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ACT-14-1493Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-215741 Permit Number: ACT -7-14-1493 Scheduled Inspection Date: July 23, 2014 Permit Type: Awnings/Canopies/Tents Inspector: Rodriguez, Jorge Inspection Type: Final Owner: , Work Classification: Miscellaneous Job Address: 9723 NE 2 Avenue Miami Shores, FL 33138- Phone Number (305)949-9049 Parcel Number 1132060134210 Project: <NONE> Contractor: ABC FLORIDA AWNING'S INC Phone: (786)619.4670 tiunamg uepanment comments CHANGE OF CANVAS ON EXISTING AWNINGS Infractio Passed Comments INSPECTOR COMMENTS False July 22, 2014 For Inspections please call: (305)762-4949 Page 10 of 24 Inspector Comments 1 Passed/ i Failed Correction Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. July 22, 2014 For Inspections please call: (305)762-4949 Page 10 of 24 Miami Shores Villages=''! Building Department JULIBY i Y ��9a � c 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 200 BUILDING Master Permit No. �?—,3 PERMIT APPLICATION Sub Permit No. ®BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING [—]MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF [:]CANCELLATION ❑ SHOP OL p �(�/�j /''CONTRACTOR DRAWINGS JOB ADDRESS:a72 )-• V) i ✓ • � `� " E City: Miami Shores County: Miami Dade Zip: fY Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): C9Inr d Art "-C-Phone#: vow / / "- /® Address: /5 /-5-f1dgr 1[4 5 . /' City: c'� l;?�e Be.? A State: FZ— Zip: 3316 2 Tenant/Lessee Name: (fac' s 60*9aa Phone#: S�Qy-789361 Email: �T'vYt�4'� . Cvuh �6 C910 CONTRACTOR: Company Name:AAC ©r, `6 1/11- L4C S Phone#: Address: �j j� ,1 -5—' City: �7/G/� ciyl a State: Zip: 330 u Qualifier Name: ,fie (-o- Phone#C�Cr)��� ` �fG �� State Certification or Registration #: Certificate of Competency #, �� DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ Type of Work: ❑ Addition Description of Work: 00 ❑ Alteration fit City: State: Square/Linear Footage of Work: ❑ New Repair/Replace -c? V1 ?C-1 Ovi LX�St�loiq Specify color of color thru tile: nervi b a -f1 Icl 1-i r Submittal Fee $ Permit Fee $ 0 CO • C Q CCF Scanning Fee $ Radon Fee $ Technology Fee $_ Training Structural Reviews $ (Revised02/24/2014) Zip: ❑ Demolition f DBPR $ Notary $ /Education Fee $ Double Fee $ Bond $ TOTAL FEE NOW DUE $I'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 ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, 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 approved and q reinspection fee will be charged. Signatu The foregoing instrument was c%0 day of AA4-4 -'mX-"975 11.60u6Sn.Ir4. me or who has produced Signature ENT 'aiX3 NS2-''4-' . e,u.0 nowledged before` Gme this . 20 (7 . by w o is personally knowr o identification and who did take an oath. NOTARY PUBLIC: as CONTRACTOR The foregoing instrument was acknowledged before me this ,,o-07—day of 20 �y . by who Is pe�n n me or who has produced as identification and who did take an oath. NOTARY PUBLIC: i Sign- `'P�' ' uw' Sign: P . t• Print: �. ; ,t,�,. p�%, UI31G K. ABLLEfa E XPII2E3 June 27 01S Seal: 9., ; Seal: „ • I P r We 0t Fior ^„ 4071398 p�g3 i�to�a�b�Yse►+rtoe OM . ur .�pJun 5,20i% •. Chen • FF0919e ############# BOntMd6011110WA Abtatti#######################################o################## APPROVED BY Plans Examiner ` Zoning Structural Review Clerk (Revised02/24/2014) Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED. IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LICENCES B. L:- COPY OF LOCAL BUSINESS TAX RECEIPT C. L- COPY OF LIABILITY INSURANCE* D. COPY OF WORKERS COMPENSATION INSURANCE* IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT B. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. C. COPY OF LIABILITY INSURACE* D. COPY OF WORKERS COMPENSATION INSURANCE* *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 Certificate must specify the description of operations or contractor license number. BUSINESS NAME: A 13C Florida A do i ss f tic • v • jj BUSINESS ADDRESS:235(oO CITY STATE FL ZIP CODE 3301(a BUSINESS PHONE: ) . ,19 - 0 FAX NUMBER QS-) 512- 731 CELL PHONE () XQUALIFIER'S NAME: 71)nd y de X? 0Sa QUALIFIER'S LIC NUMBER:,/"'*)t) (2578 l C Co Con n T Qual"ng Board COMPETENCY 'BUSINESS CERTIFICATE OF COMPETEN 10BS00581 ABC FLORIDA AWNINWS 'INC > r D.B.A.: I G DE LA SSA ZANDY T l$ Deaf od Ur ff ft rovisl c a w i Miami Shores Village Building Department -10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner - Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees, including the owner, must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if: 1. The officer owns at least 10 percent of the stock of the corporation, or in the case of an LLC, a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State, Division of Corporations; and 3. The corporation is registered and listed as active with the Florida Department of State, Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption. In these circumstances, Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company. Therefore, you may be personally liable for the worker compensation injuries of any person allowed to work under this permit. Please check with your insurance carrier since most property insurance policies DO NOT cover this type of liability. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Owner Contractor Print Name. Y} k Print Name: Signature: Signature: i State of Florida) jf State of Florida ) County of Miami -Dads) ! County of Miami -Dade) Sworn to and subscn�ed before me Sworn to and subscribed before me this day of �� 120 1 day of Ta By 9794i MILLER By l� NoiVy Public. State 01 MW (SEAL) 3. • ; • My Conon. Expires Jun S, 2018 cti �� MY COMMISSION fP EE107429 TT !>1 (SEAL) EIgRES dv-201 Tyne of Identific d Cin es _ �....._ Tyne of Id produc * * CERTIFICATE OF ELECTION TO BE EXIMM FROM FLORIDA WORKERS' COWENSATION LAW * * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE 11/14/2012 PERSON: DE LA OSA FEIN: 273406475 BUSINESS NAME AND ADDRESS: ABC FLORIDA AWUNGrS INC 2366 M 80 ST HIALEAH FL 33016 SCOPES OF BUSINESS OR TRADE: 1- CRETE CONSTRUCTION NO'C EXPIRATION DATE 11/14/2014 ZANDY T IMPORTANT: Pursuant to Chapter 448 . OW14b F.S., ae officer of a corporation wbe elects exemption from orfs chapter by filing a certificate of election ander this section may not recover benefits or compensation mater We cimpter. Puraaeat to Chapter 440.8%121, F.S., Certificates of election to be exempt... apply only wiAfe the scope of the business or trade listed on the notice of $tacit" to be exmapL Persomm to Chapter 44(.OSI13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or tie [same of the certiffate, the peran aa" an the miles or certificate no longer meets the regn1remems of this section for issaanee of a certified. The deparneeat stet) revoke a sertificate at pay time for faf ure of Me person am" on the cortakete to meet the requirements of ibis section. QUESTIONS? (850) 413-1609 MC -252 CERTIFICATE OF EIECM TO BE EXEMPT REVISED 01-11 -------------------------------------------- r� u PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA DEPARTlMIENT OF FINANCIAL SAES DIVISIM OF WORKERS' COM ENSATIM tXGG I R JCTION INOUSTRY ATE OF QECTION TO SE E111311PT FROM FLORIDA CATION LAME 9 El ECTIVE 11/14/2012 EXPIRATION DATE: 11/14/2014 PERSON: ZIWDY T DE LA OSA FEIN: 273406475 BUSINESS NANIE AND ADDRESS ABC FLORn)A AWaINGS WC 2358 W so ST HIALEW FL 33016 SCOPE OF BUSINESS OR TRADE 1- CONCRETE CONSTIGICTlt)p N= IMPORTANT F Ptn uatt to Chapter 440.05041, F.S., an officer of a corporation who O elects exemption from this chapter by filing a certificate of election 1- under this section may not recover benefits or compensation under this D t Pur3um to Chapter 440.05021, F.S., certifiicates of election to be H exempt.. apply only witidn the scope of the busiftess or trade listed on E the notice of election to be exempt R E Pursuant to Cir 440.05031, F.S., Notices of election to be exempt mW certificates of election to be exempt stall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, tte person nanned on the notice or certificate no longer meets the requires of this section for issuance of a certificate The deparenem stall awake a certificate at any tine for failure of the person named an the certificate to most the retluirements of Oft section. QUESTIONS? 48501 413-1609 10011 119-1] tb Carry bottom portion on then job, keep upper portion for Your records. OWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01-11 T 06/12/2014 10:07 3052573477 INS PAGE 01/01 CERTIFICATE* , OF LIABILITY INSURANCE 2104 THIS CER I7FICATE ISIS�Sti AS A MATTER OF tNFORNIATIORI ONLY ARID CORS RIO Rie#iTS {IRON THE CER _—�RR .1m CERT"ATE DOES NOT MRRMATIVELY OR NEGATNELY AMEMD, EXTEND OR ALTER TIIE COVERAGE AFFORDEt) til► TTE N �LICIEt3 BELOW T= CERTIFICATE OF MSU CM NOT CONSTITUTE A CXWWACT TW ISSUM RB�RM AVThMPa D REPRMENTATME OR PRODUCER, ARID THE CERTMATIr i101.D R IMPOR AN7: t the aertlfit ata holder is an IIID. the potl1111:0 ) mud be eRdOTSefL S iA Nle tams and Cormlitions of the Wim. weja4 to I Pr"k ff eee�gl ppltcip S @ 4n AndarSQment A stslement atI this does nat colder rights to Nrc CerfiRcate fmldel in Bea of audl endDrg�merlt(s). . PRODUam AaT JOSE L RI Ineursnot: Corp�at�n f'Ma� �243-9=208 NE 8111 Street FAX OM 24343122 HOMOste0d, FL 33030 R photre (7 243 sx�2 Fax M 243-9122 e � s INSURED A; GRANADAMISURAMECOMPANY ABC FLORIDA AWNINfa INC RER g' nusttR R e: 2356 w ao sT LOT Dc HIALEAH, FL 33Di6 30S s E• — • #r r I "A 1 11m POLIQES OF INSLOW IND►CATED. NOTWrn OTAMMNO puyY NLQU1REMEM CERTIFICATE MAY BE ISSUED ON MAY PERTAIPf. THE EXCLUSIONS AND CMDITIONS OF SUCH POLICIES. L INSR IYPE OF nSuwANas A GENERAL LIABILITY R COMMSMAL GENERAL LIA9►uTY A ❑❑ ❑ IIIDE G�QJR GrNL AGGREGATE UWr APPLIES PER: ® POLICY ❑ ❑ I.a ��" uAelLrrY O Ai1TQSD ❑ gCFiED1AED J HIRED AUTOS ❑ W-16 150 AUTI — O ❑ UNWELLA LIAM n O=R t 7 Excess Lute n AND 9MPLDYOt6• L►ABILr1Y Y 1 N FIc� �mUws W0010 utNEi--, I NIA SON OF ANY i AFFORDED tiYTME 0185FL0=337 TOR OTHER WITIt RESPECT TO OESCIUM HERM S SUBJECT TO ALL TIS BY PAID I LAI 01009W3 109tOIM4 DESCRIPTION Or OPERATIOW 1 1IOCAT10119 / VEHICLES IANI ACORI) fin, AdW0W ReMbb AWNNING MANUFACTURING H 1 , CERTIFICATE WX=R MIAMI SHORES VILLAGE 101X0 NE 2 AVE MIAMI, FLA 39138 3�-88¢4135 CORD 25 (2010!82) QF s 1,i.Da.QI s �cin,tn}o.00 s I 140C.—mix ss 2,m00,�,pt t BODILY NAM tear pm") S i DODri.Y IputdtY 1Per $ � S 4 EACH OCCLIg1�Nt� 6 � CANCELLATM 3M0ULD ANY OF THE ABOVE Df EO POLICIES BE CAW" THE I WWATION DATE THEIMP, NOTtM 1MLLL BE DEUVEM Ud ACCORDANCEttMN THE POLICY PROYIS10Ns. ; I AUTHORWD REt s6 JOSE L MONZON 19 AGMW CORPORATION. IN rigid reserved. nm a and 10W am regtaerod nw k-- of A00RD 6/12=4 ou000kcorn- rrrpastatma@hoftWi.com 4 , e hft sJ/blul73.m.dI.li%e corrVdekdtasp d id=cnttc3CjbyWVv c[ZlxOIA2U&flird= 1/1 Local Business Tax Receim Miami -Dade County, State of Florida -THIS IS NOT BILL - DO N07 PAY 5737093 OLPS11YESS I`IAME/LOCATION ABC FLORIDA AWNINGS INC 2356 W 80 ST 2 HIALEAH FL 33016 OVMER ABC FLORIDA AWNINGS INC Worker(s) 1 RFECEIPT NO. EXPIRES RENEWAL SEPTE '3ER 30, 2014 7010648 hest be dis ayed at puce ot Pursuant to counry Code Chzty �t SA -At! 13 R SEC. TYPE OF BUSINESS 196 SPECIALTY BUILDING CONTRACTOR BY TAX RECEIVED k 108S00581 8Y TAX GUrt`.1lcr0lt 'b45.00 07/0912.013 TXNS 1-0 1 3-01 7 456 This Local Business Tax Receipt only confirms pent of they Local Business Tax. The Receipt is not a 1►cense. pormit, or a certification of the holders qualifications. to do bminess. Herr Oust cG"IV with ®ny 90vetn"(1181 ar nongovernmental rogulatory laws and requirements which app to do busisaft The RECEIPT NO. above must be lisplelrtd sn all commercial vehicles - t�ia B"adc Code Sec -2 - For more urtuMoStion, visit 9 A e REGISTERED APFUCATION ISSUED CONCERN No. GLEN RAVENCUSTOM F'ABR ICSt LLC 1831 N PARK AVE tint 4 GLEN RAVEN NC 27217 FA -36801 Date Work Performed 336-227-621 This is to certify that the materials Lcribed on the reverse side hereof have been flame- retardant treated (or are inherently nonflamoble). 'FOR ASTRUP-COMPANY AT 2937 WEST 25th STREET CITY .- .CLEY_EGANti.- STATE-. .OHLO AA113 Certification is hereby made that: (Check "a" or "b") F ( a) The articles described on the reverse side of this Certificate have been treated with a flame- retardant chemical approved and registered by the State Fire Marshal and that the application of said chemical was done in conformance with the laws of the State of California and the Rules and Regulations of the State Fire Marshal. Name of chemical used Chem. Reg. No. Method of application (^ X (b) The articles described o,, the reverse sada hereof are ma -de from a florae -resistant fabric or material registered and approved by the State Fire Marshal for such use. Trade name of flame -resistant fabric or material used ER SUNBREI.LA Reg. No. FA-31,eo1. The flame Retardant Process Used WILL NOT Be Removed By Washing (will or will not) GLEN RAVEN CUSTOM FABRICS By STEVEN L. ELLINGTON, QEN. ' MGR. Name of Production Superintendent Title hype y ce-t tht'sici tae a Prue o C4C'7�.1'tA€ R�StT�4NC1"'tsoed fomes, "original copy" of which has been filed with the California State Fire Marshal. The ASTRUP COMPANY ® By Control/lot * Customer order l" EJANDftr1 Astrup Invoice * 2835682 JUL 111014 13'1° Quantity 12. 000 YD Description SUNBRELLA FIRESIST 8646/60 Product Code 898646 R � j Ghoces pesla Auj v\ J* vi 3 97d,5 10, 6 � tOt) - A L/61- Q � � z ®� M Lu 0 M Z 0 N R � j Ghoces pesla Auj v\ J* vi 3 97d,5 10, 6 � tOt) - A L/61-