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PL-12-18-3768, 398 NE 100th StMiami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Parcel Number 398 NE 100TH ST, Miami Shores, FL 33138 1132060135410 :ontacts PAUL & MILDRED MAJOROS Owner GARCA GROUP LLC Contractor 601 GRAND CONCOURSE, MIAMI SHORES, FL 331382473 YUREK VIGO 2428 SW 113 PL, MIAMI, FL 33165 Mobile: 3054248642 Description: GAS INSTALLATION FROM ABOVE LP TANK TO BBQ \? Valuation: $ 2,390.00 Inspection Requests: GRILL, COOK -TOP AND TANKLESS WATER HEATER 305 762 4949 Total Sq Feet: 0.00 Fees Amount Application Fee - Other $50.00 CCF $1.80 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.60 Permit Fee $50.00 Scanning Fee $9.00 Technology Fee $2.50 Total: $117.90 Building Department Copy Payments Date Paid Amt Paid Total Fees $117.90 Credit Card 01/24/2019 $67.90 Credit Card 12/27/2018 $50.00 Amount Due: $0.00 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 i j ate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above ncontractor to do the work stated. Authorized Signature: Owner / Applicant / Contractor Date January 24, 2019 Page 2 of 2 1p BUILDING PERMIT APPLICATION Miami Shores Village Building Department DEC 2, 7 2016 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 i r Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20 1 -1 Master Permit No. P 1 � 6 S_�(0_8 Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL QPLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 398 NE 100 ST Miami Shores, FL 33138-2421 City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 11 -3206-013-5410 Is the Building Historically Designated: Yes NO Occupancy Type: Residential Load: Construction Type: Gas Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): PAUL MAJOROS Phone#: 305-401-5227 Address: 398 NE 100 ST City: MIAMI SHORES State: FL Zip: 33138 Tenant/Lessee Name: Phone#: Email: PAUL.MAJOROS@GMAIL.COM CONTRACTOR: Company Name: Garca Group, LLC Phone#: 305-424-8642 Address: 7389 NW 54th Street City: Miami State: FL Zip: 33166 Qualifier Name: Yurek Vigo Phone#: 305-424-8642 State Certification or Registration #: LPG023368 Certificate of Competency #: LPG023368 DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ all alto. b 0 Square/Linear Footage of Work: Type of Work: ❑ Addition N Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of work: Gas installation form above LP tank to BBQ grill, cook -top and tankless water heater Specify color of color thru tile: Submittal Fee $ Permit Fee $ Scanning Fee $ Technology Fee $ Structural Reviews S Radon Fee $ Training/Education Fee $ CCF $ CO/CC $ DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ 6�_) . 90. (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 va/ a 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 com encement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issue ! the absence of such posted notice, the inspection will not be opprMd and a reinspection fee will bf charged. Sienatur C91� 0ail7 The foregoing instrument was acknowledged before me this 9 ,day of � CMb4t 20 49 by -1b who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: Print�arwll I?S r:�m'a as Signature. The foregoing instrument*as acknowledged before me this 18th day of December 20 18 by Yurek Vigo who is personally known to me or who has produced DL as identification and who did take an oath. NOTARY PUB L C: Sign: Print: DianelyL Perez Seal: ..............DIANELYSPEREZ Sea pIANELYSPEREZ Notary Public- State of Florida NotaryPublic-StateofFlorida Commission X GG 089678 r = Commission k GG 089678 M Comm,x Expires r3,2021 Y P P ; y' My Comm. Expires Apr 3, 2421 ********.k'****eeadadwrtrlexwet�pOft* APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Property Information Folio: 11-3206-013-5410 Property Address: 398 NE 100 ST Miami Shores, FL 33138-2421 Owner PAUL MAJOROS MILDRED MAJOROS Mailing Address 398 NE 100 ST MIAMI SHORES, FL 33138 USA PA Primary Zone 1000 SG FAMILY - 2101-2300 SQ Primary Land Use 0101 RESIDENTIAL -SINGLE FAMILY: 1 UNIT Beds / Baths / Half 4/3/0 Floors 2 Living Units 1 Actual Area 3,031 Sq.Ft Living Area 2,072 Sq.Ft Adjusted Area 2,420 Sq.Ft Lot Size 11,838.1 Sq.Ft Year Built 1937 Assessment Information Year 2018 2017' 2016 Land Value $355.285 $355,285 $296,071 Building Value $168,432 $168,432 $168,432 XF Value $4,454 $4,470 $4,486 Market Value Assessed Value $528,171 p $406,299 $528,187 $397,943 $468,989 $165,781 Benefits Information Benefit Type 2018 2017 2016 Save Our Homes Assessment $121,872 $303,208 Cap Reduction Portability Assessment $130,244 Reduction Homestead Exemption $25,000 $25,000 $25,000 Second Homestead Exemption $25,000 $25,000 $25,000 Widow Exemption $500 Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). Short Legal Description 1 534165342 MIAMI SHORES SEC 1 AMD PB 10-70 LOT 1 & 2 BLK 40 LOT SIZE 102.940 X 115 Generated On : 12/27/2018 Taxable Value Information 2018 2017 2016 County _,. Exemption Value $50,000 $50,000 $50,500 Taxable Value $356,299 $347,943 $115,281 School Board Exemption Value $25,000 $25,000 $25,500 Taxable Value $381,299 $372,943 $140,281 City Exemption Value $50,000 $501000 $50,500 Taxable Value $356,2991 $347,9431 $115,281 Regional Exemption Value Taxable Value $F D 1 $356,299 $50,000 $347,9431 $50,500 $115,281 Sales Information Previous Sale Price. OR Book -Page Qualification Description 11/01/2016 $725,000 30291-4218 !Qua[ by exam of deed 1 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/disciaimer.asp Version 1 ® AC"CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 02/15/2019 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 endomement(s). PRODUCER CONTACT NAME: Flavia M. Ribot Reyes HONK 305-239-8996 FAX No: 305-239-8988 Anchor Underwriters Inc. 10300 Sunset Drive, Suite 181 E-MAIL ADDRESS: info@anchorunderwriters.com INSURERS) AFFORDING COVERAGE NAIC# Miami, FL 33173 INSURERA: Nautilus Insurance Company 17370 INSURED INSURERB: NorGUARD Insurance Company 31470 Garca Group LLC dba Gas Plumbing Technologies INSURERC: PO BOX 651468 INSURER D : INSURER E : Miami FL 33165 INSURER F : COVERAGES CERTIFICATE NUMBER: 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 SUBR POLICY NUMBER MM POLICY EFF /DDNYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY FV__1 CLAIMS -MADE OCCUR BN963996 03/15/2018 03/16/2019 EACH OCCURRENCE $ 1,000,000 DAMAGE To ENTED PREMISES Ea occurrence) $ 100,000 MED EXP (Any one person) PERSONAL & ADV INJURY $ 5,000 $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑PRO- JECT ❑ LOC OTHER: GENERAL AGGREGATE $ 2,000,000 X PRODUCTS -COMP/OP AGG $ 2,000,000 BI/PD Deductible $ 1,000 AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ A X UMBRELLA LIAR EXCESS LIAB OCCUR CLAIMS -MADE AN048901 03/15/2018 03/16/2019 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 2,000,000 DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A GAWC076442 02/15/2019 02/15/2020 X STATUTE ERH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space Is required) License#23823 Miami Shores 10050 NE 2nd Ave Miami Shore, 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. ACORD 25 (2016/03) I1 JAAA AAJ! �/�APf11 AAf1f1Af1�T�A\. -.LI The ACORD name and logo are registered marks of ACORD i 0 AC OCERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 02/15/2019 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 endorsement(s). PRODUCER AA Insurance Services, Inc 12918 SW 133 Ct CONTACT NAME: Alina Jimenez AID"N xt: 786-518-2989 A/C No, 305-233-4289 E-MAIL ESS: jainsuranceservices@gmaii.com INSURER(S) AFFORDING COVERAGE NAIC# Miami, FL 33186 INSURERA: Infinity Auto Insurance Company 39497 INSURED INSURER B : INSURERC: Garca Group LLC dba Gas Plumbing Technologies INSURER D : 7389 NW 54TH ST INSURER E : Doral FL 33166 INSURER F : COVERAGES CERTIFICATE NUMBER: 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 OF INSURANCE ADDLSUBRTYPE INSO WVD POLICY NUMBER POLICY EFF MM/DDfYYYY POLICY EXP MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY 71 CLAIMS -MADE OCCUR EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑PRO JECT ❑ LOC OTHER: GENERAL AGGREGATE $ PRODUCTS - COMPIOP AGG $ $ A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS AUTOS ONLY Ix XHIRED NON -OWNED AUTOS ONLY AUTOS ONLY 509-80003-3245-001 04/12/2018 04/12/2019 OEaMBINED accidentSINGLE LIMIT (CEO, $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PerOPERdenDAMAGE $ P.I.P $ 10,000 UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY y / N ANYPROPRIETOR/PARTNER/EXECUTIVE I OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A SPTER ERH E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) .***********************.*****PLUMBING CONTRACTOR**********************„**�**.************.********** CFRTIFICATF I-IAI r1FR CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Miami h res THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Ave Miami Shore, FL 33138 AUTHORIZED REP^ SE�NTA,TIV,E I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 26 (2016103) The ACORD name and logo are registered marks of ACORD