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CC-13-765Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-233936 Scheduled Inspection Date: May 06, 2015 Inspector: Rodriguez, Jorge Owner: SYLVAIN, FRED Job Address: 9100 NE 2 Avenue Miami Shores, FL 33138 - Project: CHURCH Contractor: ORONI INC Building Department Comments NEW PARKING LIGHTS Permit Number: CC -4-13-765 Permit Type: Commercial Construction Inspection Type: Final Work Classification: Alteration Phone Number (305)759-6235 Parcel Number 1132060133200 Phone: (305)685-0412 Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-233881. No permit on site Failed Correction ❑ Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid May 05, 2016 For Inspections please call: (305)762-4949 Page 32 of 50 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION FBC 20 L® Permit No. Master Permit No. CC.'I `':5 -—I Permit Type: BUILDING ROOFING JOB ADDRESS: 91 rr k"Q e - City: Miami Shores County: Miami Dade Zip: �01 Folio/Parcel#: k t—]fib t 3 2 W Is the Building Historically Designated: Yes OWNER: Name (Fee Simple NO Flood Zone: Si- c City: State: FL Zip: '�3 1so Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: (' � �r-G Phone#: i5S^ (A�9— QLA 1 a Address: LiC� ��: tJ W City: State: Qualifier Name: ` Phone; State Certification or Registration #: Certificate of Competency #: Contact Phone#: Email Address: DESIGNER: Architect/Engineer: Phone#: �I Ok Value of Work for this Permit: $' ` e-= Square/Linear Footage of Work: Type of Work: ❑Addition ❑Alteration ,*ew ❑Repair/Replace ❑Demolition Description of Work: l J.e S; A kzc4 i.,� X Ili 14 Color thru tile: Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ Technology Fee $ TOTAL FEE NOW DUE $ ` ' 5 0 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 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 approvedpnd a reinspection fee will be charged. Signature ��� E6 -- Signature or Agent Contractor The foregoing instrumeVwas acknowledged before me this 08 day ofi , 20 13 > by w rspersonally known me or who has produced --------------------- As identification and who did take an oath. NOTARY PUBLIC: The foregoing instrument was acknowledged before me this4 day of z—.A, , 20 �3 , by who ersonally known to or who has produced ----------------------------- as identification and who did take an oath. Sign: ell - Print: r My Commission E �q. r�� MY•COMMISSION #EE141677 EXPIRES: OCT 26, 2015 °r" Banded through lot State Insurance APPROVED BY G Plans Examiner Structural Review NOTARY Sign: Print: 6 ' My JESUS LOPEZ O 1r _ my COMMISSION #EE141V t EXPIRES: OCT 26, 2018 handed thraugh 1St State hf (Revised 5/2/2012XRevised 3/12/2012) )(Revised 06/10/2009)(Revised 3/15/09)(Revised 7/10/2007) Zoning Clerk Dec 24 2013 12:01PM ORONI INC 305-688-9550 p.1 CERTIFICATE OF LIABILITY+*�(mm�► INSURANCE � 10P24/13 19 CERTIFICATE i8 NOT AFF ASA MATTER N GATTELYFORMATION ONLY AND CONFERS NO RIGHTS U N THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOTAFFIRIAATII/ELY OR NEQIATIVELYAMEND, EXTEND OR ALTER THE COVERjNGE 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 certNHcUm holder [San ADDITIONAL INSURED, the policyI must be endorsed. If SUBROGATim es N IS wA1vl3D, subject to the tomend cOndND=Of the policy, certain Poill may require an endorsement. A atatereard on this eeltiFloate does not confer rights to dee certificate holder In Ilan of such endom ment(e). PRODUCERTA Vicky FsmandeZ Ocdderktal Risks Services. Inc P) 433068 11690 sweat Sulfa 500 E No • (888) 420-881q vickY��c►deltYalrislcs.com Miami, F1.33984 INSURED INSURERA; AoeldenLlnsulanc0Company ; Oront Inc INSURER INsu c: 14040 NW6 Court INSURERD: North Miami, FL 33161 (305) g85-0412 INSURE E • COVERAGES CERTIFICATE NUMBER: s UMBER - THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAh�IElitD A OVE FSION NOR 7}(E OLICY 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 CONDITIONSOF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE ADD B Q�4ERALUABILRY P GYN BER LIMITS © COMMERCIAL GENERALUASIIJI•Y EACH OCCURREN E $ 9,000.0( ❑ ❑ CLA{NS4mm ❑/ OCCUR R s c s 100.000 A ❑ CPP 0006852 01 11/10/2013 11/10/2014 MED EXP (An ooze erson $ 5,000.0( ❑ PERSONAL & ADV INJURY 8 1,OpO,OC GEML AGGREGATE LIMIT APPLIES PER: GENERAL AQGRECiATE $ 2,000.0c AUTOMOBILE LIASILITY1 $ ❑ ANY AUTO MBI INGLE UMR c4 t i ❑ 2W&HED ❑ SCHEDULED BODILY INJkJRY (Per petecn) S ❑ HIRED AUTOS ❑ NED BODILY INJURY (Per eo<Jda 6 p PER T geS ❑ UMBRELLq LUkB ❑ OCCUR S EXCESS LIAR CLAIMS MADE EACH OO xitwNce S D D CN AGGREGATE S V{tORKERS COMPIENIIATION AND EMPLOYERS' L[ gWWIN S TATU ANY PROPRIETORMARTNEIVEXECUTIVE EXCLUDED? NIA i adalcryMF � A.L. EACH ACCIDENT S Ir deeaiheurger ION OF OPERATIONS below E.L. DISEASE-EAEMPLOYE li .E.L. DISEASE . PM it v r ium . DESCMPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101. Addnronal Remarks Schadake, if mea space to raq dreci General Contractor Village Of Miami Shores Bulldhg Dept 10050 N.E. 2nd Averme Mlalyd Shores, Fl. 3313E ACORD 26 (2010/06) QF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH T14E POLIC1r-PROVIS10NS. AUTHORIZED REPRESBITAMVE e' W_ZU'UACORD CORPORATION. All rights reserved, The ACORD name and logo are r"Istered marks of ACORD