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RC-18-1047Miami Shores Village 10050 N.E. 2nd Avenue NW Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Parcel Number Permit -NO. .RC -4-18-1 047 Permit Type: Residential Construction Wark Gfassifrcaiion: Alteration Permit Status: APPROVED issue Date: 5i .2tt18 Expiration: 11/05/2018 Applicant 11200 NW 5 Avenue Miami Shores, FL 33138-0000 3021360210890 Block: Lot: PAUL LEWIS Owner Information Address Phone CeII PAUL LEWIS 1 4320 CHARDONNAY Drive ROCKLEDGE FL 32955- Contractor(s) KAMEL'S PLACE LLC Phone (305)206-1566 CeII Phone Valuation: Total Sq Feet: $ 7,026.37 70 Approved: In Review Comments: Date Approved: : In Review Date Denied: Type of Construction: REPAIR FRONT WALL. Stories: Front Setback: Left Setback: Bedrooms: Plans Submitted: Yes Certificate Date: Bond Return : Occupancy: Single Family Exterior: Rear Setback: Right Setback: Bathrooms: Certificate Status: Additional Info: Classification: Residential Fees Due CCF DBPR Fee DCA Fee Education Surcharge P&Z Review Fee Permit Fee Plan Review Fee (Engineer) Scanning Fee Technology Fee Total: Amount $4.80 $3.17 $2.11 $1.60 $35.00 $210.79 $45.00 $9.00 $6.40 $317.87 Pay Date Invoice # 05/09/2018 04/20/2018 Pay Type RC-4-18-67235 Check #: 1141 Cash Amt Paid Amt Due $ 267.87 $ 50.00 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Final PE Certification Window Door Attachment Framing Insulation Drywall Screw Fill Cells Columns Window and Door Buck Review Planning Review Structural Review Electrical Review Electrical Review Building Review Plumbing Review Mechanical ti 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 permi I assume ponsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required fo :ICAL, P MB NG, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWN -S AFFIDA con ruction and zo all.the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating l authorze the above -named contractor to do the work stated. CC- 1Su.•— 60._N I A- ( May 09, 2018 Au : Owner / Applicant / Contractor / Agent epartment Copy Date Buildi 9 May 09, 2018 1 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Ave, Miami Shores, Florida 33138 Tel: 305-795-2204 Fax: 305-756-8972 Inspection Number: INSP-000161-2018 Permit Number RC-4-18-1047 Scheduled Inspection Date: September 26, 2018 Inspector: Naranjo, Ismael Owner: PAUL T LEWIS Address:,. 4320 CHARDONNAY DR ROCKLEDGE, FL 32965 Project: <NONE> Contractor: KAMEL'S PLACE LLC CARLSON K DANIEL Permit Type: Building (Residential) Inspection Type: Building Final Work Classification: Alteration Phone Number: Parcel Number: 1121360210890 Phone Number: 3052061566 Building Department Comments REPAIRFRONT WALL. Checklist Item General Comments Passed False Comments Inspector Comments Passed Failed Correction Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee Is paid. )(Z) September 25, 2018 For inspections please call: 305-762-4949 Page 16 of 26 41.10) LM BUILDING PE IT APPLICATION 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 R C Tv D AR2!0Cp3 BY: 1�` FBC 20 (-+ Master Permit No. rO ,ti) Sub Permit No. BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION EXTENSION n RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 11200 NW 5th Avenue, City: Miami Shores County: Miami Dade Zip: Folio/Parcel#:11-2136-021-0890 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Paul T. Lewis Address: P.O. Box 254062 PAFB, FL. 32925 City: PAFB State: Florida Zip: 32925 Tenant/Lessee Name: ^ ___�__.•,_•.__ _ Phone#: Email: CONTRACTOR: Company Name: lOv•'���/ ,S(Ctc,e_LL C Phone#: ;D 1{ 1,4 Address: ! [ l / iti / 4 b j --e i� City: ' 1- ` t State: (.3 ) ` S4 Zip: ' Qualifier Name: C&tr IS .?�✓ i \ 4)1,1\+ I e (-- Phone#: State Certification or Registration #: CGG f ,'S/ -i . Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ . 76Lb - 37 Square/Linear Footage of Work: 7.. 0 5 P Type of Work: n Addition n Alteration E.New [ Repair/ eplace ❑ Demolition aescription'of Work~ AR4 q,c +- P,—.,.-...%1' lk' _ S. Specify color of color thru tile: Submittal Fee $ a) Permit Fee $ 2- (v .1 Cl CCF $ CO/CC $ Scanning Fee $ �1 • Q Q Radon Fee $ 2 . ! ) DBPR $ 3 • I - Notary $ Technology Fee $ . 140 ^ Training/Education Fee $ t • 60 Double Fee $ - Structural Reviews $ . Bond $ TOTAL FEE NOW DUE $ 2(:). E3. (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 commenceme t must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absof _.. notice, the inspection will not be opproved and a reinspection fee will be charged. Signatur OWNER or AGENT The foregoing instrument was Q/F 9 day of 1 Lc-K L 7 XevviS Signature acknowledged before me this The foregoing/instrument was / 9 day of , who is personally known to ��L �SU n/ cJT me or who has produced 4-- 672.- e =�.3,5as° identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: , 20 /0 , by hnelle A Sr'rNo�CS CTOR cknowledged beforepme'this , 20 1O , by , who is personally known o me or who has produced as identification and who did take an oath. NOTARY PUBLIC: ***************** APPROVED BY Innelle P. Simons NOTARY PUBLIC :STATE OF FLORIDA Comm# GG201715 l Seal: Plans Examiner Structural Review Innelle P. Simons NOTARY PUBLIC ITATE OF FLORIDA Comm# GG201715 w•�.• v„'��pp�� /'l 2 �f �1 ��- (' ** M'*`* 4K9��+k/�k O**2************** Zoning Clerk (Revised02/24/2014) Property Search Application - Miami -Dade County Page 1 of 1 TY Summary Report Property Information Folio: 11-2136-021-0890 Property Address: 11200 NW 5 AVE Miami Shores, FL 33168-3310 Owner PAUL TYRONE LEWIS Mailing Address PO BOX 254062 PAFB, FL 32925 PA Primary Zone 5700 DUPLEXES - GENERAL Primary Land Use 0802 MULTIFAMILY 2-9 UNITS : 2 LIVING UNITS Beds / Baths / Half 5/4/0 Floors 1 Living Units 2 Actual Area Sq.Ft Living Area Sq.Ft Adjusted Area 2,359 Sq.Ft Lot Size 10,721.2 Sq.Ft Year Built 1993 Assessment Information Year 2017 2016 2015 Land Value $120,476 $48,349 $48,349 Building Value $188,909 $191,362 $193,815 XF Value $0 $0 $0 Market Value $309,385 $239,711 $242,164 Assessed Value $263,682 $239,711 $235,823 Benefits Information Benefit Type 2017 2016 2015 Non -Homestead Cap Assessment Reduction $45,703 $6,341 Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). Short Legal Description WEST SHORES PB 42-18 LOT 11 BLK 5 LOT SIZE 76.580 X 140 OR 15681-3424 0992 1 Generated On : 4/20/2018 Taxable Value Information 2017 2016 2015 County Exemption Value $0 $0 $0 Taxable Value $263,682 $239,711 $235,823 School Board Exemption Value $0 $0 $0 Taxable Value $309,385 $239,711 $242,164 City Exemption Value $0 $0 $0 Taxable Value $263,682 $239,711 $235,823 Regional Exemption Value $0 $0 SO Taxable Value $263,682 $239,711 $235.823 Sales Information Previous Sale Price OR Book -Page Qualification Description 09/01/1992 $19,000 15681-3424 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: https://www.miamidade.gov/propertysearch/ 4/20/2018 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION 'CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STR'EET, TALLAHASSEE FL 32399-0783 DANIEL, CARLSON K KAMEL'S PLACE LLC 1199 NW 88,STREET MIAMI FL 33150 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 LICENSE NUMBER PROFESSICNAL CGC1512952 - STATE OF 5ELORIDA----- DEPARTMENTIOE-BUSINESSAND-- REGULATION 4-- ISSUED 05/22/201'6— CrERTIFIETGEN AAL CONTRACTOR... ORr DANIEL CARLIS0100' KAMEL'S PLAdE-ELCI.e:' ofIS'CERT1 untrer.,the.provistons-ol'Ch,489 FS. Expiration date p*AUGli, 2018 Lisncnoopo986 DETACH HERE KEN LAWSON SECRETARY °4-", '''Pr:,,,i+0"*""•,...%,„,"w`h",;.--,...... STATE 'OF- F LORIDAS- -, N.,.., i.,..,-,-- ,,,,,, --N. .1.,_...r--DEPARTMENT OF BUSINESS AND'PROFESSIONAVREGULATION -- — --.........-"'CONSTRUCTION'INDUSTRY'LICENSING'BOARD ‘'''wy,.,''''N,4NN • ' - '.7--74.„-- --' .,..;--;-...,-;,-N-,.........4::-..\,„:„).__---,,,,,Z,,,NIS,,,_,.1N-.4*,:,,,...73/44. N.N, \A., :5C9611295-2,:00: ::,..,:.,-;:um-0,,.. `'".,„.......,r`'7;..--,---:' :L::....------..Ar-St.-:i-- .The . N ameAbejaw,IS CERTIFIED-"*"' GENERAL -CONTRACTOR Under -the proiiiiis 6f,ChdOldr489•FS. Expiration dateAUG 3f2018 0,.......,„„.,.0.......... DANIELCARLSO,N,K KAMEL'S PLACE'LL'C 1199 NVV 8-8-STREET, FL33160' «de' ISSUED: 05/22/2016 f SEQ # L1605220000986 001158 Local Business Tax Receipt Miami —Dade County, State of Florida —THIS IS NOT A BILL — DO NOT PAY 5984175 BUSINESS NAME/LOCATION —, aia'rA KAMELS PLACE LLC 8940 NW 9 CT MIAMI FL 33150 OWNER KAMELS PLACE LLC Worker(s) 1 'RECEIPT NO:.-* RENEWAL RENEWAL 6242945 LBT - 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 GENERAL BUILDING CONTRACTOR CGC1512952 PAYMENT RECEIVED BY TAX COLLECTOR $82.50 10/04/2017 ECHECK.-18-001205 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 governmental 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 8a-276. For more information, visit www.mlamidade.gov/taxcollector 1 CERTIFICATE OF LIABILITY INSURANCE DATE (M M/DDNYYY) 04/20/18 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 INSURANCE TODAY INC 4536 North UniversityDrive Lauderhill, FL 33351 CONTACT NAME: PHONE FAX Ext) (954) 915-3035 I I,/� Na)(954) 990-5236 Er AILo ADDRESS: eula@insurancetodaystore. com INSURER(S) AFFORDING COVERAGE NAIC# INSURER A: CAPITOL SPECIALTY INS INSURED KAMEL r S PLACE LLC 1199 NW 88th st MIAMI, FL 33150 INSURER B: INSURERC: 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. INSe LTR TYPE OF INSURANCE AUUL INSD SLASH YVVD POLICY NUMBER POLICY EFF (MWDD/YYYY) POLICY EXP (MM/DDNYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY CS16001449-18 8/30/178/30/18 EACH OCCURRENCE $ 1,000,000 I CLAIMS -MADE X OCCUR DAMAUE TO RENTED PREMISESiEa occurrence) $ 100,000 MEDEXP(Anyoneperson) $ 5,000 PERSONAL&ADVINJURY $ 1,000,000 GEN'L RPOLICY AGGREGATE LIMIT APPLIES PER: JECT LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OPAGG $ 1, 000, 000 $ AUTOMOBILE LIABILITY ANYAUTO 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 OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I j RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N /A ' I STATUTE I I ERH 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) GENERAL CONTRACTOR LICENSE # CGC1512952 ROOFING CONTRACTOR LICENSE # CCC1328324 VILLAGE OF MIAMI SHORES 10050 NORTHEAST 2ND AVE MIAMI SHORES, FL 33138 t SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WLL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD JIMMY PATRON'S CHIEF FINANICAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 9/3/2017 EXPIRATION DATE: 9/3/2019 PERSON: DANIEL CARLSON FEIN: 020629810 BUSINESS NAME AND ADDRESS: KAMEL'S PLACE LLC. 1199 NW 88TH STREET MIAMI FL 33150 SCOPE OF BUSINESS OR TRADE: Licensed Generoritractor Licensed Roofing Contractor IMPORTANT: Pursuant to Chapter 440.05(14), F.s., an officer of a corporation who elects exemption from this chapter by faing 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 oNy 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 (his 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. DF8-F2-DWC-282 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS? (850 413-1609 Scottsdale Insurance PO Box 4120 Scottsdale, AZ 85261-4120 Nationwide` Insured: Property: Home: Claim Rep.: Company: Business: PAUL LEWIS 11200 NW 5TH AVE MIAMI SHORES, FL 33168-3310 PO BOX 254062 PATRICK AIR FORCE, FL 32925 TJ Hoffman Nationwide E&S PO Box 4120 Scottsdale, AZ 43218-2068 Estimator: Alex Baste Claim Number: 01796627 Date Contacted: Date of Loss: Date Inspected: Date Est. Completed: Price List: Estimate: 10/24/2017 12:00 PM 10/18/2017 2:00 AM 10/26/2017 4:00 PM 12/12/2017 8:14 AM Policy Number: DFS1247858 FLMI8X_DEC17 Restoration/Service/Remodel PAUL LEWIS Cell: Home: Cellular: E-mail: (321) 480-2933 (305) 542-3049 (321)480-2933 ptyrol a®yahoo.com Business: (480) 365-5023 E-mail: tj.hoffntan@nationwide.com Business: (305) 318-5324 Type of Loss: Vehicle Date Received: 10/20/2017 2:00 AM Date Entered: 11/5/2017 5:58 PM Scottsdale Insurance PO Box 4120 Scottsdale, AZ 85261-4120 Nationwide Dear Valued Customer, Please refer to the enclosed itemized estimate. The estimate contains our valuation of the damages for the reported loss and was prepared using reasonable and customary prices for your geographic area. If this document contains estimated structural repairs and you choose to hire a contractor, please provide this estimate to them. If any hidden, or additional damage, and/or damaged items, are discovered, please contact me or have your contractor or vendor contact me immediately. Coverage for the hidden or additional damages and/or damaged items, would need to be determined, and may require an inspection/re-inspection, before any supplemental payment would be authorized. Please do not destroy, or discard any of the hidden or. additional damages, and/ordamaged items, until we have had an opportunityto review the hidden or additional damages and/or damaged items, and have reached an agreement with you on any supplemental cost. If you, your contractor, or vendor determine that there are additional building fees and/or permits associated with the estimated repairs, that may not be included in this estimate, please contact me immediately so that I may review and make a determination as to the appropriate payment. If a mortgage company is included on your claim payment check, please contact the mortgage company to discuss how to handle the proceeds of this payment. Thank you for allowing Scottsdale Insurance to serve your insurance needs. Please contact me at the numbers listed above if you have any questions regarding this estimate or any other matter pertaining to your claim. NOTICE - Section 817.234, Florida Statutes, provides in part: "Any person who knowingly and with intent to injure, defraud or deceive any insurer files a statement of claim or an application containing any false, incomplete or misleading information is guilty of a felony of the third degree." PAUL LEWIS 12/12/2017 Page:2 Scottsdale Insurance PO Box 4120 Scottsdale, AZ 85261-4120 Nationwide Door Missing Wall - Goes to Floor DESCRIPTION PAUL_LEWIS Main Level Living Room Height: 8' 416.78 SF Walls 619.76 SF Walls & Ceiling 22.55 SY Flooring 57.17. LE Ceil. Perimeter 202.99 SF Ceiling 202.99 SF Floor 51.08 LF Floor Perimeter 2' 6" X 6' 8" Opens into Exterior 3' 7" X 6' 8" Opens into Exterior QTY UNIT PRICE TAX O&P RCV DEPREC. ACV DWELLING 1. Content Manipulation charge - per 1.00 HR 32.50 0.00 6.50 39.00 (0.00) 39.00 hour 2. Clean floor - Heavy 202.99 SF 0.45 0.14 18.30 109.79 (0.00) 109.79 3. Remove Baseboard - 3 1/4" 25.54 LF 0.45 0.00 2.30 13.79 (0.00) 13.79 4. Baseboard - 3 1/4" 25.54 LF 2.85 2.06 14.98 89.83 (2.10) 87.73 5. Paint the walls - two coats 416.78 SF 0.88 5.54 74.46 446.77 (28.25) 418.52 6. Remove 1/2" drywall - hung, taped, 208.39 SF 0.41 0.00 17.08 102.52 (0.00) 102.52 with smooth wall finish 7. 1/2" drywall - hung, taped, with 208.39 SF 2.60 6.56 109.68 658.05 (6.69) 651.36 smooth wall finish 8. Remove Batt insulation - 6" - R19 - 104.19 SF 0.29 0.00 6.04 36.26 (0.00) 36.26 unfaced haft 9. Batt insulation - 6" - R19 - uafaced 104.19 SF 0.92 3.72 19.92 119.49 (3.79) 115.70 ban 10. Remove 5/8" drywall - hung, taped, 101.49 SF 0.41 0.00 8.32 49.93 (0.00) 49.93 ready for texture 11. 5/8" drywall - hung, taped, ready 101.49 SF 1.77 3.41 36.60 219.65 (0.00) 219.65 for texture 12. Remove Acoustic ceiling (popcorn) 101.50 SF . 0.45 0.00 9.14 54.82 (0.00) 54.82 texture 13. Acoustic ceiling (popcorn) texture 101.49 SF 0.83 0.35 16.92 101.51 (0.00) 101.51 14. Paint the surface arca - two coats 32.00 SF 0.88 0.43 5.72 34.31 (0.00) 34.31 15. Paint part of the ceiling - one coat 170.99 SF 0.61 1.32 21.12 126.74 (0.00) 126.74 16. Paint dooriwindow trim & jamb - 2 2.00 EA 28.90 0.53 11.66 69.99 (0.00) 69.99 coats (per side) 17. Door opening (jamb & casing) - 1.00 EA 99.13 3.84 20.58 123.55 (3.92) 119.63 32"to36"wide - paint grade 18. Exterior door, 8' tall - Detach & 1.00 EA 139.84 0.18 28.00 168.02 (0.00) 168.02 reset 19. Prime & paint door slab only - 2.00 EA 41.15 1.61 16.78 100.69 (16.40) 84.29 exterior (per side) 20. Window blind - PVC - 3.5" - 20.1 1.00 EA 148.37 6.56 31.00 185.93 (20.05) 165.88 to 32 SF PAUL LEWIS 12/1212017 Page: 3 tic :.... I Scottsdale, AZ 85261-4120 Nationwide` DESCRIPTION Scottsdale. Insurance PO Box 4120 CONTINUED - Living Room QTY UNIT PRICE TAX O&P RCV DEPREC. ACV 21. Light fixture - Detach & reset 22. Outlet 23. Detach & Reset Heat/AC register - Mechanically attached 24. Mask or cover per square foot 25. Mask wall - plastic, paper, tape (per LF) 1.00 EA 38.45 0.00 7.70 46.15 (0.00) 46.15 1.00 EA 11.38 0.10 2.30 13.78 (0.00) 13.78 1.00 EA 13.07 0.00 2.62 15.69 (0.00) 15.69 202.99 SF 0.39 0.85 16.02 96.04 (0.00) 96.04 51.08 LF 1.12 0.82 11.60 69.63 (0.00) 69.63 Dwelling Totals: 38.02 515.34 3,091.93 (81.20) 3,010.73 Totals: Living Room Door Missing Wa11- Goes to Floor DESCRIPTION 38.02 51534 3,091.93 81.20 3,010.73 Exterior Height: 8' 416.78 SF Walls 619.76 SF Walls & Ceiling 22.55 SY Flooring 57.17 LF Ceil. Perimeter 202.99 SF Ceiling 202.99 SF Floor 51.08 LF Floor Perimeter 2' 6" X 6' 8" Opens into Exterior 3' 7" X 6' 8" Opens into Exterior QTY UNIT PRICE TAX O&P RCV DEPREC. ACV DWELLING 26. Block - 8" x 8" x 16" - in place 145.87 SF 5.49 . 17.56 I63.68 982.07 (0.00) 982.07 27. Masonry - General Laborer- per 8.00 HR 32.50 0.00 52.00 312.00 (0.00) 312.00 hour 28. Paint masonry 1250.00 SF 0.79 25.38 202.58 1,215.46 (0.00) 1,215.46 29. Seal block with masonry sealer 145.87 SF 0.78 2.86 23.34 139.98 - (0.00) 139.98 30. Brick veneer 32.00 SF 11.32 9.23 74.28 445.75 (0.00) 445.75 31. Additional charge for a retrofit 1.00 EA 99.47 1.01 20.10 120.58 (0.00) 120,58 window, 12-23 sf 32. Wood window - single hung, 9-12 1.00 EA 460.78 26.12 97.38 584.28 (0.00) 584.28 sf 33. Concrete wall - Additional charge 1.00 EA 28.93 0.28 5.84 35.05 (0.00) 35.05 for vertical rise Dwelling Totals: 82.44 639.20 3,835.17 3,835.17 Totals: Exterior PAUL_LEWIS 82.44 639.20 3,835.17 0.00 3,835.17 12/12/2017 Page:4 Nationwide` ra DESCRIPTION Scottsdale Insurance PO Box 4120 Scottsdale, AZ 85261-4120 General Height: 8' 384.00 SF Walls 528.00 SF Walls & Ceiling 16.00 SY Flooring 48.00 LF Ceil. Perimeter 144.00 SF Ceiling 144.00 SF Floor 48.00 LF Floor Perimeter UNIT PRICE TAX O&P RCV DEPREC. ACV DWELLING 34. Dumpster load - Approx. 12 yards, 1-3 tons of debris 35. Plants - shrubs - deciduous - 1 gallon 36. Ornamental lmn - Labor Minimum For iron on window and doors 1.00 EA 440.00 0.00 88.00 528.00 (0.00) 528.00 4.00 EA 27.45 3.81 22.72 136.33 (0.00) 136.33 1.00 EA 213.21 0.00 42.64 255.85 (0.00) 255.85 Dwelling Totals: 3.81 153.36 920.18 920.18 Totals: General 3.81 15336 920.18 0.00 920.18 Area Dwelling Total: 124.27 1,307.90 7,847.28 (81.20) 7,766.08 Totals: Main Level 124.27 1,307.90 7,847.28 81.20 7,766.08 Area Dwelling Total: 124.27 1,307.90 7,847.28 (81.20) 7,766.08 Line Item Totals: PAUL LEWIS Grand Total Areas: 1,217.56 SF Walls 549.97 SF Floor 0.00 SF Long Wall 549.97 Floor Area 1,281.56 Exterior Wall Area 0.00 Surface Area 124.27 1,307.90 7,847.28 81.20 7,766.08 549.97 SF Ceiling 61.11 SY Flooring 0.00 SF Short Wall 605.42 Total Area 170.33 Exterior Perimeter of Walls 1,767.53 SF Walls and Ceiling 150.17 LF Floor Perimeter 162.33 LF Ceil. Perimeter 1,217.56 Interior Wall Area 0.00 Number of Squares 0.00 Total Perimeter Length 0.00 Total Ridge Length 0.00 Total Hip Length PAUL LEWIS 12/12/2017 Page: 5 Scottsdale Insurance PO Box 4120 Scottsdale, AZ 85261-4120 Nationwide` Line Item Total Material Sales Tax Subtotal Overhead Profit Replacement Cost Value Less Depreciation Actual Cash Value Less Deductible Net Glaini Total Recoverable Depreciation Net Claim if Depreciation is Recovered Summary for Dwelling Alex Baste 6,415.11 124.27 6,539.38 653.95 653.95 $7,847.28 (81.20) $7,766.08 (2,500.00) $5,266.08 81.20 S5,347.28 PAUL_LEWIS 12/12/2017 Page:6 Scottsdale Insurance PO Box 4120 Scottsdale, AZ 85261-4120 Nationwide Recap of Taxes, Overhead and Profit Overhead (10%) Profit (10%) Material Sales Tax Laundering Tax (2%) Manuf. Home Tax Storage Rental Tax (7%) (6%) (79.4) Line Items 653.95 653.95 124.27 0.00 0.00 0.00 Total PAUL_LEW1S 653.95 653.95 124.27 0.00 0.00 0.00 12/12/2017 . Page:7 Scottsdale Insurance PO Box 4120 Scottsdale, AZ 85261-4120 Nationwide Recap by Room Estimate: PAUL• LEWIS Area: Main Level Living Room 2,53/ 57 39.57% Exterior 3,113.53 48.53% General 763.01 11.89% Area Subtotal: Main Level S'ribt»tal of Areas Total PAUL_LEWIS 6,415.11 100.00% 100.00% 6.415.11 100.00% 12/12/2017 Page:8 Scottsdale Insurance PO Box 4120 Scottsdale, AZ 85261-4120 Nationwide` O&P Items Recap by Category with Depreciation RCV Deprec. ACV CLEANING CONCRETE & ASPHALT CONTENT MANIPULATION GENERAL DEMOLITION DOORS DRYWALL ELECTRICAL-3 FINISH CARPENTRY/ TRIMWORK HEAT, VENT & AIR CONDITIONING INSULATION LIGHT FIXTURES-7 LANDSCAPING MASONRY ORNAMENTAL IRON PAINTING WINDOWS - ALUMINUM WINDOW TREATMENT WINDOWS - WOOD 91.35 91.35 28.93 28.93 32.50 32.50 733.61 733.61 139.84 139.84 862.90 6.25 856.65 Eff.3-i73 1 11.3i3 171.92,...... __.. 5.62 166.30 13.07 13.07 95.85 3.54 92.31 (38.45_y 38.4 109.80 109.80 1,423.07 1,423.07 213.21 213.21 1,740.61 41.73 1,698.88 99.47 99.47 148.37 18.74 129.63 460.78 460.7 O&P Items Subtotal 6,415.11 75.88 6,339.23 Material Sales Tax 124.27 5.32 118.95 Overhead 653.95 653.95 Profit653.95 653.95 81.20 7,766.08 PAUL_LEWIS 12/12/2017 Page:9