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WS-16-1269 r Inspection Worksheet (� Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax:(305)756-8872 Inspection Number: INSP-260263 Permit Number: WS-6-16-1269 Scheduled Inspection Date:June 06,2016 Permit Type: Windows/Shutters Inspector: Mesa,Michel Inspection Type: Final Owner: SIMAS,PAUL Work Classification: Window/Door Replacement Job Address:363 NE 98 Street Miami Shores, FL 33138- Phone Number (786)258.5258 Parcel Number 1132060135640 Project: <NONE> Contractor: AMERICAN STORM PROTECTION Phone: (305)264-0446 Building Department Comments REPLACING(16)IMPACT WINDOWS AND(3)IMPACT Infracdo Passed Comments DOORS oR -INSPE ENTS False TO REPLACE EXPIRED PERMIT#WS 14-773 FRAMING INSPECTION REQUIRED. Inspector Comments Passed CREATED AS REINSPECTION FOR INSP 258640. CANCELED BY LOURDES 305-528-8213 Failed Correction Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid June 03,2016 For Inspections please calk (305)762-4949 Page 24 of 31 k(0\�( - Miami Shores Village Yx � " � Building Department MAY 1. 1018 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 — Tel:(305)795-2204 Fax:(30S)7S6-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 5+}11 FBC 20iq BUILDING Master Permit No. PERMIT APPLICATION Sub Permit No. (tUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑EXTENSION [�t!161EWAL ❑PLUMBING ❑MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑SHOP CONTRACTOR DRAWINGS JOB ADDRESS: :3 Sr7 City Miami Shores County Miami Dade Zig): 313 Folio/Parcelk l.I— 3 W&O r 3 5 (0+0 Is the Building Historically Designated:Yes.. NO Occupancy Type: Load: Construction Type- Flood Zone: BFE FFE: OWNER:Name(Fee Simple Titlpholder): ?AV L� S t M AS Phone#:365 3Tyac-1775 Address:-3(0-3 City:i A State: -PL— Zip: 3 3/ - Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: aa 11-- ICAL; %TO�_ �l e)IJ Phone#:30S -Si3-®6t Address: f 0 901 O- LI) I LI ST" -tr- t®3 City: Mol AMI T State: F j-4A Zip: ,�jj��— Qualifier Name: N Z- Phone#: LM—W W State Certification or Registration#:Cly,017C 1'5(3'Y1+ Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ 2` ., 347.00 Square/Unear Fo a of Work: 380 Type of Work: El Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition Q Description Work: IL 3) oo*P Mt Specify color of color thru tile: G Submittal Fee$ C Permit Fee$ z Idc� CCF$ t4® CO/CC$ _ Scanning Fee$ •00 Radon Fee$ • 3J DBBPPRTT$ 4 -3S. Notary$ Technology Fee$ 19 • 2Q Training/Education Fee$ t'J l J Double Fee$ Structural Reviews$ (7)_ Bond$ TOTAL FEE NOW DUE$ 29 G (Revised02/24/2014) Bon.&ng 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 ELECTRICAL WORK,PLUMBING,SIGNS, WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS and 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Pir—X Signa Owner or Agent -rr4- Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this-L—/ 20 Lia,by�o-rt J r�L'Z day of�_,20�,by P6rrf 1 J`^tM day of , who is personally known to me or who has produced who is ersonally known to me or who has produced GF/),Sb As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: �,I . NATHALIE UTAZ Print: ,Aotr110, E UTAZMy COmmiS$lOn Exp' $° Commission#FF 230936 My Co SNotary Public-State of FloridaQ= Commission#fF 230936"oQa; My Comm.Expires May 14,2019 =� M C BotttledthroughNationalNotaryAssn.` Jo�l��o?,, y omm.Expires May 14,2019 Bonded through National Notary Assn. ��k�a�S��S��S�a�sk��ds��Skksk��S�Yadsds��s �H� sksk �S�S�a�Hksk�Sskk�SskskHs�s�skksk��sk�sd�a�sskskds�s�a�skksk�� k �S�Ssk�sk J APPROVED BY J Plans Examiner Zoning Structural Review Clerk (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) Miami Shores Village MJAN 16 2015 Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 -- Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20140 BUILDING Master Permit No.IWS PERMIT APPLICATION Sub Permit No. *JILDING ❑ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL ❑PLUMBING [] MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 363 AE 99 s5 City Miami Shores County Miami Dade Zig): Folio/Parcel#: //• 3206o/35b4A4Q Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): pcv0l'S®r4j+S Phone#: _ Address: � � A—� _� /� ` J l� State: ��o, �'� City:�{{�?.LYD � CL� (� Zip: Tenant/Lessee Name: Phone#: Email: 5T,04 �1 CONTRACTOR:Company Name: t/7jf,CQJCf�� o�O 7EC�T�/L9w Phone#:3 6-1.3 -04r/9 Address: /4080/ 4W .'14 `5T- City: A A4/ State: Zip: � 3�7.2.• Qualifier Name: �d / •+J Phone#:Tzo9'iC'g/D 7 State Certification or Registration#: 1 I-3a 7Y certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: 1 Specify color of color thru tile: n 1 Submittal Fee$ Permit Fee$ LC) • 63 CCF$ CO/CC$ Scanning Fee$,:I•`�✓`J Radon Fee$ (-I• S5 cLDBPR$ �+35 Notary$ Technology Fee$ - 2d Tralning/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$VO. I (Revised02/24/2014) Bonding Company's Name(if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name((f 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. s�4* 6ZY---� Signature Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of 20 /.'5r ,by ��T day off ��O77d�}.Qd,1 ,20 /6 ,by RAii/ «.7�/h ,S ,who is personally known to J07%&�il) Rhdo rq who is personally known to me or who has produced 4C'L-'/S E as me or who has produced as Identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: KplSign: C t Print: /0 Print: Print: ••�e�% RIGOBERTO JESUS CUESTA �°;•• ••`'� RIGOBERTO JESUS CUESTA Seal: * * MY COMMISSION#EE UESTA05134o Seal: * * MY COMMISSION#EE 051340 EXPIRES:April 27,2015 EXPIRES:April 27,2015 N,9r .°P �'9r °P\Ov Bonded Thru Budget Notary Services FOF FOR: Bonded Thru Budget Notary Be*% FOF F� ################################ ########################################################################## APPROVED BY 0 Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Miami Shores Village 1G�v''� f,y 41 Building Department �Q� X0050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 INSPECTION'S PHONE NUMBER:(305)762.4949 FBC20d � BUILDING Permit No PERMIT APPLICATION Master Permit N LX�'Jt Permit Type: BUILDING ROOFING JOB ADDRESS: 31P-3 "�C CIJ;r City: Miami Shores County: Miami Dade Zip: .331-519 Folio/Parcel#: 11- 3206-o 15- 5C,40 Is the Building Historically Designated:Yes NO Flood Zone: OWNER:Name(Fee Simple Titleholder): P014 L SI M A S Phone#: Address: 563 M E 9,15-1 city: M l pgA*t 6Api Es State: FL zip: 3 3/ 3 Tenant/Lessee Name: Phone#: Email: ^- CONTRACTOR:Company Name:A d E PU CABS I D P_1 R/ _¢ Phone#:�Oss 5/3-0-5/v Address: 105?o i t4 W 144 JT S'Tc /o3 City: M 1 AIMI State: FL Zip: 3'517 2,_ Qualifier Name: Z 010C1,4hax) 'RojrL u J�Z Phone#:AOS)4 9 -810 7 State Certification or Registration#: 132 7 Certificate of Competency#: AA Contact Phone#:(.705 S 22-Al I_2> J Email Address: -.0 U 1 bTnG (a, A�W 1/L Dui•e 0*-(, DESIGNER:Architect/Engineer: Phone#: Value of Work for this Permit:$ c2.3)3 9 7 Square/Linear Footage of Work: Type of Work: DAddition DAlteration ONew ORepair/Replace ODemolition Description of Work: / /,4j dAwkds "d ✓1 vb/-e P60- Color thr'u Ills: Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Edubal5ion Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$-��=�-� Bonding Company's Name(if applicable) Bonding Company's Address City r 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 ELECTRICAL WORK,PLUMBING,SIGNS, WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS and 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 0�b=� Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this , The foregoing instrument was acknowledged before me this day of H` A,201 ,by Q U I cji NI#kday of ,20 ,by who is personally known to me or who has produced UCE1L SF lvho is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: °< ;:P�e�% RIGOBERTOJESUS CUESTA �Psr P6B RIMBERTO JESUS CUESTA ,� * MY COMMISSION#EE 051340 * * MY COMMISSION#EE 051340 EXPIRES:April 27,2015 s, EXPIRES:April 27,2015 Sign ( �j' of 11, Thm Budget Nfty swices Sign: '�--'der ve^��O annn�n, ®utig Me y emic� Print:TZ t G0 b e;r-t b aU C54-A Print: t My Commission Expires: A P�<<. a7 �� My Commission Expires: Ail` (• a7� OI Jr APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 3/12/2012)(Revised 07/10/07)(Revised 06f10/2009)(Revised 3/15/09) ACORU® DATE(MM/DONYM � CERTIFICATE OF LIABILITY INSURANCE 4/22/2014 THIS CERTIFICA-�E 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 pollcy(ies)must be endorsed. If SUBROGATION IS WANED,subject to the terns 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 CD eCT Tiffanie Ellis Heritage Insurance Services PHONE (941)723-1400 FAX062#9 Eal UM (941)723-1440 PO Box 1508AI)DL .tiffanie@beritagefla.com INSURER AFFORDING COVERAGE NAIC 0 Palmetto FL 34220 INSURERANorth Pointe Insurance Co 27740 INSURED INSURER B.Florida Citrus Business & American Storm Protection Corp INSURER C: 10801 NW 14th Street INSURER D: Suite 103 INSURER E: Miami FL 33172 INSURER F: COVERAGES CERTIFICATE NUMBER:2014-2015 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. WSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 B COMMERCIAL GENERAL LIABILITY PREMI ES rc $ 100,000 A CLAIMS-MADE ®OCCUR 8090022781 /25/2014 /25/2015 MED EXP one rson) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PlFCT RO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per accidentl UMBRELLA I" OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ B WORKERS COMPENSATION X I WC STATU- OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? N/A 106-52175 /30/2014 /30/2015 (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,H more space is required) Doors and Windows Installation Sub work. CERTIFICATE HOLDER CANCELLATION (305)756-8972 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Village ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd Ave Miami Shores, FL 33138 AUTHORIZED REPRESENTATIVE David Clements/TIFF i ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INR09.6;l9ninnri nt Tha At nOn naena anel Inn^arm ranlatararl marks of arnpn