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RC-16-245 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone:(305)795-2204 Fax:(305)7564972 Inspection Number: INSP-?A887Permit Number RC-1-16-246 Scheduled Inspection Da :May 19,2016 Permit Type: Residential Construction Inspector Mesa,Michael Inspection Type: Final Building Owner: ACOSTA,JUAN CARLOS Work Classification: Alteration Job Address:128 NE 99 Street Miami Shores,FL 33138- Phone Number Parcel Number 1132060132270 Project <NONE> Contractor. HOMEOWNER Building Department Comments STRUCTURAL REPLACE RIDGE BEAMS Infracuo Maned Comments INSPECTOR COMMENTS False Ins r C Passed Failed F7 Correction v�� e4 T Needed ❑ C W Re-Inspection a Fee No Additional Inspections can be scheduled untii re-Inspection fee Is paid 5 May 18,2016 For Inspections please call:(305)782.4849 Page 18 of 33 1 y Permit No: 12-1908 Job Name: October 15,2012 Page 1 of 1 Building Critique 1) Identify the bearing for ridge beam connection#2.The plans show a single 2x4 stud carrying the entire beam. Provide calculations showing the load path to the foundation at this connection. 2) Identify the connection and load bearing for both ends of the(4)2x12 beams.Show the path to the foundation. 3)Dimension the plans. STOPPED REVIEW Plan review is not complete,when all items above are corrected,we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re-submittal drawings. Norman Bruhn CBO 305-762-4859 Permit No: 12-1908 Job Name: October 15,2012 Page 1 of 1 Building Critique 1) Identify the bearing for ridge beam connection#2.The plans show a single 2x4 stud carrying the entire beam. Provide calculations showing the load path to the foundation at this connection. 2) Identify the connection and load bearing for both ends of the (4)2x12 beams.Show the path to the foundation. 3)Dimension the plans. STOPPED REVIEW Plan review is not complete,when all items above are corrected,we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re-submittal drawings. Norman Bruhn CBO 305-762-4859 1111111 hill!illi hill•lllll 111111111111111111 NOTICE OF COMMENCEMENT CFN 201280726006 APMMMCOPYWWBEPMOONINJOBOMIETMOFMWMWM OR Bk 23309 P9 3962 P Q P 9) RECORDED 10/11/2012 15:30:47 �Q �+ HARVEY RUVINP CLERK OF COURT PERMIT NO.� CA 2— I l TAX FOLIO NO. 11-3208.0134270 HIANI-DARE COUNTY r FLORIDA LAST PAGE STATE OF FLORIDA COUNTY OF MIAWDADE: THE UNDERSIGNED heathy gives notice that Improvernents will be made to certain neral property,and M accordance with Chapter 713,Florida Statutes,the following information Is provided It this Notice of Commencement above c+eserved for use of �g otfbra MIAMI 880=8 SEC 1 AW PS 10-7 LOT it & 61/2 or LOi' 12�& N2S8"P 1.Legal desctlpdon of property and strseHaddress:ey 128 » 99th Stmt - Miami Shores ; , 33138 2. Description of Improvement: Irgar orS>truClural Rem 3.Owner(s)name and address: _J as Carlos Acosta 128 88 99th Street - !tin$,,;Shores, FL. 33138 Interest in property: Name and address of feesimple titleholder: 4.Contractor's name,address and phone nrmrber. H.K.YO*Wa COmftn don,LLC 3840 W Hillsboro Blvd,222-Dewfaki Beach,FL 33442 5.Sunny:(Payment bond reWired by owner from contractor,If any) STATE OFF RIDA,COUNTY OF DADE Name,address and phone number Amount of bond$ 06081 ff! s 6.Landle%name and address: 7.Persons within the State of ftrida designated by Owner upon served Section 713.13(1)(a)7.,Florida Statutes, Of � Name,addressand phone number: S.in addition to himself,Owners designates the Blowing perso s a copy of the Lfenoes Notice as provided in Section 713.13(1)(b),Florida Statutes. Name,address and phone number 9.Expiration date of this Notice of Commencenent: _ 2/10/13 ow wowAon dab is 1 year from Vo date of taus a d 0wa t date is Wedleo WARNING TO OWNER:ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART 1,SECTION 713.13.FLORIDA STATUTES,AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION.IF YOU INTEND TO OBTAIN FINANCING,CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT Signaturs(s)of,pwnsr(s) 1'Owner(e)' hgrtred Officer/Director/Partner/Manager Prepared By Prepared By Print Name C • . Print Name Titie/Office Mwoftice STATE OF FLORIDA COUNTY OF MIAMI-DADE The foregoing Instrument was acWwwlodge before me the 10 day of BY ly,or Q as Ifor Personally known,or ❑produced the following type of Ida on: Signature of Notary Public: Print Name: 47 (SI AL) VERIFtC/ITiON PUR�IJANT TO SECLTION 2LS2&FLORIDA STATUTES $1.Y f - Under penalties of perjury,I doom that I have read the foregoing and that the facts stated In It are true,to the beg of my knowledge and belief. Signature(s)of Owner(p)or Owner(s)'s Authorized Of er/Diredor/Partrher/Manager who signed above: By By Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores,Florida 33138 Tel: (305)795.2204 Fax: (305)756.8972 Permit No. /Z C 12- Job 2Job Name Date STRUCTURAL CRITIQUE SHEET low l �-ly c.O M 4 60''y WWI kbp R.f'53-V'P IE�� I CERTIFICATE OF LIABILITY INSURANCEDATE 1 OW12 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($),AUTHORIZED I REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT: If the cerdftcats holder Is an ADDITIONAL INSURED,the poq 99)must be endomed. It SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may rqulre an andomelnent A statement on this certificate does not confer rights to the cerWAste holder in Neu of such endorsement(s). PRODUCIIR aLi Econo Insurance (954)428-8800 (954)427-9065 145 E.Hillsboro Blvd. CARMENCECONOINS.NET Deerfield Beach,FL 33441 Nsu AFFORDING COVERAGE NAu:a Phone (954)428-5800 Fax (954)427-9065 INgURERA: ATLANTIC CASUALTY INS.CO INSURED INSURERS: Hk Yoshida Construction,= mmmERC: 3840 W.Hillsboro Blvd. INSURER D: Deerfield Beach,FL 33442- 954 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 MAYBE 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. TYPE OF MWRANCE IA�D�DLX�UBpRI_ POLICY NUMBER ( UM ITS GENERALUAMIJTY EACH OCCURRENCE 1,000,000.00 ® COMMERCIAL GENERAL LIABILITY PDAAMGE TO RENTED S 100,000.00 A F-1 [:] MANS-MADE ® N 02!02/2012 02/02/2013 OCCUR (L030003576 MED EXP Yft ane :e 5,000.00 ❑ PERSONAL&ADV INJURY s 1,000,000.00 ❑ _-- GENERALAGGREGATE $ 2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-CoMPOP AGG S 2,000,000.00 ® POLICY ❑ moo- ❑ Loc $ AUTOMOBILE LIASKM NGLE LIMIT ❑ ANY AUTO BODILY NJURY(Per Person) $ ❑ �� AUTOS❑ SCHEDULED I BODILY NJURY(Per $ ❑ HIRED AUTOS ❑ NON-OWNEDAUTOS :e ❑ s ❑ UMBRELLA LIAO ❑OCCUR EACH OCCURRENCE S ❑ EXU UAB ❑MAW-MADE AGGREGATE S ❑ DED ❑ RETENTIONS $ WORKERS COMPENSATION WC STATU- ❑OTH- AND EMPLOYERS'LI BRM Y IN ANY PROPRIETORIPARTNEWEXECUTNE _ E.L.EACH ACCIDENT $ OFFlICER�A83ER EXCLUDED? - N I A (MandatoryIn NH) I. _1 i E.L DISEASE-EA EMPLO $ DESCRIPTION OF OPERATIONS below _ _- _ E.L DISEASE-POLICY LIMIT S I DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Atach ACORD 101,Ad sal Rem Schedule,H more space[*requireM REMODELING It REPAIR CONTRACTOR I AN�- — ---- CERTIFICATE HOLDER CANCELLATION SHOULD VE DESCRIBED POLICIES BE CANCELLED BEFORE MIAMI SHORES VILLAGE THE EXPIRA F,NOTICE WILL BE DELIVERED IN 10050 NE 2ND AVE. ACCORD OLICY PROVISIONS. MIAMI SHORES,FL 33138 AUTHORIZED 18 RD CORPORATION. All rights mm. ACORD 25(2010105)OF The C 0 and 1090 are regl6bred marks of ACORI .4 0 nP CERTIFICATE OF LIABILITY INSURANCE DATE 0108/2012 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 pollcy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terns 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 �PMM Michael D.Holleman Work Comp Associates,Inc. c 94: (561)863-9581 N,,,x (561)881-9745 P.O.Box 33297 yes: mail@WorkCompAssoc.com Palm Beach Gardens,FL 33420-3297 INSURIMM NMRDMO COVERAGE NAIc o INSURER A. Florida Citrus,Business&Ind. INSURM INSURER S: H.K.Yoshida Construction,LLC INSURER c: 3840 West Hillsboro Boulevard Suite 222 °SURM°c Deerfield Beach,FL 33442-9478 INSURER M INSURER R 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. INGR FOUL; LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MMM MID LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY $ PREMISES Ea ocwrrence CLAIMS-MADE E-1 OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY F1 SERC LOC $ AUTOMOBILE LIABILITYEl� $ a axldent ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED $ AUTOS nt $ UMBRELLALIAB OCCUR El E-1EACHOCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ AND EMPLOYED'LIABILI Y Y/N X TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT 100,000 A OFFICEIMEMBER EXCLUDED? N/A© 10649966 6/22/2012 6/22/2013 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,it more space is required) CERTIFICATE HOLDER CANCELLATION i SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Miami Shores Village Building Dept. ACCORDANCE WITH THE POLICY PROVISIONS. 10050 N E 2nd Avenue Miami Shores Village,FL 33138-2382 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD STATE OF FLORIDA DEPARTMENT 0l' BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING-BOARD (850) 487-1395 •`'�•.�+�• TALLAHASSEEEMONROE STRFLT32399-0783 YOSHIDA, RALLY K JR H K YOSHIDA CONSTRUCTION LLC 3840 W HILLSBORO BLVD #222 DEERFIELD BEACH. FL 33442 STATE OF FLORIDA AC#G 2 3 7 i L 7 Congratulationsl With this license you become one of the nearly one million DEPARTMENT OF BUSINESS AND Floridians licensed by the Department of Business and Professional Regulation. PROFESSIONAL -REGULATION Our professionals and businesses range from architects to yacht brokers,from boxers to barbeque restaurants,and they keep Florida's economy strong. CGC1515030 07/33/12 128024223 Every day we work to improve the way we do business in order to serve you better. For information about our services,please lag onto www.myfloridalicense.com. CERTIFIED GENERAL CONTRACTOR There you can find more information about our divisions and the regulations that YOSHIDA, RALLY R JR impact you,subscribe to department newsletters and learn more about the H K YOSHIDA CONSTRUCTION LLC Department's 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. IS CERTIFIED ua8er the provieioae of ch.489 FS Thank you for doing business in Florida,and congratulations on your new licensel mviratiea ase®, AUG 31, 2014 L12073102397 DETACH HERE DOCUMENTTHIS • • • BACKGROUND • AC# 6237117 STATE OF FLORIDA DEFAR NSTRUCTIONEIND STRYRLICSEN ING BOA TION SEQN L12073102397 LICENSE NBR 107/31/20121128024223 JCGC1515030 The GENERAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2014 YOSHIDA, RALLY K JR H K YOSHIDA CONSTRUCTION LLC 3840 W HILLSBORO BLVD #222 DEERFIELD BEACH FL 33442 RICK SCOTT KEN LAWSON GOVERNOR SECRETARY DISPLAY AS REQUIRED BY LAW BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895—954831-4000 VALID OCTOBER 1,2012 THROUGH SEPTEMBER 30,2013 DBA: Receipt#:180-8177 Business Name:H K YOSHIDA CONSTRUCTION LLC Business Type:CONTRACTEMRAL OORAI RR)RACTOR (GENE Owner Name:HALLY K YOSHIDA JR Business Opened:03/17/2008 Business Location:3840 W HILLSBORO BLVD 222 State/COun /Cert/R@ :CGC1515030 tY 9 DEERFIELD BEACH Exemption Code: Business Phone:954-275-3969 Rooms Seats Employees Machines Professionals 1 For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee I NSF Fee Penalty Prior Years I Collection Cost Total Paid 27.00 0.00 0.00 0.00 1 0.00 1 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: HALLY K YOSHIDA JR Receipt #01C-1i-00011382 3840 W HILLSBORO BLVD #222 Paid 08/27/2012 27.00 DEERFIELD BCH, FL 33442 2012 . 2013 a . DRIVER LICENSE CLASS E Y230-331-63-417-0 HALLY K YOSHIDA A 438'SUNSET CAY CIR BOYNTON BEACH FL 33436 :)OB 11-17.1963 SE.x tJ ISSUED 10-07-2009 H ,pows 11.17-2017 R:sT A ` CORSE PLACED 07-26-2010