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353 NE 94 St (13)I� APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described, This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Owner's Name and Address / Al 4 Lf Registered Architect and /or Engineer c C A / t2. eQ nc /). # Yeito,✓ /A( c •r! N (Ai S/ //: ( Location and legal description of lot to be built on: Lot Block Street and Number where work is to be done Name and address of licensed contractor State work to be done and purpose of building (by floors) MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT Subdivision._._ -._ 3J''3i✓ 4t_ Date U - C No,,3• Street 4/ 6-, 95 5-7! and for no other purpose. New Building Remodeling .. ____ _._ Addition -__ Repairs No. of Stories _. - To be constructed of Kind of foundation. Roof Covering - - Estimated Total cost of improvements $ 4 2-1-0 J Amount of Permit $ r' v r .- Zone cubage required Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such (public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractorsg4.6erz_1;, o work to be performed under this Remarks (Signed) /4 permit, as are licensed by Miami Shores Village. 1 STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared and who, being by me of the above described therein by him stated Permit No Disapproved (Signed) first duly sworn, upon oath deposes and says that he is the construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts tru to me well known, Date 7- 7'- _ -_ Read, Sworn to and Subscribed before me. Date -. h Notary Public, State of Florida +t(_ (. Building Inspect 8'r � My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member . ._ - Member Council Approved Date Disapproved NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty -ials and /or workmanship. Date s �.• PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Legal Description 93 Job Address C3 /U E qq ' 1 Tax Folio y , / 6/I 6 u 044 , A446, Master Permit # 39? SS / Lessee / Tenant , -b->/Y / ; /4(S Owner's Address 3.53 dV E ?l( s 1 Contracting Co. 6 11000/ r NeGh (J Qualifier ,,; fid.li /. .` : JI,■ SS# State 11QM Q O po 1 Municipal Architect /Engineer Bonding Company Mortgagor Permit Type(circle WORK DESCRIPTION one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN Reltace Cf Oh+ C�1 Square Ft. Estimated Cost(value) WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done 'n compliance with all applicable laws regulating construction and zoning. Furthermore, I auth• i - the above -named contractor to do the work stated. Notar s to • er and or Condo Pre My Comunission Expires: (' Address arm - s to Con ractor o Owner - ` My Commission Expires: 4,1 ac 4ui israin * /V . dttliiliilItiAt ' e#plrod torll no ,� * 11 FEES: PERMIT / t '?' f RADON ** * . •*' * . - * APPROVED: Zoning Mechanical Phone Address /1 7a�? 12-le _ g2Phone "l !b 7' b N. ten W• mpecy 4f r Ins.Go. Address Address F!d Puaild, Mato of FUrtd or or Owner- Builder C.C.F. t, NOTARY TOTAL DUE 7 Fire Other Building Electrical lumbing Engineering DADE COUNTY TAX COLLECTOR 140 W. FLAGLER ST. 11111 FLOOR MIAMI, FL 33 130 00- 0748567 CC NO: 000011{,83 LICENSE NO. IS HEREBY LICENSED TO DO BUSINESS NAME /LOCATION BUSINESS AS A CONTRACTOR GOLDCOAST MECHANICAL INC AS SPECIFIED HEREON. 14725 N MIAMI AVE UNNER :GOLDCOAST MECHANICAL INC NUT VALID IN: HIALEAH VILLAGE OF KEY BISCAYNE Licensee rnust register in the city where work is to be done. PAYMENT RECD. DADE GNP( TAX COLLECTOR: 09/09/92 270000114 000200.00 ' DADE COUNTY TAX COLLECTOR • 140 W. FLAGLER ST. 141h FLOOR _ MIAMI, FL 33130 BUSINESS NAME /LOCATION t;ULUCOAST MECHANICAL INC 14725 N MIAMI AVE 33168 UN.IN DADE COUNTY OWNER GOLDCOAST MECHANICAL INC c Se. Ty a of Business 196 (ENERAL MECHANICAL n+iS IS AN OCCUPA- TIONAL TAX ONLY. IT DOES NOT PERMIT THE LICENSEE TO VIOLATE ANY EXISTING REGULA- TORY OR ZONING LAWS OF THE COUNTY OR CITES NOR DOES IT EXEMPT THE UCENSEE FROM ANY OTHER LI- CENSE OR PERMIT RE- OUIRED BY LAW. THIS IS NOT A CERTIFICATION OF THE UCENSEE'S OUAUFI- CATION. PAYMENT RECEIVED DADE COUNTY TAX COLLECTOR: 09/09/92 270000 10 000045.00 SEE OTHER SIDE 1992 MUNICIPAL CONTRACTOR'S 1993 OCCUPATIONAL LICENSE DADE COUNTY — STATE OF FLORIDA PURSUANT TO DADE COUNTY ORDINANCE 66 -2 EXPIRES SEPT. 30, 1993 GENERAL MECHANICAL DO NOT FORWARD 14725ONSMIAMIINCAL INC AVE N MIAMI FL 33168 2 s y, . OCCUPATIO ALIICENg - 1 1 , r� DADE STATE OF FLORIDAI, EXPIRES SEPT 30, 1993 YI MUST BE DISPLAYED AT PLACE OF BUSINESS PURSUANT TO.COUNTY CODE CHAPTER 8A- ART&; 10 LUCU ISE��i7��d arRUNC N MIAMI EL 33160 RENEWAL LICENSE NO. C C C U 000011663 _ EMPLOYEE 10 FIRST CLASS U.S POSTAGE PAID MIAMI, FL PERMIT 00. 231 FIRST CLASS U.S. POSTAGE PAID MIAMI, FL PERMIT NO. 231 • • DEPARTMENT OF PROFESSIONAL REGULATION CONSTRUCTICN INDUSTRY LICENSING BOARD CONSTRUCTION INDUSTRY LICENSING et POST OFFICE BOX 2 JACKSONVILLE. FL 32201 DAT6tit= 05/08/91 I RR 0019191 THE REGISTERED MECHANICAL CONTRACTOR NAMED BELOW HAS REGISTERED UNDER THE PROVISIONS OF CHAPTER 489 F.S., FOR THE YEAR EXPIRING AUG 31. 1993 (MUST MEET ALL LOCAL LICENSING REQUIREPENTS PRIORI TO CONTRACTING IN ANY AREA) lJ�� C 4 LAWTON CHILES GOVERNOR r . STATE OF FLORIDA ( i 05/08/91 WALCOFF• BARTON L GOLDCOAST MECHANICAL INC' 4001 S OCEAN DRIVE HOLLYWOOD FL. 33019 DISPLAY IN A CONSPICUOUS PLACE BATCH NCW. 40072 GEORGE STU SECRETARYUD.P.R. _. LICENSE NO. R 0019191 8 AUDIT CONTROL NO. 14 2 8 8 8 0 BATCH NO. FEE AMOUNT 40072 5113_C0 LICENSEE SIGNATURE r NNLLET CARD - FOLD HERE - 1 . _ - _ �. . STATE QQ OF FLORIDA Sg DEPARTMENT EG qq C ONSTRUCTI O N O L N DU STRY � oN LICENSING BOARD REGISTERED MECHANICAL CONTRACTOR HALCOFF. BARTON L GOLDCOAST MECHANICAL INC CINDIV@ MUST MEET LOCAL LICENSINI REQ.. PRIOR TO CONTR.. IN ANT. AREA) HAS PAID THE FEE REQUIRED BY C AYTEFR 4 89 F. . S. FOR T E YEAR EXPIRING AU6 7 1553 LAWTON CHILES _ GOVERNOR GEOVGE STU SECRETAR T. JR P.R. 1 , �....._...._.. - ., t+ M...1- t DG:> }X ... Sf, fl r o �t� i.���� ®IY� b T-s• ..� .,,,,w.... + t C(. Y S _ harzt. :'� PRODUCER • B. A. C. RISK MANAGEMENT, INC. • P. O. BOX 16717 } 5 " _. :p:. -E•+ t.. . y � �e r� ISSUE DATE (MM /DD/YY) d ,:Q. P E,. x',�, f , AN -.�A �" Fi. Kb1AT.3wl • • 11 • - 1 r , r CONFERS NO RIGHTS UPON THE CERTIFICA1EI OLDER: THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 7900 PETERS ROAD PLANTATION, FLORIDA 1 COMPANIES AFFORDING COVERAGE 33318 -6717 COMPANY (305) 424 -1500 LETTER A GENERAL ACCIDENT INSURANCE COMPANY COMPANY B LETTER INSURED GOLDCOAST MECHANICAL, INC. 14725 NORTH MIAMI AVENUE , MIAMI, FLORIDA 33168 . COMPANY LETTER C _- COMPANY D LETTER . COMPANY E LEVI COVERAGE'S y ,n ... L•t F .-4Vd K ? r r 4 ' -- * i- ; #'*.i;, J - '' - iit :a3 .u;zsr . . . 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. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION. LIMITS LTR DATE (MWDD /YY) ' DATE (MWDD /YY) GENERAL LIABILITY MCP 0933174 X COMMERCIAL GENERAL LIABILITY T CLAIMS MADE X OCCUR. OWNER'S & CONTRACTOR'S PROT. 09/09/92 ; 09/09/93 GENERAL AGGREGATE $ 1,500,000. I. PRODUCTS- COMP /OP AGG. $ 1,000,000. $ ..... ,000 . .. PERSONAL & ADV. INJURY EACH OCCURRENCE i 300,000. A .._ E(yon _ - -' 50,000. FIRE DAMAGE (Any one fire) $ MED. EXPENSE (Any one person) $ 5,000. AUTOMOBILE LIABILITY A X ANY AUTO 92215 ALL OWNED AUTOS COMBINED SINGLE 09/09/92 09/09/93 LIMIT $ 300,000. .._- -..._ .... ..__...- _._...._.... -._ __-... -. .. . I BODILY INJURY $ (Per person) BODILY INJURY $ (Per accident) PROPERTY DAMAGE $ C s T L s —Y SCHEDULED AUTOS X HIRED AUTOS X NON -OWNED AUTOS GARAGE LIABILITY EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM EACH OCCURRENCE $ AGGREGATE $ — - WORKER'S COMPENSATION STATUTORY LIMITS • EACH ACCIDENT $ AND + DISEASE — POLICY LIMIT $ EMPLOYERS' LIABILITY ... DISEASE —EACH EMPLOYEE $ OTHER DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES /SPECIAL ITEMS CERTIFICATE:HOLDER �. l 0,=1 s " ' `�` �, ` ;CANCELIION � n . Xf , -...i :.x CITY OF MIAMI SHORES � BUILDING & ZONING DEPARTMENT 10050 N. E. 2ND AVENUE MIAMI SHORES, FLORIDA :A;T t •�y� K' x� t T*tj, ' -. 'LL tgrg.rF r' T_.t'_r. k "�' ;,i •s>a:: +�i. v` . 1' - E w.�,ih' , 14L'. 3Y:S �b�"iG1: .i.titcL.• S. _ d SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL .30_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAIL T MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR L :: ITY •' ANY 1N D UPON THE C• PANY, ITS AGENTS OR REPRESENTATIVES. 33138 ': TACO ISTft Oj ;">r , „ 4 _ , F V AUTHO +' ES • AT �� � OBERT B._ MA COLN :./ 4 i E E v ' �"� O, Q " 4 ) I fl 1 s h z :t• 4 Y CERTIFICATE OF INSURANCE Producer B.A.C. RISK MANAGEMENT P. O. BOX 16717 PLANTATION FL 33318 -6717 (305)424 -1500 Ext Insured GOLDCOAST MECHANICAL, INC. 14725 N. MIAMI AVENUE MIAMI 305 -945 -8387 ext. COVERAGES This is to certify that 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. CO LTR A TYPE OF INSURANCE GENERAL LIABILITY [ ] Commercial G.L. [ ] Clme -Made [ ] Occur. [ ] Owner's /Cont's Prot. [ [ AUTOMOBILE LIABILITY [ ] Any Auto [ ] All Owned Autos [ ] Scheduled Autos [ ] Hired Autos ( 1 Non -Owned Autos [ ] Garage Liability [ 1 EXCESS LIABILITY ( ] Umbrella Form [ ] Other Than Umbrella WORKER'S COMPENSATION AND EMPLOYERS' LIABILITY OTHER CERTIFICATE HOLDER CITY OF MIAMI SHORES BUILDING & ZONING DEPARTMENT 10050 N. E. 2ND AVENUE MIAMI SHORES, FLORIDA 33138 = ACORD 25 -S (07/90) FL 33168 ext. POLICY NUMBER 193 -006 This certificate is 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. Company Letter Company Letter Company Letter Company Letter Company Letter POLICY EFF. POLICY EXP. DATE mm /dd /yy DATE mm /dd /yy 01 -01 -93 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / SPECIAL ITEMS Authorized Representative: COMPANIES AFFORDING COVERAGE A THE FLORIDA CHAMBER FUND B C D E 01 -01 -94 LIMITS General Aggregate Prod- Comp /Operations Agg. Personal /Adv. Injury Each Occurrence Fire Damage (Any 1 fire) Med Exp (Any 1 person) Date: 01 -04 -93 0 0 0 0 0 0 Combined Single Limit $ 0 Bodily Injury (Per person) $ 0 Bodily Injury (Per accident) $ 0 Property Damage $ 0 Each Occurrence $ 0 Aggregate $ 0 [X] Statutory Limits Each Accident Disease- Policy Limit Disease -Each Employee $ 100000 $ 500000 $ 100000 n seen====..==== a== a===== n===____ ..... ____________====== o=====________________===== o===== ____________= == == a =o = = = =o == = == CANCELLATION: Should any of the above described policies be cancelled before the expiration date thereof, the issuing company will endeavor to mail 30 days written notice to the certificate holder named to the left, but failure to mail such notice shall impose no obligation or liability of any kind upon the company, its agents or repreeentati i 1 Date 10-D(0 Time Z'.L{5 �•r Type Insp'n 1( • t'`'L Permit No. 1`4G (Alf W3 11 0 Name (• (Alfa STt L 'mil 9_1_0 �llC rv� t Address 5S3 - Company Din StOtTe. Qti • TL G Phone # 3o s - S g ' ®L For Inspector: 10-31-0314r4Nlame & Date Approved Correction Re- Insp'n Fee MIAMI SHORES VILL GE BUILDING DEPARTM 305- 795 -2204 Building Inspection Request