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RC-15-2104 inspection Worksheet Miami Shores Village 10060 N.E.2nd Avenue Miami Shores,FL Phone:(305)795-2204 Fax: (305)756.8872 Inspection Number: INSP-241702 Permit Number. RC-8-15-2104 Scheduled Inspection Date:June 02,2016 Permit Type: Residential Construction Inspector: Mesa, Michel Inspection Type: Final Owner: ,MIMI 1 LLC Work Classification: Addition/Alteration Job Address:901 NE 97 Street Miami Shores,FL 33138- Phone Number0 � (305)647.4045 Parcel Number 1132060143310 Project: <NONE> Contractor: COLBERT INC Phone:(786)344-6463 Building Department Comments REPLACE KITCHEN CABINETS, BATHROOM VANITY Infractio Passed Comments AND RELOCATE WASHER+DRYER. NEW TANK LESS INSPECTOR COMMENTS False WATER HEATER. TO CLOSE PERMIT#RC14-2248 Inspector Comments Passed Failed El Correction a Needed Reinspection F-1 Fee No Additional Inspections can be scheduled until re--inspection fee is paid June 09,2016 For inspections please calk(305)762-4949 Page 2 of 34 y Miami Shores Village " 10050 N.E.2nd Avenue NE Miami Shores,FL 33138-0000 '-aka amu= ak Phone: (305)795-2204 '� z Expiration: 02/28/2016 Project Address Parcel Number Applicant 901 NE 97 Street 1132060143310 Miami Shores, FL 33138- Block: Lot: MIA41 1 LLC Owner Information Address Phone Cell MIA41 1 LLC 9840 NE 2 Avenue (305)807-4045 MIAMI SHORES FL 3313-8 9840 NE 2 Avenue MIAMI SHORES FL 3313-8 Contractor(s) Phone Cell Phone COLBERT INC (786)3446463 Valuation: $ 35,000.00 Total Sq Feet: 2063 Approved:In Review Available Inspections: Comments: Inspection Type: Date Approved::In Review Final PE Certification Date Denied: Drywall Type of Construction:REPLACE KITCHEN CABINETS,BA Occupancy:Single Family Miscellaneous Stories: Exterior: Window Door Attachment Front Setback: Rear Setback: Tie Beam Left Setback: Right Setback: Final Bedrooms: Bathrooms: Framing Plans Submitted:Yes Certificate Status: Insulation Certificate Date: Additional Info: Truss Insp Bond Return: Columns Classification:Residential Foundation Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Window and Door Buck CCF $21.00 Fill Cells Columns DBPR FeeInvoice# RC-8-15-56769 Wire Lathe $15.75 09/01/2015 Credit Card $1,149.50 $0.00 DCA Fee $15.75 Review Electrical Education Surcharge $7.00 Review Mechanical Permit Fee $1,050.00 Review Plumbing Scanning Fee $12.00 Review Building Technology Fee $28.00 F.Termite Letter Total: $1,149.50 F.Elevation Certificate Review Structural Declaration of Use 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 pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS 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. utherm e i authorize the above-named contractor to do the work stated. September 01, 2015 Authorized Signature:Owne / Wplicant / Contractor / Agent Date Building Department Copy September 01,2015 1 Miami Shores Village � - ` BuildingDepartment AUG 9 2015 p 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 t v BUILDING Master Permit No.-20—15— PERMIT APPLICATION Sub Permit No. UILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ENEWAL ❑PLUMBING ❑ MECHANICAL E]PUBLIC WORKS r-1 CHANGE OF ❑CANCELLATION ❑ SHOP (� �+ CONTRACTOR DRAWINGS JOB ADDRESS: I b 4E -2� J,x(5 1 2 �I City: Miami Shores County: Miami Dade Zig: 33 I q Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: 9 Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): 14xik x, �`�-1 Phone#: 7k& Z65--O Old 0 Address: l WC_ A140;0+ /rV City: &A4t 6 4hza,-s State: Zip: 5 513 Y Tenant/LesseeName: Phone#: ZLlo ZZ)S7`0JOD Email: Ax).��P'I�N� CONTRACTOR:Company Name:_ 0_00,&T w.,c— Phone#: 7S-� .3Vtl (Y0 Address: lwrt-- M- & City: &,All►d 6-4 h lr-5 State: 1et- Zip: 33) 31 Qualifier Name: Y-OwR-C. Phone#: 7Z .5'1'1-4 State Certification or Registration#:C r c /Sl ZyG Certificate of Competency#: DESIGNER:Architect/Engineer. Phone#: Address: City: State: Zip: Value of Work for this Permit:$ _K VO G Square/Linear Footage of Work: Zry ow v Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition Description of Work �� %Gly c.1� �i s �Fx s /71 Specify color of color thru tile: Submittal Fee$ Permit Fee$1 ,O5O 070 CCF$ CO/Cc$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ 1. 1 '4 �® (Revised02/24/2014) r- 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$250,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 AG NT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing in ment was acknowledged before me this �Z day of t-1-S v ,20 !S� •by �2 day of 20 by N6s;ca- A .7z4,0rLz Z. ,who' personally known t_6 Mho i ersonally known to who has produced as <1pj:�r who has produced QPj V_:_, '' y as identification and who did take an oath. identification and who did take an oath. NOTARY P C. NOTARY PUB C: n, i Sign: yu "`_ ign: Prin : i ��= Seal: '*: �': MY COMMIS510N sY EE8743t34 Seal: EXPIRES Fsb►uary 26,2017 EXPtRE8 February 25,2017 t �� s9 **s**ss*****s*s**************ss********s*sss************ss*******s****s********s*s*******s**s**********s**** APPROVED BY Plans Examiner Zoning Structural Review Clerk (ReviseM2/24/2014) ,4c�o!ed CERTIFICATE OF LIABILITY INSURANCE ��`"�D°"'"'r' 8/12/2015 +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: N the certifieate holder Is an ADDITIONAL INSURED,the poilcy(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 Ileu of such endomeme s). PRODUCER ACT Jon Rock The Contractors Choice Agency PHONE . (800)918-3584 FAX �.(877)684-9951 PO Boa 13645 ADDRESS:Jonlinginenranceonllne.a m fNSURERM AFFORDING COVERAGE MAIC# Chandler AZ 85248 INSURERA-Yreferred Contractors Insurance 12497 INSURED INSURER B: Colbert Inc. INSURER C: 3845 NW 57th Place INSURER D: INSURER E Miami FL 33166 INSUpEIt F: COVERAGES CERTIFICATE NUMBEP-<L1251616553 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. I S TYPE OF INSURANCE ADM SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE A CLAIMS-MADE �OCCUR PREMISEST $ 50,000 PCIC5026-PC&543347 5/15/2015 5/15/2016 MED EXP(Any one pemn) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEML AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 1,000,000 X POLICY C D LOC PRODUCTS-COMPIOPAGG $ 1,000,000 OTHER: $ AUTOMOBILE LIABILITYsoq $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per acddent) $ HHIIRTED AUTOS AUTOS PROPERTY DAMAGE $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS4AADE AGGREGATE $ 14DED RETENTION $ INORL AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETORIPARTNERIEXECUTIVE ❑NIA EL EACH ACCIDENT $ OFFICERIME(Myyeers UDE M N)IX� � E.L.DISEASE-EA EMPLOYE $ DESbe under G�RIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Sdarduh%may be aifadted N more space k;required) CGC1512466 CERTIFICATE HOLDER CANCELLATION (305)756-8972 felicianoj@m:iamishoresvill SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 NE 2nd Avenue ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores, FL 33138 AUTHOR®REPRESENTATIVE L Robert Rock/JON - -�-� � ®1888-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025 moim1L