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RF-17-1018 Permit No. RF-4-17-16, Miami Shores Village Permit Type:.Roof 10050 N.E.2nd Avenue NE Wdlk,0/&is.5'i7fCa1'fOf7:Gutters Miami Shores,FL 33138-0000 ° h� a Phone: (305)795 2204 Permit Status:APPROVED Is us,Date.4117/2017 Expiration: 10/1412017 Project Address Parcel Number Applicant L 0021 NE 2 Avenue 1132060134650 Miami Shores, FL Block: Lot: MIAMI SHORES VILLAGE Owner Information Address Phone Cell MIAMI SHORES VILLAGE 4 Contractor(s) Phone Cell Phone $ 800.00 Valuation: RAIN GUTTERS SOLUTIONS INC (305)270-7779 (786)718-8393 Total Sq Feet: 62 Type of Work:Gutters Available Inspections: Additional Info: Inspection Type: Classification:Residential Final Scanning:0 Review Building Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 Invoice# RF-4-17-63675 DBPR Fee $2.00 04/17/2017 Money Order $ 115.60 $0.00 DCA Fee $2.00 Education Surcharge $0.20 Notary Fee $5.00 Notary Fee $5.00 Permit Fee-Repairs $100.00 Technology Fee $0.80 Total: $115.60 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: Vftrtify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction an in F thermore,I authorize the above-named contractor to do the work stated. I April 17, 2017 Authorize Signature:Owner / Applicant / Contractor / Agent Date Buildin Department Copy April 17,2017 1 RECEIVED OFFICE: 305.270.7779 APP 12 C17 CELL: 786.718.5393 Rain Gufter 5 www rain ttersolution.com -I- I O N rainguttersolutionp@gmail.com gmail.com S L U 10890 SW 186 St Unit 45. Miami, FL 33157 13 R®c/k cuav 14e wo)*Zta �t it �V e-- �z l---2 Name Estimate Date "" lood ri /—:7 end N)e . . 0000 0000.. Address Scheduled Date •�•••• 0.00 0.00•• Io>es f4 7M M • City- State - Zip Coe 3®5 S. �� Refe l 4 ;••• ' ` ! a„ 0000. Home Phone Work / FICC ••7 •o • •• 0060.. , • 6MATEIR)AA 6 Lo Gloss White ❑Linen ❑Almond El Ivory Clay` �► "' ' ty 6 6 n� 666••• ❑High Gloss White ❑Eggshell ❑Cream ❑Wicker " d 6--�GAL1/ANIZED ❑Musket Brown ElTerratone E]Royal brown ElSandcastle ElBronze ❑ Green 0 COPPER ❑Pearl Gray ❑ Colonial Gray ❑ Blue ❑Black ❑Tuxedo Gray ❑Dark Gray ❑AL1M1NiUM _-_ Cb LOY i — € E �l _ a I , - i ........ ........ 7-1 ,0000 I ( 4 GUTTER FEET ni DOWN SPOUT FEET S y k S LEAD HEAD AMOUNT $ TOTAL FEET RAIN CHAINS LESS DEPOSIT $ WARRANTY LABOR �` '� MATERIAL 10 � V TOTAL DUE $ In event it becomes necessary for RAIN GUTTERS SOLUTION INC.,to employ theservices of an Attorney,to efrect collection of the ammount or balance due under this contract,purchaser agrees to pay seller's reasonable attorney's fees and all expenses incident thereto.When executed and asigned by both parties.This proposal becomes a contract. (2) �LAJ,')0 uplinfi=l -Tc5c,,�; Potdo Cu-homer's Signature Rain Gutters Solution, Inc. NeAh1eeiafeyot4r kunness ! -, Miami Shores Village l�� Building Department a�R � 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 \ �FBC 20VA BUILDING Master Permit No. Y -7 "' ' i l I Ol PERMIT APPLICATION Sub Permit No. F-;f BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL E]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: i c(D2—t of ;)Lno no-e- City: Miami Shores County: Miami Dade Zip: 3 13 Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: A Flood Zone: BFE: FFE: OWNER:Name(Fee SimpleTitleholder): oGiC�A�f 1V tm()rtc ` G�Ji&Mbne#: �3) 7S8— Ib`7 Address: 10 021 nF_ rt D a VP- ,J City: �A 00 I&M i S,h0(LG State: FIL zip: 25:3 13 Tenant/Lessee Name: Phone#: Email: p CONTRACTOR:Company Name: /1 AIK 9,1 #ev s 5,olv li Doi 1-"e Phone#: 305 2 3y :2�)qQ/ Address: 109`r0 S w Ire 15f &q.$ City: /I I dvti ( State: FL Zip: 3 3/S 9 Qualifier Name: 7�SUS /DVIC O Phone#: State Certification or Registration#: Certificate of Competency#: /,5 85'0 D 1 t C{ DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ 'iS oD O� Square/Linear Footage of Work: (.D 2 S G L - Type of Work: ❑ Addition ❑ Alteration n ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: I n6ta u a-t m l7T CnUfif'G rs Specify color of color thru tile: Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ • G� Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ ^( TOTAL FEE NOW DUE$ (ReAsed02/24/2014) 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 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 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 aI '►,l�1 I.1� A1 Signature Lk!2 OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of r i I �J 20 1 —1by day of APR r f ,201 by a-Q -, irro is perso� ��cs�v� 1 ,who is personally known to me or who has produced as me or who has produced_ MJC) Cp-n?Ac? --1JC_ identification and who did take an oath. identification and who did take an oath. `��1111111111/I///�7 NOTARY PUBLIC: \\\\�� .••A �E�js/�i��* NOTARY PUBLIC: .1 C 1M/SS:s/�G 11111111111//// Sign: ~• N _ Sign: .•.Qg mA:ori o Print: Print: Seal: ��i�'Sj•°::":'::•••• \�\ Seal: �l111011111IIO��OP`\`\ >6b o'��:.... •'i�J�� APPROVED BY Plans Examiner Zoning Structural Review Clerk (ReAsed02/24/2014) cTtruc es uahrying Board c.0 'EPTIFICATE uF COMPE '43SO01 14 i TEZS SOLUTION INC D.B.A.. PULIDO JESUS MANUEL Is certified under the Provisions of Chapter i n of Miami-Dade County VALID FOR CONTRACTING UNTIL 05/36!2018 QUALIFYING TRADE(S) 0049 METAL GUTTEROWNS M®� °etary ut me RoatO '- NwK miaml�ade giv �• ' n r,�ea mi Dade Cuunty retains ail property rights herein 7 } :. J12�z i Bus"in rTax Pecelpt z€ -DadeCounty, State €f Florida jj � 13i ;�++ �€lat S N BLMATio RECEIPT 0. PIRES �E E R Wi RIM 117 Must be di alayed at pla of bu is Pursuant to minty Code Chster Air } ' fllx a`I C3 $EC. TYPE 0i BU a# PINK j `PA YM ENT RECEIVED JT $+ gyp 1 }�EClAj LTY 1.11LD1 a t T clo 1� i7VL7 R�7 d 11 T�"{� C R E 1 h 0200-16-003560 IN 1 +tl tili lois Tax l CLki`�tYti� t ks s i i 111 rj' {j pt1 tMirr � � \ "ki 06 5 �d �\O ggi £: 7---7777777 E ' 3 E 1 4 qq pyy E io �maVllwe . Favi\• hA\fii. \ r y$.\ �II IN Nip VU } \•`\' _ T "f \ I 4 }� € } r E E i "s, i 3 MIii 5iu t � t' X� r WS Et t:�F€ /- £ �`" I� c �' II ME u E�3• � \ � £ � l_ 133E€ �I al ' � } � }�' \ 11C SS E" F01 F f<} a t'. �'g1 f� € a �'. � E t i •i i- ix�,,'x �1 J f z d�d3r '�1 t e € s S '' s�' g- € = r E"ssY ( _€. 1 I• l �{r i 7 '77 �" f€ i AC�® DATE(MM/DDIYYYY) ,, CERTIFICATE OF LIABILITY INSURANCE 4/13/2017 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 have ADDITIONAL INSURED provisions or 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). CONTACT PRODUCER SUNZ Insurance Solutions, LLC. ID: (TLR) NAME: Workers'Comp Department c/o TLR of Bonita, Inc PHONE 727.520-7676 x 3 NC No): 727-525-3862 700 Central Ave, Suite 500 EMAIL St. Petersburg, FL 33701 ADDRESS: cens encorehr.com INSURERS AFFORDING COVERAGE NAIC# INSURER A: SUNZ Insurance Company 34762 INSURED INSURER B: TLR of Bonita, Inc EnterpriseH R INSURER C: 700 Central Avenue Suite 500 1 INSURER D: St. Petersburg FL 33701 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 35109799 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD MWDD/YYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ �OCCUR DAMAGE S(RENTED CLAIMS-MADE PREMISES Ea occurrence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ JECT LOC PRODUCTS-COMP/OP AGG $ POLICY 1-1 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ A WORKERS COMPENSATION WCPE0000000112 6/1/2016 6/1/2017 / PER STATUTE ETH AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $ 1,000,000.00 OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000.00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 1,000,000.00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Coverage Provided for all leased employees but not subcontractors of:Rain Gutters Solution Inc Client Effective:3/10/2016 CERTIFICATE HOLDER CANCELLATION 1191 Miami Shores Village SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami h r 2nd Ave THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami shores FL 3. ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Glen J Distefano ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 35109799 1 Master Certificate I Andrea Delucchi 1 4/13/2017 8:49:48 AM (CDT) I Page 1 of 1 CERTIFICATE OF LIABILITY INSURANCE ®® Al DATE(MM/DDYYY) S U NCE /Y 04/12/17 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 1S 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 cA TEE: UNIVISTA INSURANCE NA E: G&E Insurance Consultants,Inc. PHONE FAX (305)228-8969 221 SW 42nd Ave E-MANE (305}228 8988 ac No Essf gandecodes@gmail.com Miami,FL 33134 INSURERS AFFORDING COVERAGE _ NAIC# INSURED Phone (305)508-9847 FaX 305)267-7143 INSURER A: FEDERATED NATIONAL INSURANCE CO. INSURER 0: PROGRESSIVE INSURANCE COMPANY RAIN GUTTERS SOLUTIONS INC INSURER C: 5845 SW 117 Ave INSURER D: Miami,FL 33183- (786)718-5393 INSURER E: COVERAGES INSURER F: 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 MAYBE 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 ADD UBR LTR TYPE OF INSURANCE N POLICY NUMBER MM/DDIYYYY MPMtppNYYY LIMITS GENERAL LIABILITY - EACH OCCURRENCE _ $ 1,000,000.00 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000.00 A ❑[I ❑ CLAVAS MADE OCCUR N N 07113!2016 07/13/2017 GL0000035919-00 MED EXP(Anyone person $ 5,000.0000 El PERSONAL&ADV INJURY $ 1,000, 0.00 GENERAL AGGREGATE $ 2,000,000.00 GmEN'LAGGREGAIELVAITAPPLIE LOC PRODUCTS-COMP/OP AGG $ 2,000,000.00 Q POLICY JECT ❑ PRO" ❑ LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ❑ Ea accident $ ANY AUTO BODILY INJURY(Per person) $ 10,000.00 B ❑ AUTOS NOWNED SCHEDULED AUTOS 02669931-1 - ❑ HIRED AUTOS NON-OWNED 09/14/2016 09/14/2017 BODILY INJURY(Per accident) $ 20,000.00 ❑ ❑ AUTOS PROPERTY DAMAGE $ 10,000.00 ❑ Per accident UMBRELLA LIAR []OCCUR ❑ EXCESS UAB ❑ VAS-MADE EACH OCCURRENCE $CLAAGGREGATE $ ❑ DED ❑ RETENTION$ WORKERS COMPENSATION $ AND EMPLOYERS'LIABILITY /N ❑WC IQ9YT T ❑OTH- ANY PROPRIETOR/PARTNEWEXECUTNE LIMITS OFFICER/MEMBER EXCLUDED? ElN/A E.L.EACH ACCIDENT_ $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ i DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) RAIN GUTTERS INSTALLATIONS LIC:15BS001 14 CERTIFICATE HOLDER —�l CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBE OLICI S BE/CANCE LED BEFORE MIAMI SHORES VILLAGE THE EXPIRATION DATE THEREOF,NOTI WILL B I RED IN 10050 NE 2 AV ACCORDANCE WITH THE POLICY PRO IONS MIAMI SHORES,FL 33138 AUTHORIZED REPRESENTATIVE SUSANA DIAZ ACORD 25(2010/05)QF ©1988-2010 ACOR OR RATION. All rights reserved. The ACORD name and logo are registered marks of ACORD