PLC-15-456Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-230362 Permit Number: PLC -3-15-456
Scheduled Inspection Date: March 17, 2015 Permit Type: Plumbing - Commercial
Inspector: Diaz, Osvaldo
Owner: PROPERTIES LLC, SHORE SQUARE
Job Address: 9007-9029 BISCAYNE Boulevard 9007
Miami Shores, FL 33138 -
Project: <NONE>
Inspection Type: R
Work Classification: Addition % ration
r7 r
rte,_
Phone Number (305)!f9-8040
Parcel Number 1132060110070
Contractor: MAXIMUM PLUMBING INC Phone: (954)943-7575
comments
REPLACE 1" BACK FLOW PREVENTER.
INSPECTOR COMMENTS False
nspector Comments
Passed
Failed
Correction
Needed '
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
March 16, 2015 For Inspections please call: (305)762-4949
Page 32 of 38
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A
.Me.tjun Soci ' e - ty of Saniwy Er gineering
Backfiow Ass bmbkv Field Test Report
Vate ofTest S 13- kC,
/"'U,ST0MER
COINTACT PERSON:
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OF ASSBENOLYTaSTFMPun D&L CT�J, FVB 0 SIZE:
SPA: I kL 4
RIFACrURER: _1A) (va., A-
A TER METER 9: 1q2_ 10 INLET LICE PRESSURE: psi
CHECK VALVE
RELIEF VALVE
CIUSCK VALVE 2
PRESSURE VACUUM
CAUBRATION DATE:
—CALIBRATEDBYz.,
BREAKER
f7l
AirInletoponed
ieaked
Opened —psi
leaked
A/l osed tight
did not op --n
closed tight
At psi
C3 did not open
pressure loss across check
prewum loss acToss che'mk
Check Valve-,
,/alve L� 0 psi
vahre "9
0 leaked
held at, psi
1-7 cleaned only
cleaned only
clewed only
cleaned on!v
E]
0 Mlac',-d (HSI below,�3
(list below):
replaced (list below):
R-Ei ES1.1T RESULTS
RETEST RESULTS
—RMISST RESULTS
RESTEST RESULTS
pressure loss across check
Opened at Psi
Pressure to across check q
Air inlet psi
valve psi
Valve P;i
Chk valve Fal f
REMARKS
3 PSI DIFFERENCE BETWEEN RELIEF VALVE. OPENUqG
POT -W. AND FRES UTE LOSS ,,.CROSS CHECK VALVF -1 1
<AASSED
FAILED
REPAIRDATE.
TEST EQUIP h4b-I,,T USED i^'� kC
CAUBRATION DATE:
—CALIBRATEDBYz.,
PRITNT TESTER NAM,,
SIGNATURE,
T�_
CERTIFICATION .4 EXPMES:
CERTIFYrN'G AGENCY
Q� American Society of Sanitary E4nverinj, 2000
BUILDING
PERMIT APPLICATION
Miami Shores Village
wilding Department
1 1050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
❑BUILDING ❑ ELECTRIC ROOFING
N
M
l
FBC 20 JO (� r
Master Permit No?LC�-J
" `'110
Sub Permit No.
❑ REVISION ❑ EXTENSION RENEWAL
�LUMBING ❑ MECHANICAL [ ] PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: g o o t S Ctt,y v\.v 6 Vvk
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#:-____A_ Is the Building Historically Designated: Yes NO
Occupancy Type: Load: /Construction Type: Flood Zone: y BFE: FFE:
OWNER: Name (Fee Simple Titleholder):_ _? , o y a vy'1 i..- LL Phone#:
Address:
City: _ 1 �1 %Y� \ 41� n 1 State: Zip:
Tenant/Lessee Name: _ Phone#:
Email:
CONTRACTOR: Company Name: 1a0"x ► yY1yyy\, Q 1 ury\,� t y\A Ty-\ e Phone#: "ISH —0) (3 "-3'
Address: 6 Li \`ter N W o1 L4 St SA -e- )) �
City: M.00h —01 o'State: V I^ Zip: �3 l7 (p
Qualifier Name: \)OQ�Ao"& ch p t yea Phone#:
State Certification or Registration #: CFC- I �A \ Certificate of Competency #:
DESIGNER: Architect/Engineer:
hone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 1) o o ` Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ , Alt ;ration ❑ New C&Repair/Replace ❑ Demolition
Description of Work: a c �Q I �p G� G c4 l o t. yi re y p
Specify color of color thru the
Submittal Fee Perr ; Fee $
Scanning Fee $
Technology Fee $
Structural Reviews $
(Revised02/24/2014)
Rad(_ i Fee $
raining/Education Fee $
CCF $.
DBPR $
CO/CC $ _Y_
. Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ _
Bonding Company's Name (if applicable)
Bonding Company's Address
City
Stat -
Mortgage Lender's Name (if applicable)
Zip
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, AIF 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 an,' zoning.
"WARNING TO OWNER: YO',JR 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 rotice 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 YD (4 q 1z. a- it,
OWNER or AGEN F
The foregoing instrument was acknowledged before me this
day of, f��r 20 l S . by
yo
�L�.,-YLLi who personally known to
me or who has produced (S h_s
identification and w o i t an th.
NOTARY PUBLIC:
i//
Sign: $ Ay
Print:- I;') '.;1 ''1-I-�-I*rf d
Signature
CONTRA R
The foregoing instrument was acknowledged before me this
day of 4.fp fJ 20 ) < by
LI) � 4 ko-s 'So Alt Jwho i personally known
me or who has produced —as
identification and who did take an oath.
��Z" NOTARY PUBLIC:
Seal:
Print:
Seal
YP
SILVIA FERNANDEZ
* MY COWPSION_ #
Nf��larc182017 �OF naP`O~ hooded TMu 8u'9t Notary , 8201M
APPROVED BY -lam Plans Examiner
Structural Review
(Revised02/24/2014)
��+��""�`''•., LAURA RICCETTO
Notary Public - State of Florida
3 �= My Comm. Expires Jul 15, 2018
Commission #E FF 142227
Zoning
Clerk
Detail by Entity Name
r
Florida Limited Liability Company
SHORE SQUARE PROPERTIES, LLC
Filing Information
Document Number
FEI/EIN Number
Date Filed
State
Status
Effective Date
Principal Address
696 NE 125TH STREET
NORTH MIAMI, FL 33161
Mailing Address
696 NE 125TH STREET
NORTH MIAMI, FL 33161
L11000075982
452672348
06/30/2011
FL
ACTIVE
06/28/2011
Registered Agent Name & Address
Reyes, Daisy
696 NE 125TH STREET
NORTH MIAMI, FL 33161
Name Changed: 03/20/2014
Authorized Person(s) Detail
Name & Address
Title MGR
IZHAK Y{ AM:
696 NE 125TH STREET
NORTH MIAMI, FL 33161
Title MGR
LIPTON, ALAN
649 OCEAN BLVD
GOLDEN BEACH, FL 33160
Annual Reports
Page 1 of 2
http://search. sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 3/3/2015
Detail by Entity Name
I
Report Year
Filed Date
2012
03/29/2012
2013
04/04/2013
2014
03/20/2014
Document Images
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03/2012014 ANNUAL REPORT View image in PDF forma—t---]
04/04/2013 ANNUAL REPORT View image in PDF format
03129/2012 --ANNUAL REPORT F view image in PDF format
06/30/2011 -- Florida Limited Liability I View image in PDF format
LaU•E'1[ ht and Fria a,,LPoHde,,
State of Florida, Department of State
http://search.sunbiz.org/lnquiry/CorporationSearchISearchResultDetail?inquitytype=Entity... 3/3/2015
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL I EGULATION
CONSTRUCTION INDUSTRY LICENSING SOARD
1940 NORTH MONROE STREET
TALLAHASSEE FL 32399-0783
TAPLING, DOUGLAS CRAIG JR
MAXIMUM PLUMBING INC
5415 NW 24 ST
SUITE #102
MARGATE FL 33063
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 I 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
x k STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND
PROFESSIONAL R:EGU_ATION
CFC1427180 ISSUED: 06/18/2014
CERTIFIED PLUMBING CONTRACTOR
TAPLING3, DOUGLAS CRAIG JFt'
MAXIMUM PLUM0IN1QJNC
IS CERTIFIED under the provisions of Ch.489 FS.
Expiration date AUG 31_. 2016 L1406160001137
08
KEN LAWSON, SECRE ARY
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD
The PLUMBING CONTRACTOR
Named below IS CERTIFIED
Under the provisions of Chapter 489 FS.
Expiration date: AUG 31, 2016
TAPLING, DOUGLAS CRAIG. JR
MAXIMUM PLUMBING INC
5415 NW 24 ST
SUITE #102
MARGATE FL 33063
ISSUED 06/18/2014
Rini
SEQ # L140618nnn1t'17
BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT
115S. Andrews Ave_ Rm. A-100, Ft. Lauderdale, FL 33301..1895-954-831-4000
VALID OCTOBER 1, 2014 THROUGH SEPTEMBER 30, 2015
DBA: Receipt #:182 -14 94
Business Name: MAXIMUM PLUMBING INC PLUMBING/LWN SPRNKL/CONTRACTOR
Business Type: (PLUMBING CONTR)
Owner Name: MAXIMUM PLUMBING INC Business Opened: 10/01/2006
Business Location: 5415 NW 2411H STREET STE #102 State/County/Cert/Reg:CFC1427180
MARGATE Exemption Code:
Business Phone: 9S4-943-7575
Rooms Seats Employees
Machines Professionals
8
Number of Machines For Vending Business Only
Vending Type:
Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost
Total Paid
27.00 0.00 0.00
0.00 1 0.00 1 0.00 27.00
THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS
THIS BECOMES A TAX RECEIPT' This tax is levied for the privilege of doing business within Broward County and is
non -regulatory in nature. You must meet all County and/or Municipality planning
WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when
the business is sold, business name has changed or you have moved the
business location. This receipt does not indicate that the business is legal or that
it is in compliance with State or local laws and regulations.
Mailing Address:
MAXIMUM PLUMBING INC
5415 NW 24TH STREET STE #102
MARGATE, FL 33063
2014 - 2015
Receipt #2CP-13-00000641
Paid. 07/08/2014 27.00
07/07/2014 Effective Date
ACRO CERTIFI(;ATE OF LIABILITY INSURANCEF3/3/2015
DATE(MM1DplYYYY)
THIS CERTIFICATE 15 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: M the certificate holder Is an ADDITIONAL INSURED, the PdiCY(les) must be andorsed. If SUBROGATION IS WAIVED, sutyett to
the terms and conditions of the Polley, certain policies IMAM require an andorselnant. A statement On this certificate does not corder rights to the
oertlfleste holder In Ileu of such endorsernential_
PRODUCER
T,ianne Sawyer
Fr&nklin Street insurance Servicae E(954) 513.-3180 PAx
500 N Noatshora 131vd (9-54) 1410-1101
Suite 750 Ls aline .Sawyer@FrarlklinSt . spa
Tampa FL 33609 INSURE 8 AFFORDING COVHtAGE NMC r
ar"90 INSURERA WO11100 InsuranCO Company,
Maximum Plumbing, inc. x(sums-Florida CitVuB Business r,
5415 NDP 24th St INSURER C:
Ste 102 INSURER 0:
R
Margate FL 33063 IN '
COVE RAGE$ RER F
CERTIFICATE NIl1ARFR.CL1 Al n90AAAQQ
-
Mr-VWIVN NUMULK:
THIS IST
0 CERTIFY THAT THE POLICIES OF INSJRANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREN'ENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIn. TH12 INSURANCE AFFORDED BY THE POLICIES DESCRISED HEREIN IS SUBJECT TO ALL THE TERM;,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDU CED BY PAID CLAIMS.
NSR
LTR TYPE or FNsuRANCE POucr NUNKR POLICYNUN FXPT6
GENERAL UABUM
ii COMMERCIAL, 4EHIcRAL LIABILI'{Y
EACH OCCURRENCE 311000,00
A CLAIMS -MADE$ 100,00
X OCCUR 1701232 01 /1/2014 /1/2015 MED EXP oft oerson S 5100
PERSONALS AOV INJURY $ 1,000,00
GENERAL AGGREGATE f 2.000,0-0
SEN I AGGREGATE LIMIT APPLIES PER:
F-1 - --
UC
PROOYr. - COMPlOP AGG- 1 $ 2,000,00
DESCRIPTION OF OPEItATWf161 LOCATIONS I VEHICLES (Alpofi ACORD 101, AAdManal Raapfw Sct,,W e, It more {pees is ;;w—)
Contractor License # CFC1427180
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City Of Miami Shores ACCOROANCE WITH THE POLICY PROVISIONS,
10050 NE 2nd Avenue
Miami Shorea, FL 33138 Aun+ORUDREPREsENrATaE
Ryan Cassidy/LYS =._ . _ .......- -
_.�- -
ACORD ni i nf rvj 05)
iN3626r4)1988-2010 ACORD CORPORATION. All rights reserved.
Tha 1( ARn name ftnrr Inn^ am rftnlafaearf markQ r f Ar:ADf1
l d U80000089'0N/9ti:6 1S/Lti 6 9M 8 H N IAD JNIONOld NANIM NOdd
AMONOe1LE LIABILITY
A
X ANY AUTO
fER ML— 1 000
BODILY INJURY (Pp person) S
AAIJT0S OWNED O ULrD
V110123201
/1/2014
/1/2015
L- KRMRY (Per accldet>V E
NON -OWNED
HIREDAUTOS ASS
P ERT- DAMAGE S
X Coll Dad $1.000 X Comp Ded$1.000
UMBRELLA LIAa
Uninewed Motomt $ 1 000
OC.Cl1R
PJCCE55 LIAR CLAIYS44AI'>F
EACH OCCURRENCE $
AGGREGATE
S
RETENTION
$
R
wORFMR5 COMPENSA'nom
AND EYPLGYERV LU1BILr1Y
ANY PROPRIETOR/PARTnIEq/eXECUnVE Y I N
X rATU- DTH
E.L EACH ACCIDENT S 1,000
01�1`110ERIMEMBER EXCLLOEOP TjN
(Maindatery in m)
/ A
10130103
/1/2014
E.L DISEASE - EA EMPLOYE $ 1 000
Itye�, dein b9 WNW
DESCR1Pf10N OF OPERATIONS
/1/2015
EL DISEASE. POLICY LIMIT I S 1 . 000
below
DESCRIPTION OF OPEItATWf161 LOCATIONS I VEHICLES (Alpofi ACORD 101, AAdManal Raapfw Sct,,W e, It more {pees is ;;w—)
Contractor License # CFC1427180
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City Of Miami Shores ACCOROANCE WITH THE POLICY PROVISIONS,
10050 NE 2nd Avenue
Miami Shorea, FL 33138 Aun+ORUDREPREsENrATaE
Ryan Cassidy/LYS =._ . _ .......- -
_.�- -
ACORD ni i nf rvj 05)
iN3626r4)1988-2010 ACORD CORPORATION. All rights reserved.
Tha 1( ARn name ftnrr Inn^ am rftnlafaearf markQ r f Ar:ADf1
l d U80000089'0N/9ti:6 1S/Lti 6 9M 8 H N IAD JNIONOld NANIM NOdd