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DS-15-3074 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-249206 PermixNumber: DS-12-15-3074 Scheduled Inspection Date: February 01, 2016 Permit Type: Driveways/Sidewalks/Slabs Inspector: Rodriguez,Jorge Inspection Type: Final Owner: RIVERA, FRANZ AND JASMIN Work Classification: Addition/Alteration Job Address:10255 BISCAYNE Boulevard MIAMI SHORES, FL 33161- Phone Number (305)799-0935 Parcel Number 1132050190070 Project: <NONE> Contractor: ANATOLIA CONSTRUCTION Phone: (305)3048556 Building Department Comments RELOCATE GENERATOR Infractio massed 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 January 29,2016 For Inspections please call: (305)762-4949 Page 12 of 36 Permit NO.,----D$'-I,,,24 64074 >i> Miami Shores VillageJL PetriTTy ( 3 &Fdilk )a 10050 N.E.2nd Avenue �r ClasSi�ca�cr?:A�IdilOnlAit��tt�lt�rt Miami Shores,FL 33138-0000 Phone: (305)795-2204 " Permit Stat.APPROVED _ , 12/30j `1 Expiration: 06/27/2016 Project Address Parcel Number Applicant 10255 BISCAYNE Boulevard 1132050190070 MIAMI SHORES, FL 33161- Block: Lot: FRANZ AND JASMIN RIVERA .j Owner Information Address Phone Cell FRANZ AND JASMIN RIVERA 10255 BISCAYNE Boulevard (305)199-0935 MIAMI SHORES FL 33138-2648 I 10255 BISCAYNE Boulevard MIAMI SHORES FL 33138-2648 Contractor(s) Phone Cell Phone Valuation: $ 1,000.00 ANATOLIA CONSTRUCTION (305)304-8556 Total Sci Feet: 32 Approved:In Review Available Inspections: Comments: Inspection Type: Date Approved::In Review Final Date Denied: Foundation Type of Work:RELOCATE GENERATOR Additional Info: Review Planning Bond Return Classification:Residential Review Building Scanning:1 Fees Due jAmnPay Date Pay Type Amt Paid Amt Due CCF DBPR Fee Invoice# DS-12-15-58027 12/11/2015 Credit Card $50.00 $58.60 DCA Fee Education Surcharge 12/30/2015 Credit Card $58.60 $0.00 Permit Fee Scanning Fee Technology Fee Total: 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 t e work stat . December 30, 2015 Authorized Signature:Owner / Applicant / Contractor A ate Building Department Copy December 30,2015 1 Miami Shores Village Building Department i' p 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 DEC 11, Tel:(305)795-2204 Fax:(305)756-8972 0- 1 _ v, INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 !y - BUILDING Master Permit No. FLy5 (00 PE MIT APPLICATION Sub Permit No.1�s I s 3 c-)-7tj BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: lCS'S— P-IScAnNM� City: AMiami Shores County: Miami Dade Zia:9� Folio/Parcel#: -320q -,)4Q - Qn-I%D is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): 'k- jZMjAAjN 'ia-W @(lam Phone#: Address: LAK? City: L&kk/-Mk `Zt-lofl�s State: f-C Zip: 3T3( Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: AN A'=r0l-ljq- Phone#: w Address: 65`�g CLl,9 NiNk7-b City: Al"t 'TszgpAt State: �-L.. Zip: Qualifier Name: Phone#: State Certification or Registration M Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ ® Square/Linear Footage of Work: Type of Work: ❑ Addition Ef Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: ��eyQO-M en=QCP-SiW04' Specify color of color thru tile: Submittal Fee$ J Permit Fee$ 1 l 0 CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ � (Revised02/24/2014) 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 �ip 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;xceeding$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 Signature OW ER or AGENT 61�7 NTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of QCx-C�c-4t— ,20 1,9' by 12 day of k::Cvopts1 201 by �,�n'Y�(► who' personally know o �2�dw4, ,who i per=known 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: Sign: , Print: Public State of Florida Print: Elsa rez Seal: may, ,3�� MVC ommissfa�FF 081441 00 Notary Stab of Florida ala Rd°� E OMS 01/07/2018 Seal: 11 Elsa Alvarez t�,Commission FF 081441 Expires 01107/2018 APPROVED BY Plans Examiner Zoning M Strurrural Resew-- I Clerk (RevisedO2/24/2014) STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850)487-1395 '�•��,� a 1940 NORTH MONROE SEREI TALLAHASSEE FL 32399-0783 . i UZMAN, EKREM ANATOLIA CONSTRUCTION LLC 6538 COLLINS AVE#176 MIAMI BEACH FL 33141 Congratulations! With this license you be--come one-ofthe-neariy-- one million Floridians licensed by the Department of Business and STATE CSF FLORIDA Professional Regulation. Our professionals and businesses range DEPAR EI�T OF BUSINESS AND from architects to yacht brokers,from boxers to barbeque restaurants, PROFESSIONAL REGULATION and they keep Florida's economy strong. �� Every day we work to improve the way we do business in order to CGC1515024 ISSUED: 08/27/2014 serve you better. For information about our servig3s,please log onto CERTIFIED GENE CONTRACTOR www.myfloridalicense.com. There.you can find more information about our divisions and the regulations that impact you,subscribe UZMAN,EKREM to department newsletters and learn more about the Department's ANATOLIA CONSTRUCTION LLC initiatives. Our mission at the Department is:License Efficiently,Regulate Fairly. We constantly strive to serve you better so that you can serve your IS CERTIFIED under the provisions of Ch.488 FS. customers. Thank you for doing business in Florida, EXpWn date:AUG 31,201' L74OWM03 0 and congratulations on your new license! DETACH HERE RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY STATE OF FLORIDA I DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULA'11'ION CONSTRUCTION INDUSTRY LICENSING BOARD ��CGC151�5024 � The GENERAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. ' Expiration date: AUG 31,2016 i UZMAN, EKREM ANATOLIA CONSTRUCTION LLC qn -k- SF 6538 COLLINS AVE#176MIAMI BEACH FL 33141ISSUED: 08/27/2014 DISPLAY AS REQUIRED BY LAW Q# L1408270003840 Local Business Tax Receipt Miami-Dade County, State of Florida —THIS IS NOT A BILL—DO NOT F,Y LBT. e 7050826 BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES ANATOLIA CONSTRUCTION LLC RENEWAL SEPTEMBER 30, 2016 6538 COLLINS AVE 176 7327315 MIAMI BEACH, FL 33141 Must be displayed at place of business Pursuant to County Code Chapter 8A—Art.9&10 r• OWNER SEC.TYPE OF BUSINES=S PAYMENT RECEIVED ANATOLIA CONSTRUCTION LLC 196 GENERAL BUILDING BY TAX COLLECTOR CONTRACTOR 49.50 10/02/2015 Worker(s) 1 CGC1515024 0235-16-000031 This Local Business Tax Receipt only confines payment of the Local Business Tax.The Receipt is not a license, permit,or a certification of the holder's qualifications,to do business.Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT N0.above must be displayed on all commercial vehicles—Miami—Dade Code Sec Ba-276. MIAMFDADE For more information,visit www miamidadeggv/taxcollector I s 1�OI.Nl�lic . City of Hialeah - 2015 Business Tax Receipt ,BRP OpAtE Mayor Carlos Hernandez No: 236220-29 Amount: $ 200.00 The person,firm or corp.listed here has paid the business tax required to engage in or operate the business specified subject to the regulations and restrictions of the City of Hialeah,Florida Owner EKREM UZMAN Type ofBttsiness:Commercial and Institutional Building Construction ANATOLIA CONSTRUCTION LLC Business Location: 6538 COLLINS AVE #176 MIAMI BEACH, FL 33141 392 E 10 CT Expires September 30, 2016 Validating No.: 0000 THIS IS NOT A BILL �T Dec- 11, 2015 4: 05PM Gulfstream Insurance No- 8084 P. 1 CERTIFICATE OF LIABILITY INSURANCEDATE(IIatIDWnM 12/11/2015 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 ISSUMNG INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the pollcy(les)must be endorsed_ If SU GATION IS WANED,Subject to the terms and conditions of the policy,certain polities may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsoment(s). PRODUCER CMrMonica Mendez Finney Insurance Corporation pPRRO,Nw Ext);.„954966-5533 _IP""N :954A89-8208 5601 Sheridan Streeti►oD�ss: iohnf�r',nneyins. ncecorp.com _ Hollywood,FL 33021 tlISIIRER{8)A ORDTN<i COVMW-_ NAIL e d1SURBRA: URIted S�4ally __ _ INSURED INSURERS: Anatolia Construction LLC w•suRERc: 3740 NW 78th Street#2 INSURER D: Miami,FL 33147 1SURERE: NR .. _T COVERAGES CERTIFICATE NUMGER: 00000000423987 REVISION NUMBER= 13 THIS 15 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE RIIN ISSUED TO THE INSURED NAM D ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMt NT WITH RESPECT TO WHICH THIS CERTIFICATE MAY or ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DFSC141BED HEREIN IIS SUBJECT TO ALL THE:TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMI•T5 SHOWN MAY HAVE BEEN REDUCFn BY PAID CLAIMS. POIJGYEFF POLICYExP 1 LTR R T�OF NSURANCE POLtcY NUMBER tJ1UT5 A ' X COMMMAL GENERAL LIABILITY DCGO213200 DW14QOIS 09/1412016V50NAL&ADV NCE E 1,000,000 CLAIMSMAK I n OCCUR filffe.) L„ .._. 100,O00 eP'INJURYGEN'L AGGREGATE LIMIT ANPLIGS PER: GATE $ 2,000,000 PRO- X PouCv LOC f PIOr'AOCt E , , 2000 OOO OTHER: $ AUTOp1OME LIABILITY CO= 51NC E LIMIT S (I. ANY AUTO BODILY INJURY(Pnrper.cm) $ --ALLOWNED �;TEDULED AUTOS AUTOS a0 ILYINJURY(Perxddenr) S IIiREDAUTOS NON-OWNAUTOS UMBRELLA QTY 3AMAtiF S UMBRELLA I" OCCUR M EAC IOCCURRENCE S _.. $ EXCESS LIA9 . .._ CLAIMS-MAD_E ' ` AGGREGATE I y DED I RETENTION E i I WORKERS CONPE SATION PER t]tH- ANO EMPLOYERS'LIABILITY YIN STATU R ANY PROPHR:ruk/PARTNER/E(ECUTIVE E.L EACH ACCIDENT $ _ 0FFICERAV=M9CR EXCLUDED? NIA It ym,deotury in E.L.DISEASE_EA EMPLOYE It xaihe urder und .... DESCRIPTION OF OPERATIONS Wow El- ISEASE-POLICY LIMIT S I 1 I DESCRIPTION OF OPERATIONS I LoCAnows I VENIGLEs(ACORD 101,AdditloW Mmosm BeLcduK my 5e wacfwd E ryp,s*DR"in,eq,d,ed) Contract License#CGC1515024 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village THE EXPIRATION DATE TmeRE:cw,NOTICE IMLL BE DELIVERED IN Building Department ACCORDANCE WITH THE POLICY PR VISIONS. 10050 NE 2nd Avenue Miami Shores, FL 33138- Am REPRESENT, . I MIM 01988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD Printed by MIM on December 11,2015 at 03:23PM CERTIFICATE OF LOABOL9TY INSURANCE DATE(MMIDDtYYYY) 1 2/1 01201 5 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(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 endorsement(s). PRODUCER CONTACT NAS Monica Mendez Finney Insurance Corporation PHONE 954-OW5533 FAC 95"N-8208 5601 Sheridan Street Mjohnf@finne insurancecorp.com Hollywood,FL 33021 AFFORDING COVERAGE NAICI3 INSURERA: Florlda W.C.JUA ` INSURED . INSURER B Anatolia Construction LLC INSURER C: 374.0 NW 78th Street##2 INSURER D. Miami,FL 33147 INSURER E: i INSURER F: COVERAGES CERTIFICATE NUMBER: 00000000-823987 REVISION NUMBER: 13 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 CONTRACTOR 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 ADD SUBR - POLICY NUMBER POLICY EFF POLIQ EXP COMMERCIAL GENERAL LLAB 117Y EACH OCCURRENCE $ CLAIMS-MADE F OCCUR I I I I D O S MED (Any one pmw) IS PERSONAL&ADV INJURY S . GENL AGGREGATELIMIT APPLIES PER , I ( GENERAL AGGREGATE S POLICY❑JECT LOC. ` I t 1 PRODUCTS-COMPIOPAGG S OTHER: is AUTOMOBILE LIABILITYIi` COMB SINGLE LIMB S ANY AUTO I BODILY INJURY(Per person) S ALL OWNED ( SCHEDULED AUTOS AUTOS I I BODILY INJURY(Per acddeq S HIRED AUTOS ' AUTOS 1 i (Per DAMAGE S �- , S UMBRELLA LIAR j j OCCUR i EACH OCCURRENCE S CESS LFAB CLAIMS-MADE 1 I AGGRE TE 5 DED RETENTION 5 i J S A ANDEMEMPL YERERS LIAABiLIITNY 6FR13UB-2859C99-8-15 111/29/2015 j 11/29120161 X ER ANY PROPRETORIPARTNERIEXECUTNE YIN II E.L.EACH ACCIDENT s 1,000,000 1 ® OFFICERMEMBER EXCLUDED? NIA �(Mandatory InNH) I EL DlStASE-EA EMPLOYEd S 1,000,000 DESCRIPTION OF OPERATIONS below a I E.L.DIS -POLICY LINT $ 1,000 000 f DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 901,Addidand RemadM SdwdWe,may be anaehod itn e—.pa—b requ&eM LICENSE NUMBER CGC1515024 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores!Village THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd Avenue Miami Shores, FL 33138- AUTHORrzED REPRESENT-AMUE ///1 RIM) ©1988,22014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD Printed by MIM on December 10,2015 at 12:40PM