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WS-18-1951i,� Miami Shores Village �sKO1us 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 F'LORiDp` Permit NO.-7-18-1951 Permit Type: Windows/Shutters iork Classification: Window/Door Replacer Permit Status: APPROVED Issue Date: 7126/2018 1 Expiration: 01/22/2019 Project Address Parcel Number Applicant 515 GRAND CONCOURSE 1132060171340 Miami Shores, FL Block: Lot: GREGORY PALMER Owner Information Address Phone Cell GREGORY PALMER 515 GRAND CONCOUSR (305)220-7663 FL Contractor(s) Phone Cell Phone JMEC CONSTRUCTION, LLC (954)410-4695 Type of Work: INSTALL 6 WINDOWS AND 2 DOORS No of Openings: 8 Additional Info: Classification: Residential Scanning: 1 Fees Due Amount CCF $9.00 DBPR Fee $2.70 DCA Fee $2.00 Education Surcharge $3.00 Permit Fee $180.00 Scanning Fee $3.00 Technology Fee $12.00 Total: $211.70 Valuation: _ $ 15,000.00 Total Sq Feet: 0 Pay Date Pay Type Amt Paid Amt Due I Invoice # WS-7-18-68287 07/26/2018 Credit Card $ 211.70 $ 0.00 Available Inspections: i Inspection Type: Window Door Attachment Final Review Building In consideration of the issuance to me of this permit, I a perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, dr, in�by tatements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work doneeither myself, m rvants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICQ4-, W NDO DOORSROnFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify thatl construction and zoning. Futhermore, I accurate PU that all work will be done in compliance with all applicable laws regulating mtra o do the work stated. July 26, 2018 Authorized Signature: Owner / Applic Contractor / Agent Date Building Department Copy July 26, 2018 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 PERMIT APPLICATION QBUILDING ❑ ELECTRIC ❑ ROOFING ❑PLUMBING MECHANICAL PUBLIC WORKS JOB ADDRESS: 515 Grand Concourse J1j1 9 ?018 FBC 20 Master Permit No. RC-9-16-2471 Sub Permit No .\Iq SI S_.1 015 l ❑ REVISION ❑ EXTENSION []RENEWAL CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS City Miami Shores County: Miami Dade Zia: Folio/Parcel#: Is the Building Historically Designated: Yes NO X Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Gregory Palmer Phone#: 305.525.1427 Address: 515 Grand Concourse City: Miami Shores State: FL. Zip: 33138 Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: JMEC Construction, LLC Phone#: 954.410.4695 Address_ 560 NW 39th Avenue City: Coconut Creek State: FL. Zip: 33066 Qualifier Name: Eic Finkelstein Phone#: 954.410.4695 State Certification or Registration #: CGC060569 Certificate of Competency #: DESIGNER: Architect/Engineer: Mark Campbell Phone#: 305.754.2318 Address: 373 NE 92nd Street City: Miami Shores state: FL Value of Work for this Permit: $ 15000 Square/Linear Footage of Work: Zip: 33138 Type of Work: ❑ Addition ❑ Alteration FEE New ❑ Repair/Replace ❑ Demolition Description of Work: Impact windows & doors. i 'L Specify color of color thru tile: Submittal Fee $ Permit Fee $ 1 EQ • C� CCF $ CO/CC $ Scanning Fee $ Radon Fee $ a - C� DBPR $ U Notary $ Technology Fee $ Structural Reviews $ Training/Education Fee $ Double Fee $ Bond $ (Revised02/24/2014) TOTAL FEE NOW DUE $ of (I - Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip 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. on 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 NER or AGENT The foregoing instrument was acknowledged before me this I Z day of :7'0 L_ J 20 1 by who is personally known to QJ me or who has produced as identification and who did take an oath. NOTARY &CA- Sign:K Q-0� Print: S ignature CONTRACTOR The foregoing instru ent was acknowledged before me this 17 day of 11 •� 2019 by rC'TL1L �•.. IGc,QsK.4who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: qc4�� Sign: u Print: Lzt"-2 "C4 Fc" (t�4 Seal: �o�'":.:;'�% LAURAFARLEY Seal: * MY COMMISSION M FF 188027 ` EXPIRES: March 16, 2019 se1 FofF0Q,4' BWed Thru Budget Notary Services **s**s***s*ss*****sssss*ssssss *sss**s** s�ssssss*s*s*s* +� 1 APPROVED BY / v Plans Examiner Structural Review as roe: P:��•o LAURA FARLEY MY COMMISSION t FF 188027 * * EXPIRES: March 16, 2019 ,** V0*****dlhruBuJetNot&rryServices *** *************** Zoning Clerk (Revised02/24/2014) JMECC-1 OP ID: TR .acoRn CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 07/19/2018 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 endorsements . PRODUCER Roebuck Associates Insurance Exchange LLC(A/C,No 5599 S University Drive, # 301 Davie, FL 33328 Roebuck Associates CONTACT NAME: Roebuck Associates PHONE 954-616-1800 aC No : 954$16-1888 Ext ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC N INSURER A: Wilshire Insurance Company INSURED JMEC Construction, LLC 560 NW 39th Avenue Coconut Creek, FL 33066 INSURER B : INSURER C INSURER D : INSURER E : INSURER F : rnvooer_ec r`CDTl=It'ATF fduMRFD- 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 DL rUBR POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS -MADE a OCCUR CL00238464 07/03/2018 07103/2019 DAMAGE TO RENT PREMISES Ea $ 100,00 MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 PRODUCTS - COMP/OP AGG $ 1,000,00 POLICY ❑ PRO- LOC OTHER: A AUTOMOBILE LIABILITYaccident) COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ $ UMBRELLAIJAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAO CLAIMS -MADE DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE PER TH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ OFFICERIMEMBER EXCLUDED? ❑ (Mandatory in NH) N / A E.L. DISEASE - POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) General Contractor / CGC060569 It Miami Shores Village 10050 NE 2nd Avenue 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 V T88ti-L0T4 AL VKU I.VKrVK/:I IVIY. All ngnts reservVU- ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD