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CC-12-771 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 175847 Permit Number: CC- 1 -12 -77 Scheduled Inspection Date: July 16, 2012 Inspector: Bruhn, Norman Owner: Job Address: 98 9.NE 2 Avenue Miami Shores, FL 33138- Project: <NONE> Contractor: BRIAR CONSTRUCTION Permit Type: Commercial Construction Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1132060132240 Phone: (754)376 -9631 Building Department Comments INTERIOR WALLS TO CREATE 2 OFFICE SPACE 4/09/2012 - must pick up permit and bring lic and ins. Inspector Comments Passed Aits Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. MIAMI SSORES VILLA t 10050 N• E. 2nd MENU July 16, ;20124' For Inspections please call: (305)762 -4949 Page 25 of 35 Miami -Dade County Building Department • e- Permitting Search: michde. -o http://egvsys.co.miami-dade.fl.us:1608/WWWSERV/ggvt/BNZAW922... MUNICIPAL INSPECTION REQUIREMENTS AND RE MUNICIPAL NO.2012- 026438 FOLIO: 1132060132 JOB SITE ADDRESS 9830 NE 2 AVE PROPOSED USE OFFICE - PROFESSIONAL BU LEGAL MIAMI SHORES SEC 1 AMD PB 10 -70 L APPLICATION TYPE ALTER INTERIOR 180 SQ OWNER NAME MIAMI SHORES CENTER LLC CONTRACTOR QUALIFIER PERMIT TYPE MUNICIPAL BLDG CATEGORIES 0001 MUNICIPAL GENERAL BUILDING 0 ORD 07/02/ 012 2 LDINGS /I �` EFL. PARTITION •T2 &E57FTOFLOTS3 &4& FT NITS 1 FLOORS DATE: 7/02/2012 PROCESS NUMBER: M2012003982 NEW *AMOUNT PAID 152.00 DERM 1 UP FRONT FEE- 80.00 DERM 1 MIN COMM REV( 90.00 FIRE 2000 ALTERATIONS & 104.00 FIRE 2000 FIRE UPFRT FE 32.00 FRWK 1 1ST FIRE MINO 70.00 UPMU 1 UPFRONT FEE F 25.00 3/ 9/2012 12:12 YDENIS 301203090044 CENTRAL 152.00 MUNICIPAL INSPECTION REQUIREMENTS AND RECORD 07/02/2012 MUNICIPAL NO.2012- 026438 PROCESS NO. M2012003982 FOLIO: 1132060132240 JOB SITE ADDRESS 9830 NE 2 AVE PROPOSED USE OFFICE - PROFESSIONAL BUILDINGS /INTER. PARTITION REQUIRED INSPECTIONS INIT DATE FIRE 0001 FIRE INSPECTIONS RECOMMENDED 200 FIRE HYDRANTS 208 FIRE TCO INSPECTION 211 PRELIMINARY 209 FIRE FINAL MUNICIPAL INSPECTION REQUIREMENTS AND RECORD 07/02/2012 MUNICIPAL NO.2012- 026438 PROCESS NO. M2012003982 FOLIO: 1132060132240 JOB SITE ADDRESS 9830 NE 2 AVE PROPOSED USE OFFICE - PROFESSIONAL BUILDINGS /INTER. PARTITION TO SCHEDULE A FIRE INSPECTION, PLEASE VISIT THE WEB AT VWVW.MIAMIDADE.GOV /BUILDING OR WVWV.MIAMIDADE.GOV /FIRE. YOU WILL NEED TO PROVIDE YOUR TEN DIGIT MUNICIPAL INSPECTION NUMBER AND INSPECTION TYPE. THE INSPECTION TYPE CAN BE FOUND ON YOUR INSPECTION REQUIREMENTS AND RECORDS CARD. IF YOU HAVE ANY QUESTIONS OR CONCERNS REGARDING AN INSPECTION, 1 of 2 4 `' 9/(2/(2 7/3/2012 4 :11 PM 4 Ctij — f?!a¢szse./ lq BUILDING PE ATION Master Permit No. FBC 2 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 RECEJ D JAN 1 # 012 BY° Permit No. Cat 2 Permit Type: BUILDING OWNER: Name (Fee Simple Titleholder): 't► Address: ak \® -; A S't' 'a b City: . �� State: Tenant/Lessee Name: \3' \ <— ,�� ®� �.�,.�,,, Phone #� � 00 qa4p Zip: b-b UA Phone #: Email: JOB ADDRESS: C1P ��A City: Miami Shores County: Miami Dade Zip: 3 6 13 Folio/Parcel #: Is the Building Historically Designated: Yes NO � Flood Zone: CONTRACTOR: Company Name: 8g /cox Ct IJ T ) C7✓ /ii a/ /'' Phone #: Address: J `�° �:1 \� , , City: �'= \ems State: Zip: `) �J Qualifier Name: -1i/g0 l L &O s 5./'e' Phone #: j �� 3 b -?b 3/ State Certification or Registration #: C &C 5 3 6D Certificate of Competency #: Contact Phone #: \ 4 �) �' �• � 6 \ Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: UAddition ❑Alteration Description of Work: \'.; A ,� New ORepair/Replace eras ❑Demolition ************************************200**Feesz*s**************************************** Submittal Fee $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Structural Review $ Permit Fee $ CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ 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. r' "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 6v( The foregoing instrument was acknowledged before me this 2 4 day of M ,20 ,by POI e t who is personally known to me or who has produced As identification and who did take an oath. NOTARY P IC: Sign: Print: Signature Contractor The foregoing instrument was acknowledged before me this day of , b ,20_,by ' �� v� c, - whho is personally known to me or who hi ,PS 4 c ST FWRmh, as identification and " , �� Albin o �+ ken WDD843967 Expire* JAN. 03, 2013 ' NDEn TIIRG ATLANTIC BONDING CO., INC, NOTARY PUBLIC: NOTARYPITRrdC -STAIR OFFLORID4_ P1 7O ' My Commission Expires: :•• Stacy Oskolski Commission #DD856643 4.,.0 1 Expires: APR. 08, 2013 BONGED TEC O ATLANTIC BONDING CO., INC. MasoexLarr E Pn&3 to o ti,'.• . b _ 1843967 ssion Ex „.° - 3, 2013 sD TURD A1 LAN 'llc AIOAD NGCO,]10, lededrok9: 9c*** Y: Y** tYkakde. BeYoYoYoYoY9e** *k4: oYoY9eoY***kks4ek:B9e***k **Y 9e*9e9F**** 3r4: 9ioF*4e***** *. Y******* 4:*** *3e4e9 :3::F:* **Y4e*a.9e9e:Y3r4e**** APPROVED BY (Revised 07 /10 /07XRevised 06 /10/2009XRevised 3/15/09) Plans Examiner Structural Review Zoning Clerk RECEIPT PERMIT #: 2--77 1, ❑ Contractor Owner ❑ Architect Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 DATE: 6' 'ea/7Z / Picked up 2 sets of plans and (other) Address: 78' r E 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 permitting process. Acknowledged by: PERMIT CLERK INITIAL: RESUBMITTED DATE: PERMIT CLERK INITIAL: Permit No: 12 -77 Job Name: March 12, 2012 Miami Shores Viiiage 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 2nd 1) Provide all permit applications prior to any further review. 2) Identify the fire rated demising walls tested assembly shown as 2hr rated on plans. 3) Provide supporting members for the top of wall. Plan review is not complete, when all items above are correded, we will do a 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 - 762 -4859 eAcy ot_ - V's*- 3 359_ c &9 03/15/2012 12:06 FAX 1 800 685 7530 DATA SCAN FIELD SERVICES lj 0 01 * ** * * * * * * * * * * **** * * ** * ** TX REPORT * ** * * * * * * * * * * * * * * * * * * * ** TRANSMISSION OK TX /RX NO 2339 RECIPIENT ADDRESS 913053593389 DESTINATION ID ST. TIME 03/15 12:05 TIME USE 00'25 PAGES SENT 1 RESULT OK Permit No: 12 -77 Job Name: March 12, 2012 Miami Shores Viiiage 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 2nd 1) Provide all permit applications prior to any further review. 2) Identify the fire rated demising walls tested assembly shown as 2hr rated on plans. 3) Provide supporting members for the top of wall. Plan review is not complete, when all items above are correded, we will do a 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 - 762 -4859 � X e 1 1 9 1 `1 . � 3 C1---- &-9 03/14/2012 16:33 FAX 1 800 685 7530 DATA SCAN FIELD SERVICES R001 * * * * * * * * * * * * * * * * * * * * * * * * * ** * ** ERROR TX REPORT * ** * * * * * * * * * * * * * * * * * * * * * * * * * ** TX FUNCTION WAS NOT COMPLETED TX /R% NO 2334 RECIPIENT ADDRESS 919545331147 DESTINATION ID ST. TIME 03/14 16:33 TIME USE 00'36 PAGES SENT 0 RESULT NG #0018 BUSY /NO SIGNAL Permit No: 12 -77 Job Name: March 12, 2012 Miami Shores Viiiage 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 2nd 1) Provide all permit applications prior to any further review. 2) Identify the fire rated demising walls tested assembly shown as 2hr rated on plans. 3) Provide supporting members for the top of wall. Plan review is not complete, when all items above are correded, we will do a 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 - 762 -4859 ci-- HL-1/1 Jan 18 12 09:28a Briar Construction Corp 954-452-1927 p.1 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION • CONSTRUCTION INDUSTRY LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 GOSH/NE, TYRONE ROY BRIAR CONSTRUCTION CORP 8991 SW 6Th COURT PLANTATION FL 33324-3730 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.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Departments 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 licenset (850) 487-1395 DETACH HERE BATCH NUMBER Permit No: 12 -77 Job Name: February 2, 2012 Miami Shores Viiiage 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 /A site visit identified that the work is completed and the work is p not completely shown on /plans. 15 t. 2) Pr vide letter of acknowledgement from the building owner. —"3 ti' o vide approval from Miami Dade Fire. . Provide approval from Miami Dade County DERM. Provide approval from Miami Dade County Health Dept. (DOH /HRS) 0.„,..-6) Provide all permit applications prior to any further review. ,...7) Identify the fire rated demising walls tested assemblyshown as 2hr rated on plans. 8) Provide supporting members for the top of wall. or The path of egress cannot be blocked by open doors. Doors opening to the path of egress must open 180 degreees and not impede the egress by more than 7. Plan review is not complete, when all items above are corrected, we will do a 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 - 762 -4859 PERMIT #: 12 —1 - I, Miami Shores Vitvage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 RECEIPT DATE: -GR C ❑" Contractor Owner L Architect Picked up 2 sets of plans and (other) COSa-6--12-"T Address: 1 9 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 permitting process. Acknowledged by: PERMIT CLERK INITIAL: RESUBMITTED DATE: _ 2_012,-- PERMIT CLERK INITIAL: Date: 4/12/2012 Time: 8:57 AM To: 3057568972 Brown & Brown Homest Page: 2 A ° CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 4/12/2012 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 pollcy(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 Brown & Brown Of Florida, Inc. dba T.R. Jones & Co. 1780 N Krome Ave Homestead FL 33030 CONTACT Ashley Stefanell PHONE* ExO; (305) 247 -5121 1 (A1C,No): (305) 248 -8543 ADDRESS. astefanell @bbhomestead.cosi INSURER(S)AFFORDING COVERAGE NAIL # IrsuRERAMid- Continent Casualty Ins Co GENERAL X INSURED Briar Construction, Corp. 8991 SW 6 Court Plantation FL 33324 rI1VPI:? Art WC INSURER B : INSURERC: 12/22/2011 INSURER D: EACH OCCURRENCE INSURER E : PREMISES (Ea REM INSURERF: 1V THIS INDICATED. CERTIFICATE EXCLUSIONS RCtlIJIVIN NVIYICCK: 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 TYPE OF INSURANCE ADDL JMSR SUBR wvn POLICY NUMBER (MM /DDIYYYYY) (MMIDD/YYYYI LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY 04 -GL- 000837867 12/22/2011 12/22/2012 EACH OCCURRENCE $ 1,000,000 PREMISES (Ea REM $ 100, 000 I CLAIMS -MADE X OCCUR MED EXP (Any one person) $ Excluded PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENII. AGGREGATE LIMIT APPLIES PER: POLICY n n LOC PRODUCTS - COMP /OP AGG $ 2,000,000 $ AUTOMOBILE — LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO ALL HIRED AUTOS AUTOS NON -OWNED AUTOS BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ WORKERS UMBRELLA LIAB EXCESS LIAB 1 I Ij, -°jl I I OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENT ON $ $ COMPENSATION AND AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/ N OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yyees describe under DESCRIPTION OF OPERATIONS below N/A 1 TORY LIIMITS I 10TH- E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS/VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more apace la required) CERTIFICATE HOLDER CANCELLATION (305)756 -8972 Village of Miami Shores Building Department 10050 NE 2nd Ave. Miami Shores, FL 33138 ACORD 25 (2010/05) INS025 (201005).01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE T Jones Jr. /ASHLST O 1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 07 -27 -2011 JEFF ATWATER 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 PERSON: FEIN: 09/22/2011 EXPIRATION DATE: 09/21/2013 GOSHINE TYRONE 650634916 BUSINESS NAME AND ADDRESS: BRIAR CONSTRUCTION CORP 8991 SW 8TH CT PLANTATION FL 33324 SCOPES OF BUSINESS OR TRADE 1- NEW CONSTRUCTION 3- CERTIFIED GENERAL CONTRACTOR 2- RENOVATIONS /RESTORATION IMPORTANT: Pursuant to Chapter 440 . 05(14 F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election tinder this section may not recover benefits or compensation tinder this chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on the notice of election to be exempt Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at eay time after the filing of the notice at the issuance of the certificate, the person named on the notice or certificate no longer meats the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for tellers of the person named on the certificate to meet the requirements of this section. QUESTIONS? (850) 413 -1609 OWC-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 DIVISION OF WORKERS COMPENSATION CONSTRUCTION INDUSTRY CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW EFFECTIVE 09/22/2011 EXPIRATION DATE: 09/21/2013 PERSON TYRONE GOSHINE FEIN 850834916 BUSINESS NAME AND ADDRESS: BRIAR CONSTRUCTION CORP 8991 SW 6TH CT PLANTATION, FL 33324 SCOPE OF BUSINESS OR TRADE 1- NEW CONSTRUCTION 3- CERTIFIED GENERAL CONTRACTOR 2- RENOVATIONS/RESTORATION IMPORTANT F Pursuant to Chapter 440.05114), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election 1- under this section may not recover benefits or compensation under this D chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt.. apply only within the scope of the business or trade listed an E the notice of election to be exempt E Pursuant to Chapter 440.05113), F.S., Notices of election 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 or the issuance of 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 on the certificate to meet the requirements of this section. QUESTIONS? (850) 413 -1609 CUT HERE * Carry bottom portion on the job, keep upper portion for your records. OWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01 -11 STATE OF FLORIDA DEPARTJNT OF BUSINESS AND PROFESSIONAL REGULATION : CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET __- TALLAHASSEE FL 32399-0783 GOSH/NE ,:_TYRONE ROY BRIAR CONSTRUCTION CORP 8991 SW 6TH COURT PLANTATION FL 33324-3730 Congratulations! With thls license you become one of the nearly one million Ficsidians licensed by the Department of Business and Professional Regulation. Our prate:riddle's and businesses range from architeds to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we wait to Improve the way we do business in coder to serve you better.: For Information about our services, please log onto www.myftoridalicense.com. There you can find more information about our divisions and the regulations that impart you, subscribe to department newsletters and learn more about the Department's Initiatives. Our -mission at the Department Is: !Jame 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 congrakdatorts on your nem license! BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A -100, Ft. Lauderdale, FL 33301 -1895 — 954 - 831 -4000 VAUD OCTOBER 1, 2011 THROUGH SEPTEMBER 30, 2012 DBA: Receipt #:x-80 8786 Business Name: BRIAR CONSTRUCTION CORP Business T Yp - e :GENERAL CONTRACTOR (GENE CONTRACTOR) Owner Name: TYRONE R GOSHINE Business Location: 3449 NW 19 ST LAUDERDALE LAKES Business Phone: 954-730-3791 Rooms Seats Employees 3 Business Opened:03 /09/2009 StatelCo u my /CertiReg: CGC 0 5 8360 Exemption Code: Machines Professionals For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 0.00 0.00 0.00 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non - regulatory in nature. You must meet all County and/or Municipality planning WHEN VALIDATED 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. Mailing Address: TYRONE R GOSHINE 8991 SW 6 CT PLANTATION, FL 33324 2011 - 2012 Receipt #035 -10- 00003209 Paid 09/22/2011 27.00