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RF-14-2789BUILDING PERMIT APPLICATION Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (30S) 762-4949 c R, TN' O DEC 2 2 2014 FBC 20 i -CJ Master Permit No.or I q Z Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL F-1 PLUMBING ❑ MECHANICAL E] PUBLIC WORKS . ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: Z ( IV 10,7 ;� City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: I FFE: OWNER: Name (Fee Simple Titleholder): J /z, < J/1 Phone#: - W, 931- — 1707 Address: 'Z ( -6 10 q T� -5f- City: 5f City: '44eP _5440 State: L Zip: Tenant/Lessee Name: Phone#: 7'je' Email: CONTRACTOR: Company Name: se'C'- ,, ` gs /-4 '1,nc Phone#: ;®S- go - 8314 Address: //7®® e!' 33 G l®®s City: /`7` i �� State: Zip: _3.3C>' Z Qualifier Name: �l�i�' �` FZ�0 Phone#: -7 State Certification or Registration M Certificate of Competency M 0I -S 00 lz.3q DESIGNER: Architect/Engineer: one#: Address: City: State: _ Value of Work for this Permit: $ ® ® .ate Square/Linear Footage of Work: 2c" Type of Work: ❑ Addition ❑ Alteration ❑ New Description of Work: 167 v 44- e r Specify color of color thru tile: Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Technology Fee $ Structural Reviews $ (Revised02/24/2014) Training/Education Fee $ ❑ Repair/Replace CCF $ DBPR $ Zip: ❑ Demolition CO/CC $ Notary $ Double Fee $ Bond $ 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 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 ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, 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 approved and a reinspection fee will be charged. Signature OW ER or AGENT The foregoing instrument was acknowledged before come this day oft��jbiEO , 20 Os , by kl!! / who is personally known to me or who has produceeL- ��— + as identification and who did take an oath. Signature CPNTRACTOR The foregoi g instrument was acknowledged before me this day ofA/ i L , 20, by W;ZeAdi( who is personally known to me or who has produced Irl 1�� (0 identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: --Z IvIvuldulb a4p, m Feliciano Print: pommission 1s �—� Seal: �� Epiros01112120 Seal:EE 173059 = on 0 Commissi %•,; 0- Fi�Q APPROVED BY i L/"7Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) 'ic N A� CERTIFICATE OF LIABILITY INSURANCE °"MM&=5 TIES CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONIFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THI 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 NISURER(Sh AUTHORIZED I REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. 0 the certificate hider is an mast be endorsed. the terms and conditions of the Polley, certaln polities may require an endorsement A statmwd on this certtlicate does not eontef rigida to the Comte hider in Iter of such emmrsem qst PRODUCER t OAYG- JOHNNY ' Hialeah 018cm! hm mnce OF INSURANCE (3WP1 7776 f 904 E. 25th St. hlr h_fi�h»trr� n IHialeah, FL 33013 Lam i - AFFORDM COVERAGE NAIL d - Phone _ (305 9'1-7776 -- _- Fax (305)891-2923 INSURERA: GRANADA INSURANCE COMPANY ! - .-I INSURED 1 O/03f�14 INSURER 8: SealnlBSS dU% Masters AHED EXP (My Ste $ 6,01010.000 AHED INSURER C - —I 1711 West 38 Place 1105 GENERAL AGGREGATE s Z,000,000.00 - — - — ---i INSURER u cINSURER HIALEAH. FL 33012- (561) 2555293 E' --- -- -- it NIA 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 oocumENT WIThi RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERI1t.S, ! FXM 1LRkf #kq Allen] i*AMiflTMtC AC 01 M1J C" IM1CC 1 BAIT! CL r AW "— YA— Q 1 �f If-Cf1 a nAm M Al owlmmTYPE OF INSURANCE ffF Lam i A Off- LUIBa.IIY 0 CaWAERCIAL GENERAL LIABILITYS ❑ ® CtAat&MADE ❑ OCCUR 0185FL4XX)63426 1 O/03f�14 101031015 EACH OCCURRENCE . 1 0��_00 1,000,000.00 AHED EXP (My Ste $ 6,01010.000 AHED a ADV &ENTRY S 1,000,000.00 ❑ _— GENERAL AGGREGATE s Z,000,000.00 GEWL AGGREGATE LIMIT APPLIES PER ❑ Palmy ❑ PRa ❑ Loc, PRmwm- c ompiDP AGO s 2,000,E 00 S t AUTOMOBILE LUFBMY ❑ ANY AUTO ❑ ALL OWNED SCHEOUI.ED ❑ A A ❑ KRED AUTOS ❑ A A'NEDS NIA a IN�DMSINGLE LINOT s BOD LY INJURY (Par pmamt) S ' Somy N AMY (Paraat�en S -- -� S EACH actxtRRENt S ❑ UMBRELLA LIAR ❑ OCCUR ❑ EXCESS LIAR_ V _CLA9�S�MADE 1IYCOMIPENBATM AND EMPLOYERS' LIABILITY Y I N ANY �Ef ( M I" U -� AGGREGATE S VJCSfATLF OTE- ' !�7pR ! `� E.L.AdACCiD�f S EL DISEASE - EA EMPLOYE S _ —_ EL DISEASE -POLICY LIMB S _ I 1 I + LW.*V~I lar Ur UPEMTt WM I LOCATKM I VENULES (Atlteh ACORD 101, Ad al RemaAcs Solodul% N mom spate IS FegYh" (SEAMLESS GUTTERS CERTIFICATE HOLDER j MIAMI SHORES VILLAGE 1 10050 NE 2ND AVE MIAMI SHORES FL ACORD 26 (2010LI6) QF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DBJVMM IN j ACCORDANCE WITH THE POLICY PROVISIONS. HIALEAH DISCOUNT 1 INCE O 1 010 ApORD CORPORATION. All ftMs reserved. The ACORD ftefne and logo are registered marks of ACORD - Seamless Gutter Masters, Inc. City, State IN ® l�fas2ei �a Licensed & Insured Tampa - Orlando - Polk CC# 139-2483 Miami -Dade: Tampa 813-965-7605 11-AL17275-x Orlando - Polk 407-485-9350 Martin County: MCN56074 Miami -Dade County: Martin County: 305-817-8814 561-255-5293 ❑ GREEN ❑ EGG SHELL BBB Broward County: 954-4040725 www.seamiessguttersfl.com PROPOSAL / CONTRACT SUBMITTED TO: ciy I 140w / Name 16 A) f j 0 g T H 51 Address M o Awe, I , r—L City, State IN ® l�fas2ei �a Licensed & Insured Tampa - Orlando - Polk CC# 139-2483 Miami -Dade: CC# 09BS00239 Broward: 11-AL17275-x palm Beach: 2010-03888 Martin County: MCN56074 We have workers compensation. Salesman- K%J i QQ— 16 sS—� 5 Date: N WORK TO BE PERFORMED AT: TOTAL FOOTAGE ZO® 3 -600 - JOTAL DOWNSPOUT 5)( `10= 2S:O GUARANTEE ON LABOR 2 Yrs. ❑ 5 Yrs. Permit: $ N&W . Installation Date GUTTER COLOR WHITE ❑ CREAM IVORY ❑ BROWN ❑ BRONZE ❑ GRAY ❑ L. GRAY ❑ D. GRAY ❑ CLAY ❑ COPPER ❑ GREEN ❑ EGG SHELL DOWNSPOUT COLOR O WHITE ❑ CREAM ❑ IVORY ❑ BROWN ❑ BRONZE [�:)y GRAY ❑ L. GRAY I....d D. GRAY ❑ CLAY ❑ COPPER ❑ GREEN ❑ EGG SHELL 3X4 ❑ 2X3 ❑4X5 Lmwj4. ❑ CONDUCTOR HEAD 20 YEAR WARRANTY ON MATERIAL ®®� Paid By: / z - Z_ - TOTAL $ 13cle , eck # Date pr3,� pted DEPOSIT $ ❑Cash Autho ' ature BALANCE $ . ❑ Credit Card ClieniSlenjiture By signing this proposal you accept the terms set forth in this contract. Any changes during or after the pro' ct may result additional cost. Unless stated, all gutters are installed with spikes & ferrules.All repairs are put on a 4-6 week lead time for scheduling. We are not r sponsible for any damages for example broken tyles or repairs associated with walking on an old or damage roof. As well as if a wall is hollow and it cracks when installing a downspout, also if your furring cracks do to unexpensive furring we are not responsible. Gutters will be installed under drip edge unless stated otherwise Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-232013 Permit Number: RF -12-14-2789 Scheduled Inspection Date: May 13, 2015 Permit Type: Roof Inspector: Rodriguez, Jorge Inspection Type: Final Owner: MARDINI, MARUAN Work Classification: Gutters Job Address: 26 NE 109 Street Miami Shores, FL Project: <NONE> Contractor: SEAMLESS GUTTER MASTER Building Department Comments GUTTER INSTALLATION Phone Number Parcel Number 1121360110380 INSPECTOR COMMENTS False Phone: (305)817-8814 Inspector Comments PassedJnCREATED AS REINSPECTION FOR INSP-225681. The down spouts must drain a minimum of 12" away from the walls. Failed Correction Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. May 12, 2015 For Inspections please call: (305)762-4949 Page 12 of 30 Expiration: 09112/2015 Project Address Parcel Number Applicant 26 NE 109 Street 1121360110380 MARUAN MARDINI Miami Shores, FL Block: Lot: Owner Information Address Phone Cell MARUAN MARDINI Contractor(s) Phone Cell Phone SEAMLESS GUTTER MASTER (305)817-8814 of Work: Gutters itional Info: mification: Residential nnino: 1 Fees Due Miami Shores Village CCF 10050 N.E. 2nd Avenue NE ••.• Miami Shores, FL 33138-0000 �'CttxmA Phone: (305)795.2204 Expiration: 09112/2015 Project Address Parcel Number Applicant 26 NE 109 Street 1121360110380 MARUAN MARDINI Miami Shores, FL Block: Lot: Owner Information Address Phone Cell MARUAN MARDINI Contractor(s) Phone Cell Phone SEAMLESS GUTTER MASTER (305)817-8814 of Work: Gutters itional Info: mification: Residential nnino: 1 Fees Due Amount CCF $0.60 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.20 Permit Fee - Repairs $100.00 Scanning Fee $3.00 Technology Fee $0.80 Total: $108.60 Valuation: $ 800.00 Total Sq Feet: 200 Pay Date Pay Type Amt Paid Amt Due Invoice # RF -12-14-53993 03/16/2015 Check #: 1083 $ 58.60 $ 50.00 12/22/2014 Credit Card $ 50.00 $ 0.00 Available Inspections: Inspection Type: Final Review Roof In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above-name.Kractor to do the work stated. Authorized Signature: / Agent March 16, 2015 Building Department Copy March 16, 2015 1