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RC-11-1291Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 164332 Scheduled Inspection Date: September 13, 2011 Inspector: Bruhn, Norman Owner: BREMER, MARIA Job Address: 9160 NE 8 Avenue 3J Permit Number: RC -7 -11 -1291 Miami Shores, FL Project: <NONE> Contractor: QUINTERO GENERAL CONSTRUCTION Permit Type: Residential Construction Inspection Type: Final Work Classification: Alteration Phone Number (305)759 -2892 Parcel Number 1132060440360 Phone: (786)487 -5738 Building Department Comments KITCHEN REMODEL AND FIRE RATED WALL AND DOOR FIRE Passed,W Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments ec_ September 12, 2011 For Inspections please call: (305)762 -4949 Page 14 of 14 c-1 r (k,1 1 I -Ordiv4Z BUILDING PERMIT APPLICATION Fsc zo 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 Permit Type: BUILDING ROOFING OWNER: Name (Fee Simple Titleholder): Address: ` City: i2 '/, 7%/l- Q ? "��.97 Permit No. Sit 1 '-, 2011 1, Master Permit No. Ayi / State: Phone #: #t (/6 g 3 ip Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: 9/60 4J,E 42"/ " v 3 City: Miami Shores County: Miami Dade Folio/Parcel #: Zip: Is the Building Historically Designated: Yes CONTRACTOR: Company Name: ✓(� �J� 4�+�� Phone #: f Y 67S-918 Address: 3Y © / A)4J //c /e/1R/ City: i!if 44 State. ILZ NO Flood Zone: Zip: 310 ie Qualifier Name: %ii4i� / y Phone #: 9'OQ6s Gd d 5 43 State Certification or Registration #: G 6G' /S` ? e al Certificate of Competency #: Contact Phone#: Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ /v 0 0 • Type of Work: DAddition Alteration �y Description of Work: Cl /7 eiJ n Square/Linear Footage of Work: ONew :Repair/Re lace Demolition %L2 ,�v✓ �8 82 bite, "e s fikrt + x***+ x**+ x********* *****: x*u: ********* ***** Fees**+ x+ u*** ***+ x** ******** **** x :+x***************** v , Submittal Fee $ rmit Fee $ Scanning Fee $ ' adon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ c) CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ 1 SI 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 absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature 0,z� 747 U Owner or Agent Owner or Agent The foregoing instrument was acknowledged before me this 1 `-i day of e� , 20 Lt , by 1 ��r�� s2 who is personally known to me or who has produced 1/4---t As identification and whooactidgjyipi4nIoath. �r \enis ,P,fB� p 116) NOTARY PUBLIC Sign: Print: My Commission Expires: w Co DD j fslo��1Jc r}rrrrmio,a" Contractor The foregoing instrument was ackno edged before me this day of�L , 201( , by ie� °, who is personally known to me or who has produced ��-- ( () as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: = Co ''�� My Commission Expires: 3 "...0,P/son io �`` /'' • ; p z` 9p 1 "47-O RID P **** ********* a: *x: ** ****** *: x**u: ***** ****** ******* ******* ***** ** *********** *:x:x***+xm********** ******4444 441x*** APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Permit No: 11 -1291 Job Name: July 22, 2011 Miami Shores Viiiage Building Department Building Critique Sheet 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 1) Provide an electrical permit application from a licensed electrician. Page 1 of 1 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 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 162872 Permit Number: PLC -8 -11 -1416 Scheduled Inspection Date: August 24, 2011 Inspector: Hernandez, Rafael Owner: BREMER, MARIA Job Address: 9160 NE 8 Avenue 3J Miami Shores, FL Project: <NONE> Contractor: SEA COAST CONSTRUCTION GROUP INC Permit Type: Plumbing - Commercial Inspection Type: Final Work Classification: Addition /Alteration Phone Number (305)759 -2892 Parcel Number 1132060440360 Phone: (786)385 -2139 Building Department Comments KITCHEN RENOVATIOIN Passed C� Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments August 23, 2011 For Inspections please call: (305)762 -4949 Page 9 of 23 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 Permit No, ( rl I Master Permit No. AJ( 0 5 2011 BUILDING PERMIT APPLICATION FBC 20 Permit Type: PLUMBING OWNER: Name (Fee Simple Titleholder): City: -owl I Address: Tenant/Lessee Name: Phone #: State: Phone #: Zip: j / Email: JOB ADDRESS: /6N AL, 80F R 4 P7 3 City: Miami Shores County: Miami Dade Zip: 7 3/ 3 . Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: 1ONTRACTOR: Company Name: 624 CoAc dAidw tO?4 &WU,h Phone #: 'V) 3 fr5 o±) 35 3S® G! zrat Address: r City: ale c . l State: F,( Zip: 3 30 t 2 Qualifier Name: DSO 1 PC CPA; 2 Phone#: State Certification or Registration #: CAC / 4 2. 4f irir " 2. Contact Phone #: $�3&`"S cP/ 5i Email Address: Certificate of Competency #: fg, COMsc1tu ehe E)Aint. Gog4 DESIGNER: Architect/Engineer: Phone #: XValue of Work for this Permit: $ 5 °" Square/Linear Footage of Work: Type of Work: DAddress DAlteration ❑New %Repair/Replace ODemolition )( Description of Work: / ,ca t •�% l�`� (V / S /� ' 57 ' s) * * * * * * * *** *** ** ********* * *** * ** ******* Fees:* ****+ x********** * * * * ** *** **** *********** * ** Submittal Fee $ Permit Fee $ Qt" a 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, BOTLFRS, 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 • e absence of suchposted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Owner or Agent X41 1 i41 ///_. Signature Contract The foregoing instrument was acknowledged before me this The for oing in rument was acknowled ed before me this /3, day of 5L) \ , 20 , ,, by t N A °q - Zi , day of /f d,� , 20 /l, by �°!® @� &Z , who is personally known to me or who has produced 4 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 ' BL Sign: ,�. E tes ••. Sign: v� �lir �., ,.... 12012 = Print: i; • Commission #EE89076 „ o "Y omm � • ��lA�Y PUBLIC : = My Commission xpires: �N�'CDD76590i,� ** * *** *** ****m**** * **** ** * ** * ** * **** *xti +> k ' �x`*\** �x�x�x+ x�x�x�x+ x************************* u:x:x�:x�x�:x:x�*** *�x *�xx�**** /''1nnn' My Commission Expires: APPROVED BY f—e"// Plans Examiner Zoning Structural Review Clerk (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) 1/1 A°R�'" �� iCERTIFICATE OF LIABILITY INSURANCE �� ' ��' pL „II Gp05 /11YY) 08/05/11 PRODUCER Florida Bankers Insurance 7278 SW 8 Street Miami, FL 33144 Phone (305)266 -6493 Fax (305)262 -0679 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 SEA COAST CONTRUCTION GROUP INC 1214 NELSON RD N CAPE CORAL, FL. 33993 INSURER A: AMERICAN VEHICLE INSURANCE CO. INSURER B: INSURER C: INSURER D: 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 MAYBE ISSUED OR MAYPERTAIN. THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR INSRD NERD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE ( /WI POLICY EXPIRATION DATE (MhUDD/YYI LIMITS A 1 GENERAL • • • GEN'LAGGREGATE .i LIABILITY COMMERCIAL GENERAL LIABILITY ❑ CLAIMS MADE 0 OCCUR GL- 0504002810 -01 10/08/10 10/08/11 EACH OCCURRENCE 300,000.00 DAMAGE TO RENTED PREMISES (Ea occurence) 100,000.00 MED EXP (Anyone person) 5,000.00 PERSONAL & ADV INJURY 300,000.00 GENERAL AGGREGATE 300,000.00 PRODUCTS - COMP /OPAGG 300,000.00 LIMIT APPLIES PER POLICY • PROJECT 1 LOC • AUTOMOBILE • • ❑ • • • n LIABILITY ANYAUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON OWNED AUTOS COMBINED SINGLE LIMIT (Ea ac c ident) BODI LYINJURY (Per person) BODILYINJURY (Per accident) PROPERTY DAMAGE (Per accident) • GARAGE LIABILITY ❑ ANYAUTO ❑ AUTO ONLY - EA ACCIDENT OTHER THAN EA ACC AUTO ONLY: AGG • EXCESS/UMBRELLA LIABILITY • OCCUR • CLAIMS MADE • DEDUCTIBLE ❑ RETENTION $ EACH OCCURRENCE AGGREGATE WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER / MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below ❑ WC ATU- • OTH TORYLIMITS ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICYLI MIT OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CANCELLATION CITY OF MIAMI SHORES 10050 NE 2 AVE MIAMI SHORES, FL 33138 1305- 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 LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ;;' ; :':;.;': :':' ...... ... .......... '........: :?I: • @ ACORD CORPORATION 1988 IMAIIGDADE COUNTY TAX COLLECTOR 140 W. FLAGLE R ST. 181 FLOOR ,FL 33130 2010 LOCAL DIMNESS TAX RECEIPT 2811 FIRST-CLASS MANMADE COMITY - STATE OF FLORA U.S. POSTAGE EXPIRES MUST SE DISPLAYED ATATTPLA OF Busman REAM, FL PURSUANT TO COUNTY CODE CHAPTER 8A -AR. 9 & 10 PERMIT NO. 231 623629-3 T IS NOT A - DO MOT PAY RENEWAL BUSINESS NAME/LQCAT#Qitl RECEIPT HO. 650096 -2 SEA COAST CONSTRUCTION GROUP INC STATED C8C1515019 DOING BUS IN DADE CO OAR SEA COAST CONSTRUCTION GROUP INC Sec. Type of Business 196 GENERAL BUILDII4 CONTRACTOR 'HS S MAT A LOCAL YIUC RECEIPT. TT MES HOT PERMIT THE KILMER TO YFC1LATE MW =SEM RE&UTATORT OR CMG LAWS OP THE. 0199Y OR CMS. NOR MES 11 EXB1 T THE IO DER FROM NOT 01103 MEW OR UCENSE SY LAW.11tS SO T A � sA1101 OF SEA COAST CONSTRUCTION GROUP INC RE MILDEWS LICALINCA- RODOLFO CRUZ PRES 1214 NELSON RD CAPE CORAL FL 33993 WORKER/S 1 DO NOT FORWARD xemenitecaval EALROAVE alLIECTOM 09/17/2010 09010038001 000075.00 SEE OTHER SIDE a 77 Eti�imnAt ttit ”Ahnt it ttiffiisttiitutjhhalit a DEPA • OF DMSION 0F TEM CIDASTIGCTIM i10*ISTRY CINCHFICATEOF ELECTKIR TO RE EXEMPT FROM mom% WORKERS COWEN:MON LAM EE FIVE 03/21/2011 EXPIRATION DATE: 03/20/2013 pEoSoAt MOM OM FEE% 1011 BUSINESS NAIVE AM AE S& SEA COAST CONSTRUCTION GROUP INC 1214 MINOS ROAD MOOR CAPE CORAL, FL 33993 SCOPE OF BUSINESS OR TIRADE= 1- CERTWED MOM CONTRACTOR 2- c031 ROOFING CONTRACTOR 3- MOW) GENERAL LOPRRACTOR STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487 -1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 CRUZ, RODOLFO SEA COAST CONSTRUCTION GROUP INC. 350 W 61ST ST HIALEAH - FL 33012 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better For information about our services, please log onto www.myfloridallcense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and team more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! s Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 162595 Permit Number: ELC -7 -11 -1363 Scheduled Inspection Date: August 30, 2011 Inspector: Devaney, Michael Owner: BREMER, MARIA Job Address: 9160 NE 8 Avenue 3J Miami Shores, FL Project: <NONE> Contractor: VERES ELECTRIC INC Permit Type: Electrical - Commercial Inspection Type: Final Work Classification: Addition /Alteration Phone Number (305)759 -2892 Parcel Number 1132060440360 Phone: 786- 229 -8294 Building Department Comments CHANGE 2 OUTLET Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments _tea „/"Z • ":// August 29, 2011 For Inspections please call: (305)762 -4949 Page 13 of 22 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 JAIL2 E, { r Permit NoEf-d (l 1 3 Master Permit No. Permit Type: Electrical -f OWNER: Name (Fee Simple Titleholder): � � �� /I�Qi�. Phone #: EC'‘ Address: City: , L Aril State: Tenant/Lessee Name: Email: JOB ADDRESS: 7/6c7 /tie (-4 City: Miami Shores Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: County: Miami Dade Zip: CONTRACTOR: Company Name: Address: City: V \ Qualifier Name: C,� State Certification or Registration #: Contact Phone #: DESIGNER: Architect/Engineer: \i/Aties. State: l , (' (V _ Phone #: g ( -% 1 l ft 0 Zip: sr3OJ S Phone #: 9aC /7 ? 3 0 Certificate of Competency #: Email Address: sg/Vit y �% vi S AD L / Phone #: Value of Work for this Permit: $ Type of Work: Address UAlteratiion �; Description of Work: c3�\�`�/� -- Square/Linear Footage of Work: ONew Repair/Replace Demolition S ******** ***** * * * * ** * * * * * * *** * * ***** * *** Fees************* ** * * ** * * ** * ** * *** * *** * * * ** * * * ** Submittal Fee $ S-D Scanning Fee $ Notary $ Double Fee $ Permit Fee $ /-3'' °‘" e2 CCF $ CO /CC $ Radon Fee $ DBPR $ Bond $ Training/Education Fee $ Technology Fee $ Structural Review $ TOTAL FEE NOW DUE $ J0 1 -1 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature [502,,ta fie el-14 0/2_, --- Owner or Agent Contractor The foregoing instrument was acknowledged before me this li The foregoing instrument was acknowledged before me this a (J day of `)� `'{ , 20 u , by 1'"1,,A(2_ Ar' 1`1 AC Wit) day of ` ■J ky , 20 l ( , by (A,t y.,j v,..-----, who is personally known to me or who has produced l ..' 'c who is persona 1y • wn to me or who has produced As identification and who dic:V ttumr * as identification and who did take an oath. 1 NOTARY PUBLIC: ° :- ......... S' S' ." NOTARY PUBLIC: Sign: ®,74 , ?0,1 = Sign: � , ' , : 9 Print: -�h r/r,� �l ° = Print: t�: \ �s►bFI O'" fi ° ...... -. `��,•° My Commissi F c s; MY COMMISSION # DD 938985 '',,, L Cl I? 1Q ��` �n EXPIRES: November 9 2013 'r f i i H n+, ,o %jtoms" BondedT$mt Budget Notary Services Signature C My Commission Expires: * * * * * * * * * * * * * * * * * ** APPROVED BY ... * * * * ** ***** v*************************************** * ** * * *** * * * * ** * * * * ** * **** ** * *** 2. Plans Examiner (Revised 07 /10 /07XRevised 06 /10/2009XRevised 3/15/09) Zoning Structural Review Clerk 08/18/2611 11:58 3052470208 TRINITY * * * # * * * * * x * x * x * * *2** MIAMI -LADE COUNTY TAX COLLECTOR, Miami, Florida Street 313 Please keep your receipt for future reference. Thank you and have a nice day. 7/29/2011 1300 /229 /001ILEV 0005 -0001 Lest Seq.0:0001 WI LBT # :11 191276 -6 Local Business Tax $18.73 CK CHANGE $18.75 $0.00 MIAMI -DADE COUNTY TAX COLLECTOR LOCAL BUSINESS TAX SECTION 140 W. F1agler St. - let Floor Miami, Florida 33130 TEMPORARY RECEIPT 2010 -2011 MUNICIPAL CONTRAC Local Business State /CC# :00001 VE'RES ELECTRIC INC ELECTRICAAL6CONTRACTOR RESTRICTED SSH pRESO . THIS RECEIPT IS ISSUED AS EVIDENCE OF PAYMENT FOR YOUR LOCAL BUSINESS TAX OR PERMIT. YOUR OFFICIAL RECEIPT WILL BE MAILED VALIDATION DATE ONATHIR'CEIPT, Payment Received as Gertified Above Miamf -Dade County Tax Collector II 1:MI2022M e z e p—_= e c e 11/06/2009 13:45 3052428746 ALSINAA £L1£2 ld IWVIW 15 58 MS 00001 S371d S3d3A S31SVN3 ZNI OIX13313 S3a3A abvMUOA ION 00 S /VANAOM MO13VN1NO3 3N1 0£LL10000 * 33 9- 9L2T6t •OmLd1303a 1VM3N37! AVd JON O0 -11Ig V 10N SI LC "ON llwli3d I 'Iwmw QIVd 3OVJBOd -S'i1 SSV Y - JStiid 30IS 1i3H10 33S 00'SL0000 1006Z001060'. D1UZ /91/80• }awsaro* xq. AMMO Pavo9Wrre OaAIIIUW3 wartAva imoI .ft.mininsvmxman t v1 A OMMN • �°• , .� HON Paulo tlQ AL lfl Hsu rir, 5fUNQZ H Q AmulArMCW WW�LB1pX� WU AX* NYuU It 1011z411 XVi s *$110111 1V3110115 V alf sr VDU. soouling 10 WAS 4*0S 3I7l13313 S3UA ti3NMO AIN1103 3a11a NINn IL 1S SS MS 00001 3NI 3I813311,.537l3A NOO O1 / 211Yrtilil SSaNtS09 ' 9- 9'LZT61 SIHI 116': A 'Lad - v9' ti3ldVHO 3003 A1Nn00 01.LNVfSand . SS]N1sne do 33V'1d 1V.{19AV1dSI0 391SfI • LLrz:'0t !alas S3h0dZI vatwd-u ao ZLVis AiNnoo.;ava -IWd1w • • .Litz: 1d13331i Xv1.S53Nlsn9 Wool . :0 • . YuktikitAmalAtit llmommmrovirniumr PAGE 01101 o 11 rides4e11t1m Boum • 6t33"iges3 C' t`tiF`iOAT6 OF CONi1 N , 00001 :7 VERES ELE9"�.`1 VERES CHARLES is codified under the provisions of.Cheipter 10 of Mlaml� VALID FOR CONTRACTING UNTIL 09/30 /201 IShao 5 v 31 7co -rot 1171 dc w 7 Jul 25 2011 11:52:33 EDT FROM: F2M/29869390216 MSG# 30243991 -007 -1 PAGE 003 OF 003 '4`, °!R CERTIFICATE OF LIABILITY INSURANCE U022 DATE (MM /DD/YYYY) 07 -25 -2011 THIS CERTIFICATE'S ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONALINSURED, the policy(ies) must be endorsed, If SUBROGATION'S WAIVED, subject to the terms and conditions of the policy, certain policies may require en endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER PAYCHEX INSURANCE AGENCY INC 210705 P: () - F: (888) 443 -6112 PO BOX 33015 SAN ANTONIO TX 78265 CONTACT- NAM PH NEE I FA/C rPon ess) 443 -6112 ran" ADDRESS: PRODUCER CUSTOMER 100: INSURER(8) AFFORDING COVERAGE NAIC N IN&UB:D VERES ELECTRIC INC 10000 SW 85TH ST MIAMI FL 33173 .............. ___ INSURER A : Twin City Fire In Co INSURER B = atrium COMMERCIAL GENERAL INSURER Cl INSURER D: INSURER E : INSURER F = THIS INDICATED. CERTIFICATE IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR IV TYPE OP INSURANCE INSR WW1 POLXOV NUMBER / POLICY /CD/YYYY! fA? Y :7 LfM?S OERXRAL atrium COMMERCIAL GENERAL LIABILITY OCCUR EACH OCCURRENCE 8 UAMAtah 1 U 141.1M I Ell PREMISES (Ea aaaurrenae) a CLAIMS -MADE MED EXP Any one person) 8 PERSONAL & ADV INJURY 8 GENERAL AGGREGATE 8 _GE *L AGGREGAT LIMIT A'PIES PER: PRODUCTS • COMP/0P AGG a POLICY 1 JECT LOC 8 ALITOMOHL8 L/A1B1TY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) 8 — BODILY INJURY (Per person) 8 — BODILY INJURY Was eooltlent) 8 — PROPERTY DAMAGE :Per accident) a — — a 8 UMBRELLA LAD EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE 8 AGGREGATE 8 DEDUCTIBLE RETENTION 0 a — 8 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER XCLUDED? (MenEatoryElMMC If yea, tlesorlbe untlsr DESCRIPTION OF OPERATIONS Y/ N M/A 76 WEG LR4164 09/29/2010 09/29/2011 WCSTATU OTH- x I TORY 1 IMITB FR E.L. EACH ACCIDENT 8 , O O O , O U Q below GI. DISEASE •fiA EMPLOYEE 8 1, 000, 000 E.L. DISEASE - POLICY LIMIT 8 1,000,000 DESCRIPTION OP OPE RAT IONS / LOCATIONS / VP/ECLUS fAttaoh ACORD 101, Additional Remarks Stedu$r, X man gpm' 8r miuMd) Those usual to the Insured's Operations. •eerlcl■wTC LIr I nrn City of Miami Shores 10050 NE 2ND AVE MIAMI SHORES, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTXOROTEDRMPRESd fATlVI a 7---c..... -1-7.04.,a0.4‘....- ACORD 25 (200B/09) 1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD LMG 7/25/2011 12:16:29 PM PAGE 2/002 Fax Server 43RD® CERTIFICATE OF LIABILITY INSURANCE OP ID AS J �-�' DATE(MM/DD/YYYY) 07/25/11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL ENSURED, the policy(les) must be endorsed. If SUBROGATION 15 WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER Liberty Agency Underwriters PO Box 188065 Fairfield O8 45018 Phone:888- 763 -5338 Fax:800 -845 -3666 wnlac,1 NAME: PHONE mg o, Eta): I FAX No): EADDRESS: CUSTOMERIDe: VERES-1 INSURER(S) AFFORDING COVERAGE NAIC# INSURED VERES ELECTRICAL /NC. 2858 NE 4TH STREET HOMESTEAD FL 33033 rnve_Anr_ ___••_•_ ___ ___ ---- _ INSURER A: let Natl. nos Co of America 24724 INSURER B 25CC21321140 INSURER C: 04/08/12 INSURER D: $ 1000000 INSURER E : PREMISE8 (Eatoccutrrrence) INSURER F: • • THIS INDICATED. CERTIFICATE EXCLUSIONS INSR 1.. 11•01,/ IN IY V 11111:PG11 a IS TO CERTIFY THAT THE POLICES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCR BED HEREIN IS SUBJECT TO ALL THE TERMS, AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE INSR WVD POLICY NUMBER ttrry�� (MM)DDY/YYYY) (MM D/Y ) LIMITS A GENERAL UABIUTY COMMERCIAL GENERAL LIABILITY 25CC21321140 04/06/11 04/08/12 EACH OCCURRENCE $ 1000000 X PREMISE8 (Eatoccutrrrence) $ 200000 CLAIMS -MADE I X I OCCUR MED EXP (Any one person) $ 10000 PERSONAL & ADV INJURY $ 1000000 GENERAL AGGREGATE $ 2000000 OEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2000000 X POLICY 7 PRO- I� JECT I LOC $ AUTOMOBILE UABIUTY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE OMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ $ UMBRELLA LIAR EXCESS UAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ _ AGGREGATE $ DEDUCTIBLE RETENTION $ COMPENSATION $ WORKERS $ AND EMPLOYERS' LIABILITY OFFICER/PMEMBER EXCLUDED (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS Y/N XECUTIV N /A WCSIAIU- OIN- ITORY LIMITS I ER E.L. EACH ACCIDENT $ below E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POUCY LIMIT $ DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, 11 more space le required) CERTIFICATE HoLn _ ______ _ ____ _ CITMIA4 CITY OF MIAMI SHORES VILLAGE HALL 10050 NE 2ND AVE SHORES FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2009/09) ®1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD C (�� HECK LIST PERMIT #lt' _ 1 t 3 3 LICENSES V—iaAT COUNTY CVOCCUPATIONAL ❑ MUNICIPAL 5 VLIALIBITY W/C NOC C MMENTS a -a-Pti - NAD 5 /vow�