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MC-17-2872• Project Address Miami Shores Village 10050 N.E. 2nd Avenue NW Miami Shores, FL 33138-0000 Phone: (305)795-2204 Pe 'mit Permit NO. MC -12-17-2872 Permit Type: Mechanical - Residential Work Classification: A/C Replacement Permit Status: APPROVED Issue Date: 12/12/2017 Expiration: 06/10/2018 Parcel Number Applicant 202 NW 92 Street Miami Shores, FL 33150- 1131010331220 Block: Lot: REAL ESTATE EDUCATION ANC Owner Information Address Phone Cell REAL ESTATE EDUCATION AND 202 NW 92 Street MIAMI SHORES FL 33150- (561)310-2585 202 NW 92 Street MIAMI SHORES FL 33150- Contractor(s) ALERT AIR INC Phone (786)487-0533 CeII Phone Valuation: Total Sq Feet: $ 2,800.00 0 Tons: Additional Info: REPLACE OUTDOOR CONDENSATION UNIT W Classification: Residential Approved: In Review Comments: Date Denied: Scanning: 3 Date Approved:: In Review Type of Work: REPLACE OUTDOOR CONDENSATIC Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $1.80 $2.00 $2.00 $0.60 $100.00 $9.00 $2.40 $117.80 Pay Date Pay Type Invoice # MC -12-17-65828 12/05/2017 Cash 12/12/2017 Credit Card Amt Paid Amt Due $ 50.00 $ 67.80 $ 67.80 $ 0.00 Available Inspections: Inspection Type: Final Review Mechanical 1 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. 1 understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify th- II the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zo vu . .... authorize the above-named contractor to do the work stated. December 12, 2017 Au orized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date December 12, 2017 1 T BUILDING PERMIT APPLICATION BUILDING ❑ ELECTRIC Miami Shores Village 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 ❑ ROOFING PLUMBING MECHANICAL ❑PUBLIC WORKS JOB ADDRESS: 2'O . 1 V • V 92,441 \v RECEIVED DEC 052017 (( 4‘ S{ -t FBC 201' Master Permit No. , `Cn- —� Sub Permit No. ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS City: Miami Shores County: Miami Dade Zip: i�( Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: Ar -az, f` -a z2J 4 CiiugIr 2 OWNER: Name (Fee Simple Titleholder):TiAli az, thu 6n j 5.t.1 'Q -- Phone#: 5t4- 0710 • 2-54{ �2r( Address: govt !\p • arta .'i --i-gal., City: IA2M £EaCiW Ptkebeen& State: e1Z Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Companyame: �T 4i2, c-- ne Phone#: TVi1 � ' -' 05 Address. 22)10PtC Puwo Moe City: 1-19i,264-1 State:.,/0_4_1::•/a, Zip::/��3502,S Qualifier Name: T8 6)141J Phone#: l 3(c ' (18-t' • 0543 State Certification or Registration #: (., C V 1 bS ZS Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: n City: State: Zip: Value of Work for this Permit: $ 2aCQ' Square/Linear�F000tage of Work: Type of Work: ❑ Addition❑ Alteration El� New Re ❑ pair/Replace Demolition Description of Work: Rf;�kC' f9 Dti"zto' Q. . I CorriL ?J) &f-tb&-T 1477-1 N) Specify color of color thru tile: Submittal Fee $ Permit Fee $ IMO t CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ (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 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 �11.ar‘.12ik OWNER or AGENT The foregoing instrurie t was acknowledged before me this /4ltdayof 0 Verr)bG(, , 20 26 7 by 64 ' IC_Ple. I W© ber13,'whois` rsonally known to me er who has produced as identification and who did take an oath. NOTARY PUBLIC: Si Print: Seal: 14o,ikIodATe c -S ********** APPROVED BY (Revised02/24/2014) KAMILLAH BIGGERS MY COMMISSION # 00067376 EXPIRES July 04,2021 V L, Signature CONTRACTOR The foroing instrument was acknowledged before me this day offinta--,/(12..C7, 20 / 7 , by l errrti 2 V i0b who is personally known to rri or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: Notary Public State or Florida ' Theslyn M Brown p� My Commission FF 932730 Expires 11/25/2019 ************************************************** (4s Examiner Structural Review ************ Zoning Clerk . �. Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax:(305) 756.8972 AIR CONDITIONING REPLACEMENT DATA PERMIT NUMBER: MC This form must accompany ALL air conditioning replacement permit applications. Each unit change -out must be on its own data sheet. Multiple units on single sheets are not acceptable. t a Job Address (where the work is being done): /.�02, � ' 1d'V CV./1,01ST1 Ia t r i City: Miami Shores Village County: Miami Dade Zip Code: .311 50 ALL CONDENSING UNITS MUST BE ON A 4 INCH SOLID CONCRETE SLAB ALL UNITS MUST COMPLY WITH F.E.M.A MINIMUM FLOOD ELEVATION A COPY OF THE CONTRACT IS REQUIRED WITH ALL SUBMITALS AHRI DATA SHEET REQUIRED Change disconnecting means: YES ❑ NO ❑ ARHI Sheet Attached: YES\NO Contract Attached: YES ❑ UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER ��fOObWI (WI AHU or PKG. UNIT MODEL # COND. UNIT MODEL # (G x KILO dte 1 KW HEAT NOM TONS AHU CU PKG 1) M.C.A AHU CU PKG AHU CU PKG 2) M.O.P AHU CU PKG AHU CU PKG 3) VOLTS AHU CU PKG PKG UNIT / /• PKG UNIT / / EER/SEER YES NO REPLACING DUCTS YES (NO) YES NO REPLACING THERMOSTAT ES NO YES NO NEW 4"CONCRETE SLAB YES NO YES NO NEW ROOF STAND YES O YES NO NEW RETURN PLENUM BOX YES NO 1. Minimum Circuit Ampacity (Wire Size): /.0g4ftTL- 3. Voltage of Circuit (208/240/480): '0'0Q 4. Size Disconnecting Means: 2. Maximum Overcurrent Protection (Fuse/Breaker Si 0 Contractor's Com .ny Name: _ -L&21 ' C C State Certifica Signature (Revised02/24/2014) Phone: 1 b • • vS33 tion No.Certificate of Competency Date: alifier's signature) Ar' REAL ESTATE, EDUCATION AND COMMUNITY HOUSING, MIL .4 Florida Si* Non Profit Ortaa!„aftpa ted r1 U.D. Approved Holub's A foredontre Counssll Agency INCUMBENCY CERTIFICATE FOR REAL ESTATE EDUCATION AND COMMUNITY ROUSING, INC, The undersigned Corporate Secretary certifies that the following persons listed below are duly elected officers or otherwise authorized to act on behalf of the Corporation in the capacities set forth below and in all respects to conduct business on behalf of the Corporation to include the purchase and sale of Real Estate and Authorize any and all work to be performed on owned Real Estate. NAME TSE Patricia Tracey CEO, President Michael Roberts Executive Director Elizabeth MacCali Chairman Michael Rose Pastor, Secretary Albert Martinez Director Ekaterina Drouin Treasurer Judith Brennison STATE OF FLORIDA rest NNT�y OF )„ ► . At eft. AA• Sword to (or and subscribed tiefoa this ? 7 day of 3i' t?� hey , 20 1 1 (year) of person making statement) �&Le. ersonally known - or Produce Identification 23fit nti tca on Produced. Signature: 4144,....t. Printed Name:g, r �( i t �.{ {Ds c. Title: ?4b+ ot. , + 'C..Y''( Director ,..Hi 14‘ iii PATRICIA M. TRACEY A �v; Nullity Public • State of Florida ?, aa3. Ezpltes Sep 13.2018 +' ;- Comm ton R fl 123164 cru L P. Real Estate, Education And Community Housing Inc. (R.E.A.C.H.) is a Florida 50103 Not For Profit Charitable Organization and HUD Approved Housing and Foreclosure Counseling Agency. Our mission is to inspire and motivate the low to moderate income members of our community to take the stens necessary reach for, nch:eve and maintain th . _ _--- Dream _- ..-.. to reach ..,p.,,,.,, and tat4.uw�L the AIRAci ti71[i LIL'�jrt Or bore ownership through advocacy, education, and counseling and gram assistance 8409 N. !Wintery Trait Suite F Pram Beech Gardens, Fit 334t0 0: (561) 491-1670 F: (561) 712-9666 Visit us online ®. reacb4bousing.org 2017 FLORIDA NOT FOR PROFIT CORPORATION AMENDED ANNUAL REPORT DOCUMENT# N06000000381 Entity Name: REAL ESTATE, EDUCATION AND COMMUNITY HOUSING, INC. Current Principal Place of Business: 8409 NORTH MILITARY TRAIL STE 111 PALM BEACH GARDENS, FL 33410 Current Mailing Address: 8409 N MILITARY TRAIL STE 111 PALM BEACH GARDENS, FL 33410 US FE! Number: 20-4203798 Name and Address of Current Registered Agent: TRACEY, JOHN E 8409 N MILITARY TRAIL STE 111 PALM BEACH GARDENS, FL 33410 US FILED May 11,2017 Secretary of State CC 5249251403 Certificate of Status Desired: No The ebc"e named entity submits this statement or the purpose of changing a.. _ _ entity uv .v � �� Y++: i+ yif;y^ f;u registered ufi:C$ w registered agent, or both. in Me Siete of Florida. SIGNATURE: Electronic Signature of Registered Agent Officer/Director Detail : Tine Narne Address City -State -Zip: Title Name Address City -State -Zip: Title Name Address Cfty-State-Zip: CEO, PRESIDENT TRACEY, PATRICIA 8409 N MILITARY TRAIL STE 111 PALM BEACH GARDENS FL 33410 PASTOR, SECRETARY ROSE, MICHAEL 8409 N MILITARY TRAIL STF 111 PALM BEACH GARDENS FL 33410 TREASURER DROUIN. EKATERINA 8409 NORTH MILITARY TRAIL STE 111 PALM BEACH GARDENS FL 33410 Title Nacre Address City -State -Zip: Title Name Address City -State -Zip: Title Name Address City -State -Zip: CHAIRMAN MACCALL, ELIZABETH 8409 NORTH MILITARY TRAIL STE 111 PALM BEACH GARDENS FL 33410 DIRECTOR MARTINEZ, ALBERT 8409 N MILITARY TRAIL SUITE 111 PALM BEACH GARDENS FL 33410 DIRECTOR BRENNISON, JUDITH 8409 NORTH MILITARY TRAIL STE 111 PALM BEACH GARDENS FL 33410 Date 1 hereby certify that the information indicated on this report or supplemental report is bye and accurate and that my electronic signature shall have the same legal effect as if made under oath: that 1 am an officer or director of the corporation or the receiver or trustee empowered to execute this report as required by Chapter 617, Florida Statutes; and Mat my name appears above, or on an attachment with alt other titre empowered. SIGNATURE: PATRICIA TRACEY PRESIDENT 05/11/2017 Electronic Signature of Signing Officer/Director Detail Date 2017 FLORIDA NOT FOR PROFIT CORPORATION AMENDED ANNUAL REPORT DOCUMENT# N06000000381 Entity Name: REAL ESTATE, EDUCATION AND COMMUNITY HOUSING, INC. Current Principal Place of Business: 8409 NORTH MILITARY TRAIL STE 111 PALM BEACH GARDENS, FL 33410 Current Mailing Address: 8409 N MILITARY TRAIL STE 111 PALM BEACH GARDENS, FL 33410 US FEI Number: 20-4203798 Name and Address of Current Registered Agent: TRACEY, JOHN E 8409 N MILITARY TRAIL STE 111 PALM BEACH GARDENS, FL 33410 US FILED May 11,2017 Secretary of State CC5249251403 Certificate of Status Desired: No The above named entity submits this statement for the purpose of changing its registered office or registered agent, or both, in th a state ,f F;orida. SIGNATURE: Electror•ic Signature of Registered Agent OfficerlDirector Detail : Title Name Address City -State -Zip: Title Name Acidress City -State -Zip: Title Name Address City -State -Zip: CEO, PRESIDENT TRACEY, PATRICIA 8409 N MILITARY TRAIL STE 111 PALM BEACH GARDENS FL 33410 PASTOR, SECRETARY ROSE, MICHAEL 6409 N MILITARY TRAIL STE 111 PALM BEACH GARDENS FL 33410 TREASURER DROUIN, EKATERINA 8409 NORTH MILITARY TRAIL STE 111 PALM BEACH GARDENS FL 33410 Title Name Address City -State -Zip: Title Name Address City -State -Zip: Title Name Address City -State -Zip: CHAIRMAN MACCALL, ELIZABETH 8409 NORTH MILITARY TRAIL STE 111 PALM BEACH GARDENS FL 33410 DIRECTOR MARTINEZ, ALBERT 8409 N MILITARY TRAIL SUITE 111 PALM BEACH GARDENS FL 33410 DIRECTOR BRENNISON, JUDITH 8409 NORTH MILITARY TRAIL STE 111 PALM BEACH GARDENS FL 33410 Date I hereby cert fy that the i.atormation indicated on this report or supplemental report is true and accurate and that my electronic s gnature shad have the sa-ne legal effect as if made under oath; that I am an officer or director of the corporation or the receiver or trustee empowered to execute this report as required by Chapter 617, Florida Statutes; and that my name appears above, or on an attachment with all other like empowered. SIGNATURE: PATRICIA TRACEY PRESIDENT 05/11/2017 Electronic Signature of Signing Officer/Director Detail Date ALERT AIR INC 2270 Acapulco Drive, Miramar, Florida, 33023 E-mail : cbee( bellsouth.net Phone : 786-487-0533 Date : November 22, 2017 State Of Florida County Of Broward. Before me this day personally appeared Clifton Bernard who, being duly sworn, deposes and says: That he or she will be the only person working on the project located at : 202 NW 92nd Street, Miami Shores. Florida. 33150 Contrar Signature Sworn to (9r affirmed) ansubscribed before me this S day of , 20 /7, by Personally known OR Produce Identification Type of Identification Produced 444/7"/-/A---- /R_ju.�/ Print, Type or Stamp Name of Notary .,tary Public State of Florida heslyn M Brown Ay Commisslon FF 93273r expires 11/23/701.9 Miami Shores Vivage Building Department 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. 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. State of Florida County of Miami -Dade The foregoing was acknowledge before me this .2u day of , 20_11". By, Idiot .1 f /, who s personally known to m= or has produced 'k 'FDLas identification. ''''' PATRICIA M. TRACEY _ Notary Public - State of Flor sa My Comm. Expires Sep 13, 018 Commission # FF 123764 12/5/2017 Property Search Application - Miami -Dade County OFFICE OF THE PROPERTY APPIUSER Summary Report Property Information Folio: 11-3101-033-1220 Property Address: 202 NW 92 ST Miami Shores, FL 33150-2231 Owner REAL ESTATE EDUCATION AND COMMUNITY HOUSING INC Mailing Address 202 NW 92 ST MIAMI SHORES, FL 33150 USA PA Primary Zone 0800 SGL FAMILY- 1701-1900 SQ Primary Land Use 0101 RESIDENTIAL - SINGLE FAMILY: 1 UNIT Beds / Baths / Half 2 / 1 / 0 Floors 1 Living Units 1 Actual Area Sq.Ft Living Area Sq.Ft Adjusted Area 1,154 Sq.Ft Lot Size 9,930 Sq.Ft Year Built 1940 Assessment Information Year 2017 2016 2015 Land Value $218,460 $218,460 $161,263 Building Value $80,318 $80,318 $80,318 XF Value $0 $0 $0 Market Value $298,778 $298,778 $241,581 Assessed Value $298,778 $166,506 $165,349 Benefits Information 2017' 2016 Benefit Type 2017£ 2016 2015 Save Our Homes Cap Assessment Reduction $298,778 $132,272 $76,232 Homestead Exemption $0 $25,000 $25,000 Second Homestead Exemption $141,506 $25,000 $25,000 Note: Not all benefits are applicable to all Taxable Values (i.e. County School Board, City, Regional). Short Legal Description MIAMI SHORES SEC 6 PB 10-39 LOT 1 & E1/2 LOT 2 BLK 136 LOT SIZE 79.440 X 125 OR 19647-3419 04 2001 1 Generated On : 12/5/2017 Taxable Value Information 2017' 2016 2015 County Exemption Value $0 $50,000 $50,000 Taxable Value $298,778 $116,506 $115,349 School Board Exemption Value $0 $25,000 $25,000 Taxable Value $298,778 $141,506 $140,349 City Exemption Value $0 $50,000 $50,000 Taxable Value $298,778 $116,506 $115,349 Regional Exemption Value $0 $298,778 $50,000 .._.._ _ $116,506 $50,000 Taxable Value $115,349 Sales Information Previous OR Book - Sale Price Page Qualification Description 06/30/2017 $240,000 30613-1289 Federal, state or local government agency 12/30/2016 $226,700 30372-4110 Financial inst or "In Lieu of Forclosure" stated 09/07/2016 $100 30222-4832 Corrective, tax or QCD; min consideration 04/01/2001 $102,000 19647-3419 Sales which are qualified The Office of the Property Appraiser is continually editing and updating the tax roll. 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