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RF-12-722Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 174226 Permit Number: RF -4 -12 -722 Scheduled Inspection Date: June 13, 2012 Inspector: Rodriguez, Jorge Owner: PENA, JORGE & JENNIFER Job Address: 306 NE 102 Street Miami Shores, FL 33138- Project: <NONE> Contractor: WATERTITE GUTTER CO INC Permit Type: Roof Inspection Type: Final Work Classification: Gutters Phone Number 305 - 759 -2741 Parcel Number 1132060135170 Phone: 954 -563 -2207 Building Department Comments INSTALLATION OF 6" SEAMLESS ALUMINUM GUTTER AND 3X4 DOWNSPOUTS (FRONT AND BACK) Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP- 172681. NO PLANS OR PERMIT June 13, 2012 For Inspections please call: (305)762 -4949 Page 7 of 19 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 172681 Permit Number: RF -4 -12 -722 Scheduled Inspection Date: May 24, 2012 Inspector: Bruhn, Norman Owner: PENA, JORGE & JENNIFER Job Address: 306 NE 102 Street Miami Shores, FL 33138- Project: <NONE> Contractor: WATERTITE GUTTER CO INC Permit Type: Roof Inspection Type: Final Work Classification: Gutters Phone Number 305 - 759 -2741 Parcel Number 1132060135170 Phone: 954 -563 -2207 Building Department Comments INSTALLATION OF 6" SEAMLESS ALUMINUM GUTTER AND 3X4 DOWNSPOUTS (FRONT AND BACK) Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments May 23, 2012 For Inspections please call: (305)762 -4949 Page 18 of 33 A II tNG PERMIT APPLICATION Fsc ao 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 Type: BUILDING ROOFING OWNER: Name (Fee Simple .Titleholder): r-. \q4i %e_ Pt.n' Phone# :,. Address: 3 D J.J E, 5 7� City: tili AM i �A e $ State:. zip: Tenant/Lessee Name: Phone#: Email: Permit No. APR 23'512 U ...... amvmo© Master Permit No. 710 2.0D -0 JOB ADDRESS: 30 6 City: Miami Shores Folio/Parcel#: Is the Building Historically Designated: Yes County: Miami Dade Zip: Address: a--1 6- 3 CN NO Flood Zone: CONTRACTOR: Company Name: LA)k Y 1 C �+ (,D - l��i Phone#: (CICV)�' .220 7 City: :.(`_ State: 0_, Qualifier Name: j f,,14 -n 40 M LO AJC1 State Certification rriRe tration #: Certificate of Competency #: Contact Phone#: (7 �% g DESIGNER: Architect /Engineer: Phone#: Phone#: d. 7c' C) 3 5 5 000 $ S f / 3 Email Address: 14)a n/e, / Value of Work for this Permit: $ 6 O 6 Type of Work: DAddition OAlteration Description of Work: IL:4 -0 / f -M'd or (`' 120 van)sro---- Footage of Work: 7t ORepair/Replace S V-61al�e -S .S /4-44 i�') i ".9B er ema- ODemolition Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Notary $ Training/Fducation Fee $ Double Fee $ Structural Review $ CCF $ CO/CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ S64C) 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 Fi.ECTRICAL 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 COMMENCEMENTS" 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_ ap i roved and a reinspection fee will be charged. XSignature Owner or Agent The foregoing instrument was acknowledged before me this / day of , , 201 �, by ITSutc;J2 PeA4 who is personally known to me or who has produced ��, �• �� As identification and who did take an oath. NOTARY PUBLIC: tt Si My Commission Expires. * * * * * * * * * * * * * * * * * * * **** ** ** Signature ga V %/' Contractor The foregoing instrument was acknowledged before me this 17 day of ,8 #/.i (1 , 20 i-, by t ii i�!iv. who is o ja n s . a i . ',AS 11 II ` %I who has produced as identification and who did take an oath. NOTARY PUB 1 APPROVED BY /6126 0'5 .I Pi:'., TERRY 1. C :'IA Notary Public - S 3. f: • = My Comm. Expires ,, 4 Commission # OD 853270 ''�''° '�''4''� Bonded Through Mind Noisy Alan. ** * *** * * * * * * * * * * * * * * * * * * * * * * * *. ** e sion Expires: Dig/a-0 1 3 *** * * * * * * * *** *** ***** * * * * * * *** **** 70/ Plans Examiner Zoning Structural Review Clerk (Revised 07 /10 /07)(Revised 06/10/2009)(Revised 3/15/09) %-A ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 2/27/2012 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. 'ORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to ..e 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 Corporate Insurance Advisors 100 NE 3rd Avenue Suite 1000 Ft. Lauderdale FL 33301 CNAMECT Stephanie Arnold PHONE Ertl: (954) 315 -5000 1 INC. Nol: (9$4) 315 -$050 A DRESS: sarnold@ei.afl.net INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :Mid- Continent Casualty Co. INSURED Watertite Gutter Company, Inc. 211 N.E. 32 Court Fort Lauderdale FL 33334 INSURER B :Allied Property & Casualty Ins. 29262 INSURER c :Bridgefield Employers Ins. Co. INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:11 /12 & 12/13 WC 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 IN j TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF IMMIDDIYYYY) POLICY EXP IMM/DDIYYYYI LIMITS A GENERALUABIUTY X COMMERCIAL GENERAL LIABILITY 04GL000833492 10/19/2011 10/19/2012 EACH OCCURRENCE $ 1,000,000 PRS (RENTED PREEMI EMISES (RENTED Ea $ 100, 000 I CLAIMS -MADE X OCCUR MED EXP (Arty one person) $ X $1,000 Per Claim Dad PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GGEEN'L AGGREGATE LIMIT APPLIES PER 7C 1 POLICY n JEC I I LOC PRODUCTS - COMP /OP AGG $ 2,000,000 $ AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS - X SCHEDULED AUTOS AUTOSWNED ACP 5904689372 10/19/2011 10/19 /2012 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ Included BODILY INJURY (Per accident) $ Included (Per acci DAMAGE $ Included PIP -Basic $ 10,000 UMBRELLA LIAR EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED 1 RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' UABIUTY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yyeeaa describe under DESCRIPTION OF OPERATIONS below N/A 83016079 4/1/2012 4/1/2013 I TORY ATUU- I I OTH- ER EL 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, K more space is required) Metal Gutter Fabrication and Installation Contractor. CERTIFICATE HOLDER CANCELLATION Village of Miami Shores Attn: Building & Zoning Dept. 10050 NE 2nd Avenue Miami Shores, 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 Mark Schwartz /STEFL ACORD 26 (2010/05) INS025 (201005).01 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ermi No:12 -722 Job Name: April 26, 2012 Miami Shores Vivage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 Building Critique Sheet 1) Provide detail of attachment. The gutters may not be attached through or to roofing material. 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 - 762 -4859 A-) q_ 543 °04e Home Offic 211 N 3 „ Court ` Ft. Lauderdale, FL 33334 WA 1 Established 1984 JjijJ nt- L E -FR coo 4111 t1/4.Ar-- Broward: (954) 563-2207. Dade: (305) 654-1140 Palm Bch.: (561) 241-6737 Fax: (954) 563-9940 6- & 7" Seamless Aluminum Gutters CC # 84-3663 MMX 141 WEBSITE: www.watertitegutter.net • E-MAIL: watertite@bellsouth.net CC3) 7i NAME: PROPOSAL SUBMITTED TO: 1,0 '- -t STREET: CITY: -3 • *VA: 'Y•41- PHONE: DATE: JOB NAME: STREET- CITY: STATE: We hereby submit specifications and estimates for: ® Downspout IINSTALLER ■ ( ( 2,, i( /T0_, ur. I STATE: r_ APPROVED Miami Shores Village BLDG DEPT JIM ING DEPT ,••• DATE 1111M312 SUBJECT TO COMPLIANCE WITH AU-FEDERAL sTAx AND COUNTY RULES A o-RecuLATIoNs 3 pb1-4B1 We hprebypropose to furnish labor and materials — complete in accordance with the above specifications, for the sum of: dollars ( $ ) with payment to be as follows: All material is k deviation from t the estimate. and Is vold t strikes, accidents or delays beyond our control. This proposal subject to acceptance within days strikes, Two year guarantefon Labor, Twenty years on Material. tfied. All work to be completed in a workmanlike manner according to standard practices. Any alteration or b4ng extra costs, will be executed only upon written orders, and will become an extra charge over and above Authorized Signature ACCEPTANCE OF PROPOSAL Thl above prices, specifications and conditions are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. • ACCEPTED: Date Signature Signature J 3 '14 ----+ Se -PHA ks s MAY 0 8 2012 BY: +4K s cAtvi tA);44% ‘oi,kM w 6/ C4 ■ - ye_