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RF-11-521Inspection Number: INSP - 157566 Scheduled Inspection Date: March 31, 2011 Inspector: Rodriguez, Jorge Owner: TROIKE, KEVIN Job Address: 55 NW 94 Street Project: <NONE> Miami Shores, FL 33150- Contractor: CRESPO RAIN GUTTERS Building Department Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments GUTTERS March 30, 2011 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 For Inspections please call: (305)762 -4949 Permit Number: RF -3 -11 -521 Permit Type: Roof Inspection Type: Final Work Classification: Gutters Phone Number (305)759 -6344 Parcel Number 1131010340120 Phone: (305)781 -2301 Page 6of12 BUILDING PERMIT APPLICATION FBC 20 Permit Type: BUILDING I k ' ROOFING ® C OWNER: Name (Fee Simple Titleholder): 1 � F �� PPhone: c� ©5 - cs t Q - q 4 is4 Address: et 4 `lf Value of Work for this Permit: $ Type of Work: ❑Addition 1 ❑ Description of Work: //1 Submittal Fee Permit Fee $ /(ie Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ 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 No. 1 IL— ( I �� 1 Master Permit No. MAR 23 2011 B Y: _o ..... City: M \C c ff e State: '�'R' Zip: Tenant/Lessee Name: Phone#: Email: JOB ADDRESS: ' N t -1 c�^ _ City: Miami Shores County: VCQ Miami Dade Zip: Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: O Eca rus Tido Qom- CONTRACTOR: Company Name: 0 ---X 1 -0 ?el INI Phone#: Address: 6 2 tL �� O Cit VNi\. O.JJ & State: Qualifier Name: State Certification or Registration#: Certificate of Comp Contact Phone #: �i �� -� �\ - Email Address: \9JA/ (V C.. . DESIGNER: Architect/Engineer: Phone #: Zip: ? 1 _A Phone #: )®S `S ,)�5 p 2 �. ��Q e ncy #: O ,B5 3 5 E`'&C.X tC OKA t u . es $+ td o % V vatil 0,01,13 �. iittA 00 : is1 epair/R tizeit ❑Demolition 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 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. Sign: Print: My Commissio APPROVED BY (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Sign: Print: Signa Signature Owner or Agent Contractor The foregoing instrument was ackno ledged before me this The foregoing instrument was acknowledged ore me this p_ day of 7 , 20 /J , by e — 17729 S day of (/ , 20 L , b @ 4 02. {1 who is personally known to me or who has produced who is personally known to me or who has produced As id a as identification and who did take an oath. NOTARY ' BLIC: My Commission xpires: c/ ao r3 Plans Examiner Zoning Structural Review Clerk O LLI ( J @ C U YM X Cn F 63 Z( U W LL • W3C-- 0 e CO f H £ L 0 _0 m m L 7 0 a L CL m - L I- C 7 CL �F CV C1) V> J J 00 10 0 N O CD 40 MC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 O L W 0 J O Lt. U U.(8 -r 1- • I (.5 >- • }+ 0) 1 -1- 3 C/) L 01 L(LI m -a W1 -4(00 CI CI) Qm • J 3c ¢U(3 is H H O- H W U LLI CC Cr 4-1 O CV W N CUT HERE IC) 0) CV . -4 CC .1 U (00 0) Z ( I-O O O H 0 0 0 • 63 W O m U CO i 7 W O (0 0) W 04 (6 CC J V) C_) CC CC O U CC 1- Z U CJ J C Cn CD CO F O Q H �V) Cs CI CC LU U N CC W H CC W (-> E- H W W N Q CO CO U N ) J H CC O CL - CC W LOL • CC W W V) fa I PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE • Carry bottom portion on the job, keep upper portion for your records. > 4 0 m m 4- 0 m U U XX (0(0 1- T m C U U CC-0 4a 4- CI E E CL M 11 11 11 u 11 u 11 II II II 11 11 STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CONSTRUCTION INDUSTRY CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW EFFECTIVE: 06 /02/2009 EXPIRATION DATE: 06/02/2011 PERSON: CARLOS CRESPO FEIN: 571155260 BUSINESS NAME AND ADDRESS: CRESPO DECORATIONS CORP 6281 SW 58 COURT MIAMI, FL 33143 SCOPE OF BUSINESS OR TRADE: 1- PAINTING 2- GUTTER INSTALLATION IMPORTANT O Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election I- under this section may not recover benefits or compensation under this D chapter. H Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt.. apply only within the scope of the business or trade listed on R the notice of election to be exempt E Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. QUESTIONS? (850) 413-1609 ABILITY INSURANCE D DATE(MMRIDNYYY) 03/24/11 AND CONFERS NO RIGHTS UPON THE CERTIFICATE H HOLDER. THIS A Mar. 24. 2011 11:39AM ALL CITY BIRD RD INS CERTIFICATE OF LI THIS CERTIFICATE 1S ISSUED AS A MATTER OF INFORMATION ONLY CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUT REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(Ies) the terms and condIllene of the policy, certain policies may require an endorser= eerdficate holder In lieu of such endorsement(s). PRODUCER All City Bird Rd. Insurance Agency 8476 Bind Road Miami, FL 33155 Phone (305)552 -1758 INSURED CRESPO DECORATIONS 8281 S.W. 58TH. COURT MIAMI, FL 33143 (305) 781-2301 COVERAGES CERTIFICATE NUMBER: REVIS NUMB 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 HERE N IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 6 x31 TYPE OF INSURANCE ADM SUbK POLICY'y _err POLICY EXP MISR VYVD POLICY NUMBER al M/OQ/yyy) (MMIDWYYYY) GENERAL LIABILITY _ COMMERCIAL, GENERAL LIABILITY ❑ ❑ CLAIMS-MADE (21 OCCUR 0 GEN'L AGGREGATE uMrr APPLIES PER; POLICY L I JECT ❑ LOC AUTOMOBILE LIABIUTY ❑ 0 Q ❑ ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS ❑ UMBREUA LIAB ❑ OCCUR ❑ EXCESS LIAR ❑ CLAIMS -MADE ❑ DEDUCTIBLE I1 RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y IN ANY PROPRIETOR/P ECUTIVE OFFICER/MEMBER (Mepdatory In NH) � eaoor�ibe under II'TION OF OPERATIONS below CERTIFICATE HOLDER Fax (306)226 -6418 NIA MIAMI SHORES VILLAGE BUILDING DEPARTMENT PERMIT CLERK FAX 305. 758 -8972 GL0511073299 07/14/2010 CANCELLATION AUTHOR J . REPR 07/14/2011 DESCRIPTION OP OPERATIONS I LOCATIONS I VEHICLES (Mace ACORD UM, Additional Remarks Schedule, If more apace Is required) SIDING INSTALLATION RAIN GUTTER EACH OCCURRENCE EM19ES (Ea occuaence MED EXP (Any one Demon) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Par accident, PROPERTY DAMAGE (Par accident) EACH OCCURRENCE AGGREGATE No. 0621 P. LIMITe n fCP riAM TS n Eta E.L. EACH ACCIDENT EL DISEASE - POLICY LIMIT 6 S S S E.L. DISEASE - EA EMPLOYE E$ 3 $ $ $ 6 1 1,000,000 100,000 5,000 1,000,000 2,000,000 S 2,000,000 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE ' '• LICY PROVISIONS. ® 19UB - 2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) QF The ACORD name and logo are registered marks of ACORD Miami Shores Village APPROVED y... BY DATE ZONING DEPT BLDG DEPT WITH Ai 1 RULES AND RI /2?-r sunJECTTOCOMPUANCE " T ^ Tr AND COUNTY 1 i i )1 ,; Ai. GI ,. !_ , '',IS kcal'vm ss Nw 44 St ® 7 P 74 2011 } BY: C ---1....a p,. - loose situated and being in Miami Shores Village, Flon Lot(s) Block Page of the Public Records WHEREAS, the undersigned owner(s) have and to induce the Village to grant same: NOW, THEREFORE, for good and valuable cons any ordinance o idence only. = • the title to Miami -Dade County, Florid. , (address) • ught certain developmen approval from Miani Shores and eration, the receipt d sufficiency Of Whibfi`t`s a Miami Shores Villag he above pro ded and • hall co PREPARED BY: agree: 200 . WITNESS(ES) KNOW ALL MEN BY HESE PRESENTS: WHEREAS, the undersigned 1. That the Property will not be used in violation o 2. That the property will be used for a single famil y 3. That he /she will not convey or cause to be convey conditions set forth herein. FURTHER, the undersigned declare(s) that this covenant is inte above Property and shall constitute a cov IN WITNESS WHEREOF, the undersigned has/have caused DECLARA ION OF USE by Miami S • res Village, or its successors, in accordance with the codes, rules lations of said Village then in effect. M iami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33 38 Tel: (305) 795 204 Fax: (305) 75:.8972 is /ere thAe le owners) of the f' owing described property ( "Property") fi ms iifiji ; according the plat thereof, as recorded in the Plat Book and e providing this document in consideration thereof bwledged, the undersigned do(es) hereby declare and or Miami -Dade County now in effect or hereinafter enacted. rty without requiring the successor in title to abide by all terms and stitute a restrictive covenant conceming the use, enjoyment and title to the d(s) and seal(s) to be affixed hereto on this day of OWNERS: ns and may only be released Signature Signature and Print and Print Signature Signature and Print nd Print STATE OF FLORIDA ) COUNTY OF MIAMI -DADE ) I HEREBY CERTIFY that on tr day personally appeared before me o is personally known to me or has produced (type of identification) as identification and h /she acknowledge that he/she ex ed the foregoing, freely and voluntarily, for purposes therein expressed. SWORN TO D SUBSCRIBED before me on this day of , 200 My commission expires: NOTARY PUBLIC, STATE OF FLORIDA