RC-16-208 (2) t
Miami Shores Village
10050 N.E.2nd Avenue NE
Miami Shores,FL 33138-0000 �
sor
Phone: (305)795-2204`
1 �.
r 1,� Ertl 3st' °Y k
Expiration: 08/2012016
Project Address Parcel Number Applicant
479 NE 102 Street 1132060170840
Miami Shores, FL Block: Lot: HENRIQUE SOUZA
Owner Information Address Phone cell
HENRIQUE SOUZA 479 NE 102 Street (646)320-4171
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone
JOHNNIE C COPE JR INC 305 866-8617 Valuation: $ 28,300.00
( ) (305)710-9565
- Total Sq Feet: 1750
Approved:In Review Available Inspections:
Comments: Inspection Type:
Date Approved::In Review Final PE Certification
Date Denied: Window Door Attachment
Type of Construction:INSTALL NEW WOOD FLOORS NE Occupancy:Single Family Framing
Stories:1 Exterior: Insulation
Front Setback: Rear Setback: Drywall Screw
Left Setback: Right Setback: Window and Door Buck
Bedrooms:3 Bathrooms:2 Fill Cells Columns
Plans Submitted:Yes Certfcate Status: Review Electrical
Certificate Date: Additional Info: Review Electrical
Bond Retum: Classification:Residential Review Electrical
Review Building
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Review Building
CCF $17.40 Review Planning
CO/CC FeeInvoice# RC-1-16.58452 Review Plumbing
$50.00 01/26/2016 Check#:2885 $50.00 $929.88
DBPR Fee 812,74 Review Plumbing
DCA Fee $12.74 02/22/2016 Check#:3024 $929.88 $0.00 Review Structural
Education Surcharge $5.80 Review Mechanical
Permit Fee $849.00
Scanning Fee $9.00
Technology Fee $23.20
Total: $979.88
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. Futhermore,I authorize the above-nam nt r to do the work stated.
February 22,2016
Authorized Signature:Owner / Applicant / C1 ractor / Agent Date
Building Department Copy
February 22,2016 1
Miami Shores Village
. f �
Building DepartmentJAN to nis
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
FBC 201/
BUILDING Master Permit No &
PERMIT APPLICATION Sub Permit No.
'BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP
A �y / CONTRACTOR DRAWINGS
JOB ADDRESS: / N E /0 Z~n9 S
City Miami Shores -t County: Miami Dade Zip:
Folio/Parcel#: 11 3206.• 0 /"7-" 8`f•0 Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: !j6 FFE:
OWNER:Name(Fee Simple Titleholder): 144el�ri U e 19.e Sv� Phone#:6 el ^ 52-o 91
Address: T
City: �! ,� Shim State Zip: 3j
'tenant/Lessee Name: Phone#:
Email: / /�_ -
CONTRACTOR:Company Name: ` /1/1(e & /'OZ ✓/ `PIC—Phone#: 50Y-904.417
Address 67 f§tL f
T ' 3l3�
City: i� State: Zip:
Qualifier Name V�� Phone#:
State Certification or Registration#: CIJe. 0 0� Certificate of Competency#:
DESIGNER:Afchitect/Engineer. ~ ° Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$4,01-300 Square/Linear Footage.of Work: 17 SO
Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition
Description of Work:. nqui wwd4CAeiY1 m br
1rOt(�tGQs ; nc � I7 r M i
�x-ka•v� n . L,Le wh.�eP • io Diil�.�b'r+'+�i ixs re�lar�
Specify color of color thru tile:
Submittal Fee Permit Fee$ � - CCF$ ® CO/CC$ CD
Scanning Fee$ Radon Fee$ ,ted' DBPR$ Notary$ P
Technology Fee$ �3 " Training/Education Fee$ 'Qi() Double Fee$
Structural Reviews$_ Bond$
TOTAL FEE NOW DUE$ fj
(Revised02/24/2014)
t ,
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 qj S�� Signature
OWNER or AGENT IJ CONTRACTOR
The foregoing instrument was acknowledged before me this The fo/regoing instrument was acknowledged before me this
j 2-6cc�delay of (� 20 �
by !��day of 20 1 by
SOQ24o is personally know to I -2. who is personally know 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•- &d Sign
Print: l Prir>jr:
Seal: r�"`" QUIDA JACOBS Seal: „
MY COMMISSION 0 FF43855 QUIDA JACOBS
° EXPIRES.August 14,2017 MY COMMISSION q FF43855
EXPIRES:August 14,2017
Lb a-l0fap
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
a
A REO CERTIFICATE OF LIABILITY INSURANCE
01/26/2015
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CER71FICATE 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(ies)must be endorsed. It SUBROGATION IS WANED,subject to
the terms and Conditions of the policy,certain policies may require an endorsement, A statement on this cer0cate does not confer rights to the
certificate hokter M lieu of such endorsement(s).
PRODUCER
CONTACT-
NAM*
Futurity Insurance,Irx: N : (561)361-8331
No• (561)381-6332
PO Box 4277
ADDRESS:
INSURERS)AFFORDING COVERAGE MAIC 0
Deerfield Beach FL 33442-4277 INSURMA: Western World Ins.Co.
INSURED
INSURER B:
Johnnie C.Cope,Jr.,Inc. INSURER C:
479 NE 102nd Street INSURER 0:
INSURER E
Miami ShowFL 33138 INSURERF:
COVERAGES CERTIFICATE NUMBER: REVISION NU R.
THIS 18 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWTTHSTANDINGANY REQUIREMENT,TERM OR CONDITION OFANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
C,ER71FICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCEAFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TOALLTHE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
L TYPE OF INSURANCE POLICYN�B�
LIMCrS
MILLGENERALLIABILI Y EACH OCCURRENCE $ 1.000.000
CWr SAAADE ®OCCUR PREMISEwmnw= $ 100.000
MED EXP(Any one person) $ SAW
A NPP8269955 01/22!2016 01/22/2017 PERSONALSADVINJURY $ 1.000,000
GEN LAGGREGATE LIMpRAPM IES PER GENERALAGGREGATE $ 2,000,000
POLICY®.EC7' ®LOC PRODUCTS-COMP/OPAGG $ 1.000.E
OTHER: $
AUTOMOBILE LIABILITY ) $
ANYAUTO BODILY INJURY(Per person) $
ALL OWNEDSCHEDULED
AUTOS AUTOS BODILY INJURY(Per Via) $
HIREDAUTQS 14ON-OWNED
AUTOS (Peraeeldera $
UMBRELLA LIAR OCCUR EACH OCCURRENCE $
EXCESS LIAO CLAIMS-MADE AGGREGATE $
DED I I RETENTION$ $
WORKERS COMPENSATION
AND EMPLOYERS'LL40U Y YIN [ STATUTE
ANY PROPRIETORIPARTNE RIEXECUTME
OFFICERMAEMBEREXCLUDED? D NIA E.L.EACH ACCIDENT $
H andatwy yes InIn E.L.DISEASE-EA EMPLOYEE $
DESCundw
RIPTION OF OPERATIONS belay E.L.DISEASE-POLICY UNIT $
DEP^IION OF OPERATKrNS/LOCATE/VEHK:LER(ACORD 101,Addlfonal Remarks SclmdWe,may be atl�etl I more space is requked)
Remodeling Contractor
Johnnie C.Cope Qualifer
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
Mierni Shares Village Bldg Dept ACCORDANCE WITH THE POLICY PROVISIONS.
10050 NE 2nd Ave
AUTHORIZED REPRESENTATNE
Miarrd Shores FL 33138
®1988-2014 ACORD CORPORATION. AU rights reserved.
ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD
+� DATE(r®UDDlYYY1r)
ACCM& CERTIFICATE OF LIABILITY INSURANCE
1/26/2016
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
cw tl r,v to holder In lieu of such endorsement(s).
PRODUCER NAME
ACT
TriGen Insurance Solutions, Inc.
315 BE Misner Blvd PHONE
877 987-4436 FAX : 954 252-4426
Suite 213 ADDR CERTS@TRI PIRC.COM
Boca Raton FL 33432
IN AFFORDING COVERAGE MAIC9
INSURERA:Guarantee Insurance Company 11398
BRED (904) 731-9014 INSURER B:
Convergence Employee Leasing, Inc.
Convergence Employee Leasing Ii, Inc. [NSURERC:
3951 Saymeadows Road INSURER D:
Jacksonville FL 32211 INSURER E:
INSURER F
COVERAGES CERTIFICATE NUMBER:Cert ID 11591 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 CONDMON 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 LTR TYPE OF INSURANCE POLICY NUMBER P� �F LIMITS
COMMERCIAL GENERAL LIABUM EACH OCCURRENCE $
DAMAGE TO RENTED
CLAIMS-MADE EIOCCUR PRB41SES Ea 00MO M $
MED EXPAiry one $
PERSONAL&ADV INJURY $
GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $
POLICY E JEC E]LOC PRODUCTS-COMP/OP AGG $
OTHER: $
AUTOMOBILE LIABI ITY (EeBASIN LIMIT $
ANY AUTO BODILY INJURY(Per person) $
ALL OWNED SCHEDULED BODILY INJURY(Per axbdent) $
AUTOS AUTOS
NON-OWNED PROPERTY DAMAC3E $
HIRED AUTOS AUTOS
UMBRELLA LIARHCMMS-MADE
OCCUR EACH OCCURRENCE $
EXCESS LG$ AGGREGATE $
DED I I RETENTION
A WORKERS COMPENSATION YIN
WCP500075001GIC 9/30/2015 9/30/2016 8 STATU' ER -
AND EMPLOYERS'LIABILITY
ANY PROPRIETORIPARTNERIEXECUTIVE NIA EL EACH ACCIDENT $ 1,000,000
OFFICERIMEMBER EXCLUDED?
(Mandatory in NH) EL DISEASE-EA EMPLOYEE,$ 1,000,000
N yes,deme urdw 1,000,000
DESCRIPTION OF OPERATIONS being E.L.DISEASE-POLICY LIMIT S
$
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,AddWWW RemaAw Sdndul%may be aftw*W N more space Is required)
Coverage provided for all leased employees but not subcontractors ofs Johnnie C. Cope Jr Inc
Location coverage effective: 9/30/15
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Miami Shores Village ACCORDANCE WITH THE POLICY PROVISIONS.
10050 NE 2nd Avenue AUTHORIZED REPRESENTATIVE
Miami Shores FL 33138 Cr
®1988-2013 ACORD CORPORATION. AN rights reserved.
ACORD 25(2013104) The ACORD name and logo are registered marks of ACORD
Pave 1 of 1
rn
Certificate of Completion
Miami Shores Village k
10050 NE 2 Ave, Miami Shores FI, 33138
Tel: 305-795-2204 Fax: 305-756-8972
Building Inspection Department '
i
This certificate issued pursuant to the requirements of the Florida Building Code 106.1.2 certifying that at the time of issuance this structure was in ;
compliance with the various ordinances of the jurisdiction regulating building construction or use. For the following:
�t Permit Type RESIDENTIAL CONSTRUCTION Bldg. Permit No. RC-1-16-208 ;�C°,
Owner HERNRIQUE SOUZA Contractor JOHNNIE C COPE JR INCA
Fa 5 Y"
Subdivision/Project NONE Date Issued 08/19/2016 °.
Occupancy
r Construction Type VI Load NIA
Occupancy
Square Footage 1750Type R-3
Description of INTERIOR RENOVATION Applicable Code 2014 FLORIDA BUILDING CODE
5Y
Work
Location Flood Zone X F.F.E N/A o
479 NE 102 ST
r Miami Shores FL 33138
k t�
� yNoRFs
Building Officials Approval Ismael Naranjo, CBO a�
L� � rp�e Not Transferable
�LOIR1Dp' POST IN A CONSPICUOUS PLACE #r t
� id t• ""y.,�r."t `'GS''��'0t �— '*^ -t fi i'."' �'- ''h ♦ �� � � n a f-c �� ,�<���, �ri '*qty ,�,,
N n ✓ e}dr
RT# i
by `'. . i+; t. i 'LrY:c�d� P°, ?.:vtevs• ,.; ''° is d ;.i'i# ,* 4 ., t� rF ;.
to.
.. d
INSPECTION RECORD -- POST ON SITE
R
Permit NO C-1 - 16-208
`SNORE,y`!C Miami Shores Village
� Permit Type:Residential'Ccitstruction
� 10050 N.E.2nd Avenue � %
..... "
Miami Shores,FL 33138-0000 -'" Drk Classification:Alteration
Phone: (305)795-2204 Fax: (305)756-8972
RT Issue Date: 2/22/2016
��aR�n� 08/20/20'I 6
Expires:
INSPECTION REQUESTS: (305)762-4949 or Log on at https://bldg.miamishoresvillage.com/cap
REQUESTS ARE ACCEPTED DURING 8:30AM-3:30PM FOR THE FOLLOWING BUSINESS DAY.
Requests must be received by 3 pm for following day inspections.
Residential Construction Parcel #:1132060170840
Owner's Name:HENRIQUE SOUZA Owner's Phone: (646)320-4171
Job Address: 479 NE 102 Street Total Square Feet: 1750
Miami Shores FL
Total Job Valuation: $ 28,300.00
Bond Number:
^r;/;:,.a. ;;.i./rrd/ifGn/Alal.,Adcaahc'.,, .... J.,,trriu.f/,.� :.�. ., .;..e, �.2:,«„/t:s.�,..,:N_ .ry a;:rll?.viG//f!!.✓�J/�'<.
WORK IS ALLOWED MONDAY THROUGH SATURDAY,
7:30AM-6:0013M.NO WORK IS ALLOWED ON
Contractor(s) Phone Primary Contractor SUNDAY OR HOLIDAYS. f
JOHNNIE C COPE JR INC (305)866-8617 Yes f
BUILDING INSPECTIONS ARE DONE MONDAY
THROUGH THURSDAY. ROOFING INSPECTIONS ARE
DONE MONDAY THROUGH FRIDAY. NO BUILDING
I INSPECTIONS DONE ON FRIDAY.
F
NO INSPECTION WILL BE MADE UNLESS THE PERMIT CARD!S DISPLAYED AND HAS BEEN APPROVED. PLANS ARE READLY AVAILABLE. ITIS
THE PERMIT APPLICANT'S RESPONSIBILITY TO ENSURE THAT WORK IS ACCESSIBLE AND EXPOSED FOR INSPECTION PURPOSES. NEITHER
THE BUILDING OFFICIAL NOR THE CITY SHALL BE LIABLE FOR EXPENSE ENTAILED IN THE REMOVAL OR REPLACEMENT OF ANY MATERIAL
REQUIRED TO ALLOW INSPECTION.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF' .
COMMENCEMENT MAY 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 NQj&9 OF
COMMENCEMENT, A
INSPECTIQN RECORD
STRUCTURAL ZONING ITMILIr
INSPECTIONDATE INSP INSPECTION DATE INSP INSPECTION DATE INSP
Foundation Zoning Final
Stemwall ZONING COMMENTS Rough 'tZ
Slab Water Service
Columns 1 st Lift 2"d Rough 1
Columns 2nd Lift Top Out
Tie Beam Fire Sprinklers
Truss/Rafters Septic Tank
Roof Sheathing Sewer Hook-up
Bucks Roof Drains
Windows/Doors Gas
Interior Framing INSPECTION DATE INSP LP Tank
Insulation Temporary Pole Well
Ceiling Grid 30 Day Temporary Lawn S rinklers
DrywallAff C,1 t IC Pool Bonding Main Drain
Firewall 7TO Pool Deck Bonding Pool Piping
Wire Lath Pool Wet Niche Backflow Preventor
Pool Steel Underground Interceptor
Pool Deck Footer Ground Catch Basins
Final Pool lab Condensate Drains
Final Fence Wall Rough HRS Final
Screen Enclosure Ceiling Rough -
Driveway Rough PLUMBING-COMMENTS
Driveway Base Telephone Rough
Tin Cap Telephone Final
Roof in Progress___ TV Rough
Mop in Progress TV Final
Final Roof Cable Rough
Shutters Attachment Cable Final _
Final Shutters Intercom Rough
®Raj,lsnd Guardrails Intercom Final 'om liance Alarm Rough INSPECTION DATE INSP
Alarm Final Underground Pipe
DOCUME Fire Alarm Rough
Soil Bearing Cert Fire Alarm Final Rough
Soil Treatment Cert Service Work With
Floor Elevation Survey Ventilation Rough
Reinf Unit Mas Cert ELECTRICAL COMMENTS Hood Rough
Insulation Certificate Pressure Test
Spot Survey Final Hood
Final Survey Final Ventilation
Truss Certification Final Pool Heater
STRUCTURAL COMMENTS Final Vacuum
21:11
"I. MECHANICAL COMMENTS
INSPECTION DATE INSP
Final Sprinkler
Final Alarm