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RF-15-3126 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-250189 Permit Number: RF-12-15-3126 Scheduled Inspection Date: December 31,2015 Permit Type: Roof Inspector: Rodriguez,Jorge Inspection Type: Final Owner: CRAPP,TONY AND BEATRICE Work Classification: Gutters Job Address:9304 N MIAMI Avenue Miami Shores, FL Phone Number Parcel Number 1131010340170 Project: <NONE> Contractor: RAIN GUTTERS SOLUTIONS INC Phone: (305)270-7779 Building Department Comments INSTALL RAIN GUTTERS IN THE BACK OF THE HOUSE Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-249554. Complete permit package must be on site Downspouts must extend 12" min from house Failed Correction ❑ Needed Re-Inspection a Fee No Additional Inspections can be scheduled until re-inspection fee is paid. December 30,2015 For Inspections please call: (305)762-4949 Page 8 of 10 Miami Shores Village 11t i y f 10050 N.E.2nd Avenue Nry 44 " � Miami Shores,FL 33138-0000 ` Phone: (305)795-2204 ` u'r as$u�ila 922t20'I� Expiration: 06/19/2016 Project Address Parcel Number Applicant 9304 N MIAMI Avenue 1131010340170 TONY AND BEATRICE CRAPP Miami Shores, FL Block: Lot: Owner Information Address Phone Cell TONY AND BEATRICE CRAPP 9304 N MIAMI Avenue MIAMI SHORES FL 33150-2244 Contractor(s) Phone Cell Phone Valuation: $ 450.00 RAIN GUTTERS SOLUTIONS INC (305)270-7779 (786)718-8393 Total Sq Feet: 110 Type of Work:Gutters Available Inspections: Additional Info:INSTALL RAIN GUTTERS IN THE BACK OF Inspection Type: Classification:Residential Final Scanning:3 Review Building Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 DBPR Fee Invoice# RF-12-15-58095 $2.00 12/17/2015 Check#: 1040 $50.00 $64.60 DCA Fee $2.00 Education Surcharge $0.20 12/22/2015 Check#:1044 $64.60 $0.00 Permit Fee-Repairs $100.00 Scanning Fee $9.00 Technology Fee $0.80 Total: $114.60 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is ccurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the above-nam ontr or to do the work stated. December 22, 2015 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy December 22,2015 1 Miami Shores Village RECEIVED Jl� Building Department DSC 17 2015 10050 N.E.2nd Avenue, Miami Shores,Florida 33138 BY: Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20/-<— BUILDING Master Permit No;4eQ5__ �l3 PERMIT APPLICATION sub Permit No. BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 133 Li Av-c w+ City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: �t o Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): CYc VV_,S:v,_ Phone#: Address: 93OL( M- yc," City: v®tenv-�` �k"1's State: �� Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: i' `� �!/ eP�S� S,o/U 701/0" Z;IC- Phone#: 3®S-2 90 Address: .S�e-f� 51y 41e / City: 14(4 vn / P, State: l� Zip: Qualifier Name: zli;"�!>S �C/lt do Phone#:7 S'6 7Z 9.2 3 9J� State Certification or Registration#: � �L/$� Certificate of Competency#: 1 V 84q'n e)1!f_1 DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ �-�® Square/Linear Footage of Work: I' Type of Work: ❑ Addition ❑ Alteration ❑ New ® Repair/Replace ❑ Demolition � Description of Work: 5'141io , i"C,dj i ro/u &ej,2 Z7i 7XQ &O-A- lo '7L,e do Specify color of color thru tile: Submittal Fee$ Permit Fee$ a '' CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (RevisedO2/24/2014) T 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 'tea Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this �day of b2P*I heAl ,20 t-c ,by 16 day of � .20 f" .by fJ E/ E C&A P J9 ,who is personally known to :2 U s PURL) w o is pers_Qon_ally know o me or who has produced EL 6 L as me or who has produced as identification and who d' take an oath. identification and who did take an oath. NOTARY PUBLIC• NOTARY PUBLIC: Sign: Sign: Print: 1� (. +f Print: 3 ed ")1 ak Seal: �pN ..P'k, USSETBETAMRT Seal: a°pP,.��;fie`% LISSETBETAMRT MY COMMISSION#FF 07493 * * MY COMMISSION t FF 074893 * * EXPIRES:Jouaty 19,2018EXPIRES:January 19,2018 ms's e�O` SondedTlvuSu�etNomryServtcea SordeOnSudg ft"Seftes �Fpp�0 ■*��*�*��**�����t�*�t*�**�m�x�xwix**w�*m*�***a�*a�t���*m�xwa���*�x*�+�*�x***�**��*��x*�*******�********�**�*�x��*�*****�x��* APPROVED BY �Z �� �� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) OR t t� ` .•. •....1-931 Miami Shores Village Building Department �l 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. COPY OF QUALIFIER'S STATE LICENCES B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE* D. 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._1,9<COPYOF 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: R41 r7 BUSINESS ADDRESS: 50 a J �� 117TCITY���� l STATE ZIP ?3 /?3 BUSINESS PHONE: LL05 .- :7® ��7�®/' FAX NUMBER�) CELL PHONE(�1 :217 53 73 QUALIFIER'S NAME: U !>/e 6/i t� S QUALIFIER'S LIC NUMBER: / Local Business Tax Receipt Miami-Dade County, State of Florida THIS IS NOTA Biu-DO NOT PAY 7184685 [LB T Q4611NESS NAWLOCAiTION RECEIPT NtO. EXPIRES RAIN currE s st�LuTla INC RENEtil+t,� SEPTEMBER ®; 2x96 5845 sw 117 AVE MIAMI,FL 33'183 7465445 Must be displayed at place of business Pursuant to GountyCodo Chapter 8A-Art.9&I o OW,�R �`' SEC.T�Y�+E OR SUISINESS PAYMENT ECEINEI� RAIN GUTTERS SOLUTION INC'i ; 196 � " SPECIALTY BUILDING By Tax T 00CEI E C/6 JESUS M PULIDb PRES CON-*- OR r�TOR 78;00 (19/04/20 5." f Worker(s) �t 1 '�" 15BSGIOI14 0226-15-00$616 This Local Business Tax Rece*only con firms payment of the Local Busiaess-Tax:The Receipt is not a license; permit,are certification of the holder's qualtdia oris,to do business,Holder most comply with airygovernmental or nongovoanme►tai regulatory laws and r' draments Which apply�the buslaa l The RECIi1PT id0. ve mast be displayed"on allicommercial vablales-Miami-Bade Code Soj 8a-M MiaM4 imak—'_ For more hdo�matlon,visitvaww.miamrdade g-omk ccollecwr r� r " M unici pal Contractor's Tax mei pt Miami-Dade County, State of Florida -THIS IS NOTA BILL-DO NOT PAY r C. (;1r NO: 1589001'"14 BUSINESS NAM E&OCATION RECEIPT NO. EXPIRES RAIN GUTM7S SDUJTIONI INC11 S E P T E R S, D $845 St117 Aim" 7471345 ; 16 MIAMI,R. 33183 Pursuant to County Code pea 10-24 OWNER � TYPE;OF BUS1NE,S$_ J"- i T�iN GUTrERSSDl6J'fION INC", S?'F IALTY ING Co1dTlPCTt kR PAYM E,SaT,RECEIVED BY TAXA C;OLLECtOR "'- CJO,ESl1S M PULI70 175.00- 09/0 /201 0228-1}5-005618 We receipt isrj,validinthe fdlMunicipalhies:. Dwal-Aw-i, Bi . Alllaad,',t ,Miami;Lakes,P�irr to t ayp Pirreprest, I$Iss mit.Town of LLUe�Bay. Mian Porrnore information,vi_t a { r r Tra � e Qlt Gt t ER 1 tFW ATE OF 90MC BUSINESBC elf TRAIN GUV S Std-UTK�1NO i P D.B.I mANUEL is mi hied under the pr�ovisllu�: of Chapter�0 oAiaa►7=Dade Codes JEFF ATWATER 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 certifies that the individual listed below has elected to be exempt from Florida Workers'Compensation law. EFFECTIVE DATE: 3/26/2015 EXPIRATION DATE: 3/25/2017 PERSON: VAZQUEZ-VALDIVIE GIRALDO FEIN: 461388838 BUSINESS NAME AND ADDRESS: RAIN GUTTERS SOLUTION INC 5905 SW 117TH AVE MIAMI FL 33183 SCOPES OF BUSINESS OR TRADE: SHEET METAL WORK- INSTALLATIO Pursuant to Chapter 440.05(14),F.S.,an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter.Pursuant to Chapter 440.05(12),F.S.,Certificates of election to be exempt..apply only within the scrape of the business or trade listed on the notice of election to be exempt Pursuant to Chapter 440.05(13),F.S.,Notices of election to be exempt and certificates of election to be exempt shag be subject to revocation if,at any time after the filing of the notice or the Issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate.The department shag revoke a DFS-F2-OWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS?(850)413-1609 9P015 ReportViewer ........ . ......_, o JEFF ATWATER 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 certifies that the individual listed below has elected to be exempt from Florida Workers'Compensation law. EFFECTIVE DATE: 3/23/2015 EXPIRATION DATE: 3/22/2017 PERSON: PULIDO JESUS M FEIN: 461388838 BUSINESS NAME AND ADDRESS: RAIN GUTTERS SOLUTION INC 5845 SW 117 AVE MIAMI FL 33183 SCOPES OF BUSINESS OR TRADE: SHEET METAL WORK- INSTALLATIO Ftaeuant to Cte�440.�(1'q.F.S.,an officer of a capora8anvfio elects exenpdon frorn iFUa tllirg a axtlac�a oretadion u�tree aecfion mey r�recover bete8la or ocmpereetlon oder tlis chi F�asuar4to Chita 440.0C{t�.F.S.C tales of electlan to be exenP�..�Y aNY wltFdn the�of Gia dlsiness ar tr�liated m6isss�Wro�tica of dectlan to bs mcenpt Hrevm�t to Cuter 440.05(1 .F.S„NOBces ofelec9anto ba m�anpt and �ne�tle rgtice or mEer�er�rolmgan�sthe regWrene�oft ua tlxcBonior�lasuar�ice cG'acatiemte.'nedeperuneN ahal rav�acer6fl�eat DFS-F2 DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS?(S50)413-1809 haps:I/appsStcb.cwnkrreporMmw/r /iewer.aspx?data=kdvpglrcgD703gH6TER6eP1KMZ%2FSzV XKYfBxkr SoPVy1v4NPOPN42XeirDRGXWV... 1/2 12/14/2015 MON 13: 21 FAX @Tool/ool ` • Q4 •SIC R>tJ CERTIFICATE OF LIABILITY INSURANCE DATE(MMIODNYYY) 12/14/15 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 po(Icy((es}must be endorsed. If SUBROGATION IS WAiVEp subject J t 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: GRICEL GONZALEZ PH NE FA% G E Insurance Consu(tants.)nc. ff,0,No,Ext):. .{305)228-8988 (ac No}:. (305)228-8969 9880 S.w.40th Street E-MAIL ... . ...... .. . grice15620Qcomcast.net Miami,FL 33165 �nlsuRER(synFr o>:DING covEw►cE Phone (305)228-8988 Fax (305)228-8969 .......... INSURER A:. GRANADA INSURANCE COMPANY la INSURED ................................. .... ... ............ : INSURER 8; I IN GUTTERS SOLUTIONS INC " "•"' ' •- - ..INSURER C:• 5845 SW 117 Ave �n1suRER D;.. Miami,FL 33183- (786)718-5393 .................................. ... . tNsIIRERE:.,.. __....................................................... ..... ...... ...... .. ... INSURER F COVERAGES ........................... — CERTIFICATE NUMBER: REVISION NUMBER: _ THIS lS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN 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. iLggAD LSt18R.............................. .. ....... .. Tj2......... TYPE OF INSURANCE D POLICY EFF POLICY EXP ;(NAli:Wy0.......................POLICY NUMBER.. . .... ...:.(MMID�/YYYY)..IMMtDDM1CY)........................ LIMITS GENERAL LIABILITY ..... .. ............: EACH OCCURRENCE _ $ 1,000,000.00 h(: COMMERCIAL GENERAL LIABILITYD-Al�'GE TO REEK£— $ 100,000.00 7. PREMISES c@} CLAIMS-MADE OCCUR a ofputren.. A Y 0185FLOODSO964 MED ExP(any one person) $ 5,000.00 +! 07/09/2015 07/09/2016 ' " ' ............. PERSONAL 8 ADV INJURY $ 1,000,000.00 GENERAL AGGREGATE $ 2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: PRO- PRODUCTS-COMP/OPAGG' $ 2,000,000.00 ...... JEC7...........: IOC....... i........;. AUTOMOBILE LIAatUTY . L� - i..... ANY AUTO [ BO _ _......._ n. B1NED SINGLE LIMIT AUTOS NEO SCHEDULED aDaxident)......,.. . 5 ` Y(Par HIRED AUTOS NON-OWNED UTOS BODILY INJURY(Per Person) .....: AUTOS OPER�AMAGtEa ..... dent) ar a,_. enl 5 :................_._:............................ .... i UMBRELLA UAe ;OCCUR _....... �.:::r EA EXCESS LIAR a CN OCCURRENCE ? $ i _......_.....................__................:.::-::_CLAIMS-MADE -....... ............. ... .__........,.._........ ..................................... AGGREGATE ...1 ..................................................:..$. i DEO RETENTION$ i WORKERS COMPENSATION '-- -----•----._:......................._...._.:.........._.....-- -•-•—• C TA1T._......___.-.H_�$._.....-•-_.._.,_.,____.—, AND EMPLOYERS'LIABILITY Y/N : W ttY (MIT OT . ANY PROPRIETOR/PARTNER/EXECUTNE - "Tp"'L `:' .................... OFFICEPJMEMSEREXCLUDED? E.L.EACH ACCIDENT ' $ (Mandatory in NH) . !t es,descnbe under ......... DESCRIPTION OF OPERATIONS below -�.............--._....,.. ............... I EASE-Fly EMP .........................._............................._. E.L.DISEASE-POLICY LIMIT'. $ .....-................................,...,......__...__..._._....... ...... ............:...... :. DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(AKach ACORD 181,Additional RemarksSchedule,If more space is required .... •.' """""""""""' 4 ) GUTTERES INSTALLATION AND REPAIR LIC#15BSOOI14 I i ......................................................._....._.._..._.................................... . CERTIFICATEHOLDER _..._._............_...._...................................._................................................................................................................,.....,.............._......................_............_..._.................................. . ............_..._.............._.............................. CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE MIAMI SHORE VILLAGE BUILDING DEPT THE EXPIRATION DATE THEREOF.NOTICE WILL BE DELIVERED IN CANCELLED BEFORE 10050 NE 2 AVE ACCORDANCE WITH THE POLICY PROVISIONS. MIAMI SHORES FL 33138 AUTHORIZED REPRESENTATIVE ........ ................ ......... ... ............_................ 1 i ....................................... ............................._.._._....._....................._. ACORD 25(2010/06)QF © -2 1 ACORD CORPORATION. All rights reserved. The ORD name and logo are registered marks of ACORD SY; Rs n Miami shores Village Building Department tOR1pA 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner - Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees,including the owner,must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if- 1. f:1. The officer owns at least 10 percent of the stock of the corporation, or in the case of an LLC,a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State,Division of Corporations;and 3. The corporation is registered and listed as active with the Florida Department of State,Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption and has acknowledge that he or she will not use day labor,part-time employees or subcontractors for your project.The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project.In these circumstances,Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company for day labor,part-time employees or subcontractors. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: Own r State of Florida County of Miami-Dade The foregoing was acknowledge before me this /& day of e4l ,20 By !a who is personally known to me or has produced Cas identification. Notary: SEAL: otP�`:°veno USSETOETANC0W • ''« *MY COMMISSION#FF 074893 * EXPIRES:JOU"19,2018 sr •�` BondedThruBud9elNotaryservices OF Property Search Application-Miami-Dade County Page 1 of 1 OFFICE OF THE P APPRAISER Summary Report Generated On:12/16/2015 77monow- Property information Folio: 11-31014)34-0170 u Property Add res :s9:104 N MIAMI AVE x r Miami Shores,FL 331 -2244 Owner TONY E CRAPP&W BEATRICE H ;_ rt 9304 N MIAMI AVE - Mailing Address MIAMI SHORES,FL 33150-2244 Primary Zone 1000 SGL FAMILY-2101-2300 SQ Prim Land Use 0101 RESIDENTIAL-SINGLE FAMILY:1 UNIT ' Bads I Baths/Half 2/2/0 Floors 1 Living units 1 - Actual Area Sq.Ft r ,' otography : Living Area Sq.Ft Adjusted Area 2,715 Sq.Ft Taxable Value Information Lot Size 14,040 Sq.Ft 20151 20141 2013 Year Bunt 1851 County Assessment Information Exemption Value $50,OWI $50,000 $50,000 Year 2015 2014 2013 Taxable Value 1 $88,2801 $87,1831 $85,156 Land Value $217,007 $179,628 $120,444 School Board Building Value $180,827 $176,473 $176,789 Exemption Value 1 $25,000 $25,000 $25,000 XF Value $1,667 $1,668 $1,670 Taxable Value 1 $113,2801 $112,1831 $110,156 Ma*d Value $399,501 $357.769 $2 ,903 CRY Assessed Value 1 $138,2Wl $137,1831 $135,156 Exemption Value $50,000 $50= $50,000 Taxable Value $88,2801 $87,1831 $85,156 Benefits Infor n ttlon Regional Benefit Type 2015 2014 2013 Exemption Value $WWOI $50,OWI $50,000 Save Our Homes Assessment Taxable Value $88,280 $87,183 $85,156 Cap Reduction $261,221 $220,586 $163,747 Homestead lExernplion I $25,000 1 $25,0001 $25,000 Sales Infornation Second Exemption $25,000 $25,000 $25,000 Previous Sale Price OR Book-Page Qualification Description Homestead 03/01/19W $98,000 14513-0103 Sales which are qualified Note:Not all benefits are applicable to all Taxable Values(i.e.County, 06/01/1974 $67,500 Sales which are qualified School Board,City,Regional). Short Legal Description MIAMI SHORES SEC 6A PB 12-54 LOTS 4&5 BLK 168 LOT SIZE 108.000 X 130 OR 15413-103 03901 The Office of the Property Appraiser is continually editing and updating the tax roll.This website may not railed the most current information on record.The Property Appraiser and Miami-Dade county assumes no liability,we full declaimer and User Agreement at htipjmww.miamdade goviinficidsciatmer asp http://www.miamidade.gov/propertysearch/ 12/16/2015 y M AV uo . OFFICE: 305.270.7779 11 AW CELL: 786.718.5393 Rain Gu e S O L U T 1 O rainguttersolution.jp@gmail.com 5845 SW 117th avmiami fl. 33183 Name Estima a Da e 0 Y A9 d,4 A Ve Address Scheduled Date DEC City - State - Zip Coe Referral ..?cam _-�Sys CA/9 Home Phone Work / Office ❑Lo Gloss White ❑Linen [:]Almond ❑ Ivory ElClay MATERIALS kArl High Gloss White ❑Eggshell ❑Cream ❑Wicker ❑ Coppertone ❑ Red ❑GALVANIZED El Musket Brown ❑Terratone ❑Royal brown ❑ Sandcastle ❑ Bronze ❑ Green ❑COMM ❑ Pearl Gray ❑ Colonial Gray ❑ Blue ❑ Black ❑Tuxedo Gray ❑ Dark Gray 10 ALIMINIUM i 1 _ . s , ' �s � / 4_57 o----- .�- .... I _– ---. ' —--n �r -.. _. . r ! .. ._....__....._o..........__ B`i' € DA I ZONING bEPr �.:a.. m t � — i BL[)G 05 �..._.. •.. ! SUBJECT (0 CGa1Pt'10NCg NTH J� ALL FE iAI. ••.• ..•. ,............ • i F •• ,•• _.. A3 tEeast• ATE ANL)ICUNCULAT _..... 0RlS _ ...• ... . ..._ L._.. 000460 • • • • 1ULI�ER FEET • � •�•••� ••� � LEAD HEAD bmvN SPOl1T FEET,**,,�• AMOUNT $ •••••• •• RAIN CHAINS LESS DEPOSIT $ �WARRANTUA-4011 - ✓ MATERIAL 2W "-,IV TOTAL DUE $ In event it becomes necessary for RAIN GUTTERS SOLUTION INC.,to employ theservices of an Attorney,to effect collection of the ammount or balance due under this contract,purchaser agrees to pay seller's reasonable attorney's fees and all expenses incident th eto.when executed and asigned by both parties.This proposal becomes a contract.11j C stonier s Signature Rain Gutters Solution Inc 'Wefhreciafe,yours business 1