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DS-15-896Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-234186 Permit Number: DS -4-15-896 Scheduled Inspection Date: May 07, 2015 Inspector: Rodriguez, Jorge Owner: JAMES THOMAS BLACK, TIMOTHY IAUCC eenocu Job Address: 897 NE 91 Terrace Miami Shores, FL 33138 - Project: <NONE> Contractor: BARI NATIONAL BUILDERS, LLC tiunamg uepanment comments CONTINUE OF EXISTING DRIVEWAY Permit Type: Driveways/Sidewalks/Slabs Inspection Type: Final Work Classification: Addition/Alteration Ia1=1 ►1 in, -7-T, Parcel Number 1132060050300 INSPECTOR COMMENTS False Phone: (954)537-4430 May 06, 2015 For Inspections please call: (305)762-4949 Page 38 of 42 Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-232663. Failed Correction Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. May 06, 2015 For Inspections please call: (305)762-4949 Page 38 of 42 Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 h@ Phone: (305)795-2204 Project Address Parcel Number Applicant 897 NE 91 Terrace 1132060050300 TIMOTHY JAMES MARSH JAME: Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell TIMOTHY JAMES MARSH JAMES 3250 NE 1 Avenue - --- - - - - MIAMI FL 33137- 3250 NE 1 Avenue MIAMI FL 33137- Contractor(s) Phone Cell Phone BARI NATIONAL BUILDERS, LLC (954)537-4430 In Review Approved:: In Review Denied: of Work: CONTINUE OF EXISTING DRIVEWAY Additional Info: Retum : Classification: Residential ninq: 3 Fees Due Amount Bond Type - Owners Bond $500.00 CCF $0.60 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.20 Permit Fee $100.00 Scanning Fee $9.00 Technology Fee $0.80 Total: $614.60 Valuation: $ 800.00 Total Scl Feet: 374 "] Pav Date Pav Tvoe Amt Paid Amt Due I Invoice # DS -4-15-55220 04/23/2015 Check #: 1134 04/16/2015 Credit Card Bond #: 2686 $ 564.60 $ 50.00 $ 50.00 $ 0.00 Avauaole Inspection Type: Final Foundation Review Planning Review Building 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 AFFIDAVIT: I certify th all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zon' r4rof, I authorize the above-named contractor to do the work stated. April 24, 2015 Authorized Snature: Owner / A licani/ Contractor / Agent nate Building De ent Copy April 24, 2015 1 BUILDING PERMIT APPLICATION Miami Shores Village Building Department APR .16 2015 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY: Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20l Master Permit NoS " ao_ Sub Permit No. *,PBUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP r� A// L CONTRACTOR DRAWINGS JOB ADDRESS: / �/� 91 %%r City: Miami Shores County:' Miami Dade Zip: 33 1,34E Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): / o �% �i�� Phone#: �17�J p f_27 Address:, ' i) e '? -re- r �/ CSC a City: � yl l� r"-6 State: - Zip: .33 Tenant/Lessee Name: Phone#: Email: Awj--�J CONTRACTOR: Company Name ;d ''°y� �' a� Phone#: tD Address City: n � State: Zip: , , 5, `rte Qualifier Name: Phone#: State Certification or Registration #: ` `�= �' �l '- Certificate of Competency #: DESIGNER: Architect/Engineer: ne#: Address: City: State: Zip: Value of Work for this Permit: $ g o O Square/Linear Footage of Work: S -7 Type of Work: ❑ AddiNn 'jLJ Alteration ❑ New �] Repair/Replace ❑ Demolition Description of Work: Specify colon—of color thru tile: Submittal Fee $ �"X Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Technology Fee $ Structural Reviews $ (Revised02/24/2014) Radon Fee $ Training/Education Fee $ DBPR $ Notary $ Double F,eee$$ Bond $ [ • l�� TOTAL FEE NOW DUE $ ' G_ 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 beapproved and a reinspection fee will be charged Signature OWNER or AG:��)Ie The foregoing instrument was a me this r� day of 20 13 . by T1 AA h4 6. ✓ o is personally known t me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Signature - _» CONTRACTOR The foregoing instrument was acknowledged before me this day of �,6_,`. 20 by who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Structural Review (Revised02/24/2014) Clerk /� Sign: Sign: a i� 0" m Print: Print: 46i11�10� to Seal: °•Pa9p�• iln HUGO BUENO Seal: r M� s %%j48001 Catnfn Mori r * , Notary Public - State of Florida My s99194i'�®1® �� • . • My Comm. Expires Jul 20, 2015►t�yn o Commission # EE 91364 ''� °� �•`�� Bonded Throu h N Co I t r j 1 7 APPROVED BY Plans Examiner ` Zoning Structural Review (Revised02/24/2014) Clerk Apr 161511:02a Bari Builders, Ilc 9543917238 p.1 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATIO CONSTRUCTION INDUSTRY LICENSING BOARD N • '°�" 1,940 NORTH MONROE STREET (850)487-1395 TALLAHASSEE FL 32399-D7'83 IO, ANTONIO BAR GNATIONAL BUILDERSr LLC 20918 SHERIDAN STREET PEMBROKE PINES FL 33332 0M Million C"'n9mfut ons' 'Vdh this (cense you become one of the nearly ?afessional Peg kw r, "sed �' the Dettartrrtent of Business ad from arciteetslation. Our professionals and businesses ren e and they keep FlotD yacht ida's ecofonomr from boxers to barbeque restaurants,5 my strong, EIWY day we work to improve the w sOve You better. For info about e'er business 1n order to Www Y1 ands icense�in. Th re au 5 a. please log onto aboutdivisions and the regulations en: more informaffon to department newrsletter$ and team ore t impact ou subscribe in"Ives. about the Department's Our mission at the Department is: License Eft Ate constant�!y strive io serve you better so #haft" 01y. Regulate FalNy. AlSand co ers. Thank you far doing business in Flonda,�n serve your srid'�n9ratuiattons on your new licensel RICK SCOTT; GOVERNOR MC152Wn DETACH HERE STATE OF FLORIDA ®E'ARTMENT OF BUSINESS AND PROFESSfONAL-REGULATION 01522573 1B•SUED: ° 09/fMC14 CERTIFIED GENERAL CON7'tZgCTOR DEUGIO, ANTONIO- - BARI NATIONAL BUILDE-ft LLC. . IS CERTIFIED under the provisions Ewhounut s : AUG 31.201a of Cit, 489 PS, L140970 KEN LAWSONE , SECR STATE OF FLORIDA TARY DEPARTMENT OF 13USINESS AND PROFESSIONAL CONSTRUCTION INDUSTRY LlCiF-N$IIyC, BOARD ul-ATION irm CONTRACTOR imed below IS CERTIFIED 'd'or the provfsiorts of Chanter 489 FS. phation date: AUG 31, 2016 DELIGIO, ANTONIO 808 SO 51 JOHNSON ST� ERS 2EF --C PEMBROKE PINES FL 33029 BROWARD C( NTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4Q00 VALID OCTOBER 1, 2014 THROUGH SEPTEMBER 30, 2015 . DBA:BARISNATIONAL BUILDLRSLLLC pt#:180-292806 Business Name: RBC@) GENERAL CgNTRACTOR Business Type; Owner Name; ANiTONIq DELIGIO Business Location: 20916 SHERIDAN ST Business Opened:07/29/2011 PEMBROKE PINES state/COunty/Cert/Reg:cwl522573 Business Phone: Exemption Code; Rooms Seats Employees Machines 3 Professionals 6or Vending Buslneas Only Number of Machines: Tax Amount Transfer FeeNSF Fee Penalty Vending Type: z7, 00 3.00 0.00 Collection Cost Total Paid 2.70 Prior Years 0.00 0,00 32.70 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is WHEN VALIDATED and z non-regulatory ng requirements. This Businesin nature, You must s Ta Receipt and/or st betransferred when Municipality planning the business Is sold, business name has changed or n the business location. This receipt does not Indicate that the business is legal or that it is in compliance with State or local laws and regulations. Malting Address: BAR NATIONAL BUILDERS LLC 20916 SHERIDAN ST Receipt #52A-1400000095 PEMBROKE PINES, FL 33332 Paid 10/06/2014 32.70 2014 -2015 Apr 15.15 02:38p Bari Builders, Ilc 9543917238 p.1 CERTIFICATE OF LIABILITY INSURANCE fDATE(MMMD/YYYY) PRDDucER/0412013 Insurance Office of America INC. THIS CERTIFlCATiON IS ISSUED ASA MATTER OF INFORMATION P.O. Box 162207 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR A Altamonte Springs, FL 32715-2207 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. rNsu— INSURERS AFFORDING COVERAGE NAIC # BARI NATIONAL BUILDERS, LLC INSURER A. Slate Farm General ff SUMnCO CamPany 25151 25151 Antonio Deilgio INSJRER B: state Farm Florida tnauranco Camparry 111739 EXP (Any ona Pin ) 20916 Sheridan St PEMBROKE PINES, FL 33332 NSURER C: State Farm MUlual AutomoWle Insurance company 2,417a 70739 25178 S INSURER D. GENERAL AGGREGATE COVERAGES NSURt E PRODUCTS-COMP10PAGG S ABOVE ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHEREDOCUMENT WITH RES ECT TO VMI H THIS CERTF KATE MAY BEISSUEDOR DIN MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMrrS SHOWN MAY }{qyg BEEN REDUCED BY PAID CLAIMS. I AD RINSRO TYPE OFrASURANCE POUCYNUMBER POUCYEFFECTIVE POUCYEXPIRATJDN - A GENERAL LIABILITY DATE (AMIDE DATE {MMJD0IYYYY) LIMITS I X COMMERCIAL GENERAL UASIL17Y EACH OCCURRENCE g CLAIMS MADE OCCUR PREMISES)$ X ExpolSlon Under MGL 0157549MEO 01/04/2015 EXP (Any ona Pin ) $ ground Cvllaps 01104f201fi PERSONAL&ADV INJURY S U!zN'LAGGREGATE LWITAppLES PER: GENERAL AGGREGATE $ POLICY PROS- LOC PRODUCTS-COMP10PAGG S A AUTOMOBRELIAISUTY $ ANYAUIO I I ALL OWNED AUTOS COMBINED SINGLE LIMIT (Ea aoddeM) $ SCHEDULED AUTOS INCL 0157549 I 01/04/2015 01!04!2016 BODLY INJURY X HiREDAUTOS i (Per person) 15 X NON-OV67-JED AUTOS I I BODILY INJURY r (Peraeatlem) $ GARAGELIABILFrY PROPERTY DAMAGE (PerecGden0 $ I ANY AUTO__j AUTO ONLY-EAACCIDENT S A EXCESS I UMBRELLA LIABILITY THAN EA ACC AUTO ONLY: $ J OCCUR E] CLAIMS MADE AGG EACH OCCURRENCE $ g j UGL 0157549 D®UCTIBLE 01/04/2015 01104/2016 AGGREGATE g ; X RETENTION $10,000.00 _ $ $ B W ORIS COMPENSATION AND EMPLOYEW LIABILITY g ANY PROPRIETORIPARTNERIEXECUTIVEa OFFiCER/MEAABEREXCL'JDED? y HIGWC8974502 TORY LIMITS OT f yes, des:aibe unger P'Zd4torylaNH) 01/04/2015 01/04/2016 E.L. EACHACCIDEN` -----„ $ 4 S10NS born. B OTHER I E.L. DISEASE - EA EMPLOYE $ 1 'Builders Risk E -L DISEASE - POLICY LIMIT $ 1 HIGBR5899402 $1,000,000 01!04!2015 01!04/2076 DESCRIPTION OF OPERATIONS J LOCATIONS J VEHICLES J EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PRWISIONS Miami Shores Village is added as additional Insured Written contract for both the General Liability & WIC for the General license # CGC1522035. 30 Days notice of cancellation given. Village of Miami Shores 10050 NE 2nd Ave Miami Shores, FL 33138 4,OI00,000 50,000 SAN 1,000,000 2,000,000 2,000,000 1,000,000 4,000,000 1.000,000 SHOULD ANY OF THE ABOVE DESCRISEO POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUlNO INSURER WILL ENDEAVOR TO MAIL 30 DAYS WMT UW NOTICE TO THE CERTIFICA7E HOLDER NAMED TO THE LEFT; BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGiATI NOR LIABILITYOF ANY KIND UPON THE INSURER, RS AGENTS OR REPRESENTATIVES. ACORD 25OD The ACORD name and logo are registered marks of WO ACORD CORPORATION. All rights reserved. 1001486 132849.3 04-06-2009 AP 201 a Or- z L -3G BLOCK -2 BLOCK- J V F.I.P 314' NO CAP 1.00 -CL 8 =W UMMOMI T 1J un YC F f LOT -1 •• • �• BLOCK - 2 •' •: + + • • + 14.50•••• • RI.P3/4•• 14.45 75.00 0 + • NO CAP + 13.70 e • • 25. IW- 11.54 _ _ •