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CC-11-867
Protect Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Applicant 11300 NE 2 Avenue Number: Adrian Hall Miami Shores, FL 33138 -0000 1121360010160 -07 Block: Lot: BARRY UNIVERSITY INC Owner Information Address Phone Cell BARRY UNIVERSITY INC 11300 NE 2 Avenue MIAMI SHORES FL 33161 -6628 Contractor(s) Phone EMERALD CONSTRUCTION CORPOR (954)241 -2583 CeII Phone Approved: In Review Comments: Date Approved: : In Review Date Denied: Type of Construction: INTERIOR OFFICE RENOVATION Stories: Front Setback: Left Setback: Plans Submitted: Yes Certification Date: Bond Retum : Scanning: 12 Occupancy Load: Exterior: Rear Setback: Right Setback: Certification Status: Additional Info: Classification: Commercial Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $30.00 $22.50 $22.50 $10.00 $1,500.00 $36.00 $40.00 $1,661.00 Pay Date Pay Type Invoice # CC -5-11 -40927 05/12/2011 Credit Card 06/30/2011 Check #: 1399 Amt Paid Amt Due $ 150.00 $ 1,511.00 $ 1,511.00 $ 0.00 Available Inspections: 1 1 Inspection Type: Final PE Certification Window Door Attachment Tie Beam Slab Termite Letter Framing Store Front Attachment Insulation Drywall Screw Window and Door Buck Ceiling Grid Fill Cells Columns In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy June 30, 2011 Date June 30, 2011 1 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 206 7 Permit T : BUILDIN ROOFING Permit No.'"` t Master Permit No. OWNER: Name (Fee Simple Titleholder): ,L =9,err CohIN /3141 Phone#: 3OS- ''S%gi,S Address: �/1700 ,tf_.g . to / V / City: A 4^°C t S h0'? - State: i7A07. 44 Zip: .33)6J Tenant/Lessee Name: Phone#: Email: -440'' Motif* I rr/ o P.c1-' JOB ADDRESS: /130g7 4Jt J') 1,4,4 Q -- 404 A/\1 ' 1 ,R City: Miami Shores County: Miami Dade Zip: 3316 Folio/Parcel #: / / - Z / 3 to - 008 — OOS Is the Building Historically Designated: Yes NO ✓ Flood Zone: GI I_PA- CONTRACTOR: Company Name: �/'�4,4 a 63,1,54r0 G4v'+ C Phone#: 9S9 - RziI-adS !3 Address: /F 8b Nei l S4- Qo:�r4 l j �^ ° 33 ®ter City: /' ���/��4L�1,,(tl d' �i ` State: � �t� zip: Qualifier Name: / " lirld.. i,,,m b\ es- Phone#: W q -1q 1 - 2S V'S State Certification or Registration #: 69) e ei is/ gq 7S Certificate of Competency #: Contact Phone#: '- Y) - off& Email Address: �Ic 434-/"s -)c9,e < ®r�. Gc'+ DESIGNER: Architect/Engineer: /14i tit I ®( e14 /®vs 10 t 43'S®'6 i`R4e S Phone#: 7 -96% - 4,e044) Value of Work for this Permit: $ 5O O O Square/Linear Footage of Work: ii, S.0 Type of Work: DAddition a Iteration ONew ORepair/Replace ODemolition Description of Work: 4)- e.�' /®e, 4t� /G.40%J -T '4 e'7 ,,�..%` -,q., /Al/ *ice 1ee5 o.s .09.rs i 6_ AvelJe ' € > CO, iy- e- f1.4/fr 2t a e3 C�J� e4 Y. �/ ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** d� /J d 0 tCCF $ CO /CC $ Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ ,511-t om Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) ,y/4 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 approveand a reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this d P' day of 141 AY ,2011 ,by 1311AA c 01)V440/0-0 , who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commissio ** * * * * * * * * * * ** APPROVED BY Signature Contractor The foregoing instrument was acknowledged before me this I'® day of 4117 , 20 L , by who is ep rsonally knownt9 me or who has produced as identification an NOTARY PUBLIC: Plans Examiner Structural Review (Revised 07 /10/07)(Revised 06 /10/2009)(Revised 3/15/09) ;`•James OoMMiSSioN # DD734951 S: NOV. 13, 2011 b'+ .; .nARON N0TARYGcom 1.11 SioP #,DD7 34951 h. ^'d. 16, 2011 ,r ;i4,ANa7ARY.cem V, 0- Zoning Clerk STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487 -1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 HUMBLES, MARX R EMERALD CONSTRUCTION CORPORATION 390 NE 103RD STREET MIAMI SHORES FL 33138 Congratulations! With.this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and leam more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! DETACH HERE SEE OTHER SIDE DO NOT FORWARD EMERALD CONSTRUCTION CORP MARK HUMBLES QUALIFIER 1086 NW 1 CT HALLANDALE FL 33009 hdhAdhAndJunildJuilfluishhiluliHUH CERTIFICATE OF LIABILITY INSURANCE DATE (MMJDD/YYYY) 04 /11/2011 TYPE OF INSURANCE PRODUCER (305)822 -7800 FAX (305) 558 -4294 Collinsworth, Al ter, Fowler & French LLC 8000 Governors Square Blvd Suite 301 Miami Lakes, FL 33016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIL 8 INSURED Emerald Construction Corp 1086 NW 1st Court Hallandale Beach, FL 33009 INSURERA United Specialty Ins Co GENERAL INSURERS: Sentinel Insurance Co 05106156 INSURER C: Commerce & Industry Ins Co 04/05/2012 INSURER D: $ 1,000,000 INSURER E DDAFAAGE Tgip ) 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 MAYBE 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. TN D�RG TYPE OF INSURANCE POLICY NUMBER pA pTAEryY) PLUICEY EXPIRATIONp wars A GENERAL LIABRIY COMMERCIAL GENERAL LIABILITY 05106156 04/05 /2011 04/05/2012 EACH OCCURRENCE $ 1,000,000 X DDAFAAGE Tgip ) $ 100, 000 $ 5,000 I CLAIMS MADE X OCCUR MED EXP (My one person) X Broad Form PD ONAL & ADV INJURY $ 1,000,000 X Contract Liab &XCU GENERAL AGGREGATE $ 2,000 000 GEM_ AGGREGATE LIMIT APPLIES PER: POUCY n 287 n LOC PRODUCTS - COMP/OP AGO $ 2 , 000 , 000 7 B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 21UENQT2496 08/11/2010 08/11/1911 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ R OTHER THAN EA ACC $ AUTO ONLY: AGO $ C EXCESS/UMBRELLA LIABIU Y EBU081232827 FOLLOW FORM 03/19/2011 08/11/2011 EACH OCCURRENCE $ 5,000,000 OCCUR CLAIMS MADE AGGREGATE $ 5,000,000 DEDUCTIBLE RETENTION $ 0 $ $ $ WORKERS COMPENSATION AND EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? H yes, describe under SPECIAL PROVISIONS below I wDC sTIMRS 1 I ER E.L EACH ACCIDENT $ EL DISEASE - EA EMPLOYEE $ E.L DISEASE - POLICY LIMB $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDOPSWIENT 1 SPECALL PROVISIONS Project: Barry University, 11300 NE 2 Ave, Miami Shores, Fl 33138 Certificate holder is named additional insured as respects Commercial General Liability if required by Nritten contract. Umbrella is Follow Form. *10 Day Notice of Cancellation will apply for nonpayment Miami Shores, Village of Building Dept 10050 NE 2 Avenue Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30* DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBUGATION OR LIABaITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE �� Mel Wiesel /ROSIEH •`tZ,1? ACORD 25 (2001/08) © ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001/08) Miami Shores Viiia e 9 Building Department RECEIPT PERMIT #: ij DATE: I, 0=31‘1A(.-, Qeret` 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Contractor ❑ Owner ❑ Architect icked Address: p 6 2 se •f plans and (o er) ? G, From the building department on this d to 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 Departmet to c�f'i inue permitting process. Acknowledged by: PERMIT CLERK INITIAL: RESUBMITTED DATE: ltil 4,e \1 PERMIT CLERK INITIAL: PERMIT # Cc 1 I CONTRACTOR: rn ccoak.. SUBMITTAL DATE: k ON_ ( L ADDRESS: \ pp icd NAME: RESUBMITAL DATES: PROJECT TYPE: IRlEtko — P-N? FIRE ZONING ELECTRICAL IM T FEES HRS/DERM MECHANIC)IL Permit No: 11 -867 Job Name: May 18, 2011 Miami Shores Village Building Department Building Critique Sheet 1) Plans must be approved by Miami Dade County Fire. 2) Plans must be approved by Miami dade DERM. 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 Plan review is not complete, when all items above are corrected, we will doa 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 - 795 -2204 NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. TAX FOLIO NO. 11 - 2) 3 , 3 0 STATE OF FLORIDA: COUNTY 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. 111111111111111111111111111111111111111111111 Fll+! 2011.80307636 OR Bk 27684 Ps 2285: (1ps) RECORDED 05/11/2011 13:18:25 HARVEY RUVIN, CLERK OF COURT MIAMI -DADE COUNTYf FLORIDA LAST PAGE 1. Legal description of property and street/add►esp. ! /,r /� // -3(0 52 4 , 9® e4C' . s°E 1/K 0?-,up 1/'4 /G. -f 3S PT j gsa lead w4Dr7! /}OV AI..C. J. Ave's, 540nc45- F - 33111 2. Description of improvement: 10-crier- ricer.. It,�✓44 oot Space above removed for use of recording office 3. Owner(s) name and address: /3*77 04 -a'e. 3 i4 ^ 113 Ora /OE 44/, 4.rrsr of j f44i41-A4 KlonOrY4l F C.. 3a1 Sa' Interest in property: Name and address of fee simple titleholder. 4. Contractor's name, address and phone number. #8,1/4 4d4 emckie FL pi-: cty `acl i —.2583 6. Surety: (Payment bond required by owner *pm contractor, if any) Name, address and phone umber. 41/4 Amount of bond $ it/ 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, address and phone number. 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Uenor's Notice as provided in Section 713.13(1)(6), Florida Statutes. Name, address and phone number. 9. Expiration date of this Notice of Commencement (tire expiration date Is 1 year from the date of recording unless a different date Is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE • F COMMENCEMENT Signature(s) of Owner(s) - / s)' Authorized Officer /Director/Partner /Manager Q Prepared By Prepared By SA (J� `-� e�� S Print Name ,6/a J Print Name I>�r�!i'L►:' TiUe/Office F�,.; � � Wl Title/Office STATE OF FLORIDA COUNTY OF MIAMI-DADE foregoin instrument was aclmowledged before me this 10 4k e� day of 1. 14 f ❑ Ind' dually, or NI as for 9M-' UNW/ i. t' 'Y XPersonally known, or CI pr uced the following type of identifi Signature of Notary Public: . Zol 1 Under penalties of perjury, I declare that I have , �;" v., -i i =• • .ion it �;' that the facts stated in it true, to the best of m h ge an: . et Signature(s) of Own e % er(s)'s Authorized Officer/Director /Partner/Manager who signed above: By _ By 129.01 -58 PARED 3/10 SlATEiNFLORTJA,COUNTYCFDADE i HE Y CER r tFY?hE itric is s ?rite copy of UIe c ic',nil flkd in thig• ci:ica g: depof ev 1 AD' 20 UVIT1 , my hand and Of icluE S val. MANUEL SYNALOVSKI ASSOCIATES, LLC 1800 Eller Drive, Suite 500 • Fort Lauderdale, FL 33316 • Telephone 954.961.6806 • Facsimile 954.961.6807 August 19, 2011 Norman Bruhn Building Official /Director Miami Shores Village 10050 NE Second Avenue Miami Shores, FL 33138 -2382 RE: Barry University Adrian 108 Renovations Permit No. CC -5 -11 -867 Dear Mr. Bruhn: As the Architect of Record on the above referenced project, we offer the following as clarification as it relates to the ceilings in Offices #1 44 (Rooms 104 -107). Following demolition, the existing plaster ceilings and crown mouldings were exposed and we opted to stay with the existing ceilings and preserve the historical details rather than install the 2X2 acoustical ceiling tile grid that was indicated in the permit set of plans. Please feel free to contact us should you have any questions or concems with the above. Respectfully, Manuel'Synalovski, AIA, LEED AP Managing Partner FL Lic. #11,628 02614 gii("4 MANUEL SYNALOVSKI ASSOCIATES, LLC architecture • interior design • planning Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 159742 Permit Number: CC -5 -11 -867 Scheduled Inspection Date: August 18, 2011 Inspector: Bruhn, Norman Owner: , BARRY UNIVERSITY Job Address: 11300 NE 2 Avenue Adrian 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 -07 Phone: (954)241 -2583 Building Department Comments INTERIOR OFFICE RENOVATION Passed,i(vej;ZI Failed Inspector Comments Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. August 17, 2011 For Inspections please call: (305)762 -4949 Page 8 of 46 MANUEL SYNALOVSKI ASSOCIATES, LLC 1800 Eller Drive, Suite 500 • Fort Lauderdale, FL 33316 • Telephone 954.961.6806 • Facsimile 954.961.6807 August 19, 2011 Norman Bruhn Building Official /Director Miami Shores Village 10050 NE Second Avenue Miami Shores, FL 33138 -2382 RE: Barry University Adrian 108 Renovations Permit No. CC -5 -11 -867 Dear Mr. Bruhn: As the Architect of Record on the above referenced project, we offer he 'ollow g as clarification as it relates to the ceilings in Offices #1 44 (Rooms 104 -107). Following demolition, the existing plaster ceilings and crown mouldings were exposed and we opted to stay with the existing ceilings and preserve the historical details rather than install the 2X2 acoustical ceiling tile grid that was indicated in the permit set of plans. • Please feel free to contact us should you have any questions or concems with the above. Respectfully, lar u a Synalovskl, ?;IA, LEED AP Manairig Partrfer l `Lic. #11,628 MANUEL SYNALOVSKI ASSOCIATES, LLC architecture • interior design • planning Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 159763 Permit Number: ELC -5 -11 -869 Scheduled Inspection Date: August 09, 2011 Inspector: Devaney, Michael Owner: , BARRY UNIVERSITY Job Address: 11300 NE 2 Avenue Adrian 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 -07 Phone: (786)307 -4295 Building Department Comments INSTALL NEW RECEPTACLES Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comtients-- - C/2_ August 08, 2011 For Inspections please call: (305)762 -4949 Page 6 of 27 Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Applicant 11300 NE 2 Avenue Number: Adrian Hall 1121360010160 -07 Miami Shores, FL 33138 -0000 Block: Lot: BARRY UNIVERSITY INC 1 Owner Information Address Phone CeII BARRY UNIVERSITY INC 11300 NE 2 Avenue MIAMI SHORES FL 33161 -6628 Contractor(s) Phone CeII Phone PROSTAR ELECTRICAL CONTRACTO (786)307 -4295 Valuation: Total Sq Feet: $ 5,000.00 60 1 Type of Work: NEW RECEPTACLES Additional Info: Classification: Commercial Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $3.00 $2.25 $2.25 $1.00 $150.00 $3.00 $4.00 $165.50 Pay Date Pay Type Amt Paid Amt Due Invoice # ELC-5- 11-40929 06/30/2011 Check 4: 1399 $ 165.50 $ 0.00 Available Inspections: 1 Inspection Type: Final Meter Box Alteration Relocation Fire Alarm Service Change Underground W. W. In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. June 30, 2011 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date June 30, 2011 1 Miami Shores Village s y Building Department VAX 12 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION FBC 20 Permit No. EisLi t— sGcl Master Permit No. Permit Type: Electrical OWNER: Name (Fee Simple Titleholder): Ma y (ANA J sl Phone#: Address: 1 130X N i; fZirvoi A Tenant/Lessee Name: Phone#: Zip: 3310 / vAl $M 1 ,10(16-3 State: Fl . Email: J iA® /110411. b 49 . j JOB ADDRESS: &Fay anal VinSIV J/ - AP/ V141\/ 10 ?S City: Miami Shores County: Miami Dade Zip: Folio/Parcel #: / / - 2 lab - O0® — 00S 0 Is the Building Historically Designated: Yes NO ✓ Flood Zone: CONTRACTOR: Company Name: JD - Ar fie rierr' - I Phone#: 7,96 ! 3 ° 7- 4ZciS Address: 0i® r S e„ / f %y 4" City: / tfrU i State: PL ' Zip: 3 3 ) 7 eP Qualifier Name: '/17 ,4i7,-.1e --_ .4e....,7 Phone#: 7r6 "3 °7°'9a,_s t State Certification or Registration #: C ® ®O 1®J Certificate of Competency #: Contact Phone#: 747- 307- 1l L'j Email Address: ,¢. %4:2--'1 c ylk0.3 9Jet AG..1 - C,4=14e1-7 DESIGNER: Architect/Engineer: ,'17i,, - f S'y. 4 l d"l— (1 Phone#: Value of Work for this Permit: $ <f ®0 o Square/Linear Footage of Work: 6® �' L.,./.4.1.1 Type of Work: °Address E'Alteration °New ORepair/Replace °Demolition Description of Work: .74 -31 01 1 (ce f Ad c J ors cx ) ,5411,7 .s-te 6 * * * * ** * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees************* * * * * * * * * * * * * * * *** * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ /511-400 CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ (DS-4W Bonding Company's Name (if applicable) Bonding Company's Address City State Zip "1/4/4- 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 Fi .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 ap dr0: ;, and a reinspection fee will be charged. Signature Owner or Agent /� The foregoing instrument was acknowledged before me this 10 day of MAY , 20 11 , by aaAAG6 who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission * * * * * * * * * * ** APPROVED BY Signature p Contractor The foregoing instrument was acknowledged before me this P% day of /Z , 20 )' , by 6/i ).9 who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUB Sign.. Prin +}grrie Jonathan Cuesta My Commission Expires: 1 ►,1`+l: o%COMMISSION #EE041198 o 3t� NOV. 09,2014 '+sv% RS WNW.AARONN0TARY.cam /4 6%'Y.?!/ Plans Examiner Zoning Structural Review (Revised 07 /10 /07)(Revised 06/10/2009)(Revised 3/15/09) Clerk CITY OF SWEETWATER 500 SW 109TH AVE BUSINESS TAX EP 33174 ARTMENT Business Tax Receipt PENALTY IS IMPOSED FOR FAILURE TO KEEP THIS RECEIPT DISPLAYED CONSPICUOUSLY BEGINNING. 10 /01/2010 AND ENDING: 09/30/2011 PROSTART ELECTRICAL CONTRACTOR, INC. 610 S.W. 114 AVE. #1 Sweetwater FL 33174 ARMANDO LEON (786) 3074295 ITEM DESCRIPTION 00072 ADMINISTRATIVE OFFICE LICENSE NO: 000053611003 8T001788 PROSTART ELECTRICAL CONTRACTOR, ADMINISTRATIVE LICENSE - HOME LICEI 610 S.W. 114 AVE. #1 Sweetwater FL 33174 May. 12. 2011 9:55AM Nations Insurance & Financial No, 4332 P. 1 CERTIFICATE OF LIABILITY INSURANCE OATE 2 MIDDIYYYY) 05111 /111/01.1 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 13 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 . PIWPUC R Nations Insurance & Financial Services 2370 SW 67th Ave Miami, Florida 33166 NAME: T 1.azara Sabatier FHONE (305) 267 -4541 iAtc. Nut: (305) 2674543 (117C_ Nn, Fxtl[ _ E-MAIL ADDRESS: IN$URER(S) AFFORDING COVERAGE NA100 INSURER A: Granada Insurance Com•an LIMITS INSURED Armando Leon DBA Frostar Electrical Contractor 610 SW 114th Avenue, Unit #1 Miami, FL33174 INSURER B: Ascendant Insurance Company INSURER C: INSURER D i 03129/2011 MOW E: EACH OCCURRENCE INSURER F i X COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY THE INSURED NAMED ABOVE FOR THE POLICY PERIOD OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, PAID CLAIMS TAT L TYPE OF INSURANCE ADDL I..: SUER ,•L • POLICY NUMBER POLICY EFF MMIDDIVYYY FILLY EXP MIDD LIMITS A GENERAL MIKIT' 0196FL00018257 03129/2011 0312912012 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL 11ABILITY pHEMISEE aEoccunancel s 100,000 CLAIMS -MADE Iii, OCCUR MED EXI' (Any one person) $ 5,0Q0 PERSONAL a ADV INJURY 81,000,000 GENERAL AGGREGATE $2 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OPAGG 32 000,000 �! I POLICY � JE PRCD r LOG $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ — ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS HIRED AUTOS _ SCHEDULED AUTOS NON -OWNED AUTOS BODILY INJURY (Par accident) $ PROPERTY DAMAGE (Pet accitlent) $ $ UMBRELLA LIAR EXOES5LIAO OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENT ON $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WC- 602818 09/11/2010 00/11/2011 WATU TS TOG STRY�(MI I QER TW. Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N IA E.L EACH ACCIDENT $100,000 E.LDISEASE- EAEMPLOYEE $500,000 3100.000 Eyes, desctee under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS i L-O ATIQNS I VEHICLES (Aitgch ACORD 101, Addlilonal Remarks Schedule it more apace Is required) Electrical Contractor CERTIFICATE HOLDER c Miami Shores Village Building Dept. 10050 NE 2nd 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 (2010/05) CORPORATION. All rights reserved. The ACORD name and logo are gIatered marks of ACORD 1 Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Project Address Parcel Number Applicant 11300 NE 2 Avenue Number: Adrian Hall Miami Shores, FL 33138 -0000 1121360010160 -07 Block: Lot: BARRY UNIVERSITY INC Owner Information Address Phone Cell BARRY UNIVERSITY INC 11300 NE 2 Avenue MIAMI SHORES FL 33161 -6628 Contractor(s) Phone CeII Phone EMERALD CONSTRUCTION CORPOR (954)241 -2583 Valuation: Total Sq Feet: $ 4,500.00 1500 1 Tons: Additional Info: DUCT WORK Classification' Commercial Approved: In Review Comments: Date Denied: Scanning: 1 Date Approved: : In Review Type of Work: Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $3.00 $2.25 $2.25 $1.00 $150.00 $3.00 $4.00 $165.50 Pay Date Pay Type Amt Paid Amt Due Invoice # MC -5-11 -40928 06/30/2011 Check #: 1399 $ 165.50 $ 0.00 1 Available Inspections: Inspection Type: Ventilation Final Rough Rough Duct Duct Detector Test In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. June 30, 2011 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date June 30, 2011 1 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 M AY 1 2 011 BX000000mmo ®��o®® Permit No. MC `—' `6 Master Permit No. Permit Type: MECHANICAL OWNER: Name (Fee nSimple Titleholder): R U '^nn W U/NIV SLf, Phone#: Address: ! ) 3 00 1 v C�7 n 1t� / City: tit/ J ANt► SW U 19W State: Zip: 33 Kj Tenant/Lessee Name: Phone#: Email: ®J7A ✓14-I/ / <�aiel7 . Geic.7 JOB ADDRESS: 134roz .y (Ai/ Peasc ry AOiLi AI i 10 2 City: Miami Shores County: Miami Dade Zip: Folio/Parcel #: // 2 i 3 t� t=®o ®O®� Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: 1144 AL. &®` a 11 .' l'''cr1LLJ Ali . Phone#: �.f9' 732— 6 sr 7 Address: 2 e 2 1 Soilie - e,1- Oc. 3/ 6 City: Fit, 69frd e,r i %' State: "7.0r`®c4 Zip: _S'3 i J ) Qualifier Name: A/4re, Z€ b e r7t Phone#: GlJf — 7.32 — 6 CS 7 State Certification or Registration #: 64e O -C Certificate of Competency #: 4 Contact Phone#: SY- V.? - 45( 7 Email Address:,% t J47 , rt i • 0,1-7 DESIGNER: Architect/Engineer: 0 .ry ,074-J0si4 Phone#: Value of Work for this Permit: $ 41/ ® O . 600 Square/Linear Footage of Work: 1 ®5 Type of Work: Address d Iteration s * ONew ORepair/Replace ODemolition Description of Work: r cia,e 2.(.._,,%-k-, ✓1 C cu e--k--..0 ED I' ' £ 'tf 1 t '317N/yP * * * * * *** ** *- w*** **** ***** *w** * *****w* eesw************ **** **** ** *** *e *** * * * ** * *****w* Submittal Fee $ \ Permit Fee $ t 5 V 1 OD CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ (0s 4s \k7 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 FT .F.CTRICAL 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 abs p e of such poncted noticq the inspection will not be approv ' and a reinspection fee will be charged. Signature --- Signature gn gna Owner or Agent The foregoing instrument was acknowledged before me this 1V' day of M y , 20 1 ! , by ch ODWPanA 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: lj ******** **** ******* * * * ** ***e ***sew ** Contractor The foregoing instrument was acknowledged before me this %2- day of I , 20 11_, p , by 1A/4dut , who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLI Sign: Print: iv/ My Commission Expires: Jonathan Cuesta et. + a ;f1tiCOM MISSION # EE 041198 r�� `��` :se EXPIRES: NOV. 09, 2014 �� WWW.AARONNOTARYOORI ******************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Structural Review Clerk (Revised 07 /10/07)(Revised 06 /10/2009)(Revised 3/15/09) BRO ARD COUNTY LOCAL BUSIN SS TAX RECEIPT 115 S. Andrews Ave., Rm. A -100. Ft. Lauderdale, FL 33301 -1895 — 954- 831 -4000 VALID OCTOBER 1, 2010 THROUGH SEPTEMBER 30, 2011 DBA: Business Name: WAYNE GROUP & SERVICES INC Owner Name: LEBERT W HARVEY /QUAL Business Location: 2821 SOMERSET DR 316 FT LAUDERDALE Business Phone :954- 733 -6557 Rooms Seats Employees 2 Receipt #:183 -1810 Business Type :HEATING /AIRCONDITION COT '(AIR CONDITIONING CONTRA Business Opened :10/09/2001 State/COUnty /Cert%Reg:CAC 058665 Exemption Co e:NONEXEMPT Machines Professionals For Vending Busies Only Number of Machines: Ven dine Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 0.00 0.00 0.00 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non - regulatory in nature. You must meet all County and/or Municipality planning WHEN VAUDATED 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 ration. 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: LEBERT W HARVEY /QUAL 2821 SOMERSET DR #316 FT LAUDERDALE, FL 33311 2010 - 2011 Receipt #01B -09- 00026634 Paid 08/17/2010 27.00 wwe0∎11 a ww ww• u• mo • oft oft a • w• •r► ■• •ip•a•w •• a v • ••••Al•wT MAY 17,2011 08:39A ACORPEr CE WES CERTIFICATE IS ISSINED CERTIFICATE 00E5 NOT BELOW. THIS CEIUWICATE OF REPRESENTATIVE OR TIFICATE OF LIABILITY INSURANCE page 2 DAM oralornrn V18/2011 A INVITER OF INFORMATION 018.7 AND GOMM 14014101478 UPON THE CEINIRCKIE HOLDER. WEB MELT Oft MAMMY ANIEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY NE POLICIES INSURANCE 0088 NOT CONSTITUTE A CONTRACT SEMEN THE ISSUING INSUREWS). AUTHORIZED AND TIE CIDOWIGATE HOLDER. IMPORTANT: If the ootellesto No term Ind GOTRINIONIF 01 180 TIETTEMENt61 holder kt EMI 015j1$5 PRIM= George N. Odiorne PO Boa 830 Brandon, FL 33509 Saari Nirlow nn KCIDM6NAL =MA 1,1 paEnt(les) must he sodomy* If sunocoomoh 15 WANED, subject to , NOM gaga' way Inman an endensament. A eta on this sgmtlfitatn donn net aTIEfer light6 0' MR ..earT MIINERED Wayne Group 3 Services, 2305 NW 30th Street Oakland Park COVERAGES FL Inc. 33311 ia3:3) I asok ene,4,5-1,23 JOILOOMUOA - MOMMOIMMOIMOO COMMUM mumultianina FIRST MOS CO. AigeOlLOS . ROHM C 1 NAM I MINOR D Illg‘Filgi IL! 0: 020-201.1 THM IS TO CIATIFY THAT THE - • INDICATED. NOTWIRISTANDINO CERTIFICATE Y SE ISSUED CR . SIMMONS AND CONDMONS OF =, ,! v.: OP INSURANCE REQUIREMENT, Y PRIME, . POUCIER LISTED BELOW HAVE eon TERM OR CONDITION OF ANY THE INSURANCE AFFORDED BY MOB SHORN MAY HAVE BEEN MIXT NUMMI ISSUED TO CONTRACT THE POLICIES 14140110140 97 AligragOgalk THE INSURED OR OTHER DESCRIER) PAID CLAIMS. - - ---- - - -- - NAMED ABOVE FOR THE POUCY PERIOD DOCUMENT WITH RESPECT TO WHICH THIS HEREIN IS SUBJECT TO AU.. THE TERMS, 2MR LTR TYPE DE IPTATRARBE CAMPY OCCUR JIDDLAUIR PiNt VA16 EAcM OCCURRENCE ; Nick Dellantis (C) /SEM Nr.—= COMM -- MOAT CEIMITERGIAL GENERAL WiesTO RENTED Ma accuvenc.) $ 1 CLAM-MADE Ino EXPAz one puram3 $ zo5otdak3 ArAT INJURY GENERAL AGORICATE 6 2g AZPER. ISLCIO PRODUCTS - CONIPIDP AGO $ AUTGETOBILILIANIUTT — .._ _ — ANY AUTO ALI. Ontits) Auto& SCHEDIAED AUTOS NM MOE NON-0131031 AUTOS DoMmemmEmuNIT (En Acciden0 $ BODILY INJURY Per MEET BODILY MOW (Par addend • PROPERTY (*NAGE (Persuciden0 $ - • --- $ - - • -- .- UNWELL& L1311 EXCITES 63TUI .., ,___......— =cm CLANSaucs EACH OCCURRENCE $ _----....-... AGGREGATE _ _, DEOUCTIBLE RETENTION $ I r— A ITTORRERTI COMPENITATNNi AND IRIPLIEVERBWARLOY ANY PROREE$MNARETPERUMMLINVE rmiNI=I.---- 1314111133P giatoMgeropatAross n bow_ ti /A 32104595 10/132010 10/13/2011 7 ISM 1 IDA& ELL EACH 09:010ENT $ 800,00 599,00Q 800.000 d.L. Disilltss - EA ENPLOYEE $ $ E.L. DISEASE - POUCY Lea OINcRIPTION OP ORMATIONS a 1,00ATIMISI VINICLIN Mach ACOPO in, MdbAndRease€3363303131, PPR* ems Is mime CERWICLTE • 131111211110"111"g"V""1008 • 0 Miami ITherma e* Building Depti Villag Nall irteent _______ _____ SHOULD ANY OF THE ABOVE DESCRWED POLICIES BB CANCM.LED BYROM 711 OMAR= DATE TNEREOF, NOTICE MU SE MUM= IN ACCORDANCE went 114E POUOY PROVIMONS. ------------ AUTICIREDID REPREBENTAIRRI 10050 NE 2nd Avenue Went $13014,O, FL $3138 - • • . — ... ..- ... 'n. Nick Dellantis (C) /SEM Nr.—= . . 2'. - - - • . A 20(200819*) 1181028 UMW Q1 AMIN) CORPORATION. All righ w ts e The ACORO name and logo are registered mance of CORO Department of Environmental Resources Management Miami -Dade County Plan Review Summary Process Number: 2011051913473492 FINAL CORE REVIEW DATE: 6/6/2011 OVERALL STATUS: Overall Approval PROJECT DETAILS: CONTACT DETAILS: FOLIO: 11- 2136- 000 -0050 NAME: JONATHAN CUESTA ADDRESS: 11300 NE 2 AVENUE MIAMI SHOR EMAIL: PERMIT TYPE DESC.: PHONE #: 9542412583 DISAPPROVAL CODES: ?"7 TASK REVIEWED BY STATUS DATE STATUS Initial Core Review Miguel De Armas 06/03/2011 Reviewed Comments: INTERIOR RENOVATION TO ADRAIN BLDG 108. NO INCREASE. NO ALLOCATION REQUIRED. ASBES Review Jorge Frases 06/06/2011 Approved Comments: An asbestos survey is required. Final Core Review Miguel De Armas 06/06/2011 Overall Approval PLAN CONDITIONS: NO CONDITIONS PLAN REVIEW FEES (FEES ARE SUBJECT TO CHANGE PENDING FINAL APPROVAL): FEE CODE DESCRIPTION USER DATE UNIT TOTAL D015 ................. D062 Asbestos Review DEARMM Commercial & Multifam Min Review DEARMM 06/06/2011 05/31/2011 1 $175.00 .................._..... ...._..._. 1 $90.00 Total $265.00 Coastal: EQCB: FOR MORE INFORMATION PLEASE CONTACT: YOUR DERM CORE REVIEWER: dearmm @miamidade.gov DERM PERMITTING AND 4NPECTION CENTER, 11805 SW 26 ST, 786- 315 -2800 DERM OVERTOWN TRANSIT CENTER, 701 NW 1 CT, 305 - 372 -6899 dermcr @miamidade.gov eqcb@miamidade.gov Specialty Engineering Reviews (industrial, storage tanks, industrial waste pretreatment, asbestos, paving & drainage, trees): dermengreviews @miamidade.gov NOTE: ALL SHEET MUST BE REVIEWED MIAMI -DADE COUNTY BUILDING AND NEIGHBORHOOD COMPLIANCE DEPARTMENT_ r / w Herbert S. Saffir Permitting and Inspection Center I (j 0 / ( 11805 SW 26th Street (Coral Way) • Miami, Florida 33175 -2474 • (786) 315 -2100 APPLICATION FOR MUNICIPAL PERMIT APPLICANTS THAT REQUIRE PLAN REVIEW FROM MIAMI -DADE FIRE RESCUE AND /OR DEPARMENT OF ENVIRONMENTAL RESOURCES MANAGEMENT PROVIDE MUNICIPAL PROCESS NUMBER HERE LOCATION OF IMPROVEMENTS Job Address ., 1f \ .0�-' o w C CONTRACTOR INFORMATION ON Contractor No. (, l 9\ V 415 Last four (4) digitspf Qualifier No 41 '56�T ADD Folio A N r- Z L — /*IS ' " cL) Contractor Name �e(sle -1-'u�, C Lot Block Qualifier Name krY - : Subdivision PBpg Address lD N\k-O t (-A— Metes and bounds City \\,vkaca-e, Statd- Zip 33cP TYPE OF IMPROVEMENTS [ ] New Construction on Vacant Land V Alteration Interior [ ] Alteration Exterior [ ] Relocation of Structure [ ] Enclosure [ ] Repair [ ] Repair Due to Fire [ ] Demolish [ ] Shell Only [ ] Addition Attached [ ] Addition Detached [ ] Re -Roof [ ] Foundation Only [ ] Tent Current use of property . V2h(S: Al Description of Work v∎. -r o Q,w 4 ,0 �-t, Or-S, • i Sq. Ft. Sits Floors Value of Work PERMIT TYPE [7MBLD* Category 01 REVIEW STATUS [ ] Chg. Contractor [ ] Re -Issue [ ] Re -Stamp [ ] Revision [ ] Not Applicable for Fire OWNER'S NAME Owner ( f �AA. L s °tom Address _ 3c £ c' Cit Ci fir a›State ►i —Zip 32 [ ] MELE Phone 'Y? �� " 6 fit.`. `' 3c1 0t 5 [ ] MLPG Last four (4) digits of Owner's Security No. [ ] MMEC [ ] FIRE PERSON TO PICK UP PLANS Name c \ `et' ARCHITECT / ENGINEER ftftSocial J Owner`"\G\��-` St (4.1 to s. 1: Address ` 0 `i{ + `,CUStat Address \0 )i � � cD City° L k- • Zip \ IP City s `k\ . ciceState -t°Ztp ✓ R Phoneq &4 ®q ( I —" (10"' Phone C\1/4S-k— l \.s- �- cg 5 FIRE SPECIAL REQUEST PLAN REVIEW (SRI) I am requesting a Special Request Plan Review (SRI) to be scheduled as soon as possible at the rate of $190 for the first hour and $65 per each additional hour in addition to the review fees. Minimum charge one -hour. 1st Request: Date: 2 °d Request: Date: r Request: Date: GERM OPTIONAL PLAN REVIEW (OPR) I am requesting Optional Plan Review (OPR) to be scheduled as soon as possible at the rate of $75 for each discipline. Additional review fees may apply. 1st Request: Date: 2 °d Request: Date: 3'd Request: Date: 123_01- 192 8/10 BUILDING PERMIT CATEGORIES CATEGORY DESCRIPTION PERMIT TYPE BUILDING 01 GENERAL BUILDING - COMMERCIAL MBLD 02 SUB - GENERAL BUILDING - RESIDENTIAL MBLD 08 CANVAS AWNING MBLD 10 COMMUNICATION TOWER MBLD 15 DEMOLITION MBLD 29 METAL AWNING & STORM SHUTTER MBLD 48 SCREEN ENCLOSURES MBLD 55 SWIMMING POOL MBLD 56 TENNIS COURTS (SURFACE PAVING) MBLD 86 TRAILER TIE DOWN MBLD 88 WALK -IN COOLER MBLD 91 MARINAS MBLD 92 LOW SLOPE APPLICATIONS (GRAVEL, SMOOTH MODIFIED, SINGLE PLY) MBLD 95 SHINGLES (ASPHALT, FIBERGLASS) MBLD 96 SHINGLES (METAL ROOFS/WOOD SHINGLES & SHAKE) MBLD 97 STAGE 2 VAPOR RECOVERY SYSTEM MBLD 99 SOIL IMPROVEMENT MBLD 0100 BULK STORAGE PROPANE TANK MBLD 0101 REMOVABLE STORM PANELS MBLD 0107 TILE ROOF MBLD 0110 WATER MAIN MBLD 0111 SITE PLAN MBLD 0112 INDOOR EVENT /EXHIBIT MBLD ELECTRICAL 04 FIRE ALARM SPECIALTY MELE 16 SPECIALTY WIRING MELE 38 GENERATORS MELE LPGX 01 LIQUEFIED PETROLEUM GAS MLPG 02 MISCELLANEOUS MLPG 04 LIQUEFIED PETROL. GAS /STATE MLPG MECHANICAL 09 ABOVE/BELOW GROUND TANKS /PUMPS & POLLUTANT STORAGE SYSTEM MMEC 38 COMMERCIAL HOODS MMEC 43 FIRE CHEMICAL MMEC 46 SPRAY BOOTHS MMEC 48 SMOKE CONTROL MMEC 52 RESIDENTIAL ELEVATOR MMEC FIRE 32 FIRE SPRINKLER FIRE