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RC-14-361Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-218791 Permit Number: RC -2-14-361 Scheduled Inspection Date: August 29, 2014 Permit Type: Residential Construction Inspector: Rodriguez, Jorge Inspection Type: Final Owner: GARBER, DOUGLAS Work Classification: Alteration Job Address: 53 NE 107 Street Miami Shores, FL Phone Number Parcel Number 1121360070370 Project: <NONE> Contractor: LIVING EARTH REMODELERS INC Phone: (954)925-5003 Building Department Comments REPLACE KTICHEN CABINET/REMODELING 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. August 28, 2014 For Inspections please call: (305)762-4949 Page 26 of 27 Charles C. Mitchell P.E. 924 N. Federal Hwy. Hollywood, Fla. 33023 Civil/Structural #11127 305-336-5069 May 19, 2014 Building Official Building & Zoning Dept. City of Miami Shores Miami Shores, Fla. Re: Garber Kitchen Remodel 53 NE 107` St Miami Shores, Fla. Dear Building Official, In reference to the interior wall header separating the Kitchen from the Dining Room, it was determined that the wall header is non load bearing and does not support any part of the roofing system. The wall header is only for aesthetic purposes and is not structural. Sincerely, Charles C. Mitchell, P.E. Miami Shores Village w+c Building Department FED 8 B 14 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 24 BUILDING Permit No. PERMIT APPLICATION Master Permit No. C-11 I I Permit Type: BUILDING ROOFING JOB ADDRESS: S sl City: Miami Shores County: Miami Dade Zip: l Folio/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): L.') c' G c4vy 0Phone#: r: a 1 7 v Address: 10-7 Sa City: M; ctm ; syx ye ' State: rl Zip: Tenant/Lessee Name: Phone#: Email: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑Addition alteration ❑New ❑Repair/Replace ❑Demolition Description of Work: � •",��..�(` ' f / N�-�� ,�-�, � 1 ��i;,..;ti�•� � � •w-�u�.:�.� �"�....�. Color thru tile: Submittal Fee $ 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 $ (� y' sus AC10i % CONTRACTOR: Company Name:L .., �(l _ ckyY o Qz►rY1(�t' � 1 Exrs=-'�-C�'hone#: Address: d r �1 SGS, ►'1 /!t v`�r'X, City: IV wG u State: / Zip: iso) G Qualifier Name: L '-G QG \ U V'Axl LV Phone#: State Certification or Registration #: r, c L \ Certificate of Competency #: Contact Phone#: Kr; __'D Email Address: DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑Addition alteration ❑New ❑Repair/Replace ❑Demolition Description of Work: � •",��..�(` ' f / N�-�� ,�-�, � 1 ��i;,..;ti�•� � � •w-�u�.:�.� �"�....�. Color thru tile: Submittal Fee $ 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 $ 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 approv nd a reins ction fee will be charged. Signature Signature—Aq��— ne or Ag Contractor The foregoing instrument as acknowledged before me this t c The foregoing instrument was acknowledged before me this day of Ljntnr 201, by s �Zs'� — day of 20 _, by/LC' who isOp_ersonally/known to or who has produced who is personally kn wn to moor who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: ! NOTARY PUBLIC: Sign: Sign: Print: ON TONER EAM Florida ,,, Print: •�''Pa p� 'EAMON TONER " =.='. ;` �'• My Commission Expires + : . : •` Not res Mar 5, 2011 My Comrtnssion Etepr 880934 My Commission Exp b s Notary Public -State of Florida My Commission Expires Mar 5, 2017 ,°' Commission N EE o*c ,10 Commission # EE 880934 pill 1p ( APPROVED BY ( Plans Examiner Zoning Structural Review (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) Clerk " .1 A,-, UER TIFIC TE OF LIABILITY INSURANCE DATE(MMIDD,YYYY) 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 ll,e terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rct to ights , subject holder in lieu of such endorsement(s). the PRODUCER Alliance Insurance Solutions LLC 7405 N TaITllami Trail CONTACT NAME: Sarasota, FL 34243 PHONE c o t , 941-306-3077 FAX IAIC. No): 2 80 E-MAIL ADDRESS: REVISION NUMBER: NAMED ABOVE FOR THE POLICY PERIOD WITH RESPECT TO WHICH THIS HEREIN IS SUBJECT TO ALL THE TERMS, LIMITS INSURERS' AFFORDING COVERAGE NAIC it INSURER A: SUNZ Insurance Company INSURER 8: Ase R - London - Best Rating "A" 34762 INSURED Essential HR, Inc. dba First Star HR 251 O'Connor Ridge Blvd Suite 370 wsuRER C: Catlin -2 ndic e - Uo s - es R i A" EACH OCCURRENCE $DAMAGE INSURER D: Brit Syndicate - Lloyds - Best Ralino "A" $ Irving TX 75038 INSURER E INSURER F " COVERAGES rGOTICIrATr_ e,llrner,.-r, THIS INDICATED. CERTIFICATE EXCLUSIONS IIJSR LTR "•,, IS TO CERTIFY THAT THE POLICIES NOTWITHSTANDING ANY REQUIREMENT, MAY BE ISSUED OR MAY PERTAIN, AND CONDITIONS OF SUCH POLICIES. TYPE OF INSURANCE GEPIERAL LIABILITY ,�� OF INSURANCE ADDL THE SUER i. lnocr�, '11i34b182 LISTED BELOW HAVE BEEN TERM OR CONDITION OF ANY INSURANCE AFFORDED BY THE LIMITS SHOWN MAY HAVE BEEN REDUCED POLICY NUMBERPOLICY ISSUED TO CONTRACT POLICIES BY EFF MMIDDIYYYY THE INSURED OR OTHER DOCUMENT DESCRIBED PAID CLAIMS. POLICY EXP MMIDDIYYI'Y REVISION NUMBER: NAMED ABOVE FOR THE POLICY PERIOD WITH RESPECT TO WHICH THIS HEREIN IS SUBJECT TO ALL THE TERMS, LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 0 OCCUR EACH OCCURRENCE $DAMAGE TO RENTED PREMISES Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEIJ'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY D PRO -PRODUCTS JF LOC - COMP/OP AGG $ - AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS e SCHEDULED HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ $ UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE EACH. OCCURRENCE $ AGGREGATE $ DEO LJ RETENTION $ $ A WORKEAND EMRs COMPENSATION AND EMPLOYERS LIABILITY YIN AIJY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory in and If yes, describe under � DESCRIPTION OF OPERATIONS below NIA WCPE00000184 01 10/1/2013 10/1/2014 WC STATU- oTI I - TORY LIMITS OR E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1.000,000 E.L. DISEASE - POLICY LIMIT _ $ 1,000,000 B Workers Compensation This is for informational purposes C Excess Coverage D and nothing shall create any right under such reinsurance. DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEriICLES (Attach ACORD 701, Additional RemaHcs Schedule, it more space is required) Coverage provided for all leased employees but not subcontractors of: LIVING EARTH REMODELERS INC DBA SOLAR QUEST USA IN Effective date: 101112013 CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 NE Z AVE ACCORDANCE WITH THE POLICY PROVISIONS. MIAMI SHORES, FL 33138 AUTHORIZED REPRESENTATIVE Glen J Distefano © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD. name and logo are registered marks of ACORD CERT NC.: 18345182 Todd Trowbridge 11/13/2013 6:39:02 AM Page 1 of 1 0 CERI NFICATG OF ILIABNLIT IJD n � � � E INSURANCE � DATE (MIAIDDIYYYYI 49 :DDucER '1210912p1� CO�LfiALLINSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 5000 W. ATLANTIC BLVD, ONLY .AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR MARGATE FL, 33063 ALTER TPfE C=OVERAGE AFFORDED BYTHEPOLICIES BELOW, PFI (9.5<1) 956•000G PX (95I)95G-0555 ry E.L. DISEASE -POLICY LIMIT u�sunEB — INSURERS AFFORQING COVERAGE NAIL P LIVING EARTH RENIODELEWS' INC DBA SO'LARQUESTUSA INSURER A: :FEDERATEQ NATIOhIAL IhISURANCE COMP '1121A S'0UTH2ISTAVEN0E INSURER 0' HOLLYWOOD FL 33020 II�sURF.FR C; 1119URER D; THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE A14Y REQUIREMENT, INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDIPIG TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED 9Y THE POLICIES DESCRIBED POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ISR DI HEREIN 13 SUBJECT TO ALL TRE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH I& L 113' ]1'PF � nF IN91JnAP1__�;F_.__ PoljcY DNMDER FpLICY EFFEO E i POLICY 6MXMPI AFj. TIDN GCIJBRAL LIABILITY LIMITS 1% COMMERCIAL GENERAL I,IAnII,ITY GL-nsD 100p495-02 1211612013 12116120'14 EACH OCCURREhIOE '1,000,000 13AMAGETO RENTED CLAIMS MADE [K] OCCUR r3F1�ISFS IE_i err $ 100,000 MED FXP (M�, onn pqrsonj s 5 000 _ PERSONAL A ADV INJURY IF 1,QQD1000 ' GErI'CAGGRf:OAT_F LIMIT APPLIES PCR: GFN�RuIL AGGREGATE S z'BDD 000 -. POLICY PRO. X LOC PRODUCTS - COMPIOP AGG S zID0O1000 AUTOMOBILE LIABILITY ANY AUTO COIdBINED SINGLE LIMIT S ALL OWIJED/,UTOS (Fa acold.nt) SCHEDULED AUTOS BODILY INJURY B HIRED AUTOS {Por pnrson) NON -OWNED AUT06 BODILY INJURY (Per occident) — PROPERTY DAMAGE s GARAGE LIABILITY (Per Bccldnnl) ANY AUTO AUTO ONLY- EA ACCIDENT 6 — OTHERTI-IAN EA ACC S AUTO ONLY: EXCE66)UMDRELLII L_IADILITY OCCUR 1 CLAIMS MADE DCDUCTIDI_E Re7FrJrlori q WORKEM COMPENSATliA AND EMPLOYER6' UAMLITY AllY PROPRIETOR/PARTNEWEXECUTIVE OFFICER11 ]CMBER EXCLUDED? If I'-., doncllbo Undor �iLLS.'I�l PROVISI01•IS Mlo`r 0 "r PIER _ AGG F.AOH,DCCURREI`ICC -' ' AGGREGATE S 5 9 a b WC 911 LUT 0AL LIS_ _ , C.L. EACH I ACCIDENTS E.L. DISEASE - EA ENIPLOY�E ry E.L. DISEASE -POLICY LIMIT ; IIPTIOH OF OPERA110IJS I LOCATI011STVCHICLES f E�COLU9ION9 ADDED BY ENDoAsr ENT/ SpECIAL_PROVI910PI5 GENERAL CONTRACTOR AND PLUMBING CONTRACTOR � l n-IL.r� I L I-IULUL' MIAMI SHORES VILLAGE 10050 NE 21,11) AVENUE MIAMI SHORES, FLORIDA 33138 RD 2S (2001108)' CANCELLATION SHOULD ANY OFTHB ABOVE DE6CRIBHD POLICIES BE OANCELLCO BEF0R2 THE CXPIM'RON DATE THEREOF, THE 166UING I •R WILL ENDEAVOR To IL, 'ID DAYS WRITTEN NOTICETOTHECERTIFICATEH I_DE NAMED TOTfIELEFT, U AILURETDOO50SHALL IMPOSE NO OBLIGATION OAR-LLIIA ITT OF ANY HIND UP01 INS �REfi, lib AGENT6 OR R6PRESENTATIVE9. AUTHORIZED REPRBSFNT TWE f *ACORD CORPORATION 1908 TDOJAL NEW CHARGES 251.00 Penalty Amount: .00 Previous Balance Due: .00 LQTAL AMQUIN p WDL 251.00 PURSUANT TO STATE LAW, THE LOCAL BUSINESS TAX IS LEVIED ON THE PRIVILEGE OF DOING BUSINESS WITHIN A CITY'S LIMITS, AND IS NON -REGULATORY IN NATURE. ISSUANCE OF A LOCAL BUSINESS TAX RECEIPT BY THE CITY OF HOLLYWOOD DOES NOT MEAN THAT THE CITY HAS DETERMiNFn TWAT Tum GYICTIAIf_` .,o nM^ --r