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STORM PANELS
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Ci PERMIT APPLICATION °U N ; � ' r '" Master Permit No. FBC 2001 , . = - - ='! Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) E 5 4 1 7 j/ -co 80 AM/0 Phone # 19 s/ 7s/ G S Owner's Address 2 / Z Aht) 6 73 S� City HM * /-1; 5"? D6 E S State f Zip 33 / SO BUILDING Permit Type (circle): Building Electrical Miami Shores Village Building Department Permit No. X05 — 68 Tenant/Lessee Name Phone # Job Address (where the work is being done) /2 /l)W T 3 St City Miami Shores Village County Miami-Dade Zip 3 3-/ So Is Building Historically Designated YES NO c Contractor's Company Name All eGih trg - tif0! EcCtiic S V /' -li/SPhone # Contractor's Address 6 6/ S• SAY k- t' 0 7 Zhill 6 if/ 6 c2v /7z, f3 - 5 /1-1. City IN V it State PL- Zip 331/S Qualifier '06e6.% Hc,llre4qu o1� State Certificate or Registration No. cafe e O3 -/ 2C Certificate of Competency No. CI? C 0 3 9 Z L t Architect/Engineer's Name (if applicable) Phone # $ Value of Work For this Permit Type of Work: ❑Addition Alteration // ENew 1=1 Repair/Replace ❑ Demolition Describe Work: /0 4 4 -vim/ A'O w I 3 4 ' , e I 0 f 4 1 1 (' / S ( T 5 ) i •1 Submittal Fee $ Permit Fee $ �o G' 1 CCF $ •C.) CO /CC / Notary $ / Training/Education Fee $ , (7 Technology Fee $ ",> Scanning $ es), Radon $ ,/ Zoning —' Bond $ ,— Code Enforcement $ s Structural Plan Review. $ / Total Fee Now Due $ a /3 . `1 (Continued on opposite side) 1 2 , 3 S * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Square Footage Of Work: 2 90 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 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 82500, 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 s commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit i s ed. In the l absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this day of , t.ML. , 200 tw , b tZ"tfsu Ji ( e ft - 1 4 . 4 . 6 C' , who is personally known to me or who has produced fl • / - 6. 1 +- NOTARY P Sign: Print: Chc 05/13/03 APPLICATION APPROVED BY: As identification and who did take an oath. „1.11 9.a ,, Ana M. Pereiras � Commission t DDOR .. a Expius Feb. =1, 2006 r_. Commission E._ ._ Bonded Y'hra My Commission Expires: , t p ,, ** * * * * * * * * * * * * * * * * * * * * * * * *Ifigt�� ` **�*� !`'Xx�,t itlPX.l'% V A C t* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** *********************** * * * * * * * * * * * * * * * *# *ft. * * * * * * * * * ** Signature NOTARY PUBLIC Sign: Print: Contractor The foregoing instrument was acknowledged before me this day of ,ila+i.Q, , 20 J by b 14 Ai who is personalLv known to me or who has produced as identificatiovnd who did take an oath. M. j ,941, r. `,, y „ i, Ana M. Pereiras ? .:. s Commission * DD081932 iaa Bonded Feb. 9, 2006 11t119811t i to *iTnc D — /3 o �� Plans Examiner Engineer Zoning zgql MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Buil ing Inspection Request Date � Type Insp'n t�0 y /U 1 1� YS /1'eI J Permit No. 6 P0 UU� Name eC)0i Address cam' Nw company/ 102 si rr s Phone # gsu_ 58 — 42b7 Inspection Date (l/lc Approved Correction Re- Insp'n Fee a lLeis o 162&44 tet)% c rici3 6a04) 4 Ad) A44 ,E260,t) A ptid e} 1745 ° tik MIAMI SHORES VILLAGE T 4 BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date° /0 I /05 Type Insp'n I n a ' \" -5 Permit No. J3P ®J 884 Name E3 fc r Jocobo Rub I o Address 2 A Z 1 \ 1( -0 q3 ST, Company A 1 1 U CO 4 )C7 5f' )5 Phone # (C154 ) 8 — 42O Inspection Date 0 / 5 / Approved Correction Re- Insp'n Fee 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR ADD'L INSRD TYPE OF INSURANCE POLICY NUMBER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. POLICY EFFECTIVE DATE (MM/DDIYYI POLICY EXPIRATION DATE (MM1DD/YYI LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY • SCP42894684 1/5/2005 1/5/2006 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurence) $ 100 000 CLAIMS MADE " OCCUR MED EXP (Any one person) $ 10,000 PERSONAL 8, ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEM. AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2 , 000 , 000 POLICY JEC LOC 7 n AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ — • BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ • — PROPERTY DAMAGE (Per accident) $ GARAGE LIABLITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY OCCUR n CLAIMS MADE DEDUCTIBLE • RETENTION E EACH OCCURRENCE E AGGREGATE $ $ E E B WORKERS COMPENSATION AND EMPLOYERS' UABLITY ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below 61012217 1/5/2005 1/5/2006 WC STATU- TORY LIMITS ER E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 100,000 OTHER DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES'/ EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS 954 - 783 -8775 ACORD CERTIFICATE OF LIABILITY INSURANCE DATE i o04 ") NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. . PRODUCER Bill Daly's Insurance Agency, Inc. 10235 Well Sample Rd Suite 203 Coral Springs, Fl 33065 . (954)753 -0980 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED ALL WEATHER PROTECTIVE SYSTEMS INC 5081 S STATE RD 7 UNIT 811 DAVIE, FL 33314 I INSURER A: ZURICH INSURER B:AIIC INSURER C: INSURER D: INSURER E: I MIAMI SHORES BLDG DEPT 10050 NE 2ND AVENUE MIAMI, FL 33138 305 756 - 8972 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. . AUTHORIZED REPRESENTATIVE DALY T om ` ; -e. COVERAGES CERTIFICATE HOLDER ACORD 25 (2001/08) Policy Number: CANCELLATION Date Entered: 9/10/2004 © ACORD CORPORATION 1988 Au 144312 STATE OF-FLORIDA pE PA 4 RTME 1ST :bF BUSINE=SS I =N AN-R D RO ' SSIONAL REduLATIoN CONSTRUCTION 'INDUSTRY LICENSING BOARD SEQ #L0406.0'901848 DATE 06 0;9 2004 030712966 The RESIDENTIAL .CONTRACTOR Named below IS CER- TIFIED Under the provisions of 'Chap Expiration date: AUG 31, 200 MONTEAGUDO°, ROBERT C ALL WEATHER - -PROTECTIVE SYSTEMS 5'081 S STATE ROAD 7 DAVIE FL 33314 JEB BUSH. GOVERNOR 052 0338 . P.O. BOX 5917 DAVIE, FL 33310 -5917 of zrri 0 v 'aISPMY'fAS REQUIRED BYLAW OCCUPATIONAL LICENSE CCUPAp I O ALL iE AT HER P ROTECTI°VE SYS IN 5 081 S TAT E3R147 U" Bli DAVIE DIANE CAR'R SECRETARY PRSRT FIRST CLASS U.S. POSTAGE PAID MANASOTA, FL PERMIT #710 TO: FG,TI S`Y S I W EATH ER P RUT - X811 AI.L ST ATE D 7 U 50 81 3331 4 DAVIE. F L y 1} l yi 3y n tfyll1 IIl{IIlIIt�� {t {1 {lillilf{1t'i1 REGULA 10/'01/ � RE S,BLpG rnt : CTOR GEN• 056D0 CONTR Reference: ROB ERT MONTEAG000 t ii lil��tlt�'t E Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 6/15/2005 Contractor ALL WEATHER SYSTEMS Local Phone: 954 -584 -7470 Parcel # 1131010331070 Signed: (INSPECTOR) Building Permit Permit Number: BP2005 -887 Applicant: ESTHER JACOBO RUBIO Owner: RUBIO ESTHER JACOBO JOB ADDRESS: 212 NW 93 ST Contractor's Address: 1111 SW 21 AVE Page 1 of 1 Legal Description: MIAMI SHORES SEC 6 PB 10 -39 LOT 3 BLK 135 LOT SIZE 50.000 X 123 OR Fees: Description Amount FEE2005 -8295 Building Fee $200.00 FEE2005 -8296 CCF $1.80 FEE2005 -8297 Training and Education Fee $0.60 FEE2005 -8298 Technology Fee $5.00 FEE2005 -8299 Scanning Fee $6.00 Total Fees: $213.40 Total Fees: $213.40 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 12/10/2005 Construction Value: $2,350.00 Work: 10 ALUMINUM STORM PANELS SETS c ac # )4 r3 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 responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: Act WEATHER 9 PROTECT /YE SYSTEMS, INC. N ®h's ; �' — I SE :ES Of 41- UNINUH ?/1- 0 8 S s ncc&,:nirco6 Basco 212 104) 93sF MIt }N1 Shoe -(S, (1, 33 1S0 5081 S. State Rd. 7 • Unit 811 • Davie, Florida 33314 Phone: 954 -587 -4207 • 800 - 728 -5126 • Fax: 954 -587 -4204