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RC-11-719Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 158672 Scheduled Inspection Date: July 14, 2011 Inspector: Bruhn, Norman Owner: RHODES, STEVEN Job Address: 57 NE 93 Street Miami Shores, FL 33138- Project: Permit Number: RC -4 -11 -719 <NONE> Contractor: EINHORN CONSTRUCTION Permit Type: Residential Construction Inspection Type: Final Work Classification: Addition /Alteration Phone Number (305)795 -1407 Parcel Number 1132060130400 Phone: (786)298 -1508 Building Department Comments DRYWALL REPAIR AND KITCHEN AND BATHROOM REPAIR Inspector Comments Passed 9,,t4 �ky� Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. July 13, 2011 For Inspections please call: (305)762 -4949 Page 7 of 19 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION FBC 20 Permit Type: BUILDING OWNER: Name (Fee Simple Titleholder): Address: 4 4' / Ti vim' City: /- #3.71. 4- sea4 Tenant/Lessee Name: ROOFING rj IL C 5 i° rfre ( (LC Phone #: Tar Permit No. APR Z5201 "1 • Master Permit No. State: Zip: .33 /3i Phone #: Email: JOB ADDRESS: "7 k' t 47 City: Miami Shores County: Folio/Parcel #: / i 32- CMG 0 (3 O cf b 0 Miami Dade Zip: 33/ 3 Is the Building Historically Designated: Yes CONTRACTOR: CompanhName: CJ3j( n Address: /6 0 Q f •o /7 I City: / h/r af? Cie State: Qualifier Name: S' /%/v Eio‘l 6� State Certification or Registration #: C&C 0S-2/ 9"/ 7~ Contact Phone #: Email Address: NO Flood Zone: e 4` /3c% Phone #: '4 F6 -/r2 - 6 - Certificate of Competency #: IGNER: Architect/Engineer: Phone #: Value of Work for this Permit: ' !' O Square/Linear Footage of Work: Type of Work: UAddition OAlteratio ONew Repair/Rer1 Descri ' do of Work: ryetve ** *********+ x******:x********** * **** * * ** : Fees ** ****** ************ ** * ** * * * * ***** * * * * **** Submittal Fee $ Permit Fee $ CCF $ CO /CC $ Radon Fee $ DBPR $ Bond $ Training/Education Fee $ Technology Fee $ Scanning Fee $ Notary ouble Fee $ Structural Review $ TOTAL FEE NOW DUE $ ' j Bonding Comp: 's Name (if applicable) Bonding Company's Ad City State Zip Mortgage Lender's a (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, BOTI IRS, 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 Owner or Agent The foregoing instrument was acknowledged before me this L�- day of _NW; , 20 if , by who is personally known to me or who has produced As identification and who did take NOTARY PUBLIC: Sign: Print: Signature 5-4" Contractor The foregoing instrument was acknowledged before me this. �- day ofi'fpz.-i. , 20 d l , by tai ho is personally known to me or w has produced as identification and who did take an oa My Commission Expires: 2 o(S APPROVED BY Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) NOTARY PUBLIC: Sign: Print: My Commission Zoning C Clerk ALEX SINK STATE OF FLORIDA MEV FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CERTIFICATE OF ELECTION TO RE EXEMPT FROM FLORIDA WORKERS' COMPSKSATION LAW 01F28 -20111 CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers` Compensation Taw. b-rtCT1VE DATE PERSON; FEIN; 01/28/2010 EXPIRATION DATE 01/28/2012 EINHORN SHALOM 200753537 BUSINESS NAME AND ADDRESS: EINi• DRN CONSTRUCTION INC 1606 PENNSYLVANIA AVE ;? 6 PIING BEACH FL 33138 SCOPES OF BUSINESS OR TRADE 1- CERTIFIED ROOFING CONTRACTOR 2- CERTIFIED GENERAL =TRACTOR (NPORTAR7: Persea0 to Chapter 440 . 65()4), F.S., an officer of a captain who elects exemption from aft Chapter by firing a certificate of e►ectioo niter this section may not recover benefits or 000lloototion ender this chapter. Pursuant to Chapter 440_115(12). f_S., Certificates of election to he exempt -- apply only Within the scope et the business ar trade fisted on the notice of election to be exempt. Panama to Chapter 440.0511 F.S., dices of election to be exempt and certificates of election to be exempt shall he subject 10 revocation it at aim time after the Wing of the mice or the Is a of the certificate. Oa person named tut tht mace or certificate an longer meets the requirements of this section far issuance of a certhicate. The department shall revoke a certificate al toy to ter failure of file Person named an the certificate to meet the requirements of this section. DWC -252 LtnIll-ICATE Of ELECTION TO BE EXEMPT REVISED 09 -06 QUESTIONS? (850) 413-1609 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATOR CONSTRUCTION INDUSTRY CERTIFICATE OF ELECTION TO BE EcESIIPT FROM FLORIDA WORKERS COMPENSATION LAW EFFECTIVE 01/28/2010 EXPIRATION DATE: 01/2812012 pERSOIt SHALOM EINHORN FEIN 200783537 BUSINESS NAME AND ADDRESS: 613 Rat CONSTRUCTION INC 1606 PEOISVLVAMA AVE 5 6 MAW BEACH, FE 33139 SCOPE OF BUSINESS OR TRADE 1- CERTIFIED ROOFUIC CONTRACTOR 2- Ceoiu*D GEMBIAL CONTRACTOR IMPORTANT Pte tt to Chapter 440.05(148 F.S., an officer of a corporation whO O effects exemption from this chapter by filing a certificate of .election L tam this section may not recover benefits or curementatithe under WS D dopter. Pursuant to Chiseler 440.05(12), ES_ Certificates of eleCUon to he H exempt.. apply only within the scope of the bast 011 trade listed on E the notice of election to be exempt E Pursuant to Chapter 440.05(13), Fes. Notices of etectiun to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice ar the issuance of the certificate, the person named on the notice or certificate rro forger meets the requirements of this section for issmuce of a certificate. The department shall revoke a certificate at any time for farhwe off the person named on the certificate to meet the requirements of this section. aipnDNS? 18601.411 -1809 CUT HERE * Carry bottom portion on the job, keep upper portion for your records. OWC -252 CERTIFiCATE OF ELECTION TO BE EXEMPT REVISED 09 -06 ACORD CERTIFICATE OF LIABILITY INSURANCE (305)949 -9005 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. PRODUCER ONE STOP INSURANCE AGENCY 17088 WEST DIXIE HWY NORT MIAMI BEACH, FL 33160 EINHORN CONSTRUCTION, INC 1606 PENNSYLVANIA AVE, STE # 6 MIAMI BEACH, FL 33139 INSURERS AFFORDING COVERAGE IISURERA: CANAL INDEMNITY INSURER B: INSURER C: NAIC 5 INSURER P. INSURER N> COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDMON OF ANY MAY PERT Tug INSURANCE AFFORDED BY THE CIE CDESCRIBED HEREIN 13 SUBJECT TO AU. THE TERMS, EXCLUSIONS AND CONDITIONS F SUCH POUCIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. VtiV�y�4�iit �.:;.. SR NUMBER GERM*. COMMERCIAL GENERAL LIABILITY X1 CLAIMS MADE OCCUR PIMBI DED. SLOBS PER GLUM GEN'L AGGREGATE LIMIT APPLIES PER: X1 PAY ri PAcv. 1 l Loc ABT WLELIABBJIY 1 ANY AUTO ALL OWNEDAUTOS SCHEDULED AUTOS HIREDAUTOS NON,OWNEDAUTOS GL9BO71 R 5-18 -20010 GARAGE L.IABUJTY ANY AUTO pLcESMU6{ UA4BI.ITY OCCUR 1 i CLAIMS MADE DEDUCTIBLE RETENTION E 5-18 -2011 EACH OCCURRENCE DARURETC1 RENTED pRomisEs (Ea I MEDEXPWry one passim) PERSONAL SADV INJURY GENERALAGGREGATE 1,000,000 $ 5,000 $ 1,x,000 • 2,000,000 PRODUCTS ,c:OMP PAGG s 1,000,000 COMBINEDSINGLEUMIT (Ea andel* SODILYINJURY (Pei 3 BODILY INJURY rer sodden) PROPERIYDAMAGE (Per accident) AUTO ONLY ,EA ALITOONLY: EA ACC AGO EACH OCCURRENCE AGGREGATE � s s 5 $ S S WORKERS GOISPOISKSONAND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUMVE S'PECIAPROVISIQHS DAM OTHER AWL/ Vs) I 1°a' EL EACH E.L DBE, EAEMPLOYEE E.L. DISEASE s POLICY UNIT S S DESCRIFTION OF OPERATIONS HDCATKINSHIERIOLES EXCLUSIONSADDED nexoRermasT H spEam..FRoresoms GENERAL CONTRACTOR & INTERIOR RENOVATOR * POLICY IS SUBJECT TO AUDIT AND / OR INSPECTION. CERTIFICATE CITY OF MIAMI 444 SW 2 AVE, 4TH MIAMI, FL. 33128 FAX:305 -416 -2158 OOR ACOR() 26 (2001108 CANCELLATION Maws ANYOFMS ABOVE CIESCOBED PO DE GATE THEREOF. THE ISSUING » WILL NOTICE TO VW CERT1RCATE HOLDER WANED TO WPOSE NO OLHLIGAT[ON OR UAWIY OF ANY REPRESENTAIWEIL AIMIORRED REPRESENTATIVE STUART STARR, AGENT WORMS E7tpMUSN 10 MAIL 10 DAYS WRITTEN RUT FAILURE 10 D0 SO SRALL. UPON THE INSURER, ITS MEWS OR 'AGGRO CORPORATION 1888 NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. 1/- 7/ TAX FOLIO NO. , / 3Z-0(00/366/0 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. 1111111111111 11111111111111111111111 CFN 201 1 R0346095 OR Sk 27701 Ps MO; (12s) RECORDED 05/26/2011 13:1=:17 HARVEY RUVIHr CLERK OF COURT MIAMI-DADE CDUHTYr FLORIDA LAST PAGE %� C% Space above reserveed,,foor use of recorddiing office :legal description of property and street/address: .5 72 /" f g3 5 `9% QI�G(� 6�'G /ft° �J '33430 L,Description of improvement: lvt.-I Gam- yeA,4-codd r ` 1 —1 2 r"t t (6- V(e"'` 7 ES1Eirite, f7 ' %r,Qg.E-- demo (.d- c&-t . Owner(s) name and address: Merest in property: Name and address of fee simple titleholder: ontractor's name, address and phone number L11/'%D1 Cv44S7)1/O70'1 /606; Pekld S y/U 4:a/Ai /440,41 g ct-J, 331361 5. Surety: (Payment bond required by owner from contractor, if any) Name, address and phone number: 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, address and phone number 8. In addition to himself, Owners designates the following person(s) ts,r8m§iivtil 713.13(1)(b), Florida Statutes. Name, address and phone number. 9. Expiration date of this Notice of Commencement: (the expiration date UMT OF DADE this is a tru wow atlas c y of the AD 20 Official Seal. aas°provi;, i }, tip a year from the date of recording unless a different date is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING Y• R NOTICE OF COMMENCEMENT. Signature(s) of ),/ :; er(s) or Owner(s)' Authorized Officer /Director /Partner /Manager 2 Prepared By ��� Prepared By �� 5u� c csoYe 33/3 Print Name <9-et)-e... w ,x,�� Print Name Title/Office ,AA, r Title /Office STATE OF FLORIDA tJ COUNTY OF MIAMI -DADE The foregoing instrument was acknowledged before me this 1-6 day of ;3irndividually, t2NOOO5 or fa as for ersonally known, or ❑ produced the following type of identification: Signature of Notary Public: Print Name: (SEAL) VERIFICATION PURSUANT TO SECTION 92.525. FLORIDA STATUTES Under penalties of perjury, I declare that 1 have read the foregoing and that the facts stated in it are true, to the best of my knowledge and belief. Signature(s) of Owner(s) or Owner(s)'s Authorized Officer /Director /Partner /Manager who signed above: By By MAY FRANU MY COMMISSION it DD 874487 ; EXPIRES: March 26, 2013 Bonded Thru Notary Public Underwriters ACORD D CERTIFICATE OF LIABILITY INSURANCE DATE 05/26/2011� - TYPE OF INSURANCE PRODUCER (305)949 -9005 ONE STOP INSURANCE AGENCY 17088 WEST DIXIE HWY NORT MIAMI BEACH, FL 33160 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. INSURERS AFFORDING COVERAGE NAIC # INSURED EINHORN CONSTRUCTION, INC 1606 PENNSYLVANIA AVE, STE # 6 MIAMI BEACH, FL 33139 I INSURER A: CANAL INDEMNITY 27790 INSURER B: LIABILITY COMMERCIAL GENERAL LIABILITY INSURER C: GL101536 [ INSURER D: 5-18 -2012 INSURER E: $ 300,000 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 ADD'L INSRD - TYPE OF INSURANCE POUCY NUMBER POLICY EFFECTIVE DATE(MM/DD/YY1 POLICY EXPIRATION DATE(MM/DD/Y1ft LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY GL101536 5- 18- 20011 5-18 -2012 EACH OCCURRENCE $ 300,000 X PRMSE$(Eaoccurence) $ 50,000 CLAIMS MADE X OCCUR MED EXP (Any one person) $ 5,000 X PD&BI DED. $1,000 PER CLAIM PERSONAL & ADV INJURY $ 300,000 GENERAL AGGREGATE $ 600,000 GEN'L AGGREGATE LIMIT APPLIES PER: LOC PRODUCTS >COMP/OP AGG $ 300,000 X POLICY PRO) JECT AUTOMOBILE LIABIUTY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON>OWN ED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ 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 $ EXCESS/UMBRELLALIABIUTY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below I TORY LIMITS 1 I OER > E.L. EACH ACCIDENT $ E.L. DISEASE > EA EMPLOYEE $ E.L. DISEASE > POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS GENERAL CONTRACTOR & INTERIOR RENOVATOR * POLICY IS SUBJECT TO AUDIT AND / OR INSPECTION. CERTIFICATE HOLDER CANCELLATION CITY OF MIAMI SHORES 10050 NE 2 AVE MIAMI SHORES, FL 33138 F: 305-756-8972 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE STUART STARR, AGENT ACORD 25 (2001/08) ' ACORD CORPORATION 1988 s�3 —yAINst Permit No: 11 -719 Job Name: May 3, 2011 Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 705.2204 Fax: (305) 756.8972 Page 1 of 1 Building Critique Sheet The scope of work is wrong. It shows no plumbing, electrical and does not identify the w wood posts at the exterior porch. Please correct this. ) i' ovide a post detail for the top of post. rovide insulation in the exterior walls and ceilings that are being altered. The demo keynotes do not identify item 8. Plan review is not complete, when all items above are corrected, we will doa complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Norman Bruhn CBO 305 - 795 -2204 Roc! 1 go Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 RECEIPT PERMIT #: n DATE: • �< y..e0 e /IQ ❑ Contractor ❑ Owner ❑ Architect Picked up 2 sets of plans and (other) C062-CC-1 Address: (5°1 From the building department on this date in order to have corrections done to plans And /or get County stamps. I understand that the plans need to be brought back to Miami Shores Village Building Department to continue •ermitting process. Acknowledged b PERMIT CLERK INITIAL: RESUBMITTED DATE: PERMIT CLERK INITIAL: Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 158674 Permit Number: RC -4 -11 -719 Scheduled Inspection Date: June 23, 2011 Inspector: Bruhn, Norman Owner: RHODES, STEVEN Job Address: 57 NE 93 Street Miami Shores, FL 33138- Project: <NONE> Contractor: EINHORN CONSTRUCTION Permit Type: Residential Construction Inspection Type: Drywall Work Classification: Addition /Alteration Phone Number (305)795 -1407 Parcel Number 1132060130400 Phone: (786)298 -1508 Building Department Comments DRYWALL REPAIR AND KITCHEN AND BATHROOM REPAIR Passe Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments June 22, 2011 For Inspections please call: (305)762 -4949 Page 6 of 32 Gaviria Architects Inc. June 20, 2011 Re: Family Room Ceiling 57 N.E. 93'a Street Miami Shores, Florida 33138 To Whom It May Concern, The ceiling in the family room was previously done following the proper building codes. The ceiling has the proper insulation required. Please feel free to contact me if you have any questions. Sincerely, J e Gaviria Project Architect 9427 Fountainbleau Blvd. #206 Miami, Florida 33172 T.954.610.0148 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 inspection Number: INSP - 161030 Inspection Date: June 22, 2011 Inspector: Perez, JanPierre Owner: RHODES, STEVEN Job Address: 57 NE 93 Street Miami Shores, FL 33138- Project: <NONE> Vk %V\ Permit Number: MC -6 -11 -1100 J Permit Type: Mechanical - Residential Inspection Type: Ventilation Work Classification: Addition /Alteration Contractor: RELIABLE AIR CONDITIONING REFRIGERATION & APPLIAN Phone Number (305)795 -1407 Parcel Number 1132060130400 Phone: (305)325 -9283 Building Department Comments EXHAUST FAN 2 BATHROOM Passed Inspector Comments Pt CIA Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until June 22, 2011 For Inspections please call: (305)762 -4949 Page 1 of 1 Miami Shores Village Building Department k I 14 ( 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING Permit No. 1 11 OD PERMIT APPLICATION Master Permit No. , 9m // -9/9 FBC 20 Permit Type: BUILDING OWNER: Name (Fee Simple Titleholder): •T /v� 3 S ee 7 Phone #: Address: ��/ //>1 � ® O a City: State: Zip: �j 3/ 3 9 Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: ? q3 er City: Miami Shores County: Miami Dade Zip: 33/38 Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: < % i aeirS /t- /gel- C Phone #: 70 8 f 3 2 Z 9, Z 3 -16 ll Address: S— C4-‘ .f "."- L 5-r— F( 6 D y City: ``�� State: e' Zip: 3 3/ 1+ D Qualifier Name: Ct' t�%°Z7 v vi a z Phone #: 30 T 3 2,C ? 2 P 3 State Certification or Registration #: CSC l of Yz/ 0 Certificate of Competency #: Contact Phone #: 3o1 � 3 Z'i;" 9 2-P Email Address: 61 c� G °c p `_ z o --....._ DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ 1/061. Square/Linear Footage of Work: Type of Work: Address ❑Alteration Description of Work: 3 cA' New ORe air/Replace it 1t7 ®®mod UDemolition COLOR THROUGH ROOF TILE IS REQUIRED acknowledged by: r*********** * * * * * * * * * * ** * ** * * * * * * ** * ** * ** Fees************* * * * ** * * ** * * * *** ** * * ** * *** ** * * ** Submittal Fee $ Permit Fee $ V O t. pi) CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 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 issued. In the j Bence of such posted notice, the inspection till not be approved and a reinspection fee will be charged. Signatu Owner or Agent gg The foregoing instrument was acknowledged before me this 13 day of JJtk , 20 16 , by A, az t!J who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sig Print: ant i pl 1 _ m .• 11 *Tr= My Commission Expires: uu 9tFOF F1A11 Signature Contractor The foregoing instrument was acknowledged before me this day of .../442.e. , 20 /1, by /1A"�/R d N ®3 , who is personally known to me or who has produced JOSEPH R. COLLE fl r**** ***** *** * ****** ** * * ** * * * * ** * *** * ** APPROVED BY "PITT' ��; rrg;:187 EXPIRES: September4, 2014 Bonded Thtu Budget Notary Services as identification and who did take an oath. NOTARY PUBLIC Sign: Print: My Comm % re" ION # EE 40577 EXPIRES: Z 2015 ;R;;�' Bonded T u Notary" Underwriters ******************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)(rev6/4/10) Zoning Clerk Jun.16.2011 09:25 AM Reliable Air Conditioning 305 325 9283 PAGE. 1/ 3 09 -24 -2010 ALEX SINK STATE OF FLORIDA CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE; 11/03/2010 EXPIRATION DATE: 11/02/2012 PERSON: MUNOZ HENRY FEIN: 421625146 BUSINESS NAME AND ADDRESS: RELIABLE AIR CONDITIONING REFRIGERATION & APPLIANCES INC 648 SW FIRST STREET #804 MIAMI FL 33130 SCOPES OF BUSINESS OR TRADE: 1- CERTIFIED AC CONTRACTOR IMPORTANT: Porsoeot to Chaplet 440. 115114>, F.S., eq oftleer ei a covperatlan who elects exemptioh tram this chapter by !Meg a carUlfuta of election ender this semen may oat tecaver benefits er compensation under this chapter. Pursuant to Chapter 440.051121, F.5., Certificates DI election to be exempt... apply ratty within the scope of toe bunion er true listed an me notice of election to be exempt. Parma to Chapter 440.06113), F.S., Notices of electfoe to be exempt and certilieetes of election to be exempt shelf be subject to revocation if, at troy time altar me filing of Ike notice or the lawny of the certificate, the perms named on the notice er callfleete no feoger meets the I.4eframonts el Ms section for issoaaco of a certificate. The department shall revoke a minima et my time for failure of the porno Mood oh tbo rorlfficele to a*M the Paquirememts of this setting. (WESTIONS? 1850) 413 -1608 DWC -252 CERTIFICATE OF ELECTION TO RE EXEMPT REVISED 09 -06 Jun.16.2011 09:34 AM Reliable Air Conditioning 305 325 9283 PAGE. 1/ 3 09 -24 -2010 ALEX SINK STATE OF FLORIDA CFREF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation Raw. EFFECTIVE DATE: 11/03/2010 EXPIRATION DATE: 11/02/2012 PERSON: MUNOZ HENRY FEIN: 421825146 BUSINESS NAME AND ADDRESS: RELIABLE AIR CONDITIONING REFRIGERATION & APPLIANCES INC 548 SW FIRST STREET #804 MIAMI FL 33130 SCOPES OP BUSINESS OR TRADE: 1— CERTIFIED AC CONTRACTOR * 114PIIRTAN(: Potation to Chapter 440. 05414), F.S., as officer of u eorporatio. wbo *loots exemption from ibis chaplet by Siting a certificate of electiop under this secrieo may not recover be.effis or compuaratfen under this chapter. Pursuant to Chapter 440.0012) P.S.. Certificates oI decline to be exempt.. apply only within the scope of Ibo bosf.ess or ttado fisted as the notice of electron to he exempt Pursuant to Chapter 440.05(13) F.S., Notices of election to be exempt and sertificaks of election to he exempt shay be alibied to revocation If. M any time alter the itiino of The .oche or the Issuance of the certiffeers, tbo perseq .awed oq tbo police or certificate ea tenger meets the requirements of this section for issuance of a certificate. The 4epa►leleel shall royally a certificate at any time fer failure o1 the partite named ae the cer0fieete to meet the requirements of this section. DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 QUESTIONS? 1850) 413 -1809 .AAt Rtt PRODUCER Insurance Professional Consultants 10481 SW 88 St Ste. 0.204 Miami, FL 53176 Phone (3055) 2734530 CERTIFICATE OF LIABILITY INSURANCE DATE (IVIMIDDIYYI 06/08/11 Fax (305)173 -4409 INSURED Reliable Airoonditioning Ref and Appliance Enc. 546 SW 1st St Miami, FL 33130- 1 COVERAGES • 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. INSURERS AFFORDING COVERAGE INSURER A: Nava Casualty INSURER B: INSURER C: NATO II INSURER D: INSURER E: THE POLICIES OF INSURANCE USTED 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 OF 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 INsR0 TYPE OF INSURANCE POLICY NUMBER Min. NT) DATE M Y D A =YY LIMITS A ❑ GENERAL LIABILITY El COMMERCIAL GENERAL LIABILITY 09AL070973 11/07/2010 11/07/2011 EACH OCCURRENCE 1,000,000 GE PREMISES (Ea oN (Ea 100,000 • • CLAIMS MADE u OCCUR MED EXP (Any one person) 5,000 ❑ PERSONAL & ADV INJURY 1,000,000 ❑ GENERAL AGGREGATE 2,000,000 GENII_ AGGREGATE LIMIT APPLIES PER: ❑ POLICY ❑ PROJECT 0 LOC PRODUCTS - COMP /OP AGO 2,000,000 AUTOMOBILE UABILITY ❑ ANY AUTO • ALL OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) • • SCHEDULED AUTOS ❑ HIRED AUTOS ❑ NON OWNED AUTOS • BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) • ❑ GARAGE LIABILITY • ANY AUTO ❑ AUTO ONLY - EA ACCIDENT OTHER THAN EA ACC AUTO ONLY: AGG • EXCESS / UMBRELLA LIABILITY El OCCUR ❑ CLAIMS MADE ❑ DEDUCTIBLE ❑ RETENTION S EACH OCCURRENCE AGGREGATE WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER / MEMBER EXCLUDED? (fMyandatory In NH) If PROVISIONS beim ■ INC SIATU- ❑ OTH- TORY LIMITS ER L,L, EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE EL DISEASE - POLICY LIMIT OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION Miami Shores Village 10050 NE 2nd Ave Miami Shores, FL 3313$ FAX: 305 -756 -8972 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 LEST, BUT FAILURE TO DO SO SHALL IMPOSE No OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE 19f 2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 158689 Permit Number: DEMO -4 -11 -720 Scheduled Inspection Date: June 27, 2011 Inspector: Bruhn, Norman Owner: RHODES, STEVEN Job Address: 57 NE 93 Street Miami Shores, FL 33138- Project: <NONE> Contractor: EINHORN CONSTRUCTION Permit Type: Demolition Inspection Type: Final Work Classification: Building Phone Number (305)795 -1407 Parcel Number 1132060130400 Phone: (786)298 -1508 Building Department Comments DEMOLITION OF EXTERIOR ENCLOSURE Passed J6 /( Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments June 24,2011 For Inspections please call: (305)762 -4949 Page 6 of 34 Miami Shores Village Building Department '10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION FBC 20 Permit No. APR `25.2011 Master Permit No. Permit Type: BUILDING ROOFING OWNER: Name (Fee Simple Titleholder): A/ �/ ,5•1(0.e76. , ��� -c - Phone#: Address: 44 I ,:\k 4 110 Dr' City: " /''1 i It State: C Zip: 3/ 3 2 Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: t ') 3 6 -ii z e T City: Miami Shores County: Miami Dade Zip: 373 % 3 r) Folio/Parcel #: I I 2 C C i°5 t-/ OO-- Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: F I1'Au c 01 00Y15 Le47 fig Phone #: -415'" -5 /Z — i'l. 421. City: - '-'7' , i--- State: r Qualifier Name: .j & kb(1 State Certification or Registration #: F 6 C /..r0" / ` Certificate of Competency #: Contact Phone #: Email Address: DESIGNER: Architect/Engineer: Phone#: Address: /',o'' Zip: 3.3 /3 7 Phone #: Value of Work for this Permit: $ ' • d Square/Linear Footage of Work: Type of Work: Addition Alteration ❑New �]]1 epai//Replace�, �,® demolition Description of Work: (2olo li �k �r�`T� �W� fie' /es,ie, ******* ******* * * *****m**:x **:x***** **** ** Fees: x* *a: *+ a+ xu:: x* ******* ******x:**** * *** * * ********** Submittal Fee $ Permit Fee $ ` r r'° CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ (e,D. Bonding Company's Na (if applicable) Bonding Company's Address State Zip Mortg nder's Name (if applicable) Mortgage Lender's 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, BOB FRS, 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 Owner or Agent The foregoing instrument was acknowledged before me this 2? day of /9 t2112, I ,2011 li ,by +i 14(j e who is personally known to me or o has - produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Co Signature Contractor The foregoing instrument was acknowledged before me this 2-Z_ day of Ii / ,20 jl,by 'k '4' z ° who is personally known to me or w has produced as identification and who did take an oath. NOTARY PUB_ IC: APPROVED BY Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) Sign: Print: My Commis yANI M%GE E077091 RES March 24, 2015 FbridaNala2 = Nice.: Zoning Clerk Permit Number: EL- 3- 11-451 J Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 \'v nspection Number: INSP - 161907 Inspection Date: July 12, 2011 Inspector: Devaney, Michael Owner: RHODES, STEVEN Job Address: 57 NE 93 Street Miami Shores, FL 33138- Project: <NONE> Contractor: FINETECH INC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number (305)795 -1407 Parcel Number 1132060130400 Phone: (305)267 -3785 Building Department Comments REPAIR AND REPLACE LIGHT, SWITCHES SERVICE 03/24/2011 - PER CONVERSATION WITH SILVERA HE IS TO BRING DRAWING FOR KITCHEN REMODEL SHOWING ELECTRICAL. ON HOLD UNTIL BUILDING PERMIT (MASTER) AND JONATHAN PROPOSED PERMIT IS Passed I Inspector Comments CREATED AS REINSPECTION REINSPECTION monoxide detor, 3 storage room and Add arg fault breakers. 7--- FOR INSP- 161743. CREATED AS FOR INSP- 157231. Add arc fault breaker, smoke / carbon receptacles,G. F. I. protection on 120 volt receptacles in in use covers on outside receptacles. Failed Correction Needed j---(1".70/7 // Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until For Inspections please call: (305)762 -4949 July 12, 2011 Page 1 of 1 CFN: 20110145508 BOOK 27607 PAGE 3384 DATE: 03/07/2011 09:39:39 AM DEED DOC 1,356.00 HARVEY RUVIN, CLERK OF COURT, MIA DADE CTY This Instrument Prepared by: Albertelli Law Amanda Hodgson 5404 Cypress Center Drive, Suite 300 Tampa, Florida 33609 Our File Number: TPA10 -25227 as a necessary incident to the fulfillment of conditions contained in a title insurance commitment issued by it, Property Appraisers Parcel I.D. (Folio) Number (s): 11 -3206- 013 -0400 SPECIAL WARRANTY DEED This Special Warranty Deed, made this rj f1 February 2011, between DLJ Mortgage Capital, Inc., having its place of business at : 3815 South West Temple, Salt Lake City, UT 84115 here by called the grantor, to 57 NE 93rd Street, LLC. , a Florida Limited Liability Company whose Post Office address is: 441 E Rive Alto Drive, Miami Beach, Florida 33139, hereinafter called the grantee, W I T N E S S E T H:That grantor, for and in consideration of the sum of S 10.00 and other valuable considerations, receipt whereof is hereby acknowledged, by these presents does grant, bargain, sell, aliens, remis, releases, conveys and confirms unto grantee, all that certain land situate in Miami -Dade County, Florida, viz: Lot 18 and the direst One -Half (1/2) of Lot 19, Block 3, Miami Shores Section No. 1, according to the map or plat thereof, as recorded in Plat Book 10, Page 70, of the Public Records of Miami -Dade County, Florida. TOGETHER with all the tenements, hereditatnents and appurtenances thereto belonging or in anywise appertaining. TO HAVE AND TO HOLD the same in fee simple forever. GRANTOR'S WILL WARRANT AND the said party of the first part does hereby covenant with the said party of the second part that, except as above noted, that at the time of the delivery of this deed the premises were free from all encumbrances made by it, and that it will warrant and defend the same against the lawful claims and demands of all persons claiming by, through or under it, but against none other. (wherever used herein the terms "grantor" and "grantee' included all the parties to this instrument, and the heirs, legal representatives and assigns of individuals, and the successors and assigns of corporation.) IN WITNESS WHEREOF, the grantor has caused these presents to be executed in the name, and its corporate seal to be hereunto affixed, by its proper officers thereunto duly authorized, the day and year first above written. DEED - Special Warranty Deed - Corporate Ittd t LepraPao BUILDING Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 w Permit No. 1 451 MAP r /120 EYoo�.�c►eo....a.o PERMIT APPLICATION FBC 20 Master Permit No. Permit Type: Electrical S c '] A) q C �c Q OWNER: Name (Fee Simple Titleholder): 7 3 ,� r,Z Phone #: )0S— v 1,7— I Address: l q ` 67, Rd vo A4 fro City: State: L- Zip: 3 / b Tenant/Lessee Name: r ` (M ( 004 c Email: Phone #: JOB ADDRESS: e 3 ST 1 I - 3 2-th. - O 3 ~ Q(J� (C City: Miami Shores County: Miami Dade Zip: 3,,,r)° i d Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: F-rit) L T EC ( / -4 ILK- . Phone #: SO S ` z6 7-370e. Address: 610`2 C,C / / 'I /h. CT ° City: /Lit t' (A et-1, State: F (_ Zip: 3 ( 4 Qualifier Name: (\U (S SowcAilez C� Phone #: Q S - Z ( 7` 3 7g a . State Certification or Registration #: U= Cr( 30Crl 00 b Ce ' icate of Competency #: 7 Contact Phone #: 5 - Z (6 ^:63,`x% Email Address: / 4" C3� (T� l f/1C� 1-er_.(4 - US DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit $ 15.00.00' Square/Linear Footage of Work: Type of Work: ❑Address ❑Alteration UNew 1,Repair eplace ❑Demolition Description of Work: Y� Q A 1 le U p ' �o � �.� lei .LI � �.'.�'/ �Lii 4 C- •47� ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ �✓4�0 ®"? CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) w er's dfes , � . A City a 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 afier the building permit is issued. In the ab of sue iosted notice, the inspection will not be .proved and a reinspection fee will be charged. Signature wner or Agent The fore • ing i trument was ackn wledged before me thi day of )‘\_1 N , 20 I \, by i --e o1"'t who is persopally known to me or who has produced ern . As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: , ODALYS BE IA =+r: !; ;+r MY COMMISSION # DD 951651 '>. 0. MIRES: February 27, 2014 ` Bonded ihru Notary Pubic Undenvriteis Signature C or The foregoing instrument was acknowledged before me this S day of v \P1�L. , 20 1( , by who is personally known to me or who has produced as identification and who did take an oath. My Commission Exp es: 0 4eoYoY *:F: ** Yk3: Y ********* aD r c NOTARY°PUB C: : Sign: Print: My Commiss s: 163 EXP fS IRV E SR Ju•Rly ' O 2D20IQU # D1 ROrld8Norary corn APPROVED BY Plans Examiner Zoning Structural Review (Revised 07 /10 /07XRevised 06 /10 /2009)(Revised 3/15/09) Clerk `" CERTIFICATE OF LIABILITY INSURANCE DA09/13/10�Y) Miami Shores Village PRODUCER Insurance Marketing Network 501 N. Krome Avenue Homestead, FL 33030 Phone (305)248 -5000 Fax (305)248 -1000 THIS CERTIFICATE IS ISSUED AS A MATTER OF ONLY AND CONFERS NO RIGHTS UPON THE HOLDER. THIS CERTIFICATE DOES NOT AMEND, ALTER THE COVERAGE AFFORDED BY THE POLIC INFORMATION CERT EXTEND FICATE OR ES BELOWL NAIC # INSURERS AFFORDING COVERAGE INSURED Finetech, Inc 6102 SW 14th Street Miami, FL 33144- INSURER A: Colon Insurance Com +an Af•l2Df nu inna4iflO% AC INSURER B: Aequicap Insurance Company INSURER C: INSURER 0: INSURER E: COVERAGES INSURER F: THE 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR ADD'L INSRD TYPE OF INSURANCE POLICY NUMBER SCP0708441 02 POUCY EFFECTIVE DATE (MMIDD/YY) 09/21/10 POLICY EXPIRATION DATE (MMIDD/YY) 09/21/11 LIMITS A 0 GENERAL i% • • II LIABILITY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1,000,000 PRISES (Ea RENTED ce) 100,000 I CLAIMS MADE Ci OCCUR MED EXP (Any one person) 5,000 PERSONAL & ADV INJURY 1,000,000 GENERAL AGGREGATE 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOPAGG 1,000,000 • POLICY ❑ PROJECT • LOC B AUTOMOBILE LIABILITY • ANY AUTO COMBINED SINGLE LIMIT (Ea accident), ❑ ALL OWNED AUTOS SCHEDULED AUTOS • HIRED BODILY INJURY (Per person) AUTOS NON OWNED AUTOS i n BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) AUTO ONLY - EA ACCIDENT GARAGE LIABILITY ANY AUTO • OTHER THAN EA ACC AUTO ONLY: AGG EXCESS • ❑ • /UMBRELLA LIABILITY EACH OCCURRENCE • OCCUR • CLAIMS MADE AGGREGATE DEDUCTIBLE RETENTION $ B WORKERS EMPLOYERS' LIABIUTY AND ANY PROPRIETOR / PARTNER! EXECUTIVE OFFICER / MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below WC07079432 09/21/10 09/21/11 TORY LIMITS 0 OTH- TORY LIMITS ER EL. EACH ACCIDENT 100,000 E.L. DISEASE - EA EMPLOYEE 100,000 E.L. DISEASE - POLICY LIMIT 500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES ! EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS f`CnTICIP,ATC LI,. n■.. ©ACORD CORPORATION 1988 SHOULD ANY OF THE ABOVE DESCRIBED PO ES CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING S Rf WILL ENDEAVOR TO MAIL Miami Shores Village 10 DAYS WRITTEN NOTICE TO THE E 'I ICATE HOLDER NAMED TO 10050 NE 2nd Ave. THE LEFT, BUT FAILURE TO DO SO SHAL I OSE NO OBLIGATION OR UABIUTY Miami- Springs, FI> -33438 • - _ ._.._ _... _ OF ANY KIND UPON THE INSURER ITS - t2ITS QR _REPR_ESENTAT. .IVES..._. _.__...__. _- AUTHORIZED REPRESENTATIVE Af•l2Df nu inna4iflO% AC ©ACORD CORPORATION 1988 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INS P- 157273 Scheduled Inspection Date: July 08, 2011 Inspector: Hernandez, Rafael Owner: RHODES, STEVEN Job Address: 57 NE 93 Street Miami Shores, FL 33138- Permit Number: PL- 3- 11-462 Project: <NONE> Contractor: LONCUS PLUMBING CONTRACTORS INC Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number (305)795 -1407 Parcel Number 1132060130400 Phone: 305 - 383 -9259 Building Department Comments REMODELING TWO BATH AND KITCHEN Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments July 07, 2011 For Inspections please call: (305)762 -4949 Page 2 of 7 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 4Q'2_ Permit No. V I Master Permit No. BUILDING PERMIT APPLICATION FBC 20 Permit Type: PLUMBING OWNER: Name (Fee Simple Titleholder): Address: eye— City: §MOMWE Ai 'AR 1 6 2011 BY; Phone #: �2i�o (dR' 73 ST- State: V / Zip: Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: City: Miami Shores County: Miami Dade Zip: Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: L() ' Raul 1 f h 44 ( :/ •�' hone #: ^O � to . Address: 1300 S w 70 � State: t Zip: 331 �4�. �i.,�, St'e�: '++"" � Zi • Qualifier Name: u.(,g ��L°1?� �� Phone# Off a 1 )0O'4 CONTRACTOR: Company Name: State Certification �orRegistration #:C- N24.110 it G Certificate of Competency #: Contact Phone #: - / U G 2.55. et n7 Email Address: Lo �-�`� Ao C-0 t- DESIGNER: Architect/Engineer: Phone #: Value of Work for /17 this Permit: $ � c � �� Square/Linear Footage of Work: Type of Work: Address ❑Alte ation New ORepair/Replace Description of Work: /I-71Y (Demolition ********* * * * * * * * * * * * * * * * * **** ** *** * **** Fees * ** * * * ** x****: x+ x* *********x:** ** * *** *** * * *** ** Permit Fee $ /5-° CCF $ CO /CC $ Radon Fee $ DBPR $ Bond $ Training/Education Fee $ Technology Fee $ Structural Review $ Submittal Fee $ Scanning Fee $ Notary $ Double Fee $ TOTAL FEE NOW DUE $ l.G ° 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/ - ust be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the abs e of such posted notice, the inspection will�ijot be approved and a reinspection fee will be charged. Signature Owner or Agent The foregoin, instrument was acknowledged before me this day of , 20 ,//, by ' 9 '4419% who is personally own to „ e or who has produced 0` \ \9 \11Uii °i u EV NQ�'a LU1 ' Sim iG Prim My ntification and who did take an oath. * * * * * * * * * * * * * * * * * * * * * * ** APPROVED BY Ae7 Signature Contractor The foregoing instrument as acknowledged before me this day 2 oGy 1 //1�i((Olin who is personally kno� me \4., •....•. idehti NOTAR Sign: Print: My Co ssion Expires: d take an oath. * * * * * * * * * * * * * * * * * ****: **** ******* ********** *x: *: x********** *** ******** * *******+x****** / Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Zoning Clerk