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EL-10-20-2376, 1132 NE 101st StMiami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Parcel Number 1132 NE 101ST ST, Miami Shores, FL 33138 1132050190270 :ontacts JOHN HILLMAN Owner HI -TECH ELECTRIC & FIRE CORP Contractor 1132 NE 101 ST, MIAMI SHORES, FL 331382607 EDMUNDO I JARQUIN 1500 SW 101 AVE, MIAMI, FL 33174 Business: 7863260931 .- — ---- - --------- m.--- - _w._-------- . ..... ------ . -.. Description: SAFETY CHECK FOR RECONNECTION � Valuation: $ 350.00 Inspection Requests: 305 762 4949 Total Scl Feet: 0.00 Fees Amount Application Fee - Other $50.00 CCF $0.60 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.20 Permit Fee $50.00 Scanning Fee $9.00 Technology Fee $2.50 Total: $116.30 Payments Date Paid Amt Paid Total Fees $116.30 Cash 10/19/2020 $50.00 Credit Card 10/22/2020 $66.30 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 regulating construction and zoning. Futhermore, I authorize the above named contractor to do the work stated. Autfie ecl Signature: Owner / Applicant / Contractor / Agent Date October 22, 2020 Page 2 of 2 Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Parcel Number 1132 NE 101ST ST, Miami Shores, FL 33138 1132050190270 Contacts JOHN HILLMAN Owner HI -TECH ELECTRIC & FIRE CORP Contractor i 1132 NE 101 ST, MIAMI SHORES, FL 331382607 EDMUNDO I JARQUIN 1500 SW 101 AVE, MIAMI, FL 33174 Business: 7863260931 �... Inspection Requests Description. SAFETY CHECK FOR RECONNECTION Valuation: $ 350.00HIR , 305-762-4949 Total Sq Feet. 0.00 Fees Amount Application Fee - Other $50.00 CCF $0.60 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.20 Permit Fee $50.00 Scanning Fee $9.00 Technology Fee $2.50 Tota I : $116.30 Payments Date Paid Amt Paid Total Fees $116.30 Cash 10/19/2020 $50.00 Credit Card 10/22/2020 $66.30 Amount Due: $0.00 Applicant Copy For Inspections, Call (305) 762-4949 or Log on at https://bldg.miamishoresvillage.com/cap/. Requests must be received by 3pm for following day inspections. NOTICE: In addition to the requirements of this permit, there may be AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER additional restrictions applicable to this property that may be found in the GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, public records of this county. STATE AGENCIES, OR FEDERAL AGENCIES. October 22, 2020 Page 1 of 2 NC\ -TAU . Miami Shores Village�I��z� 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 �l BUILDING PERMIT APPLI ATION ❑BUILDING ELECTRIC ❑ ROOFING 1-FBC 20 P 20 Master Permit No. r� �U' Sub Permit No. ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP C CONTRACTOR DRAWINGS JOB ADDRESS: ! 1 / �l ✓ r Folio/Parcel#: � td — 3 `Z o 5 "o19 — V 2! O Is the Building Historically Designated: Yes NO - Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): JLjIn E, N1%%,"un11 S1"• G+t�•�ti �%�t 44X)0jk�� Phone#: 3/d ""% C G"�J_S Address: 14.2. hll�e �/0 ill" City: 1�%/�fs2ts fG'�ca!�'S State: Zip: 33-l3 P Tenant/Lessee Name: N/i �q Phone#: Email CONTRACTOR: Comp�Cany Name: (nn__ — I ek+�,d" jpm cLa Phone#: !� "543-J5-'10 Address: i'sbo (W 101 rc City: u 1 1 k u Qualifier Name: State Certification or Registration #: DESIGNER: Architect/Engineer: _Zip:: 3319 ??T rr ne#: I YVIX — 0 q31 Certificate of Competency #: Address: //��`(1� City: Value of Work for this Permit: $ 3�bV , V Square/Linear Type of Work: ❑ Addition r❑I Alteration r ' ❑ New /�� Description of Work: Sa-�.Q.-4,A ` J►.I cL 4y 1(QW y\ne Specify color of color thru tile: Submittal Fee Scanning Fee $ Technology Fee $_ Structural Reviews $ Permit Fee $ CCF $_ Radon Fee $ DBPR $ Training/Education Fee $ Phone#: State: Zip: )o age of Work: Repair eplace ❑ Demolition CO/CC $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ V7lo • 30 (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 .Z. day of () a, , 20Z () by Q It -�,t4NE �kj\ 10'4V1, who is personally known to me or who has produced �l�\Jed \S r4 1 C: e l Seas identification and who did take an oath. NOTARY PUBLIC: Sign:_ Print: Seal: SELENA ARANDA ;g`.•'�.: MY COMMISSION # GG 971705 m' .a •' EXPIRES: March 22, 2024 Bonded Thru Notary Public Underwriters Signature `- 0 TRACTOR The foregoing instrument was acknowledged before me e this day of 20 Oy by on a AILQ. I who is personally known to me or who has produced iden NOT Sign Prim as APPROVED BY �c7 �E� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Property Search Application - Miami -Dade County Page 1 of 1 OFFICE OF THE PROPERTY APPRAISER .` Summary Report Property Information Folio: 11-3205-019-0270 Property Address: 1132 NE 101 ST Miami Shores, FL 33138-2607 Owner JOHN E HILLMAN SR TRS JOHN E HILLMAN SR REV TRUST Mailing Address 1132 NE 101 ST MIAMI SHORES, FL 33138 USA PA Primary Zone 1100 SGL FAMILY - 2301-2500 SQ Primary Land Use 0101 RESIDENTIAL -SINGLE FAMILY: 1 UNIT Beds / Baths / Half 3/2/0 Floors w- 2 Living Units 1 Actual Area Sq.Ft Living Area Sq.Ft Adjusted Area 1,818 Sq.Ft Lot Size 8,775 Sq.Ft Year Built Multiple (See Building Info.) Assessment Information Year 2020 2019 2018 Land Value $331,485 $331,485 $315,734 Building Value $136,460 $136,465 $136,470 XF Value $0 $0 $0 Market Value $467,945 $467,950 $452,204 Assessed Value $207,212 $202,554 $198,778 Benefits Information Benefit Type 2020 2019 2018 Save Our Homes Assessment $260,733 $265,396 $253,426 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). iShort Legal Description MIAMI SHORES SEC 8 REV PB 43-67 LOT 4 BLK 177 LOT SIZE 75.000 X 117 OR 10486-186 0879 1 COC 22258-3134 01 2004 4 Generated On : 10/19/2020 Taxable Value Information 20201 20191 2018 ............... County Exemption Value $50,000 $50,000 $50,000 Taxable Value 1 $157,212 $152,554 $148,778 School Board Exemption Value $25,000 $25,000 $25,000 Taxable Value $182,212L^ $177,554 $173,778 City Exemption Value $50,000 $50,000 $50,000 Taxable Value $157,212 $152,554 $148,778 Regional Exemption Value $50,000 $50,000 $50,000 Taxable Value $157,212 $152,554 $148,778 Sales Information Previous OR Book - Price Qualification Description Sale Page 29270 07/07/2014 $100 Corrective, tax or QCD; min consideration 1882 29204 ____�............... ._......_.. _.... 05/20/2014 $100 Corrective, tax or QCD; min consideration 0442 22258- Sales which are disqualified as a result of 01/01/2004 $0 3133 examination of the deed 22258- Sales which are disqualified as a result of 01/01/2004 $0 3134 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 https://www.miamidade.gov/Apps/PA/propertysearch/ 10/19/2020 ACCEPTANCE BY SUCCESSOR TRUSTEE I, Jill A. Hillman, pursuant to Florida Statute 736.0701 and as a consequence of the passing of John E. Hillman, Sr., hereby accept this appointment as Successor Trustee, in my sole capacity, under Article 3 Section 3.03 of the The John E. Hillman, Sr. Living Trust dated May 20, 2014. Fiduciary lawyer -client privilege in S. 90.5021 applies with respect to the Trustee and any attorney employed by the Trustee. Dated this f day of d6%- , 2020. %1 r Jill A. Hillman, Successor Trustee Address: 9334 Cattaraugus Avenue Los Angeles, California 90034 Samuel Sgnerncer Blum ATTORNEY AT LAW 2666 TIGERTAIL AVENUE, SUITE 106 COCONUT GROVE, FLORIDA 33133 TELEPHONE: (306) 8541885 TELEFAX: (305) 854-3314 E-MAFI,: sam@s8R1blum.com M : I ,- .- N�* • j tz Ron DeSands, Governor STATE OF FLORIDA Halsey Beshears, Secretary d Ronda DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD THE ELECTRICAL CONTRACTOR HEREIN IS CERTIFIED UNDER THE PROVISIONS OF CHAPTER 489, FLORIDA STATUTES JARQUIN, EDMUNDO HI -TECH ELECTRIC & FIRE CORP 1500 SW 101 AVE MIAMI k' . FL 33174 LICENSE NUMBER: EC13002608 EXPIRATION DATE: AUGUST 31, 2022 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. i BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000 VALID OCTOBER 1, 2020 THROUGH SEPTEMBER 30, 2021 DBA: Receipt #:ELECTRI CAL/ALARMS/CONTF Business Name: 1-2913 HI TECH ELECTRIC & FIRE CORP Business Type: YP (ELECTRICAL CONTRACTOR) Owner Name: EDMUNDO I JARQUIN Business Opened:12/20/2004 Business Location: 1500 SW 101 AVE State/County/Cert/Reg:EC13002608 MIAMI DADE COUNTY Exemption Code: Business Phone:786-543-5216 Rooms Seats Employees Machines Professionals 3 For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 1 0.00 0.00 0.00 0.00 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non -regulatory in nature. You must meet all County and/or Municipality planning WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. Mailing Address: EDMUNDO I JARQUIN 1500 SW 101 AVE MIAMI, FL 33174 Receipt #30A-19-00005666 Paid 09/23/2020 27.00 AJI�" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/oonrrr) 10/1912020 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 endomement(s). PRODUCER NAME C ESTHER VIDAL MUTUAL INTEREST ASSURANCE IAlCNNo Eae:305 860 2003 No:305-860 0907 ESTHER VIDAL E-MAIL ADDRF.SS-MUTUALAS OL.COM - 1295 CORAL WAY INSURER(S) AFFORDING COVERAGE NAIC X MIAMI, FL 33145 INSURERA: SECURITY NATIONAL INSURANCE CO INSURED HI -TECH ELECTRIC & FIRE CORP 1500 SW 101 AVE MIAMI, FL 33174 INSURERB: NORMAN_DY_HA_RBO_R INSURANCE_ CO. _ 29803 INSURER C : ASCENDANT INSURANCE CO ~� — ~� INSURER D : INSURER E : 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. LNTR TYPE OF INSURANCE .'INSR MULLADDLISUBR POLICY NUMBER ^^ YMlI)CD/rYYFF I MMILDOrrYYv T LIMITS A GENERAL LIABILITY i X COMMERCIAL GENERAL LIABILITY I 4CLAIMS -MADE " ' OCCUR iMED B1$500 DIED. PD $500 DIED. I i GEN'L AGGREGATE LIMIT APPLIES PER, X POLICY E OT- ' LOC SES1119418 03 10/10/2020 10/10/2021 � j EACHOCCURRENCE $ 11000,000 DAM E T ENTE PREMISES Ea occurrence $ 100,000 EXP (Anemone person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GFNERALAGGREGATE $ 2,000,000 PRODUCTS - COMPIOP AGG S 2,000,000 -- S C AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS X AUTOS NON -OWNED HIRED AUTOS AUTOS H IA124099 3/28/2020 3/28/2021 (Ea MND MIT acc dentSINGLE LIMIT) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE Per accident $ 300,000 $ 8 $ UMBRELLALIAB EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE_ I $ DIED i RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN OFFICER/MEM IF EXCLUDED? ❑Y (Mandatory in NH) If yes, describe under—" DESCRIPTION OF OPERATIONS below N I A NHFL0027752020 09/23/2020 09/23/2021 I X T RY L MIT ER EL EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE' E.L. DISEASE - POLICY LIMIT ! $ 1,000,000 S 1,000,000 i S 1,000,000 I i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Addklonal Remarks Schedule, if more space is required) ELECTRICAL CONTRACTOR - STATE LICENSE NUMBER: EC13002608 EDMUNDO JARQUIN, EC 13002608 UtK I ItIUA I t HULUtK UANULLLA I IUN MIAMI SHORES VILLAGE 10050 NE 2ND AVE 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 REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/061 The ACORD name and loco are reaistered marks of ACORD J ob 113 2 NE 101 ST N1I AYN1I S NQKe�S FL f CfAl��l�� Ey"ori aU- PP%NE1. w1 C OT11JU 3REwEeh Io0w mPm PAaG 1 i%i'rR►rrr�D 3- r1o. a R Do 1�- ® r, k ov5e,11 1'/q, u-l6 ENGt-o�D 3 -No.2 At. 100 RM? ME1ER ayAb9 0 k.-g>j;LgOV. 10 cw� C-waA 'a No, 6 5o0Qb \-j►0 DATE �,DDEPr ._t r 7 11 sJI t 1 1 IANGF WITH ALL FEDERAL All A 11) C SUN 1Y IIUI ES AND RFGUI—AIIONS 'wo'#'E of W oRv': I. SAFr✓n NECV, f-or- �ZECD f� N ECTIIA 2.. N b W OZK TEMRAEb 41-T6,A C&L1RIC a- FIRE OW LICetJ% ELI3bb2lb2 ehmot'�DD --lf\Q-L4U I is �o Z-0 Y