RC-15-1578 Inspection Worksheet
Miami Shores Village
90050 N.E.2nd Avenue Miami Shores,FL
Phone:(305)795-2204 Fax:(305)756-8872
Inspection Number: INSP-259726 Permit Number: RC-6-15-1578
Scheduled Inspection Date: May 26,2016 Permit Type: Residential Construction
Inspector: Mesa,Michel
Inspection Typr—
Owmer: HOFFMAN,SAGE Work Classification: Repair
Job Address:55 NW 94 Street
Miami Shores,FL 33150- Phone Number
Parcel Number 1131010340120
Project <NONE>
Contractor. AAA PLASTERING&DRYWALL INC Phone: (786)236.0034
Building Department Comments
RE-PLASTERING EXISTING HOUSE AND GUEST Infractio Paned Comments
HOUSE PRESSURE CLEANING CHIPPING AND INSPECTOR COMMENTS False
PLASTERING ALL WALLS AREAS.
04-25-2016
This permit was on hold pending the completion of the roof.
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP 257695. CREATED AS
REINSPECTION FOR INSP 237632. Need to paint the entire house prior to
obtaining a final approval.
Failed El
Correction
Needed
Re-inspection
Fee
No Additional Inspections can be scheduled until
re-inspection fee Is paid
k'�)
May 25,2016 For Inspections please call:(305)762-4949
Page 35 of 38
04/25/2016 15:51 FAX 3052420779 AAA PLASTERING/DRYWALL IM 002
P� 1,r= 1�-
ACUR" CERTIFICATE OF LIABILITY INSURANCE °A'E�
4/14/2016
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 ISSULNG INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER
IMPORTANT: if the certificate holder Is an ADDITIONAL INSURED,the pollcy(in)must be endorsed. If SUBROGATION IS WAIVED,subject to
the terms and conditions of the policy,certain policies may require an ondorserrrent. A statement on this certificate does not confer rights to the
certificate holder In Hsu of such endorsement(s).
PRODUCER YOrdanka Marrero
Kaes Saul® Mead & Company -me (305)558-1101 Npk
(305)922-4722
7850 Northwest 146th Street .ymarrero®kbmao.eom
Suite 200 I SU AFFORDING COVERAGE NAIC0
Miami Lakes FL 33016 lN9UR9RA:Libertv Insurance Underwriters
MSU IN9URER s thio SecurikE Insurance Canymm
AAA Plastering b Drywall, Inc. wounRcOrldaefield Emlovers Ins Co
18425 SIP 267 Street INSURER D.,
INSURER E
Samestead FL 33031 WBUIIIER F:
COVERAGES CERTIFiCATENUMSER16/17 WC,G;L,A= 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.
IiISR TYPE OF INSURANCE ap POLICY NUM ER FF LIMBS
X COMME RML GENERAL LIABILITY EACH OCCURRENCE g 21000,000
A CLAI S MADE ®OCCUR Oong, t 100,000
OrM03035-0215 4/13/2016 4/13/2017 NED EXP $ 51000
PERSONAL&AM INJURY $ 1,000,000
GiNLAGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE E 2,000,000
g POLICY JECT ❑LOC PRODUCT'S-C.OMPIOPAGG i 2,000,000
OTHER: $
AUTOMOBILE LIABILITYW.MN'dW8 1,000,000
8 S ANY AUTO BODILY INJURY(Per person) 3
AUTOS O SCHEDULED SA8 (17) 56041704 4/13/2016 4/13/2017 BODILY INJURY(Peraoai $
HIRED AUTOS AUTED
GE
MedWoermoft
Is 5,000
UNBRur J w LUUIOCCUR EACH OCCURRENCE Is
EXCESS UAa HWIMS-MADE AGGREGATE Is
D I I RETENTIONSs
11FORKER8 COMPENSATNIN x
ANO�LOYEIRB'LIABLITY
ANY PROPRIETOR/P�UTNE YIN EJ_EACH ACCIDENT $ 100,000
C Wa inum)p(CtUpFD7 N t A 0830-33794 3/4/2016 3/4/2017 E.L DISC-EA Eppel 6 100 000
I dea fteunder
D96=014 OF OPERATIO below EL DI -POLICY LIMIT 1 $ 500
1000
DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES IACORD 101,AddNond R sSeheduI%nay be dt,uhad N more
gpne is rMArgo
General Contractor - Plastering Contractor / Drywall Contractor
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Miami Shores Village THE EXPIRATION DATE THEREOF, NOTICE WILL BE DE3LPARE'sD IN
Building Department ACCORDANCE WiTH THE POLICY PROVISIO Ni&
10050 NX 2 Ave.
Miami. Shores Villag, FL 33138 AUTHOR2EDREPREMWrA7NE
Alex Perez/YMA
®1988-2014 ACORD CORPORATION. All rights reserved.
RD 215(2014101) The ACORD name and logo are registered marks of ACORD
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perrnff l'to. RC-6-15-1578
Miami Shores Village Permit Type:ReSid�ntial GoIIt # t 1 Owt
10050 N.E.2nd Avenue NW Work Classification:Repair
Miami Shores,FL 33138-0000
Permit Status:APPROVED
Phone: (305)795-2204
1 '7l8t2015 Fiviration: 01/04/2016
Project Address Parcel Number Applicant
55 NW 94 Street 1131010340120
SAGE HOFFMAN
Miami Shores, FL 33150- Block: Lot:
Owner Information Address Phone Cell
SAGE HOFFMAN 55 NW 94 Street
MIAMI SHORES FL 33138-
55 NW 94 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone $ 82 462.00
Valuation: �
AAA PLASTERING&DRYWALL INC (786)236-0034 Total Sq Feet: 3619
Approved:In Review Available Inspections:
Comments: Inspection Type:
Date Approved::In Review Final
Date Denied: Review Building
Type of Construction:RE-PLASTERING EXISTING HODS Occupancy:Single Family
Stories:2 Exterior:
Front Setback: Rear Setback:
Left Setback: Right Setback:
Bedrooms: Bathrooms:
Plans Submitted:No Certificate Status:
Certificate Date: Additional Info:
Bond Retum: Classification:Residential
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $49.80 Invoice# RC-6-15-56110
DBPR Fee $37.11 07/08/2015 Credit Card $2,639.88 $50.00
DCA Fee $37.11
Education Surcharge $16.60 06/25/2015 Credit Card $50.00 $0.00
Permit Fee $2,473.86
Scanning Fee $9.00
Technology Fee $86.40
Total: $2,689.88
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. FutheEmore I authorize the above-named contractor to do the work stated.
July 08,2015
utitorb ed Signatu er / Applicant / Contractor / Agent Date
Building Department Copy
July 08,2015 1
Miami Shores Villages
JUN 2 5 2015
Building Department BY: / �
SA N G 2nd Avenue Miami Shores Florirh 22118
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20 7
BUILDING Master Permit No.
PERMIT APPLICATION Sub Permit No.
OBUILDING ❑ ELECTRIC ❑ ROOFING REVISION EXTENSION RENEWAL
PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 55 NW 94 ST
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 11-3101-034-0120 Is the Building Historically Designated:Yes NO X
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder):SAGE HOFFMAN phone#:305-205-9977
Address:55 NW 94 ST
City: MIAMISHORES State: FLORIDA Zip: 33150
Tenant/Lessee Name: Phone#:
Email: SAGE@SAGEHOFFMAN.COM
CONTRACTOR:Company Name: AAA PLASTERING & DRYWALL, INC Phone#: 786-236-0034
Address: 18425 SW 267 ST
City: HOMESTEAD state: FLORIDA Zip: 33031
Qualifier Name: GILBERTO GONZALEZ JR. Phone#: 786-258-0255
State Certification or Registration#: CGC060236 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
82 462.00 'V 19 s uare feet
Value of Work for this Permit:$ 4 Square/Linear Footage of Works Q
Type of Work: ❑ Addition ❑ Alteration ❑"New 0 Repair/R2plajcc ;4 Demolition
Description of Work: RE - PLASTERING EXISTING FtOUSE AND GUEST HOUSE.
PRESSURE ,ING3,L.HIPPING, AND PLAS EKING ALL WALL AREAS.
0 j
i
Specify co r of color thru tile:
Submittal Fee Permit Fee$ 5•�J CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$
a
Technology Fee$ Training/Education Fee$ G IDoubli,-Fee$
Structural Reviews$
TOTAL FEE NOW DUE$
(Revised02/24/2014)
l t • P
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
ER or AGENT O CTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
0 d11 aye�orrf :J V n f .20 I fD ,by day of y V%A— ,20 tJr� .b
„oCtvCA ,who is personally known to G'� o is personally known to
me or who has produced DL -M as OpAr who has produced as
identification and who did to tification and who did take an oath.
_ L O
NOTARY PUBLIC: Notary Pubfic State of Fl or PUBLIC'
,a My Cor^••
Mar 17.2019
102797
Sign:
Print: mPIR Print• " ' AM Z
Seal' .• "�A••., �: :r• n«,�; Notary Public-State of Florida
Seal: - My Comm.Expires Jon 2,2017
%�,
�Sr� A •1 573
M iiiNp\C- Commission#Bonded Through NationalFNo3aryAsn.
v.adh
LEONAR00 PAWREZPlans Examiner Zoning
Commission#FF 102797
Structural Review Clerk
(Revised02/24/2014)
06/P4/2015 13:08 FAX 3052420779 AAA PLASTERING/DRYWALL IM 001
Miami Shores V
Building Department
R 10050 N.E.2nd Avenue
Miami Shores, Florida 33136
Tel: (305) 795.2204
Fax: (305) 756.8972
CONTRACTORS' REGISTRATION
IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR:
A._�PY OF QUALIFIER'S STATE LICENCES
B. P OF LOCAL BUSINESS TAX RECEIPT
C. OPY 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 1NSURACE*
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:
CerMcate 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.
■■rrrrrrrrrrrrrrrrrrrrrrrr•■rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
BUSINESS NAME:
BUSINESS ADDRESS: i, !AQ-4 '� -CITY STATE!T7JP 3 3 U 3 I
BUSINESS PHONE:(7i�3(o–U[� 4- FAX NUMBER(.1 o97 QL – _c77 -) of
CELL PHONE QUALIFIER'S NAME:
QUALIFIER'S LIC NUMBER: (; C __n co 0 -a 5 „
RS
RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY
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ISSUED: 08/31/2014 DISPLAY AS REQUIRED BY LAW SEQ# L1408310004675
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OWN SEC. SUIONESt pAyME; ECC
ING&DRYW ' C .196 GE BUIWNG
1 CGC06 :II?Y TAXLECTt
-05.00 07/24/2014
diECK21-14-034,449
Th Burn eceipt tms prrt of the Local Business Tax.The RIs not a
cettlfi f the he ali ice' a,to do business. HolderAft any gov
e Story Is requieemrrhts which apply to the b `
liAECEI PTI *above splayed oa aial vehigl ,- le Sec 8e878.
06/04/2015 13:11 FAX 3052420779 AAA PLASTERING/DRYWALL Q003
®
'4`C�R CERTIFICATE OF LIABILITY INSURANCE q/29"'20°'s''
'THIS CkRTIFICATE 13 ISSUED AS A.MATTER OF INFORMATION ONLY AMC)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 pol(cy(les)must be endorsed. If SUBROUTION IS WANED,"ad to
the term and conditions of the policy,certain policies may require an endorsement A statement on this cwdflcsb does not confer rights to the
certificate holder in lieu of such endoreemmpt(e),
PRODUCERT Yordsalca Marrero
Keen Battle Mead s Company (305)558-1101 PNot(305)822-4722
7850 Northwest 146th Street ILL .ymaszerolthbmoo.cc=
Suite• 200
INS AFPORDING E NAIL 0
Miami Lakes FL 33016
INSURED INBURMA-Liberty Insurance Underwriters
INSURER B Dhio Secuwitv Insurance Comwany
AAA Plastering i Drywall, Inc. INGURERC-BrIdaefield Raplovers In
a Cc
18425 S1i 267 Street INSURERD:
INSURER E:
Homestead Pz 33031 INSURER F c
COVERAGES CERTIFICATE NUMBER:15-16 GL/Auto/wC
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,
I TYPE OF INSURANCE Mumma E
x COMMEROIAL GENERAL.LIABILITY LIMfTS
EACH OCCURRENCE S 1,000,000
su
A CLAIMSMADE.Q OCCUR S 100,000
BEY,1003055 4/13/2015 4/13/2016 MED pIp(Anypwwn) $ 5,000
PERSONAL&ADV INJURY S 1,000,000
e-I AGGREGATELIMITAPPLIES PER GENERA.AGGREGATE $ 2,000,000
8 POLICY a JECT LOC PRODUCTS-COMP/0PAGO111 2,000,000
OTHEft S
AUTOMOBILE LIAR LIT1/
S 1,000,000
8 % ANY AJTO
ALLOWNED SCHEDULED BODILY INJURY(Perpem) S
AUTOSgUTOS�� BAS (16) 56041704 4/13/2015 4/13/2016 BODILY INJURY(PeraxiderM S
HIRED AUTOS AUTOS TY E
$
UMBRELLA LIAR OCCUR Mackal Damlents $ 5,000
EXCESS Las CLAIMS-MADEEACH OCCURRENCE S
AGGREGATE $
AND EMIPLOYEW LIA3LRY YIN SANY $
CER/MEMBCLII
C OFF7ER EXDD? 0 NIA E.L.EACH ACCIDENT $ 100,000
Cy
in N 0830-33764 3/4/2015 3/4/2016 E.L.DISEASE-EA EMPLOYEE S
DESCRIPTION OF OPERA $bebw 100,000
E.L.DISEASE-POLICY LIMIT S 500,000
DESCRUnM OF OPERATUM/LOCATIONS I VEHICLES(ACORD 701.AddMmd Remarks 3e1%8*11.MW be aftcbed N more space M ro*dr"
General Contractor - •Plastering Contractor / Drywall Contractor
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE
Miami Shores Village THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Building
100500 ME 22 ADeve. at:
ACCORDANCE WITH THE POLICY pROVMIONS.
Miami Shores villag, 8Z 33138 AUTNORIM REPRESEIITATME
lex Perez/JANE
ACORD 26 2014/01 ®1988-2014 ACORD CORPORATION. All rights r�rVad.
( ) The ACORD name and logo are registered marks of ACORD
1N302S r�man�i