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PLC-14-1848Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-235735 Scheduled Inspection Date: June 01, 2015 Inspector: Diaz, Osvaldo Owner: , BARRY UNIVERSITY Job Address: 11300 NE 2 Avenue LaVoie Hall Miami Shores, FL 33138-0000 Project: BARRY UNIVERSITY Contractor: AL HILL ENTERPRISES CORPORATION Building Department Comments CAP AND PLUMBING FIXTURES Permit Number: PLC -8-14-1848 Permit Type: Plumbing - Commercial Inspection Type: Final Work Classification: Addition/Alteration Phone Number Parcel Number INSPECTOR COMMENTS False 1121360010160-12 Phone: (305)687-9963 Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-218425. cancelled per AL HILL C� Failed Correction Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid May 29, 20116 For Inspections please call: (305)762-4949 Page 27 of 27 BUILDING PERMIT APPLICATION ❑BUILDING PLUMBING ❑ ELECTRIC 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 FBC 20 LQ) Master Permit No.Ca- 1 die Sub Permit No.I i l yj�U ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑ RENEWAL ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: I ! I a 0 a AVS— " Lc�yo % C, City: Miami Shores County: Miami Dade Zip: �� I Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): f B `A Qnwe- rz-� i Phone#: City: �-Ai CAm i n1n QfQ3 State: Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: T6� �� 11� to w►® 3 Vii- Phone#: Address: 111 4 ® IU Z CityjDpiA Loc (c, State: 1 rL Zip: 3—se) 54 Qualifier Name: 0 lb e ,� o (( Phone#: Z 05-G 9 1 i tip State Certification or Registration #: 0 CCertificate of Competency #: DESIGNER: Architect/E`ngineer. S�L-►l ('y9-5�d �UirylClin j K 'jCk e , ULL � 1 Phone#: S4_q(0k _ro Address: 'g 011 J( b)1'�e j �Wir_ moo City: - state: �b Zip: S3-51(0 Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New tt ❑ Repair/Replace Demolition Description of Work: P 6. K I czt Er, Specify color of 6161 ,.thri t=ile: Submittal Fee $ s r Permit Fee $ / S r CCF $ CO/CC $ Scanning Fee $ Technology Fee Structural Reviews $. (Revised02/24/2014) Radon Fee $ Training/Education Fee $ DBPR $ Notary 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 92 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. A O 4j Signature X�& rf� OWNER or AGENT The fo egoing instrument was acknowledged before me this day of A�lwr . 20 � by cSLAMN USC&L , who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Print: Seal:ro rLa �..a Y. ALa MY COMM SION 0 EMMEXPIM: Nov®ba' 12, 2014 's��ii ARV Fl. NsteryDkw=Ann C04 CONTRACTOR The fgregoing instrument was acknowledged before me this day of a_t� 20 , by \ who is a ovally kno n to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign Seal: t� L1IU42 Fq- * * m'Ek 492017 C411SS1QN9FF FIV ftWVn&'"W0i;�3Wk0 ��k�k�k**�R�kNeffi�k�k�k�k*�k�kakKe+kik*�k�k�k�k#�kakM�k�k��kakAt�kak8e�kfleffi&+k�k�kF*�k�k�k*�kNe�k�h�k�R�k�k�k�k�k�kak�F*�k�k�k*�k�k�k�k*il��k�k�k�k�b*�k�k�k�F�k�k�k�k+kik*�R�k4�k�k�k�k�k*�k*ffi�k APPROVED BY 8- Z S /y Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) H 0 0• Q:' •0 0 .. ISO Mill SATE OF. FLORIDA . 'DEPARTMENT:OF- BUs,-i` A D PROFESSIONAL REGULATION :: CON STRUCT:LON INDUSTRY i;-10ENSING: BOAR] SEQ#L12121100580 DATE BATCH NUMBERLICENSE NBR,_ 7,2 11 202 ..� 2.023,818& CFCA58101'' The 'PLUMBING CONTRACTOR. Named below IS CERTIFIED Under the provisions of Chapter$ FS, Expiration date: AUG -31, 2.014':z ZZ tag ag �m .HILL,:.A%BERT 9 AL HILL ENTERPRISES .CORPORATIONx y`# 13740 NW 19TH AVENUE UNIT 12 OPA- LOCKA FL 33054 RICK-SCOTT KEN LAWSON GOVERNOR _ SECRETARY = _ 05590 Depailme t o Businness and Licensing _ OcWpationai License : " AL HILL ENTERPRISE.* CORPORATION .1374.0; NW 19 AVE # 12-13 . OPA LOCKA,.FL 33054 LICENSE FEE $4000 IS HEREBY �10ENSED TO ENGAGE IN.THE BUSINESS; PROFESSION OR OCCUPATION OF - PROFESSIONAL SERVICES OP11-I.00KA, WITH THE FOLLOWING RESTRiCTiQNS: .>:. n UNTIL SEPTEMBER .FORCE. NOTE: 744 uuGUrJAI 1UN..` ebUIkILU HLRIUN:': .'e: CITY OF OPA-LOCKA `'. ��ff e: b� �:�• a CITY MANAGER. INTY REGULATIONS NOW IN THE SLISINFSS nR DISPLAY AS REQUIRED BY LAW City of Opa-i®cka 5973 Department of Business and Licensing 2014 Occupational License AL HILL ENTERPRISE, CORPORATION 1374Q NW 19 AVE # 12-13 OPA LOCKA FL 33054 LICENSE FEE $150.00 IS HERgBY LICfNSED TO ENGAGE IN THE BUSINESS, PROFESSION OR OCCUPATION OF CERTIFICATE OF USE OPA-LOCKA, WITH THE FOLLOWING RESTRICTIONS: sa : iNTLtiF�'1,�'kL:, , r s' i..:",`a Ep<f3NQ9/.2S1203.3 UNTIL SEPTEMBER 30, 201A .. .. ECT:fJ THE;PC7I� �F'? .:C� OI 'Ol?lA=L4CKA OE�If�IAN`7dD,`TACENl`.UNTY REGULATIONS NOW IN FORCE. 'NOTE: THIS LICENEESJ�[OTGONu�`CilUt7il IiRTIFIAiT.ION THAI`TF1E'LLCEtV5EE tS:QUALLf'9L�b T�} E?Ntii4GEN THE BUSINESS OR OCCUPATION SPECIFIED CITY OF OPA-LOCKA BY: CITY MANAGER LICENSE CLERK DISPLAY AS REQUIRED BY LAW CERTIFICATE CSF LIABILITY INSURANCE � OATEIl41A4100/1'YYY) _ , Dero4r14 rnls rrEK fIFtCATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 3 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 iNSt)RED, the policy(fesy must be endorsed If SUBROGATION IS WANED, svbJect 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). F ` PRODUCER CONTACT Lucia Estrella 1 Accurate I �r�E&x(305)226-8727 —__Ll �s (305)2 z6 878? 8300 West Flegier Suite 114 LAOP3I�SS:-�` iu0sestreila@baltsouth.net Miami, FL 33144 __ __ INSURER(SZAFPOROINGCOVERAGE Phone ,.(305 }228 8727 Fax{305)226-8767 iryINSURER A: Arch Specialty insurance Company��o s j INSURED INSURERS: Progressive Express InsuranceM -__ --. ------- Al Hill Plumbing Corp. & At Hill Enterprise Corp INSURER C Rockhill Insurance Company _ —�- 13740 NW 19th Ave Unit 12 INSURER D: United Specialty Insurance Company — : Opa-Locka, FL 33054 _INSURER E., COVERAGES --- CER_TIFICATE_NUMB_ER:_ I -- -_ REVISION NUMBER: _ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE TEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY VE—R16-D--- INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. 1NSRi iAODi$UDR, -__ TYPE OF INSURANCE-..![IZs81Va[stit -_ _POLICY NUtViBER i POLICY EFF _ -„ i LMM/DOnj POUCYEXP ' (tAMIDD _--� LIMITS - j ? © COMMERCIAL GENERAL LIABILa Y I EACH OCCIRRENCE : S 1,Ofl0,000,O0 � DA9AAGE TO RENTED ' A i ❑ ❑ CLAIMS -MADE ®occuR ; Y � Y I AGL005640-00 ❑ (�( (10123/201310/23120141 oEcurrencel 1 s 100,000.00 i � ME -1) EXP (ft one E!Ts .r y � S 10,000.00 i _ _ __�_.___ _ ' PERSaNALaADVINJURY i S 1,000,000.00 GENERALAGGREGATEAGGGGREEG--ATE - s 2,000.000.00 G�E91. AGGREGATE LIMIT APPLIES PER. 1 ❑ POLICY ® PR i PRODUi C7 S _ CpMp/OP AGG 5 2,000,000.00 :ECS❑ LOC i i S AUTOMOBILE LIABILITY aBINE4 SINGLE LIMIT i-^ © ANYAUTO I 1 LEO j 02460092-0 i ALL OWNED AUTOS B ; ❑euros ❑ Y Y j ! ( 1012212013.1012212014 BODILY INJURY (Per person) ' 5 250,000.00 BODILY INJURY (Per accident) 3 �� • 500,a00.D0 µ NON -OWNED I- NON•OWNED HIREDAUTOS ❑ AUTOS z PROPERTY pA AGE 'Q ❑ j ' /Peractldann 5 400 {)OO.00 i I s UMBRELLA LU1B ❑ OCCUR EACH OCCURRENCE 5 _ J ❑ EXCESS LIAR ❑ CLAIMS -MADE Y rr--�� A{iGREGATE 5 , :.L-t..D�� ..❑..RETENTIONS, I i S WORKERS COMPENSATION ) �_-- ....... -w-CS-TA-TU- AND OTH-s 1 ANO EMPLOYERS' LIABILITY YIN ! ; [j- t )Mffs ❑ ER ANY PROPRIETOR/PARTNEPJEXECUTIVE 1 OFFICER/MEMBER EXCLUDED'? N/ A: ( I EL• EACH ACCIDENT_ - j (MandaloryinNH}-J; I i EL.DISEASE-EAEMPLOYEES Ifyas, deac,be under 1 ; DESCRIPT$)N OF OPERATIONS tsettoa i -� I E.L. DISEASE - POUCY LIMIT, S D ' Contractors PollutionI I USSA4024592 12/02/2013 12/0212014 ,$1,000,000.00 1 i 1i „DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 10.1, Additional Remarks, Schedule, If more space is required) License #CFCA58101 .. _ CERTIFICATE HOLDER City of Miami Shores 10050 NE 2nd Ave Miami Shores Village, FI 33138 305-681-5588 ACORD 25 (2010105) OF i CANCELLATION -- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE`+ THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE PO ICY PROVISIONS. AUTHORIZED RE ES E t Lucia Estrella @ 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD QATE tI�S 7'OQIYYYY: ; CERTIFICATE OF LIABILITY INSURANCE 8/4/2014 I THIS CERTIFICATE IS ISSUED AS A NATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY DR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERISt, AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policylsesi 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 I i certificate holder in lieu of such endorsement(si. :PRODUCER ! NAM" ANDREW OGHINAN BENDELL INSURANCE GROUP INC PHONE EMP (3051249-5055 I XC N„(305) 249-500 7 PO Box 164235 �`'L biagroup@bei isouth. net Miami FL 33116-4235 ADDREss _ tNSURERls) AFP0Q0IW COVERAGE s Nnaca _ HSURER A ASSOCIATED INDUSTRIES INS COMPANY II' NSURED AL HILL PLUMBING CORPORATION 13740 NW 19TH AVE SAY#12 INSURERC OPA LOCKA, FL 33054 INSURER D _ 305-657--9963 INSURERS COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED SELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD tNDiCATED NOTWITHSTANDING ANY REOUtREMENT 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 .�_ aoaE ease INSn TYPE 0'r INSVRMCE „o .,u ivn.n POLICY NUMBERtnAf;JC{ifYYYYI :iMF,LOUNYYYt . lltail75 COMMERCIAL GENERAL LIABILITY ? EACH OCCURRENCE I CUilM5-MADE i OCCUR DAMAGE TO RENTED '' F'f2..%•MISES ;ii?t ogWrren''a!—._g ...._._...._... tAED EXP It" One;Kfr rn, �' S FPERSONAL& ,.,—_---......._— ....' ADV INJURY ':,5 ._..` NA GENL AGGREGATE LINN'- APPLIES PER - GENERAL AGGREGATE S i POLICY LSI JECOT LOC �� PRODUCTS • COMPOP AGG ' $ ' iS OTHER At}TOt,9QI3iLE LtAi3fLEFY I N D t lIMI S �yANYALtT{} 'd ,.t;)![Y INJURV -Pa• �.I ' ALL OVtiNeD �— SCHEDULE[) boulLY INJURY IPgr aj+C flm), S ' AUTOS AUTOS NA _ :..._..� NO dNED b HIRED AU ICS w ..�.... r._._; •per �c',ao; ns F ; UMBRELLA UAB �1 OCCUR EACH OCCURRENCE . EXCESS LIAR CLAIMS MA.:GENA AGGREGATE � S rtFn ' RF TFNTInNS ____ LbORKERS CCMPENSATION 'vIc 'AND EMPLOYERS' LIABILITY STATUTE ER .. ts6'r PRLPAi(:7 (JRraf,RTP:L'..£MECUTPIE V^—N q yq �q Jr, �y j r �9 �q E L EACH ACCIDENT S 1,000,000 , A QPFiL'¢.R+MEPkBEk E7tCLUC£0� ..NA A 01030441 11JGil14�d.�6.7f �. S. .. ;iMandetary m roH} I E L DISEASE' . EA EIAPLOYEE S 11000,000 I f! yyes aesctbe �ncer l Dt:SCRIPTION OF OPERATIONS oeioaa - E L DISEASE - POLICY LIMIT NA I OESCRIPW)k Or OPf 47IONS I LOCAtEONS I VEHICLES :At'GRO 10' ACcl.h na: Ra. aq.S SCPAO� u may De e�ta:.r<ch: � •-cta spark :g r@Awsr@9i PLUMBING CONTRACTOR LICENSE #CFCA58101 MIAMI SHORES VILLAGE 10050 NE 2ND AVENUE MIAMI SHORES VILLAGE, FL 33135 SHOULD ANY OE T.h THE EXPIW`101 ACCORDANCE WITH I,jTHGRCE:i REPRESEN POL€CIES BE CANCELLED 13EFOPE ITICE VAILL BE DELIVERED IN " t aS8.2Q f ACORt? CORPORATION All rights reserved ACOR.025i2C14 011 The ACORD name and loge are regrstered marks of ACORD