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CC-15-1285Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Parcel Number Applicant 11300 NE 2 Avenue Number: Nat & Health S( 1121360010160-08 BARRY UNIVERSITY Miami Shores, FL 33138-0000 Block: Lot: Owner Information Address Phone Cell BARRY UNIVERSITY 190 NW 111 Street MIAMI SHORES FL 33168- Contractor(s) Phone Cell Phone RANCO CONSTRUCTION CORP (954)920-3350 In Review Date Approved:: In Review Amount Date Denied: $4,80 Type of Construction: RENEWAL OF EXPIRED PERMIT Occupancy Load: Stories: Exterior: Front Setback: Rear Setback: Left Setback: Right Setback: Plans Submitted: Yes Certification Status: Certification Date: Additional Info: Bond Retum : Classification: Commercial Fees Due Amount CCF $4,80 DBPR Fee $3.38 DCA Fee $3.38 Education Surcharge $1.60 Notary Fee $5.00 Permit Fee $225.00 Scanning Fee $9.00 Technology Fee $6.40 Total: $258.56 Valuation: $ 7,500.00 Total Sq Feet: 915 Pay Date Pay Type Amt Paid Amt Due Invoice # CC -5-15-55747 05/28/2015 Credit Card $ 50.00 $ 208.56 06/05/2015 Credit Card $ 208.56 $ 0.00 Available Inspections: Inspection Type: Window Door Attachment Tie Beam Slab Termite Letter Framing Store Front Attachment Insulation Drywall Screw Final PE Certification Window and Door Buck Ceiling Grid Fill Cells Columns Review Building Review Planning Review Electrical Review Plumbing Review Structural Review Mechanical 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 that all the for oing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and . ut ore, I au the above-named contractor to do the work stated. June 05, 2015 Authorized Signature: Owner / Applicant / Contractor / Agent ate Building Department Copy June 05, 2015 1 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION UNE PHONE NUMBER: (305) 762-4949 BUILDING PERMIT APPLICATION ❑ BUILDING ❑ ELECTRIC ❑ ROOFING MAY 2 8 2015 FBC 20 60 Master Permit No. _CC - Z - l 3 -- ej" Sub Permit No.0 .� 46-- // 2 6®5 ❑ REVISION ❑ EXTENSION arENEWAL F-1 PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 11,Y60 4ly/-, _.7 Ad,6'n!0,9- g ecL% �S City: Miami Shores County: Miami Dade Zip• Folio/ParceW#: 4Z2_ z 3 C Is the Building Historically Designated: Yes NO 2---- Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): 8.,9"V Phone#:_30..5 =A> 1 14 D Address://O (3A— "'O 0aL&W.Zx City: IAt,a,44 , _i&d i2t�_r State: Z-7-2- Zip: _d Tenant/Lessee Name: Phone#: Email: YN ��A/7­/LyJ C Z�Wgy_' CONTRACTOR: Company Name:�'e%0ka CCIV Z22 do zz'doi e -'"I J r-4 Phone#: .5'y- X70 Address: -x/ d (ri` / City: nLLyk1L)61fa Stater Zip: �_s'o�;?6 Qualifier Name: �j�jl/�` C: S,F�®�1s/ Phone#::rZcx ��!(.e State Certification or Registration #: r G C ep Certificate of Competency #: c DESIGNER: Architect/Engineer:-Lp C,&�7-p/,�/1� a ,� ^n ,c� f �Gci�a ter= Phone#: 1�5�- �� o Address:_c2 i7 Z&4e_Z,2bo,7 2+_, w City:, �u_Y �+e�r9 State:' -CL Zip: 33,0 � Value of Work for this Permit: $ . ��� Square/Linear Footage of Work: Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Repiace ❑ Demolition Description of Work:,'-��:.��-, D.�/ y�� �,.ytr�®moi of M 1.3- ®,j 7 Specify color of color thru tile: Submittal Fee $ -2;36 , go 4V I Permit Fee $ Scanning Fee $ Technology Fee $ Structural Reviews $ (Revised02/24/2014) Radon Fee $ Training/Education Fee $ CCF $_ DBPR $ CO/CC $ _ Notary $ _ i�- C) Double Fee $ Bond $ TOTAL FEE NOW DUE $ 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. ell Signature Signature OWNER or AGENT The foregoing instrument was acknowledged before me this day of MAY � 20 6 by who is personal) known nown to J me or who has produced as v - identification and who did take an oath. NOTAevPu�,uc: A CONTRACTOR The foregoing instrument was acknowledged before me this _ day of20� by who is personally known to me or who has produced E224.1-- as identification and who did take an oath. S I,+F%�; Jatlty d Yao Seal: pfly COmmisBbn FF 18EM81 or r. Expires t r+ • g vRr Nomry Public SWO of F WW" Joanna M Feliciano 14 Commis&W FF 082753 ��a�+�a�au��a�a��ea���z��s��+xa�a�:�+�x���m *��w�►*saa a��s�ms*�x�m**�ets�s*a�a�*a�a��a��� *+�!!'Fl��8F8��*a�a�x�x�a� r�us��r APPROVED BY Plans Examiner Zoning Structural Review (Revised02/24/2014) Clerk I\IVI\ VVVI I, vVV{-1 \IYVI\ 1\1—Ir Lr\vrvvl�, vLv.6.v u,. ::STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTIOINDUSTRY LICENSING BOARD j. . ,n a CGCO28496 The GENERAL CONTRACTOR_ 4, Named below IS CERTIFIED�� Under the provisions of Chapter 489'FS. 4.x wi: Expiration date: AUG 31, 2016 SHOMAKER, RANGE G RANCO CONST CORP/ FLORIDA 251"4 HOLLYWOOD B,L s �n HOLiYooe i ado w - A` ISSUED: 08/18/2014 DISPLAY AS REQUIRED BY LAW SEQ # L1408180001636 `a rl CITY OF HOLLYWOOD LOCAL BUSINESS TAX RECEIPT -` PRINTDATE: 9%15/14 THIS IS YOUR LOCAL BUSINESS TAX RECEIPT. PLEASE DETACH AND POST IN A CONSPICUOUS PLACE AT THE BUSINESS LOCATION. PLEASE, DO NOT REMIT ANY PAYMENT'THIS IS NOT A BI LL .Bus aness Name' RANCO CONSTRUCTION CORPORATION BiliSinessLocation: 2514 HOLLYWOOD BLVD Business Class: CONTRACTOR/GENERAL Tax Basis- 2 - 4 WORKERS Receipt Number: 15 00024299 Receipt Year.. 10/01/14 Expiration Date- 09/30/15 NEW CHARGES-- (Itemized Below) 251.00 Comments:, Base Fee 251.00 Additional Charges: ..., .._^- .... -. .•. ._.. ..., �'.: ._.-.. ..._ '. -::: r..-'; .. 4... ..t.1,#.:n....�..r:-.tiles•..i"�eiU.s"t�1iYamWa�,��l�v��'.M"_� BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 - 954-831-4000 VALID OCTOBER 1, 2014 THROUGH SEPTEMBER 30, 2015 DBA: Receipt #:180-2344 GENERAL CONTRACTOR (GENERAL Business Name: FLORIDARANCCONSTRUCTION CORP OF SOUTH Business Type: CONTRACTOR) FLORI Owner Name: RANcE C SHOMAKER Business Opened:06/19/1994 Business Location: 2514 HOLLYWOOD BLVD 501 State/County/Cert/Reg:CGCO28496 HOLLYWOOD Exemption Code: Business Phone: 954-920-3350 Rooms Seats Employees Machines Professionals 2 For Vending Business Only Number of Machines: Vendina Two: Tax Amount Transfer Fee NSF Fee Penalty Prior Years I Collection Cost Total Paid 27,00 1 0.00 0.00 0.00 0.00 1 0.00 27.00 RANCO-1 OP ID: AN '4� oRoR CERTIFICATE OF LIABILITY INSURANCE °A,> ("°°"Y"' 12/16/2014 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 terms 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). MDW I urance Group Inc 362 Minorca Ave Coral Gables, FL 33134 Donald W McCartney NCAOM"�E:AcT Annmarie McCartney PHONE 305-444_2324 F Arc No):305-444-4980 ADDRESS: ammaftey@m"nsumnce.com INSURER(S) AFFORDING COVERAGE NAIL 0 INSURER A: FCCI Insurance Group 07/07/2014 INSURED Ranco Construction Corp of SFL Rance C. Shomaker INSURER B : Brid efleid Casualty 10335 INSURER C: National Trust Insurance Co- 2514 Hollywood Blvd. #501 H011ywood, FL 33020 INSURER D: Progresalvo hcsurance Co. 10193 INSURER E: GENERAL AGGREGATE $ 2,000,00 INSURERF: Emp Ben. $ norm COVERAGES CERTIFICATE NUMRFR- RFVICInM MI IMRPR- 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. IN LTR TYPE OF INSURANCE ROM SUBIR POLICY NUMBER EFF M PO EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR GL0015627 07/07/2014 - - _ 07/07/2015 EACH OCCURRENCE $ 1,000, DAMAGE TO R PREMISES occurrence $ 100,04 MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 GEML AGGREGATE LIMIT APPLIES PER: POLICY ❑ JECTPRO- F LOC OTHER: GENERAL AGGREGATE $ 2,000,00 PRODUCTS-COMPIOPAGG $ 2,000,00 Emp Ben. $ norm D AUTOMOBILE X XHIRED IJABILITY ANY AUTO ALL DULED AUTOS X AUTOS AUTOS X AUTOSVdNED 042535408 =1412014 06/14/2015 CoMBINED SINGLE LIMIT $ 1,000, 00( BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROP DAMAGE $ C X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE UMB00170892 07/07/2014 07/0712015 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 510001 DED I X I RETENTION $ 10,000 $ B AND EEMMPLOYERS' LIABILITY COMPENSATION ANY PROPRIETORIPARTNER/EXECUITVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory in NH) Ky ui�uxibe under DESG�RIPTION OF OPERATIONS below N I A 19633615 11/27/2014 11/27/2015 STATUTE X ER EL EACH ACCIDENT $ 1,000,00 EL DISEASE -EA EMPLOYEE $ 1,000,00 EL DISEASE - POLICY LIMIT $ 1,000,0 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Ranaft Schedule, may be attached B more space is requhv ) General Contractor License# CGCO28496 - GERTIFIGATI- MOLDER r'ArdC1=1 I ATInp1 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village 10050 NE 2nd Ave THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores, FL 33138 AUTHORIZED_ REPRESENTATIVE . .2ti�J1 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD