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FW-2-16-291 Permit No. FW-2-16-291 Miami Shores Village Permit Type:Fence/Wall 10050 N.E.2nd Avenue N Per il Work Classification:Wire Fence Miami Shores,FL 33138-0000 Permit Status:APPROVED Phone: (305)795-2204 FC RLDp` issue Date:2/5/2016 F Expiration: 08/03/2016 Project Address Parcel Number Applicant 9301 N BAYSHORE Drive 1132050270560 GUY&SELIN KURLANDSKI Miami Shores, FL Block: Lot: Owner Information Address Phone Cell GUY&SELIN KURLANDSKI 9301 N BAYSHORE Drive MIAMI SHORES FL 33138- 15811 COLLINS Avenue SUNNY ISLES FL 33160- Contractor(s) Phone Cell Phone Valuation: $ 600.00 CONSTRUSERVE CORP (786)380-0619 Total Sq Feet: 83 Approved: Available Inspections: Comments: Inspection Type: Date Approved: : Final Date Denied: Foundation Type of Construction:Wire Fence Additional Info: INSTALLATION OF CONSTRUCTION Review Planning Classification:Residential Scanning:2 Review Building Fees Due Amo]$2 Pay Date Pay Type Amt Paid Amt Due CCF Invoice# FW-2-16-58540 DBPR Fee DCA Fee 02/05/2016 Check#:7675 $ 111.60 $0.00 Education Surcharge Permit Fee-Wire&Wood $Scanning Fee Technology Fee Total: $11 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 p it I as responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for EL C RICAL,PLUMBING,M CHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFId , VI T: I certify th II the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction aning. Futher e, I authon the above-named contractor to do the work stated. ,(, February 05, 2016 Auth ized SigXnmnat wrier / Applicant / Contractor / Agent Date Buildi g Depent Copy February 05, 2016 1 Miami Shores Village Building Department C`ETNTED 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 FEB 0 2 2016 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20&1//i BUILDING Master Permit No. OK71. PERMIT APPLICATION Sub Permit No. (? ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP G ` CONTRACTOR DRAWINGS JOB ADDRESS: 1 3OI N Q� A, 4 SVl om .T)'e City: Miami Shores County: Miami Dade zip: Folio/Parcel#: 11 "3 w 5' 027) _0S(00 Is the Building Historically Designated:Yes NO ` Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titlehold UF 1 Phone#: Address: 0 City: PiniCwk-, SMoc State: T'l, Zip: 33135 Tenant/Lessee Name: Phone#: Email: / CONTRACTOR:Company Name: 0'0f "%(VQ r 0(P Phone#: Address: 1 I4 \/'Q- City: VAI 1 r State: zip: 33 Qualifier Name: V I Ct. Phone#: ?9(::, — 3W' C 19 State Certification or Registration#: cc)CI 1 L'4 Certificate of Competency DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ (00 - 00 Square/livax.Footage of Work: g�J Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work:US dja'Qj OF (0rL& rV CAh 0A (LAACe W 1 Specify color of color thru tile: f Submittal Fee$ Permit Fee$ 1 W CCF$ CO/CC$ �n Scanning Fee$ Radon Fee$ DBPR$ Notary$ Y� Technology Fee$ Training/Education Fee$ Double Fee$ 10 Structural Reviews$ Bond$ Q) r� TOTAL FEE NOW DUE $ f I ( v (Revised02/24/2014) ding 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. W N- r Signature CkLSignature "IfiNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this -1 I't day of 1-)J2,0Ut ber 20 15 by day of O A 201 by 60d] tkWtQULA-"b.who is personally known to Q� Ct ho is personally known to me or ho has produced as me or who has produced VdWQQD'S�Q490as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: 1 Sign: II ', Sign: Print: a W GC1 SS SUtiu- Print: 1 r Seal: tib"• , ANA LUCIA SIERRA Seal: .��.. . MY COMMISSION u FF 224104 { e+: .r. MY COMMiSS{ON q FF 224104 EXPIRES:April 23,2019 ^1 d ds EXPIRES:April 23,2019 ~�i; Bonded Thru Notary Public Underwftm 3 Bonded Thru Notary Public Underwriters ************************************************************************************************************ APPROVED BY t Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) SNORE 7 iue " Miami shores e Villa9 �y` Building Department R1Dp' 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 CONTRACTORS' REGISTRATION Fax: (305) 756.8972 IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LICENCES B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE* D. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A C RTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 Certificate_mustspecify t e escd ion o operafions or contra o�lice a b ........................................................................................... BUSINESS NAME: G OOJ S 7`�J S 2 UC C BUSINESS ADDRESS: Mb S-7 S CAJ CITY M/6 STATE FZ ZIP_a�/2L BUSINESS PHONE: (,) FAX NUMBER L ) CELL PHONE 7c B6 ) ��O— 0 CO I q QUALIFIER'S NAME: �L -00 V I LI—A fZ" GA QUALIFIER'S LIC NUMBER: C 6, 6 1 S 12 462 RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA 4 b DEPARTMENT OF BUSINESS AND PROFESSIONAL.REGULATION -CONSTRUCTION:INDUSTRY-LICENSING BOARD• . 3 CGC1612482 —The'GENERACCONTRACTOR " .. :. 'Named-beloW_IS.CERT.IFIED p .=�* _`� � � �q ;4" • °Under tfie--pF visions of"Chapter 489 FS s """ "�Expiratri'o/n..datea AUG 31a2016 -w` ;; � � , CONSTRUSERVE:C6RPr""-- 11687rSW,14" .H AVE. ,,M...... ✓ t ISSUED: 08/06/2014 DISPLAY AS REQUIRED BY LAW SEQ# L1408060001584 Local Business Tax Receipt Miami—Dade County, State of Florida -THIS IS NOT A BILL-DO NOT PAY 5945879 � &MBT, I BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES CONSTRUSERVE CORP RENEWAL SEPTEMBER 30, 2016 I 11687 SW 144 AVE 6202725 MIAMI, FL 33186 Must be displayed at place of business Pursuant to County Code i Chapter 8A-Art.9&10 OWNER SEC.TYPE OF BUSINESS - PAYMENT RECEIVED CONSTRUSERVE CORP 196 GENERAL BUILDING BY TAX COLLECTOR - CONTRACTOR -75.00 09121/2015 Worker(s) 1 CGC1512482 0241-15-003740 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 N0.above must be displayed on all commercial vehicles-Miami-Dade Code Sec Ila-276. MIMI® For more information,visit www.miamidade.govltoxcollector , ----------I._-.. .._------— A�"® CERTIFICATE OF LIABILITY INSURANCE DATE /29/2/16 _ _ _ _ _ 01!29/2016 THIS CERTIFICATE IS ISSUED A--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.,T91S 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). PHONE FAX PRODUCER NAME:CT MARCO SUAREZ i t _NAM9: 1111..1.._.111..........._....._...._ 1111_. 1111._.. _ Suarez&Associates ..,Na.Ext):_ (305)884-8664 vT(ac,yo; (305)884-6977 1(Aa�� - P.O.Box 661008 npDRLsB: framar69(Mbelisouth.net _ _ -. ---..............................._,........ Miami Springs,FL 33266 INSURERS)AFFORDING COVERAGE NAIC N _..................................... I Phone (305)884-8664 Fax (305)884-6977 INSURER_n:_,.- ENDURANCE AMERICA SPECIALTY INS CO i .. ....... INSURED I INSURERS: _.._.._............._- ............_- --1111..- ._..-..._.__.............. -- CONSTRUSERVE CORP "_INSURER C._:..__1_.___.____1 ............................................................................_,.,__ 11687 SW 144 AVE INSURER o: __®- _------------------- ._........_. MIAMI FL 33186 I 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 ANDCONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. . 1111 - - -------- INSR- ADDLSUBR lTR TYPE OF INSURANCE I POLICY EFF I POLICY EXP ...... .... 1NSR"WVD; POLICY NUMBER .- _ _a.(MMlDD/YYYYJ (MMlDD/YYYY)"--_ --- „1111. .. ., LIMITS ... a COMMERCIAL GENERAL LIABILITY i EACH OCCURRENCE .._- i..$ 1-00,000-00----] t 1 CLAIMS-MADE LTJ OCCUR i DAMAGE TO 12ENTED $ 100,000.00 PREMISES,(Ea occurrence). . MED EXP(Any one person) i $ 5,000.00 A I CBC10000415504 06/28/2015 06/2812016 ... ! ............................. .... ❑ .........................................................1111... 8 ADV INJURY ` $ 1,000,000.00 .1.1..11 .....PERSONAL............................._._ .. 1111_ _1111. GEN'L AGGREGATE LIMIT APPLIES PER: 1 GENERAL AGGREGATE ! $ 1,000,000.00 _.._....................... ................ --- ❑ POLICY ❑ PRO ❑ LOC JEC7 ( PRODUCTS-COMP/OPAGG $ 1,000,0... 0 ❑ OTHER _._ 1111. $ AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT „(Ea eccident)_` $ ❑ ANY AUTO BODILY INJURY(Per person) " $ ❑ ALL OWNED SCHEDULED .....BODIL.....Y......INJUR...J,U,R..........._-.. s AUTOS ❑ AUTOS Y(Peraccident) $ ❑_ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $❑ AUTOS FF t_ ❑ $ E] UMBRELLA LIAB OCCUR I ❑ R EACH OCCURRENCE $ (� EXCESS LIAB ❑CLAIMS-MADE ' AGGREGATE $ _ M.__DEC) El RETENTIONS $. WORKERS COMPENSATIONI PER I -t OTH AND EMPLOYERS'LIABILITY Y/N ❑--STATUTE........... ANY PROPRIETOR/PARTNER/EXECUTIVE aE.L.EACH ACCIDENT $ OFFICERtMEMBER EXCLUDED? N/A - -- (Mandatory in NH) E.L DISEASE-EA EMPLOYEE$ if yes,describe under I _. DESCRIPTION OF OPERATIONS below E.L,DISEASE-POLICY LIMIT $ I __1111 ............... ............. _..... ....... .............-......----------------------------- DESCRIPTION OF OPERATIONS f LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more apace is required) LIC#CGC1512482 .1 ........................... CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE 0 E DESCRIBED POLICIES BE CANCELLED BEFORE MIAMI SHORES VILLAGE BUILDING DEPT THE EXPIRATION D TH REOF,NOTICE WILL BE DELIVERED IN 10050 NE 2ND AVE ACCORDANCE W THE OLICY PROVISIONS. MIAMI SHORES,FL 33138 AUTHORIZE NTA VE 0 AC OR PORA All rights reserved. ACORD 25(2014/01)CIF CORD name and logo are registeted marks of ACORD AC<JR U® DATE(MWDDNYYY) `CI CERTIFICATE OF LIABILITY INSURANCE 1/28/2016 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(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 confer rights to the certificate holder In lieu of such endorsement(s). CONTAPRODUCER SUNZ Insurance Solutions, LLC. ID: (TLR) NAME: Aimee Gra c/o TLR of Bonita, Inc PHONE 727.520 7s7s x222 FAX.No: 727-525-38s2 700 Central Ave Suite 500 PW-Lao St. Petersburg, �L 33701 INSURER(S) AFFORDING COVERAGE NAILS INSURER A: SUNZ Insurance Company 34762 INTLR of Bonita, IIIc RED INSURER B: Aspen Re-London-Best Ratin "A+" EnterpriseHR INSURER c: Chaucer Syndicate-Lloyds-Best Rating"A+" 700 Central Avenue Suite 500 INSURER D: Faraday Syndicate-Lloyds-Best Rating"A+" St. Petersburg FL 33701 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 28324429 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 TYPE OF INSURANCE ADDLSUIBR POLICY EFF POLICY EXP LTR on POLICY NUMBER MMIDpIYYYYI (MMIDDIYYYYI LIMITS COMMERCIAL GENERAL LIABUTY EACH OCCURRENCE $ CLAIMS-MADE F—I OCCUR PREMISES Me nce $ MED EXP one person $ PERSONAL&ADV INJURY $ GEN1-AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑jE OT F—]LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY CO IND IN LIMIT $ EM aoddont ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PPReOPER DAMAGE $ HIRED AUTOS AUTOS a UMBRELLA LIAS OCCUR EACH OCCURRENCE $ EXCESSLJAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION WCPEO 11 6/1/2015 6/1/2016 ./ STATUTE ER AND EMPLOYERS'LIABILnY ANY PROPRIETORIPARTNERIEXEWU YIN EL EACH ACCIDENT $ 1,000,000 OFFICERIMEMBEt EXCLUDED? N/A (Mandatory M NII) EL DISEASE-EA EMPLOYEq$ 1,000,()00 Hyes describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT I$ 1,000,000 B Workers Compensation This is for informational purposes C Excess Coverage and nothing shall create any right D under such reinsurance. 'DESCRIPTION OFOPERA L TIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached N mon space is required) Coverage Provided for all leased employees but not subcontractors of:Construserve Corp. Client Effective:06/15/2015 CERTIFICATE HOLDER CANCELLATION 8638 Miami Shores Village Building Department SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 10050 NE 2nd Ave g P ACCORDANCE THE EXPIRATION WITH THE POLICY PROVISIONS WILL BE DELIVERED IN Miami Shores FL 33166 /f AUTHORIZED REPRESENTATIVE Glen J Distefano ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD ` , _-,7VED NATIONAL CONSTRUCTION RENTALS FES ' 2 TEMPORARY WFENCE PANELS 'BY, 12' W Panel Stand Panel clamp Sandbag PANEL DESCRIPTION Chain Link: 11 1/2gax23/8^ Mesh Galvanized Chain Link Frame Work: 1 3/8^diameter.OG5"w/a||galvanized tube Panel Clamp: 1 3/8"x 1 3/8" Heavy duty steel panel clamp ~ PANELSTAND . Frame~~ Cross Member i C 1O° LU 35" PANEL STAND DESCRUPTUOKJ Frame: 1 3/8"dolmneder`0WS"wall steel tubing Cross Member 5/8"x 17" steel Pegs: 3/8"z6^szh40 ° ° °° �°°°°� ° °°° � - �� BAGS ~ °°°°°� ° ° °�°°°° ° ° Two 8O |btubular sand bags placed mneach end ofthe panel stand ca ° °° °°� ° °° ° ° ° ° °�°°°° °°°° ° ° °°°°°° Construction Fence Screen Colors: Green, Black, Brown, Beige, Royal Blue Properties Material Composition Knitted HDPE High Density Pof ethelene Filament Strength 50 lbs. er ft. Material Break Stren th 500 lbs. per ft. Material Weight 145 grams per sq. meter Crystaline Melt Point 133 degrees C Composition of UV Inhibitor 1.5%a Am las CM111821 /1.5% E uaster CM106000 Shade Value 88% Flarnability Point 364 degrees C Disclaimer: Collins Company assumes no liability for the accuracy or completeness of this information or for the ultimate use by the purchaser.Collins Company disclaims any and all express, implied, or statutory standards, warranties or guarantees, including without limitation any implied warranty as to merchantability or fitness for a particular purpose or arising from a course of dealing or usage of trade as to any equipment, materials,or information fumished herewith. This document should not be construed as engineering advice. 0000.. 0000 .. 0000.. • 0000.. 0000.. .. . .. .. 0000. 0000 0000 . . 0000 0000 0000.. • 0000.. • 00 . 0• 0000.. 0000 . .