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DS-10-1109Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 8849 BISCAYNE Boulevard Miami Shores, FL PARC2003 -23 Block: Lot: BISCAYNE 88 TERR LLC 1 Owner Information Fees Due CCF Education Surcharge Miscellaneous Fee Permit Fee Technology Fee Total: Amount $0.60 $0.20 $9.00 $150.00 $0.80 $160.60 Address Parcel Number BISCAYNE 88 TERR LLC 1140 KANE CONCOURSE BAY HARBOR FL 33154- (305)868 -8203 (786)252 -9216 1 Contractor(s) Phone CONSTRUCTION DEVELOPER GROUI (305)215 -1988 Cell Phone Approved: Yes Comments: Date Approved: 6/21/2010 : Yes Date Denied: Type of Work: WALKWAY & SLAB Bond Retum : Scanning: 3 Additional Info: CONCRETE & PAVERS Classification: Commercial 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 -named contractor to do the work stated. Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Pear" 14 o Perriitf;7ype: D ys? ±de nralksiSlab Expiration: 12127 /2010 Phone Pay Date Pay Type Amt Paid Amt Due Invoice # DS -6 -10 -38212 07/01/2010 Check #: 1231 $ 160.60 $ 0.00 Applicant July 01, 2010 Date Cell Valuation: Total Sq Feet: $ 400.00 0 Available Inspections: Inspection Type: Final Sidewalk Landscaping Foundation July 01, 2010 1 11P ( BUILDING PERMIT APPLICATION FBC 20 Permit TypeeUILDIN ROOFING Owner's Address / l t0 14 a- C o r4 c ei 4L.S� City Al 14741E Pao 2 State L Contractor's Address cit A vs-t4 ru 2 p State Qualifier Name dro sTA V 0 R 5 ivt A. 4 4 Value of Work For this Permit $ *06. 0 0 Type of Work: /, ❑Addition ❑Alteration Describe Work( ll 1�- u9 2 . 5 I I -0 � '(Z Wr7:Lt_ A-+v➢l fi 1 PAVER 5 (c6 ci e) Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 Zip 33 Tenant/Lessee Name A Z 7 - E 12.+A s. t.Lc / a BA PAPA z o ' S Email Contractor's Company Name CODSjZue j i ab EVE Le Pat. Orr era' 2.© Ul i7Zi ,u Square / Linear Footage Of Work: ❑New ❑ Repair/Replace X 4L" e oiJc 16 5Lam, Ccky 607, 0 2 Phone # Permit No. DS- to • 10 - t► O9 Master Permit No. G - ?7-/Q.. 6 Owner's Name (Fee Simple Titleholder) "Bi S eati7 gg rent. LL Phone # C3 o� 960 . 20 Job Address (where the work is being done) �'� 61' .s G4 7 sod 3 1..vt› . City Miami Shores Villa a County Miami -Dade Zip FOLIO / ARCED PA R. 60 Is Building Historically Designated YES NO 1S Flood Zone Phone # fro) 2 ,5- /5 i34S Zip 3,16 0 Phone # c) q.3 • 9$0 z State Certificate or Registration No. G 4"C- /5 044 95 Certificate of Competency No. Contact Phone (`7 g') 3** - 3 9 0 E -mail Architect/Engineer's Name (if applicable) Phone # Notary $ Training/Education Fee $ [ J • 2....n Scanning $ I-00 Radon $ Double Fee $ Violation date: Structural Review. $ Total Fee Now Due $ I (oO'� See Reverse side /v ❑ Demolition .('AL ******* * * * * * * * * * * * * * * * * ** * * * * ** * * * * * ** F * * * ** * * * *** * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ Jj J oG CCF $ O.��( CO /CC $ Technology Fee $ l 10 DPBR $ Bond $ Bonding Company's Name (if applicable) NIA 'A Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) kVA 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 is the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. a , 6fri„, Signature Owner Agent The f g ing instrument was ackn rr ledged be 1 r day o , 20 , by "._, -'t .� Sign: Print: My Commission Expires: APPROVED BY (Revised 07 /10 /07)(Revised 06/10/2009) As identification and who did take an oath. NOTARY PUBLIC: a sc> 6 (' 1 0 Plans Examiner Engineer Signatur Contractor The foregoing instrument was acknowledged before me this` 9 day of ""u n e , 20 /0 by C-, u5- , c 45rrlct , who is personally known to me or who has produced who is personally known to me or who has produced NOTARY PUBLIC: Print: A-14_& • /) earn t re 7 My Commission E as identification and who did take an oath. MARIA 5. RAMIREZ MY COMMISSION 0 DD909937 EXPIRVS: July 22, 2013 Clerk checked Planning and Zoning Criteria Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Owner's Name: IGHAL GOLOFARB Job Address: 8849 BISCAYNE Boulevard Miami Shores, FL Contractor(s) Phone CONSTRUCTION DEVELOPER GROUP CORP (305)215 -1988 Primary Contractor Yes 1 Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 6/21/2010: Yes Comments: Issue Date: Not Issued Folio Number:PARC2003 -23 Owner's Phone: (305)868 -8203 Total Square Feet: 0 Total Job Valuation: $ 400.00 January 28, 2010 City of Miami Shor :s Planning and Zonin ; Board Miami Shores, Flori is Re: Letter of Author ization Honorable Board: This letter is to certi y that Pizzerias, LLC dba P Construction Consu: :ants, Inc. thru his represent. company in any and all required procedures as tI necessary to comple e the approval of the plans 1 be located at 8849 B scone Blvd. Sincerely, Manny Overton Vice President Pizzerias, LLC dba Papa John's Better Inge edients. Better l izza. pa John's is he five Mario A. City of Miam) ar the future Pal PIZZERIAS, U ;. AN NDEPENDENTLY OWNED AND • PERATED FRANCHIF RA19 ; I1IX F HWY • MIAMI Ft 1.114 • M c ' a.1774 • FAY M AI atImd Eby auth )ruing olivar to repres Shores, nay de a John's Store i o Waste, CEO Pizzerias. LLC dlb/a Papa John's 8619 S. Dixie Hwy ice, FL 33143 JaarY2$2010 To: Mandy dt ZAmg Bid Miami nova Yle 1 M . 2i Ave Miami Slates, FL 33133 (305) 795 -?? . (305) 7564972 gas) . Dear This letter is to web= both the pennissbut by LLC (d'Wa PaPa John's) and theorems :gibe owner, Wayne 38 Tied, LLC fbr Mimi Shores Village to inspect t h e leased spree at 8851 Biscayne 8 1 9 t as wis d * Pizzerias application for malts to build and occupy and operate a pi -omit and delivecy badness out of the shoppin =am According to the taut Dade Property Appsilsor web site (t6 as w+euce), the legal description of** * part,' FARMINGTON SUB P8 4847 LOT 4 SIZE 16258 SQUARE FEET COC 22120-074447-50 0304 6(6) OR 22120.074/ 0304 03 D u c e to t h e fact that b kepi p r o p e r t y condsts of lam a then one bsdld , t e lea premises roe atkbessed as :8849 Bi srayae Blvd, consisting of 2050 Square Fast located is the North wail bar of the btdid . 1001 R3RYY 0 >IAl' 01 Nam Tdic Biscayne $8 T 1140 Ka se Concourse #5 Fl.. Bay Harbour hand FL 33154 E ALEX SINK STATE OF FLORIDA CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * * CONSTRUCTION- INDUSTRY EXEMPTION EFFECTIVE DATE: PERSON: FEIN: 07/13/2010 EXPIRATION DATE: 07/12/2012 ASMAN 043709495 BUSINESS NAME AND ADDRESS: CONSTRUCTION DEVELOPER GROUP CORP 20381 NE 30TH AVE #414 AVENTURA FL 33180 SCOPES OF BUSINESS OR TRADE: 1- GENERAL CONTRACTOR MC CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09-06 DWC - 252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09-06 GUSTAVO CUT HERE 05 -21 -2010 This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. IMPORTANT: Pursuant to Chapter 440 . 05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05112), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt and certilicates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE QUESTIONS? (850) 413 - 1609 STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CONSTRUCTION INDUSTRY CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW EFFECTIVE: 07/13/2010 EXPIRATION DATE: 07/12/2012 PERSON: GUSTAVO ASMAN FEIN: 043709495 BUSINESS NAME AND ADDRESS: CONSTRUCTION DEVELOPER GROUP CORP 20381 NE 30TH AVE 0414 AVENTURA, FL 33180 SCOPE OF BUSINESS OR TRADE: 1- GENERAL CONTRACTOR IMPORTANT 0 Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election L under this section may not recover benefits or compensation under this D chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be H exempt.. apply only within the scope of the business or trade listed on R the notice of election to be exempt. E Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. QUESTIONS? (850) 413 -1609 * Carry bottom portion on the job, keep upper portion for your records. FAX 305 441 6443 FIRST CLASS INSURANCE NA ACORD CERTIFICATE OF LJABILITY INSURANCE DATE enierrfrrn touette First Class Insurance Alaiket 392 Minorca Ave Coral Gables. FL 33134 L Av Group Cap 2 0454 West Qbdw Highway entura Fl 33180 LIES THE POUCCES OF INSURANCE LISTED BELL HAVE BEEN OiSSUED TO THE INSURED NAMED ABOVE FORTHE POLICY PERK INDICATED. NOTWITHSTANDING ANY REousteata, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TOWI8OH CERTIFICATE MAY BE ISSUED OFI MAY PERTAIN, THE INSURANCEAPFORDED BY'THE ROLEXES DE ED IS PTO ALL tS THETEfl ENCLUStONS AND COMMONS OF SUCH .111k '� . N ., a,�. '; P: - i � . CERTIEICATE HOLDER IMMO, VC tVOT3ffitTE teansettacauca &MOM RIPMENth ACORD 95(2001/08) Miami Shores Village 10050 Northeast 2nd Avenue Miami Shores, Florida 33138 (305)441-20971 VS CERTIFICATE I8 AS 'A MA11D OF INFORMATION INE.YAND CONFERS NO RIGHTS UPONTHECERTIRCATE HOLQIET. THIS OSTITROATE DOES`NOTAMEND. EXTEND OR THE a GE CANCELLATION ink auwAverfotota. 30 orranourrow urestsmearsueestorroso OWL K IO UE+ON THE off. ITS rGJtlA CA ACOR2 'CORPORATION 1008