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RF-15-2017 -2017 a �5u°RFs y Ali a Miami Shores Village o�� �.Ype` � t £ �T 10050 N.E.2nd Avenue NE 'W0*'{;la Miami Shores,FL 33138-0000 ApF Phone: (305)795 2204 .: '� ��t SC1S . �. TE•.N il IORiQA. ..3 _.: Expiration: 02/15/2016 Project Address Parcel Number Applicant 311 NE 94 Street 1132060136100 _ •� ___� ��� •�________�_.••_•... __.._,.�.__ .• Miami Shores, FL 33138- Block: Lot: THOMAS SALYER Owner Information Address Phone Cell THOMAS SALYER 311 NE 94 ST MIAMI SHORES FL 33138-2831 Contractor(s) Phone Cell Phone Valuation: $ 980.00 ARION INC (305)251-1279 Total Sq Feet: 112 Type of Work:Gutters Available Inspections: Additional Info:INSTALL RAIN GUTTER AND Dew spout W Inspection Type: Classification:Residential Final Scanning:3 Review Building Review Building Fees Due Amount Pair Date Pay Type Amt Paid Amt Due CCF $0.60 Invoice# RF-8-15-58671 DBPR Fee $2.00 DCA Fee $2.00 08/11/2015 Credit Card $50.00 $64.60 Education Surcharge $0.20 08/19/2015 Check#:3188 $64.60 $0.00 Permit Fee-Repairs $100.00 Scanning Fee $9.00 Technology Fee $0.80 Total: $114.60 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 a nt, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFIN and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and/the all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above-named contractor to work stated. August 19, 2015 Authorized Signature:Owner / Applicant / Contractor / A nt Date Building Department Copy August 19,2015 1 Miami Shores Village AUG 11 2015 Building Department 10050 N.E.2nd Avenue,MiamShores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 1- INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 �.,0 BUILDING master Permit No. � 1 1' PERMIT rAPPLICATION Sub Permit No. �Iy1BUILDING n ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP ` CONTRACTOR DRAWINGS JOB ADDRESS: / If A) �. 9`F SIT ram City: Miami Shores County: Miami Dade Zip: 0 Folio/Parcel#: Is the Building Historically Designated:Yes NO�^ Occupancy Type:�SL4 , Load: Construction Type: Flood Zone: BFE: FFE: ? .7 S-7 —/ y r— "� OWNER:Name(Fee Simple Titleholder): 1 v•^ ^J Phone#: 3 c)� ��L 6`�`•7 7 !� Address:_ i�. �,�(�+( r� City: /� r / t�'9/%-.��' State: Zip: Tenant/Lessee Name: Phone#: ✓0 ' - 7 S 7 - Email: amt - 5 L2 6?`7`> - r` CONTRACTOR:Company Name: �/� �3 nJ -y- C Phone#:-36' 2- `7 I Address: ',,�0} �-�✓ r LA) City: J'f �"/. !a r.�-1 State: f C. Zip: <-7 Qualifier Name: y"- '-j Phone#:3" f. � 115 9q--- S c State Certification or Registration#: — Certificate of Competency#: Q J ,J O j > 7 DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ Square/Linear Footage of Work: //02•- Type of work: ❑ Addition ❑ Alteration New ❑ Repair/Replace ❑ Demolition Description of Work: .1-/✓�� I 1 Specify color of color thru tile: Submittal Fee$0J - C- Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$6C0 (Rev1sed02/24/2014) Bonding Company's Name(if applicable) Bonding Company's Address City State Zip 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 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 Signature OWNER or AGENT CO TR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of - ; 1C--,<1�>T 20 k4 by day of� 20 s by who is personally known toVM\Wwho is personally known to me or who has produced F\_ \Ka ( A Zn1 me or who has produced identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: 'AX Print: Print: Seal: Seal: P9'�. °est Notary Public State of Florida d 0'� Notary Public State of Florida ?� Sindia Alvarez ? Sindia Alvarez My Commission FF 156750 My Commission FF 156750 Expires 09103/2018 "to Ex ires 09.0312016 APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Construction Trades Qualifyinq Board BUSINESS CERTIFICATE OF COMPETENCY 000013371 AMOK INC D.B.A.: WYNHARD ROBERT T Is certified under the provisions of Chapter 10 of Miami-Dade County Aug. 11.2015 10 :48 AM Arion Inc. 3052513877 PAGE. 1/ 1 .......... Local Business Tax Receipt Miami-bade County, Stets of Florida THIS IS NOT A BILL - DO NOT PAY 354514 LOT BU8M858 NAMW&OCATkON RECEIPT NO, EXPIRES ARION INC RE1YEWAL SEPTEMBER 30, 2015 8723 SW 129 TERR 354514 Must be displayed at place of business MIAMI FL 33176 Pursuant to County Code Chapter BA-Art.9&10 OWNER sEc.TYPE OF BUSINESS PAYMENT RECEIVIP ARION INC 196 SPECIALTY BUILDING CONTRACTOR Worker(g) 10 000013371 BY TAX COi-i.EGTOR $75.00 08/14/2014 FPPU12-14-006979 This Local Posiness Tax Rocalpt only confirms payment at the Local Business Tax.The Receipt Is not a license, permit,ora certification of the holder's aauslifloatlone,to do h►ulnesa. Holder must comply,with any governmental or nongovammantal regulatory Iowa and-requirements which apply to the husiness. The RECEIPT NO.shows must he displayed an aH cmwllerolal Vehicles-Mlaeti-Dade Coda Sao eq-fy6 For mora information,visitlalfAtW miamidade,gev/texoollaotor I Aug. 11. 2015 10: 54 AM Arion Inc. 3052513877 PAGE. 1/ 1 ooszos Master contractor's Recei�t Mjomi�-Dade County, State of Florida THIS IS NOTA BILL - DO NOT PAY 354514 M C SUBINESS NAME&OCATION RPICRIPT NO. EXPIRES ARIQN INC NEW SEPTEMBER 3 , 2015 8723 SW 129 TERR 7453394 Must be displayed at place f husineas MIAMI FAL 33176 Pursuant to County Co Chapter 8A-Art.9&10 OWNER GEC.TYPE or 6USINESS ARION INC NWC SPECIALTY BUILDING CONTRACTOFCAYMENT RECEIVED 000013371 V TAX COLLECTOR category(s) i $175.00 08/14/2014 FPPU12-14-006979 This Local Baelness Tax Receipt only confirms payment of the Local Business Tax,The Receipt is not a Itcenee, permit or a certification oftheholder s galifications,to do business. Holder must comply with any governmental or nongovernmental regulatory taws and requirements which apply to the business, The RECEIPT NO,above must be displayed on alt commercial vehiclae-Miami-Dade Coda Sac 841-rc for Blare Infa aietlon,visit ylptppLodAmId itaQVjjeXgAtIW= A Y Ji T • i+� OP ID: MA �RSR CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 08/10/2015 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(ies) 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 CONTACT NAME: FILER INSURANCE,INC. PHONE A 9440 S.W.77 Avenue MCNA Ext);; A/C No Miami„FL 33156 ADDRESS: Mark A.BluhPRO ucER ARION01 CUSTOMER ID#: INSURERS AFFORDING COVERAGE NAIL M INSURED Arion,Inc. INSURER A:FCC)Insurance Company 10178 MVP Metals,Inc. INSURERB: 8723 SW 129th Terr Miami,FL 33176 INSURERC: INSURER D: 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. ILTRR ADDL TYPE OF INSURANCE SUER POLICY NUMBER INS Y EFF MPPY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 500,00 A X COMMERCIAL GENERAL LIABILITY CPP0007405 0710512015 07/05/2016 PREMISES a occurrence $ 100,00 CLAIMS-MADE FKOCCUR MED EXP(Any oneperson) $ 5,00 PERSONAL&ADV INJURY $ 500,00 GENERAL AGGREGATE $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 500,00 POLICY PRO-JECT F-1 LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT A X ANY AUTO CA0009153 07/05/2015 07/05/2016 (Ea accident) $ 500,00 BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (PER ACCIDENT) X NON-OWNEDAUTOS $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATIONWC STATU- OTH- AND EMPLOYERS'LIABRITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVEE.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ It yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) License#00001331 Installation of rain gutters and downspouts CERTIFICATE HOLDER CANCELLATION MIAM109 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN g ACCORDANCE WITH THE POLICY PROVISIONS. Building Department 10050 N.E.2nd Avenue AUTHORIZED REPRESENTATIVE Miami Shores,FL 33138 Marieile Beraza P184348 ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD A`oRt� CERTIFICATE OF LIABILITY INSURANCE °WEINKIDDIYYYY' 02/2612015 THIS CERTIFICATE IS ISSUED ASA 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: N the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. N SUBROGATION IS WAIVED,subject to the tends and conditions of the policy,certain polio may require an endorsement. A statement an this certificate does not confer right to the certificate hokler in lieu of such endorsement(s). PRooticst CONTACT HAM: Risk Transfer Insurance Agency LLC PHONE 707 East Was< n Street .866 48i-9363 ti� AMNet: Orlando,FL 32801 ADDRESS: INSURERS AFFORDING CO JERAGE MAIC f INSURER A-Technology Insurance Company Inc. 42376 INSURED INSURER Staffk*Oubxxnring,11,Iii,IV,V&VI Inc. $' 1776 N.Pine lslarW Road INSURER C: Suite 108 Plantation,FL 33322 INSURER D INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER-.GT3D1 DIWN 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 uLTR. TYPE OF INSURANCE POLICY NUMBERPOLICY EFF POLICY EXP UNITS GENERAL LARALITY EACH OCCURRENCE $ 3E TO RENTED CO#A ERCIAL GENERAL LIABILITY Pf2EMI'S a occ rnwwoe $ Cl AIMS-MADE F]OCCUM MED EXP(Any ate persm) $ PERSONAL 8 AM INJURY $ GENERAL AGGREGATE $ GEN`L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGG $ POLICY PRO- LOC $ AUTOMOBILE LIABILITy. COMB] SINGLE LIMIT Ea amt ANY AUTO BODILY INJURY(Par person) $ ALL OV0NED SCHEDULED BODILY INJURY(W accident) $ AUTOS AUTOS H4REDAtiTOS MON-OWNED PROPERTY DAMAGE AUTOS accident) S $ itAeRELLA I" OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMs-MADE AGGREGATEH S DED I I RETENTIONS $ A wonl¢Rs cO AT1oN C3464905 53J61/2m0310112016 x we STAT T IT AND E 1PLOYIR W LL488JT ANY PROPRETORMARTNERYEXECUr7YE Y/N E.L.EACH ACCIDENT $ 1,000,000 EXCLUDED? NIA (may In M EJ-DISEASE-EA EMPLOYEE E 1,000,000 If descnbe under DESCRIPTION OF OPERATIONS bekxv E_L DISEASE-POLICY LIMIT $ 1,000,000 $ $ S DESCRIPTION OF OPERATto[NS I LOCATIONS I VEH=E4(ANach ACORD tot,mat Reaearks scute,if mora space is Coverage is extended to the leased en44oyees of attetnate employer in all states except in rnotIopolistic states(ND,OH,WA,WY)and other states(AK,HI,ID,OK): Atmn, Inc.#1154(Effective 03(01!14) This certificate applies to: License#000013371 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIED POLICIES BE CANCELLED BEFORE THE E)anMTlON DATE THEREOF NOTICE VALL BE DELIVERED IN ACCORDANCE WffH THE POLICY PROVISOS. Miana Shores Vilag+e AUTHORIZED REPRESENTATIVE 10050 NE 21x#Avenue Miami Shores,FL 33138 Page 1 of 1 4198&2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD 0 Continuous Iain Gutters CUSTOMER ## � 5f } Rain Control Systems ORDER # - 1 i •►r r•••r r►•0•••r••►r►•r r►•r r r r r r 1••r►►•r►rrr►r•r•r•r•• r r►►r r•►r►r r r r►r►r r r►r r►r•►i•rr r:►► •►•••••••••►• ••••r••r•••••••►••r•••♦•►••f!►•►••►•►•►•••••♦►• •►•►••►►r•►►r••••••••••►•••••• •r r r r r r r r►►►r►r r►r r•r r•►r►r••r r r►•••r•r r r••r►►•♦•••r r •r r►••r •►►r r r r►►►►1►►r►r►r►►►r►r r ►r►• 8723 S.W. 129tH Terrace/Miami, Florida 33176/(305) 251-1279/Fax: (305) 251-3877 Proposal 5, J77- , F. '4... ./" '' •�., ttstey,�i f to ci •t_:ax r•�a. a_ — t � \\ ��L���1 We hereby summit specifications and estimates]for: 6 inch aluminum continuous gutter. Giza) _F_ _ ► - ' AUG 1A 2015 J � (• .t �' filly • ••• . •••••• Il •• :600:6 •00 • • •00.00 •• . .� • •0900• 0000•• •0 • 0 000 :0000: 0 0 • • • GUARANTEE: I YEAR LABOR 10 YEARS MATERIAL INSTALLATION DATE: FOOTAG : r. r Total -_.. Deposit SdI Balance S Extras Authorized Signature Date c , S• Client Signature TERMS ON THE REVER SIDE A PART OFT IS ROPOSAL ORDER CANCELLATION AFTER 3 DAYS: $50.00 ADMINISTRATION FEE PLUS PERMIT CHARGES $25.00 FEE FOR ANY RETURNED CHECKS CLIENT COPY