RF-17-2865�2N5 0`
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972 RECEIVED
INSPECTION LINE PHONE NUMBER: (305) 762-4949
F' BC 2 iq DEC 0 5 2017
Master Permit No. 4L 1--i�;2ad5)
Sub Permit No.
Q ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
,. ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
r JOB ADDRESS: 348 NW 111 TER
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#:11-2136-001-0550 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): PEGGY RENAUD Phone#:
Address: 348 NW 111 TER
City: MIAMI SHORES ~ - State: FL •.__ ._ Zip: 33168
Tenant/Lessee Name: Phone#:
Email: .
CONTRACTOR: Company Name: THE HOME DEPOT USA INC
Address: 2455 PACES FERRY RD C-11
City: ATLANTA ' State: GA
Qualifier Name: RAQUEL SWANNER
State Certification or Registration #: CCC-1331113
one#: 954-336-0881
hone#:
Certificate of Competency #:
p: 30339
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 25i Q)st Square/Linear Footage of Work: 2195C11D
Type of Work: ❑ Addition ❑■ Alteratiio�n" ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: �1 W�
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Technology Fee $
Structural Reviews $
(Revised02/24/2014)
Permit Fee $
Radon Fee $
_ Training/Education Fee $
CCF $ CO/CC $
DBPR $ Notary $
Double Fee $
_ B
AtVlp E$
I oy%-a 7 MUA (�)
JIM �d to 5oy, r3
Bonding Company's Name (if applicable)
I s
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
{ City
State
Zip
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 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 instrument was acknowledged before me this
3 day of 1�(x� ^ 20 by
fcQ,._ who is personally known to
me or who has produced /i1 �'—�--" as
identification and who did take an oath.
Print:
loe
CONTRACTOR
The fore ' g instrument was acknowledged before me this
day of I0%4 20 14 , by
RIQ.�o,, �• SW4nPlD� who is personally known
me or who has produced as
identification and ho did take an oath.
NOTARY PUBLIC: I
Sign:_
Print:
jey'f; Alberto Daniel BSbani
Seal: My Commission GG 139460 Seal: , oy"o''�.,� MARIUSKA MORALES
Expires 09/02/2021 �'•; otary Public - State of Florida
Commission # FF 220108
d�+*G�il�Di(YSrApt*13i�018 **********s*
1 Bonded through National Notary Assn.
y t Zoning
APPROVED BY Plans Examiner g
Structural Review Clerk
(Revised02/24/2014)
Home Depot Contractor License Numbers:
FL: EC0001440, CGC1514813, CRC046858, CAC1813767, CFC1426021, CFC1427642, 22640, CAC 1818831, CCC1331113,
CCC1331130
Salesperson Name and Registration Number:
Alberto Babani : R-1-128533-13-00302
Home Improvement Agreement
Home Depot U.S.A., Inc. ("Home Depot") or Service Provider named below will furnish, install and/or
service the equipment listed below at the price, terms and conditions as outlined on this form.
Customer Information:
Peggy Renaud Miami 10504993
First Name Last Name Branch Name Lead #
348 NW 111th Terrace MI MI SHORES FL 33168
Customer Address city State Zip
(305) 300-0465 —1
Home Phone# Work Phone# Cell Phone#
prenaud2103@yahoo.com
NOTICE OF RIGHT TO CANCEL: YOU MAY CANCEL THIS AGREEMENT WITHOUT PENALTY OR
OBLIGATION BY DELIVERING WRITTEN NOTICE TO HOME DEPOT AT:
6500 NW 12TH AVE SUITE 110 FT.LAUDERDALE
Address City
or Email CustomerCancellationSouth@homedepot.com
FL 33309
State Zip
BY MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNING, UNLESS THE STATE
SUPPLEMENT PROVIDES A different CANCELLATION PERIOD. THE STATE SUPPLEMENT
CONTAINS A FORM TO USE IF ONE IS SPECIFICALLY PRESCRIBED BY LAW IN YOUR STATE.
YOUR PAYMENT(S) WILL BE RETURNED WITHIN TEN (10) BUSINESS DAYS AFTER HOME
DEPOT'S RECEIPT OF YOUR NOTICE. YOU MUST MAKE AVAILABLE FOR PICKUP BY HOME
DEPOT OR PROFESSIONAL, AT YOUR SERVICE ADDRESS, AND IN SUBSTANTIALLY THE SAME
CONDITION AS WHEN DELIVERED, ANY MERCHANDISE OR MATERIALS DELIVERED TO YOU.
OR YOU MAY CONTACT HOME DEPOT FOR INSTRUCTIONS REGARDING RETURN SHIPMENT AT
HOME DEPOT'S EXPENSE.
THE LAW REQUIRES THAT THE CONTRACTOR GIVE YOU A NOTICE EXPLAINING YOUR RIGHT
TO CANIrEL. PLEASE SIGN BELOW TO ACKNOWLEDGE THAT YOU HAVE BEEN GIVEN ORAL
AND WRITTEN NOTICE OF YOUR�'RIGHT TO CANCEL,
X '"
J` f 11 /03/2017
Customer's Signature I i!I I '"' ,�-"� Date
Contract Price and Payment Schedule: Payment of the Contract Price is due upon completion unless
a different payment schedule is specified in the State Supplement.
Contract Price $ 35708.00
Minimum 0 %deposit $
Includes all applicable discounts, rebates, and , taxes.
Excludes finance charges.*
Due Immediately
Remaining balance $ 35708.00 Due upon completion
Finance Charges
*Any interest payments or other finance charges will be determined by Customer's separate cardholder
or loan agreement, to which The Home Depot is NOT a party, and will be in addition to Customer's
payment under this Agreement. Customer is subject to the terms and conditions of the cardholder or
loan agreement, as applicable. No funds should be made payable to Service Provider; however, Service
Provider may collect Customer's payment(s) made payable to The Home Depot.
Insurance proceeds will ❑ will not be used to pay some or all of the total amount of sale.
Description of Work to be Performed:
Installation of Windows
A more detailed description of the work to be performed is included in the section entitled Scope of Work
which appears on page 3 of this Agreement.
Anticipated Delivery Date / Installation Schedule
Approximate Start Date: 12/29/2017 Approximate Finish Date: 01/26/2018
All dates are approximate and subject to change based on unforeseen events including inclement
weather, permitting delays, and delays in confirming insurance coverage of Your claim for any repair, if
applicable.
Electronic Records Authorization: You are entitled to a paper copy of this Agreement if you choose. If you
consent to an e-mailed copy, your consent applies to this Agreement and all subsequent documents and
written communications related to this agreement. By contacting your Service Provider, you may update
your email address, withdraw your consent, or obtain a paper copy of the Agreement or related documents
at no charge. By providing your consent and verifying your email address above, you confirm that you
haveces to a computer that can receive and open emails and PDF documents.
s paragraph, I consent to receive only electronic records related to this transaction.
ial
Acdeptahce and 'Authorization: By signing below, you authorize Home Depot to (a) arrange for Service
Provider to perform Installation and/or (b) order and arrange for the delivery of special order merchandise,
including special order merchandise that may be custom made, as specified in this Agreement. Do not sign
if blank or incomplete. (Service Provider's/permitting information may need to be provided to You later.)
By signing, you acknowledge that you have read, understand, and accept this Agreement in its entirety,
in chiding he General Terms and Conditions and i State Supplement, if any. You further acknowledge
re; t�ing a complete copy of this Agreement. Keep it to protect your legal rights.
X
r(s) held by or on behalf of the Home Depot:
11 /03/2017
Date
Date
11 /03/2017
Date
i•.
/0yqu6 Z7
• %SH� �4 ram✓► Miami
hores Village`�� 3
evil J p,.,l" Building Department
10050 N.E.2nd Avenue
Rtto vp' Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
OWNERS'S AFFIDAVIT OF EXEMPTION
ROOF TO WALL CONNECTION HURRICANE MITIGATION RETROFIT FOR EXISTING SITE -
BUILT SINGLE FAMILY RESIDENTIAL STRUCTURES
PERSUANT TO SECTION 553.844 F.S.
To: Miami Shores Village Building Department Date: It 1201 Wk4
10050 NE 2nd Ave
Miami Shores, FI 33138
Re: Owner's Name:
- „.
Property Address: - e b4F) IAA 11—rae Mic�,ry►;
Roofing Permit Number:
Dear Building Official:
I P6'Qy 2Dr1La
certify that l am not required to retrofit the roof to wall connections of my
building because:
e'rhe just valuation for the structure for purpose of ad valorem taxation is less than $300,000.00. Please attach proof of ad
valorem taxation.
o The building was constructed in compliance with the provisions of the Florida Building Code (FBC) or with the provisions
of 1994 edition of the South Florida Building Code (1994 SFBC)
bzx�
Signature ri t Lme
State of Florida
County of Dade
The undersigned, being the first duly swom, deposes and says that he/she is the owner for the above property mentioned.
Sworn to and subscribed before me this day of U
Notary Public, Sate of Florida
Notary public State of Florida
Alberto Daniel Babani
My Commission GG 139460
Expires 09/02/2021
When the just valuation of the structure for purpose of ad valorem taxation Is equal to or more than $300,000.00, and the building was not constructed with FBC nor a 1994
SFBC. Then you must provide a budding application from a General Contractor for the Roof to Wall connection Hurricane Mitigation.
Revised on MM009
12/5/2017 Property Search Application - Miami -Dade County
OFFICE OF THE "90, FRTY APPRAISER
Summary Report
Property Information
Folio:
11-2136-001-0550
Property Address:
348 NW 111 TER
Miami Shores, FL 33168-3340
Owner
PEGGY RENAUD
Mailing Address
348 NW 111 TER
MIAMI SHORES, FL 33168-3340
PA Primary Zone
0700 SGL FAMILY - 1551-1700 SQ
Primary Land Use
0101 RESIDENTIAL - SINGLE
FAMILY: 1 UNIT
Beds / Baths / Half
3/2/0
Floors
1
Living Units
1
Actual Area
2,032 Sq.Ft
Living Area
1,454 Sq.Ft
Adjusted Area
1,702 Sq.Ft
Lot Size
____.............
7,500 Sq.Ft
Year Built
1953
Assessment Information
Year
2
20111 6
2015
Land Value
$ 334,829
$134,829
Building Value
En
$118,459
$118,459
XF Value
$21,330
$16,286
Market Value
Assessed Value
$300,803
$102,835
$274,618
$100,720�1
$269,574
$100,020
Benefits Information
Benefit Type
2017 2016 2015
Save Our Homes
Assessment
$197,968
$173,898
$169,554
Cap
Reduction
Homestead
Exemption
$25,000
$25,000
$25,000
Second Homestead
Exemption
$25,000
$25,000
$25,000
........
Note: Not all benefits are applicable to all Taxable Values (i.e. County, School
Board, City, Regional).
Generated On : 12/5/2017
Taxable Value Information
2017
i 2016
2015
County
Exemption Value
$50,000
____ $50,000
$50,000
Taxable Value
$52,835
$50,720
$50,020
School Board
Exemption Value
$25,000
$25'000�$2Taxable
Value
$77,835
$75,72 3
City
Exemption Value 1
$50,000
$50,000
$50,000
Taxable Value
$52,835
$50,720
$50,020
Regional
Exemption Value
$50,000
$50,000
$50,000
Taxable Value
$52,835
$50,720
$50,020
Sales Information
Previous Price OR Book-! Qualification Description
Sale Page
..........
--
02/01/2006 $0 24221- Sales which are disqualified as a result of
3728 examination of the deed
12/01/1984 $77,000 12383 Sales which are qualified
2643
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
0
5�s
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
FBC 20n
Master Permit No. RF-17-2865
Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑■ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 348 NW 11 TER
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 1121360010550 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): PEGGY RENAUD Phone#:
Address: 348 NW 11 TER
City: MIAMI SHORES State: FL
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: THE HOME DEPOT USA INC
Address: 2455 PACES FERRY RD C-11, ATLANTA, GA 30339
p: 33168
Phone#: `- ' ,334P —0Yxi
City.. ATLANTA State: GA Zip: 30339
Qualifier Name: RAQUEL SWANNER Phone#: 954-636-5041
State Certification or Registration #: CCC-1331113 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip: _
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace
Description of Work:
L1
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Technology Fee $_
Structural Reviews $
Permit Fee $
Radon Fee $
_ Training/Education Fee $
CCF $_
DBPR $
❑ Demolition
CO/CC $ _
Notary $
Double Fee $ _
Bond $
TOTAL FEE NOW DUE $
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
City
N/A
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
Zip
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 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.
Signatu
OWNER or AGENT
The foregoing instrument was acknowledged before me this
day of
me or who has produced
,20 , by
who is personally known to
as
identification and who did take an oath.
NOTARY PUBLIC:
Signature
NTRACTOR
The foregoinwtrument /was acknowledged before me this
p�I day of %\�1 20 � by
QlNfl 5 � , who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign: Sign:
Print:
Print:
A,N'ASTAS10
Camrnission # GG 202085
Seal: Seal ,,,,,,, My Commission Expires
L 7 April 01, 2022
as
***********************************************************************************************************
APPROVED BY L Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
1 Ilk
JUN 0 6 101
May 22, 2019
Attention: Building Department
To: City Officials.
Customer name: Peggy Renaud
Address: City: 348 NW 11 Ter, Miami Shores, FL 33168
Job number: 10494627-Renaud
This letter is to request the cancellation of permit number #RF-12-17-2865 due to property owner
cancelling contract. Work was not performed.
Please send permit refund to: Home Depot USA. Attention: Branch Coordinator
Mailing Address: 6500 NW 12 AVE UNIT 110 FORT LAUDERDALE FL 33309
MATTHEW ANASTASIO
o�P 5tate of Florida -Notary Public
Gofnmission # GG 202085
I- My comffijs5ion Expires
April 01, 20"
License number: CGC1514813-CCC1331113 STATE OF FLORIDA
COUNTY OF QGCIC"
The foregoing instrument w4s acknowledged before me this 0"�) day of IX ,
20 k°\ , by ( R69, cI 5WV�_ )•
(Signature of Notar )
(NOTARY SEAL) (Name of Notary)
Personally Known OR Produced Identification
Type of Identification Produced