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RC-18-1297 (2)
Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Permit Parcel Number Permit NO. RC-5-18-1297 Permit Type: Residential Construction Work CTassifcation: AlteratiOnt Permit Status: APPROVED Issue Date: 6/112018 Expiration: 11/28/2018 Applicant 671 NE 105 Street Miami Shores, FL 33138-2053 1122310120100 Block: Lot: CAROL INVEST USA INC Owner Information Address Phone Cell CAROL INVEST USA INC 671 NE 105 Street MIAMI SHORES FL 33138- (305)747-3098 671 NE 105 Street MIAMI SHORES FL 33138- Contractor(s) JOSEPH S. ROBBIO INC Phone (954)663-6743 Cell Phone Valuation: $ 45,000.00 Total Sq Feet: 565 Approved: In Review Comments: Date Approved: : In Review Date Denied: Type of Construction: REMODEL Stories: Front Setback: Left Setback: Bedrooms: Plans Submitted: Yes Certificate Date: Bond Return : KITCHEN, BATH, AND IN Occupancy: Single Family Exterior: Rear Setback: Right Setback: Bathrooms: Certificate Status: Additional Info: REMODEL KITCHEN, BATH, AND IN Classification: Residential Fees Due Bond Type - Contractors Bond CCF CO/CC Fee DBPR Fee DCA Fee Education Surcharge P&Z Review Fee Permit Fee Scanning Fee Technology Fee Total: Amount $500.00 $27.00 $50.00 $20.25 $13.50 $9.00 $35.00 $1, 350.00 $51.00 $36.00 $2,091.75 Pay Date Invoice # 05/16/2018 06/01/2018 Bond #: 3784 Pay Type RC-5-18-67548 Credit Card Credit Card Amt Paid Amt Due $ 50.00 $ 2,041.75 $ 2,041.75 $ 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 Electrical Review Electrical Review Building Review Mechanical Review Plumbing Review Structural 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. Futherii ore, I authorize the above -named contractor to do the work stated. Author/3.'' ignature: Owner / Applicant / Contractor / Agent June 01, 2018 Date Build' f Department Copy June 01, 2018 1 L9\ e BUILDING PERMIT APPLICATION Xi BUILDING C ELECTRIC PLUMBING MECHANICAL JOB ADDRESS: 671 NE 105 St. 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 RECEIVED MAY 16 2018 CiAC\ FBC zoi-3( Master Permit No. 11C, E- \2 `.- REVISION Sub Permit No. I CHANGE OF (—• CONTRACTOR EXTENSION I 'RENEWAL CANCELLATION I I SHOP DRAWINGS City: Miami Shores Folio/Parcel#: 11-2231-012-0100 Occupancy Type: County: Load: Construction Type: OWNER: Name (Fee Simple Titleholder): Carol Invest, USA Address: 990 Biscayne Blvd. City: Miami Suite 801 State: FI. Miami Dade Zip: 33138 Is the Building Historically Designated: Yes NO X Flood Zone: BFE: FFE: Phone#: zip: 33132 Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: Joseph S. Robbio, Inc Address: 9400 S. Meadows Circle Phone#: (954) 663-6743 City: Miramar Qualifier Name: Joseph S. Robbio State: Florida State Certification or Registration #: CBC 059462 DESIGNER: Architect/Engineer: Address: 370 NE 101 St. Value of Work for this Permit: $ 45,000 Victor Bruce Phone#: Certificate of Competency #: Type of Work: I I Addition x zip: 33025 Phone#: (305) 310-5030 City: Miami Shores State: FI• Zip: 33138 Square/Linear Footage of Work: 565 Sq. Ft. Alteration ri New ri Repair/Replace i 1 Demolition Description of Work: Remodel Kitchen, Bath, and install new master bath. All interior work Specify color of color thru,tile: co/cc $ 50. Scanning Fee $ Radon Fee $ Notary Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ Submittal Fee $' Permit Fee $ 1 350 (Revised02/24/2014) CCF $ DBPR $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding Company's Address City i State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City 4 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 performedto 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. v "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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must"be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted 'notice, the inspection will not be approved and a reinspection fee will be charged. Marco Bru Signature OWNER or AGENT The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this Signature Joseph S. Ro CONTRACTO R it GO day of IVY I L , 20 1$ , by o.(D day of A pr i I Hcirca i2 UZ21 , who i ersonally knoa)tr o jOSeloh 1Obhi 0 , who me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal LUCIA G ISASI MY COMMISSION #FF182628 .•'.Etid;r r EXPIRES December 10, 2018 8.04ea's* *El® APPROVED BY r7daNk�l��Ik I6�* * r•*** C T 1 as me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: ****************** Plans Examiner `'"�`"- LUCIA G ISASI "I. MY COMMISSION #FF182828 1,� ftiQ±.•° EXPIRES December 10, 2018 N*****s<*******************s*****x (407) 398-0153 FloridallotaryService.com ********** Zoning (Revised02/24/2014) Structural Review Clerk Property Search Application - Miami -Dade County Page 1 of 3 IMPORTANT MESSAGE PEDRO J. GARCI MIAMI-DADE PR When buying real estate property, you should not assume that property taxes will remain the same. Whenever there is a change in ownership, the assessed value of the property may reset to full market value, which could result in higher property taxes. Please use our Tax Estimator to approximate your new property taxes. The Property Appraiser does not send tax bills and does not set or collect taxes. Please visit the Tax Collector's website directy for additional information. Address Owner Name Subdivision Name Folio SEARCH: 671 NE 105 St. PROPERTY INFORMATION 0 Folio: 11-2231-012-0100 Sub -Division: GOLF VIEW ESTS CORRECTED PLAT Property Address 871 NE 105 ST Miami Shores, FL 33138-2053 Owner CAROL INVEST USA INC Mailing Address 990 BISCAYNE BLVD 802 MB 17 MIAMI, FL 33132 PA Primary Zone 1100 SGL FAMILY - 2301-2500 SO Primary Land Use 0101 RESIDENTIAL - SINGLE FAMILY : 1 UNIT Beds / Baths l Hatf 4/4/0 Floors Living Units 1 Actual Area 8,040 Sq.Ft Living Area 6,116 Sq.Ft Adjusted Area 6.336 Sq.Ft Lot Size 29,600 Sq.Ft Year Built 1950 Featured Online Tools Comparable Sales Tax Companson Suite Back to Search Results 0 ®© Glossary Non -Ad Valorem PA Additional Online Tools Property Record Cards Property Search Help Assessments Property Taxes Report Discrepancies Report Homestead Fraud Tax Estimator TRIM Notice Value Adjustment Board ASSESSMENT INFORMATION 0 BENEFITS INFORMATION 0 Year 2017 2016 2015 Land Value $810,300 $763,236 $610,500 Building Value $441,104 $141,113 $441,123 Extra Feature Value $41,607 $41,987 $28,897 Market Value $1,293,011 $1,248,336 $1.080,520 Assessed Value $1,293,011 $1,246,336 $663,790 Benefit Type 2017 2016 2015 Save Our Homes Cap Assessment Reduction $416,730 Homestead Exemption $25,000 Second Homestead Exemption $25,000 Note: Not all benefits are applicable to all Taxable Values g.e. Courtly, School Board, City, Regional). FULL LEGAL DESCRIPTION 0 https://www.miamidade.gov/propertysearch/ 4/14/2018 Property Search Application - Miami -Dade County Page 2 of 3 jj TAXABLE VALUE INFORMATION 0 2017 ICOUNTY Exemption Value Taxable Value SCHOOL BOARD Exemption Value i Taxable Value $0 $1,293,011 2018 2015 t $0 $50,000 $1,246,336 $613,790 $0 $0 $25,000 $1,293,011 $1,246,336 0638,7901 tan ! I Exemption Value $0 $0 $50.000 I i ', Taxable Value $1,293,011 $1,246,336 $613,790 l REGIONAL 1 ' Exemption Value $0 $0 $50,000 I Taxable Value $1,293,011 $1,246,336 $613,790 ' SALES INFORMATION ' 31 52 42 GOLF VIEW EST CORR PL PB 41-58 LOT 11 & THAT POR LOT 12 DESC BEG AT SW COR LOT 12 N17.5FT TO POB NELV205.17FT TO PT ON EA_ LOT 12 NWLY83.67FT SWLY194.2FT S 17.5FT TO POB LOT SIZE SITE VALUE OR 18621-3078 05 1999 1 Previous Sale Price OR Book -Page Qualification Description Previous Owner 1 Previous Owner 2 11/082017 $3,000,000 30756-1001 Dual by exam of deed ROBERT MORENO C/O SASHA B BERDEGUER PA , 05/182015 $1,050,000 29627-2110 Qual by exam of deed CHRISTOPHER HALL 05/01/1999 $500,000 18621-3078 Sales which are qualified 11/01/1995 $0 17015-2695 Sales which are disqualified as a result of examination of the deed • 09/01/1995 $390,000 16946-0421 Sales which are qualified 07/01/1971 $115,000 00000-00000 Sales which are qualified For more information about the Department of Revenue's Sales Quat0cation Codes. 2017 i 2016 2015 LAND INFORMATION Land Use GENERAL Muni Zone PA Zone R-20 1100 - SGL FAMILY - 2301-2500 SO BUILDING INFORMATION 0 Building Number Sub Area Year Built 1 1950 1 2 1978 Unit Type Square Ft. Units 29,600.00 Calc Value $810,300 Actual Sq.Ft. Living Sq.Ft. Adj Sq.Ft. Calc Value 7,988 6,116 6,319 $439,802 52 0 17 51,3021 `/ Building Sketches Available! 1 EXTRA FEATURES 0 I Description IChain -link Fence 4-5 0 high Wrought Iron Fence Patio - Terrazzo, Pebble Pool 8' res BETTER 3-8' dpth, tile 650-1000 sf Year Built 1997 1976 1976 1976 Units Calc Value 100 $830 250 $6,665 1,920 $8,112 1 $26,000 r ADDITIONAL INFORMATION • The information listed below is not derived from the Property Appraiser's Office records. It is provided for convenience and is derived from other government agencies. https://www.miamidade.gov/propertysearch/ 4/14/2018 ?etail by Entity Name Page 1 of 2 Florida Department of State org Ort'i` 7"k LIB (*Irk] ry .L+fi/pf1f L' ',l:4)J/It Department of State / Division of Corporations / Search Records / Detail By Document Number / DIVISION OF CORPORATIONS Detail by Entity Name Florida Profit Corporation ,-CAROL-INVEST-USA-INC. Filing Information Document Number P14000015318 FEI/EIN Number 38-3924898 Date Filed 02/18/2014 State FL Status ACTIVE Principal Address 990 BISCAYNE BLVD Suite 802, MB 17 MIAMI, FL 33132 Changed: 11/22/2016 Mailing Address 990 BISCAYNE BLVD Suite 802, MB 17 MIAMI, FL 33132 Changed: 11/22/2016 Registered Agent Name & Address FINLEY & BOLOGNA INTERNATIONAL 150 SE 2ND AVENUE, SUITE 1010 MIAMI, FL 33131 Name Changed: 03/26/2015 Officer/Director Detail Name & Address Title President, Treasurer, Secretary VERLICCHI MARAZZI, EMANUELA 990 BISCAYNE BLVD Suite 802, MB 17 MIAMI, FL 33132 Title VICE PRESIDENT http://search. sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 4/14/2018 ,i)etail by Entity Name Page 2 of 2 MARAZZI, CAROLINA 990 BISCAYNE BLVD. SUITE 803, MB 18 MIAMI, FL 33132 Title Director, VP 1- Bruzzi, Marco 990 BISCAYNE BLVD Suite 801, MB 16 MIAMI, FL 33132 Title Director, VP Melotti, Monica 990 BISCAYNE BLVD Suite 801, MB 16 MIAMI, FL 33132 Annual Reports Report Year Filed Date 2016 04/25/2016 2016 05/27/2016 2017 04/23/2017 Document Images 04/23/2017 -- ANNUAL REPORT 11/22/2016 -- AMENDED ANNUAL REPORT 11/16/2016 -- AMENDED ANNUAL REPORT 05/27/2016 -- AMENDED ANNUAL REPORT 04/25/2016 — ANNUAL REPORT 10/08/2015 -- AMENDED ANNUAL REPORT 10/06/2015 -- AMENDED ANNUAL REPORT 03/26/2015 — ANNUAL REPORT 02/18/2014 — Domestic Profit View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format Florida Department of State, Division of Corporations http: //search. sunbiz. org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 4/14/2018 DESARATA BUILDING CORP. 3523 GRIFFIN RD. DANIA, FLORIDA 33312 State Certified General Contractor CGC 021804 May 1,2018 Joseph S. Robbio, Inc 9400 S. Meadows Circle Miramar, Florida 33025 Re: Labor Contracting We propose to supply carpenters and laborers for demolition, concrete work, framing and drywall at 671 NE 105 St. Miami Shores. We will supply men as needed at an hourly rate to be billed on Friday and to be paid by Wednesday of the following week. All men are covered with workers compensation and liability insurance, and certificates will be provided to contractor. Hourly rates: Carpenters 35.00 per hour Laborers 24.00 per hour Thank you, Richard klowerton Accepted by STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CGCO21804 ISSUED: 08/10/2016 CERTIFIED GENERAL; CONTRACTOR HOWERTON, RICHARD'E , DESARATA BUILDING'CORP,ORATION IS CERTIFIED under the provisions of Ch.489 FS, Exp ratfon date AUG 31, 2016 L1608100001625 BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 - 954-831-4000 VALID OCTOBER 1,2017 THROUGH SEPTEMBER 30,2018 DBA: Business Name: DESARATA BUILDING CORP Business T e; L CONTRACTOR (CERTI yp GENERAL CONTRACTOR) Receipt #:G Owner Name: RICHARD EDWARD HOWERTON Business Opened:12/12/1989 Business Location: 3523 GRIFFIN RD StatelCountylCert/Reg:CGCO21804 DANIA BEACH Exemption Code: Business Phone: 954-434-7903 Rooms Seats Employees Machines Professionals 8 Tax Amount 27.00 For Vending Business Only Number of Machines: _ Vending Type: Transfer :penalty Prior Years- " 0.00 Fee 1 NSF Fee 0.00 0.00" I 0.00 Collection Cost 0.00 Total Paid 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT 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 WHEN VALIDATED 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. Mailing Address: RICHARD EDWARD HOWERTON 3523 GRIFFIN RD DANIA, FL 33312 Receipt #04B-16-00011995 Paid 09/27/2017 27.00 2017 - 2018 ACOR I DATE (MM/DD/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 1/4/2018 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. p 3775 NW 124 Avenue PHONE Coral Springs FL 33065 L INSURED Desarata Building Corporation 3523 Griffin Road, #5 Dania FL 33312 COVERAGES CERTIFICATE OF LIABILITY INSURANCE DESAR-1 CERTIFICATE NUMBER: 877831394 CONTACT NAME: Certificate Department _(AIC No,,Estlt 954-731-5566 j tq/C,No):954-731-8438 ADDRESS: certiIcates@roemer-ins.com INSURER(S) AFFORDING COVERAGE NAIC __ INSURER A _American Builders Insurance Co 11240 INSURER B: INSURER C : INSURER D : INSURER E : INSURER F : THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUR DEVISION NAMD ANU BOVEBER: 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?... -. _ADD�'SUBR'-'---'— ,__ LTR'. TYPE OF INSURANCE I `- i POLICY EFF 7 POLICY EXP i INSD I WVD : POLICY NUMBER I (MMIDD/YYYY) ; (MM/DO/YYYY) ! UNITS COMMERCIAL GENERAL LIABILITY r--t _ CLAIMS -MADE 1_ i OCCUR GEM. AGGREGATE LIMIT APPLIES PER • POLICY ( •; JECT ._-1 LOC OTHER: AUTOMOBILE LIABILITY { EACH OCCURRENCE S 5-A AGE fUREIMb•—• PREMISES (Ea occurrence) ! MED EXP (Any dne ,person) PERSONAL E ADV INJURY f GENERAL AGGREGATE - ; 5_ PRODUCTS - COMP/OP AGG -` 5 — ANY AUTO ! ALL AUTOS OWNED ' SCHEDULED I AUTOS _ HIRED AUTOS i I AUTO tiNED 1 I I DED ; I RETENTION S A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE 1OFFICER.'MEMBER EXCLUDED? , (Mandatory in NH) IDcSCRIPTION be OF OPERATIONS belay 1 UMBRELLA LIAB ' , OCCUR f EXCESS LIAR i CLAIMS-MADEI COMBINED SINGLE LIMIT s (Ea accident BODILY INJURY (Per dersor) 5 BODILY INJURY (Per accldenq ; 5. RROPERTYD'MAGE (Per accident) n Y/N! N/A Vi,CV 0227340 01 10/3/2017 10:3P018 S EACH OCCURRENCE ; S ;AGGREGATE S i5 X I PER ; OTH- I 1 STATUTE I ER E L-EACHACCIDENT ' Sy 000000 E L. DISEASE - EA EMPLOYEEi S 1_000.000 1 E.L. DISEASE - POLICY LIMIT ` S 1.000 000 DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached 11 more space is required) License# CGCO21804 CERTIFICATE HOLDER Miami Shores Village 10050 NE 2nd Avenue Miami Shores FL 33138 CANCELLATION 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 C L ACORD 25 (2014/01) ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACC D® CERTIFICATE OF LIABILITY INSURANCE ko......--'" DATE( D 01/03/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. CONFERS NO RIGHTS UPON THE CERTIFICATE OR ALTER THE COVERAGE AFFORDED BY THE HOLDEFL THIS POLICIES AUTHORIZED CONTRACT BETWEEN THE ISSUING INSURER(S), 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 10 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 NAME: Stephanie Harrison FAX 954-989-8208 s�F�i 95 4-86g'5533 I^�. Ne1 _ Est#AI lohilf@finneyfnsurancecorp.com INSURER(S) AFFORDING COVERAGE NAIC# INSURER A : Western World - INSURED Desarata Building Corp. 3523 Griffin Road Dania, FL 33312 INSURER B : INSURER C : INSURER D: INSURERE- INSURER F : • THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY 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 A ISU - INSD JM1D POLICY NUMBER EFF (M WDOIYYYX) POLICY EXP 1 LYYYY) UNITSPOUCY A X COMMERCIAL GENERALUABU.nY OCCUR NPP8432469 01/07/2018 01/07/2019 EACH OCCURRENCE $ 1,000,000 $ MED EXP (Any one person) r PERSONAL 8, ADV INJURY $ 1,000,000 GEN1. AGGREGATE LIMIT APPLIES{LI�PER: POUCY [ Jai j I LOC OTHER: GENERAL AGGREGATE $ 2,000,000 X PRODUCTS -COMP/OP AGG $ 2,000,000 $ LIABILITY SCHEDULED AUTOS NON-OWNEDU AUTOS BINED CO SINGLE LIMIT $ AUTOMOBILE ANY AUTO BODILY INJURY (Per person) $ OIANED f AUTOS ONLY HIRED AUTOS ONLY BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ 1 - ! UMBRELLA UAB OCCUR CLAIMS•W.DE EACH OCCURRENCE $ AGGREGATE $ EXCESS UAB $ DE0 ! I RETENTION $ WORKERS AND ANY OFFICER/MEMBER (Mandatory If yes COMPENSATION EMPLOYERS' UABIUTY PROPRIETOR/PARTNER/EXECUTIVE EXCWDED? In NH) describe under OF OPERATIONS Y / N NIA i STATUTE ER E.L. EACH ACCIDENT $ EL. DISEASE - EA EMPLOYEE $ below EL. DISEASE -POLICY UM1T $ DESCRIPTION Qualifier: OFOPERATIONS1 LOCATIONS 1 VEHICLES (ACORD 161, Additional Runarlo Schedule, may be attached N more space Is requited) Richard E. Howerton Licit CGCO21804 CERTIFICATE HOLDER CA 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 DEUVERED IN ACCORDANCE WITH THE POUCY PROVISIONS: AtITH07 REPRESEN�T�/'Cpt6 CD 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 ACORD 25 (2016/03) (SMH) Yt {;,;'A: -fir ) )frrittin :#:4 10050 N.E. 2nd Ave, Miami Shores, Florida 33138 Tel: 305-795-2204 Fax: 305-756-8972 Description: REMODEL KITCHEN, BATH, AND INSTALL NEW MASTER BATH. ALL INTERIOR WORK 671 NE 105 ST Miami Shores, FL 331382053 If the building is located in a special flood hazard area documentation of the as -built lowest floor elevation or lowest horizontal structural member has been provided and is retained in the records of Miami Shores Village. This certificate issued pursuant to the requirements of the Florida Building Code certifying that at the time of issuance this structure was in compliance ith the various ordinances of the jurisdiction regulating building construction or use. Not Transferable POST IN A CONSPICUOUS PLACE