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RC-13-1526 (2)
BUILDING PERMIT X Permit JOB ADDRESS: Munn' Shares Village Bu'Idng Department - -__ Tel: (305) 795.2204 Fax: (305) 756.8972 J INSPECTION'S PHONE NUMBER: (305) 762.4949 4 FBC 20 [C3 BUILDING a] Permit No. Master Permit NO.IRGI'5—" 1 ROOFING Ifiami,Shom C*UBW- Miami Du& . - Folio/Parcel #: �l `62o� DCA mcco Is the Building Historically Designated: Yes NO Flood Zone: Address: MU L N% qL - do city: _ l w 1111 state• Zip:.. Zffi13 g Ttnantaxsee.Name: Pig Email: Address: - 490 Nf4� l . City: m 1, A i State: L zip: i I✓ Qualifier Name: t® �. Phone#• 9Lc oZ 6?42- 1 State�caiion Regi tiers. UV-V:. Y 1��y _� ,Gf py* 1 Contact Phone#: Email Address: he4A 1 DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: „ _ e _ $quare/Linear Footage of Work: Type of Work: ❑Addition ❑Alteration ❑New �kepair/Replace Description of Work: ` k-" np�, Color thru tile: Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ $Uvctaral Review $ CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ ❑Demolition TOTAL FEE NOW DUE $ `� I PERMIT#�I CONTRACTOR: d }�("� VE 7 SUBMITTAL DATE: 1 ADDRESS:I Y �j NAME: t �- RESUBMITAL DATES: PROJECT TYPE: STRUCTURAL - _ ct rA�w.w • . � � S i/ Sk le MECHANICAL FEES L ,Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State zip zip- Appfimtion is Imeby made to obtain; a perms to do do wmt and fintWhidom as indkwx& Icedi�r no wott or commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating consawfim im this jurisdteffm i underamd that a sepmw permit must be swured for EL CAL NVOW PLUMBM, SKM, WELIS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC..... OWE AITMANM, I cerffy dart aft the is a== and dw aff work wift be d applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COIVIlVENCEMENT 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." Owner or Agent 1 Contractor The foregoing instrument was acknowledged fore this ®� The foregoing instrument was acknalWged before me s A04 day of T4 N , 201, by ;#4 0 by 1* . cson I� -�eor 1 g =tin ..,,..,.�., �� "iVfnU- �, , mas identfication and who did take an oath. as 1 My Commission Expires: /VZF Structural Review (Revised 3 /12/2012)(Revised 07/10/07)(Revised 06/10nAM)(Revised 3/15/09) Clerk CERTIFICATE OF LIABILITY INSURANCE 6/3/2013 producer. Lion insurance Company Thisc rtilkate Is Issued as a matter of Informaltim onlywWandlers.,ror4*11s 2739 U.S. Highway 19 N. Holiday, FL 34691 upon the cite Holder. This Certificate does not amend, emend or aNw the owatraw afforded by the policies bek w. bmurers Affdrding CoYerage NAIC # (727) 938 -5562 Insureds South East Personnel Leasing, Inc. & Subsidiaries 2739 U.S. Highway 19 N. Holiday, FL 34691 Inurerk Don Insurance Company 11075 Insurers: Inner : Insurer D: Insurer E: Coverages TM poficteeofinsufanoO hsted Wow have been r0XW named above for pouq penod IrKicated. urg any or on any w Itis certtttcata may be issued ormay pertain, the irsurarce afforded bytte po®des desaibad herein is stubjedto all f , coct siors, and conditions of such pothdes. Aggregate amtts shown may have been reduced by paid cairns. R LTR MRp Type of Insuarme Poky Number Policy Effective ewe Pricy Expiration Date Limits (MM/DD/YY) (MM/DD/YY) GENERAL L IABBJTY Each Occurrence Commercial General Liability Claims Made 13 Occur Daresp to warted ) ppremises reed EV isond Adv irtjwy r. neral aggregate Omit applies per General Aggregate Po6g ❑ Project ❑ LOC Produce- CompfOpAg9 uTOLIOBILE LJABILITY CombirredSIMIsUrM Any Auto (EA Accident) U Roft" Ao OwMd Autos scheduled led Autos (P- Person) Hied Audcs may" ?bm-Cv edAutos (FWAcddeM Property Damage (PerAaddent) EXCESSPJMBRELLA LIABILITY EadrOcaanace 000Z 0 Claims Merle Aggregate Dedu t1we A Workers Compensation and WC 71948 01101/2013 01/0112014 L12 tate- I OTI+ I Empk)yerW Liability mts ER E.L Each Accident Any proprietor/partnedex Ailliv a officertmember exduded? NO -- E. _ - LDisease - F� FJrhployee - $100,000 If Yes, describe under special provision below. E.L. Disease - Policy Limits $1,000.Qim Other Lion Insurance Company Is A.M. Best Company rated A- (Excellent). AMB # 12616 Descriptions of Operations /LocatlomslVehk leslExchtskms added by Endorsertumnpechd provisions: Client ID: 84- 65-534 Coverage only applies to active employees) of South East Employee tag Serve, Inc. that are leased to the following "aberit Company°: David Hester, M= Coverage only applies to irquries incurred by South Fast Personnel Leasing, Inc. & Substdlaries ate employees) , while working in Florida. Coverage does not apply io statutory employees) or indeperalerrt canh(s) of the Cent Company or any other entity. A list of the active employee(s) leased to the Client Company can be obtained by fWdng a request to (727) 937 -21M or by calling (727) 938-5562 Project Name: ISSUE 01 -02 -13 (SD) / REISSUE 08 -03-13 (TD) Bealn Dates 10 19 2011 CERTIRCATE HOLDER CANCELLATION MIAMI SHORES VILLAGE Should aryofte above described po6desbe carucelled before the eWraliondateftwMt the Issuing Inumv is BUILDING DEPARTMENT erdeawrto and 30 days written notice to to c819cate taidernamed to the Wt buttathre to do so sha0 impose no obtlWon wUabittly ofaryldnd upon fie usurer, Its agents w represertstives. 10050 NE 2ND AVE MIAMI SHORES, FL 33138 _ CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDNYYY) 1613013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFER 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 IWAMR(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certficate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. H SUBROGATION IS WANED, subject to the terms and condkions of the policy, certaln pollcies may nxpdm an endomement. Astatement on this certificate does not confer r%Rft to the certficate holder M lieu of such endorsement(s). PRODUCER NAME: Sarai Medina EMMANUEL INSURANCE &ASSMINC 2370 E MAVe Hialeah, FL 1 License#:D074632 PHONE . (305)693-0003 WE, No):(305)6914381 ADDRESS: man InSUranCe.Com �vsts) AF�oRD�lo ccE NAIC# INSURER A: Preferred ContractorslnS Co 12497 INSURED DAVID NESTER, INC. INSURER B: $1,000,000.00 INSURER C: X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE [n 1 OCCUR 420 NE 115 Street INSURER D: Miami,FL 33161 INSURER E: $ 50,0W.00 INSURER F: $ 5,000.00 A 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. NOTIMTHSTANDING 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. - R TYPE OF INSURANCE Ilm WVD POUCY NUMBER- (MMND/YYYY) (NIM/DD/ rm LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000.00 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE [n 1 OCCUR PREMISES ((Eaa 0=mence) $ 50,0W.00 MED EXP(A wwopemm) $ 5,000.00 A y PC2605926-00 1016012 10M13 PERSONAL BADV INJURY $1,0w,000.00 GENERAL AGGREGATE $2,000,000.00 GERL AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000.00 X POLICY WT LOC $ AUTOMOBILE LIABILITY a acddent $ BODILY INJURY (Per person) $ ANYAUTO ALLOWNED SCHEDULED AUTOS AUTOS BODILY INJURY aociderd (Per ) $ NON -ONMED HIRED AUTOS AUTOS PROPERTY DAMAGE (Per aoddent) $ $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED I I RETENTION $ r $ V\ORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN A7U. TOR LIMITS JOTER E.L. EACH ACCIDENT $ ANY PR0PPoEroR1PARTK%Ro=L WE F1 OFFICERME BER EXCLUDED? (Mandatory In NH) NIA E.L. DISEASE- EA EMPLOYEE $ Ifyes, describe wxW EL DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS belaw DESCRIPTION OF OPERATIONS ILOCATIONS /VEHICLES (A>fwhACORD IOI,Add Ren SchWWe,ff more is ragied) General Contractor CERTIFICATE HOLDER r.ANCFI I A-nnnl Miami Shores Building Dept. 10050 NE 2nd Avenue SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN MIamlShores, FL 33138 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REP ATNE 01198&2010 ACORD CORPORATION. AA rights reserved. ACORD25 (2010 /05) The ACORD name and logo are registered marks of ACORD LiczasniG BOARD 1940 NORTH MONROE STREET -lw TALLAHASSEE . FL 32399-0783 I I N . I DAVID PAM DAVID SLSTEit, INC 4 2 0 NmME 115TH STREET MIAMI FL 33161 (850) 487-1395 _0 LOROA 'STATE -10-F -IF IC RIICTION MD. S Ll-CZNSz 0 60..00� 0 Fl 6 AVID ST R N --1 I r 55 �YAS_ FNW- GLASas U.S. POSTAGE i PAID MUM F1 PEFMr NO. 231 691974 -1 THIS M A BILL - DO NOT PAY RENEWAL BUSHaMS NAME I LOCATION RECEJPT NO. 7195$2 -9 DAVID HESTER INC STATED CRC1330537 420 HE 115 ST 33161 UNIN DADE COUNTY OWNER DAVID HESTER INC [LDING CONTRACTOR TAX 07/17/2012 60060000533 000075.00 SEE OTHER SME WORKER /S 1 DO NOT FORWARD DAVID HESTER INC DAVID HESTER PRES 420 NE 115 ST MIAMI FL 33161 �rt tsr��atst�ls��tttta1 ltf#ssJistIII$IliftMIlliltsMull A w k JILL 0 9 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 mast be attached) PROPERTY OWNER: PERMIT # ADDRESS: C� FOLIO NUMBER: k X �2-� C FLOOD BASE FLOOD ELEVATION: FREEBOARD: EAST OF FL.CCCL: COST OF PAST IMPROVEMENTS (12 MONTHS): COST OF PROPOSED IMPROVEMENTS: s E5 ` ° oo (ATTACH COPY OF- CONTRACTj! TOTAL CUMULATIVE COST OF IMPROVEMENTS (past and proposed): -5c) ° L Web's-�%ac-' VALUE OF PRINCIPAL STRUCTURE OWNERS SIGNA PLANREVIEWER: Leh -a ru' PLAN REVIEWER SIGNATURE: DATE: Created on June 2009 David Hester, Inc. 420 N.E. 1157" Street Miami, Florida 33161 78&294 -0954- Office CRC1330537 Contract Agreement To: Erica Richter Re: Bathroom Renovation Address: 1269 N.E. 9e street Contract #: 20399 Date: May 22, 2013 SCOPE OF WORK: 1. Remove all the off walls, remove wall surface from floor to ceiling, ceiling to remain. 2. Install new green board on waAs, concrete hard in shower area. 3. Remove & reinstall owner's toilet 4. Install diverter valve, & tub, owner to supply. S. install owner supplied tile, and corner shelves, in tub area only. 6. Floor file & floor base also included, labor only 7. Prime and paint walls, ceiling and door. 8. Install owner supplied toilet paper holder, towel bars & hooks. 9. install owner supplied medicine cabinet/ mirror. 10. Install owner supplied light fixture. 11. Main permit & Ptum rs r i included. 6t &�,"4 NOTE: 1. No electrical work, ' es lig t ' stall is ude 7 2. Tlie, thinsets, wail set &grout not included. 3. Permit fees, not included. Total Cost: $382.5.6u;com2p1;etlon.-()O Payment Schedule upon drywall completion, $500.00 upon the completion, $5W. Authorized t: Date: 1� t Acceptance of Proposal The above prices, terms and conditions are here y accepted. You are authorized to do the work as specified. :, David Hester, Inc. 420 N.E.115P Street Miami, Florida 33161 786- 294 -0954 -Office CRC1330537 Contract Agreement To: Erica Richter Re: Punch out items Address: 1269 M.E. 9e street, Miami Shores Contract #: 20404 Date: May 22,2013 SCOPE OF WORK: B. Bathroom # 2 1. Install glass shelve above pedestal sink. �- - ` 2. Regrout as needed, included shower area. ;-, 3. Paint bathroom. ° a. C Kitchen ` 1. Rehang comer cabinet door. 2. Touchup chipped cabinet door. 3. Regrout where cabinets meet ceiling. 4. Regrout granite counters as needed. S. Paint. D. Florida Room: 1. Regrout crown molding. E. Green Bedroom: 1. New closet door painted & install { LA_VZi. 2. Sand & repaint door frame of bedroom door. F. Outside patio: 1. install new ceiling fan where existing fan was previously. H. Have mirror repaired. Note: 1. Owner to supply paints for KitchTll, - athroom & doors in green room. Total Cost: $1325.0 0 ri Vk � Payment Authorized AgenE -°_ "- It Y-,- ) \1 Date: My Home B r a - .- Show Me: Propertyhfortna�n � Search By: S�ed�xrt ,; PA Text ,IV Property Appraiser Tax Estimator Property Appraiser Tax Co marison Portability S.O.H. Calculator Lary Details: 05 -009-0260 NE 98 ST S CARROLL &W ERICA NE 98 ST MIAMI SHORES Property Informatlon: III dmary Zone: 1400 SGL FAMILY - 3001- 250 SO LUC: 001 RESIDENTIAL - SINGLE FAMILY Living Units 1 dl Sq Footage: 1,920 Lot Size: 8,175 SO FT Year Built: 1946 arket Value: RLETON SHORES PB 333,693 3-80 LOT 15 BLK 2 LOT agai Description: IZE 75.000 X 109 OR 19600 -0919 03 2001 1 OR 19600 -0919 0301 00 AscnAS¢mant Inthrmatinn- ear: 2013 2012 and Value: $148,975 142,036 wilding Value: $172,729 191,657 1297,877 arket Value: $321,704 333,693 seed Value: $302,940 EXem ttiOn Informatlon: ear: 2013 2012 Homestea $25,000 $25,000 nd Homestead: YES YES iaxanie varue Inrormasron: Year: 2013 2012 Taxing Applied Applied Authority. Exemption/ Exemption/ Taxable Value: Taxable Value: Photography - 2012 r TO EMT ;' 9 0 111 ft My Home I Property Information I Property Taxes My Neighborhood I Property Appraiser Home I Using Our Site I Phone Directory Privacy ( Disclaimer experience technical diltxcuities with the Property kdormatim application, or wish to send us your comments, questions or suggestions please emalt us at Webmaster. Web Site © 2002 Miami -Dade county. All rightsreserved. Legend .4W PropeBoundary Selected roperty Street / Highway Miami -Dade County water N YM 6 S 25 ,000/$277,940$25,000/$272,877 ��a �$ I ` Snla Infnrnatinn- Date: Amount: Olt: are qualified Additional Information: unity Development District unity Redevelopment Area aennentZone rise Zone I nd tie Development Boundary Valorem Assessments m 13A+Vlyw" vAU/--TtIe- T-, 7-0 17-1 CD ch BATHWOM RECEPTACLE ON 20 AMP CKT AND G-F I PROTECTED co < ca CD L Vj ADD SMOKE/CARBON MONOXIDE DETECTORS. ANY AND ALL CLOTH AND RUBBER INSULATED CONDUCTORS To BE REPLACED. C �& K�� s I - I - 7J, • CL �T}�CVn s� f —,� Cc .Z`\ L .� WALLS 10 I I red Tws vHn-irl <— MC q& -I*eje.+,, eas+ -�