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BPP-12-352Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 170552 Permit Number: BPP -2 -12 -352 Scheduled Inspection Date: August 16, 2012 Permit Type: Pools/Whirlpools /Hot Tubs Inspection Type: Final Owner: , BARRY UNIVERSITY Work Classification: Addition /Alteration Job Address: 11300 NE 2 Avenue Pool House Miami Shores, FL 33138 -0000 Inspector: Bruhn, Norman Project: BARRY UNIVERSITY Contractor: LOGIC BUILDERS INC Phone Number Parcel Number 1121360010160 -36 Phone: (305)512 -1149 Building Department Comments RENOVATION OF POOL SHELL, GUTTER AND COPING. POOL DECK REFINISHING POOL EQUIPMENT REPLACEMENT. Inspector Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. August 15, 2012 For Inspections please call: (305)762 -4949 Page 2 of 26 PERMIT # OPPV-2,--- 552 CONTRACTOR: I-0 IC.. ib% TO INCA SUBMITTAL DATE: .I ZPV 1q_-- ADDRESS: ` `�j d 0 IL‹.-- NAME: UNI-1 P.-,C___51____, RESUBMITAL DATES: PROJECT TYPE: i ? *, 7) l2- _ 69 C-0 iiic" l ZONING FIRE 06 7244/i STRUCTURAL IMPACT FEES ELECTRICAL.p� ��/ HRSIDERM C>k' '` ke PLUMBING p,er �,�j.• -( ''� NOC , \i, MECHANICAL BLDG i ENVIRONMENTAL ENGINEERING Rick Scott Govemor H. Frank Farmer, Jr., M.D. Ph.D. State Surgeon General AUTHORIZATION FOR OPERATION OF POOL/SPA COUNTY: MIAMI -DADE NAME OF POOL 81-f. y Lifit wer s i7y PLANS APPROVAL # /312 sP 230g -A PLANS APPROVAL DATE AP L 2C / 20/2— This is authorization from the Department of .- (earth to operate the above captioned poor as pu6lsc pool until such time as the Swimming Tool* Bathing Bface Operating Permit (ww. -f Form 919) is issued /reissuecC or until* sixty (60) days from the date of this inspection has elapse' This. authorization is based on my inspection of this poor on ,4i /A 2012.— which I found to the best of my kjaowfedge and belief, to 6e in compliance with documents approved 6y this agency. Wichae 6orowik Maid-Dade Coun >' Department oft-Leath Sarnir Elmir, PhD, PE, DEE, CEHP, Director Environmental Health and Engineering Miami -Dade County Health Department 1725 N. W. 167th Street, Miami, Florida 33056 Tel: (305) 623 -3500 Fax: (305) 623 -3502 Email: Samir Elmir @doh.state.fl.us Website: www.dadehealth.org Name of Pool 1725 N.W. 167th Street • Miami, FL 33176 PUBLIC SWIMMING POOL ENGINEERING INSPECTION REPORT alit J,d vers /77 Name of Owner Berry 1I04"i verrsr r% Location MIAMI - DADE 049 E 2 dye. (County) Address 1/390 PE 211'7 .El '41j aR. 33/4/ Plans Approval # 312-5-R 2 3 06 A2 Date *P ,26 2012- Bathing Load ° Persons Items marked "X" are not in compliance with the requirements of Chapter 64E -9 of the Florida Administrative Code and must be corrected. Continued use of the pool without making these corrections will be violations of Chapter 64E -9. Florida Administrative Code, and Chapter 514, Florida Statutes, and will place the owner subject to legal action. It is requested that the DOH agent listed below be notified when the corrections have been made so that a reinspection can be scheduled. Items marked N/A do not apply to this pool. POOL Location Size /0 ®, PQD Design Inlets Gutter Drain(s) SKIMMER(S) Number Equalizer(s) Vacuum Ftg.(s) COPING Type STEPS Dimensions Contrasting Marker DECK Min. Four Foot Impervious ( -_ ) Slip Resistant HANDRAIL MOUNTED Bottom Step ( y - H.B. ( ( ") Deck (�-- -} LADDERS Number (:J) 3' Mounted (t...4" DEPTH MARKERS Location ( ) Size ( )(t MAIN GRATE(S) /2_f 12_ Size ( 1, Seared ( LIGHT(S) Number ( ) Transformer ( ) ( OPERATION Food & Drink Prohibited ('.... ) Free Chlorine Residual ppm ( ) (Minimum 1.0 ppm) ( ) Combined available chlorine ' o ppm ( _ ) (should not exceed 0.3 ppm ( ) pH g (Range 7.2 to 7.8 ( ) Cyanuric Acid ppm ( ) (Max. 100 ppm Allowed) ( ) POOL APPEARANCE Visible Dirt Grease Line Water Level Pool Finish Color DIVING BOARD(S) Number (-4- Height ) SAFETY LINE Mounted Location Contrasting Stripe Drinking Ft EQUIPMENT ROOM Ventilation Lighting Drainage H.B. PUMP(S) .- `Z Manufacturer /aa, -'1(1 Model # w i K' t 2- H.P. 3 H &L Flowmeter Loc. 2.7g GAUGES Pressure Vacuum Gas Mask ,t//9-- (f.. --1- Self Contained Apparatus / (_ --)--- Platform Scales (` ) Life Hook(s) with pole ' ( L-)' Life Ring(s) with rope ,z6v�, -r ( Shower Poolside �. -7-,q yto'"P"''t• ( .,) Test Kit ( ) Capabilities ( ) (,____)____Vacuum Cleaner Rules for Bathers Maximum Temperature Overhead Electric Wires THERMOMETER(S) Location (`- ) q( Reading ( ) CHLORINE FEEDER(S) Type 57"'Y " Manufacturer Model # SS-A, 3-- - -• 4, Capacity g v Cpl) pH FEEDER(S) CDy. Manufacturer srr- % '' Model# CE7 -2-- 3 Capacity R'. 3'7 c''i CHLORINE ROO OR CABINET GAS CHLO M ufa Mo apac TOR ( ( FILTRATION Pressure (� Vacuum ( ) Sand ( ) Manufacturer ( ) Mod. # ( ) Number ( ) Filter Area ( ) Sight Glass ( ) CARTRIDGE Manufacturer p1,2,--T-4 Number - c c p - Y z7 Model # Filter Area ( Clearance D.E. Manuf. Filt. Area Sight Glass ( ( ( FACE PIPING Size Valves ( ) Type ( ) Pool Waste Collector Tank -Size Automatic Level Control Makeup Water Source SANITARY FACILITIES Flush Toilets Men Urinals Men Lavatories Men Showers Men Flush Toilets Women Lavatories Women Showers Women Toilet Paper Paper Towels Soap Drainage Hose Bib P� COMMENTS AND INSTRUCTIONS r'otttotc LK G Jaw. (tP! ("vote `. 4 ) A Li rr b Re )et pi* co., -t.. , C� O z/ a LC '700 A4 ti 4D 1 M) ,- ,o ,01 4vat- / Ieca hi ier 22- 7(r' Copy of this Inspection Report Received By Date of Inspection • 8 Pay..' nnu A....... Ahet (305) 623 -3554 E 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 ING PERMIT APPLICATION Permit Type: BUILDING JOB ADDRESS: /13�� /vim Z ewe City: Miami Shores County: Folio/Parcel #: Is the Building Historically Designated: Yes JUN 12.2012 FBC 20 Permit No. Master Permit No. — Z. —/ 2- -35 a ROOFING Miami Dade Zip: NO Flood Zone: OWNER: Name (Fee Simple Titleholder)_ 7" Phone!: City: Tenant/Lessee Name: Email: CONTRACTOR: Company Name: Address: ®Z..3/ 0 la. M / City: / ✓ i /(/.f///'� State: �4./.3 zip: . )f1 Qualifier Name: e --- # 1446-74--- Phone*: /Pr.: 794•... 4474 .�v e.- glype:T Certificate of Competency #: ?o) 2 Email Address: /%�% e _5;;;,,,,,,,c4.... C , DESIGNER: Architect/Engineer: Phone#: _ Phone #: ?or- 74 4,a77 State Certification or Contact Phone#: Value of Work for this Permit $ «P(/ . Square/Linear Footage of Work: Lc O Type of Work: ❑Addition ❑Alteration ❑ w ❑Repair/Replace Desert Lion of Wor `i Color thru tile: ***** *** * * * * * * ** * * ** ** **** * ***** * *+v .op ******** *** ** ***** * * ** **********ayes ****** ** Submittal Fee $ Permlt Fee $ 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 Fr RCTRICAL 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- " ^, {r' notice, the inspection will not be approvrf a reinspection fee will be charged i // Signature Owner or Agent The foregoing instrument was acknowledged before me this 1 n day of , 20 I, by Contractor ing instrument was acknowledged bef Y me s /Z,.-' , 20 Lby � who is personally known to me or who has produced who is personally known to me or who has produced • As identification and who did take an oath. as identification and who\dicppnfypath. NOTARY PUBLIC: NOTARY PUBLIC: `�.�`;1��'li .... r,� . Sign: Print: My Commission E APPROVED BY 7-02 - v i Examiner Structural Review (Revised 3 /12/2012)(Revised 07 /10/07)(Revised 06/10f2009)(Revised 3/15/09) Sign: Print: My Commission Expires: *0000 * * * * ** ** * * *** * * *** * * * ** 7 L 1` l Zoning Clerk OP ID: D3 '4�f - CERTIFICATE OF LIABILITY INSURANCE DATE(M27/1YYY) 02/27/12 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(les) 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 954- 731 -5566 W.F. Roemer Insurance Agency 4752 W. Commercial Blvd 954-731-84384AC. Fort Lauderdale, FL 33319 William F. Dowd CONTACT FAX No. Ext): (A/C, No): E-MAIL ADDRESS: PRODUCER LOGIC -1 CUSTOMER ID #: INSURER(S) AFFORDING COVERAGE NAIC # INSURED Logic Builders, Inc 20801 Biscayne Blvd #301 Aventura, FL 33180 INSURER A:Vinings Insurance Company 16632 INSURER B : Mid- Continent Casualty Co 23418 INSURER C : 07/01/11 INSURER D : EACH OCCURRENCE INSURER E : X INSURER F : $ 100,000 • REVISION 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 ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MM/DDIYYYY) POUCY EXP (MMIDD/YYYYI LIMITS B GENERAL UABIUTY COMMERCIAL GENERAL LIABILITY X OCCUR 04G L000824909 07/01/11 07/01/12 EACH OCCURRENCE $ 1,000,000 X DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 CLAIMS -MADE MED EXP (Any one person) $ EXCLUDED PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENII. AGGREGATE UMIT APPLIES PER PRODUCTS - COMP /OP AGG $ 2,000,000 7 POLICY X jE a LOC $ AUTOMOBILE UABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILYINJURY(Perperson) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ $ UMBRELLA LIAB EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS Y/ N N /A WCV007093602 08/24/11 08/24/12 WC STATU- OTH- x TORY LIMITS ER EL EACH ACCIDENT $ 1,000,000 El. DISEASE - EA EMPLOYEE $ 1,000,000 below EL DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule H more space Is required) MIAMIS2 Village of Miami Shores g 10050 NE 2 Ave. Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUT,,H��OOfRIZED REPRESENTATIVE ACORD 25 (2009/09)' © 1988-2009 ACORD CORPORATION. All rights resery ed. The ACORD name and logo are registered marks of ACORD 06/14/2.0.10 ,090422.47 CGCO5 T 1� e fi NE CONTRACTOR Name .bed ow I :' ERTIFIE [ der 'he provision . f- Cho- Expiration date: AUG 3'1,...20 Planning and Zoning Criteria Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit NO. FW -4 -12 -637 Issue Date: 4/17/2012 Expires:4/1 7/201 2 Folio Number:1121360010160 -36 Owner's Name: BARRY UNIVERSITY Job Address: 11300 2 Avenue Suite: Pool House Miami Shores, FL 33138 -0000 Owner's Phone: Total Square Feet: 240 Total Job Valuation: $ 15,000.00 Contractor(s) LOGIC BUILDERS INC Phone (305)512 -1149 Primary Contractor Yes Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 6/4/2012 : Yes Comments: 6/4/12 NEW PLAN OK Permit No: 12 -352 Job Name: June 14, 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 1) Provide approval from Miami Dade County Health Dept. (DOH /HRS) 2) Submit plans that include only the work being proposed. Remove all other pages. Any new deck area must be reviewed and approved by DOH /HRS. 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 Rick Scott Governor John H. Armstrong, MD State Surgeon General July 11,2012 Michael Sher 11300 NE 2 Ave Miami, FL 33161 RE: Contingency Letter Application Document No: API 076453 Centrax Permit Number: 13 -SC- 1418382 OSTDS Number: 11300 NE 2 Ave Miami, FL 33161 Lot: Block: Subdivision: Dear Applicant: This will acknowledge receipt of an application dated 07/02/2012 for a permit to use an existing onsite sewage treatment and disposal system located on the above referenced property. From a review of your completed application, it has been determined that your existing system is adequate for the proposed use (installation of sidewalks for handicapped persons). If you have any questions on this matter, please call our office at (305) 623 -3500. Enclosures cc: ECEU VE IT� Miami -Dade County Health Department 1725 NW 167 St, Opa Locka, FL 33056 Phone: (305) 623 -3500 . Fax: (305) 623 -3645. http: / /www.MyFloridaEH.com 1 Planning and Zoning. Criteria Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit NO. B P P -2 -12 -352 Issue Date: 4/6/2012 Expires:4 /62012 Folio Number:1121360010160 -36 Owner's Name: BARRY UNIVERSITY Job Address: 11300 2 Avenue Suite: Pool House Miami Shores, FL 33138 -0000 Owner's Phone: Total Square Feet 15000 Total Job Valuation: $ 355,000.00 Contractor(s) Phone Primary Contractor LOGIC BUILDERS INC (305)512 -1149 Yes Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 7/19/2012 : Yes Comments: 7/19/12 NEW PLANS OK MiamiShores Viiiage Building Department RECEIPT 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 2 PERMIT #: Df2f 2T V DATE: CV c D 1 I, Contractor o Owner o Architect Picked up 2 sets of plans and (other Address: From the building department on this date in order to have corrections done to plans And /or get County stamps. l 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: —1 1 2 PERMIT CLERK INITIAL: BUILDING PE FBC Permit Type: BUILDING Miami Shores Village Building Department 90050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 LICATION ROOFING OWNER: Name (Fee Simple Titleholder): Barry University Address: 11300 NE 2 Avenue Permit No. mss- Master Permit No. Phone#: 305 - 899 -3785 City: Miami Shores state: FL Zip: 33161 Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: 11300 NE 2 Avenue - Penafort Pool Renovation City: Miami Shores Folio/Parcel #: Is the Building Historically Designated: Yes County: Miami Dade zip: 33161 NO Flood Zone: CONTRACTOR: Company Name: Logic Builders Inc. Address: 20801 Biscayne Boulevard, Suite 301 City: Aventura State: FL Qualifier Name: c S q State Certification or Re 'station #: Contact Phone#: s Phone#: 305 -512 -1149 A 3OO• ` • g ti lap. : 33180 Phone #: ' 79b 476 7 Certificate of Competency #: Email Address: ' ®Ase ,6-1 e 60'44 DESIGNER: Architect/Engineer: Aquadynamics Phone#: 305 - 667 -8975 Value of Work for this Permit: $ 5 I 1 Square/Linear Footage of Work: S f 000 Type of Work: UAddition OAlteration ONew Repair/Replace ODemolition Description of Work: Rennvation of pool shell, gutter and cnping, pool neck refinishing, pool equipment replacement, , peel -c eel ti aq. raplassment- ***** **** x*+ x*******+x****+x*** **** ******Fees** *T3********** **+ ****** * * **************** Submittal Fee $ v" Permit Fee $,t2 U 1Q CCF $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ y Cj . U TOTAL FEE NOW DUE CO /CC $ Bond $ Bonding Company's Name (if applicable) N/A Bonding Company's Address " sCity State Zip Mortgage Lender's Name (if applicable) N/A 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, BOII.RRS, 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 , ' # reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this day of , 20 by . REAC6 Maa who is personall y known me or who has produced As identification and who did take an oath. NOTARY PUBLIC: The forego' g instrument was acknowledged before me this day o , 20 f7.-, by L(ie & Q-I e 1 who personally known to me or who has produced r9 -r( as. Sj11132 Lke. as identification and who did take an oath. NOTARY PUBLIC: APPROVED BY tructural Review (Revised 07 /10 /07)(Revised 06 /1Q/2009)(Revised 3/15/09) Clerk Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 RECEIPT PERMIT PERMIT ;B M 2 352. DA /1(c4/4"-°(1 o Contractor o Owner o Architect Picked up 2 sets of plans and (other) , f� Address: 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 p ess. Acknowledged b PERMIT CLERK INITIAL: _Z<A,.--\_ RESUBMITTED DATE: 30 PERMIT CLERK INITIAL; e...6 ions di 'Ch.489' L100 00706 CITY OF AVENTURA COMMUNITY DEVELOPMENT DEPARTMENT 19200 WEST COUNTRY CLUB DRIVE AVENTURA, FL 33180 305 -466 -8942 July 27, 2011 LOGIC BUILDERS INC 20801 BISCAYNE BLVD 301 AVENTURA FL 33180 This is your local Business Tax Receipt for the City of Aventura. Please post in a conspicuous place at the business location to avoid penalty. Do not remit payment as this is not abill. Business Name: Location: Recipient Name: Description: Issue Date: Fees Paid: Restrictions: CITY OF AVENTURA, FLORIDA LOCAL BUSINESS TAX RECEIPT FOR PERIOD 10/11 -09/12 Receipt 12- 00015095 Expires September 30, 2012 LOGIC BUILDERS INC 20801 BISCAYNE BLVD 301 AVENTURA FL 33180 305- 512 -1145 LOGIC BUILDERS INC PROFESSIONALS July 27, 2011 187.00 OP ID: D3 ACQREY �.._..- CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 02/27/12 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(les) 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 954- 731 -5566 W.F. Roemer Insurance Agency 4752 W. Commercial Blvd 954-7314438 Fort Lauderdale, FL 33319 William F. Dowd CONTACT NAME: FAX (NC, No. ExtI: (A/C, No): E- MAIL S: PRODUCER CUSTOMER ID #: LOGIC -1 INSURER(S) AFFORDING COVERAGE NAIC # INSURED Logic Builders, Inc • 20801 Biscayne Blvd #301 Aventura, FL 33180 INSURER A : Vinings Insurance Company 16632 INSURER B :INid- Continent Casualty Co 23418 INSURER C : 07/01/11 INSURER D : EACH OCCURRENCE INSURER E : DAMAGE TO RENTED PREMISES (Ea co INSURER F : RAGES FICATE NUMBER: REVISION 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 ADDL INSR SUBR WVD POLICY NUMBER POUCY EFF (MM/DDIYYYYI POLICY EXP (MM/DD/YYYY) LIMITS B GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY X OCCUR 04GL000824909 07/01/11 07/01/12 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea co $ 1 00,000 CLAIMS -MADE MED EXP (Any one person) $ EXCLUDED PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEM. AGGREGATE LIMIT APPUES PER POLICY X JPC-CT LOC PRODUCTS - COMP /OP AGG $ 2,000,000 7 $ AUTOMOBILE LIABILITY 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 acddent) $ $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes describe under DESCRIPTION OF OPERATIONS Y / N N / A WCV007093602 08/24/11 08/24/12 WC STATU- OTH- X TORY LIMITS ER EL EACH ACCIDENT $ 1,000,000 EL DISEASE - EA EMPLOYEE $ 1,000,000 below El. DISEASE - POUCY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule H more space is required) MIAMIS2 Village of Miami Shores g 10050 NE 2 Ave. Miami Shores, FL 33138 1 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 ACORD 25 (2009/09) © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 1 03/08/2012 16:28 FAX 1 800 685 7530 DATA SCAN FIELD SERVICES a001 $$$ass$$$$$$$$$$$$$$$ $ea TX REPORT a *e $$$$$$ass$$$$$$saaaas TRANSMISSION OK TX /RX NO 2310 RECIPIENT ADDRESS 93053563684 DESTINATION ID ST. TIME TIME USE PAGES SENT RESULT 03/08 16:27 00'59 2 OK Planning and Zoning Criteria Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax (305)758 -8972 Pontiff NO. BPP -2 -12 -352 Issue Date: Not Issued Expires:Not Issued Folio Number:1121360010160 -36 Owner's Name: BARRY UNIVERSITY Job Address: 11300 2 Avenue Suite: Pool House Miami Shores, FL 33138 -0000 Owner's Phone: Total Square Feet: 15000 Total Job Valuation: $ 355,000.00 Contractor(s) LOGIC BUILDERS INC Phone (305)512 -1149 Primary Contractor Yes Planning and Zoning Criteria and Comments Approved: Yes Comments: Date Approved: 2/29 /2012 : Yes Rt)c loos .m6, 1 Planning and Zoning Criteria Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Folio Number:1121360010160 -36 Owner's Name: BARRY UNIVERSITY Job Address: 11300 2 Avenue Suite: Pool House Miami Shores, FL 33138 -0000 Owner's Phone: Total Square Feet: 15000 Total Job Valuation: $ 355,000.00 Contractor(s) Phone Primary Contractor LOGIC BUILDERS INC (305)512 -1149 Yes Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 2/29/2012 : Yes Comments: Rtx Wsk- Permit No: 12-352 Job Name: March 7, 2012 Miami Shores Vivage 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 1) Provide approval from Miami Dade County DERM. 2) Provide all permit applications prior to any further review.Plumbing, electrical, fence. 3) Provide no diving markings per FBC 424.1:2.3.1 4) The stair rise must be uniform within a W and if the gutter is to be used as the top step then slip resistant tile must be placed the entire width of the stair.FBC 424.1.2.5.3ldentify on the plans. Plan review is not complete, when all items above are corrected, we will do acomplete 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 NOTICE OF COMMENCEMENT A RECORDEDCOPY MB' BE POSTED ON THE JOB SITE AT TIME OF FIRST NEFECIEN PERMIT NO. Lam® Fouo NO. 11- 2136 -001 -0160 STATE OF FLORIDA: COUN1Y OF MIAMI -DADE: 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. 1. Legal description of property and street/address: 11300 NE 2 Avenue Miami Shores, FL 33161 2. Description of improvement: Penafort Pool Renovation 3. Owner(s) name and address: Barry University 11300 NE 2 Avenue, Miami Shores, FL 33161 Interest in property: Owner 111111111111 11111 1111111111111111111111111111 CFN 201280147566 OR 8k 28016 Fs 1322; (1) RECORDED 03/01/2012 14.21:45 HARVEY. l UVINs CLERK OF COURT MIAMI -DADE C:OUHTYh FLORIDA LAST PAGE 1 )'t : `—S-1/ s° P� ,i' D9°2-11-32;2- Name and address of fee simple titleholder N/A 4. Contractor's name and address: Logic Builders Inc., 20801 Biscayne Boulevard, Suite 301, Aventura, FL 33180 5. Surety: (Payment bond required by owner from contractor, if any Name and address: N/A Amount of bond $ fJglrtel fl 6. Lender's name and address: N/A 9Y 7. Persons within the state of Florida designated by Owner upon L. provided by Section 1 i 3. is )t r, 7„ Florida Statutes, Name and address: 8. In addition to himself, Owners designates the following person(s) to receive a copy of the lrenor'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 sp Signature of Print Owner's Name irutce—. �� /ov-e S Sworn to and subscribed before me this = day of Notary Public • Print Notary's Name My commission expires* 113 41 -39 8/04 PAGES 20 1Z Prepared by Jeffry J Yao Address- Yao Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 172275 Permit Number: FW -4 -12 -637 Scheduled Inspection Date: August 16, 2012 Inspector: Bruhn, Norman Owner: , BARRY UNIVERSITY Job Address: 11300 NE 2 Avenue Pool House Miami Shores, FL 33138 -0000 Project: BARRY UNIVERSITY Contractor: LOGIC BUILDERS INC Permit Type: Fence/Wall Inspection Type: Anal Work Classification: Iron/Ornamental Phone Number Parcel Number 1121360010160 -36 Phone: (305)512 -1149 Building Department Comments Fence for pool Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments August 15, 2012 For Inspections please call: (305)762 -4949 Page 3 of 26 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 Permit Type: BUILDING JOB ADDRESS: //3 D /V '" Aiewee City: Miami Shores VED JUN 11 2012 FBC 20 Permit No - '� 3 7 Master Permit No... Z -/ 2 -35 a. ROOFING County: Miami Dade Zip: Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): �T �jli/ /1�dS+ ,.F Phone#: � iiilll ` Address: / City: Tenant/Lessee Name: Email: CONTRACTOR: Company Name: Address: �Z3lam�' o 41.44-4,M, City: /�' /�C,.fi.�►f' State: pza /14,/„.34 Qualifier Name: p%C_1.ele 94-' State Certification or e 'station # /�Pi , 93 5 2C) ' Certificate of Competency #: Contact Phone#: d J 796 Za 2 Email Address: ,1/i&' •J�o!'l� ri. co 0 DESIGNER: Architect/Engineer: Phone#: Zip: 331, Phone#:77i = 794-44.74 Valve of Work for this Permit: $ /1:7,/ COI"' Square/Linear Footage of Work: Type of Work: Addition °Alteration °New Description of Work: °Repair/Re. ace °Demolition Ai/e"? '! /I! V"ii fr f 4. Al 77 Color thru tile: Submittal Fee $ Permit Fee $ 3 J 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, 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 occ seven (7) days after the building permit is issued. In the absence of such posted notices, the inspection will not be approved" reinspection fee will be charged Signature Owner or Agent I The foregoing instrument was acknowledged before me this 11 day of 'JAW , ao 17,d by 1 QMa' who is personally known to me or who has produced As identification and who did take an oath. Signa Contractor The foregoin ; instrument was acknowled ..ed be , day of /t 1t. , Mae:, by �� who is personally known to me or who �`i odueed /t// iii " as identificatior��t�trpw.h riiil�rakeb"�' NOTARY PUBLIC: _ ` °' / CdO 4 My Commission Ex Sign: Print: My Commission Expires: . ;o * * ** * * * * * * * * * * * * * * * * * * * * * * ** * *** * * * * * * * * * * * * ***** *a, *** **r * ** ****** ** ** **** **seal+x*** ******* ******** ** APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 3/12/2012)(Revised 07 /10107)(Revised 06/10 2009)(Revised 3/15/09) 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 /a Permit No. /1'/L37 Master Permit No. R/ViO r 352- Plione #: Permit Type: BUILDING c ROOFING 1 -3(c)° prtJA h) r2.7 /wL JOB ADDRESS: City: Miami Shores . County: Miami Dade . Zip: 331( 1 Folio/Parcel #: Is the Building Historically Designated: Yes NO nC Flood Zone: OWNER: Name (Fee Simple Titleholder): 131)%g? 1/4-1 U MPE. p ° .°l° Phone #: ` c`J 70 5 Address: (300 Na 1✓ 2- AV%V• City: Io N H 1 S' State: r Zip: 3'd C J Tenant/Lessee Name: Phone #: Email: CONTRACTOR: Company Name: Address: i 4g! S City: Qualifier Name: State Certification or Registration #: Contact Phone #: 796 DESIGNER: Architect/Engineer: Value of Work for this Permit: $ Type of Work: ❑Addition Desclpyon of Work: 30,77-- 7 ?t - L 7 C. State: Zip: V fe e) w�7,--&W___.- Phone #: '71r- 79 = 9, -lo C , °%E, V Certificate o Competency #: 7 Email Address: /? /f 'e ( .7 ? c Phone #: OAlteration Square/Linear Footage of Work: ONew ORepair/Replace d� .4/ A� / :-lam 1,V:C3 44C ODemolition * * * * * * * * * * * *** **** r*** * *** r * * ** *** *** **Fees r** * * **** r*** *** * ** * ** *** * **** * ***** **, *** ** r Submittal Fee $ Permit Fee $ i 7 a7) CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ '2 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 suchv, ted notice, the inspection will not be approved an reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this 2rol day of N2P1 L ,2017; by Buc 1■,,NAgcs who jpersonally known or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: t MY COMNIISSION # E1136829 tat' : ffovmtba 12, 2014 F.Ncwy Discount Assoc. Co. Contractor The for &go' ng instrument was acknowledged before me this day o ,20 L k , by /71 / t rev who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC' My Commission Expire o G��y. 4........,....-e: s 0 9� ti "...4, 6'0 t� * * ** r* ****** ********* ** * * *** *** * *** *** * * **** * * ** * * * ** ** * * ** * ** * * * * ****** * ****T4p**4****0" ***** air Sign: Print: APPROVED BY G-17/1 Plans Examiner 1., t��sutln►u````\‘ Zoning Structural Review Clerk (Revised 3 /12/2012XRevised 07 /10 /07XRevised 06 /10/2009XRevised 3 /15/09) 1 Planning and Zoning Criteria Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Na FW -4 -12 -637 Issue Date: Not Issued Expires:NOt Issued Folio Number:1121360010160 -36 Owner's Name: BARRY UNIVERSITY Job Address: 11300 2 Avenue Suite: Pool House Miami Shores, FL 33138 -0000 Owner's Phone: Total Square Feet: Total Job Valuation: 293 $ 15,000.00 Contractor(s) LOGIC BUILDERS INC Phone (305)512 -1149 Primary Contractor Yes Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 4/11/2012 : Yes Comments: STRUCTURAL CALCULATIONS don/et) APR 0 4 2012 LOGIC BUILDERS, INC. G. V. Pirez Associates, Inc. Consulting Engineers 13081 SW 77th Avenue Miami, Florida 33156 Phone: (305) 412 -2200 e -mail: george @gvpirez.com George V. Pirez, PE #12294 Monica Pirez, PE #58734 1/ f WUADY1 A.�' �lOS D��pE��SI��GN 6 !f 'I ! P) INC. PaEVIEW EXCEPTMNS TAKEN EN Q REJECTED U NOTE COMMENTS ® RE -SU IIT REVIEW 10 Fon GENERAL •ONFORMANCE WITH THE DEStCid C. NCEPT AND CrAl7ACT DOCUMENTS. Markings or c r?r.z.nts evil not b? construed as reiieving the CONTHACTOR ;.oni cc ?prnu % `t the project plea and specification& nor dam: itrr : turn. 7hs CUNT-MOTOR retains responsible far details and ac,, na,,,,y, for confiir ig and correlating all quantities, job conditions and dimanSlot ?a, for stetting fabrication processes, for tee wties of a iy Kid co conWJelion, and for perfonning.his work in 4t61 112r" contu neer* • 7315 SW 87th Ave. #100 Miami, -FL 33173 PHONE; (305) 4124200 FAX: 005)412.2011 • PE #12294 - Pt, .. ..... .. .. ... ........... ............ ._ .... . _ - iiiiiiiimmo ... • A, 1,..0 • t • _f....._ _ I ,.. El • 1 ...... mi, .. tALti, .... . ..,:.,._ . Eli 1 ........... fax ,. f i 1 r •-- ., I 4 410 — . * -1- _ _j P • W Y. 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CALCULATED BY CHECKED* 11111111111PEASII 111111111 II I WM IIN • IN NEENIMUNINEVE NIMMIMIN rillINIP numwmpramom i smummumnitr mounnanamema 4 11111111111111111111111•0111 RR 11111111111 t1 .-* 111111111.1 NBLio• sr IMMUNE NM RE asiiimorstmen momes............' : imporerrar rinewriffisnes i rionanim animmummi raligart isrerm • monsii • warm minameras mom 1.3,11 FAR i mom ma 1111111111111111 NM NM II 1111iIiiiiliiiiiiliii Ehmairern ...IIII EWE 11111111111111111 RE= ENE 11.111111111g MOUE alma 16' . Ill . g ItgetriiiIi 0., A,_ i Li g - 0 Is4 . II NEW .i.3- ; - , gip• a JI.1III . c 2.34 o` ,�' MEM Air ,z _ ._.. _ _. _ ..._ _ _. .__ i ill 1111 . _ _...__ - _ t ril .. • _. d - ri " + 111 I si. - 3 5. l 0 'I• ` 111 /sail roi- 0 , ,4.C� .' Ill 8I� 11 F" � � =-=- . Eir iumearip moral .ri RE imi . . , 1 ifib: ' it. I al. .6 ,. .,, - - -- p ----- , -7 -1- -- - iv ii -• •t---- 0 --------------------- ! ----- , ..** 6 -- - --- ' MIN AI itoz riglial 1 S ' 4 istionia ina WE OM ,,, .. _ /. 1111 ' avairan - AP Il 111 ' 111111 • .,..: 4. j , 0 - 1. 47)---- L _l_f_i _ -I Fi ---- --- , _,._ ..__LI___ 1 L 1 t ...... --- --. _i_.----,---- | | ------'----��~---��-------'--1------ / 1 / � / _ | ' ---',I��-- ' °' °~ AOU NI GROUP, MC SHOP DRA''LlING REV' "..EPTICE S TAKEN ® REJECTED i ,`.:Cs}�6m,RI RE- SUBMIT s:_9 /I 13 FOR GENERAL CO7sIFORMANCE WITH THE O'ESIC CONCEPT AND CONTRACT DOCUMENTS. Markin s or comments shall not be construed as relieving the CONP 1CTOR from compliance with the project oars antspocifregorro nor de :.Mures therefrom. The CONTRACTOR remains responsible for details 4ind accuracy, for confirming anc correlating all quantities, job conditi ns and dimensions, for selecting fabrication processes, for technic as of assembly and construction, and for performing his werk a safe Miami Shores Village 1 ArPfloVED DATE WM, Min FEDERAL ZONiEG DEPT for BED bEP T SURD( C;l 1! t;UMI'I STATF ! Nf) CflltN NCI: WI111 ALL I Y !MI FS AND FIFOULATIONS POOL J� fi 5,7 MAX. 27(2 PLASTIC CAP REJECT 4' 118"» ALLOY 8081 -TPXPX0.08'r AWM.TUBE B AS PICKET, TO REJECT 4• TYP.) DETAIL No.I SCALE: 1"=1' -0" 20C1•ALUM.SHOES W/(3)No.12 X 3/4• OALV.TEK -HIX SCREW (TYP.) 2X1 •X118• ALUM.TUBE ALLOY 8081 -T8 AS HORIZONTAL TOP FENCE MEMBER (TYP.) r X 2 XX'ALUM,TUBE SCH.40 ALLOY 8031 -T3 AS POST (0 3-0" MAX(TYP.) 1•X1710.08rAWM.TUBE ALLOY 8081 -T8 AS PICKET REJECT 4" ' TO REJECT4•(TYP.) 'I X 3k" 118" \ '1- �o OM � I■ 8081 -T8A' HORIZONTAL TOP 8081-788" HORIZONTALTOP FENCE ME .T r X 2 XX° AW ALUM131-88 I ' 11 W' PO -0 ) ..,}l.,,i i• t. fro, t r" r^ •4••t• 2 x 1•xyl" ALUM.TUBE SCHAO ALLOY 808148 AS DOOR FRAME(TYP.) DETAIL No2 SCALE: 1 " =1'-O rxrXX ALUM.TUBE SCH.40 ALLOY 8081 -T8 AS POST FENCE MAGNETIC LATCH 1•-70 x 3-0" DEEP HOLE TO SET POST WI CONC.MIX CEM.(TYP.) DETAIL No.1 DETAIL No. 2 ?Xi" x.083 ALUM. TUBE ALLOY 80837 -S TO REJECT 4• (TYP.) r x 2x.122" ALUM. TUBE ALLOY8081 T -8(0 8,0" 0.C.- MAX. AS POST (TYPO rx 1•x.128• ALUM. TUBE ALLOY 881 T-6 AS HORIZONTAL ELEMENT AT TOP 8 BOTTOM (TYP.) rut' PREASSURED PLASTIC CAP (TYP.) 1.013X 3-0" DEEP HOLE TO SET POST W/ CONCJdIX CEM.(TYP.) 2x2" PREASSURED PLASTIC CAP (TYP.) ECEIVED .. APR 0 4 2012 LOGIC BUILDERS, INC.I `F NOTES: 1IP DETAIL No.3 SCALE: 3"=1' -0" SECTION A -A SCALE: 3/4'=1 -0" TYP. 1• X 1"x.083 ALUM. TUBE ALLOY 8083T -5 TO REJECT 4• (TYP.) rx r x.128• ALUM. TUBE ALLOY 8081 T -8® 12-0" O.C. MAX AS POST (TYP.) SELF - CLOSING GATE HINGES AT TOP AND BOTTOM r x r x.12S"ALUM. TUBE ALLOY 8081 T -8 AS HORIZONTAL ELEMENT AT TOP 0 BOTTOM (TYP.) 1•-0"0 X 3-0• DEEP HOLE TO SET POST W/ CONCAIDC CEM.(TYP.) SECTION B-B SCALE: 3/4"=1'-0" 1) ALL DIMENTIONS TO BE FIELD VERIFIED 2) PAINT ALL ALUMINUM IN CONTACT WITH CONCRETE WITH HEAVY - BODIED BITUMINOUS OR WATER-WHITE METHACRYLATE LACQUEt2. 1041"0, 13081 SW. 7781. Ave Mind. Florida, 33156 PHONE: 305.412.22( FAX: 302.412.2011 E- MAIL: EB 0001239 George V. Phan, P.E.812294 JOB NO DRAWN BY DESION/APPRV• G.V. FB,E: - IT L 1 1 8185 NW 98 ST. MEDLEY FL 33178 S OWN 12/i2 �*.•• F.J.R. BARRY UNIVERSITY MISCELLANIUS DETAILS eaAxmmxuos 4449 Permit No: 12 -637 Job Name: June 7, 2012 Miami Shores Viiiage Building Department Building Critique Sheet Revision 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 1) Provide approval from Miami Dade County DERM. 2) The plans provided revise several items. Provide separate permits new items. (walks, landscape, decking ect) 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 06/07/2012 10:50 FAX 1 800 685 7530 DATA SCAN FIELD SERVICES VI ow. ********************* *** TX REPORT *** ********************* TRANSMISSION OK TX/RX NO 2636 RECIPIENT ADDRESS 93053563684 DESTINATION ID ST. TIME 06/07 10:50 TIME USE 00'24 PAGES SENT 1 RESULT OK Permit No: 12-637 Job Name: June 7, 2012 Miami Shores Village 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 Revision 1) Provide approval from Miami Dade County DERM, 2) The plans provided revise several items. Provide separate permits new items. (walks, landscape, decking ect) 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 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 I3?P- 12 -352- Inspection Number: INSP - 176377 Permit Number: ELC- 3- 12-462 Scheduled Inspection Date: July 26, 2012 Inspector: Devaney, Michael Owner: , BARRY UNIVERSITY Job Address: 11300 NE 2 Avenue Pool House Miami Shores, FL 33138 -0000 Project: BARRY UNIVERSITY Contractor: ARCHITECTURAL ELECTRIC SERVICE Permit Type: Electrical - Commercial Inspection Type: Final Work Classification: Pool - Public Phone Number Parcel Number 1121360010160 -36 Building Department Comments REPLACE LIGHT POLES INSTALL NEW GFI OUTLETS CONNECT REPLACEMENT POOL PUMP Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comme Lr6,17. July 25, 2012 For Inspections please call: (305)762 -4949 Page 19 of 26 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 A RECEIVED APR 0 9 t01 BY: FBC 20 e BUILDING Permit No. PERMIT APPLICATION Master Permit No. ff - /Z Permit Type: Electrical JOB ADDRESS: /13d6 /tie-- v 2 d/4-'e -- / , ro®L City: Miami Shores County: Miami Dade Zip: Folio/Parcel #: Is the Building Historically Designated: Yes NO X OWNER: Name (Fee Simple Titleholder): 13PkR. P...4 U 1' V V CPS Address: 1 1 3)O OE 2 AVE City: M I t M1 S W ?-tS State: V- L Flood Zone: Phone #: 305 g "? 3 7.55 i 1c Tenant/Lessee Name: Phone #: Email: ref 141.' 1116a'L C,�G � -1%t- l e- Phone: 9:5S4 a c 6 d - 7. l CONTRACTOR: Company Name: Address: /A % q -t 6 l City: /' vs9 Qualifier Name: / '//&4 State Certification or Registration #: Contact Phone #: DESIGNER: Architect/Engineer: Value of Work for this Permit: $ Type of Work: ❑Address Description of Work: i"l State: Zip: 3,J Z3 Phone #: al/ f Certificate of Competency #: ® 7 t5E, 1* 957 Email Address: /CS ,�, Phone #: /Of e7a Square/Linear Footage of Work: ❑Alteration C ;Mew // ORepair/Replace ❑Demolition �vsn� ***** ** ** ** **** * * ** ***** **** * **** *** r** Fees**** **** * *** r*** r*** ** ** * * *** * * ** *** * ** * ** ** Submittal Fee $ �" ^ Q Permit Fee $ 4 "',‘" 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, 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 reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this 24%Q! day of lei , 20 11--, by Rem Lk, 1, AN it .PS , who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: 1 V Signature 4.iir* /- Contractor The foregoing trument was acknowledged before Ike this day of 4, , 20 /2 , by ✓r4.1.4 . who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Ex 2A4. ne1 Sher • 17::74968 .;� , i:h ';ti' . 16, 2013 �u:s. BONDED TURD ATLANTIC BON DING CO., INC. ********************************* �Yieok�Y4e�Y�Y�Y�F�Y�Y3e�t**** �Y9***** �Ynha4**** okvk�Y�k4e�Yde�Y�k�Y�Y�Y�Y�k�Y+ Y4r: Y�Y�Y�Y �Y9r�Y�lr+kvk3e4eotat�YaBa�*C:' vtnY*o *** %%-- Plans Examiner Zoning APPROVED BY Structural Review Clerk (Revised 07 /10 /07XRevised 06 /10/2009XRevised 3/15/09) 128112 ' DBPR - GUY, DURRANI DUDLEY; Doing Business As: ARCHITECTURAL ELECTRIC SERVICE INC, Regist... Lice se details Licensee Information Name: Main Address: County: License Mailing: LicenseLocation: License Information License Type: Rank: License Number: Status: Ucensure Date: Expires: Special Qualifications Broward Dade 12:12:32 PM 2/28/2092 GUY, DURRANI DUDLEY (Primary Name) ARCHITECTURAL ELECTRIC SERVICE INC (DBA Name) 2855 NW 210 TERR. CAROL CITY Florida 33056 DADE Registered Electrical Contractor Reg Electrical ER13013902 Current,Active 11/06/2007 08/31/2012 Qualification Effective 02/11/2011 11/06/2007 View Related License Information View License Complaint Contact Us :: 1940 North Monroe Street, Tallahassee FL 32399 :: Ca11.Center @dbar.state.fLus :: Customer Contact Center: 850.487.1395 The State of Florida is an AA /EEO employer. Copyright 2007 -2010 State of Florida, Privacy Statement Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public- records request, do not send electronic mail to th s Instead, contact the office by phone or by traditional mail. If you have any questions regardingDBPR's ADA web accessibility, please contact our Web Master at webmast er@dbar,siateJbus. httpsJlwww.myfloridalicense_c omILlcenseDetail. asp? SID= 8cid-- 9087425DCABSEAD4C8411494BE5B8514 1/ 3 ,. -CLASS -`� POSTAGE .1 PAW . " MAW IS NOT A BILL — DO NOT PAY RENEWAL RECEIPT NO. 640471- CC 0' 01E000957 OWNED pRC#iiTECTURAL ELECT 614144-'4 ommessmomlumamo ARCHITECTURAL ELECTRIC SERVICE INC DOING BUS IN DADE CO SERVICE BushleSs S�.T 6 CAL CONTRACTOR IgjfA 'CAX Tow it PERIRT THE DOES ' NOT VIOLATE Any HOLoat COUNTY o auEs. NOR ANY OMER maxmouriumnOS S au Ike Tom. TX CALEcTeft 09/23/2011 601 000075.00 01000010 I SEE OTHER SIDE — -- DO NOT FORWARD ARCHITECTURAL ELECTRIC SERVICE INC DURRANI GUY PRES 44 NE 1 ST POMPANO BEACH FL 33060 �ys�lass�ISflr: is�i►. 1}. a.. �f� :rtlssf�t!]Irla��ss�►�sr�s�� HP Officejet Pro 8500 A910 All-in-One series Fax Log for AES 954 -786 -2662 Mar 02 2012 1:16PM Last Transaction Date Time Type Station ID Duration Pages Result Digital Fax Mar 2 1:14PM Fax Sent 18505141672 2:38 7 OK N/A CTQB Construction Trades Qualifying Board BUSINESS CERTIFICATE OF COMPETENCY 07E000957 ARCHITECTURAL ELECTRIC SERVICE INC RANI Is certified under the provisions of Chapter 10 of Miami -Dade County r• 09- 29-2011 JEFF ATWATER STATE OF FLORIDA CHIEF FINANCIAL OFFICER DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF Nimes' TO BE EXEMPT FROM FLORI3A 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: 09/29/2011 EXPIRATION DATE 09/28/2013 GUY DURRANI 260697377 BUSINESS NAME AND ADDRESS: ARCHITECTURAL ELECTRIC SERVICE INC 44 NE 1ST STREET POMPANO BEACH FL 33080 SCOPES OF BUSINESS OR TRADE 1- ELECTRICAL CONTRACTOR IMPORTANT: Pnrsaant to Chapter 448. 05(14). F.S., an officer of a carparetian who elects axemptiea from this chapter by filing a certificate of election ender this section may net recover benefits or compensation under this chap ter - Pennant to Chapter 44f1.05(12). LS, Certificates of election to be exempt~ apply only within the scope of the business or trade listed an the notice of election to be exempt Pwsnant to Chapter 440.05114 F.S., Notices of 'election to he exempt and certificates of election to be exempt shall be subject to revacatina if, at any time after the filing of the notice or the issuance of the certificate, the person named on the melee or certificate no longer meets the regetremams of this sestina for issuance of a certificate. The department stmt! 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 DWC -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 Q9/29/2011 PE RSSOjNE DURRANI GUY FBI* 280697377 BUSINESS NAME AND ADDRESS: ARCHITECTURAL ELECTRIC SERVICE INC 44 NE 1sT STREET POMPANO BEACH P1. 33060 EXPIRATION DATE: 09/28/2013 SCOPE OF BUSINESS OR TRADE 1- ELECTRICAL CONTRACTOR IMPORTANT OPursaant to Chapter 440.05(14). F.S., an officer of a corporation who efts exemption from this chapter by filing a certificate of election L under this section may not recover benefits or compensation under this D chapter. Pursuant a fly only within 440.05(12). the scope election ta be or trade fisted on H exempt.. apply E the notice of election to be exempt E Pursuant to Chapter 440.05(13), FS_, 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 From:John Barnes FaxID:Riemer Insurance Page 2 of 2 Date:4/11/2012 04:34 PM Page:2 of 2 OP ID: JB '.'4. ---- ' CERTIFICATE OF LIABILITY INSURANCE DATE 04 /11DD/YYYY) 04/11 /12 THIS CERTIFICATE 13 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 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 800 - 742 -1691 Hallandale Branch Riemer Insurance Group 954 - 454-9552 PO Box 250 Hallandale, FL 33008 -0250 Star17p1n 1 Ripmar CONTACT NAME: John Barnes PHONE Ext) :954 -454 -3145 FAX tNC, No): 954- 454 -1714 Mass: jbames@riemerinsurance.com PRODUCER ID II: ARCHELI INSURER(S) AFFORDING COVERAGE NAIL 11 INSURED Architectural Electric Service Inc. Attn: Durrani Guy 44 NE 1st Street Pompano Beach, FL 33060 INSURER A : Wilshire Insurance Company GENERAL INSURER B: INSURER G: CLOO141136 CL00141136 INSURERD: 09/13/11 09/13/11 INSURER E : EACH OCCURRENCE INSURER F : 1,000,000 • THIS INDICATED. CERTIFICATE EXCLUSIONS INSR KGVISIVIV IVUIVItItK: 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 INSR SUER WVD POLICY NUMBER (MM POLICY (MWDD /YYYY) UMITS A A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLOO141136 CL00141136 09/13/11 09/13/11 09/13/12 09/13/12 EACH OCCURRENCE $ 1,000,000 X DAMAGES (RENTED PREMISES (Ea occurrence) $ 60,000 CLAIMS -MADE .X OCCUR MED EXP (Any one person) $ 5,000 X Underground Haz PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT POLICY n JE APPLIES PER: PRODUCTS - COMP /OP AGG $ 1,000,000 7 I 1 LOC $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ $ UMBRELLA LIAR EXCESS UAB CLAIMS -MADE EACH OCCURRENCE $ _OCCUR AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS Y i N N/A WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ below E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more apace is required) CERTIFICATE HOLDER CANCELLATION Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 MIAMSHI 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 ACORD 25 (2009/09) 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 171225 Permit Number: PL- 3- 12-460 Scheduled Inspection Date: August 01, 2012 Inspector: Hernandez, Rafael Owner: , BARRY UNIVERSITY Job Address: 11300 NE 2 Avenue Pool House Miami Shores, FL 33138 -0000 Project: BARRY UNIVERSITY Contractor: DILLON POOLS INC Permit Type: Plumbing - Commercial Inspection Type: Final Work Classification: Pool - Public Phone Number Parcel Number 1121360010160 -36 Phone: (954)668 -2000 Building Department Comments POOL PIPING AND EQUIPMENT Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments July 31, 2012 For Inspections please call: (305)762 -4949 Page 4 of 30 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 B�JII,DING PERMIT APPLICATION Permit T JOB ADDRESS: //3) ,de ,4e.04,e City: Miami Shores County: FB Permit No. 1�" Master Permit No. MAY 0720i2 BY: .......... 20 12: 4120 12-352 ROOFING £ , / ,e Miami Zip: Folio/Parcel #: Is the Building Historically Designated: Yes OWNER: Name (Fee Simple Titleholder): Address: l ®� City: NO Flood Zone: Phone #: Zip: Tenant/Lessee Name: Phone #: Email: CONTRACTOR: Company Name: 17f ei /4 Phone #: 1° " 794 ° X74. Address: 7o O / s t- 6 , °/ City: /4.e.4 71/414 Qualifier Name: /; fie, State Certification or Registration #: % � 67-5-24P5/ Contact Phone #: 3®" 7° 67,,4" DESIGNER: Architect/Engineer: /00, State: ,u Value of Work for this Per Type of Work: OAd Description o Email Address: Zip: '., 747 Phone #: Certificate of Competency #: ✓07®(4- e, '17 Phone #: 76f- 7 7 Square/Linear Footage of Work: ^' ONew ORepair/Replace ********* * * * * * ** * * ** * * ** * * ** * * * ** * * *** *F *** * **** ***** **** ********* *************** ** * Submittal Fee $ Permit Fee $ 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, 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 approv ' < ' nd a reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this Z3 Signature Contractor The foregoing instrument was acknowledged before me this day of AfI2LIs , 20 12, by lM G6 � 4R-✓„S , day of , 20 , by who is personally known to me or who has produced 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 PUBLIC: My Commission Expires Sign: Print: My Commission Expires: ** * * * **** * * ** ** ** * ** * ** x *** * *** *** ** *x *** * * *** * * * * **** * *** * ** * * **, *** ** ** err ****** *** ****** * * *** *** APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 3 /12/2012XRevised 07 /10 /07XRevised 06 /10/2009XRevised 3/15/09) • OP ID: D3 Ake -, °. R °� CERTIFICATE OF LIABILITY INSURANCE TDA 0V2 112 ' 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 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 Ileu of such endorsement(s). PRODUCER 954- 731 -5566 W.F. Roemer Insurance Agency 4752 W. Commercial Blvd 954- 731 -8438 Fort Lauderdale, FL 33319 William F. Dowd CONTACT FAX We No Ext): (A/C, No): E -MAIL ADDRESS: PRODUCER LOGIC -1 CUSTOMER ID #: INSURERS) AFFORDING COVERAGE NAIL # INSURED Logic Builders, Inc 20801 Biscayne Blvd #301 Aventura, FL 33180 INSURER A :Vinings Insurance Company 16632 INSURER B :Mid-Continent Casualty Co 23418 INSURER C : 07/01/11 INSURER D : EACH OCCURRENCE INSURER E : DAMAGE70RENrED PREMISES (E� occurtence) INSURER F : REVISION 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 LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MMIDD/YYYYI POLICY EXP (MM/DD/YYYYI UMITS B GENERAL X LIABILITY COMMERCIAL GENERAL X UABILITY OCCUR 04GL000824909 07/01/11 07/01/12 EACH OCCURRENCE $ 1,000,000 DAMAGE70RENrED PREMISES (E� occurtence) 100,000 $ � CLAIMS -MADE MED EXP (Any one person) $ EXCLUDED PERSONAL &ADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEM. 1 AGGREGATE LIMIT APPLIES PER: n LOC PRODUCTS - COMP /OP AGG $ 2,000,000 POLICY X JEC7 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE UMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ A WORKERS COMPENSATION AND EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS Y I N N /A WCV007093602 08/24/11 08/24/12 WC STATU OTH X TORY LIMITS ER EL EACH ACCIDENT $ 1,000,000 E.L DISEASE - EA EMPLOYEE $ 1,000,000 below EL DISEASE - POUCY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, It more space Is required) CERTIFICATE HOLDER CANCELLATION MIAMIS2 Village of Miami Shores 10050 NE 2 Ave. Miami Shores, FL 33138 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 ACORD 25 (2009/09)' © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 06/14/2010 0.904,8 477;::; C .CO59'.O: The GENERAL CONTRACTOR Named below IS ' CERTIFIED 'Under the .provisions f 'C .a a Expiration date: AUG 31, 20 >12, SEED, 1 CE EL s JAS' YOGI B I RS IN' 20801 BISC YNE. BL SUITE 301 AVENTURA CITY OF AVENTURA COMMUNITY DEVELOPMENT DEPARTMENT 19200 WEST COUNTRY CLUB DRIVE AVENTURA, FL 33180 305-466-8942 July 27, 2011 LOGIC BUILDERS INC 20801 BISCAYNE BLVD 301 AVENTURA FL 33180 This is your local Business Tax Receipt for the City of Aventura. Please post in a conspicuous place at the business location to avoid penalty. Do not remit payment as this is not a bill. Business Name: Location: Recipient Name: Description: Issue Date: Fees Paid: Restrictions: CITY OF AVENTURA, FLORIDA LOCAL BUSINESS TAX RECEIPT FOR PERIOD 10/11-09/12 Receipt 12-00015095 Expires September 30, 2012 LOGIC BUILDERS INC 20801 BISCAYNE BLVD 301 AVENTURA FL 33180 305-512-1145 LOGIC BUILDERS INC PROFESSIONALS July 27, 2011 187.00 JEFF ATVVATER CHIEF FINANCIAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION off * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW CONSTRUCTION INDUSTRY EXEMPTION 09 -02 -2011 This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: PERSON: FEIN: 10104/2010 SHER 571155795 BUSINESS NAME AND ADDRESS: LOGIC BUILDERS INC 20801 BISCAYNE BLVD #301 AVENTURE FL 33180 SCOPES OF BUSINESS OR TRADE: 1- CONSTRUCTION EXPIRATION DATE: 10/0312012 MICHAEL 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 'under this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05112), 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 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 i7WC -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 10/04/2010. EXPIRATION DATE: 10/03/2012 PERSON: MICHAEL SHER FEIN: 571155795 BUSINESS NAME AND ADDRESS: LOGIC BUILDERS 1NC 20801 BISCAYNE BLVD #301 AVENTURE, FL 33180 SCOPE OF BUSINESS OR TRADE: 1- CONSTRUCTION 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 L 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 H exempt.. apply only within the scope of the business or trade listed on Rthe notice of election to be exempt. E 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 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. DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01 -11 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 PERMI APPLICATION ' 0 2 FBC 'r FBC 4AR . s Permit No. Pu2_Lt(,Q Master Permit No. Permit Type: PLUMBING OWNER: Name (Fee Simple Titleholder): �seni, O,//v Phone # 'o 7 - co 37ST Address: /13 b® /1:‘ )/tee City: 1' "f /' Af...ei 4G5 State: Zip:33 /.P / Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: II 960 C 2, 4 — gs//4.-"7- Zs: / City: Miami Shores County: Miami Dade Zip: 331G 1 Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: -b ■ \ \Dr) ?Ob \S , 4- ric„ Phone #: eic5 Cif (Pg ' © Address: d` Set 1 X- rota e_ t rat_ City: al: k ra yr .✓ (® State: tbr4 Ack. Zip: 582!5-- Qualifier Name: TarYLCS 11,4 flb State Certification or Registration #: CPLO' —' .'a ? Certificate of Competency #: Contact Phone #: �' °' � Email Address: € ery`o i A` '0' 0 \s. cor-a -1 " _ _ DESIGNER: Architect/Engineer: * c.c, Zef,s.r 6::Pres i C.. Phone #: f>5-646-7° 817 5" Value of Work for this Permit: $ ®rPli° Square/Linear Footage of Works c, 25'F Type of Work: DAddre.ss . OAlteration 11' + Description of work a i el oi?mth' Phone #: at--fog --7 5/Z. New ORepair/Replace Ic , ODemolitiidn 5 � ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees************* * * * * * * * * * * * * *: * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ (,�0®� � CCF $ CO /CC $ Scanning Fee $ ` Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 9'53 ° 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`r a reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this day of f tai4 , 20 !Z, by RlIM .W / 4 ,,,J Why ?�T�onally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: ki Sign: Print: My Commission Expires: _ Contractor T eJo egoing instrument was acknowledged befo e me this, 1.3' day of Ld , 20 12-, by who is iers to me or w o has produced as ide NOTARY PUBLIC ,; i Y °'a''' ARICIA MORAZ?\N 1 1 ° Notary Public - State of Florida I', ri My Comm. Expires Oct 12, 2015 Allr''' "��..�' Commission • EE 131513 Si? . Print: ,A. ({'j 17 ' My Commission Expires: jO i - /6 * * ******** * * ** * * **** * **** ************************************************** ********* ******* * * ********* **** APPROVED BY Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) Zoning Clerk Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION FORM ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED OR THE VILLAGE MAY MAINTAIN A FILE WITH YOUR INFORMATION FOR A $30.00 FEE PER YEAR. IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. V COPY OF QUALIFIERS STATE LIC CARD B. `V� COPY OF LOCAL BUSINESS TAX RECEIPT C. Y COPY OF LIABILITY INSURANCE (CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPTI D. V COPY OF WORKERS COMPENSATION (EITHER CERTIFICATE OR EXCEMPTION) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT C. COPY OF LIABILITY INSURACE (CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKER COMP INSURANCE (EITHER CERTIFICATE OR EXEMPTION) YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 COMPLETE CONTRACTOR'S INFORMATION BUSINESS NAME: -D \ \Ors '®o\ 1 LPL BUSINESS ADDRESS: 119% +Pecfaani¢. rck "+ CITY n eurrt✓ STATE FL ZIP CODE 3302 BUSINESS PHONE: (q59 ) (e68- 2-Coo FAX NUMBER ( ) Lots Zoo 1 CELL PHONE (`MA ) WA--75/2— QUALIFIER'S NAME: Tctrt“ k . % L),9 QUALIFIER'S LIC NUMBER: CPC 0 Q(c, E -MAIL ADDRESS (IF APPLICABLE): 14 (burr/ c& 6; flon P • tort! Created on 3/19109 BY MLDV I RV 3/26/09 MLDV BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A -100, Ft. Lauderdale, FL 33301 -1895 — 954- 831 -4000 VALID OCTOBER 1, 2011 THROUGH SEPTEMBER 30, 2012 DBA: Business Name: DILLON POOLS INC Owner Name: JAMES H ALBURY /QUAL Business Location: 11591 INTERCHANGE CIRCLE S MIRAMAR Business Phone: 954 -362 -0300 Rooms Seats Employees 6 Receipt #:188-1062 Business Type: POOL /MARINP CONTRACTOR (SWIMMING POOL CONSTRUCTION Business Opened:12 /15/2005 State/CO unty /CertlReg:CPC 0 5 6 6 37 Exemption Code: NONEXEMPT Machines Professionals For Vending Business Only Number of Machines: Vendinc 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 Braward 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: DILLON POOLS INC 3254 NE 211 TERR AVENTURA, FL 33180 Receipt #035 -10- 00002842 Paid 09/13/2011 27.00 _ - BATCH NOVI6ER 1V*D 0(k1 5,"44 Z-Zt Xx ffiV `S' , ■ 1.V" ' 1.0 AV 'V. glt0 l9 :a. = DILLO -1 OP ID: MS COVERAGES CERTIFICATE NUMBER: REVISION 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. INSURANCE DATE(MM/DD/YYYY) 03/12/12 CERTIFICATE OF LIABILITY 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(les) 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 Insurance and Risk Management 321 - 214 -1990 of Florida, LLC 321 - 710 -2501 220 Crown Oak Centre Drive FL 32750 Rodney C Littlefield CONTACT NAME; Lee Insurance Concepts, Inc. (a/CONn o Ext): 321-214-1990 (FaC, No): 321-710-2501 a- DRESS: RodneyL@Irmtoday.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :Valley Forge Insurance Co INSURED Dillon Pools, Inc. 11591 Interchange Circle South Miramar, FL 33025 INSURER B : Continental Casualty Ins Co 12/27/12 INSURER C : Bridgefield Employers Ins. Co. 10701 INSURER D : 300 000 $ , INSURER E : INSURER F : X COVERAGES CERTIFICATE NUMBER: REVISION 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 LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A GENERAL X LABILITY COMMERCIAL GENERAL LIABILITY C4026836714 12/27/11 12/27/12 EACH OCCURRENCE $ 1,000,000 DAMAGES (RENTED PREMISES (Ea occurrence) 300 000 $ , CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE 7 POLICY X LIMIT APPLIES PER: Y a n LOG PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE X X LABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS 010-OWNED AUT C4026836700 12/27/11 12/27/12 COMBINED SINGLE LIMIT (Ea accident) 1,000 000 $ r BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ B X UMBRELLA UAB EXCESS UAB X OCCUR CLAIMS -MADE C4026836695 12/27/11 12/27/12 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED X RETENTION$ 10,000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y/ N N N / A 0830 -46987 12/27/11 12/27/12 X WC STATU- OTH- ER ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) CERTIFICATE HOLDER CANCELLATION MIAMISH Miami Shores Village g Building Department 10050 NE 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 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE `f • ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 13F? 12- 352_ Inspection Number: INSP - 171229 Permit Number: PLC -3- 12-461 Scheduled Inspection Date: July 26, 2012 Inspector: Hernandez, Rafael Owner: , BARRY UNIVERSITY Job Address: 11300 NE 2 Avenue Pool House Miami Shores, FL 33138 -0000 Project: BARRY UNIVERSITY Contractor: COJIMAR PLUMBING INC Permit Type: Plumbing - Commercial Inspection Type: Final Work Classification: Pool - Public Phone Number Parcel Number 1121360010160 -36 Phone: (305)336 -5956 Building Department Comments REPLACE SHOWER HEAD AT POOL DECK Passed Q Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Q -1--It July 25, 2012 For Inspections please call: (305)762 -4949 Page 2 of 26 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 1 Permit No. 1 2-"~ " � ! Master Permit No. 112,-- Z -/2 ®357_ BUILDING PERMIT APPLICATION FBC 20 y _F7Tr y r_ • • 3 �o..m Permit Type: PLUMBING c� q OWNER: Name (Fee Simple Title older): dd 1�P_�� Phone #: 305 0 1 I qq 70,j Address: ; ®lJ City: re/fogszil ' /1e State: Zip: 3,31•4, Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: //349 4 City: Miami Shores County: Miami Dade Zip: Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: V% Q 4'® Phone #: 3o ( 33 Address: 26 a City: ,f State: f13 Qualifier Na Zip: 3 3p2.0 State Certification or Registration #: J t 7 9 Certificate of Competency #: Contact Phone #: )---- 3,4 54 Email Address: 1, ‘49:04114 S '' d..ey %• DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ / ( ® ®. Square/Linear Footage of Work: Type of Work: DAddress n Altera • n UNew y �Repair/Re lace DDemolition Description of Work: _0/(7-,6) /fie PlAlie ° =C-1 ®®cam d fl ************* ** x:********* ***+ x** **+ x***** Fees****+ x***** ********+x***+x**** ******gum ********* Submittal Fee $ c1 Permit Fee $ /5-5 CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 1 V t `10 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 1' 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 issue. In the absence of such posted notice, the inspection will not be apprs '. d a reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this I'1 day oft , 201Z, by We avititir who is personally known t4 me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Exp Signature The forego day of Contractor strument was acknow1e ged before me this F 1, by /4 045, ersonally known to or who has produced as identification and who did tak- oath. NOTARY PUBLIC: gn: Prin lc_ ae Pr My Commis OM-Mission #1)D8; -968 Expires: MAY 16, 2013 BONDED TJIRIJ ATLANTIC BONDING CO. INC. ** ** ** **** ** * ****** *** ** *** ***J ********************************************** ***** *&****s:**** * * *** ******* ** APPROVED BY 2 2---Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) Zoning Clerk ACORD, CERTIFICATE OF LIABILITY *� INSURANCE DATE `MMIDDITY) 03/08/2012 POLICY NUMBER PRODUCER Ace Underwriting Group 5305 W. Broward Blvd. Plantation, FL 33317 954 - 581 -0202 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND HOLDER. THIS CERTIFICATE DOSS NOTOAMEND, CMEND OR IFICATE ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURED COJIMAR PLUMBING, INC. 6711 GARFIELD ST HOLLYWOOD, FL 33024 I INSURER A: American Vehicle Ins Co INSURERS: PROGRESSIVE EXPRESS INSURANCE INstlema TECHNOLOGY INSURANCE CO INSURERD: INSURER E ES 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. INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE(MM/DDNY) POLICY EXPIRATION DATEIMI4UDD/YY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY A91098 -01 03/16/12 03/16/13 EACH OCCURRENCE $1 , 000 , 0 0 0 FIRE DAMAGE (Any one tire) $100 , 000 CLAIMS MADE I X I OCCUR MED EXP (Arty one person) $ 5,000 PERSONAL 8ADVINJURY $1, 000, 000 GENERAL AGGREGATE $2, 000, 0 0 0 GENT- AGGREGATE LIMIT APPLIES PER X � POLICY 17111181" n LOC PRODUCTS - COMP /OP AGG $2,000,000 B AUTOMOBILE _ LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 06676234 -3 11/29/10 11/29/12 COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY Merriman) $10 , 000 BODILY INJURY (Per accident) $20, 0 0 0 PROPERTY DAMAGE (Per accident) • $ 10 , 000 GARAGE —II LIABILITY ANY AUTO AUTO ONLY -. EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS 7 LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION EACH OCCURRENCE $ AGGREGATE $ $ C WORKERS COMPENSATION AND Sal•LOVERSUABI"w TWC3256643 09/23/11 09/23/12 X 1 TORY UMI TS ( ER EL EACH ACCIDENT $LOO, 000 E.LDISEASE-EAEMPLOYEE $100, 000 E.L DISEASE - POLICY LIMIT $500, 000 OTHER - DESCRIPTION OF OPERATIONS /LOCATIONSNEHICLEStEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CANCELLATION Miami. Shores Village Building Dept 10050 NE 2 Ave Miami, FL 33138 305 - 756 -8972 I SHOULD ANY OF THE ABOVE DATE THEREOF, THE ISSUING NOTICE TO THE CER77FPCA IMPOSE NO OBLIGATI• REPRESENTATIVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN OLD " NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL • • +• -- OF ANY KIND UPON THE INSURER ITS AGENTS OR AUTHORIZED -4a• " j - - - ACORD 25-S (7/97) ©AGORU GL�[O'O BATCH WUM3ER LOCAL 1#f)SINESS: TAX REC EIPT :.. ,20 f A11 I•DADE !UNTY »;STAT OF FLORIDA FXPIRES SEPT 3li, 21T92 . UST BE DISPLAYED AT PLAN f)F BUSI AIITTO00411 Y+ DED41APTERSA 591948 -6 BUSINESS NAME t LOCATION COJIMAR PLUMBING INC DOING BUS IN DADE CO IS IS POTABILL— DOPIOTP4V PRENEWAL RECEIT. NO. 2720.8 617499 -9 STATE* CFC14 FIRST -CLASS U.S. POSTAGE PAID MIAMI, FL PERMIT NO. 231 OWNER COJIMAR PLUMBING INC Sec.'Type of Business. 11996APLLUMBING CONTRACTOR THIS IS BUSINESS TAX RECEIPT. IT DOES NOT PERMIT THE .HOLDER TO VIOLATE ANY EXISTING REGULATORY OR ZONING LAWS OF THE COUNTY OR CMES. NOR DOES Tt EXEMPT THE PP OORR LICENSE REWIRED BY LAW. THIS IS NOT A CERiIEICATION OF THE HOLDER'S OUALIFICA- 1 DNS. PAYMENT RECEIVED MJAMI DADEGOIINTY TAX COLLECTOR: 09/19/2011 02230018001 000075.00 SEE OTHER SIDE DO NOT FORWARD COJIMAR PLUMBING INC HECTOR SAN NICOLAS PRES. 2618 SCOTT ST HOLLYWOOD FL 33020 lltII1t4I'1'111t 111 L' Il 11111It1J1II11jIIII1II111111J1I lint