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RC-16-835 yy� S y, Miami Shores Village Perrrr Type;,Rest a>rttial Ccinstru�tl©n". 10050 N.E.2nd Avenue NE � Miami Shores,FL 3313&0000 it Phone: (305)795-2204 FLORtD>'' 'EYMi YMI f3 1 Expiration: 10/30/2016 Project Address Parcel Number Applicant 341 NE 92 Street 1132060136380 Miami Shores, FL 33138- Block: Lot: FRANK TADDEO Owner Information Address Phone Cell FRANK TADDEO 341 NE 92 Street (305)758-7493 MIAMI SHORES FL 33138-3133 Contractor(s) Phone Cell Phone $ 13,458.00 Valuation: ANN CREST CONSTRUCTION INC (305)986-8981 Total Sq Feet: 186 Approved:In Review Available Inspections: Comments: Inspection Type: Date Approved::In Review Final PE Certification Date Denied: Window Door Attachment Type of Construction:REMOVE AND REPLACE EXISTING Occupancy:Single Family Framing Stories: Exterior: Insulation Front Setback: Rear Setback: Drywall Screw Left Setback: Right Setback: Fill Cells Columns Bedrooms: Bathrooms: Window and Door Buck Plans Submitted:Yes Certificate Status: Review Planning Certificate Date: Additional Info: Review Electrical Review Building Bond Return: Classification:Residential Review Mechanical Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Review Plumbing CCF $8.40 Review Structural Invoice# RC-3-16-59194 DBPR Fee $6.06 DCA Fee $6.06 05/03!2016 Check#:10274 $297.26 $150.00 Education Surcharge $2.80 03/29/2016 Check#:10195 $150.00 $0.00 Permit Fee $403.74 Scanning Fee $9.00 Technology Fee $11.20 Total: $447.26 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. OWNERV I that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construct in u ore,I authorize the above-named contractor to do the work stated. May 03, 2016 Authorized Signature:Owner / Applicant / Contractor Agent Date Building Department Copy May 03,2016 1 4(, LLQ Miami Shores Village - ° Building Department 7By:!—Lcj 2010 a� 1 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 S-� FBC 21D BUILDING Master Permit No. PERMIT APPLICATION Sub Permit No. [) BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL F_JPLUMBING MECHANICAL PUBLIC WORKS CHANGE OF CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: f !v V City: Miami Shores County: Miami Dade Zip: 3313-5 Folio/Parcel#:11—32V(0—0 1*3 63W Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: r OWNER:Name(Fee Simple Titleholder): I Iv V , ` Phone#: 1�)525-5 37 Address: '941 ��Z.�i+ Z City: I" �` i�S State• Zip: 3> 3 � 205 Tenant/Lessee Name: Phone#: Email: / q�I CONTRACTOR:Company Name:iA n'� DN P y Phone#: ` _� Address: ( �,_�t`V/� 5 Yv fall& City: Vq �'` State: Zip:'33 Qualifier Name: c5 Phone#: l State Certification or Registration#: Certificate of Competency#: DESIGNER:Arc`hitect/Engineer: t� J(�n Li Phone#:C✓5 Z00&_ 6 Address: 1� l ✓ S I'�� ), City: M I AM) State /- Zip:` Value of Work for this Permit:$ �i� square/Linear}FF000tage of Work: 9& �2 F;i�,_ Type of Work: u Addition ❑ AI eriaP V. r] New LiJ Repair/Replace ❑ Demolitio Description of Work: Specify color of color thru tile: Submittal Fee$ t�j::M Permit Fee$ 6 CCF$ CO/CC$ Scanning Fee$ ®/ Radon Fee$ 06 DBPR$ GG _Notary$ 9C•w Technology Fee$ (t Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ .ma10 y TOTAL FEE NOW DUE (Revised02/24/2014) � 4 ' Bonding Company's Nbtne(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 sev days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved inspec 'on fee will be charged. natur Signature OWNR or GENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged beforemethis ®® day of /1/*lZQ7 r F 20 IL by �rel day of �� 20 l ' ,by ,who is p(!sonally known o �S'100 Ci/J�JO ,who is personally known to me or who has produced as me or who has produced Tj�Q\)FQ— as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: w,� alaO//�p�0� Sign: Print: Print: ROBEWCOLLIER %fie— % `p wz Seal: * MY MISSIOM#FF 190711. Seal: EXPIRN•���, t 1j�OF nov. Thn: 26,2D19 %�✓/�y;r'' ,�, 3 z� APPROVED BY to Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) rvvr♦♦_w.r,wr W-.,rvra r�r•a.e^,rrvvrr,vwraa..••..a. STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD ov 000068083 The GENERAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31,2016 0 CALVO, SIXTO JORGE • ANN-CREST CONSTRUCTION CORP 1140 S.W.84TH AVE. MIAMI FL 33144 y ISSUED: 06!10/2014 DISPLAY AS REQUIRED BY LAW SEQ# L140610OW1193 001299 Local Business Tax Receipt Miami-Dade County, State of Florida THIS IS NOTA BILL - DO NOT PAY \LBT 3578648 BUGINIM NA AVLO"TION NO. EXPIRES ANN CREST'C014=0001 CoRP RENEWAL SEPTEMBER 30, 3016 1140 SW 84 AVE 37W" MIM be dieplayed at place of Waimea MArfA1 EL 33144 Purawd to County Code OWNER SBC.TYPE OF OLMINESS SIXTO CALVO 196 GENERAL BUILDING CONTRACTOR sr X TAX rxi c AYMENT as wodw(S) 2 CGC08M $75.00 07/20/2015 CNECK21-15--098299 Tbw meal Ba Tax Receipt only conch rs payment oltbe Local Business Taos.The Receipt is ao1 a 1108060, pOro�ILoracertTflOaUonof�holdo{6gqoalMioat�ss,mdo6nsinsss:Bolderouucteoo�pfiyarltMOiry�veno0eMa1 oroongssernmeetel regulamy IBM and raphmaeffiswddoh apply to dw budaa66. The REC9Pr AIC,shave muat be dbpbrpd an all commercial whiclas-Iffi ml-Bade Code So 88-M Far more Itdoomation•vhdr DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 03/29/2016 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 policy(les) must be endorsed. If SUBROGATION IS WANED,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 endorsement(s). PRODUCER CONTACT Michael D.Holleman Work Comp Associates,Inc. PHONE ) 863-9581(561) 863-9581 ;,.,,, (561)881-9745 P.O.Box 33297 &"" mail@WorkCompAssoc.com Palm Beach Gardens,FL 33420-3297 INSURERS)AFFORDING COVERAGE NAIC D INSURER A: Bridgefield Employers Insurance Co. INSURED INSURER B: Ann-Crest Construction Corp. INSURER C: 1140 S.W.84th Avenue Miami,FL 33144-4118 INSURER D: 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. INSR AD SUBR POLICY EFF POLICY EXP -Ml ICY NIiMRF:R I fm GENERAL LIABILRY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE T RENTED $ CLAIMS-MADE ❑ OCCUR ❑ ❑ MED EXP(Any oneperson) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ AUC PRO- E LOC $ AUTOMOBILE LIABILITY El COM131NI=D $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED $ UMBRELLA LIAR OCCUR OF-1 EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION X Y/ A ANY PROPRIETOR/PARTNER/D(ECUTMIM N/ O 08 0,370020000 4/1/2015 4/1/2016 E.L.EACH ACCIDENT $ 100,000 (Mandatory in NH) �� E.L.DISEASE-EA $ 100,000 If yes,describe under E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Sixto Jorge Calvo holds license number CGC058063 for Ann-Crest Construction Corp. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Miami Shores Village ACCORDANCE WITH THE POLICY PROVISIONS. Building Department 10050 N E 2nd Avenue AUTHORIZED REPRESENTATIVE Miami Shores Village,FL 33138-2382 xz/ > L ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD :curDate><curTime>Work Comp Associates Inc.Elissa A Lucchese }� • DATE(MM/DD/YYYY) • CERTIFICATE OF LIABILITY INSURANCE 04/15/2016 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 policy(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 lieu of such endomement(s). PRODUCER CONTACT Michael D. Holleman PHONE561 863-9581 FAX 561 881-9745 Work Comp Associates, Inc. (kc.a-,F-* ( ) cvc.sol: ( ) P.O. Box 33297 E"Aa mailOWorkCompAssoc.com Palm Beach Gardens, FL 33420-3297 UMFIER(S)AFFORDING COVERAGE NAIC R INSURER A: Bridgefield Employers Insurance Co. INSURED INSURER 8: Ann-Crest Construction Corp. INSURER C: 1140 S.W.84th Avenue Miami, FL 33144-4118 INSURER D' 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. INSR AD SUB POLICY EFF POLICY EXP GENERAL LIABILITY OCCURRENCE $ COMMERCIAL GENERAL LIABILITY $ CLAMS-MADE ❑OCCUR ❑ ❑ MED EXP(Any oneperson) $ PERSONAL&ADV IMURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO LOC $ AUTOMOBILE LIABILITY ❑ ❑ $ ANY AUTO ALL OWNED SCHEDULED BODILY IMURY(Per person) $ BODILY IMURY(Per accideru) $ HIRED AUTOS NON-OWNED UMBRELLA LIAR HOCCUR ❑ ❑ EACH OCCURRENCE $ EXCESS LIAR GLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION Y/ X A ANY PROPRIETOR/PAR`rNEWEXECUTIV Y N/ N E.L.EACH ACCIDENT $ 100,00 (Mandatory In NH) � ❑ 0830370020000 4/1/2016 4/1/2017 If yea,describe under E.L.DISEASE-EA $ 100,00 E.L.DISEASE-POLICY LIMIT $ 500,00 ❑ ❑ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,It more space is required) According to DBPR,Sato Jorge Calvo holds license number CGC058063 for Ann-Crest Construction Corp. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Miami Shores Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 10050 N E 2nd Avenue Miami Shores Village,FL 3313&2382 AUTHORIZED REPRESENTATIVE. .. p ®1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD