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DEMO-12-18-3750, 1041 NE 94th StLocation Address Parcel Number 1041 NE 94TH ST, Miami Shores, FL 33138 1132050120080 Contacts MIAMI COUNTRY DAY SCHOOL INC Owner HABIFY DBA FLORIDA BUILDING Contractor MIAMI COUNTRY DAY SCHOOL INC PERFORMANCE LLC 601 NE 107 ST, MIAMI, FL 331617165 BUCK REILLY Other:3057592843 ,FL Business: 3054434900 info@habify.com Inspection Requests Description: INTERIOR DEMOLITION OF ONLY PARTITIONS Valuation: $ 10,000.00 305-762 4949 � WALLS, FIXTURES AND SURFACE MATERIALS PER PLANS Total Scl Feet: 340.00 Fees Amount Application Fee - Other $50.00 Building Demoloition Fee $200.00 CCF $6.00 DBPR Fee $3.75 DCA Fee $2.50 Education Surcharge $2.00 Scanning Fee $9.00 Structural Review ($45) $45.00 Technology Fee $6.25 Total: $324.50 Payments Date Paid Amt Paid Total Fees $324.50 Check # 1350 04/02/2019 $274.50 Check # 1033 12/21/2018 $50.00 Amount Due: $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 regulatip� construction and zoning. Futhermore, I authorize the above named contractor to do the work stated. He Authorized Signature: Owner / Applicant / Contractor / April 02, 2019 Page 2 of 2 Miami Shores Village Ec 2 2 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 20 BUILDING Master Permit No'�f "3-15o PERMIT APPLICATION Sub Permit No. OBUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 1041 NE 94th St City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 11 -3205-012-0080 Is the Building Historically Designated: Yes NO x Occupancy Type: RES Load: Construction Type: Flood Zone: BFE: FIFE: OWNER: Name (Fee Simple Titleholder): MIAMI CTRY DAY SCHOOL INC Phone#:305-779-7203 Address:601 NE 107 ST City: MIAMI State: FL Zip: 33238 Tenant/Lessee Name: Phone#:305-613-6451 Email: buttsg@miamicountryday.org martellc@miamicountryday.org CONTRACTOR: Company Name: Habify, Certified General Contractor Phone#: 305-443-4900 Address: 7442 SW 48th St City: Miami State: FL Zip: 33155 Qualifier Name: Buck Reilly Phone#: 305-443-4900 State Certification or Registration #: CGC 1520342 Certificate of Competency #: DESIGNER: Architect/Engineer: Buck Reilly Phone#: 305-443-4900 Address: 7442 SW 48th St City: Miami State: FL Zip: 33155 Value of Work for this Permit: $10,000.00 Type of Work: ❑ Addition ❑■ Alteration Description of Work: c Square/Linear Footage of Work: � 26599 Zcf J ❑ New ❑ Repair/Replace ❑ Demolition Interior demolition of only of partition walls, fixtures and surface materials per plans. Specify color of color t ru tile: Submittal Fee $ I Permit Fee $ Scanning Fee $ Technology Fee $ Structural Reviews $ Radon Fee $ Training/Education Fee $ CCF $ CO/CC $ DBPR $ Notary $ Double Fee $ Bond $ s TOTAL FEE NOW DUE $ O (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 approved and a reinspection fee will be charged. Signature OWNER or AGENT The foregoing instrument was acknowledged before me this day of A — 20 k -�5 by who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign:��� Cl1i���i(�C as d Signature CONTRACTOR The foregoing instrument was acknowledged before me this I?- day of 2.5MADEK 20 18 , by Q C. u K- Re--u who is personally known to me or who has pro uced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: �1 Sa (Y1Cc�1 i �� Print:=�,.E ''A MANOOCa1ANSeal: "�A�% LISA MANOOWAN Seal: a "4y�.blic - State of Florida Notary Public - State of Florida sion # FF 956440Commission # FF 956440Expires Feb 12. 20?0My Comm. Expires Feb 12, 2020 gh National Nmxy q sr."'********* APPROVED BY l'J l [ / Plans Examiner Zoning 1 L,7 Structural Review Clerk (Revised02/24/2014) Property Search Application - Miami -Dade County Page 1 of 1 'ROPE'RTY OFFICE OF THEI" APPRAISER Summary Report perty Information o: �_ F 11-3205-012-0080 1041 NE 94 ST Property Address: Miami Shores, FL 33138-2944 Owner _. MIAMI CTRY DAY SCHOOL INC .............. ......... _..m. Mailing Address ..... ..................... _ __ _.............._.. . ._............... 601 NE 107 ST MIAMI, FL 33238 PA Primary Zone 1400 SGL FAMILY - 3001-3250 SQ _ ......................_..-._._.............._ _ _ __._ 0101 RESIDENTIAL - SINGLE Primary Land Use FAMILY: 1 UNIT Beds / Baths / Half 3/2/0 Floors 1 Living Units 1 Actual Area 3,327 Sq.Ft Living Area 3,079 Sq.Ft Adjusted Area 3,106 Sq.Ft Lot Size 10,495.1 Sq.Ft Year Built 11940 Assessment Information Year 2018 2017 2016 Land Value $378,055 $378,055 $351,922 Building Value $232,950 $216,178 $216,178 XF Value $1,903 $1,903 $1,903 Market Value ..... ......... _......... _..........._._....�........ ......... _......_. _._ Assessed Value $612,908 ............ $612,908 $596,136 �........... $591,072 $570,003 __........._. _.._..............._....... $537,339 Benefits Information Benefit Type 2018I 2017 2016 ............. .............. _-...__.___ ..___..__.. ................. Non -Homestead Assessment Cap Reduction $5,064 $32,664 Educational Exemption $612,908 .$591,072 $537,339 . ............................_. .__.._� ............_-...............____-_.. ......_................................__-.._. _................... Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). Generated On : 12/21/ Taxable Value Information ...................._ _ ............. County 2018 20171 2 .._...... Exemption Value $612,908L $537 Taxable Value School Board $0 n$591,072 Exemption Value $612,908 $596,136 $570 Taxable Value $0 $0 City Exemption Value ' $612,908 $591,072 $537 Taxable Value $0 $0 Regional Exemption Value Taxable Value ? $612,908 $0„ $591,072 $0' $537 Sales Information Previous Sale Price OR Book -Page Qualification Descriptic 10/01/2007 $825,000 26002-4166 Sales which are qualified 01/01/1994 $150,000 16233-3661 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 Appra and Miami -Dade County assumes no liability, see full disclaimer and User Agreement at hftp://www.miamidade.gov/info/disclaimer.asp https://www.miamidade.gov/propertysearch/ 12/21 /2018 2018 FLORIDA NOT FOR PROFIT CORPORATION ANNUAL REPORT FILED DOCUMENT# 744085 Jan 16, 2018 Entity Name: MIAMI COUNTRY DAY SCHOOL, INC. Secretary of State Current Principal Place of Business: CC1220003551 601 N.E. 107TH STREET MIAMI, FL 33161 Current Mailing Address: 601 N.E. 107TH STREET MIAMI, FL 33161 FEI Number: 59-1278987 Certificate of Status Desired: Yes Name and Address of Current Registered Agent: DAVIES, JOHN 601 N.E. 107TH ST MIAMI, FL 33161 US 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 Date Officer/Director Detail Title DP Name CHRISTOPHER, BELLOWS Address 134 NE 102 STREET City -State -Zip: MIAMI SHORES FL 33138 Title DT Name FARREY, JOHN F Address 1315 BAY TERR City -State -Zip: N BAY VILLAGE FL 33141 Title 1VP Name PREMER, HOWARD Address 2010 NE 120 ROAD City -State -Zip: NORTH MIAMI FL 33181 Title IDS Name LAZENBY, MATTHEW Address 420 LINCOLN ROAD SUITE 320 City -State -Zip: MIAMI BEACH FL 33139 Title COO Name BUTTS, GARY T Address 601 NE 107 ST City -State -Zip: MIAMI FL 33161 Title 2VP Name MOORE, JAMES Address 5905 NORTH BAY ROAD City -State -Zip: MIAMI BEACH FL 33140 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 617, Florida Statutes; and that my name appears above, or on an attachment with all other like empowered. SIGNATURE: GARY T. BUTTS COO 01/16/2018 Electronic Signature of Signing Officer/Director Detail Date LIMITED POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS THAT, I, 4sSgL&!2 (Owner), do by these presents hereby make, constitute and appoint for the period of twelve (12) months from execution herein, Christopher Block, General Manager of Habify, a/k/a Florida Building Performance, LLC, Miami, Florida, my true and lawful attorney -in -fact for me and in my name, place and stead, to sign permit applications on my behalf with Miami -Dade County Building Department and with all municipalities located therein, regarding the property located at 1011 JVC 11-M rff�Pot , %1/%iW f /'ho/12t!'', Florida, Folio No. 8-92Is O(Z'OOd. I give and grant onto said attorney -in -fact, limited power and authority to do and perform the specific acts necessary or incident to the performance and execution of permit applications with Miami - Dade County Building Department and with all municipalities located therein, with power to do and perform the limited acts authorized hereby, as fully to all intents and purposes as I might or could do if personally present, with full power of substitution and revocation, hereby ratifying and confirming all that said attorney -in -fact or his substitute shall lawfully do or cause to be done by virtue hereof. IN WITNESS WHEREOF, I j, , .i (Owner), have hereunto set my hand and seal this / 0 day of Pe p'&�' b'ea , 201. Sealed and delivered in the presence of %A i Witness S'gI Ir ( Signature Owner) Prin4Witne Name: %.Is• rj ��L,����iit 1 1 - . . I . Wi ness Signature Print Witness Name: STATE OF FLORIDA ) COUNTY OF MIAMI-DADE ) The foregoing instrument was acknowledged be re me this / day of e4el'!h r 20A by (Owner). (Check one) [ ] He/She is personally k wn to me or He/She has produced V i�ert t t tion. NOTAR`-PUBLIC-STATE OF FL RQ IDA,1 DESSALINES FRANCOIS At Large�misrioned —/ ' Print, type or stainame of Notary Public: ` MY COMMISSION # GG027034 "''+„ EXPIRES September 06, 2020 0 b� !A0 RICK SCOTT, GOVERNOR JONATHAN ZACHEM, SECRETARY b a pr STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD THE GENERAL CONTRACTOR HEREIN IS CERTIFIED UNDER THE PROVISIONS OF CHAPTER 489, FLORIDA STATUTES Q REI LLY, BUCK HABIFY *4. 7442 SW 48TH ST � MIAMI FL 33155 LICENSE NUMBER: CGC1520342 EXPIRATION DATE: AUGUST 31, 2020 Always verify licenses online at MyFloridaLicense.com Do not alter this document in any form. This is your license. It is unlawful for anyone other than the licensee to use this document. A� 0® CERTIFICATE OF LIABILITY INSURANCE DATE (MMlDD/YYYY) 12/19/2018 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 endorsement(s). PRODUCER Eastern Insurance Group LLC 233 West Central St Natick MA 01760 CONTACT NAME: Lisa Murphy FAX =No (800)333-7234 Opt. 3 (A/C No:781-586-8244 E-MAIL ADDRESS: @lmurphyeasterninsurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A:Security National Insurance Co. 19879 INSURED Florida Building Performance LLC, DBA: Habify 7442 SW 48th Street Miami FL 33155 INSURER B : INSURERC: INSURERD: INSURER E : INSURERF: COVERAGES CERTIFICATE NUMBER:18-19 MASTER 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 ADDL SUER POLICY NUMBER MPWDDNYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A — 1 CLAIMS -MADE I�X , OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 SES133139602 1/16/2018 1/16/2019 PERSONAL& ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO - ELT LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ I� ALL OWNED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ j� NON -OWNED HIRED AUTOS AUTOS $ i UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OTH- STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A'I (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ N yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Florida Building Performance, LLC DBA: HABIFY 7442 SW 48th Street, Miami Fl 33155 LIC #: CGC1520342 CERTIFICATE HOLDER Miami Shores village Attn: Bldg Dept. 10050 NE 2nd Avenue Miami Shores villag, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. FL 33138 I AUTHORIZED REPRESENTATIVE John Koegel/LMURPH ��' �� ACORD 25 (2014/01) INS025 r9m40n ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD JIMMY PATRONIS CHIEF FINANICAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA V✓ORKERS' COMPENSATION LAW * * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 2/6/2018 PERSON: REILLY FEIN: 272261211 BUSINESS NAME AND ADDRESS: FLORIDA BUILDING PERFORMANCE LLC HABI FY 7442 SW 48TH STREET MIAMI FL 33155 SCOPE OF BUSINESS OR TRADE: Contractor -Project Manager, Construction Executive, Construction Manager or Construction Superintendent EXPIRATION DATE: 2/6/2020 BUCK IMPORTANT: Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS? (850)413-1609 Local Business Tax Receipt Miami -Dade County, State offlorida -THIS IS NOT A BILL - DO NOT PAY 7090012 [ FAN NO !(j - il BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES HABIFY RENEWAL SEPTEM'BER 30, 2019 7442 SW 48TH ST 7367907 Must be displayed at place of business MIAMI FL 33155 Pursuant to County Code Chapter 8A - Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS FLORIDA BUILDING PERFORMANCE LLC 196 GENERAL BUILDING CONTRACTOR PAYMENT RECEIVED C/O BUCK REILLY QUALIFIER CGC1520342 BY TAX COLLECTOR $75.00 10/01/2018 Worker(s) 5 CREDITCARD-19-000441 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 holder's 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. For more information, visit www.miamidade.gov/taxcollector