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DEMO-18-3419Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address issue Date: 11/15/2018 Parcel Number Permit NO.: DEMO-11-18-3419 Permit Type: Demolition Work Classification: Commercial Permit SfatuS: Approved Expiration: 05/08/2019 338 NW 111TH TER, Miami Shores, FL 33168 1121360010560 Contacts Citimortgage inc 1000 Technology DR, Saint Charles, MO 63304 Owner Description: REMOVE WINDOW COVERING Fees Amount Application Fee - Other Building Demoloition Fee CCF DBPR Fee DCA Fee Education Surcharge Scanning Fee Technology Fee Total: $50.00 $200.00 $0.60 $3.75 $2.50 $0.20 $9.00 $6.25 $272.30 GC WORKS, INC LANCE WAYNE Business: 3055763600 Contractor Valuation: $ 100.00 Total Sq Feet: 0.00 Inspection Requests: J 305-762.4949 Payments Total Fees Credit Card Credit Card Amount Due: Date Paid 11/15/2018 11/09/2018 Amt Paid $272.30 $222.30 $50.00 $0.00 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 named contractor to do the work stated. 1a1 TO 14 Authorized Signatu(e: Owner / Applicant / ll Contractor / Agent Date November 15, 2018 Page 2 of 2 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-001989-2018 Permit Number. DEMO-11-18-3419 Scheduled Inspection Date: November 30, 2018 Inspector: Naranjo, Ismael Owner: Citimortgage inc Address: 338 NW 111TH TER Project: Miami Shores, FL 33168 Contractor: GC WORKS, INC LANCE WAYNE Permit Type: Demolition Inspection Type: Building Final ork Classification: Commercial Phone Number: Parcel Number: 1121360010560 Phone Number: 3055763600 Building Department Comments REMOVE WINDOW COVERING Checklist Item General Comments Passed Passed False Failed Correction Needed Re -inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. Comments 11/2112018 NO ONE HOME , HOME EMPTY , NO PLANS OR PERMIT 11 /28/2018 SEE PREVIOUS COMMENTS Inspector Comments November 29, 2018 For Inspections please call: 305-762-4949 Page 37 of 45 BUILDING PERMIT APPLICATION UILDING ❑ ELECTRIC ❑ PLUMBING IVIIdI 1 II JI IU1 CJ V Midge 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 Master Permit No. Sub Permit No. ❑ ROOFING ❑ REVISION ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF CONTRACTOR JOB ADDRESS:33 8 (l9i l 11 --Ma (12 City: Miami Shores County: Miami Dade BC zo►l t'f" tnw ❑ EXTENSION ❑RENEWAL ❑ CANCELLATION Zip: Folio/Parcel#: Is the Building Historically Designated: Yes Occupancy Type: Load: Construction Type: Flood Zone: BFE: ❑ SHOP DRAWINGS NO FFE: OWNER: Name (Fee Simple Titleholder): . e- Phone#: S'7 7 - L90 - 3197 Address: / U uo <Lift c ro 0 ✓; - P n^ City: G �ti <<Gr� State: f �' 1C>. Zip: 1�369 Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: C., ( 0 CY � S f ._i_ � 1 C Phone#: 3�}s 20 6 13 Address: 1 )20 uUJ ks1XQ City: M (CO1 State: p( Qualifier Name: Orr ; 1O nCie State Certification or Reghtration #: �C 4 (12 132 Phone#: Certificate of Competency #: DESIGNER: Architect/Engineer: Address: City: t bo Value of Work for this Permit: $X 160 Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace Description of Work: cke.+v o J e- W /•-•4 C-01/ .P •�,' r‘ _ //e-p3-A-3 s ,- 4 t-e c•-1,GG."' 71 die #4 _ . • Zip: �j 2 a% Phone#: State: Zip: Square/Linear Footage of Work: Demolition Specify color of color th u tile: Submittal Fee $ 50 -pCl i Permit Fee $ 2 CO. 0.� Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ CCF $ CO/CC $ DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUES 22-2 • 3 0 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 r 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 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 abse ce of such posted, notice, the inspection will not be approved • nd a reinspection fee will be charged. Signature ER or AGENT Signature The foregoing instrument was acknowledged before me this The foregoing instrume Oq day of 0 UM / 6/f , 20 / 8 , by day of ,f (�h'in/j a oyez €ho is personally kno n to Lc r W lx0lu me or who has produced as identification and w , did take an oath. NOTARY PUBLIC: Sign: Print: Seal: iJA,MINN , I / 71 ti MARIA E. BENITEZ MY COMMISSION # FF 08563 EXPIRES: March 31, 201.k Bonded Thai Notary Public Underwriters ********************************** ******** APPROVED BY lyl **** t was acknowledged before me this (�v(Ir (' , 20 , by to me or who has produced as identification and wdid take an oath. NOTARY PUBLIC: Sign: Print:• t'l 'CDC a Seal: �el1i *****************41 Plans Examiner ...... MARIA E. BENITEZ MY COMMISSION 1 FF 085632 it:?• EXPIRES: March 31, 201tr Bonded Thru Notary Public Underwriters ***'*******.� Zoning Structural Review Clerk 2018 FLORIDA PROFIT CORPORATION ANNUAL REPORT FILED DOCUMENT# P04000134543 Feb 15, 2018 Entity Name: JMC PRESERVATION.SERVICES, INC. Secretary of State - -� - - CC9997387213 Current Principal Place of Business: 2400 SW 26TH LANE MIAMI, FL 33133 Current Mailing Address: 2400 SW 26TH LANE MIAMI, FL 33133 US FEI Number: 86-1115097 Name and Address of Current Registered Agent: CHAVEZ, JOHANNA 2400 SW 26TH LANE MIAMI, FL 33133 US 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: Electronic Signature of Registered Agent Officer/Director Detail : Title PD Title VD Name CCAAVEZ, JOHANNAJ Name CAROL, MILTON Address 2400 SW 26TH LANE Address 2400 SW 26TH LANE City -State -Zip: MIAMI FL 33133 City -State -Zip: MIAMI FL 33133 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 I 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: JOHANNA CHAVEZ PRESIDENT 02/15/2018 Electronic Signature of Signing Officer/Director Detail Date 1 cti� Code Compliance Department 10050 NE Second Ave. Miami Shores, FL 33138 RE: Property Address: 338 NW 111t Terr. MiamiShores, FL 33168 To Whom It May Concern: - Please be advised that JMC PRESERVATION SERVICES INC is a CitiMortgage Inc. authorized • representative. CitiMortgage, Inc. authorizes JMC PRESERVATION SERVICES INC and its contractors to perform preservation work at the subject property. Please allow JMC PRESERVATION SERVICES INC to obtain permits.- - If you have any questions, please contact us at: 1000 Technology Drive Department 305 - Property Preservation O'Fallon, MO 63368 1-877-290-3997 option 2 Monday - Friday from: 8:00am - 4:30pm CT S. cereiy, _ CitiMortgage, Inc. STATE OF MISSOURI COUNTY OF ST. CHARLES The foregoing instrument was .D�a.✓ 03 uzN�-T'J-f v TAR UBLIC £-io- I Datittl Bt n'ef e acknowledged before me this /0 day of -,sT , 20 47 by who is personally known to me or has produced as identification. SUSANM..OADEN Naiisry Rublio - Notary Seal Shte of Missouri Warren Col ttyy Commission #145 9352 My Commission Expires Marsh 5, 2022 NOTICES TTY Services available: Dial 711 from the United States; Dial 1-866-280-2050 from Puerto Rico. CALLS ARE RANDOMLY MONITORED AND RECORDED TO ENSURE QUALITY SERVICE. Hours of operation provided reflect general hours for the Property Preservation unit. 121 © 2018 Citigroup Inc. All rights reserved. Citi, Citi and Arc Design and other marks used herein are Service marks of Citigroup Inc. or its affiliates, used and registered throughout the world. PP0082.62915 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399-0783 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! CGC062932 w ISSUED:,6/22/2018 a Care' Y. LICENSED UNDER CHAPT 489'`FLORID STATUTES EXPIRATION DATE: —AUGUST 31 2020 so'' Local Business Tax Receipt Miami -Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 6454185 BUSINESS NAME/LOCATION GC WORKS INC 1820 SW 3 AVE MIAMI, FL 33129 OWNER GC WORKS INC LANCE D WAYNE, QUALIFIER Worker(s) 4 RECEIPT NO. RENEWAL 6722640 EXPIRES SEPTEMBER 30, 2019 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 SEC. TYPE OF BUSINESS 196 GENERAL BUILDING CONTRACTOR CGC062932 PAYMENT RECEIVED BY TAX COLLECTOR 51.75 11/06/2018 CRED ITCARD-19-006246 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 holders 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. MIAMI-DADE For more information, visit www.miamidade.gov/taxcollector i-•"', GCWORKS-01 ACORO" �•� CERTIFICATE OF LIABILITY INSURANCE STWIGG DATE 11/06/2018Y) 11/06/2018 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 Collinsworth, Alter, Fowler & French, LLC 8000 Governors Square Blvd Suite 301 Miami Lakes, FL 33016 CONTACT NAME: PHONE 305 822-7800 Fax (A/c, Ext): ( ) (Nc, No):(305) 362-2443 �N�o, noliftESS: INSURER(] AFFORDING COVERAGE NAIL # INSURER A:American Builders Insurance Company 11240 INSURED GC Works, Inc. 1820 SW 3rd Ave. Miami, FL 33129 INSURER 8 : WeSCo Insurance Company 25011 INSURER c Federal Insurance Company 20281 INSURER D : INSURER E : INSURER F : COVERAGE 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 POLIC ES 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 IMM/DD/YYYYI POLICY EXP IMM/DD/YYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY GLP023381802 01/27/2018 01/27/2019 EACH OCCURRENCE $ 1,000,000 PREMISES (Fa Occurrence) MED EXP (Any one person) $ J CLAIMS -MADE X OCCUR $ 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE POLICY x OTHER: LIMITPER: APPUES !ma LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE X LIABILITY ANY AUTO OWNED X X SCHEDULED AUTOSSVyNE AOUTOS ONLD WPP153528502 02/18/2018 01/27/2019 COMBINED SINGLE LIMIT (Ea accident) 1,000,000 $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ OAMAGE (Per aaccident) $ $ A X UMBRELLA UAB EXCESS UAB X O OCCUR CLAIMS -MADE UMB025708001 02/01/2018 01/27/2019 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 $ DED X RETENTION $ 10,000 A WORKERS AND UAILTY ANY OFFICER/MEMBER EXCLUDEDX? ECUTIVE (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y/N N / A WCV023341502 01/27/2018 01/27/2019 XOTH- STATUTE ER E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 $ C Equipment Floater 45470637 02/14/2018 02/14/2019 Leased/Rented 150,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CGC062932 NCELLATION I Miami Shores Village 9 Building Department 10050 NE 2nd Ave 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 ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD PERMIT # fl -3�-1 .__. Miami Shires Village APFRO\'ED BY DATE ZONING DEPT BLDG DEPT a, l /f q i SUBJECT 10 COMPLIANCE WT(ii ALL. FEDERAL TIONS TE CC r{ -LAW 1 ..„74/7/ (DI 0 3 n/'TT 2, 9'7/4 • 9''',i' -='1 IJ r 9V 'r) / / /'JL . 6" X 39/9 6''/X.30`1' 46. .e4 �/- ?7''X,✓e, ,zz37; .3 1/• _3'/i< 2c"i#- / 384 ks '01f)(9 P75i 6''d& . .. .. . . . • . . . • . .... .... .. .... • •• .. • • . • •. • • • • • • . • •. ..• • .. • • .. .• . •