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CC-15-3052 (2)Permit NO. CC -12-15-3052 I,Permit Type: Commercial Construction Work Classification: Alteration Permit Status: APPLIED Expires: 10/22/2016 1 For Inspections call 1(866) 701-3365) 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 Fax: (305)756-8972 Project Address 9050 BISCAYNE Boulevard Miami Shores, FL 33138 - Owner Information Issue Date: 4/25/2016 Parcel No.. 1132060100010 Address Tract No. Block No. Lot No. Section Township Phone Cell PUBLIX SUPERMARKETS, INC P 0 BOX 407 LAKELAND FL 33802-0407 (863)688-747_ Contractor(s) Phone Primary Contractor D&J CONSTRUCTION INC Yes Proposed Construction / Details CHANGE OUT REFRIGERATED CASES, UPDATE DECOR, REPAIR P1.00RING Fees Due Amount CCF $126.00 CO/CC Fee $50.00 DBPR Fee $94.50 DCA Fee $94.50 Education Surcharge $42.00 Notary Fee $0.00 Permit Fee $6,300.00 Plan Review Fee (Engineer) $120.00 Scanning Fee $60.00 Technology Fee $168.00 Total: $7,055.00 Valuation: Total Sq Feet: $ 210,000.00 0 Total I Amt Paid I Amt Due $ 13,355.00 $ 7,055.00 $ 6,300.00 Required Inspections: Inspection IVR See Permit Record Building Department Copy Monday, April 25, 2016 2 \ .,O' kS\CC° Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 BUILDING PERMIT APPLICATION •BUILDING ❑ ELECTRIC ❑ ROOFING ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS JOB ADDRESS: 9050 Biscayne Blvd Master Permit No. IBY: FB -C-2 y GGi s - 3os2 C T TED DEC 092015 Sub Permit No. ❑ REVISION ❑ EXTENSION ❑ RENEWAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS City: Miami Shores County: Miami Dade Zip: Folio/Parcel#:11-3206-010-0010 Occupancy Type: Is the Building Historically Designated: Yes NO Load: Construction Type: Flood;Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Nrthem Trust Bank ETAL % Publix Super Market phone#: 863-688-1188 Address: Post Office Box 32025 City: Lakeland Tenant/Lessee Name: Publix Super Markets Email: State: FL Zip: 33802 Phone#: CONTRACTOR: Company Name: D & J Construction Inc. Address: 3350 Bums Road Phone#: 954-587-2360 City: Ft. Lauderdale Qualifier Name: Donald A Schooley State: FL Zip: 33314 Phone#: 954-587-2360 State Certification or Registration #: CBC 028046 Certificate of Competency #: DESIGNER: Architect/Engineer: Atkins Phone#: 305-592-7272 Address: 2001 Northwest 107 Avenue City: Miami State: FL Zip: 33172 Value of Work for this Permit: $X/01040" Square/Linear Footage of Work: Type of Work: ❑ Addition n Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: Change out refrigerated cases, update decor, repair flooring Specify color of color thru`tile: �•v�� Permit Fee $pG/S W • CO CCF $ ID 6 . co,cc $ 50 • CO Scanning Fee $ 60 . Radon Fee $ 1 Li-` 50 DDBPRnn$��— r'•.5VNotary $ co Technology Fee $ 6 8 • W Training/Education Fee $ L4 l.1LJ Double Fee $ Bond $ 'Sc Submittal Fee $ 0. U0 Structural Reviews $ (a (3 (Revised02/24/2014) J TOTAL FEE NOW DUE $ 6,6 -J Ci) Bonding Company's Name (if applicable) N/A Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) N/A 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. 1 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 OWNER or AGENT The foregoing instrument was acknowledged before me this CONTRACTOR The foregoing instrument was acknowledged before me this ( _ clay of Oar fAIber— , 20' 5 , by day of k z3VQ Vyk1S-V , 20 by Pf+S' rocwt ' " , who is pPrcnnally 4.,.+..,., to IJ � kaJc a . 5 c { w I , who is me or who has produced identification and who did take an oath. NOTARY PUBLIC: Si Print: L5Joctr Seal: +O.'"' :° JODI L. SLOAN * , * MY COMMISSION # FF 184644 EXPIRES: February 5, 2019 4 of F`0>°� Bonded Thru Budget Notary Services as me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: k -(e, 143 ;4+ onall kno as ARLETTA WOOD MY COMMISSION # FF 001997 EXPIRES: May 27, 2017 Bonded Thru Notary Public Underwriters wona,. m ua. e.aeao+sm.ms ***** *arc et* ********************,********* *le ******************************************************************* APPROVED BY (Revised02/24/2014) Plans Examiner Zoning Structural Review Clerk Publix. LIMITED POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS, that PUBLIX SUPER MARKETS, INC., a Florida corporation ("Publix"), by and through it undersigned officer, having its mailing address at P. O. Box 407, Lakeland, Florida 33802-0407, pursuant to a proper Corporate Resolution, does hereby appoint ROBERT J. MCGARRITY, P.E., Director of Construction for Publix Super Markets, Inc., to do and execute all or any acts with respect to the permitting, notice of commencement, construction and occupancy of Publix stores under construction or to be constructed, or in connection with the remodeling of Publix stores, as fully as said corporation might or could do through its officers. IN WITNESS WHEREOF, the undersigned has caused the within to be duly executed by its proper officer and the seal of the corporation hereto affixed by proper authority of its Board of Directors. Two Witnesses: PUBLIX S ,44_ By: l ' . STATE OF FLORIDA COUNTY OF POLK The foregoing instrument was acknowledged before me this (9-41 day of 2012, by JOHN A. ATTAWAY, JR., Senior Vice President, General Counsel and Secretary of PUBLIX SUPER MARKETS, INC., a Florida corporation, on behalf of said corporation. He is personally known to me and did not take an oath. •ER ��1'irii.-) ,; E/r7/% John A. Attaw•nj r•iac„];'resident, General Counsel anctsy iI $% .:GIDE{ R'Q >► . 1 (Corporate' Via" '4 ; ai u 27 -� * •• SEAL i" 1, ) tS ��ly l•� �.R My Commission Expires: f.:"r.'i..'..`�i3 '. .��.". ,.n:..oCdr. _",.2';Z. ..7.::5.c.,,:" S:29 l " w°'w". .+ 2.7.1' .... ...;,'.:.�1=frir). .:57:: n2?"rw' .ECZAT. r.>w.4i.<..9�. BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 – 954-831-4000 VALID OCTOBER 1, 2015 THROUGH SEPTEMBER 30, 2016 ?' DBA: Business Name: D & J CONSTRUCTION INC Owner Name: DONALD A SCHOOLEY Business Location: 3350 BURRIS RD C DAVIE Business Phone: 587-2360 Rooms Seats Employees 30 Receipt #:7.7 GEt ERALSCONTRACTOR Business Type:CONTRACTOR) Business Opened:07/16/1993 State/County/Cert/Reg:CBc02804 6 Exemption Code: Machines Professionals For Vending Business Only Number of Machines: Vending Type: (GENERAL 4 t^` 3s; Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 81.00 0.00 0.00 0.00 0.00 0.00 81.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT WHEN VALIDATED Mailing Address: DONALD A SCHOOLEY 3350 BURRIS ROAD SUITE C DAVIE, FL 33314 RICK SCOTT, GOVERNOR This tax is levied for the privilege of doing business within Broward County and is non -regulatory in nature. You must meet all County and/or Municipality planning and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. Receipt #138-14-00008847 Paid 07/09/2015 81.00 2015 - 2016 STATE ,OF FLORIDA DEPARTMENT QF BUST "NESS AND PROFES$IQNAL' REGULATION CONSTRUCTIQN,IND-USTRY"LIOENSING.. BOARD '`K KEN LAWSON, SECRETARY LICENSE NUMBER r . CBCO28046 tom ` . The BUILDING:. CONTRACTOR Named below IS. CERTIFIED -7-7----'7- lliider--the-provisions of-05apter 4a9.7F.S:: Explrafodate • H0QL—E-Y DQIVALD • D&JCO-5 OP ID: D3 A� R0" CERTIFICATE OF LIABILITY INSURANCE DATE 11/30IDD/YYYY) 11 /30/2015 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: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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 endorsement(s). PRODUCER Brown & Brown of Florida, Inc. 1201 W Cypress Creek Rd # 130 P.O. Box 5727 Ft. Lauderdale, FL 33310-5727 Gerald J. Arch, CPCU, CIC CONTACT NAME: PHONE FAX (A/C, No. Extl: (AIC, No): .MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Amerisure Insurance Company 19488 INSURED D & J Construction, Inc. D & J Construction Services, Inc. 3350 Burris Road, Suite C Fort Lauderdale, FL 33314 INSURER B:Amerisure Mutual Ins. Co. 23396 INSURER C : 01/01/2016 INSURER D : $ 1,000,000 INSURER E : $300,000 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 TYPE OF INSURANCE ADM SUER POUCY NUMBER POUCY EFF (MM/DD/YYYYI POUCY EXP (MM/DDiYYYY) �� A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY CPP208056403 01/01/2015 01/01/2016 EACH OCCURRENCE $ 1,000,000 DAMAGES(RENTED PREMISES {Ea ocarrence) $300,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY 5 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE —1 POLICY X LIMIT APPLIES JF T PER: LOC PRODUCTS - COMP/OP AGG $ 2,000,000 Emp Ben. a 1,000,000 A AUTOMOBILE X X LABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS rliNaWNED CA205096007 01/01/2015 01/01/2016 COMBINED SINGLE LIMIT (Ea accident) 1 E ,000 ,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PRO E TY DAMAGE(PE $ $ B X UMBRELLA UAB EXCESS UAB X OCCUR CLAIMS -MADE CU206669705 01/01/2015 01/01/2016 EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 DED X RETENTION E 0 $ A WORKERS COMPENSATION AND EMPLOYERS' UABIUTY ANY PROPRIETOR/PARTNER/EXECUTNE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y/N N N / A WC205095707 01/01/2015 01/01/2016 X WC STATU- TORY LIMITS OTH ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule If more space Is required) CBC 028046 CERTIFICATE HOLDER CANCELLATION 1 Miami Shores Village g Building Department 10050 N.E. 2nd Avenue Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD D&JCO-5 OP ID: D3 A�RL�ry CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 04/05/2016 '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(ies) 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 endorsement(s). PRODUCER Brown & Brown of Florida, Inc.PHONE 1201 W Cypress Creek Rd # 130 P.O. Box 5727 Ft. Lauderdale, FL 33310-5727 Ken E Willits, CPCU, CFP, CRIS CONTACT NAME: FAX (A/C, No, Eat):954-776-2222 (A/C, No): 954-776-4446 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Ameris u re Insurance Company 19488 INSURED D & J Construction, Inc. 3350 Burris Road, Suite C Fort Lauderdale, FL 33314 INSURER B:Amerisure Mutual Ins. Co. 23396 INSURER C 01/01/2017 INSURER D : $ 1,000,000 INSURER E : INSURER F : X COVERAGES CERTIFICATE 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF JMM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY CPP208056404 01/01/2016 01/01/2017 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR PREMI ETORENTED PREMISES (Ea occurrence) $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE POLICY OTHER: X LIMIT APPLIES JECOT- PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 Emp Ben. $ 1,000,000 A AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS NON- AUTOOWNEDS CA205096008 01/01/2016 01/01/2017 (COMEaaBINEDISINGLE LIMIT $ 1,000,000 BODILYINJURY(Perperson) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE CU206669706 01/01/2016 01/01/2017 EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 DED X RETENTION $ 0 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YN ANY NYIPRRPRIETOER/P RTNER/?ECUTIVE O(Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N N/A WC205095708 01/01/2016 01/01/2017 X PER STATUTE OTH- ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CBC 028046 CERTIFICATE HOLDER CANCELLATI Miami Shores Village g Building Department 10050 N.E. 2nd Avenue Miami Shores, FL 33138 i SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 nspection Number: INSP-293325 Inspection Date: December 05, 2017 Inspector: Riveron, Alexis Owner: INC, PUBLIX SUPERMARKETS, Permit Number: CC -12-15-3052 Job Address: 9050 BISCAYNE Boulevard Miami Shores, FL 33138 - Project: <NONE> Contractor: DSJ CONSTRUCTION INC Permit Type: Commercial Construction Inspection Type: Final Building Work Classification: Alteration Phone Number (863)688-747_ Parcel Number 1132060100010 Building Department Comments CHANGE OUT REFRIGERATED CASES, UPDATE DECOR, REPAIR FLOORING fnfractia Passed Comments INSPECTOR COMMENTS False Passed Inspector Comments Failed Correction Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. For Ins December 04, 2017 ctions please call: (305)762-4949 Page 1 of 1 INSP-ECTION RECORD Miami Shores Village 10050 N.E. 2nd Avg --nue Miami Shores, FL 33138-0000 Phone: (305)795-2204 Fax: (305)756-8972 POST ON SITE Permit NO. CC -12-15-3052 Permit Type: Commercial Construction. Work Classification: Alteration Issue Date: 4/25/2016 Expires: 10/22/2016 INSPECTION REQUESTS: (305)762-4949 or Log on at https://bldg.miamishoresvillage.comlcap REQUESTS ARE ACCEPTED DURING 8:30AM - 3:30PM FOR THE FOLLOWING BUSINESS DAY. Requests must be received by 3 pm for foil. • a ,.inspectLpns. Commercial Constru Owner's Name: PUBLIX SUPERMARI4 Job Address: 9050 BISCAYNE Bo Bond Number: Contractor(s) D&J CONSTRUCTION INC Phone Primary Contractor Yes Parcel #:1132060100010 Owner's Phone: Total Square Feet: (863)688-747_ 0 Total Job Valuation: $ 210,000.00 WORK IS ALLOWED: .MONDAY THROUGH FRIDAY, 8:OOAM - 7:OOPM. SATURDAY 8:OOAM - 6:OOPM. NO WORK IS ALLOWED ON SUNDAY OR HOLIDAYS. BUILDING AND ROOFING INSPECTIONS ARE DONE MONDAY THROUGH FRIDAY. r_ �!' j:��/yam ;� �,i- ,,: �� �•�,.-- c am, Vsvuyi LOA1A &eat wed c-4,4‘,441 4iftsr s c,4,e .44 6tA eoe. 6t4 I (1.e 6 seit D 7-D/-- got 6 5-Z g mi Arc." "a "1 - Ph27 7Q -c- s¢ fr' i -C_. i1sv! ATL - /9 /L7fr't/ 6— 2,cTv ��/lam NO INSPECTION WILL BE MADE UNLESS THE PERMIT CARD IS DISPLAYED AND HAS BEEN APPROVED. PLANS ARE READLY AVAILABLE. IT IS 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 NOTICE OF COMMENCEMENT. INSPECTION RECORD STRUCTURAL INSPECTION DATE INSP Foundation Stemwall Slab Columns (1st Lift) Columns (2nd Lift) Tie Beam Truss/Rafters Roof Sheathing Bucks Windows/Doors Interior Framing Insulation Ceiling Grid, Drywall Firewall Wire Lath Pool Steel Pool Deck Final Pool Final Fence Screen Enclosure Driveway Driveway Base Tin Cap Roof in Progress Mop in Progress Final Roof Shutters Attachment Final Shutters Rails and Guardrails ADA com • liance FINAL DOCUMENTS Soil Bearing Cert Soil Treatment Cert Floor Elevation Survey Reinf Unit Mas Cert Insulation Certificate Spot Survey Final Survey Truss Certification STRUCTURAL COMMENTS ZONING INSPECTION DATE INSP Zoning Final ZONING COMMENTS ELECTRICAL INSPECTIONDATE INSP Temporary Pole 30 Day Temporary Pool Bonding Pool Deck Bonding Pool Wet Niche Underground Footer Ground Slab Wall Rough CeilingRo Roug , i Telephone Rough Telephone Final TV Rough TV Final Cable Rough Cable Final Intercom Rough Intercom Final Alarm Rough Alarm Final �� Fire Alarm Rough - . :• Fire Alarm Final Service Work With 4.7,";,K..-07141' FINAL ELECTRICAL COMMENTS PLUMBING INSPECTION DATE INSP Rough Water Service 2"d Rough Top Out Fire Sprinklers Septic Tank Sewer Hook-up Roof Drains Gas LP Tank Well Lawn Sprinklers Main Drain Pool Piping Backflow Preventor Interceptor Catch Basins Condensate Drains HRS Final FINAL PLUMBING COMMEN TS MECHANICAL INSPECTION INSP Underground Pipe Rough Ventilation Rough Hood Rough Pressure Test Final Hood Final Ventilation Final Pool Heater Final Vacuum INSPECTION Final Sprinkler Final Alarm MECHANICAL COMMENTS PEST CONTROL, INC. NOTICE OF TERMITE PROTECTIVE TREATMENT As REQUIRED BY FLORIDA BUILDING CODE (FBC) 104.2.6 As PER 104.2.6 -IF SOIL CHEMICAL BARRIER METHOD FOR TERMITE PREVENTION IS USED, FINAL EXTERIOR TREATMENT SHALL BE COMPLETED PRIOR TO FINAL BUILDING APPROVAL. DATE OF TREATMENT: 10 (3' 1 BUILDER NAME: TIME OF TREATMENT: IN i i J APPLICATORT .1 � OUT yyy TREATMENT ADDRESS: JOB #: LOT: SPRAY & TAMP CHEMICAL;4b 15 MONOLITHIC 0t; v - CHEMICAL: qo5' �r elOtZo BLOCK: UNIT: SPRAY # RESIDENTIAL S/F L/F G.� STEMWALL GALLONS SF L/F STAGE OF TREATMENT (HORIZONTAL, VERTICAL, ADJOINING SLAB, RETREAT OF DISTURBED AREA) PERIMETER TREATMENT GALLONS DATE OF TREATMENT: 1 . TIME OF TREATMENT: APPLICATOR: L/F 300 S. STATE ROAD 7 PLANTATION, FLORIDA 33317 954-584-8588 1-800-749-8588 FAX: 954-584-6117