CC-12-589Wain
Miami Shores Village
g
Building Department
05
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
B ING RECEIVED Permit No. C'Cl 525-9
PERMIT APPLICATION APR 0 5 2012 master Permit No.
RECEIVED
APR 9 § e81g
FBC 20 BY:
Permit Type: BUILDING ROOFING
OWNER: Name (Fee Simple Titleholder): h 5\iG 1 L. L. C . Phone#:
Address: O U luoop GUfQ
City:
n
Tenant/Lessee Name: �,'4 v2 J S vr£S Oil �i2 / Phone#: .3/ 3 30CS
Email:, /S(A'lC.-E • ocJ/-ANC C: J/ 4:9A2S
�00 0
State: (� . Zip: ��D--CD
1411- JOB ADDRESS: YV /IMF Z 4d A fro
City: Miami Shores
County:
Miami Dade
Zip:
Folio/Parcel#:
Is the Building Historically Designated: Yes
CONTRACTOR: Company Name: r N dA? #V b" ;ir l Phone#: OS 1?
Addres: ! 01 / /Y-G✓
City: 1 AC T$ ,C C.'7A.—d0 $ State: i.�
Qualifier Name: CA''l✓/n/ 22/LK-
State Certification or Registration #:
Contact Phone#:
DESIGNER: Architect/Engineer:
Email Aaaress:
Flood Zone:
Zip: 3.3 / Cc:I
Phone#: 7&G
Certificate of Competency #:
y •34ov.• ce •w
Phone#:
Value of Work for this Permit: $ . 4/00'`J` Square/Linear Footage of Work: /Ye
,ti i1r?)'ft..
„•,'Type of Work: Addition ration New ❑Repair/Replace ❑ Pemoliti
�.". •�','Description of Work: ,aci-41€•� /✓��1/ c� e.e �e.i.✓c .c �/-ie/ A/ S ,
' ,. Gc- / / / Stvie , / lr f �� j~ / — 3�- r�(P''= cf '/ f�c c R--- '
.
a/1Sulimittal Fee $''L� c�pD� Permit Fee $ ��'; .CCF"$ §'' coicc $
fnii:niiii ‘1‘.. - It ko
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $
F
Bonding Company's Name (if applicable) A
Bonding Company's Address
City - State
. 4^,
Zip \t/
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address •
s 3 I
City State Zip
• IF
Application is hereby made to obtain a permit to do the work and installationsas 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 ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC'
applicable laws regulating construction and zoning. Tli..: !':;
• ) 1.) A.) 4 i .. 1 j
"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 .'- ".1 ,.`�``''
Notice to pigiicccant: 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 p o `"efty is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the'f. T inspection which occurs seven' (7) days after the building permit is issued. In the absence of such posted notice, the
d yy inspectio wil of : sproved and a reinspeciion fee will be charged. '
OWNER'S AFFIDAVIT: I certify that all the foregoing information' is accurate and that all work will be done in compliance with all
APPROVED BY
Sig a �.
• wner or A en
The foregoing instrument was acknowledged before mf this
day of ,20,a,by •C arsb-/gyi,
who is persi9inown to me or `ro
Signature
Contractor
The foregoing, instrument was acknowledged before me this
�� Ill(n
cday of''i'�l�l`I,"` , 20 �by
who is personally known to me or wh
M1 - ,6 C as identification an o did take an oath.
As identification and who did take an oath.
NOTAY,' UBLIC:.\
•,, 3t
Sign: .7:')
Print:
My Commission Expires:
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/// ll STATE 01,%.‘ miner
Structural Review
NOTARY;PUBLIC:
..<• I
Sign: -
',Print: ai° V j
My Commission Expires:
3.
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(Revised 07/10/07)(Revised 06/ 10/2009)(Revi sed 3/15/09)
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I MIAMI-DADE COUNTY
' +TAX COLLECTOR
140 W. FLAGLER ST.
r 1st FLOOR
4 MIAMI, FL 33130
..*`�1 �±,�Y'�rti?a•�. �::.�. sty
`_ �w►.r__ wr
•
2011 LOCAL BUSINESS TAX RECEIPT 2012
MIAMI-DADE COUNTY - STATE: OF FLORIDA
EXPIRES SEPT. 30,, 2012
MUST BE DISPLAYED AT PLACE OF BUSINESS
PURSUANT TO COUNTY' CODE CHAPTER.8A - ART. 9 & 10
629935-8
BUSINESS NAME t LOCATION
VINWARD CONSTRUCTION CORP
1011 NW 207 ST
33169 MIAMI GARDENS
OWNER
VINWARD CONSTRUCTION CORP
Sec. Type of Business
196 GENERAL BUILDING CONTRACTOR
THIS IS ONLY A LOCAL
BUSINESS TAX RECEIPT. IT
DOES NOT PERMIT THE
HOLDER TO, VIOLATE ANY
T EXISTING REGULATORY OR
ZONING LAWS OF THE.
#. COUNTY OR CRIES. NOR
DOES IT EXEMPT THE
HOLDER FROM ANY OTHER
'-PERMIT OR LICENSE
REQUIRED BY LAW. THIS 1S
NOT A CERTIFICATION OF
THE HOLDER'S OUALIRCA-
TIONS
1
PAYMENT RECEIVED
MIALD-DADE COUNTY TAX
COLLECTOR: •
09/21/2011
-TFiIS'IS-NOT A'BI1.L = Cid' OT PAST
RENEWAL
RECEIPT NO. 6422349
STATE* :C6C1504408
FIRST-CLASS
U.S. POSTAGE 1'
PAID
MIAMI, FL
PERMIT NO. 231
WORKER/S
3
DO NOT FORWARD
VINWARD CONSTRUCTION CORP
CALVIN E ROZIER PRES
1011 NW 207 ST
MIAMI GARDENS FL 33169
A
02240018001
000045.00
II)IIftJli),,IIIlliftllit IITillflilllI11111I11ut11111IA17M1
LICENSE
ITEM
CITY OF MIAMI GARDENS
2011 CERTIFICATE OF USE 2012
EXPIRES September 30, 2012
MUST BE DISPLAYED AT PLACE OF BUSINESS
DESCRIPTION / RESTRICTIONS
CU=005365 c042
Home Office
VINWARD CONSTRUCTION CORP
1011 NW 207 ST
MIAMI GARDENS, 'FL 33055
CU
Business Name/Location 0041996
VINWARD CONSTRUCTION-CORP
1011 NW 207 ST
MIAMI GARDENS, .FL,33055
Owner/Corp. Name
ROZIER, CALVIN
Use as permitted within zone.
City of Miami Gardens Enforcement Department 1515 NW-167th ST, Building 5 Suite 200, Miami,Gardens FL,33169
LICENSE
ITEM
CITY OF MIAMI GARDENS
2011 BUSINESS TAX RECEIPT 2012
EXPIRES September 30, 2012.
MUST BE DISPLAYED AT PLACE OF BUSINESS
DESCRIPTION / RESTRICTIONS
BT-009070
2590 UNCLASSIFIED
HOME BASED: GENERAL
CONTRACTOR
VINWARD CONSTRUCTION CORP
1011 NW 207 ST
MIAMI GARDENS, FL 33055'
Business Name/Location 0041996 -
VINWARD CONSTRUCTION CORP
1011 NW 207 ST
MIAMI GARDENS, FL 33055
BT
Owner/Corp. Name
ROZIER, CALVIN
This is an business tax only. It does not permit the payee to viola
any existing regulatory or Zoning laws of the City or Miami Dade
County. Nor does itexempt the payee from any other tax or perm
required by law. This is not a certification,of the payee's qualificat
City of Miami Gardens Enforcement Department 1515 NW 167th ST, Building 5 Suite200Miami Gardens FL 33169
FROM :A&D ALL —LINES INS ASSOCIATES FAX NO. :3053872918 Mar. 23 2012 01:01PM P1
AOORQ. CERTIFICATE OF LIABILITY INSURANCE
I>NODUCER
A&D ALL —LINES INS ASSOC INC
5600 SW 135 Ave Ste 106
Miami, FL 33183
(305)463-6781
INSURED VINWARD CONSTRUCTION, INC.
1011 N.W. 207 ST.
MIAMI, FL. 33169
7 — —2399
COVERAGES
I)ATF (MM/DOIYYYY)
3/23/2012
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW_
INSURERS AFFORDING COVERAGE
INSURER A: WESTERN WORLD INSURANCE CO.
INSURER B
NAIC#
INSURER C:
INSURER D:
INSURER E:
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 Al -FORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
IN$R
ITR
ADM
*BAD
TYPF OF INSURANCE
POLICY NUMBER
POLICY CFFECC-7►IVF
D(tTF(MM/DDIW)
POLICY EXPIRATION
DATE(MMIUD/VYI
LIMITS
A
GENERA'
LIABILITY
CONMFRCIALCENENALLABILITY
11-0233
10/26/11
10/26/12
EACI'I OCCURRENCE
$ 1,000,000
X
DAMAL,t:TURENTED
PREMISES (En nccurence)
$ 100,000
n
MED EXP (Any une person)
$ 5 000
PERSONAL& ADV INJURY
,
$ 1'1O0O,000
—
GENERAL AGOREOAre
9 2,000,000
EM. AGGREGA I E LIMIT APPLIES PER:
G—
PRODUCTS -COMP/OrAGG
S 1,000,000
niPOLICY PRO-
JECT� LOC
AUTOMODILF
I (ABILITY
ANYAUTO
ALL OWN F.D AUTOS
$CHI'_UULEOAUTOS
HIRED AUTOS
NON-OWNEUAUTUS
COMBINED SINGLE LIMII
(En:ircidnnt)
_
!WILY INJURY
(Bar p rson)
BODILY INJURY
(Pnrargdnnl)
PROPERTY DAMAGE
(Per accident)
$
GARAGE
LIABILITY
ANYAUTU
AU)OONLY -EAACCIDENT
S
OTHER THAN EA ACC
$
AlITOONLY: AOG
$
CXCP$S/UMHRELLA
LIABILITY
EACH OCCURRENCE
S
OCCUR El CLAIM9MADE
AGGRECATF
$
DEMJCTIRI.F
RETENTION $
$
$
B
WORKFRSCOMPENSATIONAND
EMPLOYERS' LIABILITY
ANY IRra'luLTORIPARTNER/EXECIITIVF
aFFIr.ERIAAI:MBeR Exct_UDEO'
If yns deserlbeundIK
SPI-c.iAL PROVISIONS bellow
TORM�ITS WUTA-OthH(-
C.L. EACH ACCII)k NT
.1
E.L DISF.ASE - EA EMPLOYEE
S
E.L. DISEASE - POLICY LIMIT
$
OTHER
OFSr..RIP'I'ION OF OPERATIONS / LOCA'TIUNS /VEHIC,LEs
GENERAL CONTRACTOR
/ EXCLUSIONS ADDED me FNOORSEMENT/ SPECIAL PROVISIONS
CERTIFICATE HOLDER
CANCELLATION
CITY OF MIAMI SHORES
BUILDING DEPARTMENT
10050 NE 2ND AVENUE
MIAMI SHORES, FL 33138
ACORD 25 (2001/08)
SHOUT D ANY OF THE ABOVE DESCRIRF.D POLICIES OE CANCELLED BEFORF TI it EXPIRATION
DATE THEREOF, THE I88uING INSURER WILL FNOE.AVOR TO MAIL30 DAYS WRITTEN
NO l'II:F TO THE CERTIFICATE HO DER NAM n TO TI IC LEFT, our FAILuHE TO DO 8U SHALL
IMPOSF NO OBLIGATION OR LIAO11v�h Y KIND UPON TIIE INSURER, IT$ A01-.Nl'$ OR
RF.PRESEN'IATIVES.
AUTHORi u REPRESENTATIVF
ACORD CORPORATION 1988
ACCORD® CERTIFICATE OF LIABILITY INSURANCE
k.....►--
DATE(MMIDD/YYY))
03/29/2012
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 BETWEENTHE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDmONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
the tens 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 1-321-348-3406 1-321-348-3406
WC
WCAssociates Insurance Group
P.O. Box 331014
Orlando, FL 34786
CT
;aAME: Certificate Verification Department
(Iiuc�.No.Ext): 1-321-348-3406 FAX
1-321-348-3406
E-MAIL ADDRESS:
INSURER'S) AFFORDING COVERAGE
NAIC 8
INSURER A: Lyons Insurance Company
22128
INSURED 1-786-251-2398 1-305-690-6825
Vinward Construction Corp.
1011 NW 207th Street
Miami, FL33169
INSURER B :
INSURER C:
INSURER D :
INSURER E:
INSURER F :
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 POUCY 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 POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
I�
I TYPE OF INSURANCE
INSR
y iD
POUCY NUMBER
EFF
IMMIDDIYYYY)
POLICYY YPY)
(MMIDDI
LIMITS
GENERAL
LIABILITY
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$
PRS (aENTED
PREMISES (Ea occurrence)
$
1
CLAIMS -MADE
OCCUR
MED EXP (My one person)
$
PERSONAL 8 ADV INJURY
$
GENERAL AGGREGATE
$
GENII AGGREGATE LIMIT APPLIES PER:
—1 POLICY n JE fl LOC
PRODUCTS - COMP/OP AGG
$
$
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED
_
SCHEDULED
AUTOS
NON -OWNED
AUTOS
COMBINED SINGLE LIMIT
(Ea accident)
$
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
$
UMBRELLA LIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
$
DED RETENTION $
$
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY
OFFICER/MEMBER ORIOR PARTNER/ VE
(Mandatory in NH)
If yes:describe under
DESCRIPTION OF OPERATIONS notary
Y / N
N
N / A
WC71205512-10-26
•
10/26/2011
10/26/1012
WC STATU- OT)-1-
TORY LIMITS ER
E.L EACH ACCIDENT
$ 1,000,000
E.L DISEASE - EA EMPLOYEE
$ 1.000.000
E.L DISEASE - POUCY LIMIT
$ 1.000.000
DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required)
Should any of the above policies be cancelled before the expiration date thereof, the issuing company shall
mail a 30 day written notice of cancellation torthe certificate holder.
CERTIFICATE HOLDER
CANCELLATION
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
10050 N.E. 2nd Avenue
Miami Shores, Florida 33138
ACORD 25 (2010/05)
SHOULD ANY OF THE ABOVE DESCRIBED POUCI
THE EXPIRATION DATE THEREOF, NOTICE
ACCORDANCE WITH THE POLICY PROVISIONS. 4
NCEU.ED BEFORE
BE DEUVERED IN
®1988-2010 ACORD COR - a RATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD