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PL-13-2614
r Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795 -2204 Fax: (305) 756 -8972 INSPECTION LINE PHONE NUMBER:430S) 762 -4949 BUILDING PERMIT APPLICATION RECEIVED APR 21 2014 BY: FBC 20 Master Permit NoC - I t 13 "264 2. Sub Permit No. -" t l " 3 ""2‘,1,11 ❑BUILDING ❑ ELECTRIC ❑ ROOFING Er REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLICWORKS ❑ CHANGE CONTRACTOR ❑ CANCELLATION ❑ SHOP DRAWINGS JOB ADDRESS: lOgi R° gag I I A . City: Miami Shores County: Miami Dade Zip: 3,3138 Folio /Parcel #: t 1,2232 02 go 3 20 Is the Building Historically Designated: Yes NO 'C Occupancy Type: 11""S. Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): 44/f Ii/ 14577101/ 7-s LIC Phone#: —4A - 424.3 g 302 Address:2,900 Ai 30 /o gg .9/8 City: /flit /77!/x' i State: FLe30I2 124 Zip: 331430 \Tenant /Lessee Name: /4//4 Email: Phone#: CONTRACTOR: Company Name: 14n F oTPo011Dg co _ Address: t O t b® 4VEi J Dot DiE L RIO City: 3L State: FLD (24 0 4 Qualifier Name: t. tE --I --co_ %< L 61:_, Phone#: 4 -93/- 9/ H State Certification or Registration #: 1. 042fef f Certificate of Competency #: DESIGNER: Architect /Engineer: Nt /i – Phone#: Address: i City: State: Zip: Value of Work for this Permit: $ Square /Linear Footage of Work: Phone#: 94 - /3/'9V69j(O Zip: „Type of Work: ❑ Addition ❑ Alteration ❑ New Description of Work: P.e. — ca —cxr ;tr worsm. U MM, f4A-er Ci°'CZ- eA' 2.e9. ®M flP ■ Repair /Replace ❑ Demolition Specify color of color thru tile: Submittal Fee $ Permit Fee $ 7e?-5 CCF $ CO /CC $ Scanning Fee $.3 t' Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ ° E. t Bonding Company's Name (if applicable) 14/A - 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. A so, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seve (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reins ection fee will be charged. Signature wner or Agent Contra The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me1ih t4 this 14day of �iAfQf .I420,, by h A -CCU 0 5uday of 1 , 2014 by 1.-€51-4E- 1 Let,. who is clown 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 PUBLIC: NOTARY PUBLIC: Sign: Print: My C E" .tn ou i EE018480 Expires: ALJG• 18,2014 BONDED TRIM ATLANTIC BONDZG CO.,INC Print: My Commission TijvQ pot P' 3 C -STATE Ur iLQRIDA y ommission Expires: �s; Gustavo Gomez Tnnaission # EE018480 AUG.18,2014 ;�;;res: ••n``, CBON'DL`1GCO.,INC. BONDEDTHr,; :::LANTI ***** * ** * * * *** ***** **!F7k***** **** k*********** ****M ***O N' *+R+k ***************** ***** M***k************************ APPROVED BY ( I 2,2.1 Plans Examiner Structural Review Zoning Clerk (Revisedo2 /24 /2014)(Revised 5 /2 /2012)(Revised 3/12/2012) )(Revised 06 /10 /2009)(Revised 3 /15 /09)(Revised 7/10/2007) -+1 AC R CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 4/21/2014 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 POUCIES 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(tes) 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 Keyes Coverage Insurance 5900 Hiatus Road Tamarac FL 33321 INSURED HMF Construction Co. Attn: Leslie 9778 Napoli Woods Lane Delray Beach FL 33446 1958 NANAMME: Kristina Snelling PHONE N . ):954- 724 -7000 no Bess :ksnellingC5?keyescoverage.com INSURER B : vc. No):954- 724 -7024 INSURER(S) AFFORDING COVERAGE L NAIC # Continent Casualty A :Mid - ty Co 3418 INSURER C : INSURER D : INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER: 1639171071 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 I SR Y WVD POUCY NUMBER 04- GL- 000896175 (MMM//DD/YYYY 2/22/2014 (MM//DCD//YY�YY) 2/22/2015 LIMITS EACH OCCURRENCE $1,000,000 A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY PRMAGE TO RENTED PREMISES (Ea occurrence) $100,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $EXCLUDED X AI Per Wrtn Cont PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'LAGGREGATE UMITAPPUES PER: —1 POUCY F jECOT- n LOC PRODUCTS - COMP /OP AGG $2,000,000 $ AUTOMOBILE _ LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS _ SCHEDULED AUTOS NON -OWNED AUTOS COMBINED d(SINGLE UMIT $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ _ UMBRELLA UAB EXCESS LIAB _ OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RErENT ON $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N /A I TORY LIMITS I I0T E.L. EACH ACCIDENT $ EL DISEASE - EA EMPLOYEE $ E.L DISEASE - POLICY UMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, AddMonal Remarks Schedule, H more apace Is required) License #CFC042989 CERTIFICATE HOLDER CANCELLATION 1 Miami Shores Village 10050 NE 2nd ave Miami Shores FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVERED IN ACCORDANCE WITH THE POUCY PROVISIONS. AUTHORIZED REPRESENTATIVE Oil ilr? ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD BUILDING PERMIT APPLI Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795 -2204 Fax: (305) 756 -8972 INSPECTION LINE PHONE NUMBER: (305) 762 -4949 FBC 20 Master Permit No. f2C.. '°" () " 13-2.6 1 Z,,, Sub Permit No. E/ BUILDING ELECTRIC ROOFING `� REVISION EXTENSION RENEWAL PLUMBING ❑ MECHANICAL DPUBLICWORKS CHANGE CONTRACTOR CANCELLATION SHOP DRAWINGS JOB ADDRESS: 1 06 ✓ 6 OE 11 kv - City: Miami Shores County: Miami Dade Zip: 33(5 8 Folio /Parcel #: 1 122 3202. go3 Zo Is the Building Historically Designated: Yes NO , _ Occupancy Type: 2ES Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): 04411 i4"14:377 T3 £I Address: 2 qoo „Ave 9• 4v, City: Afrieev f7V/Z4 Tenant /Lessee Name: p/A- Email: 105T*0 ( eiDovervezo Fe-726 COY" 1 CONTRACTOR: Company Name: WEl rafiV(b (?ill2 6N772-T7&," cry. Phone#: %#65 4/64243x 22. Address: 20f 40 A/c/- ,30 4V �!O State:LOge State: 3/8 Ft.4, O4 Phone# - 4' -12s9, ?aZ Zip: .3/1510 Phone#: city: it V7Z)/24 Qualifier Name: /41 'Vet P-012-- 2-- State Certification or Registration #: DESIGNER: Architect /Engineer: Address: City: Zip: GC-7G037330 ("" Zip: Phone#:90 -464 -#.4 3 Certificate of Competency #: Phone#: State: Value of Work for this Permit: $ Square /Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Al‘R ❑ Demolition Description of Work: ',UPI: I- L. 47" Afoit&Tc72 olr#i2001t f 7a L V L . Lv';r' frMAv72 i,>e� y ° ezeni 0 f kc° - '7V • 'A' 110411W'Ce ph-rr2.i &an 0 i/ Specify color of color thru tile: Submittal Fee $ Permit Fee $ -5`"(;)) 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) 14 (A 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. Als , a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven ) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspe ion fee will be charged. Signature wner or Agent Contractor tt// The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before mel 6 1'T this 14 day ofii& L. , 20 _, bi tt?D 9040,005!(.1 day of APO -4.— , 20 boil(( Ur2 R (7,J 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. NOTARY PUBLIC: Sign: Print: �_ Print: My Commission Expires: My Comm ssion Ex • ,, AT NOTARY PUBLIC -STATE OF E? iRY PUB` ' 'AI 'L. OF FLORIDA Gustaeo Gomez ; ^romez •� �.. CommiCssion # EE018480 L �� ,' Cc , s,or * EE018480 # # # # # # # # # # # # # # # # # # # #itiTi <' eY 1F' A #oifE ## # # # # # # #MM # # # # # # # # # # # # # # # # # # # # ## # # # *t� ' ! 91csea s # # # ## BONDED a,' A /247: Plans Examiner Zoning NOTARY PUBLIC: APPROVED BY Structural Review Clerk (Revised02 /24 /2014)(Revised 5 /2 /2012)(Revised 3/12/2012) )(Revised 06 /10 /2009)(Revised 3 /15 /09)(Revised 7/10/2007) KITCHEN: REPLACE CABINETS, PLUMBING ""- ' AND -,iiiiiiii D RECEPTACLES BATHROOM: REPLACE AND 0 ING FIXTURES I i �y 10'-0 21' -2° . - - -- ° „ AND FINISHES ° 10'- -O ' REV.1 (4-16-10 BATHROOM FLOOR TO BE RAISED TO MATO BEDROOM ELEVATION WITH CONCRETE POURED 3' -5° 3' -21' 6' �:.. 4'— 4' -111 vo , 4, frA /r_ I S /VA c c Q • ¢ • • 1 r I r's• — f it I LP REV. 1(4- KITCHEN 16 -14): KITCH LAYOUT. OVER EXISTING SLAB. CONCRETE 3000 PSI Y .. li 4 • Ill fr MEDIA ROOM V V IF 13' -7° 0 II • 4%„, V� 0 , Q ''• QQ � OU — T- 16' -0° 9' -10° BATHROOM: REPLACE PLUMBING FD(TURES AND FINISHES `' Q�;% �9 V �. C., , � �v( co OWNER: MM INVESTMENTS, LLC co , ATE: JOB ADDRESS: 10659 NE 11 AVE, Miami Shores REV.1: 4 -16 -14 SCOPE OF WORK: REMODEL BATHROOMS AND KITCHEN PERMIT: NOTES: TO SEPTIC 3° TEST TANK TEE 2° 3" TEST TEE SHOWER 2° 3° 2° rl 1/2" 2° 3° 2" STUDOR LAV TOILET 4° VENT 1/2° LAV OWNER: AAM INVESTMENTS, LLC DATE: JOB ADDRESS: 10659 NE 11 AVE, Miami Shores REV.1: 4 -16 -14 SCOPE OF WORK: REMODEL BATHROOMS AND KITCHEN PERMIT: NOTES: