CC-14-2680 1
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-247233 Permit Number: CC-12-14-2680
Scheduled Inspection Date: November 05, 2015 Permit Type: Commercial Construction
Inspector: Rodriguez,Jorge Inspection Type: Final Building
Owner: , BARRY UNIVERSITY Work Classification: Addition
Job Address:11300 NE 2 Avenue Health &Sports
Miami Shores, FL 33138-0000
Phone Number
Parcel Number 1121360010160-23
Project: BARRY UNIVERSITY
Contractor: ARCHON AIR MANAGEMENT CORP Phone: (305)592-8552
Building Department Comments
MODIFICATION OF ROOFTOP AC UNIT STEEL FRAME Infractio Passed comments
OPENINGS TO ACCEPT NEW ROOFTOP UNITS AND INSPECTOR COMMENTS False
CURBS.
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-224825. 9:00 am left mess no
reply
Failed PLEASE CALL FERNANDO ORTIZ(786)508-5571
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
November 04,2015 For Inspections please call: (305)762-4949 Page 23 of 35
Miami Shores Village
Building Department _
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
,A
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20 ICS
BUILDING Master Permit No.MC14-1502
PERMIT APPLICATION Sub Permit No. 0_02__ 14- �0
0 BUILDING ❑ ELECTRIC ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL EJPUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 11300 NE 2 Avenue- HSC Building
Citv: Miami Shores County: Miami Dade zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder):Barry University Phone#:305-899-3785
Address: 11300 NE 2 Avenue
City. Miami Shores State: FL Zip: 33161
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: Archon Air Management Phone#: 786-336-8766
Address: 2501 NW 74 Avenue
City: Miami State: FL Zip: 33132
Qualifier Name: Carlos Romero Phone#: 786-336-8766
State Certification or Registration M Certificate of Competency#: CMC 1249975
DESIGNER:Architect/Engineer: Saad Elia EI Hage Consulting Engineers Inc. Phone#: 954-771-8149
Address:5901 NW 9 Avenue Suite 104 City. FT Lauderdale state: FL Zip: 33004
Value of Work for this Permit:$31,000.00 Square/Linear Footage of Work:
Type of Work: ❑ Addition K Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: Modification of rooftop AC unit steel frame openings to accept new rooftop units and curbs.
Specify color of color thru tile:
Submittal Fee Permit Fee$q3O ' v(�
a CCF$ CO/CC$
Scanning Fee$ Radon Fee$_ DBPR$ Notary$
Technology Fee$ Training/Education
Fee$ Double Fee$
Structural Reviews$IrDIC", - ('l��. 6 Bond$
TOTAL FEE NOW DUE$ 4 ^�
(Revised02/24/2014)
r �jyy
Bonding Company's Name(if applicable) N/A
Bonding Company's Address
City State Zip
Mortgage Lender's Name(if applicable)
Mortgage Lender's Address
City State 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 i in the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
JSignature Sign ure It
OWNER or AGENT CONTRACTOR
The foregoing instrumeefnt�was acyknn ledged before me this The foregoing instrument was acknowledged before me this
TIN day of L 20 by byday of 20 1Y ,by
.SUSAN R�OS�Iv'(L,Ip�. who is personally known o Gam✓ � %C,SZ"� W� t
onally known to
me or who has produced as me or who has producedas .3
Giorida
identification and who did take an oath. identification and who did 2018
66
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: .a......•, —slime
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n : _ Notary P�JR-Stat c ¢" u.��^�— ida
=N, ag My Comm.Expires 14.201 2018
Jepry,I Vao
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4� • Mi GCmmasion FF 168481 �'�n lot%
?p�* Expkea 1111=018 -
APPROVED BY Plans Examiner Zoning
is
l t Structural Review Clerk
(Revised02/24/2014)
RICK SCOTT GOVERNOR KEN LAWSON,SECRETARY
t STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
�- CONSTRUCTTQN:INDUSTRY LICENSING.BOARD.
EI1lLG1249975•
•The.-VIECHANICAL CONTRACTOR
r6tr►etl borow IS CERTIFIED
#i�e:Provisins of Ctapter...49 FS..... �... I���
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piration-date: UG 3.7 2WE
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ISSUED: 09/0712014 DISPLAY AS REQUIRED BY LAW SE.Q L1409070003322
RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY
# STATE OF FLORIDA
DEPARTMENT OF BUSfNESS AND PROFESSIONAL REGULATION
i" CONSTRUCTIgN.INDUSTRY LICENSING BOARD
CA1305.7548
The:GLASS B AIR.CONDITIONI NG.CONTRA
I: CTQ,i
,.. Naffned-berow IS CERTIFIED,
r •um&ttle prov1sions•of Chapter 489 i=S.
Eu kation date: AUG 31,2016
L: i9RCIi0N AtE'� NAG!~� RP Wt
.y,':;.,._�''�.`�'�.1-IV,�125.57.,•..:.-.:.::,,� I,,��,sp;�,��,�.. ,,T„ ,. :�. � � t�+r
7�S-^�•' � �N�4•.�:,�ry.t": _ .�-`"'� qi-.� •1M,pSi •,� .. •R�1 b. `4:
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ISSUED: 09/07/2014 DISPLAYAS REQUIRED BY LAW SEQ# L1409070002748
RICK SCOTT. GOVFRNnR
003099
Local .Business Tax Receipt
Miarni- Dade County, State of Florida �LBT
—THIS IS NOTA BILL - DO NOT PAY
3871283
N.
BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES
ARCHON AIRMANAGEMENTLORP RENEWAL SEPTEMBER 30, 2015
2501 NW 74 AVE CT 4041588 Must be displayed at place of business
MIAMI FL 35122 Pursuant to County Code
Chapter 8A—Art.9&10
SEC.TYPE OF BUSINESS
OWNER 196 SPEC MECHANICAL CONTRACTOR PAYMENT RECEIVED
ARCHON AIR MANAGEMENT CORP BY TAX COLLECTOR
Worker(s) 2 CAC057574 $75.00 07/24/2014
FPPU05-14-014153
This Local Business Tax Receipt only confirms payment of the Local Business Tax.The Receipt is not a license,
penult,or a certification of the holder's qualifications,to do business. Holder must comply with any governmental
or nongovernmental regulatory laws and requirements which apply to the business.
The RECEIPT N0.above must be displayed on all commercial vehicles—Miami-Dade Code Sec ea-276.
For more information,visit www.miamidade.00vhaxcoll"r
01/21/2015 09:35 305GG22150 PALAU PAGE 02/02
A
0?Rllr3eCERTIFICATE OF LIABILITY INSURANCE DATE(Mm/DOIYYYY)
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(ies)must Be andoreed.if SUBROGATION IS WAIVED,
of the policy,curtain policies may require an endorsement,A statement on this certificate does not Cehfcr rights to the certicate hostler In lieu of suto the e and conditions
endorsement(s).
PRODUCER
CONTACT NAME:
PHONE A1C,No.Ext): 1 800.277-1620 x4600 FAX A1C No): 727 799-0704
FlankCrum Insurance Agency,Inc, E-MAILAObRESS:
1 DO South Missouri Avenue INSURER 3 AFFORDING COVERAGE
Clearwater,FL 33756 NAIc
INSURED INSURER A: Frank Winston Crum Insurance Co. 11600
INSURER B:
[INSURER C:
FRANKCRUM L/C/F ARCHON AIR MANAGEMENT,CORP. INSURER D:
100 SOUTH MISSOURI AVENUE INSURER E:
CLEARWATER FL 33756
COVERAt3Es INSURER P:
CERTIFICATE NUMBER: 289282 REVISION NUMBER;
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAME ABOVE FOR THE POLICY PERIOD IMbICATEo,
NOTWITHSTANDING ANYREQUIREMENT,AFF R DED B TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY 13E ISSUED OR MAY
PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN
MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSh
LTRTYPE OP INSURANCE ADDL SUER
GENERAL UAStLrry IM-010 WVD POLICY NUMBER WDDfrPCILMY FF iPwoo�vl
(MnvDOIYYYY) M uMns
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $
DAMAO YO RENTEO
CLAWS.MADE =OCCUR PREMIE F o"rwca 3
WO EXP{Any one pormn) 8
PERSONAL LADY INIURY S
GENI AGGREGATE OMIT APPLIES PER: GENERAL AGGREGATE $
I-OLIOY PROJECT LOO PRODUCTS-COMPIOP AGG S
AUTOMOBILE LTA RM S
ANYAUTO COMBINED SINGLE LIMIT 5
ALL OWNED SCHEDULED %. _
URY Per n 6
AUTOS AUTOS
MIRED AUTOS NON.OWN$D RY(Per eumem) 8
AUTOS PROPERTYDAMAGE ,�
UMBRELLq�LIARCCCUR:EXcGsg LIFENCE DED E 8
WORKERS COMPENSATION ANO S
A EMPLOYER$�LwearrY WC201500000 01/01/2015 01/01/2018 ATUTORY 0TH.
ANY PgoPRIETOR/PARTNEWEXEcUTIVE YIN MITS EROFFICERMEMBR,R EXCLUDE07 � NIA
�1eO�P'Y CIDENT
Iry06.QeiCrlD0 toltlOr
DE31 IPTIO{.t OF OPERATION$below El 0 RA E.EA EMPLOYEE 1 e0Q 000
-F-i.'DIae&3E-POL4YJ_IMrr 'ALM
RESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACOR 1101,Addltion;U Remarks,Schadulo,If mo►e bhace Ic r®qulrutl)
EFFECTIVE 05/05/2009,COVERAGE IS FOR 100%OF THE EMPLOYEES OF FRANKCRUM LEASED TO ARCHON AIR MANAGEMENT,CORP.(CLIENT)
FOR WHOM THE CLIENT IS REPORTING HOURS TO FRANKCRUM.COVERAGE IS NOT EXTENDED TO STATUTORY EMPLOYEES.
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE T41ERr;OF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE
POLICY PROVISIONS.
MIAMI SHORES VILLAGE AUTHORRED REPReSENTATNE
10050 NE 2ND AVE.
MIAMI SHORES,FL 33138
ACORD 25(2010/08) Thea ®1088-2010 ACORD CORPORATION.All rights reserved.
ACORD namm and Logo are registered marks of ACORD
0
9
Miami shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax:.(305) 756.8972
Page 1 of 1
Permit No:cC/4
Structural Critique Sheet
444
� , X .
T
STOPPED REVIEW
Plan review is not complete,when all items above are corrected,we will do a complete plan review.
If any sheets are voided, remove them from the plans and replace with new revised sheets and Include one
set of voided sheets in the re-submittal drawings.
Mehdi As of
♦SN-.
.ns allot" Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
MIAMI SHORES VILLAGE
NOTICE TO BUILDING DEPARTMENT
OF EMPLOYMENT AS SPECIAL INSPECTOR UNDER
THE FLORIDA BUILDING CODE
I (We)have been retained by 5A&Q`1 LJ N l VELD71(to perform special inspector services under
the Florida Building Code at the 030 rC4UF iup U0il ��Ltj'f,project on the below listed structures as of
'D SCEABf f- ,2014(date).I am a registered architect or professional engineer licensed in the State of Florida.
PROCESS NUMBERS: cC_ 12 - 14 - :2r,Fn
❑ SPECIAL INSPECTOR FOR PILING,FBC 1822.1.20(R4404.6.1.20)
❑ SPECIAL INSPECTOR FOR TRUSSES>35'LONG OR 6'HIGH 2319.17.2.4.2(R4409.6.17.2A.2)
❑ SPECIAL INSPECTOR FOR REINFORCED MASONRY,FBC 2122.4(R4407.5.4)
C_5--SPECIAL INSPECTOR FOR STEEL CONNECTIONS,FBC 2218.2(R4408.5.2)
❑ SPECIAL INSPECTOR FOR SOIL COMPACTION,FBC 1820.3.1(R4404.4.3.1)
❑ SPECIAL INSPECTOR FOR PRECAST UNITS&ATTACHMENTS,FBC 1927.12(R4405.9.12)
❑ SPECIAL INSPECTOR FOR
Note:Only the marked boxes apply.
The following individual(s)employed by this firm or me are authgrized representatives to perform inspection
1. AoLn t!(,9AG-e--- 2.
3. 4.
*Special Inspectors util zing authorized representatives shat insure the authorized representative is qualified by education or
licensure to perform the duties assigned by the Special Inspector. The qualifications shall include licensure as a professional
engineer or architect; graduation from an engineering education program in civil or structural engineering; graduation from an
architectural education program;successful completion of the NCEES
Fundamental Examination;or registration as building inspector or general contractor.
I, (we)will notify Miami Shores Village Building Department of any changes regarding authorized personnel performing inspection
services.
I, (we) understand that a Special Inspector inspection log for each building must be displayed in a convenient location on the site
for reference by the Miami Shores Village Building Department Inspector. All mandatory inspections, as required by the Florida
Building Code,must be performed by the County.The Village building inspections must be called for on all mandatory inspections.
Inspections performed by the Special Inspector hired by the Owner are in addition to the mandatory inspections performed by the
Department. Further, upon completion of the work under each Building Permit I will submit to the Building Inspector at the time of
final ins I'V@ntJeq�mp inspection log form and a sealed statement indicating that,to the best of my knowledge, belief and
prod 1 nal j90" ortions of the project outlined above meet the intent of the Florida Building Code and are in
>6istantiaL- d approved plans.
. ned an ti = Engineer/Architect
Name —C
t (PW l r
Address
�l Phone No. -74 4AAq(4 ::77
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