RF-14-375Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 208054 Permit Number: RF -2 -14 -375
Scheduled Inspection Date: March 11, 2014 Permit Type: Roof
Inspector: Rodriguez, Jorge
Inspection Type: Final
Owner: MOORE, ERIC Work Classification: Gutters
Job Address: 9304 NE 9 Place
Miami Shores, FL Phone Number
Parcel Number 1132060070080
Project: <NONE>
Contractor: WATERTITE GUTTER CO INC Phone: 954- 563 -2207
tsunaing uepartment comments
6" white seamless aluminum gutter and downspout front
entry and in back
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
March 10, 2014 For Inspections please call: (305)762 -4949 Page 21 of 38
Miami Shores Village
f(►�I . Building Department
10050 N.E.2nd Avenue Miami Shores Florida 33138
Tel: (305) 795.2204 Fag: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
I bill I M 1
Permit No.
RECEIVED
K!214
FBC 20 L-D
PERMIT APPLICATION Master Permit No.-" N - 5`1 5
Permit Type: BUILDING ROOFING
® �
JOB ADDRESS: -1 3 ®y � � �1
City: Miami Shores County: Miami Dade Zip: `� 3 13 9
Folio/Parcel #:
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee Simple Titleholder)
Address: -! 3o v A) E' f"—
City: /'11011%1
Tenant/Lessee Name:
Email: o e V
G ®fie—, Phone#: ('7 v) a Fz) ' 0 / 3 /
State: RZ • Zip: 3 51-3
CONTRACTOR: Compan�yj Nam: (�� `i'� ��� i1�- �^/�° Phone#: Uq 56 3 - -;L w 7
Address: )j I
City: FT- Lqje,^ '
le. State: �%+. p: .333 31
Qualifier Name: r -' ® V M PhoneW20 )a 3- 2--w 7
State Certificatio or R gistration #: Certifica41 bf / o�tency #: �. 5 O ®�%
Contact Phone#: 190 3:9 Email Address: e✓ f�/ ®'� I��l��� ' �a�
DESIGNER: Architect/Engineer: Phone#:
��
s
Valve of Work for this Permit: $ Yj? Square/I.mear Footage of Work: 50'(0,4U. 4 3 P -`
Type of Work: DAddidon DAlteration ONettw A&epair/Replace
Description of Work: 6 Lil 4 SeA-rW4-%S Qfi 4
Color thru tile:
Submittal Fee $ S CP Permit Fee $ CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ TraininglEducation Fee $ Technology Fee $
Double Fee $ Structural Review $ U G
TOTAL FEE NOW DUE $ t - D
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
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 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 a roved and a reinspection fee will be charged
�[ --✓
f ` Signature Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this
20 ��, by � c- /L'ivr1,2E:
w known to or who has produced
As identification and who did take an oath.
PUBLIC:
fly rsion Expires:
181,
OVED BY
Ig-0 1,7
The foregoing instrument was acknowledged before me thiso"
day of , 20& -, by �� Y° ,
who is rsonally kno to me or who has produced.
o
Plans Examiner
Structural Review
(Revisal NIZ2012)(Revised 07 /10/07)(Revised 06/10/2009)(Revised 3/15/09)
as identification and who did take an a(S 1
NOTARY PUBLIC: x
Print: 2 L, C' d
My Commission Expires:
lL4i�l�
MMMAMP
Zoning
Clerk
QUALIFYING TRADE(S)
0049 META. GUTTEF2IU',i NS
r:
SesretotY of &* 802nd -ir»u rrexms ade.F *� evre mare
13
CERTIFICATE F LIABILITY 1 URA CE
DATE
!2
TYPE OF iNSURANCS
3»
[ 10/18
THIS CERTIFICATE 13 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. It the certificate holder is an A,DDITi NAL INSURED, the policy (IBS) 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 this eertitkate aloes not confer rights to the
.certificate holder In lieu of such endoreeme $ .
PP400M
Corporate Insurance Advisors
1uO 3rd Avenue
� CBtiiE3rine Shertelnlieb
PROMS (gSt) 315 -5000 �� tasa'axs -sass
Ca�erineaciafl.not
suite � laoo
Ft. Lauderdale FL 33301
_
MSU SI AFFQRDING t VERAGE
NAIC e
INSURERAM-d- Continent Casualty Co.
0/10/2013
�tsaRert
Watertite Gutter Company, Inc.
211 N.E. 32 Court
m B:Phileg2 : hia. Insurance Co.
$ 1,000,005
wsuRmc -arid efield E l2 rs Ins. Co..
s 100, 000
ML4mo.
$ &;uolude
INSURER F, _
S 1,000,000
Fort Lauderdale FL 33334
INSU Rat` :
GENERAL AGGREGATE
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE U61ED 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 MICH 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.
LT R
TYPE OF iNSURANCS
F4LiCYN M
POLICY Ew
POLICY
LIMITS
A
t4Eidt?RAL UAet6iTY
X COMMI RaCtat GEWRAL LIABILITY
CLAIMS-MADE a] OCCUR
4- GL- 000887820
0/10/2013
0I19l24014
EACH OCCURRENCE
$ 1,000,005
MMI&EAS ift
s 100, 000
MED EXP (A qy0ft,EMV
$ &;uolude
PERSONAL &AWINJURY
S 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GEt LAGGREGATEUtmTAPPLIESP€R:
x POLICY PRO- LOG
PRODUCTS - C1PtOPAGG
_
$ 2,000,000
$
B
- AUTOMOBILE LIABILITY _
X ANY AUTO
ALL .AUTOS D �f�LEO
HIR9O AUTOS AUTOS ED
tiPAl$9Rf93.H
Of18 %2tl3
$311912019
a 8ttt I
S 1,000,000
BODILY INJURY (Per parson)
$
BCiDlLYRNJURY.(Peracadent)
$
PROPERTY DA E
.�
P B88ic
$ 12,000
UMBR6 A LIAB
M(CESS.LIAB
OCCUR
CLANSAIADE
EACH OCCURRENCE
$
AC�GREWE
S
O
DE RETEtMON$
S
O
vvowm compeSAnoN
Alias tPLOYERS' IJAaA l7Y
ANY PROPRIET0PJPARTNEPJEE(ECUTiVE Y f N
OFPICE(ialstEA98ER EKCLUDE+3? ®
(ts�,�to,y txtatR)
WRIm "114 VOPERATIONS 0,10,
N!A
30s 609
JilzOaa
11 >2014
wcSTATU
—_
E.4, EACH ACCIDENT
S 1,000,000
F-L olsEAStr - EA EMPLOYEE
s 1,000,000
E.L. TEA5e- POLICY uMiT
s 1,000,000
DESCRIPTION CF OPERATIONS I LOCATM$ I VEIIOLES (Attach ACORD 101, Addffl*rM Rentarka Schadula, Ili more space is required)
Metal Gutter Fabrication and Installation Contractor.
village of Miami Shores
Attn: Building E. Zoning Dept.
10050 t1E 2nd Avenue
Miami Shores, VL 33138
(20401051
SHOULD ANY OF THE ABOVE D SCRIBE# POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE VWLL BE DELIVERED IN
ACCORDANCE iMTK THE POLICY PROVISIONS-
Schwartz * * * * %ANGi62,
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yeti (954) 56-3--207 J
Daties (305)-,,,6 54 1140_ .