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ACT-15-2756 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-246808 Permit Number: ACT-10-15-2756 Scheduled Inspection Date: December 02,2015 Permit Type: Awnings/Canopies/Tents Inspector: Rodriguez,Jorge Inspection Type: Final Owner: HARKRADER, EDWARD Work Classification: Repair Job Address:806 NE 97 Street Miami Shores, FL Phone Number Parcel Number 1132060142760 Project: <NONE> Contractor: MIAMI AWNING CO Phone: (305)576-2029 Building Department Comments FABRIC RECOVER FOR FRONT ENTRY DOOR AND Infractio Passed Comments REAR INSPECTOR COMMENTS False P ctorComrrents Passed �- � L Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. December 01,2015 For Inspections please call: (305)762-4949 Page 17 of 40 Miami Shores Village Building Department aof'A 9201155 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 BUILDING Master Permit No. AC`(- 1'5— 2-756 PERMIT APPLICATION Sub Permit No. 'BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL PUBLIC WORKS r-� CHANGE OF FICANCELLATION FISHOP p CONTRACTOR DRAWINGS JOB ADDRESS: 8 C)ce City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 14( -16 a®G Q®f--' ® Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder):f—')t4h" [-- ;4&VWRAX C� Phone#:%66- 24r"-2500 Address: V7,5715 Oul 6 ,&,khE City: H 0i, "( State: '� Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name:_ I 4°�ECI,i�Z Ce, Phone#: �C2�-'�a� 2 0 17 Address: o)qoj� t"L vi City: 1.1S,NL! State: Zip:°?J`3 '2. Qualifier Name: LC't'tA,V--L-- Phone#: '-b-05 'X5-16"2-®9-7 State Certification or Registration#: Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ �-C 00 O G quare 'near Footage of Work: ® Type of Work: ❑ Addition ❑ Alteration ❑ New Q Repair/Replace ❑ Demolition Description of Work:-FA 6 at e-- V-VE(5d\(EV' Tf-�'- t-L`r E"-C�Z`� Specify color of color thru tile: Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (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 The foregoing instrument was acknowledged before me this �2 day of ��PT"t!ZF- 20 15 by ,,24A2 STeN.00�day of 0P .20 15 by M who is personally known to IC4+b9L gC6Ly 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 PUBLIC: NOTARY PUBLIC: Sign: Jzaynkc Sign: Print: Print: >� ttrae Seal: r Notary Public state of Florida �^ Ted A Linze Seal: 0 v Notary public state of Florida y, My Commission FF 015054 ^ Ted A Linze �eoP po Expires 06/3012017 �y, a My Commission FF 015054 Expires 0613012017 APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) MIAMAWN-02 WENDY .4CORv" CERTIFICATE OF LIABILITY INSURANCE DATE 1022/20151f) 10/22/2015 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 lieu of such endorsement(s). PRODUCER CONTACT NAME: Acrisure,LLC dib/a InSource PHONE 305 670-6111 FAX 9500 South Dadeland Boulevard .No.FA:( ) AIC No):(305 670-9699 4th Floor ADDRDRESS:email@lnsource4nc.com Miami,FL 33156-2867 INSURER(8)AFFORDING COVERAGE NAIC S INSURER A:FCCI Insurance Company 10178 INSURED INSURER B:National Trust Insurance Co. 20141 Miami Awning Co.;Miami Beach Awning Co.,Inc.dba INSURER C:Zenith Insurance Company 13269 3905 N.W.31 Avenue INSURER D: Miami,FL 33142 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 ADOLSUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVQ POLICY NUMBER W=DIYYM (MM/DDIYYMLIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 CLAIMS MADE 0 OCCUR GL00109246 10/1312015 10/13/2016PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEML AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICYJET E LOC PRODUCTS-COMP/OP AGG $_ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBBIINED SINGLE LIMIT $ 1,000,000 (Ea adent A X ANY AUTO CA001697506 10/13/2015 10/13/2016 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per accident) $ XX NON-OWNED PROPERTY accident) DAMAGE $ HIRED AUTOS AUTOS X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,00 B EXCESS UAB CLAIMS-MADE UMB00114176 10/13/2015 10/13/2016 AGGREGATE $ 5,000,000 DED X RETENTION$ 10,000 $ WORKERS COMPENSATION X STATUTE ER AND EMPLOYERS LIABILITY C ANY PROPRIETORIPARTNERIEXECUTIVE YIN Z065165613 10/13/2015 10/13/2016 E.L.EACH ACCIDENT $ 1,000,00 OFFICER/MEMBER EXCLUDED? NI N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,00 Use describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,00 A Equipment Floater CM00056856 10/13/2015 10/13/2016 Scheduled 172,58 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached N more space is required) Miami awnings manufacturer and contractor of fabric awnings. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village Building Department THE EXPIRATION' DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 NE 2nd Avenue ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores,FL 33138 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD y CERTIFICATE OF FLAME RETARDANCE MIAMI AWNING ISSUED TO: INNOVATIVE 1NDUSTMAL SOLUTIONS 3020 HIGH RIDGE ROAD NUMBER: BOYNTON BEACH, FL 33426 DATE: 04-15-2013 #76054 THIS CERTIFICATE OF COMPLIANCE IS ISSUED TO VERIFY THAT THE ITEMS OR AREAS DESCRIBED BELOW ON THIS CERTIFICATE HAVE BEEN TREATED WITH FLAME COATTm. FLAME COATTm IS A CLASS A FIRE RETARDANT. De$cr tione�iri t�ructu re, etc• p see 44.• itA1 S OF SUNBRELLA CAPTAINS NAVY, TREATED W/FLAMECOAT IstF.P.A. 701 SMALL SCALE, CLASS A. A.S.T.M.E-84, FLAME SPREAD:10 SMOKE DENSITY:25, :..•. . .. .. 6YTER FLAME AVG:0.0 sec CALIFORNIA TITLE 19 SECTION 1237, CALIFORNIA TB 117E PERMENANT TREATMENT/WILL NOT WASH OFF FOR INTERIOR&EXTERIOR USE GtST�� r. 0 •00 04-15-2013 !� of catj,� 0000• •�•• 0000•• ��. •7Z ISSUED BY: 00000 • '•' i 1 • OCT 2 2dr 9'F� A�h� • �� IR _ Pa t ?ETP` ur.-1201.01 521-F Eagleton Downs Drive ,, ,.. Pineville NC 28134 (704) 543-0903 LMR&ces Director GA-1201.01(General)Note:Fabrics and/or materials described on this certificate are intended for interior use unless otherwise stated. Due to the number that can diminish flame M retardancy,this fabric should be periodically retested to insure it retains its effectiveness. We do not warrant the length of time that the fabric remains fire retardant. We do state that when it leaves our facility,it meets the stated code. Certificate void if material is exposed to open flame or extremely hot lights or electrical wiring. co 0 0 N Lo v- N ILL. NE 97TH STREET N o a o Z 0 0 � W I-- W CUP '' ' 101 3 �- OCT 2g2015 L 102-P � Z Oq 9 o T a o R 0 EXISTING RESIDENCE co 12 @ 806 NE 97TH STREET, -- _ w " U MIAMI,FL 33138 co SL \ J 2 o 0 o SL 'c SL 13" 4 � � � �� Z 4 l W z 102 ISOMETRIC 1 0- � a N o __ _®_ z 23. w 4a g 1-0 19 �_ � I ° o a v o FABRIC L INE ' 2 ' > ' ^ i ,�. v Q c 5 C a � ,CT/P __ 3 ., cl 12" RDPE QN Lu O WZ � � INS U > Q `c DETAIL VALANCE 6'' Z Mao 2 LL. LL 2 1"o A :z 12>> RAE � � O VA T RECOVER OseeNLY.see SL 12" ,P-o � yrX NO STRUCTURAL:A. L:�EMTI0NS:TO SLBif EXISTIN(j*FPAME: 37,= FABRIC TO BE*8WN f E�L;A.; 101 ISOMETRIC COLOR TO BE OCEAN'N'BLU #N79. s —1-0 t