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EL-17-2192 (2)Miami Shores Village 10050 N.E. 2nd Avenue NE " Miami Shores, FL 33138-0000 aos Phone: (305)795 2204 FCORIDA Permit No. EL-8-17-2192 0 Permit Type: Electrical - Residential ' Wofk Classification: Addition/Alteration Permit Status: APPROVED Issue Date: 9/5/2017 1 Expiration: 03/04/2018 Project Address Parcel Number Applicant 1111 NE 91 Terrace 1132050010120 Miami Shores, FL 33138- Block: Lot: ANDREA & UWE KREUTER uwner mtormation Address Phone Cell ANDREA & UWE KREUTER 1111 NE 91 Terrace MIAMI SHORES FL 33138- 5161 COLLINS Avenue MIAMI BEACH FL 33139- Contractor(s) Phone Cell Phone HENRY RODRIGUEZ ELECTRICAL CC (305)218-7878 of Work: ELECTRICAL FOR NEW BATHROOM MASTER onal Info: ification: Residential ling: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $9.00 $3.38 $3.38 $3.00 $225.00 $3.00 $12.00 $258.76 ValuLSqFeeLt: 15,000.00 Tota0 Pay Date Pay Type Amt Paid Amt Due Invoice # EL-8-17-66033 09/05/2017 Check #: 016468 $ 208.76 $ 50.00 08/30/2017 Check #: 016454 $ 50.00 $ 0.00 mvanawe inspections: Inspection Type: Final Meter Box Relocation Fire Alarm Service Change Review Electrical W. W. Underground 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: 1-eel a e gping information is accurate and that all work will be done in compliance with all applicable laws regulating construction a z ni crth'erir re, I autho ' e the above -named contractor to do the work stated. September 05, 2017 kAuiborized Si natu Applicant / Contractor / Agent Date Building Department Copy September 05, 2017 1 CV-) c Qm� t ( --rZG <Z�I-z G646+a 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 BUILDING PERMIT APPLICATION ❑BUILDING V ELECTRIC ❑ ROOFING G 3 0 2017 �FjBC/20 1 `�- Master Permit No. P10-) b -' l2 GG Sub Permit No. B--F� - G) 92, ❑ REVISION ❑ EXTENSION [-]RENEWAL PLUMBING MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 4111 NE 91 Tcymce� City: Miami Shores County: Miami Dade Zip: Folio/Parcel#:1- ?S - 06 — 001..- D120 Is the Building Historically Designated: Yes NO Occupancy Type: Load: \Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): �'nUH-Ci [�SeAe.,t, Phone#: Address: l\u k)E 9 t- T6a1 City: �,L"wS State: i Zip: :;�T5 Tenant/Lessee Name: \4 vjy`e-a t Phone#: Email: �� CONTRACTOR: Company Name: kP%ftd` 1 ®� �-l� Z �Ie`I �Ic �, l "� Phone#:" K Ofi - 2Y Address: 2j r City: State: � Zip: J� S Qualifier Name: C-a'si . �-- Phone#: State Certification or Registration #: CyGy2- (-1 ( Certificate of Competency M DESIGNER: Architect/Engineer: Phone#: Address: J City: State: Zip: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: 09 Addition ❑ Alteration ❑ New t - ❑ Repair/Replace ❑ Demolition Description of Work: li6L.-, VICCw u c�,H �V� t E� WO, Specify color of color thru tile: 00 Submittal Fee $ Permit Fee $ 270 1m4' CCF $ CO/CC $ Scanning Fee $ Technology Fee $ Structural Reviews $ Radon Fee $ Training/Education Fee $ DBPR $ Notary Double Fee $ Bond $ a TOTAL FEE NOW DUE $ 2- Jb ' 1 (Revised02/24/2014) Bonding Company's Name (if applicable) 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 a roved and a reinspection fee will be charged. Signature Signature OWNER or AGENT CONTRA R The foregoing instrument was acknowledged before me this `Z G day of -'Sum 20 4 —? by who is personally known to me or who has produced as me or who has produced — % as identification and who did take an oath. identification and who did take an oath NOTARY PUBLIC: NOTARY PUBLIC: Sign: �� Sign: 2 Print: / ' 11 -i/l%%i 961 a P �"�` Print: A Ill IV " MARTA HE MARTA HERNANDEZ = RNANDEZ v: .: Seal: :` Seal: =+E' MY COMMISSION # GG005090 ;�c MY COMMISSION # GG005090 �[ amain?' EXPIRES July 02, 2020 EXPIRES July 02, 2020 (ao7) 399 O153 F�orkf,Nw„yservice.com aor) 399.0+ ************************************************************** ***** APPROVED B -910'lNe —C-/ y Plans Examiner Zoning Structural Review (Revised02/24/2014) Clerk Property Search Application - Miami -Dade County Page 1 of 1 FFICE F TOHE PROPERTY O0 APPRAISER Summary Report Property Information Folio: 11-3205-001-0120 Property Address: 1111 NE 91 TER Miami Shores, FL 33138-3403 Owner ANDREA KREUTER UWE KREUTER Mailing Address 5161 COLLINS AVE 1017 MIAMI BEACH, FL 33139 USA PA Primary Zone 1100 SG FAMILY - 2301-2500 SQ Primary Land Use 0101 RESIDENTIAL -SINGLE FAMILY: 1 UNIT Beds / Baths / Half 3/3/0 Floors 1 Living Units 1 Actual Area 2,717 Sq.Ft Living Area 1,838 Sq.Ft Adjusted Area 2,309 Sq.Ft Lot Size 12,500 Sq.Ft Year Built 1959 Assessment Information Year 2017 2016 2015 Land Value $450,000 $419,000 $381,000 Building Value $160,706 $160,706 $160,706 XF Value $33,299 $33,668 $21,784 Market Value $644,005 $613,374 $563,490 Assessed Value $644,005 $613,374 $563,490 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 5 53 42 WATERSEDGE PB 9-141 LOTS 14 & 15 BLK 1 LOT SIZE IRREGULAR OR 21148-4136 03 2003 1 Generated On : 8/30/2017 Taxable Value Information 2017 2016 2015 County Exemption Value $0 $0 $0 Taxable Value $644,005 $613,374 $563,490 School Board Exemption Value $0 $0 $0 Taxable Value $644,005 $613,374 $563,490 City Exemption Value $0 $0 $0 Taxable Value $644,005 $613,374 $563,490 Regional Exemption Value $0 $0 $0 Taxable Value $644,005 $613,374 $563,490 Sales Information Previous OR Book - Price Qualification Description Sale Page 03/08/2016 $775,000 29999-2309 Qual by exam of deed Financial inst or "In Lieu of 01/27/2015 $584,300 29502-4936 Forclosure" stated Financial inst or "in Lieu of 10/23/2014 $550,100 29367-4804 Forclosure" stated 03/01/2006 $765,000 24378-4103 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 http://www.miamidade.gov/propertysearch/ 8/30/2017 * . COUNTY Department of Regulatory and Economic Resources Board Administration Section 11805 SW 201 Street (Coral Way) • Room 230 Miami, Florida 33175-2474 Telephone 786-315-2573 Fax 786-315-2570 www.niiamidade.gov/development MEMO TO: 11 uil Ting Officials in iami Dade County �. FROM: Secretary of he oar _--`---' Board of Rules and Appeals DATE: February 241h, 2016 SUBJECT: Certificate of Reinstatement Henry Rodriguez Electrical Contractor Inc. Henry Anthony Rodriguez, Qualifying Agent State License HECO002411 14522 SW 14211 Place Circle Miami, FL 33186 As a result of the Board of Rules and Appeals meeting held on January 2111, 2016, it was previously advised that the above Contractor's permitting privileges were administratively suspended in Miami - Dade County. This is to inform your Department that the above Contractor's permitting privileges have now been ADMINISTRATIVELY REINSTATED in Miami -Dade County. If you have any questions concerning this matter, please do not hesitate to contact Daniel VueIta, Contractor Enforcement Supervisor at 786-315-2562 or via email at DV045@miamidade.gov. miamidade.gov. r45_..... 142 PLACE CIR MIAMI, : L 3318ba837 LK78 1'-15-1964 SE r M rgg;;g'tt.$6.ZLitt .....''uyri - t�cs�f+f5 S1-S8-2� REST SIC" E :1:.raan+: eA a mp wire4 sarert--, <a'�en rc r.r �aNwlr e.r tigsW W 1r. STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399-0783 RODRIGUEZ, HENRYANTHONY HENRY RODRIGUEZ ELECTRICAL CONTRACTOR INC. 14522 SW 142ND PLACE CIRCLE MIAMI FL 33186 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! RICK SCOTT, GOVERNOR STATE OF FLORIDA DEPARTMENT OF; B PROFESSI4NAL-RE EC0002411 1S UED. CERTIFIED EL', •RICAiti,GONTF RODRIGUEZ,'A E�1R HENRY RODRIGUEZ'Etl 'f'. n (850) 487-1395 NESS AND -ATION )7/06/2016 FOR ONTRAC IS -CERTIFIED under.the provisions of Ch.489 FS. EiWNethn date : _AUG_31, 2018 L160708=1373 DETACH HERE KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD EC0002411 fhe ELECTRICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2018)- f � - RODRIGUEZ, HENRYANTHONYr HENRY RODRIGUEZ E6EGTRICAL CONTRACTOR INC. , 14622 S W 142 PLACE,CIR'CL"E' MIAMI •FL3318fi' ISSUED: 07/06/2016 DISPLAY AS REQUIRED BY LAW SEQ # L1607060001373 003M Local Business Tax Receipt Miami -Dade County, State of Rodda THIS IS NOT A BILL - DO NOT PAY 5116330 LBT BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES RODRIGUEZ HENRY ELECTRICAL CONTRACTOR RENEWAL SEPTEMBER 30, 2017 14522 SW 142 PL CIR 6344379 Must be displayed at place of business MIAMI FL 33186 Pursuant to County Code Chapter BA -Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS PAYMENT RECEIVED RODRIGUEZ HENRY 196 ELECTRICAL CONTRACTOR BY TAX COLLECTOR EC0002411 $75.00 09/20/2016 Worker(s) 1 CREDTTCARD-16-055137 This local Basisass Tax Raoaipt ndy confirms Parneatof the Local Tax. The Receipt is Not a lie11830. pwmiL or a artiRoatioa of do holders gwRRatieas, to do huairm- Holder snot comply with any scimmi anal or nongovernmental ngslatory ism and requirements VA&k apply to do business. The RECEIPT NO. above and be displayed on all comamial vehicin - Miami4lads Code Sec Sa-VIL For mom iniomudM visit sLcoRd CERTIFICATE OF LIABILITY INSURANCE DA 8/28/17 PRODUCER Ramallo Assurance Inc. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 12955 S.W. 42nd Street ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Miami, FL 33175 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.__ Phone (305)207-1332 Fax (305)207-1343 INSURERS AFFORDING COVERAGE _ NAIC # INSURED Henry Rodriguez Electrical Contractor Inc INSURER A: Granada Ins Co -IN SURER B: Progressive _ 14522 SW 142 PLINSURER C:Circ' INSURER o: _ Miami FL 33186 INSURER E: COVERAGES INSURER F: 1 I MI: FVLICIEB VI- INSURANCE US ED 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. e _ LIMITS EACH OCCURRENCE 1,000,000 INSR LTR ADD'L INSAD TYPE OF INSURANCE POLICY NUMBER IPOUCY EFFECTIVE DATE (MMMD_YY) { _ POLICY EXPIRATION DATE (MM/DD/W GENERAL LIABILITY ❑/ COMMERCIAL GENERAL LIABILITY 0185FL00052736 09/13/16 09/13/17 DAMAGE TO RENTED PREMISES (Fa occurenceZ 100,000 A ❑ ❑ ❑ CLAIMS MADE ❑ OCCUR ❑ MED EXP (Any one person) 5,000 PERSONAL 6 ADV INJURY 1,000,000 ❑ GENERAL AGGREGATE 2,000,000 GEWL AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG 2,000,000 ❑ POLICY ❑ PROJECT ❑ LOC _ 06/23/16 08/23/17 AUTOMOBILE LIABILITY ❑ ANY AUTO 75902890 COMBINED SINGLE LIMIT (Ea aorident) 1.000,000 B ❑ ❑ ALL OWNED AUTOS EVI SCHEDULED AUTOS ❑ HIRED AUTOS ❑ NON OWNED AUTOS BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE ❑ 1GARAGE LIABILITY ❑ ANY AUTO EXCESSAJMBRELLA LIABILITY ❑ ❑ OCCUR ❑ CLAIMS MADE ❑ DEDUCTIBLE ❑ RETENTION $ EMPLOYERS' LIABILI Y ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER / MEMBER EXCLUDED? If yes, describe Linder OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS License: Rodriguez, Henry Anthony EC0002411 CERTIFICATE HOLDER Village of Miami Shores Building Department 10050 NE 2 Ave Miami Shores FI 33138 AUTO ONLY - EA ACCIDENT _ OTHER THAN EA ACC AUTO ONLY AGG� EACH OCCURRENCE AGGREGATE T— C TORY LIMITS ❑ ERH E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT I SPECIAL PROVISIONS CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR UABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2001108) OF 0 ACORD CORPORATION 1988 A & CERTIFICATE OF LIABILITY INSURANCE DATE (MMMONYYY) 04n9/2017 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 andoreement(s). PRODUCER FrankCrum Insurance Agency, Inc. 100 South Missouri Avenue Clearwater FL 33756 CONTACT NAME: PHONE A/C No, Ext : 800 277-1620 X4800 FAX A/C, No): 797-0704 E-MAIL ADDRESS: INSU S AFFORDING COVERAGE NA= INSURER A: Frank Winston Crum Insurance Company 11600 INSURED FrankCrum L/C/F Henry Rodriguez Electrical Contractor, Inc. 100 South Missouri Avenue Clearwater FL 33756 INSURER B: INSURER C: INSURER D: INSURER E: INSURER F: ^=12"CI `AT MIrMCGO• AnFsun KtVr11[lM a1l1MKCK_ 2 v 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. RJR LTR T,� INSURANCE ADDL INSRD SUER VWD POLICY NUMBER POLICY EFF MMIDD/YYYY) POLICY EXPO (MMIDDNYYY) LIMI COMMACAL GENERAL LIABILITY CWMS-MADE OCCUR EACH OCCURRENCE S DAMAGE TO RENTED PREMISES En occx ce $ MED EXP (Arty ene person) $ PERSONAL a ADV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE t PRODUCTS-COMP/OP AGO S POLICY a PROJECT a LOC $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT aedden III BODILY INJURY Per arson S ANY AUTO OVIMED AUTOS SCHEDULED ONLY AUTOS BODILY INJURY (Per accident) S PR DAMAGE S HIRED AUTOS NON-WVNED ONLY AUTOS ONLY S UMBRELLA LIAR OCCUR EACH OCURRENCE $ AGGREGATE 3 EXCESS LIAB CIAIMS'MADE.; DED I I RETENTIONS S WORKERS COMPENSATION AND WC201700000 01/01/2017 01/01/2018 X PER STATUTE DTR A EMPLOYERS' LIABILITY Y/N E.L. EACH ACCIDENT $1,000,000 ANY PROPRIETORIPARTNERIFXECUTIVE OFFICERIMEMBER EXCLUDED? N/A E.L. DISEASE -EA EMPLOYEE $t 000 000 fMsswaborY F ) if yea, describe undo DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT 11111.000aw DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached N more apace Is required) Effective 05/30/2016, coverage is for 100% of the employees of FrankCrum leased to Henry Rodriguez Electrical Contractor, Inc. (Client) for whom the client is reporting hours to FrankCrum. Coverage is not extended to statutory employees. rrerlcr/`ATc U" nFw 1.AMUI-ELAN run 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 REP SENTATIVE Miami Shore village Building Department 10050 NE 2nd Ave Miami Shores, FL 33138-2382 01988-2016 ACORD CORPORATION. All rights reserved. ACORD 26 (2016103) The ACORD name and logo are registered marks of ACORD