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RC-15-1721 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-248263 Permit Number: RC-7-15-1721 Scheduled Inspection Date: November 24, 2015 Permit Type: Residential Construction Inspector: Rodriguez, Jorge Inspection Type: Final Owner: RUARK,JOHN Work Classification: Alteration Job Address:9909 NE 4 Avenue Road Miami Shores, FL Phone Number (410)610-2148 Parcel Number 1132060171310 Project: <NONE> Contractor: JMEC CONSTRUCTION, LLC Phone: (954)410-4695 Building Department Comments INSTALL TRAY CEILINGS/FLOORING AS PER PLANS Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. November 23, 2015 For Inspections please call: (305)762-4949 Page 18 of 25 T:,, i t z- RAIN r t . 00, ;;f r , t { d d y f q � h f i t S � } t Miami Shores Village Building Department ! UL, 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 I r * Z Tel: (305)795-2204 Fax: (305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 _FBC 2 � 01y BUILDING Master Permit No. - 2- 1 PER IT APPLICATION Sub Permit No. BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP Q/+� r L� CONTRACTOR DRAWINGS JOB ADDRESS: t�`tel. �Q `� `T `�y4�r[� City: Miami Shores County: Miami Dade Zip: ��' (�. to Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder) X Phone#: q,11-2— 1 ��y Address: kR te Plod / City: /�I JAA &ZL� State: �L. Zip: Tenant/Lessee Name: Phone#: Email: Z�/C►-- CONTRACTOR:Company Name: (fC V Oi0 <LC- Phone#: . `"K Address: SCO O N W ?,2 9 , &Z CC— City: zM e2a^--c-e..k.... State: �'` Zip: Qualifier Name: mil C 1=1 N1�..fS�J7���{ Phone#:454 U K 4idsT State Certification or Registration#:_ r- Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ 3 r d'O'O Square/Linear Footage of -9-9� Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: ^ ♦ Cfr3l 'L Its Specify color of colrror�thru tile: Submittal Fee$ W Permit Fee$ ,Uw ' CCF$ CO/CC$ - Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ (7, TOTAL FEE NOW DUE$ I 14 9 eo (Revised02/24/2014) Bonding Company's Name(if applicable) i 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 issued. In the absence of such posted notice, the inspectionwill not be approved and a reinspec ' n ee will be charged. a �Signatu Signature OWNER or AGENT CONTRACTOR The foregoing instru ent was acknowledged before me this The foregoing instrument was acknowledged before me this day off 20 I by 7 day of V 20 r J^ by t-, who is personally known to C-1 44��Sl"L,.,who is personally known to me or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUB C: NOTARY PUBLIC: `4- � c( -�hSign: Sign: Print: L Gt t�r`a t Print: v ao ..., Seal: moo. % LAURA FARLd Seal: MYCOMMISS #FF 188027 MY COMMISSION#FF 188027 * * EXPIRES:March 16,2019 * EXPIRES:March 16,2019 �'+ o,,,dF Bonded Thru B4d Notary ServW N'r�or���� Bonded Thru Budge!Notary Servka ***************************** ****************************************************************************** (Y� APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) 15NvREs rs ..,. � ..... Miami Vhores Villa9e Building Department �OR1N� 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. ✓ COPY OF QUALIFIER'S STATE LICENCES B. L,' /COPY OF LOCAL BUSINESS TAX RECEIPT C. ✓/COPY OF LIABILITY INSURANCE* D. t/ COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 Certificate must specify the description of operations or contractor license number. BUSINESS NAME: Tin>X (-10111S1-"67)1910 LLL BUSINESS ADDRESS: D /'y• W 55/i*CITY 40r10'r LA"TATE FL ZIP BUSINESS PHONE: (q—" )�10 i D FAX NUMBER( CELL PHONE g�!Ztj0.'40S QUALIFIER'S NAME: QUALIFIER'S LIC NUMBER: one million Floridians licensed by the Uepartment of business and , Professional Regulation. Our professionals and businesses rangea mss, STATE OF FLORIDA from architects to yacht brokers,from boxers to barbeque restaurants, DEPARTMENT OF BUSINESS AND and they keep Florida's economy strong. PROFESSIC;�4AL AEGULAT IO11 Every day we work to improve the way we do business in order to CGC060569 S g x;06/14/2015 serve you better. For information about our services, please log onto m ff www.myfloridalicense.com. There you can find more information CERTIFIED GEN�1�#CDNTRQC `OR about our divisions and the regulations that impact you, subscribe FINKELSTEINLE 10" OT�TT w to department newsletters and learn more about the Department's JMEC CONSTRt1�TIf�N IAC" initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, IS CERTIFIED under the provisions of Ch.489 FS and congratulations on your new license! Expiration date : AUG 31,2016 L1506140000551 DETACH HERE RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTIONINDUSTRY LICENSING BOARD C0006o569 The GENERAL CONTRACTOR Narhed:below IS CERTIFIED Under"the.provsions of Chapter 489 FS. � -" Expiration date: AUG-31,.2016 " RNKELSTEtN,. ER1G SCOT �� JmEE CONSTRt7CT#O � � -254!",,NW 1ITtW" AN" �w fONIIkNr BEA h r w ISSUED: 06/14/2015 DISPLAYAS REQUIRED BY LAW SEQ# L1506140000551 BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000 VALID OCTOBER 1,2015 THROUGH SEPTEMBER 30, 2016 DBA: Receipt#:180-270179 Business Name; JMEC CONSTRUCTION LLC GENERAL CONTRACTOR (GENERAL° Business Type:DCONSTRACTOR)} Owner Name:ERIC FINELSTEIN Business Opened:07/01/2015 Business Location: 560 NW 39 AVE State/County/Cert/Reg:CGC060569 COCONUT CREEK Exemption Code: Business Phone: 954-410-4695 %Z Rooms Seats Employees Machines Professionals For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 0.00 0.00 0. 00 27.00 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 non-regulatory in nature. You must meet all County and/or Municipality planning WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved 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. Mailing Address: JMEC CONSTRUCTION LLC Receipt #01A-14-00007441 N39 AVE COC Paid 07/01/2015 27.00 f` COCONUT T CREEK, FL 33066 2015 - 2016 - - EEI - �. BROVVARD UNIIM( ",L t SINI SS 4 CP�' City of Coconut Creek BUSINESST RECEIPT Name of Business: JMEC CONSTRUCTION, LLC Business ID: 1500000170 Business Address: EXPIRES 9/30/2015 560 NW 39 AVE COCONUT CREEK, FL 33066 APPLICATION FEE 000000 0000003101 25.00 HOME BASED BUSINESS-OFFICE ONLY 096000 HL11000394 102.10 JMECC-1 OP ID:TR A�COyRL7" CERTIFICATE OF LIABILITY INSURANCE DATE 07110IDDIYYYY) 07110/2015 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 Neu of such endorsement(s). PRODUCER CONTACT Roebuck Associates insurance NAME: Roebuck Associates Exchange LLC QVC,PHallo Ext):954-616-1800 1 FAx No: 954-616-1888 5599 S University Drive, #301 Davie, FL 33328 ADDRESS: Roebuck Associates INSURER(S)AFFORDING COVERAGE MAIC* INSURERA:United Specialty Ins Co. INSURED JMEC Construction, LLC INSURER 8: 560 NW 39th Avenue INSURERC: Coconut Creek,FL 33066 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. INSR AVOL 3UI5H POLICY EFF POLICY EXP TR TYPE OF INSURANCE ImQn WVD POLICY NUMBER MID MIDD LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,0001 CLAIMS-MADE OCCUR USA4095498 07/03/2015 07/03/2016 PREMISES Ea occurrence $ 100,00 MED EXP(Any one person) $ 5,0 PERSONAL&ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,0 POLICY �ECT LOC PRODUCTS-COMP/OP AGG $ 1,000,00 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ �O OWNED SCHEDULED BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS MADE AGGREGATE $ DED I I RETENTION $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? F-1NIAE.L.EACH ACCIDENT $ (Mandatory In NH) E.L DISEASE-EA EMPLOYEE $ yes,describe under DE.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached K mora space Is required) General Contractor / CGCO60569 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Village of Miami Shores THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN g ACCORDANCE VATH THE POLICY PROVISIONS. 1005 NE 2nd Ave. Miami Shores Village, FL 33138 AUTHORIZED REPRESENTATIVE 7v-e�4--,- ��� G 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD we JEFF ATWATER CHIEF FINANCIAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS'COMPENSATION **CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS'COMPENSATION LAW CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual fisted below has elected to be exempt from Florida Workers'Compensation law. EFFECTIVE DATE: 2/26/2015 EXPIRATION DATE: 2/25/2017 PERSON: FINKELSTEIN ERIC S FEIN: 471325353 BUSINESS NAME AND ADDRESS: JMEC CONSTRUCTION LLC 560 NW 39TH AVENUE COCONUT CREEK FL 33066 SCOPES OF BUSINESS OR TRADE: LICENSED GENERAL CONTRACTOR Pursuant to Chapter 440.05(14),F.S.,an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter.Pursuant to Chapter 440.05(12),F.S.,Certificates of election to be exempt...apply only within the scope of the business or trade listed on the notice of election to be exempt.Pursuant to Chapter 440.05(13),F.S.,Notices of election to be exempt and certfficates of election to be exempt shall be subject to revocation if,at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate.The department shall revoke a DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS?(850)413-1609 ' f JMEC Construction LLC 560 NW 39 Ave Coconut Creek,Fl. 33066 CGC 060569 7/10/2015 State of Florida County of Dade Before me this day personally appeared Eric Finkelstein who \being duly sworn, deposes and says , that he will be the only person working on the project located at IJ ` t✓ LA "�%./f- ! !tA Luso I (> Sworn to and subscribed before me this---i'2- day of�44*2015 Personally known Print name-Laura Farley * * W COAMwfISSM!FF 188027 EXPIRES:Much 16,2019 �1?a,,d"`O� BaMed'fhru8udyetN�Y �, M iami Shores villagemill NINE Building Department ORiDp' 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner — Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees,including the owner,must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if 1. The officer owns at least 10 percent of the stock of the corporation, or in the case of an LLC,a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State,Division of Corporations;and 3. The corporation is registered and listed as active with the Florida Department of State,Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption and has acknowledge that he or she will not use day labor,part-time employees or subcontractors for your project.The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project. In these circumstances,Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company for day labor,part-time employees or subcontractors. BY SIGNING BELO YOU ACKNOWL E THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: Owner State of Florida County of Miami-Dade The f going w e before e this 7 day of 20 1 5� i By IDI elutm, who is personally known to me or has produced as identification. Notary: �t►�`;ptw,, tAURAFARIV SEAL: * My COMMISM�FF 188027 * EXPIRES:kWch 16,2018 ''�.� ��°e BadedThruBudpelM�YBavka JMEC Construction, LLC 560 NW 39 Ave. Coconut Creek,Fl.33066 License CGC 060569 305 525-1427 954 410-4695 Miami Shores Building and Zoning. Permit#RC-15-1721 Date 7/20/2015 JUL Z 0 9909 NE 4"h Ave. Rd. Miami 3138 John Ruark,owner Eric Finkelstein Pres.JMEC Construction Hereby Hold Harmless the Village of Miami Shores for any incidents at above address until issuance of approved building permit State of Florida County of Miami-Dade The foregoing was acknowledge before me on this t o day o 2015 Personally known By �.r1. �a� '....' ...... `►— � ••.• ; ... .' By t G ,S rsonally known •••••• :....: IIA Notary t ' ...... .... ..... Seal: cam;°.`° LAUEiAAFARIEY COMMISSION 1i FF 188027 * EXPIRES:Marc►16,2019 ' ��'orM.°��� BgldldTMuBndgetN�rySElviaf '••' : •• �•� • • JMEC Construction, LLC 560 NW 39 Ave. Coconut Creek, Fl. 33066 License CGC 060569 305 525-1427 954 410-4695 Miami Shores Building and Zoning. Permit#RC-15-1721 Date 7/20/2015 Please be advised we are applying for a pre- permit start approval,for 9909 NE 4th Ave.Road Miami Shores F1.33138 Eric Finkelstein for JMEC Construction 11=- 1 log --- -- State of Florida County of Miami-Dade The foregoing was acknowledge before me on this_qday of 2015 BY W onally known Notary Seal: eO P `k+ (�UpAFAiY.EY �....• W(;pMA1 ON#FF 188027 . •••• •••••• * EXPIRES: I*18,2019 • • • '�;��� (�OIIdId1hN dtid#�1 ry ••.�•• •• too*:* • August 10, 2015 Miami Shores Village Building Department 10050 NE 2nd Avenue Miami Shores, Florida 33138 Resoonses to Building Comments Permit Number: RC 15-1721 Address: 9909 NE 4th Avenue Road Building Critique: 1. See sheet A-2 for clarification: Existing wood doors to be replaced with same size doors; 2. Please see sheet A-2 for cross section of drywall soffit; 3. See sheet E-3 for locations of smoke detectors; Electrical Critique: 1. See sheet E-3 for locations of smoke detectors; Plumbing Critique: I. See sheet A-0 for corrected code; 2. See note 8 in sheet A-2 and General Note in Plumbing Fixture Connection Schedule in sheet P-1; 3. See sheets P-1 & A-1 for locations of water line and septic system (as per our meeting); 4. As per our meeting, no additional plumbing fixtures are getting added, only the relocation of the bar sink; Please do not hesitate to contact me if you have any questions and/or comments Si cerely, .•.• • • •090600 ...... go 0 • • 0000•• 0000 :.00:- • • ' Vict . Bruce A.l.. ., LE R AP 0.0'•• 0 0 0 0 0 0 •'•0 0 Vice President&Arch eect 06:64: •"' "••• AR-0017103 0000 ••••0• 0020•• • ••••r• • • • • • • 0000•• • 0 • •0 • 00* 00.0• • A&1 associates,Inc. •0• 370 NE 101-0 Street Miami Shores, Florida 33138 telephone 305-310-5030 fax 1-877-408-8280 email vbruceC4ai-associates,net