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PT-10-432Project Address Owner Information Fees Due CCF Education Surcharge Permit Fee Technology Fee Total: Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795 -2204 Contractor(s) Phone Cell Phone SUMMERS PROFESSIONAL SERVICE (305)232 -1527 (305)232 -2236 Amount $6.00 $2.00 $300.00 $8.00 $316.00 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Parcel Number Phone Type of Work: Exterior Color: Additional Info: Classification: Commercial Color: _Approved Color: _Approved_ Code Comments: ALUMINUM FENCE - BLACK Color: _Denied Pay Date Pay Type Amt Paid Amt Due Invoice # PT -3 -10 -37316 04/02/2010 Check #: 12001 $ 316.00 $ 0.00 Applicant April 02, 2010 Date CeII Type: Pa tion Nom; • • PROVE Expiration: 09/13/2010 11300 2 Avenue Miami Shores, FL 33138- 1121360010160 Block: 1 Lot: 2 BARRY UNIVERSITY INC BARRY UNIVERSITY INC Address 11300 2 Avenue MIAMI SHORES FL 33161 -6628 Valuation: Total Sq Feet: $ 10,000.00 Available Inspections: Inspection Type: Final 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. April 02, 2010 1 BUILDING PERMIT APPLICAA.TION FBC 2004 Permit Type: PAINT PERMIT Owner's Name (Fee Simple Titleholder) 1 rr7 t)NI (0-e1S Owner's Address //,300 N6" 4 ,7 Air Cit i1 /GI M / :State -P Tenant/Lessee Name E -MAIL: Job Address (where the work is being done) City FOLIO / PARCEL # Is Building Historically Designated YES NO X, Contractor's Company Name Contractor's Address City OWNER BUILDER: t, WARMING - O1'NI:R R .YL)l1R IMPK0t) IE NT Vl I'kO a , K Permit Fee $ Miami Shores Village County g q7 SW /029 7 P oo Selo Miami Shores Village Building Department 10050 N.E.2nd Avenue. Miami Shores, Florida 331 38 BI: Tel: (305) 795.2204 Fax: (305) 756.8972 Permit Not 10 Master Permit No. Phone # Zip 3 3 16 Phone # EUESCED 11 19 /300 E 2- 111 S 1\1 'lam Miami -Dade Zip 3 3 Phone # 3O 1 - 2.3Z -1-$ zi 33/4 ,71 /AIM % > State - F!' Qualifier Name ANe�2'Pui mu I sh,,7 Phone # 3 r Z 32 ' /5 State Certificate or Registration No. Certificate of Competency No. Value of Work For this Permit $ /01 DOD Type of Work: ❑ Addition / ❑ Alteration / ❑New / Describe Work: 42. /4' 1 " exe -e > 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 (hat a separate permit must he secured for S. WELLS. POOLS, FURNACES, BOILERS. HEATERS, TANKS and AIR CONDITIONERS, ETC AILURE TO RECORD A NO 1 'E OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR TY. IF YOU INTEND TO OBI ' �• ' iPPOEV OS LENDER OR AN ATTORNEY BEFORE MENCEMENT." J ri;d va /ties eeling $ 1 /a' d /)1r "/n emus promise in good /aiih that 0 copy of the pe 'i`wh `. properly is subject id tfr. ment. iAlso. a certified copy oldie recorded notice ser°et3 #`R a % r the building pertnil is :shied. In the absence of such posted notice. the suance ofa building permit with an notice nfcr im roc ne a s "ac en law brochure wi /I be delivered to of ca ninencemen! rnusl be posted at the job site for the • first inspection which oc inspection will not be approved and a reinspeclion, fee will be charged. xxxxxxww******'vY****9 *** *dr**** &oYde******* Fees**** 4eirx *3c9rx drat*ic*ir*****i:aY ****r**** Y•i ********,t CcF$ ( D. ±00 r.� Repair /Replace {� Technology Fee: D Training /Education Fee $ 0.'00 Notary $ Code Enforcement $ Double Fee $ Zoning $ . Total Fee Now Due $ 31t ow See Reverse side -* Signature Directions: Please circle corresponding number to appropriate color sample. Walls: Fascia: Drip Cap /Drip Cadge: Soffit: Roof: I 3 3 4 Flower Bins: 1 2 3 4 Shutters: I 3 4 Awnings: I 2 3 4 Chimney: I 2 3 4 Doors and Door Jams: 1 2 3 4 Garage Doors: I 2 3 4 Railings: 1 2 3 4 Fences: 2 3 4 All brick (simulated or regular): Stucco Banding: 1 Any other Stucco Features: Accessory Buildings Other: OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all ap►le laws regulating construction and zoning. Owner or Agent 3 The foregoing instrument was acknowledged before me this / 0 day of rh . 20 Z). by_ F-�+ae wc.x. S . who ispersonally known to me or who has piuduced As identification and who did take an oath. NOTA •, PUBLIC: PAINT COLOR APPROVAL AND AGREEMENT All elements on the site must be listed and indicate the color to be painted 4 4 Signature 6, Sign: 1 Print: 1..:;74410., I''h.• My Commission Expires: • S I Notary Public - State of Florida • E My Comm. Expires Jun 18.2013 Commission • DD 863031 tn7' " Bonded Through NOM Noisy bits. / 21/ /7 4. Contractor The foregoing instrument was acknowledged before me thiss • / day of q . 20J0. by ketra /nG /. —4 4: f who ism rsan ll L_n n i me or who has produced as identification and who did take an oath. Maury LINDA S. MITTS Notary Public • State of Florida Expires Jun 18, 2013 # 00 8413031 ONION NINO Nobly Men. NOTA Y PUBLIC: ign: int: y Commission Expires: ***************** ******* ******************xx**ie i AC*********************** * **************** * ******* ****it 4e&** • APPLICATION APPROVE[) BY: Plans Examiner Preservation Board A i.a• Code Enliircement Attach color samples with name and number. (Revised 04/2410; O6/17/21)08 078154508-11.- The GENERAL COrRT Named belOw IS OE IF Under the proviSiOns of= Expiration date: AUG 31, 20 111-4Slit 8811 S MIAMI , SE V RtakCE PL 33176 ..H CI GOVERNOR - ,OF FLORIDA_ __4 - SIONAL REGULATION MING BOARD SEQ# L0806170112 IRED BY LAW CHUCK DRAGO INTERIM SECRETARY AC# DATE BATCH NUMBER GOVERNOR DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD SEQ# L0905200075 LICENSE NBR 05/20/2009 088220990 QB30208 STATE OF FLORIDA The BUSINESS ORGANIZATION Named below IS QUALIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2011 (THIS IS NOT A LICENSE TO PERFORM WORK. THIS ALLOWS COMPANY TO DO BUSINESS ONLY IF IT HAS A QUALIFIER.) SUMMERS PROFESSIONAL SERVICES INC 8897 SW 129TH TERRACE MIAMI FL 33176 CHARLIE CRIST CHARLES W. DRAGO DISPLAY AS REQUIRED BY LAW SECRETARY 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. tNSK LIR AUU L NERD, TYPE OF INSURANCE POLICY NUMBER P OLICY EFFECTIVE DATE (MMIDDIW) POLICY EXPIRATON DATE (MMIDDfYY) LIMITS A INSSURERA rccz comment. INSURANCE co. GENERAL LIABILITY COMNERCTAL GENERAL LIABILITY CPP003242 5 01/01/10 01/01/11 EACH OCCURRENCE $ 1,000,000 X PRREEMISES (E a omuence) $ 300,000 CLAIMS MADE X I OCCUR MED EXP (My one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT_ AGGREGATE LIMIT APPLIES PER: — I POLICY I I1 LOC PRODUCTS - COMP /OP AGG $ 2,000,000 A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS CA0004009 -7 01/01/10 01/01/11 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY' AGG $ A EXCESS/UMBRELLA X X LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ UMB0001993 -7 01/01/10 01/01/11 EACH OCCURRENCE $ 1 , 0 0 0 , 0 00 AGGREGATE $ 1,000,000 $ $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARMER/EXECUTIVE OFFICER/MEMBEREXCLUDED? If yes. describe under SPECIAL PROVISIONS below AWC1004421 01/01/10 01/01/11 X ITORY S I I I E.L. EACH ACCIDENT 81000000 E.I. DISEASE - EA EMPLOYEE $ 1000000 E.L. DISEASE - POLICY LIMIT $ 100000 0 OTHER DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS *30 DAY CANCELLATION NOTICE EXCEPT 10 DAYS FOR NON PAYMENT OF PREMIUM ACCRA, CERTIFICATE OF LIABILITY INSURANCE OP ID n SUMP9 -1 DA (WNW/WY) 02/03/10 vat A I�l1G[ REPRES ( _ -- ---- --- --- -- -- PRODUCER BUTLER, BUCKLEY, DEETS INC. 6161 BLUE LAGOON DR. , STE 420 MIAMI FL 33126 Phone: 305 -2 62 -0086 THIS CERTIFICATE I3 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 NAIC # INSURED SUMMERS PROFESSIONAL PAINTING INC. & SUMMER PROFESSSONAL SER 8977 S .W • 3129TH TERRACE INSSURERA rccz comment. INSURANCE co. 33472 IN 8: ASSOCIATED INDUSTRIES or sr INSURER C: INSURER D: INSURER E: MIASHVI MIAMI SHORES VILLAGE BUILDING & ZONING 10050 N E 2 AVE. MIAMI SHORES FL 33138 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 DO SO SHALL KIND IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. vat A I�l1G[ REPRES ( _ -- ---- --- --- -- -- rrom:Ueni vatasso raxiu.col.n ma COVERAGES ACORD 25 (2001/08) ratje L Ut J IdgtC J.JftV IV 1 1 .VU ,11Y■ raac.e. VI J CANCELLATION CO NT16 2009 LOCAL B I 1, L ADE N MOST E DISPL t3II PURSUANT TO , OUN1 & 716 y9 THIS IS NOT A BILL - DO NOT PAY RENEWAL su S NI UMM R E PR . 0 0 F ' S •SIGNAL SERVICES INC ' STATE#C0C 'a7 9 ©2 0' -2 889` SW 129 TERR 33176 UNIN DADS COUNTY OWNER • SUMMERS PROFESSIONAL SERVICES. IN Sec T at , usi 19 GENE L BULGING CONTRACTOR IS ONLY A LOCAL TAX RECE P . #1 tES NOT P,�' �7 THE ILCER. TO VIOLATE IS11NG REGULATORY o orgy THE C iUNTY OR C N R EXEMPT THE HADER ANY CTN OR L1yENiE 8Y lY F NQT A . CATION q - HOLDERS aeA NS: PA = •:RECEIVED E;COUNTY TAX 07/09/2009 60080000282 000.085.00 SEE OTHER SIDE DO NOT FORWARD RKER/S 12 SUMMERS PROFESSIONAL SERVICES INC ANDREW MULSHINE PRES 8897 SW 129 TERR MIAMI FL 33176 286 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 138227 Permit Number: PT- 3- 10-432 Scheduled Inspection Date: June 22, 2010 Inspector: Bruhn, Norman Owner: , BARRY UNIVERSITY Job Address: 11300 NE 2 Avenue Miami Shores, FL 33138- Project: <NONE> Contractor: SUMMERS PROFESSIONAL SERVICES INC Building Department Comments June 21, 2010 For Inspections please call: (305)762 -4949 Permit Type: Paint Inspection Type: Final Work Classification: New Phone Number Parcel Number 1121360010160 Phone: (305)232 -1527 SAND AND PAINT PERIMETER ALUMINUM FENCE Passed 6'0.2/ Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CC Page 6 of 26 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 138227 Permit Number: PT- 3- 10-432 Scheduled Inspection Date: June 22, 2010 Inspector: Bruhn, Norman Owner: , BARRY UNIVERSITY Job Address: 11300 NE 2 Avenue Miami Shores, FL 33138- Project: <NONE> Contractor: SUMMERS PROFESSIONAL SERVICES INC Building Department Comments June 21, 2010 For Inspections please call: (305)762 -4949 Permit Type: Paint Inspection Type: Final Work Classification: New Phone Number Parcel Number 1121360010160 Phone: (305)232 -1527 SAND AND PAINT PERIMETER ALUMINUM FENCE Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Page 6 of 26