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EL-18-347 Permit No. EL-2-18-347 t. �sNO1S L,� 10050 N.E.2nd Avenue NE Miami Shores Village Permit Type:Electrical-Residential 'Per �• r � Work Classification:Temp for Test - Miami Shores, FL 33138-0000 Permit Status:APPROVED Phone: (305)795-2204 FCORtOp issue oatw 2/1612ii18 Expiration: 08/14/2018 Project Address Parcel Number Applicant 1255 NE 99 Street 1132050090100 JOSH WOL'LOWICK Miami Shores, FL 33138-2642 Block: Lot: Owner Information Address Phone Cell JOSH WOLLOWICK 1255 NE 99 Street (305)531-0970 FL 33142- 1255 NE 99 Street FL 33142- Contractor(s) Phone Cell Phone Valuation: $ 100.00 MEP CONTRACTORS (786)930-7700 Total Sq Feet: 0 Type of Work:TEMP FOR TEST Available Inspections: Additional Info: Inspection Type: Classification:Residential Final Scanning:3 Review Electrical i Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 DBPR Fee Invoice# EL-2-18-66410 $2.00 02/15/2018 Credit Card $64.60 $50.00 DCA Fee $2.00 Education Surcharge $0.20 02/09/2018 Credit Card $50.00 $0.00 Permit Fee-Additions/Alterations $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: ce ' �alleregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning F eze the above-named contractor to do the work stated. February 15, 2018 Authorize t e:Owner / Applicant / Contractor / Agent Date Buildin Department Copy February 19,2018 1 a. Miami Shores Village R:Ec Building Department B 4 0X81 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 RECEIVED Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FEB 0 9 2018 FBC 2011S^ BUILDING Master Permit No. P_C --J-.(o r PERMIT APPLICATION Sub Permit No. IFW 8 - 3 47 ❑BUILDING M/ELECTRIC ❑ ROOFING ❑REVISION ❑ EXTENSION EJRENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP / / q c� CONTRACTOR DRAWINGS JOB ADDRESS: /02S� /� l 1 5 City: Miami Shores County: Miami Dade Zip: 33 / 3 Folio/Parcel#: /f 3 ZOS— O D-11 — O 00 Is the Building Historically Designated:Yes `NO Occupancy Type: Load: Construction Type: ° Flood Zone:_ BFE: z FFE: OWNER: Name(Fee Simple Titleholder): 0 [0 C Phone#: Address: I,ZS� /Q e 919 $_- City: /I 1 i (i7 t �h-��Fe S State: Zip: .3_�) /_3 Tenant/Lessee Name: -Phone#: Email: ' CONTRACTOR:Company Name: ' C.-O�W V�Gf�' Phone#� ���3� r• Address: L2 J till . /.3 y�x City: Stater Zip: 3 3 I �b^7 7 Qualifier Name: � f� ig o0(al . Phone#: q �� /,3- ?-7-oo State Certification or Registration#: J�'li /30 V ���b _Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: 'City: State: Zip: Value of Work for this Permit:$ �y�+ ° Square/Linear Footage of Work: Type of.Work:1*,;F❑ Addition ❑7 Alteration ❑ New ❑ Repair/Replace ❑ Demolition F De'scription'of Work: �y..y Specify color,of 'blor thru tile: Submittal F ee$ + Permit Fee$ %��+Q7G'� CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ t Technology Fee$ Training/Education Fee$ Double Fee$' Structural Reviews$ Bond$ / [ /� TOTAL FEE NOW DUE$ 6 • 1W (Revised02/24/2014) Bonding Company's Name(if applicable) / Bonding Gompariy's'A+ddress State Zi .I City's� _t.���I p iMortgage Lender's Name(if applicable) Mortgage Lender's Address City �. 'k State Zip Application is hereby made to obtain a permit to do the work andlinstallations 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. c "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." s i 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 insp tion will not be approved and a reinspection fee will be charged. Signature Signature s � , OW R or AGENT CONTRACT R The foregoing instrument as acknowledged before me this The foregoing instrument was acknowledged before me this y�day of DGL�� .20 by day of -FLJC� 1 ,2J �5 by SSL WO b0u+IC-k- who i ersonally kr to y�� � �N who is personally known to me or who has produced as me or who has produced — V as identification and who did take an oath. identification and'who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: 1ARLEIIt Sign: ,/lam C-�'"'"'' r Sign: `� •'G•MMINISs��G Print: Print: 81: FIX Seal: �''= CO�h4JI1SS10N fF1299 8 Seal: 9:oFF9 , E(PIRES:• June 4, 2015 �ga�� �h 60 e� j APPROVED B Plans Examiner Zoning F` Structural Review Clerk (Revised02/24/2014) r I SNORES tNC.7933 � Miami Shores Village Building Department "" 10050 N.E.2nd Avenue d Miami Shores, Florida 33138 Tel: (305) 795.2204 ORiDp' Fax: (305) 756.8972 AFFIDAVIT FOR 30 DAY TEMPORARY-ELECTRIC SERVICE r NOTE: ELECTRIC SERVICE WILL BE DISCONNECTED "WITHOUT NOTICE" UPON 30 DAY TERMINATION UNLESS APPLICATION IS RENEWED. It is understood that the temporary-electrical approval by the Miami Shores Village, Building Department given in connection with the building being constructed under: Building Permit N: f.C., 1(� — IF S.Z Electrical Permit N: At Address: /2 5 11K AC/A q Miami Shores, FL 33 /3 For Owners: J6 s &b I I o cvr'C,i , and is being given only for construction purpose or for testing the following equipment in said structure: air Cav,d�f�.�, (oI-c _P fbt, ,4 I��-rte• (r.ew c.�.d I'�c.�s�C� �irsues) The owner does herby agree to as ume the responsibility f ma ntaining the installation in such manner at there is no hazard to life or property. Such approval is in no event to be considered a RELEASE of said structure for the purpose of use and occupancy, and no occupancy shall be granted or permitted until further inspections have been called for and approved by the inspection divisions concerned, and/or a Certificate of Occupancy or Completion is obtained. The undersigned also understands that the temporary electric approval is subject to rescission and cancellation and electric power can be cut off at the discretion of the building official and will be disconcerted of ie building concerned is occupied before final inspections are approved and/or obtained a Certificate of Occupancy or Completion. Note: Failure to comply with the provisions of this affidavit will result in your benun�abno o of�tain future Temporary for Test permits. I, os 0t^+r , being first duly sworn, depose and say that I am the owner of the above described property, and that I agree that the structure covered in this agreement shall not be occupied until the building contractor has obtained approval of final inspections and/or obtained a Certificate of Occupancy of Completion. Note: Failure to comply with the provisions of this affidavit will result in your ing unabl tain fut a Temporary for Test permits. 1 7(, Signature oR Ker Signat ar, yp„ ,ISSIGM, FF12013S Eto5: ,lune' q,. 2018 I, G �►-r ]�oo�p�.� , being duly sworn, depose and say that I' 'lee cffor the above-described pr and that 'ons as now existing'viYI 19not create a safety hazard if temporary s ice is F •. MAHARAI K.GONZALEZ *: r: MY COMMISSION#GG 044602 Signature of Ele C n ra or ,F .5- B.M.XPIR S:November 2,2020 JCef Notary / Notary Public Underwriters y I, F6,q,0G1 SC-o r4le�7e,S , being first dul �o !r ,,Ase and say that I am the Building Contractor of the above described property and that I will not s.�F ,n�f �of this building until final inspections have been called for by the contractors and sub-controYsoiac�:ate final approval by the Inspection division obtained and that I have the authority insofar as f e ''er of said pF4perty is concerned to prohibit occupancy until such f' al i s ec 'ons re obtained and/or a33,90ficat1l, Occ# ncy or Comp etion is iss d. 954 64 gna re Bui ing Contractor �T�;;��rrunm���eii ill Signature of Notary T r Signature of Inspector Signature of Notary t { ACO® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YVY1) `,..� 02/07/2018 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(les)must have ADDITIONAL INSURED provisions or 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). I PRODUCER , CONTACT Maximo Dopazo CPIA NAME: Dopazo&Associates Inc PHONE FAx (AIC, No. Ext1: (305)470-8500 A/C No): (866)647-9673 8725 NW 18th Terr Ste 300 E-MAIL max@dopazo.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Miami FL 33172 INSURERA: Granada Insurance Cc 16870 INSURED INSURER B: Retail First Ins Cc , 10700 MEP Contractors Corp INSURER C: 12401 SW 134th Ct Unit 15 INSURER D: INSURER E: Miami FL 33186 INSURER F: COVERAGES CERTIFICATE NUMBER: CL182719307 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 AUUL bUtSH POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD MM/DD LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 + CLAIMS-MADE �OCCURA A 100,000 PREMISES Ea occurrence $ MED EXP(Any one person) $ 5,000 A 0185FL00079114 02/05/2018 02/05/2019 PERSONAL&ADVINJURV $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERALAGGREGATE $ 2,000,000 { X POLICY ❑ PRO- 2,000,000 JECT LOC PRODUCTS-COMP/OPAGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANYAUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATU v/N TE I I ER B ANY PROPRIETOR/PARTNER/EXECUTIVE N/A 0520-53980 04/25/2017 04/25/2018 E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Electrical work-within buildings. i CERTIFICATE HOLDER CANCELLATION 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 Avenue 1 AUTHORIZED REPRESENTATIVE Miami Shores FL 33138 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ai5sis Local�Business�7�X� 4 Mlaml=Dade'Coilnty, S#ate of FlarldaY THIS IS NOT A BILL 00 NOT PAY `" ,4 t z r ev 7199777 �L a -BUSINESS NAME IO`f.1kE161K3 ,esz� s4 rs L !! yypJJ e k h rxi -L-111 M E P COMRACtQRS -CO `'' »NEWAI. r SEi�TE1NIERk' 12401 $W 134 CT 15 74$2337 Must tie d�spiayei at place`bfbusrnsss MIAMI FL 33186 ` ,`Pursuant to County Gode - _ 4 _•Chapter 8A 'Art 9'&10 OWNER. SE 3a TYPE OF BUSINESS MEP CONTRACTORS CORP: 196 ELECTRICAL CONTRACTOR t. PAYMENT,RECEIVED s EC13007484``d BY TAX COLLECTOR". C/O EMIL BODDEN PRES Workers) ,.. 6 - ?< $75.00 09/19/2017. _ tCREDITCARG6- 7-059643_- This Local Business Tax Receipt only confirmSpa yment afthe Local Business Tax.The Receipt is not a license, ' permit orp certification-of the holders uelifieations;to do business. Holder must comply with any governmental ,-; or nongotremmeMal regulatory laws inrequirements which apply to the busieeu .a Tha RECEIPT NO`above must be displayed on all commercial vehiMesz Miami Nda,&de Sec 8a4M. For more I fination,visit*;k6,miemidade gov/tetccoilec"or re f - f i 1 4 Property Search Application - Miami-Dade County Page 1 of 1 OFFIUftE OF TH"'T 'PROPERT'Aym APPR A ISER Summary Report Generated On:2/9/2018 Property Information Folio: 11-3205-009-0100 Property Address: 1255 NE 99 ST Miami Shores,FL 33138-2642 Owner JOSH WOLLOWICK ` 1255 NE 99 ST Mailing Address MIAMI SHORES, FL 33138 USA PA Primary Zone 1400 SGL FAMILY-3001-3250 SQ 0101 RESIDENTIAL-SINGLE Primary Land Use FAMILY: 1 UNIT ^ s Beds/Baths/Half 3/2/1 Floors 1 Living Units 1 Actual Area 3,022 Sq.Ft i Living Area 1,851 Sq.Ft 2017 Aerial Ph Adjusted Area 2,353 Sq.Ft Taxable Value Information Lot Size 12,262.5 Sq.Ft 2017 2016 2015 Year Built 1950 County Assessment Information Exemption Value $0 1 $0 $50,000 Year 2017 2016 2015 Taxable Value 1 $592,8351 $562,3721 $218,291 Land Value $441,822 $411,211 $374,478 School Board Building Value $131,297 $131,297 $165,134 Exemption Value $0 $0 $25,000 XF Value $19,716 $19,864 $14,182 Taxable Value $592,835 $562,3721 $243,291 Market Value $592,835 $562,372 $553,794 City Assessed Value $592,835 $562,372 $268,291 Exemption Value $0 $0 $50,000 Taxable Value $592,835 $562,372 $218,291 Benefits Information Regional Benefit _. Type 2017 2016 2015 Exemption Value $0 $0 $50,000 Save Our Homes Cap Assessment Reduction $285,503 Taxable Value 1 $592,835 $562,372 $218,291 Homestead Exemption $25,000 Second Homestead Exemption $25,000 Sales Information Previous OR Book- Note:Not all benefits are applicable to all Taxable Values(i.e.County, Sale Price Pae Qualification Description School Board,City, Regional). 9 03/16/2015 $540,000 29552-3101 Qual by exam of deed Short Legal Description 08/01/2012 $100 28235-3194 Corrective,tax or QCD;min 5 53 42 consideration EARLETON SHORES PB 43-80 LOT 13&W1/2 LOT 14 BLK 1 LOT SIZE IRREGULAR OR 13302-477 0487 5 The Office of the Property Appraiser is continually editing and updating the tax roll.This website may not reflect the most current information on record.The Property Appraiser and Miami-Dade County assumes no liability,see full disclaimer and User Agreement at hftp://www.miamidade.gov/info/disclaimer.asp Version: http://www.miamidade.gov/propertysearch/ 2/9/2018