CC-12-116Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Mnspection Number: INSP - 177375
Permit Number: CC -1 -12 -116
Inspection Date: August 14, 2012
Inspector: Bruhn, Norman
Owner: , BARRY UNIVERSITY
Job Address: 11300 NE 2 Avenue Thompson Hall
Miami Shores, FL 33138 -0000
Project: BARRY UNIVERSITY
Contractor: ANDALE GROUP LLC
Permit Type: Commercial Construction
Inspection Type: Final
Work Classification: Alteration
Phone Number
Parcel Number 1121360010160 -02
Phone: (305)715 -7335
Building Department Comments
STRUCTURAL REPAIR WORK UPTURN BEAM
Inspector Comments
91
Passed /
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
August 14, 2012
For Inspections please call: (305)762 -4949
Page 1 of 1
SAAD ELIA EL -HAGE
CONSULTING ENGINEERS, INC.
5601 NW 9TH AVENUE, sum 401 / FORT LAUDERDALE, FL 33309
OFFICE (954) 771 -8149 / FAX (954) 771 -8169
July 5, 2012
• STRUCTURAL BUILDING DESIGN
• THRESHOLD INSPECTIONS
• POOL STRUCTURE DESIGN
Final (Thompson hall Penthouse concrete restoration)
Building Official
Miami Shores Village
Building and Zoning Department
Miami Shores, Florida
Re: Barry Thompsonhall Penthouse
Miami Shores, Florida
Permit#: CC -1 -12 -116
Dear Building Official,
1, Saad El -Rage, having performed and approved the required inspections, as indicated in the
attached approved inspection reports 1 -9, hereby attest that to the best of my knowledge, belief, and
professional judgements, the concrete restoration repair of the penthouse floor, ceiling, upturn beam,
masonry block are in compliance with the approved plans and other approved permit documents, ACI,
and Florida Building Code.
Should you have any questions or need any additional information, please do not hesitate to contact
me.
SAAD ELIA EL -HAGE
CONSULTING ENGINEERS, INC.
' 5601 NW 9TH AVENUE, SUITE 401 / FORT LAUDERDALE, FL 33309
OFFICE (954) 771 -8149 / FAX: (954) 771 -8169
FIELD REPORT NO: 01
• STRUCTURAL BUILDING DESIGN
• THRESHOLD INSPECTIONS
• POOL STRUCTURE DESIGN
TO: Chief Building Inspector Date: 4-3-2012
Miami Shores Village Permit #: cc- 1- 12-116
Building & Zoning Department Project Barry Thompsonhall, penthouse
Location: Miami Shores
Contractor: Andale Group
Owner:
Weather: Temp:
Time: A.M.
Present at Job site: Milton
File :112 -003
The following was noted:
Items inspected:
Progress inspection:
Concrete 4" pad west side
*Vertical dowel (ok)
*Bonding agents (ok)
Floor curb west side
*Vertical dowels (ok)
*Bonding agents (ok)
Note:
Discussed with contractor the repair procedure for the rest of the work.
Saad Et -Rage Inspector
Saad EI -Hage P.E.#42550
Special Inspector #0965
SAAD ELIA EL -HAGE
CONSULTING ENGINEERS, INC.
6601 NW 8TH AVENUE, SUITE 401 / FORT LAUDERDALE, FL 33309
OFFICE: (854) 771 -8149 / FAX (954) 771 -8169
FIELD REPORT NO: 02
• STRUCTURAL BUILDING DESK3N
• THRESHOLD INSPECTIONS
• POOL STRUCTURE DESIGN
TO: Chief Building inspector Date: 4-19 -2012
Miami Shores Village Permit #: cc-1-12-116
Building & Zoning Department Project: Barry Thompsonhall, penthouse
Location: Miami Shores
Contractor: Andale Group
Owner:
Weather: Temp:
Time: A.M.
Present at job site: Milton
File :112 -003
The following was noted:
Items inspected:
Progress inspection:
Shoring second floor and first floor (ok)
Concrete 4" pad (east side)
*Vertical dowel (ok)
*Bonding agents (ok)
Floor curb (east side)
*Vertical dowels (ok)
*Bonding agents (ok)
Floor patch repair
*Reber splices and welds (ok)
Note:
Upturn beam repair at east side and NE corner. Damage is extended to the NE corner. G.C. to chip all
spelling concrete, expose all rusted steel. Repair as per the procedure specified in the structural
documents.
Saad El -Hage Inspector
Saad EI -Hage P.E.#42550
Special Inspector #0965
SAAD ELIA EL -HAGE
CONSULTING ENGINEERS, INC.
• 5601 NW 9TH AVENUE, SUITE 401 / FORT LAUDERDALE, FL 33309
OFFICE: (954) 771 -8149 / FAX (954) 771 -8169
FIELD REPORT NO: 03
• STRUCTURAL BUILDING DESIGN
• THRESHOLD INSPECTIONS
• POOL STRUCTURE DESIGN
TO: Chief Building Inspector Date: 4-24-2012
Miami Shores Village Permit #: cc-1-12-116
Building & Zoning Department Project: Barry Thompsonhall, penthouse
Location: Miami Shores
Contractor: Andale Group
Owner:
Weather: Temp:
Time: P.M.
Present at job site: Milton
File :112 -003
The following was noted:
Items inspected:
Masonry reinforced dowels (north side)
Dowels, epoxy (ok)
Saad El -Hage inspector
Saad El -Hage P.E.#42550
Special Inspector #0965
SAAD ELIA EL -HAGE
CONSULTING ENGINEERS, INC.
' 5601 NW 9TH AVENUE, SUITE 401 / FORT LAUDERDALE, FL 33309
OFFICE: (954) 771 -8149 / FAX: (954) 771 -8169
FIELD REPORT NO: 04
• STRUCTURAL BUILDING DESIGN
•THRESHOLD INSPECTIONS
• POOL STRUCTURE DESIGN
TO: Chief Building inspector Date: 5 -15 -2012
Miami Shores Village Permit #: cc-1-12-116
Building & Zoning Department Project Barry Thompsonhali, penthouse
Location: Miami Shores
Contractor: Andale Group
Owner:
Weather: Temp:
Time: P.M.
Present at job site: Milton
File :112 -003
The following was noted:
Items inspected:
A. Upturn beam (east side)
Reinforcing top horizontal steel (ok)
Stirrups dowels and welds (ok)
Bonding agents (ok)
Preparation for concrete pour is complete.
B. Existing floor opening dosure:
Perimeter steel angles and anchors (ok)
Metal deck and welds (ok)
Reinforcing steel (ok)
Saad El -Hage P.E.#42550
Special inspector #0965
SAAD ELIA EL -HAGE
CONSULTING ENGINEERS, INC.
• 5601 NW 9TH AVENUE, SUITE 401 1 FORT LAUDERDALE, FL 33309
OFFICE: (954) 771 -8149 / FAX: (954) 771 -8169
FIELD REPORT NO: 05
TO: Chief Building inspector
Miami Shores Village
Building & Zoning Department
The following was noted:
Items inspected:
Monitor concrete pour
Upturn concrete beam
Floor curbs
Floor openings dosure
Masonry wall in fill (west side)
Concrete pour is complete. (o.k.)
Saad El -Rage Inspector
• STRUCTURAL BUILDING DESIGN
•THRESHOLD INSPECTIONS
• POOL STRUCTURE DESIGN
Date: 5-16 -2012
Permit #: cc -1 -12 -116
Project Barry Thompsonhall, penthouse
Location: Miami Shores
Contractor. Andale Group
Owner.
Weather: Temp:
Time: A.M.
Present at job site: Milton
File :112 -003
j
Saad El-Hage P.E.#42550
Spedal Inspector #0965
SAAD ELIA EL -HAGE
CONSULTING ENGINEERS, INC.
• 5601 NW 911-I AVENUE, SUITE 401 / FORT LAUDERDALE, FL 33309
OFFICE: (954) 771 -8149 / FAX: (954) 771 -8169.
FIELD REPORT NO: 06
• STRUCTURAL BUILDING DESIGN
• THRESHOLD INSPECTIONS
• POOL STRUCTURE DESIGN
TO: Chief Building Inspector Date: 6-7 -2012
Miami Shores Village Permit #: cc -1 -12 -116
Building & Zoning Department Project Barry Thompsonhall, penthouse
Location: Miami Shores
Contractor: Andale Group
ft Owner:
Weather: Temp:
Time: A.M.
Present at job site: Milton
File :112 -003
The following was noted :\
Items inspected:
Masonry block walls reinforcing (south and southwest corner)
Dowels and epoxy (ok)
Reinforcing (ok)
Saad El -Hage inspector
Saad El -Hage P.E,#42550
Spedal Inspector #0965
SAAD ELIA EL -HAGE
CONSULTING ENGINEERS, INC.
5601 NW 9TH AVENUE, SUITE 401 / FORT LAUDERDALE, FL 33309
OFFICE: (954) 771 -8149 / FAX: (954) 771 -8169
FIELD REPORT NO: 07
TO: Chief Building Inspector Date: 6-11 -2012
Miami Shores Village Permit #: cc-1-12-116
Building & Zoning Department Project: Barry Thompsonhall, penthouse
Location: Miami Shores
Contractor: Andaie Group
Owner.
Weather: Temp:
Time: A.M.
Present at job site: Milton
File :112-003
• STRUCTURAL BUILDING DESIGN
• THRESHOLD INSPECTIONS
• POOL STRUCTURE DESIGN
The following was noted:
Items inspected:
A. Masonry block walls reinforcing over upturn beam (East side)
Dowels and epoxy (ok)
Reinforcing (ok)
B. Cracks repair
Around 2 existing roof openings
Removal of spelling concrete (ok)
New reinforcing splices and welds (ok)
Bonding agents (ok)
C. Ceiling patch repair at west side and east side
Saad El -Hage inspector
//—/••
Saad El-Rage P.E.#42550
Spedal inspector #0965
SAAD ELIA EL -HAGE
CONSULTING ENGINEERS, INC.
• 5601 NW 9TH AVENUE, SUITE 401 1 FORT LAUDERDALE, FL 33309
OFFICE: (954) 771 -8149 / FAX (954) 771 -8169
TO: Chief Building Inspector
Miami Shores Village
Building & Zoning Department
The following was noted:
FIELD REPORT NO: 08
• STRUCTURAL BUILDING DESIGN
• THRESHOLD INSPECTIONS
• POOL STRUCTURE DESIGN
Date: 6-26 -2012
Permit #: cc-1-12-116
Project Barry Thompsonhall, penthouse
Location: Miami Shores
Contractor: Andale Group
Owner.
Weather: Temp:
Time: P.M.
Present at job site: Milton
File:112-003
Items inspected:
A) Ceiling repair: remaining ceiling opening edge rust are repaired. (o.k.)
B) Penthouse floor patches repair (ok)
C) Outside face of upturn beam:( 1 location about 1 ft long patch at bottom ,at the South end of
the beam)
Chip spelling concrete at bottom portion
Expose Reber
Remove rust
Apply bonding agent
Patch with concrete admixture as per structural documents
Saad El -Hage Inspector
i
Saad El-Hage P.E.#42550
Special inspector #0965
SAAD ELIA EL -HAGS
CONSULTING ENGINEERS, INC.
' 5601 NW 9TH AVENUE, SUITE 401 / FORT LAUDERDALE, FL 33309
OFFICE: (954) 771 -8149 / FAX: (954) 771 -8169
FIELD REPORT NO: 09
• STRUCTURAL BUILDING DESIGN
*THRESHOLD INSPECTIONS
• POOL STRUCTURE DESIGN
TO: Chief Building Inspector Date: 6-28 -2012
Miami Shores Village Permit 8: cc -1 -12 -116
Building & Zoning Department Project: Barry Thom
psonhall, penthouse
Location: Miami Shores
Contractor. Andale Group
Owner:
Weather: Temp:
Time: P.M.
Present at job site: Milton
File:112 -003
The following was noted:
Items inspected:
Upturn beam outside face patch repair is ( ok.)
Saad EI -Hage Inspector
Saad El -Hage P.E.1142550
Spedal inspector 80965
4 4toil9—' (4.\-
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B T TILTING
Miami Shores Village REcEIVEI -)
Building Department JAN 2 4 2012
JO
rk
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
By'
Tel: (305) 795.2204 Fax: (305) 756.8972 —
INSPECTION'S PHONE NUMBER: (305) 762.4949
PERMIT APPLICATION
FBC-20
Permit Type: BUILDING ROOFING
Permit No. CC' k 7%11
Master Permit No.
OWNER: Name (Fee Simple Titleholder): gA .tl L 1 �(,�( Phone#:
Address: I13VQ NEE 2.61 AYl
City: eel I AM' 54641k1S State: F
zip: -3? t lei'
Tenant/Lessee Name: Phone #:
Email:
JOB ADDRESS: BMA t/ I v iv. r r/ — 6' 1 A P 20 .ilLAArililotk„
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #:
Is the Building Historically Designated: Yes
NO Flood Zone:
CONTRACTOR: Company Name: A4 }ALE G + 00 I P I L - 1 — C _ Pho ee# 5 "71S 733
291 ,.)r.J7 1L ALIE
City: / 3I 4441 State: F..... zip: gc3. i 2Z- f
Qualifier Name: IN I S L. / Z f L- Phone #: .39S-E15 ' -as-5 `7
State Certification or Registration #: c C. /511t&2 Certificate of Competency #: CC�G/) if 3c c
Contact Phone #: sos n -QS/ Email Address: AAA a mdc,k1Rode. COVA
DESIGNER: Architect/Engineer: SA4b E U k - e 4 H Pr6,6 Phone #: 95"/".77) - S ) iiii
Address:
Value of Work for this Permit: $ 010 £ V
Type of Work: ❑Addition ❑Alteration
Description of Work: ,Srt OCrOi.kL_
Square/Linear Footage of Work: bv1_
DNew epair/Replace ODemolition
eepAi (ZOOS
41)
Submittal Fee $—'--) Permit Fee $ c070 CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $;f 't- ' mot a 0
TOTAL FEE NOW DUE $2 0 SO ,
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 tiyill not be approved + a reinspection fee will be charged.
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this 17
day of ,TAM AIN , 20 fR , by B CC' IUVr1A20 „
who is Rersonally known to me or who has produced ` . •�..
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Signature—
go �>► A
act() 7aiel
The foregoing instrument was acknowledged before me this
day of , ),44./t.agy 20A, by , s4
who isge�
or who has produced
as identification and who did take an oath. /1111110N1
My Commission Expires:
NOTARY „PUBLIC:
ualo +lllo0,
a��i1NP,
y..... �, •i
Sign:..
Print:
= * : s..o •
My ComEnssston E i J Q
114,411-4/4. ZP41.1c.thlt. :are
* * * * * * * * * * * * * * * * * * * * **
APPROVED BY
* * * * * * * * * * * * * **
Plans Examiner
/164 / `2 / {, ructural Review
(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)
Zoning
Clerk
r -
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF RRST INSPECTION
PERMIT NO. TAX FOLIO NO.
STATE OF FLORIDA:
COUNTY OF MFAMI -DADS:
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real
property, and In accordance with Chapter 713, Florida Statutes, the following information
is provided in this Notice of Commencement.
111111111111111111111111111111111111111111111
CF14 2O12;iceO2=347#.6
OR 8Iq 28057 P9,4415; (1i}9)
RECORDED 04 /i f3/20i12 12 :11 :48
HARVEY R:Ub'I1'1r CLERK. OF COURT
MIAMI -DAC'E C0UNTYr FLORIDA
LAST P'A{ E {
1. Legal description of property and street/address: 'EMI V t4 (Vu-5 T y
1130() lc. 2ooI AVG. NtiAMi •5%0 S i 33)61
2. Description of improvement: 1WP.SoN 51J(M Q.k. Vv4394IS
3. Owner(s) name and address: i3Ae -4' iV Gi-i•Ty
130 tv 2-, d PJ) j M iI1MW1 OlIkE 'F<., 331 J I
Interest ifitzproperty:
Name and address of fee simple titleholder:
4. Contractor's name and address: ANMA G 1/01A I LL G
2- 1 N W 7r -AV X11 NA 1 . 1 c_., 33122.
5. Surety: (Payment bond required by owner from contractor, if any)
Name and address:
Amount of bond $
6. Lender's name and address:
7. Persons within the state of Florida designated by Owner upon whom notices or other documents May be served as
provided by Section 713.13(1)(a)7., Florida Statutes,
Name and address:
8. In addition to himself, Owners designates the following .person(s) to receive a copy of the Lienor's Notice as provided
in Section 713.13(1)(b), Florida Statutes.
Name and address:
9. Expiration date of this Notice of Commencement the expiration date is 1 year from the date of recording unless a
different date is s ed)
Signature of Owner \' T j/A
Print Owner's Name L1 J DA f e`e't,CO N u Prepared by - v ` j "it
Sworn to and subscribed before me this Z`7 day of M Aad i , 20 I Z.
Notary Public
Print Notary's Name
My commission expires:
123.01 -52 PAGE 4 0102
Address:
TRT 61 _ i irt� 2:9 CO4a iry caw- DADE
Hf- li'�OYCARTI(b Oat ift,wa. *,,eccpy cf. ffe
rigfiiu'I 7cs or .� t• `� 1
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and 063pal
Permit No: 12 -116
Job Name:
February 7, 2012
Miami Shores Viiiage
Building Department
Building Critique Sheet
1) Provide approval from Miami Dade County DERM.
2) Provide corrections for structural.
3) Provide a completed special inspector form.
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Page 1 of 1
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
FAx 3(--S`12 -S&I")1_
02/07/2012 15:32 FAX 1 800 685 7530
DATA SCAN FIELD SERVICES
I oo1
* * * * * * * * * * * * * * * * * * * **
* ** TX REPORT * **
* * * * * * * * * * * * * * * * * * * **
TRANSMISSION OK
TX /RX NO 2208
RECIPIENT ADDRESS 93055925937
DESTINATION ID
ST. TIME 02/07 15:31
TIME USE 00'33
PAGES SENT 1
RESULT OK
Permit No: 12 -116
Job Name:
February 7, 2012
M iami hores Village
Building Department
Building Critique Sheet
1) Provide approval from Miami Dade County DERM.
2) Provide corrections for structural.
3) Provide a completed special inspector form.
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Page 1 of 1
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
c-Ax
N.4 keel a
SE0 `7 E4
v'
The C - C0NXRAC C
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}Na),(305)
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r_ACH OCCURRENCE
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03/15/2011
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03/15/20 2
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CERTIFICATE HOLDER
CANCELLATION
AI Y.W. X
Miami Shores Village
Building Department
10050 N.E. 2nd Avenue
Miami Shores, FL 33138
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
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1/8/2012
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 policy (ies) must be endorsed. If SUBROGATION 1S 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
FRANKCRUM INSURANCE AGENCY, INC.
100 S. MISSOURI AVE.
CLEARWATER FL 33756
INSURED
FrankCrum 1- 800 -277 -1620
100 S MISSOURI AVENUE
CLEARWATER FL 33756
Mahn
RAND
Pa0N0
(0.tG�Rq ecp
atr
1.80D- 277 -1820 x4800
pcX Ap ji
727 - 787.0704
INSURER A:
INSURERS) AFFORDING COVERAGE
FRANK WINSTON CRUM INSURANCE, INC.
NAIL#
11600
INSURER 8:
INSURER G:
INSURER P.
INSURER E:
INSURER R:
REVISION NUMBER:
COVERAGES unt[tmtuntctvut ego. ,-. .....
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN RUED TO THE INSURED NAMED ABOVE FOR 171E POLICY PERIOD INDICATED
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY
PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. UMITS SHOWN
MAY HAVE BEEN REDUCED BY PAID CLAIMS. –
WAR
LTR
TYPE OF INSURANCE
ADM
INSR
/11/BR
END
POLICY NUMBER
POLICY PJ'P
BENVI Dn'YTYI
POLICY EXP
(IMEDIEYM)
LEADS
GENERAL
LIABILITY
OOMMERCW. GENERAL UIE
ItriNLIS-MADE iir7 OCCUR
EACH OCCURRENCE
1
8
DAMAGE TO RENTED
PREMiSESpivawtm:ee)
arepervaD
$
MEDEXP INN
PERSONAL &ADV INJURY
$
GENERAL AGGREGATE
"-„
$
• COMP/0P AGO
GGERI �ANDREOATE
UNIT APIRJEB PERK(
TIPBOJEW I jLOC
PRODUCTS
$
AUTOMOBILE
IPoLNY
IJAEMY
ANYAUro
ALL OWNED
AUTOS
HIRED AUTOS
—SCHEDULED
NOM -OWNED
�%
QoMSINEO BINDLE IJRIIC
(Ea eaddeaQ
$
9ODILYUIJURY (Per p )
$
BODILY INJURY (Par ataidenq
$
_AUTOS
15ROPEiRTYDAMARN?
PR
$
$
�,AUTO3
ULCIIREUA
SE (cES8 DABS
—�
ODOUR
CL -MADE
-c -
-' -
._...,..
EAWiocCUR[RENDE
$
ADDREDATE
$
$
DED I I RETENTION$
A
WORKERS
EMPLOYERS'
ANY PROPRIETOR/
OFFlCER/MENBEREXCLUDED?
IMmulelawIn
If yes, deccUmumdar
DES0RIPTION
COMPENSATION AND
LIABILITY
PARTNERlEXECUTNE
OF OP3RATIONS below
YIN
WA
W0201200000
e
1/112012
a 1/112013
p \\
\
.
7pfp aTnn1 oTR
x LTOTRY JAmT4 ni
EL EACH ACCIDENT
$1,000,000
$1,000,000
(
El. DISEASE - EAEMPLOYEE
E.L. DISEASE - POLICY LIMIT
,000,000
DEacRIP11oNOP
EFFECTIVE
REPORTING
OPERATIONS I LOCATIONS :VEHICLES (Attach /WORD 101, AddlDOnalRemoksI lala,dule,Imote spays brequired)
12/15/2008, COVERAGE IS FOR 100% OF THE EMPLOYEES OF FRANKCRUM LEASED TO ANDALE GROUP, LLC (CLIENT) FOR WHOM THE CLIENT IS
HOURS TO FRANKCRUM. COVERAGE IS NOT EXTENDED TO STATUTORY EMPLOYEES.
CANCELLATMIN
CERTIFICATE HOLDER
Miami Shores Village
Building Department
10050 N.E. 2nd Avenue
Miami Shores, FL 33138
SHOULD ANY OF THE *nov DESCRIBED POLIDIES 33 CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS,
AUTROREEDREPRESENTATIVE
rjZ.7'/
ACORD 25 (2010/06)
The ACORD nano and fogo are registered marks of ACORD
01888 -2010 ACORD CORPORATION. All rights resermod..
I►
MIAMI -DADE COUNTY
TAX COLLECTOR
140 W. FLAGLER ST.
1st FLOOR
MIAMI, FL 33130
2011 LOCAL BUSINESS TAX RECEIPT 2012 FIRST -CLASS
MIAMI -DADE COUNTY - STATE OF FLORIDA U.S. POSTAGE
EXPIRES SEPT. 30, 2012 PAID
MUST BE DISPLAYED AT PLACE OF BUSINESS MIAMI, FL
PURSUANT TO COUNTY CODE CHAPTER SA ART. 9 & 10 PERMIT NO.231
621206-2 �Es2
BusI�NUArtmbh `11 C
2501 NW 74 AVE
33122 UNIN DADE COUNTY
TI-HS IS NOT A BILL — DO NOT PAY RENEWAL
S T 647668 -3
OWANDALE GROUP LLC
Secf eafHusLr BUILDING CONTRACTOR WORKE1
THIS IS ONLY A LOCAL
BUSINESS TAX RECEIPT. IT
DOES NOT PERMIT THE
HOLDER TO VIOLATE ANY
EXISTING REGULATORY OR
ZONING LAWS OF THE
COUNTY OR CRIES. NOR
DOES IT EXEMPT THE
HOLDER FROM ANY OTHER
PERMIT OR LICENSE
REQUIRED BY LAW. THIS IS
NOT A CERTIFICATION OF
THE HOLDERS QUALIFICA-
TIONS.
PAYMENT RECEIVED
MIAMI-DADE COUNTY TAX
COLLECTOR:
07/25/2011
60020000579
000075.00
SEE OTHER SIDE
DO NOT FORWARD
ANDALE GROUP LLC
DANIEL AZEL
2501 NW 74 AVE
MIAMI FL 33122
i, /i111111171tii :Ii ;il/i,ilt iii tifTi7iliiiil,iii!li1F'ii;4 §,►
Miami Shores Viiiage
Building Department
RECEIPT
PERMIT #: Z ^ .� I (2) DATE: ( % %
l
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
ntractor
❑ Owner
❑ Architect
Picked up 2 sets of plans and (other)
Address: e� �` 1.c40 -yifku
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: "6
PERMIT CLERK INITIAL:
4., 4. V .• a 40 si 4.0 • Si* 4' Ad MI 0 VV.".
fOW.b,410i 84•0064•
Miami Shores Village
Building Department
tOSISO 14.E. 2-4 Avenue, Miami Snores, PI 33131
Tel: 303-391-2304 • Fir 3034564172
IJAB,0114.314r.
Inca mined by (time of owner/agent;
0 Speeiel 1 pcetot serviCal under dig Florida Buil int Code at 'protect (ad
31)0
• Misini Wets, es of
1 ion a rogis Atehitt.et r Profeesional Pngineer lieeneed b t.:%e Scale of Florid*.
ettAIi4r1- Nt.ina212:
inspector
Special inspector
O Special Inspector
o Special Inspector
CI Special tinSpector
o Special inspector
O Specialitspeetor
for Reinforced Unit Masnrtry, FBC 2122.4
for Trusses over 35 Ft. Long clrG Pt. High, PBC 2319.17,2.4.2
for Brett Connecoomi, RC 2218.2
for Soil Cornpaetion, PBC 1820.3.1
for Precast Urtits & Attachments, FBC 1927.12.2
for Pilings, FUC 1822.1.20.
for , r y>
The following individut/s(s) employed by this firm ar rug ate authorized to perform inspections
• r
2.
(sse3 urvInsittod Om Spatial Inspector impel:due Cor enste betiding mum 44 disployed in s convenient loastnie on Om AO los
' reetreace lisy Maid Sham Butt.disi Dopertreati ineMmax. mandato:1 Itispeedtwat, ei requital by ore ?bride Eletkibis Co*.
mum be pariternert by Miami Moms. The building inspections maim 1240.4 fix di ritiodenny Intonations. febusettost FeriePeed
the Spatial Mipitoor Wrest £p f/us 010m, i to tto ahattiltdrty itespecitompsobolood kr the &Wilt* Looponomt.
Rakes. upon sompledeu °Caw work pay Bu Petmk„ 1 mai submit ut tai Miami Reitrei buildirti Demean* at the class
btfcrr flaw impede' the essupleted impulichn log fano lad 4 urged suareoet hulleeltns tbm, es the beet of fay knOvasalgt.,
0110 to4 preen toast Judipneet *coo pottions GCtb . croJsat asiiined shim meet Ilia Wool/eft Florida BufltdoS Cede Sod Ore in
sabetatell gesogdwo pisno.
Signed and Sealed
D414:(9 **" 1:*
Engincer( eliitoet
Name
(Print) L
dr. 0/ A.4.4.11")1KAYF 44/
M1/4 ,fir. 1:g
Addres s
photo .1-44 j ZI 4/49
Fl.orids Lieeme No:
ivtiarrn Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Per No. •
Job N
Date d,L,
STRUCTURAL CRITIQUE SHEET
Bey f
r 4 a iseAti- egetric en •
1 1 moo,
S 4 Tta " "a r14 ®e r III •+W:P CV7 r
,s.yoed
Q't ,s-
. use ryy,, (2.
V : 41 4• 4 • Y. It 4' tha. 4041.6 0.11t, 4140■PVI
10404'44411 LOOM.
Miami Shores Village
Building Department
IMO W.F. 2 Avenue, Miami byes. n 33 i
Tesi: IOS-295-22.04 *fir 103434497Z
Q.E.IAA1JliWicaQILTJISZR
rzi,,BAliagAlaja: Nagfaig,
rr
1 rvio hhvc Lvoca Ruined by (moue of ownerfesenf;
to oartrirm Special itISICCItle services under the Florida Build Coda at as)
11100IS 74 4\14 , Miami Shores, t.. Noe),
1 a til 4 registered ArchiwzI or Professional engineer licensed LI the Stilt of
le KIZNI IT NUMBER;
'pecisi Inspector for Reinforced 1Jott Masonry, PBC 2122.4
Special Inspector for Trusses over 35 Pt. Long or 6 Ft. High, PBC 2319.17.2.4.2
O Special Irispectur for Steel Conriection$, PBC 2218.2
O Special tospecinr for Sod Conyaction, PBC 1820.3.1
C Special inspector for Precast Urtits & Attachments, FBC 1927.12.2
• Special inspector for Pilings, FBC 1822.1.20.
Speciallespootof for dAelc.r aqIN't*
licrrti pease lock 0010 &lamely
The fallowing incividtods(a) employed by this firm or rot am authorised to perfoms inspitOions
--seSithr044. 4-- Aa
.04.40■•■■■■e1d.re APO.
(we) liedialload dal s 40414 Inspector fantaON too Cos each building MO be dientsyed e etovenlent fang*, On dea Al Ste
Tatman tw the 141ssii Show Etnthtleg Clepertmeni Inspector. Ail mandatory Iospnedora, le rewired by toe Florida emeibis Cock.
now bs yertenned ty Mlaat Shores. The bottling int:tandem rnuatbe celled Sr all mamba" dupeations. Imps:nem Perioniga te.
As *mint Astor hirtd ms Oiefter OM mandatory fropscHowrpoolonua ir the IhdliNg &prima
' nether, men completion oldie work u1%ds Bi lding Permit. I en submit es the MI m Budding Dopeetneent el the dens
bare the final lasosodon cho onesplated iimpectkgs *inn and e sealed statiattal ani, to ins best of My klannisetas,
rd progisameld ludionekt lbws pedleas aid* ernjeet matinee above meet die Wen �!u Florida 1U4%( Cede and are in
rittatirtat asoontanoo plans
Stgrud and Sealed
-
rieride Ueeuie
di
A