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MC-17-1210
er r nra MCS-'17-1210 Miami Shores Village Pet & lm �'11�-Col'mercial Ifit�r 10050 N.E.2nd Avenue NE '- Cf€�.�stffcattan;Addition/Alteration Miami Shores,FL 33138-0000 y .•. Permit Staters:APPROVER a Phone: (305)795-2204 its /311617 Expiration: 10/30/2017 Project Address Parcel Number Applicant L11300 NE 2 Avenue Number: Library 1121360000050-03 BARRY UNIVERSITY INC Miami Shores, FL 33138-0000 Block: Lot: Owner Information Address Phone Cell LBARRY UNIVERSITY INC 11300 NE 2 Avenue MIAMI SHORES FL 33161-6628 m� YmY' Y 11300 NE 2 Avenue MIAMI SHORES FL 33161-6628 Contractor(s) Phone Cell Phone $ 1,500.00 li TRIUMPH AC&REFRIGERATION COF (786)512-0548 Valuation: i' Total Sq Feet: 0 Tons: Available Inspections: Additional Info:A/C GRILL REPLACEMENT. Inspection Type: Classification:Commercial Ventilation Approved:In Review Final Comments: Date Approved::In Review Rough Date Denied: Type of Work: Rough Duct Scanning:1 Duct Detector Test Review Mechanical Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 Invoice# MC-5-17-63888 DBPR Fee $2.25 05/03/2017 Credit Card $ 110.70 $50.00 DCA Fee $2.25 Education Surcharge $0.40 05/02/2017 Credit Card $50.00 $0.00 Permit Fee $150.00 Scanning Fee $3.00 Technology Fee $1.60 Total: $160.70 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 AFFIDA IT: 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 zor iut ore,I authorize the above-named contractor to do the work stated. May 03, 2017 Auth d Sig to e:Owner / Applicant / Contractor / Agent Date Building Department Copy May 03,2017 1 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 ln` FBC 2019 BUILDING Master Permit No.CC- ` l--' I PERMIT APPLICATION Sub Permit No. HQ. Q— (-Z--) (0 ❑BUILDING F-1 ELECTRIC ROOFING Ej REVISION [:] EXTENSION RENEWAL F-1 PLUMBING (MECHANICAL ❑PUBLIC WORKS [:] CHANGE OF ❑ CANCELLATION ❑ SHOP �( P j� I �J CONTRACTOR DRAWINGS JOB ADDRESS ` 3®0 Iv �,� nL AJQ' 3uit L24 123 City: Miami Shores County: Miami Dade Zip: 11Y Y Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Floo Zone: BFE: FFE: c � p OWNER:Name(Fee Simple Titleholder): v y- Phone#: Address: 1 - City: tate: Zip: :33 (o Tenant/Lessee Name: ------ Phone#: Email: CONTRACTOR::Ccmpany Name: r�Jro�6/c, , 70 or Cyp Phone#: ,30� , "75-r` 6S 2Y Address: $I ® �' r3.&1 fsu k' City: O t�l ea h State: Zip: 23 3®t Qualifier Name: IQ.� Phone#: fi$6 j e 20 r' State Certification or Registration#: 'a-` e:/ ZZ Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ * Square/Linear Footage of Work: Type of Work: ❑ Additi n ❑ Alteration ❑ New K.Repair/Replace ❑ Demolition Description of Work: s I I SZ 12 G e n Specify color of color thru tile: Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ !1 �® (Revised02/24/2014) 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In e nce of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature L404,hlu laij Signature— OWNER or AGENT J�WrN'TRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day Of ftl 20 by �ay of 120 C7 by who is personally known to who is personally known to me or who has produced as me orwho has produced fLbL TffZ-000 -77-M3-bas identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIQ NOTARY PUBLIC: S840%. 28, Si Sign: Pri 0 Pri -b WA' i 2,20 'W�- 337 Noury Pow Stm of FWds Seal: S d1hN J. 'is"J Y80 My emmwWw FF 16901 gxl*"11/124018 04 A A APPROVED BY ******[a*s*lxa iner Zoning Structural Review Clerk (Revised02/24/2014) May. 2, 2017 2:56PM FIRST GENERAL INSURANCE No, 4303 P. 1 .aI�C�.aRI�°D CERTIFICATE OF LIABILITY INSURANCE DATE06/02Dnn'YY) 05!02117 ,71115 CERTIFICATE 1$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 SY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the cerilflCate bolder Is an AODITIONAL INSURED,the policy(lea)must be endorsed. If SUBROGATION 19 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 11011 of such endorsement(s). PRODUCER cot- C E• First General Insurance PHONE 305)817-0303 �FAX vc No), (305)817-0333__ i 7900 NW 155 St.Suite 102 --�Lg�CbfU2on®trstgenerabnsurance.com Miami Lakes,FL 33018 INSURER(S)AFFORDING COVERAGE NAIL e Phone (305)817-0303 Fax (305)817-0333 INSURER A I AMTRUST NORTH AMERICA INSURED INSURER B: ASCENDANT TRIUMPH AC&REFRIGERATION CORP INSURER C! PROGRESSIVE 8821 N W 112 TERRACE INSURER D: HIALEAH GARDENS.FL 33018 305 INS e: 1. COVERAGES CERTIFICATE INSURER F NUMBER: REVISION NUMBER* THIS IS TO CERYIFY 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 CONTRACTOR OTHER DOCUMENT WfrH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, �gEXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN'MAY HAVE BEEN REDUCED BY PAID CLAIMS. L•TR TYPE OF INSURANCE ADD 6UBR MIOI!lLD�EFF POLICY EXP POLICY NUMBER LIMITS GENERAL LIABILITY "• EACH OCCURRENCE 1 000,000.00 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED B ❑ ElCLAWIS•MADE © OCCUR GL--058��-2 Mee EXP Aneone e $ 100,000.00 ❑ Y 10/2412018 10/24/2017 on 3 5,000.00 PERSONAL a ADV INJURY $ 1,000,000.00 GEN@RAL AGGREGATE 2,000,000.00 GEN'LAGGREGATE LIMITAPPLIES PER: POLICY El ❑ LOC PRO- PRODUCTS-COMP/OPAGG $ 1,000,000,00 $ AUTOMOBILE LIABILITY �MBWED IN LE LIMIT 100,000.00 ❑ ANY AUTO BODILYWJURY(PerPerm) S C ❑ U7 SWNEO AAUTTOSSULEO N 004293464 NON-OWNED 02/03/'2017 02/03/2018 SODILYINJURY(par acadenl $ ❑ HIRED AUTOS ❑ AUTOS P OPERTY DAMAGE $ ElPERSONAL INJURY $ 10,000.00 ❑ UMBRELLA LIAR ❑OCCUR ❑ t:XCSSS LIAR ❑ CLAIMS-MADE EACH OCCURRENCE $ ❑ AGGREGATE $DED El RETENTIONS WORKERS COMP@NSATION AND EMPLOYERS LABILITY Y/N V WC STAN- AN ©0TH• NONE Y PROPRIETORMARTNERMXECUT(VE A lnnd4N � �CWDE09 NIA AWC1083151 E'-EnCHACCIDENT $ 1,000000.00lwyIH05/01/2017 05012018 It yes desaibeunder EL.0189ME-EAEMPLOYE $ 1,000,000.00 DE�SU`RIPTION OF OPERATIONS below E.L.D19EASE-POLICY LIMIT s 1,000,000.00 DESCRIPTION OF OPERATIONS/LOOAMON3/VEHICLE$(All-ch ACORD ici,Addlllonal Remarks Schedule,It mora space la iepulretl) A/C REPAIR&INSTALLATION i FAX:305-756-6972 I CERTIFICATE HOLDER CANCELLATION — I MIAMI SHORES VILLAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED713&0RE THE EXPIRATION DATE THEREOF,NOTICE WILL BI:DELIVERED IN BUILDING DEPARTMENT ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2 AVENUE AUTHORIZED REPRESENTATIVE I MIAMI SHORES,FL 33138 ROSIE BRUZON ACORD 26(2010/05)QF 01988.2010 ACORD CORPORATION* CORORATION. 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