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RF-11-1607Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 163968 Permit Number: RF -8 -11 -1607 Scheduled Inspection Date: September 08, 2011 Inspector: Bruhn, Norman Owner: LEE, PATRICK & LESLIE Job Address: 1122 NE 97 Street Miami Shores, FL 33138- Project: <NONE> Contractor: ARION INC Permit Type: Roof Inspection Type: Final Work Classification: Gutters Phone Number Parcel Number 1132050170170 Phone: (305) 251 -1279 Building Department Comments INSTALL RAIN GUTTERS Inspector Comments Passed G- Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. September 07, 2011 For Inspections please call: (305)762 -4949 Page 38 of 47 Miami Shores Village Building DepartmentCEIVED 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 AUG 1 2011 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BY BUILDING PERMIT APPLICATION FBC 20 07 Permit Type: BUILDING ROOFING OWNER: Name (Fee Simple Titleholder): Address: 3-7 -- A/6. 0 City: /VI State: ?7.-- Permit No (21 k -' Master Permit No. r Phone #: % f� -. Z / G Zip: 31(32' Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: 14.2-42---- 4 ) C ? d J City: Miami Shores County: Miami Dade Zip: Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: 6044--./ Address: ' , 2, Phone #: o d `7.� % City: , State: fZ_ . Zip: ! > " e / �Z Qualifier Name: d >_.� % �J`� �� .�� Phone #: �� f- % � �- J' ---7 State Certification or Registration #: Certificate of Competency #: 00:-.101 7 3' —7 / Contact Phone #: c, Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ ?S(3 Square/Linear Footage of Work: 9e Type of Work: ❑Addition ❑Alteration Description of Work: , d.J G ..J C- 15S I 9 I✓!' New ❑Repair/Replace ❑Demolition ******** * * * * * * * * * * * * * * * * * * * * * * * * * ** * * ** Fees************* * * * * * * * * * * * * * * * * * * * * * * *** * * * * ** Submittal Fee $ ' Permit Fee $ / O b °41 CCF $ CO /CC $ Scanning Fee $ Radon Fee $ ( DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ ✓ G�'CQej 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 b+approv.%`: d reinspection fee will be charged. Signature Signature er or Agent l Contractet` r� The fore oing ' s trument was a kn wledged before e this 5 I The foregoing instrumen w..:. c u owled d before me this J, day of , 20 I i , by��� day of , 20 < <, by c✓ 4�71�a1,'� A who is p rso ally kno tgyme or who has produced who is personally known to me or who has produced D 4 /4�'�Cidntification and who did take an oath. as identification and who did take an oath. oiuuiuw� NOTARY PUBLIC: NOTARY PUBLIC: e���`��` t ,..ii tS Sign: bYj \ � a rv.a ap .93, Sign: !/ _,e_ ..• °,�. _ Print: .:,' ;� �e1S�! ,.�"" Print: o i `' ®4 My Commission Expires: �° °• ' O /,/ '/�iin ... iS t\A`���� My Commission Expires: APPROVED BY a‘&4 96 f Plans Examiner Zoning Structural Review Clerk (Revised 07 /10 /07)(Revised 06 /10 /2009XRevised 3/15/09) Continuous Rain Gutters �RI®N SEP 0 2 2011 1?ain Control Systems 1 0-- \(.,Qo- CUSTOMER # 3 1 L ORDER # Propo We here 8723 S.W. 129th Terrace / Miami, Florida 33176 / (305) 251 -1279 / Fax (305) 251-3877 Miami Scores VilWage APPROVED BY DATE ZONING DEPT BLDG DEPT ?::"./( FEDERAL Al 10NS 3`:UI1,11 -CT 10 COMP! IANCE WITH AI_L S IA fE ANh CC1l IN I YH1 31 .FS AND RFGUI r - -.- ' : -: ; e� . �� P A ° A for: 6 inch [umfin' um continuous gutter. (A) 14 ,. 8� h� tor GUARANTEE: 1 YEAR LABOR 10 YEARS MATERIAL INSTALLATION DATE: FOOTAGE: -71 e C„,- rrIT, Extras: Plus Permit Fee and $50 Precessin Authorized Signature * ----� TERMS ON THE ' -,' SID . ARE A PART OF S CLIENT COPY Permit No: 11 -1607 Job Name: August 31, 2011 Miami Shores Village Building Department Building Critique Sheet 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 1) Provide a plan showing the layout of the structure and the location of the gutter and downspouts. Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Norman Bruhn CBO 305 - 795 -2204 CTQB Construction Trades Qualifying Board BUSINESS CERTIFICATE OF COMPETENCY 00001337/ ARION INC DBA- WYN RICHARD ROBERT Is certified under the provisions of Chapter 10 of Miami -Dade County, VALID FOR CONTRACTING UNTIL O9 /30/2012;; I • 035451 -4 BUSINESS NAME / LOCATION ARION INC 8723 SW 129 TERR 33176 UNIN DADE COUNTY 2010 LOCAL BUSINE$r8TAX RECEIPT 2011 MIAMI- DADE .COUNTY -'STATE OF FLORIDA EXPIRES SEPt 30 3011 MUST BE DISPLAYED At PLACE OF BUSINESS PURSUANT TO COUNTY CODE CHAPTER 8A - ART, 0 THIS IS NOT A BILL — DO NOT PAY OWNER ARION INC Sec. Type of Business ryas �s 1,2f AngsiALTY BUSINESS TAX RECEIPT. IT DOES NONMIT THE HOLD G RT O PEEODULATTORY OR cotter( H CITIES. -NOR DOES IT EXEMPT'.. THE HOLDER FROM ANY OTHER PERgWIT__ OR LICENSE WITDD BY LAW. ore i NOT A CERTIFICATION N THE ROUTERS QUALIFICA- PAYMENT RECEIVED MMMI -DADS COUNTY TAX COLLECTOR:.. 08/13/2010 60050000004 000075.00 SEE OTHER SIDE FIRST-CLASS U.S. POSTAGE PAID MIAMI, FL PERMIT NO. 231 RENEWAL RECEIPT NO. 035451 -4 CC * 000013371 WORKER /S BUILDING CONTRACTOR .10 DO NOT FORWARD ARION INC RICHARD R WYNNE PRES 8723 SW 129 TERR MIAMI FL 33176 • 18 fIbtOA , Cpl'#T1RACTOFI TAX AtOEIPT T 'A &TATS 4 F FL ARION INC RICHARD R WYNNE PRES 8723 SW 129 TERR MIAMI FL 33176 ti ACORN' CERTIFICATE OF LIABILITY INSURANCE OP ID: DT DATE (IV M/DD/YYYY) 08/30/11 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 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 FILER INSURANCE, INC. 9440 S.W. 77 Avenue Miami„ FL33156 Mark A. Bluh 305 - 270 -2100 305 - 270 -2195 CONTACT NAME: PHONE MC. No. Ext): FAX (AIC, No): E-MAIL ADDRESS: PRODUCER ARION01 CUSTOMER ID# INSURER(S) AFFORDING COVERAGE NAIC 0 INSURED Arlon, Inc. MVP Metals, Inc. 8723 SW 129th Terr Miami, FL 33176 INSURER A: FCCI Insurance Company 10178 INSURER B: INSURER C: INSURER D : INSURER E : INSURER F : COVERAGES 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 INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. OLICY PERIOD O WHICH THIS L THE TERMS, INSR TYPE OF INSURANCE INER SUBR POLICY NUMBER (M��DIYYYY) (MM/DDIYYYY) LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY X OCCUR CPP0007405 07/05/11 07/05/12 EACH OCCURRENCE $ 500,000 X PREMI ES (RENTED PREMISES (Ea oxurrence) $ 100,000 CLAIMS-MADE MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 500,000 GEN'L GENERAL AGGREGATE $ 1,000,000 AGGREGATE LIMIT APPLIES PER' POLICY JFCT LOC PRODUCTS - COMP /OP AGG $ 500,000 $ A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS CA0009153 07/05/11 07/05/12 COMBINED SINGLE LIMIT (Ea accident) $ 600,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X $ $ UMBRELLA LIAR EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A WC STATU- CA-H- TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule if more space is required) Miami Shores Village g 10050 NE 2nd Avenue Miami Shores, FL 33138 MIAMISH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELNERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE A268851 , -- , DARYL TORRES - ACORD 26 (2009/09) © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD _ ACORafl® CERTIFICATE OF LIABILITY INSURANCE ‘....------ DATE(MM/DD/YYYY) 05/12/2011 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(Ies) must 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 Risk Transfer Programs, LLC 219 East Livingston Street Orlando, FL 32801 CONT/kCT NAME: FAx (AFCNNo Ext): 866 -481 -9363 , No): E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :CastlePoint National Insurance Company 40134 INSURED Stafflink Outsourcing, II, III, IV, V & VI Inc. 1776 N. Pine Island Road Suite 108 Plantation, FL 33322 INSURER B :Tower Insurance Company of New York 44300 INSURER C : INSURER D : $ INSURER E : $ INSURER F : COVERAGES CERTIFICATE NUMBER:A37P4B5M 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 INSR SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES (Ea occurrence) $ CLAIMS -MADE OCCUR MED EXP (My one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP /OP AGG $ GE 'L AGGREGATE POLICY LIMIT APPLIES , JECT PER: LOC $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS UAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENTION $ A B WORKERS COMPENSATION AND EMPLOYERS' LIABIUTY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N /A WSLTHPE00020007 WSLTHPE00014902 03/01/2011 03/01/2012 X TORY AT Ts I OT ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 $ $ $ $ $ DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Coverage is extended to the leased employees of alternate employer (Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Michigan, Missouri, Pennsylvania, Tennessee, Texas and Virginia Coverage Only.)Arion, Inc. #1154 CERTIFICATE HOLDER CANCELLATION Miami Shores Village 10050 NE 2nd Avenue Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATETHEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) Page 1 of 1 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD