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CC-12-1770Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 187776 Permit Number: CC -9 -12 -1770 Scheduled Inspection Date: March 25, 2013 Inspector: Bruhn, Norman Owner: MILITANA, JOHN Job Address: 8801 BISCAYNE Boulevard Miami Shores, FL Project: <NONE> Contractor: ACE CONSTRUCTION Permit Type: Commercial Construction Inspection Type: Final Work Classification: Repair Phone Number Parcel Number 1132060280240 Phone: (305)892 -8453 Building Department Comments REPLACE DROP CEILING Infractio Passed Comments INSPECTOR COMMENTS False Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP- 178891. No access. Post plans and permit. NB March 22, 2013 For Inspections please call: (305)762 -4949 Page 38 of 48 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 \,--k-kc Inspection Number: INSP- 185063 Permit Number: ELC -10 -12 -1894 Scheduled Inspection Date: February 04, 2013 Inspector: Devaney, Michael Owner: MILITANA, JOHN Job Address: 8801 BISCAYNE Boulevard Miami Shores, FL Project <NONE> Contractor: METRO ELECTRIC SERVICE INC Permit Type: Electrical - Commercial Inspection Type: Rough Work Classification: Addition /Alteration Phone Number Parcel Number 1132060280240 Phone: 305 - 945 -1991 Building Department Comments RE- INTALL 2 X 4 FIXTURES Infractio Passed Comments INSPECTOR COMMENTS False Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP - 184942. February 01, 2013 For Inspections please call: (305)762 -4949 Page 36 of 45 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: S'8 0 I City: Miami Shores '�SLnr.�Yz Qt .i A County: ECG E1VED OCT 0 _' 2012 FBC 20 Cc) Permit No. 2 `-C Master Permit No CGj 2 H 1 C) X03 Miami Dade Zip: 73/3(5' Folio/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): J 1t t� 1111 i I i +-o-Ant... Phone#: 5 o C 7 c (o (E, q Address: g /r0 I t t sc ,,,� (b ‘,..4., 9 t 0 City: M , a-+�. , S 0 re 4 State: Zip: 3 3) 3 ,1' Tenant/Lessee Name: C 4 CA b r C r te . , w 8 - c s 4 6 re-- @ q k1/44 -;1 ' (=D iv' CONTRACTOR: Company Name: /vt 772 a F1, 7'/11G g - ' 0co. / Phone#P,O)' 9 `f — / %d)/ Address: /5 04-0 /y° Q-© 414 . City: J, 4?7/4177/ State: W---19 Zip; i el Qualifier Name: 0 , S A /24(O V1) Phone#: '4 0,5" 91/45-- 00 State Certification or Registration #: i C + 0 0 00 S g Certificate of Competency . Contact Phone#: /i "1'"t el a --1 °) °) ! Email Address: METRO.. rl r'- r,p i C. J417tM4/1- i aP)rin DESIGNER: Architect/Engineer: Phone#: Email: Phone#: 3 0a" 7S:9 G Z 7 Value of Work for this Permit: $ BOO• 00 Square/Linear Footage of Work: Type of Work: °Addressnn °Alteration UNew °Repair/Replace °Demolition Description of Work: ;r? 2Ki I I Z—)CL( [= 'tI+urQ f * * * * * * * * * * * * * *: **********************Fees************************************ Submittal Fee $ 4I/ Permit Fee $ /0 e'' . 07 0 Scanning Fee $ ` Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ I'1 8 kip 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 jutiisdiction: I understand thara separate permitmust be secured#or ELECTRICAL WOM 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 attac t. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which o' urs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approv and , reinspection fee will be charged Signature Signature 411.9:07, o - ent Contractor The foreg ing instru -nt was acknowledged before me this ALL The foregoing instrument was acknowledged . fore me this day of ,20 /x, , by �P J Mr (-J4 , day of 0 LE— "I,20`2,, by W who is perso ly 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 P IC: Sign: 44,/ ."7-2 Print: NOTARY PUBLIC: Sign: lct7iti� Print: My Co -, My RUTH A. BYDASH MY COMMISSION # D0958017 * * * * * * ** * �' * * *s 1 Al �r t4**M**** **** * ** * **** *** * * *** 407) 396- 0133 ploric Welerysb 9CC9na APPROVED BY /-' T A oe /2 Plans Examiner Zoning a a a a a r a a -Am_, uiy "b,xpires: JOUBERT PIERRE erl Notary Public - State of Florida -'• `> 4 • My Comm. Expires Apr 30, 2016 4:- Commission # EE 194096 * **9tflft iftiffiltegfer. * * * ** NMI � "WV 'WV Structural Review Clerk (Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) r Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 rn o Inspection Number: INSP- 179080 Permit Number: MC -9 -12 -1794 Scheduled Inspection Date: March 18, 2013 Inspector: Perez, JanPierre Owner: MILITANA, JOHN Job Address: 8801 BISCAYNE Boulevard Miami Shores, FL Project <NONE> Contractor: METROPOLITAN AIR CONDITIONING INC Permit Type: Mechanical - Commercial Inspection Type: Final Work Classification: Repair Phone Number Parcel Number 1132060280240 Phone: 305 - 264 -4646 Building Department Comments DUCT WORK REPAIR Infractio Passed Comments INSPECTOR COMMENTS False Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments March 15, 2013 For Inspections please call: (305)762 -4949 Page 7 of 54 Miami Shores Village AVE) g Building Department El? 27 2092 u. 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 2010 Permit Type: MECHANICAL 4k,fr.*.W Permit No. L. I12 " I 1 c1A1 Master Permit No. Ca-i2 — 1 OWNER: Name (Fee Simple Titleholder): Vic, O k fl I ' ; (i Phone#: 3o S '1Sd3 6 to i I Address: S) ft I `<!t' S C c>.a.. d 3 tuft 4/ O/ City: SIAM V Y-e S State: l Zip: 3 3) 3 f Tenant/Lessee Name: Cd / b t-.. Phone #: 3 n 5' 7s-d-- 6x- 7 T Email: 2i, ° cap , -c A-b r* e, ( c nn o�.c , &t o., JOB ADDRESS: ISTO ( a' S G ,...e 6 (,) c( to y City: Miami Shores County: Miami Dade Zip: 3 3) 3 p Folio/Parcel #: ( I — 3P,0 (p — v 2-9 - 6 ..Z `i 0 Is the Building Historically Designated: Yes NO ✓ Flood Zone: CONTRACTOR: Company Name: M.- A-��I■'k+1 44,0.., ( Phone #: 3()S 2b'/- V(004 Address: C / 7 %% 60 L5D 34: City: it-kt Qiv,.,� State: Pi- Zip: a 310 (p Qualifier Name: es inc9 IOC- ( CXY // om Phone #: State Certification or Registration #: otf3 q) n Certificate of Competency #: Contact Phone #: Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ g'®, CD Square/Linear Footage of Work: Type of Work: DAddress , UAlteration New DRepair/Replace ODemolition Description of Work: /(4" f#.' . Y %k 1k %�1� �1kfi� 1t721t 1�.'I tah lj *Rig * * * * * * * * * * * * * * * ** ' * * * * * * * * *T * * ** Submittal Fee $ Permit Fee $ U(�]y CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOIT .ERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AlkIIAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved , reinspection ' ' will be charged. Signature or Agent The foreg instrumen was acknowledged before me this a 0 day of /1 _ , 20 /Z,, by t( %Y1 i Cl , who is •nl known to me or who has produced s identification and who did take an oath. NOTARY P Sign: • APPROVED BY Contractor The foregoing instrument was acknowledged before me (th°,,iss 0147 day of Cif """'"" , 20 -�, by ¶ 3& € `-t X "2L te who is personally known to me or who has produced 'Pear.i.a. 14 as identtfication and who did take an oath. Sign: Print: My Commission Expires: *+x* ,a .x * * ** ** :+ x**+ x*+ xx,* *+ x*************+ x* ***+x*****+r*******+x*** "Plans Examiner Zoning Structural Review (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Clerk ACORD CERTIFICATE OF LIABILITY INSURANCE mu maws) 09/26/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: IT the certificate holder Is an ADDITIONAL INSURED, the policypas) must be endorsed. If SUBROGATION IS WANED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER G.DAVID HARRIS INSURANCE, INC. 5245 N.W. 36 STREET SUITE 200 MIAMI SPRINGS FL 33166 - min a Metropolitan Air Conditioning, Inc. 6917 N.W. 50 Street Miami FL 33166- mwm MARTHA AERRI RA Na s,q, (305) 885 -2055 NARTHAPGDRINSGRANCE.COM cam. ID n T N�uc (3os) aes -2005 WON* i01COV _ . anus= A ,ESSEX INSURANCE CC IPANY- .B:BUSINESS FIRST INSURANCE___._ Nate INSURER C : EAMSR E : INSURER F • REVISION NUMBER: �W THIS INDICATED. CERTIFICATE _EXCLUSIONS MR .. IS ,V,..v TO CERTIFY THAT THE POUCIES NOTWITHSTANDING ANY REQUIREMENT, MAY BE ISSUED OR MAY PERTAIN, AND CONDITIONS OF SUCH OF INSURANCE POLICIES. morass EAR THE Aria LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. —_ - . . _ MS OP POLICY RUNNER gaion intro VaY M MAIM A oENENUNL MOM/ COnsAl3hC1AL0a?IERAL LIABWTY acc,091 _0/28/2011 / / / / / / ! / / / x/28/2012 / / / / / / / / / / EACH OCCURRENCE TOREiTEO ?REM NIEa9omma,oa)_.. MED Opa $ 1, 000 , 000 $ _ _ 100,000 $ 5, 000 X I CLAIMSAIADE OCCUR ,pan). RSOnAL a a m I m u R Y _ _ _ $ 1, 000 r 000 GENERAL AGGREGATE _ ..... PRODUCTS- (3pwOPAG�i. I 2,000, 000 . _._ .. 1,000,000 GEHLAGGREGATELIMITAPPUESPE POLICY n o n $ —I AU WI LE UAEE1IY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS / / ! 1 / / / / / / / / / / / / / ! / / / / / / / / COMBINED SINGLE LIMIT (Ea N oem+) BODILY INJURY 'pet— wean- BODILY INJURY (Pet.. ... PROPERLY DAMAGE _- • -- -• - -. _ . $ $ -' -- ._ _� . $ ^ — - $ .-- _ .. -.— .. _ $ _ — --- MORELIA UAB OCCUR / / / / / / / / / / / / / / / / EACFI 0Cx:URRENCE. .....k____ AGGREGATE -__ . _ ..-_-.-_ _. . . _ _____ .. 8 .._____. - $ F__ EMMS UM CLAMS-WOE DEDUCTIBLE ._.. . • AIR ON B WbRIMS AMA ANY H ,, }z, COMMIMON NSPLOYN' W S IY PROPra�NOR+P N/A 521 -0904S 08/03/2012 / / / / / / 08/03/2013 / / / ! / / W� STA1�. 0 N- ORY UdIITB EL EACH ACCIDENT _.. $ .,LOO, 000 _.... ELINSEABE_PA GYFLOYEE $ 090,000 ib under ' iFTION OF OPERATIONS 6elew E.L DISEASE - POLICY LIMIT $ 100.009 / ! / / / / / / ommammm AIR OF OPacATERA I LOOAIIIMS I V®Rd.S coserranass CONTRACTOR. pooh MORO UM, AddlEmad Wmado adMdde, E man rpm is eaga6m4 a CERTIFICATE HOLDER t ) Miami Shores Village Building Department 10050 N.B. 2nd Avenue Miami Shores Ti 33138- SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION TE THEREOF, NOTICE WILL BE DEWERED IN ACCORDANCE E POLICY PROVISIONS. ACORD 25 (2009/05) e 19110-2009 ACORD CORPORATION. All rights reserved. IN8025 teal The ACORD nine and logo are registered marks of ACORD AC# 19082 STATE OF FLORIDA PARTMENT'OF' BUSINESS' AND PROFESSIONAL 'REGULATION • ;: CONS:TRUCTION INDUSTRY LICENSING: BOARD- ,,„ LICENSE NBR,:': SEQ# L120707003.22 11043440 C 043 9 1 The CLASS B AIR CONDITIONING "C' Named below IS CERTIFIED Under the provisions of Chapt Expiration date: AUG 31, 2014 GONZALEZ,'RIGOBERTO • METROPOLITAN: AIR COND.INC 6917 NW 50TH STREET MIAMI FL R/ CI( SCOTT DISPLAY AS REQUIRED BY LAW KEN LAWSON SECRETARY FIRST -CLASS U.S. POSTAGE PAID MIAMI, FL PERMIT NO. 231 156851 -9 THIS IS NOT A BILL — DO NOT PAY RENEWAL BUSINESS NAME / LOCATION RECEIPT NO. 156851 -9 METROPOLITAN AIR CONDITIONING INC STATE# CAC043919 6917 NW 50 ST 33166 UNIN DADE COUNTY OWNER METROPOLITAN AIR CONDITIONING IN Sec. Type of Business WORKER /S 196 SPEC MECHANICAL CONTRACTOR 10 THIS IS ONLY A LOCAL BUSINESS TAX RECEIPT. IT DOES NOT PERMIT THE HOLDER TO VIOLATE ANY EXISTING REGULATORY OR ZONING LAWS OF THE DO NOT FORWARD COUNTY OR CITIES. NOR DOES IT EXEMPT THE HOLDER FROM ANY OTHER METROPOLITAN AIR CONDITIONING INC PERMIT OR UCENSE REQUIRED BY LAW. TIES IS 6917 NW 50 ST NOT A CERTIFICATION OF THE HOLDER'S S OU/ QUAW(aCA- MIAMI FL 33166 noNS. PAYMENT RECEIVED MIAMI -DADE COUNTY TAX COLLECTOR: 08/09/2012 60010000127 000075.00 ,ttj�ttt��tttt�jt�¢ ttt�f► ts�ti +t�lattt��tatf�tttt�l�ttt�tli} SEE OTHER SIDE -y 2012-11-02 14:10 • A, CORO Metropolitan A/C 3052672525» 1800 685 7530 P1/2 CERTIFICATE OF LIABILITY INSURANCE 1 10/30/2012 THUS 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 REP ,REEENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER IMPORTANT: If the cedifloste holder Is an ADDITIONAL INSURED, the policy(fes) muse be endorsed. If SUBROGATION IS WANED, subject to the terms and conditions of the policy, minks policies may require an endorsement A materna* on this certificate does not confer rights to the certificate holder In lieu of such endoreementK O.DANID HARRIS INSURANCE, INC. 5245 N.W. 36 STREET SUITE 200 MIAMI SWINGS FL 33166- MOO Metropolitan Air Conditioning, Ina. 6917 N.W. 50 Street Miami COVERAGES FL 33166- COM= NNW MARTHA IIIIREERA Mar- noN (305) 085-2055 i =aim NARTENIGDNINSURANCS Cat pc. mop T305) ONS-geos 11118111=1— ponnios o 0.9.V092 1019.10 sesont A ESSEX INSURANCE CCDIPANI mem • :BUSINESS FIRST INSURANCE MONO NAUSEA : INOMEN I MINN P REVISION NUMBER: THIS INDICATED. CERTIFICATE EXCUUSIONS IS OPORAL TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED DELON HAVE BEEN NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN ISSUED TO CONTRACT THE POLICIES REMCED BY iN memm. 1.0/20/2012 / / / / / / / / / / 0 / THE INSURED OR OTHER DESCHEED PAID CLAIMS. jFat3___._.__.__._.___liW— X0/28/2013 / / / / / / / / / / / / NAMED ABOVE FOR THE POLICY PERIOD DOCUMENT WITH RESPECT TO WHICH THIS HEREIN IS SUBJECT TO ALL THE TERMS, wawa WORM COMERCIAIAMMSWUNKAT I malm‘mam CZ OCCUR max jur_vas___________ mum POUDY n ame —"TiTRIVii—e—PiNder10,-- 301917, . • „in ffACH OCCURRENCE 11AKMME70116.1TOY--- _BEIEMISERIEteccutingsAL.$ MEIMDAtxx one Map) $ 1,000,009 A X 109,000 $ 5,000 Pelson& a MN SWAY $ 1,000,000 OET.TRAL PAGREGATE . ppopum-complop AGG $ 2,000,000 OWL ASCREGA LIMIT APPI.MS PEFt . $ 3., 000, 0004 POLICY ..4' III LOC $ imams ANY AUTO AM OWNED AUTOS tX;HEOULED AUTOS MED AUTOS NON.OWNEO AUTOS / / / / / / / / / / / / / / / / / / / / I / / / / / CONITINST SINGLE umn- - ---- 4 • —____7, SODILY INJURY (Pw paw ) $ — BODILY INJURY (Pet soddsne $ PROPERTY DAMAGE (Par a:Word) $ . .. —.... S . _...... ,-- ONNUA WO masa TAB OCCUR CLAMS-MADE / / / / / / / / / / / I / / /1 F.ACH Of:CURSE/4CE AGGREGATE $ $ DMACTIME RMENTION $ -- $ S.----........----, B OMEN OONNINIATIO0 NO ONLOWN, LONLAN NW MWOMMMOMMOOWMA ONOMUMON ODIUMW (Illonesloy la NH) CI marTsaslovunds? oc OPERATIONS bo b" CIA 140.-peo4e 00/03/2012 / / / / / / 011/03/2013 / / / / I / 1 tR- _____FArdaL E.L EACH Amapa $ LOAN LI- DISEASE- EA inotatse s_ 600,B1.9 $ MAME EL. MEW - MIXT MT I/ / / II / / ONOUPON OP ammo* i =AMA / O210280 (Mike ACCOP 014 Wood Iftrolis Ohio* II ono ewe In 0.0104 AIR COIWITICIIMIO CONTRACTOR. CERTIFICATE HOLDER CANCELLATION ) Miami Shores Village Building Department 100E0 N.B. 2nd Avenue Miami Shores Fl 33138- ACORD 2s (2009/0e) mon moo The ACORD name and logo are registered marEITIZACOR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE TN , NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE . PRoVISIONS. 0 1 RPORATION. All rights reserved. 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 i _ B IL. ING PERMIT APPLICATION P 2 I ;01 FBC201 Permit No. 'L — 1' T Master Permit No. Permit Type: BUILDING ROOFING JOB ADDRESS: ? R d I (' S t-fr'`v 4L g I V S 'I I° 5 City: Miami Shores County: Miami Dade Zip: 3 J t 3 e Folio/Parcel #: Is the Building Historically Designated: Yes NO ✓ Flood Zone: OWNER: Name (Fee Simple Titleholder): �b 4 i /tri E �. / -�'�NA Phone #: 30 S S' 16 iv'I I Address: 6 610 1 i SC h. w e %3 (■P 74 (0 ) City: C\ i Ja vv SG-o r e S State: l zip: 6 3 f 3? Tenant/Lessee Name: �G� (A- 6 Phone #: 3 bS-' 7Sb? (,2 7 V Email: 9 • , a .c: b v,e .64 i C tl wk CONTRACTOR: Company Name: A Coil S � (u L I I n A Phone #: 3 65-$ X12 y S Address: I\ C1 50 W C 1 Xt 2. vv.! City: (\ I O m e State: L Zip: '';1 b 1 Qualifier Name: A \ stn E s, p ('k Phone #: 2, 6 5 % rJ ci a S State Certification or Registration #: C GC ti S\ I a?, Certificate of Competency #: Contact Phone #: Email Address: CE,S ct 40■; ,,t-101 AC P • C °of) DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ BOO f Square/Linear Footage of Work: 350 Type of Work: ❑Addition ❑Alteration UNew Repair/Replace UDemolition Description of Work: a?p\CxCO CJ (op CP`tk∎at, .X� kPS7 35b Sk f� (,)t> P,Pct<<cq() re-In', P. )(t nn c. t 1(hi-- -00-Q4 e r Color thru tile: ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * *** Fee /J s************* * * * * * * ** * * * * ** **** * *** * * * ** * * ** c2c Submittal Fee $ ° 4� Permit Fee $ U CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 109 .1D 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 a nspection fee will be charged. Signature Signature gent Contractor The foregoing instrument was acknowledged before me this ,30 The foregoing instrument was acknowledged before me this 7 day of , 20 i , by 4,3 M (t-1 g 4 , day of Se her- , 20 (t. , by f\ ant ( t who is perso y 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. QQs.ano k.t}ow 0 as identification and who did take an oath. NOTARY PUBLIC: Sign: Prin Ne134 A. B ASH My -3 ton/UNION # DD868017 My Sign: Print: C QE, `. R A COLLAZO • ••• v•JJ ,+ �•p@,, EXPIRES May 21, 2014 i 111 EXPIRES March 27, 2014 (407) 398 0153 FlondallotaryServlce.com (407) 153 — > tier* >r**** *** * * * * * ** ** * * * * * * * * * * *** * * * * * * * * *** ** * * **> tier * * ***** ** * * * * * *** **** ** * * * * * * * * * * * * * ***,r * * * *** * * * * ** APPROVED BY 4/(1-r,?-41----. Plans Examiner Zoning Structural Review Clerk (Revised 5/2 /2012XRevised 3/12/2012) )(Revised 06 /10 /2009)(Revised 3 /15 /09XRevised 7/10/2007) THIS DOCUMENT HAS'A;COLORED BACKGROUND' MICROPRINTING+ LINEMARK ' PATENTED PAPER I ATIQI SE LIz0s*.8473' BATCH NUMBER DISPLAY AS REQUIRED BY LAW 580692 -3 BUSINESS NAME I LOCATION ACE CONSTRUCTION 11950 W DIXIE HWY 33161 UNIN DADE COUNTY FIRST -CLASS U.S. POSTAGE PAID MIAMI, FL PERMIT NO. 231 THIS IS NOT A BILL — DO NOT PAY RENEWAL RECEIPT NO. 605473 -8 STATE* C6C1511239 OWNER EGERT CONSTRUCTION INC Sec. Type of Business nits Is 116 wRAL BUILDING CONTRACTOR BUSINESS TAX RECEIPT. R DOES NOT PERMIT PIE HOLDER TO VIOLATE ANY EXISTING REGULATORY OR ZONING LAWS OF THE COUNTY OR CMES. NOR DOES IT EXEMPT THE HOLDER FROM ANY OTHER PERMIT OR LICENSE REQUIRED SY LAW. THIS IS NOT A CERTIFICATION OF THE HOLDER'S OUALIFICA- TIONS. PAYMENT RECEIVED p..11AMI.OADE COUNTY TAX OLLECTOR: 07/26/2012 60080000207 000100.00 SEE= OTHER SIDE WORKER /S 15 DO NOT FORWARD ACE CONSTRUCTION ALAN SCOTT EGERT PRES 11950 W DIXIE HWY MIAMI FL 33161 Ili' IIIIII,,,IIl III, L,..II III lit I T Hill lIII,I,II,I,IiIIliril! CERTIFICATE OF LIABILITY INSURANCE DATE (MM/ODIYYYY} 33/ TE(M2 11:08 PM 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 cerficate holder Is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement a statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Eighpoint Risk Services LLC 5510 LBJ Freeway, Suite 1200 Dallas, TX 75240 CONTACT NAM PROAT Iac,NO,enq: (800)728 -0823 FAX INC, Nop(972)404 -0380 eaeao.aesaeas: INSURERS AFFORDING COVERAGE RAC Si INSURER A:Companion Property and Casualty Insurance Company 12157 INSURED: AMS 1/c/f: EGERT CONSTRUCTION INC. , DBA ACE CONSTRUCTION 11950 WEST DIXIE HIGHWAY MIAMI, FL 33161 Phone: (305) 892 -8453 Fax: (305) 892 -9968 INSURER B:COmpanion Property and Casualty insurance Company 12157 INSURER C:xcAN ZURICH INSURANCE COMPANY FLG4080762 INSURER D: 07/09/2012 INSURER E: $ T 000000 INSURER F: $ 100000 COVERAGES CERTIFICATE NUMBER: AC12- 1501388- 1089415 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAME 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. LIMBS SHOWN MAY HAVF BFEN RFIN ICFr) RY PAID CI AIMS INSR LTR TYPE OF INSURANCE SRL SUER WWI POLICY NUMBER POLICY EFF DATE (MM!DDIYYI POLICY EXP DATE (MM/DD/YY) LIMITS A GENERAL e X UABIUTY COMMERCIAL GENERAL LIABILITY ❑ ❑ FLG4080762 07/09/2011 07/09/2012 EACH OCCURRENCE $ T 000000 P BES(Eaoceueesa) $ 100000 CLAIMS MADE X OCCUR MED EXP.(Anyone person) $ 5000 PERSONAL $ADV INJURY $ 1000000 GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY I—I JPECT n LOC PRODUCTS - COMP /OP AGG $ 2000000 _ $ AUTOMOBILE v❑ LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS ® - COMBINED SINGLE LIMIT (Ea acctdent) $ BODILY INJURY (Per person) $ BODILY INURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ - - - -- - - -- $ _UMBRELLA LIABLAIMS•MADE EXCESS LWB HC OCCUR ❑ ❑ EACH OCCURRENCE $ AGGREGATE $ — DEDUCTIBLE RETENTION $ $ $ B WORKERS COMPENSATION EMPLOYERS' UABIUTY ANY PROPERIETOR/EXECUTIVE OFFICER.MEMBEREXCLUDED? (Mandatory In NH) It yes, describe under SPECIAL PROVISION below AND N/A a DPE2627274 04/01/2012 04/01/2013 X' TORY LIMITS I IT-41- E.L. EACH ACCIDENT $ 1000000 © E.L. DISEASE - FA EMPLOYEE $ 1000000 E.L. DISEASE - POLICY LIMIT $ 1000000 C Scheduled Equi ❑ ® EC68544214 4/29/2011 4/29/2012 Equipment 31390 DESCRIPTION OF OPERATIONS /LOCATIONSNEHICLES(Attached ACORD101, Additional Rama 1. This certificate > 1 s in effec provided the c Roy/ rage is t ov, ded r anY era 0 ss for whit tj1'le A lie$ to 1 Dot tfie m QQo ee8 ofp le s d to DGERTT e ectllve 04%01/2012 '2 pinsured -s arforded Workers co-employer under the policy for employees ease rom ka Schedule, If more space Is required ien 's account is in god standin with AMS. c 7,ezlt ztof x'e�or l ty� o ASS C6NSRU����ION jNC- , AgAt,:l;g $STS RUCTIbN, Compensation & Employers liablllty as a Ants CERTIFICATE HOLDER CANCELLATION CITY OF MIAMI SHORES MIAMI SHORES BUILDING DEPT. 10050 N.E. 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 �.�+� •a ._ ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All right reserved PERMIT #: CC_Ia I`1^10 Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 RECEIPT DATE: ( 0 2, I VI-- -- I m 17int0 ❑ Contractor trikOwner ❑ Architect Picked up 2 sets of plans and (other) Address: � I 615 `j'ik-- 01x 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 ne to be bra ught back to Miami Shores Village Building Department to continue pe j Acknowledged by: PERMIT CLERK INITIAL: RESUBMITTED DATE: I b �'I Z PERMIT CLERK INITIAL: 1.5A 9 rmit ON- I P o: 12 -1770 Job Name: September 25, 2012 Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Building Critique Sheet 1) Provide approval from Miami Dade County DERM /PERA. 2) Provide an electrical permit application prior to any further review. Page 1 of 1 Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Norman Bruhn CBO 305 - 762 -4859 2012 -10-05 11:08 Metropolitan A/C 3052672525» /7( `• P 1/1 401- 19 07>4.0. A 4/ sirtof OX 44; ei E .�h DEPT SUBJECT +0 CCMPI JAN CE WI rI-i ALL PEDE TATE AND Cc I ^N, f riI,LES AND REGULATI N.S toe piffrq' r "e 1 RAitpte-t›— ctiop tit...1.s will. c„0, V. n p--4- A N q1.17"' T-g4-71 117 2,14 rAL „,v,) ,PA4L UM. tr. DEPARTMENT OF EN VIRMIMENTAL RESOURCES ANAGE T I :0 CORE REVIEWER (PRINT): IGNA As 110 t I 7 DATE #' tN 2A:z Z "'117 • 7 7,777777.... 7777,- PY • ECENED OCT 0 2 201? gir ga■ ■•• ale Ai 7T n flir. 2. i i N i w Yam i Derm Number: 2012 -1002- 1145 -5681 Contact Name: MR JOHN MILITANA Contact Phone: (805)758 -6691 Folio: 11-3206-028-0240 Project Name: DROP CEILING REPLACEMENT Date Received: 10/02/2012 CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) PT /10/2012 02:22 PM 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 R PRODUC A HE CERTIFICATE DER IMPORTANT: If the cerficate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. a statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER Highpoint Risk Services LLC 5501 LBJ Freeway, Suite 1200 Dallas, TX 75240 eansacraays mass .aga* (800 728-0923 Imam. tot(972)404 -0380 ammmona INSURERS AFFORDING COVERAGE sac # INSURER A:caepmioa amperes sae Caaaalty Inatome Company 1.2 /57 INSURED: MB /f 1 c / EtiERT CONSTRUCTION INC., DMA ACE CONSTRUCTION 11950 WEST DIXIE HIGHWAY' MIAMI, PL 33161 Phone: (305) 892 -8453 Fax: (305) 892 -9968 r M/Ca AAttlee ..._�.�.�.��...._-_ -- INSURER $: Campanian amperes and CaeualtY reentrance Company 12157 INSURER C:AMasxcna WHICa lasmwacs CONPAay CLAIMS MADE INSURER D: $ 5000 INSURER E. INSURER F: PERSONAL 6 ADC INJURY THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAME ABOVE FOR THE POLICY PERIOD INDICATED. NOTW ITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAN PERTAIN. THE INSURANCE AFFORDED BY THE POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN mAy HAVE RFEN REDUCED RY PALO CLAIMS 11IV9)i i rc TYPE OF INSURANCE ❑ MR 0 POLICY NUMBER FLd35090762 POLICY EFF DATE IMMIDDIYY), 07/09/2012 POLICY EXP DATE `MMIDDIYYI 07/09/2013 LIMITS EACH OCCURRENCE $ 1000000 $ 100000 A GENERAL x LIABILITY COMMERCIALGENERN.LUABIUn x OCCUR E EB Tg CLAIMS MADE MEDEXP (Any ono prom) $ 5000 PERSONAL 6 ADC INJURY $ 1000000 GENERAL AGGREGATE $ 2000000 GENT. AAG�GREGATEUMW APP(`U^ESSPER: IMUCY I-1 J5ECT I I LO PRODUCTS - COMP/OP AGO $ 2000000 $ AUTOMOBILE - B LIABILITY ANYACTO ALL OWNED ACTOR SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS ■ ❑ COMBINED SINGLE LAIF Me scalar:) $ BODILY INJURY (Per pstarn) $ BODILY INURY (Par accident) $ PRDEERTYDAMAC4E 9'a+eoddetdj $ $ ■ $ — UMBRELLA LIAR EXCESS LIAR .IdalE OCCUR El 0 EACH OCCURRENCE $ AGGREGATE $ DEDUCIBLE RETENTION $ $ $ B WO KERS COMPENSATION AND EMPLOYERS'LIAHILITy Y(� ANY PROPERIEfORtE)(ECUTIVE Iw 1 (Mandatory EXCLUDED? (Mande oe Elbe H) SPECIAL PROVISION below N/A OPE26272740260 04/01/2012 04/01/2013 X WC BTATU- p - I TORY LINITSI I °M EL. EACH ACCIDENT $ 1000000 . EL DISEASE -EA EMPLOYEE $ 1000000 E.L DISEASE - POLICY LIMIT $ 1000000 c Scheduled Equi ❑ EC69544214 4/29/2011 4/29/2012 Equipment 31390 DESCRIPTION OPOPERATION SILOCATI0NSIVEHNLE5(Attaehed ACORD101, Additional Remo 1. This c rtificate in effec , ro ided th c oa a e isli $$ o eo f r an a or whic E e ec veo09 /0 Y em /Qo ee e arias;ne tl rm co -amp dyer undder t e policy for s e e am o era p ogees ease from Its schedule, If more apace Is required ien1's ac ount is in standing g with ARS. p @pt �g11 pt � or �y� g� uNToN C nsation & to Comp RUCTION IP(Emp dyers Yia"�3ii y as a' ANS. CITY OF NIANI SHORES NIAI4I SHORES BUILDING DEPT. 10050 N.E. 2nd AVE. MIAMI SHORES, Fl 33138 Armen 'iS 1A11A,4Mt1 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 -- g — 2070 ACORD CORPORATION. All right reserved