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RC-10-1409 (2)Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 168443 Scheduled Inspection Date: January 23, 2012 Inspector: Rodriguez, Jorge Owner: HUNTER, MARK Permit Number: RC -8 -10 -1409 Job Address: 1245 NE 93 Street Miami Shores, FL Project: <NONE> Contractor: BARI NATIONAL BUILDERS INC Permit Type: Residential Construction Inspection Type: Final Work Classification: Alteration Phone Number (917)604 -8328 Parcel Number 1132050270070 Phone: (954)218 -5390 Building Department Comments KITCHEN REMODEL NEW FLOORING, NEW KITCHEN CAB, UPGRADE ELECTRICAL, PAINT. Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP- 154245. CREATED AS REINSPECTION FOR INSP- 149741. Plumbing must be approved. Provide a mechanical permit for the hood. NB 01/05/12 - INSP. CANCELLED PER OWNER.JR January 20, 2012 For Inspections please call: (305)762 -4949 Page 21 of 47 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 t, INSPECTION'S PHONE NUMBER: (305) 762.4949 Z � rI ,... � f�Q`,� BU DING Permit No. PERMIT APPLICATION Master Permit No. QC 'O — it--WSA FBC 20 RECEIVED NOV 3 6 2011 BY. Permit Type(UILDING OWNER: Name (Fee Simple Titleholder): Address: VIRG 1t) e_ 013 Gk. City: k\ C7,,n■ c- -VlC)c) ROOFING 1c\on \-cr( Phone #: ckl •4O Ct tB 9e V State: Zip: 3 31 Email: JOB ADDRESS: \ lid_ c.-k Gk. City: Miami Shores County: Folio/Parcel #: \\ — 3 2 O S —©2 Cc-.).4 0 Is the Building Historically Designated: Yes NO Tenant/Lessee Name: Phone#: Miami Dade Zip: 3' \3 B CONTRACTOR: Company Name: , .., .q .. Address: X33 j Wa. 2C . Q3iAC(7 Phone #: 00-k 3c\\ Flood Zone: c&-- `3I_4L3� City: NA\c(OU �-( 1 State: Qualifier Name: �pCa �\ C Q1--c \ State Certification or Registration #: a Certificate of Competency #: Contact Phone#: �y3°\ \2 1 Email Address: C t�1�SlOnTCpYrG C(3 M Phone#: zip: 33®2c1 Phone #: c --1- C \ --"4432.F A. DESIGNER: Architect/Engineer: Value of Work for this Permit: $ 0 Square/Linear Footage of Work: n Type of DescriptHgn of Wo �.a k rle,' UNew ❑Rep o K uoccn_ C. Q2nPtCA 1 at-A. at-Aj Jo qn ;n,'A7 X6: itit rA **** *************** **************W71 *F H+H�K��/�kA��t aB�** **#****** ******************** Submittal Fee $ Permit Fee $ �� 1+� �L ��(�/ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ 4 j 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 AliFIDAVIT: 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 wi not be approved and a reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this c\ day of k..)c)Cr\ aC, 20 IL, by crY -k \--Cr( who • ersonally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: I�TARY PIMLIC -STATE ALA My Co Signature Contractor The foregoing instrument was acknowledged before me this - day of \ 1 , 20 AL by �� \Q, 6\ d. , o is personally known tome or who has produced as identification and who did take an oath. NOTARY PUBLIC: APPROVED BY Sign: Print: My Co 117,--// Plans Examiner Zoning Structural Review (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Clerk 1 28, 2011 Mark Hunter 1245 NE 93`d St Miami Shores, Florida 0 General Contractors ® CGC060015 Insured Ref.: Permit # RC 10 -1409 Code violation for the HVAC permit Dear Mr. Hunter: I acknowledge that the permit for this project will be transferred to another contractor and accept it. Should you have any questions or wish to discuss the above further please feel free to contact us. Sincerely, 11/15/2011 10:02 FAX 1 800 685 7530 DATA SCAN FIELD SERVICES W001/001 - 1..0 d Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR / ARCHITECT Permit.N.e C10 — %4°Ck Owner's Name (Fee Simple Title Holder): 1T'\ ®(V- \—\ V(1\ e r Owner's Address: 2.4G OF C G City: °orn sh� State : �=L Job Address (Of where work is being done): City: Miami Shores ¥. Contractor's Company Name: \2L\ \J Ck3 Phone #: p114 6c \S 3z B Zip Code: 3313 3, g\-. State: Florida Zip Code: 3313&) Address:--3 p \ W L� Phone #: Ck st- g1-102-cA City: i \kc oc State: Zlp Code: Qualifier's Name : r■vve c-c&\ 0 , Lic. Number: CG C. 1S0o13 49„ Phone #: Architect) Engineer of Record Name: Address: City: State: Zip Code: Describe Work: I hereby certify that the work has been abandoned and/or the contractorlarchitect is unable or unwilling to complete the contract. I hold the Building Official and the Miami Shores harmless for all legal involvement. Signature 0 Sl? Signatu �V\ owner or Agent The foregoing instrument was aknowledged before me this day of �N ,2Ol1,by tArrc'L )'W16( Who personally knownio me or who has produced as indentitication. Notary Public: Sign: '1(j Seal: gussmarkomNOISSIPMCIDia WWI AD RIMS -mono MAN VTERIIA MIEN ntractoror '- flea The foregoing instrument was aknowledged before me this day of \\ \< 20t\by 4\iYQ\ G *� 0. who it-personally known to me or who has produced as indentification. Nota Pu lic: X Sign: Seal: r OFFICIAL SEAL MANE VV ELLA NOTARY PUBLIC -STATE OF IMMO IN COMMISSION EXPIRES'e3121112 Lubin Bergman Organisation Inc .5 Revere Drive Suite 370 Aort break, IL 60062 : 947 -763-5 Bari Rational Builders Tony Dalai* 10242 Mr 47 St #26 Sunrise, 6°L 33351 THE POLE= OF MORAN= L0.MSOW ow MIN ISSUED TOTi0. MU= SUNVIDABOVE PAY Pip ANY MEENFEENEIT. TEM OR mom OF ANY COACT OR OMR COMMENT VM14 HOMY TO WHEW Ti'0.4 CE RTIRCATE MAY BE NERRO OR MAY THE ENEMAKE AFFORDED BY TIE i- '., INESORENET WRENS 0. Ste= TO KIMMINS, EMMONS AM CESENTHINS OP SUCH TE UWE SUM MAY H 0. ...¢ , Pig GEt4ERAL LLVIIIiY * COMIERCIAL MUM. LIME ► Osumi Smplos 3e' —smamed SDK RIMY fl t 193L0157549 • 01/04/11 01/4/12 ,000.000, I MB EV Ven en a 5.000 MEWL PESSMIE/DIDESMY .4 .„Q100,, 000 i 1 a .2,009,000 reoners-uarropies s 2.000.000 ANYAISIO ALL OWNED AUKS SCHEDULED Nue MED AiYf48 INL0157549 • 01/04/11 01/04/12 imT • 1,000,000 b .1 • Rpm/Aso 5 Mart MAW • EXCESS / UREMIA iJfY il OCCUR amiss= Ramose s X0:000 coissiimes AMEAMWDEMIMEMY viii Me= ExttRW. Q B U0L0157549 . .01/04/11 ammommeos s $-Q0Q.000 i ,_ 0 2.000.000 01/04/12 ; $ bb teNCC 974502 01/04/11 stinDERS RISK Si 99402 12/9/10 MIMI ;. 01/04/12 kea. s 1.900.990 s a 1.000.000 . POL V er s 1.000.000, 12/9/11 $1,000,000 oescossou (iwOPERA110114i MOONS tVEISCIES ISECUESIONSACESOBVERDORSEINDUSSIECMLON4LSOUS City of Tosarac is added as additional insured. 30 Days noose of cancellation Oman, additional insured . le attached. PRINFATE tiara mumoweammostummatemmatiosim 30 9i um* ;:.: commas KOUUSIN MEDTO VIE SailkaarlaaVia is/VDS0 Oa faa y. The *CCM name oboss segistaid nunts 01 AC0 BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A -100. Ft. Lauderdale, FL 33301 -1895 — 954- 831 -4000 VALID OCTOBER 1, ?11 THROUGH SEPTEMBER 30, 2012 DBA:DIVISIONV7 CONTRACTOR LLC Business Name: BARI NATIONAL BUILDERS LLC Owner Name: CEFALO, DANIEL D. Business Location: 3121 SW 186 TERRACE MIRAMAR Business Phone: Rooms Employees 3 Receipt #:180- 242806 Business Type:GENERAL CONTRACTOR () Business Opened:07/29/2011 StatelCountyiCeri iReg: CGC 15 0 9 3 4 9 Exemption Code NONEXEMPT Machines Professionals Number of Machines: For Vending Business Only Tax Amount Transfer Fee NSF Fee . Penalty Prior Years Can Cost Total Pali 27.00 27.00 0.00 0.00 0.00 0.00 0.00 THIS RECEIPT MUST BE THIS BECOMES A TAX RECEIPT WHEN VALIDATED Mailing Address: ANTONIO DELIGIO P.O. BOX 267896 FT LAUDERDALE, FL 33326 POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS This tax is levied for the privilege of doing business within Brawand County and is non - regulatory in nature. You must meet all County and/or Municipality planning and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. Receipt #04A -10- 00010999 Paid 07/29/2011 27.00 2011 - 2012 STATE CW KERMA AGO OF 8178INN88 Amp raoresszotaL RECULATION CGC1569349 09/01 /i0 108061890 CERTIFIED COMMIE CONTRACToR CMCUA4 DAM= Z8 =MI= muter the proefirkeut of x+.689 as geMeatice Oreaa APS 31, 2013 1400901 03236 Alms r 2L1 93 CERTIFICATE OF LIABILITY INSURANCE PRODUCER Lubin Bergman Organization Inc 5 Revere Drive Suite 370 Northbrook, IL 60062 84'7- 763 -cz30 INSURED DATE(MMJDD/YYYY) 19/1•/9A11 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# Bari National Builders Inc Tony Deligio 824 N. Lake St Mundelein, IL 60060 INSURER A: M - pawley Tns C INSURER B: 'Pha Hari -FOrd INSURER C: INSURER D: INSURER E: 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. LLIR SR TYPE OF INSURANCE POLICY NUMBER ��yy DATE(MMIDD/WYYE p DATIE(MMIDD LMT x Y GENERAL LIABILrrY COMMERCIAL GENERAL LIABU.RY MGL0157549 01/04/11 01/4/12 EACH OCCURRENCE $ 1,00n,000 $ 50,000 $ 5,000 PREMISEfEa occ to CLAIMS MADE ® OCCUR MED EXP (Any one pavan) mirpl evsi Unds. PEHSONALSAOVINJURY $ 1, 000,000 o*+ rgrn1Tnri Col lapin GENERAL AGGREGATE $ 1 000,000 GEM. AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $2,000,000 POLICY II JECT I x l LOC A AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS MGL0157549 01/04/11 01/04/12 COMBINED SINGLE UMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODU.YIUURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABUJTY ANYAUTO AUTO ONLY -EA ACCIDENT $ ■ OTHER THAN EAACC $ AUTO ONLY: AGO $ A EXCESS 1 UMBRELLA LIABILITY UGL0157549 01/04/11 01/04/12 EACH OCCURRENCE $ 9 , 000 , 000 - $ 2 , 000 , 000 $ ri OCCUR CLAIMS MADE AGGREGATE DEDUCTIBLE RETEINMON $10 nnn $ y $ x WORKERS AND EMPLOYERS' ANY PROPREETOR,PARINERIEXECUTIVE OFFICERANENBER tym,dsdoy Ifya descdbeunder SPECIAL COMPENSATION ' LIABILITY Y1 HIGWC8974502 01/04/11 01/04/12 I W c STATU I (ER EL EACH ACCIDENT $ 1,000,000 $ 1 n n 0 0 0 0 EXCLUDED? Y E.L. DISEASE- EA EMPLOYEE in NH) PROVISIONS below EL DISEASE - POLICY LIMIT , , $ 1 n n n 000 B OTHER BUILDERS RISK HIGBR5899402 12/9/10 12/9/11 , $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS Village of Miami Shores is added as additional insured. 30 Days notice of cancellation given, additional insured is attached. bGn nr,v" ... . w....r..l Village of Miami Shores 10050 Northeast 2nd Avenue Miami Shores, FL 33138 -2382 .......... --- ..._.. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEPORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR To NAIL DAYS WRITTEN Norm . , . TE HOLDER RANED TO THE LEFT, BUT FAO.tRE TO DD SO SHALL BMPOSE NO OSUGA ,f, OR LIABILITY OF ANY !r UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.. AUTHORIZED REP = r,Y. z • • `) li dfkl ACORD2S(2009/01) The ACORD name and logo are registered marks of ACORD PROalCER CERTIFICATE OF UA =.ubin Soprgaaan OrganiwatJon Sao 5 Revere Drive Suite 370 Northbrook, IL 60062 Bari National Builders 'no Tony Deligio 924 N. Lake St Mundelein, IL 60060 COVERAGES THE POLICIES OR INSURANCE LISTED 5ELOW ANY RECIUMBAENT. TERM OR CONDITION FCL5�AX AGGREGATE INSURANCE V welt man ENe LTA Ire On INM WW1* AEN RAL LLABUY PR COAL GENERAL UABLTTY ■■ CLAIMEmADE oocuR Y PI . os3 On Tiada $r.,.ia r east AGGREGATE LINT APPLIES PER • mum' ■ . !7 LOC A{ROMOSILE EJABILIW �ILITY INSURANCE � r - "�"m "'"' 0 1� �i MN Ts OR BELOW. MIS CERTIFICATE IS ISSUED AS A GAITER OF RIIF ONLY AND COMPIM G NO REBAMM UPON %IDE a HOLLIER. THIS CERTIFICATE DOES NOT AMIGO, EXTEND _ LTER THE COVERAGE AFFORDED SY THE POLICIES INSURERS AFFORDING COVERAGE NAM lam" 144. parr ?r Co LN8URER Eft in. st. *PIrd BUI R m mwma DI INSURER E: HAVE EN MUSD TO THE INSURED NAM ASOVG MN THE POLICY PERIOD maDATED, NOTINWHGTANO OF ANY BE CONTRACT ON OTHER cocu tENT wet RESPECT TO WHIOIt CE,RTIFIGATE MAY RE ISSUED ING OR BY THE POLICIES DESCRIBED HERE N Ig SUBJECT TO ALL THE TERM, EXCLUSIONS AND CONDITIONS OF SUCH HAVE BEEN REDucED BY PAib CLAM. PCLIOY NUMBER L0157549 MCL0157549 magtVgrOMMIr 01/04/11 01/04/11 01/4/12 01/04/12 !AOf O IG _Ilia mumps) it 50, 000. mmmoomummmim $ 5, nrl0 TONAL &ADVNAM S GENERAL AGGREGATE B WWI .1190 PROOUOTS.CONROPAGQ s ,.n00.000 COMBINED MEOW Leer s 1,000,000 BODILYDULIRY (Pk Posen) (Pm ° I Y S ro 1MAGs B GARAGE IJAEEJTY ARTAUI= AUTO ONLY -EA ACCIDENT $ AUIbON1.Yt EA ACC $ A OMEmmmmuAUAIRum o00LRt D MANS MADE DEDUCIBLE R*TEXTION s ins nnp wCRNENS ccAVINSAT10N AND EMPLOYERS'Lwiuty wAr raAaRiToMPNOf III la 1DIN RB asolboundor PROVISioNs eairw OTHER BUILDERS RISE YEN 11 UGL0157549 01/04/11 01/04/12 EACH OCCURREvCE AGO AGGREGATE S $ x:,000,000. • ,400, 011(1. s $ 0 HIGWC8974502 01/04/11 01/04/12 EIGBR5899402 12/9/10 12/9/11 ...Orepecnt aF OPERATIONS I LOCATIONS /WEITr=/EXCLUSIONS ADDED BY E]DORSeMENT! BPEaAL PROVISIONS IirsTl"T"e I. 1° ELEAOODCro8Nr _ 1,0n0 000 ELaT .EA5MPt VEE S 1 . Mtn nnn 4.LiEADE- Po.rT Laur i 1 - 4Q000 _ $1,000,000 Village of Miami Shores is added as additional insured. 30 Days notice of cancellation given, additional insured is attached. CERTIFICATE HOLDER village of Miami Shores 10050 Northeast 2nd Avenue Miami. Shores, FL 33138 -2382 ACORDZS 0 +) 111 d ELLAT WO= AKf OF TIM ABOVII Mond= .a ram BE CMS MEM nS IJD9R*ION DAN DOW No mom ERIKA m l OMOAVOR TO Rai Dan WBATOI AovimmIT1 won no gam OR &M/ELO T Or Nif woo on fewe% fro nom oft 7B BgIBEA ENl 707E LB%T. BUT rALMII 7o DO SO Enna AUTHORIZED RE 'r� =, -t: 4 _i A `d The ACORD neme end logo are registered merles of ACORD ram . 0EEL S89 008 L c< 8EZL- 16E-VE6 311 EMIRS IUV9 L6 ZL 51-ZI -1102 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 20 930).ERCED AUG 0 5 ZO1U BY:....� Permit No. ROO �" Master Permit No. Permit Type: BUILDING OWNER: Name (Fee Simple Titleholder): Ml1r yy .- D. +1u n+-pr Phone #:q ` g - 8 2-8 Address: 1 G 45 N. e cis - Sq" City: MIAMI Sf 1G rES state: 'FL. zip: 3313&,. Tenant/Lessee Name: r••41 A Phone #: Email: JOB ADDRESS: 1245 N• C • 9s62-5-1-- • City: Miami Shores County: Folio/Parcel #: i I -3205 - OZI -0010 Miami Dade Zip: 3 513 8 Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: P1 n : r-}- • ASSOC 1 Ca ► h Phone #: 51-"5 (Q 3 Address: ;33) is - C: • A2. n—g- Si- • City: -F1-. Lau d e rda I e State: FL. S 1-1-' Lac K zip:333 08 Qualifier Name: C.© Q State Certification or Registration #: C. Ell. oka0015 Certificate of Competency #: N ) Pr Contact Phone#:g54,'Li) 12 -t01 1 Email Address: DESIGNER: Architect/Engineer: St-1r DES I &j 0\I b owner Phone #: Phone #: 14mv Value of Work for this Permit: $3:0.421-eer Square/Linear Footage of Work: Type of Work: DAddress Description of Work: etec- -ria) l ,v) '\,lAlteration ❑New ❑Repair/Replace ❑Demolition COLOR THROUGH ROOF TILE IS REQUIRED acknowledged by: ********* * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ** Fees*** * * * * * * * * * * * * * * * * ** * * * * * * * ** *^** Submittal Fee $ Permit Fee $ CJ 0 92— CCF $ Scanning Fee $ Radon Fee $ Notary $ Double Fee $ Structural Review $ Training/Education Fee $ a4 * * * * * * ** CO /CC $ DBPR $ Bond $ Technology Fee $ 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 Owner or Agent The foregoing instrument was acknowledged before me this day of who is personb11v known to me or who has produced Contactor y r _ The forego g instrument was acknowledged before me this 3 20 (0 by • E iK fl y , day of (f C 20 /U , by fee 79"/ a yJ y who is pers ly known to me or who has produced Pe- As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: Sign: 0‘/: t071. Print: My Commission xpires: MY COMMISSION # DD854159 EXPIRES: January 25, 2013 y Fl. Notary Distant Assam Co. NOTARY PUBLIC: Sign: Print: My Commission Expires: �y ^ ""S 9IP Wye PoPuolf 7 a-03 ti5f4gli z Nv'SSa/100 * a � aO.4 °810? 1Zlsn6ny:S311IdX3 R \ t a 4****************** ****** a Yit*9taaaaaYairaYstsYde** QraYx tkaYaYaYj&, k*** Jr4¢ 9t4rx **aYdrdctYtYa4drsYa4aYaYakaYaa4r*s4icaYakatr4sksY9c**mmgi =glim vskaa9saYQf,�.� .. . APPROVED BY ( /f'/ 0 Plans Examiner Zoning Structural Review Clerk (Revised 13ii (#? teaise 4 i /2009XRevised 3/15/09Xrev6/4/10) NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST i1JPECTlON PERMIT NO. RC- -10 - 149 TAX FOUO NO.11- 3205-027 -0070 STATE OF FLORIDA: COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to gain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement 111111111111111111111111111111111111111111111 C F14 201080546135 OR Bk 27355 F's 42431 Up RECORDED 08; 12/2010 13:17:05 HARVEY RUV'INr CLERK OF COURT MIAMI -DADE COUNTYr FLORIDA LAST PAGE 1. Legal description of property and street /address: BAY LURE PB 44-63 LOT 6 LESS WLY25FT BLK 1 &W25FT OF LOT 7 LOT SIZE 75.000 X 151 OR 18792-1099 09 1999 1 COC 21751 -3431 09 2003 4 1245NE93rdST 2. Description of improvement INTERIOR RENOVATION 3. Owner(s) name and address: MARK D HUNTER 1245 NE 93 ST MIAMI SHORES FL 33138- Interest in property: Name and address of fee simple titleholder: 4. Contractor's name and address: Antonio Deligio BNB, INC President PO Box 267896 Ft Lauderdale, FL 33326 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 provided by Section 713.13(1)(a)7., Florida Statutes, Name and address: 8. In addition to hknseif, Owners designates the foliowi in Section 713.13(1)(b), Florida Statutes. Name and address: or • er documents may be son(s) to receive a copy of the Lienor's Notice as 9. Expiration date of this Notice - Commencement (the expiration date is 1 year from the date of recording un d -` t date is specified nature a of Owner Print Owner's NameMESEEBEERREEM Sworn to and subscribed before me this Notary Public, Print Notary's Name Fred Roy My commission expires: 123.01 -52 MOE 4 W02 S harI LY1 rtav- 5 day of AUG , 20 IQ. 41: • Nn LVHQ 1 - ACORQ. CERTIFICATE OF LIABILITY ttVSURANCE 1 07/23/2010 PRODUCER THIS CERTIFICATE 18 ISSUED AS A MATTER OF INFORMATION ONLY AND Gulf stream Insurance Agency, Inc. HOLDER. THIS CERTIFICATE TIR� NOT AMENR . G OR 5833 Janson Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Hoilywoo8 FL 33021- INSURERS AFFORDING COVERAGE . INSURED INAA: United Specialty Ins. Co. Plan Art Associates Inc and Six' lircbitectural mama P -A- MUM O• 3331 N.E. 32nd St. INSURER 0: 1rt Lauderdale FL 33308- INSURER E: COVERAGES THE POUCIES 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. AGOREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. - L78R TYPEOFRTSUAANCE POLICVNUMBER DATEINODDNY) DATE(YWDWYYZ_ UMEB -GENERAL LIABILITY / / / 1 EACH RENCE $ 1,000,000 X Comm �RCut. GENERAL WSW( FIRE DAMAGE (Any $ 100,000 CLAI00 DE X occuR 04 0090424 04/24/2010 044!24/2011 MEDEWNA�YWt6Po+onn1 S 5,000 P6ASONALSaDVIN.wRY $ 1,000,000 / / / / DENERALAGGREGATEe $ 2, 000, 000 GENtAG0REDATEUMITAPPUESP8t PRODUCTS- t PALO $ 2,000,000 X POLICY ■ .ECT ■ WO / / / _/ AUTOMOBILE MEOW / 1 1 / CONDINEDSINEAEU ' _ ANY AUTO (EA ) ' S ALL OWNEDAUmS / ! / / BODILY INJURY _ S�ULEDAU QS ( mew) 5 _ HIRED ASJ 0$ / / / 1 SaILVINJURY _ NON- OWNEOAUros Teracddwa) s ! / / / PROPERTY DAMAGE (Per ) $ GARAGELUIBWYY AUTO ONLY - EAAOOIDENT 5 _ R ANY AUTO / / / / OTHER THAN EA ACC $ AUTO ONLY: AGp $ EXCESS marry / / ' / / EACH OCCURRENCE $ • OCOUR NI CLAIMS MADE AGGREGATE S 0 RDEDUCrtBLE / / / / S RETENT�V S $ R ' 0NAND / / / / (T'" [AI L iv ELEACHACCIDeNT $ / / / / EL DISEASE- EA EMPLOYEE S EL. DISEASE- POLICY LOST 3 oTHet 1 ! / 1 DES0RIPR0N0POi A1I0NSSLOCAT10NS NQUCLEDUCLU$I0NSADDE08Y PROVISIONS Fas(#95A- 566 -3286 CERTIFICATE HOLDER 1 ACOF 1Y I L$DDtI 0NA1.lM$URED: INSURER T.ETTEIU CANCELLATION Miami Shore Village Building Department 10050 NE 2id Ave Miami Shores, FI. 33313 SHOULD ANY OF THE ABOVE 009001500 POLICIES 00 CANCELLED BEFORE THE EXPIRATION DATE THIEF. VIE UISIMTR INSURER WILL anuunvDR TO MAa. 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE MOLDER NA000 TO THE LEFT, BUT FAILURE TO DD SO SHALL I NO OBLIDATION OR MEOW OP ANT 11TND UPON THE ui9U000.ITS AMTS OR REP • ■ -., • Al1YEs. AllUIOR® 1 : LASER FbRI* no. - MOW RD CORPORATION 198E Page 1 of : COVERAGES THE POUCIES 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. AGOREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. - L78R TYPEOFRTSUAANCE POLICVNUMBER DATEINODDNY) DATE(YWDWYYZ_ UMEB -GENERAL LIABILITY / / / 1 EACH RENCE $ 1,000,000 X Comm �RCut. GENERAL WSW( FIRE DAMAGE (Any $ 100,000 CLAI00 DE X occuR 04 0090424 04/24/2010 044!24/2011 MEDEWNA�YWt6Po+onn1 S 5,000 P6ASONALSaDVIN.wRY $ 1,000,000 / / / / DENERALAGGREGATEe $ 2, 000, 000 GENtAG0REDATEUMITAPPUESP8t PRODUCTS- t PALO $ 2,000,000 X POLICY ■ .ECT ■ WO / / / _/ AUTOMOBILE MEOW / 1 1 / CONDINEDSINEAEU ' _ ANY AUTO (EA ) ' S ALL OWNEDAUmS / ! / / BODILY INJURY _ S�ULEDAU QS ( mew) 5 _ HIRED ASJ 0$ / / / 1 SaILVINJURY _ NON- OWNEOAUros Teracddwa) s ! / / / PROPERTY DAMAGE (Per ) $ GARAGELUIBWYY AUTO ONLY - EAAOOIDENT 5 _ R ANY AUTO / / / / OTHER THAN EA ACC $ AUTO ONLY: AGp $ EXCESS marry / / ' / / EACH OCCURRENCE $ • OCOUR NI CLAIMS MADE AGGREGATE S 0 RDEDUCrtBLE / / / / S RETENT�V S $ R ' 0NAND / / / / (T'" [AI L iv ELEACHACCIDeNT $ / / / / EL DISEASE- EA EMPLOYEE S EL. DISEASE- POLICY LOST 3 oTHet 1 ! / 1 DES0RIPR0N0POi A1I0NSSLOCAT10NS NQUCLEDUCLU$I0NSADDE08Y PROVISIONS Fas(#95A- 566 -3286 CERTIFICATE HOLDER 1 ACOF 1Y I L$DDtI 0NA1.lM$URED: INSURER T.ETTEIU CANCELLATION Miami Shore Village Building Department 10050 NE 2id Ave Miami Shores, FI. 33313 SHOULD ANY OF THE ABOVE 009001500 POLICIES 00 CANCELLED BEFORE THE EXPIRATION DATE THIEF. VIE UISIMTR INSURER WILL anuunvDR TO MAa. 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE MOLDER NA000 TO THE LEFT, BUT FAILURE TO DD SO SHALL I NO OBLIDATION OR MEOW OP ANT 11TND UPON THE ui9U000.ITS AMTS OR REP • ■ -., • Al1YEs. AllUIOR® 1 : LASER FbRI* no. - MOW RD CORPORATION 198E Page 1 of : CERTIFICATE HOLDER 1 ACOF 1Y I L$DDtI 0NA1.lM$URED: INSURER T.ETTEIU CANCELLATION Miami Shore Village Building Department 10050 NE 2id Ave Miami Shores, FI. 33313 SHOULD ANY OF THE ABOVE 009001500 POLICIES 00 CANCELLED BEFORE THE EXPIRATION DATE THIEF. VIE UISIMTR INSURER WILL anuunvDR TO MAa. 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE MOLDER NA000 TO THE LEFT, BUT FAILURE TO DD SO SHALL I NO OBLIDATION OR MEOW OP ANT 11TND UPON THE ui9U000.ITS AMTS OR REP • ■ -., • Al1YEs. AllUIOR® 1 : LASER FbRI* no. - MOW RD CORPORATION 198E Page 1 of : Simon Architectural Group are'itNiuse • enginccrsng • am'argchon alanagenen To whom it may concern, AUG 1 3 2010 3331 N.E. 32nd Street Ft. Lauderdale Florida 33308 P:954.566.7298 F:9543663286 This letter is to inform you of the scope of work at location 1245 N.W. 93`C Street Miami Shores. The work being preformed is demo and removal of 2 interior non bearing walls located in the kitchen area. All cabinets are to be removed and replaced with new cabinets. No drywall on the exterior walls is to be removed. No moving of plumbing just reinstalling of existing plumbing and new appliances. The work to be performed is sanding, patching, priming, painting, and installing new hard wood floors and framing and building of new partition wall for kitchen breakfast nook. Framing and building of new non bearing interior wall for new office. We understand that we must obtain inspection of framing and electric inspection prior to drywall installation.