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DEMO-10-944\‘0\ 11 „9 CILIL f BUILDING PERMIT APPLICATION FBC 200X iami Shores Village 1)) 34 MAY 2 5 2010 Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. Q J Permit No. Permit Type (circle): 1 uilding JRoofing r Owner's Name (Fee Simple Titleholder) C /�v/4 L�4rrAGy4j Phone # "' "� ` C) Owner's Address 6 Rg 7 we 7 ,4g— ,,r4/410-/,' / City /14/ , , State / Zip )7/fl' Tenant/Lessee Name Phone # Job Address (where the work is being done) / 3 A/ hJ f/ ST City Miami Shores Village County Miami -Dade FOLIO / PARCEL # //— 3 /d / — o 2 J - c yo D Zip ?-3 ✓1, Is Building Historically Designated YES NO k Contractor's Company Name , L' 4 •/474/ L L G Phone # Contractor's Address A Y t4 y 4 City /%f i .S1fD ✓!) State Certificate or Registration No. Qualifier Name J 4W State is hi/n o Zip 11/11 Phone # 7v S - 76- 2 YY,/ Certificate of Competency No. Architect/Engineer's Name (if applicable) .‘92/ZA e."4-144., , Phone # nriS 724430 3 Value of Work For this Permit $ d Square / Linear Footage Of Work: Type of Work: ['Addition ['Alteration ['New N' Repair/Replace Describe Work: , 6- E-c771, ,04-1 e� ,/ Demolition *************************************** ees************* * * * ** * ** * * * * ** * * ** * * *** * * * * ** ** ^ Submittal Fee $ 1 Permit Fee $ CCF $ -C7( CO /CC Notary $5,00 Training/Education Fee $ B .00 Technology Fee $ 4.0 0 Scanning $ yip , O� Radon $ 0 , C)) DPBR $ - ® 5 Zoning $ Bond $ Structural Review. $ Code Enforcement $ Double Fee $ Total Fee Now Due $ See Reverse side 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 Agent The I foregoing instrument was acknowledged before me this 3 day of 0.)A Ni , 20 O , by C-) I fl I`j 4. G r` who is personally known ,too a or who has produced CC O24 L /(, 3 ),t'i L, 7 ,20 klAs identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Gl k M o /LS 1 C, .old t My Commission Expires: The foreg day of Contractor g instrument was ackn. , ledg d befor me this 20.10 by who is personal known to me or who has pro i uced as identification and who did take an oath. NOTAR Sign: Print: PUBLIC: �t i I, ■ A 1 1 iii i t � .a9t'' tai . 1 MP Lli ' � � , °,,���� n�yv ' ∎: `9,F�: :eV;).1 703. ;1 e - :;1;r• 00, ************, t * * * * * * ** * * * * * * * ** * ** *** * ** * * ** t***, r************ ***** * * *** * ** * * ** *,r *,t **** * * *E i * * 1****** `•'4eva„q �0� My Commission Expires: APPLICATION APPROVED BY: (Revised 07/10/07) NOTARY PliBLICSTATE OF FLO 1A a" " ", Linda Mid. Lal #: rCommission #DDS 67 S ' Expires: DEC. 02, 2012 BONDED MU ATLANTIC BONDING CO., INC. Plans Examiner Engineer Zoning /-itti• ,f�o ✓P� f f /Id' Prepared by and Return to: Bay Title and Escrow Company Dawn White 1227 Rogers Street, Suite E Clearwater, FL 33756 Our File Number: 09 -0693 Parcel ID #: 1131010230400 For official use by Clerk's office only 11111111111111111111111111111111111111111 1111 CFH 2010R0270354 OR Bk 27259 Pas 1570 - 1571; (2Pasi RECORDED 04/22/2010 15:28:51 DEED DOC TAX 246.00 HARVEY RUVIN, CLERK OF COURT MIAMI -DADE COUNTY► FLORIDA STATE OF 1 45 SPECIAL WARRANTY DEED COUNTY OF J� QrHni. l (Corporate Seller) THIS INDENTURE, made this 2010, between Citibank, N. A., as Trustee for Certificateholders of Structured Asset Mo$gage Investments 11 Trust 2007 -AR6, Mortgage Pass - Through Certificates, Series 2007 -AR6, party of the first part, and Labrada Investment Group, LLC, a Florida limited liability company, whose mailing address is: 6883 NE 3rd Avenue, Miami, FL 33138, party /parties of the second part, WITNESSETH: First party, for and in consideration of the sum of TEN AND NO /100 DOLLARS ($10.00) and other valuable considerations, receipt whereof is hereby acknowledged, does hereby grant, bargain, sell, aliens, remises, releases, conveys and confirms unto second party /parties, his/hi r /their heirs and assigns, the following described property, towit: LOT 16 and the East 25 feet of LOTS 5, 6, 7 and 8, in BLOCK 5, of BONMAR PARK ADDITION, according to the map or plat thereof recorded in Plat Book 24, Page 71, of the Public Records of Dade County, Florida. More commonly known as: 173 NW 99TH STREET, Miami, Florida 33150 Subject, however, to all covenants, conditions, restrictions, reservations, limitations, easements and to all applicable zoning ordinances and/and restrictions and prohibitions imposed by governmental authorities, if any. TOGETHER with all the tenements, hereditaments and appurtenances thereto belonging or in anywise appertaining. TO HAVE AND TO HOLD the same in fee simple forever. AND the party of the first part hereby covenants with said party of the second part, that it is lawfully seized of said land in fee simple: that it has good right and lawful authority to sell and convey said land; that it hereby fully warrants the title to said land and will defend the same against the lawful claims of all persons claiming by, through or under the party of the first part. DEED - Special Warranty Deed - Corporate OR BK 27259 PG 1571 LAST PAGE IN WITNESS WHEREOF, first party has signed and seal . escnt the date sct forth on Signed sealed and delivered I t 'IAA 2010. Print witness name State of __19tzvo_/ County of Etibank, N. A., as Trustee for Certificateholdcrs of Structured Asset Mortgage Investments 1I Trust 2007 -AR6, Mortgage Pass - Through Certificates, Series 2007 -AR6 by EMC Mortgage Corporation as Attorney in Fact Print Name: Ass tg et V c '1.11ident Address: 800 State way, ypass, Lewisville, TX 75067 (Corporate Seal) THE FOREGOING 1NSTRUMEEN� n cknowledged before me this 1 ay of 2010 by: S id nt of EMC Mortgage rporation as Attorney in Fact for Citibank, N. A., as er ' icate�olders of Structured Asset Mortgage Investments 11 Trust 2007 -AR6, Mortgage " Pass - Through Certificates, Series 2007 -AR6 who is personally known to me or who has produced driver's license as identification. Notary ',u i he Print No • ry Name My Commission Expires: Notary Seal 4 More commonly known as: 173 NW 99TH STREET, Miami, Florida 33150 DEED - Special Warranty Deed - Corporate JEANETTA L JACKSON My Commission Expires Nov 27, 2010 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 144397 Permit Number: DEMO -5 -10 -944 Scheduled Inspection Date: August 01, 2011 Inspector: Bruhn, Norman Owner: TRS, CITY BANK Job Address: 173 NW 99 Street Miami Shores, FL 33138- Project: <NONE> Contractor: STANLEY SUMMER LLC Permit Type: Demolition Inspection Type: Final Work Classification: Building Phone Number Parcel Number 1131010230400 Phone: (305)776 -2443 Building Department Comments SELECTIVE DEMOLITION OF ILEGAL MODIFICATIONS COMPLETED PRIOR TO NEW OWNERSHIP Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments C'G July 29, 2011 For Inspections please call: (305)762 -4949 Page 3 of 30 1 l soever -o 6 atrY4 Miami Shores Village k, *1[11 — C,� TO cA k. INSP. BUILDING j7l'1 1 c PERMIT APPLICATION FBC 20 Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 JUL 1 9 REC'O Permit No. IXMCI 0--q44— Master Permit No. Permit Type: BUILDING ROOFING OWNER: Name (Fee Simple Titlel\oider) L»t j mµ,3 rr17-2- Phone#: 30 S 9. 4, `�'1 r S S. Address: 1'4- 3 ' J t) ekc, c City: kkt 40� State: Zip: 13 l 50 Tenant/Lessee Name: Phone#: Email: JOB ADDRESS: (I- City: Miami Shores Folio/Parcel #: County: Miami Dade Zip: -311 S v Is the Building Historically Designated: Yes CONTRACTOR: Company Name: Address: ����of " City: "0. ,c ;#o.,Y/ Qualifier Name: <4,0 NO °' Flood Zone: ‘%t fe/,//44/ C ( Phone #: �d 2 Yi.°1 State: Phone #: Zip: ?I'1 State Certification or Registration # Certificate of Competency #: Contact Phone #: DESIGNER: Architect/Engineer: Phone #: Email Address: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑Addition ,❑Alteration ❑New ❑Re air/Replace ❑Demolition Description of Work: '2E 1i �1 C r �i 046' O —941 *** *+ x****** ******* ******+x*** *** * * * *a:***Fees ** Permit Fee $ CCF $ CO /CC $ Radon Fee $ DBPR $ Bond $ Training/Education Fee $ Technology Fee $ Structural Review $ Submittal Fee $_, _ Scanning Fee $ 3. g).,) Notary $ Double Fee $ ********** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 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 comm :ncement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. I he absence ,.j such posted notice, the inspection will not bit and ' spection fee will be charged. lir Owner or Age The foregoing instrument was acknowledged before me this day f . l , 20 \� , by I — . _IA'�.i2- Y whois Retsonaly ]cylo One or who has produced .Sentification and who did take an oath. Sign: Print: My Conunission Expires: Signature Contractor The fore o'ng instrument was acknowledged before me this ICI day of ' l , 2011, by 1A1 \ /4-`' who is personally known to me or who has produced as identification did take an oath. \‘‘‘t \�� t „ / /// V13S 1, ..sue APPROVED BY Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) NOTARY PUBLIC:`` Sign: Print: My Commission Expiyes: ° �� � \CD \\” s /s /� ®'d�ltutti�eit w e' Zoning Clerk 07/25/2011 14:45 FAX 3055547090 The First Ins PRODUCER First Insurance Group 10957SW40St Miami, FL 33165 Phone (305)221-7876 a001 /001 CERTIFICATE OF LIABILITY INSURANCE 1 DATE(MMIDD/YY) 07/25/11 THIS CERTIFICATE IS 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 in FOLIC ES GELOW. INSURED STANLEY SUMMER LLC. 408 Grand Concourse Miami Shores, FL 33138- 305 Fax (305)554 -7090 INSURERS AFFORDING COVERAGE COVERAGES INSURER A: ACCIDENT INS CO NAIC # INSURER B: INSURER C: INSURER D: INSURER E: THE POLICIES OF INSURANCE LISTED 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. WM Aim LTR =RD TYPE OF INSURANCE POLICY NUMBER A GENERAL LIABILITY ▪ COMMERCIAL, GENERAL LIABILITY 0 CLAIMS MADE ❑ OCCUR GEN'L AGGREGATE LIMIT APPLIES PER; ❑ POLCY ❑ PROJECT ❑ LOC AGL9003785 AIro� o M NDDE MM I NYI 01/24/2011 AUTOMOBILE LIABILITY ❑ ANY AUTO ❑ ALL OWNED AUTOS ❑ ❑ SCHEDULED AUTOS E7 HIRED AUTOS ❑ NON OWNED AUTOS n GARAGE LIABILITY ❑ ❑ ANYAUTO 0 EXCESS / UMBRELLA LABILITY O OCCUR ❑ CLAIMS MADE I� DEDUCTIBLE ❑ RETaN11ON $ WORKERS COMPENSATION AND EMPLOYERS' L IABILJ1Y YIN ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER / MEMBER EXCLUDED? (Mandatory describe and SPE IAL PROVISIONS brow OTHER 01/24/2012 LIMIT EACH OCCURRENCE DAMAGE T'0 (Ea occurrence) 1,000,000 100,000 MED EXP (Any one person) 5,000 PERSONAL It ADV INJURY 1,000,000 GENERAL AGGREGATE 1,000,000 PRODUCTS - COMP/OP AGG 1,000,000 COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per sodded/ PROPERTY DAMAGE (Per acclden) AUTO ONLY - EA ACCIDENT OTHER THAN AUTO ONLY EA ACC AGG EACH OCCURRENCE AGGREGATE ❑ R TA - ❑ HRH_ E.L EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATION$ 1 VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS GENERAL CONTRACTOR LIABILITY CERTIFICATE HOLDER MIAMI SHORES VILLAGE 10050 NE 2nd AVENUE MIAMI SHORES, FL 33138 305 7021798 ACORD 25 12009 101) QF CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 1 1- • 0 0: • TION OR IUTY OF ANY KIND UPON THE INSURER, ITS AGENTS • it '� y �. x. irr. 7►1�� \ \\11R ®7988 -2pOS ACORD CORP •T +7 \, -.- ��'f� IghtS roomed. The ACORD name and logo are •tr _ arks of ACORD AUTHORIZED REPRESENTATIVE 07/25/2011 14:43 FAX 3055547090 PRODUCER Rat insurance Group 10967 SW 40 St Mlarnl, FL 331E5 Phone (305)221 -7878 The First Ins 121001/001 DATE (MOONY) 07/25/11 THIS CERTIFICATE 18 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE MOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR AL TIER 1 HE COVE GE AEE REED BV TWB pG INSURERS AFFORDING COVERAGE NA1C INSURER A: ACCIDENT INS CO INSURER 9: CERTIFICATE OF LIABILITY INSURANCE INSURED STANLEY SUMMER LLC. 408 Grand Concourse MIarni Shores, FL 33138. 1305 COVERAGES Fax 0305)5544080 INS3.1I3ER C,: INSURER D: INSURER E: THE POUCIES OF INSURANCE LISTED 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 POUCHES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH OMR ADM • ovum' POLICIES. AGGREGATE LASTS SHOWN MAY HAVE BEEN REDUCED 9Y PAID CLAIMS. P rue r TYPE OF INSURANCE ter SMUT= T' 1NIVDOM MY/I DATE (Y1ppNY} LIMITS LIABILITY COMMERCIAL GENERAL LIABILJTY 00 CLAIMS MADE ❑ OCCUR 0 GEN'LAGGREGATE LIMIT APPLIES PER: ❑ POLICY C PROJECT ❑ LOG A AUTOMOBILE LIABILITY ❑ ANY AUTO C ALL OWNEDAUTOS Q Lu SCHEDULED AUTOS ❑ HIRED AUTOS ❑ NON OWNED AUTOS !© GARAGE uAn1LITY ❑ ANY ALTO ❑ EXCESS, UMBRELLA LIABILITY ❑ OCCUR ❑ CLAIMS MADE ❑ DEDUCTIBLE • RETENTION S AGL9003785 i 01/24/2011 01/24/2012 EACH OCCURRENCE PREMISES DAMAGE (Ea occurrence) RENTED MED EXP (Any one person) PERSONAL &ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG 1,000,000 100.000 5,000 1.000,000 1,000,000 1.000,000 COMBINED SINGLE LIMIT (Ea aecltlent) BODILY INJURY (Per parson) BODILY INJURY (Par =Went) WORKERS COMPS TION AND EMPLOYERS' LIABILITY ANY PROPRIETOR / PARTNER, EXECUTIVE YIN OFFICER MEMBER EXCLUOEDT (Maendatary In NNqgH)) SPEC PROVISIONS bone OTHER PROPERTY DAMAGE (Per aeafderrt) AUTO ONLY • EA ACCIDENT OTHER THAN EA ACC AUTO ONLY: AGG EACH OCCURRENCE AGGREGATE 1NC t3TATU- G OTH- �J,O @Y LIMIT$ ER EL EACH ACCIDENT E L. DSEASE - FA EMPLOYEE EL DISEASE • POLICY L&IT DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHJCLES 1 EccLus,ONS ADDED BY ENDORSEMENT I SPFCiAL PROVISIONS GENERAL CONTRACTOR LIABILITY CERTIFICATE HOLDER MIAMI SHORES VILLAGE 10050 NE 2nd AVENUE MIAMI SHORES, FL 33138 305 7621798 AOORD 25 (2009101) OF CANCELLATION SHOULD ANY or THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING IN SURCR WILL ENDEAVOR TO MAIL 30 DAYS WInTTEIN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL WOE • 0 TOON OR ILITY OF ANY KIND UPON THE INSURER. ITS AGENTS • r irr. ow '1� It1�t• D1 968 -2009 ACORD CORP y r I Ights reserved, The ACORD name and logo are �` rise of ACORD AUTHORIZED REPRESENTATIVE 7r 7r - /79z 1,'d 86L I•Z9L90C esou!ds3peuwng eZp:01. L L 9Z Inc ACQRQTM CERTIFICATE LIABILITY INSURANCE PRODUCER - THIS CERTIFICATE IS 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 POLICIES BELOW, Insurance Center of Dade Inc. 3165 W. 4 Ave Suite 3 Hialeah FL, 33012 _1805r818:4818 INSURED MAJESTY ELECTRIC SERVICE CORP 8704 N.W. 112 ST. HIALEAH GARDENS, FL 33018 COVERAGES DATE IMMIDOIYY) 11/4/20iA INSURERS AFFORDING COVERAGE INSURER A: INSURER B• INSURER C: INSURER D: ASCENDANT INSURANCE CO. ASCENDANT INSURANCE CO. INSURER E: 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN�� NOTICE TO THE CERTIFICATE HOLDER NAMED T' SI FIT, :UT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF A KIND U 0 NE INSURER, ITS AGENTS OR REPRESENTATIVES. TYPE OF INSURANCE POLICY NUMBER GL- 56932 POLICY EFFECTIVE DATE IMM/DDIYVI 11/01/10 POLICY EXPIRATION DATE IMWDDIYY) 11/01/11 LIMITS A GENERAL g LIABILITY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 511 9 QO, 0 G D FIRE DAMAGE (Arty one (Ate) i $ 50.000 $ 1,000 $1.000, 000 112,000,0Po $� 0 00 0 0 1 CLAIMS MADE _L OCCUR MED EXP (My one person) PERSONAL aADVINJURY GENERAL AGGREGATE PRODUCTS - COMP/OP ADO GEN 1 AGGREGATE LIMIT APPLIES PER T POLICY n JECaT l j LOC rO AUTOMOBILE ^^ uaBIUTY N AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS — COMBINED SINGLE LIMIT (Ea accident) _. $ BODILY INJURY (Per person) $ BODILY INJURY (Peteacidetd) J $ PROPERTY DAMAGE (Par accident) $ GARAGE LIABILITY R ANY AUTO AUTO ONLY - EA ACCIDENT S OTHER THAN EA ACC $ AUTO ONLY• ACS; 3 EXCESS UADIUTY OCCUR CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ $ DEDUCTIBLE RETENTION $ $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WC312838 11/01/10 11/01/11 WC $TAI ((�� + 01 H- X I TORY LFMIT9 1 I ER E.L. EACH ACCIDENT $100.00 $500,000 E.L DISEASE - EA EMPLOYEE E.L. DISEASE- POLICY LIMIT ,$100.000 i OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS ELECTRICAL WITHIN LIMITS CERTIFICATE HOLDER ADDITIONAL INSURED: INSURER LETTER: CANCELLATION MIAMI SHORES BLDG. DEPT. 10050N. E 2ND AVE MIAMI, SHORES, FL. 33138 FAX: 305 - 756 -8972 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVO 0 MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED T' SI FIT, :UT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF A KIND U 0 NE INSURER, ITS AGENTS OR REPRESENTATIVES. _ AUTNORREDREPRESENTATIVE a 7 ACORD 26 -8 (7(97) 5/£ d Ci ACORD CORPORATION 1988 0£GL G89 008 1 «089ZGZ8G0£ 3D:113313 Ais vw 8980 LZ -60 -6602 Permit No: 10 -944 Job Name: June 23, 2010 Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 Building Critique Sheet 1) All doors and windows that are altered must be impact resistant. Provide all product approvals. Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Norman Bruhn CBO 305 - 795 -2204 Permit No: 10 -944 Job Name: June 23, 2010 Miami Shores Viage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 Building Critique Sheet 1) All doors and windows that are altered must be impact resistant. Provide all product approvals. Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Norman Bruhn CBO 305 - 795 -2204 Permit No: 10 -944 t�Fiame: -) May 28, 2010 Miami Shores Vuiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Building Critique Sheet 1) Provide electrical, plumbing and mechanical permit applications. 2) Provide design wind Toads for all new /altered openings. 3) All doors and windows that are altered must be impact resistant. Page 1 of 1 Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Norman Bruhn CBO 305 - 795 -2204 1111111111111111111111111111111111111111111 CFN 2010R034r97 6 OR 8k 27295 Pas 4785 - 4786 2a9s) RECORDED 05/25/2010 11:02:3 HARVEY RUV'IN, CLERK OF COURT MIAMI -DADE COUNTY? FLORIDA Permit No. Tax Folio No. NOTICE OF COMMENCEMENT STATE OF A7,94.1 � COUNTY OF £.r c/e THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Description of property (legal description anil s address, ' available): � J / 1.7 „ r r a+� �i c - 5u l27%ib / /-3 /0/ -'U 3 -- .6:40't O 2. General description of improvement: 3. Owner information: b) Interest in property: c) Name and address of fee simple title holder (if other than Owner): 4. Contractor (name and address): y �rs�Gld 6 0y Low4 . /';r4 °' , i l j3f 5. Surety: a) Name and address: b) Amount of bond: $ 6. Lender (name and address): OR Bk 27295 PG 478 LAST PAGE 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 and address) 8. In addition to himself, Owner designates of _ (address) to receive a copy of the Lienor's Notice as provided in section 713.13(1)(b), Florida Statutes. 9. Expiration date of notice of commencement (the expiration date is one year from the date of recording unless a different date is specified): STATE OF FLORIDA, COUNTY OF DADE 1 HEREBY CERTIFY that thl fcopy of the original ljeqi this ott'c ,on.i day4f t I7_,;"-,' ,, ,A020 („. -' WITNE S my hand and Oast °'eat. HARVEY RU YIN, CLERK; of i uTounty Courts By �- °--.) • D.C. 4 ) c STATE OF C Owner) By: Print Name: k 404 Print Title:14fed' Address: COUNTY OF M J I./} 1)/119C ,�(� SWORN TO and � subscribed before me this ay of 11. cq , c�O 0� by (name), as C' i ei►h L $ b `y /title) of V w Kef (name of corporation), a (State) corporation, on behalf of the corporation. sr /She [please check as applicable] / / is personally known to me, or has produced / - / �t er PL. ' (state) driver's license, or / / 'her i=1 L I (v 3 9 (7a (type of identifiin) as identification. ©'44 —v Prepared / eflg3 /tie- 3c' "e Pit X411. r( 3-313f (Printed Name) NOTARY PUBLIC, STATE OF (Commission Expiration Date) 'RSA uncia C om #D ` ; irce QO l BOom �Q OLOVICDONDI - ca, 1 Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Expiration: 12/22/2010 Applicant 173 NW 99 Street Miami Shores, FL 33138- 1131010230400 Block: Lot: CITYBANK TRS Owner Information Address Phone Celt CITYBANK TRS 121 BYPASS LEWISVILLE TX 75067- Contractor(s) STANLEY SUMMER LLC Phone (305)776 -2443 Cell Phone Valuation: Total Sq Feet: $ 200.00 0 Type of Work: Exterior Color: desert camel, white Additional Info: Classification: Residential Color: desert camel, white_Approved Color: desert camel, white_Approved_ Code Comments: BEHR - WALLS - DESERT CAMEL Color: desert camel, white_Denied Fees Due CCF Education Surcharge Notary Fee Permit Fee Technology Fee Total: Amount $0.60 $0.20 $5.00 $60.00 $0.80 $66.60 Pay Date Pay Type Amt Paid Amt Due Invoice # PT -6 -10 -38211 06/28/2010 Check #: 1038 $ 66.60 $ 0.00 Available Inspections: Inspection Type: Final 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. June 28, 2010 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date June 28, 2010 1 fP I Miami Shores Village Buildin g Department artment 2Uld /0050 N.E.2nd Avenue, Miami Shores, Florida 33138 `%i4r (305) 795.2204 nazi (305) 756.8972 Permit No. PT - (4 - 10- 11e8 Master Permit No. /0 — rky BUILDING PERMIT APPLICATION FBC 2004 Permit Type: PAINT PERMIT Owner's Name (Fee Simple Titleholder) 'r7®/. " d 7-- /41 Phone # 6' D _ e; e� C' Owner's Address City /Lit' h/t1b State Zip '7 3 / 35 Tenant/Lessee Name Phone # E -MAIL: Job Address (where the work is being done) / -7 3 City Miami Shores Villas e County Miami -Dade Zip 3/ c :) FOLIO / PARCEL # 1, - 3) /,P/ —0 - d, A Is Building historically Designated YES NO L. Contractor's Company Name � 4/ j dJ/,/1/14.`5_ Z e Phone # v� � - ZJ/f,% Contractor's Address t22 6q91 / enaiekt. City "m4 f vt'1 �^ State ,'-e_ Zip Qualifier Name „57,44, Phone # 7a5 = - Z V 7 State Certificate or Re g iration No. Certificate of Competency No. OWNER BUILDER: Value of Work For this Permit $ Describe Work: Pte' Type of Work: ❑ Addition / ❑ Alteration / ENew / ❑ Repair/Replace 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 "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. * * * * * * ** * * * * ** * * ** ***** * * * * ** * ** * * * ** Fees *, * * * ** * * * * * * * * * * * **** * * * * * *** * **** *** *, * ** Permit Fee $ CCF $ n • Technology Fee: D a Training/Education Fee $ 0 t Notary $ 5.00 Code Enforcement CD Double Fee $ Zoning $ Total Fee Now Due $ See Reverse side -+ PAINT COLOR APPROVAL AND AGREEMENT All elements on the site must be listed and indicate the color to be painted Directions: Please circle corresponding number to appropriate color sample. Walls: 1 2 3 4 Fascia: 2 3 4 Drip Cap/Drip Edge: 1 © 3 Soffit: 1 2 3 Roof: Flower Bins: 1 2 3 Shutters: 1 4 4 1 2 3 4 4 2 3 4 Awnings: 1 Chimney: 1 2 3 4 2 3 4 Doors and Door Jams: Garage Doors: 1 Railings: 1 Fences: 1 3 4 3 4 3 4 2 3 4 All brick (simulated or regular): 1 2 Stucco Banding: 1 2 3 Any other Stucco Features: 1 2 3 Accessory Buildings Other: Attapy ` ` and f320F -4 ;, Desert Camel 2f�f. \t/ 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. 41, . Agent The foregoinginstrument was acknowledged before me this day of 3',Titt20 /�, by g t e,f) Li L et fj e fi b il , who is personally known to me or who has produced 7 z® /em/t' .b /d ! Ltf NOT Sign: As identification and who did take an oath. //if ram. _ ,ILIt1IL� 7 I - ION # DD 772335 EXPIRES April 24, 20 12 RoiidanotaIvservlce.com My Commission Expires * * * * * * * * * * * * * * * * ** * *Al Signature Contractor �`'% The foregoing instrument was acknowledged before me this 1 ! day of apt.- , 20 , by1 who ' orally o� le- who has produced as identificati . u and who did 1 t oath. ,�� \111 r11/ NOTARY PUBLIC• Sign: Print: My Conunission Expires: crl 1 _ � _ i •. 00 ev C /1/4 APPLICATION APPROVED BY: Plans rxaminer Preservation Board Code Enforcement (Revised 04/24/07) 1 Protect Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Expiration: 12/21/2010 Applicant 173 NW 99 Street Miami Shores, FL 33138- 1131010230400 Block: Lot: CITYBANK TRS Owner Information Address Phone Cell CITYBANK TRS 121 BYPASS LEWISVILLE TX 75067- i Contractor(s) TALAVERA NC & REFRIG INC Phone (305)446 -0501 Cell Phone Valuation: Total Sq Feet: $ 400.00 209 1 Tons: Additional Info: Classification: Residential Approved: In Review Comments: Date Denied: Scanning: 1 Date Approved: : In Review Type of Work: Fees Due CCF DBPR Surcharge Education Surcharge Permit Fee Radon Surcharge Scanning Fee Technology Fee Total: Amount $0.60 $1.05 $0.20 $100.00 $1.05 $3.00 $0.80 $106.70 Pay Date Pay Type Amt Paid Amt Due Invoice # MC -6 -10 -38210 06/28/2010 Check #: 1038 $ 106.70 $ 0.00 Available inspections: Inspection Type: Ventilation Final Hood Rough Duct Underground 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. June 28, 2010 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date June 28, 2010 1 1 Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Project Address Parcel Number Applicant 173 NW 99 Street Miami Shores, FL 33138- 1131010230400 Block: Lot: CITYBANK TRS Owner Information Address Phone Cell CITYBANK TRS 121 BYPASS LEWISVILLE TX 75067- Contractor(s) Phone Cell Phone TALAVERA A/C & REFRIG INC (305)446 -0501 Valuation: Total Sq Feet: $ 400.00 209 1 Tons: Additional Info: Classification: Residential Approved: In Review Comments: Date Denied: Scanning: 1 Date Approved: : In Review Type of Work: Fees Due CCF DBPR Surcharge Education Surcharge Permit Fee Radon Surcharge Scanning Fee Technology Fee Total: Amount $0.60 $1.05 $0.20 0100.00 $1.05 $3.00 $0.80 $106.70 Pay Date Pay Type Amt Paid Amt Due Invoice # MC -6 -10 -38210 06/28/2010 Check #: 1038 $ 106.70 $ 0.00 UST N TIME Available Inspections: Inspection Type: Ventilation Final Hood Rough Duct Underground Applicant Copy For Inspections, Call (305) 795 -2204. Requests must be received by 3 pm 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 GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT the public records of this county. DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. June 28, 2010 2 Miami Shores Village Building Department 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 APPLICATION FBC 20 Permit Type: MECHANICAL OWNER: Name (Fee Simple Titleholder): Permit No. MC-, (a- (0 - 1101 Master Permit No. / —� 4./1/2 Address: g5f City: / r9 ,t i State: Zip: 3 3/ SS Tenant/Lessee Name: Phone #: Email: Phone #: 7- 65 JOB ADDRESS: / `� .3 q( City: Miami Shores County: Miami Dade Zip: 3 3/ 4-0 Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: /. LV & ft- /c. 46%2 t@ '' i .i Phone#: 1 s'69 " 5 fib - Z-r3 Zf Address: £9E0 sLA) ca f{-v -e_ City: 0•- Qiaa.4t State: Tj . _ Zip: 33L q Qualifier Name: - S° ,84 S, Phone #: .00'59a -0u State Certification or Registration #: -WO 411 L r Certificate of Competency #: 0 DD 1 P9 4 6 Contact Phone #: -7n," v913- Z3Z A (, Email Address: 413 irC fl aZ (:0,2L co,` DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ 9- G, Square/Linear Footage of Work: c P7 Type of Work: ❑Address CAAlteration UNew ❑Repair/Replace ❑Demolition Description of Work: / 6,12#41L-6---- T/P,4//,74.4 .4C® 1./ew / "17s *** * * * * * * * * * * * * * * * * * * * * * * * * **** * ** * **A.”************************************* Submittal Fee $ Permit Fee $ V " "�' CCF $ 0 AP 0 CO /CC $ Scanning Fee $ J00 Radon Fee $ \ _D a DBPR $ _ 0 > Bond $ Notary $ Training/Education Fee $ b - Technology Fee $ C). Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ O1 •1 CD 4 7;2/ 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. Si Signature r or Agent Contractor The foregoing instrument was acknowledged be re this ( "` The foregoing instrument was acknowledged before me 's V �/ � 20 v by 4 lT" day of !� l� , 20 1 Ti,, by (O /�/1%� f day of J !� / y '� who is personally known to me or who has produced who is personally know to me or who has produced • r as identification and who did take an oath. NOTARY PUBLIC: As identification and who did take an oath. NOTARY LIC: Sign: Print: &/L/ t"( My Commission Expires: APPROVED BY 1.1 e. s;uwinoijS!ON # DD 948507 EXPIRES: January 7, 2014 % Ags bonde'l Thi N.loh Public Undeiwriteis . ram Sign: Print: ?E2 /f►- U; lv' ' v 4 My Commission Expires. MY COMMISSION IONO DD 948507 41 _ 9onded Tf W N azy Public 7u,nde wrftas * * * * * * ***** k***aaxlcs k********* ***# ********** * *******.h**** ********* 71' Plans Examiner _ Zoning Structural Review (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Clerk Permit No: 10 -944 Job Name: May 28, 2010 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Building Critique Sheet 1) Provide electrical, plumbing and mechanical permit applications. 2) Provide design wind Toads for all new /altered openings. 3) All doors and windows that are altered mustbe impact resistant. Page 1 of 1 Plan review is not compete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Norman Bruhn CBO 305 - 795 -2204 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 146383 Permit Number: MC -6 -10 -1107 Scheduled Inspection Date: August 31, 2010 Inspector: Perez, JanPierre Owner: TRS, CITY BANK Job Address: 173 NW 99 Street Miami Shores, FL 33138- Project: <NONE> Contractor: TALAVERA A/C & REFRIG INC Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1131010230400 Phone: (305)446 -0501 Building Department Comments ELIMINATE AC VENT INTO GARAGE Inspector Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. August 30, 2010 For Inspections please call: (305)762 -4949 Page 5 of 18 �io5 ct8l 4b5 wa�tlm� 40-ytivv, (Eve4 Miami Shores Village Building Department 1:003IIVED gi JUN 0 8 2010 VI BY: 'y 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 01 Permit No. BUILDING PERMIT APPLICATION FBC 20 Permit Type: PLUMBING OWNER: Name (Fee Simple Titleholder): Master Permit No. 4i4 ,‘, Address: Cneg 5 `�E 3 4, IOP City: / l 4e4 I • State: /-7/ Zip: 3? / Tenant/Lessee Name: Phone#: Email: Phone#: JOB ADDRESS: % City: Miami Shores Folio/Parcel #: County: Miami Dade Zip: 3 ?/ Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: ; / / / . (., 5 e,. re> Phone #: 3 - 6 63 Address: o (/ /6,`' c' City: /7 ( / State: Zip: 33 / 5-S---- - Qualifier Name: °' "i > 7 L o % ,.r Phone#: 3.o S . bp3 • ,257-/- State Certification or Registration #: C "791,2. _< 12 (I- '90.Certificate of Competency #: Contact Phone#: Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ 3 5 ' Square/Linear Footage of Work: LAlteration UNew ORepair/Replace emolition 7 le7 J i 5/ Type of Work: ❑Address Desc r_ ' tion of Work: 5 * * * * * ***** * *** ** * * ** * ******* * ** **** * * ** Fees** *************** ***** *** * *** **** ******** *** Submittal Fee $ \\.r? Permit Fee $ C d CCF $ dJ ° �� CO /CC $ Scanning Fee $ 5.(..) V "1 RRadon Fee $ k .05 DBPR $ 1 a CD 'S Bond $ Notary $ Training/Education Fee $ 0 • 2-4D Technology Fee $ 0, 5-CD Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 6 ®7 0 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 APN'll1)AVIT: 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. Owner or Agent The foregoing instrument was acknowledged before me this day of1( , 20 J by k Cf.7/ who is pe /onally known to me or who has produced t tep1 LC—As identification and who did take an oath. NOTAR.�'�' UBLIC: Sign: 414,02, Printr 6 My Commission Expi APPROVED BY Okliff,i DEBRA A WILLIAMS °= MY COMMISSION # DD772335 ' ],aai1,4sQ 4 EXPIRES Ap ti ril 24, 2012 * * *** * * * * * * * * * * * ** y ¢JiQ191�tSaA36W �x , u hit (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) Signature Contractor The foregoing instrument was acknowledged before me this 9 day of 1fit0.iLe� , 20 by C /45 �2i,(4 who is personally known to me or who has produced as identification and who did take an bath. NOTARY PUBLIC: Plans Examiner Sign: Print: My Commission Expires: MOISES ABADI MY COMMISSION #DD775285 Bonded through 1st State Insurance Zoning Structural Review Clerk Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION FORM ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED OR THE VILLAGE MAY MAINTAIN A FILE WITH YOUR INFORMATION FOR A $30.00 FEE PER YEAR. IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. VCOPY OF QUALIFIER'S STATE LIC CARD B. COPY OF LOCAL BUSINESS TAX RECEIPT C. V COPY OF LIABILITY INSURANCE (CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPT) D. ,r/' COPY OF WORKERS COMPENSATION (EITHER CERTIFICATE OR EXCEMPTION) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT C. COPY OF LIABILITY INSURACE (CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKER COMP INSURANCE (EITHER CERTIFICATE OR EXEMPTION) YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 COMPLETE CONTRACTOR'S INFORMATION BUSINESS NAME: /16 C SUS; erg, L. L C BUSINESS ADDRESS: 5001 5. w. 74/ Ct< ,'off CITY /"1 %a-'- STATE Pg. ZIP CODE 3 3 !s5 BUSINESS PHONE: (365 ) Co 63 - 2S ?p FAX NUMBER (3oS ) (o G 3 - CELL PHONE ( ) QUALIFIER'S NAME: 67 us )--c—v* o z QUALIFIER'S LIC NUMBER: - rc- 12 g q(( 7 E -MAIL ADDRESS (IF APPLICABLE): i' <<- - "1c- Sc r v. r7e.. 1L Created on 3119109 BY MLDV 1 RV 3126109 MLDV q Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 145721 Permit Number: PL -6 -10 -1049 Scheduled Inspection Date: August 25, 2010 Inspector: Hernandez, Rafael Owner: TRS, CITY BANK Job Address: 173 NW 99 Street Miami Shores, FL 33138- Project: <NONE> Contractor: MC&C SERVICES LLC Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1131010230400 Phone: (305)663 -2870 Building Department Comments CAP END, ONE TOILET, ONE SINK AND ONE SHOWER Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments August 24, 2010 For Inspections please call: (305)762 -4949 Page 6 of 26 08/30/2010 08 :16 FAX 1 800 685 7530 DATA SCAN FIELD SERVICES Q001/001 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number INSP- 145850 Scheduled Inspection Date: August 30, 2010 Inspector. Devaney, Michael Owner: TRS, CITY BANK Job Address: 173 NW 99 Street Miami Shores, FL 33138- Project <NONE> Contractor. MAJESTY ELECTRIC SERVICES CORP Permit Number DEMO -6 -10 -1063 Permit Type: Demolition Inspection Type: Final Work Classification: Electric Phone Number Parcel Number 1131010230400 Phone: 305- 825 -2680 Building Department Comments REMOVE 3 RECEPTACLES 2 SWITCH REMOVING 4 OUTLETS AND REMOVING SUBPANELS Inspector Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- Inspection fee is paid. August 27, 2010 For Inspections please call: (305)762 -4949 Page 8 of 34 Protect Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Applicant 173 NW 99 Street Miami Shores, FL 33138- Owner Information Address 1131010230400 Block: Lot: CITYBANK TRS Phone Cell CITYBANK TRS 121 BYPASS LEWISVILLE TX 75067- Contractor(s) Phone MAJESTY ELECTRIC SERVICES CORI 305 - 825 -2680 CeII Phone Valuation: Total Sq Feet: $ 300.00 100 1 Type of Demo: Electric Additional Info: ELECTRICAL DEMO Classification: Residential Scanning: 1 Fees Due CCF DBPR Surcharge Education Surcharge Permit Fee Permit Fee Radon Surcharge Scanning Fee Submittal Fee Submittal Reversal Fee Technology Fee Total: Amount $0.60 $0.50 $0.20 $0.00 $100.00 $0.50 $3.00 $50.00 ($50.00) $0.80 $105.60 Pay Date Pay Type Amt -Paid Amt Due Invoice # DEMO -6 -10 -38162 06/10/2010 Check #: 1032 $ 50.00 $ 55.60 06/28/2010 Check #: 1038 $ 55.60 $ 0.00 Available Inspections: Inspection Type: Final 1 I 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. June 28, 2010 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date June 28, 2010 1 6116 ho r� Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 r� Permit No. Dan() I v — OJD2 Master Permit No. / 0 14' 4' BUILDING PERMIT APPLICATION FBC 20 Permit Type: Electrical OWNER: Name (Fee Simple Titleholder): Address: 3 City: �/ emu/ Tenant/Lessee Name: Phone #: al , .4A4706 i. JUN 40 glio :..L..r` ........... Phone #: 3O5 -2q7 State: 1C / Zip: Email: JOB ADDRESS: / 7 /L Lc? '7 City: Miami Shores County: Miami Dade Zip: '330 .O Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: �7"P / rnr 7-4 / e- Sck wee Phone#: CONTRACTOR: Company Name: /4 7 Address: 7 ? / y�� 7i9t/ City: /-/,,4J e•,9/, 4 /l, jt /i/ State: Qualifier Name: ,�' 9/ 4 r State Certification or Registration #: Contact Phone #: :3©c e 5- 2(, ' DESIGNER: Architect/Engineer: Zip: 3 : c/ e- Phone#: 3 ece26.- Z( Certificate of Competency #: 0 J/700a/6j Y Email Address: Phone #: Value of Work for this Permit: $ 3 09,. U t' Type of Wor Address VAlteration Description o Work: ' 7,10,0 VI --� tiZTE,a n%l��• Square/Linear Footage of Work: ONew ORepair/Replace ,Demolition Submittal Fe Scanning Fee $ Notary $ Double Fee $ Structural Review $ ***************************************Fees************* *** * **** * *x�x� *�x�x.x**** **** * * *** $ Permit Fee $ ,J��G r G‘`;' CCF $ CO /CC $ Radon Fee $ .i� DBPR $ 0 b0 Bond $ Training/Education Fee $ O'a V Technology Fee $ �' 0 TOTAL FEE NOW DUE $ n .Sv ., e/() / 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 Ali 'DAVIT: 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. Si attire .i" Owner or Agent The fore.; • 1g instrument was acknowledged before me this day of O�: ho is personally known to me or who has produced tL. Del u As identification and who did take an oath. NOTARY PUBLIC: ,20 iaby Ltw ZiNtgh/ —' , Sign: Print. My Comm * * * * * * ** es: DEBRA A WILLIAMS MY COMMISSION # DD772335 ;yrme EXPIRES April 24, 2012 (407) 398-0153 APPROVED B: Contractor The foregoing instrument was acknowl day of J4't` ,20 /6,by perso d before m this if L kip known to me or who has produced *S identification and wh take an oath. NOTARY Sign: Print: My Commission % JEFFREY B. PRICE 1' MMY COMMISSION 8 0D 939233 ,xi EXPIRES: November 9, 2013 ;IF Banded Thru Notary Public Underwriters ono * * * ** . * *** * ** ***** *** **** **** * * ***** ** /2 0✓6-1,6' Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) * * ** * ** * * * *. ** Zoning Clerk s 3a du se r,, k brat .41,gA( 0001 QUALIFYING TRADE(S) ELECTRICAL yn k.0tOirylcn6 (-U 14-c)CA'rP iMt DADS C0W' TAX COLLECTOR 1Ad! W FL.AOLER S7 st FL00R AMIs FL 3313 LOCAL BUSINESS TAX IIEDEOt ..1 AMI DARE COUNTY STATE OF FLORIDA mUST SE DISPLAYED AT 1;1.1 .ACE OF BUSINESS UA ?IT TO GOUNTtF BODE CHAPTER 8A ART ?9 & 1 SEE OTHER SIDE DO NOT FORWARD MAJESTY ELECTRIC SERVICE CORP RAFAEL GUTA PRES 8704 NW 112 ST HIALEAH GARDENS FL 33018 La x stir ,ttnatifiu"Lty,hbtrttmt "L,i w DO NOT FORWARD MAJESTY ELECTRIC SERVICE CORP RAFAEL GUTA PRES 8704 NW 112 ST HIALEAH GARDENS FL 33018 �„ �ti ��, �t, ��, �t, it��i�ti, t�,, i, 1t►,1,1��1,�tlli�ft,S�,ltt'�4,1 ACORD. CERTIFICATE OF LIABILITY INSURANCE PRODUCER Insurance Center of Dade Inc. 3165 W. 4 Ave Suite B Hialeah FL, 33012 305 - 818 -1818 INSURED MAJESTY ELECTRIC SERVICE CORP 8704 N.W. 112 ST. .. HIALEAH GARDENS, FL 33018 DATE (MM/DD/YY) 10/29/4 THIS CERTIFICATE IS 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 POLICIES BELOW INSURERS AFFORDING COVERAGE INSURER A• ACCIDENT INSURANCE CO INSURER.B: TECHNOLOGY INSURANCE CO INSURER C: .'INSURER D: INSURERE: «' COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.' ' I SR P TYPE OF INSURANCE P POLICY NUMBER D POCTOY EFFECTIVE P POLICY EXPIRATION- U UMITS A L GENERAL LUIBRITY„ ,. E LG259562 1 • 10/28/10 P EACH OCCURRENCE $ $1 , 000,00 • X C COMMEACIAL GENERAL LIABILITY F FIRE DAMAGE (Any one Ore) $ CLAIMS'MADE X X O OCCUR M MED EXP (Any one person) $ $ 1/90 PERSONAL &ADVINJURY $ • G GENERAL AGGREGATE $ ACORD 25-5 (7/97) O ACORD CORPORATION 1988