CC-13-1818 (2) v\,3Miami Shor es Village
Building Department ,: yd
r? 10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795.2204 Fax:(305)756.8972
INSPECTION'S PHONE NUMBER:(30S)762.4949
ID
FBC 20 lO'
BUILDING Permit No.
PERMIT APPLICATION Master Permit No. L G l 3 —' I'(S'
Permit Type: BUILDING ROOFING
JOB ADDRESS:, 6C7
City: Miami Shores County: Dade Zip:.3313,T
Folio/Parcel#:
Is the Building Historically Designated:Yes O Flood Zone:
OWNER:Name(Fee Simple Titleholder): - Phone#:�IC •7d ld ���
Address: —7 --
City:
city: S state: Zip: a
Tenant/Lessee Name: Phone#:
Email: 1- e v&A
w �
CONTRACTOR:Company Name:1POM .r 6O2-9X62 MA-0JX MA-AXC. Phone#:
Address 2 "-cu '
City: State• Zip:775-3(.2- 4C
Qualifier Name: Phone#:
State Certification or Registration#: 4:26- C9512V Certificate of competency#:
Contact Phone#: I hs ��e'� Z�? Email Address:_Pe[o201rCYn CP �tyc At L- C&"--
DESIGNER:Architect/Engineer: c 0-te, Phone#: d2 —%(f) `ZZ [�
Value of Work for this Permit:$ �'�� Square/Linear Footage of Work:
Type of Work: OAddition DAlteration DNew DRepair/Replace DDemolition
Description of Work:
Color thru tile:
Submittal Fee$ Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$
TOTAL FEE NOW DUE$
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 ELECTRICAL WORK,PLUMBING,SIGNS,
WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS and 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: AIL!�FURE TO RECORD A NOTICE OF
COMMENCEMENT T IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO J 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 h' ccars-sere days after the building permit is issued. In the absence of such posted notice, the
5nspection will no e a e d e' echo fee will be charged.
x` -
Si�na Signature
Owner or Agent a- Contractor
The fore o'ng instrument was acknowledged before me this The foregoing instrument was ackno ged before e this
day of�,2011,by 17 Gl__s� 4 ICefi&. 'df , day of 20 ,by
who' rso ally kno to me or who has produced who' pers na y cno to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Si S'
Prmt: A, Print-
My Commission Expires: q�•�,�� LAuRAawkwam My Commission Exp°t ""-B`'O LAURA BOURNE BURIMTER
* MY COMMISSION I DD ONI MY COMMISSION 8 DO 859461
�. EXPIRES:June 9,2013 EXPIRES:June 9,2813
9r8pp o�``Q Bauled Pvu BWV O V M ��'�� o�``Oe BOrm Tluu Budget Notary Services
$aak+k,kB+R*+�&d8daN&+kk,k,k,k&wddkk $��#Hk,k �+Q,k kk H�kk,kkkkkk9dk,k,k+SERB+B,BdR#B,kik[+ReF#8B8kkklkk,B+d#9,kRk��&Hnk�q&A,k,kkd+k,3k,k&kH,
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
Aug, 29. 2013 8:49AM No. 2175 P. 3
CERTIFICATE OF LIABILITY INSURANCE
DAYE(MMfODKYYV)
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
RI!PRESENTATfVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT; If the certificate holder Is an ADDITIONAL INSURED,the policy(les)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 Border rights to the
Certificate holder In lieu of such endorsement(s).
pRObUCER ALL CITY INSURANCE INC-ACI cAONTACT Javier Gutierrez
275 FONTAINEBLEAU BLVD. PHONE (305)463-9431 PAX
(305)436-6797
SUITE 190 uuarrez(r�allutylns.com
MIAMI FL 33172 Ns E
RA[d
-fN'UMRA:MID-CONTINENT CASUALTY CO
INSURED —
ERBi
PRIORITY CONSTRUCTION MANAGEMENT,INC.
RC-
4631 NW 5 ST
MIAMI FL 33126-
COVERAGES CERTIFICATE NUMBER;06 REVISION NUMBER:01
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.
M TYPE OF INSURANCE ADOL au POLICY EFF CY TIP
LIMITS
A GENSRALLIABIUTY 04GLB83563 06/24/2013 08/2412014 S 1,000,000
T—
X COMMERCIAL GENERAL4A81LITY I DAMAGE TO RENTED 100000
PRFMIqF-quCepc
cLA1MSMADE OCCUR aEW*An one eraon EXCLUDED
PERSONALaADVINJURV 1,000,00�--
GENERAL AGGREGATE 110001000
EN'LA00REGATELIMITAPPLIESPER: li PRODU T - P
X POLICY L $
AUTONCBILE I-UIBILITy COMBINEDSINGLE LIMIT
�d
ANY AUTO BO DI LYINJURY(PerPwaon) s
UTSED SCHEDULED
OWDA
OS BODILY INJURY(Per soddeno SONNEHIREOAU703
_
AUTOS IROPERTYDAMAOE
uAlER6LLALIAO OCCUR I r CURRENCE
EXCESS LIAB lAIM3 MADE
AGGREGATE
RETENTIONS
1VORKERSOOMFENOATION Wl;STA OTH-
MID EMPLOYERS'LIABILITY
ANY PROPRIEYOR/PARTNER/EXECUTNE r
OFRCERRA6MBER EXCLUDED? NIA aL.EACH
(Mandalcry In IIH) _ --
Ir e9,deaC(Me under. D)SEASE-EA EAiPLOYEE
TIAN F OPERATIONS below
EL DISEASE-POLICY LIMIT
DE CRIPTION OP OFERATIONO I LOCATIONS I VEHICLES(Aaaah ACORD lot.Additional Remarks Schedule,If more spxc#li regUlpd)
G NERAL CONTRACTOR
CERTIFICATE HOLDER CANCELLATION Al COMMMQ
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
MIAMI SHORES VILLAGE THE EXPIRATION DATE THEREOF, NOYICE WILL BE DIELIVERED IN
10050 NE 2ND AVE ACCORDANCE WITH THE POLICY PROVISIONS,
MIAMI SHORES FL 33138- AUTHOR1zEDREPRESENrAT1VE
a
O 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 26(2010/05) The ACORD name and logo are registered marks of ACORD
Aug, 29. 2013 8:48AM No. 2175 P. 1
.TEFF ATWATER STATE OF FLORIDA
CHIEF FINANCIAL OFFICER
DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS'COMPENSATION
* ' CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW "
CONSTRUCTION INDUSTRY EXEMPTION
This certifies that the individual listed below has elected to be exempt from Florida Workers'Compensation law.
EFFECTIVE DATE: 8/12/2013 EXPIRATION DATE: 8/12/2016
PERSON: DEARMAS OMAR F
FEIN: 650697045
BUSINESS NAME AND ADDRESS:
PRIORITY CONSTRUCTION MANAGEMENT INC
4631 NW 5 ST
MIAMI FL 33126
SCOPES OF BUSINESS OR TRADE:
LICENSED GENERAL
CONTRACTOR
Pursuant to Chapter 440.05(14),F.S.,an officer of a corporation who elects exemption from this chapter by filing a certificate or election under this section may
not recover benefits or compensation under this chapter.Pursuant to Chapter 440.05(12),F.S.,Cerilficates of elscllon to be exempt,.,apply only wilhin the scope
of the business or trade listed on the notice of election to be exempt.Pursuant to Chapter 440.05(13),F.S..Notices of election to be exempt and certificates of
election to be exempt shall be subject to revocation if,at any time after the filing of the notice or the issuance or the certificate,the person named on the notice or
certificate no longer meets the requirements of this section for issuance of a certificate.The department shall revoke a certificate at any time for failure of the
.person named on the certificate to meet the requirements or this section,
DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 07-12 QUESTIONS?(850)413-1609
1 `` �.���1..•
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Aug, 29. 2013 8:48AM No, 2175 P. 2
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RECORDED 10/16/2013 10952:20
HARVEY CLERK OF
NOTICE OF COMMENCEMENT MIAMI-Y DADERUVINCOUNTYr FLORIDACOURT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIMEOFFIRST INSPECTION LAST PAGE
PERMIT NO.CjLII
TAX FOLIO No.1�37 3
STATE OF FLORIDA:
COUNTY OF MIAMI-DADE:
THE UNDERSIGNED hereby gives notice that Improvements win be made to certain real
property,and In accordance with Chapter 713,Florida Statutes,the following Infomiation
Is provided In this Notice of Commencement
Space above reamed for use of recording offic,
1.Legal description of property and streaVaddress:
2.DeI
3.Owner(s)name and address:
Interest In property:
Name and address of fee simple titleholder: j r,
4.CO,ntractor's name,ad and phon u bar:
5.Surety. 3MY-4:
ent bond required by owner from ontractor,R any)
Name,address and phone number:
Amount of bond
6.Lender's name and address:
7.Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by
Section 713.13(1)(a)7.,Florida Statutes,Name,address and phone number. I
9 F-1 L 3mteris -4..-,C; -e&7-
11; _XrS 44,6111 J&_701�1.M 41,9773
8.In addition to himself,Owners designates the following person(s)to receive a copy of thd Lienor's Motice as provided in Section
713.13(1)(6),Florida Statutes.
Name,address and phone number
9.Expiration date of this Notice of Commencement,
(the expiration date Is 1 year from the date of recording untess a different date Is Specified)
WARNING TO OWNER:ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMIENTARE CONSIDERED
IMPROPER PAYMENTS UNDER CHAPTER 713,PART 1,SECTION 713.13.FLORIDA STATUTES,AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY.A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
FIRST INSPECTION.IF YOUR! . D TO OBTAINTINANCING,CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK
OR RECORDINGTICE O COMMENCEMENT.
Signatu s,df Officer/Director/Partner/Manager
Prepared"BY Prepared By
Print Nqme
Print Name
TMG/Office Title/Office
*STATE OF FLORIDA
COUNTY OF MIAMI-DADE
The foregoing instrument was acknowledged before.me this__LL day of I'J,
BY-
U Individually,or U as for
aPersOnally known,or LJ produced the following type of identificatiom.
Signature of Notary Public:
Print Name: t (410
(SEAL)
VERIFICATION PURSUANT'M SECTION 9211 FLORIDA ITAUM OLGA ALVARADO
jAy COWASSION 0 FF056162
Under penalties of perjury,I declare that I have read the foregoing and WWgtM.S�cqpotxd*w 22,2017
on
that the facts stated In It are true,to the best of my knowledge and belief. 999---Y
Signature(S)Of Owner(s)or Owner(s)'s Authorized Officer/Director/Partner/Manager who signed above.
By By
123.01-S2 PAGES 3/10
A
,T QRF;gp
,ft,COUNTY OF DADS c
F
I HE, IFY that thts Is a Me copy of the CL64W
Idgibw Aw#f ft office,M-day of
nrr .16 2013 A.D.20�
dvlTNr:SS my hand and OffloW Sod.
HJERK,of amuft a CaLoft
32'M"
541�.RES
Miami shores Village
s�
Building Department las
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204 R1VA
Fax: (305)756.8972
Page 1 of 1
Permit No: e C- 13 -1 'Z I
Structural Critique Sheet
�fl� IJ�.Q/W\ BBV►v, Cl rC�,� ��-,� t �l�'�.
mac,.,;, ham• In.
STOPPED REVIEW
Plan review is not complete,when all items above are corrected,we will do a complete plan review.
If any sheets are voided,remove them from the plans and replace with new revised sheets and include one
set of voided sheets in the re-submittal drawings.
Mehdi Asraf
t
5�►oREs G
M iami Shores village
Building Department . „ n�
10050 N.E.2nd Avenue
Miami Shores, Florida 33138 �hMrm So
.���
Tel: (305) 795.2204 LORIpA
Fax: (305) 756.8972
October 25, 2013
Permit No: CC13-1818
Building Critique Review
1. SIGN AND DATE CORRECTION MADE TO DETAIL 6/A-8
2. DETAIL PROVIDE FOR THE NEW CMU WALL SHOWS A STEM WALL ABOVE
THE EXISTING FOUNDATION WITH THE NEW VERTICAL REINFORCEMENT
EMBEDDED A MINIMUM OF 6" INTO THE FOOTING AND THE BLOCK WALL
STARTING ABOVE THE SLAB. PROVIDE DETAIL FOR THE STEM WALL OR
SHOW NEW WALL EXTENDING DOWN TO THE FOUNDATION.
Ismael Naranjo
Building Official
Plan review is not complete, when all items above are corrected, we will do a complete
plan review.
If any sheets are voided, remove them from the plans and replace with new revised
sheets and include one set of voided sheets in the re-submittal drawings.
Miami shores Village
Building Department
10050 N.E.2nd Avenue .�,.
Miami Shores, Florida 33138
Tel: (305)795.2204 OR'Ipp►
Fax: (305) 756.8972
August 12, 2013
Permit No: CC13-1818
Building Critique– Syed Ashraf
1. 1) Provide approval from FIRE, DERM & HEALTH DEPT. I
2. 2) These appear to be separate tenant spaces. Wall type '3' needs to be a fire wall. Show
complete details of wall type 3.
3. 3) Provide details of the new CMU wall addition. — se.� sa/A-%z
r w t1 +a4�e 'D3Tr*A lm
Plumbina Critique– Osvaldo Diaz a� •r(-.� -7rcti yla��
1. 1. FBC 107.1 PROVIDE DERM APPROVAL
2. 2. FBCP 604. PLUMBING FIXTURES SHALL COMPLY W/MIAM-DADE WATER
EFFICIENCY CODE 8-31
3. 3.FBCA 605.1 URINAL RIMM SHALL BE SET NO HIGHER THAN 17 INCHES
Electrical Critique
1. Send to Miami Dade fire first.
Mechanical Critique
1. Need Fire Approval
Plan review is not complete, when all items above are corrected, we will do a complete plan review.
If any sheets are voided, remove them from the plans and replace with new revised sheets and include
one set of voided sheets in the re-submittall drawings.
oC.n
I L
move Miami shoresVillage
L�N P Building Department
lOR1UA 10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
RECEIPT
PERMIT#: v I ATE: (�
Contractor
• Owner
•Architect
Picked up 2 sets of plans and (otl
Address:
From the building department on this date in order to have corrections done to plans
And/or get County stamps. I understand that the plans need to be brought back to Miami
Shores Village Building Department to continue permitting process.
Acknowledged by:
PERMIT CLERK INITIAL:
RESUBMITTED DATE:
PERMIT CLERK INITIAL:
OR
Mianil hores Village
Building Department some
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204 ��OR1DA
Fax: (305) 756.8972
Date: 8- 13-11
Permit No: *C C - 12, ./i f Q
Plumbing Critique
G J/
F BC. pCC L ' ig Ijdl CS l- N i
Osvaldo "Ozzie" Diaz
Chief Plumbing Inspector
Plan review is not complete, when all items above are corrected, we will do a complete
plan review.
If any sheets are voided, remove them from the plans and replace with new revised
sheets and include one set of voided sheets in the re-submittal drawings.