ACT-18-1085Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Issue Date: St
Permit NO. ACT-4-18-1 085
Penn!! Type: Awnings/Canopies/Tents
Work CJaasitication: New
Permit Status: APPROVED
2018 Expiration: 10/30/2018
Parcel Number
Applicant
11300 NE 2 Avenue Number: Landon Studer 1121360010160-26
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:
$ 8,200.00
Total Sq Feet: 600
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
Amount
$5.40
$3.69
$2.46
$1.80
$50.00
$246.00
$9.00
$7.20
Total: $325.55
Pay Date Pay Type
Invoice # ACT-4-18-67288
05/03/2018 Credit Card
04/25/2018 Credit Card
Amt Paid Amt Due
$ 275.55 $ 50.00
$ 50.00 $ 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 that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated.
Authorized Signature: Owner / Applicant / Contractor
Building Department Copy
May 03, 2018
May 03, 2018
Date
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
PERMIT APPLICATION
BUILDING ❑ ELECTRIC ❑ ROOFING
PLUMBING ❑ MECHANICAL ❑ PUBLIC WORKS
JOB ADDRESS: 11300-NE 2 Avenue - Landon
City:
Miami Shores County:
RECEIVEE
APR 2 5 2018
62 t) Ck( 4-1
FBC�' 2U1
Master Permit No. PCC1}18 -tOg.S
Sub Permit No.
❑ REVISION ❑ EXTENSION ❑RENEWAL
CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
Miami Dade Zip: 33161
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type:
Load: Construction Type:
Flood Zone:
BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Barry University Phone#:305-899-3995
Address: 11300 NE 2 Avenue
City: Miami Shores State: FL Zip: 33161
Tenant/Lessee Name: Phone#: 305-899-3995
Email:
CONTRACTOR: Company Name:
/ e Y /JC )) (Yl 35 (Am 14m &I) Phone#: 30 " yef )
Address: 9'/( 1q') i 4V`
City: / / CQ`2.C/ State:
Qualifier Name: 6 man SQ Y/1,40,5 t—
State Certification or Registration #:
DESIGNER: Architect/Engineer:
Address:
Z//i9-
xi/4-
Value of Work for this Permit: $ Z260
Type of Work: ❑ Addition ❑ Alteration
Description of Work:
Zip: 3 30 /
Phone#: 7 8-6- 3 Viz—kQ,3 y
Certificate of Competency #:
Phone#: '1/$
City: State: Zip:
Square/Linear Footage of Work: (0 0
❑ New
Repair/Replace ❑ Demolition
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ CCF $
Scanning Fee $ Radon Fee $ DBPR $
Technology Fee $ Training/Education Fee $
Structural Reviews $
(Revised02/24/2014)
CO/CC $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE$ 2� S •.�
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 instrument was acknowledged before me this
lO17\1 day of L AM n,20 I ,by
'1llSvLL KNn who i personally sown to
me or who has produced as
identification and who did take an oath.
NOTARY PUB :
Sign:
Print:
Seal:
ATM
Notary Public State of Flo da
Jeffry J Yao
My Commission FF 168481
a Or Expires 11/12/2018
****************************
APPROVED BY
*
*****************
Signature
2 �
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of _/t✓/ , 20 / , by
1C zmon Sa7 h /oS , who is personally known to
me or who has produced .S 5-3 Z- 7 S3 3G f -O
identification and who did take an oath.
NOTARY PUBLIC:
Sign:aa; Waal-45'7
/4/077/a of oa/o s
Print:
Seal: t�r�
jp .,... WRIA E PALACIOS
* Commission *GO 109593
• Expires June 11, 2021
**********************
Plans Examiner / ( j Zoning
Structural Review Clerk
(Revised02/24/2014)
/430o OA-
Contractor Signature
Sworn o (or affirmed) and subscribed be this /7 day of
by /ci<mvn Sa.n
AWNGS
SHUTTERS,
Marto etComen ciaiadd
f.Ytlma.lA+Mdnq.;
Rey's Awnings & Shutters Corp.
8041 W 21th Ave
Hialeah, FL 33016
Telephone: 305-820-9890
Email: RevsawningsPvahoo.com
Date:
State of
County of
Before me this daypersonallyappeared �m Set, S who, being duly sworn deposes
ppY
and says:
That he or she will be the only person working on the project located at:
6c)//c6K,
. 20/g
Personally know v
OR Produced Identification
Type of Identification Produced ,
/r/ / • l %/'ct7•D
Print, Type or Stamp Name of Notary
:O!R.:". MARIA E PALACI03
* Commission # GG 109593
Expires June
.r of iaPe9 Now tin Budget 1 2021
iami hores Vi llage
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. Ha. 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 irn.luding 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 atleast 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 andhas ;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 thathe or she_wli
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:
State of Florida
County of Miami -Dade
The f oing was acknow
By cScoow
Notary
SEAL:
Owner
ebefore me this aday of
(3,6“.1fA
2_423 0
who ispersonally;known to me or has produced
as identification,
_...tom.
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DATE
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SPAMi-DARE GC /
LOP,. PER4,13T
EXTENSION
4 BY
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ON SITE
Certificate of Flame ResistanceCAL
FIRE
S.HCE ,RYS
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:
10/27/2017
This is to certify that the materials described below have been treated with a flame-retardant chemical or are inherently
nonflammable.
FOR: Trivantage, LLC
ADDRESS: 1831 North Park Ave.
CITY: Glen Raven STATE: NC 27217
Certification is hereby made that: (Check "a" or "b")
(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 Fireyvlars 1. • • • • • •
Name of chemical used:
Method of application:
.. . ....
.
Chemical Regisiraiiori il:
.... .. .
. . . •
. .
.... • •
..
(b) The articles described at the bottom of this Certificate are made from a flame-resistant.falIdaor material.
registered and approved by the State Fire Marshal for such use. .
Trade Name of flame -resistant
fabric or material used: REINFORCED VINYL
. . .
•
.
..
..
. ..
Registr$tiort,#:. F-06901 :.
.. . -- -
. . .
.. •
The Flame -Retardant Process Used Will Not Be Removed By Washing
DONALD E. KAUFFMANN
STEPHANIE MUMMERT, Q C MANAGER
Name of Applicator or Production Superintendent Title
.
RCNs # 00000000001061863863
CUSTOMER ORDER NO.
CUSTOMER INVOICE NO. 1765573
YARDS OR QUANTITY 50.00
DESCRIPTION Weblon Coastline Plus #CP-2797
62" Almond (Standard Pack 50
Yards)
ITEM NUMBER 857897
...
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.
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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
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REVIEW j
Disapp Not Applicable
Revision Process
Date
o.
Approved
Disapp J Not Applicable
TJ
0000630696
Feb 24 16 01€3t53a
A\�O\DTito
NOTE: ALL SHEET MUST BE REVIEWED
FMQAG11il-DAIDE COUNTY DEPARTMENT OF REGULATORY AND ECONOrIJ C RESOURCES
Heirbera S. Seffir Permitting end inbpectiori Center
11305 SW 26th Stroet (Coral Way) 0 Miami, Florida 33175-2474 o (786) 315-2000
APPLOCA7OON FOR MUNOC9PAL PERMIT APPUUCA TS
THAT R! Q ORE PLAN RIEVOIEW FROM Mii OAN-DADC FORE RESCUE
AND/OR SNMIIRONMENTALL SERVIIC
P
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ca
PROVIDE IIIUNICIPAL pR►CESS NUMBEFI HEIRE
Job Address 11300
Folio 117.(1600
Lot Block
Subdivit ion PI:3pq
Motes and bounds
Contractor No,
Last four (4) digits of Qualifier No. .
Contractor Nara
Qualifier Name
Address
City Stato Zip
[ ] .New Construction on [ ] Demolish
Vacant Land [ ] Shell Only
[ ] Alteration Interior [ ] Addition Attached
[ ] Alter;atiori Exterior [ ] Addition Detached
[ [ Relocation of Structure [ ) Iie-l-ioot
[ i Enclosure j •j Foundation Only.
[ ] Repair ( ] Tent
[ ] rtepair Due to Fire
PERMIT TYPE
( j MELD°
Category
( ] MELE
[ ] MLPG
( ] MMEC
[ ] FIRE
REVIEW STAT US
••••
Current use of -property b I ` €
• •
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Description ot. Wore ' 4•hr rt • •• • •
•
Sq., Ft'ta
Value of Work
Units ••moors • • ••
•••• • ••
[ j Chg. Contractor
[• J fie-tssuo
[ 1 Pc -Stamp
[ j Revision
[ ] Not Applicable for
Fire
Name ° .4 ./
I
Address``__ ,
e�1 [�( {{�� rr
City. ` CieN �`._. State Zip"J9e1
„ono -)f'Zd' fO
OWNER'S NAME
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Owner
Address • •
City Stake ___ •.Zip_... •
• • • •
Phone •• • •• •
Last four (4) digits of
Owner's Social Security,_No,
Owner
Address
•
• • •
City `_ State Zip --..-----•--
Phone
/ am requesting a Special Request Plan Review (SRI) to be scheduled as soon as possible at rho rare of.2p9 for the first how
and $11,b0 per each additional hour in addition to the review foes. Minimum charge one -hour.
1^' Request:
2ro Request:
3") Request:
�..— Date:
Date:
Date:
I am requesting -Optional Plan Review (OPR) to be' scheduled as soon as possible at the rate of $75 for each discipline.
Additional review fees may Apply,
1 •' Request: Date:
2^" Request: Dale:
3"' Request: -. _....._ Date:
17301-I27 4/14