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FW-04-22-1039Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Parcel Number 28 NW 111TH ST, Miami Shores, FL 33168 1121360030350 Contacts ._._._................ ._...W_._.____......._......._v......_...._..._._.__.___........ _.._..._ i JJAB LLC Owner BAIRES CONSTRUCTION CORP Contractor 5901 NW 151 ST 126, Miami, FL 33015 SERGIO SANTANA 7601 BYRON AVE 5B, MIAMI BEACH, FL 33141 Business: 7862875802 ._....__.____...,.__............._..._....................._.....__._.._.___._......__.........._...._.._._.._........__...___........__...,__....__. _........ .. _.._____..._.......__.___._.M__........______.__........ i - Inspection Requests: Description: RENEWAL METAL FENCE - REPLACING EXPIRED K Valuation: $ 1,000.00 305-Z62 4949' ` PERMIT FW 03 O8 438 Total Sq Feet: 0.00 Fees Amount Payments Date Paid Amt Paid 100% Permit Renewal Fee $100.00 Total Fees $100.00 Credit Card 04/28/2022 $100.00 Total: $100.00 Amount Due: $0.00 Building Department Copy 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 / Agent Date April 28, 2022 Page 2 of 2 RIP - Miami Shores Village CEIVED Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Mr.ZL Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 0 LA — ZZ _ i b , FBC20 -0 ceela-x- BUILDING Master Permit No.� -'� j PER PLICATION ❑BUILDING_ ❑ ELECTRIC ❑ ROOFING [—]PLUMBING ❑ MECHANICAL ❑ PUBLIC WORKS JOB ADDRESS: ­2 V N W L� t "*--\ S J Sub Permit No. ❑ REVISION ❑ EXTENSION A ENEWAL �HANGE OF ❑ CANCELLATION ❑ SHOP ONTRACTOR DRAWINGS City: Miami Shores County: Miami Dade Zip: _�_b 16 bJ Folio/Parcel#: the Building Historically Designated: Yes NO Occupancy Type: Load: , �jConstruction Type: Flood Zone: - OWNER: Name (Fee Simple Titleholder): "`moo ���nwe �Ls a-- BFE: FFE: ne#: --5DS �S'q 00S Address: City: \G 1I State: _Zip: Tenant/Lessee Name: Phone#: Email:P4ar-� PPil,�7L�T CONTRACTOR: Company Name: r2c?_C a-Z Phone#: , ' -? -P-).-)- 0 �3 t' u Address:7— City: ;��/ i� State: ��� Zip: 7, 25 D Qualifier Name:._`��—`7 !� ��!�+� Phone#: State Certification or Registration #: (�6L /S-/b (— Certificate of Competency #: DESIGNER: Architect/Engineer: hone#: Address: City: State: Zip: Value of Work for this Permit: Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: 062il/�0_71 '04 Specify color of color thru tile: Submittal Fee $ Scanning Fee $ Permit Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ CCF $_ CO/CC $ DBPR $ Notary Double Fee $ Bond $ 10-1 An7/)A P)n9 Al TOTAL FEE NOW DUE $ 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 posted notice, the inspection will not be app ve and a reinspection fee will be charged. OWNER or A&ENT The foregoing instrument was acknowledged before me this ell, day of_A�r,., r 20 L� , by a,�a, s n-who is personally known to me or who has produced identification and who did take an oath. as Signature CONTRACTOR The foregoing instr721Eg t was acknowledged before me this �� day of 20—, by j m ., who iCersonally know o me or who has produced as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: P KURY INDY CASTILLO ?Q� .1 Notary Public • State of Florida ®` Commission It HH 230746 S•gn: d' Sign: �' �l 2026 Bonded through National Notary Assn. Print: �gva�O I -, y` _ Print: ti Seal: Seal: �tipR SILVIO MOREIRA et Notary Public = State of Florida Comm# HH133080 iN lgxplres 5J23/2025 **************** *********** **** ** ********x*************************** *** xres *************** ****** APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) PAGE 33 JOB : 06-7253 i LOCATION SKETCH (j NT 2"1 '7r- 2 E5 1, 1, i A ` J 1 "J. SCALE 1 "= 10 EGAL DESCRIPTION:Lot 3,Block 220,MIAMI SHORES EXTENSION,according to the Plat thereof as recorded in Plat Book 43,page 40 of the Public Records of Dade County,Florida.— GENERAL NOTES 1) OWNERSHIP IS SUBJECT TO OPINION OF TITLE. 2) EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED INSTRUMENTS, IF ANY, AFFECTING THIS PROPERTY. 3) (2.22) DENOTES THOSE ELEVATIONS REFERRED TO N/A DATUM. 4) LOCATION AND IDENTIFICATION OF UTILITIES ON AND/OR ADJACENT TO THE PROPERTY WERE NOT SECURED AS SUCH INFORMATION WAS NOT REQUESTED. 5) THIS PROPERTY IS WITHIN THE LIMITS OF THE FLOOD ZONE X 6) NO UNDERGROUND LOCATIONS WERE DONE BY THIS COMPANY. CERTIFIED TO:Marie C. Toussaint DATE: March 01,2006 APPLICABLE ZONING, UNDERGROUND, ZONING AND BUILDING SET BACKS, MUST BE CHECKED BY OWNER, ARCHITECT OR BUILDER BEFORE DESIGN OR CONSTRUCTION BEGINS ON THIS PROPERTY. I HEREBY CERTIFY: That the attached Plan of Survey of the above described property is true and correct to the best of my knowledge, information and belief, as recently surveyed and platted under my direction, also that there are not above -ground encroachments other than those shown. This survey meets the minimum technical standards set fora, by the Florida Board of Land Surveyors CNID s pursuant to Chapter 61G17-6, Florida Administrative Code, Section 472-027, Florida Statues. SURVEYING, INC ; lw L.B. NO. 3333 ,/y Lazaro 0. Alonso 6157 NW 167TH STREET, F15 Professional Lard Surveyor MIAMI, FLORIDA 33015 Certificate No. 3590State of Florida 305/512 4940 THIS IS A BOUNDARY SURVEY NOT VALID UNLESS SEALED WITH AN EMBOSSED SURVEYOR'S SEAL 1 It 1 M I N 1 r t Z 0 W + l0 / 1j 2 PLAN OF SURVEY 1 SCALE 1 " = 2-o\ O f! A .... ARC DISTANCE A/C...AIR CONDITIONING CBS... CONCRETE BLOCK STRUCTURE O.U.L... OVERHEAD UTILITY LINE CL... CLEAR C/L... CENTER LINE RAD... RADIAL ENC... ENCROACHMENT RNV... RIGHT OF WAY... FIP... FOUND IRON PIPE O.H... OVER HEAD W.M....WATER METER C.H....CHORD DISTANCE PIL... PROPERTY LINE CONC...CGNCRETE F.H. FIRE HYDRANT UP ... UTILITY POLE R... RADIUS U.E...UTILITY EASEMENT A ... CENTRAL ANGLE R... RADIUS PL... PLANTER T... TANGENT C,B.... CATCH BASIN Miami Shores village . �C�'}� Building Department MAC �-=-� 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Y' ----------- - Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING Permit No. F�0U '45 K PERMIT APPLICATION Master Permit No. FB C 2004 Permit Type (circle): ouilding..� Roofing Owner's Name (Fee Simple Titleholder) 9,11rip _ (-- , 76"na/rY % Phone # 3 CAS jc 81.E ' Owner's Address 2 e5 (A) City Iq/LP. �11J) �,�,` State Zip as — Tenant/Lessee Name Phone # Job Address (where the work is being done) City Miami Shores Ville County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES NO Contractor's Company Name +V V i ��� NC; I O ,u R i N c' S L L C- Phone # 'Pik 3& 6 27Z Contractor's Address 37 ow 11;;ry?Xle A - City M 1A M I n StateFL © R 1 u Zip 33117 Qualifier Name VV NC Q N S I� F G !fit C j � Y't 1 A P Phone # 7 �;( qk 2'-7 Z- 4` State Certificate or Registration No. Certificate of Competency No. F_ ®7o 123'L Architect/Engineer's Name (if applicable) Xn Value of Work For this Permit 0 Square oinearootage Of Work: (� Type of Work: ❑Addition ❑Alteration ❑New ❑ Repair/Replace ❑ Demolition Submittal Fee $ Permit Fee $ ` 00 f CCF $ CO/CC Notary $ Training/Education Fee $o .2n Technology Fee $ or 'Sm Scanning $ Radon $ Bond $ Structural Review. $ DPBR $ Zoning $ Code Enforcement $ Double Fee Total Fee Now Due $_ 09 - See Reverse side -4 Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State WE 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 ' ' Signature r' Owner or Agent Contractor (� , The foregoing instrument was acknowledged before tt me this The foregoing instrument was acknowledged before me this 10 " day of , 20 , bytag ���i�e1Fl^�tday ofy i 204§-b UL.,tm L�� �r who is personally known to me or who has produced who is personally known to me or who has produced L-- As identification and who did take an oath. NOTARWUBLIC: O. ��'l4RY*P(�9�iC JEAN ROLAND IGMLI ?ON Sign: ....__ . Print: ref * EXPIRES: October 3, 2008 V rF r`i,, ° Bonded Thru Budget Not@Y Service; My Commission Expires: APPLICATION APPROVED BY: (Revised 07/10/07) identification and who did take an oath. NOTARY PUBLIC: .j&kN ROLAVII COL{MON MY COMMISSIN # DD urb0529 * EXPIRES: October 8, 2008 Sign: ed Thru Budget Notary Services E OF F� Print: My Commission Expires: Plans Examiner Engineer Zoning O Z O �' i E a u aJ 0 v w LO " W DC Q Q� V) L m O W W v1 J p M Q m Z j = Z p N u O Z w M E V� V� Q a `n N c 0 cj�O 'a) 4- W W w U N � U b 0 V O V Z � _ O N _J O U C� u o � CC rn Q 0 W W La u 0 1 Z z � _ � ~ m FW- c � c O Q Lu Z Z �t�' Q _ V) 0 W� p oa QOo�1, spa � c Q tmo Z = 1NW Ucn Q W ;O a� +� o Z ZU w Sw~uQ L O O ZO Q u� O p c I LL Q 0 W T ! O w w F- w Q ai o Z w O a) LLI U O = a U F- 0 M o Q � a 0 W 0 0 I-h Local Business Tax Receipt Miami —Dade County, State of Florida —THIS IS NOT A BILL — DO NOT PAY 7166976 RECEIPT NO. RENEWAL BUSINESS NAME/LOCATION 7445477 BARES CONSTRUCTION CORP 7601 BYRON AVE UNIT 5B MIAMI, FL 33141 � ll EXPIRES SEPTEMBER 30, 2022 Must be displayed at place of business Pursuant to County Code Chapter 8A —Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS PAYMENT RECEIVED BAIRES CONSTRUCTION CORP 196 GENERAL BUILDING BY TAX COLLECTOR C/O JUAN RODRIGUEZ CONTRACTOR 45.00 07/23/2021 Worker(s) 1 CGC1516753 INT-21-350971 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit, or a certification of the holder's qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT NO. above must be displayed on all commercial vehicles— Miami —Dade Code Sec Ba-276. M®D For more information, visit www.miamidade.gov/taxcollector CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) k-s— 03/15/2022 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 policy(ios) 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 endorsement(,). PRODUCER CONTACT ANGELA DEHART GOMEZ NAME: Morgan Insurance Group Inc Nc No, Exl): (305) 222-9001 (AA/c, No): (305) 222-9006 13155 SW 42nd St # 107 ADDR1ESS: angela@mmorganinsgrp.com Miami, FL 33175 INSURERS) AFFORDING COVERAGE NAIC # Phone (305) 222-9001 Fax (305) 222-9006 INSURERA: COLONY INSURANCE COMPANY INSURED INSURER B : INFINITY BAIRES CONSTRUCTION CORP INSURER C : 1010 NE 211 TERR INSURER D : INSURER E : Miami FL 33179 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 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 ILTR . TYPE OF INSURANCE NSRLSWVD POLICY NUMBER UBR POLICY EFF POLICY EXP LIMITS . (MM/DD/YYYY), (MM/DD/YYYY), i� COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ _ 1,000,000-00 DAMAGE TO RENT ED CLAIMS -MADE LJ OCCUR PREMISES Ea occurrence) $ 100,000.00 A Y Y ' NPP8840127 01/17/2022 1 01/17/2023 MED EXP (Any one person) $ 5,000.00 PERSONAL & ADV INJURY I $ 1,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: - GENERAL AGGREGATE _ $ 2,000,000.00 POLICY F] PE �- LOC PRODUCTS -COMP/OP AGG I $ 2,000,000.00 L-J OTHER $ AUTOMOBILE LIABILITY ANY AUTO SCHEDULED 8 I ❑ AUTOS ONLY AUTOS N Y 509800001211001 HIRED NON -OWNED u AUTOS ONLY AUTOS ONLY 11 ! UMBRELLA LIAB i'OCCUR EXCESS LIAB ❑ CLAIMS -MADE n DED F] RETENTION$ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETORIPARTNER/EXECUTNT_ OFFICERIMEMBEREXCLUDED? NIA (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below COMeBINED j SINGLE LIMIT I $ (EaBODILY INJURY (Per person) i $ 25,000.00 07/25/2021 07/25/2022 BODILY INJURY (Per aawont) $ 50,000.00 (ER,, aE ,,,,PER DAMAGE i $ $ i EACH OCCURRENCE ($ AGGREGATE �$ $ STATUTE n FORH ' E.L. EACH ACCIDENT $ E L DISEASE - EA EMPLOYEEI $ E.L. DISEASE - POLICY LIMIT I $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORO 101, Additional Remarks Schedule, if more space Is required) Baires Construction Corp General Contractor SERGIO SANTANA, LICENSE NUMBER CGC1516753, CERTIFICATE HOLDER City of Miami Shores Village Building Department 10050 NE 2nd Avenue Miami Shores, FL 33138 CANCELLATION 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 Ageto VeArt �vme3 01988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) QF The ACORD name and logo are registered marks of ACORD Date CERTIFICATE OF LIABILITY INSURANCE 3/15/2022 Producer'' Plymouth Insurance Agency This Certificate is issued as a matter of information only and confers no 2739 U.S. Highway 19 N. rights upon the Certificate Holder. This Certificate does not amend, extend or alter the coverage afforded by the policies below. Holiday, FL 34691 (727) 938-5562 Insurers Affording Coverage NAIC # insured: South East Personnel Leasing, Inc. & Subsidiaries Insurer A: Lion Insurance Company 11075 2739 U.S. Highway 19 N. Insurer B: Insurer C: Holiday, FL 34691 Insurer D: Insurer E: Coverages 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. Aggregate limits shown may have been reduced by paid claims. INSR LTR ADDL INSRD Type of Insurance Policy Number Policy Effective Date (MM/DD/YY) Policy Expiration Date(MM/DD/YY) Limits GENERAL LIABILITY Each Occurrence Commercial General Liability Damage to rented premises (EA Claims Made13 Occur occurrence) $ Mad Exp Personal Adv Injury General aggregate limit applies per: Policy ❑Project ❑ LOC General Aggregate Products - Comp/Op Agg AUTOMOBILE LIABILITY Combined Single Limit (EA Accident) Any Auto Bodily Injury All Owned Autos (Per Person) Scheduled Autos Bodily Injury Hired Autos Non -Owned Autos (Per Accident) Property Damage (Per Accident) EXCESS/UMBRELLA LIABILITY Each Occurrence Aggregate Occur ❑ Claims Made Deductible A Workers Compensation and x I WC Statu- I OTH- Employers' Liability WC 71949 01/01/2022 01/01/2023 tory Limits ER E.L. Each Accident " $1,000,000 Any proprietor/partner/executive officer/member E.L. Disease- Ea Employee $1,000,000 excluded? NO If Yes, describe under special provisions below. E.L. Disease -Policy Limits $1,000,000 Other Lion Insurance Company is A.M. Best Company rated A (Excellent). AMB # 12616 Descriptions of Operations/Locations/Vehicies/Exclusions added by Endorsement(Special Provisions: Client ID: 91-67-881 Coverage only applies to active employee(s) of South East Personnel Leasing, Inc. & Subsidiaries that are leased to the following "Client Company": Baires Construction Corp Coverage only applies to injuries incurred by South East Personnel Leasing, Inc. & Subsidiaries active employee(s), while working in: FL. Coverage does not apply to statutory employee(s) or independent contractor(s) of the Client Company or any other entity. A list of the active employee(s) leased to the Client Company can be obtained by faxing a request to (727) 937-2138 or email certificates@lioninsurancecompany.com Project Name: SERGIO SANTANA, LICENSE NUMBER CGC1516753, AS QUALIFIER. ISSUE 03-15-22 (KLT) in Date: 7 2 2020 CERTIFICATE HOLDER CANCELLATION CITY OF MIAMI SHORES VILLAGE Should any of the above described policies be cancelled before the expiration date thereof, the issuing insurer will endeavor to mail 30 days written notice to the certificate holder named to the left, but failure to BUILDING DEPARTMENT do so shall impose no obligation or liability of any kind upon the insurer, its agents or representatives. — -- 10050 NE 2ND AVENUE MIAMI SHORES, FL 33138--- Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Permit NO. FW-3-08-438 Permit Type: Fence/Wall Perill'it Work Classification: Iron/Ornamental Permit Status: APPROVED Parcel Number Issue Date:311712008 Expiration:09/13/2008 Applicant 28 NW 111 Street 1121360030350 Miami Shores, FL 33168-4322 Block: Lot: MARIE TOUSSAINT MARIE TOUSSAINT 28 NW 111 Street MIAMI SHORES FL 33168-4322 Contractor(s) Phone Cell Phone WIS'S ENGINEERING, LLC (786)306-2724 Approved: Yes Comments: Date Approved: 3/12/2008 : Yes Date Denied: Type of Construction: Other Classification: Residential Additional Info: ALUMINUM /5' HIGH MAX Fees Due Amount CC F $0.60 Education Surcharge $0.20 Permit Fee - Wire & Wood $100.00 Scanning Fee $6.00 Technology Fee $2.50 Total: $109.30 Phone (305)220-1163 [Val uation: $ 1,000.00 Total Sq Feet: 26 I Total I Amt Paid I Amt Due $ 0.00 $ 0.00 1 $ 0.00 I Payment Type: `7 PAID Available Inspections: Inspection Type: 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. March 17, 2008 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Monday, March 17, 2008 1 `yNaRSGi` Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL fNiEB N 0 FCORIDp' Phone: (305)795-2204 Fax: (305)756-8972 inspection Number: INSP- Inspection Date: 03/24/2008 Inspector: Grande, Claudio Owner: TOUSSAINT, MARIE Job Address: 28 111 Street NW Miami Shores, FL 33168-4322 Project: <NONE> Permit Number: FW-3-08-438 Permit Type: Fence/Wall Inspection Type: -Vurd4 r Work Classification: Iron/Ornamental Phone Number (305)220-1163 Parcel Number 1121360030350 Block: Lot: Contractor: WIS'S ENGINEERING, LLC Phone: (786)306-2724 t5miallng uepartment Comments ALUMINUM FENCE ON SIDES OF THE HOUSE 5 FEET <3 HIGHT Passed Failed Correction Needed Re -Inspection Fee ❑ ($75) No Additional Inspections can be scheduled until re -inspection fee is paid. 11 Inspector Comments CC Thursday, March 20, 2008 Page 1 of 2 l Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 �v Phone: (305)795-2204 Fax: (305)756-8972 Folio Number:1121360030350 ................................................................................................................................................................................................ Owner's Name: MARIE TOUSSAINT Job Address: 28 111 Street NW Miami Shores, FL 33168-4322 ................................................. Owner's Phone: Total Square Feet: Total Job Valuation: ............................ 220-1163 26 $ 1,000.00 ................................................................................................................................................................................................................................................ . Contractor(s) Phone Primary Contractor Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 3/12/2008 : Yes Comments: