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MC-09-22-2363Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Permit NO.: MC-09-22-2363 Permit Type: Mechanical - Residential Work Classification: Alteration Permit Status: Approved Issue Date:11/04/2022 Expiration:05/04/2023 Location Address Parcel Number Project 431 NE 100TH ST, Miami Shores, FL 33138 1132060170500 ONLINE PERMITS Contacts ERIN HALLORAN Owner EVENINGS DE LIGHT INC Applicant 451 NE 91 ST, MIAMI SHORES, FL 33138 DAVID ALAN ZISMAN Other: 3522623193 HALLORAN.ERIN@GMAIL.COM 9621 S DIXIE HWY, PINECREST, FL 33156 Business: 7862369894 jzisman@bellsouth.net Erin Halloran Applicant EVENINGS DE LIGHT INC Contractor 431 NE 100th ST, Miami Shores, FL 33138 DAVID ALAN ZISMAN Mobile: 786-763-2813 halloran.erin@gmail.com 9621 S DIXIE HWY, PINECREST, FL 33156 Business: 7862369894 jzisman@bellsouth.net '^ brute & bruce,lnc. Architect victor brute 370 NE 101st Street, Miami Shores, FL 33138 Business: 3053105030 vb@b2-ai.com Other: 3053105030 Inspection Requests: Description: INSTALLATION OF PRE FAB FIREPLACE -see Valuation: $ 5,000.00 305-762-4949 online RC-06-21-1520 Total Sq Feet: 412.00 Fees Amount Application Fee - Other $50.00 CCF $3.00 DBPR Fee $2.63 DCA Fee $2.00 Education Surcharge $1.50 Permit Fee $125.00 ',canning Fee $6.00 ethnology Fee $17.50 Total: $207.63 Building Department Copy Payments Date Paid Amt Paid Total Fees $207.63 Credit Card 11/04/2022 $207.63 Amount Due: $0.00 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. Y' Authorized Signature: Owner ! Contractor I Agent Date r ovember 04, 2022 Page 2 of 2 ENTERED 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 ❑N MECHANICAL ❑CHANGE OF CONTRACTOR JOB ADDRESS:431 NE 100TH ST SEP 15 20ZZ FBC 207-0 Master Permit No. RC-06-21-1520 Sub Permit No. MC-0 I- 22 -230 ❑ REVISION ❑ EXTENSION [-]RENEWAL ❑ CANCELLATION ❑ SHOP DRAWINGS City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 11-3206-017-0500 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Erin Hallorn Phone#: Add'.«A31 NE 100TH ST City: Miami Shores State: Florida Zip: 33138 Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: Evening's Delight Address: 9621 S Dixie Hwy 7862369894 Email: jzisman@bellsouth.net Qualifier Name: David Zisman Phone#: 7862369894 State Certification or Registration #: CAC054723 Certificate of Competency #: DESIGNER: Architect/Engineer: Address: City: State: _Zip: Value of Work for this Permit: $5000 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of work: Installation of pre fab fireplace Specify color of color thru tile: Submittal Fee $ Permit Fee $ CCF $ 3 co CO/CC $ Scanning Fee $ (,v - OC7 DCA Fee $ ?,= . C>O DBPR $ �?-. to 3 Notary $ Technology Fee $ 1-7- Sb Training/Education Fee $ (' 5V Double Fee $ _ Structural Reviews $ (Revised04/05/2022) P&Z Review $ Bond $ TOTAL FEE NOW DUE $ -2 b_7 • C-j 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 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 pasted notice, the inspection will not be approved and a reinspection fee will be charged. Signature� Signature / OWNER or AGENT NTRACTOR The foregoing instrumentwasacknowledged before me this & day of � � � -1�� 20 Z 2- . by er- i e) who is personally known to me or who ha�oduced ic�i- -Dr ✓ors (-"c as identification and who did take an oath. NOTARY PUBLIC: The foregoing instrument was acknowledged before me this 1%_dayof Sgg�jt 6tlr 20 Z.2 by 1 v,d Z %Sw' . who is personally known to me or who has produced _ identification and who did NOTARY PUBLIC: Print: V L ✓ I -e-nrw- 4 d-,-, Print: Seal: `5, =h ay APPROVED BY (Revised04/05/2022) Vivienne Yao Comm.:HH 222410 Expires: Jan. 31, 2026 Seal: Q64s Examiner Structural Review an oath. p) JJani#=F��ndu Flari4 My Commiaion HH 109994 EX0=030=25 as *** Zoning Clerk Ron DeSantis, Governor STATE OF FLORIDA Melanie S. Griffin, Secretary DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD THE CLASS B AIR CONDITIONING CONTRACTOR HEREIN IS CERTIFIED UNDER THE ENTEaED �i-' 1 5 2022 PROVISIONS OF CHAPTER 489, FLORIDA STATUTES ZISMAN, DAVID ALAN EVENING'S DELIGHT OF FT. LAUDERDALE, INC. 9621 SOUTH DIXIE HIGHWAY MIAMI FL 33156 LICENSE NUMBER: CAC054723 EXPIRATION DATE: AUGUST 31, 2024 Always verify licenses online at MyFloridaLicense.com Do not alter this document in any form. This is your license. It is unlawful for anyone other than the licensee to use this document. Florida pr 002369 Local Business Tax Receipt Miami —Dade County, State of Florida -THIS IS NOT A BILL -DO NOT PAY 227611 LBT BUSINESS NAMF,TOOtnON RERBPTNB. EXPIRES EVENINGS DELIGHT OF FT LAUDERDALE INC RENEWAL SEPTEMBER 30, 2023 9621 S DIXIE HWY 227611 Must be displayed at place of business PINECREST FL 33156-2804 Pursuant to County Code Chapter BA - Art 9 & 10 OMAIER SEC. TYPE OF BUSINESS PAYMENT RECENEB EVENINGS DELIGHT OF FTLAUDERDALE 196 SPEC MECHANICAL CONTRACTOR RYTAxCOLLECTOR CAC054723 $45.00 07/19/2022 Worker(s) 10 CHKK21-22-048790 This Local Business Tax Receipt only canfitms payment of the Local BueinessTax. The Receipt is not a license, permit, or a certification of the holders qualifications, to do business. Holdermustcomply with any 9WOOM190fal or ooagovemmeldal regulatory laws and mquirementowhich apply to the business. The RECEIPT NO. above must he displayed an all commercial vehicles -Miami -Dade Code Sec Sa-276. For more information,visitiamid d ao hex Ilea r ENTERED SIP 16 20?2 �•jj 003930 Local Business Tax Receipt Miami —Dade County, State of Florida —THIS IS NOTA BILL —DO NOT PAY 2812122 BUSINESS NAM MrATION flECEIPTNO. EVENINGS DELIGHT OF FT LAUDERDALE INC RENEWAL 9621 S DIXIE`HVVY 2944339 PINECRESTFL33156-2804 EXPIRES SEPTEMBER 30, 2023 Must be displayed at place of business Pursuant to County Code Chapter 8A — Art 9 & 10 OWNER SEC. TYPE OF BUSINESS EVENINGS DELIGHT OF FT LAUDERDALE 196 SUB —BUILDING CONTRACTOR PAYMENTRECENEO CRC055385 BYTAXCOUECTOR $45.00 07/19/2022 Worker(s) 1 CHECK21-22--048795 This Local Business Tax Receipt only confirme paXmeot of the Local BusinessTax. The Receipt is not license, Permit or a cadificeBon of the holders qualificahoro, to do business. Holdermust comply with any governmental Of uorgovemnerdal regulatory laws and mquiremanbwhich apply to the huslas". The RECEIPT No. above must be displayed an all commercial vehicles —Miami —Dade Code Sac Ba-276. Forman, information, visit Wmniamidod2mayttamollector ENTERED SEP 15 202 BY: 030874 i Local Business Tax Receipt Miami —Dade County, State of Florida -THIS IS NOT A BILL -DO NOT PAY 227611 BUSINESS NAMEAOCAMON EVENINGS DELIGHT OF FT LAUDERDALE INC 9621 S DIXIE HWY PINECREST FL 33156-2804 LBT RECEIPT NO. EXPIRES RENEWAL SEPTEMBER 30, 2023 7506936 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art 9 & 10 OWNER SEC. TYPE OF BUSINESS EVENINGS DELIGHT OF FT LAUDERDALE 196 SPECIALTY BUILDING CONTRACTOR PAYMENTRECEIYED CCC056371 BYTAx COLIECTOR $45.00 07/19/2022 WoTker(s) i CHECK21-22-049373 This Local Business Tax Receiptonly confirms paymentof the Local Business Tax. The Receipt is not a license, permit, or a certification of the holders qualifications, be do business. Holdermust comply with any govemmemal or nongovemmemai regulatory laws and requirements which apply to the Imams". The RECEIPT NO. above most be displayed on all commercial vehicles- Mimi -Dade Code Sac Sa-276. For more information, visit mmw 4niamidade,govtWarallactor ENTERED SEP 15 Z,ZZ BY: AC�RD® CERTIFICATE OF LIABILITY INSURANCE DATE (WWDDft`Y M 9/27/2022 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 pollcy(les) must have ADDITIONAL INSURED Provisions or 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 CONTACT NANtE Morris and Reynolds Insurance PHONE FAX 14821 S Dixie Hwy .......... .--------- _.i!cL!fo}__ Miami FL 33176 _AOQ_RESS, Ciltmorrisandreynolds.com INSURERS} /AFFORDING COVERAGE _NAIC # ....... - ..... .. _. __._._._._ . INSURER A : FFVA Mutual Insurance Co. 10385 INSURED EVENDE--01 Evening's De -Light of Ft Lauderdale Inc. INSURER a Indian Harbor insurance Compan} ._ 36!4,0 ....... 9621 South Dixie Highway .ENsttttERC. ..... ..... ........................ ..._.. Miami FL 33156 INSURER _. INSURER E : INSURER F OVERAGES CERTIFICATE NUMBER:1130976473 REVISION NUMBER! ' I IIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD I�, DICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS t;=RTIFICATE 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' _----_---- ;. ,SUSR. - LizTYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP - MMD MMIDD LIMITS B X I COMMERCIAL GENERAL LIABILITY ESGO05690402 6/20/2022 6/20/2023 ;EACH OCCURRENCE $1 000,000 w CLAIMS-MADEXOCCUR E $ rmrsao -PRNtRA7.$.4Eu 9 I . . $500,000 _... ....................._._._.._ . MED EKP .... .............Any ante person.. $ 5 000.- ._..._...........-.. .. I...........J ....�- �. .,__-.�� ..... .._.................. PERSONAL & ADV INJURY $1.000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE E $ATE 2.000,000 —, r .. X PRo- - -- .... ....__....._.........._ . _ _ . POLICY ` JECT---__-; LOC I PRODUCTS CAMPIOP AGG ... T S 2,000,000 - OTHER: $ AUTOMOBILE LIABILITY { COM IN SINGLE LIMIT (Ea..G14M11}.._........ ...._...... _... $_ I ANY AUTO BODILY INJURY (Per person} $ OWNED :SCHEDULED ; j AUTOS ONLY : AUTOS BODILY INJURY (Per aocidtmt) $ _ _$ HIRED NON -OWNED PROPERTY DAMAGE AUTOS ONLY --_ AUTOS ONLY UMBRELLA LlAB F ;OCCUR EACH OCCURRENCE $ _...... _..... __.- ............................ € I EXCESS LIAR ............. ......... _.._........._ �.. - .. L _.CLAIMS MADE: AGGREGATE .........�...... .... ..... ......_.... . DEO RETENTION $ $ A , WORKERS COMPENSATION WC840-0035143-2022A 9/14/2022 9/14/2023 PER OTH AND EMPLOYERS' LIABILITY Y 1 N ANYPROPRIETORIPARTNERIEXECUTIVE , NIA A OFFICERIMEMBEREXCLUDED? s E.L. EACH ACCIDENT __ _._.___ ._....... _.. $ 500.000 (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE: $ 500,000 If yes. describe under _.... - ._......................_........----------_....._. DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If mom space Is required) License #CAC054723 Miami Shores Village Building Department 10050 NE 2 Avenue Miami Shares FL 33138 UANGtLI_A I IUN 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 a40__._ ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD