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RC-13-886
Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 193736 Permit Number: RC -4 -13 -886 Scheduled Inspection Date: June 18, 2013 Inspector: Bruhn, Norman Permit Type: Residential Construction Inspection Type: Final Building Owner: GOMEZ, MIREYA Work Classification: Alteration Job Address: 715 NE 91 Street 4 -A Miami Shores, FL Project: <NONE> Contractor: QUINTERO GENERAL CONSTRUCTION Phone Number Parcel Number 1132060440060 Phone: (786)487 -5738 Building Department Comments RELOCATE AND INSTALL DOOR AND FRAMING FIRE RATED TO CURE A CODE VIOLATION Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments A') 61-7,6* Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. June 18, 2013 For Inspections please call: (305)762 -4949 Page 21 of 25 (° \°:0()"/ V 00 4\ BUILDING 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 30 36)- 5'166 PERMIT APPLICATION Permit Type: BUILDING JOB ADDRESS: 11 J /Y / P t; ra i Imcmtvg APR 2 ,• 20I3 Permit No. Fe613- ti5Ce Master Permit No. ROOFING City: Miami Shores Folio/Parcel #: 11 ' 04400bO County: Miami Dade Zip: S 313 e Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): /M oC/✓ 712407. t0M/71t1 t F&, MOO- FELI Z Mk Address: 1 Is W 110 bvieeT f 'I- City: In Anil 5 #101 State: Tenant/Lessee Name: F4' to Dad ,11 Email: Ft?I J'f l A 9 KA-R[S/7A hole) -G‘v+ Zip: s3/ 3 ' Phone #: 7/11 - 370 - -07b1r- CONTRACTOR: Company Name: iUir✓ it-0 lE141t24l tder) 4g 42, Phone #: 78b''477 -1735- Address: S $p mu) 112.e raznik City: H(I (,Eg3f 17A-0Det4s State: Qualifier Name: ge2rrolit 0 kr,A/ rw FL. Zip: 3) 0 < 8 Phone #: 7/6 _47 g State Certification or Registration #: Certificate of Competency #: 131C-2 �% t Contact Phone #: ?J 7I 5 3 3-4g Email Address: ', i01i 4 -nit R row. co", DESIGNER: Architect/Engineer: e . DR1il0 ffOf2'roN 11,5P CIA-T 5 Phone #: 30.fri 17? 8 Value of Work for this Permit: $ 0 a. Square/Linear Footage of Work: J 0 5F Type of Work: ❑Addition�+a UAlteration UNew �' --ep °eair/Replace ODemolition Description of Work: _1-3S A../..ace) 600,„- -,� I ':.J a(V Color thru tile: ********* a *** * * ** ***** ****** ** ** **** ** ** ees9* * * *** *** ******** ******** * * ** ********** ** �j L"J Submittal Fee $ Permit Fee $ / J C/ d CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ I 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 o attachment. Also, % •,y of the recorded notice of commencement must be posted at the job site for the first ins 'ec hich occurs seven (7) days aft ' building permit is issued. In the absence of such posted notice, the inspection wi, no e p. roved and a reinspect.ion fee wil! barged. Signature er or Agent Contractor The +`oregoing instrument was acknowledged before me this 2-b The foregoing instrument was acknowledged before me this 2 day of COP( , 2011, by 66.."/T o1r re Arm 11 , 20 j , by Bel' rig( di, C?l i fri ,0 who is p sonally known to me j who has produced who is personally known to me or who has produced Ft b L, as identification and who did take an oath. As identification and who did take an oath. NOTARY PUBLIC: Sign:,r Print: My Commission Expires: * * * * * * * * * * * * * * * * * * * * * ** APPROVED BY jug * * * ** * ILY RUIZ Ifitory PSI N ^ Mate of Florida Moro§ Aug 26 2015 QA 1821911 * 1t 106633 3 :46 / —i�lans Examiner NOTARY PUBLIC: Sign: Print: frra4f ob _p s ® s My Commission Expire 4 ARACELY RUIZ A s �� Notary Public • State of Florida , My Comm. Expires Aug 26, 2015 "� tom ."- * * *.antit14t}4r0„IIre 106633 , ok Bonded Through National Notary Assn. Zoning * * * * * * * * * * * * * * * * * * * * *1 Structural Review Clerk (Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 04/24/13 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certflcate holder in lieu of such endorsement(s). PRODUCER Access Insurance Group 8726 N.W. 26th Street, Suite #1 1 Dora!, FL 33172 Phone (305) 592 -7700 Fax (305) 593 -8785 CONTACT NAME: PHONE . ): (305) 592 -7700 a No): (305) 593 -8785 (A/C DDRESS: barbara @accessinsgroup.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: ESSEX INSURANCE COMPANY N INSURED QUINTERO GENERAL CONTRACTOR CORP 8801 NW 112 TERR Hialeah Gardens, FL 33018 305 INSURER B : 11/21/2012 INSURER C : EACH OCCURRENCE INSURER D : PRaENTED PREEMIMI ESES S (RENTED occurrence) INSURER E : MED EXP (Any one person) INSURER F : PERSONAL &ADVINJURY COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDLSUBR INSR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A GENERAL LIABILITY V COMMERCIAL GENERAL LIABILITY ❑ ❑ CLAIMS -MADE V OCCUR ❑ N 3DL8842 11/21/2012 11/21/2013 EACH OCCURRENCE $ 1,000,000.00 PRaENTED PREEMIMI ESES S (RENTED occurrence) $ 100,000.00 MED EXP (Any one person) $ 5,000.00 PERSONAL &ADVINJURY $ 1,000,000.00 ❑ GENERAL AGGREGATE $ 2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: ❑ POLICY ❑ JECT LOC PRODUCTS - COMP /OP AGG $ 2,000,000.00 $ AUTOMOBILE LIABILITY ❑ ANY AUTO ❑ AUTOS OWNED ❑ SCHEDULED NON -OWNED ❑ HIRED AUTOS ❑ AUTOS ❑ ❑ COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ ❑ UMBRELLA LIAB ❑ OCCUR ❑ EXCESS LIAR ❑ CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ ❑ DED ❑ RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER /EXECUTIVE N / A ❑ TORY STLATU- ❑ 0R E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ If yes describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) CERTIFICATE HOLDER CANCELLATION MIAMI SHORES 10050 NE 2 AVE MIAMI, 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) QF © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Miami Shores Vivage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 May 2, 2013 Permit No: RC13 -886 Building Critique 1. Provide approval letter from the condominium association. NB Norman Bruhn CBO 305 - 762 -4859 Norman Bruhn CBO 305 - 762 -4859 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. Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 May 2, 2013 Permit No: RC13 -886 Building Critique 1. Provide approval letter from the condominium association. NB Norman Bruhn CBO 305 - 762 -4859 Norman Bruhn CBO 305 - 762 -4859 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. ?fie Slimes Plaza East Condominium Association, Inc. 745 North East91d Street Miami Shores, FL 33138 305 - 759 -9069 / FAX 305- 759 -2101 E-MAIL soe123 @att.net May 4, 2013 Miami Shores Village Building Dept. 10050 NE 2nd Avenue Miami Shores, FL 33138 Dear Sir / Madam: This letter will serve as your confirmation that "Quintero General Contractor, Corp" has been contracted by the owner of Unit 4A, 715 NE 91 Street, Miami Shores, Fla., and is authorized by the Board of Directors of the Shores Plaza East Condominium Association to perform alterations to said Unit. Should you have any questions regarding the enclosed, please feel free to contact the condominium office. Sincerely yours, Q-NtA 1,/ Ro rt Gonzalez President cc: file 05/02/2013 10:10 FAX 1 800 685 7530 DATA SCAN FIELD SERVICES II 001 ********************* *** TX REPORT *** ********************* TRANSMISSION OK TX/RX NO 3563 RECIPIENT ADDRESS 93053625966 DESTINATION ID ST. TIME 05/02 10:10 TIME USE 00 19 PAGES SENT 1 RESULT OK Miami Shores Village Building Department 10050 N.E.2oci Avenuc Miami Shores, Ronda 33138 'r el: (30b) 705.2204 Pax: (305) 756.8972 May 2, 2013 Permit No: RC13..886 Building Critique, 1. Provide approval letter from the condominium association, NB Norman Bruhn CBO 305-762-4859