FW-13-866 (2)Miami Shores Village
�
Building n .\1�, , �� u lding Departure t
e
90050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
M INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING 'PERMIT AP41�ATI
ON
FBC 20
Permit Type. UILDING ROOFING
APR 2J 2013,
Permit No. 1
Master Permit No.
OWNER: Name (Fee Simple Titleholder): Barry University, Inc. Phone#: (305)899-4054
Address: 11300 Northeast 2nd Avenue
city: Miami Shores
state: Florida zip: 33161
Tenant/Lessee Name: Phone#:
Email:
JOB ADDRESS: 11300 Northeast 2nd Avenue ®�, %�•
City: Miami Shores County: Miami Dade —+-�r Zip: 33161
Follo/Parcel#: 1121360000050
Is the Building Historically Designated: Yes
NO Flood Zone:
CONTRACTOR: Company Name: Engel Construction, Inc. Phone_#: (954)583-1109
Address: 1523 Southwest 21st Avenue
city: Fort Lauderdale state: Florida Zip: 33312
Qualifier Name: RobertA. Engel Phone#: X954)583-1109
State Certification or Registration #: CGCO15973 Certificate of Competency #:
Contact Phone#: Email Address:
DESIGNER: Architect/Engineer: NSA Phone#:
Value of Work for this Permit: $ 4,653.00 Square/Linear Footage of Work: 49 L. F.
Type of Work: ❑Addition OAlteration U lew ORepair/Replace ODemolition
Description of Work: Furnish and Install 49 L.F. of 8' high galvanized fence by Broad Auditorium - g(A
cart area. '
Submittal Fee $ Permit Fee $ CCF $ CO/CC $
Scanning Fee $
Notary $
Radon Fee $
Training/Education Fee $
DBPR $ Bond $
Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $
Bonding Company's Name (if applicable)
Bonding Cor pany's Address
City
State
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 poste notice, the
inspection will not be qpproveAord a reinspection fee will be charged.
Signature )qLSignature
Owner or Agent
The foregoing instrument was acknowledged before me this
day of -k941, 20 IS, by W&CO 9MMW ,
who is nersonall known to me or who has produced
As identification and who did take an oath.
NOTARY U]
Sign:
Print:
My Commission
Contractor
The foregoing instrument was acknowledged before me this 9th
day of April , 2013, by Robert A. Engel ,
who is personally known to me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
APPROVED BY ! Plans Examiner
Structural Review
(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
Print:
My
Zoning
Clerk
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
May 2, 2013
Permit No: FW13-866
Planning Critique
1. PLASTIC STRIPS ARE NOT PERMITTED TO BE INSERTED IN A CHAIN LINK
FENCE
David Daquisto
305-762-4864
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.
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
May 2, 2013
Permit No: FW13-866
Planning CritiQue
1. PLASTIC STRIPS ARE NOT PERMITTED TO BE INSERTED IN A CHAIN LINK
FENCE
David Daquisto
305-762-4864
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.
05/02/2013 10:12 FAX 1 800 685 7530 DATA SCAN FIELD SERVICES
*********************
*** TX REPORT ***
TRANSMISSION OK
Tx/RX NO
RECIPIENT ADDRESS
DESTINATION ID
ST. TIME
TIME USE
PAGES SENT
RESULT
Miamioresills e
9
Building Depm'ment
Miami Shores, Florida. 33138
Tot: (306) 795.2.20,11
Fax: (305) 756.£972
May 2. 2013
Permit No: FW 13-866
3564
919545831144
05/02 10:11
00'47
1
OK
Planning Critique
0 001
1. PLASTIC STRIPS ARE NOT PERMITTED TO BE INSERTED IN A CHAIN LINK
FENCE
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
CONTRACTORS' REGISTRATION FORM
ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS
SUBMITTED OR THE VILLAGE MAY MAINTAIN A FILE WITH YOUR INFORMATION FOR A $30.00 FEE PER YEAR.
IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR:
A.—X COPY OF QUALIFIER'S STATE LIC CARD
B. X COPY OF LOCAL BUSINESS TAX RECEIPT
C. X COPY OF LIABILITY INSURANCE (CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPT)
D. X COPY OF WORKERS COMPENSATION (EITHER CERTIFICATE OR EXEMPTION)
IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY:
A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER
B. COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT
C. COPY OF LIABILITY INSURACE (CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPT)
D. COPY OF WORKER COMP INSURANCE (EITHER CERTIFICATE OR EXEMPTION)
YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW:
MIAMI SHORES VILLAGE BLDG DEPT
10050 NE 2ND AVE
MIAMI SHORES, FL 33138
COMPLETE CONTRACTOR'S INFORMATION
BUSINESS NAME: _Engel Construction, Inc_
BUSINESS ADDRESS: 1523 S.W. 21st Avenue CITY Ft. Lauderdale
STATE Florida ZIP CODE 33312
BUSINESS PHONE: L954 ) 583-1109 FAX NUMBER 9( 54) 583-1144
CELL PHONE L954) 646-4511 QUALIFIER'S NAME: Robert A. Engel
QUALIFIER'S LIC NUMBER: CGC015973
E-MAIL ADDRESS (IF APPLICABLE):
Created on 3119109 BY MLDV 1 RV 3126109 MLDV
.AC<9RV CERTIFICATE OF LIABILITY INSURANCE
E(MMlDD
711T4r2012
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
Bateman Gordon and Sands
3050 North Federal Hwy
Lighthouse Point FL 33064
CONTACT
NAME:
PHONE1_ FAX
No
E-MAIL
ADDRESS:
GL208055004
INSURERS AFFORDING COVERAGE NAIC #
INSURERA;Amerisure Mutual Insurance Co. 23396
EACH OCCURRENCE $1,000,000
INSURED ENGCO
INSURER B;AMedSUreInsurance Co. 19488
INSURER C:
Engel Construction Inc.
Engel Plumbing
1523 SW 21 Avenue
INSURER D
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY X PRO LOC
Fort Lauderdale FL 33312
INSURER E:
INSURER F
AUTOMOBILE
X
X
COVERAGES CERTIFICATE NUMBER: 1537433599 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
LTR
TYPE OF INSURANCE
ADDLISUBR
INSR
WVD
POLICY NUMBER
POLICY EFF
MMIDDNYYYI
POLICY EXP
IMMIDDNYYY)LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE KI OCCUR
X XCU/Contractual
GL208055004
1/1/2013
/1/2014
EACH OCCURRENCE $1,000,000
PREMISES(Ea occurrence $300,000
MED EXP (Any one person) $10,000
PERSONAL 8 ADV INJURY $1,000,000
X Broad Form PD
GENERAL AGGREGATE $2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY X PRO LOC
PRODUCTS - COMP/OP AGG $2,000,000
$
B
AUTOMOBILE
X
X
W►BILITYCA20805570002
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
HIRED AUTOS X NON -OWNED
AUTOS
/1/2013
/1/2014
Ea accident $1,000,000
BODILY INJURY (Per person) $
BODILY INJURY (Per accident) $
PROPERTY DAMAGE
Per a.,danI $
A
X
UMBRELLA LIAR
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
CU20805840002
/1/2013
/1/2014
EACH OCCURRENCE $2,000,000
AGGREGATE $2,000,000
OED X I RETENTION$O
$
B
WORKERS COMPENSATION
AND EMPLOYERS LIABILITY Y I NER
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
If es, describe under
DESCRIPTION OF OPERATIONS below
NIA
WC20664300302
1/1/2013
/112014
X I WC STATU- 0TH -
E.L. EACH ACCIDENT $1,000,000
E.L. DISEASE -EA EMPLOYEE $1,000,000
E.L. DISEASE -POLICY LIMIT I $1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space Is required)
Miami Shores Village
Building Department
10050 NE 2nd Ave
Miami Shores FL 33138
GANGELLATION
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
C 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
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Business Name: V;k
Owner Name: RoBFATk -A kii&t
Business Lmtlon. 3.523 SW 2.1 AVE
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TaxAmpurit T ODSt Total Paid
1.00
THIS RSCUPT. MUST BE: POSTED CONSPMPOPMXINNOWA ACE OPSUSINESIS
THIS BECOM A TAX RECEIPT This tax. is levied for the priv e.cfA*abpshes County and is
nonpIgnning
-fe ulWory In nature. Your aridtor Munict
t OR COMO" ' ***
Su0JM'Oss'T4X4 �lp ' ttAnsferra.d Oen
WHEN VAUDATED and,whing -requirements. This'
Is
the businessas .. anged or- you *have, moved .the
.sold, businessh'
busimoss.,lombon., Thispe.W0,0(wopoit In"ft'01it thwbusiness. Is legal. or that
It is In ObrOpliance. with State.or 'I IOW UW �M.
Mailing Address.
ROBERT A ENGEL
1523 SW 21 AVE Paid 07/23/2-012 :27.00
FQRT LAUDERDALE, FL 33312
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