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CC-16-24 (2) Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756.8972 Inspection Number: INSP-256402 Permit Number: CC-1-16-24 Scheduled Inspection Date:April 08,2016 Permit Type: Commercial Construction Inspector: Rodriguez,Jorge Inspection Type: Final Owner: , BARRY UNIVERSITY Work Classification: Addition Job Address:11300 NE 2 Avenue Wiegand&Annex Miami Shores, FL 33138-0000 Phone Number Parcel Number 1121360010160-09 Project: BARRY UNIVERSITY Contractor: INTEGRAL SOLUTIONS GROUP CO Phone: (786)402-1140 Building Department Comments BUILT-IN KIOSK FOR THE SALE OF SANDWICHES SODA Infractio Passed Comments JUICE COFFEE&PASTRIES. INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-256266. CREATED AS REINSPECTION FOR INSP-256192 Must pass fire No permit/contractor on site Failed Correction ❑ Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid April 07,2016 For Inspections please call: (305)762-4949 Page 18 of 27 y Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-256402 Permit Number: CC-1-16-24 Scheduled Inspection Date:April 08,2016 Permit Type: Commercial Construction Inspector: Rodriguez,Jorge Inspection Type: Final Owner: , BARRY UNIVERSITY Work Classification: Addition Job Address:11300 NE 2 Avenue Wi'egand&Annex Miami Shores, FL 33138-0000 Phone Number Parcel Number 1121360010160-09 Project: BARRY UNIVERSITY Contractor: INTEGRAL SOLUTIONS GROUP CO Phone: (786)402-1140 Building Department Comments BUILT-IN KIOSK FOR THE SALE OF SANDWICHES SODA Infractlo Passed Comments JUICE COFFEE&PASTRIES. INSPECTOR COMMENTS False Inspector Comments CREATED AS REINSPECTION FOR INSP-256266. CREATED AS Passed REINSPECTION FOR INSP-256192 Must pass fire A9 No permit/contractor on site Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid April 07,2016 For Inspections please call: (305)762-4949 Page 18 of 27 a F a Miami Shores Village 10050 N.E.2nd Avenue NE ; Miami Shores,FL 33138-0000 i`" Phone: (305)795-2204 ,r Expiration: 08131/2016 Project Address Parcel Number Applicant 11300 NE 2 Avenue Number: Wiegand &Anr 1121360010160-09 BARRY UNIVERSITY INC Miami Shores, FL 33138-0000 Block: Lot: Owner Information Address Phone Cell BARRY UNIVERSITY INC 11300 NE 2 Avenue MIAMI SHORES FL 33161-6628 11300 NE 2 Avenue MIAMI SHORES FL 33161-6628 Contractors) Phone Cell Phone INTEGRAL SOLUTIONS GROUP CO (786)402-1140 Valuation: $ 15,000.00 Total Sq Feet: 150 Approved:In Review Available Inspections: Comments: Inspection Type: Date Approved::In Review Final Building Date Denied: Second Floor Slab Type of Construction:BUILT-IN KIOSK FOR THE SALE OF Occupancy Load: Second Floor Tie Bond Beam Stories: Exterior. Final PE Certification Front Setback: Rear Setback: Shutter Final Left Setback: Right Setback: Tie Beam Bond Beam Plans Submitted:Yes Certification Status: Window Door Attachment Certification Date: Additional Info: Slab Bond Retum: Classification:Commercial Termite Letter Scannin :5 Framing mill Insulation Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Floor Trusses CCF $9.00 Drywall Screw DBPR Fee $6.75 Invoice# CC-1-16.58242 Trusses Plan Submittal DCA Fee $6.75 03/04/2016 Credit Card $427.50 $200.00 Roof Sheathing Education Surcharge $3.00 01/07/2016 Credit Card $200.00 $0.00 Spot Survey Notary Fee $5.00 Wall Sheathing Permit Fee $450.00 Shutter Attachment Pian Review Fee(Engineer) $120.00 Rake Beam Scanning Fee $15.00 Footing Technology Fee $12.00 Window and Door Buck Total: $627.50 Roof Trusses Density Fill Cells Columns Wire Lathe Stem Wall Footer Review Electrical Review Electrical r Review Structural Review Plumbing Review Plumbing Review Planning Review Building Review Building Review Mechanical In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations March 04,2016 1 Miami Shores Village g L JAN 07 2015 J,9 Building Department X;F \ 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Y: Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 BUILDING Master Permit No./)2 4-4— 2 PERMIT APPLICATION Sub Permit No. NBUILDING []ELECTRIC ❑ ROOFING ❑ REVISION [:)EXTENSION ❑RENEWAL PLUMBING MECHANICAL ❑PUBUC WORKS ❑ CHANGE OF ❑CANCELLATION [:] SHOP CONTRACTOR DRAWINGS SOB ADDRESS: Viegand-Le Cafe- 11300.NE 2nd Ave City Miami Shores County: Miami Dade Zio: 4, d Folto/ParceW#. ®!',2S36 m a®D - OP.00 js the SuiM ng Historically Designated:Yes NO X Occupancy Type: Load: Construction Type: r�3A Flood Zone: BFE: FFE: OWNER:Name(Fee simple Titleholder):Barry University oda :5Cq one# 305-899-3V5 ' 3 Address:11300 NE 2nd Avenue City. Miami Shores State• FL gyp: 33161 Tenant/Lessee Name: Phone#: Email:1po@barry.edu CONTRACTOR:Company Name: l.0 to( 6o6.4os 6 �, Co Phone#: •,r iz.a� Address. E ,g2 City: zip: 3,316 2. Qualifier Name: - Phone#.. State Certification or Registration#: CGc. t Sb9 42,X- Certiflcate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for thIs Permit:$ Square/Linear Footage of Wait 150 5 e. Type of Wait: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: ,0111-T W AC9W --5046 aZ �aJ,&-Ay SpecW color of color thru We: submntai Fee$ PermIt Fee$ •G�) CCF$ ` ' CO Co/Cc$ 0 'GQ) Scanning Fee$1� ��� Radon fee$ G DBPR$ 6 ---�S3 0D Notary$ Technology Fee$ clJ Tralnin$/Education Fee$ Double Fee$ Structural Reviews$,Q-0 -00 Bond$ rA 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$25W,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 A ENT �ONTRACIOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this �_day of A?49-C• .20 by ` '��day of 201 ,by B 6=who is personally known to �1 tT�z. � 6.�� who is personally known to me or who has produced - as me or who has produced -- V — as �\��tilti t�!►1/!// Identification and who did take an oath. identification and who did take an NOTARY PUBLIC: NOTARY PUBLIC: 0612416 ''• Si Sign: � '�� Qu���C• _ Print: Print: etw�113959:'pQ Notary Public State of Flora Seal: Joanna M Feliciano ? ` My Commission FF 082753 w no Expires 01/12/201 444 � • 4 144444 444 4444444444444#4444444444444444#44444444444444444444444444444444444 APPROVED BY Plans Examiner Zoning _ Structural Review Clerk (Revised02/24/2014) STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD 850) 487-1395 a CONS f 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 DEPRADINE NAVAS,VICTOR ANTONIO INTEGRAL SOLUTIONS GROUP CO 1680 NE 168TH STREET NORTH MIAMI BEACH )FL 33162 I I CongratuWwns! W4h V w license you become one of ttee hearty one mnkm t taidians ficensed by the Doportrment of Business and Professional R lion. Our professionals and tursineases range 'fir STATE OF FLORIDA Won arm to yacht txokWS.Irw boxers to bareeque nts. DEPARTMENT OF BUSINESS AND and they keep Floridn's economy PROFESSt lAL REGULATION Emery clay we work to improve the way we do business in order to CGC1509425 "-ISSUE 07/17%2014 seas you better. For irdorrr"an about ow services,plane tog ontoV www.mylUrl�lleenswoo:n. Thera you teen rid more inWmateon CERTIFIED GEIS.COt�TOR about our diviso' ne and beet�tions that impact you.�soibe DEPRADINONTO to department nee ors=loam more about the Department's INTEGRAL E initiatwes Our mission at the Department is 1.4efte Efhoenfty.Regulate Fairty. Ift cornta sb*e to you bettor so that you can serve year customers. TWk you for doing business in Florida, is caRric'IEQ v"del tilt wo.,siane or cre 4e9 rs and cons ony our now License, a rwo Aun3r ..h., 4 aT�rcw��a+ DETACH HERE RICK SCOTT.GOVERNOR KEN LAWSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUGTm INDUSTRY LICENSING BOARD CGG 19t!'8429 The GENERAL CONTRACTOR Named tv IS CERTIFIED Under Ste Iu'OvWonls of CtwgW 489 FS. Expiration daft: AUG 31, 2016 OEPRADINE NAVAS.VICT ANTONIO INTEGRAL.SOLUTIONS GROW CO � 1680 NE 168TH STREET, ,. NORTH MIAMI SEACM FL 33162 i M IM rsa,+rnn+d ni t`.Ot AY AC Rr-ni IIRFn Ry I AW ecn a I rata+aznn++art Local BusinessTax Receipt Miami—Dade County,State of Florida [LBT THts IS NOT A SU-DO Pf0'C PAY 66608964 I3u411BIIEsS toAlocaTION RECEIPT aro. EXPIRES t NTEGNS GROUP FiAt.Soi.uno RENEWAL .� SF..F�TEMBER 30, 216 CO :: 584 73 be delayed at place of business 250 'E,152 STREET Purs6ht to County Code lU[(AMI,f L 33162 Chapter Ba-Art.9&10 OWNER SEC.TYPE OF BUSINESS PAYMENT RECEIVED INTEGRAL SOLUTIONS GROUP CO 196 GENERAL BUILDING BY TAX COLLECTOR CONTRACTOR 156.25 02/12/2016 Workers) 1 CGC1599425 0247-16- 2423 This Local Buslom rax Receipt.Iy coallgea pepaeat of tre Local Boalne s rax.The Receipt is act a I1001130. peredt or a owdRcaton ol1Ue holder's 10 do business.Holder must cOrePip with my 601=1008'4or aongo l regulatory laws and requbantsulawbiab apply to the buslum The RECEIPT N0.abo+re=W be displaredon ell oommere10l wddol"-MkMl-DWe Code SaaBe-M MUkf4® For.mre hdomretlou,vhdt ` CERTIFICATE OF LIABILITY INSURANCE F DAO2J16/�16'" PRODUCER Capital Insurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1940 NE 163rd Street HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Nath N wd Beach,FL 33162 &MR T14E COVERAGE AFFORDED BY THE S BELOW. Phare(305)944.4416 Fax (305)944.5519 INSURERS AFFORDING COVERAGE NAIC# • Accident Insurance INSURED Integral Solutions Group In�ctor Depradine INSURER B: 1680 NE 168th Street INS R Q. North Miami Beach, FL 33162 (786)402-1140 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAD CLAIMS. INSR ADIYLTYPE OF INSURANCE POLICY NUMBER DATE��� DATE EXW1YY ad LIMITS GENERALUABIL17Y EACH OCCURRENCE 1,000,000.00 AMA® ENT COMMERCIAL GENERAL LIABILITY CPP 0017046-01 10/07/2015 10/07/2016 PREMISES TO a oecur�r mm 100,000.00 Ell] CLAIMS MADE ❑ OCCUR MED EXP(Anyone Pte) 5,000.00 A ® ❑ PERSONAL&ADV INJURY 1,000,000.00 ❑ GENERAL AGGREGATE 1,000,000.00 GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG 1,000,000.00 ❑ POLICY ❑PROJECT ❑ LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ❑ ANY AUTO Ea accident) ❑ ALL OWNED AUTOS BODILY INJURY ❑ ❑ SCHEDULED AUTOS Per ❑ HIRED AUTOS BODILY INJURY ❑ NON OWNED AUTOS (Per accident) ❑ PROPERTY DAMAGE Per accident GSE ILrrY AUTO ONLY-EA ACCIDENT ❑ ❑ ANY AUTO OTHER THAN EA ACC ❑ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE ❑ OCCUR ❑ CLAIMS MADE AGGREGATE ❑ DEDUCTIBLE ❑ RETENTION $ WORKERS COMPENSATION AND ❑ WC STAT ❑ OTH EMPLOYERS'LIABILITYFIR ANY PROPRIETOR/PARTNER/EXECUTIVE YM E.L.EACH ACCIDENT OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE If yes desPRbe*under E.L.DISEASE-POLICY LIMIT OSIONS below OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Certificate Holder is not an additional insured. Uc#CGC1509425 CERTIFICATE HOLDER CANCELLATION MOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL City Of Miami Shores 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO 10050 NE 2nd Avenue TAT,�T FAILURE TO Do SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Miami Shores Villages, FL 33138 AUTHOROM REPRESENTATIVE Fax 305-756-8972 ACORD 25(2008/01)OF ©1988-2009 ACORD CORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD I ..., p, 1A Miami shores Y Building Department �ART1 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305)795.2204 Fax: (305)756.8972 Notice to Owner — Workers' Compensation Insurance Exemption ,t - f 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 BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: Owner State of Florida County of Miami-Dadei�, The foregoing was acknowledge before me this ! " day of�2i1AA ,20_t� . By Su f?A-%hMA(, who is personally known to me or has produced as identification. No y Smimeo RR 1tN1 s 11/1�1b INTEGRAL SOLUTIONS GROUP, Co. Construction,Inspections&Engineering Contractors 250 ne 152 street Miami,Fl. 33162 Ph: 786-402-1140 Date: 02-17-16 State of Florida County of Miami Dade Before me this day personally appeared Victor Depradine who,being duly sworn, deposes and says: That he will be the only person working for Integral Solutions Group, Co on the project located at: 11300 ne 2 Ave. Nfiami Shores Fl. 33161 (Barry University Le caf6 International) Sworn to and subscribed before me this day of e 2016,by 2 Personally know Or Produced Identification Type of Identification Produced [010 ,�� stir Notary Public State of Flora Joanna M Feliciano My Commission FF 082753 �,0 Expires 0 1/1 212 01 8 Print, Type or Stamp Name of Notary A 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 listed below has elected to be exempt from Florida Workers'Compensation law. EFFECTIVE DATE: 2222016 EXPIRA71ON DATE: 2212018 PERSON: DEPRADINE VICTOR FEIN: 202857856 BUSINESS NAME AND ADDRESS: INTEGRAL SOLUTIONS GROUP CO 250 NE 152 STREET MIAMI FL 33162 SCOPES OF BUSINESS OR TRADE: LICENSED GENERAL CONTRACTOR Pursuant to Chapter 440.05(141 F.S.,an officer of a corporation who elects exemption from anis chapter by fikg a certificate of election under this section may riot recover its or oompensation urxier this chapter Punward to Chapter 440 05(12),F.S.,Certificates of election to be exempt...apply ordy win the scope of the bu mess or trade faded on the notice of election to be exempt.Pursuant to Chapter 440.05(131 F.S.,Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if,at any time atter the fftq of the notice or the krsLwm of the cerci=W the person named on the notice or certifxate no forger meets the requirements or this section for issuence of a certificate.The department shall revoke a DFS-F2-DWG252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS?(850)413-1609 r R Miami Shores Village Building Department evil is���M 10050 N.E.2nd Avenue Miami Shores, Florida 33138 tiee� Tel: (305)795.2204 IORIDA Fax: (305)756.8972 BUILDING CRITIQUE DATE: 02-09-2016 PERMIT NUMBER: 16-24 1. License contractor required for the project. w Miami Shores Village Building Department �►LO�tIVA 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305)756.8972 RECEIPT PERMITM Z`{ DATE: I, ❑ Contractor ❑ Owner Architect Picked up 2 sets of plans and (other) Address: r S't From the building department on this date in order to have corrections done to plans And/or get County stamps. I understand that the plans need to be brought back to Miami Shores Village Building Department to contiZpeg;, ss. Acknowledged by: PERMIT CLERK INITIAL: RESUBMITTED DATE: r I PERMIT CLERK INITI