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WS-18-1992Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address ue D Permit NO. WS-7-18-1992 Permit Type: Windows/Shutters Work Classification: Door Replacement Permit Status: APPROVED /1/2018 Expiration: 01/28/2019 Parcel Number Applicant 933 NE 99 Street Miami Shores, FL 1132060340250 Block: Lot: MARK GALLO Owner Information Address Phone Cell MARK GALLO 933 NE 99 ST MIAMI SHORES FL 33138-2568 Contractor(s) FOUR BLR DOORS CORP Phone (305)776-2443 Cell Phone Valuation: Total Sq Feet: $ 1,500.00 0 Type of Work: REMOVE FRONT DOOR AND REPLACE WITH No of Openings: 1 Additional Info: Classification: Residential Scanning: 3 Fees Due, CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $o.00 $o.00 $o.00 $0.00 $55.00 $0.00 $0.00 $55.00 Pay Date Pay Type Invoice # WS-7-18-68335 07/25/2018 Check #: 3743 $ 50.00 $ 5.00 08/01/2018 Check #: 3759 $ 5.00 $ 0.00 Available Inspections: Inspection Type: Window Door Attachment Final Review Building 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 A Amt Paid Amt Due AVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating constructiory zonin Futhermore, I authorizea work stated. he above -named ntr`actor o do th Authorized Signature: Owner / p��nt / ontractor / Agent August 01, 2018 Date Building Department Copy August 01, 2018 1 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Ave, Miami Shores, Florida 33138 Tel: 305-795-2204 Fax: 305-756-8972 Inspection Number. INSP-001161-2018 Permit Number. WS-7-18-1992 Scheduled inspection Date: November 05, 2018 Inspector: Naranjo, Ismael Owner: MARK GALLO Address: 933 NE 99 ST Project Mlaml Shores, FL Contractor: FOUR BLR DOORS CORP , STANLEY ABBOTT SUMNER Permit Type: Windows/Shutters Inspection Type: Framing Work Classification: Door Replacement Phone Number: Parcel Number: 1132060340250 Phone Number. 3057762443 Building Department Comments REMOVE FRONT DOOR AND REPLACE WITH IMPACT DOOR. Checklist Item General Comments Passed False Comments 10/29/2018: THIS PERMIT IS TO REPLACE PERMIT#WS17-1128. FRAMINC INSPECTION PASSED ON 08/23/2017. (SEE ATTACHED INSPECTION HISTORY REPORT) S.A. Inspector Comments Passed Failed Correction Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. November 02, 2018 For Inspections please call: 305-762-4949 Page 3 of 38 r BUILDING 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 LINE PHONE NUMBER: (305) 762-4949 FBC 2011 b-l-h Master Permit No. IJVS 18 - 9 12 Sub Permit No. /1BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: ifI N E. ct S I City: Miami Shores 4 County: Miami Dade Zip: 31`66 Folio/Parcel#: //^ 320 fd -O "O2O Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: OWNER: Name (Fee Simple Titleholder): L C&VK Crai tO Address: CI j E got cS Flood Zone: BFE: FFE: Phone#: City: OA. (X1(Y1l SiIO``€ State: V' V01. kdG` Zip: 331 36 Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name:\\�C "it)kk ��� S Cr..X p Phone#: 3oS—g 56-9166 Address:59A3 fW 15°1. City: ).,1Q ,1-u'(i(l i (_U L(Q j State: Ir—C 0lU Zip: 3 30 \ 4 Qualifier Name: Phone#: State Certification or Registration #: Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ 1,SdO Square/Linear Footage of Work: d Type of Work: I I Addition Alteration 1 n n New ❑ Repair/Replace PI Demolition Description of Work: I TemOV'Q. Tron - 'boo( avid f1K ppcc`e wtW tmpaC.- ,LOOf ,2XQir•Qd ?'evmi1-- WS 1-1- 112$ Specify color of color thru tile: S-5• q Submittal Fee $ 4:'•' SO?Olidpermit Fee $ Cs CCF $ CO/CC $ Scanning Fee $ Radon Fee $ 0 ' a DBPR $ 9' . O Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ 5' C,Z) (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 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 c whose property is subject to a it .. I for the first inspection wh' h . • inspection will no- be appr• e.. P 1 Signature ,AI/ r NER or AGENT The foregoing instrum day of 04 Gnl of the notice of commencement and construction lien law brochure will be delivered to the person ent. Also, a certified copy of the recorded notice of commencement must be posted at the job site seven (7) days after the building permit is issued. In the absence of such posted notice, the reinspection fee will be charged. 0 ONTRACTOR t was acknowledged before me this The foregoing instrument w. acknowledged before me this 201 by day of , 20_, by me or who has produced , who is personally known to identification and who did take an oath. RY PUB NOTARY PUBLIC: Sign Print: Seal: MARIA ARRIETA OMMISSION # FF 184276 December 17, 2018 u Budget Notary Ser;ices as me or who has produced ho ersagallyknown to identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: c\HRY sppp TFOF F09' MARIA ARRIETA MY COMMISSION # FF184276 EXFIRES: December 17, 2018 Boded Thru Budget Notary Services as *********************************************************************************************************** APPROVED BY Plans Examiner Zoning (Revised02/24/2014) Structural Review Clerk Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Inspection requirements for: Windows, Doors, Skylights or Fixed Glass (cladding) Permits Upon issuance of permits for the scope of work involving the removal, changing and/or replacement of any type of windows, doors, sidelites, skylights or fixed glass (cladding) the permit holder or qualifier bearing his signature on the permit application shall abide by the requirements of this department and comply with the following statement: Upon obtaining window and/or door permits for the installation of same, it is the responsibility of the permit holder to request window/door framing in -progress inspection, prior to concealment of any horizontal or vertical clip mullion, bucks, shims, etc. Inspector will also verify anchor type, edge distance, embedment and spacing. The purpose for this inspection, is for the verification of conformance with Product Approval (NOA). Ackn • ledgement: r/Owner Signature Date ' t Name ACORU CERTIFICATE OF LIABILITY INSURANCE ‘..� DATE(MM/DD%YYYY) 07/17/2018 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 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). PRODUCER Q INSURANCE LLC. 2531 NW 72 Ave Suite A MIAMI FL 33122 CONTACT Sandy Aldana PHONEp/e. Ern:305-994-9981FAX C Nolc 1800-775-0576 ADDRESS: crs©q-insurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Catlin Specialty Insurance Company 15989 INSURED FOUR BLR DOOR CORP 5743 Nw 159 St Miami Lakes FL 33014 INSURER B : INSURER C : INSURER D : INSURER E : INSURER F: • • 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 POUCY NUMBER POLICY EFF #MM/DD/YYYY) POLICY EXP IMM/DDIYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY N/A N/A 2028413B 07/14/2018 07/14/2019 EACH OCCURRENCE S 1,000.000 CLAIMS -MADE �, OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) 5 100,000 MED EXP (My one parson) S 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEM. XPOLICY'S, AGGREGATE LIMIT APPLIES PER: jRa LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG S 2,000,000 Deductible S 500 AUTOMOBILE LIABIUTY ANY AUTO OWNED _ SCHEDULED AUTOS NON -OWNED AUTOS ONLY COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) S BODILY INJURY ) (Per accident) S PROPERTY DAMAGE (Per accident) S S UMBRELLA UAB EXCESS UAB _ OCCUR CLAIMS -MADE EACH OCCURRENCE S AGGREGATE S DED RETENT ON S 5 WORKERS COMPENSATION AND EMPLOYERS' UABILRY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? C (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A PER OTH- STATUTE ER E.L. EACH ACCIDENT S E.L. DISEASE • EA EMPLOYEE 5 E.L. DISEASE - POLICY LIMIT S DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Carpentry -Interior Window and Door Installation). This certificate has no additional Insured or waiver subrogation. FICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE 10050 NE 2ND AVE MIAMI SHORE FL 33138 ACORD 25 (2016/03) 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 01988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD