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RF-12-1959 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 C"C' Inspection Number: INSP-180228 Permit Number: RF-10-12-1959 Scheduled Inspection Date:June 05,2013 Permit Type: Roof Inspector: Rodriguez,Jorge Inspection Type: Final Roof Owner: , BARRY UNIVERSITY Work Classification: Repair Roof Job Address:11300 NE 2 Avenue Nat&Health Sc Miami Shores, FL 33138-0000 Phone Number Parcel Number 1121360010160-08 Project: BARRY UNIVERSITY Contractor: CERTIFIED ROOFING SPECIALIST INC Phone: (954)781-7663 Building Department Comments DEMOLITION AND RENOVATION OF PHYSICAL SCIENCE infractlo Passed Comments LABS INCLUDING NEW ROOF PENETRATIONS. NEW INSPECTOR COMMENTS False FLASHINGS AT CURBS MODIFIED ROOFING Inspector Comments Passed a Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. June 06,20113 For Inspections please call: (305)7624949 Page 3 of 47 l� 3 Miami Shores Village Building Department A�� 9 13 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 LCs BUILDING Permit No. PERMIT APPLICATION Master Permit No. Permit Type: BUILDING ROOFING JOB ADDRESS: 11300 NE 2nd Avenue, City: Miami Shores County: Miami Dade 71p: 33161 Folio/Parcelt Is the Building Historically Designated:Yes NO X Flood Zone: OWNER:Name(Fee Simple Titleholder):Barry Uninversity Phone#: Address: 11300 NE 2nd Avenue City: Miami Shores State: FL zip: 33161 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: Certified Roofing Specialists Inc. Phone#: 954-781-7663 Address: 3440 NW 25th Avenue City: Pompano Beach State: FL Zip: 33069 Qualifier Name: Eugene O. Fall Phone#: 954-781-7663 State Certification or Registration t CCCO27419 Certificate of Competency#: Contact Phone#: 954-781-7663 Email Address: efowler @certifiedcontractinggroup.com DESIGNER:AmhitectBngineer. Manuel Synalovski Associates Phone#: (9554)961-6806 Value of Work for this Permit:$5729.00 Square/Linear Footage of Work: Type of Work: UAddition MAlteration UNew URepair/Replace ODemolition Description of Work: Cut open existing roofing down to concrete structure. Patch back roof around new penetrations and mechanical equipment. ro& 5c it:,vc c `2/6 h ® a)6 Color thru tile: �x���xxx�x��xx��x�xx�xx���xxx�xxxxxxxxxFeesnx � �x �x��x��x������ax��x�xxxx�xx� Submittal Fee$ Permit Fee$ Z T$ 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 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 appr and a reinspection fee will be charged. Signature Signature Zy Owner or Agent ;� C ntractor The foregoing instrument was acknowledged before me this a� The fore oin instrument w acknowledged before me this 21st day of J j1,r;1,20 I-,by NIOG EWQJa E /a day of January ,20 y Eugene O. Fall , who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTAR)AIUBLIQ NOTAR UBL1Q , Sign: Sip: Print: ` p� M. Laurlcella My Commission Ex 71 J.YAO My Commi �ode�."UR10ELLA �� �` a"�MY Co MM1*SION#DD 857544 o' FLNowyDh=MAs=Co "'�^ ..o � !*XP�ReS Fe 03,2013 1.900.3NOTARY .. _ xx �ca3sdv�ak�crkwiaksssab APPROVED BY .r. �.1 Plans Examiner Zoning Structural Review Clerk (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) I '� I Miami- Shores Village Building Department OCT 18 2012 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Q Tel:(305)795.2204 Fax:(305)756.8972 - INSPECTION'S PHONE NUMBER:(305)762,4949 FBC 20 BUILDING Permit No. Y7_,r (c15 PERMIT APPLICATION Master Permit No. Permit Type: BUILDING ROOFING - - SOB '"' �%- City: Miami Shores County: U el . Zip: 331' 61 Folio/Parcel# �! Is the Building Historically Designated:Yes NO '`' lod Zone: OWNER:Name(Fee Simple Titleholder): NY UW/v?C, a e#: 30.5,• Ii - 300o Address: 11300 PC 2""o �9 v r City: r 9�ni 5aaAri State: FC. Zip: 3316 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: B V f9,V iR- R ®®9ap&(V SilCgr na'M lN2�hyQne#: 01T+ '117. °�1®7 Address: it �c> 15W l a no &E g 5017- _y a (V City: amp.4" 18 ea CA State: Zip:, Qualifier Nam Phone#:%4 27°' 12)Z State Certification or Registration#: fie., 0S7 46 'Cgrtr Cate pe 10TCY#• Contact Phonekq%;Y ' �1_ 11°M Email Address: DESIGNER:Architect/Engineer: Phonek Value of Work for this Permit:$ 1y f 9 Q• Square/Linear Footage of Work:�;�®� 64sh1��� Type of Work: ❑Addition *Iteration ❑New ORepair/Replacee ODemolition Description of Work: � 2a 0 � ✓ ! � ®r— t" G L Se_)CA.VC6 yb as *N 44 a ,9 Am tile: ..n• Submittafteer ` ermit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$' DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ Bonding Company's Name(if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) 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 i`formation is iccuraie and that pil work will be done in compliance with all --applicable laws regufatin p� s - -- -- c ' "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 fir 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 reinspection fee will be charged. Signature Signatu e Owner or Agent s Contractor was acknowledged before me this --3 oin instrument was acknowledged before me this �'' The fore • in iris nt a ac The foregoing tru t ge g tr•tre g day of Ocl' ,201 a—,by `dayzbf � '`' ,20�,by who is personally known to me or who has produced who is ersonally known to me lor who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY P L !� r Sign- Sign: Print: Print ®k Z M Commission E ire • M Co My Notary Pub9c State of Florida MY CO 9aidatwtw 4•pll 1, JAWER MARTINEZ My Commiss an ODSOe128 z° �4',y E>�Ira4osJ06=4--- tbN�.-.Str3deofI skskds8a�ssksksk=kk+kH�kBs.k s _ k=kskS+kk:kkk8+skRk'kDkkk'k >y- uummissat•D-D 8N APPROVED BY Qom'Glans Examiner Mning Structural Review Clerk (Revised 3/12/2012)(Revisedd 07/10/07)(Revised 06/10/2009 N Revised 3/15/09) STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 TALLAHASSEE FL MONROE STREET 32399-0783 MITALA, JOHN B INFINITY ROOFING AND SHEET METAL INC 11874 ISLAND LAKES LN. BOCA RATON FL 33498 I STATE OF FLORIDA AC# 6 21,3 8 S ? G- Congratulationsl With this license you become one of the nearly one million j DEPARTMENT OF BUSINESS AND { Floridians licensed by the Department of Business and Professional Regulation. I PROFESSIONAL REGULATION Our professionals and businesses range from architects to yacht brokers,from I j boxers to barbeque restaurants,and they keep Florida's economy strong. CCC057467 08/06/12 120052439 Every day we work to.improve the way we do business in order to serve you betteri For information about our services,please log onto www.myfloridalicense.com. CERTIFIZI:� ROOFING CONTRACTOR There you can find more information about our divisions and the regulations that MITALA, JOHN`,8 j impact you,subscribe to department newsletters and learn more about the INFINITY ROOFING AND SHEET METAL 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. IS CERTIFIED under the pzovistoae of ch:489 Fs Thank you for doing business in Florida,and congratulations on your new licensel amir.eioa sae®t AUG 31, 2414 L120e0604243 DETACH HERE AC# 2 8 57b STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY" LICENSING BOARD SEA L2208Q60Q243 l .• a - LICENSE NBR j 576;20121120052439 CCC057467. I The ROOFING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489';_ FS. Expiration date: AUG 31, 2014 i i MITALA, JOHN B INFINITY ROOFING AND SHEET METAL INC 1150 SW 10TH AVE f STE 201W POMPANO BEACH FL 33069 I RICK SCOTT KEN LAWSON GOVERNOR SECRETARY l __ _ . DISPLAY AS REQUIRED BY LAW 4 S '4'c�°-R° CERTIFICATE OF LIABILITY INSURANCE 5/24/20 2 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). PRODUCER TA T NAME: Frank H. Furman, Inc. PHONE (954)943-5050 A�;(954)943-5417 1314 East Atlantic Blvd. ADDR6; P. 0. Box 1927 PRODUCER 00002201 .Pompano Beach FL 33061 INSURER(S)AFFORDING COVERAGE NAIC 0 INSURED INSURERA First Mercury Insurance Company 10657 INSURER B.ValleY Fore Ins 20508 Infinity Roofing And Sheet Metal Inc INSURERCAmerican Guarantee & Liability 6247 1150 S W 10th Ave, Suite #201W INSURERD:Brid afield Employers Ins Co 10701 INSURER E S Pompano Beach FL 33069-1326 INSURER F: COVERAGES CERTIFICATE NUMBERXay 2012 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 AVOL SU13RI POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER NWD LIMIT8 GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO X COMMERCIAL GENERAL LIABILITY PREMISES(RENTED occurrence) $ 50,000 A =1 CLAIMS-MADE Fx-]OCCUR NJCGLOOOOOI144301 /25/2012 /25/2013 MED EXP(Any one persoM $ EXCLUDED X XCU & Contractual PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEWL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,000 POLICY X PRa LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X ANY AUTO B ALL OWNED AUTOS 2083041073 /25/2012 /25/2013 BODILY INJURY(Per person) $ BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ X HIRED AUTOS (Per accident) X NON-OWNED AUTOS Uninsured motorist combined $ PIP-Basic $ X UMBRELLA LIAR X OCCUR is FOLLOWING FORM OF EACH OCCURRENCE $ 5,000,000 EXCESS LIAR CLAIMS-MADE . AUTO AND AWL LIM AGGREGATE $ 5,000,000 DEDUCTIBLE $ C X RETENTION $ Q UC967203404 /25/2012 /25/2013 $ D WORKERS COMPENSATION X WC STATU OTH AND EMPLOYERS'LIABILITY ANY P R PRAETOR EXCLUDED?ECUrM® NIA E.L EACH ACCIDENT $ 11000,000 (Mandatory in NH) 830-38636 /1/2012 /1/2013 E.L.DISEASE-EA EMPLOYE $ 11000.000 If yes, escribe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,AddKiorusi Remarks SchedWe,I more space to 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 Village ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd Avenue Miami Shores, FL 33138 AUTHORIZED REPRESENTATIVE Frank Furaan, Jr/C3 ACORD 26(2009109) ©1988-2009 ACORD CORPORATION. All rights reserved. INS028 poot)o9) The ACORD name and logo are registered marks of ACORD Ngg .ffi hof T� 1c k .,... ` 0. � I Wit I .7w-ph W y• ' ` t � ,� � �:�``2�` `".. �,rr' r "' �` z �X� Tk""3x�q;�<. "' ra'�'-a` y,�' �.�.�"."� � - y ��a x t . f +l 34 m s IPWAUMWF on WAY Am AIR ova ATUAW, JoWd MAN, kly Its MWAMT low " , Y ( J N 3 4 �y y ' � l .�...m.�nw,.�wmr�ws_....�s�...r...�.�....�nn.�_.rr...rr�..+w. ......w.—w-r�..u.a�a._�r..r� ...w_wnwsm.'..v b�_ ....�_�•�earoa :�,'..... ....................................... ............................................................................. ............... ......................... ................. ........... BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm.A-100, Ft. Lauderdale, FL 33301-1895—954-831-4000 VALID OCTOBER 1,2012 THROUGH SEPTEMBER 30,2013 DBA:INFINITY ROOFING AND SHEET METAL Receipt 9:185-1498 Business Name: Business Type:ROOFING/SHEET METAL COINWMI TOR INC (ROOFING CONTRACTOR) OwnerName:joHN. B mtTALA / QuAL Business Opened:o 9/o s/2 o o 6 Business Location:liso SW 10 AVE #2011 State/County/Cort/Reg-.CCCO57467 POMPANO BEACH Exemption Code: Business Phone:954-917-7107 Rooms 1100% omploy"s Machines Pr Is .18 For vam"evein"a—dawy Number of Machines: ±ending Type: Tax Amount Transfer F!LL NW F" "lly Collection cost Total Paid 5.401 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 so County and/or Municipality planning WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transfenred when the business is sold, business name has changed or you have moved the business location.This receipt does not Indicate that the business is legal or that it is In compliance with State or local lam and regulations. Mailing Address, INFINITY ROOFING AND SHEET METAL I' Receipt #30A-11-00004230 1150 SW 10 AVE #201W Paid 06/14/2012 59.40 POMPANO BEACH, FL 33069 2012 - 2013 . ..... ........ ..... ........ ................... ....................................................... lk" &A-A&AW 6,A- ......