ACT-18-1084Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permi
Parcel Number
Permit NO. ACT-4-18-1084
Permit Type: Awnings/Canopies/Tents
Work Classfication:: New
Permit Status: APPROVED
5/3/2018
Expiration: 10/30/2018
Applicant
11300 NE 2 Avenue Number: O'IaughlinHall 1121360000050-07
Miami Shores, FL 33138-0000 Block: Lot:
BARRY UNIVERSITY INC
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
REY'S AWNINGS AND SHUTTERS CO (305)820-9890 (305)820-9890
Valuation:
$ 2,650.00
Total Sq Feet: 400
Approved: In Review
Comments:
Date Approved: : In Review
Date Denied:
Type of Work: REPLACE FABRIC AWNINGS
Classification: Commercial
Code Comments: :
Code Denied:
Additional Info: REPLACE FABRIC AWNINGS
Color Approved: In Review: In Review
Code Approved: : In Review
Scanning: 3
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
P&Z Review Fee
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$1.80
$2.00
$2.00
$0.60
$50.00
$100.00
$9.00
$2.40
$167.80
Pay Date Pay Type
Invoice # .ACT-4-18-67287
04/25/2018 Credit Card
05/03/2018 Credit Card
Amt Paid Amt Due
$ 50.00 $ 117.80
$ 117.80 $ 0.00
Available Inspections:
Inspection Type:
Final
Foundation
Review Building
Review Planning
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 that all the foregoing information is accurate and th- all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore, I authorize the above -named contractor to do e work stated.
Authorized Signature: Owner / Applicant / Contractor
Building Department Copy
May 03, 2018
May 03, 2018
Date
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
BUILDING Master Permit No.
PERMIT APPLICATION Sub Permit No.
[L�BUILDING n ELECTRIC ❑ ROOFING
RECEIVED
APR 2 5 2018
C.Q
FBC 201 "1'
PcC+ loe3 y
❑ REVISION 0 EXTENSION
PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION
CONTRACTOR
JOB ADDRESS: 11300 NE 2 Avenue - O'Laughlin
City: Miami Shores
County: Miami Dade
I I
RENEWAL
SHOP
DRAWINGS
Zip: 33161
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type:
Load: Construction Type:
OWNER: Name (Fee Simple Titleholder): Barry University
Address: 11300 NE 2 Avenue
City: Miami Shores State: FL
Flood Zone:
BFE: FFE:
Phone#:305-899-3995
Zip: 33161
Tenant/Lessee Name: Phone#: 305-899-3995
Email:
CONTRACTOR: Company Name: 7 4.1)11 ( 14 35 &lei .t� 'S (k!/ Ll4/'Phone#: 3O5 — �' 7 —10
Address:
State: pi--
Qualifier
movl Se has
State Certification or Registration #: I✓8'/SQO 85/
,( DESIGNER: Architect/Engineer: /l/9'
Name: /
City: /// CQ'�
Address:
Zip: 3 30
Phone#: 7 8-6- 3 Yl_.—efflJ,V
Certificate of Competency #:
Phone#: 4//
State: Zip:
Value of Work for this Permit: $ S 0
City:
Square/Linear Footage of Work: / O()
Type of Work: ❑ Addition ❑ Alteration ❑ New
Description of Work: �� (l e G
Repair/Replace } ❑ Demolition
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 I-4 •
(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 the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature
OWNER or AGENT
The foregoing instrum nt was acknowledged befor e this
day of A IU 20 t , by
kortN L , why is nPrconall: ra
me or who has produced as
identification and who did take an oath.
NOTARY P
Sign:
Print:
Seal:
i 'F Notary Public State of Florida
Jeffry J Yao
154. ij My Commission FF 168481
aid*° Expires 11/12/2018
*
APPROVED BY
410 _
*
Signature�..—
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of G/ , 20 / Cr , by
'n io h ..S ' t c , who is personally known to
me or who has produced .S 5 3 Z 7,010,'30 i s0
identification and who did take an oath.
NOTARY PUBLIC:
Sign:�6��Gf0�'��
Print: Q re/a F toido/oS
Seal: .►rY,L MARIAEPALACIOS
�,...` Commis/Ion 1i GG 109593
c.* Expires June 11, 2021
*******************:tee ***1' IkAj000494MB Menk*********************
,�.
Plans Examiner
Structural Review
Zoning
Clerk
(Revised02/24/2014)
W NGS
SHUTTERS�
'Agenutacturer of COMPACteilli MCI
T ,fisNaMiI AWAhgS;.. -.
Rey's Awnings & Shutters Corp.
8041 W 21th Ave
Hialeah, FL 33016
Telephone: 3 05-820-98 90
Email: Reysawnings@vahoo.com
Date:
State of
County of Ctrie_
Before me this day personally appeared //¢ Nth Yfwho, being duly sworn deposes
and says:
That he or she will be the only person working on the project located at:
Ik-CC—c),4 rZ')
/73 Co (OF /zci
ontractor Signature
Swo (or affirmed) an subscribed be this /7 day of
by /'Q/m'/Orl 5C1 11 /12S
Personally know
OR Produced Identification
Type of Identification Produced
;pt*;` ::;'9i,E, MARIA E PALACIOS
* Commission 0 GG 109593
Expires June 11, 2021
1r4-OF FI Boedod Thu Stodge( Notary Swim
Print, Type or Stamp Name of Notary
hores 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:
I. 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 listedas an officer of the corporation in the records of the Florida
Department of State, Division of Corporations; and
,:3. The corporation isregisteredand 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 requestinga 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 your project, 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:
Owner
State of Florida
County of Miami-Dades.
The foregoing was acknowledge t e 're me this 62t day. of
By
Notary:
SEAL:
,20
who' is personally known to, me or has produced'
as identification.
TTE MELCNIOR11E
Nary Public 4tals,of florid
Commission M.iF 0K20s'
My Conn. Expires Soo 19, 2020
SmilesNotary Iks a./
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DATE ZS ' u BY
Certificate of Flame Resistance .,.a
CALF
FIRE
MUCE ,"85
Registered Fabric
or Concern Number
F-06901
Issued By:
HERCULITE PRODUCTS INC
ABERDEEN ROAD COMPANY
PO BOX 435
EMIGSVILLE, PA 19175-8310
Date treated or manufactured:
10/10/2017
This is to certify that the materials described below have been treated with a flame-retardant chemical or are inherently
nonflammable.
FOR: Trivantage, LLC
CITY: Glen Raven
ADDRESS: 1831 North Park Ave.
STATE: NC 27217
Certification is hereby made that: (Check "a" or "b")
X
(a) The articles described at the bottom of this Certificate have been treated with a flame-retardant chemical
approved and registered by the State Fire Marshal and the application of said chemical was done in conformance
with the laws of the State of California and the Rules and Regulations of the State Fire Marshal. • • • •
• •
Name of chemical used:
Method of application:
• •
Chemical Registration #:
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(b) The articles described at the bottom of this Certificate are made from a flame -resistant fabric or materi§l • • •
registered and approved by the State Fire Marshal for such use. "• • • • •
•• •• •• •
•
Trade Name of flame -resistant
fabric or material used:
REINFORCED VINYL ' Registraiionlf:: F-06AQ1:•
• •
The Flame -Retardant Process Used Will Not Be Removed By Wasfiing •• • • • • • •
DONALD E. KAUFFMANN
Name of Applicator or Production Superintendent
STEPHANIE MUMMERT, Q C MANAGER
Title
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RCNs # 00000000001055648629
CUSTOMER ORDER NO.
CUSTOMER INVOICE NO. 1748013
YARDS OR QUANTITY 29.00
DESCRIPTION
Weblon Coastline Plus #CP-2726
62" Deep Red (Standard Pack 50
Yards)
ITEM NUMBER 857226
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We hereby certify the above to accurately reflect the information contained within a "CERTIFICATE OF FLAME RESISTANCE" issued to
Trivantage, LLC from the registrant set forth above. A copy of the original Certificate of Flame Resistance is available upon
request to Trivantage, LLC and the registration information set forth above is on record with the California State Fire Marshal.
MAILING ADDRESS
REY CANVAS
8041 W 21 AVE
HIALEAH, FL 33016
.l rocess No:
Munici s al Ins k No:
....roiect Name:
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Addres9c
•• INITIAL REVIEW Applicable
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A��ll UST EV AWE D
MLf eR41-OAOE COUNTY DEPAf TMENT.OF REGULATORY AND fECONOMIIC PESCU'RCtS
[r errbert S. Saffir f er`rrsitton9 and )nspcctiort Ceatct?
11805 SW 26th Street (Coral Way) 0 Miami, Florida 33175-2474 0 (786) 315-2000
APPLGO4TDON FOR MUNPC(PAL PERMGTE' APPUCA ijTS
THAT REOU[I[R[E PUN FEV'U[ W, FROM.L> tiQA M,(-DADC F(RE RESCUE
AND/OR ! NINTROM E[ TALL. SECES
'Job'Address.
Folio-' 413
PROVIDE MsttilL \tlCtCAI-OCIESS NUMBER CBEIFfIS
OO cD'j
Lot Flock
Subdivision
PD3pq
Metes and bounds
PERMIT T PIE
[ J New Construction on [ J • Demolish
Vacant Land [ ]Shell Only
[ J Alteration Interior [ J Addition Attached
[ ] Alteration Exterior [ J Arldilic>rt 17eiached
1 [ Relocation of Structure [ ] Re -Roof
[ I, Enclo nuro 1 I Foundation Only
[ J Rermir [ ] Tent
[ J Repair Due to Fire
[ 1 M13LD°
Cateiory
[ J MELE
[ J MLPG
[ j MMEC
[ J FIRE
'Name
'Address
-CitY74Pr.K ,._.. Stat
Phan;: 305 2c?-RC(C'V
[ J Chg. Contractor- •
[ J Fie -Issue
[, 1 Re -Stamp
1 ] Revision
[ ] Not Applicable for
Fire
77,,,,
ZipsgO,
Contractor No.
Last four (4) digits of Qualifier No. .
Contractor Narne
Qualifier Name
Address
City ((�� State
..Current uso'of-propert7C0
Description ot Work
Zip
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Vhl0i5 oof Work 1 ,V-6o
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OWNER'S NAME
Owner
Address
City
Phoru
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Owner's Social Security No, • • •
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Address
City. State —Zip--........-
Phone
1 am requesting a Special Request Plan l?eviow (SF?!) to be scheduled as soon as pp$siblc at rho rote of $209 for the firs! hour
end $/1.b0 per each additional hour in addition to the review fees. Minimum charge one -hour.
1 A' Request: Date:
2Id RegDear:
3", Request:
Date:
Date:
I am requesting Optional Plan Review (OPRJ to bo scheduled ee soon as possible at the rate of $75 for each discipline.
Additional review fees may apply,
1" Request:
200 Request:
3"' Request:
Date:
Dale:
Date:
2..01-152 4n;
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