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RC-13-0782 (2)Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 189393 Permit Number: RC-4- 13-782 Scheduled Inspection Date: November 07, 2013 Permit Type: Residential Construction Inspector: Rodriguez, Jorge Owner: , MIAMI PROPERTY SOLUTIONS Job Address: 1155 NE 103 Street Miami Shores, FL 33138- Project: <NONE> Inspection Type. Final Work Classification: Addition /Alteration Phone Number Parcel Number 1122320310080 Contractor: GAZA CONSTRUCTION Phone: (954)882 -2672 tsuuamq uepanment comments REPLACE KITCHEN CABINETS AND MASTER 11131OULIV r0"wu " ""°"" BATHROOM, INSTALL TWO POCKET DOORS IN MASTEF INSPECTOR COMMENTS False BATH November 06, 2013 For Inspections please call: (305)762 -4949 Page 5 of 40 Inspector Comments Passed Failed Correction Needed a Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. November 06, 2013 For Inspections please call: (305)762 -4949 Page 5 of 40 ® Shores Village [APR 16 2013 b ,1 Building Department ---------- 7 —.-- B ,, , 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 B Y.- YC Tel: (305} 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION FBC 20 Permit No. 3-1 Master Permit No. Permit Type: "UELDI�G) ROOFING JOB ADDPXSS:_..j155 � e 10b 6f City: Miami Shores . County: Miami Dade —zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: % P "Qo Pop P ne#: fo?_ OWNER: Name (Fee Simple Titleholder): 4-�On , 0 � i �'4 � 36 City: State: �__ I—, - zip: Tenant/Ussee Name: phone* Email: ti CONTRACTOR: Company Name: ( MN i✓O�*-qWMCP JNC, q A Address: z a o P City: x Vj kkk Qualifier Name: State Certification or Registration #: U �!'> L 0 % DW Contact Phonek qS-A • I i 2- - _t4 _oEmail Address: 4p: T5 ew Phone#- ' SA - "00 17 - iM_ _Certificate of Competency #: 0 IXAZ E C- 1\ 4A C-P_ - 0-OV-1 DESIGNER: Architect/Engineer: Phonek Value of Work for this Permit: $ 06& Square/Linear Footage of Work: f Type of Work: UAddition 13AIteration UNew Description of W �VAJ /-, /_r` _/ - -4- + IT,, f I - 1511 %C44 _-p_v-a 5 id � Color thra d1e: Submittal Fee $ Pe 't Fee $ 4��_o CCF $ CO/CC $ Notary Training/Education Fee $ Structural Review $ I °; Technology Fee $ -7 TOTAL FEE NOW DUE $ ;4 I Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip r, 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 AFF A T: I certify that all the foregoing information is accurate and that all work will he done in compliance with all applicable laws regulating construction and zoning. 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 (3) days after the building permit is issued. In the absence of such posted notice, the inspection will not be app and a einspection fee will be charged. Signature Signature Owner The foregoing instrument was , ac is / day of for , 24 L3, by i d Ile , who is personally known to me or who has produced As identification and who did take an oath, Contractor The foregoing instrument was acknowledged before this day of 24 �L;, by .... PV who is personallly known to me or who has produced - identification and who did take an oath. p�ffink���s&���sk�hh��h APPROVED BY `J _AF Plans Examiner Zoning Structural Review Clerk (Revised 0711(/07)(Revised 0611012009HRevised 3115/09) 07 -31 -2012 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: 10/07/2012 PERSON: ECHEVERRI FEIN: 260219689 BUSINESS NAME AND ADDRESS: GAIA CONSTRUCTION INC 2314 WILSON ST HOLLYWOOD FL 33020 SCOPES OF BUSINESS OR TRADE: 1- LICENSED GENERAL CONTRACTOR EXPIRATION DATE: 10/07/2014 OSCAR IMPORTANT: Pursuant to Chapter 440 . 05114), F.S., an officer of a corporation who alecis exemption from this chapter by filing a certificate of electron under this section may not recover bessfits or compensation under this chapter. Pursuant to Chapter 440.051121, 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 440.05113!, F.S., Notices of election to be exempt and certificates of electron to be exempt shell be subject to revocation if, at any time after the tiling 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 most the requirements of this section. QUESTIONS? (850) 413-1609 DWC -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 EI..ECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW 0 EFFECTIVE: 10/07/2012 EXPIRATION DATE: 10/07/2014 PERSON: OSCAR ECHEVERRI FEIN: 260219689 BUSINESS NAME AND ADDRESS: GAZA CONSTRUCTION INC 2314 WILSON ST HOLLYWOOD, FL 33020 SCOPE OF BUSINESS OR TRADE: 1- LICENSED GENERAL CONTRACTOR IMPORTANT F Pursuant to Chapter 440.051141, F.S., an officer of a corporation who O 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 440.05021, F.S., Certificates of election to be H exempt... apply only within the scope of the business or trade listed on E the notice of election to be exempt R E Pursuant to Chapter 440.05031, 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 jab, keep upper portion for your records. C DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01 -11 , iii: 1 BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A -100, Ft. Lauderdale, FL 33301 -1895 — 954 -831 -4000 VALID OCTOBER 1, 2012 THROUGH SEPTEMBER 3Q, 2013 Ome: GAIA CONSTRUCTION INC Rss Type: GENERAL CONTRACTOR Business Name: Business Type: Owner Name: OSCAR EDINSON ECHEVERRI Business Opened:10 /12/2008 Business Location: 2314 WILSON ST State /County /Cort/Reg:CGC1516136 HOLLYWOOD Exemption Code: Business Phone: Room seats Employees Machines Professionals 1 For Vending Business Only Wum6ar of Machinn,a� vAndi..., T....m• Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost j Total Paid 27.00 0.00 0.00 0.00 0.00 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 Municipality planning WHEN VALIDATED 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. Mailing Address: GAIA CONSTRUCTION INC 2314 WILSON ST HOLLYWOOD, FL 33020 2012 -2013 Receipt #02A- 11- 00003476 Paid 07/13/2012 27.00 ECHEVERRI, OSCAR EDINSON GAIA CONSTRUCTION INC 2314 WILSON ST HOLLYWOOD FL 33020 (850) 487-1395 Congratulations! With this license you become one of the nearly one million ---------- STATE Of KORMA AC#. 6" 4 9 2 18 4 DEPA-AtM1*T- bP'. BUSMSS AM Floridians licensed by the Department of Business and Professional Regulation. I Our professionals and businesses range from architects to yacht broke brokers, from PRI boxers to barbeque restaurants, and they keep Florida's economy strong. CGC1 5 16 13 6 2 128005311 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.myfloddalicanse.com. L&U CC TRACTOR There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the GAZA,: CONO! Departments 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! i 1S ' CERTIFT-33) under, tbs- 9,Fovi.4340US Of,.Ch-409 FS ' Rz; ;izttioa date. AUG -3.1, -2014 L2207D901000 DETACH HERE DISPLAY AS REQUIRED BY LAW CERTIFICATE OF LIABILITY INSURANCE X08 3°°"""' 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 tents 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 Florida Bankers Insurance 7278 SW 8 Street Miami, FL 33144 Phone (305)266 -6493 Fax (305)262 -0679 RmNE CT MARTA ALONSO PHONE X66493- FAC NO, 30 262 -0679 L marta@florida bankersinsurance.com PRODUCER ER In CUST INSURERS AFFORDING COVERAGE NAIC# INSURED GAIA CONSTRUCTION, INC 2314 WILSON ST HOLLYWOOD, FL 33020 INSURER A: AMERICAN VEHICLE INSURANCE COMPANY GENERAL LIABILITY INSURER B: INSURER C: INSURER D: EACH OCCURRENCE INSURER E: 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 ADDL IN SR SUBS D POLICY NUMBER POLICY MWDD E PM/DD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000.000.00 0 COMMERCIAL GENERAL LIABILITY DAMAGE TO REN15- PREMISES Ea occurrence $ 100.000.00 MED EXP (Any one person) $ 5.000.00 A F-] F-1 CLAIMS-MADE © OCCUR El GL- 0504005442 -02 07/16/2012 07/16/2013 PERSONAL & ADV INJURY PERSONAL $ 1,000.000.00 ❑ GENERAL AGGREGATE $ 1,000.000.00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000.000.00 $ Q POLICY ❑ PRO' ❑ LOC AUTOMOBILE LIABILITY ❑ ANY AUTO ❑ ALL OWNED AUTOS ❑ SCHEDULEDAUTOS ❑ HIRED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ ❑ NON -OWNED AUTOS $ ❑ $ ❑ UMBRELLA LIAB ❑ OCCUR EACH OCCURRENCE $ AGGREGATE $ ❑ EXCESS LAB ❑ CLAIMS -MADE ❑ DEDUCTIBLE $ $ ❑ RETENTION $ WORKERS COMPENSATION WCSTATU- OTH- AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER/EXECUTNE OFFICER/MEMBER EXCLUDED? N /A E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) E.L. DISEASE - POLICY LIMIT $ If yes descdbe under DES&APTION OF OPERATIONS below DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) CERTIFICATE HOLDER CANCELLATION ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) QF The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN MIAMI SHORES VILLAGE BLDG DEPT ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd AVE AUTHORIZED REPRESENTATIVE b MIAMI SHORES, FL 33138 ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) QF The ACORD name and logo are registered marks of ACORD t AFR 2.1 2013 In actor ce m FE1�IA regulaho and ami Shores Village 1~lo�cl D�mag „e �'reveni on O*mnce the costs of,' improvements must heomtor. 1 he costs of anyimpovementa m the past 1 L months and the '} a fi costs of any piposed improeinenls mus�f be shown on the worksheet "Thies cost "of mirorements`niitst include demolition, raw and fimsheii materials` (include those donated), labor (including volunteer and{ self - perFOrdied ;` coiistructioil s pc is 6tv arid' management, and o�erl ead an d profit:' A list` of it ns the Costs of which are to be included airQ1 as'those'ezcluded is attached for your reference. (A Copy of the-Contract must be attached) PROPERTY.OWNER:: Pte— %f 0-1 ADDRESS: FOLIO NUMBER: FLOOD ZONE: "•„ BASE FLOOD ELEVATION £' FREEBOARD: EAST OF FL.CCCL: �^ COST OF PAST IMPROVEN[ENTS (11MONTHS): COST OF PROPOSED lM[PROVEMENTS :;; / (ATTACH CO,I'Y OFrCONTRACT) TOTAL CUMULATIVE _COST OF IIGIPROVEMENTS (past and proposed),::: VALUE OF PRINCIPAL STRUCTURE °(attach appraisal): OWNERS SIGNA hl DATE• , PLAN VIEWER SIGNATURE• DATE: �/~°` SUBSTANTIAL IIVIPROVEMENT / DA GE LIST (NOTE. THISLISTISINTENDED FOR GUIDANCE QNLxY 1$ NOT ALL INCLUSIVE) ITEMS TO BE INCLUDED ALL STRU' 'fiUAL'�it,L TS, INCLUDING Foundations including,, Spread footing, Continuous footing, isolated footing, piles awed pIle`caps Slabs including; Monolithic, floating, elevated Wails" inclgdng; Exterior walls, Bearing walls, -Shear walls Beams, Tie Beams, Columns and Posts Wood decking, Floor and Roof Sheathing Trusses, Joist Windows /Doors ALL BUILDING ELEMENTS, INCLUDING Interior Partitions, Walls, Columns Drywall, Ceilings, Built in Furniture, Cabinets, Vanities All Fixtures . Flooring, Tile, Carpet, Stone, Linoleum, ect. All Finishes including Drywall, Paint, Stucco Plaster, Paneling, Tile, Marble, and Moldings Roofing Material ALL HARDWARE ALL UTILITY and SERVICE EQUIPMENT HVAC Electrical System and Equipment Plumbing System and Equipment Security System and Equipment Central Vacuum System Plumbing Fixtures Lighting Fixtures and Ceiling Fans Water Systems including Softeners /Filtration Created on June 2009 ALSO:T. a . All Labor and other Costs associated with _°? r , ConstructionAanagement /Supervision -a Overhead and Profit Equivalent cost for Donated Materials Volunteer Labor (including owners and friends) Any Improvements Beyond Pre = damaged Condition, including; Utility Upgrades Code Upgrades ITEMS TO BE EXCUpED , , Plans and Specifications Survey: Costs:. , ; Elevation Certificate Costs Permit fees Debris' Remoial $ a E Items not oonsdered to'be REAL Property Rugs, Furniture, Refrigerator, A,ppilan, cps not Bujlt -in Ouiside'Improvernents, including; Landscaping Sidewalks.: Patios Fences Yard lights Sheds Gazebos Irrigation Pool