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RC-17-2158 (2)Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION Permit Type: Electrical JOB ADDRESS: f!( Y v 1 0 57 s T City: FBC 20Ie( RECEIVED SEP 2 8 DV Permit No. Master Permit No. la C-A - 2- 1 s2( FoLto, 0b I '2136,' 005_ e332o Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO / Flood Zone: OWNER: Name (Fee Simple Titleholder): D L V V 12-A-N L e ®! C Phone#: Address: 5 kIW lc) S sT City: pi 64a 5K7n State: FLOP H DA Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: AL 5'(t2 cap ELEG, COPT- Phone#: 766-2.2 -• 66 1e, Address: S-(p(o s w j"f/f -`l City: MIA-/- 1 State: FL, Zip: ;3 14 4 Qualifier Name: 124 fO (4 L0 R-Gi' T E �r Phone#:,�(�—��-�j'�pb�! �o State Certification or Registration #: E'Ccoot D Certificate of Competency #: Contact Phone#: Email Address: ES (%DLL p eC e f -cm Co m DESIGNER: Architect/Engineer: Phone#: O d Value of Work for this Permit: $ 3 7 0 P Square/Linear Footage of Work: Type of Work: ❑Address ❑Alteration ❑New epair/Replace ❑Demolition Description of Work: T e lu p b(2.4-12 ( L -E G . lj %Z t � � i✓ p711 00) Dz (a el ********************************: ******Fees*******************:x: *********************** Submittal Fee $ Permit Fee $ I.-mt Dl' CCF $ CO/CC $ Radon Fee $ DBPR $ Bond $ Training/Education Fee $ Technology Fee $ Scanning Fee $ Notary $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 $2500. the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature 70 Owner or Agent The foregoing instrument was acknowledged before me this CR�Aek. day of �( , 20 17_, by D rcct LBO Signature ' Contractor The foregoing instrument was acknowledged before me this' /417 ih day of V1i 20 17, by jC► via-1 , who is personally known to me or who has produced who is As iLdenAjati Io l aylow.iktbb�q�d� ke an oath. CNOTARY_PU$LIC: J Sign: Print: / My Commission Expires: ack,/o / vt :i'l * **** , :****** ******* APPROVED BY me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: err .. My Com issi n Expires: 'I�l � �fl � �„� NO!i Y Public 01,, c • Stan a 1 Z Florida 1 Conanhion • ff 986412 $** 14,4l 401011AF6 to *i********************************x ************* A z gsAPLj' Plans Examiner Structural Review V`" :ice°��; AALIYAH MERCEDES ALVARADO .,,..:.... MY COMMISSION #FF075410 o EXPIRES December 10, 2017 (407) 398-0t53 FloridallotaryService.com Zoning Clerk (Revised 3/12/2012 )(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) 005t74- — - Local Business Tax Receipt Miami -Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 0886 BtNESS NAME/LOCATION ALES GROUP ELECTRICAL CONTRACTORS 896 SW 70 AVE MIAMI FL 33144 OWNER "ALES GROUP INC Worker(s) I. RECEIPT NO. RENEWAL 722667E EXPIRES SEPTENIBER 30, 2017 Must be displayed at place of business , Pursuant to County Code Chapter RA - Art. 9 & ib SEC. TYPE OF BUSINESS - 196 ELECTRICAL CONTRACTOR EC0001288 PAYMENT AECEtVED BY TAX COLLECTOR $75.00 09,07/2016 _ECHECK-16-175623 This Local Business Tax Receipt only confirms payment of the Local Business Tax.. The Receipt is not a license, permit, or a certification of the holder's qualifications, to do business,` Holder must comply with any governmenta or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT NO, above must be displayed on all commercial vehicles= Miami -Dade Code' Sec Sa-276. for more information, visit www.miamidade.goyttanQINCtor AC: C)RL?' CERTIFICATE OF LIABILITY INSURANCE DATE (MMtDONYY' ) 14/3/2017 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 ANDYS ASSURANCE AGENCIES 1441 W Flagler St Miami, FL 33135 License#:A223890 INSURED ALES GROUP INC 896 SW 70th AVE MIAMI, FL 33144 NAMEACTANDY RODRIGUEZ JR PtiJCNo,Extt: (305) 642-8407 iLJCcNo) (305) 643-5969 ADDRESS andyjr@andysassurance.com INSURER(SI AFFORDING. COVERAGE NAICK INSURER A CATLIN SPECIALTY INS CO INSURER 8 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 TYPE OF INSURANCE Idrttri Ush ` 1 POLICY e r POLICY EXP LTR I INSR BAND 1 POLICY NUMBER I(MM/OD/YYYY) (MM/ODNYYY) 1 A X COMMERCIAL GENERAL LIABILITY CLAIMS•MADE ' X I OCCUR GENT. AGGREGATE LIMIT APPLIES PER PRO- 1 >....XI POLICY 1 JECT i 1 LOC _. -..; OTHER' 1000113070 LIMITS EACH OCCURRENCE j s 1, 000,000 ' PREMISES O(E EccurNT rrrence) 1 $ 100 , 000 1 MEOEXP(Anyoneperson) I $ 5,000.1 i01/03/17 01/03/18 PERSONAL$ADV INJURY IS 1,000,000 GENERAL. AGGREGATE .$ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 AUTOMOBILE LIABILITY i ANY AUTO I-- ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS UMBRELLA LUAE • EXCESS LIAR 1 DED 1 RETENTION OCCUR CLAIMS -MADE YIN i __�tNlA !WORKERS COMPENSATION !AND EMPLOYERS' LIABILITY ;ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED» (Mandatory In NH) It yes, describe under DESCRIPTION OF OPERATIONS below COMBINED SINGLE LIMIT a accident) BODILY INJURY (Per person) BODILY INJURY (Per accident} 1 S 1Per accident) IEACH OCCURRENCE AGGREGATE E.L EACH ACCIDENT j $ '. E L DISEASE - EA EMPLOYEia $ E L DISEASE - POLICY LIMIT $ PER I OTH- STATUTE ( iER !DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORO 101, Additional Remarks Schedule, may be attached if more space is required) 'Concrete Construction (91560), Electrical Work (92478), General Contractor (91580) & 'Subcontracted Work (91585), Plumbing (98482), Tile/Stone/Marble Work (99746) CERTIFICATE HOLDER CANCELLATION Miami Shores Village Building Department 10050 NE 2 Avenue Miami Shores, Fl 33138 SHOULD ANY OF THE ABOVE DESC ED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THER NOTICE WILL BE DELIVERED IN ACCORdi5ANCE WITH THE POLIO OVISIONS. AUTHOR, ED REPRESENTATIV 1988-2013 ACORD Clt'C f7PORATION. All rights reserved. ACORD25(2013/04) The ACORD name and logo are registered ma of ACORD JEFF ATWATER CHIEF FINANCIAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERSCOMPENSATION CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW " CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual fisted below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 1/3/2016 EXPIRATION DATE: 1/2/2018 PERSON: LORENTE RAMON FEIN: 592157712 BUSINESS NAME AND ADDRESS: ALES GROUP INC 896 SW 70 AVENUE MIAMI FL 33144 SCOPES OF BUSINESS OR TRADE: LICENSED GENERAL LICENSED ELECTRICAL DOOR AND WINDOW CONTRACTOR CONTRACTOR INSTALLATION 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 DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS? (850)413-1609 Property Search Application - Miami -Dade County Page 1 of 1 Summary Report Property Information Folio: 11-2136-005-0320 Property Address: 5 NW 105 ST Miami Shores, FL 33150-1241 Owner DEBORAH LEONE Mailing Address 5 NW 105 ST MIAMI, FL 33150-1241 PA Primary Zone 0800 SGL FAMILY - 1701-1900 SQ Primary Land Use 0101 RESIDENTIAL - SINGLE FAMILY : 1 UNIT Beds / Baths / Half 2/2/0 Floors 1 Living Units 1 Actual Area 1,379 Sq.Ft Living Area 1,324 Sq.Ft Adjusted Area 1,242 Sq.Ft Lot Size 9,225 Sq.Ft Year Built 1941 Assessment Information Year 2017 2016 2015 Land Value $198,007 $166,118 $166,118 Building Value $89,157 $89,227 $82,267 XF Value $20,403 $20,403 $13,083 Market Value $307,567 $275,748 $261,468 Assessed Value $103,199 $101,077 $90,734 Benefits Information Benefit Type 2017 2016 2015 Save Our Homes Cap Assessment Reduction $204,368 $174,671 $170,734 Homestead Exemption $25,000 $25,000 $25,000 Second Homestead Exemption $25,000 $25,000 $25,000 Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). Short Legal Description DUNNINGS MIAMI SHORES EXT NO 1 PB 41-51 LOT 16 BLK 203 LOT SIZE 75.000 X 123 OR 12244-2479 0884 1 Generated On : 9/28/2017 Taxable Value Information 2017 2016 2015 County Exemption Value $50,000 $50,000 $50,000 Taxable Value $53,199 $51,077 $40,734 School Board Exemption Value $25,000 $25,000 $25,000 Taxable Value $78,199 $76,077 $65,734 City Exemption Value $50,000 $50,000 $50,000 Taxable Value $53,199 $51,077 $40,734 Regional Exemption Value $50,000 $50,000 $50,000 Taxable Value $53,199 $51,077 $40,734 Sales Information Previous Sale Price OR Book -Page ' Qualification Description 08/01/1984 $65,000 12244-2479 !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 Appraiser and Miami -Dade County assumes no liability, see full disclaimer and User Agreement at http://www.miamidade.gov/info/disclaimer.asp Version: http://www.miamidade.gov/propertysearch/ 9/28/2017