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RF-18-1196Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Permit Parcel Number Issue Date: 5/16 Permit NO. RF-5-18-1196 Permit Type: Roof Work Ciessifk'ation: Repair Roof Permit Status: APPROVED Expiration: 11/12/2018 Applicant 10659 NE 10 Place Miami Shores, FL 1122320280540 Block: Lot: JUAN RIVERA Owner Information Address Phone Cell JUAN RIVERA 10659 NE 10 Place MIAMI SHORES FL 33138- 10659 NE 10 Place MIAMI SHORES FL 33138- Contractor(s) PRAXIS INDUSTRIES INC Phone (305)777-8911 Cell Phone Valuation: Total Sq Feet: $ 1,000.00 12 Type of Work: Repair Additional Info: REMOVE TILE FROM OVER FRONT DOOR, R Classification: Residential Scanning: 3 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee - Repairs Scanning Fee Technology Fee Total: Amount $0.60 $2.00 $2.00 $0.20 $100.00 $9.00 $0.80 $114.60 Pay Date Pay Type Invoice # RF-5-18-67420 05/16/2018 Cash 05/04/2018 Credit Card Amt Paid Amt Due $ 64.60 $ 50.00 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Roof Repair Final Roof Review Roof 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 stri t conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I as me responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICA , PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFID construction and z Authorized I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating Futhermore, I authorize the above -named contractor to do the work stated. nature: Owner / Applicant / Contractor / Agent May 16, 2018 Date Building Department Copy May 16, 2018 1 BUILDING PERMIT APPLICATION Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 — --gam INSPECTION LINE PHONE NUMBER: (305) 762-4949 r ('�` FBC 20 n- Master Permit No."I e - I lq� Sub Permit No. ❑BUILDING ❑ ELECTRIC /ROOFING Li REVISION ❑ EXTENSION RENEWAL RECEIVED L042 8 BY• � El PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: k06 U t0.-F(n 3 City: Miami Shores County: Miami Dade Zip: ?j' I Folio/Parcel#: t 1'' LZV--OZ? OyO Is the Building Historically Designated: Yes NO ./ Occupancy Type `c{i Load: Construction Type: Flood Zone: BFE: FFE: �1C ,l OWNER: Name (Fee Simple Titleholder): +JL 6r) cAry- d 1Z ikho,r7:71 Phone#: 3x 1S3 d Address: \OC Sio1 ?J.r 1:3r1--0\ City: C�(4Umi SY'\t7c-i. State: T(. Zip: 3 13c Tenant/Lessee Name: Phone#: Email: t i�,c-7-1...> \•P eeMa:it .cc:a4.r-N CONTRACTOR: Company Name: ai(SaS f vS'iW25 (LX._ Phone#: .. &f= U 3 . Address: l t>(5 ut:7 I.Z C S t' S A,r 324 City: tAltek I State: Zip: 3.3 C t Qualifier Name: \ LA A$ LL-+ ''cd>S Phone#: •' -fi'6 : 4•irRc • 3i41 State Certification or Registration #: CI -CC— (3 2.-r2,31-f: Certificate of Competency #: DESIGNER: Architect/Engineer: 1 Phone#: Address: City: State: Zip: Value of Work for this Permit: $ ICAO Square/Linear Footage of Work: P l2 55 '+ . Type of Work: ❑ Addition ❑ Alteration ❑ New E- Repair/Replace n Demolition Description of Work: ©ae -n£-6 40wt DUE< TR c,J7 3 '/, 'Pez+L4ci= S TTc- ( 4 i friiv CA,, !) E'J 'k fat s- STicrG antis IJZc-A y AC Sc'i '�Z �-E L� ��1G-Cvi . r Specify color of color thru tile: $wwr�- ac, (..f i;-) . 5 `^ Submittal Fee $ \) Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $(.0 OStructural Reviews $ Bond $ .(' o TOTAL FEE NOW DUE $ q v` (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 ppro spection fee will be charged. Signa The for Signature OWNER or AGENT CONTRACTOR _oing instrument was acknowledged before me this The foregoing instrument wps acknowledged before me this (l day of (-1 j , 20 IQ) , by is day of Aravti , 201 t , by 'PezotI4t4424 I/•✓t"21-who is personally known to tc.11.4S LlcwkkoS me or who has producedt.- identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: as me or who has produced as identification and who did take an oath. NOTARY PUBLIC: L) L i cw,cc GFtCI c.11s 20� M =P'� •= 1v;Y GGM c\115. Sea ,�ic':j pMe,t� •: G e19 yp1REs P P Nice.coK• =� ,s, CHAE C b F,PP� 10 • .Z � deNoa< So �.`�..� EXt'1RE . SoNlce.wn'• .1y3 sibs APPROVED BY /' Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Property Search Application - Miami -Dade County Page 1 of 2 Summary Report Property Information Folio: 11-2232-028-0540 Property Address: 10659 NE 10 PL Miami Shores, FL 33138-2103 Owner JUAN FERNANDO RIVERA Mailing Address 10659 NE 10 PL MIAMI SHORES, FL 33138 USA PA Primary Zone 1000 SGL FAMILY - 2101-2300 SQ Primary Land Use 0802 MULTIFAMILY 2-9 UNITS : 2 LIVING UNITS Beds/Baths/Half 3/3/0 Floors 1 Living Units 2 Actual Area Sq.Ft Living Area Sq.Ft Adjusted Area 3,635 Sq.Ft Lot Size 18,525 Sq.Ft Year Built 1947 Assessment Information Year 2017 2016 2015 Land Value $454,262 $337,451 $268,231 Building Value $215,678 $237,621 $237,621 XF Value $7,878 $7,977 $6,398 Market Value $677,818 $583,049 $512,250 Assessed Value $677,818 $583,049 $325,737 Benefits Information Benefit Type 2017 2016 2015 Save Our Homes Cap Assessment Reduction $186,513 Homestead Exemption $25,000 $25,000 Second Homestead Exemption $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 ESTATES PB 47-58 S5FT LOT 2 ALL LOT 3 & N57.5FT LOT 4 BLK 4 LOT SIZE 142.50 X 130 OR 19729-4248 05 2001 1 Generated On : 5/4/ Taxable Value Information 2017 2016 2 County Exemption Value $50,000 $0 $50. Taxable Value $627,818 $583,049 $275. School Board Exemption Value $25,000 $0 $25. Taxable Value $652,818 $583,049 $300. City Exemption Value $50,000 $0 $50. Taxable Value $627,818 $583,049 $275. Regional Exemption Value I $50,000 $0 $50 Taxable Value $627,818 $583,049 $275. Sales Information Previous Sale Price OR Book - Pa a 9 Qualification Description 01/28/2016 $100 30305- 4796 Corrective, tax or QCD; min consideration 01/28/2016 $780,000 29947 2873 Qual by exam of deed 09/01/2003 $0 21723- 3004 Sales which are disqualified as a resi of examination of the deed 05/01/2001 $210,000 19729- 4248 Sales which are qualified 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 Appra https://www.miamidade.gov/propertysearch/ 5/4/2018 Local Business Tax Receipt Miami -Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 6077804 BUSINESS NAM E/LOCATION PRAXIS INDUSTRIES INC 1065 NE 125 ST STE 321 N MIAMI, FL 33161 OWNER PRAXIS INDUSTRIES INC C/O ILIAS LEKAKOS PRES Worker(s) 1 RECEIPT NO. RENEWAL 6340160 EXPIRES SEPTEMBER 30, 2018 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 SEC, TYPE OF BUSINESS 196 SPECIALTY BUILDING CONTRACTOR CCC1328234 PAYM ENT RECEIVED BY TAX COLLECTOR 45.00 10/02/2017 0222-18-000004 This local Business Tax Pace pt only con-mops/marl of the local Business Tax. The Receipt is not a license, permit, or a certi "cation of the kidder's qual I "cations, to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The Rt t3Pf NQ above mut be displayed on all commercial vehicles- Miami -Dade Code Sec Ba-276. MIAMH]4b For more information, visitwww.niarridade.goviiaxcdlector 7:nrr R® Q COQ Cc CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 5/3/2018 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(ies) 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). PRODUCER SUNZ Insurance Solutions, LLC. ID: (Sunshine Workforq`,'IEACT 28101 Race Track Road Bonita Springs , FL 34135 Jasmine Hernandez PHONE FAX Ext): 239 498-9675 INC. No): E ANo IL ADDRESS: infoAsunshineworkforce.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: SUNZ Insurance Company 34762 INSURED Sunshine Workforce LLC 28101 Race Track Road Bonita Springs FL 34135 INSURER B : INSURER C : INSURERD: INSURER E : INSURER F : .. COVERAGES CERTIFICATE NUMBER: 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. INSR LTR TYPE OF INSURANCE ADDL INSD SUER WV!) POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL 8 ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES JECT PER: LOC GENERAL AGGREGATE $ PRODUCTS-COMP/OPAGG $ $ AUTOMOBILE _ LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY SCHEDULED AUTOS NON -OWNED AUTOS ONLY COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident)$ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB O OCCUR CLAIMS -MADE _ EACH OCCURRENCE $ AGGREGATE $ DED RETENT ON $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYP R MEMBER XCLUDEEXECUTIVE OFFI(Mandatory In NH) If yes, describe under.• DESCRIPTION OF OPERATIONS below Y / N N N /A WC003-00004-018 1/30/2018 1/30/2019 1 STATUTE OH ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1.000.000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Workers' Compensation coverage applies only to those temporary employees assigned by Sunshine Workforce, LLC, but does not extend any other rights or endorsements, unless explicitly requested. Cover pertains to employees of SUNSHINE WORKFORCE LLC assigned to PRAXIS INDUSTRIES INC. CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Glen J Distefano 4-47 ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 41683696 1 01/30/2017 1 Sunshine Workforce LLC STF 477 MASTER CERT 1 Jazmin Hernandez 15/3/2018 8:50:44 AM (EDT) 1 Page 1 of 1 ROOF ASSEMBLIES AND Hour yr atnus.. unw Master Permit No. Florida Building Code 6th Edition (2017) High -Velocity Hurricane Zone Uniform Permit Application Form rr Section A (General information) Contractor's Name ?R l> kikA s i2it'S Process No. 1 1 1 Job Address - to6n 3C t 0 pi.../1- t , ''"k -5 rtGf2C-s - I I • ROOF CATEGORY 1 CI Low Slope CI Mechanically Fastened Tile MortadAdhesive Set Tiles I Ci Asphaltic Shingles CI Metal Panel/Shingles Ci Wood Shingles/Shakes I O Prescriptive BUR-RAS 150 I ROOF TYPE 1 O New roof Repair 0 Maintenance Cl Reroofing 0 Recovering .6 ROOF SYSTEM INFORMATION1 Low Slope Roof Area (SF) — G — Steep Sloped Roof AREA (SSF)�. ft Total (SF) � g, It 1 I Section B (Roof Plan) i Sketch Roof Plan: Illustrate all levels and sections. roof drains, scuppers, overflow and overflow drains. ar n Include dimen- stuns of sections and levels. dearly Identify dimensions of elevated pressure zones • •• •. • ▪ • •• • . • .• • • .. • . • ▪ • • • • . . • • • • • • • • • • • • • • • • • • • • 4 ••••, • . • • . . Tx •• • • • • • • • • N • • . •;, • • M •• • • Q 0 LU -J J ti 2 J • LU C 0 3 Lu LL 0 SECTION 1524 HIGH VELOCITY HURRICANE ZONES — REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS 1524.1 Scope. As it pertains to the section, it is the responsibility of roofing contractor to'provide the owner with the required roofing permit, and to explain to the owner the content of the section. The provisions of Section R4402 govern the minimum requirements and standards of the industry for roofing system installations. Additionally, the following items should be addressed as part of the agreement between the owner ant the contractor. The owner's initial in the designated space indicates that the item has been explained. • .. . . . . ... . • . . . . .... • • .... 4. Cc up . .. ... ner/A§e Renailing wood decks: When replacing roofing, the existing wood roof deck may have to renailed in accordance with the current provisions of Section R4403. (The roof deck is usually cealed prior to removing the existing roof system). Exposed Ceiling: Exposed, open beam ceilings are where the underside of the roof decking b:\viewed from below. The owner may wish to maintain the architectural.appearance; therefore, ing nail penetration of the underside of the decking may not be acceptable. This provides the option of taining the appearance. Overflow scuppers (wail outlets): It is required that rainwater flows off so that the roof is rloaded from a buildup of water. Perimeter/edge wall or other roof extension may block this charge if overflow scupp s (wall outlets) are not provided. It may be necessary to install overflow cs in aordance the requirements of Sections R4402, R4403 and R4413. : .... • • .... ature •j o6s1 1,r too,pi morn(shorri :. PkIperty Rddtisgs' ••• • • .. • • • •••• • • • Revised on 7/9/2009 LD;07/01/2015; Contractor Signature Date Permit Number