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EL-18-63 (2)`yy�o+e v c Proiect Address Miami Shores Village 10050 N.E. 2nd Avenue NW Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit NO, EL-1-18-63 Permit Type: Electrical - Residential Pen Work Classification: Addition Permit Status: APPROVED Parcel Number Issue Date:1/10/201'8 1 Expiration: 07/09/2018 Applicant 190 NW 101 Street 1131010230170 RICARD PROPHETE Miami Shores, FL Block: Lot: Owner Information Address Phone Cell RICARD PROPHETE 190 NW 101 ST MIAMI FL 33150-1214 Contractor(s) Phone Cell Phone QUINTANA ELECTRIC BROTHERS IN( (305)986-5893 (305)681-5317 of Work: ADDITION LIGHT, RECEPTACLE AND NEW onal Info: ification: Residential ping: 3 Fees Due Amount CCF $6.00 DBPR Fee $5.25 DCA Fee $3.50 Education Surcharge $2.00 Permit Fee - Additions/Alterations $350.00 Scanning Fee $9.00 Technology Fee $8.00 Total: $383.75 Valuation: $ 10,000.00 Total Sq Feet: 0 Pay Date Pay Type Amt Paid Amt Due Invoice # EL-1-18-66081 01/10/2018 Credit Card $ 333.75 $ 50.00 01/09/2018 Credit Card $ 50.00 $ 0.00 Available Inspections: Inspection Type: Review Electrical Ll 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 he foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction_ and zoning.Erm ut orej 1-uthorize the above -named contractor to do the work stated. VJI n.r, �,�r �, I l,. 111y////\\ January 10, 2018 Autho zed ignature:Ow / Applicant / Contractor / Agent Date Building Departm"6nt Copy January 10, 2018 1 'C�lou�� P�- SeCl� Miami Shores Village REc E! VEp Building Department JAN �\ J 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 091017 J Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 e0l FBC 20h BUILDING Master Permit No.`�,d -/%- ,2.� d PERMIT APPLICATION Sub Permit No. FA—ls -(03 ❑BUILDING ,`ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [—]RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS [:]CHANGE OF [:]CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 00 0 A)U) / Dl ST Folio/Parcel#: �l '_Z�_3 O/�/ - T Occupancy Type: Load: Construction Type: / J-D s the Building Historically Designated: Yes NO Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): 210-141cb kz.& ?1i u� oPhone#:. . Address: l iV IJbL) / D j 4T city: rm /A, n / S11D'ZE� State: t:1- Zip: 33/3-D Tenant/Lessee Name: Email: CONTRACTOR: Company Name: �(!�l/��iC9�/9i ��% �%� G %�%GJ (� _PgLhone#: Address:�� City: /r/ •�wi State: /r Zip: �//J� Z Qualifier Name: �g�' �� !�' fiV�� Phone#: �67/ 4�S?(7Z, State Certification or Registration #: /C� (,00 25W Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: Value of wgrk:foi;,this Permit: $ /� f�"� �` o Square/Linear Footage of Work: State: Zip: Type,of diVork: -,Addition ❑ Alteration ❑ New ❑Repair/Replace ❑ Dem lition Descriptitin of Wofk: -�jj %' /J %%ice G �� % f`Gd A �FW ' .� .s:'.A.l.V•,hlpky+.•+. yam..... .,r«...mo-..•.. �r..� ' 7 CYc L;.�;v �_ u �,,• 'ram [ SpecJfy colpr-,r thru tile: Submittal Fee $ Permit Fee $ /©' ©� CCF $ CO/CC $ Scanning Fee $ Radon Fee $ 3 , � DBPR $ 5 • L5 Technology Fee $ Training/Education Fee $ Notary $, Double Fee $ Structural Reviews $ (Revised02/24/2014) Bond $ TOTAL FEE NOW DUE $ _31 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 Zi 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 charge Signature la'rc Z"& OWNER or AGENT The foregoing instrument was acknowledged before me this day of 20 Q by twho personally own to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sig' � • Print: ""'", RAWELA.SCAFWR000M :.:MT SS rr- 242191 Seal: 'r EXPIRES: October IS, 2019 j Bv4ed ThN N t V Pdk Und6r* tefs d. Signature CONTRACTOR The foregoing instrument was acknowledged before me this day of 75Ayr',ggn, v1 , 20 19 by 1i,tAIn A,v&2 , who isn to me or who has produced as identification and who did take an oath. ########################################################################################################## APPROVED BY Liz ` 'Y/¢'� ` Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Property Search Application - Miami -Dade County Page 1 of 2 OFFICE OF THE ` PROPERTY Summary Report Property Information Folio: 11-3101-023-0170 Property Address: 190 NW 101 ST Miami Shores, FL 33150-1214 Owner RICARD PROPHETE MARLEINE PROPHETE Mailing Address ............................ ......_._................. PA Primary Zone 190 NW 101 ST MIAMI, FL 33150 USA _......... ........ _..... ____ 0800 SGL FAMILY - 1701-1900 SQ Primary Land Use 0101 RESIDENTIAL -SINGLE FAMILY: 1 UNIT Beds / Baths / Half 2/2/0 Floors 1 Living Units 1 Actual Area 1,403 Sq.Ft Living Area 1,117 Sq.Ft Adjusted Area 1,260 Sq.Ft Lot Size 8,100 Sq.Ft Year Built 1940 Assessment Information Year 2017 2016 2015 Land Value $178,398 $178,398 $131,771 Building Value $87,696 $87,696 $87,696 XF Value $0 $0 $0 Market Value $266,094 $266,094 $219,467 Assessed Value $87,706 $85,903 $85,306 Benefits Information Benefit Type 2017 2016 2015 _........ ... ................__ Save Our Homes Assessment ... -.............. $178,388 $180,191 $134,161 Cap Reduction Homestead Exemption $25,000 $25,000 $25,000 Second Exemption $25,000 $25,000 $25,000 Homestead Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). Short Legal Description 1 5341 BONMAR PK ADD A RE SUB PB 24-71 W75FT LOTS 1 TO 4 INC BLK 3 LOT SIZE 75.000 X 108 73R-285545 Generated On : 1/9/2018 Taxable Value Information 2017 2016 2015 County Exemption Value $50,000 $50,000 $50,000 Taxable Value $37,7061 $35,903 $35,306 School Board Exemption Value $25,000 $25,000 $25,000 Taxable Value $62,706 $60,903 $60,306 City Exemption Value $50,000 $50,0001 $50,000 Taxable Value $37,706 $35,903 $35,306 Regional Exemption Value $50,000 $50,000 $50,000 Taxable Value $37,706$35,903 S35,306 Sales Information Previous Price': ' OR Book- OR ' Qualification Description Sale Page Corrective, tax or QCD; min 05/03/2013 $100 28628-0347 consideration 10/01/1986 $55,900 13048-0644 Sales which are qualified 11/01/1973 $35,000 00000-00000 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 Countv assumes no liabilitv. see full disclaimer and User Agreement at htti)://www.miamidade.aov/info/disclaimer.aso http://www.miamidade.gov/propertysearch/ 1 /9/2018 FromAdanys Marin FaxID:9544520450 Date:1/3/2018 9:54:31 AM Page: 2 of 2 .�coRV CERTIFICATE OF LIABILITY INSURANCE FDATE(MMroDIYYYI� 1/3/2018 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 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 endorsements . PRODUCER CNTANAME CT Certificate Department BB Insurance Marketing Inc PHONE FAx 10167 W Sunrise Blvd : 888-728-0817 ac No:954-452-0450 EDDA IL certificates@bbimi.com 3rd Floor Plantation FL 33322 INSURERt3aAFFORDINGCOVERAGE ................_.._............_._. __._..__.__.. .. INSURER A: zenith Insurance Company -NAICM 13269 INSURED QUINELE-01 MISURER B Quintana Electric Brothers, Inc. 4801 SW 6th Street _suREn c Miami FL 33134 INSURER D: MSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 1666487127 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 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 LTR TYPE OF INSURANCE , i POLICY EFF JbIso WVo I POLICY NUMBER i MMIODIYYYY) POLICY EXP IMMIDDIYYYYi LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCEDAMAGE S TO CLAIMS -MADE OCCUR PREMISES Ea occmnce E MEO EXP (Any one person) S PERSONAL d ADV INJURY S GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S POLICY DjERa LOC PRODUCTS - COMPf0P AGG S $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE L MI S BODILY INJURY (Per person) E ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) E NON -OWNED HIRED AUTOS AUTOS (PePROPERTY DAMAGE S E UMBRELLA IJAS OCCUR EACH OCCURRENCE S AGGREGATE S F7(CE59 LIAR CLAIMS -MADE DED RETENTION E S A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN N ANY PROPRIETORIPARTNEPJEXECUTNE � OFFICERIMEMBER EXCLUDED? Y i Z134694001 12113/2017 € N I A; i I 12/13/2018 X P R H- ....,.., STA7I�TE _ ........ .ER „__ ..................... E.L. EACH ACCIDENT ..._.._......_....._.._..........._............._.._. ........... ............... _.... .. 6500,000 (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below ` ` E.L. DISEASE - EA EMPLOYE �_._�.. E.L. DISEASE - POLICY LIMIT S 500,00o _._......_....___..__.__._.___..--... $ 5W .OW DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required) Electrical Contractor Miami Shores Village Building Department 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 DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED EPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD