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RC-15-1931
Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-245822 Permit Number: RC-7-15-1931 Scheduled Inspection Date: October 22,2015 Permit Type: Residential Construction Inspector: Rodriguez,Jorge Inspection Type: Final Owner: RIVERO,ARIANNA Work Classification: Repair Job Address:280 NE 95 Street Miami Shores, FL 33138-2712 Phone Number Parcel Number 1132060133710 Project: <NONE> Contractor: RAUSA BUILDERS INC Phone: (305)554-5711 Building Department Comments SANDING AND POLISHING WOOD FLOORS Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-240350. CANCELLED BY ALFONSO 786-237-5154 Failed Correction ❑ Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid. October 21,2015 For Inspections please call: (305)762-4949 Page 19 of 55 R, 115 Miami Shores Village 00 + #d4nitial Gonist#"u'otit tl 10050 N.E.2nd Avenue NE Vi+ (�M$sFPrcafrdr. op "•• "" Miami Shores,FL 33138-0000 t F'#-V1f `t4iWS APFO. ED z � Phone: (305)795-2204 UR 31120'i:i . _ Expiration: 02/27/2016 Project Address Parcel Number Applicant 280 NE 95 Street 1132060133710 ARIANNA RIVERO � Miami Shores, FL 33138-2712 Block: Lot: Owner Information Address Phone Cell ARIANNA RIVERO FL 110 SW 12 Street MIAMI FL 33130- Contractor(s) Phone Cell Phone Valuation: $ 1,500.00 RAUSA BUILDERS INC (305)554-5711 (305)970-7253 __............... .. _.,,, Total Sq Feet: 200 Approved:In Review Available Inspections: Comments: Inspection Type: Date Approved: :In Review Final Date Denied: Review Electrical Type of Construction:SANDING AND POLISHING WOOD Occupancy:Single Family Review Electrical Stories: Exterior: Review Building Front Setback: Rear Setback: Review Building Left Setback: Right Setback: Bedrooms: Bathrooms: Plans Submitted:Yes Certificate Status: Certificate Date: Additional Info: Bond Return: Classification:Residential Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 Invoice# RC-7-15-56542 DBPR Fee $2.00 DCA Fee $2.00 07/30/2015 Check#:13799 $50.00 $66.20 Education Surcharge $0.40 08/31/2015 Check*13896 $66.20 $0.00 Permit Fee $100.00 Scanning Fee $9.00 Technology Fee $1.60 Total: $116.20 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_4y either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WI S,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoi �in ation is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize ve-named contractor to do the work stated. August 31, 2015 Authorized Signature:Owner / Applicant / Co tractor / Agent Date Building Department Copy August 31,2015 1 Miami Shores Village g JUL 3 0 2015 Building Department . g p �Y 60 1 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 > Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 F B C 20 BUILDING Master Permit No. PERMIT APPLICATION Sub Permit No. ro-IBUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 280 ne 95 st City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 11-3206-013-3710 Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder):ARIEL EXPOSITO &ARIANNA RIVERO phone#: Address:280 ne 95 st City: miami shores State: florida Zip: 33138 Tenant/Lessee Name: ARIEL EXPOSITO &ARIANNA RIVERO Phone#: Email: CONTRACTOR:Company Name: RAUSA BUILDERS CORP Phone#: 305-554-5711 Address: 7111 SW 42 ST City: MIAMI State: FLORIDA Zip: 33155 Qualifier Name: NELSON HERNANDEZ Phone#: 30255545711 State Certification or Registration M CGC1510038 Certificate of Competency M DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ Square/Linear Footage of Work: ZOO Type of Work: ❑ Addition [F Alteration ❑ New r Repair/Replace El Demolition Description of Work: '5""dll4.t'c C"—d k lk M)Ll 19Y/VC-d 1P Icr,;(L!�k Specify color of color thru tile: Submittal Fee$ 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$ h, (Revised02/24/2014) 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 t ttachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspectionw occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be ap r e and a reinspection fee will be charged. Signature Signature OW4 ER or AGENT CONTRACTOR The for going instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of 20�� by day of 0 20 1� by Ga ``__ who is personally known to k'4�sc �'y�nrT"�-7 who is personally known to me or who has produceal ID as� me or who has produced as identifica i n and who did take an oath. identificatk and who did take an oath. NOTARY NOTARY PU S n: Sig Print: tate of Florida Print: 01 �3 . nd�,: _-75 }� Seal: v i� �r 1Ec275 Seal: sr ?, �:.�"ovgv. �,,,.�q�u , .a,aa_ ,a'.-�.�r,,c:^-`,�''y3at;;�:.M�,��; __ �r-:�� . ',r":'w ., y,.. _- .• _i=. IL APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) 5t1Otc-193,2 0RFS G�! ..•. .....� Miami shores Village Building Department RIDA 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. X COPY OF QUALIFIER'S STATE LICENCES B. X COPY OF LOCAL BUSINESS TAX RECEIPT C. X COPY OF LIABILITY INSURANCE* D. X COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES,FL 33138 Certificate must specify the description of operations or contractor license number. ........................................................................................... BUSINESS NAME: RAUSA BUILDERS CORP BUSINESS ADDRESS: 7111 SW 42 ST CITY MIAMI STATE FL Zip 33155 BUSINESS PHONE: 3( 05 ) 554-5711 FAX NUMBER 7( 86 1 558-7290 CELL PHONE(-305 ) 970-7253 QUALIFIER'S NAME: NELSON HERNANDEZ QUALIFIER'S LIC NUMBER: CCC1329860 AND CGC1510038 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850)487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 HERNANDEZ, NELSON RAUSA BUILDERS CORP. 7111 SW 42 STREET MIAMI FL 33155 Congretulationsl With this licenseyou lime one ofdie nearly one million Floridians lic ensed by the Department of Business and Professional Regulation. Our professionals and businesses range STATE OF FLORIDA from architects to yacht brokers,from boxers to barbeque restaurants, and they keep Florida's economy strong. DEPARTMENT BUSINESS AND PROFESSIONALL REGULATION Every day we work to improve dre way we do business in order to CGC1510038/' ISSUED., 08/03/2014 serve you better. For irnformation about our services,please log onto 14: www.myfloddalitertse.com. There you can find more information CERTIFIED GENERAL C'OWRACTOR about our divisions and the regulations that Impact you,subscribe HERNANDO�,NELSON to department newsletters and learn more about the Departmenfe Initiatim � RAUSA BUILDERS CORE Our misson at the Department Is:License Effidently,Regulate Fairly. constantlyWe Thank you br doing business Ibetter so nnFloyou can ride ��your { I$CERTIFIED under the or customers. ovlsbne of Ch,489 FS. and congratulations on your new licensel E dam:AUG 31,2MG ems+ DETACH HERE RICK_SCOTT,_OOVERNOR KEN LAWSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD qt wC1btoD38 The GENERAL CONTRACTOR Named below IS CERTIFIED we Under the provisions Df Chapter 489 FS. Expiration date: AUG 31,2016 HERNANDEZ, NELSON b • RAUSA BUILDERS CORP. Y 7.111 SW 42 STREET _ r MIAMI - FL 33155 0� d 001498 Local Business Tax Receipt Miami-Dade County, State of Florida -THIS IS NOTA BILL - DO NOT PAY ILBT./ 5681128 BUSINESS NAMWLOCATION RECEIPT NO. EXPIRES RAUSA BUILDERS CORP KNEWAL SEPTEMBER 30, 2016 7111 SW 42 ST 5925475 Must be displayed at place of business MIAMI FL 33155 Pursuant to County Cade Chapter 8A-Art 9&10 SEC.TYPE OF BUSINESS OWNER SEC. RECEIVED RAUSA BUILDERS CORP 196 GENERAL BUILDING CONTRACTOR BY TAX COLLECTOR Worker(s) 1 CGC1510038 $75.00 07/01/2015 ECHECK-15-156207 This Local Business Tax Receipt only am firms payment of the Local Business Tan.The Receipt Is not a Ilrense, or nongovernmental�regor a aof the ulatory laws,and requirements which apply the businHoWer ess. vriffi any governmental The RECEIPT N0.ohm must be displayed on all commercial vehicles-Waral-Bads Code Seo go-= For mom hdormadon.visit 002636 Local Business Tax Receipt Miami-Dade-,County, State of Florida -THIS IS NOTA BILL - DDNOT PAY \.LBT_�/ 6973953 BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES RAUSA BUILDERS CORP REMAL SEPTEMBER 30, 2016 7111 SW 42 Sr 7249584 Must be displayed at place of business MIAMI FL 33155 Pursuant to County Code Chapter 8A-Art 9&10 OWNER SEC.TYPE OF BUSINESS PAYMENT RECBIVED RAUSA BUILDERS CORP 196 SPECIALTY BUILDING CONTRACTOR BY TAX COLLECTOR Worker(s) 2 CCC1329860 $75.00 07/01/2015 ECHECK-15-156208 This Local Business Tax Receipt only cad ms payment of the Local Bushes Tax.The Receipt is not a Rlxasa. permit,ora certilicadom of the holders ualRicatlsne,b do begins=Holder moat comply with ani govemmwMal W nomgovermnealal regulatory laws and requirements which apply to the been$= The RECDPT N0.above must be displayed on a0 commercial vehicles-Miami-Oahe Code See go-M For more information,visit wmiamidada.aarftaxcollector ATE ACORD. CERTIFICATE OF LIABILITY INSURANCE 007/23 /20 51 PRODUCER 305-227-0082 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION CAROLINA INSURANCE CONSULTANTS ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE $250 W FLAGLER STREET,STE 116 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. I MIAMI,FL 33144 INSURERS AFFORDING COVERAGE INSURED INSURER A: SENECA SPECIALTY INSURANCE COMPANY MUSA BUILDERS CORP. INSURER e: 7111 SW 42ND STREET INSURER C: MIAMI, FL 33155 INSURER 0: INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRID TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE IMMIDDIM LJb117S GENERAL LIABILITY EACH OCCURRENCE 5 1,000,()00 A COMMERCIAL GENERAL LIABILITY BAK-3631944 10/07/2014 10/07/2015 FIRE DAMAGE(Any one fire) $ 100,000 CLAIMS MADE FX OCCUR MED EXP(Any one person) S 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGO S 2,000,000 POLICY PRO- LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMB ANY AUTO (Ea accident) S ALL OWNED AUTOS BODILY INJURY i SCHEOULEDAUTOS (Perperson) S HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) 5 PROPERTY DAMAGE S (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE S I OCCUR FICLAIMS MADE AGGREGATE $ i S DEDUCTIBLE $ RETENTION 5 S A - OTH- ! WORKERS COMPENSATION AND TORY LIMITS R EMPLOYERS'LIABILITY E.L.EACHACCIDENT S i E.L.DISEASE-EA EMPLOYEq S E.L.DISEASE-POLICY UMTF S OTHER t DESCRIPTION OF OPERATIONS!LOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECI4L PROVISIONS STATE LICENSE#CGC1510038 j CERTIFICATE HOLDER X ADDITIONAL INSURED:ENSURER LETTER CANCELLATION. __ .... . .._... .... . ... ... SHOULD ANY OF THE ABOVE DESCRIBED-- -- - -- - � POLIOS BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN MIAMI SHORES VILLAGE BUILDING DEPARTMENT NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL – 1005O NE-2–AVE–NUE IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS ENTS OR —. ... k MIAMI SNORES,FL 33138 REPRESENTATIVES. --------------------------------—...AUTHORIZED REPRESENTATIVE--------------------....------ -- - i ACORD 25-S(7197) ®ACO TION 1988 I CERTIFICATE OF LIABILITY INSURANCE 7107/23/2015 TE(MM/DD/YYYY) 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 lies)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: PHONE A/C,No,Ext): 1-800-277-1620 x4800 FAX AIC,No): 727 797-0704 FrankCrum Insurance Agency,Inc. E-MAIL ADDRESS: 100 South Missouri Avenue INSURER(S)AFFORDING COVERAGE NAIC# Clearwater,FL 33756 INSURER& Frank Winston Crum Insurance Co. 11600 INSURED INSURER B: INSURER C. FrankCrum L/C/F Rausa Builders Corp. INSURER D: 100 South Missouri Avenue INSURER E: Clearwater FL 33756 INSURER F: COVERAGES CERTIFICATE NUMBER: 321281 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAME 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSRD WVD (MM/DD/YYM (MM/DDAYM GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES(Ea=.) $ CLAIMS-MADE =OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY 71 PROJECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ a acxitleM ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per aoddent) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION AND WC201600000 01/01/2015 01/01/2016 XWC'LIM.ORv R E'R A EMPLOYERS'LIABILITY Y/N IMRS E ANY PROPRIETOR/PARTNER/EXECU nVE OFFICERIMEMBER EXCLUDED? 0 N/A E.L.EACH ACCIDENT $1,00,000 (Mandatory in NH) If yes,describe under E.L.DISEASE-EA EMPLOYEE $1,0D0,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMB $1,0DO.D00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks,Schedule,if more space is required) Effective 05/16/2015,coverage is for 100%of the employees of FrankCrum leased to Rausa Builders Corp.(Client)for whom the client is reporting hours to FrankCrum.Coverage is not extended to statutory employees. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shore Village Building Department AUTHORIZED REPRESENTATIVE 2nd Avenue Miami Miami Shores,FL 33138 ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD