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RF-18-975 (2)Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Permit NO. RF--� $-975 Permit Type: Roof Work Classification: Tile Permit Status: APPROVED Expiration: 10/23/2018 Parcel Number Applicant 580 NE 92 Street Miami Shores, FL 1132060141340 Block: Lot: MABEL STOBS Owner Information Address Phone Cell MABEL STOBS 9969 NE 4 AVE RD MIAMI SHORES FL 33138-2439 Contractor(s) PRUDENTIS ROOFING Phone (305)297-4674 Cell Phone Valuation: Total Sq Feet: $ 40,000.00 4576 Type of Work: New Roof Additional Info: TILE RE ROOF TEAR OFF RE NAIL DECK Classification: Residential Scanning: 3 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee - New Roof Scanning Fee Technology Fee Total: Amount $24.00 $5.25 $3.50 $8.00 $350.00 $9.00 $32.00 $431.75 Pay Date Invoice # 04/12/2018 04/26/2018 Pay Type RF-4-18-67147 Check #: 3506 $ 50.00 $ 381.75 Check #: 3511 $ 381.75 $ 0.00 Amt Paid Amt Due Available Inspections: Inspection Type: Up Lift Report Tin Cap Final Roof Hot Mop Tile In Progress Nailing Affidavit 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 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 A!DAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction 4d zoning. F ermore, I authorize the above -named contractor to do the work stated. "FieA $,e •Scs) q71� lei. Author ed i nature: / Applicant / Contractor / Agent April 26, 2018 Date Buildinj Department Copy April 26, 2018 1 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 BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC ® ROOFING Li PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS JOB ADDRESS: 580 NE 92nd Street FBC 20 Master Permit No. _RF OC 2780 Sub Permit No. Ki.te- q1S ❑ REVISION ❑ EXTENSION, ENEWAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS City:. Miami Shores Folio/Parcel#: 11-3206-014-1340 Occupancy Type: Load: OWNER: Name (Fee Simple Titleholder): Address: 9505 NE 5 Ave - City: Miami Shores + County: Construction Type: J. Robert Stobs, II' Miami Dade Zip: 33138 Is the Building Historically Designated: Yes -,".NO X Flood Zone: State: FL Tenant/Lessee Name: Stobs Bros. Construction Co. Email: Bobastobs.com BFE: FFE: (305)751-1692 Phone#: (305)757-6564 - Fax Zip: 33138 Phone#: (305)751-1692 CONTRACTOR: Company Name7PR Rv�1�N`f is P on4e#O 3�5— z��-�6�4 Address: N -a z. City: �� ^^ • State: Qualifier Name: R ArJ, -'.- ��RZA State Certification or Registration #: e-CC. 132985 N/A DESIGNER: Architect/Engineer: Address: _ City: zip: `3 3 \ S S Phone#: 3 `4 Certificate of Competency #: Phone#: State: — . Zip: Value of Work for this Permit: $ 40,000 Square/Linear Footage of Work: 4576 sf Type of Work: ❑ Addition ❑ Alteration ❑ New X❑ Repair/Replace ❑ Demolition Description of Work: Tile Roof Tear Off - Renail deck in accordance with code #30 felt - tin cap - self -adhered PnlyStir k TuPlus - Monur flat profile tile: white in PolyPro adhesive - all flashings to be 24 gal. Ex—ea.:.tw�aaalw;:J,�w`..� • 1 y i Specify color offco/or thru tile: White Submittal Fee $ Qt _.:Permit Fee $,.. Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ • CCF $ _ .—CO/CG$,--0.-.4., ;o.. DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ , ' (Revised02/24/2014) Bonding Company's Name (if applicable) N//� Bonding Company's Address City State — Zip ' Mortgage Lender's Name (if applicable) ` Mortgage Lender's Address City State Zip 2-0 • Applications. hereby mail ;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 The foregoing instrument was acknowledged before me this " 12 day of l' , 20 (LI , by l4 , who is personally known to me or who has produced • identification and who did take an oath. NOTARY PUBLIC: as Sign: Print: Seal: ******* APPROVED BY MILDRED Y GOMEZ Notary Public - State of Florida Commission k GG 124261 My Comm. Expire Aug 24, 2021 Bid t 1 9l'Y1k* Signature ONTRACTOR The foregoing instrument was acknowledged before me this 12 day oft'7 % , 20 jg , by fc(S Cc CanceLlwho is personally knns.rn e— mepr who has produced 41/49 as identification and who did take an'oath. NOTARY PUBLIC: Sign: Print: Seal: Plans Examiner Structural Review MILDRED Y,GOMEZ Notary Public - State of Florida Commission f GG 124261%. My Comm. Expires 4ug 24, 2021 Bonded through National Natar.y Assn. , Zoning Clerk (Revised02/24/2014) 4/12/2018 Property Search Application - Miami -Dade County 1..aOFFICECE }^rx PROPERTY AISER Summary Report Property Information Folio: 11-3206-014-1340 Property Address: 580 NE 92 ST Miami Shores, FL 33138-3173 Owner J ROBERT STOBS & DONALD JR TR SHIRLEY STOBS & CAROL SUE TR Mailing Address 9505 NE 5 AVE MIAMI SHORES, FL 33138-2728 PA Primary Zone 6600 COMMERCIAL - LIBERAL Primary Land Use 1913 PROFESSIONAL SERVICE BLDG : OFFICE BUILDING Beds / Baths / Half 0/2/0 Floors 1 Living Units 0 Actual Area Sq.Ft Living Area Sq.Ft Adjusted Area 3,472 Sq.Ft Lot Size 10,423 Sq.Ft Year Built 1960 Assessment Information Year 2017 2016 2015 Land Value $469,035 $469,035 $312,690 Building Value $183,411 $175,267 $158,271 XF Value $11,503 $11,675 $11,846 Market Value $663,949 $655,977 $482,807 Assessed Value $420,689 $382,445 $347,678 Benefits Information Benefit Type 2017 2016 2015 Non -Homestead Cap Assessment Reduction $243,260 $273,532 $135,129 Note: Not all benefits are applicable to all Taxable Values (i.e. Coun y, School Board, City, Regional). Short Legal Description MIAMI SHORES SEC 2 PB 10-37 NELY1/2 LOT 24 BLK 59 & TR C PER PB 35-40 LOT SIZE 10423 SQUARE FEET COC 25681-4484 05 2007 5 Generated On : 4/12/2018 Taxable Value Information 2017 2016 2015 County Exemption Value $0 $0 $0 Taxable Value $420,689 $382,445 $347,678 School Board Exemption Value $0 $0 $0 Taxable Value $663,949 $655,977 $482,807 City Exemption Value $0 $0 $0 Taxable Value $420,689 $382,445 $347,678 Regional Exemption Value $0 $0 $0 Taxable Value $420,689 $382,445 $347,678 Sales Information Previous OR Sale Price Book- Qualification Description Page 05/01/2007 $0 25681- Sales which are disqualified as a result of 4484 examination of the deed 07/01/1996 $0 17272- Sales which are disqualified as a result of 2564 examination of the deed 09/01/1988 $185,000 13809 Sales which are qualified 3240 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 http://www.miamidade.gov/info/disclaimer.asp Version: STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399-0783 GARZA, FRANCISCO PRUDENTIS ROOFING 7003 N WATERWAY DR #202 MIAMI FL 33155-2896 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! RICK SCOTT, GOVERNOR r ,STATE -OF FLORIDA; DEPAR 11t `CCC1329854 tS e Tk •c,,und€t t-h ae�3�o�e� DETACH HERE KEN LAWSON, SECRETARY STATE` OF'FLORIDA ' . .DEPARTMENT OF. BUSINESSANb.PROFEssIONARIEGULATION E. CONSTRUCTION INDUSTRY LICE ISING.BOARD LICENSE NUMBER , .,_ am �' M ' , ti, ,,�. N "aN's4‘",,\e\.�� C.0C1 29851-°' :,,'" �.-. . '"" ""» w •.. , • ',�. N\ \''.-,",":*., 6.ROOFING CONT F1E@ACIOR-: armed Delow:tS CERTI, , - -Uhder the .visions f C, r<489 FS Expiraficip.dafe -A,U :3 , -2018 ISSUED: 07/17/2016 DISPLAY AS REQUIRED BY LAW SEQ # L1607170001285 Local Busi ness Tax lecei pt Miami -Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 6969142 BUSINESS NAM E/LOCATION PRUDENTIS ROOFING 7003 N WATERWAY DR STE 202 MIAMI, FL 33155 OWNER PRECAD INC Workers) m RECEIPT NO. RENEWAL 7244833 l 1.11111111B71/ 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 10 CCC1329851 PAYMENT RECEIVED BY TAX COLLECTOR 75.00 07/20/2017 0237-1T-005021 This Local Business Tax F ceipt only con"rrrs payment of the Local Business Tax. The Receipt is not a license, pernit, or a certi "cation of the holder's quail "cations, to do business. Folder mist candy with any governmental ornongoyermental regulatory lams and requirements which apply tothe business The REM PTNQabove must bedisplayed onall comerclalvehcles- Miami -Cede CodeSectte-27& For more irfometion, visit www.nianidade.govitaxcdlector A� oe CERTIFICATE OF LIABILITY INSURANCE DATE (MMND/WYY) 4/11/2018 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 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 Frank H. Furman, Inc.)- 1314 East Atlantic Blvd. P. 0. Box 1927 Pompano Beach FL 33061 CONTACT CT Nicole Towsley, CPCU (954)943-5050 FAX (, pm: (954)942-6310 ADDDREss:nicolet@furmaninsurance.com IISURER(S) AFFORDING COVERAGE NAIC e i, uRERA:Lloyds of London INSURED Precad Inc, dba Prudentis Roofing 7003 N. Waterway Drive #202 Miami FL 33155-2896 INSURER B :Ohio Security Insurance CO 24082 INSURERC: INSURERD: INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER:12/15/17 - 1/1/19 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 POUCIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 1NSR LTR TYPE OF INSURANCE ADDL SUER WVD POLICY NUMBER POLICY EFF (MMIDD/MYYY1 POLICY UPLIMITS IMMIDD/YYYY1 A I _WW2 COMMERCIAL GENERAL LIABILITY MCI8COL000050301 12/15/2017 1/1/2019 EACH OCCURRENCE $ 1,000,000 GE TO RENTED PREMMISES Ea occurrence) $ 100,000 CLAIMS -MADE X OCCUR MEDEXP(Anyoneperson) $ excluded PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L I AGGREGATE POLICY OTHER: LIMIT APPLIES O- JET PER: LOC PRODUCTS - COMP/OP AGO $ 2,000,000 Employee Benefits $ 1,000,000 B AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS x _ _ SCHEDULED AUTOS NO_ AUTOS BA8 18 55810065 12/15/2017 12/15/2018 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ (Per ((PerPROPERTYaccident) $ PIP -Basic $ 10,000 A X UMBRELLA LAB EXCESS LBW I OCCUR CLAIMS MADE UCISCBL000050401 12/15/2017 1/1/2019 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 $ DED RETENTIONS WORKERS COMPENSATION AND EMPLOYERS' LABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) It yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A I PERTUTE I I ER E.L EACH ACCIDENT $ EL DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Roofing Contractor License CCC 1329851 CERTIFICATE HOLDER CANCELLATION i@msvfl.gov Miami Shores Village Building Dept. 10050 NE 2 Ave. Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Dirk DeJong/NT ACORD 25 (2014/01) 1NS025 (201401) ®1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE I 4/11/2018 Producer. Plymouth Insurance Agency 2739 U.S. Highway 19 N. Holiday, FL 34691 (727) 938-5562 This Certificate is issued as a matter of information only and confers no right9 upon tyre Certificate Holder. This Certificate does not amend, extend or alter the coverage afforded by the polities below. Insurers Affording Coverage NAIC # Insured: South East Personnel Leasing, Inc. &Subsidiaries 2739 U.S. Highway 19 N. Holiday, FL 34691 Insurer A: Lion Insurance Company 11075 Insurer B: Insurer C: Insurer D: Insurer E: Coverages 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. Aggregate limits shown may have been reduced by paid daims. INSR LTR ADDL INSRD Type of Insurance Policy Number Policy Effective Date (MM/DD/YY) Policy Expiration Date (MM/DD/YY) Limits GENERAL LIABILITY Commercial General Liability Each Occurrence $ Damage Damage to rented prenYses (EA $ Claims Made Occur Med Exp $ Adv Injury $ General D aggregate limit applies perPersonal Policy ❑ Project ❑ LOC General Aggregate $ Products - Comp/Op Agg $ AUTOMOBILE ,..r MIN _ LIABILITY Any Auto All Owned Autos Scheduled Autos Hired Autos Non -Owned Autos Combined Single Limit (EA Accident) $ Bodily Ivry (Per Person) $ Bodily Injury (Per Accident) $ Property Damage (Per Accident) $ EXCESS/UMBRELLA ROccur LIABILITY ❑ Claims Made Deductible Each Occurrence Aggregate A Workers Compensation and Employers' Liability Any proprietor/partner/executive officer/member excluded? NO If Yes, describe under special provisions below. WC 71949 01/01/2018 01/01/2019 x l We Statu- tory Umits I 1OTH- ER E.L. Each Accident $1,000,000 E.L. Disease - Ea Employee $1,000,000 E.L. Disease - Policy Limits $1,000,000 Other Lion Insurance Company is A.M. Best Company rated A (Excellent). AMB # 12616 Descriptions of Operations/Locations/Vehicles/Exclusions added by Endorsement/Special Provisions: Client ID: 81-67-084 Coverage only applies to active employee(s) of South East Personnel Leasing, Inc. & Subsidiaries that are leased to the following "Client Company": Precad, Inc. dba Pnidentis Roofing Coverage only applies to injuries incurred by South East Personnel Leasing, Inc. & Subsidiaries active employee(s), while working in: FL Coverage does not apply to statutory employee(s) or independent contractor(s) of the Client Company or any other entity. A list of the active employee(s) leased to the Client Company can be obtained by faxing a request to (727) 937-2138 or by calling (727) 938-5562. Project Name: FRANCISCO GARZA LICENSE NUMBER CCC1329851 AS QUALIFIER. ISSUE 04-11-18 (KLR) Begin Date 4/19/2012 CERTFICATE HOLDER CANCELLATION VILLAGE OF MIAMI SHORES VILLAGE BUILDING DEPARTMENT 10050 NE2 AVENUE MIAMI SHORES, FL 33138 Should any of the above described policies be cancelled before the expiration date thereof, the issuing insurer will endeavor to mail 30 days written notice to the certificate holder named to the left, but failure to do so shall impose no obligation or liability of any kind upon the Insurer, Its agents or representatives. ' ' ,w.at/� ^ - i •-- ---'