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CC-11-1204Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: I NS P- 162873 Scheduled Inspection Date: August 08, 2011 Inspector: Bruhn, Norman Owner: , BARRY UNIVERSITY Job Address: 11300 NE 2 Avenue Miami Shores, FL 33138- Project: BARRY UNIVERSITY Contractor: HERMAN EILBERG CONTRACTOR INC Permit Number: CC -7 -11 -1204 Permit Type: Commercial Construction Inspection Type: Final Work Classification: New Phone Number Parcel Number 1121360010160 Phone: (954)695 -0324 Building Department Comments REMOVE AND REPLACE APPROX 165 SQ FT OF CONCRETE CITY SIDEWALK IN FIVE LOCATIONS ALONG 111 ST JUST WEST OF NE 2 AVE, TO LEVEL PANELS. ALSO REMOVE AND REPLACE 100SQ FT OF CONCRETE SIDEWALK PANELS TO THE SOUTH POOL AREA. Passed o��� Failed Inspector Comments PERMIT TAPE TO TREE ON SW OF POOL Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. August 05, 2011 For Inspections please call: (305)762 -4949 Page 37 of 37 07/18/2011 10:13 FAX 1 800 685 7530 DATA SCAN FIELD SERVICES Ij001 * * * * * * * * * * * * * * * * * * * ** * ** TX REPORT *** * * * * * * ** * * * * * * * * * * * ** TRANSMISSION OK TX /RX NO 1577 RECIPIENT ADDRESS 93052592933 DESTINATION ID ST. TIME 07/18 10:13 TIME USE 00'18 PAGES SENT 1 RESULT OK ik 41- r i3 Permit No: 10 -1204 Job Name: July 14, 2011 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 Building Critique Sheet Door 1) The product approval submitted does not match the plans. Provide a letter of verification from the designer that this is the product approval to be used. 2) The product approval submitted is a poor copy, the top and bottom of the plans are cut off. The plans must be labeled per the product approval cover sheet section "Approval Documents ". 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 CB0 305 -795 -2204 1 Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Applicant 11300 NE 2 Avenue Miami Shores, FL 33138- 1121360010160 Block: 1 Lot: 2 BARRY UNIVERSITY INC Owner Information Address Phone CeII BARRY UNIVERSITY INC 11300 NE 2 Avenue MIAMI SHORES FL 33161 -6628 J Contractor(s) Phone Cell Phone HERMAN EILBERG CONTRACTOR IN( (954)695 -0324 Valuation: Total Sq Feet: $ 3,475.00 265 1 Approved: Yes Comments: Date Approved: 7/12/2011: Yes Date Denied: Type of Construction: SIDEWALK REPLACEMENT Stories: Front Setback: Left Setback: Plans Submitted: Certification Date: Bond Retum : Scanning: 2 Occupancy Load: Exterior: Rear Setback: Right Setback: Certification Status: Additional Info: Classification: Commercial Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $2.40 $2.25 $2.25 $0.80 $150.00 $6.00 $3.20 $166.90 Pay Date Pay Type Invoice # CC -7- 11-41361 07/07/2011 Check #: 3159 $ 50.00 $ 116.90 07/25/2011 Check #: 3161 $ 116.90 $ 0.00 Amt Paid Amt Due Available Inspections: Inspection Type: Final Building Second Floor Slab Second Floor Tie Bond Beam Final PE Certification Shutter Final Tie Beam Bond Beam Window Door Attachment Slab Termite Letter Framing Insulation Floor Trusses Drywall Screw Trusses Plan Submittal Roof Sheathing Spot Survey Wall Sheathing Footer Column Pads Rake Beam Window and Door Buck Roof Trusses Density Fill Cells Columns Wire Lathe Stem Wall Footer F. Elevation Certificate NOC In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated. Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy July 25, 2011 Date July 25, 2011 1 119-clit (244\0?- ul 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 momr,i7F7r( 1[11 JUL o BYo oeevo°e °oo°o ee d . BUILDING Permit NoC,V 1 ` �! 9104 PERMIT APPLICATION Master Permit No. FBC 20 Permit Type: BUILDING ROOFING OWNER: Name (Fee Simple Titleholder)8PR 0 1V [ Y ITY Phone #g05-'o / Qq i 4'110 Address:tA, M 13 C� Co NgET. 2.. AVE; 'M / City: r 1 S FfOR S State: FL Zip: 3 3 tp ( Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: f R 3 0 0 NJ1E 2.610 E. (I ci.. KLE 2.610 AVE") City: Miami Shores County: Miami Dade Zip: 33141 Folio/Parcel #: 11— 213 6 -0 of - 0 t 6 Is the Building Historically Designated: Yes NO ✓ Flood Zone: CONTRACTOR: Company Name: +(ER f I , OFI LDET G Co all f rve.e Phone #: ddress: 222. 4 (00 Lk W E ` 11 uCO i_ SPE N65 State: -FL tP Qualifier Name: #ERM A N c zip: D'3 3 �^ Phone #:(454 —695-0324 State Certification or Registration #: ( & . / Sw C 3 C S Certificate of Competency #: mail Address: __f t 4‘..„5 (�/ 'e/( G et 7 B DESIGNER: Architect/Engineer: Phone #: ontact Phone #: Value of Work for this Permit: $ &14r7 gi0C3 Square/4ea dotage of Work: 1G J 4 Type of Work: ❑Addition CIAlteration New IiRepair/Replace ❑Demolition Description of Work: R VE 4- REP CE A-i PROX I 165 IP OF CONCRETE Cry 5 L cirr Lo Y C 3 uST NE 2.`b Ott D LEVEL PAtsJEL,$6 ALs° Remo VE 1- REPLACE" /00 Z 0AKRE. 3 D 'Pi uc P4a i s° -m e sir t kEA- ***************************************Fees******************************************** Submittal Fee $ Permit Fee $ 6)e) ® CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOWDUE$ libiCI® 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 th nce of such posted notice, the inspection will not be approv- r d a reinspection fee will be charged. 7- Signature Owner or Agent The foregoing instrument was acknowledged before me this • tOtrs. The foregoing instrument was acknowledged before me this) -4, day oft-54P; , 20 11 by " i O 2 ' , day of. -t, r��_, 20 l l , by rm r who is personally known to me or who has produced who is kersonally°knowr to me o ho has produced As identification and who did take an oath. as identification and who did take an oath. Signature Contractor NOTARY PUBLIC: APPROVED BY (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) Plans Examiner Structural Review NOTARY PUBLIC: NOTARY L.1- •st CIF FxwCi LA $0""4.., Denise Schwartz �lgvp'2 tz Iv' €Commission #DD8979G, pires: AUG. 25, 2013 My Commission Expires: 8/ S /4G \ Zoning Clerk NOTICE OF COMMENCEMENT A MDR = COPY MUST BE POSTED ON THE JOB SITE AT TIME OF RHST INSPECTION PERMIT. NOCC— — l ( 2011 TAX FOLIO NO. S rAr k OF FLORIDA: COUNTY OF MIAMI -DADE: NE UNDERSIGNED hereby gives notice that improvements will be made to property, end in accordance with Chapter 713, Florida Statutes, the following R is provided in this Notice of Commencement. By STATE OF 1 HEREBY uriginsl har i, 1. 11111111111111111111111111111111111111111111 CFN 2011R04 4- 6 3 7' 3 . OR Bk 27748 Ps 0822; C1) RECORDED 07/07/2011 1%a20A19 HARVEY RUV'IHr CLERK OF COURT MIAMI-DADE COMM FLORIDA LAST PAGE LORIDA, COUNTY OF DADE R7 FY that this is a y of the on day al AD2O See.[ Comfy Cowie D.C. 1. Legal description of property and street/address: Barry University 11300 NE 2nd Ave, Miami Shores, FL 33161 2. Description of improvement: Sidewalk Replacement 3.Owner(s) name and address: Barry University - Campus 11300:NE 2nd Ave, Miami Shores, FL 33161 interest itt property: Name and address of fee simple titleholder: 4. Contractor's name and address: Classic Concrete 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(1Xa)7., Florida Statutes, Name and address: 8. in addition to himself, Owners designates the following person(s) to receive a copy of the Lienors Notice as provided in motion 713.13(1)(b), Florida Statutes. Name and address: 9. Expiration date of this Notice of Commencement (the expiration date is 1 year from the date of recording unless a different da Med) Signe %!- of Owner I J Print Owner's Name �2MGfi G t)VtLi aS Prepared by i¢ Sworn to and subscribed before me thus, (t$ S-day of ...1--(11`1•V: , 20 . Notary Public Print Notary's Name My commission expires: Address: JEFF ATWATER CHIEF FINANCIAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION M-09-2011 * * 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: PERSON: FEIN: 05109/2011 EXPIRATION DATE 05/08/2013 EILBERG HERMAN 650281101 BUSINESS NAME AND ADDRESS: HERMAN EILBERG CONTRACTOR INC 322 NW 100TH LANE CORAL SPRINGS FL 33071 SCOPES OF BUSINESS OR TRADE: 1- CERTIFIED GENERAL CONTRACTOR IMPORTANT: Pursuant lo Chapter 440 . 05(14), 1.5.. an allicer of a corporation who elects exemption from this chapter by Ailing a certificate of election under 11110 section may eat recover benefits or compensation under this chapter, Pursuant to Chapter 440.05(121, F.5., Certificates of election la be exempt... apply only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chaplet 440.05(131. 1,5.. Notices of election to be exempt and cerlilicales of election 10 be exempt shall be subject Io revocation il, at any lime after the filing of the mice or the issuance of the certificate, the person named on the notice 01 certificate no 'angel meets the requirements of this section In issuance o1 a cerulicele. The department shall revoke a certilicaie at any lime for failure ul thn parson name3 an the certificate to meet the requirements of this section. QUESTIONS? (8501 413 -1609 DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01 -11 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF (FLORIDA DEPARTMENT OF FINANCIAL SERVICES DMSION OF WORKERS' COMPENSATION CONSTRUCTION INDUSTRY CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW EFFECTIVE: 05/09/2011 EXPIRATION DATE: 05/08/2013 PERSON: HERMAN EILBERG FEIN: 55U281101 BUSINESS NAME AND ADDRESS: HEIWAN bitbERG CONTRAC ION INC 322 NW 100TH LANE CORAL SPRINGS, Fl 33071 SCOPE OF BUSINESS OR TRADE: I- CERTIFIED GENERAL CONTRACTOR IMPORTANT • Pursuant to Chapter 440.051141, F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election L under this section may not recover benefits or compensation under this D chapter. Pursuant o Chapter 440.051121, F.&, Certificates of election to be H ▪ exempt.. apply only within the scope of the business or trade listed on • the uutit:a of election to be CACltlpt R E Pursuant to Chapter 440.051131. F.S. _ Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation it at any time offer the filing nf the nntire M the igctmnce nf the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named an the certificate to meet the requirements of this section. QUESTIONS? 18501 413- 1609 CUT HERE * Carry bottom portion on the job, keep upper portion for your records. nue -752 CERTIFICATE OF ELECTION ifl BE EXERifl REVISE[ B1 -11 Planning and Zoning Criteria Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Folio Number:1121360010160 Owner's Name: BARRY UNIVERSITY Job Address: 11300 2 Avenue Miami Shores, FL 33138- Owner's Phone: Total Square Feet: 265 Total Job Valuation: $ 3,475.00 Contractor(s) HERMAN EILBERG CONTRACTOR INC Phone Primary Contractor (954)695 -0324 Yes Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 7/12/2011: Yes Comments: