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RC-13-2276 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-200700 Permit Number: RC-10-13-2276 Scheduled Inspection Date: December 20,2013 Permit Type: Residential Construction Inspector: Rodriguez,Jorge Inspection Type: Final Owner: GEORGE CRAVERO JTRS, RUTH Work Classification: Addition/Alteration "0' C Job Address:551 NE 93 Street Miami Shores, FL 33138- Phone Number Parcel Number 1132060141010 Project: <NONE> Contractor: ANN CREST CONSTRUCTION INC Phone: (305)986-8981 Building Department Comments INSTALL 2 TOILETS INSTALL 2 SHOWER VALVES Infractio Passed Comments INSTALL 1 SINK INSTALL 1 SHOWER PAN LINER WITH INSPECTOR COMMENTS False DRAINS Inspector Comments Passed _d�m Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. December 19,2013 For Inspections please call: (305)762.4949 Page 8 of 27 I . f ffff iif ff fiiif iffi fffff f ill fff ff if fill CFN 2013R0753492 OR Bk 28832 Ps 28864; (lps) RECORDED 07123/'2013 07:20:13 NOTICE OF COMMENCEMENT HARVEY RUVINP CLERK, of COURT A RECORDED COPY MUST BE POSTED ON THE JOB S"AT.TIMAE.OF , tt4$PECTiON HIANI-DADS COUNTY r FLORIDA � Z LAST PACE PERMIT NOR�i'dO`'1�i 1:f�TA3f POCIO No. STATE OF FLAIDA COUNTY OF MIAMI-DADE: THE UNDERSIGNED hereby gN rlotice`ti�at 1►npr9vements will be made to certain real property,and In aboordririce wfth Chants i i,Florida,Statutes,the following Information Is provided in this Notice of Commencement, closed not ro andstroevaddress: (0 5� ltZ• W11�1y�,t1 S•S-1' -sez-Z p j 2.Description of improvement: 3.Own")nine ifrid ildtire"ss: (bow-vorr pz� Interest.in property: Name and address of fee simple t tleholder. 4.Contractor's,name,add and phone number 5.Suret)r (Payment bt ►d requhed y owner m contrao2 ff any) Name,.addross and,phone bar: Amount of bond$ 8.LenWs name and address: 7.Persons Hilton the rState of Florida designated by Owner upon whom notices or other documents may be served as provided by Sectlori 713.13r1xa)7.,Florida Sffitutea Name,adiiress and phone number., N 119. . 8.In addition to himself,Owners designates the following 713.19(1x6),Florida person(s)to receive a copy of the Uenor's Notice as provided in Section Statutes, Name,Wdres§and phone number_/✓.1 9.Expiration date of this Notice of Commencement - N,e e><p 0on date Is 1 yearfrom fire date of recording untm a different date Is sped" WARDTO OWNER:AIJY PAYMBNTS MADE BY THE OWNER.AFTER THE EVIRATION OF THE NOTICE OF COMMENCEMENTARE CONSIDERED IMPROPER PAYMENTS UDDER dMAPTER 713,PART 1,SEGTiON 713.13:FLO�IDA'STATUTES,AND CAN RESULT IN YOUR PAYING TWICE FOR iMP,RQ_VfMENTS TO YOUR PROPERTY'`A NOTICE OF COMAAENCEMENT MUST BE RECORDED AND`POSTED ON THE JOH SITE l3EFOAE THE FIRST IN$PEtiTI.ON,IF YOU INTENQ TO OBTAIN•FINANCINQ,CONSULT WITH YOUR LEWDER OR AN ATTORNEY BEFORE COMMENCINQ WORK OR'I#ECftiNQ YOUR NOTICE OF COMMENCEMENT, xSignift*s)of r Owfteris)'Authorized OIQW/Dlrector/Parbw/Manager Prepred By Prepared Print Name . T '; ✓ >b a Print Name Title/Offlce_ r uc Two/Office STATE Op FLORIDA COUN*61F M IAMI-DADE The foregoing "strums was acknowiedgedtbefore me the d- of BY- Jndtviduaily,or ❑as for 0 Plereffially known,or produced the„faHoWing type.014entification: C;4( T,t Signa4ve of.Notary PybDo: - - Print Name: (SEAy. * *MYCOMMiS,SION#DD Wffi EXPIRES:June 25,2014 Under rielties of Perjury,.I declare that 1 have read ft-foregoing y �''�an�`o: � that the lhdts stated in it are tale,to the best of my latpwiedge and be8ef. Signatu )o s)or Owner(s)'s Authorized Of loor/Dlrector/Partner/Manager who signed above: By By O A,MUNTY OF DARE ,�^, o s 1 HEREBY CE No couNi �A cuar rC �dn�,nr Ire s�.rt dayof _ 0 St1' 13 AD20 KONES and oft 1w&d. moo` HA R of rd County Courts D.C. c�nz<+ . �" �-'- '' Miami Shores Village ®eT ®8 2013 �� Building Department BY= ��J 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 INSPECTION'S PHONE NUMBER:(305)762.4949 FBC 20 BUILDING Permit No. PERMIT APPLICATION Master Permit No. 13 Permit Type: BUILDING ROOFING JOB ADDRESS:_ C5 5 L Nv� g City: Miami Shores County: Miami Dade Zip: 3??1 70 Folio/Parcel#: 11 3w(o —v E—[0 w Is the Building Historically Designated:Yes NO Flood Zone: OWNER:Name(Fee Simple Titleholder): Phone :1 Address: City: —State: Zip: 3�175 Tenant/Lessee Name: Phone#: Email: "*_"Fj CONTRACTOR:Company Name: AA—C)1.6 t_4VPjS Address: c5vo 1 V V`ej City: State: 1 Zip: Qualifier Name: Phone#: �t State Certification or Re 'stration#• Certificate f Competenc #: Contact Phon Email Address:)q� DESIGNER:Architect/Engineer:�_1N MA 12 1 % , W�}'1 ,�•�Ci. Phone Value of Work for this Permit:$ �/ 155.b� Square/Linear Xepajr/Repl e of Work: I 1Z,�T• r4 Type of Work: ❑Addition ❑Alteration ❑New ac gDzInolition Description of Work: Z LA Color thru tile: ��m��n�x��x��.xu•��•�xa•x.�•x•n�.x��•�F��xx�.xx+x��.x.xx.x��•x��x��x��.x•x�x��xx�� Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ T 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 proved and a reinspection fee will be charged Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this 'b The foregoing instrument was acknowledged before me this-t day of 120 0,by �� . C',R{��CT, day of RWF 20 A'---'�,by et)aQ CMO , who is personally known to me or who has produced CCGO who is personally known to me or who has produced ;W 6-5 —40-His identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLI : Sign: Sign: Print: Print: ets':::��i. ANDREWIZMMINE M Commission Expire : * e t * MY COMMISSION#DD 995475 M Commission Ex ' es: * * IN COMMISSION#DD 995475 My p EXPIRES:June 25,2014 y p e EXPIRES:June 25,2014 Bonded Tleu SWO Notary Services +iF�AOQ`O Bonded Thru& Nc�y APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) /4/2013 11:57 AM Sandra Harrelson -> Page 2 of 2 y�. ANNCR-2 OP ID:SH i�40111 ."4 DATE(MMIDDIYYYY) .-- CERTIFICATE OF LIABILITY INSURANCE 1 010412 01 3 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER Phone:407-660-8282 N ME. Brown&Brown of Florida,Inc. Fax:407-660-2012 PHONE FAX 2600 Lake Lucien Dr.,Ste.330 c No): Maitland,FL 32751-7234 E-MAIL House-Brown 8r Brown ADDRESS: INSURER AFFORDING COVERAGE NAICS INSURER A:Accident Insurance Company Inc INSURED Ann-Crest Construction Corp INSURER B: 1140 SW 84th Avenue Miami,FL 33144 INSURER C: INSURER D INSURER E: 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 ADD S B POLICY EFF POLICY EXP [Nag VL%rn POLICY NUMBER LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY CPP000518101 08/2812013 08/26/2014 PRBv115Eg Ea occurrence $ 100,00 CLAIMS-MADE Fx-1 OCCUR MED EXP(Anyone person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 X POLICY PRO- LOC 7 $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT a ident ANYAUTO BODILY INJURY(Per person) $ AAUUTO OWNED SCHEDULED BODILY INJURY(Peraccident) $ HIREDAUTOS AUTOS PROPERTYDAMAGE Per aocide t $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION WORKERS COMPENSATION WCSTATU- OTH AND EMPLOYERS'LIABILITY YIN TORY LIMITS ER- ANY PRO'RETOR/PARTNERIEXECUTNE E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED7 N/A (Mandatary In NH) E.L.DISEASE-EA EMPLOYE $ If yea,desatbe urW� DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) CERTIFICATE HOLDER CANCELLATION MIAMIS1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building Dept. ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd Avenue Miami Shores, FL 33138 AUTHORIZED REPRESENTATIVE ®1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010 105) The ACORD name and logo are registered marks of ACORD 1 Oct 041311:11 a Sixto Calvo (305)266-1166 p.3 0 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET TALLAHASSEE W . FL 32399-0783 CALVO, SIXTO JORGE ANN-CREST CONSTRUCTION CORP 1140 S.W. 84TH AVE. MIAMI FL 33144 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 r ange from architects to yacht brokers,from FRQFE9SX0X1%L.:--REGUWEcw boxers to barbeque restaurants,and they keep Florida's economy strong. CG C 056Q6`3.,.`**.... 1260035118 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.myfloridalleense.com. CERTIFIED ZMERAL CONTRACTOR:i- There you can find more Information about our divisions and the regulations that I.;: ,'s= '.JORGE Impact you,subscribe to department newsletters and learn more about the -ANN-CREST;'CONSTRUCTION. 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 licenset I pjeje-9-da•cr.•ci;489 Fs date.-ILUG31,-:2014 1=-b7660160z DETACH HERE A'C# 6189415 STATE OF FLORIP.A.:.. -. TjTi&�113TUSXNESa 9D PROFESSIONAL• ON C -REGULATION C 'ION INDUSTRY BOARD. • SEQ#L12070601001 DATE BATCH NUMBER jeIC 107/06./2012- 13.26003578 -6dic056 This*•GjbWRAL CONTRACTOR: .Named below IS CERTIFIED Undar the--piovisions of• `Chapt4t- 489. Expiration date: AUG 31, 2014 CALVO, .SIXTO 'JORGE ANN-CREST CONSTRUCTION.. CORP 140 S.W. 84TH AVE. 1 , MIAMI FL 33144 RICK Scaft. KEN LAWSON GOVERNOR _ SECRETARY DISPLAY LAY AS REQUIRED BY LAW Oct 04 13 11:11 a Sixto Calvo (305)266-1166 p.2 t10166fi Local Business Tax Receipt Miami—Dade County, State of Florida THIS IS NOT A BILL-DO NOT PAY 3578598 LBT BUSINEW NAMEILOCATMA1 Recap^r No. EXPIRES ANN CREST CONTRUCUON CORP WINIEWAL SEPTEMBER 30, 2011f 1140 5W 84 AVE 3759746 Must TE MIAMI FL 33144 played at place of business Pursuant to County Code Chapter SA-Art.9&10 °VMES SEC.TYPE OF SUSRNESS SIRTO CALVO 796 GENERAL BUILDING CONTRACTOR PAYMENT RECEIVED Worker(s) 2 196 G NE 13Y TAX COLLEMR $75.00 07/03//20.13 FPPU11-13--001128 Thislaml Bnsi=T-Beeaipt wly cono ms payment oftbe Local B3*e8STm`The Receipt isnot a llcoose, Parrott or a earti&celion of the holders gaalltieatleas,to do bostoe". Holder most comply w"soy ltaremmaatal or as"aova nmerual rsgulemry Iaovs amt regotrements which apptyto the bosTuresa fth The RECEIPT NM above must be displayed on all commercial Vehicles-Miaml--page Code Sao$a-276. Formare kdarmason.r'.sjp 1<curDate> curTime>Work Comp Associates Inc.Elissa A Lucchese CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 10/04/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). FRROW01IR C E"Or Michael D.Holleman PHONE Work Comp Associates,Inc. 1.0: (561)863'9581 i c.r.,k {561}881-9745 EMAL P.O.Box 33297 .00RESS: mailoWorkCompAssoc.com Palm Beach Gardens,FL 33420-3297 INSURER(S)AFFORMOCOVERAGE NAICV INSURER A: Bridgelield Employers Insurance Co. INSURED INSURER 8: Ann-Crest Construction Corp. INSURER C: 1140 S.W.84th Avenue INSURER D: Miami,FL 33144-4118 INSURER E: INSURER F: 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. S D U L O P TYPE OF INSURANCE GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY rancAl 1 $ CLAIMS-MADE 0 OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG $ POLICY JECT LOC $ AUTOMOBILE LIABILITY md I $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED =SCHEDULED BODILY INJURY(Par accident) $ AUTOS AUTOS HIREDAUTOS NON-OWNED $AMfItudl AUTOS Mar UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ OED I I RETENTION$ WORKERS COMPENSATION X AND EMPLOYERS'LIABILITY YIN TO f I S ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ 100,000 A OFFICEIMEMBEREXCLUDED? a NIA 0830370020000 4!1/2013 4/1/2014 E.L.DISEASE-EA EMPLOYEE $ 100,000 (Mandatory In NH) If yes,describe under E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,11 more apace is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Building Dept. ACCORDANCE WITH THE POLICY PROVISIONS, 10050 N E 2nd Avenue Miami Shores,FL 33138 AUTHORIZED REPRESENTATIVE a ine-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010108) The ACORD name and logo are registered marks of ACORD