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PIC-17-391 Miami Shores Village moo` Building Department 2\x r E_� " 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 . �5� Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 2011 BUILDING Master Permit No.p i C —3G PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL FN�PLUIVIBING ❑ MECHANICAL ❑PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 11300 NE 2ND AVE LANDON STUDENT UNION (RUSSELL KITCHEN DINNING AREA) City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 1121360010160-09 Is the Building Historically Designated:Yes NO X Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder):BARRY UNIVERSITY INC Phone#:305-899-4910 Address: 11300 NE 2ND AVE City: MIAMI SHORES State: FL Zip: 33161 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: MARLIN PLUMBING OF MIAMI, INC Phone#: 305-652-3031 Address: 20145 NE 16TH PLACE City: NORTH MIAMI BEACH State: FL Zip: 33179 Qualifier Name: EDWARD J WALKER Phone#: 305-652-3031 State Certification or Registration#: CFC048292 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$2,200.00 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New N Repair/Replace ❑ Demolition Description of Work: Supply and install approx 8ft of 1"galvanize gas line from kitchen towards serving line Specify color of color thru tile: ..��^^ •$O Submittal Fee$—!X�r^?P1� ' Permit Fee$ �® CCF$ CO/CC$ Scanning Fee$ vl Radon Fee$ 2• Z S DBPPR�^$��11 Z. '2-S Notary$ Technology Fee$ �• C�® Training/Education Fee$ d W v Double Fee$ Structural-Reviews$ Bond$ TOTAL FEE NOW DUE$ `j O (Revised02/24/2014) 4 ' r 1 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 on estimated value exceeding$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature OWNER or AGENT CON CTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of ' 20 � 7 ,by day of Fe-briAo r4 ,20 1-7 by who is personally known to VJCLIke4-,who is personally to or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PU C: NOTARY PUBLIC: ,, �� Sp , 41 Sign: Sign: M Comm.E-P Dec 0 2017 ,�� 11 - No FF 070897 - Print: Print: M � Je"J Y8o • PUBLIC Seal: My Commlaslon FF 188481 ] Seal: � o era Explrea 11w12rto18 •� p 04 M OF � APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) f 47 7 s; !T14W 9 Miami Shores Village �M Pow#Typa Pjutt1 t Eta-Com#11ePG):) 10050 N.E.2nd Avenue NE WwWaspftafion:AdditiontA)t+ do Miami Shores,FL 33138-0000 .. ate. POmft Sta#us'APPROVE, " Phone: (305)795-2204 xZoRm� :- [��tion: 8l26l2 17 I$ 712017 Project Address Parcel Number Applicant 11300 NE 2 Avenue Number: Landon Studer 1121360010160-26 BARRY UNIVERSITY INC Miami Shores, FL 33138-0000 Block: Lot: Owner Information Address Phone Cell BARRY UNIVERSITY INC 11300 NE 2 Avenue MIAMI SHORES FL 33161-6628 11300 NE 2 Avenue MIAMI SHORES FL 33161-6628 Contractor(s) Phone Cell Phone Valuation: $ 2,200.00 '', MARLIN PLUMBING OF MIAMI INC 305-652-6108 _.... .. ,,,...M . Total Sq Feet: 0 Type of Work:SUPPLY AND INSTALL APPROX 8FT OF 1 Available Inspections: Type of Piping: Inspection Type: Additional Info:SUPPLY AND INSTALL APPROX 8FT OF 1 Top Out Classification:Commercial Re Pipe Scanning:3 Main Drain Heater Water Service Final Water Main Lavatory Review Plumbing Underground Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.80 Invoice# PLC-2-17-62950 DBPR Fee $2'25 02/15/2017 Check#:2488 $50.00 $118.30 DCA Fee $2.25 Education Surcharge $0.60 02/27/2017 Check#:2492 $ 118.30 $0.00 Permit Fee $150.00 Scanning Fee $9.00 Technology Fee $2.40 Total: $168.30 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 all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction i!�*zoning. F ore,I authorize the above-named contractor to do the work stated. �f February 27, 2017 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy February 27,2017 1 af ; 20145 N.E. 16" Place North Miami Beach, FL 33179 Ph: 305-652-3031 Fax: 305-652-3135 License#CFC048292 March 29, 2017 Barry University Landon Hall 11300 NE 2 Ave Miami Shores, FL 33138 Permit 6 -2-17-391 Gas Drop Test To Whom It May Concern: This is to advise you that Marlin Plumbing has performed the necessary required gas drop test as per Miami Dade. This drop test was performed in accordance with NFPA 54 Natural Gas Code. The gas piping and the gas main has held 11"on WC for 15 minutes without dropping. If you have any questions or desire any additional information please feel free to contact me. Sincerely, Edward J. Walk STATE OF FL A ) COUNTY OF DackO— ) The foregoing instrument was acknowledged before me this 29 of Mamzc k 20 1-1 by Fdule..rd Ti WoL I Ker ,who is personally known to me or who has produced as identification and who did take an oath. 0001��/I�i�:. NOTARY PUBLIC, STAIE OF FLORIDA 140.FF • c OF ,RIM 1 11 OO MARLIN PLUMBING OF MIAMI, INC 20145 NE 16T" PLACE NORTH MIAMI BEACH, FL 33179 11-30o N c Zn.c, Ave- G�'C 0�.�0�9 0� i M.►�nig 5h8ye,S� �(,, 3 3 13� e,4 un an j FES 1 `n17 n�h� room d �y Cs taS y----- NO FF 0797 NOTARY + PI�LIC r 1 Imo" ,`AOFTF/11111��, PROPOSAL MARLIN PLUMBING OF MIAMI, INC. 20145 N.E.16th PLACE, NORTH MIAMI BEACH, FL 33179 (305)652.3031 fax(305)652.3135 License CFC048292 PROPOSAL SUBMITTED TO WORK TO BE PERFORMED AT Name:Barry University Name:Landon Cafeteria Street:11300 NE 2nd AVE Miami Shores FL Phone:954-263-0015 We hereby propose to fumish the materials and perform the labor necessary for the completion of: 1. Marlin Plumbing to supply and install approximately 8'feet of V inch gas supply line,from kitchen area towards serving lin.Materials used will be galvanized pipe and fittings. NOTE:Any deviations from scope of work mentioned above will be extra to contract and done at time and materials, Marlin Plumbing not responsible any landscaping,floors,walls or tile patching.Permits fees are extra to contract. 50%UPON START AND 50%UPON COMPLETION All Material and Workmanship is Guaranteed for One(1)Year starting from Completion date. Note: Marlin Plumbing will not be responsible for any underground water pipes,sprinkler lines,gas or electric lines while doing any trenching. If needed,Marlin will call for location services to mark services. All materials and workmanship is guaranteed for one(1)year from the completion date of the contract to be as specified,and the above work to be performed in accordance with the drawings and specifications submitted for the above work and completed in a workmanlike manner for the sum of Rm In the event that the customer fails to make any payments to Marlin Plumbing in accordance with the terms and conditions of this agreement, Marlin Plumbing shall be entitled to all reasonable attomey's fees on collection and/or litigation or other court proceeding including attomey's fees on appeal. Respectfully submitted:Marlin Plumbing of Miami,Inc. By:Raul Bringas Date:1/4/2017 ACCEPTANCE OF PROPOSAL The above price,specifications,and conditions are satisfactory and are hereby accepted.You are authorized to do the work as specified.Payments will be made as outlined above. Any alteration or deviation from above specifications involving extra costs will be executed only upon written order and will become an extra charge over and above the estimate.All agreements are contingent upon strikes,accidents or delays beyond our control. Date: Signature: Date: Signature: ' marlinpropdoc/form 1/1998 DATE(MM/DD/YYYY) D ACIOR 'W CERTIFICATE OF LIABILITY INSURANCE 2/14/2017 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 cAONTAcTNAME: Lauren Mayer Keyes Coverage Insurance PHONE 954-724-7000 F4X 954-724-7024 5900 Hiatus Road E-MAIL Tamarac FL 33321 .Imayer@keyescoverage.com INSURERS AFFORDING COVERAGE NAIC# INSURERA:Wesco Ins Co -25011 INSURED 5937 INSURERB:Zenith Insurance Co. 13269 Marlin Plumbing of Miami, Inc. INSURERC:American Automobile Insurance Compa -21849 20145 N.E. 16th Place Miami FL 33179 INSURER D: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:335787392 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 ADDLSUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DD MM/DD A X COMMERCIAL GENERAL LIABILITY Y Y WPP115738602 5/8/2016 5/8/2017 EACH OCCURRENCE $1,000,000 CLAIMS-MADE X❑OCCUR PREMISES E.occu encs $100,000 MED EXP(Any one person) $5,000 PERSONAL 8 ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY JECTPRO- LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ C AUTOMOBILE LIABILITY Y Y MZA80323214 211/2017 2/1/2018 COMBINED SINGLE LIMIT $ Ea accident 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION y Z133838101 12/1/2016 12/1/2017X1PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE YIN NIA E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? 71 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached H more space Is required) Plumbing Contractor License#CFC048292 CERTIFICATE HOLDER CANCELLATION 30 Days Notice/10 Days for Non-Pay SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE MIAMI SHORES VILLAGE BUILDING DEPARTMENT THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 NE 2ND AVENUE ACCORDANCE WITH THE POLICY PROVISIONS. MIAMI SHORES FL 33138 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD CFC048292 The PLUMBING CONTRACTORx Named below IS CERTIFIED Under the provisions of Chapter 489 FS. ,.. Expiration dater AUG 31, 2018 " WALKER;EDWARD MARLIN PLUMBING.ORI M1 tNC 20145 NE 16TH P . NORTH MIAMI- 33179 ,ter- a^�a3ma�F� r� i :T s � ', '�', t r,� �. �.y.sr. � ■ ISSUED: 07/31/2016 DISPLAY AS REQUIRED BY LAW SECT# L1607310003108 000asl Local Business Tax Receipt Miami-Dade County, State of Florida -THIS IS NOT A BILL DO NOT PAY 2503465 BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES MARLIN PLUMBING OF MIAMI INC RENEWAL SEPTEMBER 30, 2017 20145 NE 16 PL 2627108 Must be displayed at place of business MIAMI FL 33179 Pursuant to County Code Chapter 8A-Art.9&10 OWNER SEC.TYPE OF BUSINESS _" MARLIN PLUMBING OF MIAMI INC 196 PLUMBING CONTRACTOR PAYMENT RECEIVED CFC048292 BY TAX COLLECTOR Worker(s) 1 $75.00 08/19/2016 CREDITCARD-16-048212 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 he displayed on all commercial vehicles-Miami-Dade Code Sec 6a-276. For more information,visit www.miamidadegovltaxcollector