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DS-15-742Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-231434 Permit Number: DS -4-15-742 Scheduled Inspection Date: May 15, 2015 Inspector: Rodriguez, Jorge Owner: , BARRY UNIVERSITY Job Address: 11300 NE 2 Avenue Miami Shores, FL 33138-0000 Project: <NONE> Contractor: P133 CONSTRUCTION CORP sunamg Department comments Permit Type: Driveways/Sidewalks/Slabs Inspection Type: Final Work Classification: New Phone Number Parcel Number 1121360000050 Phone: (305)389-0065 NEW SIDEWALKS AT BENINCASA AND O'LAUGHLIN Infractio Passed Comments BUILDINGS I INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction ❑ Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. May 14, 2015 For Inspections please call: (305)762-4949 Page 5 of 27 Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 11300 NE 2 Avenue Miami Shores, FL 33138-0000 Parcel Number 1121360000050 Block: Lot: BARRY UNIVERSITY INC Owner Information Address Phone Cell BARRY UNIVERSITY INC 11300 NE 2 Avenue MIAMI SHORES FL 33161-6628 11300 NE 2 Avenue MIAMI SHORES FL 33161-6628 Contractor(s) Phone Cell Phone PP3 CONSTRUCTION CORP (305)389-0065 (305)757-5129 In Review Approved:: In Review Denied: of Work: NEW SIDEWALKS AT BENINCASA AND O Additional Info: Retum : Classification: Commercial ninq: 3 Fees Due Amount CCF $7.20 DBPR Fee $2.25 DCA Fee $2.25 Education Surcharge $2.40 Permit Fee $150.00 Scanning Fee $9.00 Technology Fee $9.60 Total: $182.70 Valuation: $ 12,000.00 Total Sq Feet: 1000 Pay Date Pay Type Amt Paid Amt Due Invoice # DS -4-15-55020 04/27/2015 Credit Card 04/01/2015 Credit Card $ 132.70 $ 50.00 $ 50.00 $ 0.00 Avauaole Inspection Type: Final Foundation In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AF certify that a foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction aFuthe e, Iabove named contractor to do the work stated. April 27, 2015 Au razed Signature: er pplicant / Contractor / Agent Date Bu"fling Department Copy April 27, 2015 1 a1�31�a�5 BUILDING PERMIT APPLICATION 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 OBUILDING ❑ ELECTRIC ❑ ROOFING APR OtZffi FBC 20 l O Master Permit No. -� I Sub Permit No. ❑ REVISION ❑ EXTENSION ❑ RENEWAL ❑PLUMBING [:]MECHANICAL ❑PUBLIC WORKS [:]CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 11300 NE 2nd Avenue City: Miami Shores County: Miami Dade Zip: 33161 Folio/Parcel#: Is the Building Historically Designated: Yes NO XX Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Barry University, Inc. Phone#: 305-899-3797 Address: 11300 NE 2nd Avenue City: Miami Shores State: Florida Zip: 33161 Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: PP3 Construction, Corp. Phone#: 305-389-0065 Address: 750 NE 96th Street City: Miami Shores State: Florida Zip: 33138 Qualifier Name: Gabriel Rodriguez Phone#: 305-389-0065 State Certification or Registration #: CGC1516509 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State Zip: Value of Work for this Permit: $12,000 Square/Linear Footage of Work: 1000 SF Type of Work: ❑ Addition ❑ Alteration New ❑ Repair/Replace Description of Work: New sidewalks at Bennincasa and O'Laughlin Buildings ❑ Demolition Specify color of color thru tile: Submittal Fee $ n ° Permit Fee $ VA CCF $ CO/CC $ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ (Revisedo2/24/2014) DBPR $ Notary Double Fee $ Bond $ TOTAL FEE NOW DUE $ '2* l Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip 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 a reinspection fee will be charged. 6 Signature —"..Signature OWNERorAGENT CONTZCTOR The foregoing instrument was acknowledged before me this t31 5V nday of �/'P'x�1 20 LS , by �u1•�U� Iws � w� hoismamannlly known to meor who has produced identification and who did take an oath. NOTARY PUBLIC: Notary Public Stfa o0 Fb*M Jeft J Yao +A My Commission FF 188481 p,µ Expkes 11/1202018 The foregoing instrument was acknowledged before me this day of _ _Atka, , 20 IS by %�;V DAA& Z who is personally known to as me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign:_ Print: Seal: Notary Pubic State d FWWa Js" J Yao +�My Cormnissim FF 188481 q Ei*m 11N2*018 P APPROVED BY ` v Plans Examiner Structural Review (Revised02/24/2014) as W /l Zoning Clerk � Ro® CERTIFICATE OF LIABILITY INSURANCE DATE(MWDD/YYYY) 03/23/2015 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 terns 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). PRODUCERN Merchant Insurance Solutions 12326 Isabella Drive c Staid Merchant NAME PHONE (239) 823-4382 ----T—FAX No : (111)111-1111 Aool�: smerchant@merchantinsurancesolufions.com INSURER(S) AFFORDING COVERAGE NAIC 0 000642270 INSURERA: James River Ins Co Bonita Springs FL 34135 INSURED INSURERS: Wesco IrIS CO INSURER C : Florida Citrus Business Industries Fund PP3 Contruction Corp INSURER D: 750 NE 96th Street INSURER E: PRODUCTS-COMP/OPAGG $ 2,000,000 INSURER F: Miami FL 33138 COVERAGES CERTIFICATE NUMRFR! REVISION NUMRFR- 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. INS TYPE OF INSURANCE ADDLSUBR D POLICY NUMBER POLICY EFF MIDDIYYYY) POLICY EXP (MMIDDfYYYY11 LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE XOCCUR 000642270 10/10/2014 10/10/2015 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED— PREMISES Ea occunym $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL &ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY 0 ECT LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMP/OPAGG $ 2,000,000 $ B AUTOMOBILE X LIABILITY ANY AUTO ALL ED �/ AUTOSSCH /� NON -OWNED HIREDAUTOS X AUTOS WPP112766401 10/10/2014 10/10/2015 COMBINED SINGLE LIMIT $ 1,000,000 Es accident) BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERDAMAGE $ UMBRELLA LIAB EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROMEMBER/EXCLUERIE ECUTIVE Y❑ (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 10649201 03/14/2015 03/14/2016 X STATUTE -ToRH I-LEACHACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEd $ 1,000,000 E.L. DISEASE - POLICY LIMrr I $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached B more space is requhed) General Contractor SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN The Village of Miami Shores ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd Avenue AUTHORIZED REPRESENTATIVE Miami Shores FL 33138 @ 1588-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD ,n .. r S s• ••• 28&wa J ee • _. CL+�•SYZO �M/FACUL pry, I x COFk'ICE , •3PT-T1 I 11WC; dot. (a—STY. c.e.s.) ' all 6ll r S. E `wry_ W11 j // rw•d%1 r.f'+rr%n!tq `'b d. icy Idi MOE v TM (i ,mss Tr C.B.S.) to . . .... ...... ...... .... ...... •••• •••• ••••• r S s• ••• 28&wa J ee • _. CL+�•SYZO �M/FACUL pry, I x COFk'ICE , •3PT-T1 I 11WC; dot. (a—STY. c.e.s.) ' all 6ll r S. 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