RC-14-809Miami 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
FBC 20
BUILDING Permit No.
PERMIT APPLICATION Master Permit No., 19 -
Permit Type: BUILDING ROOFING
JOB ADDRESS: 9/`y lCs ef�
City: Miami Shores County: Miami Dade Zip: 331 3ci
Folio/Parcel #: D 0 01 0
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): ' "VO '''‘\6-4 J Phone#: 604 - 3 `II
Address: ‘41.-. Vs 1- sek 44A:7-
City: `iAV't°\ "AN State: Zip: 33 13
Tenant/Lessee Name: S\1;
Phone #:
Email: ®'
CONTRACTOR: Company Name: %Ct9 -7` ' 01\1 ?, Q' Phone #: A4 ° �) I " —10k)
Address: ci. O %-lam 43/N '
City: Q �..ta\-3t • 14. 5 State: Zip: 31.33
Qualifier Name: 0 `b (-4 %4 `.4X ytr. k Phone#: N\ s S31 1/4k4
State Certification or Registration #: CAL 'A (s.-"d....0 Certificate of Competency #:
Contact Phone #:43\1 5- \4\N1 Q Email Address: '1t� ®��et4w Qs4 >d. S),)
DESIGNER: Architect/Engineer: ® Phone #:
Value of Work for this Permit: $ `y, s-(60, Square/Linear Footage of Work: �J
Type of Work: ❑Addition alteration
UNew l]Repair/Replace ❑Demolition
Description of Work: ��.� 0
i Sr �� w� � �� .r ��'
Color thru tile:
***** x**** pax\ �x *a�x�+a****** **a�+�a��x *�xa��r� *** ** Fees* �v. x**************** �xa��x�xm x�x�x�x�x� *�x�xa�a�a��x�xa��x *•x***
Submittal Fee $ Sr J v "(. ) 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 $ 1
+ 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 he approved and a reinspection fee will he charged.
Signature
Owner or Agent
The foregoing instrument "was acknowledged before me this
day of P iv , 204 , by PAS 1,4i.oh
who is personally known to me or who has produced I B,.
As identification and who did take an oath.
NOTARY PUBLIC:
115
Sign:
Print:
My Commission Expires:
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPROVED BY
Signature
Contractor
The foregoing instrument was acknowledged before me this 21
day of Aft0 , 20/ , by OSChi Only j v
who is personally known to me or who has produced Ri14-o
as identification and who did take an oath.
Sign:
Print:
My Commission Expires: 11114)
a,a **** * * ** ,* ***x, w, x, v****** *********, x*a, *****•r***** ***xxa,*** * *+a*• ***
Plans Examiner
Structural Review
(Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
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
DELGADO, OSCAR ENRIQUE
BARI NATIONAL BUILDERS, LLC
2706 MISTY OAKS CIR.
ROYAL PALM BEACH FL 33411
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.myfloridaticense.com. There you can find more information
about our divisions and the regulations that impact you, subscribe
to department newsletters and learn more about the Department's
initiatives.
Our mission at the Department is: License Efficiently, Regulate Fairly.
We co qtly strive to serve you better so that you can serve your
ix b:marrs Thank you for doing business In Florida,
and congratulations on your new license!
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND
PROFESSIONAL REGULATION
CGCI 522035 ISSUED: 02/06/2014
CERTIFIED GENERAL CONTRACTOR
DELGADO • ENRIQU ,-
I NATIONAL BUI�r
IS CERTIFIED under the provisions of Ch.489 FS.
&waft date : AUG 31, 2014 L1402060000499
The Department of State is leading the commemoration of Florida's 500th anniversary in 2013.
lit For more information, please go to www.VivaFlorida.org.
Mt 11111111 ;
DETACH HERE
RICK SCOTT, GOVERNOR STATE OF FLORIDA KEN LAWSON, SECRETARY
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION yi
CONSTRUCTION INDUSTRY LICENSING BOARD
LICENSE NUMBER
The GENERAL CONTRACTOR
Named below IS CERTIFIED
Under the provisions of Chapter 489 FS.
Expiration date: AUG 31, 2014
2085
UNIT 104
PEMBROKE PINES FL 33029
ISSUED: 02/0612014 SEQ # 11
DISPLAY AS REQUIRED BY LAW
VIVA A RIDA 59r.
BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT
115 S. Andrews Ave., Rm. A -100, Ft. Lauderdale, FL 33301 -1895 — 954- 831 -4000
VALID OCTOBER 1, 2013 THROUGH SEPTEMBER 30, 2014
Receipt # :a8 CONNTRACTOR
Business Type:
Owner Name: CEFALO, DArnaL D. Business Opened:07 /29/2011
Business Location: 3121 SW 186 TERRACE StatelCounty /Cert/Reg :C3C1809349
MIRAMAR Exemption Code:
Business Phone:
Rooms
Number of Machhues:
Employees :: Machines Professionals
3
"Far Vending: ausiness Only
Vend! rlig Typo:
Tax Amount
Transfer Fee _
NSF Fee
Penalty
Prior Year;
. Collection Cost
Total Paid
2/.00
0.00:-
0.00
.:; . 0.00
0400
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 Munbdpality planning
WHEN VALIDATED and zoning requirernenb. This Business Tax Receipt must be transferred 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 laws and regulations.
Mailing Address:
ANTONIO DELIGIO
P.O. BOX 267896
FT LAUDERDALE, FL 33326
Receipt 8048 -12- 00001917
Paid 09/27/2013 27.00
.11 �O MAR /!A.R' -M.:11 0,114./ ► :11' ,yR. P...A :A.a.U.._ mike .•w •,w.w.�
TACO D®
CERTIFICATE OF LIABILITY INSURANCE
DATE ( DDIYYYY)
01/04/2013
PRODUCER
LUBIN BERGMAN ORGINAZATION INC.
5 Revere Drive Suite 370
ANorth Brook, IL 60062
847- 9412014
THIS CERTIFICATION 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
NAIC #
INSURED
BARI NATIONAL BUILDERS, LLC
Antonio Deliglo
20916 Sheridan St
PEMBROKE PINES, FL 33332
INSURER A: State Farm General Insurance Company 25151
25151
INSURER B State Farm Florida Insurance Company 10739
10739
INSURER C: State Farm Mutual Automobile busman= Company 25178
25178
INSURER D:
INSURER E
COVERAGES
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
ADM D
I
TYPE OF INSURANCE
POLICY NUM
DA l
DA TE
UNITS
A
GENERAL
LIABILITY
COMMERCIAL GENERAL LIABILITY
MGL 0157549
01/0412014
01/0412015
_
EACH OCCURRENCE
$ 1,000.000
X
DAMAGE
PREMISES TO )
$ 50,000
CLAIMS MADE X OCCUR
MED MCP (Any one person)
$ 5.000
X
Expolsion Under
PERSONAL &ADV INJURY
$ 1.000,000
ground Collaps
GENERAL AGGREGATE
$ 2,000,000
GENII
AGGREGATE LIMIT APPLES PER:
POLICY n n LOC
PRODUCTS - COMP/OP AGO
$ 2,000,000
$
A
AUTOMOBILE
LIABILft1f
ANY AUTO
ALL OWNED AUTOS
SCHEDLR ED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
MIX 0157549
01/84/2014
01104/2015
COMBINED SINGLE LIMIT
(Ea accident)
a
$ 1.000,000
INJURY
(Per person)
$ 1,000,000
X
BODILY INJURY
(Pert)
$
X
PROPERTY DAMAGE
(Per accident)
$ 1.000.000
GARAGE
LIABILITY
ANYAUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
AUTO ONLY: AGG
$
A
EXCESS I UMBRELLA LIABILITY
UGL 0157549
01/04/2014
01/04/2015
EACH OCCURRENCE
$ 5,000.000
I OCCUR CLAIMS MADE
AGGREGATE
$ 5,000,000
DEDUCTIBLE
RETENTION $10,000.00
$
$
X
$
B
WORK
EMPLOYERS'
ANY PROPRIETORIPAA?N�E
OFFICER/MEMBER
S RC AL
COMPENSATION Alm
LIABILITY �Y! N
OCCLUDED? I ' I
HIGWC 8974502
01104/2014
01/04/2015
I TOC STA I S I i
EL EACH ACCIDENT
$ 1,000,000
EL DISEASE - EA EMPLOYEE
$ 1,000,000
PRO beans
DISEASE - POLICY MIT
$ 1,000,000
B
OTHER
Builders Risk
HIGBR581M402
01/04/2014
_EL
01/04/2015
$1,00$1,000,000 ,
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS BY ENDOWMENT / SPECIAL PROVISIONS
Miami Shores Village is added as additional insured written contract for both
the General Liability & WIC for the General license # CGC1522035. 30 Days notice of cancellation given.
CERTIFICATE HOLDER
ELLATION
Village of Miami Shores
10050 NE 2nd Ave
Miami Shores, FL 33138
ACORD 25 (2009101)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WIRTTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
NO OBLIGATION OR LIABILITY OF ANY HIS UPON THE INSURER, ITS AGENTS OR
A
1988-2009 ACORD CORPORATION. AU rights reserved.
The ACORD tome and logo are registered marks of ACORD 1001486 132849.3 04.0E -2009
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ami Shores Village
APPROVED
BY
DATE
ZONING DEPT
_
,
BLDG DEPT
oz_
SUBJECT tO CCMPU4NCE WITH ALL FEDERAL
STATE ANv CY IjN t °f RULES AND REGULATIONS
\\r
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MIAMI SNORES BAY VIEW
1.51 4o
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0.65'
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1000
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201 A5P1 -1 . ROAD
SHEET 2 OP 2
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FD1/21
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Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 215158
Scheduled Inspection Date: July 02, 2014
Inspector: Rodriguez, Jorge
Owner: HUNTER, MARK
Job Address: 1245 NE 93 Street
Miami Shores, FL 33138-
Project <NONE>
Contractor: BARI NATIONAL BUILDERS LLC
Permit Number: RC- 4- 14-809
Permit Type: Residential Construction
Inspection Type: Final Building
Work Classification: Alteration
Phone Number (917)604 -8328
Parcel Number 1132050270070
Phone: (954)391 -7029
Building Department Comments
DEMO DRYWALL INSULATE AND RE DRYWALL
Infractio
Passed Comments
INSPECTOR COMMENTS
False
Inspector Comments
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
July 01, 2014
For Inspections please call: (305)762 -4949
Page 29 of 31