Loading...
9534 NE 2 AVE (3)MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date3\Q‘N 5 Type Insp'n ra___ Permit No. L L-- Name Address 17 0 Compan r4 i Phone # 7 0 5 _ /l' — L l it f j Inspection Date e 3\ 1 A` C7 Approved ❑ Correction Re-Insp'n Fee GGG ❑��` Certificate of Occupancy Inspection Permit OL -3 170 NE 96 ST Village Cafe Express A certificate of occupancy cannot be issued until the following items are addressed: • Need final electrical inspection approved for permit EL 2004 -289 • Need final plumbing inspection approved for permit PL 2004 -314 • Need final fire department inspection approved. • Need to pay for ($509.43) building permit BP 2004 -1252, and pass final inspection. This is the permit for the interior alteration. Imburgia Construction Services, Inc. has been contacted numerous times and needs to provide the following items before the permit can be issued: • A notice of commencement • Proof of workmen's compensation insurance • Proof liability insurance • Proof of a qualified business license • Proof of an occupational license NOTE: THIS SPACE CANNOT BE OCCUPIED UNTIL A CERTIFICATE OF OCCUPANCY IS ISSUED BY THE MIAMI SHORES BUILDING DEPARTMENT PER FLORIDA BUILDING CODE 106.1.1 Curtis Craig, Building Official 305 - 795 -2204 3/24/05 OCCUPATIONAL LICEN CO SAFETY INSPECTION APPLICATION Building Owner's Name Owner's Address c i f City Hi*/ ,``) 'S State Zip 3 /J Business Name E5E'fe Ct r e 9L7V ,e C co, / /vv Business Owners ame f 31 Address ea=7"0 ( Suite City Miami Shores State Florida Zip 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. BUSINESS OWNER Signature The foregoing instrument was acknowledged before me thi a' day of c9- (' , 20 O.5 , by /d/ �clh'0 , who is personally known to me or who has . produced L V/ (/ S Z1c &i NOTARY PUB Sign: Print: My Commission Expires: V03 Building Officials Approval: Miami Shores Village Build' �:� = 1��:'� - nt e(CC',4 �J ri X//77A<d Phone # ? 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795 -2204 Fax: (305) 756 -8972 Permit No. 0- 2- 0 ID. Loc ID Phone # 3 OS . 3- 7777 as identification and who did take an oath. e79/74/063 g 08- / d (6-V �. 05 /11/03 Business Name Business Owners Name Address City '1/00 o Miami Shores Building Officials Approval: Miami Shores Village Building Department Certificate of Occupancy The following business is issued a Certificate of Occupancy and can apply for a Business Occupational License: LC State Florida Zip 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795 -2204 Fax: (305) 756 -8972 Permit No. OL Phone # 3(13'/ 3A0• yewQ 2 Suite 3 Date :ev. 0413/03) 1:75d0c OCCUPATIONAL LICENSE I ,► ?E!!un En CO SAFETY INSPECTION 1 tta 2 , 2nn5Per APPLICATION Ec Phone #& 5 3 00 Owner's Address ( 0 1,S CA ' /ijl &UGI-. U v 1Z0 6 City 14 I k-A 1 State FL Zip 35 / 3 8 Building Owner's Name Business Owners Name C. ..rr) k 1 &"C. Phone #3O3 " 31 4l43 Business Name Address 1 fO Ni E. TK �Cl City Miami Shores OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compli. - with all applicable laws regulating construction and zoning. BUSINESS O ►f4 Signature ff/J a fry The foregoin: instrument was acknowledged before me this Z 3 day of 1 f R. C 1' 4 , 20 Oc , by MA-SC I40 W produced as identification.and who did take an oath. NOTARY PUBLIC: RAF RAFAR. MORALES Sign: L� • * MY COMMISSION I DD 3332,33 Print: /e4 F MO /'A L CS EXPIRES: July 15, 2008 +r i.0 Bonded Nu Budget Notary Was My Commission Expires: Building Officials Approval: Miami Shores Village Building Department Loc E.XP2e State Florida Zip 3 3 / 3 5 ^3) '4/ q 3 r(,�S l til 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795 -2204 Fax: (305) 756 -8972 't No. 01_— a0 ID Suite who is personally known to m or who has . 00) i 02/28/2005 10:59 FAX 3057546260 JUDY OCONNOR CPA PA uc, 4e/ eloon 1b: 4b MIAMI SHORES U I LLAGF 4 3057546260 TO THE VILLAGE CLERK MIAMI SHORES VILLAGE APPLICATION FOR OCCUPATIONAL LICENSE As required by the Miami Shores Code of Ordinances, I hereby make application for a license for. 7) Real name of person(s), firm or corporation: =4&l /a '7PUC7'7 o7 We-6 J. Telephone4(5 - n707 2) Fictitious name of person(s), firm or corporation (if used in business): 3) Location of business (License shall apply to only one location): 5/5 n/E 92 . 4) If a firm, the names of the members of the firm, and if a corporation, the names of the officers //A of the corporation: / Pres. i.S �-ib w''C l a Sec. Vice -Pres. Treas. 5) • Name of person(s) who will manage, control or direct the business to be transacted in Miami Shores Village: 6) Nature of Business: eGIO57,E_U /oit) A1,,,rA/ 4 11,r (If merchant, list general lines of merchandise; if professional or service establishment, kinds of services rendered). 7) Information for determination of License Tax (Answer FULLY all applicable questions). (a) (b) (c) (d) LICENSE COST INSURANCE/REAL ESTATE COMPANY OR AGENCY: Number of Salespeople MERCHANTS: (including food stores) Value of stock carried RESTAURANTS, SODA FOUNTAINS, LUNCH COUNTERS: No. of seats/stools, standing counter space Motels/ Apartments No. of Rooms and/or units SIGNATURE OF APPLICANT: 9rp DATE: 1b. 28, ,?005 11002/004 NO.151 P002 357546260 02/28/2005 10:59 FAX 3057546260 fmburgia Construction Services 595 N.E. 92 Street Miami Shores, Florida 33138 Telephone (305) 754 -6212 Facsimile (305) 754 -6260 TO: Genny FACSIMILE TRANSMITTAL SHEET FROM: Genevieve Clay COMPANY: Miami Shores Village DATE: 2/28/05 FAX NO.: 305- 756 -8972 RE: Louis Imburgia ❑ URGENT ❑ FOR REVIEW ❑ PER REQUEST ❑ PLEASE REPLY ❑ DATA REQUEST NOTES /COMMENTS JUDY OCONNOR CPA PA V1001/004 TOTAL NO. OF PAGES INCLUDING COVER: 4 Please see attached documents: Application for Occupational License, Proof of liability insurance, and State of Florida License. As stated previously Mr. Imburgia is exempt from Workman's Compensation Insurance due to the fact that he is a single owner with no employees. If you have any questions, please feel free to contact me at 305- 754 -6212. Thank you for your time on this matter. dell° e6(1 ,6k e.e 6a, 441-19 IF YOU DO NOT RECEIVE ALL PAGES AS INDICATED, PLEASE CALL 02/28/2005 10:59 FAX 3057546260 uzizz /OS TUE 09:28 FAX New Renewal of Number No. PCL2136587 DECLARATIONS Item 1. Name of Insured and Mailing Address; LOUIS S. IMBURGIA 5021 LONDON WAY MIAMI SHORES, FL 33138 TYPE OF POLICY OR COVERAGE Automobile Liability and Uninsured/Underinsured Motorists Recreational Vehicle Liability including Passenger Bodily Injury Liability Watercraft Liability Comprehensive Personal Liability Rental Property Liability Classification Code: Policy Premium: Policy Fee: Service Fee: Surplus Lines Tax: Total: PCLD (12/2000) OMW 99921 $973.00 $35.00 $3.02 $50.40 $1,067.42 THE CBCIABRITY PERSONAL UMBRELLA LL044,1TY Pp Bodily injury United States Liability Insurance Group Item 2. POLICY PERIOD: This policy period begins and ends at 12:01 A.M. Standard Time at the named insured's address above. Effective Date: 03/02/2004 Expiration Date: 03/02/2005 Item 3. POLICY LIMITS: Coverage A - Personal Umbrella Liability $1,000,000 Self Insured Retention $0 Coverage B - Excess Uninsured Motorists Coverage $25,000 Each Accident IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY. WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY_ Item 4. Residence - Coverage is provided to those residences that are covered by underlying insurance Item 5. Owned automobiles and owned recreational Vehicles - Coverage is provided to those owned automobites and owned recreational vehicles that are covered by underlying Insurance. Item 6. Required Underlying Insurance Coverage: You agree that the higher of the MINIMUM UNDERLYING LIMITS below, cute linlit shown on the PCL 117 - Schedule of Underlying Insurance Endorsement (if the PCL 117 is shown below); (1) is in force and will continue in force; and (2) insures all residences, automobiles, recreational vehicles, or watercraft owned by, leased or regularly furnished to you. Property Damage Bodily Injury Property Damage Bodily injury Property Damage $300,000 PCLJ (03/03) - Personal Umbrella Liability Policy PCL122 (03/03) - Rejection of Coverage B - Excess Uninsured Motorists PCL120(04/03) - Exam Uninsured Motorist Coverage Endorsement USLI Privacy Notice JUDY OCONNOR CPA PA 190 South Warner Road Wayne, PA 19087 United States Liability Insurance Company 0 Mount Vernon Fire Insurance Company 0 U.S. Underwriters Insurance Company MINIMUM UNDERLYING LIMITS DUAL LIMIT OR Agent: 096074 AGENCY $250,000 $500,000 $100,000 $250,000 $500,000 $100,000 Customer Copy each person each accident each accident each person each accident each accident $250,000 each person $500,000 each accident $100,000 each accident Bodily Injury, Personal Injury and Property Damage Combined Subject to the following Formss�' UNES Averse, $1 Pe 33 LTOO PROD. AGENT: ADDRESS: This k>surartce Is Issued pur uant to the Roads Surplus Unes Lan d-b�a rEbeEen of 1M ti<rt fit et any recavety tar the obligation of Ile , l iaq ; v y. AGENTS COUNTERSIGNATURE: B .4V .■■1 n .. SINGLE LIMIT $300,000 Bodily Injury and Property Damage Combined $300,000 Bodily Injury and Property Damage Combined $300,000 Bodily Injury and Property Damage Combined Authorized Representative Issued Date: 03/03/2004 a 003/004 0001 3057546260 03/23/2005 16:49 FAX 3057546260 JUDY OCONNOR CPA PA Imburgia Construction Services 595 N.E. 92 Street Miami Shores, Florida 33138 Telephone (305) 754 -6212 Facsimile (305) 754 -6260 TO: Genny COMPANY: Miami Shores Village FAX NO.: 305- 756 -8972 RE: Louis Imburgia ❑ URGENT ❑ FOR RE' NOTES /COMMENTS If you have any questioi you for your timi L- FACSIMILE TRANSMITTAL SHEET FROM: Genevieve Clay DATE: 03/23/05 TOTAL NO. OF PAGES INCLUDING COVFQ• - Please see the attached n n , „�/{�., as a certificate holder to Mr. Imburgia's polic `t Lf Gv / REQUEST 754 -6212. - c. -kr IF YOU DO NOT RECEIVE ALL PAGES AS INDICATED, PLEASE CALL el 001/003 03/23/2005 16:49 FAX 3057546260 JUDY OCONNOR CPA PA • - ;S: r- IMBURGIA, LOUIS & CATHY 5021 LONDON WAY MIAMI SHORES FL 33138 Type: COND UNIT OWNRS Coverage information A -BLDG PROP 460800 B -PERS PROP 204800 C-LOSS USE ACT LOSS D -LOSS ASES 1000 L -PERS LZAB 300000 DMG TO PROP 500 M- MED /PERS 1000 Prev risk: 200,000 Deductibles applied:1000 ALL PER Messages: Year built: Zone: Sub zone: #ofunits: Building Grade : 04 Insp . Imprvd: Amt Pct 2003 06 01 01 +0 +0.000 • . FL. 33024 ( 361.1677 ARCH 18, 2005 B Ph. (305)754 -6212 SFFL Policy: 79 -PY-- 9683 -0 B Yr issd: 1989 Xref: YRs with SF: 9+ Fire Policy Status Renew date: DEC -26 -05 Premium: 2,105.00 Written date: DEC -26 -03 Amount paid: Date paid: Bill to: Prev prem: Term: CONT Constr: MASONRY Home alert: FC SA DH FE 2105.00 NOV -17 -04 INSD •1, 665 Rating claims: 00 Clean slate: 02 -07 -02 FL EMPAS 0002/003 2.00 03/23/2005 16:49 FAX 3057546260 JUDY OCONNOR CPA PA POLICY#: 79-PY-9683-0 B IMBURGIA, LOUIS & CATHY 5021 LONDON WAY MIAMI SHORES, FL 33138 PHONE#: (B) 305 Eff date:(03/18/05) Curr date: (03/18/05) Time: (04:29 PM) **ADDITIONAL INTEREST CHANGES** Rnwl bill to: End bill to: Change: Type: Subset #: Loan #: Copy of policy MTG,RMKS (add ) (see remark ) is needed. REMARKS APPLY TO: Fire N TALLARICO INS AGCY INC 954-431-6777 INITIALS(YR ) (800) 3E51-1577 MARCH 18, 2005 COND UNIT OWNRS 0003/003 AGENT COPY AGENT: F603/2227 Add'l Interest Name & Address: (N) (VILLAGE OF MIAMI SHORES ) W(10050 NE 2ND AVE ) ) ( )( 1 ) 1 ) ) ( ) ( ) City: (Mmmi SHORES ) St: (FL) ZIP: (33138 ) RO REMARKS: (THE ASSOCIATION IS REQUESTING THAT THEY BE LISTED AS A CERTIFICATE) ( HOLDER State Farm Florida Insurance Company A Stock Company With Home Offices in Winter Haven, Florida 7401 Cypress Gardens Blvd. Winter Haven, FL 33888 -0007 Addl Insured - Sections I & II VILLAGE OF MIAMI SHORES 10050 NE 2ND AVE MIAMI SHORES FL 33138 -2304 UNITOWNERS POLICY - FORM 6 Coverages & Property Limits of Liability SECTION I A Building Property B Personal Property C Loss of Use D Loss Assessment SECTION II L Personal Liability (Each Occurrence) Damage to Property of Others M Medical Payments to Others (Each Person) Forms, Options, & Endorsements Homeowners Policy -Form 6 Motor Vehicle Endorsement Policy Endorsement Back -Up of Sewer or Drain Cpic Policy Perils Exclusion Amendatory Endorsement Jewelry and Furs $2,500 Each Article/$5,000Ag regate Home Computer $ Replacement Cost - Contents J- 2227 -F603 F H 460,800 204,800 Actual Loss Sustained $ 1,000 $ 300,000 $ 500 $ 1,000 FP- 7926.FL FE -5396 FE -5320 FE -5702 FE -7592 FE- 7210.5 Option JF Option HC Option RC For questions, problems, or to obtain information about coverage call: 954 - 431 -6777 DECLARATIONS PAGE Policy Number 79 -PY- 9683 -0 Policy Period Effective Date Expiration Date 12 Months DEC 26 2004 DEC 26 2005 The policy period begins and ends at 12:01 am standard time at the residence premises. Named Insured IMBURGIA, LOUIS & CATHY 5021 LONDON WAY MIAMI SHORES FL 3313 Automatic Renewal - If the policy period is shown as 12 months, this policy will be renewed automatically subject to the premiums, rules and forms in effect for each succeeding policy period. If this policy is terminated, we will give you and the Mortgagee /Lienholderwritten notice in compliance with the policy provisions or as required by law. Location of Residence Premises Your policy is amended MAR 18 2005 Same as Insured's Address ADDL INSURED NAME & ADDRESS ADDED Inflation Coverage Index: 189.7 Deductibles - Section 1 All Losses In case of loss under this policy, the deductibles will be applied l per occurrence and will be deducted from the amount of the oss. Other deductibles may apply - refer to policy. Endorsement Premium Discounts Applied: Home Alert Home /Auto Claim Record Sprinkler Other limits and exclusions may apply - refer to your policy Your policy consists of this page, any endorsements and the policy form. Please keep these together. FP- 7002.4C N TALLARICO INS AGCY INC 4320 251 Al 954 - 431 -6777 N Prepared MAR 21 2005 555-7020 AMENDED MAR 18 2005 $ 1,000 NONE 555- 7020.1 Rev. 10 -2002 (o1f0391c) rHoouCER Insurance Plus, Inc. 9254 Bird Road Miami, FL 3:3185 (305)551 -4933 INSURED 3056628838 03/29/2005 09:14 3056628838 A CORip TM„ CERTIFICATE OF LIABILITY INSURANCE 03/23/05 I...I Fab Interior And Exterior Inc 20341 NE 30 Ave #6 -103 Miami, FL 33180 COVERAGES • Nb 1 POLICIES OF INSURANCE LISTED 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, ENCLUSIANR AND CONDITIONS OF 6u0 nip. AGGREGATE LIMITS at IOWN MAY HAVE BEEN REDUCtU I3Y PAID CLAIMS. INSRI ADD'L ...... LrR ".,rrosRD TYPE OF INSURANCE POLICY EFFECTIVE I POLICY EXPIRAnoN POLICY NUMBER DATE (MM(ooY) I DATE (MMVgDm) LIMITS • GENERAL LIABILITY nr EAI,H OCCURRENCE 1,000,000 I. AGE T 'REN ED "' "' '" 0510CG00001 06/16!04 06 /1fil05 PREMISES 1,000 .._ 'I..1 CLAIMS MADE [ 10, A - - MED EXP ( nne person) 10,000 f J I OCCUR Li PERSONAL & ADV INJURY 1,00000 ,0 GENERAL AGGREGATE 2,000,000 ._. DEN'L AGGREGATE LIMIT APPLIES PER: rrcuuUCTS - COMP /OP AGG 2,D00 OO,000 __.. - I " , POLICY I .. I PROJECT I I LOC rLE LIABILITY — - - -- I I ALL OWNED AUTOS L I ANYAul0 Ili COMBINEaccident) D sINCLC LIMIT (Ea -- • - 1..1 SCHEDULED AUTOS t �� I BODILY INJURY I... I HIRED AUTOS Tor pereon) I. I NON OWNED AUTOS - BODILY INJURY (Per accident) GARAGE LIABILITY .I ANY AUTO I.: I EXCESS LIABILITY OCCUR I I CLAIMS MADE I I DEDUCTIBLE Li RETENTION WORKERS COMPENSATION ANC FMPI.. DYERS , LIABILITY ANY ROPRIETOR / PARTNER / EXECUTNE OFFICER / MEMBER EXCLUDED? If yes, describe under SPECIAL rHUVISIONS below OTHER DESCRIPTION OF OPERATIONS! LOCATIONS 1 VEHICLES ! EXCLUSIONS ADDED BY ENDORSEMENT !SPECIAL PROVISIONS CERTIFICATE HOLDER O ACRD 25 (2001/08) MIAMI SHORE VILLAGE BUILDING DEPARTMENT 10050 NE SECOND AVE MIAMI SHORE, FL 331382382 INSURANCE PLUS: DATE (MM/DD/YY) THIS CERTIFICATE IS ISSUED nS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTENn OR _ .. AI.TtK TH COVERAGE AFFORDED THE POLICIES BLOW___ INSURERS AFFORDING COVERAGE NAME # INSURER A: TapCO Underwriters, Inn INSURER B: INSURER C: INSURER D: INSURER E; AUTHORIZED REPRESENTA NORA L. LAFAURIE PROPERTY DAMAGE (Per accident) AUTO ONLY - EA ACCIDENT OTHER THAN EA ACC AUTO ONLY: AGG EACH OCCURRENCE AGGREGATE - " I STATI I. - E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE 1 E.L. DISEASE - POLICY LIMIT PAGE 01 H CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIED DC CANCELLED BepORE 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 D OF ANT KIND UPON THE IN • SO SHALI,IMPOSE NO OBLIGATION OR LIABILITY R R; ITS S O REPRESENTATIVES. E RATION 1958 MIAMI SHORES'tiLL'AGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date 4\P\• Type Insp'n FA44 I A,1r / Permit No. Name , /' ; r ff, .,,,S Address 0 4, q6 Company F413 r� Phone # Inspection Date Approved Correction Re- Insp'n Fee ling Officials Approval: Miami Shores Village Building Department Certificate of Occupancy The following address is issued a Certificate of Occupancy 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795 -2204 Fax: (305) 756 -8972 Permit No. BP 2004 -11252 Date: 4/12/05 Address: 170 NE 96 ST- Village Cafe Express City Miami Shores State Florida Zip This Certificate of Occupancy is issued for the above address. This certificate verifies that the building or structure has met the requirements of Florida Building Code 106.1.2. However, this certificate does not constitute any representation or warranty. 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 -a` BUILDING 1711/i PER1VIIT APPLIC 'Ieo r'nc Master Permit No. Permit T■ Plumbing Mechanical Roofing Owner's Na • J,+11 p Lie Phone # 305/e) / 3, 170 FBC 20e1 Owner's Ad' City Tenant/Lessc Job Address , % T f) eft City � tl `� Miami -Dade Zip Is Building I. Contractor's _ _.��,:' ( Phone # Contractor's Address (O-4o I-V-- City V. t P " ' � ,6/ State tt Qualifier 9j1 lid State Certificate or Registration No. Architect /Engineer's Name (if applicable) $ Value of Work For this Permit 1 3, Oa Type of Work: ❑Addition yy-- ❑Alteration �, ❑� New I=1 Repair /Replace 11] Demolition Describe Work: ,.L/VTER, i LL2 /e- O Ti L fa.d Submittal Fee $ Notary $ J Scanning $ Total Fee Now Due $ Training /Education Fee $ (Continued on opposite side) Miami Shores Village Building Department * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Permit Fee $ Radon $ Code Enforcement $ Structural Plan Review. $ Zip Permit No. aC d 1 /c Phone # Zip 3 l s s' Certificate of Competency No. Phone # Square Footage Of Work: CCF $ 'f • 4 CO /CC ? C )t Technology Fee $ /,r- Zoning Bond $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: 1 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 NOTARY PUBLIC: Sign: Print: Chc 05/13/03 NOTARY PUBLI Owner or Agent Contractor The foregoing instrument was acknowledged before me this T . ego'ng instrument was acknowle ed before n e this a day of , 20 , by , day o �!:atJ� 20 i� by who is personally known to me or who has produced s pe sonally known to •r who has produced As identification and who did take an oath. as identification and who did take an oath. E xpir e + a ' o. My Commission Expires: A issi Expires: *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** *** * In c. * * * * * * * * * * * * *** * * ** *U * * ** ***** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: _ Plans Examiner Engineer Zoning Ce Permit OL 170 NE 96 Village Ca A certifica 1 i r • iau.....� ,7...,.. - .5 N ed final electrical inspection approved for permit EL 004 -289 Need final plumbing inspection approved for permit PL 2004 -314 Need final ire department inspection approved Ne • : to pay for ($509.43) building permit BP 2004 -1252, nd pass final inspection. This is the permit for the interior alteration. Imburgia Construction Services, Inc. has been contacted numerous times and needs to provide the followi items before the permit can be issued: • &-fiot of commencement orkmen's compensation insurance of liability insurance • P f of a qualified business license •Proof of an occupational license NOTE: THIS SPACE CANNOT BE OCCUPIED UNTIL A CERTIFICATE OF OCCUPANCY IS ISSUED BY THE MIAMI SHORES BUILDING DEPARTMENT PER FLORIDA BUILDING CODE 106.1.1 Curtis Craig, Building Official 305 - 795 -2204 3/24/05 Inspection d until the following MIAMI -DADE FIRE RESCUE DEPARTMENT FIRE INSPECTION REPORT CONTINUATION OCCUPANT U I U :/ C P F �� P (J ADDRESS / 7° N' e • 96-/ o S ?S- et-9 P a 00 '-✓ -/ /age I of Pages INSPECTOR 0 0 t. D AT E ° /2 ® ©S c NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. TAX FOLIO NO. 1 t 3 0 (0 0 1 3 2 "' STATE OF FLORIDA: COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Legal description of property and street /address: 2. Description of improvement: ee i. D I 0" /st! cobvigils o U /L 3. Owner(s) name and address: C-tA rk. L LC- Interest in property: Name and address of fee simple titleholder: Lee, L t " c vv. t' �^n ' 4. Coractor's name and address: ,dc: 1 � I `1,4)(5 ; - 5/.3)' 5. Surety: (Payment bond required by owner from contractor, if any) Name and address: Amount of bond $ 6. Lender's name and address: 7. Persons within the state of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes, Name and address: 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name and address: 9. Expiration date of t is Notice of Commencement: (the expiration date is 1 year from the date of recording unless a different date is spec' ied) Signature of Owner Print Owner's Name z ' " t' 1\1 Prepared by °{L t.2ov - ^' • • Sworn to and subscribed ) a ,r Sc A u. I Notary Public. Print Notary's Name MY commission exoir before me this ,90 day of t t- L ' • 20 (15 t, Anchrw Vogel � =: °_.* ,: : Commission # D • .�� � ? E:puet: Nnv 2 7007 ........... . Aama Notary 1- SO0- 350=51fs1 ,STATE OF FLORIDA, COUNTY OF DADS 1 HEREBY CERTiFY that this is a true co y of the � / day of oregmaf Cited in this COL " (�1 C , A 0 20 V' TN.ESS my hand and Official Seal. IN, CLER , • Pre nd CQunty Courts D.C. Ats1 SG.or S 73 1 K- - 2--C I V /r Address: 4 � 111111111111111111111111111111111111111111111 C=F rol 2OO__ OR Bk 23222 Pc 0507; (1pe) RECORDED 03/31 /2005 11011 :13 6 HARVEY R:UVIH► CLERK. OF COURT MIAl'1I -DADE COUNTY? FLORIDA LAST F'AGE: 4.1 0 1%, 0 -70 L_ 3 3 - c Miami Shores Village 10050 NE 2nd Avenue Building Permit Phone: 305 - 795 -2204 Permit Number: BP2004 -1252 Printed: 2/22/2005 Applicant: Owner: JOB ADDRESS: 170 NE 96 Parcel # 1132060132630 ST Contractor IMBURGIA CONSTRUCTION SERVICES, INCContractor's Address: 595 NE 91 ST Local Phone: 305/525 - 5707 Legal Description: 1 53 41 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 1 TO 3 INC BLK 20 Fees: Description Amount FEE2005 -1721 Building Fee $465.00 FEE2005 -1722 CCF $9.60 FEE2005 -1723 CO /CC $50.00 FEE2005 -1724 Notary Fee $5.00 FEE2005 -1725 Training and Education Fee $3.20 FEE2005 -1726 Technology Fee $11.63 FEE2005 -1727 Scanning Fee $15.00 FEE2005 -1728 Submittal Fee ($50.00) Total Fees: $509.43 Total Fees: $509.43 Total Receipts: $0.00 �C Permit Status: APPROVED Permit Expiration: 3/14/2005 Construction Value: $15,500.00 Work: INTERIOR FLOOR, TILE, PAINT AND COUNTER TOPS AS PER PLAN. Signed: (INSPECTOR) Page 1 of 1 At 3 1 Signed: (Contractor or Builder) BY: 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 responisibility for all work done by either myself, my agent, servants or employes. Miami Shores Village Building Department BUILDING CRITIQUE SHEET 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. &P Job Name 15 6 16° 61 22 6q __sue 21■.4\4_ AS . �� � � 1iW - -., Ard Miami Snores village Building Department ELECTRICAL CRITIQUE SHEET /77 (/*--51- e_ 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. 7 7I / " / z 5 Job Name 1/, GGi e.._ ���� 1 4D-- be„.0,frte-pt .6 - 4/ (9 8s 6( State Certificate or Registration No. Architect/Engineer's Name (if applicable) 1 1C1S1 $ Value of Work For this Permit Type of Work: 0Addition Describe Work: 1 t'■4tti FL-V51-- . 4 6 KA Submittal Fee $ 50 -00 Permit Fee $, - Notary $ Training/Education Feet' Scanning $ /5 Radon $ Code Enforcement $ Structural Plan Review. $ Total Fee Now Due $ (Continued on opposite side) * * * * * * * * * * * * * * * * • 5O9. $hores Village a Department 4 ...4:1 1138 • Miami-Dade Zip - '3 1 5 - )( 4:6 /11114 Oig tki` Phone # ( (71‘ Zip 331313 Zoning •■•••■=1.111• -mit No. RECEOVED 1 5 2004 mit No. ON- 1252 lechanical Roofing 9 ' 91 - lace 0 Demolition - A C0/5C C Technology Fee $ /1,e3 Bond $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State 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 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 issu'1. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. day of My Commission Expires: Owner or Agent Chc 05/13/03 Signature Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 20 , by , day of , 20 _ , by who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: Print: ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ************************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * **************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Plans Examiner Engineer t �C <+' 7) i /61,- Zoning My Commission Expires: FEB 0 8 3 Miami Shores Village Building and Zoning Department Miami Shores, Fl 33138 Very truly your (print name) clo � / STATE OF FLORIDA COUNTY OF DADE: HOLD HARMLESS m4-3 RE: Property located at (adress and legal description) l7C A /C- ?y S } (FA -kaut 57m) SflAC /✓a-Z-4 4 6" C i ,'f Date /oC Per Al 8P (R-50? Gentlemen: Ccn ccc'° As of subject property, I request the cancellation of permit number (La iair. issued to 12k1 ec t - , for the following reason: Date of last inspection: 3/ r, I hereby apply as owner - builder, o authorize (new contractor) to apply for such / // / ( G L , t Le• e the construction onsubject property. I agree to hold N ,. , Z° GL G /�� ",( i< d personnel harmless and relieve them from any respo / damage, cost or expense (including 7' attorney's fee) re ` 9 � , � permit or the issuance of a new permit. I furthermore a eyTP /Li ��-� squired, of_work performed.:under the permit for whic �.— ;� 6,14 Sworn to and subscribed before me this 1 j day of Notary Public, State of Florida at Large Prime co . ractor (only if subcia Y • c • r holds pe ► it or if c • qualifier). The undersigned, being the first duly sworn, deposes and says that he /she is the legal owner of the above property. • rti 3' rD 0 gas £IVMi, Atlantic Bonding : ;►A!'��': r .,, Ginn D 1' 2319 84 Mabel Vargas = = Commission tiDD231984 �. `I):Q Expires: Jul 63, 2007 ;9' z,iiA BondedThru ' " Atlantic Bonding Co . Inc YOUR ADDRESS: ACKNOWLEDGE BY (SIGNATURE) FILE RETURNED: DACE , t, en it ila BUILDING AND ZONING DEPARTMENT 10030 N.C. SECOND AVENUE MIAMI SNORES. FLORIDA 33130.23132 TELEPHONE t303) 703.2204 FAX C3031 730.3272 PLEASE PRINT DATE : 3-Y-os TIME: 3 2 I f NAME OF PERSON REQUESTING TEE FILE • ADDRESS OF FTT REQUESTED: oIt INFORMATION REQUESTED: C S Ark.,. S I UNDERSTAND THAT ALL DOCUMENTS IN THIS FILE ARE PROPERTY OF MIAMI SHORES VILLAGE AND TEAT NO DOCUMENTS MAY BE REMOVED FROM TEIS FILE. YOU MAY GET UP TO FOUR (4) COMPLIMENTARY COPIES. ADDITIONAL COPIES WILL BE FURNISHED AT 0.15 CENTS PER PAGE, NOT INCLUDING BLUE PRINTS. TIME: RETURNED TO: