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PLC-5-18-1320, 9050 NE 8 AveOREst'` Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 EH Phone: (305)795-2204 ��ORLDp` Project Address Parcel Number Applicant a050 NE 8 Avenue 1132060110020 Miami Shores, FL 33138-3283 Block: Lot: GHG-SDB001 LLC GHG-SDB001 LLC Address 9050 NE 8 Avenue MIAMI SHORES FL 33138- 9050 NE 8 Avenue MIAMI SHORES FL 33138- ontractor(s) Phone Cell Phone HN REMODELING & MAINTENANCE (954)558-1704 Type of Work: REPLACE FAUCETS IN KITCHEN AND BATH Type of Piping: Additional Info: REPLACE FAUCETS IN KITCHEN AND BATH Classification: Commercial Scanning: 3 Fees Due Amount CCF $1.20 DBPR Fee $6.00 DCA Fee $4.00 Education Surcharge $0.40 Permit Fee $400.00 Scanning Fee $9.00 Technology Fee $1.60 Total: $422.20 Phone ., Cell (305)374-3529 Valuation: $ 2,000.00 Total Sq Feet: p Pay Date Pay Type Amt Paid Amit Due Invoice # PLC-5-18-67571 05/16/2018 Credit Card $ 50.00 $ 372.20 06/22/2018 Credit Card $ 372.20 $ 0.00 mvaname inspections: Inspection Type: Top Out Re Pipe Main Drain Heater Water Service Final Water Main Lavatory Underground Review Plumbing 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 regulating construction and zoning. Futhermore, I authorize the above-na ontractor to do the work stated. June 22, 2018 Authorized Signature: Owner / Applicant Contractor / Agent Date Building Department Copy June 22, 2018 1 0) W6)-ts Inspection Worksheet y-- Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-309219 Permit Nun_-te :,,,PLC-5-18-1320 Scheduled Inspection Date: July 31, 2018 Inspector: Cabrera, Miguel Owner: , Job Address: 9050 NE 8 Avenue Miami Shores, FL 33138-3283 Project: <NONE> Contractor: JHN REMODELING & MAINTENANCE SERVICES INC tsuiming uepartment comments REPLACE FAU TS IN KITCHEN AND BATHROOM UNIT#13 , 8 ND #14 Permit Type: Plumbing = mercial Inspection Type: Final Work Classification: Addition/Alteration Phone Number (305)374-3529 Parcel Number 1132060110020 INSPECTOR COMMENTS False Phone: (954)558-1704 Inspector Comments Passed a CREATED AS REINSPECTION FOR INSP-304311. CANCELLED BY SANTIAGO AT 9:33 AM Failed Correction ❑ -Of0.�0�•0��- Needed Re -Inspection ❑ .�f �� �� Fee ` No Additional Inspections can be scheduled until re -inspection fee is paid. 7 July 30, 2018 For Inspections please call: (305)762-4949 Page 21 of 25 BUILDING PERMIT APPLICATION Miami Shores Village Building Department MAY 16 2018 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 L' 41 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 -t-� FBC 20 1--:V Master Permit No.9'c 1(�3 — 13z/ Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL M"PILUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 9 w-D ry B S A- L- GI n d �4 o City: Miami Shores County: Miami Dade Zip: 33 13 Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): GHG- S®AUDj L L L Phone#: Sox "- 2)-4 -15 Address: /J3O1 6 '" Ave, . City: N. A K'IM i State: �L Zip: 33161 Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: -TIN qaL Iy\c.\;��cL+��.�t�pPhone#:Q50-%0; LA Address: -47 <%SS I\; yv S 1 City: TQ w1c"Yc�-Az. State: EL Zip: 3 3 32 i Qualifier Name: J k a O L (I a e>— Phone#: (9 S00 S-SS " 17 9"1 State Certification or Registration #: C- F -= 1 y 25 %-( i 0 Certificate of Competency #: DESIGNER: Architect/Engineer: hone#: Address: City: State: Zip: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition Description of Work: �x � � R c �_�i+5 1 " � c� t +n CA,n-1 Specify color of color thru tile: Submittal Fee $ Scanning Fee $ Technology Fee $ Structural Reviews $ Permit Fee $Z10111116-1*- CCF $ Radon Fee $ DBPR Training/Education Fee $ CO/CC $ Notary $ Double Fee $ Bond $ (Revised02/24/2014) TOTAL FEE NOW DUE $ 13-7Z. ?� 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 Ot GENT foregoing instrument ed before me this day of 20 by a,: ho is personally known to me or who has produced lk_�1 �' as identification and who did take an oath. Signature CONTRACTOR AID. The foregoing instrument was acknowledged before me this I day of — /,jam'+'! 20 L by C' C lLyc' tl who is�krsonally known t me or who has produced identification and who did take an oath. NOTARY PUBLIC: / NOTARY PUBLIC: Sign. Sign: Print: — ,�„� ; Print: .- MY COMMISSION # FF 123197 Seal: ; ` = EXPIRES: June i, 2018 :y •, of v4,r Bonded Thru Notary Public Underwriters Seal: o�*RY°Ue� Jorge Nieto _ Notary Public - State of Florida Commission #GG 95563 ;r o` Expires 4/18/2021 APPROVED BY � x/ Ll� Plans Examiner as Zoning Structural Review (Revised02/24/2014) Clerk To: Page 4 of 7 2018-05-16 19:41:32 (GMT) 13054686243 From: GHG-AM GHG-AM Prepared by: Jennise Rodriguez Legal Assistant Almazan Law 7901 Ludlam Rd. Suite 100 Miami, FL 33143 305-665-6681 File Number: APA17-2208 Return to: Alan .J. Marcus, Attorney at Law 20803 Biscayne Blvd., Suite 301. Aventura, FL 33180 Parcel identification No.: 06-2219-000-1530,30-3109-018-0450 30-3109-018-0460, 30-3109-018-0570 30-3109-018-0580,08-2128-006-0010 08-2128-006-0011, 08-2128-006-0170 30-2133-002-1670,11-3206-011-0020 08-2128-006-0171 Space Above This Line For Recording Data] CFN: 20180214668 BOOK 30933 PAGE 2871 DATE:04/1 V2018 08:50:17 AM DEED DOC 37,800,00 SURTAX 28,350.00 HARVEY RUVIN. CLERK OF COURT, MIA-DADE CTY Special Warranty Deed This Special Warranty Deed made this U7 day of /'ram, t�`t, 20I81 between CRISTOBAL GIL and CARIDAD CASTILLO, husband and wife, as to Parcel 1, PR.IS APAR'fM' ENTS LLC, a Florida limited liability company, as to Parcels 2, 3 and 4, and VERONA APARTMENTS MANAGEMENT, INC., a Florida corporation, as to Parcel 5 whose post office address is I2924 Ixora Cir., North Miami, FL 33181, grantor, and GHG-SDB001 LLC, a Florida limited liability company whose post office address is 12301 NE 6 Avenue, North Miami, FL 33161, grantee: (Wheuover used hctoiu the icons gcantw null gsantcc iuoludc allthc pa figs to lhia inatnancnt and the Moira, lognl nprc ontativoe., and aceignc of individuate, and the successors and assigns of corporations, mists and mistees) Witnesseth, that said grantor, for and in consideration of the sum TEN AND NO/] 00 DOLLARS (S1.0.00) and other good and valuable considerations to said grantor in hand paid by said grantee, the receipt whereof is hereby acknowledged, has granted, bargained, and sold to the said grantee, and grantee's heirs and. assigns forever, the following described land, situate, lying and being in Miami -Dade County, Florida, to -wit: See Exhibit "A." attached hereto and made a part hereof as if fully set forth herein. Together with all the tenements, hcrcditamcnts and appurtenances thereto belonging or in anywise appertaining. To Have and to Hold, the same in fee simple forever. And the grantor hereby covenants with said grantee that the grantor is lawfully seized of said land in fee simple; that the grantor has good right and lawful authority to sell and convey said land; that the grantor hereby fiilly warrants the title to said land and will defend the same against the lawful claims of all persons claiming by, through or under grantors. DoubleTime® To: Page 5 of 7 2018-05-16 19:41:32 (GMT) 13054686243 From: GHG-AM GHG-AM CFN: 20180214668 BOOK 30933 PAGE 2872 In Witness Whereof, grantor has hereunto set grantor's hand and seal the day and year lust above written. Signed, sealed and delivered in our presence: 4 CRIS ORAL GIL CARID CASTILLO PRIS APART ENTS LLC, a Florida limited liability company By: _ CRI OBAL GIL, Manager C ASTILLO, Manager VERONA APARTMENTS MANAGEMENT, INC., a Florida corp lion By: _ CRIS t ORAL GIL, Director Special 111arraaty !Jeer! - Page 2 DoubleTlme® To: Page 6 of 7 2018-05-16 19:41:32 (GMT) 13054686243 From: GHG-AM GHG-AM CFN: 20180214668 BOOK 30933 PAGE 2873 State of Florida County of Miami -bade The foregoing instrument was acknowledged before me this day of 1. t .` ? 2018, by CRISTOBAL GIL and CARIDAD CASTILLO, who [�j are personally knovvn to me or L] have produced a �nver's license as identification. [Notary Sea]] ; St" JENNISE ROMGUi Z *: MY COMMISSiOril # FF 902043 EXPIRES: JUIy 21, 2019 "�.A', « •• t3crsded Thru tiot�y PuW"ciJndenxifes State of Florida County of Miami -Dade Notary Public Printed Name: My Commission Expires: The foregoing instrument was acknowledged before me this f:. t- day of .A '' 4 t�-2018, by CRISTOBAL GIL and CARIDAD CAST�AO, as Managers of PRIS APARTMENTS LLC, a Florida limited liability company, on behalf of the company. They] are personally known to me or [� have produced a driver's license as idgntificAtion. [Notary Seal] JENNISE RODRIGUEZ r MY CAMMISSt0N 0 FF 902043 EXPIRES: July 21, 2018 .•' Banded Th. Notary PUM Und.,M esa State of Florida County of Miami -Dade Notary Public Printed Name: My Commission Expires: i. "ry 31 r r"• , The foregoing instrument was acknowledged before me this '. day of'), !1'{ ;; 2018, by CRISTOBAL GIL, as Director of VERONA APARTMENTS MANAGEMENT, INC., a Florida corporation, on behalf of the corporation. He L is personally known to me or [_] has produced a driver's license as identificationrti [Notary Seal] JENNISE RODRIGUEZ MY COMMISSION 9 FF 902W EXPIRES: JUIy 21, 2019 Bonded Thru 1" Pubric Undamr m Notary Public Printed N My Specfrrl Warranty Deed - Page 3 DoubleTirnO' To: Page 7 of 7 2018-05-16 19:41:32 (GMT) 13054686243 From: GHG-AM GHG-AM CFN: 20180214668 BOOK 30933 PAGE 2874 Parcel 1: EXHIBIT A The South 132 feet of the East One-half (1/2) of the Southeast quarter (1/4) of the Southeast quarter (1/4) of the Northwest quarter (1/4), less the East 35 feet; the South 35 feet and the West 25 feet thereof; also the above street lines so formed to be connected at the intersection with radii of 25 feet; of Section 19, Township 52 South, Range 42 East, lying and being in Miami -Dade County, Florida. Parcel 2: Lots 1 through 7, and Lots 15 through 21, Block 5 of Pinedale, according to the Plat thereof, as recorded in Plat Book 22, Page 32, of the Public Records of Miami -Dade County, Florida. Parcel 3: Lots 1 and 20, Block 1, Resubdivision of Tracts 25 and 26 of Nile Gardens Section II, according to the Plat thereof, as recorded in Plat Book 43, Page 84, of the Public Records of Miami -Dade County, Florida. Parcel 4: Lot 5, Block 8, of Second Addition to Acme Gulfair, according to the Plat thereof, as recorded in Plat Book 44, Page 68, of the Public Records of Miami -Dade County, Florida. Parcel 5: Lot 3, Asbury Park, according to the plat thereof, as recorded in Plat Book 4, Page 110, of the Public Records of Miami -Dade County, Florida. 511.5/201 L Detail by Entity Name Divisic.), of CCI'PCRA�Eras s i r r1 / r a a r n f ,ear. Department of State / Division of Corporatizons % Search Records / Detail By Document Number Detail by Entity Name Florida Limited Liability Company GHG-SDB001 LLC Filing Information Document Number L18000029646 FEI/EIN Number NONE Date Filed 02/01/2018 State FL Status ACTIVE Principal Address 12301 NE 6 AVENUE NORTH MIAMI, FL 33161 UN Mailing Address 12301 NE 6 AVENUE NORTH MIAMI, FL 33161 UN Registered Agent Name & Address GHG AM LLC 12301 NE 6 AVENUE NORTH MIAMI, FL 33161 Authorized Person(s) Detail Name & Address Title MGR GLOBAL HORIZONS GROUP LLLP 12301 NE 6 AVENUE NORTH MIAMI, FL 33161 UN Annual Reports No Annual Reports Filed Document Images 02.01r2018 -- Florida Lin•,ited Liability View image in PDF format http://search.sun biz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=EntityName&directionType=Initial&searchNameOrder=GHGSDB001 %20L 1 E 5/1.5/2018 ' Detail by Entity Name an offi', ulE �',,Jfl7,adn Cep2rtatnt of State / Division of Corporations / Search Records / Detail Sy Document Number http://search.sunbiz,org/lnquiry/CorporationSearch/SearchResultDetail?inquirytype=EntityName&directionType=Initia[&searchNameOrder=GLOBALHORIZONS Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LICENCES B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE* D. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 Certificate must specify the description of operations or contractor license number. .......................................................................................... BUSINESS NAME: _.T P BUSINESS ADDRESS: -Y 7 013 N'yv $ i Tt y-Y . CITY TG —\ G �� C STATES ZIP .33 3 'L i BUSINESS PHONE: - J 55 — 17 0 q FAX NUMBER ( ) CELL PHONE (I AN y 1 7 - 14 QUALIFIER'S NAME: 0 C' �v QUALIFIER'S LIC NUMBER: C. 1: C 1 4 Z'j q- '7 0 JHN REMODELING AND MAINTENANCE May 16, 2018 State of Florida County of Miami Dade Before me this day personally appeared Jhony Ochoa who, being duly sworn, deposes and says: That he will be the only person working on the project located at: 9050 NE 8 Ave. Miami Shores, FL 33138 Sworn to (or affirmed) and subscribed before this 6 �day of -Al 1 tky , 2018. By I � 0 V, X 0 C� 0. Personally kno Or produced identification Type of identification �J v Print, type or stamp Name of Notary Y F6e Jorge Nieto Notary Public - State of Florida Commission $GG 95563 "•g a� Expires 411 BJ2021 'koPIF Sonded th-ough Cynanotary STATE OF FLORIDA DEPAP.WENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-139. 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399-0783 OCHOA, JH0NY ALEXANDER JHN REMODELING & MAINTENANCE SERVICES 1NC 5708 NW 81 ST TER IAIVARAC FL 33321 Congratulationsi 'Nth this license you becor;e one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range R STATE OF Fl I- CRIDA from architects to yacht brokers, from boxers to barbeque DEPARTMEN7,10F, BUSINESS AND 'PROFESS restaurants, and they keep Florida's econorny strong. -'1-L 'REGULATION Every day we work to improve the way we dolousinessin order CFC1429470,;1;?' 7/04/20 to serve you better. For inforrnaflon about our services, please log onto www.myflaridalleense.com. There you can find more CERTIRED PLU" N CCTiT13.YcCTGiR information about our divisions and the regulations that impact bbHO A,, JH0N*'-*, you, subscribe to department newsletters and learn more about JHN;W .RODEL SERV! the Department's initiatives. 41 Our mission at the Department is: License Efficien6y, Regulate Fairly. We constantly strive to serve you better so lti at you car. serve your customers. Thank you for doing bi:sinesa in Florida, IS.CkRTJFIOD lde" -!a, Pro vis cnlz afchAasFS. , and congratulatier.s on your new license! EXPV.=rdVZ-: AUG 261'8 DETACH HERE RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD L CFC1429470 The PLUMBING CONTRACTOR Named below IS CERTIFIED Wye. Under the provisions of Chapter 489 FS, Expirati6n date: AUG 31, 2018 ham` OCHOA, JHONYALEX.ANDEFVC-;.;-�' � un JHN REMODELING & MAIN#ANGE SER'4CES,INC 5708. N1W 81 ST.TIER:�-.-,, TAMARAC F. U, i�3 k I' Man. ISSUIF0. 17MAON8 r)l.qPl AY A,13 Rr--1^jl 1IRFI) RY 1 AJAJ ;A7 UWWV X . JM REWDnING U MAINTENMCEReceipt#OSC-16-00005975 TAMARAC, FL a3321 CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYW) F5,1612018 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 CONTACT API Group xNNo r,, 954 977-8584 F 5720 Margate Blvd Enna Ss. teea@groupapi.com INSURE 5 AFFORDING COVERAGE NAIC 0 Margate FL 33063 INSURER A • ARCH SPECIALTY INS CO INSURED INSURER B : NAUTILUS INS CO INSURER C : PROGRESSIVE EXPRESS INS CO JHN REMODELING & MAINTENANCE INC INSURER D : 5708 NW 81ST TERR INSURER E: TAMARAC FL 33321 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 CONTRACTOR 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 POLICY EFF I POLICY EXP LIMITS A COMIRERCIAL GENERAL LIABILITY CLAIMS MADE X❑ OCCUR AGLOO4725301 05124/2018 05/24/2019 EACH OCCURRENCE $ 1,000,000.00 X DAMAGE TO RENTED $ 100,000.00 VIED EXP (Any oneperson) s 5,000.00 PERSONAL & ADV INJURY $ 1,000,000.00 GEML AGGREGATE LIMIT APPLIES PER: X POLICY PRO ❑ JECT F1 LOC OTHER: GENERAL AGGREGATE $ 2,000,000.00 PRODUCTS-COMPlOPAGG $ 2,000,000.00 $ C AUTOMOBILE X LIABILITY ANY AUT OWNED X SCHEDULED AUTOS ONLY AUTOS ED AUTOSHIR AUTOS ONLY X NON-OWNE ONLDD 040397620 07/27/2017 07/27/2018 COMBINED SINGLE LIMIT $ 1,000 000.00 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) S PROPERTY DAMAGE s B X UMBRELLA LIAB X EXCESS LIAR OCCUR CLAIMS -MADE AN041330 7/26/2017 7/2612018 EACH OCCURRENCE S 1,000,000.00 AGGREGATE $ 1,000,000.00 DED I X i RETENTION 0 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETORIPARTNERIEXECUTIVE❑ OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If Yyes describe under DESCRIPTION OF OPERATIONS below NIA I H- PER OTITF STA'n PR E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE S E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 1D1. Additional Remarks Schedule, may be attached it more space Is required) .General Contractor CGC1516834, Plumbing CFC1429470, AC-CAC1816491, Roofing CCC1330641 I IFICAl a HOLDER VILLAGE OF MIAMI SHORES 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 ©1988-2015 ACORD ORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD JEFF ATWATER CHIEF FINAMCAL OFFICER L • ��rb &ti STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 5/22/2017 EXPIRATION DATE: 5/22/2019 PERSON: OCHOA JHONY FEIN: 263587890 BUSINESS NAME AND ADDRESS: JHN REMODELING & MAINTENANCE SERVICES, INC. 5708 NW 81 TER TAMARAC FL 33321 SCOPE OF BUSINESS OR TRADE: Licensed General Contractor Licensed Plumbing Contractor Licensed Roofing Contractor Haating, Ventilation, Air - Conditioning and Refrigeration Systems installation, Service and Repair, Shop. Yard & Drivers 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(12j 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. Purstaant to Chapter 440.05(13), F.S., Notices of election to be exempt and certificates of election to be exempt shalt be suNect to revocation lf, 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. 0FS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS? (850)413-1609 Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner -Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees, including the owner, must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if: I . The officer owns at least 10 percent of the stock of the corporation, or in the case of an LLC, a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State, Division of Corporations; and 3. The corporation is registered and listed as active with the Florida Department of State, Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption and has acknowledge that he or she will not use day labor, part-time employees or subcontractors for your project. The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project. In these circumstances, Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company for day labor, part-time employees or subcontractors. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: Owne State of Florida County of Miami -Dade The foregoing was acknowledge before me this day of <J f) V►Q 20%. By J k o j / i �Z k U K, I who is personally known to me or has produced as identification. Notary: ) V UI* SEAL: '�PRrn Jorge Nieta y Notar Public • State of Florida Expires 4/18/2021 Sondad through Cynanotary El Al 1. AL VY L,'JECT TO COMPLIANCE I ITH ALL FED EPrL 1-; /�TF AND (',Ol JNTY FRULFS AND RFOULAM,1\13 VERONA AM 5 9M NE 8: AVE MIAN SHORES FL: 33 c F-C 4 • .... ...... 00*0 0000 00000 • ...... , . • • ...... . . . . .. . • . . ..... . ao RECE, VEa MAY 31 1018 Y'A.. .... .... ..... ...... . . ..... .... . ...... . . . . ...... Miami Shores Village Building Department MAY 31 2019 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 k FBC 2B(� �� BUILDING Master Permit No. y W —1 1 `( PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING 0 REVISION ❑ EXTENSION ❑RENEWAL ❑■ PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 9050 NE 8 AVE #8 AND #14 Folio/Parcel#: 11-3206-011-0020 Is the Occupancy Type: Load: Construction Type: OWNER: Name (Fee Simple Titleholder): GHG-SDB001 L4C Address: 12301 NE 6 AVE City: NORHT MIAMI VNIFL Tenant/Lessee Name: y Email: I/Historically signated: Yes NO _ Flood Zo BFE: FFE: ne#: 305-374-3529 1 p: 33161 CONTRACTOR: Company Na e: JHN WMODE NG AND MAINTENANCE ' 154-558-1704 Address: 5708 NW 81 T RR City: TAMARAC State: FL Qualifier Name: JHONY OCHO Phone#: State Certification or Registratio CFC1429470 Certificate of Competency #: DESIGNER: Architect/Engin r- Phone#: Address: City: State: Value of Work for this Permit: $ 1000 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑■ Alteration ❑ New ❑ Repair/Replace Description of Work: REPLACE SINKS AND FAUCETS IN KITCHEN AND BATHROOM Specify color of color thru tile: Submittal Fee $ SO •� Permit Fee $ Scanning Fee $ 131�Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ 321 1 -558-1704 Zip: ❑ Demolition CCF $ CO/CC $ DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ (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 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 charged. t Signature OWNER or AGE The foregoing instrument waas� acknowledged before me this Qt-Z q -day of lti 20 It by kho is personally known to me or who has produced A- k J 0_12,as identification and who did take an oath. NOTARYPUB Sign P Seal °; EXPIRES: June 1, 2018 „Rf;a'% Bonded Thru Notary Public Underwriter. Signatu *rnstrument was acknowledged before me this day of _A20 I, by / (2(-W who is personallhow or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign:_ Print: Seal: ******************************************************************* APPROVED BY L Plans Examiner Jorge Nieto Notary Public - State of Florida Commission #GG 95563 Expires 4/18/2021 Zoning Structural Review (Revised02/24/2014) Clerk Property Search Application - Miami -Dade County Page 1 of 1 OFFICE OF THE PROPERTY APPRAISER Summary Report Property Information Folio: 11-3206-011-0020 Property Address: 9050 NE 8 AVE Miami Shores, FL 33138-3283 Owner VERONA APARTMENTS MGMT INC %CRISTOBAL GIL Mailing Address 9050 NE 8 AVE #18 MIAMI SHORES, FL 33138-3283 PA Primary Zone 3000 MULTI -FAMILY - GENERAL 0303 MULTIFAMILY 10 UNITS Primary Land Use PLUS: MULTIFAMILY 3 OR MORE UNITS Beds I Baths / Half 16 / 16 / 0 Floors 1 Living Units 16 Actual Area Sq.Ft Living Area Sq.Ft Adjusted Area 9,797 Sq.Ft Lot Size 31,697 Sq. Ft Year Built 1957 Assessment Information Year 2017 2016 2015 Land Value $887,516 $887,516 $570,546 Building Value $10,000 $96,982 $440,584 XF Value $0 $0 $0 Market Value 4____�$897,516 $984,498 $1,011,130 Assessed Value i $897,514 $815,922 $741,748 Benefits Information ,Benefit Type 2017€ 2016 2015 Non -Homestead Assessment $2 $168,576 $269,382 Cap Reduction Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). ASBURY PARK PB 4-110 LOT 3 LOT SIZE 109.300 X 290 OR 21197-1186 0403 1 Generated On : 6/1/2018 Taxable Value Information 20175 2016 2015 County Exemption Value $0 $0 $0 Taxable Value $897,514 $815,922 $741,748 School Board Exemption Value $0 $0 $0 Taxable Value $897,516 $984,498 $1,011,130 City Exemption Value $0 $0 $0 Taxable Value $897,514 $815,922 $741,748 Regional - Exemption Value $0 $0 $0 Taxable Value $897,514 $815,9221 $741,748 Sales Information Previous OR Book - Price Qualification Description Sale Page 21197 04/01/2003 $700,000 Sales which are qualified 1186 19081- 04/01/2000 $500,000 Sales which are qualified 2594 ........... 01/01/1995 $0 16665- Sales which are disqualified as a result 2235 of examination of the deed 01/01/1994 $0 00000- Sales which are disqualified as a result 00000 of examination of the deed 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: https://www.miamidade.gov/propertysearch/ 6/1 /2018