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FW-18-2538BUILDING PERMIT APPLICATION X Miami Shores Village Imo, ; �: S P2.Sx18 Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY: Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 BUILDING n ELECTRIC n ROOFING FBC 20 l� Master Permit No. At-T- A' /007 Sub Permit No. fW IS 2-939 REVISION I I EXTENSION (RENEWAL PLUMBING n MECHANICAL PUBLIC WORKS n CHANGE OF I I CANCELLATION fl SHOP JOB ADDRESS: 671 NE 105 St. City: CONTRACTOR DRAWINGS Miami Shores County: Miami Dade Zip: Folio/Parcel#: 11-2231-012-0100 Occupancy Type: Is the Building Historically Designated: Yes NO Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Carol Invest USA Phone#: Address: 990 Biscayne Blvd. City: Miami State: FI. Zio: 33132 Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: Joseph S. Robbio, Inc Phone#: (954) 663-6743 Address: 9400 S. Meadows Circle City: Miramar State: FI. Zip: 33025 Qualifier Name: Joseph S. Robbio Phone#: (954) 663-6743 State Certification or Registration #: CBC 059462 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ 20,000 Square/Linear Footage of Work: 480 L/F Type of Work: I I Addition n Alteration y New n Repair/Replace I I Demolition Description of Work: Install 48" high Aluminum picket fence on the sides and rear of property. Install 2 sets of double gates Specify color of color thru tile: Submittal Fee $ Scanning Fee $ Technology Fee $ Structural Reviews $ Permit Fee $ CCF $ CO/CC $ Radon Fee $ DBPR $ 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 State Zip iviortgage Lender's Name (if applicable) Mortgage Lenders Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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 rnust be secured for ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, AIR CONDITIONERS, ET' OWNER'S AFF1D.AVIT: i certify that all the foregoing inforrnation is accurate and that all work will be -done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FA(LUIRE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT ±N YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. 4E YOU INTEND TO OBTAIN F NANC;NG, CONSULT WITH YOUR LENDER QR AN ATTORNEY ORNEY BEFORE RECORDING YOUR NOTTCE 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 churned. Signature Marco Br�lzzi OWNER or`AGENT The Pore oing instrument was acknowledged before me this -12 day of 5pJte►mhe✓ .20 14S ,by 1a day of f)ep1mh~€,Y ,20 l/5 ,by Marco Bruzzi , who is naNy i.naLA' • ,o Joseph S. Robbio , who is ersonaily knowto me or who has produced as me or 'vho has produced as identification and who did take an oath. NOTARY PU?UC: Joseph S. Robbio - Signature -7 // CONTRACTOR identification and 'mho did take an oath. NOTARY PUBLIC: Sign(t,(i(•,t Q �G<- - Print: X'1 G. G�1 a:,I Seat ;o ".."-.90 LUCIA G ISASI • MY COMMISSION #FF182628 _ , . EXPIRES December 10, 2018 Iaaz);seae , s:.,FioridalloSaty.SPrrjcq:Gqm APPROVED BY The foregoing instrument was acknowledged before me this Sign: Print: Seal: Plans Examiner Structural Review SGS LUCIA G ISASI MY COMMISSION #FF182628 ''' cF' EXPIRES December 10, 2018 j=i�l ��iaiPc3aFt8taijr5�ivc��coyh� � ' ; Zoning Clerk tRe:'is€dO2I24/201=1 DESARATA BUILDING CORP. 3523 GRIFFIN RD. DANIA, FLORIDA 33312 State Certified General Contractor CGC 021804 September 21, 2018 Joseph S. Robbio, Inc 9400 S. Meadows Circle Miramar, Florida 33025 Re: Labor Contracting Supply labor to install aluminum picket fence at the rear and east side of property Located at 671 NE 105 St. Insta11 2 sets of double gates ( one on the east side and one on the west side) Fence to be installed as per plan, Labor only ( material supplied by GC.) Total Thank you, and fW,erton Accepted Date 4,200.00 • },s ...� ;, RICK SCOTT, GOVERNOR ry :, .SAI►.•ma�yy,,, STATE OF DEPARTMENT OF BUSINEAND CONSTRUC, JONATHAN FLORIDA OFESSIONAL -YYLIC ZACHEM, SECRETARY REGULATION NG BOARD FI rida THE GENE' • et, to = ; '; f EASTER- I I p UNDER THE PROVIS - o ER 48_9--FLORIDFA TA UTES a• ,' r 'itB �U I-� 9i2b:!AR LD i V`.GORPPRA4 - . {. 04 '_•". -.-a., �►,,. *x ,f �.I 4 lawn) , ..� 3� '� sR, Fl RI AD. - ! !r ` A;NtA -A .k6a3,1 ..-.. / .,. ., . ' ��� ' { L1C �N #MBE `�C CC O*• .04 J Ili EXPIRATI NtDA ICU 31, 2020 Always verify licenses online at MyFloridaLicense.com ,� -�I Do not alter this document in any form. "';r .o . This is your license. It is unlawful for anyone other than the licensee to use this document. ■I. BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000 VALID OCTOBER 1, 2018 THROUGH SEPTEMBER 30, 2019 DBA: Business Name: DESARATA BUILDING CORP Owner Name: RI CHARD EDWARD HOWERTON Business Location: 3523 GRIFFIN RD DANIA BEACH Business Phone: 954-434-7903 Rooms Seats Employees 8 Receipt #:GENERAL18ONTRACTOR (CERTIFIED Business Type: GENERAL CONTRACTOR) Business Opened:12/12/1989 State/County/Cert/Reg : CGC o 21804 Exemption Code: Machines Professionals For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 0.00 0.00 0.00 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT WHEN VALIDATED Mailing Address: RICHARD EDWARD HOWERTON 3523 GRIFFIN RD DANIA, FL 33312 This tax is levied for the privilege of doing business within Broward County and is non -regulatory in nature. You must meet all County and/or Municipality planning and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. Receipt #05A-17-00010614 Paid 08/29/2018 27.00 a� o® CERTIFICATE OF LIABILITY INSURANCE DATE (MMYY IOD,YY) 01 /03/2018 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 Finney Insurance Corporation 5601 Sheridan Street Hollywood, FL 33021 CONTANAME: CT Stephanie Harrison PHONE S5y 466'55 (A C No: 954-989 8208 INC No. ExtL- E—MAILADDRESS: johrif@finneyinsurancecorp.com INSURER(S) AFFORDINO COVERAGE NAIC # INSURER A : Western World INSURED Desarata Building Corp. 3523 Griffin Road Dania, FL 33312 INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : • 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 MD POUCY NUMBER POLICY EFF (MM/DD/YYYYJ POLICY EXP IMMIDD/YYYYI LIMITS A X COMMERCIAL GENERALUABILnY NPP8432469 01/07/2018 01107/2019 EACH OCCURRENCE Si 1,000,000 X OCCUR DAMAGE TO PREMISES (EaENTED occurrence) $ 100,000 CLAIMS -MADE MED EXP (Any one person) $ 5 000 PERSONAL & ADV INJURY $ 1,000,000 APPLIES PER: GENERAL AGGREGATE $ 2,000,000 GEN'L X AGGREGATE LIMIT LOC PRODUCTS-COMP/OPAGG $ 2,000,,000 POLICY OTHER: JPRO- ECT $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT jEa $ ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY HIRED AUTOS NON -OWNED PROPERTY DAMAGE (Per accident[) $ _ AUTOS ONLY .__ AUTOS ONLY $ UMBRELLA LIAB EACH OCCURRENCE $ EXCESS UAB O OCCUR AGGREGATE $ DED I RETENTION CLAIMS -MADE $ $ WORKERS COMPENSATION PER STATUTE OTH- ER AND EMPLOYERS' UABIUTY Y i N E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? N / A E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If Yes, describe under E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Qualifier: Richard E. Howerton Lic# CGCO21804 CERTIFICATE HOLDER A Miami Shores Village Building Dept. 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. (SMH) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Printed by SMH on January 03, 2018 at 12:28PM 1AUTHORIZE REPRESENT % ACORD 25 (2016103) ' `�c R CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDD/YYYY) 1/4/2018 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 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 W.F. Roemer Insurance Agency, Inc. 3775 NW 124 Avenue PHONE g54 Coral Springs FL 33065 INSURED Desarata Building Corporation 3523 Griffin Road, #5 Dania FL 33312 DESAR-1 COVERAGES CERTIFICATE NUMBER: 877831394 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HA INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORC EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE INSRT �...—_ AODLSUBR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER _GEN'L AGGREGATE LIMIT APPLIES PER: POLICY . PRO- f I JECT { LOC IOTHER: I COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I J OCCUR AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS A HIRED AUTOS CONTACT NAME: Certificate Department 1ACC .No, xg_ =731 5566 i FAXtq(c,No) : 954-731-8438- ADDRESS: certificateS r0emer-Ins.com INSURER(S) AFFORDING COVERAGE INSURER A : American Builders Insurance CO _ 11240 INSURER B_ —. '-- -- INSURER C : INSURER D: INSURER E INSURER F : UMBRELLA LIAB EXCESS LIAB SCHEDULED AUTOS NON -OWNED AUTOS OCCUR I CLAIMS -MADE DED IE RETENTION S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y/N II NIA WCV 0227340 01 DESCRIPTION OF OPERATIONS/ LOCATIONS 7 VEHICLES (ACORD 101, Additional Remarks Schedul License# CGCO21804 CERTIFICATE HOLDER Miami Shores Village 10050 NE 2nd Avenue Miami Shores FL 33138 O REVISION NUMBER; RIGS t 'lc tivaur<EL) NAMED OF ANY CONTRACT OR OTHER DOCUMENT WITH ORESPECT TOR THE L WHICH ICY THIS IED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, : BEEN REDUCED BY PAID CLAIMS. POUCY EFF I POLICY EXP I (MMIDD/YYYY) I (MM/DD/YYYY) I I I LIMITS `EACH OCCURRENCE S I'DAMAGE=TO-RENTED -.._. PREMISES (Ea occurrence) $ I MED EXP (Any one person) . 5 t PERSONAL E ADV INJURY IGENERAL AGGREGATE 1 PRODUCTS - COMP/OP AGG I S a S S (COMBINED SINGLE LIMIT aEa accident) 1 BODILY INJURY (Per person) 1 BODILY INJURY (Per accident) PROPERTY DAMAGE ,(peraccident), s S 5 5 S , ( EACH OCCURRENCE AGGREGATE ~ g S 10/312017 1 1013/2018 X I STATUTE,.-i I ERH ; E.L. EACH ACCIDENT 1 S 1,000,000 —� E L. DISEASE - EA EMPLOYEEI 5 1 000,000 E.L. DISEASE - POLICY LIMIT S 1,000000 aoD I may be attached if more space is required) '`A klelCI 1 ATI�•• 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 t lCsta‘ ACORD 25 (2014/01) © 1988-2014 ACORD CORPORATION, All rights reserved. The ACORD name and logo are registered marks of ACORD 2018 FLORIDA PROFIT CORPORATION AMENDED ANNUAL REPORT DOCUMENT# P14000015318 Entity Name: CAROL INVEST USA, INC. Current Principal Place of Business: 990 BISCAYNE BLVD SUITE 802, MB 17 MIAMI, FL 33132 Current Mailing Address: 990 BISCAYNE BLVD SUITE 802, MB 17 MIAMI, FL 33132 US FEI Number: 38-3924898 Name and Address of Current Registered Agent: BOLOGNA, ESQ., STEFANIA 100 S.E. SECOND STREET SUITE 3800 MIAMI, FL 33131 US FILED Jul 16, 2018 Secretary of State CC8272000295 Certificate of Status Desired: No ' The above named entity submits this statement for the purpose of changing its registered office or registered agent, or both, in the State of Florida. SIGNATURE: STEFANIA BOLOGNA, ESQ. 07/16/2018 Electronic Signature of Registered Agent Officer/Director Detail : Title Name Address City -State -Zip: Title Name Address City -State -Zip: Title Name Address City -State -Zip: PRESIDENT, TREASURER, SECRETARY VERLICCHI MARAZZI, EMANUELA 990 BISCAYNE BLVD SUITE 802, MB 17 MIAMI FL 33132 DIRECTOR, VP BRUZZI, MARCO 990 BISCAYNE BLVD SUITE 801, MB 16 MIAMI FL 33132 ASST. SECRETARY BOLOGNA, STEFANIA 100 SE 2ND STREET 3800 MIAMI FL 33131 Title Name Address City -State -Zip: Title Name Address City -State -Zip: VICE PRESIDENT MARAZZI, CAROLINA 990 BISCAYNE BLVD. SUITE 803, MB 18 MIAMI FL 33132 DIRECTOR, VP MELOTTI, MONICA 990 BISCAYNE BLVD SUITE 801, MB 16 MIAMI FL 33132 Date I hereby certify that the information indicated on this report or supplemental report is true and accurate and that my electronic signature shall have the same legal effect as if made under oath; that l am an officer or director of the corporation or the receiver or trustee empowered to execute this report as required by Chapter 607, Florida Statutes; and that my name appears above, or on an attachment with all other like empowered. SIGNATURE: MARCO BRUZZI VICE PRESIDENT 07/16/2018 Electronic Signature of Signing Officer/Director Detail Date Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Permit NO.: FW-09-18-2538 Permit Type: Fence/Wall Work Classification: Wire Fence Permit Status: Approved Issue Date: 09j26/2018 I Expiration: 03/25/2019 Parcel Number Project 671 NE 105 ST, Miami Shores, FL 33138-2053 1122310120100 <NONE> Contacts Owner 671 NE 105 ST, MIAMI SHORES, FL 33138 (305)747-3098 JOSEPH S. ROBBIO INC 9400 S MEADOWS CIR, MIRAMAR, FL 33025 (954)663-6743 Contractor Description: INSTALL 48" HIGH ALUMINUM PICKET FENCE ON THE SIDES AND REAR OF PROPERTY. INSTALL 2 SETS OF DOUBLE GATES. Fees Amount Application Fee - Other CCF DBPR Fee DCA Fee Education Surcharge Planning and Zoning Review Fee Scanning Fee Technology Fee Wire and Wood Fence Fee Total: $50.00 $12.00 $7.20 $4.80 $4.00 $35.00 $9.00 $12.00 $430.00 $564.00 Applicant 671 NE 105 ST, MIAMI SHORES, FL 33138 (305)747-3098 Payments Total Fees Credit Card Amount Due: Amt Paid $564.00 $564.00 $0.00 Permit Received By Inspection Requests: 305-762-4949 Inspections: Inspection Type Foundation Building Final Date Building Department Copy 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 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. Futhermore, I authorize the above na d contractor to do the work stated. %en Authorize • ' • ature: Owner / Applicant / C tractor / Agent Date s Septe er 26, 2018 Page 2 of 4 2' ALUMINUM CAP i'xi'x0.062 ALUMINUM PICKET 2x2xi' ALUMINUM POST 2' ALUMINUM BOTTOM RAIL GRADE 5'-0' O.C., MAX. 4' MAX. \,/\/\/1\ \ /\/\/10x24 CONC. FOOTING\/ '/ '/ '/\ Y / / / , \/- / X/- \ . : / / / , / / \// \\ /\//\\/. \ . \ . \ . \ . \ . \ /\ AA26031388 VICTOR J. BRUCE AR-0017103 + ID-4961 P.O. Box 530019 Miami Shores, Rodda 33153 • • • i let 305-310-5030 • • • • • • • %mai: vb6b2-al.com • • • •••••• •• it, • •x • • • • •••••• •••4/ • • .••.•• • • • • • •• • • • • •••. • •• •• ••••.• • • .•• •. `• ill :r. i • .• • • • • • • • • •• • •. • • z• CI •• • W� —� z N J Z E W +u� LI- W u O mO z • • ALUM. FENCE DETAIL SCALE: 3/4'=I'-0' • • • II • ••••• •..••. • • O 000000 • • • I.•.• • • \\\ SEAL \/< txa-17—I! leum Dealptlite Reject1.i• Brunt Residence - New Fence 671 NE 1051h Sheet Miami Shores, Florida 33138 Date Ref* numb•: 0353-brual hubs Ilk Aluminum Fence Detail SK-1 OF 1