Loading...
RC-12-431Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 171020 Permit Number: RC- 3- 12-431 Scheduled Inspection Date: April 10, 2012 Inspector: Bruhn, Norman Owner: PARENTE, WILLIAM Job Address: 171 NE 100 Street Miami Shores, FL 33138- Project: <NONE> Contractor: BLUSKY RESTORATION Permit Type: Residential Construction Inspection Type: Final Work Classification: Repair Phone Number (305)758 -8833 Parcel Number 1132060132060 Phone: (305)789 -4258 Building Department Comments REPAIRS TO t1 -11 INTERIOR CEILING & REPLACEMENT OF 2 RAFTERS Inspector Comments passe/jr 47A-it Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. April 09, 2012 For Inspections please call: (305)762 -4949 Page 10 of 16 AMERICAN BUILDING ENGINEERS° February 29, 2012 Mr. Norman Biuhn Chief Building Official City of Miami Shores Village Miami Shores, Florida 33138 Phone (305) 795 -2204 Fax (305) 756 -8972 RE: 171 NE 100 Street Miami Shores, Florida 33138 Owner: William Parente Permit: RF- 1 -12 -20 Wood sheathing repair and replacement of two (2) rafters. Dear Mr. Biuhn: File # 0212 -008 As per your request the inspection of the above property was done on February 28th, 2012. The replacement of tongue and grove was done with 3 8d ring shank; the two (2) wood rafters were strapped properly as per Florida Building Code. In order to avoid any possible misunderstanding, we wish to specifically advise that nothing in this report should be construed, either directly or indirectly, as a guarantee of condition of any portion of this structure. To the best of our knowledge and ability, this report represents an accurate appraisal of the present conditions of this building, based upon visual examination of observed conditions to the extent reasonably possible. No warranties or representations are intended, nor should any be construed. e We appreciate the o . ortunity to assist you on this project, Should you have any uestions or req '. a any additional information; please do not hesitate to call us. S'ricerely, Awe can Building Engineers 4 - Borujerdi, P. E. .E. # 38553 AMERICAN BUILDING ENGINEERS, INC 1842 East Oakland Park Boulevard Fort Lauderdale, Florida 33306 Phone (954) 739 -5099 Fax (954) 739 -5153 B' PE FBC 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 DING PLICATION Permit Type: BUILDING ROOFING OWNER: Name (Fee Simple Titleholder):, V 111 a rerVlte • Phone#: Address: 1 7 City: M i i't S O)� ES State: r L Zip: 3 313 8 RECEIVED OR 1 2 2012 Permit No. Master Permit No Rl 2— _LB) Tenant/Lessee Name: Email: Phone #: JOB ADDRESS: 111 1\1- E. 100 T h J 1 REET City: Miami Shores County: Miami Dade Zip: 331 3 f Folio/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: Je V - Ci-9 ia7r Phone#; CONTRACTOR: Company Name: ;1 LA„ S Address: Ci " 1 L� City: d P. State: Qualifier Name: P t State Certification or Registration #: - G12-5-5( 9'2-1 Contact Phone#: - . C 2.-S Email Address: DESIGNER: Architect/Engineer: Zip: ant l2 Phone#k n 3. • 4 2-S- Certificate of Competency #: Phone#: Value of Work for this Permit $ �=�1 �L� ° Square/Linear Footage of Work: Type of Work: OAdditio OAlte tion ONew XRepair/Replace a ODemolition e rrs td Ti - 11 rntenor cel ling -4-- Description of Work: (Aeon Anr- +*****`* * * ******** ******* * ********* **** Fees * * * * * ***** ******* ***** *** ****a *** *** **** * ** Submittal Fee $ �tJ e ( Permit Fee $ /b d", Scanning Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ Radon Fee $ 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) (%S dit r� Mortgage Lender's Address ' I I Atha tit, �4 City 0 fitii eo ( /304 J State Zip V2.10( 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 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 pasted at the job site for the first inspection which occurs seven (7) days after the building permit is Issued. absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Le."' /in/ Owner or Agent Contractor The foregoing instrument was acknowledged before me this 13 X The foregoing instrument was acknowledged before me this FE. Signature „)( Sign day of ,20 LL, by 1.0 T4. L IAM PAIIEAPrE , day of 3 i , 20 12— by -61W 0 P•S(,) ovolHIIid /4 ` who is personally known to me or who hair; s a' as identification NOTARY PUBLIC: who is personally known to me or who has produced 5 E. eR r2 er b As identification and who did take an oath. NOTARY PUBLIC: Sign: / v ' N/ ' Sign. Pint: My Commis `'' n Exp `/ /3d ��� 2013 an 34 did take an •oM V NOTAPk • PUBLIC ,! tr/9 F COI -0 e,tct print Dorn My Commission Expires i io �n Exp .I€9.2eut3 ****+ a**** *+n************** * **** * *******+ +ass****** * *de *t=* Maya * *** t ******* Plans Examiner Zoning APPROVED BY ;21/.4 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 CONTRACTORS' REGISTRATION FORM ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED OR THE VILLAGE MAY MAINTAIN A FILE WITH YOUR INFORMATION FOR A $30.00 FEE PER YEAR IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LIC CARD B. COPY OF LOCAL BUSINESS TAX RECEIPT X C. COPY OF LIABILITY INSURANCE (CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPT) X D. COPY OF WORKERS COMPENSATION (EITHER CERTIFICATE OR EXCEMPTION) IF CONTRACTOR HAS A MIAMI DADE COUNTY. CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT C. COPY OF LIABILITY INSURACE (CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKER COMP INSURANCE (EITHER CERTIFICATE OR EXEMPTION) YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 -Q I COMPLETE CONTRACTOR'S INFORMATION BUSINESS NAME: B1 U S k y gesfOra l 10 i1 BUSINESS ADDRESS: MB tiki Rafe P61 ©UJ CITY + L WC(erddtlP. STATE EL ZIP CODE 33315 BUSINESS PHONE: (95�I ) S14 - 7-713 FAX NUMBER (`19f) 7b0 jg CELL PHONE ( ) QUALIFIER'S NAME: Drexu P LS fit, QUALIFIER'S LIC NUMBER: C 6 C 12 5 g j E -MAIL ADDRESS (IF APPLICABLE): h pcoilict 096101 �s I • CO r J Created on 3119109 BY MLDV 1 RV 3126109 MLDV Client#: 68235 8BLUSKY ACORD,. CERTIFICATE OF LIABILITY INSURANCE 1 DATE 0011/DDIYYYY) 2/07/2 2/07/2012 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(les) 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 Willis of Colorado, Inc. 720 South Colorado Boulevard Suite 600N Denver, CO 80246 CONTACT NAME: PN FAX (E , )` 303 722 -7776 Ira, No): 303-722-8862 MAIL ADDS` INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Gemini Insurance Company 10833 INSURED Blusky Restoration Contractors, Inc. 9767 East Easter Ave. Centennial, CO 80112 INSURER B : Arch Specialty Insurance Compan 21199 INSURER C : Zurich American Ins Company 16535 INSURER D : Pinnacol Assurance 41190 INSURER E: Massachusetts Bay Ins Co 17350 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 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 ADDLSUBR INSR WVD POLICY NUMBER POL�CY EFF (MM/DDIYYYY) POLICY EXP (MM/DD/YYYY) LIMITS A B GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY BGR0000115504 All states PD Ded:$5000 12EMP7189500 LA & NY BI/PD Ded:$5000 05/01/2011 except 05/01/2011 05/01/2012 LA & NY 05/01/2012 EACH OCCURRENCE $1,000,000 NRIEI?E��rrrance) $ 300,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 5,000 PERSONAL 8ADVINJURY $1,000,000_ GENERAL AGGREGATE $2,000,000 GEM_ AGGREGATE LIMIT APPLIES PER: POLICY n JEC 1I LOC PRODUCTS - COMP /OPAGG $2,000,000 $ E AUTOMOBILE X LIABIUTY ANY AUTO ALL OWNED AUTOS HIRED AUTOS _ SCHEDULED AUTOS NON -OWNED AUTOS ADF9126550 05/01/2011 05/01/2012 COMBINED SINGLE UMR (Ea accident)_ BODILY INJURY (Per person) _$1,000,000 $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ B X UMBRELLA UAB EXCESS LIAR X OCCUR CLAIMS -MADE 12EMX7189800 05/01/2011 05/01/2012 EACH OCCURRENCE $9,000,000 AGGREGATE $9,000,000 $ DED Xi RETENTION $10000 C D WORKERS COMPENSATION AND EMPLOYERS' UABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory datory In NH) DESCRION OF OPERATIONS below Y / N lJ N / A 969177300 CA,FL,GA,KS,MO,TX 4104134 - CO 05/01/2011 05/01/2011 05/01/2012 05/01/2012 X TrOORYrLIMMITS W- E.L EACH ACCIDENT $1,000,000 E DISEASE - EA EMPLOYEE .L $1,000,000 E.L DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, N more space Is required) CERTIFICATE HOLDER CANCELLATION Miami Shores Village Building Department 10050 N. E. 2nd Avenue Miami, FL 33138 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 © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S899986/M795741 COLEA T 115 S. Andrews Ave., Rm. A -100, Ft. Lauderdale, FL 33301 -1895 — 954- 831 -4000 VALID OCTOBER 1, 2011 THROUGH SEPTEMBER 30, 2012 DBA: Business Name: MUSKY RESTORATION CONSTRACTORS INC Receipt #:180 - 242747 Business Type:' cONTRACr0R CONTRACTOR) Owner Name: RISPING, DREW c Business Opened:07 /26/2011 Business Locatlon:9767 E. EASTER AVENUE S elGounfy /Cert/Reg;( 301258121 OUT OF STATE Exemption Ccde:NONExEMPT Business Phone: 303- 789 -4258 Rooms Seats Employees 8 Machines Profeesionats For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee . NSF Fee . Penaltyr . - ... Prior Years Collection Cost Total Paid 27.00 0.00. •0 00: : 0.00. • o..ob 0.00 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non - regulatory in nature. You must meet all County and/or Munldpallty planning and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. WHEN VALIDATED Mailing Address: MUSKY RESTORATION CONSTRACTORS IN 9767 E. EASTER AVENUE CENTENNIAL, CO 80112 Receipt #028 -10- 00002225 Paid 07/26/2011 27.00 sa:LO ZLO / L /So EOO /6Co •c1 LEE# From: 03/12/2012 07 : 28 8337 P. 001/003 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTE MONROE STREET TALLAHAS SEE FL 32399-0783 DUPING, DREW C DUMMY RESTORATION CONTRACTORS INC 9767 E RASTER AVE CENTENNIAL CO 80112 Congratulations, With this license you become one of the nearly one million • Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbecue restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. 't For information about our services, please log onto www.mygorldalicense.com. There you can find more information about our divisions and the regulations that Impact you, subscribe to deparbrient newsletters and-learn more about the Department's Our mission at the Department le: Llianse Effidengy, Regulate Fairly. We constantly strive to serve you better so that you oar serve your customers. Thank you for doing business in Florida, and congratulations on your new Hoene& DETACH HERE WMWEOFFIARDA AO* q 5 S DEFARTMENI OF BUSINESS AND PROFESSION* , 48,9oLATioN 0GC1520286":--• 01/20/X2 110031690 PLUS= RESTORWP;W:tqPNTRACTOAS X .4 .t. =TIMED: : • ...,00WRACTOR szszarmi • •. Zgi CRILIMPZED =tog the pigovigione ez Ch.489 levications dna& I az, 2012 L120%2000719 laiteattcatWeiMea,VWWij-11$•V Qs:.11MENT.1-1,n5Wtb t.T.09.E;pT,Apf.<.p.RpliN.a:•..1.11b i f:J e4EIVI TENTED:PA. %*4104.740,444WWW4tY4figi AC #5954 5 STATE OF FLORIDA DE1;4RTIIiiinag "n I 611zitiEWIRPERNSILBSEARELAT xctona. komar L1203.2000719 , • BATCH NUM3ER 01.20 2012 L EN • ..; lithe 110031690 CGC152028V The GENERAL CONTRACtOR )/V ' Named. below XS CERTX3tIED 'Under the.provisione of Chapta#w Expiration dates AUG 31, 2012 BISFING DREW C • amincr kESTORkTXON COMTRACTOiS.,: 2320 CLERMONT ST DENVER CO 80207 ,ZIOD (04-rkafi.4. RICE SCOTT GOVERNOR • • • DISPLAY AS.REQUIRED BY LAW KEILLawson SECRETARY CITY OF FORT LAUDERDALE BUSINESS TAX YEAR 2011 - 2012' g)-mice ae Cenwioa BUSINESS TAX DIVISION 700 NW 19 AVENUE, FORT LAUDERDALE, FLORIDA 33311 (954)828 -5195 Business ID: 1001157u BLUESKY RESTORATION CONTRACTORS INC Business Addre 1883 STATES 8 101 �§P'FICE USE ONLY • Tax Category: T :732693 BLUESKY RESTORATION CONTRACTORS INC:.' TERRY SHADWICK CEO 1883 STATE ROAD 84 FORT LAUDERDALE, FL. * **DETACH AND POST THIS RECEIPT IN A CONSPICUOUS PLACE * ** Business ID: Tax Number: Business Name: Business Address: Business Owner: Fee: 1001157 732693 BLUESKY RESTORATION CONTRACTORS INC 1883 STATE ROAD 84 # 101 SHADWICK,TERRY CEO ✓ This Receipt issued for the period commencing October 1st and ending September 30t of the years shown above. ✓ If you have moved your business, please complete below and bring it into our office. ✓ A transfer of business location is subject to zoning approval. Please bring this receipt in to our office to obtain the necessary approval. ✓ If you have sold your business, please sign below and mail it to our office, or provide it to the Purchaser to bring into our office along with a Bill of Sale. ✓ A Transfer fee applies of 10% of the annual business tax fee, not less than $3.00, no more than tOn An sa:LO aLoz /ZL /Eo Eoaiaoo'd LEE#