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MC-14-2592 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 e, Inspection Number: INSP-226903 Permit Number: MC-11-14-2592 Scheduled Inspection Date: January 26,2015 Permit Type: Mechanical - Commercial Inspector: Perez,JanPierre Inspection Type: Final Owner: , BARRY UNIVERSITY Work Classification: Addition/Alteration Job Address: 11300 NE 2 Avenue Thompson Hall Miami Shores, FL 33138-0000 Phone Number Parcel Number 1121360010160-02 Project: BARRY UNIVERSITY Contractor: ADVANCED HOOD SYSTEMS LLC Phone: (954)571-2339 Building Department Comments RELOCATE 1 TYPE 1 COMMERCIAL KITCHEN HOOD Infractio Passed Comments (EXISTING)AND INSTALL 1 SUPPLY FAN INSPECTOR COMMENTS False L5 Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-223942. Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. January 23,2016 For Inspections please call: (305)762-4949 Page 24 of 34 1 17 —t �rVl / l -f " Z.�T z I ADVAN04 OP ID: CE ,44Co LX CERTIFICATE OF LIABILITY INSURANCE DATE(MMMDnYM 01/19/2015 THIS CERIWICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO iRIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFIC DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR )LTE THE COVERAGE AFFORDED BY THE POLICIES BELOW. IS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BE! EN THE ISSUING INSURER(S), AUTHORIZED REPRESE ATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORT : If the certificate holder Is an ADDITIONAL INSURED,the policy(les) must be e',domed. If SUBROGATION IS WAIVED,subject to the terms d conditions of the policy,certain policies may require an endorsement. A state �ent on this certificate does not confer rights to the certificate older In lieu of such endamement(s). PRODUCER CONTACT Wilson,Wasl um and Forster NAME: Sarah J. ishbum 16505 N.W.1 Avenue PHONN .305-666 36 Af N.):305-W2-7778 Miami,FL 33,J. Was bum -m ADDDRESS:certificate ,@wwfins.com Sarah J. INSU 8 AFFORDING COVERAGE NAIC# INSURER A:Arch Spe I laity Insurance Co. 21199 INSURED dvanced Hood Systems,LLC INSURERB:WESC01 surance Company 25011 601 Lyons Road#F-4 INSURERC:Torus S clal Insurance Co. oconut Creek,FL 33073 p -INSURER D:Ascanda tCommercial Ins,Inc. INSURER E: INSURER F: COVERAGE CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO ERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOT E INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT O' OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFIC) MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES :ESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSION AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PI CLAIMS. ILTSRRE OF INSURANCE L yyyD POLICY NUMBER POLICY EFF P p EXP LIMITS A X COM IAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 -AIMS-MADE a OCCUR AGL0021147-00 01/17/2015 01 17/2016 DAMAGE TO RENTEff- ppEMISES Meoxurrence $ 100,00 MED EXP(Any one person) $ 10,00 PERSONAL&ADV INJURY $ 11000,0 GEN'L AGG MGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO- F7 POU EIJECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTH : $ AUTOMOBILELIABILITY COMB s=,SINGLE LIMIT B X ANY) O P1228297-00 01/17/2015 014712016 BODILY INJURY Per $ 1,000,000 ( person) $ ALL O ED SCHEDULED AUTO AUTOS BODILY INJURY(Per acddent) $ HIR AUTOS NON-OWNED PROPERTY DAMAGE AUTOS (per accident $ $ UMBR.LLA LIAR X OCCUR EACH OCCURRENCE $ 1,000,000 C X ESNICS, LIAB CLAIMS-MADE 876631_150ALI 01/17/2015 01117/2016 AGGREGATE $ 1,000,000 DED RETENTION$ Prods/Com $ 1,000,000 WORKERS PENSATION PER OTH- AND EMPL 'LIABILITY STATUTE ER D ANY PRO ORMARTNER/E ECUTIVE YIN N WC-63129-4 04/28/2014 8/2015 E.L.EACH ACCIDENT $ 11000,000 OFFICERIM BER EXCLUDED? N I A (MyaelaMetory andNH)er E.L.DISEASE-EA EMPLOYE $ 1,000,000 DESCRIPTI OF OPERATIONS below E.L DISEASE-POLICY LIMIT I$ 1,000,000 DESCRIPTION OF ERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be atMchad if more spice Is required) Jeff T.Sews d License#CSC1110285 CERTIFICAT HOLDER CANCELLATION MIAMIS4 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE lami Shores Village THE EXPIRATION I ATE THEREOF, NOTICE WILL BE DELIVERED IN uilding Department ACCORDANCE WITH''HE POLICYPROVISIONS. 1 050 NE 2nd Avenue AUTHOR®REPRESENT Jami Shores,FL 33138 41f1% ©1988-2 4 ACORD CORPORATION. All rights reserved. ACORD 25( 14/01) The ACORD name and logo are registered marks of CORD I Miami Shores Village wnv �' 14 Building Department r: - -_ 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 20K) BUILDING Master Permit No. I-Zl 186 PERMIT APPLICATION Sub Permit No. MQ- kq- 2- ❑BUILDING ❑ ELECTRIC ❑ ROOFING REVISION [:] EXTENSION RENEWAL ❑PLUMBING Do MECHANICAL ❑PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 11_'no0 /vim City: Miami Shores County: Miami Dade Zip: --SZ966 Folio/Parcel#: //"7,136- UO©—<DoLs Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): Q ��� C-OCL-G,� Phone#: Address: //%?00 /�e city: /`?/.div!/J���t State: G!�_ Zip: .33�� / Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: .�dy.Ib�1SysrE�s Phone#: Address: 6460f "OA45 Aeo*a j City:��/Jy7�. C .�� State: 40:2__ Zip: 3 0 Qualifier Name: -1/�Cw /• `=� i�b Q Phone#• � /''�.3 State Certification or Registration#: GAG/�I 404?.-86 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ ®� ��`� Square/Linear Footage of Work: Type of Work: ❑ Addition Alteration ❑ New `'`Repair/Replace ❑�Demolition ,,�/�,/��y Description of Work: 7E /" 7Yi�1 4qo% ����L el���`� ��j ZY2,, Specify color of color thru tile: Submittal Fee$ � Permit Fee$ E)C)CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ OG (Revised02/24/2014) Bonding Company's Name(if applicable) 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this Thae�;foreg�ing instruumeent was acknowledged before me this 30* pda_y of�TQ�_20 ly by day of Arr 20 by -SUSAA RAWKIN AL who is personally known to �zjrf Efiy9 who N'personally know to me or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Pri Vi Print: Gfl� '" SEY JEFFRY J.YAO vF Commission#EE 832519 Se MY COMMISSION#EE36M Seal: Vita a Expires Novemberl5,2016 dA� EXPUM:November 12,2014 %'/�, ��+,c°:��� Bad 7WU TMy F8W b=W= 0'VM18 IAM0.NFNO'TARY FL NWazy Dismw As=Co. �k�k�k4�k�k�k**+k�k�kAe�k�k�k�kMtN�9�ffi9�M��k+k�k�k�k�k+k&+N�k#�k+f< �k�k�k �k�k Nt.k�kAe�k ek yt8e$�k�k�k�k�k�k Nt yt�kek�kBe�N tk Kakfle tk tk gwkekBe�kAeBwk�k�k�ktle�k�kffi�k&&�k&�kN�M�ffi�N y�NeN�MeNt�lt�k&+k�k�k�k APPROVED BY Plans Examiner Zoning U I '—T Structural Review Clerk (Revised02/24/2014) C � t RICK SCOTT,GOVERNOR KEN LA ON,SECRETARY yy��g� ,[yy��a■-��� a■spCnGULA■rs■ ��y{ :f ••::.. 1!ARTIM Rnl�bP iY_ ffi6 FN As TME A aana, �M�JII MVP �ip F A3a � yti • Apy ate.� QYONVROAV d �`�.,,,.,��'T ,vw,.._... ,.Waw.�,.�:�.�.h.....r......a»r�a. w�� � ev.._. ...� .��%�.-.-a�v.:�. �.e�.� °,`��-•.. <�„_��...���'�?�..:�.-�„f.,�k�e.�",.c.9.,�.�.v_".�...5... �-3.1Waw,'�v+,.,':'.w����+�� ISSUED; 060=14 DISPLAY A$REQUIRED BY LAW SEC 0 L1406220001483 a ----Ilk _C . I 1 115 S.Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 9.5"31-4000 VALID OCTOBER 1,2014 THROUGH SEPTEMBER Sit,2015 DBA: R apt : Bualn daaa . VANC D HOOD SYS LL ALLO HETYPES C0_ RI TYPO:(SHEET MAL COQ CT ) Owner Name:jsFF THom mm Business Cpe :07/10/2009 Business L n:6 01 LYONS RD F4 S rttY/ :CSC11.1,0295 COCONUT CREEK Exempffon Collo: Business Ph0n0:954- 71-2339 ROOM SeatsEmployees ls 7 fery only 14�nt�r+�i�ctr VeinfinoType.. TaxAmunt Trsn F NSF F eir r Y00r aM t Tout Paid 27.00 0.00 0.00 0.66T 0.00 0.00 27.00 THIS RECEIPT MUST BE POSTED ONSPICU USLY IN YOUR PLACE OF BUSINESS MIS BECOMES A TAT(RECEIPT Ttris tax Is levied for ft privilege of doing business within Bmward County and Is non-vegulatory in nature.You must meet an County and/or Municipality planning WHEN VAUDATED and zoning FequIrements.Tads Business Tax Receipt must be trarderred when the business Is sold, business a has dwqed or you have moved ft business location.This recelpt does not Indicate ttW the business Is legal or that it Is in compliance with State or local lam and regulallons, Mailing Ad JEFF THOMAS SEWARD Receipt OIA-1.3-00005814 x 4601 LYONS RD t#F-4 Pal. 08/07/2014 27.00 COCONUT CREEK, FL 33073 2014 - 2015 CERTIFICATE OF LIABILITY IN 111/06/14/06/14 URANCE aATE( THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIG UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE OVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEE THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certiflmte holder is an ADDITIONAL INSURED,the pollcy(les)must be endorsed. if SUB OGATION IS WAIVED,subject to the terns and conditions of the policy,certain policies may require an endorsement A statement on this cats does not confer rights to the certificate holder in Ileu of such endorsement(s). ME PRODUCER CONTACT TRICIA C TERA Nations Best Insurance PH NE (954)61 09 FAX No): (954)289-8107 6508 SW 39 Street EL tricla@ nsbest corn Davis,FL 33314 INSU 9 AFFORDING COVERAGE MAIC B Phone 954 289-8104 Fax 954)616-8514 INSURER A: ASCEND COMMERCIAL INSURANCE 13683 INSURED INSURER B: ASCEND COMMERCIAL INSURANCE 13683 Advanced Hood Systems,LLC INSURER C: ASCEND COMMERCIAL INSURANCE 13683 6601 Lyons Road F4 INSURER D: ASCEND COMMERCIAL INSURANCE 13683 Coconut Creek,FL 33073 (954)571-2339 INSURER E: MAI I RNATIONAL INSURER F• COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INS RED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR R DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIB D HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID MS. INSR TYPE OF INSURANCE ADD UBR POLICY NUMBER 4wooY EFF P p EXP LIMITS LTRvim GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000.00 E TO Q COMMERCIAL GENERAL uABiLnY DREAMS S f RENTED $ 100,000.00 A [-] E] CLAIMS-MADER OCCUR N N GL-36722-3 01/17/2014 01/ 7/2015 MED EXP(Any one person $ 5,000.00 PERSONAL&ADV INJURY $ 1,000,000.00 ❑ GENERAL AGGREGATE $ 2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 1,000,000.00 ❑ POLICY ❑ PRO- ❑ LOC $ AUTOMOBILE LIABILnY �MB�IN�D INGLE LIMIT 1,000,000.00 n ❑ ANY AUTO BODILY INJURY(Per person) $ B ❑� �OOSS AAUTOS SCHEDULED N N CA-28996-3 01/17/2014 01/ 7/2015 BODILY INJURY(Per ddent $NON-OWNED FHIRED AUTOS ® (fir RO=J.Y AMAGE $ El I UM see $ 500,000.00 ❑ UMBRELLA LIAR ❑OCCUR EACH OCCURRENCE $ 1,000 000.00 d EXCESS LIAR G L-36722-3 C ❑ CLAMS-MADE N N 01/17/2014 017/2015 AGGREGATE $ 2,000,000.00 DED rm RETEoN s Products Aggregate $ 1,000,000.00 WORKERS COMPENSATION ElH WC 3TATU ❑OE AND EMPLOYED'LIABILITY Y I N D ANY PROEW RIETO R EXCLUDED? N/A N EC�E WC-63129 E.L.EACH ACCIDENT $ 1 0001000.00 04/28/2014 04 8/2015 (Mandatory In NH) ® I E.L.DISEASE-EA EMPLOYE $ 1,000,000.00 If yyeeaa,dead oft under DESCRQ�TION OF OPERATIONS below E.L.DISEASE-POLICY uMIT $ 1,000,000.00 E CONTENTS BPP N BEA10575 10/19/2014 10 9/2015 LIMTT:$115,000/DED$1,000 THEFT INCL. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,N more space is j oquired) Contractor License#CSC1110285 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village Building Dept THE EXPIRATION DAI E THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH E POLICY PROVISIONS. 10050 NE 2nd Ave Miami Shores,FL 33138 AUTHORIZED REPRESENT Tricia Catera B It W2010 ACORD CORPORATION. Ali rights reserved. ACORD 25(2010/05)QF The A ORD name and logo are registered marks of ACORD ii I I I