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DS-12-2240Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 182048 Permit Number: DS -11 -12 -2240 Scheduled Inspection Date: March 12, 2013 Inspector: Rodriguez, Jorge Owner: PROPERTIES LLC, SHORE SQUARE Job Address: 9031 -9069 BISCAYNE Boulevard Miami Shores, FL 33138- Project: <NONE> Contractor: A&A FONTE INC Permit Type: Driveways /Sidewalks /Slabs Inspection Type: Final Work Classification: Addition /Alteration Phone Number (305)779 -8040 Parcel Number 1132060110051 -31 Phone: (305)512 -4739 Building Department Comments ASPHALT REPAIR AND OVERLAY HANDICAP RAMP DETAIL CLARIFICATION Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. March 11, 2013 For Inspections please call: (305)762 -4949 Page 6 of 23 do) q 113— IZk^) BtJII;DING PERMIT APPLICATION 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 Permit Type: JOB ADDRESS: FBC ID Permit No. 1-3 1 o Master Permit No. BUILDING ROOFING 9 03 L_Nt . City: Miami Shores County: Miami Dade Zip: Folio/Parcel #: I' 3 2' 0(001 I 00 — l Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): Te UQ ' (C 1(h'e`j Phone #: r5'8 "qQ Address: (..0C11.0 NCE, k 2b- city: "\ t( A State: A-1— Zip: 3 ) CAP 1 Tenant/Lessee Name: Phone #: Email: CONTRACTOR:` Compannyp Name: r 4"fik -I-0 ' Tt✓ Q Address: R(3 V V +' .ILQ.E:O J Yt t� B Phone #: 305 — s) 2. `4739 City: —` \� Qualifier Name: Q V� Zip: 3301E Phone #: State Certification or Registration #: �0 Certificate of Competency #: .tom ®C,b // Contact Phone #: Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ of e(/ • Square/Linear Footage of Work: Type of Work: °Addition Description of Work: °Alteration UNew °Repair/Replace °Demolition C lor thru tile: f t ftCPR 1c , * * * * * * * * * * * * * * * * * * * *F Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ d CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ • 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S ANN'IDAVIT: 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 occur seven (7) days after the building permit is issued. In th ; absence of such posted notice, the inspection will not be ap o =.�' d a reinspection fee will be charged. Signature /� Signature i wner or Agent i • ntractor A. 9ent was acknowledged before me this The forego g instrument a knowled ed before me 026 20 V-- , by i`�1��.ZhGt� , day of Pil'n , 20 y 1 r- , The foregoing ins day of i L,!I1(1;ir whop 'c.Tersnnown to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Ldp (tr1P o My Commission Expires: NOTARY PUBLIC: Sign: Print: My Commission Expires: 1.11 • MANUELA ARROYAVE * * * * * * * * * * * * * * * * * * ** , y * ,+N}1k£fatiM1iSSIl fi4 • �,i,�•r,• EXPIRES July 18, 2015 (407) 393 -0153 FloridalloarvSsrv,ce.com Plans Examiner Structural Review (Revised 5/2/2012)(Revised 3/12/2012) XRevised 06 /10/2009XRevised 3 /15 /09)(Revised 7/10/2007) Clerk CTQB Construction Trades Qualifying Board BUSINESS.CERTIFICATE OF COMPETENCY E0601146 A & A FONTE, INC 'D.B.A.: H N JOSEPH is certified under the provisions of Chapter 10 of Miami -Dade County QUALIFYING TRADE(S) 0001 GENERAL ENGINEERING Charles Danger P.E. &ereary of IM Board Licensing Portal - License Search Page 1 of 1 1:45:45 PM 1/15/2013 Data Contained In Search Results Is Current As Of 01/15/2013 01:44 PM. Search Results Please see our alossary of terms for an explanation of the license status shown in these search results. For additional information, including any complaints or discipline, click on the name. License Type Certified Underground Utility and Excavation Contractor Name Name Type A & A FONTE INC DBA License Number/ Rank CUC1224088 Cert Under Main Address *: 233 VISCAYA AVENUE CORAL GABLES, FL 33134 Mailing Address *: 12963 W OKEECHOBEE RD #8 HIALEAH GARDENS, FL 33018 Certified Underground CUC1224088 Utility and ARMAKAN, BAHRAM Primary Cert Under Excavation Contractor Main Address *: 233 VISCAYA AVENUE CORAL GABLES, FL 33134 Mailing Address *: 12963 W OKEECHOBEE RD #8 HIALEAH GARDENS, FL 33018 Status/ Expires Current, Active 08/31/2014 Current, Active 08/31/2014 * denotes Main Address - This address is the Primary Address on file. Mailing Address - This is the address where the mail associated with a particular license will be sent (if different from the Main or License Location addresses). License Location Address - This is the address where the place of business is physically located. 1940 North Monroe Street. Tallahassee FL 32399 :: Email: Customer Contact Center :: Customer Contact Center: 850.487.1395 The State of Florida is an AA /EEO employer. Copvriaht 2007 -2010 State of Florida. privacy Statement Under Florida law, email addresses are public records. If you do not want your email address released in response to a public - records request, do not send electronic mail to this entity. Instead, contact the office by phone or by traditional mall. If you have any questions, please contact 850.487.1395. *Pursuant to Section 455.275(1), Florida Statutes, effective October 1, 2012, licensees licensed under Chapter 455, F.S. must provide the Department with an email address if they have one. The emails provided may be used for official communication with the licensee. However email addresses are public record. If you do not wish to supply a personal address, please provide the Department with an email address which can be made available to the public. Please see our Chapter 455 page to determine if you are affected by this change. https:// www.myfloridalicense.com/w111.asp ?mode =2 &search= LicNbr &SID= &brd = &typ= 1/15/2013 PERMIT # 2;2 --22 CONTRACTOR: � 4 ^ F N_ SUBMITTAL DATE: I I 0 � 0 �7` 12 ADDRESS: c,o gj ( ��t�" t Z 8L 4JO NAME: St---( C SQLx2 C 2c Y i RESUBMITAL DATES: PROJECT TYPE: ZONING STRUCTURAL FIRE IMPACT FEES ELECTRICAL PLUMBING !MECHANICAL HRS/DERM A&AFO -1 OP ID: AG A'�,.. ---- CERTIFICATE OF LIABILITY INSURANCE °01107` /201' 3 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: H the certificate holder is an ADDITIONAL INSURED, the policy(tes) must be endorsed. B 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 Phone: 305-384-7800 BROWN & BROWN OF FLORIDA INC 14900 NW 79th Court Suite/MOO Fax: 305-714-4401 Mlaml Lakes, FL 33016.5869 Ramon A Rodrigues Nei. nAln� EaU tom. Not L ADDRESS: INSURdCS) AFFORDING COVERAGE NA1C a INSURER A : FCC I Commercial Insurance Co 33472 INSURED A & A Fonts, Inc. Andres Fonte, Jr. 12963 W Okeechobee Road 08 Hialeah Gardens, FL 33018 INSURER a :FCC1 insurance Company 10178 INSURER C :National Trust Insurance Co. 20141 INSURER D: /MBEs tE a nee) INSURER E : INSURER F : X 1 OCCUR CERTIFICATE • THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED 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 POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTRI _ TYPE OF INSURANCE nom, K&Eat UMBER n arvy :c 04/01/2012 jade LIMITS A GENERAL X UARIUTY COMMERCIAL GENERAL LIABILITY GL00132691 0410112013 EACH OCCURRENCE $ 1,000,000 /MBEs tE a nee) $ 100,000 CLAIMS -MADE X 1 OCCUR MED EXP (Any one person} $ 5,000 X Contractual Uabl PERSONAL & ADV INJURY $ 1,000,000 GENERALAGGREGATE $ 2400,000 GENT. AGGREGATE UMIT APPUESPER: 7 POLICY I I LOC A I PRODUCTS - COMP/OP AGO $ 2,000,000 $ C AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED HIRED AUTOS SCHEDULED NON-OWNED CA00208821 04/0112012 04/01/2013 (j) (SINGLE UMrc $ 1,000,000 SODILY INJURY (Per Pereon) $ BODILY INJURY (Per accident) $ (Per ;AMAGE $ $ UMBRELLA LIAR EXCESS LIAR X OCCUR CLAIMS -MADE UMB001407301 04/01/2012 04101/2013 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ DED I X I RETENTION $ 101000 $ B WORKERSCOMPENSATION ANDEMPLOYER$' IIUTY LUU ANY PROPRIETOR/PARTNER/EXECUTIVE YJN OFFICER/MEMBER EXCLUDED? LJ (Mandatory M NH) If yes, describe under DESCRIPTION OPERATIONS below N I A 001WC12A83837 04/01/2012 0410112013 WCSTATU- X OTH- TORY LIMITS 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 1 LOCATIONS 1 VEHICLES (Attach ACORD 101, Additions! Remarks Sch,dtd*, 11 more spat* is required) CERTIFICATE HOLDER CANCELLATION Mlaml Shores Village Building Dept 10050 NE 2nd Avenue Miami Shores, FL 33138 SHOULD ANY CF 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 THIS IS NOT A BILL — DO NOT PAY RECEIPT NO. 30-7167406 CC N0: E0601146 BUSINESS NAME / LOCATION A & A FONTE INC 12963 W OKEECHOBEE RD OWNER :A & A FONTE INC SEE BACK OF RECEIPT FOR A LIST OF NON - PARTICIPATING MUNICIPALITIES Receipt holder must register in the city where work is to be done. '17170 112 12 02280004001 000300.00 FIRST -CLASS U.9. POSTAGE PAID MIAMI, FL PERMIT NO. 23 RECEIPT HOLDER MAY DO BUSINESS AS A CONTRACTOR AS SPECIFIED HEREON. GENERAL BUILDING CONTRACTOR DO NOT FORWARD A & A FONTE INC ANDRES FONTE PRES 12963 W OKEECHOBEE RD B HIALEAH GARDENS FL 33018 1 'TM14AU0 71 1WfA1 A . FIRST -CL U.S. POST 1St FLOOR . PAID MIAM4FL3 MIAMI, PERMIT NC 594765-1 8 AN� Fr�N�E INC 12963 W OKEECHOBEE RD 33018 HIALEAH GARDENS THIS IS NOT A SILL — DO NOT PAY pp�ttRENEWAL CC #RECI �EIOb0146 8 owA & A FONTE INC 1Ye to iL BUILDING CONTRACTOR WDRK13 /S THIS IS ONLY A LOCAL BUSINESS TAX RECEIPT. fr COES NOT PERMIT THE HOLCBR TO VIOLATE ANY ZONING REGULATORY W F THE COUNTY OR. Non DO NOT FORWARD noes R EXEMPT THE MFR PROM ANY MIER REQUIRED NOT A B3TIRCATION OF THE WS QUALIFICA- TIONS. PAYMENT RECEIVED MUTAIFOADE COUNTY TAX COLLECTOR: 60030000059 000054.00 SEE OTHER SIDE A & A FONTE INC ANDRES FONTE PRES 12963 W OKEECHOBEE RD 8 HIALEAH GARDENS FL 33018 1111111 1 111111 I MI11111111 1111 11 1111111111/1111111111111ML°i11 716740 -6 Miami Shores Village Building Department RECEIPT 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 PERMIT* 1 _ 4(3 DATE: - I ) a 1, C'a� fLd�.�©,, • 1�t�YLNt. t�Z . o Contractor o Owner o Architect Picked up 2 sets of plans and (other) 9O2 Address: From the building department on this date in order to have corrections done to plans And /or get County stamps. I understand that the plans need to be brought back to Miami Shores Village Building Department to continue permitting process. Acknowledged by: PERMIT CLERK INITIAL: eff/fig-- RESUBMITTED DATE: PERMIT CLERK INITIAL: www.sunbiz.org - Department of State Page 1 of 2 Home Contact Us E- Filing Services Document Searches Forms Help Previous on List Next on List No Events No Name History Return To List Detail by Entity Name Florida Limited Liability Company SHORE SQUARE PROPERTIES, LLC Filing Information Document Number L11000075982 FEUEIN Number 452672348 Date Filed 06/30/2011 State FL Status ACTIVE Effective Date 06/28/2011 Principal Address 696 NE 125TH STREET NORTH MIAMI FL 33161 US Mailing Address 696 NE 125TH STREET NORTH MIAMI FL 33161 US Registered Agent Name & Address ROBERT A. BRANDT, PA 696 NE 125TH STREET NORTH MIAMI FL 33161 US Manager /Member Detail Name & Address Title MGR IZHAK, YORAM 696 NE 125TH STREET NORTH MIAMI FL 33161 US Title MGR LIPTON, ALAN 649 OCEAN BLVD GOLDEN BEACH FL 33160 Annual Reports Report Year Filed Date 2012 03/29/2012 Document Images 03/29/2012 — ANNUAL REPORT Entity Name Search http: / /sunbiz.org/ scripts /cordet.exe ?action= DETFIL &inq_doc number= L11000075982 &i... 11/26/2012 www.sunbiz.org - Department of State 08/30/2011 — Florida Limited Liability PDF forty Note: This is not official record. See documents if question or conflict. Previous on List Next on List Return To List No Events No Name History 1 Home I Contact us I Document Searches 1 E- Filinq Services I Forms I Help 1 Copyright© and Privacy Policies State of Florida, Department of State Page 2 of 2 Entity Name Search Sub http: / /sunbiz.org/ scripts /cordet.exe ?action= DETFIL &ing_doc number= L11000075982 &i... 11/26/2012 Permit No: 12 -2240 Job Name: December 3, 2012 Building Critique Page 1 of 1 The plans must show the area of work. This permit is required for the repair of asphalt for new sewer line and removal of the septic system /tanks. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Norman Bruhn CBO 305 - 762 -4859 Permit No: 12 -2240 Job Name: December 3, 2012 Building Critique Page 1 of 1 - The plans must show the area of work. This permit is required for the repair of asphalt for new sewer line and removal of the septic system /tanks. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Norman Bruhn CBO 305- 762 -4859 Code Cpani)laa ice Con7sultU g • tolation Resolution' Ope E p e Perm t ClosJje Gei,tilicatiotl; " PiansY er"Iiitt Ex ed�tiii'g,° ennlitAdrninistration' nspeGuoi regilispeCtioli Wa k Through Pre�Su mrttaI Tell lit I pEoveanents Lie!) Mitigatioii RICARDO E. BERMUDEZ ct-L PlansRunner Permitting 8[ Code Compliance Services Tel: 305.989.0311 Fax: 305.226.8698 P.O. Box 559043 Miami, FL 33255 -9043 nerco`;