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RC-14-356 (2)BUILD)[NG 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. FBC 20 PERMIT APPLICATION Master Permit No. A C N ' S6 o. Permit Type: BUILDING ROOFING JOB ADDRESS: t f14 0 1;�_ �.i� . y ,yam City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Il- '�`.n C_ [amt - 002jo Ifs the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): C�S ��� , Phone#: Address a City: State: Zip: '3.3) C> Tenantkzssee Name: Phone#: Email: CONTRACTOR: Company Name: I �- � KhC4 Cq �p Phone#: ��8C) 2 -ZZ, l8)-6 r Address: 11TOO KC- 4k:yk C6v r + City: 44kq rn i State: zip: 3.313 8 Qualifier Name: LUIS T-1* -A ` 1R- "'Phone#: [I State Certification or Registration #: C-GqG A4-1Lb q0 Certificate of Competency #: Contact Phone#: (I SC ) Z'zz. lq 1 6 Email Address: DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑Addition QAlterOation ❑New �� ❑Repair/Replac`er `- ❑,Detmolition Description of Work: �('a� A f1L ► `� �P:'f rL*e� c,�le C�� J1A A lot r Color thru tile: Submittal Fee $� `!/ Permit Fee $ f CCF $ CO/CC $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ DBPR $ Bond $ sm. 00 Technology Fee $ TOTAL FEE NOW DUE $ Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED. IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LICENCES B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE* D. COPY OF WORKERS COMPENSATION INSURANCE* IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT B. COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT C. COPY OF LIABILITY INSURACE* D. COPY OF WORKERS COMPENSATION INSURANCE* *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 ■•rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr� COMPLETE CONTRACTOR'S INFORMATION BUSINESS NAME: BUSINESS ADDRESS: i L w aid ,r• CITY STATE q `- ZIP CODE fk 1 '� l BUSINESS PHONE: OLE—) % g i c FAX NUMBER (__) CELL PHONE �_) QUALIFIER'S NAME: Fk' QUALIFIER'S LIC NUMBER: _ "(L,.ys 1i ®l c Created on 3119109 BY MLDV 1 RV 3126109 MLDV I RV 6127111 AS ` CERTIFICATE OF LIABILITY INSURANCEDA O(MM 4/2014 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: H the certificate holder is an ADDITIONAL INSURED, the poticy(ies) 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 Hsu of such endomemenf(s). PRODUCER CONTACT Vcky Fernandez Occidental Risks Services, Ittc PHONE (305 433-4 8 FAX NO). (305) 420-6814 MAIL Jcky@occ)dentaldsks.com 11890 SW 8st Suite 500 INSURERS AFFORDING COVERAGE NAIL e Miami, FL 33184 INSURER A : Repubfic-Vanguard Insurance Company Phone 305) 433-4068 Fax 888) 678-2045 INSURED INSURER B: INSURER C: The Narsha Group LLC INSURER 0: 7500 N.E. 4th Court INSURER E: Miami, FL 33138 INSURER F : COVERAGES CERTIFICATE NUMBER: KCVISIUN 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. INSR LTR TYPE OF INSURANCE ADDLSUBR IRID POLICY NUMBER ODY EFF IMMID POLICY EXP LIMITS A GENERAL LIABILITY © COMMERCIAL GENERAL LIABILITY F-1❑ CLAIMS -MADE © OCCUR ❑ Y N PGLOO4816-13 082013 08/08/2014 C CURRENCE $ 1,000,000.00 D Ids ce $ 100,000.00 M m EXP (Aa nen $ 5,000.00 PERSONAL& A4V 9NJURY $ 1,000,000.00 GENERAL AGG GATE $ 2,000,000.00 GEML AGGREGATE LIAR APPLIES PER: ❑ POLICY ElFRO- ❑ LOC PRODUCTS - 4bmptop AGG $ 2,000,000.00 $ AUTOMOBILE LIABILITYOMBIN ❑ ANYauTo ALL OWNED SCHEDULED ❑ AUTOS ❑ AUTOS ❑ HIRED AUTOS ❑ AUTOSW NED ❑ SINGLE LIMIT a e eI ent LY INJURY (Per person) $ �DILY INJURY (Per accident) $ PRO entDAMAGE $ $ ❑ UMBRELLA UAB [:]OCCUR ❑ EXCESS UAB ❑ CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ El DED RETENITON $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETORIPARTNEROMCUTtVE OFFICEWMEMSER EXCLUDED? pundatany In NH) E-1E.L. I ves. describe under DESCRIPTION OF OPERATIONS bekyw NIA W C STATU OTH E.L. EACH ACCIDENT $ DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, B mwre space Is required) GENERAL CONTRACTOR CERTIFICATE HOLDER CANCELLATION O 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) OF The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE VILLAGE OF MIAMI SHORES 10050 NE 2 AVENUE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. MIAMI SHORES VILLAGE FL 33138 AUTHORIZED REPRESENTATIVE O 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) OF The ACORD name and logo are registered marks of ACORD CGC UCENSEjpeg STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET .+ TALLAHASSEE FL 32399-0783 NARANJO LUIS FELIPE THS NARfiHA GROUP, LLC 7500 NE 4 COURT MILMT FL 33138 Congratulations! With this ficense you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong, Every day we work to improve the way we do business in order to serve you better. For IMormadon about our services, please log onto www.my0oridafeo"e.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department Is: License Efficiently, Regulate Fairly. We oonstarrtly strive to serve you tetter so that you can serve your customers. Thank you for doing business in Florida. and congratulations on your new license! STATE OF FLOMA AC# 6 30,? & 2 9 DEPART14ENT OF BUSINESS AND PROFESSIONAL REGULATION CGCISII070 08/27/12 128057219 CERTIFIED GENERAL CONTRACTOR NARANJO, LUIS FELIPE THE MARSHA GROUP, LLC IS CERTIFIED -d®r the p,—iSion- as Ch.489 FS a pass — ace, AUG 31, 2014 =082702110 DETACH HERE THIS DOCUMFNTHAS O • . AC#6307129 STATE OF FLORIDA DEPARTMENTS?ONRIIppggSTLICgg ONINDUSTRY Np STRYNppNtL REGULATION OARD SEQ L12082702110 The GENERAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chappter.409 FS, ftpiration date% AUG 31, 2014 NARANJO, LUIS FELIPE THE NARSHA GROUP, LLC NS 4.COIIRT MIAMI FL 33138 RICK SCOTT GOVERNOR DISPLAY AS REQUIRED BY LAW KEN LAWSON SECRETARY 2/12/14 11:49 PM about:blank Page 1 of 1 occ license receipt Jpg 2/12/14 11:49 PM -014 details - Business Tax Account MARSHA GROUP LLC THE - TaxSys - Miami -Da... Page l of 1 .I r an 1iaat- -, .GaU"(►a Tax CollecborHorne Search .Reports Shopping Cart 204 Deftft --- Busmm T&X ACM1111111 NARSHA GROUP LLC THE Business Tax Account #6729553 Ac cow t details Account history -20-14-----101- 2012 I 2011 Paid Paid Paid Paid Account number: 8728553 Business start date: 1210//2010 Business address: NARSHA GROUP LLC THE 7500 NE 4 CT MIAMI, FL 33138 Physical business location: MIAMI Receipt And Occupations Owner(s): NARSNA GROUP LLC THE 7500 NE 4 CT MIAMI, FL 33138 Mailing address: NARSHA GROUP LLC THE LUIS FELIPE NARANJO MGR 7500 NE 4 CT MIAMI, FL 33138 It Print account application (PDF) Receipt 7002987 Paid 2013-10-07 $49.50 ronfrec dng 10101P2013 NAICS code: Recelpt #CREDITCARD-14000471 Print 3ENERAL BUILDING 4013012014 2389 this bill :ONTRACTOR Units: I 4ddlttottal documentation reciLdrad: CGC1511070 State/County License or Certificate t> k iness tax."accounts/6729553 10/7'201 �Tic7bL mess tax/accoun1bV67i4S4'2 I^ _- about:blank Page 1 of 1 JEFF ATWATER CHIEF FINANCIAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION *' CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW CONSTRUCTION iINDUSTRY EXEMPTION This Certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 9/14/2013 EXPIRATION DATE: 9/14/2015 PERSON: NARANJO FEIN: 273052567 BUSINESS NAME AND ADDRESS: THE NARSHA GROUP LLC 7500 NE 4 COURT MIAMI LUIS FL 33138 SCOPES OF 9US1&i11" OR TRADE: LICEN,siffGENERAL CONTRACTOR ° ^� F Pursuant to Chapter 440.05(14), F. S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exampt... apply only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05(13), F.S. Notices of election to be exempt and certificates of election to be exempt shell be subject to revocation if, at arty time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirernents of this sectiom DFS -F2 DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 07-12 QUESTIONS? (850)413-1W9 2/12/2014 Detail by Entity Name f"$ZI0�R-0.14t'_'i*'_t,...�..�"' EiAitA' ,ijar"E� {��SS loadAq�r Florida Limited Liability Company JESSAM INVESTMENTS, LLC Filing Information Document Number L03000051105 FEVEIN Number 201002548 Date Filed 12/09/2003 State FL Status ACTIVE Last Event CANCEL ADM DISS/REV Event Date Filed 03/09/2010 Event Effective Date NONE Principal Address 3980194 TH LANE SUNNY ISLES, FL 33160 Changed: 01/04/2007 Mailing Address 3980194 TH LANE SUNNY ISLES, FL 33160 Changed: 02/20/2012 Registered Agent Name & Address HESKIEL, RAOUL 3980 194 TH LANE SUNNY ISLES BEACH, FL 33160 Address Changed: 01/04/2007 Authorized Person(s) Detail Name & Address Title MGRM HESKIEL, RAOUL 3980 194 TH LANE SUNNY ISLES BEACH, FL 33160 http://Seareb sunbiz.orglInquiry/CDrporationSearchtSearchResuliDetalE.ntityNamelflal-103000051105-3495a484-4854-4305-8533-4f2l3l554297jessam%20invest... 1/2 Prepared by: Aibe UM law 5404 Cypress CenterDrive Smite 300 Tama, Florida 33609 Our No Ntattier: TPA13 3606 i as a necessary incident to the Ufillmem of ootdidons contained in a title fi u mm commitmem issued by it Property Appraisers Parcel I.D. (folio) Number (s):11-3206-001-0030 CFN: 20130582618 BOOK 28740 PAGE 2018 DATE:07/2512013 09:28:13 AM DEED DOC 1,458.00 HARVEY RUVIN, CLERK OF COURT, MIA-DADE CTY SPECIAL WARRANTY DEED Thin Special Warranty Deed, made thV rl 0 n9y of July 2013 by OneWest Bank FSB, having its place of business at: 888 l3. Walnut Avenue, Pasadena, CA 91101 here by called the grantor, to Jean Investments LLC , whose Post Office address is: 3980194th Lane, Smmy isles Beach, FL 33160 hereinafter called the grantee, W I T N E S S E T H:That p antor, for and in consideration of the sum of $10.00 and other valuable cortsiderations, receipt whereof is hereby acknowledged, by these presents does grant, bargain, sell, aliens, remise, releases, conveys and -confirms unto grantee, all that certain land situate in Mlsmi-Dade County, Florida, viz: Lot Three (3) of Marilyn Heights, wording to plat thereof, recorded in Plat Book 41, at Page 8, of the Public Remnis of Dade County, Florida. See Attached Exhibit TOGETHER with all the tenements, hereditaments and appurtenances thereto belonging or in anywise ing- TO HAVE AND TO HOLD the same in fee simple forever. GRANTOR'S WILL WARRANT and forever defend the right and title to the above-described real property unto the Cnantees against the claims of all people, claiming by, through or under Grantor's, but not otherwise. (v www used herein tke tams "w=W wd -®ramie• mdluded all the parties to nys ice, ane the kegs, Ierl representatives and snows of indWWook and rte amesememi assigns efomparatiam) IN WITNESS WHEREOF, the grantor has caused these presents to be executed in the name, and its corporate seal to be hereunto affixed, by its proper officers thereunto duly authorized, the day and year first above written. QWB REO. = a DivWofi of OneWist Bank FSB 2900 Esperann Crossing Aus* TX- 78758 July 11,2011 AWL Landers wW rj.de Compasues R& OneWest Bank FSB To whom it mq concern: I Louise Cham, Assistant Vice Pre hdMbycertify tbqtthe C"pwftIle, is. .a.truc.and correct copy of Moludi at MC"P r98UIWb-WdAfidY held, molstotis ate still to force and that Schafte- D-2: Officers Authorized v Dispasitit► REO A ;Asset Managas- Auftwization in$trwfiens a HUD -f Moments I'fidbwcertify -the REO Asset zbft*anpatfboned dooWnerb: Should you have egy-clpestions at the number listed above. Sincerely, It Louise Chavef--- Assistant Vice: resident R60 Department Phone: 512 250-2728 Loiltisc.chav CFN: 20130582618 BOOK 28740 PAGE 2020 Authority i*.of0WBREO, LLC, a-& ition M legded.4uthority LL, duly passed by the Board of Nwch qi[orums were Present actibulas boh taken io any n of .0neWest Bank, FSB Mously- provided to you Mors 4iaid Associatift voted, that said. ,lo.nWiff . ythe.effect-of xecute Documents and Ins wents Relafing.to REO siplidihg agreements, s&1bs!eowdcts;cscr0w Is -listed on Exhibit.A have tfil authority to -sign the. v additional 4ocummitation, Blease W freeto contact me Page I 1 Signed, and delivered in the prime of �-- Witt,= print witam mime Vritness sigoatnre ® AIMBObe Priatwitrmss name State of TEXAS MUMS County of CFN: 20130582618 BOOK 28740 PAGE 2019 Onewest Bank FSB Print Name. Title: The forego ft instrument was acknowledged be#8re me the day of July 2013 ladwChW A LEO by as for OneWest Bank FSB on behalf of the company. He/I is personally known to me or who has produced driver license(s) as identification. P#��YEIVIITOI Print Notary Name MY Communion ka, xplres: Notary Seal Seal) 4, STEP HEN late Of Notary WubliC, S18ta Of Texas ?�I a ���a MY Commission Expires August 24, 2013 Seal) i EXHIBIT A Schedule D-2: Officers Authorized to Disposition' Aguilar, Victor Amold, 3eff abm Cluis Bing,:Beth Blaschke, Ken Caruso, Scare Ca,Toa meq, Sean Deir. Tim Evans, Tony Fisher, rbii CFN: 20130582618 BOOK 28740 PAGE 2021 Documents and. Insmments Relating to REO Flom, Rudy Gtft% David LaBrack, Ken Murphy, Pam i PompA, Michael) Ransom, Tim Schneider, Dian Todryk, William(Matt) Mills, Kelsey ` Waft tan, 081,1 i Page 12 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner - Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees, including the owner, must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if- The f The officer owns at least 10 percent of the stock of the corporation, or in the case of an LLC, a statement attesting to the minimum 10 percent ownership; The officer is listed as an officer of the corporation in the records of the Florida Department of State, Division of Corporations; and The corporation is registered and listed as active with the Florida Department of State, Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption. In these circumstances, Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company. Therefore. you may be personally liable for the worker compensation iniuries of any person allowed to work under this permit Please check with your insurance carrier since most property insurance policies DO NOT cover this type of liability. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS CONTENTS. Owner Print Name: Signature: State of Florida ) _ County of Miami -Dade ) Sworn to and subscribed before me this day of LJ , 20)9.. By ®[w�sd� e Print Name: Signature: (AV 13 fvA i State of Florida ) County of Miami -Dade ) Sworn to and sub 'bed before day of A oil 21 .10 ype of Iden—ti UNDERSTAND ITS ' 0911312014 • ,�1p� PUBIIC• ..Commission # 'Willi ; • 025801: nliIWo ` Miami Shores Village 10050 N.E. 2nd Avenue .Miami Shores, FL 33138-0000 Phone: (305)795-2204 Fax: (305)756-8972 Permit No. RC -2-14-356 Issue Date 817/2014 ry n -.r. -11-111-1- Expires:02/03/2015 INSPECTION REQUESTS: (305)762-4949 or Log on at https://bidg.miamishoresvillage.com/cap REQUESTS ARE ACCEPTED DURING 8:30AM - 3:30PM FOR THE FOLLOWING BUSINESS DAY. Requests must be received by 3 pm for following day Inspections. Residential Construction Parcel #:1132060010030 I Owner's Name: RAOUL HESKIEL Owner's Phone: Job Address: 1405 NE 9 Avenue Total Square Feet: 500 MiamiShoreS,. F Bond Number: 2450_ Total Job Valuation: $ 40,000.00 Centragkdsi Phone Primary Contractor THE NARSHA GROUP, LLC (786)222-1876 Yes WORK IS ALLOWED MONDAY THROUGH SATURDAY, 7:30AM - 6:00PM. NO WORK IS ALLOWED ON SUNDAY OR HOLIDAYS, BUILDING INSPECTIONS ARE DONE MONDAY THROUGH THURSDAY. ROOFING INSPECTIONS ARE DONE MONDAY THROUGH FRIDAY. NO BUILDING INSPECTIONS DONE ON FRIDAY. NO INSPECTION WILL BE MADE UNLESS THE PERMIT CARD IS DISPLAYED AND HAS BEEN APPROVED. PLANS ARE READLY AVAILABLE. ITIS THE PERMIT APPLICANTS RESPONSIBILITY TO ENSURE THAT WORK IS ACCESSIBLE AND EXPOSED FOR INSPECTION PURPOSES. NEITHER THE BUILDING OFFICIAL NOR THE CITY SHALL BE LIABLE FOR EXPENSE ENTAILED IN THE REMOVAL OR REPLACEMENT OF ANY MATERIAL WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY 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. 1F YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. ORD INS 1h1 R ' 'I�y.�P SON Foundation onirtgF SternwallRough = Stab Muter Service Columns. 1,st iJft Columns 2nd Lift Out Tie Beam F` e'S rink TrusslRafters ;f1c Tank Roof Sheathing Sevier Hook -up Bucks-Roof.Drains Windows/D�ors 4 `'' � Gas' Interior Frai lfi Om 1NP Tank Insulation Celli : Grid lawn $ rinklers _ DryviWltor F�pgl Bo , :` ein Drain' i Firavvalt !�o Deoltdn Peril Pin Wire hath = 1, t 'rhe Pool Sleet Pool Deck . !^osiertcxand tch Basins. Final Pool Slaty sale Qrarns . Final Fence Wali Rou ` 1$:Fial. Screen,lnclo�urs: Ceil.n Ro: h , ,° Driveway Rough Drivewa ` Base fele ho6O ou h Tin Ca _ Tel ° hone Final Roof ln:Plrogress TV Hou MOO in Pro rasa TV Final, ` Final.Rfi ti a' h777777 Shutters Attachment: ..1=tjtiai Final Shutters Intercom Rough Rails and GuardraHs Intrcorn Final ' ADA cdm ii:knce Ala Roti° h'1"If Om 1N$P Ala r<n Find rewind Pim lPI� i v Flre rAta*000011' y,til So BearingCartFirer "inaf Soi11 Treatment Cert SSEtr>+ice 1Nbrk With R Floor Elevation Suri `latiOn Rou Reinf Unhi Mas Cert ' E IGA1 Jill ... Itod; ou ' h s Inulatiotr erttfiate' fissure"Test S t Serve Firtat Hcibd Final Surve F`inat� Ventilation, Truss Ceriilioation, Final Pool, Heated uOT�U MNT3 Fiita}.1/acuum a ! M nail S rinkier Final Alarm Q J Mission: nh,; Rick Scott To protect, promote & Improve the health Governor of all peostate, coupntyl&Florida community through orts. i John H. Armstrong, MD, FACS HEALTHState Surgeon General & Secretary Vision: To be the Healthiest State In the Nation May 14, 2014 Raoul Heskiel 3980 194 Lane North Miami Beach, FL 33160 RE: Modification to a Single Family Residence - No Bedroom Addition Application Document Number: AP1143238 Centrax Permit Number: 13 -SC -1532804 9405 NE 9 Avenue Miami, FL 33138 Lot: 3 Block: Subdivision: Marilyn Heights Dear Applicant, This will acknowledge receipt of a floor plan and site plan on 04/14/2014 for the use of the existing onsite sewage treatment and disposal system located on the above referenced property. Proposed interior remodeling. No objection letter was issued by C. Icaza on 05/14/14. This office has reviewed and verified the floor plan and site plan you submitted, for the proposed remodeling addition or modification to your single-family home. Based on the information you provided, the Health Department concludes that the proposed remodeling addition or modification is not adding a bedroom and that it does not appear to cover any part of the existing system or encroach on the required setback or unobstructed area. No existing system inspection or evaluation and assessment, or modification, replacement, or upgrade authorization is required. Because an inspection or evaluation of the existing septic system was not conducted, the Department cannot attest to the existing system's current condition, size, or adequacy to serve the proposed use. You may request a voluntary inspection and assessment of your system from a licensed septic tank contractor or plumber, or a person certified under section 381.0101, Florida Statutes. If you have any questions, please call our office at (305) 623-3500. Sincerely. N / t Carlos a Engineer III Department of Health in Dade County Florida Department of Health www.FioridasHealth.com In Dade County - - , Florida TWITTER:HealthyFLA PHONE: (305) 623-3500 FACEBOOK:FLDepartmentofHealth .N YOUTUBE:fldoh BUILDING PERMIT APPLICA Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 JUL 014 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949- } _ FB 20 Master Permit No. `4 N Sub Permit No. c -)q-9' BUILDINGZANICAL RIC [:]ROOFING ❑ REVISION F-1EXTENSION [:]RENEWAL❑PLUMBING PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS IA \ JOB ADDRESS: NV City: Miami Shores Countv: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): i"( 1 N1c) 6;—(2 Phone#: 3 o� 7� 2c)4 Address: , L(� }i IANE City: V (_& 9V A ' State: Zip: ?�oP I Tenant/Lessee Name: Phone#: Email: e R-My-cn4v wi�- : ' Phone'#, L I JT70�7 City: AAA C. _ State: v Z' Qualifier Name: QJ Phone#: qL State Certification or Registertificate of Competency #: DESIGNER: Architect/Engineer: \ Phone#: Address: City: State: Zip: Value of Work for this Permit: $ �� f��� Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration New e_- Repair/Replace ❑P�Demolitio D intin f Work: W �, 1� r _S' Specify color of color thru tile: 1 Submittal Fee $ Permit Fee $ 1 CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ 5. a (Revised02/24/2014) C,w- Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, AIR CONDITIONERS, ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien I brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of men nt must be posted at, the job site for the first inspection which occurs seven (7) days after the building permit is issuelil In e a sen a of such p ed notice, the inspection will not be approved and a reinspection fee will be charged. The foregoing inst 3 I day of me or who has 4�EN ° &f ore me this ZO , by who is personally known to ..1L. %1r� K,(—as identification and who did take an oath. NOTARY PUBLIC: 0\\' *ii •� yes Sign: Print: Seal: �'�, C°��5 •, �, STSG CO The foregoing instrument was acknowledged before me this day of V 20 , by CLM o is personally known to me or who has prod identification ands NOTARY PUBLIC: Sign: Print: Seal: 10r-7 as take an oath. \\NU 1 I I 11/1 //1/ S 51 f Ve 5 4314612416 ••'••. V p06liC •. C.nmfi115S14 n _� OFn����`� APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) P. E. Goldsmith 141 NW 96`h Street Miami Shores, Fl 33150 Jan 26, 2015 Miami Shores Building Department 10080 N.E. Second Avenue Miami Shores, Fl 33138-2382 To whom it may concern. Please cancel all previous outstanding permit applications for exterior work, driveway, deck, patio and gazebo, etc., from Poinciana Development Grp. Permit Application # `s below: Close Permit application #'s: DS -11-14-2432 Driveway, sidewalk -slabs 11/05/2014 s> DGT-10-14-23A4 Decks/Gazebos/Trellises 10/22/2014 Owner 1/26/15 -F =Stals of FloridaF 1587508 (WG! -I -T90.M i. Miami Shores Village OCT 22 2014 Building Department- e IMSO N.E.2nd Avenue, Miami Shores, Florida 33138 / Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION UNE PHONE NUMBER: (305) 762-4949 FBC 20d BUILDING gaster Permit ftnc-TT i 4 2;,`���. PERMIT APPLICATION Sub Permit No. "LlILDING ❑ ELECTRIC [] ROOFING [D REVISION ❑ EXTENSION pRENEWAL ❑ PLUMBING ❑ MECHANICAL ❑ PUBLIC WORKS JOB ADDRESS: _ 141 NW 96 Street ❑ CHANGE OF ❑ CANCELLATION E] SHOP CONTRACTOR DRAWINGS City Miami Shores County Miami Dade zip: Faflo/Parcel#: 11-3101-025-011 Q !s the Building Historically Designated: Yes id0 Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Peter Goldsmith Phone#: Address 141 NW 96 St City: Miami Shores State: Fl Zip: Tenant/Lessee Name. Phone#: Email: goldsmithpe@comcast.net CONTRACTOR: Company Name: Poinciana Development Group Inc Phone#: Address: 697 N Miami Ave #3 City: Miami State: FI Qualifier Name: Linda Forrest State Certification or Registration #: CGCO49650 Certificate of Competency # DESIGNER: Ardtitect/Engineer: N/A Phone#: Address: City —State: Value of Work for this Permit: $ $ 10000 Square/Unear Footage of Work: Type of Work: ❑ Addition ❑ Alteration © New ❑ Repair/Replace Description of Work: Wood Deck 305-469-5806 33136 Zip: 1250 SF ❑ Demolition Spec* coktr of color thra We: Submittal Fee $ so R 65 Peru Fee $ CCF $ CO/CC $ scanning Fee $ Radon fee $ Technology Fee $ Trainfng%Education Fee $ Structural Renews $ (ReW&d02/24/W14) DBPR $ Nosy $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) So "ing gpmpany's Address City State Tip Mortgage Lender's blame (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 ELECTRIC, PLUMBING, SIGNS, 'POOLS, FURNACES, BOILERS, HEATERS, TANKS, Alli 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 $25W, 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 cerrdfied 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 ani ain tion feq vi charged. $Signature OWNER or AGENT The foregoing instrument was acknowledged before me this 17 day of Oct 20 14 , by ►'�(j D i o r' personally known to me or who has as identification a iadrooft- NOTARYPUBL PRY B^c MYRDIES PLUMMER MY COMMISSION #FF002912 Print: Seal: Signature A CONTRACTOR The foregoing in as acknowledged before me this 17 day of 20 14 , by U 2bally known to me or who has produced as identification and J46 did take an oath. NOTARY PUBLIC: Print: Seal: 398.0153 MYRDIES PLUMMER MY CONANTISSiON #FF002912 ««««,«««««««««««««««ss««««««««+«««««««««««s«««,s«««««««�«««««««««««««««««««a««•«««««««««««««s«««s««««««mss«««« APPROVED BY (Revise0212412014) Plans Examiner Structural Review Zoning Clerk I FEB 0 toil bJoL/2Ar BY: We, 'b - 10-14- 2226 / DEtk.. wort -k_, i C;.ntc:� LLL 111k -1-222 -Q,) (a/g *Qrs —rw I Aeux O I I, Q �� Nagy PulDliC Siad of FIOI d® Bindle A4Veraz X�s� My Commission FF 188780 JNP :4tmc OA103/2018 L�# r ' `r Miami Shores Village t -_ Building Department OCT 019 014 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20 (0 BUILDING Master PermitNoJ)6,'-T14—Tb7k' PER IT APPLICATION Sub Permit No. UILDING ❑ ELECTRIC ❑ ROOFING .❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS •..❑'CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: A © I'ScclzyL UL citw Miami Shores Coun Miami Dade Zip: J Folio/Parcel#: 14— 320e= 019-400610 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): t_L Address: : 1 ` City: jq\CA ( ' 1� Tenant/Lessee Name: Email: CONTRACTOR: Company Name: ®1..1 Address: A\ q 2 -v)4r-1 City: H\1'v.,\—ecor-�k a 1� Zip: I i � s Qualifier Name: Phone#: State Certification or Registration #: GNU awl S!2M Certificate of Competency #: DESIGNER: Architect/Engineer: `i/1R'ClA-22: repoPhone#: Address: (OEM GALIIN--)1?(o City: AA l6 State: Zip: 31�r l Value of Work for this Permit: $ 2c0Oo Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration p ®�, &W _ _ ❑ Repair/Replace ❑ Demolition Description of Work: Specify color of color thru the: Submittal Fee $ Permit Fee $ Scanning Fee $. Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ _ (Revised02/24/2014) a a.me9 , yt 4eodi i+; -i: iY r:K k� ' �X�t rr�, .ate-• r 6 . r r a Co/CC $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ _ Ir t, 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 wor ill be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that asst om, it must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, AIR COND �, OWNER'S AFFIDAVIT: I certify that all the�t�'Qsl 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachme6t. f;A iso, a certified copy of the recorded notice of comdnencemLsnt must be posted at the job site for the first inspection which occurs'seven (7) days after the building permit is issued. In the Bence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. - f Signature Signature' Zl OWNER or AGENT RACTOR The foregoing instrument was acknowledged before me thi ing instrument was acknowledged before me this day of 20 1 b� Q day of Oct ►3&-4? 20 by �1Q(xi L. • Qd d��%l ,who is personally known to whoCSP onally k n to me or who has produced lit lV as me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: /o4Pp APPROVED BY (Revised02/24/2014) DENISE 60W.Z Notary pwft • Slate of "oft My—Comm— EKPIMS Sep 1$. 2011 identification and who did take an oath. NOTARY PUBLIC: Sign � L A" Print: &sA— At Seal: NaMy PW* StdO Of FWrMa Elsa AM= My Comte FF 081441 Plans Examiner _ Zoning I'V4i Structural Review Clerk •��"��s~ Miami Shores Village --�--j r- - Building Department OCT 00 014 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 - INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20 BUILDING Master Permit PER IT APPLICATION Sub Permit No. 7UILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL F-1 PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: i01 5 Occupancy Type: Load OWNER: Name (Fee Simple 0 Is the Building Historically Designated: Yes NO Construction Type: Flood Zone: City: State: Tenant/Lessee Name: Email: BFE: FFE: CONTRACTOR: Company Name: A N-,iTv2;A Gawk %act *j LLC Phone#: 313 $ Address: S4 2 — En ts-V \C;_4N-'1 ' i i�1�t City: iALeQ. 1'l o � State: F L Zip: �y Qualifier Name: - ,%P_ Phone#: State Certification or Registration #: L_ac Certificate of Competency #: m; DESIGNER: Architect/Engineer: Phone#: Address: 6S38 C_e&L ^b ApIC J7 City: ;M i A PVI State: t --L Zip: Value of Work for this Permit: $ 00 Square/Unear Footage of Work: Type of Work: ET'Addition ElAlteration ElNew ElRepair/Replace ❑Demolition Description of Work: 06ue Specify color of color thru tile: Submittal Fee $ Permit Fee $ Scanning Fee $ Technology Fee Structural Reviews $ (Revised02/24/2014) Radon Fee $ Training/Education Fee $ C�`/CC Double Fee $ Bond $ ARIPCI 101 TOTAL FEE NOW DU P^ Bonding Company's Name (if applicable) d Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip A Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING,' SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, AIR CONDITIONERS, ETC..... , OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE' OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR -PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the senceo s h posted notice, the inspection will not be approved and a reinspection fee will be charged. 7� , �` Signature Signature /0/7 1A ,A OWNER or AGENT C CTOR The foregoing instrument was acknowledged before this V) day of �' _, 20 .4- . by �;W-4 a - Q VP A who is personally known to me or who has produced. _ as identification and who did take an oath. The foregoi strument was acknowledged before me this 6. day of OCCCi6ee- , 20 by bEV-2-eftA u arJ , who i etsonally kno to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: -,�- Ze., Print: WZ� IIJI Y Y'C,-'F-n Print: Seal: Seal: Shft Elm Akwa Y l�'ue•••, ' FF 081441 DENISE fiOMEY Notary Public -State of Florkla Expirwollo7me ,i�1��R�t�6ER16e��i&a�Alxlxlxlxlxl��x**�xl�+t*l�s�s�***�x*>k�xlx !x r>klxlxlxx�>h**a�*s�a��lxlx�x>k*x�m**>kx�lx�x�*>k+�+� ••.;;o�� ��:••' Commission # EE 836154 APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) 02 -102115- -Tc),. MlAmt -4"oacm v 1 LL 4 E- ,BQtuO(N6 l )fFAC7r1A-=l'*3T Q c ; IZC--10— 14-2229 / 5 qe-g wa" -Too W�tcm-,- ' - "Pi T, FkM# 1 �w�arl,aM FEB 0,2 2015 vg 4v,r .4 -AnaA— 1 t`g C o4e% cA4"zn LLL A ppI: �. g4w, - el—', wo" w 1Aq-- von I 4� n Ithiliq - Fkmv%& Q 2-m� LLL PC -10--14— 2228 4-ar wwL Notary Public Stats Of FlOffda ' Sindia A v8MZ •` My Commission FF 158750 F.xljirog 00103120118.R.+,t�