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RF-14-1712IUJI r wr w w Miami Siores Village- Building Department 7AuG7 2014 10050 N.E2nd Avenue, Miami 9wes, Ronda 33138 BY: Tei: (3D5) 795-M Fax (305) 7568972 IN9cPiON t1NEPHOVENWMR (W5) 762-4W �- ■3100M= FBC20 (-Q) Master Permit No.7FF - H -1 -� 1 Sib Permit No. i = ll.. :1d1 • •l..11rF-tj IR 7- rim OANIR NMN (Fee Simple Titiel-ader): e ' ✓ r ,rFhanedk 3 U —963— aty: sate Terant/Less�Name: � _ -- Finail: of aWlIlkam owpany Matra 041., a ,J . �,NG s 9-7.1-.3 sw/ i.? 4 0i=r3ar Address: 2 i_iQ2� q 2- gyp: 3 3117 G 3os'__�.r's-fz�9 Sete aati�cation or I�stration # - `—' Certificate � ��, #. C! 0 0 0 / � 3"7 ! DESIGNERArchiteci/E�gineer: Fhone#: Address: aty: State: ,ap: Value of Work for this ftrftt: Square/ Linear Footage of VVaric 11-7 LIAIAW �. Type of Work: ❑ Adr Wn ❑ Alteration ,New ❑ hair/R*laOS ❑ Dernoiitio, Description of Work r r �'7 :., ,ti-,,. CIA dfy color of color thru tile: Submittal Fee$ � Rwftt CXF$ OOfCJC$ Scanning Fee $ Radon Fee $ DSR $� y $ Te&Wogy Fee $ Training/ education Fee $ Double Fee $ Structural Ponew+s $ Bond $ cWW=2u2M) TOTALFmNoA wE$ k BondirigCbMPMVsName (If applicable) Bonding fbmpW SAddress 0 State MOrtgage LOXWS Name (if applicable) MortgW I.ax 'sAddrese city Zip State ZIP. Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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 ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, AIR CONDITIONERS, ETC..... OWN87SAFRIDAMT. 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. "WAMING M OWER YOUR FA UJF;r= TCS RE00FV A N0110E OF COMMBiXEVIWr 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 YOURWMEOFCOCAMBVCEME T" Notics to Applicant: As a aonthtion to the isle of a building permit with an estimated value eslaowding $250, the > icaant must promise in good faith that a copy of the notice of an i miencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the re=ded mice of col. U11a KNIFIsatt must' posted at the job site for the first inspection whirl occursseven (� after the building perrrut is issued. In the absence of such posted notice, the inspection will rpt be ap}�roved and a rdr ct� will be dwged. OWNEk6r AGENT The foregoing Instrument was acknowledged before me this Q day of f� as t. 20 Jll by S who is personally known to me or who has producedD e 1,0 e'Q 6 as Identification and who did take an oath. NOTARY PUBLIC: SUSAN WYNNE Notary Public. -.State of Florida My Comm. Expiris Nov:16, 2016 F .--•1?d Througk0N*-Mr-,-,Acsn APPROVED BY QWseM/24/2M4) The foregoing instrument before me this day of ty a� AJ I ,aQ who !!::naRy7�wn to me or who has produ d Identification and who did take an oath. NOTARY PUBLIC: Wll� Stafe of FSeal: Notary Pu sic- Londa ,My Comm, Expirds Nov'16. 2016 �,F60aF Commission. .# EE. 850584 Banded Through WOM11 Notary Assn M�R�Y�U�66�bitltt*9iil�i;iri#i#Ba�AiOrt�kleyri • Mt t�k�Yf.A� 01 Plans Examiner Zoning Structural Review Clerk OP ID: DT .4�%- ® CERTIFICATE OF LIABILITY INSURANCE 0810612014( "' 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 this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER FILER INSURANCE, INC. 9440 S.W. 77 Avenue Miami , FL 33168 Mark 1st. Bluh CONTACT PHONE Pax A/ Arc No ADDRESS: WOMER ARION01 INSUREIM AFFORDING COVERAGE NAIC # GENERAL LIABILITY INSURED Arlon, Inc. INSURER A:FCCI Insurande Company 10178 MVP Metals, Inc. 8723 SW 129th Terr INSURER 0: Miami, FL 33176 INSURER c X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCURMED INSURER D: INSURER E : 07/05/2014 INSURER F: DAMAGE O a rrence $ 100,00 COVERAGES CFRTIFICATF RIIIMIRFR• ocvlmnlU Auunneo. 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. TR TYPE OF INSURANCE Im ACCORDANCE WITH THE POLICY PROVISIONS. POLICY NUMBER POS EFF POLICY LIMITS ---+ DARYL TORRES - A20151 GENERAL LIABILITY EACH OCCURRENCE $ 600,0001 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCURMED CPP0007405 07/05/2014 07/05/2015&ES DAMAGE O a rrence $ 100,00 EXP (Any one n) $ 5,00 PERSONAL & ADV INJURY $ 500,00 GENERAL AGGREGATE $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 500,90 POLICY PRO LOC $ A AUTOMOBILE LIABILITY X ANY AuTo CA0009153 07105!2014 07/05/2015 COMBINED SINGLE LIMIT(Ea accidard) $ 500,00 BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per acddent) $ SCHEDULEDAUTOS FIRED AUTOS PROPERTY DAMAGE $ (PER ACCIDENT) X NON-OWNEDAUTOS $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DEDUCTIBLE $ $ RETENTION WORXERS COMPENSATION AND EMPLOYERS LIABILITY Y / N ANY PROPRIETORIPARTNER/DECUTNE OFFlLEWMEM BER EXCLUDED? MarmUftry In NH) 11d-,deunder N / A WCSTATU- OTH- TORY LIMITS E L EACH ACCIDENT $ E.L. DISEASE - EA ENIPLOYE $ E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS below I -T DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, Itmare space Is required) cense # 00001331 Installation of rain gutters and downspouts CERTIFICATE HOLDER f'Afdfl=l I A n4MM MIAM109 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village g THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 10050 N.E. 2nd Avenue AUTHORIZED REPRESENTATIVE Miami Shores, FL 33138 ---+ DARYL TORRES - A20151 ©1988 2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD Jeff Lmwo 9275 N. Bayehore Dr. Miami Shores, FL 33138 �\ 01, .4. .to 6,v X, We hereby submit specifications and estimates for: 6 inch aluminum continuous gutter. Authorized Signature TERMS ON THE i Date( &, client Signature I N . SIDE APART OF ppOS�„ ORDER C ELLATION AFTER 3 DAYS: $50.00 AD TION FEE WORK TICKET PLUSP CHARGES $1.5.00 FEE FOR ANY RETURNED CHECKS Sl JRJ CT O C M IA E TH LL ED ,4 �� • • • • • y • • • S AT AN CO NT 7RUESND R LA Authorized Signature TERMS ON THE i Date( &, client Signature I N . SIDE APART OF ppOS�„ ORDER C ELLATION AFTER 3 DAYS: $50.00 AD TION FEE WORK TICKET PLUSP CHARGES $1.5.00 FEE FOR ANY RETURNED CHECKS Sl JRJ CT O C M IA E TH LL ED _ �� • • • • • y • • • S AT AN CO NT 7RUESND R LA • www • • 60 u• •• 4690•9 0 GUARANIZ& 1 YEAR LABOR 10 YEARS MATERIAL INSTAISAMN DATE: . . 0 " • •' 0 FCaOTAGEi Total $ Deposit $ +� - Balance $ Extras: "Ird Aj P? P-0 _. Authorized Signature TERMS ON THE i Date( &, client Signature I N . SIDE APART OF ppOS�„ ORDER C ELLATION AFTER 3 DAYS: $50.00 AD TION FEE WORK TICKET PLUSP CHARGES $1.5.00 FEE FOR ANY RETURNED CHECKS