FW-17-1999E
E
1
4
Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit
Permit NO. FW -8-17-1999
Permit Type: Fence/Wail
Work Classification: Iron/Ornamental
Permit Status: APPROVED
Issue Date: 8/23/2017
Expiration: 02/19/2018
Parcel Number
Applicant
1135 NE 100 Street
Miami Shores, FL 33138-
1132050340050
Block: Lot:
THOMAS WENSJOE
Owner Information
Address
1135 NE 100 Street
MIAMI SHORES FL 33138
Phone
Cell
Contractor(s)
NOVA IRONWORK CORP
Phone
(305)586-2904
CeII Phone
Valuation:
$ 7,500.00
Total Sq Feet: 300
Approved:
Comments:
Date Approved: :
Date Denied:
Type of Construction: Other
Classification: Residential
Additional Info: METAL PICKET FENCE 6'-0 HEIGHT
Scanning: 3
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Notary Fee
Permit Fee - Wire & Wood
Scanning Fee
Technology Fee
Total:
Amount
$4.80
$4.50
$4.50
$1.60
$5.00
$300.00
$9.00
$6.40
$335.80
Pay Date Pay Type
Invoice # FW -8-17-64803
08/23/2017 Credit Card $ 285.80 $ 50.00
08/08/2017 Check #: 1070 $ 50.00 $ 0.00
Amt Paid Amt Due
Available Inspections:
Inspection Type:
Final
Foundation
Review Building
Review Building
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 AF he foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
co. -nd horize the above-named contractor to do the work stated.
Author] ed Siture:/ Applicant / Contractor / Agent
Buildirfg Depment Copy
August 23, 2017
August 23, 2017
Date
1
`—abcimct.s Guei2doLe
BUILDING
PERMIT APPLICATION
BUILDING ❑ ELECTRIC
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
❑ ROOFING
PLUMBING ❑ MECHANICAL PUBLIC WORKS
• JOB ADDRESS:
/Cs /U /00
AU 08 2017
FBC2014
Master Permit No. ¶w 11— i 99
Sub Permit No.
Stin
❑ REVISION ❑ EXTENSION ❑ RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
City: Miami Shores County:
Miami Dade
Zip: 33tje`
Folio/Parcel#: / / — 3Z 05- 03V- 0 05 0 Is the Building Historically Designated: Yes
Occupancy Type:
Load: Construction Type: Flood Zone: BFE:
NO
FFE:
1 OWNER: Name (Fee Simple Titleholder): / CLS W ei. J O Phone#: 786 -cot -gee
Address: !SS t' V E S
City: /'�1YI'I D �j Cto'r�� State: �` Zip: JJ � �
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: Ala t, -+-✓.-opt, 1444
Address: 150 AY %y Ave,
Phone#: SO6 -06-ZOO
City: /VL I (AIM1 State: T1 - Zip: 33166
Qualifier Name: '_"nb'(' Ivo i/D Phone#:
State Certification or Registration #: 13 P)00 if 9V) Certificate of Competency #:
DESIGNER: Architect/Engineer:
Address:
Value of Work for this Permit: $
'7 600 .°o
Type of Work: ❑ Addition ❑ nn QAlteration
. Description of Work: AAt1lt( P► t
i 'i Fe lr''�it Pa c� t•1 Yjt':; ..• �•i 1. r._
City:
Phone#:
Square/Linear Footage of Work:
State: Zip:
300
❑ New ❑ Repair/Replace
�O
hN fl ,ykf
•
n Demolition
Species.. co/arof Color tliru
Submittal Fee $ `w Pal d
Scanning Fee $ ¶•
Permit Fee $
Radon Fee $
3oo
1.50
Technology Fee $ 6 ' 4 0 Training/Education Fee $
Structural Reviews $
(Revised02/24/2014)
CCF $ ,4•• Bo
DBPR $ ' .30
1.60
CO/CC $
Notary $ 5
Double Fee $
Bond $ •\
TOTAL FEE NOW DUE $ 22:6 n Sa
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. t absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
ature
(_OWNER•orA
The foregoing in f rument was acknowledged before me this
day of --an--1/4-t_, 20 1-1 , by
��wl'1rJ �Qo is personally known to
me or who has produced421` �'sJ1 as
identification and who did take an oath.
NOTARY, PLJBLICv
Sign:
Print:
Seal:
11111111/1
•Y6' % 6, NZ10=
APPROVED BY
-> ;oN IR-
;
4 •
:
NOVA Iron Works Corp
3301NW71St
Miami FL 33147
Phone 305-266-1446
CC License 13-BS/00492
July 18, 2017
State of Florida
County of Dade
RECEIVED
RECEIVED
AUG 012017
Before me this day personally appeared )-'I1 ✓ 1q714/` -/C-41-6 , who being duly
sworn, deposes and says:
That he or she will be the only person working on the project located at:
Lt nen, l� ��-
ctor Signature
Swor tp(or affirmed) and subscribed before me this
2017.
Personally know V
day of
OR produced identification
Type of Identification produced
7.
hni c� MYCOMMISSIONo►SEcvFNFFi736 4
Bo�PIRES`June 14, 2078
LAW
Print, Type or Stamp Name of Notary
it -
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Notice to Owner — Workers' Compensation Insurance Exemption
Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05
allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to
obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure:
An employer in the construction industry who employs one or more part-time or full-time
employees, including the owner, must obtain workers' compensation coverage. Corporate officers
or members of a limited liability company (LLC) in the construction industry may elect to be
exempt if:
1. The officer owns at least 10 percent of the stock of the corporation, or in the case of
an LLC, a statement attesting to the minimum 10 percent ownership;
2. The officer is listed as an officer of the corporation in the records of the Florida
Department of State, Division of Corporations; and
3. The corporation is registered and listed as active with the Florida Department of
State, Division of Corporations.
No more than three corporate officers per corporation or limited liability company members are
allowed to be exempt. Construction exemptions are valid for a period of two years or until a
voluntary revocation is filed or the exemption is revoked by the Division.
Your contractor is requesting a permit under this workers' compensation exemption and has acknowledge that he or she will not use
day labor, part-time employees or subcontractors for your project. The contractor has provided an affidavit stating that he or she will
be the only person allowed to, work on yourproject. In these circumstances, Miami Shores Village does not require verification of
workers' compensation insurance coverage from the contractor's company for day labor, part-time employees or subcontractors.
BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS
CONTENTS.
Signature:
State of Florida
County of Miami -Dade
The foregoing was acknowledge before me this 5 day of U (.., , 20 ` �.
who is personally known to me or has produced
Notary:
SEAL:
\‘‘‘�� 11 VOW cation.
ACS D
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
08/01/17
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).
1
PRODUCER
Excellence Insurance Agency
3801 SW 107 Avenue
Miami, FL 33165
Phone (305)226-390.0
INSURED
NOVA IRONWORK CORP
8450 SW 20 TERRACE
MIAMI, FL 33155
COVERAGES
Fax (305)226-3997
CONTACT
NAME: Marcos A. Alvarez
PHONE
IC No-Ext);_.__(305)226-3900 l wc, No)_— (305)226_3997
E-MAIL
SSLCHernandez@Excellenceinsurance.net
INSURERS) AFFORDING COVERAGE NAIL # 1
INSURER A : Travelers Property Casualty Co of America 25674
INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
11
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 AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
ADDLGUBR . POLICY EFF POLICY EXP ._._
LTR TYPE OF INSURANCE
INSR WY POLICY NUMBER _LMM/DD/YYYY) LMM/DD/YYYY) LIMITS
GENERAL LIABILITY
A
Q COMMERCIAL GENERAL LIABILITY
❑ ❑ CLAIMS -MADE O OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:
❑ POLICY ❑OI__._._a
–PRO-
ILE-LIABILLV.
❑ ANY AUTO
❑ AUTOS OWNED SCHEDULED
ALL ❑
AUTOS
❑ HIRED AUTOS ❑ NON -OWNED
AUTOS
❑ UMBRELLA LIAB ❑
OCCUR
U EXCESS LIAB ❑ CLAIMS -MADE
❑ DED ❑ RETENTIONS
Y
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?�1 N / A
(Mandatory in NH) '
If yes, describe under
-DESCRIPTION OF OPERATIONS below
Y
660-7D993113
10/29/2016
EACH OCCURRENCE -- $ 1,000,000.00
DAMAGE TO RENTED $ 300,000.00
PREMISES_LEa occurrence)
MED EXP (Any one person) $ 5,000.00
10/29/2017
PERSONAL & ADV INJURY $ 1,000,000.00
GENERAL AGGREGATE $ 2,000,000.00
PRODUCTS - COMP/OP AGG $ 2,000,000.00
$
BODILY INJURY (Per person)
BODILY INJURY (Per accident
PROPERTY DAMAGE
(Per accident)
$
$
$
EACH OCCURRENCE $
---r--
AGGREGATE — $
WC STATU- OTH-
-IQ6YJJMLT_s_ 0
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE $
E.L. DISEASE - POLICY LIMIT $
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required)
Lic#. 13BS00492 Fence Erections
CERTIFICATE HOLDER
L_
Miami Shore Village
10050 NE 2nd Ave
Miami Shores, FL 33138
ACORD 25 (2010/05) QF
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
I I AUTHORIZED REPRESENTATIVE
@ 1988-2010 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
Payment Receipt
V&C Supply Ornamental Corporation
MIAMI, FL 33142
Main: 305-634-9040
Fax: 305-634-5404
Received From:
Nova Iron works
Nova Iron Work
3301 NW 71ST STREET
33147 MIAMI FL SUITE C
Date Received 08/14/2017
Payment Method Debit Card
Check/Ref. No. #5219-8042
Invoices Paid
Date Number Amount Applied
Payment Amount $3,523.46
07/11/2017 77535 -$102.10
07/13/2017 77677 -$936.75
07/17/2017 77862 -$1,312.44
07/18/2017 77967 -$1,021.30
07/25/2017 78400 -$150.87
Page 1
(305)634-0120
V C SUPPLY ORNAMENTAL
3601 I'M 50TH ST
MIAMI, FL 33142
0814 2017
11:2013
DEBIT CARD
DEBIT SALE
Card tr XXXXXXXXXXXX80+2
Network: INTERLINK
Chip Card: US DEBIT
AID: 40000000980840
ATC: 004F
TC: 1ECCC3B2C83E2119
SEQ : 18
Batch ;f: 1079
INVOICE 19
Approval Code: 882499
Entry Method: Chip Read
Mode Issuer - PIN Verified
SALE AMOUNT $3523,46
1 HANK YOU!
PLEASE COME AGAIN
CUSTOMER COPY
Provide 21/"
cap on posts.
2%6"x21/6"x.125"
Tube posts
1"x1"x.062"
Tube Pickets
Welded/Mechanical Aluminum Fence
Miami, Florida
II
2' x 1 " x .093"
'Tube`rails
2"
3
T
2500 psi
Conc.
Notes:
1/e" typ
—►I 10"o
36"
(1)1JL'Q
72" Max. ►
2"1/6x2'/"x.125"
y Tube posts
A
< 4" spacing
2"x1"x1"x%"
Aluminum angle
(attach with (2) #10 x 1" Tec
screws into post & rail)
6"
777
777
3
2"x1"x.093"
Tube rails
• • • • • • • • •
• Typical fence section
Typical fencepanet • •
•• ••• •- • • • ••
• ••• • • • •
• • • • ••••
▪ ••
•••-
• • •• • • • • • • ••
All components exe
Gate pa.
Mater
ail/Post connections shall be shop welded usirlg 511.1;3 or Alter er wired • - •
- — • e powder coated after fabrication.
�6061 6:luminum. ••• • • • • ••• • •
Desi • : 201 �' B o , & ASCE 7-10, wind speed 75 mph, exposure C. ; ; ; ; •; ; ••
Copies . •' . • awing without an original signature and seal of the engideed ate r\ 11:1 ; ;.•.;
No changes are allowed withoutwritten authorization from the engined."' • • • • • • • •
•.This fence is not designed: for use as a balcony rail or other raised structural barrior.
•
FLS.
ASS. 6,' . TES
'�,' .,µ: ..� i 1V C3 .
William F. Flaherty, P.E. 25221
1351 SE 4th Avenue
Pompano Beach, Florida 33060
Certificate of Authorization #26223