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RF-12-740Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number. I NSP- 172783 Scheduled Inspection Date: May 31, 2012 Inspector. Bruhn, Norman Owner: DAVIS, WILLIAM Job Address: 405 NE 99 Street Project: Miami Shores, FL 33138 -2461 <NONE> Contractor: WATERTITE GUTTER CO INC Permit Number: RF -4 -12 -740 Permit Type: Roof Inspection Type: Final Work Classification: Gutters Phone Number Parcel Number 1132060170390 Phone: 954 - 563 -2207 Building Department Comments 6" SCAMLESS ALUMINUM GUTTER AND 3X4" DOWNSPOUT IN BACK Inspector Comments Passe cl(41 Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. May 30, 2012 For Inspections please call: (305)762 -4949 Page 6 of 26 /lit- 0064Ai- B DING PERMIT APPLICATION FBC 20 Miami Shores Village /4 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. APR 2 5 201. Lili BY:— Master Permit No. Permit Type: BUILDING ROOFING OWNER: Name (Fee Simple Titleholder): A) , \RV Phone# 0 71 5 ^ 7,x Address: 1 0 5 /V. f° '( City: Ull �l to; Shope -5 State: zip: Tenant/Lessee Name: Phone#: Email• JOB ADDRESS: 90-5-- e: 9 r City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: L5A 0' f % -e-. ,% C © -'- Address: - Phone#: City: F 1 d. State: Qualifier Name: ,rd t,11 �� 1'J1 -. State Certification or Registration #: Zip: 3-3 3 3 y Phone#, 7Ij ✓ a -2-v1 Certificate of Competency #: 95 B 5 c CD 51 Contact Phone#: Email Address: DESIGNER: Architect/Engineer. Phone#: Value of Work for this Permit: $ • Type of Work: °Addition °Alteration New f3Repair/Replace t4. titd, Description of Work: 6' • 1z, Al /owl kw,- o A `� ` P'/4 G `� ,/ spc �,: T d nl b/4/1 °Demolition ****** ** **** *** *** * ** *aye * * *** * ** ** ** Fees *** * * ***** * * ** * ***** *** * * * * *** ** *way * ****e ** Submittal Fee $ Permit Fee $ AO Q C) CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ /034(00 ' a 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 s s 'ect to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first insp ' n which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will approved and a reinspection fee will be charged. Owner or Agent The fore instrument was acknowledged before me this day of A fA, ,20 113-,by 1 l who . personally known tome r who has produced As identification and who did take an oath. Print � My a.�piY NMI &M -Ptama • r My Comm. Feb B, 2013 z';; Commission 000 853270 Bonded Through NWond Notary Aun. ** ** *** * ***** * * * **** * **** ** Signature 174, Contractor The foregoing instrument was acknowledged before me this ,-4.5 day of Ai f , 20 t 2 , by tip who to me or who has produced as identification and who did take an oath NOTARY PUBLI • ' t Prin !% i s . .. My Al t�� a =,�G�ri,t • • Comm. Expires Feb 8.2013 • `- �• Commission 0 Do 853270 ' ,, „'dg's Barbed Through National APPROVED BY SI' V L Plans Examiner Structural Review (Revised 07 /10/07)(Revised 06/10/2009)(Revised 3/15109) Zoning Clerk TaffitY .i vWpyi lo g9W. • „iidto 4981asNA1 ouc!+Jvg, OiSEE73 prj lk na as,mmo:i re4A ip.E101.104-Atimlool5;,:rp,A .. 14OT0i411)3.4'Y}iM3f sbit01a 16 9 E/2 - 3iIM %1Eir.0.4 £ c?a 2g9igx? .mmoD vM 0 9TSEE19 Go noi; zifrfi nEtAvtElEVISEnvicii r600tfli b4e ;1o2 x • AC•i D® CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 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 CONTACT Ste hanie Arnold NAME: P PHONE (954) 315-5000 (A/C. No. Extl: FAX (A/C, No): (954) 315-5050 E-MAIL sarnold@ciafl.net ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC 5 INSURED Watertite Gutter Company, Inc. 211 N.E. 32 Court Fort Lauderdale FL 33334 INSURER A :Mid- Continent Casualty Co. INSURERB: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 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 ADDL �R ...MR SUBR WVD POLICY NUMBER ( POLICY MMtDD/YYYYY' ) (MM /DD/YPOLICY EXP YYY) A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY 04GL000833492 10/19/2011 10/19/2012 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ X $1,000 Per Claim Ded PERSONAL &ADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L X AGGREGATE POLICY LIMIT APPLIES PRO- JECT PER LOC PRODUCTS - COMP /OP AGG $ 2,000,000 $ AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS ^ X SCHEDULED AUTOS NON -OWNED AUTOS ACP 5904689372 10/19/2011 10/19/2012 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 $ Included BODILY INJURY (Per person) BODILY INJURY (Per accident) $ Included PROPERTY DAMAGE (Per accident) $ Included PIP -Basic $ 10,000 UMBRELLA LIAB EXCESS LIAB * OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RET ENT ON $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER n NH) EXCLUDED? (Mandatory If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A 83016079 4/1/2012 4/1/2013 WC STATU - TORY LIMITS OTH- 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) 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 25 (2010/05) INS025 (201005) 01 6:7 - © 1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD f�y LI 1`- C3) i �L/ . c , 1-1_ (t Horne Office 211 N.E. 32nd Court - Ft. Lauderdale, FL 33334 wActrEEnr- TIE GU 7 1_ IER CO. Established 1984 A 6" & 7" Seamless Aluminum Gutters. CC # 84-3863 MMX Broward: (954) 563-2207 Dade: (305) 654-1140 Palm Bch.: (561) 241-6737 Fax: (954) 563-9940 WEBSITE: www.watertitegutter.net • E-MAIL watertiteebellsouth.net PROPOSAL —7i 2,7 6 NAME: STREET CRY: STATE: PROPOSAL SUBMITTED TO: tlAb (tit 0 PHONE: JOB NAME: STFEER CITY: DATE: 1 (-3(1_(-11ch,-4 4-(c) IS- /V 4_:- •99 )4-4( Si-iv/LES STATE: s ® Downspout 2:- Kafir 11111111RignE APPROVED ZONING DEPT BLDG DEPT es Village BY DATE I NI glA SIM SUBJECT TO COMPLIANCE WITH ALL FEDERAL STATE AND COI NTY RULES AND REGULATIONS INSTALLER COMPLETED PD SB We hereby propose to furnish labor and materials — complete in accordance with the above specificatiOns, for the sum of wth payment to be as follows: Two yeaVguaaantee on Labor, twenty years on Material. to be cornpleted in a workmanlike manner according to standard practices. My alteration or costs, will be executed only upon written orders, and will become an extra charge over and above the estimate. All agreem co nt • •=1,, accidents or delays beyond our control. This propose] sjibject to acceptance within and Is void thereafter at the option of the undersigned. Authorized Signature days ACCEPTANCE OF The 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: Signature MAY C 8 (-- (0 Cilbry" S 5 " (10 cd;4---1,1 (ocwota. AezAra- A-44;07 12;4 51( kA6rt Pe it No: 12 -740 Job Name: April 30, 2012 Miami Shores Village 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. Gutter must not be attachedto or through 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