COLLECTOR $75.00 07/28/2014 CREDITCARD-14-030157 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 comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT NO. above must be displayed on all commercial vehicles - Miami -Dade Code Sec 8a-276. For more information, visit www.miamidade.gov/taxcollector STATE -OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD LICENSE NUMBER The PLUMBING CONTRACTOR Named below IS CERTIFIED Under the provisions•of Chapter 489 FS. Expiration date: AUG -31, 2016 CHAPLIN, ROBERT L - — _^ HORIZON PLUMBING &•MECHANICAL CONTRACTORS.INC . 5220SW114CT - _ - 'Z.-. • — - MIAMI - FL 33165 ti. • 1 a �. ISSUED: 08/03/2014 DISPLAY AS REQUIRED BY LAW SEQ # L1408030003214 L a 8 S #JV ASO o CERTIFICATE OF LIABILITY INSURANCE DATE Y)6Aois 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 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 Frank H. Furman, Inc. 1314 East Atlantic Blvd. P. 0. Box 1927 Pompano Beach FL 33061 CONTACT Sharon R. Myers, AAI, CRIS P_- No. Est): (954) 943-5050 FAX No): (954)942-6310 E-MAIL ADDRESS: sharonm@furmaninsurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA:Starr Surplus Lines Ins Co 13604 INSURED Horizon Plumbing & Mechanical Contractors, Inc 10871 SW 188th Street Suite #1 Miami FL 33157 INSURER B:National Trust Ins Co 20141 INsuRERcCommerce & Industry Insurance 19410 INSURERD:FCCI Insurance Co 10178 INSURERE: $ 50,000 INSURER F : AGES CERTIFICATE NUMBER:2015 Master w/o end# 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 INSR SUBR WVD POLICY NUMBER POLICY EFF (MMIDD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY SLPGGL0241001 4/1/2015 4/1/2016 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 50,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE —1 POLICY LIMIT APPLIES PER: X .78 --LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS - _ SCHEDULED AUTOS NON -OWNED AUTOS CA0018288 4/1/2015 4/1/2016 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident ) $ PROPERTY DAMAGE (Per accident) $ PIP -Basic $ 10,000 C X UMBRELLA LIAB EXCESS LIAB X _ OCCUR CLAIMS -MADE 8E044158353 4/1/2015 4/1/2016 EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 DED X RETENTION$ 10,000 $ D WORKERS COMPENSATION,WC AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEM ER EXCLUDED? (MandatoryE.L. If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N N / A 001WC15A66548 4/1/2015 4/1/2016 STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ 500 , 000 DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500,000 D Inland Marine Contractors Equipment CM000679601 4/1/2015 4/1/2016 Leased&Rented $100,000 Deductible $1,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Plumbing Contractor CFC056992 CERTIFICATE HOLDER CANCELLATION Miami Shores Village building Department 10050 NE 2nd Ave Miami Shores, FL 33138 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 Dirk DeJong/SR ACORD 25 (2010/05) INS025 /2ntnnsi (11 © 1988-2010 ACORD CORPORATION. All rights reserved. Tho ArflP l n,mo .nri Innn oro ronicfororl morlrc of ArflRrl