Loading...
DS-14-695 "l laf Miami Shores Village �cE Building DepartmentApR o 2014 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 BY; INSPECTION'S PHONE NUMBER:(305)762.4949 FBC 20k'9 BUILDING Permit No. PERMIT APPLICATION Master Permit No. I ` (001 S Permit Type: RAILWIP i UK � , 1mw JOB ADDRESS: 2, A•w 03 ';"r. City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes Flood Zone: OWNER:Name(Fee Simple Titleholder): AP RS*LX'7 I-P Phone#:—` "9-* 777 3 3)cd Address: i2w b,- a is C&w a %'L_Y"a * ;?o� City: /r/Is A^na% State: P + Zip: Tenant/Lessee Name: /zIA Phone#: Email: ,XA viV2 C4 P Aon.. e.,,m CONTRACTOR:Company Name: ry IV•Ny Q :f.4,! tAmALg i.vim Phone#:3 —1y Z Address: 1'7 q q N l v d"74 S 1 City: /I i�M State: Zip: 3317-C Qualifier Name:T E7 PA7- ED GAA A Phone#: State Certification or Registration#: Certificate of Competency#: bD g Contact Phone#: o r 7 3 7 Email Address: e,QAI_kV a It t kV LnM DESIGNER:Architect/Engineer: N Phone#: Value of Work for this Permit:$ �' Square/Linear Footage of Work: Z Se. 5 �- Type of Work: OAddition OAlteration 5Wew A<epair/Replace ODemolition Description of Work: Wo-%-e- Gs.. .[i A-tl .s,of.,&C' nA.'iryr -A.&,% l&c. oGf)' .M�n•....; f7A,.'r_re,� Ari P14AA'r *--1 co•- .. 1P�T 4 Color thru tile: Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ t Bondig Company's Name(ifapplicable) Bonding Company's Address City a n 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 aseparat tq ELECTRICAL WORK,PLUMBING,SIGNS, WELLS,POOLS,FURNACES,BOILERS,HEATERS,T S,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 reinspec ' n fee will be charged. Signature Signa �h o Owner or Agent v `rt on actor The foregoing instrument was acknowledged before me this \ The fo mg instrument was acknowledged before me this day of Aft - ,20�L,by K4WI M G j .Uir-Vy1day of APS..L ,20#,by Q r' PA2 who is personally known tome or who has produced �-'tQ. wh s personally kno�TFFRZication tomewho hasproduced As identification and who did take an oath. and who did take an oath. NOTARY PUBLIC: ��>>ui urrpNOTARY PUBLIC: Sign: �/ Sign: Ira Print: - 16 = Print: LLE My Commission Expires: ��c�'�F�jjC My Co s +ps � 011-'' EXPIRES June 27,2015 Fl 0 R APPROVED BY + Plans Examiner � . [ l� Zoning Structural Review Clerk (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) r '° ,' CERTIFICATE OF LIABILITY INSURANCE °A�o`M4�o r14° ) 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. It 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 endorsemerd(s). PRODUCER WEACT Insure Safe Inc 09%. . (305)303-7080 FAX No): (786)362-6474 2246 SW 57th Avenue ADDRESS& insuresafeinc@yahoo.com Miami,FL 33155 INSURER(M AFFORDING COVERAGE NAIC 0 Phone (305)303-7080 Fax (305)267-4206 INSURER A: QBE Specialty Insurance Company 11515 INSURED INSURER B: Bridgefield Employers Insurance Company 31267 Sunny Brick Pavers,Inc. k 'i SRC: E ' 1744 NW 6th Street ': I :R D t.:_ . :!r Miami,FL 33125 (305)742-3374 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. IOLIC E$R TYPE OF INSURANCE ADD UBR POLICY NUMBER M POLICYEFF PMIDD EXP LIMITS 'K GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000.00 ® COMMERCIAL GENERAL LIABILITY PREMMISES(Eaoccurrence) $ 100,000.00 ❑ F-1CLAIMS-MADE [:] OCCUR SCL0001741-01 09/21/2013 09/21/2014 MED EXP(Any one person) $ 5,000.00 A ❑ PERSONAL&ADV INJURY $ 1,000,000.00 ❑ GENERAL AGGREGATE $ 2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUOTS-OOMP/OP AGG $ 2,000,000.00 ❑ POLICY ❑ PRO ❑ LOC $ AUTOMOBILE LIABILITY CO,Msodd�D SINGLE LIMIT $ ❑ ANY AUTO BODILY INJURY(Per person) $ ❑ AALLL,TOWNED ❑ SACOESDULED BODILY INJURY(Per accident) $ ❑ HIRED AUTOS [:1 AUTOS NED P�aPERdYMAGE $ ❑ ❑ $ [:] UMBRELLA LIAB [:]OCCUR EACH OCCURRENCE $ ❑ EXCESS LIAR ❑CLAIMS-MADE AGGREGATE $ ❑ DED ❑ RETENTION$ $ WORKERS COMPENSATION ®WC STATU- ❑OM EMPLOYERS'LIABILITY Y I N B ER OFFICEWMEMBER�EXCLUDED?�EOUTNE NIA 83048125 05/17/2013 05/172014 E.LEACH ACCIDENT $ 1,000,000.00 (Mandatory in NH) a E1-DISEASE-EA EMPLOYE $ 1,000,000.00 If yes describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000.00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACach ACORD 101,Additional Rernarks Schedule,If more space is required) Brick Paving Installation CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Buildin g Department ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd Avenue AUTHORIZED REPRESENTATIVE Miami Shores,FL 33138 4044-w a. ©1888-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05)QF The ACORD name and logo are registered marks of ACORD ro= CTQ rrac*s „, � , BUSINESS CERTWICA `E, OF COMPETENCY 0 8 B 0 0 958 �a �bINt(l;` K NAN. ERS INC ,.ta .. D.B .A. : DIE PAZ EDGAR Is certified under the provisions ns f Cha r 10 of Miami- F y , «y. s a� 17775IV,7-si 75 `4. 'TA "1 3 S{,t� rl.k. E T i y L i U 44h Luca l 13ur - 0s Tac Receipt Miami—Dade County, State 4f Florida THIS IS NOT A BILI DO NOT PAY 60972:24 IRUStNESS NAME/LOCATION RECEIPT NO. SUNNY BRICK PAVERS INC RENEWAL EXPIRES OPERATING IN DADE COUNTY 635 855 SEPTEMBF-R 3Q, 20-14 MIAMI, FL 33999 Must be displayed at Place o#business Pursuant to County Code Chapter SA -Art_ 9&10 OWNER SEC. TYPE OF BUSINESS SUNNY BRICK PAVERS INC 196 SPECIALTY BUILDING PAYMENT RECEIVED BY TAX COLLECTOR CONTRACTOR Worker(s) 08 8500958 75.00 09/30/2010224-13-00142 This Local Business Tax Receipt only confirms payment of the local Business Tax,The Receipt is vial a license, ermit,or a certification of the holder's qualifications,to do business.Holder must comply with any%%vetnhvievital qtr nongovernmental regulatory laws and requirements which apply to the business, The RECEIPT N0. above must be displayed on all commercial vehicles-Miami-DAIlt Code SocBn-TX. MtAMt Far more information,visit www.miamid> dam. o aWik a �,. � ,:,,., m...:.�, ... .. ,.. ,�... ,x..�, vR t _ ,.,. ..., ,,„... ... t_-i, fs x pa A t^ � � � _ " �e � t _. k r �. � f a -' ..�..`. ..x m� r, ., +....=,.�`e .. y a, .. .. �t .gin � ,y - V A IIS t' Municipal Contractor's Tax Receipt Miami--f?odoCounty, Stolo (it VIllti6f, Ib hIU NO t A(Yl A.s 110NO 1 i'AV 0:'NO 0wkmltri�o, - -- — RVOINS rf.NAMSn Cil-a fMAN N A f�- EXPIRES an1N't WICK PAW W, wSF_PTF�:MB R 30, 2014 'Y,.F11 T Ai !!dSI r,W .; N ,��L14 Iri:;.i t5 /I Ali stI'1 h43.TR NA,W 1'.w A1UTA.ylu1 M I t d Y.u.M.♦w 1'�u wu.nt Av C.e uieq C"sem!• tt�Nt+si DA. Ai+.9b 1Q Owm,'7 YYY'R Of IIUfNNiv an PAYMf.NT RRCt tVi.17 1+Fdtir tUti< t t. t,> Y�x `-I`t(11MI'Y(SUtLI3NP Ct:fil'fBV fAntot k's(JWA Ir'ol(i rturtf��� 1.r rna 1.1•A adb+.WNt W W w mi r MId r,Ai Seri IMx4e11sRttY 17M m I Miami Shores Village Building DepartmentZE 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 1® BUILDING Master Permit No. PERMIT APPLICATION Sub Permit No. UILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS VCHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: AIL4/ I (?S 5T, City Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): CA P 0 C-87, _\1 1,C Phone#: Address: 00 -to '7-y City: /14 AAA,- State: 'EL. Zip: Z Z I K Tenant/Lessee Name: //a A. Phone#: ?�T c7-7 l 01 Email: XA V;"Fa 0 C �'&Ag�.gZ CONTRACTOR:Company Name:C'�,P Pg V?Fn t S C,L L. Phone#: Address: City: State Zip: Qualifier Name: '/ U,TIC CA P+) %�t`c`�L� Phone#: State Certification or Registration M A 5_3 Certificate of Competency M 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 L`Repair/Replace ❑ Demolition Description of Work: FA W Xe, A__ b /K 1�1Mn^ f 7�.:vcgy-�., � P/i.�►v 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) 1 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 reinspect* fee will be charged. Signature Signature OWNER or AGENT CONTRACTOR The foregoing instru ant was acknowledged before me this The foregoing instrument was acknowledged before me this day of 20 by day of ,20 ��. .by who is personally known to xaweI� ®�e, ,w//hho�o is personally known to me or who has produced('�31 —_ me or who has produced �Q'?S `�5� � identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign Sign: Seal: d�"eo Notary Public state of Florida Seal: REM ate of FloridacianoJoanna M Feliciano FF 082743° My Commission FF 082753 018 For0 Expires 01/12/2018 *e+s�xe�xe*e * *ee*e**esr***e�x**ss*wswwe�xea�s��xs��s�ree**ss*asap***�*** estems�ss�s�ses�sea�ea* APPROVED BY �'-� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Miami shores Village Building Department 10050 N.E.2nd Avenue fiZOR Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR I ARCHITECT Permit WD C L1 Ll 6�r Owner's Name(Fee Simple Title Holder): CAP 44*L f• L [ Phone M `?LC" 774 31 e Owner's Address: cam';1 AX eijet) 9 I'l U' City: State : FL Zip Code:T I 91 Job Address(Of where work is being done): Z /Lfv City: Miami Shores State:—Florida Zip Code: Contractor's Company Name: CaP Eu tP-My`s L c _ Phone#: s 77?L31 d 1 Address: Pte.,,. tr ov-v�rc City: State: Zip Code: Qualifier's Name : CAe-q, c4Y-z tr" Lic. Number: C 6 1 Q3 Architect/Engineer of Record Name: Phone M Address: City: State: Zip Code: Describe Work: Asjz1— ` I hereby certify that the work has been abandoned and/or the contractor/architect is unable or unwilling to complete the contract. I hold the Building Official and the Miami Shor mless for all legal involvement. Signature Signature r or Agent P0656r or Archh ect The foregoing instrument was aknowledged before me )gyp The foregoing instrument was aknowledged before me thi day of ,20 ,by 1/, !�/o`er' this day o 20 by Who' a y no who has produced who i rsonally known to me r who has produced as indentification. as indentificafion. Notary Public: Notary Public: Sign: Notary Public state of Florida 10111111111111 Joanna M Feliciano My commission FF 082753 F % Notary Puy/e state FOdda ExpiMs01/1212018 . J08nna M1 FelicianFF o �y Commis oswo F-xlpires 082753 Of/1212018 O • • • • ■ Complete Items 1,2,and 3.Also complete Item 4 If Restricted Delivery is desired. 0 Agent A Print your name and address on the reverse Addressee so that we can return the card to you. g, by Plead Nettie) C. of De ■ Attach this card to the back of the malipiece, Z'L or on thq front if space permits. D. Is dellmy address different from p ent 1? 0 Y 1. Article Addressed m: If YES,enter delivery address below: 0 No 17 ��k tiw 6� S'f. r Mta,� ��. 33 ray �: service TAM r 0 CerNed Mail• 0 Priorlty Map Express'° 0 Regietered 0 Return Receipt for Merchandise 0 Insured Map 0 Collect on Delivery 4. Restricted DepverO Yes 2. Art le Number '7(ly �81p pppp 7739 8844 mfr&n Ps Form 3811,July 2013 Domestle Return Receipt l to , CwD m IJ T [m�. Postage $ CerNed Fee C3Retum Receipt Fee 0 (Eado>Smem Required) 0 Restricted DelNery T. C3 _Q �f Total PostagQ g Fes$ t� TO `(V� --�- -- I3i�l --- - S rl Ct orpoBhyft. °--- ------------ ----------------- �• 31 z �," 4 4 CAP�ZEALTY Ld 12000 BISCAYNE BLVD SUITE 704 Miami FI 33181 Miami 18th 2014 M. Armando Sunny Brick Pavers Inc. 1744 NW 6th Street Miami FI 33125 By certified Mail Dear Sir, As per our conversation I am changing contractor on permit DS-4-14-695 opened by you regarding paving works on the property 2 NW 108th St. in Miami Shores. New Contractor will be Cap Properties LLC and myself as General Contractor. You will be hired to provide the labor, equipment and material for the paving works. Sincerely t i apdevielle er Manager Realty LC