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RC-11-1196Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 161605 Permit Number: RC -7 -11 -1196 Scheduled Inspection Date: January 18, 2012 Inspector: Bruhn, Norman Owner: Job Address: 180 NW 103 Street Miami Shores, FL 33150- Project: <NONE> Contractor: CH GLOBAL CONSTRUCTION LLC Permit Type: Residential Construction Inspection Type: Final Work Classification: Kitchen Cabinets Phone Number (305)825 -7080 Parcel Number 1131010230020 Phone: (305)824 -8719 Building Department Comments KITCHEN REMODEL Passed /1 A <ft,) Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments January 17, 2012 For Inspections please call: (305)762 -4949 Page 5 of 49 iliatA0, 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 Tvtwae: BUILDIN ROOFING OWNER: Name (Fee Simple Titleholder): ;,4J 64 Prefer 74 L 4e. Phone #: 3V :L; 7080 Address: 64CCV eoo2p %eil )62 01 £a k (?. Permit NOfcIH19I P Master Permit No. City: Gro &.; 14 &.5 State: FZ. Zip: 33b1 L Tenant/Lessee Name: Phone #: Email: J v;teora z bey /.6e4,fti gyre-/- JOB ADDRESS: / Ye) N&/ Ji,Y City: Miami Shores Folio/Parcel #: 1/ " 3 I / - ;1 ®0e2-'0 Is the Building Historically Designated: Yes County: Miami Dade Zip: 33 /hf D NO ' Flood Zone: CONTRACTOR: Company Name: e/4 4 /6" 6a % lte,7 /4,Y2 /� #'� °i, Phone #: 60s 8z - 87 19 Address: /5474c, /t% teal -27 m ^ 4: C r - _) 31 City: //s G'� e e5 State: Fi Zip: c Iii/' Qualifier Name: l - ern 6 r Lh lie Phone #: 744 " 6-4/ - 415 7 State Certification or Registration #: d e'd C 15 I 1 lo5 q Certificate of Competency #: Contact Phone #: Email Address: DESIGNER: Architect/Engineer: e)6(ei9 r— J . 0 n f..Cz IE Phone #: 60.1 -" 33 - �'oJ Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑Addition CIAlteration UNew / ❑Repair/Replace Description of Work: 144.,„ ❑Demolition * *** ** *** ********** ****************x *** Fees * * * ** ** *******+xx *******•x*********+x*****x *** Submittal Fee $ Permit Fee $ (90) 56o CCF $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ CO /CC $ Bond $ TOTAL FEE NOW DUE $ n • e? • 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 p is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for th first i sec • which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection t be approved and a reinspection 'll be charged. Sig The fo day of Owner or Agent going instrument was acknowledged before me this(' Signature Contractor The foregoing instrument was acknowledged before me this 5 th , 20 , by ,9i/i Z. (/%Z tclaf 2- day of Ton E , 20 j 1 , by it ofis Qr e--.4144t who has produced who is personall known tom or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: -I— %1Leit-), 4 M My Commission Expires: APPROVED BY 4910 P% Notary Public State of Florida r e Clara Martinez 9 My Commission D0784587 oP0oa` Expires 05/01 /2012 '" (4X41 Plans Examiner NOTARY PUBLIC: Sign: Gitra Print: . L.1e4riei Go p My Commission Expires: LOPEZ -DIAZ NOTARY PUBLIC STATE OF FLORIDA Comm# EE090662 grapireser42415 Zoning Structural Review Clerk (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO.K €' 7 "// - /f7f' TAX FOUO NO. I if 3/0,— t9 Z3 - ©DEO STATE OF FLORIDA: COUNTY OF MIAMI -DADE: STATE THE UNDERSIGNED hereby gives notice that improvements will be made to certaiinHE property, and in accordance with Chapter 713, Florida Statutes, the following inform is provided in this Notice of Commencement. 1111111111111111111111111111111111111111111 11 CFN 2011R0508042 OR Bk 27775 Ps 2284; (1130 RECORDED 08/01/2011 12 :37 :47 HARVEY RLIVIN, CLERK OF COURT MIAMI- CDACDE COUNTY? FLORIDA LAST PAGE FLORIDA, COUNTY OF DADE CERTIFY that Mkt copy of the In on _ doyd AD20 %� Seat At RK, of and county Courts WITNE HA By • 1. Legal description of property and street/address: S r b-% t_ pit. ad t aaeo :•4W jo3 1241 s:`7-MEL-1' / HtAsp i . lOt'gpA. " 2. Description of improvement: X 'EP.rorrns.3 i wa iL i `irci-i %fit MA CsoE �+f� 3. Owner(s) name and address: f- /n,u/ 1P . 'e/1-4 c T 1.4„C.,-. Interest in property: Space above reserved for use of recording office Ly iime J.b 1.9 ,AA�u '&A'r'='o4 e 71ofy Name and address of fee simple titleholder. .S &' 4 e 4. Contractor's name, address and phone number cirk trif Q tSAt C.0 IVY ST a24J C.T ro 1 t s Lt.. 154 4-10 Atkf 4 c.3' , 11- / M (Anil F_Ai s F3 f.. 3301 is 5. Surety: (Payment bond required by owner frorp ntractor, if any) ft Name, address and phone lumber. NN Amount of bond $ 14/4 6. Lender's name and add i nat 7. Persons within the State of Florida g d ed by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes, / 1 Name, address and phone number. Jai ' "` 1,1a2,411...6), ,, 6.10o raw �,ra ; �t> &(3,),_., L44kEJ, Y--(. 330111 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Uenor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name, address and phone number ul4 9. Expiration date of this Notice of Commencement (the expiration date Is 1 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 IMPROVE, �.��� S TO • - • - • •ERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST IN -, - . = F YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR REC. ��'T%�" � YOUR NOTICE OF COMMENCEM �i- Sig = Pr Pri Title/ STATE COU • r,:or• -ne 1)F FLORIDA OF MIAMI -DADE s)' Authorize ZO irector/Partner /Manager Prepared By Print Name Title /Office The for- • oing inptrument was acknowledged before me this �� day of By £72 t-' /'' �- C/d/ 2- 4u ❑ Individually, or ❑ as for )l ersonally known, or ❑ produced the following type of identification: Signature of Notary Public: Print Name: (SEAL) VERIFICATION PURSUANT TO SECTION 92.525. FLORIDA STATUTES U• =nalties • perjury, I declare that I have read the foregoing and s stated in it are true, to the best of my knowledge and belief. s) of Owner(s) or Owner(s)'s Auth • zed Offi ' irector/Partner/Manager who signed above: By t Notary Public State of Florida ,, Clara Martinez My Commission 00784587 „00� Expires 05/01 /2012 MmM~o4oE COUNTY TAX COLLECTOR 140 W FLAGLER ST MIAMI, FL 33130 652086-1 BUSINESS NAME / LOCATION CH GLOBAL CONSTRUCTION LLC 15476 NW 77 CT� 330I6 MIAMI LAKES 2010 LOCAL BUSINESS TAX RECEIPT 2011 EXPIRES SEPT 30, 2011 MUST BE DISPLAYED ��''^^~`E~-B"S'w=Sw PURSUANT TmCOUNTY DE CHAPTER 8A - ART. 9 & 10 NcYTA kR(L--O���TPA� RENEWAL neCaprwu 679120-7 STATF# CGC1517852 287 U.S. POSTAGE PAID MIAMI, FL PERMIT NO. 231 OWNER Sec. CONSTRUCTION LLC �.Type =Business BUSINESS TAX RECEIPT. IT DOES NOT PERMIT THE HOLDER TO VIOLATE ANY ExISTiNG REGULATORY OR ZONINC LAWS OF THE COUNTY OR CITIES. NOR DOES IT EXEMPT THE HOLDER FROM ANY OTHER PERMIT OR LICENSE REQUIRED BY LAW. THIS IS NOT A CERTIFICATION OF i-HE HOLDER'S QUALIFICA- TIONS PAYMENT RECF.IVED MIAMIaDADE COUNTY TAX 07/08/2010 09010106001 000045.00 SEE OTHER SIDE BUILDING CONTRACTOR WORKER/S 1 DO NOT FORWARD CH GLOBAL CONSTRUCTION LLC MUMBERTO CHAVEZ MGRM 15476 NW 77 CT 287 MIAMI LAKES FL 33016 11111 `^w.\\^\\`°\ \\[ , �.\\ STATE OF FLORIDA AC# 14'-1:4-6319 DEPARTMENT OF ausrsEss AND PROFESSIONAL REGULATION CERTIFIED GENERAL CONTRACTOR ��' GLOBAL CONSTRUCTION LLC IS CERTIFIED under Expiration date.: �� — ---_ ~~~.~~`+ ‘~ t._'��,��~_��� �_� Policy Number. Date Entered: A R® CERTIFICATE - LIABILITY INSURANCE NCE D TE ) 5 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 INSURED, the poiicy(ies) must be endorsed. If SUBROGATION IS 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 cOONNT CT }ARIA J GRELA INFINITY INSURANCE GROUP, LLC 8181 NW 36 ST SUITE 1010 DORAL PL 33166 P(410. No. Padk (305) 597 -7787 Np); (305) 597 -6477 E-MAIL I7~TP'INITYGROUP @BELL80UTH.NET ADDRESS INSURERS) AFFORDING COVERAGE NAIC 0 APPALACHIAN UNDERWRITERS INC INSURER A : r UABIUTY INSURED CH GLOBAL CONTRUTION, LLC 15476 NW 77 CT SUITE 287 MIAMI LAKES, P'1, 33016 INSURER B: BASS GL- 873926 -01 INSURER C : 5/13/2012 INSURER D : $ 1,000,000 INSURER E: PREMISES tea oaxavence) INSURER F : CERTIFICATE NUMBER THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE INSR WVD POUCY NUMBER ( WD WYW) (taAjnnDIYYYY) OMITS A GENERAL LIABILPIY GENERAL CLAIMS-MADE UABIUTY GL- 873926 -01 5/13 /2011 5/13/2012 EACH OCCURRENCE $ 1,000,000 AIKY PREMISES tea oaxavence) $ 100,000 Fri OCCUR MW EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPUES PER: PRODUCTS - COMP/OP AGO $ 1,000,000 POLICY I I PECT I I LOC $ AUTOMOBILE _1 LIABILITY ANY AUTO AUTOOSNED HIRED AUTOS AUTOSULEO NON-OWNED OM accident) O SINGLE LIMIT (Ea $ — BODILY INJURY (Per person) $ _ _ BODILY INJURY (Peralxadenl) $ PROPERTY ecn() DAMAGE $ $ E UMBRELLALWB OCCUR EXCESS LIAB Fl CLAIMS•MADE X X X:L- 2117558 11/12/2010 - 11/12/2011 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 DED 1 RETENTION $ 3 A WORKERS COMPENSATION AND EMPLOYERS' LIABILRY ANYPROPREMBER/PARTNERtJ OFFICERib1EMaER EXCLUDED? (Mandatory In NH) rc yes, describe under DESCRIPTION OF OPERATIONS T N NIA X 30000241 —� 11 6/7/2011 5/7/2012 WC STATU- 1 EMI- TORY LIMITS t ER E.L. EACH ACCIDENT $ 500,000 XECUTIVE y E.L. DISEASE - EAEMPLOYEE $ 500,000 below E.L. DISEASE • POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, N more space Is requtred) CERTIFICATE HOLDER CANCELLATION Miami Shores Village Building Department 10050 NE 2nd Avenue Miami Shores, FL 33138 ACORD 25 (2010105) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POUCY PROVISIONS. AUTHORIZED REPRESENTATIVE r ®19884010 ACORD C RPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Produced using Forms Boss Pius software. ww .FormsBosa.cmm; Impressive PubNshkig 800.208.1977