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RC-11-115Inspection Number: INSP - 155205 Scheduled Inspection Date: March 21, 2011 Inspector: Bruhn, Norman Owner: BROOKS, FLORENCE Job Address: 1500 NE 104 Street Project: <NONE> Contractor: HERMAN EILBERG CONTRACTOR INC Building Department Comments DRYWALL REPLACEMENT IN DINING & LIVING ROOM Passed % �71/4-i Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. March 18, 2011 Miami Shores, FL 33138- Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspector Comments cc For Inspections please call: (305)762 -4949 Permit Number: RC -1 -11 -115 Permit Type: Residential Construction Inspection Type: Final Building Work Classification: Alteration Phone Number Parcel Number 1122320320350 Phone: (954)695 -0324 Page 17 of 37 NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. Re-1-11-1/ rTAX FOLIO NO. STATE OF 1 HEREBY CE STATE OF FLORIDA: COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to d' property, and in accordance with Chapter 713, Florida Statutes, the following iNigigt is provided in this Notice of Commencement. By 1. Legal description of property and street/address: 2. Description of improvement: 129.01-62 PA 3/10 1 11111111111 11111111111111111111111111111 1111 CIFt4 2011 80 1 02086 OR Bk 27587 Ps 2 351; (1Ps RECORDED 02/15/23)11 09:44:01 HARVEY RUVIN, CLERK OF COURT MIAMI —DALE COIJNTYr FLORIDA LAST PAGE Space above reserved for use of recording office IA.) 13etAlt. 3. Owner(s) name and address: Interest in property: Name and address of fee simple titleholder. 4. Contractor's name, address and phone number. ..? Signature(s) of Owner(s) or Owner(s)' Authorized Officer /Director/Partner/Manager , Prepared By Prepared By L O Print Name Print Name 1,4 9 5 LA) taa- — W 5. Surety: (Payment bond required by owner from contractor, if any) Name, address and phone number. Amount of bond $ 6. Lender's name and address: 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes, Name, address and phone number. 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. // ^ O Z Name, address and phone number. 1 L� 4 bul"4' [ • - r ° ® ( + fl O l3 .4 AL ��, fi / s / 9. Expiration date of this No of Commencement: (the expiration date is 1 year from the date of recording unless a different date Is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Title /Office Title /Office STATE OF FLORIDA COUNTY OF MIAMI -DADE j r The foregoing • strument was acknowledg before me this � (a day of By . 4 -Q r� 1 e1— f / c �-7 — ,J ndividually, or as 6 • ti�L,, for Personally known, or ❑ pr uced the following type of identification: Signature of Notary Public: Print Name: (SEAL) VERIFICATION PURSUANT TO SECTION 92.525. FLORIDA STATUTES Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true, to the best of my knowledge and belief. Signature(s) of Owner(s) or Qer(s)'s A •razed Officer/Di ctor/Partner/Manager who signed above: By y1 �,r_ 1� l �6i rtZ l . I By Zvi) Grcm�� oo -�h L4a�e_ Project Address Owner Information Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number 1500 NE 104 Street Miami Shores, FL 33138- 1122320320350 Block: Lot: FLORENCE BROOKS Address Phone FLORENCE BROOKS 1500 NE 104 ST MIAMI SHORES FL 33138 -2666 1 Contractor(s) Phone CeII Phone HERMAN EILBERG CONTRACTOR IN( (954)695 -0324 Approved: In Review Comments: Date Approved: : In Review Date Denied: Type of Construction: DRYWALL REPLACEMENT Stories: Front Setback: Left Setback: Bedrooms: Plans Submitted: Certificate Date: Bond Retum : Occupancy: Single Family Exterior: Rear Setback: Right Setback: Bathrooms: Certificate Status: Additional Info: Classification: Residential Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $9.60 07.02 $7.02 $3.20 $468.00 $9.00 $12.80 $516.64 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy February 15, 2011 Pay Date Pay Type Invoice # RC -1 -11 -39883 01/24/2011 Cash 02/15/2011 Credit Card Amt Paid Amt Due $ 50.00 $ 466.64 $ 466.64 $ 0.00 Applicant CeII Valuation: Total Sq Feet: $ 15,600.00 572 1 Date Available Inspections: I nspection Type: Final PE Certification Shutter Final Window Door Attachment Tie Beam Slab Termite Letter Framing Insulation Drywall Screw Shutter Attachment Window and Door Buck Ceiling Grid Fill Cells Columns Declaration of Use 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. February 15, 2011 1 a 6M- gl Ili— aNiaillb 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 �� BUILDING Permit No. V-(:):j I -- I 1 PERMIT APPLICATION Master Permit No. FBC 20 Permit Type: BUILDING OWNER: Name (Fee Simple Titleholder): Fl ore. (, l r O p V. S Phone #: Address: erD 1 5 1 (o a\16 t O 4 St e fi City: Wl l 0. trVt 1 S ko re 5 State: nark' d a_ Tenant/Lessee Name: Email: Sk®(R.T 4S(0 e iOe_l(soufin•r\el JOB ADDRESS: 15 00 1Q-e" 10 4 - S i-r e. o f City: Miami Shores County: Miami Dade Folio/Parcel #: It . Z 2. C3 3 Z -- 0 3S Is the Building Historically Designated: Yes CONTRACTOR: Company Name: 1 ' !i4 tu- % c.‘ Address: 3 2-2 M C 1 / 10 e /ce ...,% City: i e y..A%'1 5,,,114: ) State: J L Zip: 31 d7 Qualifier Name: / /.e» t ct u--, L �, a1 _4^,fi State Certification or Registration #: C 6-- C / r' 633 e) Certificate of Competency #: o f L 4 ‘ 2 ° . : , e 'L/ /s 4. I ., 7 Contact Phone #: 9 P / -6 5' ( 3 y Email Address: DESIGNER: Architect/Engineer: Square/Linear Footage of Work: _ ❑New ❑Repair/Replace ❑Demolition Description of Work: ia-e", c 10A y /•/.� 1/ ,.• a 0 1 giita 11 '7 LOf TFLROl ROOF TILE IS REQUIRED acknowledged by Value of Work for this Permit: $ Type of Work: Address ❑Alteration Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ Miami Shores Village Building Department NO Flood Zone: * * *, * *** * * * * ** ** * * * * * * * * * * * * * * * * * *** * ** F * * * * * * * g ie* * * * * * ** * * * * * * * , ** * * ** H ** ** * Zip: 3313 e Phone #: Phone #: Submittal Fee $ Permit Fee $ CCF $ CO /CC $ omvir I' 8i JAN 24 2011 BY- 7136 Zip: 3 3 l Phone #: Phone #: /r �/ / / '' c,.7 2 DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ iiy Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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. Signatur Owner Agent The foregoing instrument was acknowledged before me this I'! NOTARY PUBLIC: Sign: Print: My Commission Expires: 20_,by wn to me or who has produced Contractor /74:06 ‘44,4,-% < < The foregoing instrument was acknowledged before me this -j day of ,cr■ (J/.t r , 20 , by i-149(000,n who is personally known to me or who has produced °FLDL Signature As identification and who did take an oath. C4 (6, V )as identification and who did take an oath. (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)(rev6/4/10) Plans Examiner Structural Review NOTARY PUBLIC: Sign: Print: STEPti . LLEN Notary Public - State of Florida My Comm. Expo Jan 8.2013 CgnmissW N ational Nosy Man. My Commission Expires: * * * * * * * * * * * * * * * * * * * * * * ** Zoning Clerk EFFECTIVE DATE: PERSON- FEIN: EILBERG 650281101 BUSINESS NAME AND ADDRESS: HERMAN EILBERG CONTRACTOR INC 322 N.W. 100 LANE CORAL SPRINGS FL 33071 DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CONSTRUCTION INDUUSTRY CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA wORKr t8' COMPENSATION LAW EFFECTIVE: 05/13/2009 EXPIRATION DATE: 05/13/2011 PERSON: HERMAN EILBERG FEIN. 650281101 BUSINESS NAME AND ADDRESS: HERMAN Ell BERG CON IRAC IOH INC 322 N.W. IOn LANE CUKAL SYKIN6S, 1L 34ull SCOPE OF BUSINESS OR TRADE 1 - RE NOWATION3'NC9TOr1ATtON . CCrlTIrico ciCNCrIA CO?iTTIAC' O@ MC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 ALEX SINK STATE OF FLORIDA CHIEF FfNANCtPL OrriDER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS C IVIPENSATWN LAW CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Work rs' Compensation law. 0511312009 EXPIRATION DATE: 05/13/2011 HERMAN SCOPES OF BUSINESS OR TRADE: 1- RENOVATIONS /RESTORATION 2- CERTIFIED GENERAL CONTRACTOR 05 -13 -2009 IhIPORTANT: Pursuant to Chapter 440 05(14), F.S., an officer al a corporation who elects exemption from this chapter by Jilin + a certificate al election under this section may 1101 recover benefits or compensation under this chapter. Pursuant to Chapter 440.0b(12), F.S., Certificates of election o 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(10), F.S., Notices of el Mien to be exempt and certificates of election to he exempt ahnll he subject to revocation 0, of any time otter the filing of the notice or the laminae* of rho cordite to, Ma parson named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall reaoke a certifica e al any lime fur failure of the person named on the certificate to meet the requirements al this section. QUESTIONS? (850) 41 -1609 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE CUT HERE 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 L under this section may not recover benefits or compensation under this D chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be H exempt.. apply only within the scope of the business or trade listed on R the notice of election to be exempt. E 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 3f the notice or the issuance of the certificate, The person named on the notice or certificate no (anger nieeta the requirements of this section for issuance of a certificate. The department shall revoke a certif cote at any time for failure of the person named on the certificate to meet the requirements of this section * Carry bottom portion on the job, keep upper portion for your records. QUESTIONS? (850) 413-1609 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 11-HS 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 TYPE OF INSURANCE -1.. INSR SUER WVD POLICY NUMBER POLICY EFF IMMI0D/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY 08104342 8/16/2010 8/16/2011 EACH OCCURRENCE $ 1,000,000 X DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 CLAIMS-MADE X I OCCUR MED EXP (Any one person) $ 5,000 PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER —I PRODUCTS - COMP /OPAGG 8 2,000,000 POUCY JEC F LOC $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per peison) $ BODILY BWURY(Per accident) $ PROPERTY DAMAGE (Per ardent) $ $ $ UMBRELLA UAB EXCESS LIAB OCCUR CI AIMS-MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY RC�F E( BER (Mandatory In NH) If yas dnxaibe der DESCRIPTION under RIPTION OF OPERATIONS ! N N ! A 1 W ST IM U I I ER Cam€ I Y EL EACH ACCIDENT $ below EL DISEASE- EA EMPLOYEE $ EL DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, ',more apace Is required) m:Carmela F. Smith - TLSG To:Herman Ellberg Contractor Inc, 0S104342 (13057568972) 09:25 0//24/11GMT -05 Pg 02-02 ACCORD - 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 15 WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on thls certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER The Lombard Street Group 10 Fairway Drive Suite 302 Deerfield Beach FL 33441 INSURED Herman Eilberg Contractor Inc 322 NW 100 Lane Coral Springs CERTIFICATE OF LIABILITY INSURANCE FL 33071 CONTACT TLSG NAME: I A PHONE Fxt) (954) 426 -1994 I IAIC. No): (954)426 -1907 ADDRI SS : oerts@tlsg.net PRODUCER WR ID 0 00001139 INSURER(S) AFFORDING COVERAGE INSURER A :United Specialty Ins Co INSURER 8: INSURER C: INSURER D : INSURER E : INSURER F • I DATE(MM/DD/YYYY) 1/24/2011 NAIC 12537 COVERAGES ACORD 25 (2009/09) INS025 (200909) CERTIFICATE NUMBER:2010 -A CANCELLATION REVISION NUMBER: (305) 756-8972 Miami. Shores Bldg Dept 1005 NE 2 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 Kenneth Schwartz, CIC, CRM O 1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD • PERMIT # BASE FLOOD ELEVATION: COST OF PAST IMPROVEMENTS (12 MONTHS): (ATTACH COPY OF CONTRACT) OWNERS SIGNATURE: , PLANREVIEWER: (19-c, f1 - 5 PLAN REVIEWER SIGNATURE: Created on June 2009 CUMULATIVE SUBSTANTIAL IMPROVEMENT VERIFICATION WORK SHEET In accordance with FEMA regulation and Miami Shores Village Flood Damage Prevention Ordinance the costs of all improvements must be monitored. The costs of any improvements in the past 12 months and the costs of any proposed improvements must be shown on the worksheet. The cost of improvements must include demolition, raw and finished materials (include those donated), labor (including volunteer and self - performed), construction supervision and management, and overhead and profit. A list of items the costs of which are to be included as well as those excluded is attached for your reference. (A Copy of the Contract must be attached) PROPERTY OWNER: b y . V 0 0 S ADDRESS: � 0 b L 1 0 c-1- FOLIO NUMBER: FLOOD ZONE: FREEBOARD: EAST OF FL.CCCL: COST OF PROPOSED IMPROVEMENTS: V to 0 0 0 0 TOTAL CUMULATIVE COST OF IMPROVEMENTS (past and proposed): VALUE OF PRINCIPAL STRUCTURE (attach appraisal): l '59 / 0 vb3 u DATE: H -, FEB 102011 SUBSTANTIAL IMPROVEMENT / DAMAGE LIST (NOTE: THIS LIST IS INTENDED FOR GUIDANCE ONLY, AND IS NOT ALL INCLUSIVE) ITEMS TO BE INCLUDED ALL STRUCTUAL ELEMENTS, INCLUDING Foundations including; Spread footing, Continuous footing, isolated footing, piles and pile caps Slabs including; Monolithic, floating, elevated Walls including; Exterior walls, Bearing walls, Shear walls Beams, Tie Beams, Columns and Posts Wood decking, Floor and Roof Sheathing Trusses, Joist Windows /Doors ALL BUILDING ELEMENTS, INCLUDING Interior Partitions, Walls, Columns Drywall, Ceilings, Built in Furniture, Cabinets, Vanities All Fixtures Flooring, Tile, Carpet, Stone, Linoleum, ect. All Finishes including Drywall, Paint, Stucco Plaster, Paneling, Tile, Marble, and Moldings Roofing Material ALL HARDWARE ALL UTILITY and SERVICE EQUIPMENT HVAC Electrical System and Equipment Plumbing System and Equipment Security System and Equipment Central Vacuum System Plumbing Fixtures Lighting Fixtures and Ceiling Fans Water Systems including Softeners /Filtration Created on June 2009 ALSO: All Labor and other Costs associated with Demolition, Removing, Replacing, Installing Building or Altering Building Components Construction Management / Supervision Overhead and Profit Equivalent cost for: Donated Materials Volunteer Labor (including owners and friends) Any Improvements Beyond Pre - damaged Condition, including; Utility Upgrades Code Upgrades ITEMS TO BE EXCLUDED Plans and Specifications Survey Costs Elevation Certificate Costs Permit fees Debris Removal Items not considered to be REAL Property Rugs, Furniture, Refrigerator, Appliances not Built -in Outside Improvements, Including; Landscaping Sidewalks Patios Fences Yard lights Sheds Gazebos Irrigation Pool 4 Primary Zone: 1100 SINGLE FAMILY RESIDENCE MAX: 0001 RESIDENTIAL- SINGLE FAMILY Bedsffitalbs: 312 Floors: 1 Living Units: 1 Adi Sq F001811e: 2.338 Lot Size: 8,850 SO FT Year Bunt 1980 Legal Description: 32 52 42 RIVER BAY PARK ADM P1340-72 LOT 14 BLX 4 LOT SIZE 75.000 X 118 OR 15594-2841 0792 1 Foffo No.: 2010 2009 Taxing Authority: Appffed Exemption/ Taxable Value: Applied Exemption/ Taxable Value: I ear: Regional: $50,500/$111,739 $50,500/$107,474 County: $50,500/$111,739 050,5004107,474 City: 050,50010111,739 $50,5001$107,474 School Board: 025,50010136,739 025.500/$132,474 Foffo No.: 2010 Property: 1500 NE 104 ST Mailing Address: FLORENCE F BROOKS 1518 NE 104 ST MIAMI SHORES FL 33138-2668 Year 2010 2009 Land Value: 0106,604 $154,864 Building Value: $159,503 0202,744 Market Value: $266,107 $357,608 Assessed Valuec $162,239 $157,974 Year 2010 2009 $25,000 025,000 YES YES 0500 0500 Property Information Report My Home Property Information Report Details: Propedv htonnation: Assessment Infonnation: Infonnatkm: Ta:udde Value Infonmdlon: Sale Warmth= rxr Page 1 of 1 'We) a.t(cSr - .......... Sale Date: Sale Amount Sale CYR: Sales Quatiticalion Desalption: 7/2000 $0 Sales which are disquaffffed as a result of examination of the deed This report was created on 218120118:51:57 PM for reference purposes only. Web Site © 2002 Miami-Dade County. All rights reserved. MIAMI-DADE . "' ................. http://gisims2.miamidade.gov/MyHome/proptext_printasp?folio=1122320320350&emd= 2/8/2011 Herman Eilberg Contractor Inc. 322 NW 100th Lane Coral Springs, FL 33071 Invoice 10018 Phone 954 695 0324 Fax 954 827 8079 E-mail , . eilberg@bellsouth.net Bill To RE: Guardian 1500 NE 104 Street Miami Shores, 33138 Diana Shoaf Data 1/11/2011 License No. CGC1506369 Quantity Description Unft Price Amount Remove all drywall from ceilings in living room. and dinning room. And other areas as needed. Insulate with R -30 Re Drywall areas where drywall was removed: plaster prime and paint. Repair cracks on walls in all areas of the house. Prime and paint bathroom: other areas as needed Check on all duct work; Re attach supply duct to living and dining areas. All permits included. Trash container will be on premises. Half payment due up front $7800,00 Balance of $7,800.00 due upon clean up and completion once inspection is approved 15,600.00 15,600.00 Architect plans not included if needed to be billed at cost Contract to be impl ted upon signature and deposit d ETLe,� � 'f /clip e. 2 v IP/- /3--// &I LIAR. a`ue /- �o -d.o ♦r . T . r I $15,60010 Payments/Credits $0.00 Balance Due $15,600.00 Herman Eilberg Contractor Inc. 322 NW 100 Lane Coral Springs, FL 33071 CGC1506369 Cell 954 695 0324 Fax 954 827 8079 13'9 Bedroom 2 Smoke and carbon dioxide detectors. Hard wired 120 volt battery back up and interconnected U N 7'6 6 Guest Bathroom. Bedroom 3 -Closet Close Close Clo Structural 2'7 21'6 265 Living room Dining room. Structural: Replace drywall ceiling only 5/8" X type. Insulate all non insulated areas as needed (R19) min. - . Living Room � �C��B1�IF�� FEB 0 1 2011 Florence F. Brooks 1500 NE 104 StreeBY: Miami Shores, FL 33138 786 877 8319 305 758 5350 Dinning Room Master Bedroom Closet 6'8 e\\ 2410 Garage 911 Kitchen Master Bath 810 rn 0 ? • • ... • • • . .. • . • • • .• • • • • • • • ••• • ▪ • • • • • • ...... • 2014Dita DEPT .. .. • i'10 . alete larni Shores Village APPROVED DI DATE 1000MPUANCE INIT14 PAL FEDERAL STATE AND cowry rams Are twoulAn I Scheduled Inspection Date: March 15, 2011 Inspector: Devaney, Michael Owner: BROOKS, FLORENCE Job Address: 1500 NE 104 Street Project: <NONE> Contractor: P&M ELECTRIC INC Building Department Comments March 15, 2011 Miami Shores, FL 33138- Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 157211 Permit Number: EL -1 -11 -159 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1122320320350 Phone: (305)949 -6373 ELECTRICAL WORK FOR DRYWALL REPLACEMENT Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP- 155421. NO one home. For Inspections please call: (305)762 -4949 Page 22 of 26 BUILDING PERMIT APPLICATION FBC 20 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 Permit Type: Electrical _ OWNER: Name (Fee Simple Titleholder): F' t oV-?iriC. G. F. 13 YOO �S Phone#: - °,� 7 , Address: City: Tenant/Lessee Name: Email: t So o N 13 t o 4 '.. Miami Shores Village Building Department VAA: 0 wt.; S Lure 5 State: �- �t — Zip: 3 3( 3 S t o af 4 Cto eHrai. it so 0i4, , JOB ADDRESS: 1 S o o N 1! 104 S4- City: Miami Shores County: Miami Dade Folio/Parcel #: Is the Building Historically Designated: Yes NO x Flood Zone: CONTRACTOR: Company Name: 1 ' V / eA7 - 1 C i iz C v Phone #: 'J ?V9--- de 7 2 Address: e� 9.Y6 4/6 City: d" 4 41 State: Qualifier Name: T_ 1/-e2SJ€ State Certification or Registration #: /,..744/6 Certificate of Competency #: Contact Phone#: i r 3 P7,), V Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: ° 7 S e,.- Square/Linear Footage of Work: Type•of Work: ❑Address ❑Alteration ❑New Description of Work:" ' / ..s.7442_740 Q/ 7c 4,!) v Permit No. ) l ovi - e\kr1 IAN a 1 2oi1 gi BY: ..... Master Permit No. 4 ®`/''/�c Z Ve 6 & '1 1 -. 319 Phone#: zip: 53 1 v Zip: _ /e?' Phone#: -2S -5 9 ?-V ORepair/Replace ❑Demolition ®4 ( �lG�/ /� �✓ 3. * ************** ***** **************x: **** F *****?*** *** ****** *** *************+x******** % Z , e� S eo Submittal Fee $ Permit Fee $ /I 4f 'e - `' CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 APPROVED BY hi414ti ` YtA Owner or Q day of who s personall own to me or who has produced As ide NOTARY PUBLIC: Sign: k.I - -iib] A Print: 1//,, let P-e A l My Commission Expires: 2 # / e Plans Examiner Structural Review (Revised 07!10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) Signature The foregoing instrument was acknowledged Qefore me this 3 ( The fo N , ,ory ;fPk DEBORA F�.Ut�pl •MY COMMISSI # DD 741512 EXPIRES: April 6, 2012 20 /1 , by Cm'. , day of N Contractor ent was ackngleded be*ore this ,20IJ ,by' o me or who has produced l id ntification and who did take an oath. PUBLI Sign: Print: My Commission Expires: ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** f! Zoning Clerk ACORD„, CERTIFICATE OF LIABILITY INSURANCE f 0 8/ 1 9 /2 0"010 PRODUCER INSURED I The Conrad Agency Inc 4690 N Powerline Rd Deerfield Beach, FI 33073 954 - 969 -3399 THIS CERTIFICATE 1S ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. INSURERS AFFORDING COVERAGE NAIC # P and M Electric, Inc. 1936 NE 148 St North Miami Beach, FI 33181 (305)949 -6373 INSURER& Guarantee Insurance 120850 INSURER B- INSURERC " — —_ _ - - "__. Imp - . " INSURER E: , F,5 INIR 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 TIE POLICIES DESCRIBED NEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. GENERAL LUURIJTY CI NIMERCIAL GENERAL UAe4m I CUWAS MADE [] OCCUR GEWI. AGGREGATE LIMIT SPADES PER POLICY AUTOMOBILE LABILITY ANY AUTO AU.OWKEDAUiOS • SCHEDULEDAUTOS ■ HIRED AUTOS NOIIAUTOS LIABILITY ANY AUTO EXCESINUNERELIALJABBJTY OCCUR El CLAM MADE DEDUCTIdLL RETENTION $ WORKS COMPENSATION AltO EMPLOYERS' LUMPY Y ANY PRO PRIETOR/PARTNERNFIIECU'IIVE OFFICERIMEASZR MINDED? tfe, dosed* under SPECIAL PROVISIONS below DESCRIPTION OP OPERATIONS YLOCAT U YOWLER / EXCUISKINS ROM BYBII Nk T/SPECIAL PRoVISIONS CERTIFICATE HOLDER Village of Miami Shores 10050 Ne 2nd Ave Miami Shores, Ff 33138 ACORD 25 PRO- LOC POLICY NUMBER GWGC100010321 -110 FOUCY - 'T r 1 08/18/10 CANCELLATION 08/18/11 OCCURRENCE PERSONAL II ADV INJURY $ A rr.tN -'q' 1. 1Eeocowsnae) MED (Paw ens person) GENERALAGORECATE $ PRODUCTS -COMP/OP AGG i (=SINGLE LIMIT BODILY WAIRY (Per woos) BODILY INJURY CPeTeo ) PROPERTY DAMAGE (PPrsocklNNi AUTO ONLY -EAA NT $ OTHER THAN AUTO ONLY. r a $ $ $ EA ACC $ AGO $ EACH OCCURRENCE $ AGGREGATE $ ffiYATU TH T O TOR 1 I EA i s $ E.L. EACH ACC1DEINT 811.000.000 E L. DISEASE -EA EMPLOYEE Ti EL. DISEASE - POUCYUMTT $ .1 1.1.1 I I IU� SHOULD ANY DP TEt ABOVE DESCRIES) POLICIES BE CANCELLED BEFORE TIE EXPIRATION DATE TEEREOP. TIE ISEUUIO INSURER WILL ENDEAVOR TO MAIL CATE WRITTEN NOTICE TO TEE CERTIFICATE IOLDER NAMEO TO TICE LEFT, BUT FAILURE TO 00 80 MALL IMPOSE NO OBUOATION ea UABaJTY OF ANY IOND UPON THE INSURER. ITS AGENTS OR REPRESENTATIVES. AUTHORIZE REPRESENTATIVE Bret1 C M ACORD CORPORATION 1988 ACORD. CERTIFICATE OF LIABILITY INSURANCE 110/222010 PEER INSURED I / The Conrad Agency Inc 4690 N Powerline Rd Deerfield Beach, FI 33073 954 - 969 -3399 P and M Electric, Inc. 1936 NE 148 St North Miami Beach, FI 33181 (305949 -6373 ONLY AND ISSUED U O T T THIS AND ONFERSNO RIGHTS MATTER THE INFORMATION CCERIIFFI AE HOLDER. 11418 CERTIFICATE DOES NOT AMEND EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSU>iERA Mount Vernon Fire Insurance Co. NAIC • 1 : -11 INSURERS I,,,C I, CI INEIRERE COVERAGES THE POLICIES ANY REQUIREMENT MAY PERTAIN. POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDtCATED NOTWITHSTANDING TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH AGGREGATE L IMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS CERERALLIABaJIY i l l COMMERCIAL GENERAL U ABILflY ■ III DANES MADE ■ DO=UR • POLICY WHIM IFFIcTrWa:FAALif+IV ,',%:41.-Ig LOUTS ©iliKo'L''ai �� 1 1 Eso 1 1r1 riming r r�li•I•1'IIII� I S 111 11'1 -001010- CA 10/21/10 ...c 10/21/11 ...• . 1;: =Yi ■ .' -• s ,,; al. 'E1Millt• PER60mAt. aAoviNtuRY -- L - c -...r « ... r . AGO NI GEAGGREGATELWU'APPUEB ■ POLICY., LOC ■ AUTOINDOLEMCNUTY ■ ■ ANY ALL QIWEDAUTOS scHETR LED AUTO4 NIREOAUTOB NOIEDAUTOS COMMIT <PH Fawn) Par Awns* OARAGELI BILJTY ANY AUTO EA ACC 4 .i << Ell ! F_ SNNBRELIAUMWY OCCUR EJ C LAUTSMADE E0.CH000IJRREHCE 0.6GREQATE DEDUCTIBLE RETENTION f WORICEA8COLRElRATQsAND EIIPLOYERSUABSS1f ANY oFFICENNEPOJEREXCUJOE01 Il = T TA t ° ' R EL EAi?t ACC1ENT EL• 01SEA8E- EA Dot 0!1Ef EL OISEA •POUC!LIMIT y OTHER OEM WAHOROF OPERATIONS ILOCATION SMICIESIEXCLUSDNB ADDED SY ENDORSEMENT' INCCIALPROVISIONS CERTIFICATE HOLDER Village of Miami Shores 10050 Ne 2nd Ave Miami Shores, FI 33138 ACORD 25 (2001108) CANCEU.AT1ON simian AIN Of THE ABOVE DESCRIBED POIICIES BECANCETLED BEFORE THE 6IPIRAICN DATE TNEREnF, DIE ISSUING INSURER tail. ENDEAVOR TO WIfL BAYS WNITTE1i NOM=E TO THE CERTWICATE HOIDEIt NANSI TO THE LEFT, BUT FAL,URE 1000 60 SHAM duos NO OBUGAADN OR INIBI.ITY OF AIY IC/D UPON TIE NEUPER, ITS AGENTS OR REPRESENTAIIVEB. AUTHORIZED RFDRESENTATNE P BIBit C MEW ® ACORD CORPORATION 1988