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RC-11-411Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 178703 Permit Number: RC -3- 11-411 Scheduled Inspection Date: September 28, 2012 Inspector: Bruhn, Norman Owner: Job Address: 1450 NE 101 Street Miami Shores, FL Project: <NONE> Contractor: AGE OF EMPIRE INC Permit Type: Residential Construction Inspection Type: Final Building Work Classification: Alteration Phone Number Parcel Number 1132050240040 Phone: (305)851 -5897 Building Department Comments REMOVE AND REPLACE DRYWALL stop work order issued by building official. Work exceeds permit. Must comply with Flood zone regulations. 12/23/12 missing noc from new contractor Infractlo Passed Comments INSPECTOR COMMENTS False 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- 178665, September 28, 2012 For Inspections please call: (305)762 -4949 Page 12 of 18 PERMIT # O6 � l ` I 1 1 CONTRACTOR:E;.l FL r244.0 C.a.( artscJ '' C 1 SUBMITTAL DATE: 1 ( 1 2012 ADDRESS: t q 1 tO ST-- NAME: '7 CE-1 QA-- DO RESUBMITAL DATES: PROJECT TYPE: le-47C --- '(�Z -1/41 - j 1 ZONING FIRE STRUCTURAL IMPACT FEES ELECT ICAL HRSIDERM NOC ; PLUMBING - = ---- MECHANICAL BLDG PERMIT # ) 411 CONTRACTOR Ifl �n� j� • SUBMITTAL DATE: ADDRESS: I -- 0 `�I I j ST NAME: RESUBMITAL DATES: PROJECT TYPE: u*- \icr.44- ZONIN FIRE STRUCTURAL IMP 3j FE S c% 4/17 ELECTRIC L HRS ' E PLUMBING V73 N MECHANICAL BLDG Certificate of Completion Miami Shores Village 10050 NE 2 Ave, Miami Shores FL, 33138 Tel: 305 -795 -2204 Fax: 305 - 758 -8972 Building inspection Department This certificate issued pursuant to the requirements of the Florida Building Code 106.1.2 certifying that at the time of issuance this structure was in compliance with the various ordinances of the jurisdiction regulating building construction or use. For the following: Square Footage Description of Work Not Transferable POST IN A CONSPICUOUS PLACE 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 j Permit No. fl -411 Master Permit No. BUILDING PERMIT APPLICATION FBC 20 FEB 0 m02 PI Permit Type:4 UILDING ROOFING OWNER: Name (Fee Simple Titleholder): t''z,ck GO.; Co ) Phone #: Address: {{x�/4/5 4 /0 / s4 ./ City: t cmi S/;e(5 State: FL Zip: Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: /L/.5b 1/4". City: Miami Shores County: Miami Dade Zip: Folio/Parcel #: Is the Building Historically Designated: Yes NO CONTRACTOR: Company Name: Address: ...v6 Sr.•) i4 City: Mici ran State: Qualifier Name: „Marc-elf ' P /Vs r7-56 Flood Zone: A6 ,G Phone#: ®S - ?S I ^ 551 7 Zip: 3.3/ 7y Phone#: State Certification or Registration #: CG C. /...5 /1437 ' Certificate of Competency #: Contact Phone#: 365 - 3 ®d - (S ` ^Z Email Address: -- DESIGNER: Architect/Engineer: Air n p ID v5 ttc r Phone#: 7n_ %' 2 - 6/ 78" Value of Work for this Permit: $ 73 4o6 C 9. Square/Linear Footage of Work: 31/Alteration Description of Work '...om r .os, pc . ► f k• et) n , (-; /nom. CQ/Ira.'L /7r/1'tt'e•G Type of Work: ❑Addition UNew ORepair/Replace UDemolition * *** *** *4*+ +x******* **+a*+ *** Fees* ****a:************** *+ x******* ***+x*+x*****+x*** Submittal Fee $ Permit Fee $ /..re' CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 81 -0 Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if lapplicable) 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 CONDmONERS, 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 �1 ..err/ Owner or gent The foregoing instrument waslacknowledged befor me this 3111 The foregoing instrument was acknowl ed(befo a me this g day of 20 i 2- , by Niaw 1)2.� 21ecra PJvt3 4.atepl-t day of leo t , 20 by who is personal known to me or who has produced I L 4 tom" w''io is i. ersonall kno to me or who has produced j .. identification and who did take an oath. d., / —0 My Commissio Expires: SAIYED SHABBAR JAWAID Notary Public, State of Florida Commission. EE 107495 My (t@mm, impitee June 29, 2015 r OTA Sign: Print: My Commission entification and who did take an oath. Y PUBLIC: t,,N1Y s/4 • pub%tC 'State o �, Notary rSt Sep 23, 2015 My Comm. Expires EE 128510 Commission peen. V Bonded through Natio::al Notary sklksklksksksk ** *********~MRTIr -it A********s m -g4, 11 1 1 a *ik** Ni***+kik***ik+k+k**+k+k*** APPROVED BY Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06/10/2 )(Revised 3/15/09) Zoning Clerk Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2294 Fax: ( CHANGE OF RCHITECT L' JAN 2 7 . 2 W Permit N. t 3-I I -4 ll BY: .... ... Owner's Name (Fee Simple Title Holder): AO r r i1z;. l`ti,o ` Phone #: Owner's Address: /1f.S1) 445 /61 s). City: M,411 sh, e State Pt Zip Code: Job Address (Of where work is being don /4,156 �& f6/ .Si'- City: Miami Shores State: Florida Zip Code: Contractor's Company Name: 4 op £ .1C• Phone #: Address: 224 gem.) /c5/ C -; City: Mi no State: .t1 Zip Code: ..3.3 /7'/ Qualifier's Name : r ,;i e) 14 , ® Lic. Number: CGS: - /5 / 4' 79 Architect/ Engineer of Record Name: 44 J u i - Phone #: `7blr -'4e)2 �l `7� Address: 79i 1, di/J l MTh yoiqz,4.e City: -�� O/ State: ,'$ DA. Zip Code: 5!l 01 ONTRACTOR/ Describe Work: —SArk\es- � \ t 6411 I hereby certify that the work has been abandoned andlor the contractor /architect is unable or unwilling to complete the contract. I hold the Building Official and the Miami Shores harmless for all legal involvement. Signature •wne .r •e,, The foregoing instrument was aknowledged before me this `a'da o .," ,20/%2by i-14Z. TZA e or who has produced as indentification. Nota Si Sea ado 11 My Commission 00833188 poi r Expires 10/22/2012 Signature Contractor or Architect The foregoing instrument aknowledged before me this % 7 day of c)cA✓l , 20izby Arc p-)1.0 Afilvs0 MI p-rrsonally kno n to or who has roduced F1 indentification. Nota Sign: Seal: 4�� P`9,h �... —— r•••uyy CLAUDIA tP CUSILLOS $ `A, Notary Public - State of Florida ` ( z • My COMM. Expires Sep 23,2015 �� f �� Commission ri EE 128510 ,,; no% Bonded Through Natio.11 Notary Assn. I ltVi1 •1 164111, 1IVL 4,...1111..611 I I U5 1 111...1, v 1-1S-7 se 1 1L .-71.7LI7— 18041 E scyne Boulevard. Suite 501 Aver tura, Florida 33160 DATE: TO: A N: MOM: RE Frank H. Ho Attorney at Law SFAX PAGE . dr' LV J. V1• •..7611 II I I 1 Phone: (30 5) 792 Fax: (305)) 792 -5582 Nsieht IL HEL NcE• v j , vAri.4,D Gis c ' 15km, 1'iy GE: Z PLcl o>€ ► S4 r c k E evEL-fezb c, Number of ;4Ih'9 i 1 4 4 4 1 c` this Fax Number (3O5) 792-5582 (°051S -'43o, Fax [, 111 .1, If you have any problems receiving this telefax, please telep the . 1 I i :> at (305) 792-5582. My direct telefax Y Yt .1 (305) 792 -5582. This telefax the use of the transndssicm, or the that any have received this telefax in error, please tel to Ilse at the �:i;lCF' Ilr. CO above. If you are not the �•, le for deliv= wl.= ; it ;II i PPwl4';4.; 1 are collect THANK YOU Y of this recipient, you If you and return the for FROM :Frank Holtzman FAX NO. :305 792 5582 Jan. 19 2012 09:35AM P2 AL GENE E This Mutual General Release ("Release") is made and entered into on the date set forth on the signature page hereof, by and between Wells Fargo ts, N.A. Maritza Gaiqui as Co- Guardians of the Property of Natasha Gaiqui ("Owner'), Saad Homes, Inc. ("Contractor"). REAS, Owner contracted for the services of Contractor to be performed at 1450 N.E. 101 Street, Miami Shores, FL 331313;; and REAS, a dispute arose among Owner and Contractor - 1211 4 t the work; and REAS, the parties have agreed to settle their disputes by the execution of this Mutual General Release. NOW, THEREFORE, in consideration of the mutual covenants, promises and other good and valuable consideration recited in this Release, the receipt and sufficiency of which are hereby acknowledged by the parties, the parties to this Release agree as follows; 1. RELEASE BY OWNER: Wells Fargo Bank, N.A. Maritza Gaiqui as Co- Guardians of the Property of Natasha Gaiqui hereby release, acquit, satisfy forever discharge Homes, Inc. of and from all, and all manner of action and actions, cause and causes of action, suits, debts, dues, sums of money, accounts, reckonings, bonds, bills, specialties, covenants, contracts, controversies, agreements, promises, variances, trespasses, damages, judgments, executions, claims and demands whatsoever, in law or in equity, which they every had, now have or which any personal representative, successor, heir or assign hereafter can, shall or may have against Contractor for or upon any reason or by reason of any matter, cause or thing whatsoever, from the beginning of time to the date of these presents. ; 2. RELEASE BY CONT CTOR: Sam! Homes, Inc. hereby releases, acquits, satisfies and forever discharges Owner of and from all, and all manner of action and actions, cause and causes of action, suits, debts, dues, sums of money, accounts, reckonings, bonds, bills, specialties, covenants, contracts, controversies, agreements, promises, variances, trespasses', damages, j 7.4 ents, executions, claims and demands whatsoever, in law or in equity; .which it ever had, now has or which any personal representative, successor, heir or assign hereafter can, shall or may have against Owner for or upon any reason or by reason of any matter, cause or thing whatsoever, from the beginning of time to the date of these presents. 3. COUNTERPARTS: This Release may be executed in counterparts, and a facsimile copy shall constitute an original for all purposes. 20332 [ .000 )100006241 FROM :Frank Holtzman STATE OF FLORIDA } COUNTY OF BROWARD The for 2011 by who is personal]. identification. FAX NO. :305 792 5582 Jan. 19 2012 09:36AM P3 SAAD HOMES, INC. Name: __A. c F E GlL(4NaCEP E t was acknowledged before me this the of who produced My commission expires: (11:•Z,e, CA MY MUNSON I OD NUE EXPIRES: ke. meta &weft ay* ibtay eintel 203321 .000V002964_1 y of Desataber 3 re-A aad Homes, Inc.„ as CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 01/27/12 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(les) 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 endorsement(s). PRODUCER Acceptance Insurance Services 6887 S.W. 40th St Miami, FL 33155 Phone (305)740-0515 Fax (305)740-0518 CONTACT NAME: Rene E. Samayoa ( a� . Emit): (305 )740-0515 I No): (305)740-0518 AiC ADDRESS: rene@acceptanceinsservices.com INSURER(S) AFFORDING COVERAGE NAIL 0 INSURER A : United Specialty Insurance Company 12537 INSURED Age of Empire Inc. 226 SW 104 Ct Miami, FL 33174- (305) 851-5897 INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I TRR TYPE OF INSURANCE INSR WVD POUCY NUMBER { POLICY MIDD YYYY) UNITS A GENERAL LIABILITY N N NS1210865 09/16/2011 09/16/2012 EACH OCCURRENCE $ 1,000,000.00 DAMAGE GE SO RENTED ISES (Ea occurrence) $ 100,000.00 COMMERCIAL GENERAL LIABILITY ❑ ❑ CLAIMS -MADE V OCCUR ❑ MED EXP (Any one person) $ 5,000.00 PERSONAL & ADV INJURY $ 1,000,000.00 ❑ GENERAL AGGREGATE $ 2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑ JEC °T ❑ LOC PRODUCTS - COMP /OP AGG $ 2,000,000.00 $ AUTOMOBILE UABILITY ❑ ANY AUTO CO BINEDtSINGLE LIMB (Ea $ BODILY INJURY (Per person) $ ALL OWNED SCHEDULED ❑ AUTOS IN AUTOS ❑ HIRED AUTOS ❑ AUNOOSWNED ❑ ❑ BODILY INJURY (Per accident) $ rarE RAMAGE r�� $ ❑ UMBRELLA LIAB ❑ OCCUR ❑ EXCESS LIAB ❑ CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ ❑ DED ❑ RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LlABIUTY Y / N ANY PROPRETORIPARTNER/EXECUTIVE N / A ❑ WC S �U ❑ OTH- E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) EL DISEASE - EA EMPLOYE $ If yes describe under DESCRIPTION OF OPERATIONS below EL DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) GENERAL AND ROOFING CONTRACTOR SPECIALIZED IN REMODELING, RESTAURATION AND PLUMBING. CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE BUILDING DEPARTMENT 10050 NE 2nd Ave MIAMI SHORES, FL, 33138 !FAX 305- 756 -8972 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 6 ACORD 25 (2010/05) QF © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ALONSO, MARCELINO ; JUAN AGE OF EMPIRE INC 6760 SW 50TH TER MIAMI r•. .AC# Tit 3. STS F. K s ORIDA BUSINESS AND PROFESSIONAL REGULATION R'UC'TION INDUSTRY LICENSING BoARIi omutip, L1042801030 DATE BATCH NUMBER ya`as. rt9 III » 4.a 464' k • 3F r. the provi s io E a`iration date: At k tit Chapter 489 FS, SO. ' MA:RCELINO OF :.EMPIRE • :SW. 54TH:.-. :TER CHARLIE CRZST GOVERNOR CHARLIE DIEM INTERIM ERIM • SECRETARY b STATE OF FLO DEPARTME DATE BATCH NUMBER. 28/2:01 EiE;'.. belc the= atio CONS?' LI:CEN TRY:`: I LONSO, MARCELINO JUAN AGE OF EMPIRE .INC 67.60 SW 50TH TER 1KLAMI FL ; 3155 DISPLAY AS `.REQUIRED BY LAW LIES INTERIM: S CRETTARY 5,4 54° .w STATE OF FLORt A DEPAR'TMEI`I' tI' $t3 :° AND PR(` C N ' 'RUC' . ADO L C SSI i rNAL R LNG • BOA L TI ON SEQ# .Q2 3 DATE BATCH NUMBER 0PFI hal the aticSrr' IED Qiisw of Chap t.. . AUG 31, 2012, ATLQIwo j I+ A,RCELINQ JUAN AGE OF EMPI.IE .I C. 6760 SW 50TH TERRACE MIAMI FL 33155 RICK: SCOTT GOVERNOR DISPLAY AS REQUIRED BY .LAW CHARLIE LIEM SECRETARY 03 -25 -2011 JEFF ATWATER STATE OF FLORIDA CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' 'COMPENSATION LAW CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has, elected to be exempt from Florida Workers Compensation law: EFFECTIVE DATE: PERSON: FEIN: 03/25/2011 EXPIRATION DATE: 03/24/2013 ALONSO MARCELINO 260439458 BUSINESS NAME AND ADDRESS: AGE OF EMPIRE INC 6760 SW 50TH TER MIAMI FL 33155 -5702 SCOPES OF BUSINESS OR TRADE: 1- CERTIFIED PLUMBING CONTRACTOR 3- CERTIFIED GENERAL CONTRACTOR 2- CERTIFIED ROOFING CONTRACTOR 4- CERTIFIED UNDERGROUND UTILITIE IMPORTANT: Pursuant to Chapter 440. 05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05112), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on the notice of election to he exempt. 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 alter the filing of the notice or the issuance of the certificate, the person named 00 the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. QUESTIONS? (850) 413 -160 DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01 -11 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CONSTRUCTION INDUSTRY CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW EFFECTIVE: 03/25/2011 EXPIRATION DATE: 03/24/2013 PERSON: MARCELI`a1 ALONSO FEIN: 280439458 BUSINESS NAME AND ADDRESS: AGE OF EMPIRE INC 6760 SW 50TH TER MIAMI, FL 33155 -5702 SCOPE OF BUSINESS OR TRADE 1- CERTIFIED PLUMBING CONTRACTOR 2- CERTIFIED ROOFING CONTRACTOR 3- CERTIFIED GENERAL CONTRACTOR 4- CERTIFIED UNDERGROUND UTILITIE 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 E the notice of election to be exempt R 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 of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. QUESTIONS? (850) 413 -1609 CUT HERE * Carry bottom portion on the job, keep upper portion for your records. DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01 -11 CHANGE OF CONTRACTO Permit N. J�, G /// Owner's Name (Fee Simple Title Holder): Owner's Address: I O 4/5 /o1 s4- City: ;8yn; .shark Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Phone #: State : irL. Zip Code: Job Address (Of where work is being done): /B /S,6 ,irE / ®/ City: Miami Shores State: Florida Zip Code: Contractor's Company Name: Phone #: Address: . City: State: Zip Code: Qualifier's Name : Lic. Number: Architect) Engineer of Record Name: Lino S.fica-zek , . #: ' M° , -oe34 Address: e0q `NAL 8P4 City: rn'i, State: FL Describe Work: i4 e i iJ rA M Zip Code: W1t0 I hereby certify that the work has been abandoned andlor the contr unable or unwilling to complete the contract. I hold the Building mi Shores harmless for all legal involvement. Signet ` erorAgent The foregoing instrument was aknowledged before me this ri day of t' ,t ,201t,by /l(00.,ea0401 Who personally know • =me or who has produced as indentification. Signature to /architect is I and the Contractor or rchitect The foregoing instrument was aknowledged this 21 day of 20/Zby efore me eer,/o S. erez -- c--=g2I 12rVn who.i ersonally known - or who has produced as indentification. Notary Public: MY COMMISSION #EEosi l EXPIRES' May 4, 2015 eadedThru a; .iy Pnbr: otpvites RECEIVED MAR ,g1Z CHANGE OF CONTRACTO Permit N. .-3 -'11 -4-II Owner's Name (Fee Simple Title Holder): filor`\\ Zck- Owner's Address: 1 Lt.TO Ate lol s°j-. City: A feimi State : FL- Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Phone #: Job Address (Of where work is being done): %4'Sl? 4/ /D1 �J Zip Code: City: Miami Shores State: Florida Zip Code: Contractor's Company Name: Phone #: Address: • City: State: Zip Code: Qualifier's Name : Lic. Number: Architect/ Engineer of Record Name:AJ4 -Li Address: 56,) /1)- ) City: C4,72-. 8 Y. State: fi®,e4P.a Zip Code: Il'c Phone #: "7A6, - 401 -40/1 Describe Work: I hereby certify that the work has been abandoned and/or the contractor /architect is unable or unwilling to complete the contract. I hold the Building Official an • the iami Shores harmless for all legal involve ent. Signature— A Fob Ag The foregoing ins _ ent was aknowledged before me this 16 day of F.4 ,20iz,by. 4 o+W /G, Who . ersonally known o me or who has produced asindentification. Nota Sign: Public: 41%k MARCc.LINO JUAN A ...NSO MY COMMI?' ;.ON # `:E074153 EXPtr AarCh 16, 2015 .com ; v.14' %, MARCELJMO `RJAN ALONSO . `: MY COMMIc:Sr(Jf4 # EE074153 ; " EEXPIR '4arrh 16, 2015 Oift. (4OI13iG•'J "On:. .: ' :ry' viCe.COm Signature I JI Contractor or Architect The foregoing instrument was aknowledged before me I this 14r day off , 242-by /:<rm'� L/ liar who is sonally knowno me or who has produced �i►"1P�i�. MARCELINoailA tgatgb • ` = MY COMMISSION # EE074153 Notary Pu 'c: .3�., �% " s.• EXPIRES March 16, 2015 "-----(407) 388.0153 FbridallotaryServtce.com Sign: Seal: SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete Items 1, 2, and 3. Also complete item 4 if Restricted Delivery Is desired. • Print your name and address on the reverse so that we can retum the card to you. • Attach this card to the back of the mailpiece, or on the front If space permits. 1. Article Addressed to: Gke\.0 A-. Akc-T1 i5e‘o &41 3 Akekvvii FL 33i7.5 B. R =:• =hued by (Printed Name) O Agent O Addressee C. Dat of Del ery 5 z. D. Is delivery address different from item 1? ■ Yes It YES, enter delivery address below: 0 No 3. Ser Cert Type Certiffed Mali 0 Registered 0 Insured Mall 0 Express Mail 0 Return Receipt for Merchandise ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) 0 Yes 2, Article Number (Transfer from servIce Labe) 7004 0750 0001 9095 9662 PS Form 3811, February 2004 Domestic Return Receipt UNITED STATES POSTALL, SERVICE 102585.02 -M -1540 First -Class Mai Postage & Fees Paid LISPS Permit No 0 -10 Sender. Please print your name, address, and ZIP+4 in this box • a IyS3 NIA tot s -= Mietwo Skbre.s 1 Ft 351343- 1..i1111I11111i1f1t1111 111 111111 #11111111111.11111111It+i111l 8 USPS.com® - Track & Confirm English Customer Service CIUSPSCOM Quick Tools Track & Confirm GET EMAIL UPDATES PRINT DETAILS YOUR LABEL NUMBER 70040760000190959662 Check on Another Item What's your label (or receipt) number? LEGAL Privacy Policy > Terms of Use > iroA, No FEAR Act EEO Data> Copyrighlo 2012 USPS. All Rights Reserved. USPS Mobile Ship a Package SERVICE Send Mail STATUS OF YOUR ITEM Delivered Processed through USPS Sort Facility Undeliverable as Addressed Processed through LISPS Sort Facility • ON USPS.COM Government Services > Buy Stamps & Shop > Print a Label with Postage > Customer Service Site Index> Find Manage Your Mail DATE 8 TIME February 25, 2012, 3:16 pm February 25, 2012, 1:08 am February 21, 2012, 3:38 pm Page 1 of 1 Register /Sign In Search USPS.com or Track Packages Shop LOCATION MIAMI, FL33175 MIAMI, FL 33152 MIAMI, FL 33185 February 20, 2012, 9:28 pm i MIAMI, FL 33152 ON ABOUT.USPS.COM About USPS Home > Newsroom > Mail Service Updates > Forms & Publications > Careers > Business Solutions FEATURES Certified Mail'" OTHER LISPS SITES Business Customer Gateway > Postal Inspectors , Inspector General > Postal Explorer Ayat,IJ https: // tools .usps.com/ go/ TrackConfirmActioninput ?gtc_tLabels1= 700407500001909596... 2/27/2012 Permit No: 11-411 Job Name: March 9, 2012 Miami Shores V 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 Revision Change of Designer I2i 12- 1) This home is in a high hazard flood zone and must comply with the floodplain management regulations. Provide a corrected substantial improvement verification work sheet signed by the owner's representative. The detailed contract and cost does not include fixtures and finish items. The cost dab must be complete and detailed including fixtures, flooring and finishes. ,42.2.112.- 2) The plans show that no plumbing work to be done but fixture are being removed and replaced. The plan scope shows no work in the bathroom but the bathrooms have been demolished without permits 3) The plans submitted do not accurately describe the work that has been started. Revise the plans to show the work in the field STOPPED REVIEW 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 - 762 -4859 maa cam` a� 1 Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Applicant 1450 NE 101 Street Miami Shores, FL 1132050240040 Block: Lot: NATASHA GAIQUI & MARITZA G Owner Information Address Phone Cell NATASHA GAIQUI & MARITZA GAIQUI & FIRST UNION PO BOX 400621C MOORE JACKSONVILLE FL 32231 -0062 Contractor(s) AGE OF EMPIRE INC Phone CeII Phone (786)402 -6178 Approved: In Review Comments: Date Approved: : In Review Date Denied: Type of Construction: INTERIOR REMODEL & REPAIR Stories: Front Setback: Left Setback: Bedrooms: Plans Submitted: Yes Certificate Date: _Bond Return : Occupancy: Single Family Exterior: Rear Setback: Right Setback: Bathrooms: Certificate Status: Additional Info: Classification: Residential Fees Due CCF CCF Change of Contractor Fee Change of Contractor Fee DBPR Fee DBPR Fee DCA Fee DCA Fee Education Surcharge Education Surcharge Permit Fee Permit Fee Revision Fee Scanning Fee Scanning Fee Scanning Fee Technology Fee Technology Fee Total: Amount $48.00 $57.00 $75.00 $75.00 $42.73 $36.00 $42.73 $36.00 $16.00 $19.00 $2,400.00 $0.00 $2,848.39 $21.00 $21.00 $21.00 $76.00 $64.00 $5,898.85 Pay Date Pay Type Invoice # RC -2 -12 -43304 04/03/2012 Credit Card Invoice # 03/08/2011 05/13/2011 05/13/2011 Amt Paid Amt Due RC -3 -11 -40310 Check #: 8419 Check #: 8707 Check #: 71334 $ 3,277.85 $ 0.00 $ 250.00 $ 2,371.00 $ 221.00 $ 2,150.00 $ 2,150.00 $ 0.00 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Available Inspections: Inspection Type: Final PE Certification Shutter Final Window Door Attach ment Tie Beam Slab Termite Letter Insulation Drywall Screw Shutter Attachment Window and Door Buck Ceiling Grid Fill Cells Columns Framing Declaration of Use , April 03, 2012 Date April 03, 2012 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 BU D G PERMIT APPLICATION Permit Type: Electrical JOB ADDRESS: 1450 NE 101 Street. • 11 i aO ice, s) [-3Y: FBC 20 Permit No. CO " Lqn Master Permit No. Li City: Miami Shores Folio/Parcel #: 11- 3205 -024 -0040 County: Miami Dade Zip: 33138 Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): Maritza Gaiqui Phone#: 45 - 332 - 9950 Address: 1450 NE 101 Street City: Miami Shares State: __ FL Zip: 1313R Tenant/Lessee Name: Phone#: --Email: • CONTRACTOR: Company Name: �- s1c1NOE £��Irn.Arl 1 fie,��1C. Phone #: 3D5•`3�'O. c s4 Address: SQ "'W S ' h Sc) i+"E 2fD. City: t--/1.1, 4-4"011 State: l 0t2- I )4 Qualifier Name: 52-0442-00 5t t2E2 -- �tAi t Phone #: X5. B o ,4 zip: 13C State Certification or Registration #: EC- 15736 e( ' Certificate of Competency #: iJ4, SPCr:PaL 4•.1 e, P i. C.E_.1.LEt. Contact Phone #: 305• • 0351 Email Address: DESIGNER: Architect/Engineer: Mr. Arnold Villar Phone#: Value of Work for this Permit: $ ;lJ Square/Linear Footage of Work: Type of Work: ❑Address UAlteration UNew ORepair Description of Work: 1-4,...1-r, c ... 1 ..tVtsjarr 1011Iw.i '° ***************************************F ************* *m ******+ n **** * * * ******m******** Submittal Fee $ Permit Fee $ �. "°"C'' 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 brochur will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commence t must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the to nce of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature Owner or Agent The foregoing instrument was acknowledged before me this day of , 20 _, by who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: Contractor The foregoing instrument was acknowledged before me this 20 day ofJUh1 , 20 12-, by 12D0 S. Fa rez4Alcov4 who is personally known, to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: * * * * * * * * * * * * * * * * * * * ** **** **: x***** *m *+ x** **:x****** ********** ** * * * ** **: x****** *: x***** * *** *s:*****:x:x:x********* APPROVED BY Zl> Plans Examiner Structural Review (Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Zoning Clerk ^' 'VLrI I'avo� 1 Shores Village Miami dc, V' Building Department SIA ( 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Kr d� Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING Permit No. /GG-' 1/- ' W PERMIT APPLICATION Master Permit No. FBC 20 Permit Typ .•BUILDING ROOFING OWNER: Name (Fee e itleholder): �-t- 11 • Address: ` U , - City: (0 i� t ' OYt'' Tenant/Lessee Name: Phone #: 2,4 ^CYKie Email: Phone #: 5 -012Gi - l qi2. State: 0 iLk e� Zip: JOB ADDRESS: 460 tvE- tot City: Miami Shores County: Miami Dade Folio/Parcel #: r J -D2,11 —0 014 0 Is the Building Historically Designated: Yes NO Flood Zone: Zip: CONTRACTOR: Company Name: Address: City: Qualifier Name: State Certification or Registration #: Phone #: -J�`ZJ"2`" t C Zip: C D 1 5 • [� Phone#: 1) c6 Ze'j -- "l —` ` 2. t4? Certificate of Competency #: Email Ad ess: hO v�eE e6coL ` Dr'? 00. 6' Phone#: 1585)52 )- S? L / 7 476 - Contact Phone #: DESIGNER: Architect/Engineer: -Value of Work for this Permit: $ Type of Work: ❑ Description of Wo k: • Square/Linear Footage of Work: 3 2 o c) ❑New epair/Replace• C ti ❑Demolition Submittal Fee $ Permit F Scanning Fees$ Radon F Notary $ Training/Ed' Double Fee $ Structural Re y *Fe .. $ 1'! cation F * ** DBPR T i * * ** * * * ** *** * * * ** CO /CC $ Bond,$ ogy Fe OTAL FEE N 7 DUE $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Ni/4 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 ET.ECTRICAL 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 �� r 1 _� ° Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this The fore oiig ' trument was acknowledged before me this day of , 201 L , by , day of %l, 20 .by to me or who has produced who is personally known to me or who has produced s identi``cation and who did take an oath. as id ,(ti <tion and z ho did take an oath. NOTAR My Commission Expires:* 4 of APPROVED BY 7- e ASIAN MY CO '413$10N # OD 1111862 EXP thES: Jrhtd 24, 2013 !Wed llen &Net Retry Santos Sign: Print: My Commission Expires: l9TFOF FtP* AOD401862 EXPIRES: Mt 24, 2013 !lorded lieu Bal tMariSanteee Plans Examiner Zoning Structural Review Clerk (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) October 28, 2011 Gaiqui Residence 1450 NE 101 ST Miami Shores, FL 33138 RE: Permit Nos: RC -3 -11 -411, EL -4 -11 -746, MC- 411 -745 Gaiqui's Residence Mold Remediation Attn: Mr.Norman Bruhn Building Official Director: Dear Mr. Bruhn; pqM7Y3 �+, Nov 0 1 2011 At this time we respectfully request an extension of the above building permit for a period of 90 days. One of the reasons for this extension is an additional claim that has been submitted to the insurance company due to more mold found during the demolition process, we are all working together to resolve this matter and continue this project. We appreciate your cooperation on this matter. Sincerely, Saad Homes, Inc. (Builder) 046 Homeowners' signature Miami Shores Building Dept. 10050 NE 2nd Ave Miami Shores, FL 33138 Current Owner 1450 NE 101 Street Miami Shores, FL Permit Number: EL -441 -745 Permit Type: Electrical - Residential Expiration Date: 11 /09/2011 Date of last Inspection: 01/01/2999 Please contact the Building Department at 305 - 795 -2204 Miami Shores Budding Dept. 10050 NE 2nd Ave Miami Shores, FL 33138 Maisel From33138 W!11/2011 031A 00041855017 Current Owner 1450 NE 101 Street Miami Shores, FL Permit Number: RC- 3- 11-411 Permit Type: Residential Construction Expiration Date: 5/2011 Date of last Inspection: 01/01/2999 Please contact the Building Department at 305 -795 -2204 g P � o 0 en 1 ji EN g oc it 04 — 2") 1 3 41 i8 1 rri 2 P.1 I' co iN A i gai .�1 1 S jllA w NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO., - j.- 1,t -i-41 t TAX FOLIO NO. 113205- 024 -0040 STATE OF FLORIDA: COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements 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. Legal description of property and street / address: Miami Shores Bay PK Ests AMD PB 56-86, Lot 8 BLK 1, 1450 NE 101 ST, Miami Shores, FL 2. Description of improvement: Remodeling and mold removal 3. Owner(s) name and address: Wachovia Bank & Maritza Gaiqui, Natasha Gaiqui Guardianship CIO Wachovia Bank 1450 NE 101 ST, Miami Shores, FL 33138 Interest in Property: Living Owner Name and address of fee simple titleholder: 4. Contractor's name and address: SAAD HOMES, INC. 18601 WENTWORTH DRIVE. MIAMI, FI 33015 5. Surety: (Payment bond required by owner from contractor, if any) Name and Address: Amount of bond $_N /A 6. Lender's name and address: tcaqi 7. Persons within the state of Florida designated by Owner upon whom notices or other documents be served as provided by Section 713.13(1)(a)7:, 'Florida Statutes. Name and Address: Maritza Gaiquin, 1450 NE 101 ST, Miami Shores, FI 33138 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor Notice as provided in Section 713.13(1)(b), Florida Statutes. Name and Address: 0 0, 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a different date is specified) >'17 a• re of own Print • wner's N. it Sworn to and subscribed before me this Notary Public: Print Notary's Name: My commission expires: "day of t-tO rde , 20 1 .:;'4, CA(i NASLAN • * COMMISSIiN I DI1t* 2 4. . EXPIRES: Jane 24, 2613 'got b m /� 1ta y7 a DOCUMENT COVER PAGE For those documents not providing the required space on the first page, this cover page must be attached. It must describe the document in sufficient detail to prohibit its transference to another document. An additional recording fee for this page must be remitted. Description of Document: Illc0 111113111111111111111111111 CFt4 201180220375 OR Bk 27643 Pss 1704 - 1705; l2Psss RECORDED 04/06/2011 12:33:38 HARVEY RUVIW, CLERK OF COURT MIAMI -OADE COLNTYr FLORIDA (Mortgage, Deed, Construction Lien, Etc.) Given By: (Name(s) of Grantors or Mortgagors) To: ( Name(s) of Grantees or Mortgagees) cutlArv--E--;, 18,„ Property Description: (If Applicable) As more fully described in above described document. F.S. 695.26 Requirements for recording instruments affecting real property — (Relevant excerpts of statute) (1) No instrument by which the title to real property or any interest therein is conveyed, assigned, encumbered, or otherwise disposed of shall be recorded by the clerk of the circuit court unless: (e) A 3 -inch by 3 -inch space at the top right -hand corner on the first page and a,1-inch by 3 -Inch space at the top right -hand corner on each subsequent are reserved for use by the clerk of the court... Permit No: 11-411 Job Name: April 12, 2011 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 785.2204 Fax: (305) 756.8972 Page 1 of 1 Building Critique Sheet 2nd 1) All permit applications must be submitted prior to any further review.(electrical, mechanical) Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove fiem 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 bos.S2_9-(11001 04/12/2011 16:11 FAX 1 800 685 7530 DATA SCAN FIELD SERVICES 11001 * * * * * * * * * * * * * * * * * * *** * ** TX REPORT * ** * * * * * * * * * * * * * * * * * * * ** TRANSMISSION OK TX /RX NO 1266 RECIPIENT ADDRESS 93058299109 DESTINATION ID ST. TIME 04/12 16:10 TIME USE 00'17 PAGES SENT 1 RESULT OK 41\ali Permit No: 11-411 Job Name: April 12, 2011 Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Pagel oft Building Critique Sheet 2nd 1) All permit applications must be submitted prior to any further review.(electrical, mechanical) Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove ttem 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 bos.V.9.q1001 03/21/2011 12:28 FAX 1 800 685 7530 DATA SCAN FIELD SERVICES 11001 * * *** * ** * * ** * * * * * * * ** * ** TX REPORT * ** * * * * * * * * * * * * * * * * * * * ** TRANSMISSION OK TX /RX NO 1196 RECIPIENT ADDRESS 93058299109 DESTINATION ID ST. TIME 03/21 12:27 TIME USE 00'56 PAGES SENT 2 RESULT OK 5191 tt Ciacii,C6) Permit No: 11-411 Job Name: March 21, 2011 Miami Shores Village Building Department Building Critique Sheet 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 1) All permit applications must be submitted prior to any further review.(electrical, mechanical, plumbing) 2) Corrections for electrical must be completed. 3) Provide a detailed scope of work. The scope shows work you indicated you would not be doing. 4) Provide wall details showing reconstruction. 5) Mark plans to show area of repair. Plan review is not complete, when all items above are corrected, we will doa 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 cax -- -91 01 Permit No 11-411 Job Name: March 21, 2011 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 Page 1 of 1 1) All permit applications must be submitted prior to any further review.(electrical, mechanical, plumbing) 2) Corrections for electrical must be completed. 3) Provide a detailed scope of work. The scope shows work you indicated you would not be doing. 4) Provide wall details showing reconstruction. 5) Mark plans to show area of repair. Plan review is not complete, when all items above are corrected, we will doa 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 cal 5, ,1-21 ofi NOTICE A RECORDED COPY MUST BE OF COMMENCEMENT POSTED ON THE JOB SITE AT TIME OF FIST INSPECTION PERMIT NO.RC 411 STATE OF FLORIDA: COUNTY OF MIAMI -DADS TAX FOLIO NO. 11- 3205 -024 -0040 THE UNDERSIGNED hereby gives notice that improvements 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. 111111111111111111111111111111111111111111111 CFN 201280290112 OR Bk 28084 Ps 2197; (1os) RECORDED 04/24/2012 11:49:56 HARVEY RUVIN? CLERIC OF COURT MIAMI -DADE COUNTY? FLORIDA LAST PAGE Space above reserved for use of recording office 1. Legal description of property and street /address: Residential / 1450 NE 101 Street, Miami Shores 33138 2. Description of improvement Interior Remodeling 3. Owner(s) name and address: Maritza Gaiqui Interest in propetty: Name and address of fee simple titleholder. 4. Contractor's name, address and phone number. AGE OF EMPIRE Inc / 11475 SW 43rd Terrace, Miami, FL 33165 5. Surety: (Payment bond required by owner;om contractor, if any} Name, address and phon9 nu r: � /I/ Amount of bond $ /G/ 6. Lender's name and address: 1ii- 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(1Ma)7., Fkvida Statutes, � Name, address and phone number. 01,'r 3 Ai-01z, .� /4 s'(7'76' 3Ti2 8. In addition to himself, Owners designates the fdllowing person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name, address and phone number. 9. Expiration date of this Notice of Commencement the expiration date Is 1 year frau the date of recording unless a different date Is specified) WARNING TO OWNER: ANY PAYMENTS MADE BYTHE 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. Signature(s) of Owner(s) or Owner(s)' Authorized Officer/Director/Partner/Manager Prepared By Prepared By Print Name %'�' �T -, /} �,� / ( lI , Print Name Title/Office Trtle/Office STATE OF FLORIDA COUNTY OF MIAMI -DADE The regoing instrument was acknowledged before me this By Moor 1 tL't V 41'el- Individually, or ❑ as / for ❑ Personally known, or produced the following type of k 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. 2.4 day of A�el t 2012. arrtffircAJl1 n- -(-.. Jw21c5sci R Lan% Notaty Pu5114, State of MELISSA R. LAX_ Cbmmissbn# EE 107488 Ores June 28; 2015 r(s) or • _ s)'s Authorized Officer /Oirector/Partner/Manaber.who BY STATE OF FLORIDA, COUNT OF DADE I HEREBY CERTIFY that this is a true copy of the orrgrnal tHed ig tit jlce on day of ��1'111�R L� .G o , A D 20 WITNES fj� and and Official Seal. HARVE �� d IN, CLERK, ofCircwt and County Courts By v// So '/ D.C. 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 BUILDING ROOFING OWNER: Name (Fee Simple Titleholder): )J\,('-'4.- c‘ Phone#: Address: siti5-i-e5 NFL \p■ City: A+`Nc. -r.., Permit No. c� Master Permit No. 0—C 1 I I l 1 State: Zip: '37g -:?,\--8- f Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: City: Miami Shores County: Folio/Parcel #: 11 -3ZbS b2 v\ _ csNAO Pik k i Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: AE.. 017- Phone#: 305 S5 - .Sa57? Address: 226 O d City: ,∎'i G.•e,v■t- , State: 1 L Zip: 33‘761, Qualifier Name: iikke,r A.emr..5 cti Phone#: 30S -3C0- ©17 Z State Certification or Registration #: GGC.151 t-1379. Certificate of Competency #: Contact Phone#: 305 — 3c — I V12 Email Address: GrC�� — 5e. ire i nG. Cr :v.1 DESIGNER: Architect/Engineer: L-,0k) Mar' v ✓, &sib Phone #: w, COO Gi -r Mk Valtian 4 o�n r/VICIIS411g1fle 't Value of Work for this Permit: $ V7 LA (a .62 Square/Linear Footage of Work: 3iS 6b Ate•'+ <?'; , q4(0 •(n ,ZINew LlKenair/Renlace UDemolition Type of Work: UAddition Description of Work: No, l ,54-"11 /.:.c Vafas 0.e11 (lP _SnRo ku c f rs **********N= ****+ k****sk******ds******* *** PP..** k** d: *N>> k* ***aR*sH**** *****N <<hN= ******+ksk*ek**** CCF $ • CO /CC $ Submittal Fee $ Permit Fee $ Scanning Fee $ . Radon Fee $ 42. •*1 DDBPR $ 42 ' 71— Bond $ Notary $ Training/Education Fee $ 1'" I', )' Technology Fee $ —)(0- CO Double Fee $ Structural Review $ Cbatult vf- Cov-J- if TOTAL FEE NOW DUE $.. kr:). 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 COMMENCEMEMP MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, 'CONSULT WITII 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 properly 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 day of 1L-,20d1�,by t , 12A. 6410!1' , who is personally known to me or who has produced R"0 As, identification and who.did take an oath. 1110111/v //1, NOTARY PUBLIC: Sign: Print: My Commission Expires: * * * ***>x* * * * * ** **** * * ** * ** APPROVED BY Signature Contractor The foregoing instrument was acknowledged before me this �� day of NIL( , 2012, by f1 1•1'0 At e$46(.) who is personally known to me or who has produced t �� as identification and who did take an oath. 1 4 1 1 1 1 1 111111 ✓'% / /VI NOTARY PUBLI :: ��``44 • .s _ r ¢� Sign: -n ._, as =,•� :-. it... pr�w Print: .mra CO T±� i ©�.� Ca ••ire Plans'Examirier' Structural Review (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) My Commission Expires: //C�©RIDP•• .. 11"nitsniitw�� Zoning Clerk I 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 fmished 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: Maritza Guaqui PERMIT # Existing Permit Number RC -3 -11 -411 ADDRESS: 1450 NE 101 Street FOLIO NUMBER: 11- 3205- 024 -0040 FLOOD ZONE: BASE FLOOD ELEVATION: FREEBOARD: EAST OF FL.CCCL: /~ COST OF PAST IMPROVEMENTS (12 MONTHS): $28,442.00 (See attached copy of contract) COST OF PROPOSED IMPROVEMENTS: 5174,946.62 (See attached copies) (ATTACH COPY OF CONTRACT) TOTAL CUMULATIVE COST OF IMPROVEMENTS (past and proposed): $203,388.62 VALUE OF PRINCIPAL STRUCTURE (attach appraisal): $437,642 ( See attached) OWNERS SIGNATURE: DATE: PLANREVIEWER: PLAN REVIEWER SIGNATURE: DATE: PX.I.— Miami -Dade My Home My Home iarnida + e.gov Show Me: Property tnformatlon Search 8y: Select item N Text only trill Properly Appraiser Tax Estimator lig Property Appraiser Tex {:oroarison I+'1 Portability S.O.H. Calculator Summary Details: Form No 11- 3205. 024.0044 Property: 1450 NE 101 ST Mailing WACHOVIA BANK & Address: MARITZA GAIOUI Living Units: NATASHA GAIOIA Adj Sq Footage GUARDIANSHIP Lot Size C/O WACHOVIA BANK Year Built: FLO 135ITAX UNIT JACKSONVILLE FL Legal ,32203 -0062 Prooerty Iniormatlon: ACTIVE TOOL: SELECT Primary Zone: 1600 SINGLE FAMILY RESIDENCE CLl/C: 0001 REStDENTIAI Sti4GLE FAMILY Beds/Baths: 13/2 EM Floors: 1 Living Units: MIMIEMAIIIILint Adj Sq Footage 3.608 Lot Size .60 SO FT Year Built: 1954 MIAMI S P8S 6PK S AMID 86 Legal LOT 8 BLK 1 LOT SIZE Description: 102.930 X 120 OR 13934- 10651288 i OR 13934 - 10651288 00 nt Information: aZIIIIIIIIIMI 2010 2009 Homestead; $25,000 EM =16=11111 $437,642 MUD MIMIEMAIIIILint 95. $500 MEM formation: Year: 2010 2009 Homestead; $25,000 525,000 2nd Homestead; YES YES Disabilit . $500 $500 Taxable Value Information: Year: 2010 2009 Taxing Authority: Applied Exemption/ Taxable Value- Applied ET mpcble Vain: Regional. County: 550,5001 5474,659 550,500/ 5474.659 $50,500/ 5460,853 550,500/ 5460.853 City: 550.500/ 5474,659 $50,500/ $460.853 q.ds..n, Priati - 525,500/ $25,500/ Aerial Photography • 2009 0 11611 My Horne 1 Property Information 'Property Taxes !MY Netohborhood !Property Appraiser }tomo 1 Using Our Site 1 phone Directory' privacy 1 Disclaimer 11 you experience technical difficulties with the Property information application, or Wish to send us your comments, questions or suggestions please email us at Webmaster. Web Site &i 2002 Miami•Dade County. All rights reserved. Page 1 of 2 MIAMI•DAD.,>' Legend • Property • Boundary • Selected Property ifte Street i✓ Highway ltiamt•Dade County ® Water K1 <J C41 ttJl1 JAMESD, trimagamo R• Lie 11 1 H* M. amalgam Uti aqU t 5tltign$4 UbtN1 U .LNta Vy�MMi de1101fitbus JAMES sk0139741UFt. JR. I ItiA R ZING, SHEET ME At.. at SUPPLY CO. 430101714 WASIIIRSOM arrllat7 71979t 41- Nasesla to February Ail. 441st. Strait Miami Sharma* PL. 33198 1 Earn :1:7;g:=1411°11 aola.andbM1 thbd+l4 t 1:11sc . ""%fi j 1 2ItI.l►arda ° ewi @ Who ■%Latin, roofing an 'than entire reoldento to this wood . *Attars to remain is place. 1 3011 !eft tiscappaeI..to the woo8 ah■sthlag. �+pse lnialiod iastall ElaohLfl ° en all eaves . x2: lied sea tlsngae to all ploalaingg Vent* . 019. Valli. metal fleshings for tan Ventiiatfwl. Why =with lot etQDP cod t. dhtag0 liners/ surface stelae flos1►in!ps to mast bldg. ga.1i, metal hip and xid+Fa eAe, gel . metal galloya. ter Iaogusra Roll color thru comsat WA over entire area Oasis aA ssivo. poemit rovo r ,vuitraah.t 'end warranty. pad TOTAL -- #27,875.(0 1910 all 911 all work As aksted Vteaept install 160r. caPPor llahhlate ell eatiVas fed Sass. oollPer valley metal. - ;3,350.00 I I 1041•411 ratted wood ahsathing at max. fvise ylt1 at txislOO pat e Luigi!' motorize of lag at 13.50 par et $0.50 par ft., plywood replaced at ab9.00 /ghee( at►d renalling .a e9 0P /aa i ' requital. e(l)se ppsidsn s ie subjeatad to mitigation, Des attached, for more info. 1-'Att. dl itatemate 7 Install Maier Saxony Slate 900 white • cator Chru the bi place tin tier iiancpara Roll. ...--- $28p422a00 I aJ t Altamaha ill is available for FPL rebate of $525400 upun FPI. ate: GUADAt87$@ N1i rTRAN$FRRAh sow* twits Mme #410.40 *00401.114Atiewast gdellisoksObadrivlovesta iskatorpoom cu aasr -,t am 211 /11 edd ■*raw eA� ►M aw, sw,�rweo rsors new head oteeposfiemboAmersOpmestragovow wmpdftbmovirmeamwmwhoologftwOm 4.04 6Nreg=• rowasep.or.oRA011ealsbmrst r n, yg i rpa".'se+ e1 rL1N.�e +pot � Over 71 Years of Se te` w,, \l s %n SC ,� aci3'h °f'�'vt 11 Dhdslr N 1000 1050 2050 DEMOLITION.. 2000 Trash Container 2072 DEMO: Mechanical Air System 2070 DEMO: Interior Mirrors 2071 DEMO: Interior walls and ceiling panels 2073 DEMO: Kitchen & Laundry room floor 3730 Remove wall hung A/C units and Patch $200 FINISH CARPENTRY 6210 Baseboard 6750 Attic Latter 7000 THERMAL& MOIS11JR OTECTi 7100 "squeen (12MIL) 9260 DRYWALL AND INSULLATION 9261 Installation of'Durock wall and Insulation 9300 FLOORING TILE 9310 Ceramic Bathroom Tiles Installation 9311 Ceramic Kitchen Tiles Installation 9312 Ceramic Laundry room Tiles Installation 15400 PLUMBIN 15441 Lavatory 15442 Watercloset ( Tank Type ) 15443 Shower 15444 Bar Sink 15445 Kitchen Sink & Garbage disposal 15446 Refridgerator line 15447 Washer Machine 15448 Laundry Sink 15500 MECHANICAL . HVAC 15890 Metal A/C Duct work 16000 ELECTRICAL 16050 Reinstall existing light fixtures 16495 Reinstall existing smoke detectors TOTAL FOR CONSTRUCTION ADD - As per site visit. 6111 Replace Damaged Ceiling joist (8LF) 6150 Install new plywood and durock 6310 Door Casings 6410 Crown Moldings 16490 Replace Switches and Duplex Receptacles STATE CERTIFIED Sat, QLJALIFIEL GEN EB.A..L C(DNTRACTtDR RC+C�i)� ITT G PLI..:T 1413ING UTILITY ... EXCA\T.ATIC )N SCHEDULE F VALtIES DESCRIPTION General Conditions Overhead & Profit 4TY UNIT RICE 1 Lump Sum $ 9,600.00 $ Percentage $ 15,102.20 $ $ EA $ 400.00 $ 1 Lump Sum $ 750.00 $ 0 Lump Sum $ 500.00 1 Lump Sum $ 6,487.00 $ 255 Sq. F $ 2.00 $ 2 Lump Sum $ 140.00 $ E! �� Overhead & Profit TOTAL FOR ADDITIONAL CONSTRUCTION DRANO TOTAL FOR PROJECT TENSION 9,600.00 15,102.20 94,22700 1,200,00 750.00 6,487.00 510.00 280.00 0.00. X00.00 680.09 $,760.00 5,760.00 29,100.00 29,100.00 1,69400 406.00 962.50 325.50 400.00 500.00 1,000.00 450.00 1,000.00 350.00 300.00 300.00 150 00 8,250.00 3830 1:00 2,500.00 800.00 •,613.20 900 LF ,, $ 4.00 1 3600 116 275 93 Lump Sum $ 680.00 Sq.F $ Lump Sum $ 29,1 Sq.F Sq. F Sq. F EA 1 EA 1 EA 1 EA 1 EA 1 EA EA EA 20 3.50 3.50 3.50 400.00 500.00 1,000.00 450.00 1;000.00 350.00 300.00 300.00 Lump Sum EA $ 8 EA $ 8,250.00 10 1 600 1 35 125.00 $ 100.00 $ EA $ 85.00 $ Lump Sum $ 1,635.00 $ LF $ 3.50 $ Lump Sum $ 4,000.00 $ EA $ 50.00 $ .ageofempirelnc com 103,015.2 Client Initial(s) X: ®Cell 305 - 300 - 0172 # Office: 305 - 851- 5897 4 Fax: 305 6 C0C1514379 - CCC1329676 - CFC1427603 - CUC1224581 850.00 1,63500 2,100.00 4,000.00 1,750.00 10,335.00 2,069.00 12 402.00 C) 1-4 14-1N11:1 I I 7 ,T i T`°` C" ' I C) , `° C_ STA1 E CERTIFIED & QUALIFIED GENERAL C .(DNT CTC)R . RC c3FING PLUMBING UTILITY - EXC. VATIQ SCOPE OF 107.1 The contractor is to furnish all labor, material, and equipment + Master, Plumbing, Electrical, and Mechanical permit is required. I Demo Remove all interior wall & ceiling drywall Remove wall mirrors • Remove all mechanical ductwork Remove all door casings Remove kitchen and laundry room floors. • Remove (2) A/C wail units. Rough & Finish Carpentry 1 oft Installation of Visqueen underneath the house. • Replace damaged laundry room wood partitions Installation of Metal hi -hat (furring strips) in ceiling. Install Rigid in perimeter walls and R -30 BAT paperback Insulation in ceiling. Install Den Armor Plus 5/8" Drywall In walls and ceilings level 5 Install kitchen, laundry, & north bathroom plywood and durock floor • Patch wall where A/C all units were. • Install 7I A" base board and corner round. Installation of crown molding only match existing In the (Entry, Family room, Living room, & Dining room) to • Installation of casings 31/4" around doors. 1 > Plumbing Installation ONLY • (1) Lavatory • (1) Water closet (Tank Type • (1) Shower liner (1) Bar Sink (1) Kitchen Sink, Garbage Disposal, & Dish Washer • (1) Refrigerator water line (1) Washer Machine (1) 'Laundry Sink www.ageofem pireinc.com 305 -- 300 -- 0172 * Office 305 - 851 - 5897 ®Celt: Client Initials) X Fax: 305 - 663 CUC1224581 CGC1514379 CCC1329675 - CFC1427603 - C' . r T C ' CD STAI L. CERfl LED & QUAU 1 D CADNTRAc-rc-3R ROC)FING G PLUMBING UTILITY Viz... EXC AVAT N Mechanical • Install METAL ductwork r Electrical Install Door Casings throughout ® (20) Reinstall existing lighting fixtures, (8) Reinstall smoke detectors E> Clean UP: ® (35) Replace duplex and switches. • Trash Container is included for construction waste only. • Debris removal from site and detail cleaning prior to occupancy. As per site visit, all electrical switches and duplex receptacle need to be replaced. New plywood and du- rock needs to be installed in the bathroom and kitchen before tile installation. There are damaged ceiling joist that are need of replacement i.e., master bedroom. The crown molding installation to match existing, installed only in Entry foyer, family, living, and dining room. In addition, new door casings will be needed. >Rough & Finish Carpentry • Replace Damaged Ceiling Joist (8LF) Install new plywood and durock in kitchen and bath Install Door Casings throughout • Install Crown Moldings in Entry foyer, family, living, and dining room:.. Electrical: ® (35) Replace duplex and switches. /Ill! /ffl/lltl // 1111/ 11/ I/II/I//// If I// / /////II////// /U///////lltl/ // END \\\\\\\1\11\1 \\\ \ \\ \ \ \\\ \\it \ \ \ \ \ \� wwvv.ageofempireinc.cbm MOM% \\\\\\\\\\k\WA\\\\\\\\ Client Initial(s) . -Cell: 305 - 300 - 0172 Office: 305 - 851 - 5897 Fax: 305 - 663 k7t CGC1514379 - CCC1329675 - CFC1427603 CUC1224581 ESTIMATE#2852 NEW IMAGEdesigris Ivc. PATRICK IHASZ PRESIDENT (954) 632-9829 Fax #1(866)646-1485 nidcab@bellsouth.net 5030 NW 109 Avenue Suite 1 Sunrise, FL 33351 Custom Carpentry Wail Units Kitchens Reception Desks Furniture Maritza Getout 1450 NE 101 Street Miami Shores FL 33138 Home (305) 758-5037 Work Mobil (305) 332-9950 Fax maritzaele©aol.com Date December 26, 2011 Item Description Amount RE: Granite Kitchen Countertops - Fabrication & Installation Golden Typhoon 2CM > Fabrication of custom granite counter tops for home kitchen. Sizes and specifications as provided by client Measurements to be verified and templated for fabrication. Ogee" edge detail. - 1 112" "Golden Typhoon 2CM° Granite material provided by client. - Backsplashes - FuH 18". Includes window sill, around window, and behind oven wall. - Edge: Ogee - (1) Undermount Sink cut out and polish. - (1) Undermount Stainless Steel Sink excluded, provided by client. - (1) Faucet excluded, provided by client. We hereby propose to furnish labor and materials - complete in accordance with the above specifications,for the sum of: $4,782.90 Payments to be made as follows: 50% Deposit of $2,391.45 25% Upon Cabinet & Molding Installation. 25% Balance due upon completion. All material is guaranteed to be as specified. All work to be completed in a workmanlike manner to standard practices. Any alteration or deviation from above specifications Involving extra costs, will be executed only upon written orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accfclenis or delays beyond our control. This proposal subject to acceptance within 30 days and is void thereafter at the option of the undersigned. SUBTOTAL: SALES TAX PROPOSAL TOTAL: $4,320.00 $150.00 $0.00 782.90 ACCEPTANCE OF PROPOS Above pricing, specifications and conditions are hereby accepted. You are authorized to do Accepted: Signature: fled, P nts as outItn Date: ,icetg' *7 /*- Signature: invol s ar dtie arid payable upon rer.elpf.. After 30 days a service charge will be added at the rate of 1 112% per month. Costs incurred as a result of non-payment of any invoice including court costs and attorney's fees will be paid by cllerit NEW I ESTIMATE #2 31 GEdesigns Custom Carpentry Wall Units Kitchens PATRICK IHASZ PRESIDENT (9544) 632 -9829 Fax #1(866)646 -1485 nidcab @bellsouth.net 5030 NW 109 Avenue Suite 1 Sunrise, FL. 33351 Reception Desks Furniture Maritza Caiqui 1450 NE 101 Street Miami Shores FL 33138 Home (305) 758 -5037 Work Mobil (305)332 -9950 Fax maritzaele @aol.corn Date December 26, 2011 Item Description Amount RE: Custom "Cherry Pearl" Laundry Room Cabinetry > Fabrication of Laundry Room cabinetry. All 3/4" Birch plywood construction. Adjustable Interior shelving. Heavy duty 22" full extension "soft close" drawer slides. slum 110 degree concealed soft closing clip on hinges. Sizes and specifications as per drawings provided. Cabinets - Frame less 314" Birch Plywood. Exterior finish Counters lBacksplash Doors Freight charges Handles Stain Finishing Accessories Select Cherry wood and veneer, matching Laminate. - Granite Fabrication & Installation only, (Invoice #2934) Excludes sink and - Granite (invoice #2934) - "Manhattan " style select Cherry, optional routed drawer fronts. - Shipping doors and drawer fronts. - (22) To be Chosen, ($10.00 allowance) - "Cherry Pearl" - Sanding Sealer, Semi -gloss lacquer; doors, drawer fronts, - (1) False front tray. - (1) Clothing Rod. - (1) Toe Kick Pull -out. - Crown Molding > Detailed 3D computer drawings provided. > Delivery and Installation to Miami Shores * Prices do not include electrical or plumbing. We hereby propose to furnish labor and materials - complete in accordance with the above specificatiions,for the sum of: $8,439.30 Payments to be made as follows: SALES TAX: 50% Deposit of $4,219.65 PROPOSAL TOTAL: 25% Upon Cabinet & Molding installation. 25% Balance due upon completion. All material Is guaranteed to be as specified. All work to be completed in a workmanlike manner to standard practices. Any alteration or deviation from above specifications involving extra costs, will be executed only upon written orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. This proposal subject to acceptance within 30 days and is vold thereafter at the option of the undersigned olding, finished J SUBTOTAL: $2,742.10, $1,107.10' $1.432.00 $127.00 $220.00 $824.00 $25.00 $35.00 $85.00 $380.00 $45.00 $865.00 552.10 ACCEPTANCE OF PROPOSA Above pricing, specifications and conditions are hereby accepted. You are authorized to , Accepted: Date: ar due d ayabte upon recelp incurred as a result of non- paymer Signature. Signet e: _ days a service charge I tae added at the rate of 1 112 °% per month. any invoice including court costs and attorney's fees will be paid by client NEW IMAGEde ESTIMATE #2934 (gins tine Custom Carpentry Wall units Kitchens PATRICK iHASZ PRESIDENT (954) 632 -9829 Fax #1 (866)646 -1485 nidoab @belisouth.net so3o NWY 109 Avenue Suite I Sunrise, FL. 33351 Reception Desks Furniture Maritza Galqui 1450 NE 101 Street Miami Shores FL 33138 Home (305) 758 -5037 Work Mobil (305)332-9950 Fax maritzaele@aol.com Date January 11, 2012 Item Description Amount RE: Custom "Cherry Pearl" > Fabrication of custom kitchen cabinetry. All 3/4" Birch plywood construction. Adjustable interior shelving. Heavy duty 22" full extension "soft close" drawer slides. Blum 110 degree concealed soft dosing dip on hinges. Sizes and specifications as per drawings provided. Cabinets - Frame Less 3/4" pre - finished Birch plywood. CP laminate int. glass cabs. Exterior finish - Select Cherry wood and veneer w/ "Cherry Peari" finish, matching laminate. Counters - Granite fabrication & Installation; (Estimate *2852). Sink and faucet excluded. Backsplash - Full 18" Granite fabrication and installation; (Estimate *2852). Doors -- "Manhattan" style Doors, Routed drawer fronts, and DW Door installed. Freight charges - Shipping charge for doors and drawer fronts. Handles - (38) To be chosen, ($10.00 allowance), (10) Touch latches for glass doors. Stain - "Cherry Pearl" Finishing - Sanding Seater, Semi -gloss lacquer; doors, drawer fronts, molding, fin. ends. Accessories - (1) False front tray. - (1) Garbage pull out, (1) Recycle garbage pull -out. - (4) Interior cabinet pull out trays with matching wood fronts. - (2) Base, (1) tipper finished end columns. (1) Full depth Fridge wall. (4) Hydraulic lifts Installed for (2) Pop up doors. - (4) 1 1/4" Flat Wire Antique Pewter *39276. - Tray organizer panels installed. - (1) 3/4 Lazy Suzan, (1) Half Moon pull -out. - (2) Spice pull -outs. (1) Toe kick pull out in Oven cabinet. - Three piece Cherry crown molding, Under cabinet molding. - (10) Custom Leaded clear glass door inserts. (4) Clear glass shelves. - .Slim Under cabinet fluorescent lighting. - (10) Interior cabinet LED lights. (1) Transformer. > Detailed 3D computer drawings provided. > Delivery and Installation to Miami Shores. * Prices do not include electrical or plumbing. * We hereby propose to furnish labor and materials - complete In accordance with the above specifications,for the sum of: $24,839.75 Payments to be made as follows: 50% Deposit of $12,419.88 25% Upon Cabinet & Molding installation. 25% Balance due upon completion. All material Is guaranteed to be as specified. An work to be completed in a workmanlike manner to standard practices. Any alteration or deviation from above specifications involving extra costs, will be executed only upon written orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control, This proposal subject to acceptance within 30 days and Is void thereafter at the option of the undersigned. SUBTOTAL: SALES TAX: PROPOSAL TOTAL: $8,642.86 $4,424.86 $238.00 $440.00 $54.00 $1,425.00 $25.00 $230.00 $340.00 $485.00 $80,00 $580.00 $65.00 $225.00 $330.00 $624.00 $1.965.00 $420.00 $681.00 $75.00 $1,866.00 1$$24 839:75 ACCEPTANCE OF PROPOS Above pricing, specifications and conditions are hereby accepted. You are authorized Accepted: Signature• Payments as outlined. Date: / d G7 % 7 el / �- Signature: Inv ces are due and payable upon receipt.. After 30 days a service charge will be added at the rate oft 1/2% per month. Co is incurred as a result of non - payment of any invoice including court costs and attorney's fees will be paid by client. f APPLIANCES Grisel Fernandez Sales Selection Consultant 6300 S. Dixie Highway I Miami, P1.33143 of 305-669-0910 ext, 225 1 4x: 305.661.4322 e-mail: gfernandez @Flo idaBuHderApp1Eancescom website: www.FloriclaSublerAppliances.com FlortdaSublerApppiiartces.com HOW IMMI P' 04 4%1(e= BILL TO: LIONSTONE DEVELOPMENT 605 LINCOLN ROAD, 5 FLOOR T.305 672 -5466 Miami Beach FL 33139 SALES QUOTE #: 11407885 sQ ! QUOTE DATE: 12/t7/20I1 PAGE# 1 SHOWROOM: MIAMI SHOWROOM CUSTOMER #: 28124 TERMS: Prepayment Required SHIP TO: 450 IJE. 101 5170 T i+14' t 451 0 ' % ATTN;ARNOLD 786 402 -6178 Miami Beach FL 33143 CUSTOMER P.O. SHIP VIA: JOB CONTACT: ARNOLD AA( ARNIOLD 305 612 -5466 CONTACT & PHONE: DATE REQUIRED: 3129/2012 SPECIAL INSTRUCTIONS: TAX ID: ORIGINAL ORDERDATE: 12/1712011, RELATED ORDTYPE/NO: / QTY t 1• g. 5 4- •1 MODEL NUMBER JS42SEDUDW AN210 2175RFS00 5036WS REBATEJX1V5036WS JEC0536ADS JMW2430WS JDB3600AWX N.YP55 REBATEJDB3600AWX 1 EWFLS70JSS 1 u.EIVMED70JSS 2 E1'WD15SS 1 C6 1 110107 1 PACBIB F- 5MA2499 DESCRIPTION 1 REF BI 42" 26 CF SLV .?ISP EURO 5 FT 1/4" PVC ICMAKER SUPPLY ULN 24° UC RHREF/FRZR SS 36° WALL HD FLT C3LS 600CFM 4SP JEN NAT CONSUMER PROMO REBATE JENN JEC0536ADS C/TOP SS JEN 30"MICRO /OVN,CONV,SPEED SS JEN F/1 TALL TUB D/W, BL CONSL PVC D/W INSTALL KIT W/ELBOW JEN NAT CONSUMER PROMO REBATE LAUNDRY AREA ELX 27 °F/L WASHER$ILVER SANDS ELX 27 °F/L E1..EC DRYER,SILVER ELX 15°LNDRY.PEDSTL,SLVR SANDS NDA C6 30 AMP DRYER CORD 6FT BUILDERS BEST PIPE D & I 8 PC BUILT IN SYR EXT. WARRANTY DESCRIPTION 2 UnT PRICE EXT PRICE REF BI 42" 26 CF SLY DISP EURO 8,199.00 8,199,00 10.00 10.00 I ECHELON, FROST FREE 1,799.00 1,799.00 36° WALL HD FLT GLS 600CFM 4SP 2,299.00 2,299.00 2,299.00- 2,299.00 - JENN JEC0536ADS MOP SS 1,499.00 1,499.00 SS HANDLES COLOR LCD DISPLAY 3,899.00 3,899.00 BLACK CONSOLE/ REVERSIBLE PNL 1,149.00 1,149.00 PVC D11V INSTALL KIT W /ELBOW 21.00 21.00 1 ,149.00- 1,14900- S.1CF,92- CYCLE,WAVE TOUCH SAND,STEAM,8CF,92- CYC,WAVE TCH W /GLIDE TOUCH DRAWER NDA C6 30 AMP DRYER CORD 6FT BUILDERS BEST PIPE - DIa es.. 1,599.00 1,599.00 1,599.00 1,599.00 249,00 498.00 15.00 15.00 10.00 10.00 799.00 799.00 1,299.92 1,299.92 Ja,.a. i ,240 43,4344 1.00> mi god) 406 Ir► ti 2411 1711:4 VA/- t•AA.1140 7 'LfZCjt 16 %v 11"0`° - j,,.t a t17,724.- )21 W.W.II— 454 AS O` 14 '°t 4 7 q•'y ppo4 ef,t, J ILI,1T 4)0E 11,14 z0.47-0 leuL /504 k1pkl/ MERCHANDISE: DELIVERY: SUB TOTAL: WARRANTY: INSTALLATION: FREIGHT: SALES TAX: DEPOSIT: BALANCE DUE: 19 ,148.00 799.00 21,246.92 1,299.92 1,245.87 1 22,492.79; ESTABLISHED 1924 114' WHOLESALE HARDWARE CO.. INC. P.O. BOX 819500 • NORTH MIAMI, FLORIDA 33281-9500 1850 N.E. 146th STREET • MIAMI, FLORIDA 33181 MIAMI: (305) 947-5451 • BRWD/MONROFJPLM BCH: 930-5451 FAX: 305440-8959 WEB SITE www.tatteys.com • FED. I.D. #59-0238860 SOLD T.OD:. KBHITZA SPIOUI 1450 N.E 1015T 141IIIff FL 33138 INVOICE 12/22/11 . OF .0, PAGE (SALES ORDER # 74016 (INVOICE DATE: QNVOICE # J SHIP TO: HRRITZCI c111 1480 N. E 10151 305-3R-9950 14E411 OWE, FL 33138 - ss*ALEI PEn1§ Osr M ER' PHOVF.V.<1,!' , to 5 z liBM1i1 E1111 s 0,00f wniTE3.0 ;„W ANcHi-r ebzwi I2MD 1111111 40441«.4411:1,1 11,E R AL S_TOMERJJIjIIjJJIINIEYIIJIi1DJWiW .61;7:5-81.lp EWAVa-ey .1 a skAA14,11,14%4,- V h,--41114k , MOO t IPTI ,40-#Tawart JAVIER PLEASE ORDER ***************0******* I RAC NR-8344/14T L01 VOLT NRII TRIG WT BAFFLE 2 WAC HR-802 NEW CMIST.HOUSING R/XFMR 3 SAP 51960 SOU NRIG FL EXN 0 IN FOR cat 51566 waime0041- TEMDEQI NETLPRI wessik. LVI 3" GIMBAL RING WHITE 564116 12.5)(141 LT PN1T SILVER W/HANDCUT CRYS NI RI9 ITZD FROSTED 2525X23,5 811 CIIND CMRO CIR. CRYSTAL Mil 12V BIPI 528120 8 SWR R9950NR704240 CRYSTAL ATTRACTION TRIM RINSLET CM- C NA 543517 9 RPL 8301H1 4" LIRI WILT 14C. AIR TIGHT HONG 5014 WRIG • Inspect all goods upon receipt. Report shortages or damaged goods within 5 days from pick up or delivery date. Non 'special-order' goods must be returned, in original package, within 31) days from pick up or delivery date. This invoice must accompany the return. All returned goods will be inspected and may be subject to a restocking charge. • All special-order sales, including freight and tax, require a deposit. 'Special order' goods -cannot be canceled or returned, unless approved by factory, and will be subject to factory's restocking charge. 4,4041 4.4001MiL' PAID/RECEIVED BY: If a credit card is used, I agree to pay above credit card amount awarding to card issuer agreement, SIGNATURE PRINTED NAME 41,4 "Idle IIE1' 9 ESTABLISHED 1924 WHOLESALE HARDWARE Ca. INC. P.O. BOX 619500 • NORTH MIAMI, FLORIDA 33261 -9500 1850 N.E. 146th STREET • MIAMI, FLORIDA 33181 MIAMI: (305) 947 -5451 • BRWD/MONROE/PLM BCH: 930 -5451 FAX: 305-940-8959 • WEB SITE www.tarreys.com it FED. I.D. # 59.0238880 SOLD TI RITZA GRL[ JI 1450 N.E 101ST MIfNI, FL 3,3138 INVO CE 12/22 /11 NO. OF PAGE # 2 (SALES ORDER # 4016710 INVOICE DATE: 740767-6 \INVOICE # SHIP TO: MARITZA GAINIUI 1480 N,E 101S1 .3005- -332 - •99`.60 MIf-gdI SW1llc, FL 33138 - §roMtEfl O cus to WFxPO GRIP =rN ORDER BAL LESI ORDER IWRIT SFtANCH /T o" 0 ea' 0 ea 2 ea 11 FOR F8110 -39 481 < "1 12X6 21T 8TH8 C RItt T E 3511 .69 t2X81LT SCIC ETCHED/ S NOBLE BRNZ 14B--6041 WATT F1ST A19 130V ORDER--2 SPECIAL ORDER -ACCS /CITE 117, THIS SPECIAL ORDER PERCHMDISE MAY NOT BE CAMELED OR RETURNED. ESTIMATED DELIVERY TIME HILL DE BETHEEN TO WEEKS OR BETWEEN TO DAYS EX LUDIN8 tEEMENDS. THESE TERNS AND C0NDITIDNS ARE UNDERSTOOD AND f CCEPTED BY CUNSTtR, X MIST HAVE CUSTOMER'S SINa ATURE IN- tiRDER TO PROCEED! * DEPOSIT RECEIPT L st Page • Inspect all goods upon receipt. Report shortages or damaged goods within 5 days from pick up or delivery date. Non `special- order' goods must be returned, in original package, within days from pick up or delivery date. This invoice must accompany the return. All returned goods will be inspected and may be subject to a restocking charge. • Alt `special- order' sales, including freight and tax, require a deposit. `Special order' goods cannot be canceled or returned, unless approved by factory, and will be subject to factory's restocking charge. PAID/RECEIVED BY: If a credit card is used, I agree to pay above credit card SIGNATURE taunt according to card issuer agreement. D NAME DEC 23, 2011 CUST SHOWROOM TAXABLE FL QUOTE# YOL81301 TERMS : C.O.D. SPLES SLMN YOL ATTN OF : SH001 CENTURY WHOLESALE, INC. *** QUOTE *** t.W.66, 0 /PA r ,SHIP TO MARZ,ZA II 305.332.9950 (4i 1i 14. 4.01,01N-V1 PAGE: 1 1 FPO, rl.c05— 44+1, Mr- ciAP 15re .1) / YOLIV,,7 P EXPIRES : 08/13/11 ENTERED : 08/13/11 QUANTITY DESCRIPTION PRICE 1.00 1..00 1.00 EA EA EA --- MUSIC /THERAPIST ROOM SHOWER DAZZLE MULTI RGH P/BAL VLV L/STP CXC AM R110 TRIM FOR DAZZLE B/S VLV CP AM T028500002 IN2ITION 2 IN 1 SHOWER DR 58065 DAZZLE POWDER ROOM AUCET 1.00 EA DAZZLE MINISPREAD LAVATORY AM 6028240002 COMPACT CADET TOILET 1- 1 1.00 EA EA .00 EA 1.00 EA 1.00 EA 1.00 EA COMPACT CADET3 1PC TOILET AS 2403012020 WAX BOWL RING(CENTURY) HV 007005 3/8X7/8X12 SS TOILET SUPPLY KE PP23805 POWDER ROOM PEDESTAL ANTIQUITY SLAB 4 WHITE AS 0224014020 AMTIQUITY PEDSTL ONLY WHITE AS 731007400020 12" LAVATORY SUPPLY 3/8X3/8 KE PP23809 --i ------ [POWDER ROOM - --- TOILET COMPACT CADET EXTENSION Pg. 9,,,0 — 421 -*1 53,660 PER 68,936 PER 97.802 PER 53.66* 68.94* 97.80* 207.321 PER 207.32* 388.679 PER 0.982 PER 2.407 PER 160.839 PER 114.587 PER 2.407 PER. THANK YOU FOR YOUR PATRONAGE! PRICES ARE SUBJECT TO CHANGE YITHOUT NOTICE! 388.68* 0.98* 2.41* 160.84* 114.59* 2.41* • DEC 23, 2011 CUSTOMER SH001 SHOWROOM TAXABLE FL CENTURY WHOLESALE, INC- *** QUOTE *** PAGE: 2 SHIP TO MARIZA GAIKUI 305.332.9950 - QUOTE# : YOL 301 TERMS : C.O.D. SALES SLMN : YOL EXPIRES : 08/13/11 ATTN OF : ENTERED : 08/13/11 QUANTITY DESCRIPTION PRICE EXTENSION Pt-- 1.00 EA COMPACT CADET3 IPC TOILET AS 2403012020 1.00 EA WAX BOWL RING(CENTURY) HV 007005 2.00 EA 3/8X7/8X12 SS TOILET SUPPLY KE PP23805 MUSIC ROOM VANITY24' 1.00 EA FAENZA VANITY HI B919-24-001TE 1.00 EA CERAMIC BASIN ONE HOLE HI CB-5124-WH 1.00 EA VERO SGL HANDLE LAV FCT MOM DE 553LF KITCHEN SINK 1.00 EA UNDERMOUNT SINK MMUS FR KBX12034 2.00 EA SATIN NKL STRAINER BASKET FR 900SN -4 41 KITCHEN FAUCET 1.00 EA KITCHEN FAUCET DE 4453-DST MEDICINE CABINET 1.00 EA MEDICINE CABINET HI MP9-24-030TL 388.679 PER 0.982 PER 2.407 PER 700.000 PER 250.000 PER 217.717 PER 1233.679 PER 85.755 PER 388.68* 0.98* 4.81* 700.00* 250.00* 217.72* 1233.68* 171.51* 161.838 PER 161.84* 320.000 PER 320.00* MERCHANDISE 4546.85 OTHER TAX ( 1.00%) FREIGHT TOTAL THANK YOU FOR YOUR PATRONAGE! PRICES ARE SUBJECT TO CHANGE qITHOUT NOTICE! 0.00 318.28 0.00 Miami Location 7500 NW 8th Street Miami FL - 33126 www.slabdepot.com Creeks tt Marble LLC Phone: 305- 264 -2077 Fax: 425- 955 -1428 Sold To Walk In - Miami Miami FL Ph: 305 -000 -0000 Sales Order - Customer Cop 27002 I Order Date Est. Ship Date Jan 14, 2012 Page: 1 of 1 Ship To Stone Impression Miami FL P.O. No Sldemark Terms Prepaid Rep DMP Delivery Method Item Material She Quantity Unit Price Amount Other Breccia Oniclata 3cm PIECE $150.00 Notes Mariiza Gafqui 305 332 9950 Items Subtotal Sales Tax (7%) Other Delivery Charge Total Payments Balance Due $0.00 $10.50 $150.00 $10.00 $170.50 - $170,50 $0.00 Terms & Conditions 1. Please sign and fax back this Sales Order as your order confirmation to enable us to deliver the materials ordered by you. 2. We will not be able to deliver the material without receiving this signed and confirmed Sales Order. 3. The sizes Indicated above are the approximate sizes. The material will be re- measured at the time of delivery. The actual sizes will be Indicated on the delivery order. (applicable for slabs only). 4. No Returns will be accepted after 30 days from the delivery date. 5. 15% restocking fee will be applicable on all returns. All returns have to be pre - approved. Customer Copy sem/. by STORE MOAT SYSTEMS Miami Showroom: 3325 NW 79 Ave. Miami, FL 33122 Phone: (305) 471.9552 • Fax: {305) 418.2154 North Mlami: 14700 Biscayne Blvd., North Miami Beach, FL 33181 Phone: (305) 940.0021 • Fax: (305) 9450024 West Palm Beach: 3500 45 Street, Suite 15, West Palm Beach, FL 33407 Phone: (581) 616-2223 • Fax: (501) 491 -1004 Warehouse: 7007 NW 30 ST MIAMI FL 33122 Phone: (305) 418 -8925 • Fax: (305) 716 -0160 Pompano: 1790 N. Powerline Rd. Pompano Beach, FL 33089 Phase: (954) 523 -6050 • Fax: (954) 823.8051 �•y Sales Order Page: 1 Order Number: 1487708 Order Date: 1/14/2012 Salesperson: DR • • Customer P.O.: Ship Via: Sales Tax Code: FL DA WhoDid: DR Sold To: MARITZA GAIQUI 1450 NE 11 STR Miami, FL 33138 Phone: (305) 332 -9950 01- 0124464 Ship To: MARITZA GAIQUI 1450 NE 11 STR Miami, FL 33138 ALL APPROVED SALE RETURNS WILL BE SUBJECT TO A RESTOCKING DEDUCTION OF 25% AND WILL BE PAID BY CHECK THE SECOND FRIDAY AFTER THE RETURN DATE. ABSOLUTELY NO RETURNS AFTER 15 DAYS Ordered Unit item Number/Descrlptlon Whse Price Amount 13.92 SF 51.48 SF 6.00 PC 0.00 W08- TRAVLUC24 004 3.59 TRANI AVORIO /60LUC 8X24 (10.56 SF)) P12- TRAVMAT 004 5.00 TRANI AVOR1O /60 PERSEO 12X12 (12.87 SF) MATTE L01- LUCMOK 004 28.00 LUCILLA MOKA/60 1X24 /FABR FABRICATION « <Bulinase for wall and for step curb »> « <BULLNOSE FOR FLOOR NEEDS TO BE FROM THE 12X12 MAT FINISHED AND THE POSITION OF THE BULLNOSES CHAN 000 .45c 00 P x' as v4 1. Merchandise must be returned to place of purchase. 2. Cash refunds will ba paid by check whhin f 0 business days by mall. PLEASE SEE OTHER TERMS ON BACK. X F l 440, els s,s� g 4041 to 4t QS��AO� 265.37 257.40 168.00 139.50 EXAMINE CAREFULLY COLOR TONE & CALIBER AS WE ARE NOT RESPONSIBLE ONCE THIS MATERIAL IS INSTALLED. WE WILL NOT GUARANTEE NOR ALLOW RETURNS OF MERCHANDISE ON SPECIAL SALES OR MARBLE PRODUCTS. NO GARANTIZAMOS NI ACEPTAMOS DEVOLUCIONES DE MERCANCIA EN VENTA ESPECIAL. I HAVE READ AND AGREE WITH ALL TERMS LISTED ON THE BACK OF THIS ORDER. 02/08/2012 NOVUS 888.39 Net Order: -Less Discount: Freight: Sales Tax: . Order Total: Less Deposit: Order Balance: 830,27 0.00 0.00 58.12 888.39 888:39 0.00 Tile and Marble - MIAMI SHOWROOM Customer information Street: Zip code: 33183 Cardholder Signature MARITZA PEREZ oitte if cSi" Transaction information i Date: Net Amount: 3325 NW 79 AVENUE Miami Florida 33122 305 - 471 -9552 a Sale 02/08/2012 1:28 PM $888.39 Card Number: ' * * * * * * * ** *1057 Merchant ID: Auth Code: Processed as: Reference No.: Trace No.: 498 00848R DISCOVER 1155544390 1006585763 Invoices Sri': 1487708 lb Response sg��,4pp,ved o9r Entry Methttfoo � t '� * Match CV: Matc�i�`C��+i�s� p Match AVS: I Agree to Pay Above Total Amount According to Card Issuer Agreement (Merchant Agreement if Credit Voucher). 4 CASA LINDAT1LE & MARBLE DIST. INC. 3435 N.W. 79th Ave. • Miami, FL 33122 Tel: 305-592-3200 • Fax: 305-593-2640 Toll Free: 1-800-683-0607 sr000esoct O PEREZ SAIQUI ,MARITZA L 306-332-9950 D MARITZAELE@AOL.COM T 1450 NE 101 ST o LMMI SHORE, FL 33138 J INVOICE S H PEREZ SAIQUI ,MARITZA 1 305-332-9950 MARITZAELEZAOL.COM T 1450 NE 101 ST O MIAMI SHORE, FL 33138 U.S.A. PAGE INVOICE NO. INVOICE DATE ■.! 1 7 80090 1/21/12 OVER PURCHASE ORDER NO. •.. ......: 81-HP VIA • • ..... :.. • : - • :•:.. 1 :::'. .:- •:.... •:i:::.% ...: ..:,: . •.:. .• • :.;;::::: :TERMS ....::.:::::::..i.- i. i.:::•:..!:..::.•:.:;... DATE SHIPPED SLMN i CUSTOMER • PICK TICKET. NO. •,.:•1.'. NO RETURNS PICK UP * *CASH-CREDIT CARD-CHECK* 1/21/12 2501 SOLD AS-IS/FINAL SALE * 100112-000 AL INSTRUCTIONS ORDERED QTY. SHIPPED SQ. FT. • , - REF. NO. . ITEM NO. : . ' .° .. - DESCRIPTION - PRICE UN AMOUNT •'. *** CUSTOMER UNDERSTANDS NO RETURNS WILL BE ACCEPTED*** . * SALE1CLEARANCE MERCHANDISE IS SOLD AS-IS/FINAL SALE * 00 198.00 EA .00 0A/P0/4 OA/P0/4 TE.M. 1.6150 EA 319.77 AMBAR ONYX POLISHED -4X4 . 4X4IN - SPECIAL ORDER 00 5.00 SH .00 OA/PO/MS/1 OA/P0/MS/1 TE.M. 20.0000 SH 100.00 AMBAR ONYX POLISHED 1X1 12X12IN -SPECIAL ORDER MESHED 1X1 MOSAIC 00 10.00 EA .00 135875 ONYX MOLDIN M.I. 6.3000 EA 63.00 CARAMEL ONYX PENCIL(360PC/) * IX12IN -CLEARANCE/FINAL HONED MOLDING 00 1.00 LF .00 079006 CUTS -MARB, FABRICATIO 1.5050 LF 1.51 lightly polish FABRICATION/LABOR FEE - 8 CUSTOMER'S SPECIFICATIONS tal /2r" V7 i • #oatc).1 g- , iect to terms and conditions printed on reverse side Customer signature: "-le '4 - SUB-TOTAL SHIPPING & HANDLING TAX • SUE-TOTAL . . DEPOSIT ' BALANCE DU ' . 484.28 .00 33.90 519.18 5113.18 .00 j OFFICE Diana Ramirez Account Executive Miami Showroom Main Warehouse 3326 NW 79th Ave. 8925 NW 27 Street Miami, FL 33122 Dural, FL 33172 T. 306.471.0562 % 305M8.8925 F: 306.418.2154 • F: 306.418.8297 C: 305.807.0401 dramlrez®usetlleand marbte.net usetl Ieendmarbie.net Miami Showroom: 3325 NW 79 Ave. Miami. FL 33122 Phone: (305) 471.9552 • Fax: (305) 418 -2154 North Miami: 14700 Biscayne Blvd., Noah Miami Beach, FL 33181 Phone: (305) 940-0021 • Fax (305) 945 -0024 West Palm Beach: 350045 Street, Suite 15, West Palm Beech, FL 33407 Phone: (561) 616-2223 • Fax: (561) 491 -1004 Warehouse: 7007 NW 30 ST MIAMI FL 33122. Phone: (305) 418-8.9-25* Fax (305) 716 -0160 Pompano: 1790 N. Powerline Rd. Pompano Beech, FL 33069 Phone: (954) 623-6050* Fax: (954) 623 -6051 01- 0124464 Quote Page: 1 Order Number: 1487708 Order Date: 1114/2012 Salesperson: DR Customer P.O.: Ship Via: Sales Tax Code: FL DA WhoDid: DR Ship To: MARITZA GAIOUI 1450 NE 11 STR Miami, FL 33138 (ILL BE SUBJECT 70 A RESTOCKING DEDUCTION OF 25% AND WILL BE PAID BY CHECK THE SECOND FRIDAY AFTER THE RETURN DATE. ABSOLUTELY NO RETURNS AFTER 15 DAYS m Number/Description Whse Price Amount • 1.00 SF 1.00 1.00 SF 0.00 0.00 W08-TRAVLUC24 -4--4 • TRANI AVORIO/60 LUC 8X24 (10.56 SF)) F7NIV -- r 4 1,-- L.LaMULKO gam• 004 9 724 r P 12 TRAVMAT - 004 6 �0 0'� L. TRANI AVORIO /60 PERSEO.12X12 (12.87 SF) MATE tf PC QM2.5 TAVAMI2 �:) 1 iz_. }�%� t'^4 • 004 Z.. T. TRAV. ANDES VAINILLA MOULDING CHAIR RAIL 2.5X12 /FABR FABRICATION FABRICATION BLLNOSE 4.5 XLF 1. Merchandise must be returned to place at purchase. 2. Cesh rehmde will be paid by check within 10 business days by mail. PLEASE SEE OTHER TERMS ON BACK. 001-A-P-obil=:- X 3.59 28.00 5.00 12.50 3.59 28.00 5.00 0.00 0.00 EXAMINE CAREFULLY COLOR TONE & CALIBER AS WE ARE NOT RESPONSIBLE ONCE THIS MATERIAL 1S INSTALLED. WE WILL NOT GUARANTEE NOR ALLOW RETURNS OF MERCHANDISE ON SPECIAL SALES OR MARBLE PRODUCTS. NO GARANTIZAMOS NI ACEPTAMOS DEVOLUCIONES DE MERCANCIA EN VENTA ESPECIAL 1 HAVE READ AND AGREE WITH ALL TERMS LISTED ON 11-40 BACK OF THIS ORDER. Net Order: Less Discount Freight Sales Tax Order Total: 36.59 0.00 0.00 2.57 39.16 DECEIVED MAR A 2 2(11Z $Y: 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: k 4 , v } r s4 i 1 44 � Cori` PERMIT # 12-'6% ' � � 11 •:4-1 / A ADDRESS: 1 �h o 4.1g. Ss--" D/ 25L f / e 3 f 3 g FOLIO NUMBER: FLOOD ZONE: BASE FLOOD ELEVATION: FREEBOARD: EAST OF FL.CCCL: COST OF PAST IMPROVEMENTS (12 MONTHS): 1, a a COST OF PROPOSED IMPROVEMENTS: (ATTACH COPY OF CONTRACT) TOTAL CUMULATIVE COST OF IMPROVEMENTS (past and proposed): 4)0 ei • .zo VALUE OF PRINCIPAL STRUCTURE (attach appraisal): PpviViz..4 Y Ar 14- 3E476✓ 6 )iE OWNERS SIGNATURE: /%� 1 `/ q.�° DATE: Cl -4 ;4)) PLANREVIEWER: PLAN REVIEWER SIGNATURE: DATE: Created on June 2009 Miami -Dade My Home My Home idlest e.go Show Me: Property Information Search By: Select Item g Text only 12 Property Appraiser Tax Estimator Property Appraiser Tax Comparison m Portability S.O.H. Calculator Summary Details: Folio No.: 11- 3205 -024 -0040 Property: 1450 NE 101 ST Mailing WACHOVIA BANK & Address: MARITZA GAIQUI Living Units: NATASHA GAIOIA Adj Sq Footage: GUARDIANSHIP Lot Size: C/O WACHOVIA BANK Year Built: FL0135/TAX UNIT JACKSONVILLE FL 32203 -0062 Property Information: Primary Zone: 1600 SINGLE FAMILY RESIDENCE CLUC: 0001 RESIDENTIAL - SINGLE FAMILY Beds /Baths: 3/2 Floors: 1 Living Units: 1 Adj Sq Footage: 3,608 Lot Size: 12,351.60 SO FT Year Built: 1954 MIAMI SHORES BAY PK ESTS AMD PB 56 -86 Legal LOT 8 BLK 1 LOT SIZE Description: 102.930 X 120 OR 13934 -1065 1288 1 OR 13934 -1065 1288 00 Assessment Information: Year: 2010 2009 Land Value: $742,356 $1,156,554 puilding Value: $437,642 $462,972 Market Value: $1,179,998$1,619,526 $500 Assessed Value: $525,159 $511,353 Exemation Information: Year: 2010 2009 Homestead: $25,000 $25,000 2nd Homestead: YES YES Disability: $500 $500 Taxable Value Information: Year: 2010 2009 Taxing Authority: Applied Exemption/ Taxable Value: Applied Exemption/ Taxable Value: Regional: $50,500/ $474,659 County: $50,500/ $474,659 $50,500/ $460,853 $50,500/ $460,853 City: $50,500/ $474,659 $50,500/ $460,853 Ghnnl Rnnrrl• $25,500/ $25,500/ Page 1 of 2 ACTIVE TOOL: SELECT Aerial Photography - 2009 0 116 ft My Home 1 Property Information 1 Property Taxes My Neighborhood 1 Property Appraiser Home 1 Using Our Site 1 Phone Directory 1 Privacy 1 Disclaimer If you experience technical difficulties with the Property Information application, or wish to send us your comments, questions or suggestions please email us at Webmaster. Web Site © 2002 Miami -Dade County. All rights reserved, ed Legend Property Boundary Selected Property Street Highway Miami -Dade County Water http: / /gisims2. miamidade .gov /MyHome /propmap.asp 8/1/2011 AIA Document MOT 2007 Standard Form of Agreement Between Owner and Contractor fora Project of Limited Scope AGREEMENT made as of the 4th day of January m the year 2012 (In words, indicate day, month and year:) BETWEEN the Owner (Name, legal status, address and other information) s Fargo Bank, NA & Maritza Gaiqui,'Co- Guardians. 145 ONE 141St rt Miami Shores, FL 33138 and the Contractors (Name, legal status, add ess and other infonna/ion) AGE OF EMPIRE Inc.' 226 SW 104th! Miami, FL 33174 for the following Project: (Name, location and detailed description) woodepifilerftosser- ,doff a %... &c aa. mi' aidilA �"�aa 1450 NE mist ;Miami Shores, FL 33138 Interior 1 Tome Renovation. The Architect: (;Name, legal status, address and other it motion) Mr. Arnold Villar 198 Terrace Miami, FL 33189 The Owner and Contractor agree as follows. See attached scope of work. This docurrient has ttnportarrt legal consequences, Consultation with an attt rney is encouraged with respect to its completion or modlficatioi . 0, A1' 6,44 *4 4 AIA Document A107 r4. — 2007. Copyright © 1936.1951,1958,1961,1963,1966, 1070, 1974, 1979, 1987, 1997 and 2007 by The Amsrlcen Institute of Architects. WANING: Ills Ate Document Is protected ty t,i.9. c opyripht Law and international Treaties. Unearthed:rad rapredectlon or tilstribution of this At, l ocarne , or eny portion of it, may result in severe civil and criminal penalties, and wilt be prosecuted to the !workman extant posstble under the law. Thts document was created on 01104/2012 10:56:30 under th a ternisof AIA Documents-or.-Demand' no. 2009388506 , and is not for resale. This document is tensed by The American Institute of Architeetsior tine -Grin usa only, and may not be reproduced prior to fts completion, tar5ioano4a TABLE OF ARTICLES 1 THE WORK OF THIS CONTRACT 2 3 4 5 6 8 9 10 11 12 13 14 15 16 17 18 19 20 21 DATE OF COMMENCEMENT AND SUBSTANTIAL COMPLETION CONTRACT SUM PAYMENT DISPUTE RESOLUTION ENUMERATION OF CONTRACT DOCUMENTS GENERAL PROVISIONS OWNER CONTRACTOR ARCHITECT SUBCONTRACTORS CONSTRUCTION BY OWNER OR BY SEPARATE CONTRACTORS CHANGES IN THE WORK TIME PAYMENTS AND COMPLETION PROTECTION OF PERSONS AND PROPERTY INSURANCE & BONDS CORRECTION OF WORK MISCELLANEOUS PROVISIONS TERMINATION OF THE CONTRACT CLAIMS AND DISPUTES ARTICLE 1 THE WORK OF THIS CONTRACT The Contractor shall execute the Work described in the Contract Documents, except as specifically indicated in the Contract Documents to be the responsibility ofothers. ARTICLE 2 DATE OF COMMENCEMENT AND SUBSTANTIAL COMPLETION § 2.1 The date of commencement of the Work shall be the date of this Agreement unless a different date is stated below or provision is made for the date to be fixed in a notice to proceed issued by the Owner. (insert the date of contntencement, tilt differs front the date of this Agreement or, if applicable, state that the date will be fixed in a ,notice to proceed) The Date of Commencement shall be the filing of the Notice of at the city ofMtami.Shores 2.2 The Contract Time shall be measured from the date of commencement. AIA Document A107TM —2007. Copyright ® 1936, 1951, 1968, 1961, 1963 ,1966,1970,1974,1978,1987,1997 and 2007 by The American Institute of Architects, WARNING: `Plots AIAe Doeuonent is protected by IJ.S. Copyright law and intarnnttottal Treaties. Unauthorized reproduction or distribution of We AIAeDocurnent, or any portion of It, tray result in severe chr i and criminal wattles, and wlii t prosecuted to the maim= Meat possible under the law. This document was created on 01/041 201210:58:30 under the terms of AKA Documents -on- Demand," order no. 2008388508 , and is not for resale. This document Is Ncansed by The American institute of Architects for one -time use only, and may not be produced prior Jolts completion. § 2.3 The Contractor shall achieve Substantial Completion of the entire Work not later than Ninety Working ( 90 ) days from the date of commencement, or as follows: (Insert number of calendar days Alternatively, a calendar date may be used when coordinated with the date of commencement. if appropriate, insert requirementsfor earlier Substantial Completion of certain portions of the Work) Portion of 'Work Substantial Completion Date See attached Scope of Wo rk A107.1 Ninety (90) working days from filing of Notice of Commencement, subject to adjustments of this Contract Time as provided in the Contr t Documents. (,Insert provisions, if any, for liquidated damages relating to f tlure t achieve Substantial Completion on bore oaf or bonus payttrentsfor early completion of r' If from the Nofice of Commencement is�com__p1ete wit in the Ninety (90) working days for scope identified, a penalty of 100.00 per day will be assessed. ARTICLE 3 CONTRACT SDNI § 3.1 The Owner Mall pay the Contractor the Contract Sum in current funds for the Contractor's performance of the Contract. The Contract Sufa shall be one of the following: (Check the appropriate box) Stipulated Sum, in accordance with Section 3.2 below ❑ Cost of the Work plus the Contractor's Fee, in accordance with Section 3.3 below O Cost of Work plus the Contractor's Fee with a Guaranteed Maximum Price, in accordance with ection 3.4 below (Based on the selection above, cons ete' Section 3.2, 3.3 or 3.4 below) § 3.2 The Stipulated Sum shall be t 0' tO 15 .2-0 eitiaelitullirettand Sbr iHtodt ltl eadlaTwaatt y n 0111210 ), subject to additions and deductions as provided in the Contract Documents. § 32,1 The Stipulated Sum is based upon the following alternates, if any, which are described in the Contact Documents and are hereby accepted by the Owner: (State the numbers or other identification of accepted alternates If the bidding or proposal documents permit the Owner to accept other alternates subsequent to the execution of this Agreement, attach a schedule oaf such other alternates showing the amount for each and the date when that amount expires) NOT APPLICABLE init.` utnent m07,. — 2007. Copyright tit 1938,1951,1958 ,1961,1993,1986,1970,1674,1976,190, '1997 end 2007 by he American institute of . WAf;NING: Vita AIAsDocument is precluded bit #J"'S.1 fp t Law and tntarnetion' Treettes. Upauthortzed reproduction► or utlon of AIWA i unteat or any paitlon of doney result in severe eivii and cdndnat penalties, and will be prosecuted to tl}o nmxbmen: at possible tho lew Thie document was treated on 01104/201210:58 :30 undertthe terms ofA A Dar umefits on.,Liemandut Order 2008388506 , midis not for resets. Tills document la loomed by American institute ofArchtects for one -time use only, and may not bs reproduced later tolts contpi an. § 3.2,2 Unit prices, if any: (Ideng& and state the unit price, and the quantity limitations, )Parry, to whic Item NOT APPLICABLE Units and Limitations §3.2.3 Allowances included in the Stipulated Sum, if any: (1dentl fy allowance acrd state exclusions, Zany, from the allowance price.) Item NOT APPLICABLE Allowance Ire unit price will be applicable) Price per Unit ($0.00) § 3.3 Cost of the Work Plus Con actor's Fee § 3.3.1 The Cost of the Work is as defined in Exhibit A, Determination of the Cost ofthe Work. § 3.3.2 The Contractor's Fee: (State a lump sum, percentage ofCost ofthe Work or other for determining the Contractor's Fee and the method of a�{jtrstmenttothe Feefor changes in the Work) NOT APPLICABLE § 3.4 Cost of the Work Plus Contractor's Fee With a Guaranteed Maximum Price § 3.4.1 The Cost of the Work is as defined in Exhibit A, Determination ofthe Cost of Work. § 3.4.2 The Contractor's' Fee: (State a hump suin, percentage of Cost of the iVork or other provision for determining the Contractor's Fee and the method ofadjustmeut to the Fee for changes in the Work) NOT APPLICABLE § 3.4.3 Guaranteed Maximum Price § 3.4.3,1 The sum of the Cost of the Work and the Coniiactor's Fee is guaranteed by the Contractor not to exceed ($ ), subject to additions and deductions by changes in the Work as provided in the Contract Documents. Such maximum sum is referred to in the Contract Documents as the Guaranteed Maximum Price. Costs which would cause the Guaranteed Maximum Price to be exceeded shall be paid by the Contractor without reimbursement by the Owner. (Insert specific provisions if the Contractor is to participate in airy savings) NOT APPLICABLE Init. AIA Document A107'"' —2007 Copyright @ 1936,1951,1958,1981,1983 ,1868,1970,1974.1978,1987.1997 and 2007 by The American Institute-of Architects. wAlitHINS: This AIA'Documitot te protected by U.S. Copyright Lew and International Treaties. unauthorized reproduction or dlstribittion of this Aletiocument, or any p rtioat of It, may result in severe civil and criminal penalties, and will In prosecuted to the maxim= extent possible under the law. This document was created on 01/0412012 10:56:30 under the terms of AIA Documenis•on- DernandTM order no. 2008398506 , and Is not for resale. This document is licensed by The American Institute of Architects for one -brine use only, end may not be reproduced prior torts completion. § 3.4.3.2 TThe Guaranteed Maximum Price is based on the Ilowing alternates, fany, which are described in the Con Documents and are hereby accepted by the Owner: NOT APPLICABLE 3.4.3.3 Unit Prices, if any: (Ident jy and state the unit price, and state the quantity limitations, if any, to which the unit price will be ql plieable) Item NOT APPLICABLE § Init. Units and Limitations Price per Unit 00.00J 3.4.3.4 Allowances included in the Guaranteed. Maximum Price, if any: (Ident and state the amounts of any allowances, and state whether they include labor, materials, or both.} Item NOT APPLICABLE Aliowance § 3.4.3.5 Assumptions, if any, on which the Guaranteed !Maximum Price is based: NOT APPLICABLE ARTICLE 4 PAYMENTS § 4.1 Progress Payments § 4.1.1 Based upon Applications for Payment submitted to the Architect by the Contractor and Certificates for Payment issued by the Architect, the Owner shall make progress payments, on account of the Contract Sum to the Contractor as provided below and elsewhere in the Contract Documents. 41.2 The period covered by each Application for Payment shall be one calendar month ending on the last day o, onth, or as follows: Payment shall be made every fifteen (15) ndar days or Twice (2} a month. § 4.1.3 Provided that an Application for Payment is received by the Architect not tt t later than the st & 1 ? day of a month, the Owner shall make payment of the certified amount to the Contractor not later than the 1 lth & 25th day of the Same month. If an Application for Payment is received by the Architect after the date fixed above, payment shall be made by the Owner not later than Not Applicable ( ) days after the Architect receives the Application for Payment. (Federal, state or local laws may require payment within a certain period of ti, ie) • AIA Document A107*" — 2007. copyright 01936,1951,1958,1961,1963, 1966,1970,1974,1978,1987,1997 and 2007 by The American Institute of Architects. 1NO: ibis AlAs Document is protected by 1.10. Copyright Law and international 'treaties. unauthorized reproduction or distribution of thls AIAeaocument, or an may resutt kn severe awn and criminal partaitles. and -wilt be pressured to the me.tmam y pgrtton of ft, extent possible under the law. This document was created an 01/04!201210 :56:30 tinderr the terms of Qocu ents- ort•Demandm order no. 20006386506 , and is not for resale. This document Is licensed by The Amedaan Institute of Archlects for one -time use only; and may not be reproduced prior to its completion._ 5 § 4.1.4 Retainage, ifany, shall be withheld as follows: There will be a zero (0) percent retainage for this contract. § 4.1.5 Payments due and unpaid under the Contract shall bear interest orn the date payment is due at the rate stated below, or in the absence thereof, at the legal rate prevailing from time to time at the place where the Project is located. (Insert rate of interest agreed upon, ifany.) There will be a 0% interest rate for late payments. § 4.2 Final Payment § 4.2.1 Final payment, constituting the entire unpaid balance oldie Contract Sum, shall be made by the Owner to the Contractor when .1 the Contractor has fully performed the Contract except for the Contractor's responsibility to correct Work as provided in Section 18.2, and to satisfy other requirements, if any, which extend beyond final payments .2 the contractor has submitted a final accounting for the Cost of the Work, where payment is on the basis of the Cost of the Work with or without a guaranteed maximum price; and .3 a final Certificate for Payment has been issued by the Architect« § 4.2.2 The Owner's final payment to the Contractor shall be made no later than 30 days after the issuance of the Architect's final Certificate for Payment, or as follows: Final Releases of liens, & Finalized Master Permit. ARTICLE 5 DISPUTE RESOLUTION § 5.1 Binding Dispute Resolution For any claim subject to, but not resolved by, mediation pursuant to Section 21.3, the method of binding dispute resolution shall be as follows: (Check the appropriate box. If the Owner and Contractor do not select a method of binding dispute resolution helms', or do not subsequently agree in wriling to a binding dispute resolution method other than litigation claims will be resoh.ed in a court of competent ) fthi Arbitration pursuant to Section 214 of this Agreement 0 Litigation in a court of competent jurisdiction 0 Other: (Spec/6') ..................... ARTICLE 6 ENUMERATION OF CONTRACT DOCUMENTS § 6.1 The Contract Documents are defined in Article 7 and except for Modifications issued after execution of is Agreement, are enumerated in the sections below, § 6.1.1 The Agreement is this executed A A Doen rent A107-2007, Standard Form of Agreement Between. Owner and Contractor for a Project of Limited Scope. AMA Document A107", —2007. copyright 1935,1951,1958,1981,1953,1958 1970.1974.1978,1987,1997 and 2007 by The American Iastitufe of Architects. iiitAftilligOr This Atellocumeni is protected by U.B. Copyright Law and irttornettorial Trtnities. unauthorised reproduction or dishibuIion of this AIA' Document, or any portion of b, may mutt in severe civil and criminal- penalties, end uuNI be prosecuted to the rum ratan: extent possible under the kw. This document was created on 01/04/201210:85:30 under the terms of AIA Documents.on•Demand'" order no. 2008388688 and is not for resale. This document is licensed by The American institute of Architects for ono -9nte use only. and may not be reproduced prior to its completion. § 6.1.2 The Supplementary and other Conditions of the Contract: Document Title NOT APPLICABLE Date Pages § 6.1.3 The Specifications: (Either list the Specifications here or refer to an exhibit necked to this Agreement) Section NOT .APPLICABLE ............... Title § 6.1.4 The Drawings: (Either list the Drawings liege Number M -1 M -2 M-3 E -1 E-2 § 6.1.6 The Addenda, if any: Date Pages exhibit attached to this Agreetnettt.) Tide Date Mechanical January 13, 2012 Mechanical January 13, 2012 Mechanical January 13, 2012 Electrical January 13, 2012 Electrical January 13., 2012 Number Date Pages NOT APPLICABLE Portions of Addenda relating to bidding requirements are not part of the Contract Documents unless the bidding requirements are enumerated in this Article 6. § 6.1.6 Additional documents, if any, forming part of the Contract Documents: .1 Exhibit A, Determination of Cost of the Work, if applicable. .2 AIA Document E201 T 2007, Digital Data Protocol Exhibit, if completed, or the following :: A Document A10704 2007. Copyright 5) 1936,1951,1858,1961,1863 ,1866.1970,1974,1978,1987,1997 and 2007 by The American institute of Architects. d: This Ale Docu ent 1$ protected by U.S. Copyright Law and le.#ettrat;zrietYreaties. -Unauthorized mfgoduallOn or MatrlIndlon of this Ale Document, or any portion of it, may result In severe otvii rin+ti or nnivat penalties, end will be prosecutors to the rnmdm T. +M old Posorofe under . the lazy. Thisdoeument was created on 01/0412012 10:56:30 under the terms of AKA Bocumenfs- on- Demandv order no. 2808388508 ; and is not for ems. This document is licensed by The American institute of Architects for ono -time use only, and may not be reproduced prior tolls cocnpieticn. .3 Other documents. (List here any additional documents that are intended tofu ►n part of the Contract Ar;:cutttents) SCOPE OF WORK A107.1 ARTICLE 7 GENERAL PROVISIONS § 7.1 The Contract Documents The Contract Documents are enumerated in Article 6 and consist of this' Agreement (including, ifnpplicable, Supplementary; and other Conditions of the Contract), Drawings, Specifications, Addenda issued prior to the execution of this Agreement, other cleeements listed in this Agreement and Modifications issued after execution of this Agreement. A Modification is (1) a written amendment to the Contract signed by both parties, (2) a Change Order, (3) a Construction Change Directive or (4) a written order for a minor change in the Work issued by the Architect The intent of the Contract Documents is to include all items necessary for the proper execution and completion of the Work by the Contractor. The Contract Documents are complementary, and what is required. by one shall be as binding as if required by all; performance by the Contractor shall be required to the extent consistent with the Contract Documents and reasonably inferable from them as being necessary to produce the indicated results. § 7.2 The Contract The Contract Documents form the Contract for Construction. The Contract represents the entire and integrated agreement between the patties hereto and supersedes prior negotiations, representations or agreements, either written, or Aral. The Contract maybe amended or modified only by a Modification. The Contract Documents shall not be construed to create a contractual relationship of any .kind between any persons or entities other than the Owner and the Contractor. § 7.3 The Work The term "Work" means the construction and services required by the Contract Documents, whether completed or partially completed, and includes all other labor, materials, equipment and services' provided or to be provided by the Contractor to fulfill the Contractor's obligations. The Work may constitute the whole or a part of the Project. § 7.4lnstruments of Service Instruments of Service are representations, in any medium of expression now known or later developed, of the tangible and intangible creative work performed by the Architect and the Architect's consultants under their respective professional services agreements. Instruments ofService may include, without limitation, studies, surveys, models, sketches, drawings, specifications, and other similar materials. § 7.5 Ownership and Use of Drawrings, Specifications and Other Instruments of Service § 7.5.1 The Architect and the Architect's consultants shall be deemed the authors and owners of their respective Instruments of Service, including the Drawings and Specifications, and will retain all common law, statutory and other reserved rights, including copyrights, The Contractor, Subcontractors, Sub- subcontractors, and material or equipment suppliers shall not own or claim a copyright in the Instruments of Service. Submittal or distribution to meet official regulatory requirements' or for other purposes in connection with this Project is not to be construed as publication in derogation of the Architect's or Architect's consultants' reserved rights. 7.5.2 The Contractor, Subcontractors, Sub - subcontractors and material or equipment suppliers are authorized to lase and reproduce the Instruments of Service provided to theta solely and exclusively for execution of the Work. All copies made under this authorization shall bear the copyright notice, if any, shown on the instruments of Service. The Contractor, Subcontractors, Sub - subcontractors, and material or equipment suppliers may not use the Instruments of Service on other projects or for additions to this Project outside the scope of the Work without the specific written consent of the Owner, Architect and the Architect's consultants. § 7.6 Transmission of Data in Digital Form lithe parties intend to transmit Instruments of Service or any other information or documentation in digital form, they shall endeavor to establish necessary protocols governing such transmission, unless <otherwise provided in the Agreement or in the Contract Documents. 1 A Document A1077, -.2007. Copyright 0 1936,1951,1958,1861 ,1963,1966,1970,1974,1978,1987, 't897 and 2007 by The American Institute of Architects. WARNING: This AIA Document Is protected U.S. Copyright and international Tres tles. Unilutherized reproduction or distribution of this AIA°rtocumeni or any whoa of it may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the tally. Thus document was created on 011041201210:58:30 under the terms of AIA Documents -on- Demand's^ order no. 2008388506 , and is not for resale. This document is licensed by The American Institute of Architects for one time use only, and may not be reproduced prior to its completion. ARTICLE 8 OWNER § 8.1 Information and Service$ Required of the Owner § 8.1.1 The Owner shalt furnish all necessary surveys and a legal description of the site; § 8.1.2 The Contractor shall be entitled to rely on the accuracy of information furnished by the Owner but shall exercise proper precautions relating to the safe performance of the Work. § 8.1.3 Except for permits and fees that are the responsiibility of the Contractor under the Contract Documents, including those required under Section 9.6,1, the Owner shall secure and pay for otherrnecessary approvals, easements, assessments and charges required for the construction, use or occupancy ofpermanent structures or for permanent changes in existing facilities. § 8.2 Owner's Right to Stop the Work lithe Contractor fails to correct Work which is not in accordance ~with the requirements oldie Contract Documents, or repeatedly fails to carry out the Work in accordance with the Contract Documents, the Owner may issue a written order to the Contractor to stop the Work, or any portion thereof; until the cause for such order is eliminated; however, the right the Owner to stop the Work shall not give rise to a duty on the part ofthe Owner to exercise this right for the benefit of the Contractor or any other person or entity. § 8.3 Owner's Right to Carry Out the Work lithe Contractor defaults or neglects to carry out the Work in accordance with the Contract Documents, and fails within a ten -day period after receipt of written notice from the Owner to commence and continue correction of such default or neglect with diligence and promptness, the Owner, without prejudice to any other remedy the Owner may have, may f such deficiencies and may deduct the reasonable cost thereof, including Owner's expenses and compensation for the Architect's services made necessary thereby, from the payment then or thereafter due the Contractor. ARTICLE 9 CONTRACTOR § 9.1 Review of Contract Documents and Field Conditions by Contractor § 9.1.1 Execution of the Contract by the Contractor is a representation that the Contractor has visited the site, become generally familiar with local conditions under which the Work is to beperfonned and correlated personal observations with requirements of the Contract Documents. § 9.1.2 Bemuse the Contract Documents are complementary, the Contractor shall, before starting each portion of-the Work; carefully study and compare the various Contract Documents relative to that portion of the Work, as well as the information furnished by the Owner pursuant to Section 8.1.1, shall take field measurements of any existing conditions related to that portion of the Work and shall observe any conditions at the site affecting it. These obligations are for the purpose of facilitating coordination and construction by the Contractor and are not for the purpose of discovering errors, omissions, or inconsistencies in the Contract Documents; however, the Contractor shall promptly report to the Architect any errors, inconsistencies, or omissions discovered by or made known to the Contractor as a request for information in such form as the Architect may require. It is recognized that the Contractor's review is made in the Contractor's capacity as contractor and not as a licensed design professional unless otherwise specifically provided in the Contract Documents. § 91.3' The Contractor is not required to ascertain that the Contract Documents are in accordance with applicable laws, statutes, ordinances, codes, rules and regulations, or lawful orders of public authorities, but the Contractor shall promptly report to the Architect any nonconformity discovered by or made known to the Contractor as a request for information in such form as the Architect may require, § 9,2 Supervision and Construction Procedures 92.1 The Contractor shall supervise and direct the Work, using the Contractor's best skill and attention. The Contractor shall be solely responsible for and have control over construction means, methods, techniques, sequences and procedures, and for coordinating all portions of the Work under the Contract, unless the Contract Documents give other specific instructions concerning these matters, 2 The Contractor shall be responsible to the Owner for acts and omissions of the Contractor's employees, Subcontractors and their agents and employees, and other persons or entities performing portions of the Work fo . behalf of the Contractor or any of its Subcontractors. Init. r Document A107"" — 2007. Copyright@ 1936,1951,1958,1981,19 03,1960,1870,1974,1978,1987,1997 and 2007 by The American inalitide *l Architects. WAfttliffik Thie AIA�Oonument Is protected by I1,S. Copyright Law and lutenist 1 Tr . unauthorized reproducliplt of distribution ands this AlAeCoeumant, or any portion of it may result In severe civil and miming penalties, and will be prosecute :1 tit tpte €ha'imurf extent possible ender 'helm This document was crested on 011041201210:56:30 under the terms °I AA Docurnents on t)emand"" order no. 2008388508 , and is not for resale This document Is licensed by The American Institute of Architects for one-time use only, and tway notbe reproduced prior to its completion. § 9.3 Labor and Materials § 9.3.1 Unless otherwise provided in the Contract Documents, the Contractor shall provide and pay for labor, materials, equipment, tools, construction equipment and machinery, water, heat, utilities, transportation, and other facilities and services necessary for proper execution and completion of the Work whether temporary or permanent and whether or not incorporated or to be incorporated in the Work. § 9.3.2 The Contractor shall enforce strict discipline and good order among the Contractor's employees and other persons carrying out the Work, The Contractor shall not permit employment of unfit persons or persons not skilled in tasks assigned to them. § 9.3.3 The Contractor may make a substitution only with the consent of the Owner, after evaluation by the Architect and in accordance with a Modification. § 9.4 Warranty The Contractor warrants to the Owner and Architect that materials and equipment furnished under the Contract will be of good quality and new unless the Contract Documents require or permit otherwise. The Contractor further warrants that the Work will conform to the requirements of the Contract Documents and will be free from ducts, except for those inherent in the quality of the Work the Contract Documents require or permit. Work, materials, or equipment not conforming to these reg urements may be considered defective. The Contractor's warranty excludes remedy for damage or defect caused by abuse, alterations to the Work not executed by the Contractor, improper or insufficient maintenance improper operation or normal wear and tear under normal usage. § 9.5 Taxes The Contractor shall pay sales, consumer, use and other similar taxes that are legally enacted when bids are received or negotiations concluded, whether or not yet effective or merely scheduled to go into effect. § 9.6 Permits, Fees, Notices, and Compliance with Laws § 9.6.1 Unless otherwise provided in the Contract Documents, the Contractor shall secure and pay for the building permit as well as other permits, fees, licenses and inspections by government agencies necessary for proper execution and completion of the Work that are customarily secured after execution of the Contract and legally required at the time bids are received or negotiations concluded; § 96.2 The Contractor shall comply with and give notices required by applicable laws, statutes, ordinances, codes, rules and regulations, and lawful orders of public authorities applicable to performance of the Work. if the Contractor performs Work knowing it to be contrary to applicable laws, statutes, ordinances, codes, rules andregulations, or lawful orders of public authorities, the Contractor shall assume appropriate responsibility for such Work and shall bear the costs attributable to correction. § 9.7 Allowances The Contractor shall include in the Contract Sum all allowances stated in the Contract Documents. The Owner shall select materials and .equipment under allowances with reasonable promptness. Allowance amounts shall include the costs to the Contractor of materials and equipment delivered at the site and all required taxes, less applicable trade discounts. Allowance amounts shall not include the Contractor's costs for unloading and handling at the site, labor, installation, overhead, and profit § 9.8 Contractor's Construction Schedules § 9.8.1 The Contractor,;:promptly after being awarded the Contract, shall prepare and submit for the Owner's and Architect's inf onuatien a Contractor's construction schedule for the Work. The schedule shall not exceed time limits current under the Contract Documents, shall be revised at appropriate intervals as required by the conditions of the Work and Project, shall be related to the entire Project to the extent required by the Contract Documents, and shall provide for expeditious and practicable execution of the Work. § 9.8.2 The Contractor shall perform the Work in general accordance with the most recent schedule submitted to the Owner and Architect. § 9.9 Submittals § 9.9.1 The Contractor shall review for compliance with the Contract Documents and submit to the Architect Shop Drawings, Product Data, Samples and similar submittals required by the Contract Document$ in coordination with the Contractor's construction schedule and hi such sequence as to allow the Architect reasonable time for review. By JA Document A107'"' •2007. Co pyright 9838 ,1951,1858,1861,1963,1866,1870, 1874,1878,1887,1987 and 2007 by The American institute of ordc---' pik Arehlects. WARNING: This AtA' Document is protected by U.S. Copyright Law and lniermtionel Inseam Unauthorized rem'oductica or distribution of this AiAr'Document, or any portion of it, may result to severe civil and criminal penalties, arid will be prosecuted to the oundetum 1 extent possible under the law. This document Was created on 0110+1201210:56:30 under Motors of AIA Documents- on- bemand"! order r o. 2008385508 , end is not for resale. This document is licensed by The American Institute of Architects for onetirnouse only, and may. not be reproduced prior tilts completion. submitting Shop Drawings, Product Data Samples and similar submittals, the Contractor represents to the Owner and Architect that the Contractor has (1) reviewed and approved them; (2) determined and verified materials, field measurements and field construction criteria related thereto, or will do so; and (3) checked and coordinated the information contained within such submittals with the requirements of the Work and of the contract Documents. The Work shall be in accordance with approved submittals. § 9.92 Shop Drawings, Product Data Samples and similar submittals are not Contract Documents. § 9.10 Use of Site The Contractor shall co mitre operations at the site to areas permitted by applicable laws, statutes, ordinances, codes, rules and regulations, lawful orders of authorities, and the Contract Documents and shall not unreasonably encumber the site with materials or equipment. § 9.11 Cutting and Patching The Contractor shall be responsible for cutting, fitting or patching required to complete the Work or to make parts fit together properly. § 9.12 Cleaning Up ., The Contractor shall keep the premises and surrounding area free from accumulation of waste materials or rubbish caused by operations under the Contract. At completion of the Work, the Contractor shall remove waste materials, rubbish, the Contractor's tolls, construction equipment, machinery and surplus material from and about the Project. § 9.13 Royalties, Patents and Copyrights NOT APPLICABLE The Contractor shall pay all royalties and license fees. The Contractor shall defend suits or claims for infringement of copyrights and patent rights and shall hold the Owner and Architect harmless from loss on account thereof, but shall not be responsible for such defense or loss when a particular design, process or product ofa particular manufacturer or manufacturers is required by the Contract Documents or where the copyright violations are contained in Drawings, Specifications or other documents prepared by the Owner or Architect. However, lithe Contractor has reason to believe that the required design, process or product is an infringement ofa copyright or a patent, the Contractor shall be responsible for such loss unless such information is promptly furnished to the Architect. § 9.14 Access to Work The Contractor shall provide the Owner and Architect access to the Work in preparation and progress wherever located.. § 9.15 Indemnification § 9.15.1 To the fullest extent permitted by law, the Contractor shall indemnify and hold harmless the Owner, Architect, Architect's consultants and agents and employees of any of from and against claims, damages, losses and expenses, including but not limited to attorneys' fees, arising out of or resulting from performance of the Work, provided that such claim, damage, loss or expense is attributable to bodily injury, sickness, disease or death, or to injury to or destruction of tangible property (other than the Work itself), but only to the extent caused by the negligent acts or omissions of the Contractor, a Subcontractor, anyone directly or indirectly employed by their or anyone for whose acts they may be liable; regardless of whether or not such claim, damage, loss or expense is caused in part by a party indemnified hereunder. Such obligation shall not be construed to negate, abridge, or reduce other rights or obligations of indemnity which would otherwise exist as to a party or person described in this Section 9.15.1. § 9.15.2 In claims against any person or entity indemnified under this Section 9.15 by an employee of the Contractor, a Subcontractor, anyone directly or indirectly employed by them or anyone for whose acts they may be liable, the indemnification obligation under Section 9.15.1 shall not be limited by a limitation on amount or type of damages, compensation or benefits payable by or for the Contractor or Subcontractor under workers' compensation acts; disability benefit acts or other employee benefit acts. ARTICLE 10 ARCHITECT § 10.1 The Architect will provide administration of the Contract and will be an Owner's representative during construction, until the date the Architect issues the final Certificate for Payment. The Architect will have authority to act on behalf the to the of extent in the Contract Documents, unless otherwise modified in writing in accordance § 10.2 The Architect will visit the site at intervals appropriate to the stage of the construction to become generally familiar with the progress and quality of portion of the Work completed, and to determine in general, if the Work observed is AIA Document Al 07'm —2007. Copyright! 1838,1951,1958,1961,1969,1966, 1970,1874,1978,1887,1997 and 2007 by The American institute s. WARNING: This AIAeDocumant Is protected by U.S. Copyright 1.aw andluternetuanal Tmalies. Unauthorised seproduado i or distrtbudon of this Dom/want, or any portion of it, may result in severe civil and criminal' pastas, and will be prosecuted to the truth um extent possible under tits law. This document was treated on 01104!201210:56 :30 under theterms of AlA comments -nn t)emandm order no. 2008388506 , and is not for resale. This document is lCerreed by The American Institute of Architects for one•time use only, and may not be reproduced prior to its completion. being performed in amanner indicating that the Work, when fully completed, will be in accordance with the Contract Documents. However, the Architect will not be required to make exhaustive or continuous on -site inspections to cheek the quality or quantity ofthe Work. The Architect willnot have oontrol over, charge of, or responsibility for, the construction means, methods, techniques, sequences or procedures, or for safety precautions and programs in connection with the Work, since these are solely the'Contractorr's rights and responsibilities under the Contract Documents. § 10.3 On the basis ofthe site visits, the Architect will keep the Owner reasonably informed about the progress and quality of the portion ofthe Work completed, and report to the Owner (1) known deviations from the Contract Documents and from the most recent construction schedule submitted by the Contractor, and (2) defects and deficiencies observed in the Work. The Architect will not be responsible for the Contractor's failure to perform the .................... Work in accordance with the requirements of the Contract Documents. The Architect will not have control over or charge of and will not be responsible for acts or omissions of the Contractor, Subcontractors, or their agents or employees, or any other persons or entities performing portions of the Work. 10.4 Based on the Architect's evaluations of the Work and of the Contractor's Applications for Payment, the Architect will review and certify the amounts due the Contractor and will issue Certificates for Payment in such amounts. § 10.5 The Architect has authority to reject Work that does not conform to the Contract Documents and to require inspection or testing of the Work. § 10.6 The Architect will review and approve or take other appropriate action upon the Contractor's submittals such as Shop Drawings, Product Data and Samples, but only for the limited purpose of checking for eonforntance with information given and the design concept expressed in the Contract Documents. 410.1 The Architect will interpret and decide matters concerning performance under, and requirements of, the Contract Documents on written request of either the Owner or Contractor. The Architect will make initial decisions on all claim s disputes and other matters in question between the Owner and Contractor but will not be liable for results of interpretations or decisions rendered in good faith.. $10.8 The Architect's decisions on matters relating to aesthetic effect will be final if consistent with the intent expressed in the Contract Documents. § 10.9 Duties, responsibilities and limitations of authority of the Architect as set forth in the, Contract DocumeConsent nts shall not be restricted, modified or extended without written consent of the Owner, Contractor and Architect. not be unreasonably withheld. ARTICLE 11 SUBCONTRACTORS § 11.1 A Subcontractor is a person or entity who has a direct contract with the Contractor to perform -a portion of the Work at the site. § 11.2 Unless otherwise stated in the Contract Documents or the bidding requirements, the Contractor, as soon as practicable after award of the Contract, shall furnish in writing to the Owner through the Architect the names of the Subcontractors or suppliers for each of the principal portions ofthe Work. The Contractor shall not contract with any Subcontractor or supplier to whom the Owner or Architect has made reasonable written objection within ten days after receipt ofthe Contractor's list of Subcontractors and suppliers. if the proposed but rejected Subcontractor was reasonably capable of perfonning the Work, the Contract Sum and Contract Time shall be increased or decreased by the difference, if any, occasioned by such change, and an appropriate Change Order shall be issued before commencement of the substitute Subcontractor's Work. The Contractor shall not be required to eontract with anyone to whom the Contractor has made reasonable objection. § 11.3 Contracts between the Contractor and Subcontractors shall (1) require each Subcontractor, to the extent ofthe Work to be performed by the Subcontractor, to be bound to the Contractor by the terms ofthe Contract Documents, and n assume toward the Contractor all the obligations and responsibilities, including the responsibility for safety of the Subcontractor's Work, which the Contractor, by the Contract Documents, assumes toward the Owner and Architect, and (2) allow the Subcontractor the benefit of all rights, remedies and redress against the Contractor that the Contractor, by these Contract Documents, has against the Owner. Document A107TM —2007. Copyright @ 193$,1951,1958,1961,1983,1806, 1970, 1974, 1878,1987, 1997 and 2007 WIND American institute of Architects. WARidit e: title AIA' Der ufnent is protected by 03 Ought Lew and international Treatise. Unauthorized reproduction er dletribai ofthis AtA Document, or any portion of may result In Severs Viiin and criminal- penalties, and will be prosecuted to the maxims extent possible under the taw. This document was created on 011041201210:58:30 under the leans of AIA Documents-on-Demential order no. 2008388500 , end is not for resole. This document Is licensed by The American institute of Architects for one-lime use only, end may not be reproduced prior to Its Completion. ARTICLE 12 CONSTRUCTION BY OWNER OR BY SEPARATE CONTRACTORS § 12.1 The Owner reserves the right to perform construction or operations related to the Project with the Owner's own forces, and to award separate contracts in connection with other portions of the Project or other costruction or operations on the site under conditions of the contract identical or substantially similar to these, including those portions related to insurance and waiver of subrogation. If the Contractor claims that delay or additional cost is involved because of *retraction by the Owner, the Contractor shall make such claim as provided in Article 21. § 12:2 The Contractor shall afford the Owner and separate contractors reasonable opportunity for introduction and storage of their materials and equipment and performance of their activities, and shall connect and coordinate the Contractor's activities with theirs as required by the Contract Documents. § 12.3 The Owner shall be reimbursed by the Contractor for costs incurred by the Owner which are payable to a separate contractor beeause of delays, improperlytinied activities or defective construction ofthe Contractor. The Owner shall be responsible to the Contractor for costs incurred by the Contractor because of delays, improperly timed activities, damage to the Work or defective construction ofa separate contractor. ARTICLE 13 CHANGES IN THE WORK § 13.1 By appropriate Modification, changes in the Work may be accomplished after execution of the Contract. The Owner, without invalidating the Contract, may order changes in the Work within the general scope of the Contract consisting of additions, deletions or other revisions, with the Contract Sum and Contract Time being adjusted accordingly; Such changes in the Work shall be authorized by written Change Order signed by the Owner, Contractor and Architect, or by written Construction Change Directive signed by the Owner and Architect. § 13.2 Adjustments in the Contract Sum and Contract Time resulting from a change in the Work shall be determined by mutual agreement of the parties or, in the case of a Construction Change Directive signed only by the Owner and Architect, by the Contractor's Cost of labor, material, equipment, and reasonable overhead and profit, unless the parties agree on another method for determining the cost or credit. Pending final determination of total cost ofa Construction Change Directive, the Contractor may request payment for Work completed pursuant to the Construction Change Directive, The Architect will make an interim determination of the amount of payment due for purposes of certifying the Contractor's monthly Application for Payment When the Owner and Contractor agree on adjustments to the Contract Sum and Contract Time arising from a Construction Change Directive, the Architect will prepare a Change Order. § 13.3 The Architect will have authority to order minor changes in the Work not involving adjustment in the Contract Sum or extension of the Contract Time and not inconsistent with the intent ofthe Contract Documents. Such changes shall be effected by written order and shall be binding on the Owner and Contractor. The Contractor shall catty out such written orders promptly. § 13.4 1f Concealed or unknown physical conditions are encountered at the site that differ materially from those indicated in the Contract Documents or from those conditions ordinarily found to exist, the Contract Sum and :Contract Time shall be equitably adjusted as mutually agreed between the Owner and Contractor; provided that the Contractor provides notice to the Owner and Architect promptly and before conditions are disturbed. ARTICLE 14 TIME § 14.1 Time limits stated in the Contract Documents are of the essence of the Contract, By executing the Agreement the Contractor confirms that the Contract Time is a reasonableperiod for performing the Work. § 14.2 Unless otherwise provided, Contract Time is the period of time, including authorized adjustments, allotted in the Contract Documents for Substantial Completion of the Work. §' 14.3 The term "day" as used in the Contract Documents shall mean calendar day unless otherwise specifically defined. § 14.411e date of Substantial Completion is the date certified by the Architect in accordance with Section 15.13. § 14.5 If the Contractor is delayed* any in the commencement or progress of the Work by changes ordered in the Work, by labor disputes, fire, unusual delay -in deliveries,'abnomtal adverse weather conditions not reasonably anticipatable, unavoidable casualties or any causes beyond the Contractor's control, or by other causes which the Architect determines may justify delay, then the Contract Time shalibe extended by Change Order for such reasonable time as the Architect may determine, subject to the provisions of Article 21. MA Document A10T" - 2007. Copyright © 1936, 1951, 1958,1961,190,1000.1070. 074.1070.1907,1007 and 2007 Ono Amertcan lnsttuteof Init. prohiteds. WAnt NC : This A Aenooument pmtected by U.S, Copyright Ls* and intorristional Irsaile% ttrrauthorized r roducilo r t .+- distribution of this AtA'> Document, or any portion of it may result in bevere civil and cdminm penat8es, and will Us prosecuted to the maximum extentpeaslitta under the tats. ibis document was created on 011041201210:56:30 under the terms of Documents.on- Demand1" order no. 2008388506 , and IS not for resale. This document is licensed by The Amerlaan Institute of Architects for one -time use only. and may not be reproduced pciorto its completion. ARTICLE 15 PAYMENTS AND COMPLETION § 15.1 Applications for Payment § 15.1.1 Where the Contract is based on a Stipulated Sunt or the Cost afire Work with a Guaranteed Maximum Price, the Contractor shall submit to the Architect, before the first Application for Payment, a schedule of values, allocating the entire Contract Sum to the various portions ofthe Work, prepared in such form and supported by such data to substantiate its accuracy as the Architect may require. This schedule, unless objected to by the Architect, shall be used in reviewing the Contractor's Applications for Payment. § 15.12 With each Application for Payment where the Contract Sum is based upon the Cost of the Work, or the Cost ofthe Work with a Guaranteed hilaxinium Price, the Contractor shall submit payrolls, petty Cash accounts, receipted invoices or invoices with check vouchers attached, and any other evidence required by the Owner to deitionstrttethat cash disbursements already made by the Contractor on account of the Cost of the Work equal or exceed (1) progress payments already received by the Contractor, less (2) that portion of those payments attributable to the Contractor's Fee; plus (3) payrolls for the period covered by the present Application for Payment. § 15.1.3 Payments shall be made on account of materials and equipment delivered and suitably stored at the site for subsequent incorporation in the Work. If approved in advance by the Owner, payment may similarly be made for materials and equipment stored, and protected from damage, off the site at a location agreed upon in writing. § 15.14 The Contractor warrants that title to all Work covered by an Application for Payment will pass to the Owner no later than the time of payment, The Contractor further warrants that upon submittal of an Application for Payment all Work for which Certificates for Payment have been previously issued and payments received from the Owner shall, to the best ofthe Contractor's knowledge, information and belief, be free and clear aliens, claims, security interests or other encumbrances adverse to the Owner's interests. § 152 Certificates for Payment § 15.2.1 The Architect will, within seven days after receipt of the Contractor's Application for Payment, either issue to the Owner a Certificate for Payment, with a copy to the Contractor, for such amount as the Architect is properly due, or notify the Contractor and Owner in writing ofthe Architect's reasons for withholding certification in whole or in part as provided in Section 1523. § 15,2.2 The issuance of a Certificate for Payment will constitute a representation by the Architect to the Owner, based on the Architect's evaluations of the Work and the data comprising the Application for Payment, that, to the best ofthe Architect's knowledge, information and belief the Work has progressed to the point indicated and that the quality of the Work is in accordance with the Contract Documents. The foregoing representations are subject to an evaluation of the Work for conformance with the Contract Documents upon Substantial Completion, to results of subsequent tests and inspections, to correction of minor deviations from the Contract Documents prior to completion and to specific qualifications expressed by the Architect. The issuance of a Certificate for Payment will further constitute a representation that the Contractor is entitled to payment in the amount certified. However, the issuance of a Certificate for Payment will not be a representation that the Architect has (1) made exhaustive or continuous on -site inspections to check the quality or quantity of Work, (2) reviewed construction means, methods, techniques, sequences or procedures, (3) reviewed copies of requisitions received from Subcontractors and material suppliers and other data requested by the Owner to substantiate the Contractor's right to payment, or (4) made examination to ascertain how or for what purpose the Contractor has used money previously paid on account afire Contract Sum. § 15,2.3 The Architect may withhold a Certificate for Payment in whole or in part, to the extent reasonably necessary to protect the Owner, if in the Architect's opinion the representations to the (honer required by Section' 15 .2.2 cannot be made. if the Architect is unable to certify payment in the amount of the Application, the Architect will notify the Contractor turd Owner as provided in Section 152.1. If the Contractor and the Architect cannot agree on a revised amount, the Architect will promptly issue a Certificate for Payment for the amount for which the Architect is able to make such representations to the Owner. The Architect may also withhold a Certificate for Payment or, because of subsequently discovered evidence, may nullify the whole or a part of a Certificate for Payment previously issued, to such extent as may be necessary in the Architect's opinion to protect the Owner from loss for which the Contractor is responsible, including loss resulting from acts and omissions described in Section 9.22, because of .1 defective Work not remedied; 2 third party claims filed or reasonable evidence indicating probable filing of such claims unless security acceptable to the Owner is provided by the Contractor; .3 failure of the Contractor to make payments properly to Subcontractors or for labor, materials or equipment; Decanted A107'" - 2007. Copyright 0 1936 ,1951,1988,1861,1983,1886,1870, 1974, 1978, 1987, 1897 and 2007 by The American Institute of Architects. G: This Ale DoeuMent is protected kalif, Copyright Law and International Treaties, Unauthorized reproduction or distrthution of this AIAeDccument, Of any portion of It, may result In severe siva and criminal penalties, and wilt be prosecute/I to tits maximum extent possible under tits taw. This dominant was created on 01/04/201210:58:30 under the terms of Documents on Demand" order no. 2008388506. and is not for regale. This document is licensed by American mute of Architects forone -lima use only, and may not be reproduced prior to Its completion. .4 reasonable evidence that the Work cannot be completed for the unpaid balance of the Contract Sum; .5 damage to the Owner or a separate contractor; .6 reasonable evidence that the Work will not be completed within the Contract Time and that the unpaid balance would not be adequate to cover actual or liquidated damages for the anticipated delay; or .7 repeated failure to carry out the Work in accordance with the Contract Documents. § 15.2.4 When the above reasons for withholding eettificat on are removed, certification will be made for amounts previously withheld. § 15.3 Progress Payments § 15.3.1 The Contractor shall pay each Subcontractor, no later than seven days after receipt of payment, the atioumt to which the Subcontractor is entitled, reflecting percentages actually retained from payments to the Contractor on account old= Subcontractor's portion of the Work. The Contractor shall, by appropriate agreement with each Subcontractor, require each Subcontractor to make payments to sub- subcontractors in similar manner § 15.3.2 Neither the Owner nor Architect shall have an obligation to pay or see to the payment ofniortey to a Subcontractor except as may otherwise be required by law. § 15.3.3 A Certificate for Payment, a progress payment, or partial or entire use or occupancy of the Project by the Owner shall net constitute acceptance of Work not in accordance with the Contract Documents. § 15,4 Substantial Completion § 15.4.1 Substantial Completion is the stage in the progress of the Work when the Work or designated portion thereof sufficiently complete in accordance with the Contract Documents so that the Owner can occupy or utilize the Work for its intended use. § 15.4.2 When the Contractor considers that the Work, or a portion thereof which the Owner agrees to accept separately, is substantially complete, the Contractor shall prepare and submit to the Architect a comprehensive list of items to be completed or corrected prior to final payment. Failure to include an item on such list does not alter the responsibility of the Contractor to complete all Work in accordance with the Contract Documents. § 15.4.3 Upon receipt of the Contractor's list, the Architect wilt make an inspection to determine whether the Work or designated portion thereof is substantially complete. When the Architect determines that the Work or designated portion thereof is substantially complete, the Architect will issue a Certificate of Substantial Completion which shalt establish the date of Substantial Completion, establish responsibilities of Owner and Contractor for security, maintenance, heat, utilities, damage to the Work and insurance, and fix the time within which the Contractor shall finish all items on the list accompanying the Certificate. Warranties required by the Contract Documents shall commence on the date of Substantial Completion of the Work or designated portion thereof unless otherwise provided in the Certificate of Substantial Completion. 15.4.4 The Certificate of Substantial Completion shall be submitted to the Owner and Contractor for their written acceptance of responsibilities assigned to them in such Certificate. Upon such acceptance and consent of surety, if any, the Owner shall make payment of retainer applying to such Work or designated portion thereof. Such payment shall be adjusted for Work that is incomplete or not in accordance with the requirements of the Contract Documents, § 15.5 Final Completion and Final Payment § 15.5.1 Upon receipt of the Contractor's written notice that the Work is ready for final inspection and acceptance and ,upon receipt of a final Application for Payment, the Architect will promptly make such inspection and, when the Architect fnds`the Work acceptable under the Contract Documents and the Contract fully performed, the Architect will promptly issue a final Certificate for Payment stating that to the best of the Architect's knowledge, information and belief, and an the basis of the Architect's on-site visits and inspections, the Work has been completed in accordance with terms and conditions of Contract Documents and that the entire balance foetid to be due the Contractor and noted in the final Certificate is due and payable. The Architect's final Certificate for Payment will constitute a further representation that conditions stated in Section 15.5.2 as precedent to the Contractor's being entitled to final payment have been fulfilled. § 15.5.2 Final payment shall not become dueuntil the Contractor has delivered to the Owner a complete release of all liens arising out of this Contract or receipts in full covering all labor, materials and equipment for which a lien could be filed, or a bond satisfactory to the Owner to Indemnify the Owner against such lien.If such Lien remains unsatisfied AIA DocumentA107m —2007. Copyright 1G 1936 1951,1968,1961,1963,1986,100 1974.'1978,1987,1997 and 2007 by The Americen institute of tilt. WARNING: o: This AtA°focument Is protected by118.0opyright Lew and International Treaties. Unauthorized reProduction or stri button of tints Ate Document, or any portion of it may result Wetmore civil and criminal pen elan alit be prosecuted to the maximum esttont le under the lam. This document was crested on 01(041201210:88:30 under the terms Of AIA Documents- on- oemand'a order m 200838850 and is not for resale. This document is "'tensed by The Amedcen Institute of Architects forme -time use only, and may not be reproduced prior to its completion, after payments are made, the Contractor shall refund to the Owner all money that the Owner may be compelled to pay in discharging such lien, including costs and reasonable attorneys' fees. § 15.5.3 The making of final payment shall constitute a waiver of claims by the Owner except those arising frem .1 liens, claims, security interests or encumbrances arising out of Contract and unsettled; .2 failure of the Wcalt to comply with the requirements of the Contract Documents; or .3 terms of special warranties required by the Contract Documents, 15.5.4 Acceptance of final payment by the Contractor, a "Subcontractor or material supplier shall constitute a waiver of claims by that payee except those previously made in writing and identified by that payee as unsettled at the time of final Application for Payment. ARTICLE 16 PROTECTION OF PERSONS AND PROPERTY § 16.1 Safety Precautions and Programs The Contractor shall be responsible for initiating, maintaining and supervising all safety precautions and programs in connection with the performance of the Contract. The Contractor. shall take reasonable precautions for safety of, and shall provide reasonable protection to prevent damage, injury or loss to .1 employees on the Work and other persons who may be affected thereby; 2 the: Work and materials and equipment to be incorporated therein, whether in storage on or off the site, under care, custody or control of the Contractor or the Contractor's Subcontractors or Sub- subcontractors; and other property at the site or adjacent thereto, such as trees, shrubs, lawns, walks, pavements, roadways, structures and utilities not designated for removal, relocation or replacement in the course of construction. The Contractor shall comply with and give notices required by applicable laws, statutes, ordinances, codes, rules and regulations, and iawfu4 orders of public authorities bearing on safety of persons and property and their protection from damage, injury; or loss. The Contractor shall promptly remedy damage and loss to property caused in whole or in part by the Contractor, a Subcontractor, a sub - subcontractor, or anyone directly or indirectly employed by any of them, or by anyone for whose acts they may be liable and for which the Contractor is responsible under Sections 16.1.2 and 16.1.3, except for damage or loss attributable to acts or omissions of the Owner or Architect or by- anyone for whose acts either of them may be liable, and not attributable to the fault or negligence of the Contractor. The foregoing obligations of the Contractor are in addition to the Contractor's obligations under Section 9.15. §16.2 Hazardous Materials § 16.2.1 The Contractor is responsible for compliance with the requirements of the Contract Documents regarding hazardous materials. If the Contractor encounters a'hazardous material or substance not addressed in the Contract Documents, and if reasonable precautions will be inadequate to prevent foreseeable bodily injury or death to persons faulting from a material or substance, including but not limited to asbestos or polychlorinated biphenyl (PCB), encountered on the site by the Contractor, the Contractor shall, upon recognizing the condition, immediately stop Work in the affected area and report the condition to the Owner and Architect in writing. When the material or substance has been rendered harmless, Work in the affected area shall resume upon written agreement of Owner and Contractor. By Change Order, the Contract Time shall be extended appropriately and the Contract Sum shall be increased in the amount of the Contractor's reasonable additional costs of shutdown, delay and start-up. § 16.2.2 To the fullest extent permitted by law, the Owner shall indemnify and hold harmless the Contractor, Subcontractors, Architect, Architect's consultants and agents and employees deny of them from and against claims, damages, lose& and expenses, including but not limited to attorneys' fees, arising out of or resulting from performance of the Work in the affected area, if in fact, the material or substance presents the risk of bodily injury or death as described in Section 16.2.1 and has not been rendered harmless; provided that such claim, damage, loss or expense is attributable to bodily injury, sickness, disease or death, or to injury to or destruction of tangible property (other than the Work itself), except to the extent that such damage, loss or expense is due to the fault or negligence ofthe party seeking indemnity. If, without negligence on the part of the Contractor, the Contractor is held liable by a government agency for the §16. cost 1st remediation of a hazardous material or substance solely by reason of performing Work as required by the Contract Documents, the Owner shall indemmfy the Contractor for all cost and expense thereby incurred. DocumentA 07"1 -4047. Copyright 1936, 1951,1958,1961,1963,1966, 1970,1974,197% 1987, 1997 and 2007 by The American Institute of Architects. WARMING "this Ate pocurnent is protected by US. Copyright Law and international TreoUas. Unauthorized reproduction or distribution of this AIAe Document, or any portion of it, may ramble severe ctvti and criminal pence, and will be prosecuted bathe maximum eident t eas1bl0 under the law, this dooumentwas created on 011041201210:6&30 under the terms of AIA Documents-on-Demand " order no. 2008388506 , and is not for resale. This document is licensed by The American Institute of Architects forone -hme use only and may net be reproduced prior tails won. Init. ARTICLE 17 INSURANCE AND BONDS No bonds § 17.1 The Contractor shall purchase from, and maintain in a company or companies lawfully authorized to do business in the jurisdiction in which the Project is located, insurance for protection from claims under workers' compensation acts and other employee benefit acts which are applicable, claims for damages because of bodily injury, including death, and claims for damages, other than to the Work itself, to property which may arise out of or result from the Contractor's operations and completed operations under the Contract, whether such operations be by the Contractor or by a Subcontractor or anyone directly or indirectly employed by any of them. This insurance shall be written for not less than litriits of liability specified in the Contract Documents or required by law, whichever coverage is greater, and shall include contractual liability insurance applicable to the Contractor's obligations under Section 9.15. Certificates of Insurance acceptable to the Owner shall he filed with the Owner prior to commencement of Work. Each policy shall contain a provision that the policy will not be canceled or allowed to expire until at least 30 days' prior written notice has been given to the Owner. The Contractor shall cause the commercial liability coverage required by the Contract Documents to include (1) the Owner, the Architect and the Arch'itect's Consultants as additional insureds for claims caused in whole or in part by the Contractor's negligent acts or omissions during the Contractor's operations; and (2) the Owner as an additional insured for claims caused in whose or in part by the Contractor's negligent acts or omissions during the Contractor's conipleted operations. § 17,2 Owner's Liability Insurance The Owner shall be responsible for purchasing and maintaining the Owner's usual liability insurance. § 17.3 property insurance § 17.3.1 Tlnless'otherwise provided, the Owner shall purchase and maintain, art a company or companies lawfully authorized to do business in the jurisdiction in which the Project is located,, property insurance on a- risk" or equivalent policy fonn, including builder's risk, in the amount of the initial Contract Sum, plus the value of subsequent modifications and cost of materials supplied and installed by others, comprising total value forthe entire Project at the ite on a replacement cost basis without optional deductibles. Such property insurance shall be maintained, unless otherwise provided in the Contract Documents or otherwise agreed in writing by all persons and entities who are benegciaries of such insurance, until final payment has been trade as provided in Section 15.5 or until AO person or entity other than the Owner has an insurable interest in the property required by this Section 17.3.1 to be covered, whichever is later. This insurance shall include interests oldie Owner, the Contractor, Subcontractors and sub subcontractors in the Project. § 17.3.2 The Owner shall file a copy of each policy with the Contractor before an exposure to loss may occur, Bach policyshall contain a provision beat the policy will not be canceled or allowed to expire, and that its limits will not be reduced, until at least 30 days' prior written notice has been given to the Contractor. § 17.3.3 The Owner and Contractor waive all rights against (1) each other and any of their subcontractors, sub- subeontra+Ctors,'agents and employees, each of the other, and (2) the Architect, Architect's consultants, separate contractors described in Article 12, if any, and any of their subcontractors, sub - subcontractors, agents and employees for damages can ced by,fire or other causes ()floss to the extent covered by property insurance obtained pursuant to Section 17.3 or other property insurance applicable to the Work, except such rights as they have to proceeds of such insurance held by the Owner as fiduciary. The Owner or Contractor, as appropriate, shall require of the Architect, Architect's consultants, separate contractors described in Article 12, if any, and the subcontractors, sub - subcontractors, agents and employees of any of them, by appropriate agreements, written where legally required for validity, similar waivers each in favor of other parties enumerated herein. The policies shall provide such waivers of subrogation by endorsement or otherwise. A waiver Of shall be effective as to a person or entity even though that person or entity would otherwise have a duty of indemnification, contractual or otherwise, did not pay the insurance premium directly or indirectly, and whether or not the person or entity had an insurable interest in the property damaged. § 17.3.4 A loss insured under the Owner's property insurance shall be adjusted by the Owner as fiduciary and made payable to the Owner as fiduciary for the insureds, as their interests may appear, subject to requirements of applicable mortgagee clause. The Contractor shall pay Subcontractors their just shares of insurance proceeds received by the Contractor, and by appropriate agreements., written where legally required for validity, shall require Subcontractors to make payments to their sub- subcontractors in similar rainier. AIA Document Al07T" -2007. Copyright OD 1936,1951,1958,196 4,1983,1966,1970,1974,1978,1987 1997 and 2097 by The American institute of Architects. WARNING this AIeuocwnent is protected by U.S. Copyright Law and intsrnatIonal Treelike. linallthciricdd reproduction or distribution of this Ale M ument, or portion of it, may result in severe civil and crinthiel penattlea, and win .ha pnisecuted to the maximum extant possible under the law. This document was txeateden 011041201240:58:30 unde t the tense atAlAbo [umenis.en- Demand'"order no. 2009368588 , and is not for resale. This'doatmant is-licensed by The American institute ofArehitects for onetime use only, and may not be reproduced prior to its completion. § 11.4 Performance Bond and Payment Bond NOT O?LTCAl3E § 17.4.1 The Owner shall have the right to require the Contractor to furnish bonds covering faithful performance of the Contract and payment of -obligations arising thereunder as stipulated in bidding requirements or specifically required in the Contract Documents on the date of execution ofthe Contract. § 17.4,2 Upon the request duly person or entity appearing to be a potential beneficiary of bonds covering payment of obligations arising under the Contract, the Contractor shall promptly furnish a copy of the bonds or shall authorize a copy to be furnished. ARTICLE 18 CORRECTION OF WORK § 18.1 The Contractor shall promptly correct Work rejected bythe Architect of failing to conform to the requirements of the contract Documents, whether discovered before or after Substantial Completion and whetheror not fabricated, installed or completed Costs of correcting such rejected Work, including additional testing and inspections, the cost ofuneovering and replacement, and compensation for the Architect's services and expenses made necessary thereby, shall be at the Contractor's expense, -unless conversable under Section A2,7.3 in Exhibit A, Determination ofthe Cost ofthe Work. § 18,2 in addition to the Contractor's obligations under Section 9.4, if, within one year after the date of Substantial Completion ofthe Work or designated portion thereof or after the date for commencement of warranties established under Section 15.4.3, or by terms of an applicable special warranty required by the Contract Documents, any yof the Work is found to be not in accordance with the requirements of the Contract Documents, the Contractor shall correct it promptly after receipt of written notice from the Owner to do so unless the Owner has previously given the Contractor a written acceptanne of such condition, The Owner shall give such notice promptly after discovery of the condition. During the one - year- period for correction of Work, if the Owner fails to notify the Contractor and give the Contractor an opportunity to make the correction, the Owner waives the rights to require correction by the Contractor and to make a claim for breach of warranty. 18.$ If the Contractor fails to correct nonconforniing Work within a reasonable time, the Owner may correct it in accordance with Section 8.3. § 18,4 The one -year perioi after Substantial Completio portion oldie Work, § 18.5 The one -year period for correction of Work shall not be extended by corrective Work performed by the Contractor pursuant to this Article 18. correction of Work shall be extended with respect to portions of Work first performed by the period of time between Substantial Completion and the actual completion of that ARTICLE 19 MISCELLANEOUS PROVISIONS § 19,1 Assignment of Contract Neither party to the Contract shall assign the Contract without written consent of the other, except that the Owner may, without consent ofthe Contractor, assign the Contract to a lender providing construction financing for the Project if the lender assumes the Owner's rights and obligations under the Contract Documents. The Contractor shall execute all consents reasonably required to facilitate such assignment. § 19,2 Governing Law The Contract shall be governed by the law of the place where the Project is located, except, that if the parties have selected arbitration as the method of binding dispute resolution, the Federal Arbitration Act shall govern Section 21.4. § 19.3 Tests and inspections "Pests, inspections and approvals of portions of the Work required by the Contract .Documents or by applicable laws, statutes, ordinances, codes, rules and regulations or lawful orders of public authorities shall be made at an appropriate time. Unless otherwise provided, the Contractor shall make arrangements for such tests, inspections and approvals with an independent testing laboratory or entity aeceptable to the Owner, or with the appropriate public authority, and shall bear all related costs of tests, inspections and approvals. The Contractor shall give the Architect timely notice ofwhen and where tests and inspections are to be made so that the Architect may be present for such procedures. The Owner . shall bear costs of (1) tests, inspections or approvals that do not become requirements until after bids are received or negotiations concluded, and (2) tests, inspections ar approvals where building codes or applicable laws or regulations prohibit the Owner from delegating the costs to the Contractor. NA Document A1072" — 2007. Copyaight O 1936.1951, 1958, 1981,_18.83 ,1988,1970,1974,1978,1987,1997 and 2007 by The American Institute of Architects. WAttfaND: This alOoocrawara Is protected by V.. Copyright Lase and international Treatise. tinautirart esd reproduction e' distribution of this A1Aa ua5ent, *tarty portion of it, may rota* In severe civil and criminal penalties, and will be.preseeuted Lathe maxfrnrum ,--- extent possible under the law, This document was created on 0111Mti201210.56 30 under tf a terms of ALA Documents -on- Demand"! order no. 2008388608 , and Is not for resale. This document is licensed ay rile American Institute of Archtects for onetime use only, and may notb rei roduted prior to its completion. § 19.4 Commencement of Statutory Limitation Period The Owner and Contractor shall conuneuce all claims and causes of action, whether in contract, tort, breach of warranty or otherwise, against the other arising out of or related to the Contract in accordance with the requirements of the final dispute resolution method selected in the Agreement within the period specified by applicable law, but in any case not more than 10 years after the date of Substantial Completion of the Work. The Owner and Contractor waive alt claims and causes of not commenced in accordance with this Section 19.4. ARTICLE 20 TERMINATION OF THE CONTRACT § 20.1 Termination by the Contractor If the Architect fails to certify payment as provided in Section 15.2.1 for a period of 30 days through no fault of the Contractor, or if the Owner fails to make payment as provided in Section 4.1.3 for a period of 30 days, the Contractor may, upon seven additional days' written notice to the Owner and the Architect, terminate the Contract and recover from the Owner payment for Work executed, including reasonable overhead and profit, costs incurred by reason of such termination, and damages. 20.2 Termination by the Owner for Cause § 20.2.1 The Owner may terminate the Contract if the Contractor .1 repeatedly rettnses or fails to supply enough properly skilled workers or proper materials; .2 fails to make payment to Subcontractors for materials or labor in accordance with the respective agreements between the Contractor and the Subcontractors; repeatedly disregards applicable laws, statutes, ordinances, codes, rules and regulations or lawful orders rtf a public authority; or otherwise is guilty of substantial breach of a provision of the Contract Documents. 20,2.2 When any of the above reasons exists, the Owner, upon certification by the Architect that sufficient cause exists to justify such action, ruby, without prejudice to any other remedy the Owner may have and after giving the Contractor seven days' written notice, terminate the Contract and take possession of the site and of all materials, equipment, tools, and construction equipment and machinery thereon owned by the Contractor and may finish the Work by whatever reasonable method the Owner may deem expedient. Upon request of the Contractor, the Owner shall furnish` to the Contractor a detailed accounting of the costs incurred by the Owner in finishing the Work. § 20.2.3 When the Owner terminates the Contract for one of the reasons stated in Section 202.1, the Contractor shall not be entitled to receive further payn>ean until the Work is finished. § 20.2.4 If the unpaid balance of the Contract Sum exceeds costs of finishing the Work, including compensation for the Architect' services and expenses made necessary thereby, and other damages incurred by the Owner and not expressly waived, such excess shall be paid to the Contractor. Ifsuch costs and damages exceed the unpaid balance, the Contractor shall pay the difference to the Owner. The amount to be paid to the Contractor or Owner, as the case may be, shall be certified by the Architect, upon application, and this obligation for payment shall survive termination of the Contract § 20.3 Termination by the Owner for Convenience The Owner may, at any time, teniniinate the Contract for the Owner's convenience and without cause. The Contractor shall be entitled to receive payment for Work executed, and costs incurred by reason of such termination, along with reasonable overhead and profit on the Work not executed. ARTICLE 21 CLAIMS AND DISPUTES § 21.1 Claims, disputes and other matters in question arising out of or relating to this Contract, including those alleging an error or omission by the Architect but excluding those arising under Section 16.2, shall be referred initially to the Architect for decision. Such matters, except those waived as provided for in Section 21.8 and Sections 15,3 .3 and 15.5.4, shall, after initial decision by the Architect or 30 days after submission of matter to the Architect, be subject to mediation as a condition precedent to binding dispute resolution. § 21.2 If a claim, dispute or other matter in question relates to or is the subject of a mechanic's lien, the party asserting such matter may proceed in accordance with applicable law to comply with the lien notice or filing deadlines. § 21.3 The parties shall endeavor to resolve their disputes by mediation which, unless the parties mutually agree otherwise, shall be administered by the American Arbitration Association in accordance with their Construction Industry Mediation Procedures in effect on the date of the Agreement. A request for mediation shall be made in writing, delivered to the other party to this Agreement, and filed with the person or entity administering the mediation. The kilt* AIA Document A107T"' — 2047. Copyright wine, 1961,'1963,1986, "1970,1974,1978, 1987,.1997 and 2007 by The Amedcan institute of - rchHets, WARNING: this me umeni is protected try 11.x. Cppyij9htLaw end tnt n 41 Trestles. Unauthorised reproduction or distribution of tide AlA Document, or Walton of It, many' meta to savors ON and Lrltrmtnai t alti , and will osecoted to themaximum J extent possible under the taw This document was created on 01104f2012 14:86:30 Under the tafrt s of AIA Documents- on- Derpand" order no 2008388506 , and is not for reside. This docwbeniis licensed by The American insects of Architects' for one -time use only, and may not be reproduced prior to its completion. request may be made concurrently with the binding dispute resolution but, in such event, mediation shall proceed In advance of binding dispute resolution proceedings, which shall be stayed pending mediation for a period of 60 days from the date of filing, unless stayed for a longer period by agreement of the parties or court'. order. Ilan arbitration is stayed pursuant to this Section, the parties may nonetheless proceed to the selection of the arbitrator(s) and agree upon a schedule for later proceedings. § 21,4 if the parties have selected arbitration as the method for binding dispute resolution in the Agreement, any claim, subject to, but not resolved by, mediation shall be subject to arbitration which, unless the parties mutually agree otherwise, shall be administered by the American Arbitration Association, in accordance with the Construction Industry Arbitration Rules in enact on the date of this Agreement. Demand for arbitration shall be made in writing, delivered to the other party to the Contract, and filed with the person or entity administering the arbitration. The award rendered by the arbitrator or arbitrators shalt be final, and judgnient may be entered upon it in accordance with applicable law in any court having jurisdiction thereof. 21.5 Either party, at its sole discretion, may consolidate an arbitration conducted under this Agreement with any other arbitration to which it is a party provided that (1) the arbitration agreement governing the other arbitration permits consolidation; (2) the arbitrations to be consolidated substantially involve common questions of law or fact; and (3) the arbitrations employ materially similar procedural rules and methods for selecting arbitrator(s). § 21.6 Any party to an arbitration may include by joinder persons or entities substantially involved in a common question of law or fact whose presence is required if complete relief is to be accorded in arbitration provided that the party sought to be joined consents in writing to such joinder. Consent to arbitration involving an additional person or entity shall not constitute consent to arbitration of a Claire not described in the written Consent. § 21.1 The foregoing agreement to arbitrate and other agreements to arbitrate with an additional person or entity duty consented to by parties to the Agreement shall be specifically enforceable under applicable law in any court having jurisdiction thereof. § 21,8 Claims for Consequential Damages The Contractor and Owner waive claims against each other for consequential damages arising out of or relating to this Contract. This mutual waiver includes .1 datnages incurred by the Owner for rental expenses, for losses of use, income, profit, financing, business and reputation, and for loss of management 'or employee productivity or of the services of such persons; and .2 damages incurred by the Contractor for principal office expenses including the compensation of personnel stationed there, for losses of financing, business and reputation, and for loss of profit except anticipated profit arising directly from the Work. This mutual waiver is applicable, without limitation, to all consequential damages due to either party's termination in accordance with Article 20. Nothing contained in this Section 21.8 shall be deemed to preclude an award of liquidated damages, when applicable, in accordance with the requirements of the Contract Documents. .ems : is - Vie. 4" re. Sz ec,t. *eD p4. CA AA .�+ A. 5,E+ 0-05,04r :Ati ment entered into as of the day and year first written above. 1 \3X11 tza Gtalqu r�i ;_. c imrdiars. (Printed name and titre) Marcelino Alonso President. (Printed name and title) ALA Document A1077, -2007. Copyright © 1938,1951,1958,1961,1963 ,1989,1970,1974,1978,1987,1987 and 2007 Witte Amodean institute of Architects. WARNaNtt: This ALA lliocuntent is protected by U.S Copyrtht raw and itttemationat Treatiea. Unauthorised reproduction or distribution of this AlAebocument, or erw portion . of it, nay result in severe civic and criminal penalties, and will tit prosecuted to true -MO*1 m extent possible under the law . Ibis documentwas Createdon 011041201210:66 :30 under the terms of,AIAnacuments- omiaemandmorder no, 2008388506 , and is not for resale. This document is licensed by The American lns6tute of Archneets forma-dine use only, and may not be reproducedpdortoItscom eiion. k.. STATE CERTIFIED 6m, QUALM-LED GENERAL CONTRACTOR ROOFING PLL7h,413ING UTILITY & EXCAVATION SCHEDULE EDULE OF VALUES Division i N . a DESCRIPTION 1000 General Conditions 1050 Overhead St Profit 2050 DEMOLITION 2000 Trash Container 2072 DEMO: Mechanical Air System 2070 DEMO: Interior Mirrors 2071 DEMO: Interior walls and ceiling panels 2073 DEMO: Kitchen ,& Laundry room floor 3730 Remove wall hung A/C units and Patch 620#0 6210 6750 70010" THERMAL $c MOISTURE_ .PROTECTIOM1 7190 Visqueen (12MIL) 9260' DRYWALLAND INS ILtATlO1\l;' 9261 FINISH s ARPENT-RV Baseboard Attic Latter 400.00 750.00 $ 500.00 $ 6,487.00 $ • 2.00 $ $ 140.00 TENSI 9,600.00 15,102.20 ,2 .1 1,200,.00 750.00 64487.00 510.00 280.00 28 00 ,600.00 680.00 760. 10 1.60 5,760.00 P. '14.04:40 29,100 00 $ 29,100 00 1'694.00 3.50 $ 406.00 3.50 $F 962.50 3.50 $ 325.50 Installation of Durock wall and Insulation 9300 _ FLOORING TI 9310 Ceramic Bathroom Tiles Installation 9311 Ceramic Kitchen Tiles Installation 9312 Ceramic Laundry roam Tiles Installation 15400 T' IJM$ , 15441 Lavatory 15442 Watercioset ( Tank Type ) 15443 Shower 15444 Bar Sink 15445 Kitchen Sink 8r. Garbage disposal 15446 Refridgerator line 15447 Washer Machine 15448 Laund A Sink 15 00 M HN I AL 15890 Metal A/C Duct work 16000 16050 Reinstall existing light fixtures 16495 Reinstall :existing smoke detectors TOTAL FOR CONSTRUCTION ADD - As per site visit. 6111 Replace Damaged Ceiling joist (SLF) 6150 Install new plywood and durock 6310 Door Casings 6410 Crown Moldings 16490 Replace Switches and Duplex Receptacles 1 400.Oi7 $ 500.00 $ 1,000.00 $ 450.00 $ 1,-000.00 $ 350.00 $ 300.00 300.00 400.,00 $ 500.00 $ 1,000.00 • 450.00 $ 1,000.00 $ 350.00 • 300.00 $ 300.00 7.50,00,; 8,250.00 Overhead St Profit TOTAL FOR ADDITIONAL CONSTRUCTION GRANO TOTAL FOR PROJECT 10 1 600 1 35 EA Lump Sum LF Lump Sum EA tananitageofemplrelne.com 'Cell. 305 - 300 - 0172 Office: 305 - 851 5897 b Fax: 305 CGC1514379 CCC1329676 CFC1427803 »GUGi34881 a 125.00 $ 2,500.00 $ 100.00 $ 800.00 90,614.20 85.00 1,635.00 $ 3.50 $ 4,000_00 $ 50.00 1 D3,o1.5.2 11' 850.00 1,635 00 2,100.00 4,000.00 1,750.00 10,335.00 2,067.00 $ 12.0.'.00 Client Initial(s) X: OH' 1+]`IF'I11 STATE CERTIFIED z. QUALIFIED GENERAL CONTRACTOR Ri:CQEINC PLUMBING UTILITY Eq. EXCAVATION SCOPE OF WORK: A107.1 The contractor is to furnish all labor, material, and equipment Master, Plumbing, Electrical, and Mechanical permit is required I•°• Demo • • Remove all intertor wall & ceiling drywall • Remove wall mirrors • Remove all mechanical ductwork • Remove all door casings • Remove kitchen and laundry room floors • Remove (2) A/C wall units. 1 of 2 Rough & Finish Carpentry Installation of Vlsqueen underneath the house, • Replace damaged laundry room wood partitions • Installation of Metal hi -hat (furring strips) In ceiling. • Install Rigid In perimeter walls and R -30 BAT paperback Insulation in ceiling. • install Den Armor Pius 5/8" Drywall In walls and ceilings level 5 • Install kitchen, laundry, & north bathroom plywood and durock floor Patch wall where NC wall units were. • Install VA" base board and comer round. • Installation of crown molding only In the (Entry, Family room, Living room, & Dining room) to match existing • Installation of casings 31/a" around doors. Plumbing Installation ONLY • (1) Lavatory • (1) Water closet (Tank Type (1) Shower liner • (1) Bar Sink • (1) Kitchen Sink, Garbage Disposal, & Dish Washer (1) Refrigerator water line • (1) Washer Machine (1) Laundry Sink www.ageofempirelnc.corn Client nitial(s) X. -Cell: 305 a -:300 — 0I 72 •Offfice 305 — 851 -- 5897 • Fax: 305 -- 66 3 CGC1514270 - CCC1329675 CFC1427803 CUC1224581 A_ 1-41 f + TINT T_,- r C STA i 8 CEEMFIED & QUALIFIED GENERAL CONTRACTOR R ROOFING PLUMBING UTILITY . EXCAVATION Mechanical • Install METAL duct work > Electrical (20) Reinstall existing lighting fixtures. (8) Reinstall smoke detectors I> Cean UP: Trash Container Is included for construction waste only. Debris removal from site and detail cleaning prior to occupancy.. As per site visit, all electrical switches and duplex receptacle need to be replaced. New plywood and du- rock needs to be installed in the bathroom and kitchen before tile installation. There are damaged ceiling joist that are need of replacement i.e., master bedroom. The crown molding installation to match existing, installed only in Entry foyer, family, living, and dining room. In addition, new door casings will be needed. I > Rough & Finish Carpentry • Replace Damaged Ceiling Joist (8LF) • Install new plywood and durock in kitchen and bath Install Door Casings throughout m Install Crown Moldings in Entry foyer, family, living, and dining room. I> Electrical:, a (35) Replace duplex and switches. 1II/ /0I0/II /fI /II///fIII// / / /f0I/ /III / ///I/ /II//// /////IIi/// END \\\\\\\ 1\ M\\\\1 \i\\MM\\ \ \ \'\\A\\\\\ \\\\\ \ \ \\\\ \\ \\\ %\yAW Client initial(s) www.ageofempireine.com =Cell 305 - 300 - 0172 e Office: 305 - 851 - 5897 Fax: 30 5 - 663 k \\ \411\1\\\\\\\ CGC1514376 - CCC1329675 - CFC1427603 - CUC1224581 git01)02_,docej v� I� ZbbM.-7 -7BUI I WI495{rv^1 PERMIT APPLICATION 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 Permit Type: ( BUILDING JOB ADDRESS: /0'5?--) £F !3 ( Y Illi JUL 2 4 2612 L BY: amova_o- m- __.eoom— FBC 20 Permit No. Master Permit No. A0-1-11 ROOFING City: Miami Shores Folio/Parcel #: Is the Building Historically Designated: Yes County: /-;4° Miami Dade Zip: a / c1' NO Flood Zone: OWNER: Name (Fee Simple Titleholder): /"IGr 77ric,. 44i/,& Phone #: (3°5) 332- C f 0 Address: /4KO AJS ID! St"' City: )-4torn Thor CS State: n_ Zip: .0 13•Er Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: Ay- O 1∎011 `v�. Address: � .5("/ 0G¢4' Zr. ' U City: M t arri t State: F./- Qualifier Name: ICU/070 A[00W y State Certification or Registration #: (al <'l 157? Contact Phone #: C3°17 /If °•8 7 Phone #: `_ 15/ ° 7 1 Zip: ,331 rei- Phone#: &'J gee" 0 Mt Certificate of Competency #: Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $G Square/Linear Footage of Work: Type of Work: DAddition QAlteration ONew Description of Work: At 401 all ;ate LL tt J vV ORepair/Replace ODemolition Color thru tile: ******** **** ** **+ x****************** **** Fees***** ******* *+ x******+ x**********+x**** * * * ***** Submittal Fee $ Scanning Fee $ Notary $ Double Fee $ v Permit Fee $ r CCF $ CO /CC $ Radon Fee $ DBPR $ Bond $ Training/Education Fee $ Technology Fee $ Structural Review $ TOTAL FEE NOW DUE $ �3 9 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: L, 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 dittachment. 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 Ownerior Agent The fore: •ing instrument was acknowledged before me this 0" day of !t ,20 /2..,by %t /72A 4.z e gcto who is personally known to nie or who has produced R.,pail As ideltification and who did take an oath, NOTARY PUBLIC: Sign: Print: My Co Signature ,L, Contractor The foreg ' g instrument was acknowledged before me this 2- day of a , 20 22_, by /�.r ca. 1 o/ti0' who is pe onally known to me or who has produced[ as identification and who did take an oath. NOTARY PUBLIC: APPROVED BY Plans Examiner Structural Review (Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) Sign: Print: My Comm Lir 4 7 Al; • es: ROBERT MARTELL MY COMMISSION # EE195314 • EXPIRES May 02, 2016 ** Zoning Clerk Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 179103 Permit Number: RC- 3- 11-411 Inspection Date: September 27, 2012 Inspector: Bruhn, Norman Owner: Job Address: 1450 NE 101 Street Miami Shores, FL Project: <NONE> Contractor: AGE OF EMPIRE INC Permit Type: Residential Construction Inspection Type: F. Insulation Certificate Work Classification: Alteration Phone Number Parcel Number 1132050240040 Phone: (305)851 -5897 Building Department Comments REMOVE AND REPLACE DRYWALL stop work order issued by building official. Work exceeds permit. Must comply with Flood zone regulations. 12/23/12 missing noc from new contractor Infractio Passed Comments INSPECTOR COMMENTS False Passed ,% /I- Inspector Comments Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until For Inspections please call: (305)762 -4949 September 27, 2012 Page 1 of 1 RADCD PLUM INSULATION CERTIFICATE FROM: Marcelino Alonso AGE OF EMPIRE INC. 3220 SW 93 Place Miami, FL 33165 DATE: September 20, 2012 MASTER PERMIT #: RC11 -411. PROPERTY ADDRESS: 1450 NE 101 Street Miami Shores, FL 33162 CLIENT CONTACT: Ms. Maritza Gaiqui. To whom it may concern: This letter is to certify that in accordance to the approved building plans for the above reference permit; our firm is certifying that this residential home project has R -30 batt insulation throughout the ceiling area(s) that were shown on the plans and rigid foam throughout the interior envelope / perimeter walls. If you have any questions please don't hesitate to call us. Sincerely, Marcel Alonso President www.ageofempireinc.com • Office: 305 — 851— 5897 • Fax: 305 — 663 — 5769 CGC1514379 - CCC1329675 - CFC1427603 - CUC1224581 Permit No: R@ -L ° 4U Job Name: 2010 Miami Shores Vuiage Building Department Building Critique Sheet 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 LaA r a one ate, fro(Ait.)s, 7-Z 7--z ,z 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. Jorge Rodriguez 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- 178043 Permit Number: EL -4 -11 -746 Scheduled Inspection Date: September 18, 2012 Inspector: Devaney, Michael Owner: Job Address: 1450 NE 101 Street Miami Shores, FL Project: <NONE> Contractor: DESIGNONE ELECTRICAL CONTRACTOR INC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132050240040 Phone: (305)860 -0361 Building Department Comments CHANGE LAMPS CHANGE COVERS AND PLATES 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- 158925. Add G.F.I. receptacles outside and in bathrooms. Put breaker locks on stove top and oven. Add 2 receptacles to kitchen counter and one in bar. 15 amp fuses for small A. C. C. U.. / 2_ September 17, 2012 For Inspections please call: (305)762 -4949 Page 11 of 25 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 Permit No. E. BUILDING PERMIT APPLICATION FBC 20 Permit Type: OWNER: Name (Fee Simple Titleholder): Address: 1' L 01 J • State: 'L-o rcle1 iNit I-'76 City: 1'1� i ci im Master Permit No. Phone #: B_- ®____w ®e Zip: Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: IA N. to City: Miami Shores County: Miami Dade Zip: Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: D i e n - l o W E f=L� 1�oCAls CO rt, Phone #: •'3 ° O 4 Address: 8041 -VV 200 City: M 1 C4 rn % State: 1 Zip: 33 130 Qualifier Name:-0.71e 0 ? ` ,l - ° G-1 Pr Phone #: b - .' e9 State Certification or Registration #: 5-C I O 2 Be, Certificate of Competency #: Contact Phone #: ' 0581 Email Address: VJ De-t--60 1O . &J � e_ ®'l C= . DESIGNER: Architect/Engineer: 14) LL 4J1 D- b047-ei Phone#: /13.5"-- Jb0—e14,74- Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑Address CI iteration ❑New ❑Repair/Replace ❑Demolition Description of Work:''. ******** * * * * **** **** ** * ** *** * ****** * *** Fees************* ****** ******* * * *** * ** * ********* Submittal Fee $ Permit Fee $ ?" e 0 CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ _ TOTAL FEE NOW DUE $ n I_ 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 o 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: X 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 exc promise in good faith that a copy of the notice of commencement and construction lien law brochu whose property is subject to attachment. Also, a certified copy of the recorded notice of commence for the first inspection which occurs seven (7) days after the building permit is issued. In the a inspection not .e o',proved and a reinspection fee will be charged. / /%f/iSignatur `I � � �� Signature r G • er or Agent / ontra or The foregoing instrumentt�wa ackno ged before me this • The foreg g ' strument was acknow edged before me this 2� i day of J,44 , 20�, lily I7ZA J ie,vi , day of ct • , 20 12-, by eraCk S<A7DreZ- 1x414 ding $2500, the applicant must will delivered to the person e posted at the job site uch posted notice, the w_o is ersonally knownt me or who has produced As identification and who did take an oath. NOTARY PUB C: Sign: Print: My C M Commission 00833188 u -L,6 0§:1 a2 .r2c12 whoois pe . nally kn t e or who has produced as identification and who did take an oath. BLIC: My ommission Expires: ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPROVED BY 0‘217-- Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Zoning Clerk Rx Date /Time FEB-27-2012(MON) 13:14 1 800 685 7530 02/27/20112 13:03 FAX 1 800 685 7530 DATA SCAN FIELD SERVICES Permit N. a -`1' 4,5a P. 001 jo01 /001 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR / ARCHITECT Owner's Name (Fee Simple Title Holder): Qjtl' IGi C.IG) 9ui Phone #: Owner's Address:, i City: ►y lr G rni ©rt State : Zip Code: 03/17- " Job Address (Of where work is being done): I N . 101 City: Miami Shores State: Florida Contractor's Company Name: DIBSI,EACNE l✓ 1e CAL COOT-Phone #: Address: ecoi ' V∎1 `thteZt ITS ZOD City: h✓Gt Oni 1 State: riOnCin Qualifier's Name : Z % eZEZ- -GALCOrAkic. Number: Zip Code: 305- ®-654 Zip Code: �� 1 -G- 1300 & Architect/ Engineer of Record Name: Phone #: Address: City: State: Zip Code: Describe Work: � C)► L t Ca- Cliff I hereby certify that the work has been abandoned andlor the contrac rla hitect is unable or unwilling to complete the contract. I hold the Building 0 >t cial nd the i Sh • es harmless for all legal involvement., Signature % "' owner The foregoing instrument was aknowled ed before me this day of c:1t, r, ,20JZ,by anJQ1 ear Who is perto Ian lan ly known td� me or who has produced f as indentification. Notary 1_* fa,* �;uzl COMMISSION 5E087863 �� neu Nobly 4, 2015 Contracto or Architect The foregoing instrument was aknowledged before me this 2 q day of 4€10. 20I2by eierado. who' rsonally knob me or who has produced as indentification. EXPIRES: May 4.2015 • Bonded Inns t4Otaty oubIMt}ndeiwr=ers C1vir - 5((,fl AsCo 1 SENDER: COMPLETE THIS SECTION • Complete Items 1, 2, and 3. Also complete Item 4 if Restricted Delivery Is desired. • Print your name and address on the reverse so that we can retum the card to you. • Attach this card to the back of the mailplece, or on the front If space permits. 1, Article Addressed to: I NAO 12,4 123 itike-Me- FL. 3317' COMPLETE THIS SECTION ON DELIVERY A. Signature X B. Received by (Printed Name) ❑ Agent 0 Addressee C. Date of Delivery D, Is delivery address different from item 1? 0 Yes If YES, enter delivery address below: 0 No 3. Type Certified Mall 0 Express Mali 0 Registered 0 Return Receipt for Merchandise 0 Insured Mall 0 C.O.D. 4. Restricted Delivery? (Extra Fee) 0 Yes 2. Article Number (Transfer from service label) 7004 0750 0001 9095 9679 PS Form 3811, February 2004 Domestic Retum Receipt L 102595 -02 -M -1540 UNITED STATES POSTAL SERVICE First -Class Mail Postage & Fees Paid LISPS Permit No. G -10 • Sender: Please print your name, address, and ZIP +4 in this box • AAGrr,Tz 1L15o ° /s,4 S a 33/137 W5b41& log s-4-1- 11E: i 54e--0,5 , F i 55/5 7004 0750 0001 9095 9679 At3 c FC0057700105181 U.S. POSTAGO, $5.31 FCM LETTEW 33144 Date or sale 02/18/12 t 02 1P00 °d'. 09242254 NIXIE 331 DE 1 DO Q3/i3 RETURN TO SENDER NOT DELIVERABLE AS ADDRESSED UNABLE TO FORWARD i"� BO: 33131061350 *0708- 0E3293 -18 -40 j4 J j114 ) 111 1)11) 1411131) 413 )131rr•iirr.lirr10,111rrl11111 Miami Shores Village 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. x COPY OF QUALIFIER'S STATE LIC CARD B. x COPY OF LOCAL BUSINESS TAX RECEIPT C. X COPY OF LIABILITY INSURANCE (CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPT) D. x 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: DESIGNONE ELECTRICAL CONTRACTOR, INC BUSINESS ADDRESS: 809 SW 8TH STREET SUITE 200 CITY MIAMI STATE FLORIDA ZIP CODE 33130 BUSINESS PHONE: ( 305 ) 860 -0384 FAX NUMBER ( 305 ) 860 -0361 CELL PHONE O QUALIFIER'S NAME: GERARDO SIXTO PEREZ - GALCERAN QUALIFIER'S LIC NUMBER: EC- 13003686 E -MAIL ADDRESS (IF APPLICABLE): Created on 3119109 BY MLDV I RV 3126109 MLDV FIRST-CLASS U.S. POSTAGE PAID MIAMI, FL PERMIT NO. 231 621545 -3 THIS IS NOT A BILL - DO NOT PAY RENEWAL BU S Llt aRICAL CONTRACTOR STAT # I 1 03686 648017 -2 INC 809 SW 8 ST 33130 MIAMI °VSIGNONE ELECTRICAL CONTRACTOR SeciTy e ViteT ICAL CONTRACTOR THIS IS ONLY A LOCAL BUSINESS TAX RECEIPT. IT DOES NOT PERMIT THE HOLDER TO VIOLATE ANY EXISTING REGULATORY OR ZONING LAWS OF THE COUNTY OR CITIES. NOR DOES IT EXEMPT THE HOLDER FROM ANY OTHER PERMIT OR LICENSE REQUIRED BY LAW. THIS IS NOT A CERTIFICATION OF THE HOLDER'S QUALIRCA- TIONS. PAYMENT RECEIVED MIAMI-DADE COUNTY TAX COLLECTOR: 09/15/2011 60040000452 000045.00 SEE OTHER SIDE 200 WORKER /S 1 DO NOT FORWARD DESIGNONE ELECTRICAL CONTRACTOR INC GERARDO S PEREZ PRES 247 SW 8 ST #217 MIAMI FL 33130 1 1.1 1111 1 111111111 !1111111111111111111111111111 181 1 13 'V a! BATCH NUMBER .p' jt°' �yg+ �qq {µd4 -'r r cam a°�+RkW�'pSMq Z %';�,� � ��:e . .St,," -'•rf� jl ~ '�f,+�^+,vs � 5i"'j; ✓ YC .... .„t g� ,r fg� °3.' �a ��4 ACQRQ,,,, CERTIFICATE OF LIABILITY INSURANCE 2/21/20 2 PRODUCER SOL INSURANCE AGENCY 1370 W Flagler St Miami, FL 33135 (305) 643 -2333 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 NAIC# INSURED DESIGNONE ELECTRICAL CONTRACTOR, INC 247 SW 8 ST #217 MIAMI , FL 33130 305- 860 -0384 1 INSURER A: ASCENDANT INS CO A INSURER B: GENERAL INSURER C: GL- 33752 -2 INSURER D: 09/23/12 INSURER E: $ 1,000,000 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. INSR LTR ADD'L INSRD TYPE OF INSURANCE POLICY NUMBER POUCY EFFECTIVE DATE (MM/DD/YY) POLICY EXPIRATION DATE (MM/DD/YY) LIMITS A A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY GL- 33752 -2 09/23/11 09/23/12 EACH OCCURRENCE $ 1,000,000 X AMGE TO RENTED PREM SES (Ea occurence) $ 100,000 CLAIMS MADE X OCCUR MED EXP (Any one person) $ 5,000 PERSONAL&ADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICYnJEa flLOC PRODUCTS - COMP /OP AGG $ 1,000,000 $I AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON - OWNEDAUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Peraccident) $ PROPERTY DAMAGE (Peraccident) $ GARAGE LIABILITY ANYAUTO AUTO ONLY -EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ —I OCCUR I I CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ 1 $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLT� D ?ECUfIVE It es, describe under SPECIAL PROVISIONS below WC604715 -0 10/14/11 10/14/12 WCSTATU- ' OTH- TORYLIMITS ER E.L EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE ES 1,000,000 E.L DISEASE - POUCY LIMIT $ 1,000,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS LOCAL ELECTRICAL CONTRACTOR COMPANY CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES , FL 33138 I 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 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2001108) ©ACORD CORPORATION 1988 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: Electrical OWNER: Name (Fee Simple Titleholder): Address: (45-0 NJ E r APR z 8 2011 BY: •seesoeSe0664,4,,041504,, Master Permit No.Pj 0 -3 -1 1- 4 P i Cct a c1 to l Phone #: WET. - egg '2,- City: (X trrA 1 ` _ State: —001,1' C(6 - Zip: Tenant/Lessee Name: Phone #: Email: Dry- 5 COL . Ci JOB ADDRESS: 1 City: Miami Shores County: Miami Dade Zip: , is Folio/Parcel #: M 24 -- 0 0 q Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: ` - T e _ _ 6 . 1 C ' Phone #: '-?'0 A5 1 -2'20-7 Address. U Cf 0 Ni, GO t 9-? i City: Ci e1r� 1 State: 1. Zip: 1 '7 e Qualifier Name: (� � CO .-e C Phone #: State Certification or Registration #: 1 C)C ° ?-(. 1 2_ Certificate of Competency #: Contact Phone #: Email Address: DESIGNER: Architect/Engineer: C c 1 [ o . s A . l t J C L Phone #: W5---D -q C Value of Work for this Permit: $ 0 C30 Square/Linear Footage of Work: Type of Work: OAddress OAlteration ONew ORepair/Replace ODemolition Description of Work: ai y. MPS / C,loe re e, !S > P { Ua T ******** * * * * * *** * * * * * * * * * * * * * * * * * * * * * ** Fees************* * * * * * *** * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ / e'reOe CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ Technology Fee . Bolding 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 absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged Signature Signa Owner or Agent The foregoing instrument was acknowledged before me this day of ,20,_,by who is personally known to me or who hay produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Contractor The foregoing instrument was acknowledged before me this t.q 011_,by day of who is personally known to me or who has produced on and who did take an oath. NOTARY r- +„, LIC Sign: Print: @at- rne Lte) My Commission Expires: My Commission Expires.,, "' � EXPIfIE9: Jos 21, 2119 Noma Baled Thru Bligst Nay Sates APPLICATION APPROVED BY: (Revised 02108/06) PA- ,z6 izp,t_ 26- Plans Examiner Engineer Zoning ' �' CERTIFICATE OF LIABILITY INSURANCE CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. OR ALTER THE COVERAGE AFFORDED BY THE CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED DATE(IMEADOIYYYY) 05110/11 THIS POLICIES THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: IT the certificate holder is an ADDITIONAL INSURED, the polloy(les) must be endorsed. If SUBROGATION IS WANED, 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 0f such endorsement(s). PRWUCBR Florida General Agency 15280 NW 79 et., Ste, 10a Miami Lakes, FL 33016 Phone 0822.0783 Fax 305 -26 -0911 Ci01T CT F irk F„t): (305)82k -0 %S$ 1 PA. Na (305)826 -0911 AODRgem fiCeidagenerel@rsil.com __ INSURERi& AFFORDING COVERAGE NAECd INSURER A: NATIONAL GROUP INSURANCE INSURED Jas Electric Inc", 12490 NW 124 St Ray 5 Medley, FL 33178- (305) 218.9492 I,a1..s. AM.* INSURER B : 121113/2010 INSURER C: EACH OCCURRENCE INSURER D: PREMISES �R 1 INSYRfR E: ❑ • CLAIMS -MADE )♦ OCCUR INSURER P • $ 5,000.00 CERTIFICATE NUMBER: • THIS INDICATED CERTIFICATE EXCLUSIONS IS TO CERTIFY THAT THE POLICES OF INSURANCE LISTED SEI.QW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD NOTWITHSTANDING ANY REQUIREMENT, TERM OR CQNDmON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS MAY BE ISSUED OR MAY PERTAIN THE -INSURANCE AFFORDED BY THE POLICIES DI SCRIEED HEREIN IS suBJECT TO ALL THE TERMS, AND CONDITIONS OP SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LR T TYPE OF INSURANCE INSR UM POLICY N9ER (M DPI IO POLICY E IMmfirYL LIMITS A GENERAL LIABILITY n COMMERCIAL GENERAL uABELITY 04L000004.01 121113/2010 1X11 awl 1 EACH OCCURRENCE S 1,000,000,00 PREMISES �R 1 1 100,000.00 ❑ • CLAIMS -MADE )♦ OCCUR MED s✓ (P (Any one person $ 5,000.00 ❑ PERSONAL & Aov INJURY $ 1,000,000.00 $ 2,000,000.00 ❑ GENERAL AGGREGATE GEM. AGGREGATE LIMIT APPLIES PER PRODUCTS . COMP /OP AGG $ 1,000,000.00 • POLICY ❑ 23a ❑ LOC _ $ AUTOMOBILE UABILITY ❑ ANY AUTO • AALLUTOTNED ❑ BRAE° (C MBW�e SINGLE LIMIT E BODILY INJURY (Pet person) , $ BODILY INJURY (Per accident) $ aHIRED AUTOS ❑ PROPERTY A MADE accident $ ❑ UMBREl.Fl1IJAB ❑ OCCUR ❑ Exoess 'JAB • CLAMS -MADE EACH OCCURRENCE $ AGGREGATE • DED • RE1EdnON $ $ WORKERS COMPENSATION ANC EMPLOYERS' LWBILR Y Y IN ANY PRO A� OFFICWALE�R EXCLUDED? N 1 A yy� • ER E EL. EACH ACCIDENT $ Mandatory in NA E It deem,* E.L. 0I ASE - EA EMPLOYE $ yes. ender DEScRIPTtoN OF OPERATIONS moot E.L. DISEASE . POLICY LIMIT $ DESCRIPTION OP OPERATIONS 1 LOCATIONS 1 VEHICLES (Attach AOORD 101, AddWonal Rename Schedule, if mere space is required) 01 AND PD $500 DEDUCTIBLE ELECTRICAL WORK WITHIN BUILDINGS weer.r.r,.......- •......... - - CELLATION MIAMI SHORE VILLAGE BUILDING DEPARTMENT 10050 NE 2ND AVE MIAMI SHORE FL 33138 ACORD 25 (2010105) OF iF /T :abed SHOULD ANY OF THE ABOVE DESCRIBED POLICIES SE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERS') IN AC .;, CE WITH `THE POLICY PROVISIONS- g19811-21310 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD t T6092890£ : coo Jd 217:80 I TOZ- 1.tiW -0T • • • -(113 rtaBOI AE.SX 1.k S['ATE QP ROM A. " VIVEP MOM OFF1d114 oEPR C1. OP PINANCIA ',�tai DIVISION OP WORKERS' COW i�S ' d 0 BVICANCRI BP REMO* ft NE-Main atala MAMA AROISEW . WIPA10161P 1..41.11T. 46., CoKsTRugnow INDUSTITY EXIEWTON • This wales that the indMEINI listed below has d1. eobill to 130 .t pit front id Waters Condithbetion law. EFFECTIVe DAT& sarm®1Z009• EIXPIRATION DATE: 10103i2011 PERSON: .SOTO JUWQ E PEIrt 651351127 llitiONESS I 'MINIM 72E5 1+7 C4114 uttla MAME PL sow SCOPES OP BUSINESS DE TRA'IE: 1- ELECTRICAL tDNTRPCTOR .11001M fatcrat re MOW 440 - AB1t4}, .1.8.. m � Ws mot WO alb do litre tits Fdfe¢t9Y by alien a certificate at Odom slur this setaeDg�q ant taaven banes or eetabda4anvn Wee 1.b trA� 6tsF✓ 1 e E.. 'Codified= e® tt15 be 4 ... cagy d colic viable ille sf raboye • aP al be e We pees no ra V, dm after Me rtl 06 Our oano • r 100 Ifs ss tit air cerrareaD. et Pin mod 55 tOa .astZaa or totottlfhtir as kw a*te 4>d► teems tdrota el bni neaanat tar tame of a .ccoV it o{a- •:16s detriment *al revoke 0 erefiftiolle ;V toy rise fat Micro 0t tits room woad on the d Verd dm tali9lttaoaat's.af We 130410. 0111131100157 166E 413 -.1011 it-162 CERTINIIATI OF fifileill3N TO 8E EX1 M T 111VlSED 02 -0S ft•, 0. .OF • • PLEASE 411 /T BUT TEE CARD RELVIN AND RETAIN FDA - FUTURE REFERENCE IMPORTANT PUr$Uant to 1htter 441011' 4 . alt Officer of a ssrpera kl B vibe 1 elects a mptiah from tide mew by filing s F;ereceste - *def Cris dedflorf may noe ecoover benefits or oo- :,- cation , adder 1hl4 D chapter. • Furst ant iC t o 444.05114 51.& t1ettfirates s O1. a ass '1.9 1rb ft! anPIY ordu to hie the steps of the hied on REVIZMWORVIY AAR= Titdi EFFErritle 101t0S /2OD9 *Rtpa WOE: fe/ol2a11 PE R O4k 411.10 : - 45021.1.1117 1#li31)S NAM ,A1112 Amon' s Ern aEOme arc rats W44111 WE HitaAtb a. aeon' -s int .osy. c1�U$1NESS (21.1711.0a. — ... -- ... _ _.. . le ancee0i. • Ithi notice el Waldo he Minim PorMOaet'ta Moot= 440fif1ffi, F.$ , Note as s/ a an o- is be exempt and eertifiatttes p1 etaetlan to he mar= a^.a me a.1,ar. to Isontotian if, et flay time after the ftliltd of the acres or ate mime of the certificate, tie person noes an die met se or cornf,cere no lager the requtratestde of this oeaaotr far .00tetsce of a certificate, The depertntdut she11 reVCka a eertftfcete bate far failure of the Fallon nomad. oh the, Certificate to megS tae requirements of this eR „YY. CLI IDNS? 188Uj 419-1848 Cud' HERE 4 Carr}r bottom Portion tee the ,ate, keep upper portion for your record% awc-as2 MR= OF Liitnagrid BB EXEMPT AEVISEI us-QS 8.2:aesd s.— .,.-' ----s v .n —_— TI60928S0£:w0Jd L2:0T TILE- At:U -£Z aIA1M.DADE 00111 9Y 2010 LOCAL 1919$I1NESS TAX amain 2041 FIRST -CLASS T LECTOR ADA1691 -DADS COUNTY. STATE OF FLORIDA U.B. POSTAGE • 1401A .ACi m ST. EXPIRES OEM 30, 2011 PAID. • 14101.00R MUST BE DISPLAYED AT PLACE OF BUMF= IMAM FL IRAK FL 03190 PURSUANT TO COUNTY CODE CHAPTER SA - ART. 9 & 10 PERMIT fax 231 THJSISPLOT'A BILL— DOPLOTPAY BUe P a E1LOCATION WEC AL429988 -9 J E S ELECTRIC INC STATER EC13002612 32490 NW 124 ST 5 33178 UNI11 DADE COUNTY OMER J E 3 ELECTRIC INC CacaypscfEuMnese WORKER/S CTRICA . CONTRACTOR ac 1 re DO I1MT FORWARD � ca OANTY t 07/28/2010 7 halts 11 i!t 314 4 144 111 11 4 11 1 0 ©0075.00 's sss s toss » sns sss ► $1 su ss st s stns SEE OTHER HIDE J E S ELECTRIC INC JULIO E SOTO PRES 7285 W 34 LA HIAL.EAH FL 33018 d L2 :0T TT02 AHW -£T T T60928S02: ° .d Licensing Portal - License Relationships rage 1 vi, z Licensee Name: Ranii: 501.0, JULIO E Electrical Contractor Primary Status: Current Secondary Active Related License Information Number SF:ss 1te18t�ed Party' rypQ i?at+e License Number: License Expirafion Date: Original license Date: Relationship Relation Effective Current 3.E.S. ELECTRIC INC Primary Qualifying Agent P[jf i4‘l Related License Search License Type View all relined licensee First Name Last Name License Number Reek 13002612 05/31/2012 02/10/2005 02/10/2005 >.iectatcal Business Information Expiration Date Praia To Expiration Dante Page 1 of 1 1 Terns of Use 1 1 artveof Materna* 1 .. z.--. •• +aw • - .- .._.� -.... ...... _..- .�_..£.CS _.._.. ..:� .Yrssxs. rr.z- .. ... ....� -. ..� • ktp3J/www.m,Y oridaticense.romflicense telatio a.asp ?SID=&Iici 912364 9/7/2010 8,9:aeed TT60928S02:w0Jd 82:0T TI02- J,tiW -ET Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 175202 Permit Number: MC -4 -11 -745 Scheduled Inspection Date: August 08, 2012 Inspector: Perez, JanPierre Owner: Job Address: 1450 NE 101 Street Miami Shores, FL Project: <NONE> Contractor: UNIVERSE MECHANICAL AND A/C INC Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132050240040 Phone: (786)348 -1034 Building Department Comments CHANGE DUCT WORK -247 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- 158916. August 07, 2012 For Inspections please call: (305)762 -4949 Page 9 of 33 I 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: CHANICAL RECEIVED MAR 0 2 2012 IA� Permit No. MG 11-145 Master Permit NJ- c') —4 0 OWNER: Name (Fee Simp a Tittieholder): cyst •� Z� �.�c % .; Phone #: Address: 1"150 445 /6/ _VA City: M/e rre, 5/16,ei Tenant/Lessee Name: Email: State: f Zip: 3305" Phone#: JOB ADDRESS: /41S-a5 oi/E City: Miami Shores County: Miami Dade Zip: 3 3 (3 a. Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: 6 V e M1 Str - ' it&V tA't o .rt.) Phone #: 86. ? f e l' 3 t( Address: -e N \ f 0 r City: P t (.A K I State: PC v AA. OA Zip: 3 '3 1 gZ Qualifier Name: C- Lon) Oiso 1• 12---E1 Phone #: 3 g E 0 3 4( State Certification or Registration #: C ►••l - i2-461c 3 8 Certificate of Competency #: 0 vEifl - IQiR.fort. Contact Phone #: Z? 6 3 1. 1 a 3 4 DESIGNER: Architect/Engineer: AZVA &-4,6V Email Address: CA- A V 0 i° Phone#: eb 2.' 60/76 Value of Work for this Permit: $ 'I ® d a - ° a Square/Linear Footage of Work: New E�Reot�pair/Replace ❑Demolition f 1416, g 6 eT *L PJ C-1 ood Q , Type of Work: ❑Address ❑Alteration * * ** * * * * * * * * * * ** * * * * * * * * * * ** * *0,* * * ** Fees************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $/ Permit Fee $_ 15 . CCF $ CO /CC $ Scanning Fee $ (Q Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ Technology 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 CONDmONERS, 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 co encement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In '- e absence L such posted notice, the inspec '.n w' 1 nort b proved nd a reinspection fee will be charged. Signat The foregoing instrument was acknowledged before me this day of 5- , 20 /2 , by i :, A11-00 1/ 144,4 it, Signature actor The foregoing instrument wa acknowledged before me this , day of , 2s' 11; by who is personally known to me or who has produced gi4MWAi who is personally kn to me or who has produced NOTA Si t�- 0 Notary PUHIie State of Florida LAmaldo Villar MyComnlission &D -F` 8 00 Expires 10/2. 1 ij/ d take an oath. My Commission Expires: APPROVED BY as identification and who did take an oath. Notary Public • Me if m. Ewe Feb 18, 2813 Corandiskm CO 0 • • T J s Examiner Zoning Structural Review (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Clerk Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 AIR CONDITIONING REPLACEMENT DATA PERMIT NUMBER: MC This form must accompany ALL air conditioning replacement permit applications. Each unit change -out must be on its own data sheet. Multiple units on single sheets are not acceptable. Job Address (where the work is being done): City: Miami Shores Village County: Miami Dade Zip Code: ALL CONDENSING UNITS MUST BE ON A 4 INCH SOLID CONCRETE SLAB ALL UNITS MUST COMPLY WITH F.E.M.A MINIMUM FLOOD ELEVATION A COPY OF THE CONTRACT IS REQUIRED WITH ALL SUBMITALS ARI (AHRI) DATA SHEET REQUIRED Change Disconnecting means: YES ❑ NO ❑ ARHI Sheet Attached: YES ❑ NO ❑ Contract Attached: YES ❑ UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER AHU or PKG. UNIT MODEL # COND. UNIT MODEL # KW HEAT NOM TONS AHU CU PKG 1) M.C.A AHU CU PKG AHU CU PKG 2) M.O.P AHU CU PKG AHU CU PKG 3) VOLTS AHU CU PKG PKG UNIT / / PKG UNIT / / EERISEER YES NO REPLACING DUCTS YES NO YES NO REPLACING THERMOSTAT YES NO ., YES NO NEW 4 "CONCRETE SLAB YES NO YES NO NEW ROOF STAND YES NO YES NO E , - -, NEW RETURN PLENUM BOX YES NO 1. Minimum Circuit Ampacity (Wire Size): 2. Maximum Overcurrent Protection (Fuse /Breaker Size): 3. Voltage of Circuit (208/240/480): 4. Size Disconnecting Means: Contractor's Company Name: Phone: State Certificate or Registration N. Certificate of Competency N. Signature Date: (Quaiifler's signature only) Permit N. Miami Shores Vivage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR I ARCHITECT Owner's Name (Fee Simple Title Holder): /friar; -zet Owner's Address: ) 4! 5i YE /6,. . City: �i (ie�d ,SiittreS .6a ;etiSi Phone #: State : EL Zip Code: Job Address (Of where work is being done): /9s-d ,y / s City: Miami Shores State: Florida Zip Code: Contractor's Company Name: Oy■kserst Ake�\■c -�vc.A Se.c— Phone #: *n-(6 -3H6 -103 y Address: X12 &ice 135 City: Ak,c <n-,. Qualifier's Name : Lic. Number: c---,C: /291538° Architect/ Engineer of Record Name: Phone #: Address: City: State: Zip Code: State: FL c , Zip Code: 33)1- Describe Work: I hereby certify that the work has been abandoned and/or the contractorlarchitect is unable or unwilling to complete the contract. I hold the Buildin s Official and the ami/ hores harmless for all legal in Signature er or Agen The forego 'g ins ment was aknowledged before me this /4 day of FF�h ,20 8 Z. by,i1 _,,I i a, 440; .o Who i ;�. = rsona no. -to me or who has produced as indentification. Nota Sign: Seal: Pu tic: �.+° .�'; MARCELINO JUAN ALONSO i'l ;`z MY COMMISSION # EE074153 4' .9t.. e, EXPIR March 16, 2015 (407) 398.0153 ± ;0,..,d.+otary5ervice.com Signature The foregoing in ant was akn "1/ ' dged before me this `�3 Jday of !�'Zby who is personally k•wn to 'e or who has produced as indentiflcation. 1 I Y if Notary Publi Sign: Seal: CAMP Notary Public • State of Ronda My Comm. Expires Feb 18,2813 Commission • OD 862331 - .., _ DA r B,A.TC.. NUMBER AICIONIZICr CERTIFICATE OF LIABILITY INSURANCE OP ID: MA DATE (NWDDIyyyy) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HODER.I 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 endorsements). PRODUCER iSure Insurance Brokers 2700 SW 137 AVE Miami, FL 33175 Javier A. Fernandez INSURED Universe Mechanical & Air Conditioning Inc. 812NW135CT Miami, FL 33182 COVERAGES INSURERS) AFFORDING COVERAGE INSURER A: Cypress Property & Casualty NAIC # 10953 INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : 305-223-2533 305 - 220 -0765 CONTACT NAM PHONE INC. E-NWL No. Extk ADDRESS: PRODUCER UNIVE 2 CUSTOMER ID #: IFAX (MC, No) CERTIFICATE NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED REVISION D 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, INSR EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. L 'SUER WYD ADDL INSR TYPE OF INSURANCE A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I X ( OCCUR POLICY NUMBER GEN'L AGGREGATE LIMIT APPLIES PER: n POLICY n JECTT n LOC AUTOMOBILE UABILJTY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS GFL- 1009501 (D/YYYY) 11/20/11 IMPSRDYIYYIYYI 11/20/12 EACH OCCURRENCE UNITS DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) $ 1,000,000 $ 100,000 PERSONAL & ADV INJURY 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGO $ 2,000,000 UMBRELLA LIAB OCCUR EXCESS LIAR CLALMS -MADE COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) $ BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) $ DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Yr"7 OFFICER/MEMBER EXCLUDED? ' I (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below EACH OCCURRENCE AGGREGATE $ N/A LL.IIMI S I 0.1H- TORY $ E.L. EACH ACCIDENT E.L DISEASE - EA EMPLOYEE $ DESCRI N OF OF noys / / VEHICLE ttach ACORD 1 Adaltlo R ks Schedule, If more space Is required) AIR CONDMONING SYSTEMS INSTALLATION, SERVICE, OR REPAIR CERTIFICATE HOLDER E.L. DISEASE - POLICY LIMIT CANCELLATION MIAMISI Miami Shores Village, FLA Fax: 305-756-8972 10050 NE 2nd Avenue Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED ACORD 25 (2009/09) © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 01 -09 -2012 JEFF ATWATER STATE OF FLORIDA -CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE PERSON: FEIN: 01/09/2012 EXPIRATION DATE: 01 /08/2014 REY CLAUDIO J 271153383 BUSINESS NAME AND ADDRESS: UNIVERSE MECHANICAL AND AIR CONDITIONING INC 812 NW 135 COURT MIAMI FL 33182 SCOPES OF BUSINESS OR TRADE 1- AIR CONDITIONING CONTRACTOR 3- VENTILATION 2- REFRIGERATION IMPORTANT: Pursuant to Chapter 440 . 05(14), F.S., an officer of a corporation who elects exemption from this chapter by tiling a certificate of election coder this section may not recover benefits or compensation ender this chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on the notice of election to be exempt. Putsnaut 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 a, at any time after the filing of the notice or the issuance of the certificate. the person named oa the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. QUESTIONS? (8501 413 -1609 NC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01 -11 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA DEPARTMENT OF FINANCIAL. SERVICES DIVISION OF WORKERS COMPENSATION CONSTRUCTION I IDUSTRY CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS COMPENSATION LAW EFFECTIVE 01/09/2012 EXPIRATION DATE: 01/08/2014 PERSON CUUJDIO J REY FEIN 271153383 BUSINESS NAME AND ADDRESS: UNIVERSE MECHANICAL AND AIR CONDITIONING INC 812 NW 135 COURT MIAMI, FL 33182 SCOPE OF BUSINESS OR TRADE 1- AIR CONDITIONING CONTRACTOR 2- REFRIGERATION 3- VENTILATION IMPORTANT F Pursuant to Chapter 440.05114), F.S., an officer of a corporation who O 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 Rthe 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 of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. QUESTIONS? (850) 413 -1609 CUT HERE * Carry bottom portion on the job, keep upper portion for your records. NC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01 -11 SENDER: COMPLETE THIS SECTION ■ Complete items 1, 2, and 3. Also complete item 4 If Restricted Delivery Is desired. • Print your name and address on the reverse so that we can retum the card to you. • Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: Article Number (Transfer from service rebel) , 33612 COMPLETE THIS SECTION ON DELIVERY A. Signature X B. Received by (Printed Name) If YES, enter delivery address below: 0 No 1 0 Agent 0 Addressee 1 C. Date of Delivery D. Is delivery address different from ite m 1? ❑ Yes 3. Type vprCertified Mail 0 Express Mall 0 Registered 0 Return Receipt for Merchandise 0 Insured Mall 0 C.O.D. 4. Restricted Delivery? (Extra Fee) 7004 0750 0001 9095 9686 l EYee PS f=orm 3811, February 2004 Domestic Return Receipt 162595 -0240 -1540 UNITED STATES POSTAL, SERVICE First-Class Mail Postage & Fees Paid LISPS Permit No. G -10 • Sender: Please print your name, address, and ZIP +4 in this box • AcKr 'r C;41-s.)41 A-any j L .351.3T T C■ q‘31 i L(5 /VC_ i i spa /)11c;11 MS Ft_ 33/ ll NI 1 7004 0750 0001 9095 9686 FC0057700305181 U.S. POSTAG $5.31 FCM LETTER 33144 Date of sale 02/18/12 Nf 02 1P00 09242254 NIA= 030 CE 1 06 02/20/1.2 RETURN TO SEN ©ER NO SUCH NUMBER UNABLE TO FORWARD Be, ao.2. ea63Bs© Ar.O7t33- GiszB2- 1.0 -40 1,,JJ,,,))„ „JJ„ JJ,)f,J„ ,),J,1.) „�„1J,;J)„1,J,J),1 „),),) imam. snores v inage Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Owner's Name (Fee Sim i le Titleholcer) Own is dress 1 5D - City 1 0 ` State Tenant/Lessee Name Permit No. Master Permit No. Electrical Plumbing Mechanical) Roofing �y n Phone # C � D i� —(2) C Zip Phone # rr'' Job Address (where the work is being done) r l `'l3 N3 Ti 10 C City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO Contractor's Company Name A CSC K A Cs R e,p A/ R Phone # 3 0 5 et 7_8 02-0 y Contractor's Address / £ $ 0 Le.) . e4 6/ L S A iI City i A C �e A A. State / 4 Qualifier t14 /V U e / A GA / A Z A IQ Zip 2 3 ( ' 2 _ State Certificate or Registration No. C: A C 0 5 ' 1 SPar- rertifi to Competency No. ag(44.0 A- hone # (v - L Architect/Engineer's Name (if applicable) $ Value of Work For this Permit CC-X-2 , OD Square Footage Of Work: Type of Work: ❑Addition ['Alteration ❑New ❑ Repair/Replace ❑ Demolition Describe Work: GI/ A.1.) to o f4 * * ******* * **** *** * ** ** * s* *************************** Submittal Fee $ Permit Fee $ CCF $ Notary $ Training/Education Fee $ Technology Fee $ CO /CC Scanning $ Radon $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ Total Fee Now Due $ \ o :10 (Continued on opposite side) Bonding Company's Name (if a oplicable) Bonding Company's Address City , r State Zip 1 P Mortg ge- ,endertts Mane (ifit Mortgage Lender's Address City cable) State Zip Application is hereby made to optain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuaul a 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 W(iRK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, OILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I ce that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating co etion and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR ROVEMENTS 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 condi promise in good faith that a co whose property is subject to att for the first inspection which o inspection will not be approved Signature ion to the issuance of a building permit with an estimated value exceeding $2500, the applicant must of the notice of commencement and construction lien law brochure will be delivered to the person hment. Also, a certified copy of the recorded notice of commencement must be posted at the job site curs seven (7) days after the building permit is issued In the absence of such posted notice, the d a reinspection fee will be charged. Owner or Agent The foregoing instrument was acknowledged before me this day of ,20_,by who is personally known to me o NOTARY PUBLIC: Sign: Print: The foregoing ' ent was acknowledged before me thi day of 20 ( by who has produced who is personally known to As identif_cation and who did take an oath. as iden NOTARY PUBLIC: Mal Sign: ARRAN pro uced to . id an oath. My Conunission Expires: Print: m "i My Commission Expires: * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * * ** ** * * * * ** APPLICATION APPROVED B Cho 05/13/03 Plans Examiner Engineer Zoning ADDENDUM. TO BUILDING PERMIT APPLICATION (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER • RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR MAIN SERVICE REPAIR/METER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUND TANKS LAVATORY OVEN ABOVE (.ROUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS SHOWER MOTORS OVER 1- 3 11' HOT WATER BOILERS 5fNK, POT /3 COMP. MOTORS OVER 3- 5 If MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP COOLING TOWERS WATER CLOSET MOTORS OVER 100 HP VIOLATION INDIRECT WASTES -- A/C WINDOW REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS • HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER- REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS ;SIGN TRANSFORMERS UTILITY -SEWER _ SIGN TIME CLOCK UTILITY -WATER FIXTURES • SEPTIC TANK ANTENNA RELAY _ TELEVISION OUTLETS _ DRAINFIELD, 4' TILE/RES. VIOLATION _ PUMP & ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. CATCH BASIN DISCHARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE. STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) GAS PIPING FROM, ,31-A ;D.v)" FAX N0: Maya 03 2011 10:31AM. P1 LE A/C I Installations - Replacement 1680 W. 38 PL, SUITE Al - HIALEAH, FL 33012 Off: (305) 828 -0204 Fax: (305) 828 -0281 Cell: (786) 229 -7465 License and Insu 0 SERVICE CONTRACT Li TIME AND MATERIALS TOTAL An maiormt is I 9eerenleee to be as anetaled. As Wilt to be aorntemi in a ennimarlRki manner according to modem prances. any alteration or Othixt in from ibbve smegialtionsineniving extra miter estubetexecuted only Wan wntten meth., end will biome an extra champ over and agreements cofltt l ant wion sfraut t, aeementbrWays beyond aur cow trot owner to carry firth tornado and old necessary trutaanu. Qta`trorkma ere My covered by Workmen's Compppkot rnserance. Acceptance of proposal - The above ptsci, speolfisatione and condi. bens are satisfactory end are hereby accepted. You are authorized to d0 Me work as speaficd Payment will be made as Otrtlinefi above.. in the evem this proposal is accepted and paytnenl is to be in installments. ALEX A /C. *p all have the right to Inmed ateiy close all work. ALEX A/C or its agents, stem have the right to enter the vtomloes and remove any equipment or pmpetty placed on the prernises by • ALEX A/C.. In the event legal action is brought pursuant to this cvntaet ALEX A /C.. shall recover reasonable attorney's fees and cost In additkm to any and all sums due hereu der. ALEX A/C., liability for damages or for obilgsvons under this contltsot to the Purchaser shan not exceed the purchase prise. SIGNATURE:" THIS ACCOUNT IS SUBJECT TO A FINANCE CHARGE OF 1% PER MONTH IF NOT PAID IN FULL WITHIN 10 DAYS OF RECEIPT OF THE MONTHLY STATEMENT. 05/12/2011 01:01 3058299109 FROM :ADD ALL - LINES INS ASSOCIATES ,A_CORD,,, CERTIFICATE OF LIABILITY INSURANCE PRODUCER SAADHOMES FAX NO. :3053872918 A&D ALL -LINES INSURANCE ASSOC INC 82 49 NW 36th st *218 *iazo3, FL 331,E6 30,463 -6781 AUX A/c REPAIAS, XNO. 1680 W. 38 PLACE, SAY A -1 HIALEAH, FL 33012 -- I COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE ANY REQUIRIE NT, TERM OR OONDRN}N OF ANY CONTRACT OR OTHER DOCUMENT WITH R p GT TOE PW I1 H This CD�FIC�,A MANY DE ISSUED OK MAY PERTAIN. THE INSURANCE AFRORDIED SYTie POUCIES DE2CRIizEO HEREIN 15 SUBJECT TO ALL THE TERMS, EXGLUS►ONSAND coNDi7PI0 4$ OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAID GLAINEk. PAGE 02/02 May. 12 2011 09:1SRP1 p1 kumEommolYryr �iJ2/2011 THIS CERTIFICATE IS 188UED 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 E11► 'NE SIRIss BELOW. INSURERS AFFORDING COVERAGE NAILS INSURSRAk AMERTCAN VEHICLE INC Co. maim go mum =TM. Eveam8 6 Deemer MED INSURER C FC rth INSURER E INEMER E: POLICY UNARM GI.- 0511053543 08/28/10 08/28/11 OARS DACE ocOLMIONDE PERSONAL &ACVKim GENERAL AGG@EGATS PRODf, OTS eamimPACC =MED e. LINT CNLY•PAACCIDONT WoNTANTS FAACC 10890613 04/01/12 FAIRA9c1OGIT 04.018EAEI FA VOL EL. ThEEASE -Pa ay LSar $ 800,000_ _ 100,000, DELSCRIFh'MN OF OPERATIONN I LCCATwNB ! A/C SERVICES LIRT/O NYENDORSEIWENTiSPEE" PROVISION/II HOLDER CITE OP ZIP SHORES E3tTXr.DXNG DEPARTMENT 10050 MK 2ND AVRITETE MAME SHORES, t14 33138 ILL Anom **Az Afer Olt TM MOVE D S IRi5D POLICIES RE Wien= OEMORE NE ExpiRA DATA THEREOF. THE MUM uisURER r_N WILL P.ND6AVOR TD . � -fib DAyS > NOYIL'E TO RC rFI A" IN mum . >?IB + � OBLa61► . OUY FNLtn1p'�p pO gip 3r1A<1. TIDN OR UTs. AM' upon THE /REARS!, Amar$ OR REPRESemrl{ ing ACORD25{2001/08) GIDACORD CORPORATION 1$ FROM :A&D ALL -LINES INS ASSOCIATES FAX NO. :3053872918 May. 12 2011 09:16AM P1 ACORD. CERTIFICATE OF LIABILITY INSURANCE 5E12/ 01 5/..12/.2011 INFORMATION CERTIFICATE EXTEND OR BELOW. PRODUCER A&D ALL —LINES INSURANCE ASSOC INC 8249 NW 36th St *218 Miami., FL 33166 (305) 463 -6781 THIS CERTIFICATE IS ISSUED AS A MATTER OF ONLY AND CONFERS NO RIGHTS UPON THE HOLDER. THIS CERTIFICATE DOES NOT AMEND, ALTER THE COVERAGE AFFORDED BY THE POLICIES INSURERS AFFORDING COVERAGE NAIC$ INSURED ALEX A/C REPAIRS, INC. 1680 W. 38 PLACE, BAY A -1 HIALEAH, FL 33012 1NSURERA AMERICAN VEHICLE INS. CO. INSURER B: FLORIDA CSTEDE, E 8$ si !Mow Emu INSURER c: FUBA INSURER D: INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN 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 DESCRIBDED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS $ 10WNMAYHAVEBEENREDUCEDBYPAIDCLAIMS. �y �p� IV pQ�� p��{A��p IN-731-1 U TYPE OP INSURANCE POLICY NUMBER DA�E[MAAIa�,uT�� OA7EY(MMIDOfM N GENERAL LIABILITY COMMERCIA • GENERAL LIABILITY CLAIMS RIME E OCCUR GE 'L AGGREGATE LIMIT APPUES PER POLICY 7 jEcT n 1.00 GL- 0511053543 08/28/10 08/28/11 UWIITS EACH OCCURRENCE $ PREMISE $ M®p(P (Anyone person) $ PERSONAL & AM INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGO $ 1,000,000 ■ 100,.. 000 5,000 1,000,000 2,000,000 1, 000,, 040 AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS SCI•ILTDULRD AUTOS HIRED AUTOS NON- OWNL'DAUTOs GARAGE LIABILITY ANYAUTO EXCESSAIMBREI,LA LIABILITY OCCUR I_1 CWUMBMADE B DEDUCTHILE RETENTION $ (Ea accident) LE LIMIT (PRLp) (lir INJURY PROPERTY MANAGE (Pe r $ WORRERSCOMPENBATIONAND EMPLOYERS' LIABILITY ANY FROPRIETORIPARIN@RrERECUTIVE OFFJ R* a R EXO.UDED? SPECIAL PROVISIONS beiav OTHER 10640613 AUTO ONLY - EAACCIDENT $ OTHER O THAN EAACC $ AGG $ EACH OCCURRENCE AGGREGATE 04/01/11 xlAWIDA1 103F E.L EACH ACCIDENT $ 100 , 000 04/01/12 E.LDISEASE •RA EMPLOYEE $ 500,000 EL DISEASE - POLICY L6WT B 100,000 DESCRIPTION OFOPERATIONS/ LOCATIONS /VEHICLE'S/ EEXCLUSIONSADDED BY ENDORSEMENT /SPECIAL PROVISIONS A/C SERVICES CERIFICATE HOLDER CITY OF MIAMI SHORES BUILDING DEPARTMENT 10050 NE 2ND AVENUE MIAMI SHORES, FL 33138 ACORD 28(2001108) CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAO DAYS WRITTEN NOTICE TO THE CPRTIFICATE HOLDER = • THE . x bUT FAILURE TO DO,$O SMALL IMPOSE NO OBLIGATION OR LIAR A( • UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTA BIACORD CORPORATION 1988 FROM : FAX NO. : May. 12 2011 09:42AM P1 .44i442.1-4,1# 4.,Z0 l• FROM : FAX NO. : May. 13 2011 11 :41RM P1 Do Ilan QRiiiti4Rti PEDRO: ;: ' VE A. * • • PRE' P•'�L 33'01.2 • 53 SAAHO ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE (MM011 YY) 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(tes) 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 endorsement(s). PRODUCER Advanced Ins UMW of Boca Raton 21845 Powerline Rd-Ste 205 Boca Raton, FL 33433 954 963 -6666 CONTACT NAME: PHONE 954 963 -6666 FAX 9549641438 No, Ext): (A/C, No): 549641438 -MAIL ADDRESS: - PRODUCER CUSTOMER ID #: INSURER(S) AFFORDING COVERAGE NAIC # INSURED Saad Homes Inc. 18601 Wentworth Drive Miami, FL 33015 INSURER A: Mid-Continent Casualty Company INSURER B: Bridgefield Employers Ins. Co. 04GL00081551 INSURER C 03/09/2012 INSURER D : $1,000,000 $1 00,000 INSURER E : DAMAGE PREMISES (Ea occurrence) INSURER F : CLAIMS -MADE 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 DESCR BED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL NSR EUBR NVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A GENERALLIABILIIY COMMERCIAL GENERAL LIABILITY OCCUR 04GL00081551 03/09/2011 03/09/2012 EACH OCCURRENCE $1,000,000 $1 00,000 X DAMAGE PREMISES (Ea occurrence) CLAIMS -MADE X MED EXP (My one person) $Exclu£t_ed X PD Ded: $1,000 PERSONAL &ADVINJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 7 POLICY n JFa fl LOC PRODUCTS - COMP/OP AGG s2,000,000 $ A AUTOMOBILE UABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS 04GL00081551 03/09/2011 03/09/2012 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X $ UMBRELLA LIAR EXCESS UAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ _ AGGREGATE $ DEDUCTIBLE RETENTION $ $ B WORKERS COMPENSATION EMPLOYERS' LIABILITY ANY PROPRIETOREXAC NERIE A (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS EC YN NIA 83028713 03/01/2011 03/01/2012 X WCSTATU- OTH- ER TORY LIMITS E.L. EACH ACCIDENT $500,000 E.L. DISEASE - EA EMPLOYEE $500,000 below E.L. DISEASE - POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more apace is required) CERTIFICATE HOLDER CANCELLATION City Of Miami Shores 10050 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 ACORD 25 (2009/09) 1 of 1 #S729053/M728189 t J `7 ©1988 -2009 AC RD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD KAD 05/12/2011 01:01 3058299109 FROM FRX N0. : SAADHOMES PAGE 01/02 May. 12 2011 05; 42RM P1 f Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Applicant 1450 NE 101 Street Miami Shores, FL 1132050240040 Block: Lot: NATASHA GAIQUI & MARITZA G Owner Information Address Phone CeII NATASHA GAIQUI & MARITZA GAIQUI & FIRST UNION PO BOX 40062/C MOORE JACKSONVILLE FL 32231 -0062 1 Contractor(s) ALEX A/C REPAIR Phone (305)828 -0204 Cell Phone Valuation: Total Sq Feet: $ 2,000.00 0 1 Tons: Additional Info: CHANGE DUCT WORK Classification: Residential Approved: In Review Comments: Date Denied: Scanning: 1 Date Approved: : In Review Type of Work: , Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $1.20 $2.25 $2.25 $0.40 $150.00 $3.00 $1.60 $160.70 , Pay Date Pay Type Amt Paid Amt Due Invoice # MC -4-11 -40743 05/13/2011 Check #: 8707 $ 160.70 $ 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. May 13, 2011 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date May 13, 2011 1 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 169635 Permit Number: PL -2 -12 -198 Scheduled Inspection Date: September 06, 2012 Permit Type: Plumbing - Residential Inspector: Hernandez, Rafael Inspection Type: Final Owner: Work Classification: Addition /Alteration Job Address: 1450 NE 101 Street Miami Shores, FL Project: <NONE> Phone Number Parcel Number 1132050240040 Contractor: AGE OF EMPIRE INC Phone: (305)851 -5897 Building Department Comments INSTALL NEW SHOWER, WATER CLOSET LAVATORY KITCHEN SINK AND FRIDGE WATER SUPPLY (ONLY SET) Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comment September 05, 2012 For Inspections please call: (305)762 -4949 Page 3 of 26 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 Permit No. 77 �� Master Permit No. '�,._..) 1) — 41 1 t BUILDING PERMIT APPLICATION FBC 20 Permit Typ . PLUMB OWNER: Nam ee Simple itleholder): /A0.44* Address: ��//�� /1)50 A/L. (D 1 City: Maras', 5j% B Y: Tom.® J Iiu Phone#: State: F1 . Zip: Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: /1/50 W /4/ City: Miami Shores Folio/Parcel #: //3x502= 16®14 County: Miami Dade Zip: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: AGE OF PZE zAic, Phone#: 36c- /- d� Address: £2 to L4 City: AiGA o 3.3 L State: F L Zip: Qualifier Name: t4 r�/a,0 e Phone #: State Certification or Registration #: ��L — / g2..761,3 Certificate of Competency #: Contact Phone #:.jam -KS f `5117 Email Address: /74a A ' i►L . CotM DESIGNER: Architect/Engineer: ) A—% Y4 Phone #: 4616 P 1e, L e '4 Value of Work for this Permit: $ 3 O .' Square/Linear Footage of Work: Type of Work. OAddress alteration New ORepair/Replace ❑Demolition Description of Work: '1ro5 .\\ fg G\e‘ �e-r- 1 C � 1 ''1 �� `=,cn eS® w �a G S Ofi�y s� r�. i. a **** ** ******* ****** ************m****** Fees: ************* ** **** **** * **may * ******+x+x***** Submittal Fee $ Permit Fee $ /5-e, CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 1 (o -3 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 t commenced prior to the iss construction in this jurisdicti WELLS, POOLS, FURNAC obtain a permit to do the work and installations as indicated. I certify that no work or installation has ance of a permit and that all work will be performed to meet the standards of all laws regulating n. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, S, BOTT.ERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AIFR)AVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating co struction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMEN 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 co promise in good faith that a whose property is subject to for the first inspection whic inspection will not bg approv ition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must opy of the notice of commencement and construction lien law brochure will be delivered to the person ttachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the and a reinspection fee will be charged. The foregoing instrument was ackn nledged before me this ' day of AJL ,20) ,b(y Tat ,61) , who is pe e or who has produced As idei!tification an who did take an oath. NOTARY PUBL Sign: Print: My Co * * * * * * * * * * * * * * * * * * * * * * * * - * * ** * * * * * ** * * * ** Signature / Contractor The foregoing instrument was acknowledged before me this 27 .)erson , 20/2 , by , %rcj+%e) A ,050 erson lly known to me or who has produced f .:li ntification and who did take an oath. BLIC: Print: ,j '= My , "LIP' Comm. Expires Sep 23, 2015 �'A: Commission # EE 128810 My Co pit tied Through Natio;,ai Notary Assn. day of ho is APPROVED BY / e2 / ZFians Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) OTA Y P Zoning Clerk