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DS-18-590Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address 5 NE 107 Street Miami Shores, FL 33161-7029 Owner Information Address Permit. NO. DS-3-18-590 PPermit Type: Driveways/Sidewalks/Slabs e rm' Work Classification: Addition/Alteration Permit Status: APPROVED Issue Date: 6/5/2018 Expiration: 12/02/2018 Parcel Number 1121360070330 Block: Lot: Phone Applicant TIMOTHY A WILLIAMS Cell TIMOTHY A WILLIAMS 5 NE 107 Street MIAMI SHORES FL 33161- (786)877-1808 5 NE 107 Street MIAMI SHORES FL 33161- Valuation: Total Sq Feet: $ 55,000.00 2100 Approved: In Review Comments: Date Approved:: In Review Date Denied: Type of Work: REMOVE OLD EXTERIOR TILES AND INS Bond Return : Scanning: 3 Additional Info: REMOVE OLD EXTERIOR TILES AN Classification: Residential Fees Due Bond Type - Owners Bond CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $500.00 $33.00 $3.00 $2.00 $11.00 $200.00 $9.00 $44.00 $802.00 Pay Date Pay Type Invoice # DS-3-18-66707 06/05/2018 Credit Card 03/08/2018 Credit Card Bond #: 3789 Amt Paid Amt Due $ 752.00 $ 50.00 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Final Foundation Review Building Review Building Review Planning 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 zoni• Fut' - more, I authorize the above -named contractor to do the work stated. Auth7.1" 077 �•�+ IV / Applicant / `Contrac • / Agent Buildin a De - ment Copy pY June 05, 2018 Date June 05, 2018 1 BUILDING PERMIT 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 Master Permit No. Sub Permit No. RECEIVEL M 0 8 2018 CD-4-�AR�� FBC 20� Ds l8-Scl0 BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION PLUMBING ❑ MECHANICAL ❑ PUBLIC WORKS CHANGE OF El CANCELLATION CONTRACTOR JOB ADDRESS: 5 NC z� S TQ.EG 1' El RENEWAL SHOP DRAWINGS City: Miami Shores County: Miami Dade Folio/Parcel#: Is the Building Historically Designated: Yes Occupancy Type: Load: Construction Type: Flood Zone: OWNER: Name (Fee Simple Titleholder): T 1 M TT & y V/ L L w/ 1 S Address: .5 Ai E /01 1 +1 STQ 7 City: M i4 ,M / .S k q Q� S State: F L Tenant/Lessee Name: TI M Q TN y 1A f LL (/0h 5 Email: Zip: 3 NI 6 1 NO BFE: FFE: Phone#: g-r ? 94 QO*2_ Zip: 3 3 IC Phone#: O111 3 94 9.43 _ •CONTRACTOR: Company Name: GA) b,b L(. Address: .5acl P w -2 2 Q City: M I A M I 6 EA &k State: "FL - Qualifier Name: 4 E2 f O CP6 A (Lazo c.A State Certification or Registration #: C. G C • 52.5 Qo 4 Phone#: 11, p44 Zip: 331 3 Q Phone#:1,a6 fe'44 Certificate of Competency #: DESIGNER: Architect/ineer: Phone#: Address: ry,Y City: State: Zip: Value of Work for this Permit: $fSS-07: o Type of Work: ❑ Addition ❑ Alteration Description of Work: KQV C Square/Linear Footage of Work: (2 4O o. ❑ New ❑ Repair/Replace ❑ Demolition o LD x-i&Lo (L Yi >-t Y Al JQ ! N S T i t (_ ,V w Specify color of colorthru tile: Submittal Fee $ Permit Fee $ CCF $ Scanning Fee $ Radon Fee $ DBPR $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ CO/CC $ Notary $ (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 deliveredto 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 OWNER or AGENT The foregoing instrumentrwas acknowledged before me this 0 day of it?A'R-LW ' , 20 4 8 by I r{ QT N V U1 I i�A.IAM who is personally known to me or who has produced identification and who did take an oath. NOT• ARY PUB C: Sign. Prin Seal: ********* -9"'%;: AGOSTINO PEZZATINI MY COMMISSION #FF113522 • ens EXPIRES April 16, 2018 iO7) 398-0153 : sx F1orldallol=rySlkltiee.com APPROVED BY as Signature CONTRACTOR The foregoing instrument was acknowle• dged before me this 01 day of HA 2t4-1 , 20 18 , by AGBe.Q4 Q CPR A (240C S , who is personally known to me or who has produced identification and who did take an oath.. NOTARY PUBLIC: Sign: Pri Seal: **************** Plans Examiner `'"t"`'• AGOSTINO PEZZATINI . MY COMMISSION #FF113522 •','i,;d�:` EXPIRES April 16, 2018 t�► . Structural Review -37/r as Zoning Clerk (Revised02/24/2014) RICK SCOTT, GOVERNOR CGC1525005 MATILDE MILLER, INTERIM SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD The GENERAL CONTRACTOR Named below IS CERTIFIED` Under the- provisions of Chapter 489 FS. Expiration date:-AUG 31,.,2018 j� 1! 4rt i RODRIGUEZ:CASARROCASALBERTO ENRIQUE 4 `" ©NDD`LLCr '"1 .- 1500 BAY' ROAD, %APT,#228 MIAMIBEACH,-'";,FL33139 ISSUED: 02/02/2017 1 DISPLAY AS REQUIRED BY LAW SEQ # L1702020000847 oit 1 1 •... _-.. i.Vi.viaIsa. to of Business Tax Receip Miami-DadeGourtty, Staten-of-Ftorida- -THIS IS NOT A BILL - t�O NOT PAY 7204967 BUSINESS NAM E/LOCATIOhI' 4 CNDD L'LC I504BAY, RD<228` MIAMI BEACH FL 33139 rq OWNER' Ff .GNDD LIC ? C/O GAIA SONZOGNI MGR Employee(s) 1 {1 ,e RECEIPT vor-EXPIRES RENEWAL, a EPTE ISER ,30, 2018 74879/5 Must be displayed at place ot business Pursuant tb County Code Chapter *Pk— Art. 9 & 10 ' sec. TYP�.OF t3us1N8t38 � / i 4'"*.' 11 213' SERVICE BUSINESS PAYMENr� LL Cf It $45119 0i 25/20i 7 . s CREOITCA ,17-06250f4f o Thin Locat usinass Tilt Rec.I(ppt� only:conftrms paytaant o1 tha West Balsam Tax. The Rog tls not a lic/nu. pgrmiL or a certiflcetiotl at theltoldatli tflcattonL to do bileinsss. Holder Must eet tptT any *TOO y or noogovsmmental ragulatoty` laws`an'd rsquiraments which apply t0 tI busbteu. 'Th RECEIPT;NO.�above must ba displiyed oof MI commercial �vabtcl y . �e Soo Stalk* For more lutotmation, visit ..- .. .. , ? . :K "" : '' t. `j A oRd CERTIFICATE O LIABtLITY'INSURANCE S-----r DATE (MM1DD/YYYY) 211 /2_018 THIS CERTIFICATE 1S ISSUED AS A MATTER OF INFORMATION ONLY CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS BY THE POLICIES AUTHORIZED EXTEND OR ALTER THE COVERAGE AFFORDED A CONTRACT BETWEEN THE ISSUING INSURER(S), IMPORTANT: If the certificate holder Ie an ADDITIONAL INSURED the poNcy(le* must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION 1S 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 SUNZ Insurance Solutions, LLC. ID: (Cornerstone) c% Cornerstone Capital Group, Inc. 10 Willow Road, Building 3, Suite 151 Maple Shade, NJ 0805 CamtiE Zachary King PHONE FAX wc. NO. E s72�as-5os9 (AIC. Ne); E-MAIL ADDRESS: coi.requestsecomerstonepeo.com INSURERLSIAFFORD4NG COVERAGE NAIC INSURERA: SUNZ Insurance Company 34762 INSURED Cornerstone Capital Group, Inc. 10 Willow Road, Building 3 Suite 151 Maple Shade NJ 08052 INSURER B : INSURER C: INSURER D : INSURER E : INSURER F_: COVERAGES CERTIFICATE 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 Wmi 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. SR LTR TYPE OF INSURANCE ADM INSD SUBR WMD POLICY NUMBER (MNIDD/YYYY) (MMIDWYYYY) UNITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S CLAIMS�AADE OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) S PERSONAL & ADV INJURY ; GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE ; PRODUCTS - COMP/OP AGG ; S AUTOMOBILELIABILnY AUTO A OWOS Y HRED AUTOS ONLY _ A UK NON -OWNED AUTOS ONLY CO BIe SINGLE LIMIT (EaANY $ BODILY INJURY (Per person) ; BODILY INJURY (Per accident) ; PROPERTY DAMAGE (Per acddent) s S UMBRELLA LIAB EXCESS IJAB rR CLAIMS -MADE EACH OCCURRENCE ; AGGREGATE S DED RETENTION$ $ A WORICERSCOMPENSA11ON PAD EMPLOYLIABIUTY ANYPROPRIETORIPARTNER/EXECUflVE OFFICERIMEMBEREXCLUDED9 (Mandatory In NH) IIf vyeeee,� describe under DESGRIPi1Qbl OF OPERATIONS Wog Y/N N NIA WC005-00001-018 WCPE0000038202 1/1/2018 1/1/2017 1/1/2019 1/1/2018 i1..7.1,;OT ER E.L EACH ACCIDENT ;1,000,000 EL DISEASE - EA EMPLOYEE S 1.0Q0.000 . E.L DISEASE - POLICY UCLA , $1.OQQ,000 DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (ACORD 101, Additional RemaAw Schedule, may be attached if more space Is required) Coverage provided for all leased employees but not subcontractors of: GNDD LLC Client Effective: 5/8/2017 CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE BLDG DEPT 10050-NE 2N0 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 WiTFITHE POLICY PROVISIONS. .aulsltoRcEas+EPREsaxr+Lrn€ 4 D Glen .1 Distefano ACORD 25 (2018103) ©1988 2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 39507118 I Cornerstone Capital Group PEO 005 MASTER CERT I Shawna Calcatera 112/26/2017 4:12:13 PM (EST) I Page 1 of 1 Act:"RD— CERTIFICATE OF LIABILITY INSURANCE DATE 1141M/DD/TYYYI 03/05/2018 PRODUCER PAMELA BRUMER INS AGENCY Allstate Insurance Company 141 Alton Rd Miami Beach, FL 33139 THIS CERTIFICATE IS ISSUED AS A MA'TTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED r GNDD LLC 1500 BAY RD # 228 MIAMI BEACH FL 33139 j INSURERA: SCOTTSDALE INSURANCE CO INSURER B INSURER C: INSURER 0: INSURER E: COVERAGES 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 AU. THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH , POUC1ES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. `Am- 1NbR LTR INsRD TYPE OF INSURANCE POLICY NUMBER IPA laingirlakr(EWN LIMITS A GENERALLIABILITY '.. COMMERCIAL GENERAL LIABILITY D CLAIMS WOE gi OCCUR D CPS2502799 ',- 08i26/2017 .. ,,08/26/2018 EACH OCCURRENCE $ 1,000,000.00 FonesyswiENomn..) $ 100.000.00 MED ii(P (My one person) $ 5,000.00 PERSONAL &ADV INJURY $ 1,000,000.00 —.I GENERAL AGGREGAT8 $ 2,000,000.00 COWL AGGREGATE WAIT Appues PER: —1 POLICY fl PROJECT LOC PRODUCTS - COMP/OPAGG 1.000.000,00 AUTOMOBILE UAEOLITY D ANYAIJTO D ALL OWNED AUTOS D SCHEDULED AUTOS HIRED AUTOS D NON.OWNEDAUTOS D , . , COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) , $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ —1 GARAGE massry ANyAuTo - AUTO ONLY- EAACCIDENT $ •j OTHER THAN EAACC $ AUTO ONLY: AGG $ EXCESS/UNIBRELLA ILIAB)LITY D OCCUR El CLAIMS MADE D moue -sax —I. RETENTION EACH OCCURRENCE $ AGGREGATE $ $ WORKERS COMPENSATION AND EMPLOYERS' I I All IT' ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? Eyes, describe under SPECIAL PROVISIONS below 'Ll TOVAITS nw E.L. EACH ACCIDENT $ EL DISEASE- EA EMPLOYEE E.L. DISEASE - POUCY LIMIT OTHER uEbLHipTioN OF OPERATIONS / LocArfoss 1 VEHICLES rEXcLusioNb ADDED BY ENDORS.4ENt fbPEUAL PROtSION§ GNDD LLC - CGC 1525005 CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 ACORD 26 (2001/08) SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIF E HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL WIPOSE NO 9I3u�ATION OF ANY KIND UPON THE INSURER, ITS AGENTS OR 0 ACORD CORPORATION 1988 3/8/2018 Property Search Application - Miami -Dade County Summary Report 1 Property Information Folio: 11-2136-007-0330 Property Address: 5 NE 107 ST Miami Shores, FL 33161-7029 Owner TIMOTHY A WILLIAMS ELIZABETH WILLIAMS Mailing Address 455 NE 5 CT BOCA RATON, FL 33432 USA PA Primary Zone 1000 SGL FAMILY - 2101-2300 SQ Primary Land Use 0101 RESIDENTIAL - SINGLE FAMILY: 1 UNIT Beds / Baths / Half 3/2/0 Floors 1 Living Units 1 Actual Area 2,422 Sq.Ft Living Area 2,044 Sq.Ft Adjusted Area 2,227 Sq.Ft Lot Size 9,225 Sq.Ft Year Built 1949 Assessment Information Year 2017 2016 2015 Land Value $230,638 $198,007 $163,894 Building Value $154,999 $154,999 $154,999 XF Value $30,802 $31,164 $20,453 Market Value $416,439 $384,170 $339,346 Assessed Value $416,439 $384,170 $339,346 Benefits Information Benefit Type 2017 2016 2015 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 3 PB 42-33 LOT 9 BLK 210 LOT SIZE 75.000 X 123 OR 19257-1926 06 2000 1 Generated On : 3/8/2018 Taxable Value Information 2017 2016 2015 County Exemption Value $0 $0 $0 Taxable Value $416,439 $384,170 $339,346 School Board Exemption Value $0 $0 $0 Taxable Value $416,439 $384,170 $339,346 City Exemption Value $0 $0 $0 Taxable Value $416,439 $384,170 $339,346 Regional Exemption Value $0 $0 $0 Taxable Value $416,439' $384,170 $339,346 Sales Information Previous Sale price OR e Book - Page Qualification Description 01/11/2018 $665,000 30839-3559 Qual by exam of deed 03/12/2015 $359,100 29539-2107 Financial inst or "In Lieu of Forclosure" stated 07/29/2013 $100 28770-0750 Corrective, tax or QCD; min consideration 06/01/2000 $189,000 19257-1926 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: