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RF-12-677Inspection 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- 173487 Permit Number: RF -4 -12 -677 Scheduled Inspection Date: June 24, 2013 Inspector: Bruhn, Norman Owner: STOBS, CAROL Job Address: 815 NE 99 Street Miami Shores, FL 33138- Project: <NONE> Contractor: STOBS BROTHERS CONSTRUCTION CO Permit Type: Roof Inspection Type: Final Work Classification: Hurricane Mitigation Phone Number (305)751 -1692 Parcel Number 1132060340100 Phone: 305 - 751 -1692 Building Department Comments MITIGATION NEW METAL STRAPPING TO EACH RAFTER 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- 172466. Strap attachment ok , complete work and schedule final. NB June 21, 2013 For Inspections please call: (305)762 -4949 Page 3 of 37 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 BUILDING PERMIT APPLICATION Permit Type: BUILDING JOB ADDRESS: g15 ME , ciP S+c-e. 4 FBC 20 t3 Permit No. Master Permit NocZite4 ROOFING City: Miami Shores County: Miami Dade Folio/Parcel#: _ 3 � 034 ° 1 0 1D Is the Building Historically Designated: Yes NO Flood Zone: Zip: 33 138 OWNER: Name (Fee Simple Titleholder): p CA .q I \ 7 Phone#: 0,c %5L %g Zc� Address: R e'S N E 9 S -e T _ e City: Ni 1 AN% I SIA e 0V-I State: f--- Zip: 33 1.3 ff Tenant/Lessee Name: Phone#: mail: CONTRACTOR: Company Name: 4-6 is errs C� .A-41u G�vn Phone#: 36S-7S( -16q 2 Address: 58o A/ S ct 2, 1 S 1 e. `' G City: M (� o S� .e .X State: Zip: .� 0 Qualifier Name: + 5 Phone#: 30s-751-(6q2- State Certification or Registration #: Contact Phone #: 31)5-75'1 °-13 ci' Email Address: 1 ( S4L3-s , C vA DESIGNER: Architect/Engineer: Phone#: GCt�e e') t 1 QS S Certificate of Competency #: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: DAddition °Alteration °New DRepair/Replace °Demolition Description of Work: Color thru tile: ** ****** ************** * **** x**** ** *r ***F **** six***. x*** ***** *** * * **** ** * *** * * *** *a**** Submittal Fee $ Permit Fee $ E. W 03 CCF $ CO /CC $ Scanning Fee $ 5 ( Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ ��i` 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 AItiDAVIT: 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 be approved and a reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this day of %`" , 20 by by cQ , who is personally known to me or who has produced (1-3k--1 As identification and who did take an oath. ` - • YaVIVl The foregoinglinstrument was acknowledged before me this 2-0 day of one, , 20 �J, by 1 6- SSCSA, who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC:. NOTARY PUBLIC: Sign: Print: My Commission Expires: cup ** * * * * * * * * * * * * * * * **********+f jrTVt>∎ t0**** *** ***** ******** **** ******" APPROVED BY Plans Examiner Structural Review (Revised 3 /12/2012)(Revised 07 /10/07)(Revised 06/10/2009)(Revised 3/15/09) �Y pue <�c MELISSA RAMIREZ Notary Public - State of Florida Comm. Expires Aug 24, 2013 Na 044 Commission # DD 917941 *r * * * * * * * * * * * * * * * * * * * ** r a Zoning Clerk 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 BUILDING PERM PLICATION FBC 211 Permit No. Master Permit No. Permit Type: BUILDING ROOFING OWNER: Name (Fee Simple Titleholder): Carol S. Stobs Phone #: 305 - 754 -8520 Address: 815 N. E. 99th Street City: Miami Shores State: Florida Zip: 33138 Tenant/Lessee Name: Phone #: Email: car o 11 @s t ob s .com JOB ADDRESS: 815 N. E. 99th TSireet City: Miami Shores County: Miami Dade Zip: 33138 Folio/Parcel #: Is the Building Historically Designated: Yes NO X Flood Zone: AN(6,L 7 — - 2- 13 1 CONTRACTOR: Company Name: Stobs Bros. Construction Co. Phone #: 305 - 751 -1692 Address: 580 N. E. 92nd Street City: Miami Shores State: Florida zip: 33138 Qualifier Name: J. Robert Stobs II Phone #: 305- 751 -1692 State Certification or Registration #: Certificate of Competency #: Contact Phone #: 305 - 751 -1692 Email Address: Bob2 @stobs.com DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ i '? 3 u 1 0 Square/Linear Footage of Work: Type of Work: Addition OAlteration ONew ORepair/Replace ODemolition Description of Work: Insurance Mitigation - install new metal strapping to each rafter in the entire house. Furnish and install new stucco soffit, center vented with screens. **** * * * * * ****** ** ** ***** *****+ x********* Fees*** ****** ****+ x**** **** ******a:******+x******* Submittal Fee $ 9 ` ermit Fee $ And e CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ C$ I • (1 Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) CitiMortgage Mortgage Lender's Address P.O. Box 689196 City Des Moines State IA Zip 50368 -9196 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 FT.ECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOTT ] RS, 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 IN`'TEND 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 reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this 11 day of Al0 V6 ,2012,by &IVOI S 6 3 who is personally known to me or who has produced ®' As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: Signature Contractor; The foregoing instrument was acknowledged before me this 11 day of A ptl I 0 , 2012 , by1 r+ 6, 0 8 , who is personally known to me or who has produced �— as identification and who did take an oath. NOTARY PUBLIC: APPROVED BY Notary Public - State of Florida • My Comm. Expires Aug 24, 2013 Commission # DD 917941 Sign: Print: My Commission Ex ,, , MELISSA RAMIREZ , Notary Public - State of Florida iii My Comm. Expires Aug 24, 2013 ",,tor .,,TS Commission # DD 917941 ******* ** ******************************* ** * * * * * * * *** ** * * * * * ****** * * * * ** Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) Zoning Clerk STOBBRO -02 KAREN Ai-•• j� CERTIFICATE OF LIABILITY INSURANCE r„ .. DATE(MM/DD/YYYn 4/2/2012 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 thls certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER License # NPN 2332080 InSource, Inc. P.O. Box 561567 Miami, FL 33256 -1567 CONTACT NAME: PHONE 305 670.6111 FAX 3 INC. No. Ext): ( ) (A/C, No): (05) 670 -9699 E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: National Fire Ins -Co.- Hartford 20478 INSURED Stobs Bros. Construction Co. J. Robert Stobs (I 580 N.E. 92 Street Miami Shores, FL 33138 INSURER B : American Casualty Co. 20427 INSURER C : Transportation Insurance Co. 20494 INSURER D : Valley Forge Insurance Co. 20508 .INSURER E : $ 100,000 INSURER F : $ 5,000 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 POLIC ES 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 INSR SUBR WVD POLICY NUMBER POUCY EFF (MM/DD/YYYY) POUCY EXP (MM/DD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY 4015527515 4/1/2012 4/1/2013 EACH OCCURRENCE $ 1,000,000 DAMAGE TO (Ea RENTED PREMISES occurrence) $ 100,000 MED EXP (Any one person) $ 5,000 CLAIMS -MADE X OCCUR PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ 1,000,000 GENII AGGREGATE -1 POLICY X LIMIT APPLIES PER 1,28-r n LOC $ B AUTOMOBILE X LIABILITY ANY AUTO • ALL HIRED AUTOS • _ X SCHEDULED NON -0VJNED AUTOS 4015527434 4/1/2012 4/1/2013 COMBINED SINGLE UMIT (Ea accident) 1 000 000 $ > > BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ C X UMBRELLA LIAB EXCESS UAB X OCCUR CLAIMS -MADE 4015527479 4/1/2012 4/1/2013 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 $ DED X RETENTON$ 10,000 D WORKERS COMPENSATION AND EMPLOYERS' UABIUTY AND ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N N / A 1073762447 4/1/2012 4/1/2013 X T1BOORY 8TATU- LIMITS X OTH- - °R E.L EACH ACCIDENT $ 1,000,000 E.L DISEASE - EA EMPLOYEE $ 1,000,000 E.L DISEASE - POLICY UMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) General Contractor CERTIFICATE HOLDER CANCELLATION • City of Miami Shores Building & Zoning Dept 10050 N.E. 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 ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD V V V 1 V V V V 4- AN MIAMI SHORES VILLAGE LOCAL BUSINESS TAX RECEIPT STOBS BROTHERS CONSTRUCTION CO. 580 N.E. 92 ST. MIAMI SHORES, FL 33138 Certificate No. Issue Date Expiration Account Number THIS CERTIFIES'THAT STOBS BROTHERS CONSTRUCTION has paid the Business Tax to the Village Clerk's Miami Shores Village. Type Description 0000004965 07/25/2011 09/30/2012 04367 Office of 1402 LOCAL BUSINESS TAX RECEIPT Address: 580 NE 92 ST. Fee: 126.63 This Business Tax Receipt must be displaed in a conspicuous place. A penalty is imposed for failure to keep this Receipt exhibited at your place of business. Miami Shores Villa se, Florida t Date Issued: `LAI• " %F0o►i By: This Business�TkX Receipt is not transferrable Approval of the Village Clerk. r Nvr 'vim NiVr Nvr Nvr ,. N, Nvr R'ArRTPT - =1 1 1 1 1 1 1 1 1 -4 Nvr -4 4 026554 -6 sU STOBSN BRO BROS CO 580 NE 92 ST. 33138 MIAMI SHORES THIS IS NOT A BILL - DO NOT PAY tRENEWAL STATE* CGC001055 026554 -6 OWNER STOBS BROS CONSTRUCTION CO SeciTae oGESNERAL BUILDING CONTRACTOR THIS IS ONLY A LOCAL BUSINESS TAX RECEIPT. IT DOES NOT PERMIT THE HOLDER TO VIOLATE ANY EXISTING REGULATORY OR ZONING LAWS OF THE COUNTY OR CITIES. NOR DOES IT EXEMPT THE HOLDER FROM ANY OTHER PERMIT OR LICENSE REQUIRED BY LAW. THIS IS NOT A CERTIFICATION OF THE QUALIFICA- TIONS. PAYMENT RECEIVED MUUXMDADE COUNTY TAX COLLECTOR: 08/09 /2011 60040000447 000090.00 SEE OTHER SIDE FIRST-CLASS U.S. POSTAGE PAID MIAMI, FL PERMIT NO. 231 WORKER /S 25 DO NOT FORWARD STOBS BROS CONSTRUCTION CO 580 NE 92 ST MIAMI SHORES FL 33138 it1)111-11 *li11 lliti!# k 11/ 41111191/!1111} /411' #194118 t1 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION 'INDUSTRY LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 STOBS, JAMES R II STOBS BROTHERS CONST CO 580 NE 92ND ST MIAMI SHORES FL 33138 -3173 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 barbeque 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 For information about our services, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! DETACH HERE (850) 487 -1395 BATCH NUMBER k) i.) E k `" u�i�"rs►'�t +ALT'S -b- (7 C,-7 x!a ILs1tJ -40 -b(4bc'., 6 ZA�F1 EE. EXLSTi rt& * t,E t E Arm to 1i2 ta.'i,t4 cc,NCRFTE ANAcito2s 7r: 41- 3/Y 4 12-r- (0"3--- Miami Shores Village APPROVED BY DATE ZONING DEPT BLDG DEPT ��� / ''/' - ?� i SUBJECT TO COMPLIANCE WITH ALL FEDERAL STATE AND COUNTY RULES AND REGULATIONS )(Sim 'Rs° NI MTs - t) z