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REV-17-2297Poo R BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC PLUMBING 4MECHANICAL JOB ADDRESS: 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 ❑ PUBLIC WORKS 3cr? NE 9G City: Miami Shores Folio/Parcel#: Occupancy Type: REVISION Master Permit No. Sub Permit No. ❑ EXTENSION ❑ CHANGE OF CONTRACTOR County: Miami Dade RECEIVED SE 2 @ 017 )(c.A_ $Y• - FBC 20 (LI ,46.-3 / 7 - 6g� El RENEWAL ❑ CANCELLATION ❑ SHOP DRAWINGS Zip: 3/f / Is the Building Historically Designated: Yes Load: OWNER: Name (Fee Simple Titleholder): Address: City: Construction Type: Flood Zone: ,7-/1(12 /) KF,Z /i/E 9 et-457-- BFE: Phone#: NO FFE: 44 l 1 r 5 �C�S State: 1—/ G t-%(i[ Zip: 3/ 7j / Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: p--IDII ns Address: t 920 '-O A J Q City: Aar -Li State: Phone#: 30S F2(_ Zip: 3(� Qualifier Name: s4\0 )► 2 S 4.0 -C\GA Phone#:,S05': c (g555 State Certification or. Registration #: 0 Certificate of Competency #: • DESIGNER: Architect/Engineer: i Address: City: Phone#: 1 � / — i i State: Zip: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work:- a„{Addition ❑ Alteration 1, ❑ New ❑ Repair/Replace IT Demolition s:• _ Description of Work �(IJ\M 5 1nn `m ! l + Q►,� RflSQ x a Specify color of color thru tile: Submittal Fee $ Permit Fee $ J • CCF $ Scanning Fee $ 3, 03 Radon Fee $ DBPR $ Technology Fee $ Structural Reviews $ CO/CC $ Notary $ Training/Education Fee $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ • (Revised02/24/2014) Bonding Company's Name (if'applicable) Bonding Company's Address City. ___. t31 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 r yrk r 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. _ ( `� v +\ ) "WARNING 'TO' OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY i 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."L .. i , • Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500,1he 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 cap' 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. OWNER or AGENT The foregoing instrument was acknowledged before me this _ day of Sas ▪ ���Y, 20 ra , by +cYThk..)Y , who is personally known to me or who has produced t �(Q.r\'2— as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: ************************ APPROVED BY Signature RACTOR The for instrumeht w. acknowledged before` me this ay of ��1�, 20 L" , by me or who has produced `` nn I�^^ly known to IXWY 'Y ' �(�J� as -h 1i identification and who did take an oath. NOTARY PUBLIC: Sig Print: Seal: Plans Examiner MYCOM MARAI K. GpN�LE2 g,•'Ft°"•'' 'IRES: �N*GC 44602 `BOnded Nu. November2, 2020 blic Underwriters ******************************************** Zoning Structural Review Clerk (Revised02/24/2014) Property Search Application - Miami -Dade County Page 1 of 2 Summary Report Property Information Folio: 11-3206-013-5621 Property Address: 347 NE 98 ST Miami Shores, FL 33138-2409 Owner ARTHUR BAKER ANNETTE FELDER Mailing Address 347 NE 98 ST MIAMI SHORES, FL 33138 USA PA Primary Zone 1000 SGL FAMILY - 2101-2300 SQ Primary Land Use 0101 RESIDENTIAL - SINGLE FAMILY : 1 UNIT Beds/Baths/Half 4/4/0 Floors 1 Living Units 1 Actual Area 3,224 Sq.Ft Living Area 2,468 Sq.Ft Adjusted Area 2,823 Sq.Ft Lot Size 11,500 Sq.Ft Year Built 1961 Assessment Information Year 2017 2016 2015 Land Value $345,138 $287,615 $276,299 Building Value $196,481 $196,481 $196,481 XF Value $611 $619 $549 Market Value $542,230 $484,715 $473,329 Assessed Value $542,230 $484,715 $194,479 Benefits Information Benefit Save Our Homes Cap Type 2017 2016 2015 $278,850 Assessment Reduction Homestead Exemption $25,000 $25,000 Second Homestead Exemption $25,000 $25,000 Widow Exemption $500 Note: Not all benefits are applicable to all Taxable Values i.e. County, School Board, City, Regional). Short Legal Description 1 53 41-6 53 42 MIAMI SHORES SEC 1 AMD PB 10-70 LOTS 16 & 17 BLK 41 LOT SIZE 100.000 X 115 73R131128 Generated On : 9/26/2017 Taxable Value Information 2017 2016 2015 County Exemption Value $50,000 $0 $50,500 Taxable Value $492,230 $484,715 $143,979 School Board Exemption Value $25,000 $0 $25,500 Taxable Value $517,230 $484,715 $168,979 City Exemption Value $50,000 $0 $50,500 Taxable Value $492,230 $484,715 $143,979 Regional Exemption Value $50,000 $0 $50,500 Taxable Value $492,230 $484,715 $143,979 Sales Information Previous Sale Price OR Book - Pa 9a Qualification Description 03/15/2016 $692,500 30013 2454 Qual by exam of deed 06/01/2008 $0 26503- 4802 Sales which are disqualified as a result of examination of the deed 06/01/1973 $74,000 00000-Sales which are qualified 00000 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 http://www.miamidade.gov/propertysearch/ 9/26/2017 ACOlRD® CERTIFICATE OF LIABILITY INSURANCE `...►� DATE(MM/DDmYY) 09/25/2017 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 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 A&A Underwriters Inc. 8778 SW 8th St Miami FL 33174 CONTACT NAME: Pablo M Conde PH N o. (305) 220-7447 (NC, No): (305) 220-4821 ADDRESS: Pmc@aaunderwriters.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: WESTERN WORLD INSURANCE COMPANY 13196 INSURED Montes De Oca State Corp 1820 SW 70th Ave Miami FL 33155 INSURER B : INSURER C : INSURER D : 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 SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY NPP8398318 09/08/2017 09/08/2018 EACH OCCURRENCE $ 1 ,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE X LIMIT APPLIES PRO- JECT PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OP AGG $ 1,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' UABIUTY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A PER STATUTE OTH- ER E.L. EACH ACCIDENT $ E.L. 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) Certified Mechanical Contractor. Licence # CMC1250513 CERTIFICATE HOLDER CANCELLATION Miami Shores Village Building Department 10050 NE 2nd Avenue 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 ACORD 25 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD PLEASE CUT OUT CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CONSTRUCTION INDUSTRY EXEMPTION CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW EFFECTIVE DATE: 9/18/2017 PERSON: MONTESDEOCA JULIO FEIN: 473021106 BUSINESS NAME AND ADDRESS: MONTES DE OCA STATE CORP 15892 SW 138 TERR MIAMI FL SCOPE OF BUSINESS OR TRADE: EXPIRATION DATE: 9/18/2019 Heating, Ventilation, Air. Sheet Metal Work Installation Conditioning and Refrigeration & Drivers Systems Installation. Service and Repair. Shop, Yard & Drivers C 33196 F 0 L D H E R E IMPORTANT Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS? (850)413-1609