PT-09-1129 Miami Shores Village
4 ' 6
Building Department +
10050 N.!_;2nd Avenue. Miami Shores, f lorida 33139
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING Permit No. PT 1- -112.
PERMIT APPLICATION Master Permit It
FBC 2004
Permit Type PAINT PERMIT
Owner's Name (Fee Simple Titleholder) 11 v o I D (A 6. LL L PI e # q I �� 4
Owner's Address q� /, � C&
-
City VW&MMLate U r( Zip /
Tenant /Lessee Name Phone # _
E- MAIL: —U - y IJ 9 V L�
Job Address (where the work is being done) -J — : j 0 S re e �- -
City _ __. Miami Shores Village County Miami -Dade Zip
a
POLIO / PARCEL # ( � - 6 i 1 `> S
Is Building Historically Designated YES _ NO
Contractor's Company Name ` C� \V�� b QG S'P one
Contractor's Address Z(0 1 go S
City - - a State Zip 4 A 7,
Qualifier Name Phone #
State Certificate or Registration No. O R 96 0 y` 3 Certificate of Competency No.
OWNER BUILDER: 0 AV H t fL q cc p2 le,i V `T t rL
Value of Work For this Permit $ Type of Work: ❑ Addition / ❑ Alteration / nNew/ ❑ Repair /Replace
0 v ROOF [-)06 s T�-iMS n.C2 w� dlS.
Describe Work: ' PO-1 n �X TC R u S A2A r� Q
_
Application is herchy made to obtain a permit to do the work and installations as indicated. I certify thatno work or installation has commenced prior to the issuance ora permit
and that all work will be pertoma d to meet the standards ol'all laws regulatinaconstruction in this jurisdiction. I understand (fiat a separate permit nwst be secured liu
EL CTRICAI. WORK. PLUMBING, SIGNS WEI..LS. POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE. FOR
IMPROVEMENTS TO YOUR PROPL11TV. IF YOU INTEND TO OBTAIN FINANCING; CONSULT WITH YOUR LENDER OR AN ATTORNEY REFORt
RECORDING YOUR NOTICE OF COMMENCEMENT."
Notice to. I ppl icant: As it condition to the issuance ol'a building permit with an estimated value exceeding $2500. the applicant nual promise in gocxl faith that it copy gfthe
notice cif conrrrrencc them and construction lien lem brochure will be delivered to the person whose property is subjecl to attachment. Also. a certified copy gf the recorded notice
of cntrrmencenreni muss he posted at the joh 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 he approved and a reinsltection, fee will be charged..
Permit Fee $ CCF $ Technology Fee:
Training /Education Fee $ Notary $ Code Enforcement$
Double Fee $ Zoning $ Total Fee Now Due $
See Reverse side -a
PAINT COLOR APPROVAL AND AGREEMENT
All elements on the site must be listed and indicate the color to be painted
Directions: Please circle corresponding number to appropriate color sample.
Walls:56'to`� l 2 3 4 Attach color samples with name and
Fascia: 1,5WI0 a ? 3 4 number.
Drip Cap /Drip Edge: 1 2 SVJ Wa b 4 �
Soffit I 2 -- -- , 4 � D � (-' W�rTe S of
Flo\,ver Bins 1 2 3 4
Shutters: 1 2 3 4 �p
Awnings 1 2 3 4 2 x l4 UJh l ►` 5 w -o0 6
Chimney: 1 2 3 4�
Doors and Door.lams: 1100s2 3 4
Garage Doors: 10 2 3 4
Railings: 1 2 3 4 3 X T 2 - 4
Fences• 1O SI 2 3
W
4 f� G 5 sS
All brick (simulated or regular ) I 2 3 4
Stucco Banding: l 2 3 4 `
Any other Stucco Features: 1 2 3 4 4 xTrZt� (r/�1.L S vv a 0 v
Accessory Buildings Other: T
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in
compliance with , applicable laws r gulating construction and zoning.
Signature Signature
-Owner or Agent Contractor
The for eoi g instrument was aclino ledged et'ire me ��� The fore in insf ment was ack edged be' r me thi.
day of —
.200 by� Y ltitJ day of 20by �i►
w is ; personal known to me of wlio has produced _ who is ersonail known to me or who has produced
v -` As identiticatio l and who did tal:� i�h � - pentitieation and who di take w
NOTAR (IO�C�1'� �� N TAR IC:
Sign: 0 Sign: �ti
J W
Print: _°" Print:
My Commission is xpires: �`t�Nte,�(;, My Commission Expires:
O i �
APPLICATION APPROVED.RY: Plans Examiner
Preservation board
Code Bilbreement
(Revised 0412410
PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE
STATE OF FLORIDA IMPORTANT
DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS COMPENSATION F Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who
CONSTRUCTION INDUSTRY O elects exemption from this chapter by filing a certificate of election
CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA .6 L under this Section
WORKERS' COMPENSATION LAW . may not recover benefits or compensation under this
^ "` D chapter.
EFFECTIVE: 08/28/2008 EXPIRATION DATE: 08/28/2010
PERSON: FRANKLIN A WCIA 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
FEIN: 204515964 R the notice of election to be exempt
BUSINESS NAME AND ADDRESS:
G/F PAINTING SPECIALIST INC E Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt
2618 SW 14 DR 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
DEERFIELD BEACH, FL 33442 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
SCOPE OF BUSINESS OR TRADE: person named on the certificate to meet the requirements of this
1 - PAINTING section.
QUESTIONS? (850) 413 -1609
CUT HERE
Carry bottom portion on the job, keep upper portion for your records.
OWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06
E C
W*
CTQB
,a.
Construction Trades Qualifying Board
. ` BUSINESS CERTIFICATE OF COMF1iTEN&;
06BS00513
G/F PAINTING SPECIALIST INC
D.B.A.:
G AR IC A'FRANKLIN
Is certified under the provisions of Chapter 10 of Miami -Dads; Gountg, •`-
... r
QUALIFYING TRADE(S)
0078 PAINTING
.Hem6rdo Gonzalez P.E. ` 10
Secretary of the Board
NGarrii -Dade Courtly retatna -a0 Property rtgFils herein. www.m craft e.9o�/builmrgoode
MIAMI -DADE COUNTY, FLORIDA FINANCE DEPARTME
MIAMI DARE TAX COLLECTION DIVISION
` ° z 140 W. FLAGLER STREET
MIAMI, FLORIDA 33130
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IMPORTANT'. THE INFORMATION HEREIN DOES NOT NECESSARILY CONTAIN ALL PERTINENT FACTS WITH REGAWS
TO REAL ESTATE CLOSINGS AND OTHER SIMILAR ACTIVITIES.
MIAMI -DADE COUNTY, FLORIDA FINANCE DEPARTM
MIAMI DARE TAX COLLECTION DIVISION
140 W. FLAGLER STREET
"FL MIAMI, FLORIDA 33130
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IMPORTANT: THE INFORMATION HEREIN DOES NOT NECESSARILY CONTAIN ALL PERTINENT FACTS WITH RE GARDS
TO REAL ESTATE CLOSINGS AND OTHER SIMILAR ACTIVITIES.
7 07 0911;55a 3058187357 P.1
AA C(2 CERTIFICATE OF LIABILITY INSURANCE ° "' E `"' ° ""D"" 2
PRODUCER 7 7 00
THIS CERTIFICATE IS ISSUED AS A mATTER OF IINFORMATION
DELMAR INSURANCE INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1665 w 68 $t Ste 209 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Hialeah, FL 33014 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
1 305)818-7355 INSURERS AFFORDING COVERAGE NAIC#
NSURED GF PAINTING SPECIALIST INC INSURER A
sxPsr caMEBCraL nqSUAPa= CmWnrlY
INSURER &
2618 SW 1$ DRIVE INSURER c
DEERFIELD , rL 33442 INSPIRER Or
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OVERAGES INSURER
THE POLICIES OF INSURANCE LISTED
ANY REQUIREMENT, TERM BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
OR CONDTION OF ANY CONTRACT OR OTHER DOCUMENT W17H RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED SY THE POLICIES DESCR18ED HEREIN 1S SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE UMITS SHOWN KAy HAVE BEEN REDUCED BY PAIDCLAIMS.
L
�p rLJAOLrrY POLICY NUMBER DCA CY EFFENE P LILY ON LI�AII S
TE EACH OCCURRENCE �51 000
L IABILITY UANIAGE
OCCUR P REMISE Ea oecaaer�c 000
A MEDEXP(kWonepereon) $ 5 000
GL- 306320 06/29/09 01125/10 PERSONALBADVINJIIRY s 1 ' 000,000
GEN1 AGGREGATE LIMIT APPLIES PER
a AGATE a I- 000,000
X POLICY PRO- LoC PRODUCTS - COMPIOPAGG $ 1 00 000
AUTOMOBILE LIABILITY
ANYAUTO C } INGLELBAIT $
ALLOWNEDAUTOS
SCHEDULEDAUTOS SODILYWJURY $
HIRED AUTOS (Per persm)
NON- OWNEDAUTOS BODILYINAIRY $
IPere�crcierrt}
I = E $
GARAGE LIABIJI'Y
ANYAUTO AUTOONLY- EAACCIDENT &
OTHERTHAN EAACC S
AUTOONLY: AGG $
EXCESSAIMBRBI A LIABILITY f
OCCUR CI CLAIMSMADE I EACH OCCURRENCE g
AGGREGATE $
DEDUCTIBLE $
RETENTION $ $
WORKERSCOMPENSAMONAND $
EMPLOYERS' LIABILITY RYLIM fTo ANY PR W4303ER EXC CUrNE . E.L EACH ACCIDENT $
OPP E9cCXU�D�
Nyee,dmenleunder E.L. DISEASE EA EJNPLOY $
S PECIAI PROVLSIONS helow
OTHER E.L DISEASE- POLICY LIAT $
SCRUMON OF OPERATIONS! LOCATIONS! VEHICLES! EXCLUSIONS - DDED BY ENDORSEMENT/ SPECIALPROVISIONS
ATIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
MIAMI SHORES VI DATE THEREOF, THE ISSUING INWER WILL ENDEAVOR TO MAIL
10050 HE 2 AVE �Q- °A WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL
MIAMI FL 33138 IMPOSE NO OBLIGAMON OR LIABILITY OF ANY HIND UPON THE INSURER. ITS AGENTS OR
RZX 305- 756 -8972 REPRESENTATIVES,
ATTN. VZVIAN CMILLAS AUTHO SENTa
ORD25(2001108) CA ,
OACORD CORPORATION 1988