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CC-12-8114 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 177625 Permit Number: CC -5 -12 -811 Scheduled Inspection Date: August 21, 2012 Inspector: Bruhn, Norman Owner: , BARRY UNIVERSITY Job Address: 11300 NE 2 Avenue Weber Hall Miami Shores, FL 33138 -0000 Project BARRY UNIVERSITY Contractor: EMERALD CONSTRUCTION CORPORATION Permit Type: Commercial Construction Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1121360010160 -13 Phone: (954)241 -2583 Building Department Comments RENOVATE EXISTING WEBER COMMUNITY BATHROOMS Inspector Comments Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. August 20, 2012 For Inspections please call: (305)762 -4949 Page 19 of 19 '.e-Permitting MUNICIPAL INSPECTION REQUIREMENTS AND RECORD 08/19/2012 MUNICI PAL NO.2012- 048457 FOLIO: 1121360000050 JOB SITE ADDRESS 11300 NE 2 AVE PROPOSED USE SCHOOL BUILDINGS /BATHROOM RENOVATION LEGAL 36 52 41 40 AC SE1 /4 OF NE1 /4 LESS E35FT & LESS APPLICATION TYPE ALTER INTERIOR 650 SOFT 1 UNITS 1 FLOORS OWNER NAME BARRY COLLEGE CONTRACTOR QUALIFIER PERMIT TYPE MUNICIPAL BLDG CATEGORIES 0001 MUNICIPAL GENERAL BUILDING DATE: 8/19/2012 PROCESS NUMBER: M2012008546 NEW *AMOUNT PAID 257.00 DERM 1 ASBESTOS REVI 175.00 DERM 1 UP FRONT FEE- 80.00 DERM 1 MIN COMM REV( 90.00 FIRE 40000 ALTERATIONS & 104.00 FIRE 40000 FIRE UPFRT FE 32.00 UPMU 1 UPFRONT FEE F 25.00 7/ 9/2012 16:00 MARIA77 261207090108 CENTRAL 257.00 MUNICIPAL INSPECTION REQUIREMENTS AND RECORD 08/19/2012 MUNICIPAL NO.2012- 048457 PROCESS NO. M2012008546 FOLIO: 1121360000050 JOB SITE ADDRESS 11300 NE 2 AVE PROPOSED USE SCHOOL BUILDINGS /BATHROOM RENOVATION REQUIRED INSPECTIONS INIT DATE FIRE 0001 FIRE INSPECTIONS RECOMMENDED 200FIRE HYDRANTS 208FIRE TCO INSPECTION 211 PRELIMINARY 209FIRE FINAL Flu/ 2,-- MUNICIPAL INSPECTION REQUIREMENTS AND RECORD 08/19/2012 MUNICIPAL NO.2012- 048457 PROCESS NO. M2012008546 FOLIO: 1121360000050 JOB SITE ADDRESS 11300 NE 2 AVE PROPOSED USE SCHOOL BUILDINGS /BATHROOM RENOVATION INSP INSP INSPECTION DISP RESULT INSP TYPE DATE !-- ----,- COMMENTS !CODE DATE INIT • NOTICE OF COMMENCEMENT A RECORDED COPY MUST MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. CCi // /63-- TAX FOUO NO.. // 2/ 3 ooh °OO5o STATE OF FLORIDA.. COUNTY OF MLAMI -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. viii um mii mii um iim imi mi uii CFN 2012:R044-7989' OR Bk 23163 Ps 1762; (1es) RECORDED 06/26/2012 09:22:13 HARVEY RUVINr CLERK. OF COURT MIAMI -DADE COUNTY, FLORIDA LAST PAGE 1. Legal -description of property and street/address: I2 UNI\It`/ I t 3Cf3 'hd AV6 33161 2. Description of improvement: .1Peea, frrW Qon f1/4 VoAN Ati 3. Owners) name and address: &PLOY COO iV d 1I---/ 11.300 fJ 5 7-/N4 tall E,` M J 331 Interest ir►,property: Name and address of fee simple titleholder. 4. Contractor's name and address: & f l 1) Cept\i b.t a ci `� 10 86 Al IA) i' cower, t b * ( 6#c#f- 3 soo 9 5. Surety: (Payment bond required by owner from contractor, if any) Name and address: A)//4- 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: !W A- 8. in addition to himself, Owners designates the following in Section 713.13(1)(b), Florida Statutes., "tip >f�$c9C50 Name and address: �l or fr l.QRIDP. COU T°^ YF DPI 9. Expiration date of this Notice of Commencement: (the exp different date is specified) ��.G. )) WITNESS :L3IRE: !' _f�� � � •� c: •f.6ecording unless a Signature of Owner Print Owner's Name -1 Noii'� -"�(p� Sworn to and subscribed before me this 7!Z day of Notary Public Print Notary's Name My commission expires: Prepared by J K' > \r a r! 20�� �j Address: 1/300 /vE AVE t�l ar t 5'r `s) Z = 33 /6/ r - • CC12 -5I) 1 "� /. 41,' P &Z STRUCT �,°'f ' C' EL ! - fi- ,t07- MC pi, BLDG 'IJ 11 • Miami Shores Village Building Department 40050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 B I ING PERMIT APPLICATION Permit Type: BUILDING , JOB ADDRESS: 300 NE skesi,litE FBC 20 Permit No. PC /1 2-' 19 Master Permit 1`u. City: Miami Shores County: Folio/Parcel #: . 2 1 3 6 — 0 0 0 — 0 0 5 0 Miami Dade ROOFING (w rte-) 33/61 Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): ig 2/-`d 1I2 6 S i r'f Phone #: q— 39-96" Address: 113C'C) NE Z1 Z1,-10 Ai; C City: Pt41 Awl l Si- ebeCT- State: . Zip: 33161 Tenant/Lessee Name: -eFF/Zi f )6i-0 Phone#: 3t6 ?gel- 39195-- Email: IA-0 ®° I (I' -14-. & 2.4y, L CONTRACTOR: Company Name: i �- CC 135 1"/Z -�10/' Phone#: eg 'a7"/ ",c-F3 Address: i O 'g4 f lJp J 1 co (�t `r City: l7 D � C�rioel f State: Zip: 3 - C D� Qualifier Name: M IR 'K ti-al ISLE' Phone#: State Certification or Registration #: C &t✓ lf I5/ ?7S Certificate of Competency #: Contact Phone #: �'�- a f f 2-983 Email Address: SO tdaS 6''�'1G `� CAS ieSte d Cat.Po Ct DESIGNER: Architect/Engineer: ki\9U L 90,14) 1 is9iC o Phone #: ty e U U r ` C ZOO pp Value of Work for this Permit: $ d Off, d Square/Linear Footage of Work: Type of Work: DAddition ' Alteration ONew O) Repair/Replace ODemolition Description of Work: Ya rle4 rN l d� s Color thru tile: ***************************************F + n***************** ******** * * ** r************* Oa 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 $ k 005:CP Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) 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 FT.ECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature 44- �.�cc�,cJ Owner or Agent Contractor The foregoing instrument was acknowledged before me this 2-4•14 The foregoing instrument was acknowledged before me this day ofJl 6 , 20 1-2/, by LINDA P r'rd1 , day of 3/4' , 20 / 4-, by , who is personally known, to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY P LI : 7-4 Sign: e= Sign- I, Print: � ` � , . � y • 1 t t i Print �IIG ZT a �. d - ION # EE36829 •OW ona h My Commission Expires: d tan CtleSta COMMISSION #EEO4119$ ���'• Y�p(PIRES; •,A�o••. NOV. 09, 2014 �nw''a• ',WAVAARONNOTARY *******************************************************************************************************itaVIY My Commission Exp APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) MANUEL SYNALOVSKI ASSOCIATES Miami Shores Village c/o Building Department 10050 N.E. 2"d Avenue Miami Shores, Florida 33138 RE: Barry University —Webber Bath Permit No. CCR -8-1.2' 4311 This is in response to Building Critique Sheet dated 5/15/12 and Mechanical Critique Sheet dated 5.8.12, and Electrical Critique sheet. Building Critique: 1. Provide approval from Miami Dade fire See attached approval from Miami Dade Fire. Q Provide approval from Miami Dade County DERM See the attached DERM approval. 3. Provide ell pemilt applications prior to any further review. See the attached permit applications approval. 4. Identify the fire rated walls et the corridor Der MBC existing Ch. 7All condors in the area of work must comply with the condor 'Nine werfBC 2010. As discussed reviewer, item has been addressed. Mechanical Critique: 1. Missing HVAC design schedule See updated and revised sheet M -001, and M -100 for the attached HVAC design schedule. Electrical Critique: 1. Need Miami Dade County Fire Aoprova/ See attached Miami Dade County Fire approval. In advance, we thank you for your attention to this matter. Do not hesitate to contact us should you have any questions with the above. Respectfully, St Hatzidakis A Architecture • Planning • Interior Design 1800 Eller Drive, Suite 500 • Fort Lauderdale, FL 33316 • Telephone 954.961.6806 • Facsimile 954.961.6807 PERMIT #: /A ' !/ Miami Shores V Building Department RECEIPT 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 DATE: `° 027 -- Contractor Owner Architect Picked up 2 sets of plans and (other) WC Address: l d l b IJ f J 1 (dal? b G✓ 1-IL 3.30), 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 Departure _t to continue permitting process. Acknowledged by: PERMIT CLERK INITIAL: RESUBMITTED DATE: PERMIT CLERK INITIAL: Permit No: Preliminary Weber Bath Job Name: May 15, 2012 Miami Shores Village Building Department Building Critique Sheet 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 Fire. 2) Provide approval from Miami Dade County DERM. 3) Provide all permit applications prior to any further review. 4) Identify the fire rated walls at the corridor per FBC Existing Ch. 7. Al!corridors in the area of work must comply with the corridor rating per the FBC 2010. 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 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Date: Date: Permit #: Mechanical Critique Sheet Lot Review Completed by: Jan Pierre Perez Chief Mechanical Inspector Permit No: 12- el/ Job Name: // p ®a; ,T'A Date: 9 kay e,rt_ IV1 lami Shores Village Building Department ELECTRIC Critique Sheet 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 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. Review Complete by: Michael A. Devaney SR. Chief Electrical Inspector so- IVI iami Shores Vniage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 MIAMI SHORES VILLAGE NOTICE TO BUILDING DEPARTMENT OF EMPLOYMENT AS SPECIAL INSPECTOR UNDER THE FLORIDA BUILDING CODE I (We) have been retained by t6Aleitif ttio,v5tst-ty to perform special inspector services under the Florida Building Code at the Vje, ""g",:m s project on the below listed structures as of (date). I am a registered architect or professional engineer licensed in the State of Florida. PROCESS NUMBERS: ❑ SPECIAL INSPECTOR FOR PILING, FBC 1822.1.20 (R4404.6.1.20) o SPECIAL INSPECTOR FOR TRUSSES >35' LONG OR 6' HIGH 2319.17.2.4.2 (R4409.6.17.2.4.2) ❑ SPECIAL INSPECTOR FOR REINFORCED MASONRY, FBC 2122.4 (R4407.5.4) ❑ SPECIAL INSPECTOR FOR STEEL CONNECTIONS, FBC 2218.2 (R4408.5.2) o SPECIAL INSPECTOR FOR SOIL COMPACTION, FBC 1820.3.1 (R4404.4.3.1) o SPECIAL INSPECTOR FOR PRECAST UNITS & ATTACHMENTS, FBC 1927.12 (R4405.9.12) „„..e'' SPECIAL INSPECTOR FOR o Note: Only the marked boxes apply. The following individual(s) employed by this firm or me are authorized representatives to perform inspection * 1. ./444x2. 4. *Special Inspectors utilizing authorized representatives shall insuf the authorized representative is qualified by education or licensure to perform the duties assigned by the Special Inspector. The qualifications shall include licensure as a professional engineer or architect; graduation from an engineering education program in civil or structural engineering; graduation from an architectural education program; successful completion of the NCEES Fundamental Examination; or registration as building inspector or general contractor. I, (we) will notify Miami Shores Village Building Department of any changes regarding authorized personnel performing inspection services. I, (we) understand that a Special Inspector inspection log for each building must be displayed in a convenient location on the site for reference by the Miami Shores Village Building Department Inspector. All mandatory inspections, as required by the Florida Building Code, must be performed by the County. The Village building inspections must be called for on all mandatory inspections. Inspections performed by the Special Inspector hired by the Owner are in addition to the mandatory inspections performed by the Department. Further, upon completion of the work under each Building Permit I will submit to the Building Inspector at the time of final inspection the completed inspection log form and a sealed statement indicating that, to the best of my knowledge, belief and professional judgment th • -e portions of the project outlined above meet the intent of the Florida Building Code and are in rda e approved plans. Engineer/Architect _ _ Name c�G�Ap �.[ —AA A-c j' C 4o?J J o Address dress � —�o � �� 9 AVM, W40/ DATE: Created on 6/10/2009 Phone No. b fs -% 77/-8/4i Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 MIAMI SHORES VILLAGE NOTICE TO BUILDING DEPARTMENT V■ OF EMPLOYMENT AS SPECIAL INSPECTOR UNDER THE FLORIDA BUILDING CODE I (We) have been retained by /9477 'Jw' l'cj to perform special inspector services under the Florida Building Code at the IA e. tdqs-eize4 project on the below listed structures as of (date). I am a registered architect or professional engineer licensed in the State of Florida. PROCESS NUMBERS: o SPECIAL INSPECTOR FOR PILING, FBC 1822.1.20 (R4404.6.1.20) o SPECIAL INSPECTOR FOR TRUSSES >35' LONG OR 6' HIGH 2319.17.2.4.2 (R4409.6.17.2.4.2) o SPECIAL INSPECTOR FOR REINFORCED MASONRY, FBC 2122.4 (R4407.5.4) o SPECIAL INSPECTOR FOR STEEL CONNECTIONS, FBC 2218.2 (R4408.5.2) o SPECIAL INSPECTOR FOR SOIL COMPACTION, FBC 1820.3.1 (R4404.4.3.1) o SPECIAL INSPECTOR FOR PRECA T UNITS & ATTACHMENTS, BC 1927.12 (R4405. .12) a---SPECIAL INSPECTOR FOR Note: Only the marked boxes apply. 1 The folio n individual s employed by this firm or me are authorized representatives to perform inspection * G --14A-4,— 2. 3. 4. *Special Inspectors' utilizing authorized representatives shall insure the authorized representative is qualified by education or licensure to perform the duties assigned by the Special Inspector. The qualifications shall include licensure as a professional engineer or architect; graduation from an engineering education program in civil or structural engineering; graduation from an architectural education program; successful completion of the NCEES Fundamental Examination; or registration as building inspector or general contractor. I, (we) will notify Miami Shores Village Building Department of any changes regarding authorized personnel performing inspection services. I, (we) understand that a Special Inspector inspection log for each building must be displayed in a convenient location on the site for reference by the Miami Shores Village Building Department Inspector. All mandatory inspections, as required by the Florida Building Code, must be performed by the County. The Village building inspections must be called for on all mandatory inspections. Inspections performed by the Special Inspector hired by the Owner are in addition to the mandatory inspections performed by the Department. Further, upon completion of the work under each Building Permit I will submit to the Building Inspector at the time of final inspection the completed inspection log form and a sealed statement indicating that, to the best of my knowledge, belief and professional judgment those portion of the project outlined above meet the intent of the Florida Building Code and are in substantial accordance with the - : • • ed plans. Sign le • Engineer /Architect S7 /� __ Name �' 04-441.'n �l 144W P. f 4't f f Address � / �� 47 A- k /emsj DATE: Created on 6/10/2009 Phone No. GUYS: THIS IS A PRELIMINARY REVIEW FOR BARRY UNIVERSITY. PLEASE REVIEW, MAKE COMMENTS AND GIVE IT BACK TO US ASAP. THANKS! ELECTRICAL ❑ /PLUMBING MECHANICAL �)(STRUCTURAL BUILDING B� s DING 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 PERMIT APPLICATION FBC 20 • Permit N Master Permit No. MA 032612 B Y: a - ---- -- ----- -- Permit Type: BUILDING ROOFING Owner's Name (Fee Simple Titleholder) Barry University Phone # 305_811., -)761s- Owner's Address 11300 NE rd Ave City Miami Shores State FL Zip 33138 Tenant/Lessee Name Phone # Email Job Address (where the work is being done) 4r ' ay GlNwvpry vo ,,rrc comma/NAN e.At row City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # 11- 2136 -000 -0050 Is Building Historically Designated YES NO Flood Zone Contractor's Company Name tyA Contractor's Address Phone # City State Zip Qualifier Name Phone # State Certificate or Registration No. Certificate of Competency No. Contact Phone E -mail Architect/Engineer's Name (if applicable) p\AKfok t j" i N 14 LD\k 1 Phone # Value of Work For this Permit $ Type of Work: ['Addition I�' teration Describe Work: NO \JA� C opVA L N1rc1 79/ 1xoi (130(0 Square / Linear Footage Of Work: ❑New ❑ Repair/Replace ❑ Demolition * * * * *, ** * * * * *** ****** * * * * *** **** * *** * ** Fees * *** * * * *** * * * * *, *** *** ** * * * * * * * * * * * *** * * **** Submittal Fee $ Permit Fee $ CCF $ Notary $ Training/Education Fee $ Scanning $ Radon $ DPBR $ Double Fee $ Violation date: Structural Review. $ CO /CC $ Technology Fee $ Bond $ Total Fee Now Due $ See Reverse side -> 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 jig reinspection fee will be charged. Signature ler Owner or Agent The foregoing instrument was acknowledged before me this day of MAY , 20 9a , by (is D1{ who is personally knowsV me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expir APPROVED BY Signature Contractor The foregoing instrument was acknowledged before me this day of , 20 , by who is personally known to me or who has produced as identification and who did take an oath. Plans Examiner Engineer (Revised 07 /10 /07XRevised 06 /10/2009) NOTARY PUBLIC: Sign: Print: My Commission Expires: Zoning Clerk checked Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 1 2 -- E' 1 1 Inspection Number: INSP- 175766 Permit Number: ELC -7 -12 -1290 Scheduled Inspection Date: August 16, 2012 Inspector: Devaney, Michael Owner: , BARRY UNIVERSITY Job Address: 11300 NE 2 Avenue Weber Hall Miami Shores, FL 33138 -0000 Project: BARRY UNIVERSITY Contractor: PROSTAR ELECTRICAL CONTRACTOR INC Permit Type: Electrical - Commercial Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1121360010160 -13 Phone: (786)307 -4295 Building Department Comments ELECTRICAL FOR INTERIOR REMODEL Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comme August 15, 2012 For Inspections please call: (305)762 -4949 Page 8 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: Electrical JOB ADDRESS: 113f,C WE .21'1-4 AVE /64A.G IT: 1-11i JUL -1 BY: FBC 20 Permit No. ` 12'4 ILR ' Master Permit No. CC,— I2-1 CriL 1,-) City: Miami Shores County: Folio/Parcel #: I f— f 36 —o00— 0050 Is the Building Historically Designated: Yes Miami Dade Zip: "I 61 NO Flood Zone: OWNER: Name (Fee Simple Titleholder): &W° ( tQAi 1U 4I' I Phone #: 50''' T qq —34MC Address: d/ 3CD N& G City: MI Ii1,44i , tle t2 State: Tenant/Lessee Name: Z iFie t Email: f Ots f * /SLY a 4^`bik Zip: 3i6 Phone #: t'QP' i'9S Phone#: 131), , zb CONTRACTOR: Compaq �y ����--..,, Name: ¶rAL % Address: (4 0 S 1 9 t) city: ( Qualifier Name: State Certification or Registration #: p State: N i�,o Le E-0000 qoj Contact Phone #: A Email Address: DESIGNER: Architect/Engineer: M4NLI X- ./ 5 yt .0 ' &rj ASSOE V Phone #: Zip:33171 Phone #: Certificate of Competency #: 14 .Iepai Value of Work for this Permit: $ (9/ 0 Type of Work: ❑Address )(Alteration ,�1 Description of Work: � �� Q ,T �, `t'� N yep ms Ill 1• Square/Linear Footage of Work: ONew ORepair/Re . Iace ODemolition +x*************** *****+ x***+ x***** **w ****p ees************** *****+ x**+ x********m+a***+x ******* 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 s•-• Zip Mortgage Lender's Name (if applicable) P 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 iss, e' \n the absence of suc osted notice, the inspection will not be approved and a reinspection fee will be charged. Signature c? )77. gsZe:0,0,1) Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this Z-7 '19 The foregoing instrument was acknowledged before me this 2 2- day of —111'1% , 20 It by u I' )A I day of JOB , 20 � , by 4:444,00,0) , 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 . BLIC: Sign: Print: My Commission Expir * * * * * * * * * * * * * * * * ** APPROVED B NOTARY PUB IC: Sign: Print: ,p��Y p� �i*.f M Jonathan Cuesta y Commission Expires: `ro.• ~��' +: MISSIONIlE 041198 .`S: fit •ce %'' -A`' a : EXPIRES: NOV 09, 2014 X5 17` ∎ °', WWW,AARONNOr �x�xx�x��x: x�xx�a�***************** �x�x�: x��xx: x�u:m �x�x�x�x ** **+x+x** ** *** *+x�x** **** ** � *** *�x****** **M x 2e e•2- /(,re/1•/ Plans Examiner Zoning Structural Review Clerk (Revised 3 /12 /2012)(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 175780 Permit Number: MC -7 -12 -1292 Scheduled Inspection Date: August 15, 2012 Inspector: Perez, JanPierre Owner: , BARRY UNIVERSITY Job Address: 11300 NE 2 Avenue Weber Hall Miami Shores, FL 33138 -0000 Project: BARRY UNIVERSITY Contractor: WAYNE GROUP & SERVICES INC Permit Type: Mechanical - Commercial Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1121360010160 -13 Phone: (954)242 -9806 Building Department Comments MECHANICAL WORK AT WEBER BATHROOM RENOV. Inspector Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. August 14, 2012 For Inspections please call: (305)762 -4949 Page 16 of 34 Miami Shores Village Building Department c", a 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 �j Permit No. tte i Y Master Permit No. CC C- / _ $ / d BUILDING PERMIT APPLICATION FBC 20 Permit Type: MECHANICAL p .� OWNER: Name (Fee Simple Titleholder): & y �tA) 1 V c S1 Q "( Address: 1/300 /4e a,* &3($z City: 5H-elkes State: Tenant/Lessee Name: J PFL °f '''f 6 Email: l `� �$ r 1t44( 8m4ey, Phone#: 3W- 75q- 3c c JOB ADDRESS: /13a7 /4E-- kvehake zip: 33/6/ Phone #: '?t- 3q'q- City: Miami Shores County: Folio/Parcel #: A/36 °°©. * ° 00SO a Miami Dade Zip: 331 6 Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: WAVAI C 6 6,71qP Phone #: Address: City: Qualifier Name: State Certification or Registration #: 0 Se b bt° Contact Phone #: Email Address: MAO f'�b ,/ M n4N N S,1 ,pal \'3 p P Le,' t f State: DESIGNER: Architect/Engineer: Phone #: Certificate of Competency #: °°' 47/14 1441 rocsA. Cgo Phone#: Zip: 3 '") 1 est( Value of Work for this Permit: $ l c 0 0 00 Square/Linear Footage of Work: Alteration New ORepair/Replace Description of Work: • ` -AN ��+� U -1 L ADS &ri_ gAT ,,ii 1 W�A� " V V Type of Work: DAddress ODemolition *************** **** * ******** **+x**+xt **** *F *** �+xu****** ** * * * * * **** ** �a�x *,x�x�x *�x�x�x+�** **** Submittal Fee $ Permit Fee $ G S D .19`11 CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ i ��� -Om c)--e Bonding ,Company's Name (if applicable) ,I/4 Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip /,//A 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 A}FH)AVIT: 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 poste 1 notice, the inspection will not be approved and a reinspection fee will be charged. Signature 14 ) o Owner or Agent The foregoing instrument was acknowledged before me this . Y day of -UR' ,20 by 14 t 4 ie Op s personal v known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: My Commission Expir Signature Contractor The foregoing instrument was acknowledged before me this day of , 20 0 L, by Q iA-7 - L Leger , who is personally known to me or who has !!produced as identification and who did take an oath. NOTARY PUB - Sign My Commission Expires: r 2,:„:4.p Jonathan Cuesta +a ....yo V4. "� ' COMMISSION #EE 041198 .... ' .F EXPIRES: NOV. 09, 2014 *** * * * *** * ** ****mix * * * * *x** ***ai° * *# �x INIMA APPROVED BY ans Examiner Zoning Structural Review Clerk (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 175775 Permit Number: PLC -7 -12 -1291 Scheduled Inspection Date: August 17, 2012 Inspector: Hernandez, Rafael Owner: , BARRY UNIVERSITY Job Address: 11300 NE 2 Avenue Weber Hall Miami Shores, FL 33138 -0000 Project: BARRY UNIVERSITY Contractor: A STREAMLINE PLUMBING INC Permit Type: Plumbing - Commercial Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1121360010160 -13 Phone: (754)234 -1405 Building Department Comments PLUMBING FOR INTERIOR REMODEL Passed X Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments August 16, 2012 For Inspections please call: (305)762 -4949 Page 3 of 17 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 FBC20 Permit Type: PLUMBING Permit No. M a s t e r P e r m i t N o . C / . —Fit OWNER: Name (Fee Simple Titleholder): ' ' is ;* tP31 UP' 5iTy Phone#: 30,x: - ,_c- Address: 1 -3O0 W a!,21-$ , kk City: p.44 tht4 : State Tenant/Lessee Name: le t5-`' f Email: -7 y4-0 MME, RACeil 4 G' -bo- ss b Zip: B Phone#;. JOB ADDRESS: ! / 30e I(E A).--b q t City: Miami Shores County: Folio/Parcel#: //® /. 34— ,600 00 Sb Is the Building IHistori aUy Designated: 'Yes Miami Dade '3i 6 NO, Flood Zone: CONTRACTOR: Company Name: ,� c \�" 1 mp y A ®c' j Phone#: �* , a Address: 3 1 1 4 6 �p City: ti- . NJJ ( State: �°° Zip: Qualifier Name: /7711 cS 64~1.-7 State Certification or Registration #: C-' C AO- 6o Certificate of Competency*: Phone # 7974-2-34,- f o Contact Phone #: fl g rS (17.9-3 Email Address: A-.S / R UI7E / f XICS Value of Work for this Permit: $ ri 0 40 Square/Linear Footage of Work: Type of Work: Address Alteration ODemolition �f fL (. 6 , . f Description of Work: '�,,,� ��i �° n' � � t;� 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) Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this 7/-2 day of 3 ,2001, by LiNJA ei a( who is personally known o me or who has produced As identification and who did take an oath. NOTARY P IC: Sign: Print: My Commission Expire * * * * * * * * * * * * * * * * ** APPROVED BY 1 The foregoing instrument was acknowledged - fore day of J��� , 20 (2-, by dr who is personally known tome or who has produced as identification and who did take an oath. NOTARY P LIC: Sign: Print My mission Expires: onathan Cuesta QE COMMISSION #EE041198 °• EXPIRES: NOV. 09,2014 wwW,AARONNOTARY.com *** *** * * * ******+s+k****** * *** k*** *** ****•b * *+p**+k****+s*+t ****+>< * ***** ********* Flans Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Zoning Clerk DBPR - GARVEY, FRANCIS W; Doing Business As: A STREAMLINE PLUMBING I... Page 1 of 1 12 :47:41 PM 7/11/2012 Licensee Details Licensee Information Name: Main Address: County: License Mailing: LicenseLocation: County: License Information License Type: Rank: License Number: Status: Licensure Date: Expires: Special Qualifications Construction Business GARVEY, FRANCIS W (Primary Name) A STREAMLINE PLUMBING INC (DBA Name) 5341 SW 188 AVE SOUTHWEST RANCHES Florida 33332 BROWARD 5260 SW 8 CT PLANTATION FL 33317 BROWARD Certified Plumbing Contractor Cert Plumbing CFC1426015 Current,Active 09/05/2003 08/31/2012 Qualification Effective 09/05/2003 View Related License Information View License Complaint 1940 North Monroe Street, T.Ilahassee F 32399 :: Email: Customer Contact Center :: Customer Contact Center: 850.487.1395 The State of Florida is an AA/EEO employer. Coovriaht 2007 -2010 State of Pl. ride, privacy Staten', =ni 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 this entity. Instead, contact the office by phone or by traditional mail. If you have any questions, please contact 850.487.1395. https: / /www.myfloridalicense. com/LicenseDetail. asp? SID= &id= 601EB339D 131256B2A6... 7/11/2012 Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 CONTRACTORS' REGISTRATION FORM Fax: (305) 756.8972 ALL CONTRACTORS MUST PROVIDE COPIES OP 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. IP CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. B. C. D. COPY OF QUALIFIER'S STATE LIC CARD 'fir COPY OF LOCAL BUSINESS TAX RECEIPT /"- COPY OF LIABILITY INSURANCE (CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPT) COPY OF WORKERS COMPENSATION "EITHER CERTIFICATE OR EXCEMPTIONI IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPET NCY: A, a C. D. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT COPY OF LIABILITY INSURACE ,(CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPTI 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 BUSINESS NAME: ,j^ COMPLETE CONTRACTOR'S INFORMATION Sl p efdik...i i N/ BUSINESS ADDRESS: 4 b3 9- /V (A.) 'f3- � CITY T-14-e/b6IT STATE Ft. ZIP CODE `3 3 30 7 BUSINESS PHONE: (75t. ) S41--C 119;3 FAX NUMBER (Z 5.'6) 6 ga 3 Pi/ CELL PHONE A .40-- 3 /Y°S� QUALIFIER'S NAME: I�' W �Y ayr-v QUALIFIER'S LIC NUMBER: CPC— (14,74 Cl5 E -MAIL ADDRESS (IF APPLICABLE): 1 AliLlostf Created on 3119109 BY MLUV I RV 3126109 MWV BUSINESS TAX RECEIPT CITY OF OAKLAND PARK 2011-2012 MAILING ADDRESS A STREAMLINE PLUMBING INC 5260 SW 8TH CT PLANTATION, FL 33317 NAME AND LOCATION OF LICENSEE A STREAMLINE PLUMBING INC 4632 Nyy...4 TER . . . . OAIMAND .FL ;3009 • .• ISSUED DATE: September 09, 2011 , • • 'LICENSE NUMBER 2012001043 ORIGINAL NUMBER 9400509 LICENSE EXPIRES - • '9/30/2012 THE PERSON OR FIRM NAMED ABOVE IS HEREBY LICENSED TO ENGAGE IN THE BUSINESS PROFESSION OR OCCUPATION LISTED BELOW IN THE CITY OF OAKLAND PARK FLORIDA. BUSINESS CODE BUSINESS DESCRIPTION RESTRICTIONS 06550 PLUMBING CONTRACTOR LICENSE MUST BE CONSPICUOUSLY POSTED AT THE PLACE OF BUSINESS SHOWN CERTIFICATE OF LIABILITY INSURANCE °"'�i��'°' 6/21I2o12 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(its) must be endorsed. If SUBROGATION 15 WAIVED. subject to the terms and conditions of the policy, certain pollcles may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in Ilan of such endalseme s). PRODUGI�i Keyes Coverage Insurance NAME: KAREN BRYAN 5900 Hiatus Road ?NON o arc No A. P SS: kbryatuakey�ecove rage . cam PRODUCER somQ%ID II: 101 ?3 II Tamarae FL 33321 INSURED A Streamline Plumbing, Inc. 4954 SW 24th Ave Dania Beach FL 33312 COVERAGES INSURERS) AFFORDING COVERAGE INSURERA110 Coc3,ated Industries Ins. co. WSURER B : INSURFRO I NAIC D 23140 INSURER D: INSURER E INSURER F• GERTIFICATI~ NUMBER iioi$4 THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE WHICH THIS CERI IPICAA'INOTWITHSTANDING MAY IED O MAY TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS PERTTAIN %WD 90$ 7 rcmviziwN NUMBER: LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY THE NSURANCE A� AFFORDED BYY TTHE�POUCIES DESCRIBED DOCUMENT IS SUBJECT OF SUCH POLICIES. UMrr$ SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TO INSR '�' "FE OF INSURANCE LIAEILITY n DOWN (NSR POLICY NUMBER POLIO (MM1D0 UCY EXP rr LIMITS EACH OCCURRENCE 8 GENERAL LIABILITY COMML�RCIAI. GENERAL CLAIMS -MADE DAMAt3E l O REN LED (Es oesuffenae] $ mac MED EXP WV ogre person) $ PERSONAL & ADV INJURY S — GENERAL AGGREGATE 5 `GEENt AGGREGATE LIMIT APPLIES PER; PRODUCTS,- 00MP10 AGO $ - ) POLICY IFar I I L00 AUTOMOSI E LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS CQMBIN @O SINGLE LIMIT (Ea +!) $ — BODILY INJURY (Ferpelsotli S — BODILY INJURY (PST eex q $ PROPERTY DAMAGE $ S $ UMSREW►Lsks EXOESS LUAB I OCCUR CLAIMS -MADE EACHQCCURRENDB $ AGGREGATE DEDUCTIBLE REYENT1QN a $ $ A WORKERSCOMP2NSAT10N AND EMPLOYERS' UAEW7Y OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes. do7g1ba tinter DESCRIPTION OF OPERATIONS YI NIA lLWC1009978 9/27-/'01x. 5 /RJ.' 0X$ YJCSTA OT Ft. X J�RYLII SI I sR -- 0�� 7 E.L EACH ACCIDENT 51.000. 000 below E.L DISEASE • EA EMPLOYEE $1, 000, 000 E.L, DISEASE - POLICY LIMIT $1 000. 000 DESCRIPTION OF OPERATIONS! LOCATIONS/VW-00M (A1(soh ACORD 101, Additional Remelts Schad uia,11 more toms is rssuiredl CANCELLATION Miami Shores Village Bldg Dept 10050 NE 2n1. Ave Miami Shores FL 33138 ACORD 25 (2009109) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH NE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 01988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and Togo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE ASTRE-1 OP ID: 1Z DATE (MMIDD/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOL E4R.1 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; W the certificate holder is an ADDITIONAL INSURED, the policy(ies) must he 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 rigs to the certificate holder in lieu of Such endorsemegt(s) • PRODUCER Advanced Insurance & Financial 12240 SW 53rd St. Ste. 501 Cooper City, FL 33330 Advanced Insurance & Financial INSURED A Streamline Plumbing, Inc. Joe Moran or Francis Garvey 5431 SW 188th Avenue Southwest Ranches, FL 33332 COVERAGES 954- 436 -4027 Parr 954 - 680.7065 PHIS "e &MAIL AoCIRESSr CERTIFICATE NUMBER: F (A/C. No): INSURER03) AFFORDING COVERAGE NAM SURER A :Scottsdale Insurance Co. INSURER a : Mercury Insurance Group 111202 INSURER C : INSURER D; _INSURER E : I INSURER P J THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAW BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT wall 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 SUCI-I POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIM $. IL'JR TYPE OF INSURANCE A122,b1 llaj .� M �' - - -' �� POLICY "PI _INSR 1 VIn/D iaDLIOV NUMBER fM1inn n JIYINLA)D/YYY`fl �3ERF.rWL LIABILITY A © COMMERCIAL GENERAL LIABILITY 8 GJ,AIMS -MADE X OCCUR [ GEN'LAGGREGATE LIMrrAPPLIES PER I A POLICY PRO.. j'7 EDT' I I LOC AUTOMOBILE LIABILITY X x x ANY AUTO ALL OWNED AUTOS HIRED AUTOS X x X CPS1684921 06/14/12 SCHEDULED AUTOS NON - OWNED AUTOS FLC7019343 -1 06/14/13 LgWnB $ EACH OCCURRENCE DAMAGE TO I{kN'I ea PREMISES (_Ea rgtc9) 1,000,000 100,000 MED EXPJAny ono pet8*n) 5,00o PERSONAL a ADV INJURY GENERAL AGGREGATE $ 1,000,000 s 2,000,009 1,000,000 PRODUCT$ - COMP /OP AGG 1 $ 06/21/12 UMBRELLA LIAR EXCESS LIAR DED 1 1 RETENTION s OCCUR CLAIMS -MADE WORKERS COMPENSATION AND EMPLOYER$ LIP ll.rrY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED'? (Mandatory in NH) II yes. describe under DESCRIPTION OF OPERATI N$ below 06/21/13 MIMI:3RM SINGLE LIMT Me accident) 1,000,000 BODILY INJURY (Per perm) 3 BODILY INJURY (Par accident) PROpERTY DAMAGE „qv accident) 8 5 Y INi N/A EACH OCCURRENCE S AGGREGATE S DESCRIPTION OF OPERATIONS / LOCATIONS/ VERICLES (Attach ACORD 101. Additional Remarks Schwa/ie. if mom apace is required) Commercial & Residential Plumbing Certificate holder is also listed as additional insured. WC STATU• I i OTH- TORY LINTS I ES EL EACH ACCIDENT g E.L. DISEASE - EA EMPLOYEE 3 E.L. DISEASE • POLICY LIMIT 3 CERTIFICATE HOLDER Miami Shores Village Building Dept 10050 NE 2nd Avenue Miami Shores, FL 33138 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCr:1.LED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE el 1988 -2010 ACORD CORP- ORPORATION. Alf rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD