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RC-14-2234/QLI� /4 -✓R _ = ex? 713./ ; / `%i, j ‘f ,A3660_„ 12 ,/1"r7- ".41,—;-i- ) i 3.- bt...„ 7/14-- r-'- vs -A..' i-tr (iv,/( (ice Gid., • !.+-f /G -c Lv /0: zo - s,10- d° (J L-.- f1 // -4'- L_ IR, Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Pe mit Issue Date: 312 Permit NO. RC -10-14-2234 Permit Type: Residential Construction Work Classification: Alteration Permit Status: APPROVED 2015 Expiration: 09/21/2015 Parcel Number Applicant 1680 NE 104 Street Miami Shores, FL 1122320320440 Block: Lot: AMIR KERMANI Owner Information Address Phone CeII AMIR KERMANI 3180 S OCEAN DRIVE HALLANDALE BEACH FL 33009- (305)965-0170 Contractor(s) Phone GREATSTONE DEVELOPEMTN INC (786)236-4967 CeII Phone Valuation: Total Sq Feet: $ 105,000.00 2559 Approved: In Review Comments: Date Approved: : In Review Date Denied: Type of Construction: DEMOLITION OF EXTERIOR META Stories: Front Setback: Left Setback: Bedrooms: Plans Submitted: Yes Certificate Date: Bond Return : Occupancy: Single Family Exterior: Rear Setback: Right Setback: Bathrooms: Certificate Status: Additional Info: Classification: Residential Fees Due CCF CO/CC Fee DBPR Fee DCA Fee Education Surcharge Permit Fee Plan Review Fee (Engineer) Plan Review Fee (Engineer) Scanning Fee Technology Fee Amount $63.00 $50.00 $47.25 $47.25 $21.00 $3,150.00 $120.00 $160.00 $51.00 $84.00 Total: $3,793.50 Pay Date Pay Type Invoice # RC -10-14-53248 03/25/2015 Check #: 1261 10/10/2014 Check #: 1156 Amt Paid Amt Due $ 3,593.50 $ 200.00 $ 200.00 $ 0.00 Available Inspections: Inspection Type: Final PE Certification Window Door Attachment Framing Insulation Drywall Screw Window and Door Buck Fill Cells Columns Review Electrical Review Electrical Review Planning Review Planning Review Planning Review Building Review Building Review Building Review Mechanical Review Plumbing Review Plumbing Review Plumbing Review Structural Review Structural 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: ertify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zo ' thermore, I authorize the above-named contractor to do the work stated. March 25, 2015 Aorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy March 25, 2015 1 q C(1'4 \75 n\°-7* Nt° 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 0 ROOFING FBC20iO Master Permit No. RC 14-2234 Sub Permit No. REVISION 0 EXTENSION RENEWAL ❑PLUMBING ❑ MECHANICAL OPUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR JOB ADDRESS: 1680 NE 104th Street DRAWINGS City: Miami Shores County: Miami Dade Zip: 33138 Folio/Parcel#:11-2232-032-0440 Is the Building Historically Designated: Yes NO No Occupancy Type: SGL FAM Load: Construction Type: Masonry Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Amir A Kermani Phone#: 305-965-0170 Address: 3180 S. Ocean Drive # 1514 City: Hallandale Beach State: Florida Zip: 33009 Tenant/Lessee Name: N/A Phone#: N/A Email: N/A CONTRACTOR: Company Name: Greatstone Development, Inc. Phone#: 786-236-4967 Address: 3839 west 16th Avenue City: Hialeah State: Florida Qualifier Name: Shahin Etessam Phone#: State Certification or Registration #: CGC056715 Certificate of Competency #: 305-592-1363 Zip: 33012 786-236-4967 DESIGNER: Architect/Engineer: Pascual Perez Kiliddjian Phone#: Address: 1300 NW 84th AvenueDoral FI 33126 City: State: Zip: Value of Work for this Permit: $1 Si/ Sq are Linear Footage of Work: Type of Work: El Addition 0 Alteration ❑ New 11 Repair/Repllace,� I DDemolition � Description of Work: + iM O i)4 TTil.) Qe- . •1= X i1 (L i — (0 1 )2.4 +t 04 ai ,p3cp Flag Specify color of color thru tile: Submittal Fee $ Permit Fee $ --- 5 • (0 CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE$ GCPjl • Cil (Revised02/24/2014) Bonding Company's Name (if applicable) N/A Bonding Company's Address N/A City N/A 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 co,' 1 ent must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is iss - • a •sence of such posted notice, the inspection will not be approve • • nd a reinspection fee will be charged. Signature Signature=/i(�/r.— OWNER or AGENT a NTRACTOR' The foregoing instrument was acknowledged before me this , 20 /J ' , by day of me or who has produced who is personally known to identification and who did take an oath. NOTARY PUBLIC: Sign/ Print: The foregoing instrument was acknowledged before me this 3 day of ce,'JP_/y>sT' , 20 1f^ , by _e–.714..ciaviriho is personally known to as me or who has produced as identification and who did take an oath. NOTARY PUBLIC: •I• Notary Pudic State of Florida 4 Joanna M Feliciano My Commission FF 082753 Neuf Expires 01/12/2018 .'i Sign. Print: demia...: -VI' dour ,-ier-11111. 4104411100111 a e of Florida Joanna M Feliciano -f �y, ` My Commission FF 082753 oci- Expires 01/12/2018 Seal: **8**/ �i/***'*************************8***8*8****8* *********4*************8*** s, APPROVED BY (Revised02/24/2014) Plans Examiner Structural Review Zoning Clerk 1 1 # Of Units Avg. SQF Hard Cost 1 2502 General Construction Per Unit Budget Total Alarm, Security and camera 0 0 $ - Appliances 0 0 $ - Cabinets, Including tops 5.9952 15000 $ 15,000.00 Cable, TV, Phone Outlets 0 0 $ - Cleaning 0.31974 800 $ 800.00 Closet Shelving 0 0 $ - Concrete Wood Shell 3.9968 10000 $ 10,000.00 Counter Top Corianl Marble 0 $ - Counter Top Culture Marble, and roman 0.6195 1550 $ 1,550.00 Deco Columns, and Accents 0 0 $ - Deco Iron/Railings 0 0 $ - Drive, Walks, Entry 0 0 $ - Electrical, phone, cable 0 0 $ - Electrical Fixtures 0 0 $ - Excavation, Fill, Grading, Including Trash 0.79936 2000 $ 2,000.00 Flooring Carpet 0 0 $ - Flooring Tile, Marble 2.68408 6715.56 $ 6,715.56 Garage Doors With Openers 0 0 $ - Glass Block 0 0 $ - Gutters/ Deco Shutters 0 0 $ - Gyperete Sub -Flooring 0 0 $ - Hambro Flooring 0 $ - Hurricane Shutters 0 0 $ - HVAC 0 0 $ - Insulation 0.19984 500 $ 500.00 Interior Framing & Drywall 0.79936 2000 $ 2,000.00 Irrigation 0 0 $ - Landscaping 0 0 $ - Mail Boxes 0 0 $ - Mirrors 0 0 $ - Painting 1.01918 2550 $ 2,550.00 Plumbing Fixture 0 0 $ - Pool 0 0 $ - PlumbinglSand 0 0 $ - Roofing 10.3917 26000 $ 26,000.00 Shower Enclosure, mirrors, shelves 0 0 $ - Sidewalks 0 0 $ - Sod 0 0 $ - Stairs & Railing 0 0 $ - Survey 0 0 $ - Stucco 0.79936 2000 $ 2,000.00 Trash Load Out( see excavation) 0 0 $ - Trim Carpentry & Finish 1.9984 5000 $ 5,000.00 Windows & Sliding Glass Doors 10.7914 27000 $ 27,000.00 Wood Fences 0 0 $ - Wood Trusses 0 0 $ - 0 $ - Subtotal General Construction hard Cost Cost/ft $ 40.41 $ 101,115.56 $ 101,115.56 AUG -23-2016 11:06 From: To:3057568972 Paee:2/2 OP ID: GA '4� �" CERTIFICATE OF LIABILITY INSURANCE DATEIMI /201 YY) 08/23/2016 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(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 Insurance Marketers Inc. 2600 Douglas Road Suite 712 Coral Gables, FL 33134 Maria Iglesias CONTACT NAME: PHONE (AIC, No, Ext):_ I Ea No): POLICY NUMBER ADDRESS: PRODUCER CUSTOMER ID IS: VOLTE- INSVRER(S) AFFORDING COVERAGE INSURER A : Technology Insurance Co. NAIC B 42376 INSURED VOLTECH ELECTRIC CO INC. 6979 NW 53 TERRACE MIAMI, FL 33166 ^^wmftA-------.-.--__ •..------ INSURER e OCCUR INSURER C : INSURER D : INSURER E EACH OCCURRENCE INSURER F : . • THIS INDICATED. CERTIFICATE EXCLUSIONS -- KtVISIUN NUMULK: IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY PERIOD TO WHICH THIS ALL THE TERMS, - INSR LTR TYPE OF INSURANCE ADDL INSR SUERPOLICY WVD POLICY NUMBER EFF (MM/PP/YYYY), POLICY EXP (MMIPWYYYYI LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY OCCUR EACH OCCURRENCE $ . DAMAGE TO RENTED PRFMIFS (Fe occurrence) $ CLAIMS MAGE MED EXP (Any one person) 3 $ - PERSONA! R ADV INJURY GEN'L "- AGGREGATE LIMIT APPLIES PER:PRODUCTS I. 1,78: I 1 LOC GENERALAOOREGAIE S - COMP/OP AGO 3 -1_POLICY $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDUI FD AUTOS HIRED AVT03 NON -OWNED AUTOS ' COMBINED SINGLE LIMIT (En accident) $ _ BODILY INJURY (Per Fallon) S BODILY INJURY (Per accident) $ PROPERTY DAMAGE (PFR ACCIDENT) S S $ UMBRELLA LWe EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE S AGGREGATE $ DEDUCTIBLE RETENTION S S S A WORJCERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PRDPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? 'mandatory lnNH) It yes, DES(:RIPTION OF OPERATIONS Y / N N / A TWC3522004 01/21/2016 01/21/2017 WC STAru- OTH- _. I TORY LIMITS I x I ER F I .EACH ACCIDENT $ 1,000,000 below E.LDISEASE- EAEMPLOYEE S 1,000,000 E.L DISEASE - POLICY LIMIT $ 1.000.000 DESCRIPTION OF OPERATIONS 1 LOCATIONS 11 VEHICLES Attach ACORD 101, Additional Remarks Schedule if more ace le required) B �UCTIBLES AND EXCLUSIONS LRISTED ON THE POLICY O THE TERMS, CONDITIONS, CERTIFICATE WOI nFR - - -- _ N MIAMISV MIAMI SHORES VILLAGE BUILDING DEPARTMENT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE \gati ACORD 25 (2009/09) ®1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD f fl111-7-L11:--(1177 TESTING & ENGINEERING SERVICES. INC. STRUCTURAL STEEL INSPECTION REPORT Miami Shores Village 10050 Northeast 2"d Avenue Miami Shores, FL 33138 Project: Residence Permit # 2014-2234 1680 N.E. 104th Street Miami Shores, Florida Nelco Testing and Engineering Services, Inc. Project Number: SI -160166 January 13, 201 /2-C,—/ d —1V— ZZ 3 � 006- Dear Sirs, In accordance with request and authorization from CD Group, Inc. a representative of Nelco Testing and Engineering Services, Inc. performed a Structural steel Inspection at the above referenced project. This inspection was performed by means of reviewing plans, and specifications. Components were inspected after welding and bolting, and evaluated to ensure compliance of approved plans, and/or any deficiencies found during inspection that would need to be corrected. Components inspected: • Steel Beams and Columns • Welding of steel I-beam connections to embed in concrete columns. • Welding of steel 1 -beam connections to steel columns. • All bolted connections between wood beams and steel buckets. Upon inspection, the following was noted: It is our professional opinion that the above mentioned components and connections as listed above, were found to be in general accordance with approved project plans, and specifications. Nelco Testing and Engineering Services, Inc. appreciates the opportunity of assisting you in this project. If you have any questions, or if we may be of further assistance, please do not hesitate to contact us. Respectfully submitted, Nelco Testing and Engineering Services, Inc. Vinayagart\ILA\c Professional Engineer No. 63107 State of Florida 13370 SW 131 Street, Suite 105, Miami, FL. 33186 (305) 259-9779 Nelcol iijbellsouth.net www.NelcoTesting.com ? c�,.a.. •:w=^::r•:-`.y'. �;."v�,;;- .> 97ay.�,�. • ca,- rc t'yj,it'�•YS - fw Fi iU,•�tynt. ;; _]IFii>y. iL. ; .�.r1�''VE N n?,d: .'+;yy�x.,, TM �'.,y,.l:.�;• _ s?fgyjlr NAA �.. .,...�: :-:fY,..n.�;...,%5..:;Su•,.it�i.�Y�-'v.�FiwLt]}f�ff,'.c�`.s�:..K:�lAYaFk�' il���9��u�'.�:2 ��Y :-i S s;9:sY �E'5:�'e 7•`r�. �� s. - � y Iro. vu r i. '�-::3 Y} w�i4:�i5'n: Y t��6`s i.� 2 �.rr ..i�.Yx��.: � lam. . , '1H�f'. ...:.4:;ti.1 NaV�(nn-GRAs1ries Page 1 of I Welder Qualification Test Record QD-IG-GMAW WOTR No. QD-1G-GMAW Welder Name DANIEL QUINONES WPS No. NuVuc-GRP1 TO GRP1-G Revision A VVeId r Id QD-G MAW Dale 5/14/2012 Variables Record Actual Values Used In Qualification Qualification Range Process IT.thle 4.10. Ile;n (21) GMAW GMAW ��. I ooster Ivlodc (GkdAW): Short -Cu. Glohul;u Spr;e. F;hors-Circuiting Glr.t.,ulai SprayN Type (',lams:' F:)arhine Se'nu-Auk', Auto Manual Machine to 5ent!-Aulq Giu1(, N . Number of Electrode:, Single • fvlulliple Single 1vltdtittle CttrrenuPol,uity AC DCEP DCEN Pulsed . AC , j , DCEP DCEN , Pulsed Position (Table 4.10, Item (5)) Flat Flat, 1G, 1F, 2F V/etrl Progression: (Tablo 4.10, Item (7)) Uf> • Down ' • Up Down Backing IT able 4.10. Item (01) UseBacking With Backing .• Without Backing 1J Consumable Insert (GTAW) Use Insert !AVilh Insert • Without Insert F Lmior aliSpec A-36 to A-36 GR1 OR GR2 Thickness (Platte): Groove in ) .375 .125 .750 in 4 Fillet (in ) N/A .125 Unlimited in Thickness (Pipeitube): Groove in ) N/A .125 - .750 in Fillet tin ) N/A .125 - Unlimited in Dianteter(Pipe): Groove in ) N/A 24 - Unlimited in Fillet ( ) N/A Any Unlimited in Notes NONE NONE Filler Metal (Table 10. Item (3)) Spec. A 5-18 A 5-18 Class. ER -70S6 ER -70S2 ER -70S3 ER -70S4 ER -70S6 ER -70S7 F -No. F-6 F-6 GasiF(ux Type (Table 4.10. Item (4)) 75%Ar/25%CO2 : 75%Ar/25%CO2 Other FLOW RATE 27CFH VISUAL INSPECTION (4.8.1) Acceptable Yes GUIDED BEND TEST RESULTS (4.30.5) Type Result -type ROOT PASS FACE= PASS Appealn,tce N/A Result Fillet Test Results (4.30.2.3 and 4.30.4.1) Fillet Size N/A Macroetch N/A Fracture: Test Root Penetration N/A Description Inspected By ALBERT HERMIDA Test No. QD-1G-GMAW OrganizationContinentaf Welding Inspection 5/14/2012 RADIOGRAPHIC TEST RESULTS (4.30.3.1) Film ldeilliticniton No Result Remark NIA • i't i:.f. Interpreted By N/A Organization N/A Test No. QD-'IG-GMAW Date 5/14/2012 We, the unuersigned cerla(y that ttie statements in tills iecorrl are correct anti that the test melds were prepared. wearied, ;toil Irslecl u> accordance With the requirements el section 4 of ANSI/AWS D1.1. ( 10 1 Structural Welding Code -Sleet. Fvlaanuladiiier NuVue Industries Per AWS D1.1 Authorized By ALBERT HERMIDA SCWI//12010018 Date 5/14/2012 ;•;(,.uin,v rerlt •. • .7.1' x4r.' •-r*...• • -3r, • „ .••••••..'• • rr".',Af'• 1-#'7'.• • •••Jf: N-1•1 , Ng 37▪ .'1 .; 1:Ay.;•;•,,` , -•te44: ,•.;• - - Certificate of Completion Miami Shores Village 10050 NE 2 Ave, Miami Shores FL, 33138 Tel: 305-795-2204 Fax: 305-756-8972 Building Inspection Department i,::' k : ;:4 •,,nif.:,/st. A: .,u: This certificate issued pursuant to the requirements of the Florida Building Code 106.1.2 certifying that at the time of issuance this structure was in :..er .z.:. • -2,7,..4,?..._,:. compliance with the various ordinances of the jurisdiction regulating building construction or use. For the following: • ..t-y'f, '-.:, tr.,!..1... .11.4;,• pier- 1 •'- c •;,...L.,.;ti-X-,-: Permit Type ;'; AMIR KERMANI Contractor GREATSTONE DEVELOPMENT INC Owner k .).. .... • Subdivision/Project NONE /Date Issued 11/28/2016 Occupancy -.1.•,- ••••;,•:471.! ---- 4:.!:.9:4•17,:,-;:,...",..:`.1"..,..g.:::..1,1:•::„.1-.;3 •,...:,-,x ..-4,,-;...,....,..-▪ •. Construction Type V - B Load N/A .1:41.:c.r?•,,?-?:-.5.ti, Occupancy Pik w..4.„.t.f.0,,,,, ▪ • 1.- ... -...• .r.;;;; Square Footage 2559 Type R -3 :;,,o's: ,i!,..- • -....:. RESIDENTIAL CONSTRUCTION Bldg. Permit No. Description of Applicable INTERIOR ALTERATION Work Code Location 1680 NE 104 ST Miami Shores FL 33138 RC -10-14-2234 Building Officials Approval Not Transferable POST IN A CONSPICUOUS PLACE • • • (-0 Ismael Naranjo, CBO • • • • < 1 „werr "&t."1.1i7d-••••:-'`- - • Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-271691 Permit Number: RC -10-14-2234 Scheduled Inspection Date: November 28, 2016 Inspector: Naranjo, Ismael Owner: KERMANI, AMIR Job Address: 1680 NE 104 Street Miami Shores, FL Project: <NONE> Contractor: GREATSTONE DEVELOPEMTN INC Permit Type: Residential Construction Inspection Type: Final Work Classification: Alteration Phone Number (305)965-0170 Parcel Number 1122320320440 Phone: (786)236-4967 Building Department Comments DEMOLITION OF EXTERIOR METAL TRELLISES, REPLACE DOOR AND WINDWOS. REPLACE AC, NEW KITCHEN, NEW PLUMBINGA DN ELECTRICAL PANEL AND FIXTURES. NEW FLOORING AND PAINT. A stop work order was issued on 05-22-15 for work performed beyond the approved plans. on July 2,_.2n15 the contractor and the propPrty owner re-suhin,lted Nldns reflecting the full extend to proceed with the review, please take a I provided for accuracy. Passed 09-18-151. Naranjo Base 011 tlle unila[ on piovided by tI�C revise plans it is my opinion th - - - . tim vfetioved under this per it doe- not substantial improvement. Infractio Passed Comments INSPECTOR COMMENTS False of the work. o.k. Dntractor and the e the scope of Donstitutes a Correction Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. November 23, 2016 For Inspections please call: (305)762-4949 Page 16 of 23 `S�� - 7426 INSPECTIONRECO�.D POST oNSITE Permit NO. RC -10-14-2234 Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 Fax (305)756-8972 Permit Type: Residential Construction Work Classification: Alteration Issue Date: 3/25/2015 Amor r INSPECTION REQUESTS: (305)762-4949 or Log on at https://bldg.miamishoresvillage.com/cap REQUESTS ARE ACCEPTED DURING 8:30AM - 3:30PM FOR THE FOLLOWING BUSINESS DAY. Requests must be received by 3 pm for following day inspections. Expires: 09/21/2015 5 Residential Construction Parcel #:1122320320440 Owner's Name: AM IR KERMANI Job Address: 1680 NE 104 Street Bond Number: Miami Shores. FL Contractor(s) Phone Primary Contractor GREATSTONE DEVELOPEMTN INC (786)236-4967 Yes Owner's Phone: (305)965-0170 Total Square Feet: 2559 Total Job Valuation: $ 105,000.00 WORK IS ALLOWED MONDAY THROUGH SATURDAY, 7:30AM - 6:OOPM. NO WORK IS ALLOWED ON SUNDAY OR HOLIDAYS. BUILDING INSPECTIONS ARE DONE MONDAY THROUGH THURSDAY. ROOFING INSPECTIONS ARE DONE MONDAY THROUGH FRIDAY. NO BUILDING INSPECTIONS DONE ON FRIDAY. Veld as/ J h- eZeb G _ w h/ I it_ 1--r Gam► • < �(44/.e-Y 1t { -p`+Jwy� `11 � J U11‘. i r �r u iilf i.L- 42,L L,1.11 li IILJil► 1 %mssl cert (a she -f p k-/0 4 ��lr112 NO INSPECTION WILL BE MADE UNLESS THE PERMIT CARD IS DISPLAYED AND HAS BEEN APPROVED. PLANS ARE READLY AVAILABLE. IT IS THE PERMIT APPLICANT'S RESPONSIBILITY TO ENSURE THAT WORK iS ACCESSIBLE AND EXPOSED FOR INSPECTION PURPOSES. NEITHER THE BUILDING OFFICIAL NOR THE CITY SHALL BE LIABLE FOR EXPENSE ENTAILED IN THE REMOVAL OR REPLACEMENT OF ANY MATERIAL REQUIRED TO ALLOW INSPECTION. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY 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 YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. INSPECTION RECORD STRUCTURAL INSP INSPECTION DATE INSP Foundation Rough Stemwall Water Service Slab ELECTRICAL Columns (1st Lift) .,,�z/7/ DATE INSP Columns (2nd Lift) Fire Sprinklers ` Tie Beam Sewer Hook-up Truss/Rafters Roof Drains Roof Sheathing Gas Bucks LP Tank Windows/Doors Well /i l fo Interior Framing Insulation Ceiling Grid fL Main Drain 0/0i Drywall a Firewall Ceiling Rou h Wire Lath 102 13/062'/5am Pool Steel Telephone Rough Pool Deck Telephone Final Final Pool TV Rough % Final Fence TV Final Screen Enclosure Cable Rou • h PLUMBING Co MMENTS Driveway Cable Final Driveway Base Intercom Rough Tin Cap Intercom Final INSP Roof in Progress Alarm Rough Mop in Progress Alarm Final AI4 Final Roof Fire Alarm Rough `Ut1, Shutters Attachment Fire Alarm Final Final Shutters Service Work With ELECTRICAL COMMENTS Rails and Guardrails , 04-' '/ - Verr 5.0 l i ADA com • fiance FINAL, IV DOCUMENT Soil Bearing Cert Final Ventilation Soil Treatment Cert Final Pool Heater A Floor Elevation Surve Final Vacuum rOr Reinf Unit Mas Cert FINAL Insulation Certificate MECHANICAL COM E Spot Survey Final Survey e " °-A- CLC > Truss Certification STRUCTURAL COMMENTS ity ZONING INSPECTION DATE INSP Zoning Final titft,lAii ZONING COMMENTS (/ Z-15 Rough Water Service ELECTRICAL INSPECTION DATE INSP Temporary Pole Fire Sprinklers Septic Tank 30 Day Temporary Sewer Hook-up Pool Bonding Roof Drains Pool Deck Bonding Gas rPool Wet Niche LP Tank Underground Well Footer Ground Lawn Sprinklers Slab Main Drain Wall Rough Pool Piping Ceiling Rou h Backflow Preventor Rough %% ) 13/062'/5am Interceptor Telephone Rough Catch Basins Telephone Final Condensate Drains TV Rough % HRS Final TV Final FINAL �a Cable Rou • h PLUMBING Co MMENTS Cable Final Intercom Rough MECHANICAL INSPECTION Intercom Final INSP Underground Pipe Alarm Rough avr� �4I1 Alarm Final AI4 Roush` Fire Alarm Rough `Ut1, Fire Alarm Final entilation Rough Service Work With ELECTRICAL COMMENTS Hood Rough , 04-' '/ - Verr 5.0 l i Pressure Test PLUMBING INSPECTION DAN INSP titft,lAii 1 (/ Z-15 Rough Water Service 2n Rough • Top Out !i'"(..tir It n• Fire Sprinklers Septic Tank Sewer Hook-up Roof Drains Gas LP Tank Well Lawn Sprinklers Main Drain Pool Piping Backflow Preventor Interceptor Catch Basins Condensate Drains % HRS Final FINAL �a `L,.A PLUMBING Co MMENTS MECHANICAL INSPECTION DATE INSP Underground Pipe avr� �4I1 &v1� AI4 Roush` ? `Ut1, entilation Rough Hood Rough Pressure Test Final Hood Final Ventilation Final Pool Heater A Final Vacuum rOr v� FINAL MECHANICAL COM E ! ' e " °-A- CLC > Miami Shores Village Building Department 10050 N.E. 2nd Avenue Miami Shores, FL 33138 RE: Residence 1680 N.E. 104th Street Miami Shores, Florida Permit No. RC -10-14-2234 Dear Building Official: EU MILE= TESTING £s ENGINEERING SERVICES, INC November 22, 2016 We hereby attest that to the best of our knowledge, belief and professional judgment, the structural and envelope components of the above referenced structure are in compliance with the approved plans and other approved permit documents. We also attest that to the best of our knowledge, belief and professional judgment the approved permit plans represent the as -built condition of the structural and envelope components of said structure. This document is prepared in accordance with the Florida Building Code, and is being submitted to the Village of Miami Shores Building Department at the time of final inspection for the above referenced structure. Should you have any questions or need additional information, please do not hesitate to contact us. Reskptfuliy submitted, Nelco Testing and Engineering Services, Inc. Vinayagar 1\47an\VL1--\‘k Professional Engineer No. 63107 State of Florida 13370 SW 131 Street, Suite 105, Miami, FL. 33186 (305) 259-9779 LSA NSPECTION ECO D Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 Fax (305)756-8972 7,96 — 6 Z POST ON SITE Permit NO. RC -10-14-2234 Permit Type: Residential Construction Work Classification: Alteration Issue Date: 3/25/2015 Expires: 09/21/2015 INSPECTION REQUESTS: (305)762-4949 or Log on at https:/IbIdg.miamishoresvillage.comlcap REQUESTS ARE ACCEPTED DURING 8:30AM - 3:30PM FOR THE FOLLOWING BUSINESS DAY. Requests must be received by 3 pm for following day inspections. MOP Residential Construction Parcel #:1122320320440 Owner's Name: AMIR KERMANI Job Address: Bond Number: 1680 NE 104 Street Miami Shores. FL Contractor(s) Phone Primary Contractor GREATSTONE DEVELOPEMTN INC (786)236-4967 Yes Owner's Phone: (305)965-0170 Total Square Feet: 2559 Total Job Valuation: rwrz„asrz r:srax.vor77cr, .r/ WORK IS ALLOWED MOND T ROUGH SATURDAY, 7:30AM - 6:OOPM. NO WORK IS ALLOWED ON SUNDAY OR HOLIDAYS. BUILDING INSPECTIONS ARE DONE MONDAY THROUGH THURSDAY. ROOFING INSPECTIONS ARE DONE MONDAY THROUGH FRIDAY. NO BUILDING INSPECTIONS DONE ON FRIDAY. — Av.i�--�� f/ /e, .- ��,t% r a,e. 44 ea -4„--04 c , 5-41,1 tl t -- 11.E 1041Y 41-A/ 6< kifiyazycs f h1/j ! NO INSPECTION WILL BE MADE UNLESS THE PERMIT CARD IS DISPLAYED AND HAS BEEN APPROVED. PLANS ARE READLY AVAILABLE. IT IS THE PERMIT APPLICANTS RESPONSIBILITY TO ENSURE THAT WORK IS ACCESSIBLE AND EXPOSED FOR INSPECTION PURPOSES. NEITHER THE BUILDING OFFICIAL NOR THE CITY SHALL BE LIABLE FOR EXPENSE ENTAILED IN THE REMOVAL OR REPLACEMENT OF ANY MATERIAL REQUIRED TO ALLOW INSPECTION. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY 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 YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. INSPECTION RECORD a:` STRUCTURAL INSPECTION DATE INSP Foundation Zoning Fina! Stemwall ZONING COMMENTS Rough Slab Water Service Columns (t st Lift) j!7 . Columns (End Lift) 30 Day Temporary Toe Out Tie Beam r Pool Bonding Fire Sprinklers Truss/Rafters Pool Deck Bonding Septic Tank Roof Sheathinn 'Pool Wet Niche Sewer Hook-up Bucks 1111111111111111 Roof Drains Windows/Doors, Footer Ground Gas Interior Framin• 11 Slab LP Tank Insulation M/l„ all Rough Well rI Ceiling (arid Ceiling Rou . h Lawn Sprinklers Drywall NreYs 62'°f Firewall Telephone Rough ME Wire Lath>Airi MA 1 Backflow Preventor Pool Steel rM Interceptor Pool Deck TV Final Catch Basins Final Pool _IIIIII Condensate Drains Final Fence Cable Final HRS Final Screen Enclosure Intercom Rough FINAL, f C Driveway Intercom Final Driveway Base Alarm Rough Tin Ca•� Alarm Final MECHANICAL INSPECTION Roof in Progress Fire Alarm Rough 4. --- Mop in Progress Final Roof Fire Alarm Final ;t Shutters Attachment Service Work With I N A Lr•-•!.' Rough Ilp Final Shutters ELECTRICAL COMMENTS �/'u- r t f,---t7 Rails and Guardrails Ventilation Rough ADA com•liance Hood Rough FINAL,. DOCUMENTS Soil BearinCg pert Soil Treatment Cert Final Ventilation Floor Elevation Surve Final Pool Heater Reinf Unit Mas Cert Insulation Certifica�`e S••tSurvey FINAL s �. Final Survey 4 .,,,S�' id 'tliMi �0� _ !�- Truss Certification STRUCTURAL COMMENTS S ZONING INSPECTION DATE INSP Zoning Fina! ZONING COMMENTS Rough Water Service ELECTRICAL INSPECTION DATE INSP Tem ora Pole O� 30 Day Temporary Toe Out -C r Pool Bonding Fire Sprinklers Pool Deck Bonding Septic Tank 'Pool Wet Niche Sewer Hook-up Underground Roof Drains Footer Ground Gas Slab LP Tank all Rough Well rI Ceiling Rou . h Lawn Sprinklers Rough � : �. 62'°f Telephone Rough Pool Piping Telephone Final Backflow Preventor TV Rough Interceptor TV Final Catch Basins Cable Rough Condensate Drains Cable Final HRS Final Intercom Rough FINAL, f C Intercom Final Alarm Rough Alarm Final MECHANICAL INSPECTION DATE Fire Alarm Rough 4. --- Fire Alarm Final ;t Service Work With I N A Lr•-•!.' Rough Ilp ELECTRICAL COMMENTS �/'u- r t f,---t7 Ventilation Rough INSPECTION Final S •rinider PLUMBING INSPECTION DAA =':. INSP Rough Water Service o Rough, Toe Out -C Fire Sprinklers Septic Tank Sewer Hook-up Roof Drains Gas LP Tank Well rI Lawn Sprinklers Main Drain Pool Piping Backflow Preventor Interceptor Catch Basins Condensate Drains HRS Final FINAL, f C PLUMBING C MMENTS MECHANICAL INSPECTION DATE INSP Underground Pipe Pcv1444,4'�' J2li4 ;t Rough Ilp Ventilation Rough Hood Rough Pressure Test Final Hood Final Ventilation Final Pool Heater Final Vacuum FINAL s �. MECHANICAL COMMS 4 .,,,S�' id 'tliMi �0� _ !�- <' 4' ) �} �.,i�CC/ MIAM?I:Yt Miami -Dade County Building Department 11805 S.W. 26 Street, Miami, FL 33175-2474 www.miamidade. ecn :'buildin t et 1.1t1,t' via Building Permit No: 20i Project Name: Job Address: 223L/ $0 Insulation Certificate Insulation is installed in the structure described below as follows: Work Area R-5 Rigid Board Exterior Walls Baffles R-30 Batt Fiberglass to Garage Attic R-30 Batt Fiberglass in Attic Job Name: KERMANI RESIDENCE Job Address: 1680 NE 104TH STREET Item Installed .75" x 4' x 8' Hunter XCI Foil Baffle, CORG 24" x 23" R-30 16" x 48" - Kraft - EcoBatts R-30 24" x 48" - Kraft - EcoBatts Installed By: TCI CONTRACTING LLC DBA INSTALLED BUILDING PRODUCTS .Insulation Contractor Signature Of Miami AKA. ANY SEASON INSULATION Insulation contractor CC# 1330869 G.0/BUILDER Bags / Sq Feet Date Certified: 1'7/c //92/t G.0/Builders Signature Building Contracting CC# Date Ceritified: seiN �� 9A°` stabs --ami 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 o3 — S'HA-441nr BUILDING 2,:25 _Am%a-C,zl� PERMIT APPLICATION ►'1 BUILDING ❑ ELECTRIC ❑ ROOFING EI PLUMBING D MECHANICAL El PUBLIC WORKS JOB ADDRESS: 1680 NE 104th Street Master Permit No. Sub Permit No. F,TVED OCT 092014 FBC 201 '•c_, 4 - 9a 39 ❑ REVISION ❑ EXTENSION RENEWAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS City: Miami Shores County: Miami Dade Zip: 33138 Folio/Parcel#:11-2232-032-0440 Is the Building Historically Designated: Yes NO No Occupancy Type: SGL FAM Load: Construction Type: Masonry Flood Zone: OWNER: Name (Fee Simple Titleholder): Amir A Kermani Address: 3180 S. Ocean Drive # 1514 BFE: FFE: Phone#: 305-965-0170 City: Hallandale Beach State: Florida zip: 33009 Tenant/Lessee Name: N/A Phone#: N/A Email: N/A CONTRACTOR: Company Name: Greatstone Development, Inc. Phone#: 786-236-4967 Address: 3839 west 16th Avenue City: Hialeah Qualifier Name: Shahin Etessam State: Florida zip: 33012 Phone#: 786-236-4967 State Certification or Registration #: CGC056715 Certificate of Competency #: Phone#: 305-592-1363 DESIGNER: Architect/Engineer: Pascual Perez Klllddjlan Address: 1300 NW 84th Avenue Value of Work for this Perm P/P Type of Work: ❑ Addition 0 Alteration City: Doral state: FI zip: 33126 Square/Linear Footage of Work: 2559 SQF as per property appraiser ❑ New 0 Repair/Replace 0 Demolition Description of Work: Demolition of exterior metal trellises, replacement of doors and windows with Impact doors and windows replacement of Air Conditioning with new and more efficient HVAC, New kitchen, new plumbing and electrical panel and fixtures New flooring and paint. Resurfacing the pool and pool deck, New roof. ' - r?.ti_ 3 g-( syn Specify color of color thru tile: Submittal Fee $ Permit Fee $ 310 . CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR$ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ 4l/ TOTAL FEE NOW DUE $ J . (Revised02/24/2014) Bonding Company's Name (if applicable) N/A Bonding Company's Address N/A City N/A 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 issu absence of such posted notice, the inspection will not be approv • and a reinspection fee will be charged. OWNER or AGENT The foregoing instrument ew�acknowledged before me this The foregoing instrument was acknowledgedabefore me this (0 day of ©� / 20 /� by �� day of C�OCET , 20 1A. , by 141,1110 Keg MA -A! / , who is personally known to S1rtaW1v‘ ���- �1, who is personally known to Signature k CONTRACTOR me or who has produced identification and who did take an oath. NOTARY PUB as me or who has produced identification and who did take an oath. NOTARY PUBLIC: as Sign: Prin Seal: r r:'. •«_ MY COMMISSIO # EE140187 '• 2015 •.1' °' EXPIRES October 23, (407) 398-0153 FloridallotaryService.com MYCOQ+ / �;,GN#Eh,71626 E FIRES MMe)' 7, 2016 Fended Thru Nrdari PuhGc Underwriter ***************************************Ik****/**##-+Y********************************************************* APPROVED BY I Plans Examiner I � . qa ' '(j Zoning (Revised02/24/2014) Structural Review Clerk STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 ETESSAM, SHAHIN GREATSTONE DEVELOPMENT INC 1844 NORTH NOB HILL STE 246 PLANTATION FL 33322 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in older to serve you better. For information about our services, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! DETACH HERE RICK SCOTT, GOVERNOR STATE OF FLORIDA j DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CGC056715 ISSUED' 05/29/2014 CERTIFIED GENERAL CONTRACTOR ETESSAM, SHAHIN GREATSTONE DEVELOPMENT INC IS CERTIFIED under the provisions of Ch.489 FS. Expiravon date AUG 31, 2016 L1405290002003 KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD LICENSE NUMBER The GENERAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 ETESSAM, SHAHIN GREATSTONE DEVELOPMENT INC 1844 NORTH NOB HILL STE 246 PLANTATION FL 33322 ISSUED: 05/29/2014 DISPLAY AS REQUIRED BY LAW SEG # L1405290002003 BROWARD COUNTY LOCAL BUSINESS'TAX"RECEIPT 115 S. And VALID OCTOBER 11, 201400, Ft. a THROUGH SEPTEMBER 30, 2015uderdale, FL 33301-1895 — 000 DBA: GREATSTONE DEVELOPMENT Business Name: Owner Name: SHAHIN ETESSAM Business Location: 1844 N NOB HILL RD PLANTATION Business Phone: 954-494-6913 Rooms Seats' ti INC 34 L23 CONTRACTOR (GENERA Business Type:CONTRACTOR) Receipt #:GENERA Business Opened:09/01/1998 246 State/County/Cert/Reg:CGC056715 Exemption Code: Employee, ) , \ Machines , 2 i Professionals Tax Amount Number of Machines: Transfer Fee 27.00 0.00 For Vending Business Only Vending Type: -_NSF_Fee I_ _t?enaity _ Prior Years 0.001J't 4„ 0.00 l� l ;)0.0u 0': Collection Cost Total Paid 0.00 27.00 THIS RECEIPT MUST BE THIS BECOMES A TAX RECEIPT WHEN VALIDATED Mailing Address: SHAHIN ETESSAM 1844 N NOB HILL RD #246 PLANTATION, FL 33322 POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS This tax is levied for the privilege of doing business within Broward County and is non -regulatory in nature. You must meet all County and/or Municipality planning and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in corilpliance with State or local laws and regulations. Receipt #1CP-13-00005090 Paid 07/14/2014 27.00 2014 - 2015 OP ID: MCAR ACRO" keie.� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 10/09/14 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 305-442-9507 Insurance Marketers, Inc.305-447-8527 2600 Douglas Road Suite 712 Coral Gables, FL 33134 Evarist Milian, Jr. CONTACTNAME: PHONE FAX INC. No. Ext): (A/C, No): E-MAIL ADDRESS: PRODUCER GREA-10 CUSTOMER ID #: INSURER(S) AFFORDING COVERAGE NAIC # INSURED Greatstone Development Inc. 3839 W. 16th Avenue Hialeah, FL 33012 INSURER A: Starr Surplus Lines Ins Co INSURER B : Mt. Hawley Insurance Co. SIPGGL02398-00 INSURER C : 03/21/15 INSURER D : S 1,000,000 INSURER E : s 100,000 INSURER F : CLAIMS -MADE 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 AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUER WV. POLICY NUMBER POLICY EFF (MM/DDIYYYY) POLICY EXP IMMIDDIYYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY I •• I OCCUR SIPGGL02398-00 03/21/14 03/21/15 EACH OCCURRENCE S 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurcence) s 100,000 CLAIMS -MADE MED EXP (Any one person) $ 5,000 PERSONAL 8, ADV INJURY S 1,000,000 GENERAL AGGREGATE S 2,000,000 �GEN'L AGGREGATE LIMIT APPLIES PER: n I POLICY JFCT LOC PRODUCTS - COMP/OP AGG $ 2,000,000 Emp Ben. s 1,000,000 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) S BODILY INJURY (Per person) S BODILY INJURY (Per accident) S PROPERTY DAMAGE (Per accident) S S $ B X UMBRELLA LIAB EXCESS UAB X OCCUR CLAIMS -MADE MXL0371504 03/21/14 03/21/15 EACH OCCURRENCE $ 5,000,000 AGGREGATE S 5,000,000 DEDUCTIBLE RETENTION S S S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y 1 N ANY PROPRIETORIPARTNERIEXECUTNE OFFICER/MEMBER EXCLUDED?ri (Mandatory In NH) If yes. describe under DESCRIPTION OF OPERATIONS below N / A WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT S E.L. DISEASE - EA EMPLOYEE S E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule if more space Is required) Coverages are subject to the terms, condtitions, deductibles and exclusions as show in the polity. CGC#056715 CERTIFICATE HOLDER CANCELLATION I VILLAMI Village of Miami Shores 9 10050 NE 2nd Avenue Miami Shores, FL 33138-2382 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE a CJ ACORD 25 (2009/09) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORL® CERTIFICATE OF LIABILITY INSURANCE 4.......---" DATEIMMIDDYYYY) 10/9/2014 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 POUCIES 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 Ileu of such endorsement(s). PRODUCER INSURANCE MARKETERS INC. 2600 S DOUGLAS ROAD SUITE 712 CORAL GABLES FL 33134 CONTACT NAME: MARIA A IGLESIAS FAX wCNNo. Extl:.(1.5447A5n7 NO: ADD ESS: MIGI FSIASOINSLIRANCFMRKT COM INSURER(S) AFFORDING COVERAGE NAIC N INSURER A : FWCJUA LIABIU Y COMMERCIAL GENERAL UABILITY INSURED GREATSTONE DEVELOPMENT INC 3839 W 18TH AVENUE HIALEAH FL 33012 FEIN: 650862963 INSURER 5: INSURERC: INSURER 0 : S INSURER E : $ INSURER F : $ COVERAGES CERTIFICATE NUMBER: 1410090019 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 LTR TYPE OF INSURANCE ADOLSUBR INSR WOO POLICY NUMBER POLICY EFF (MMIOOIYYYY) POLICY EXP (MWD LIMITS GENERAL LIABIU Y COMMERCIAL GENERAL UABILITY EACH OCCURRENCE S PRREEMISESO(Ea Eoc srence) $ MED EXP (Any ons person) $ CLAIMS -MADE C OCCUR PERSONAL & ADV INJURY S GENERAL AGGREGATE $ PRODUCTS -COMP/ P AGO $ GENT. AGGREGATE LIMIT APPUES PER: 7 POLICY T1 /EDT n LOC $ AUTOMOBILE — UABIUTY ANY AUTO ALL OWNED AUTOS HIRED AUTOS _ _ SCHEDULED AUTOS N -OWNED AUTOS (l CEOMBINE�DISINGLE LIMIT occid) ; BODILY INJURY (Per parson) $ BODILY INJURY (Per sodden() $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA IJAB EXCESS UAB — OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENTION $ A WO AND ANY OFFICE/MEMBER (Mandatory fyea DESCRIPTION )KERS COI EMPLOYERS' PROPRIETOR/PARTNERIEXEC &turboNunder OF ENSATION LIABILITY UTIVE EXCLUDED? OPERATIONS below Y / N Y N 1 A D3$3M98A MINIMUM PREMIUM POLICY 9/30/2014 9/30/2015 X WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ 1.000.000.00 E.L. DISEASE - EA EMPLOYEE S 1,000,000.00 E.L DISEASE - POUCY MUT 11,000,000.00 CC DESCRIPTION OF OPERATIONS I LOCATIONS ( VEHICLES (Attach ACORD 101, Additional Remarks Schedule, E more space Is required) CGC#056175 CERTIFICATE HOLDER CANCELLATION Village of Miami Shores 10050 NE 2nd Ave Miami PhonelNumber 305-4429507 ACORD 25 (2010/05) FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE(\:A� ®1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 RG 14-ZZ3CI Inspection Number: INSP-266035 Permit Number: EL -3-15-566 Scheduled Inspection Date: August 26, 2016 Inspector: Devaney, Michael Owner: KERMANI, AMIR Job Address: 1680 NE 104 Street Miami Shores, FL Project: <NONE> Contractor: VOLTECH ELECTRIC CO INC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Phone Number (305)965-0170 Parcel Number 1122320320440 Phone: (305)218-6166 Building Department Comments REMODEL - ELECTRICAL WORK REPAIR. Infractio Passed Comments INSPECTOR COMMENTS False Passed Failed Correction Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP-265982. Move smoke detectors to 3 feet away from retur - : rills. /11g,„..6 August 25, 2016 For Inspections please call: (305)762-4949 Page 18 of 36