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RF-14-321"~ Miami Shores Village Building Department PFS Q ® zot� I 918150 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 /15 INSPECTION'S PHONE NUMBER: (305) 762.4949 (/ SOS sAc4r - %,; J c -A 5 t'rv1. FBC 20 BUILDING PERMIT APPLICATION Permit Type: BUILDING Permit No. Master Permit No. IL F 14 JOB ADDRESS: —1--306 N6. G. toy 6T. City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: l�: Name (Fee Simple Titleholder): �Address: l:; ®5 N F' t Z)L] S -re e City: Nl l kgy� t .SFnos'e State: F t c r t e(W -7,313W Tenant/L-essee Name: II Phone#: Email:oL�1�®b CONTRACTOR: Company Name: (5 u i TrP-,9f A -AJ is ��= �' S� -�-� `-4 Phone#: 30 S --� 01 02-7 Address: 73 ? -`iw @ LFq' Cou tZ City: M f A m Y State t` 1- 012-f ,'D/_1, Zip: P Q �. Qualifier Name: U00-00 ZV U L U & C A , Phone#: 1 S(s *% 0 S I State Certification or Registration #: Certificate of Competency #: 038300490. Contact Phone#: Email Address: ; !V ®@ r cl i r'1.0 Q41�eys sit t O ✓Lt i' m 4 DESIGNER: Architect/Engineer• Phone#: Value of Work for this Permit: $ ( 06-31 Square/Linear Footage of Work: q '53 Type of Work: DAddition OAlteration ®New ORepair/Replace ODemolition Color thru tile: Submittal Fee $, SD, ny Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Notary $ Radon Fee $ DBPR $ Bond $ Training/Educal3on Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ =- 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 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 EMPROVEMENTS 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 r ' ection fee will be charged. !�V ` Signature � Signature b� '� I l Owner or Agent ^/ Contractor The foregoing instrument' was acknowledged before me this day of heb 2a, 20 i , by Wthie l b N i Co leo c , who is personally known to -mg or who has produced As identification and who did take an oath. NOTARY PUBLIC: The foregoin instrument was acknowledged before me this /mj day of � ,20t-%-,bye7�_ �G2i who is personally known to me or who has produced Z `�: ► v� - L1 c rznu. as identification and who did take an oath. ."•"'v"P'�. MELISSA R GURLACZ Notary Public . State of Florida Sign:+ 2015 Commission # EE 58653 Print •�' Asan. My Commission Expire NOTARY PUBLIC: o", *. Angelica I. Martinez `a°O ems.'-�0111R!SSi4dLy #'Ei44686 Sign: iRES: NOV. 08, 2015 Ala �� '�.,�o fl°o` yyWW,AARONNOTARY.com Print: Y C6® My Commission Expires: Moi 00, W(J— e��>��a�x��ae>s�>s��>ss��xx��a�>��>s��x��*�>s��a�e�a•x>s>�>��>��>��>�e�>s�e��>��>s�a�>�� APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 3/12/2012)(Rcvised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) Feb 20.2014 1:18PM HP LASERJET FAX p,1 CERTIFICATE OF INSURANCE ISSUE DATE 2!2012014 THIS CERTIFICATE IS ISSUED AS AMA ITER AFFIRMATIVELYOR NEGATIVELY AMEND, NOT CONSTITUTE A CONRACT BETWEEN IMPORTANT, W- THE CERTIFICATE HOLDER TERMS AND CONDITIONS OF THE POLICY, C RIGHTS TO THE CERTIFICATE HOLDER IN Ul INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT OR ALTERTHE COVERAGE AFFORDED 13Y THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUDER, AND THE CERTIFICATE HOLDER. I AN ADDITIONAL INSURED, THE POLICYpESI MUST BE ENDORSED. IF SUBROGATION 18 WAIVED, SUBJECT TO THE ERTAIN POLICIES MAY REQUIRE AN ENDORSEMENT. A STATEMENT ON TIUS CERTIFICATE DOES NOT CONFER OF SUCH ENDORSMI ENT(M. PRODUCER S.G. &Assoc Ins Brokers. Inc 9999 :Surwt Drive Suite 102 Miami - FL 33173 INSURERS) AFFORDING COVERAGE INSURER A: CanopIUS US insurance, Inc INSURER B: NIA INSURED Gutterman's Services, Inc 938 Southwest 149th Court Miami, FL 33194 INSURER C: INSURER D: INSURER E: NIA COVERAGES THIS IS TO CERTIFY THAT THE POUCI POLICY PERIOD INDICATED. NOTWIT RESPECT TO WHICH THIS CERTIFICA HEREIN IS SUBJECT TO ALL THE TE PAID CLAIMS. OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUREQ NAMED ABOVE FOR THE TANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH E IfAAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED , EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY INSR LTR TYPE OF INSURANCE POLICY NLIMS POU Y EFFECTM DATE POLICY EXPIRATION DATE LIMITS A GENERALLIAe1LITY OUS009 6/1/2013 SM12014 GENERAL AGGREGATE 800,000 300,00 300,000 304,000 100.000 5,000 PRODUCTS-COM/OP AGG. PERSONAL & ADV. INJURY EACH OCCURRENCE DAMAGE PREM RENTED TO YOU MED EXPENSE (Any one person) B PERSONAL LIABILITY COMBINDED SINGLE LIMIT MEDICAL PAYMENTS TO OTHERS C EXCESS LIABILITY EACH OCCURRENCE AGGREGATE D E PROPERTY BUILDING CONTENTS BUSINESS INCOME IS INSURANCE IS ISSUED PUR CARRIERS DO NOT HAVE THE PR FOR THE OBLIGATION OF AN INS SURPLUS LINES INSURERS' P AGENCY. ANT TO THE FLORIDA SURPLUS LINES LAW. PERSONS INSURED BY SURPLUS LINESNT TECTION OF THE FLORIDA GUARAY ACT TO THE EXTENT OF ANY RIGHT OF RECOVERY LVENT UNLICENSED INSURER. LICY RATES AND FORMS ARE NOT APPROVED BY ANY FLORIDA REGULATORY DESCRIPTION OF OPERA'noNs I SPE-CIALl Sheet Motel work outside Y ITEMS SURPLUS UNES AGENT VIRGINIA C, 18677 FEATHERSOUND DRIVE PO PHILLIPS UCEINSE#A20688a X 17066 CLEARWATER, FLORIDA 33762 CERTIFICATE HOLDF-R V1089e of Miami Shore$ Miami NE 2nd. Avenue Miami , FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES Be CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL 13E DELIVERED IN ACCORDANCE WITH THE POLICY PROVISION. AUTHORIZED SIGNATURE JEFF ATWATER r� CHIEF FINANCIAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW* CONSTRUCTION INDUSTRY EXEMPTION This cerfffes that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 12/13/2013 EXPIRATION DATE: 12/13/2015 PERSON: ZULUAGA JORGE E FEIN: 651179334 BUSINESS NAME AND ADDRESS: GUTTERMAN'S SERVICES INC 938 SW 149 COURT MIAMI FL 33194 SCOPES OF BUSINESS OR TRADE: GUTTER INSTALLATION GUTTER CLEANING Pursuant to Chapter 440VR14), F.S., an officer of a corpor8tcvr who etects exemption from this chopw by Iftq a oertificets of ems+ under this section may not moovsr berrrtfits or compensation tattler this chapter. Pum ant to Chapilar 440.05112] F.S., Certiffeata of elertiort to be - appy wily within the scops of the twshtess or trade Hated on the notice of election to be exempt. Pursuant to Chapter 440.05(1 33, F.S„ Notices of elactim to to exempt arta certificates of election to be exempt shelf bs "act to revocation If, at any time after ft f fang of the notice or the hwance of the certificate, the person named on the nodes or canific" no longe► meets the requirements of ttfs section for issuanes of a cartitleme. The department shall revoke a eeNtcate at any time for failure of the person named on the caMtsits to meet the rewirements of the section. DFS -F2 DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 07-12 QUESTIONS? (850)413.1609 i Municipal Contractor's Tax Receipt Miami—Dade County, State of Florida —THIS IS NOT A BILL — DO NOT PAY CC NO: 03BS00490 BUSINESS NAMEMOCATION GUITERMANS SERVICES INC 938 SW 149 CT MIAMI, FL 33194 el MC RECEIPT NO. EXPIRES NEW BUSINESS SEPTEMBER 30, 2014 7436342 Must be displayed at place of business Pursuant to County Code Sec 10-24 OWNER TYPE OF BUSINESS GUTTERMANS SERVICES INC SPECIALTY BUILDING CONTRACTOR Restricted to City of Coral Gables MIAMI-m)For more information, visit www miamidade govRaxcollector PAYMENT RECEIVED BY TAX COLLECTOR 40.00 08/26/2013 0228-13-001190 c� 0 Q 0 In event it b or balance 4 When executed and signed by both parties, this proposal becomes a contract. Gutterman's Services, Inc., will honor a five year guarantee upon completion of installation of your continuous gutters system. This guarantee covers the installation and materials. Our suppliers guarantees the baked on enamel finish for twenty years against cracking, chipping or peeling. We will repair or replace any part necessary if it is a direct result of faulty materials. We do not cover damage due to neglect or lack of proper maintenance. We do not cover damages that have occurred from abuse or acts of nature. JOB APPOINTMENT ..�n s erv�ce-s Inc. *' 6"' C�•7NTIN000S RAIN GUTTERS t - COLOR • --- r fo S- ICV C;a%Gi AA �. VICES, TNC. r�Y'�u1_tersmiami_net SUBSTANTIAL IMPROVEMENT OR SUBSTANTIAL DAMAGE APPLICATION FOR SUBSTANTIAL DAMAGE OR SUBSTANTIAL IMPROVEMENT REVIEW Property Add Property Owner's Property Owner's Address: f:>ANe Property Owner's Phone Number: Contractor's Name: ALUA-6A-- S139 Contractor's Address: '-38- SL)J ] q C7j(Jrel . M'AAAJ. Contractor's Phone Number: a 0:5 3 i Flood Zone BFE Lowest Floor Elevation (Excluding garage or carport) Check one of the following: [ ] I am attaching a State Certified Appraiser's report, valuing the structure at: KI am not attaching a State Certified Appraiser's report and I accept the use of the valuation of my property that has been recorded by the County Property Appraiser's Office. SIGNATUR Property Or Contractor: Date: a - ;Z&- 2- 2,o'4 SUBSTANTIAL IMPROVEMENT OR SUBSTANTIAL DAMAGE PROPERTY OWNER'S SUBSTANTIAL DAMAGE OR SUBSTANTIAL IMPROVEMENT AFFIDAVIT 3302 Contractor's Name: Profr Mo t wner's tlarrig)elc®l. Property Owner's Address: Property Owner's Phone Number �g�o" I hereby attest that the list of work and cost estimate submitted with my Substantial Damage or Substantial Improvement Application reflects ALL OF THE WORK TO BE CONDUCTED on the subject structure including all additions, improvements and repairs and, if the work is the result of Substantial Damage, this work will return the structure at least to the "before damage" condition and bring the structure into compliance with all applicable codes. Neither I nor any subcontractor or agent will make any repairs or perform any work on the subject structure other than what has been included in the attached list. I UNDERSTAND THAT I AM SUBJECT TO ENFORCEMENT ACTION, WHICH MAY INCLUDE FINES, IF ANY INSPECTION OF THE PROPERTY REVEALS THAT I, OR MY CONTRACTOR, HAVE MADE REPAIRS OR IMPROVEMENTS NOT INCLUDED ON THE ATTACHED LIST OF REPAIRS OR THE APPROVED BUILDING PLANS. See attached itemized list. STATE OF FL or Id cA C�611JUI X11; Before me this day personally appeared YY1 t Cjasa:C k MI M i eCLAk , who, being duly swom, deposes and pays t t he/she has read, understands, and agrees to comply with all the aforem ned onditi Prop rty wner's Signa ure Sworn to and subscribed before me this _ day Rbrwav, 20_L�. Notary Public a e o •till I MELISSA R. GURLAC2 My commission ex , re Notary Public • State of Florida • •= My Comm. Expires Jan 25, 2015 Commission # EE 58653 oma.` h` W �� Bonded Through National Notary Assn. SUBSTANTIAL IMPROVEMENT OR SUBSTANTIAL DAMAGE CONTRACTOR'S SUBSTANTIAL DAMAGE OR SUBSTANTIAL IMPROVEMENT AFFIDAVIT Property Address: /a Ds Ali' to S1 7= ^A-" Contractor's Name: Contractor's Company Name. rrT-61&1AA t S a J�fC , Contractor's Address: C. C-0 Contractor's Phone Number: Contractor's State Registration or Certification Number: 'a C- ®-�( 91 � Contractor's We Registration Number (if applicable): I hereby attest that I, or a member of my staff, personally inspected the subject property and produced the attached itemized list of repairs, reconstruction and/or remodeling which are hereby submitted for a Substantial Damage or Substantial Improvement Review. The list of work contains ALL OF THE WORK TO BE CONDUCTED on the subject property. If the property sustained Substantial Damage, this list of Work, will return the structure to at least its condition prior to damage and bring the structure into compliance with all applicable codes. I further attest that all additions, improvements or repairs proposed for the subject building are included in this estimate and that neither I nor any subcontractor or agent representing me will make any repairs or perform any work on the subject structure other than what has been included in the attached list. I UNDERSTAND THAT I AM SUBJECT TO ENFORCEMENT ACTION, WHICH MAY INCLUDE FINES, IF ANY INSPECTION OF THE PROPERTY REVEALS THAT I, OR MY CONTRACTOR, HAVE MADE REPAIRS OR IMPROVEMENTS NOT INCLUDED ON THE ATTACHED LIST OF REPAIRS OR THE APPROVED BUILDING PLANS. See attached itemized list. STATE OF 4-'7LCXZ i r2-lk COUNTY OF rn u El, C Before me this day personally appeared -5 -2—Q "Q who, being duly sworn, deposes and sa s that he/she has read, understands, and agrees to comply with all the aforementio d conditions, at ",t- .4 Q- - or`acto s gnature Sven to and subscribed before me this e day of 20 11&\\"' Notary Public State of My commission expires:CA t" cr. o C •� i � ••�= elO O y � �