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RF-12-720Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: I NS P- 175258 Scheduled Inspection Date: June 29, 2012 Inspector: Bruhn, Norman Owner: GRATEROL, RAFAEL Permit Number: RF -4 -12 -720 Job Address: 240 NE 99 Street Miami Shores, FL 33138- Project <NONE> Contractor: USA PROFESSIONAL GUTTERS INC Permit Type: Roof Inspection Type: Final Work Classification: Gutters Phone Number Parcel Number 1132060134330 Phone: (305)835 -7461 Building Department Comments NEW GUTTERS Passed ,i9� . 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 - 172676. No plans or permit posted. NB June 28, 2012 For Inspections please call: (305)762 -4949 Page 7 of 7 5) - IIZ ®33src. 9 L9 74f? BULL ING PERMIT APPLICATION 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 No. Master Permit No. RECEIVED APR 232012 BY._ FBC 20 i) Permit Type: BUILDING ROOFING OWNER: Name (Fee Simple Titleholder): DeICA4 'REAP Phone#: 0 - Za°I cib 03 Address: &AO iNAr Qqr 5ilaet City: tar* Shous State: florti Tenant/Lessee Name: Email: cO JOB ADDRESS: P Zip: acids Phone #: auto NE a ct-rh 51-Y120- City: Miami Shores County: Miami Dade Zip: ail 3°, Folio/Parcel #: Is the Building Historically Designated: Yes NO X Flood Zone: CONTRACTOR: Company Name: Address: 1341Z° Nu7 33 i4Y City: M.G4rvYn State: V-1 gip: 3 3111. Qualifier Name: Phone #: State Certification or Registration #: Certificate of Competency #: Contact Phone #: Email Address: DESIGNER: Architect/Engineer: Phone #: uSA Qd. Pnoressioma Qcur Cyk1enS Phone #: 305 b3 4ei Value of Work for this Permit: $ VX . d3 Square/Linear Footage of Work: Type of Work: ❑Addition OAlteration Description of Work: Ne.44,1 CA C.2s New ORepair/Replace ODemolition **** **,x********�u * **** Fees* iii * * ** * *4* * *ix"ix* .i,** x *.i* x*** * *+x*�x** ** **** ! © caxi Permit Fee $ e CCF $ CO /CC $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ DBPR $ Bond $ Technology Fee $ TOTAL FEFI NOW DUE $ 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, BO1T.F,RS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: 1 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 be approved and a reins ection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this Aojcfrs day of � �7 t , 20 t2-, by C\ personally known to mei or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: Signature �G Contractor The foregoing instrument was acknowledged before me this q5 day of d L , 20 if L by J OS !°L 2/Vl -, who is personally known to me or who has produced 7 C..+ t f as identification and who did take an oath. * * ** * ** * * * * * * * * * * * ** ** * * * * *** APPROVED BY '4`'�1� Plans Examiner Structural Review (Revised 07110 /07)(Revised 06 /10/2009)(Revised 3/15/09) NOTARY PUBLIC: Sign: Print: 010%1 My Commission Expires: Ul1t /Hi m - 7 _ for", •. W cam' fss: a . Zoning Clerk 1-1 Per i I N 1 -720 Job Name: April 24, 2012 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 detail of connection to structure. The gutter must not beattached or attached through any 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 FIRST -CLASS U.S POSTAGE PAID MIAMI, FL:. PERMIT NO 231 THIS IS NOT A BILL — DO NOT PAID 686801 -3 AIEW BUSINESS NAME 1 LOCATION , . RECEIPT NO, USA PROFESSIONAL, RA1N GUTTERS C B 098500591 8920 NW 33r - AVE RD`, 33147 UNIX DADE COUNTY. OWNER USA PROFESSIONAL Sec. Type of Business 1 6. CIALTY Bt TIES ES ONL A BUSINESS TAX RECEIPT. DOES NOT PERMIT THE HOLDER TO VIOLATE ANY ZONNRoGUtATORY OR EOUNTY IA ORV 8 NOR pool TT EXEMPT Iss PROM ANY DRIER. OR .LICENSE OWNED BY LAW. THIS IS r A CERTIRcATION OP THE ROLDER S QUARIflCA- TIONM- PFVMDE TAX quaTrom 09/12.72011 02210002001 000075,00 SEE OTHER SIDE AIN GUTTER S Il DING C'ti~NIRACTT DO NOT FORWARD USA PROFESSIONAL RAIN GUTTERS INC JOSE G RIVERA PRES 8920 NW 33 AVE RD MIAMI FL 33147 111111111111111111i111,),I„ hIi1iti ,1,i111i,1,11i111,14g,I.I CTQB Construction Trades Qualifying Board BUSINESS CERTIFICATE OF COMPETENCY 09BS00591 USA PROFESSIONAL RAIN GUTTERS INC RIVERA JOSE G Is certified under the provisions of Chapter 10 of Miami -Dade County VALID FOR CONTRACTING UNTIL 09/30/2012 MIAMI -DAOE COUNTY TAX COLLECTOR 140 W. FLAGLER ST. let FLOOR MIAMI, FL 33130 2011 MUNICIPAL CONTRACTOR'S 301; TAX RECEIPT MIAMI -DADE COUNTY - STATE OF FLORIDA PURSUANT TO COUNTY CODE SEC, 10-24 EXPIRES SEPT, S0, 2012 THIS IS NOT A BILL — DO NOT PAY CC NO 09B500591' RECEIPT NO. 30- 7142870 BUSINESS NAME / LOCATION USA PROFESSIONAL RAIN GUTTERS INC 8920 NW 33 AVE ':RD OWNER :USA PROFESSIONAL. RAIN GUTTERS INC .. SEE BACK OF RECEIPT FOR A LIST OF NON - PARTICIPATING MUNICIPALITIES Receipt holder must register in the city where work is'to be done. PAYMENT - RECEIVED. MIAMI -DADS COUNTY TAX: 0 /.2/2011 02210002002 0001.75.00 FIRST-CLASS U.S. POSTAGE PAID MIAMI, FL' PERMIT NO. 231 RECEIPT HOLDER MAY DO BUSINESS AS A CONTRACTOR AS SPECIFIED HEREON. SPECIALTY BUILDING CONTRACTOR DO NOT FORWARD USA PROFESSIONAL RAIN GUTTERS INC JOSE G RIVERA PRES 8920 NW 33 AVE RD MIAMI FL 33147 11111111 /I)1111fii1llllTi117Ii VSA PROFE$SIONMI 1111 sups lit RESIDENCIAL & COMERCIAL 8920 N.W 33 Av. Rd Miami FI, 3 47A 3 2012 r" Ph: 305 835 7461 FAX: 305 835 5 CJSTOMER: ,AI-Ac..4_ - Name: C,: �/: a�� c //_ fi — Address: '5 /I'G /2L. j ; L. 3"/ .5442 fi City,State: C-,/ 0 } (g 3 Phone: J Ad PROPOSAL /CONTRACT Ci Date- 1. I - Time: C Cust0 iMi Shores ViIIa9e,_, APPROVED BY DATE IIMIIIIIIIIMIIM ZONING DEPT &BM:DEPT ,-' ECM Mutat TO COMPLIANCE WITH AM FEEERAL ?;TATE AND COUNTY RULES AND REC3U .ATIONS Of 2.1 A4 ti TOTAL FOOTAGE: 2 Li 2 TOTAL DOWNSPOUT s so ( s060) CASH: CHECK: TOTAL $: DEPOSIT $: BALANCE $: COEDIT CARD: 5 YEAR GUARANTEE ' ON LABOR ! 20 YEAR OURANTEE Ott EXCEPT Damage resulting from accident, mbu*e. abuse. neglect or from other than normal and ordinary use of the product TERMS OF PAYMENT. Payment In full due upon completion. Contracts which state a draw cut of date and payment release date are the only exceptions and must be signed by representatives of both parties. FINANCE CHARGE: Finance charge In amount of the lesser of 1.5% per month (18% per annum). or the mardmum allowed by law will be added to all invoices that ere 30 days past due. APPROVAL: No alterations or additional work shall be performed unless agreed to by USA Seamless Rain Gutters, Inc. beforehand. In wafting. We are not responsible for damage to roof tiles. shingles or fascia boards. 3 CC # 09BS00591 GUTTER COLOR ErSAITE ❑ BRONZE ❑ EGGSHELL ❑ GREEN ❑ GRAY ❑ ALMOND ❑ OTHER ❑ Music r BROWN ❑ CAMEO ❑ SUDTONE ❑ CLASSIC CREAM ❑ ROYAL BROWN DOWNSPOUT COLOR WHITE ❑ BRONZE ❑ EGGSHELL ❑ GREEN ❑ GRAY ❑ ALMOND 0 2x ❑ CONDUCTOR HEAD ❑ OTHER ❑ MUSKET BROWN ❑ CAMEO ❑ SANDTONE ❑ CLASSIC CREAM ❑ ROYAL BROWN 3x4 ■ 6 236 -41 STEEL CLIENT SIGNATURE. DATE. AUTHORIZED SIGNATURE- email: usaprofessionalraingutters @hotmail.com USA PROFESSIONAL RAIN GUTIERS Inc. 71 26 USA PROFESSIONAL RAIN GUTTERS INC. PROPERTY : 240 NE 99 ST M[AMI SHORE MIAMI SHORES FL 3313 y OWNER: DELIA REYES, RAFAEL GRATEROL INSTRUCTIONS OF GUTTERS INSTALLATION 1.OPEN TO THE FLASHING FOR INTRODUCIOR THE GUTTERS 2. TO CUT THE CORNERS OF THE METAL TO CLOSE THE UNION 3. TO MAINTAIN TO THE GUTTERS WITH SPICES EACH 3 FT OF DISTANCE 4. TO SEAL THE CORNERS WITH RESISTANT SPECIAL SEALANT TO THE WATER 5. TO INSTALL THE DOWNPOUT IN THE ASSIGNED AREA • Apr. 23. 2012 10:10AM FLORIDA BANKERS INSURANCE No.5202 P. 1/1 Aeicx CERTIFICATE OF LIABILITY INSURANCE D"E`MMIDEVYYTY) 0423112 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: 9the certificate holder Is an ADDITIONAL INSIMED, the pokes) must be endorse& ITHRBROGATION ISWAIVED, subject to thetenns and conditions of the policy, certain policies may require an endorsement Astatemeftonthis certificate does not confer rights to the certificate holder In Iieu of such endorsement(s). PRODUCER Florida Bankers Insurance 7278 SW 8 Street Miami, FL 33144 Phone (305)266-6493 Fax (305)262 -0679 NAME: MARTA ALONSO ( , E, n: (305) 266 -6493- 1 ( , Not (305) 262-0679 = : martatidloridabankersinswcutce.com PRODUCER tot: INSURER(S) AFFORDING cow NAIL a INSURED USA PROFESSIONAL RAIN GUTTERS, INC 8920 NW 33 Ave Rd MIAMI, FL 33147- INSURER A : ALTERRA EXCESS & SURPLUS INSURANCE C III B : GENERAL UABLLITY RI COMMERCIAL GENERAL mount INSURER C : INSURER D : 09252011 INSURER E : EAT i OCOJRRENCE INSURER F : 300.000.00 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFYTHAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR COMMON OF ANY CONTRACT OR OTHER CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAYHAVE BEEN REDUCED BY PAID NAMED ABOVE FOR THE POLICY PERIOD THIS TERMS, DOCUMENT WfTH RESPECT TO WHICH HEREIN IS SUBJECT TO ALL THE NW LTR TYPE OF INSURANCE SR YWD POLICY NUMBER (�) pCLLAI�MSS..� t oDm�1 MOTS A GENERAL UABLLITY RI COMMERCIAL GENERAL mount BINDERS 11 -1590 09252011 091252012 EAT i OCOJRRENCE $ 300.000.00 MSEs oc�ence) $ 100.000.00 ❑ ■ CLAIMS-MADE ■ OCQJ ❑ Iv D EXP (Any one per) $ 5.000.00 PERSONAL 8 ADY INJURY $ 300.000.00 • GENERAL AGGREGATE $ 6001100.00 GENT. AGGREGATE LIMIT APFUES PER Q POLICY • JIM ❑ LOC PRODUCTS - cOM'IOP ACS $ 300.000.00 $ AUTOMOBILE LIABILITY ❑ ANY AUTO • ALL OWNED AUTOS COMBINED SINGLE LIMIT (Ea acciden0 $ BODILY INJURY (Pet parson) $ BODILY INJUNi (Per accident) $ • SCFEnLEOAUTOS PROPERTY DAMAGE (Per accident) $ • PARED AUTOS NI NON-OWNED AUTOS $ $ ❑ ❑ UMBRELLA UPS i OCCUR ❑ EXCESS LAB ❑ ammsH64DE EACH OCQfRREfNCE $ AGGREGATE $ ❑ RAE 0 RETENTION $ $ $ WORKERS COAtPENSATION ANT) EMPLOYERS' LIABLlTY YIN /A WCSTAIU- 1�1 W- n TOI21f LIM1S 1 1 ER EL EACH ACCIDENT $ ANY PROPRETORIPARTNEIVEXECUIVE ( IN OFFICF3 A R ExCLUI3Em El. DISEASE - EA EMPLOYEE $ (Mandatory In NH) If yes, describe uncle DESCRIPTION OF OPERATIONS below E.L. ISEASE- POLICY UNIT $ DESCRIPTION OF OPERATIONS T LOCATIONS I VEHICLES (Attach ACORD 101, Adder Remarks mule, it more space Is regtdred) CERTIFICATE HOLDER CANCELLATION • MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2nd AVE MIAMI SHORES, FL 33138 fax 305 -646 -1529 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE Ti�OF, NOTE WILL BE DELIVERHB IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE =- ACORD 25 (2009109) CIF ®1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 10 -21 -2011 JEFF ATWATER STATE OF FLORIDA CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: PERSON: 10/21/2011 EXPIRATION DATE: 10/20/2013 RIVERA JOSE G FEIN: 270661185 BUSINESS NAME AND ADDRESS: USA PROFESSIONAL RAIN GUTTERS INC 8920 N.M. 33 AVE. ROAD MIAMI FL 33147 SCOPES OF BUSINESS OR TRADE: 1- GUTTER INSTALLATION * IMPORTANT: Pursuant to Chapter 440 . 05114 F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05112), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt 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 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 person named on the certificate to meet the requirements of this section. QUESTIONS? (850) 413-1609 OWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01 -11 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CONSTRUCTION INDUSTRY CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW EFFECTIVE 10/21/2011 EXPIRATION DATE: 10/20/2013 PERSON: JOSE G RIVERA FEIN: 270881185 BUSINESS NAME AND ADDRESS: USA PROFESSIONAL RAIN GUTTERS INC 9920 N.W. 33 AVE. ROAD MIAMI, FL 33147 SCOPE OF BUSINESS OR TRADE 1- GUTTER INSTALLATION IMPORTANT Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election L under this section may not recover benefits or compensation under this D chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be H exempt... apply only within the scope of the business or trade listed on Rthe notice of election to be exempt E Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt 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 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 person named on the certificate to meet the requirements of this 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 01 -11