DS-14-2040 0-P-e-ouN Miami Shores Village
EDBuilding Department
SEP 18 2014
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 201
BUILDING �� A Master Permit No.-05P-4-2046
PERMIT APPLICATION .p��wl � IT- Sub Permit No.
QBUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL iVUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 1225 NE 92 STREET
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#:11-3205-027-0300 Is the Building Historically Designated:Yes NO X
Occupancy Type: Load: Construction Type: Flood Zone: BFE: l� j FFE:
OWNER:Name(Fee Simple Titleholder):SAME AS ABOVE I reO ('` Phone#:Address:1225 NE 92 STREET
City: MIAMI SHORES State: FLORIDA Zip: 33138
Tenant/Lessee Name: OWNER Phone#:
Email:
CONTRACTOR:Company Name: ROSS MANANGEMENT SER76ft 9 N C Phone#: 954-200-0604
Address: 5325 NW 109TH LANE
City: CORAL SPRINGH State: FLORIDA Zip: 33076
Qualifier Name: BARRY GRIEPER Phone#: 954-200-0607
State Certification or Registration M CGC1507522 Certificate of Competency#:
DESIGNER:Architect/Engineer: N/A Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$12,000.00 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New 0 Repair/Replace ❑ Demolition
Description of work: TRAVERTINE PAVERS 1,200 SQ FT POOL DECK AREA
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ CCF$ L b CO/CC$
Scanning Fee$ -Q0 Radon Fee$ c:) -___D�� DBPR$ Notary$
Technology Fee . (?)("7) Training/Education Fee$ �° Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ / L
(Revised02/24/2014)
Bonding Company's Nathe(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 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 absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
h
Signature Signature
OWNER or AGENT CONT
The foregoing instrument was acknowl ged before me this The foregoing instrument was ackn before me this
day ofl 0 by day of ssz "° (L'+ ' by
who iperso u 1 I" , who is per's y known to
me or who has produced I(� !jJ(�' me or who has produced bi u cA as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign• Sign
Print: %� Print:lit
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Seal' 1C:131 e:t:
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APPROVED BY Plans Examiner Zoning
Structural Review Clerk
{Revisedo2/24/2014)
r A
i
R OFFICE CF THE PROPERTY
Summary Report
Generated On:9118/2014
Property Information
Folio: 11-3205-027-0300
Property Address: 1225 NE 92 ST
KAREN BLAIRira.db
Owner PREDRAG STARCEVIC
Mailing Address 1225 NE 92 ST
MIAMI SHORES,FL 33138
Primary Zone 1100 SGL FAMILY-2301-2500 SQ
Primary Land Use 0101 RESIDENTIAL-SINGLE n
FAMILY:1 UNIT
Beds/Baths/Half 413/0
Floors 1
Living Units 1 s
Actual Area 2,965 Sq.Ft
Living Area 2,396 Sq.Ft 40
Adjusted Area 2,673 Sq.Ft
Lot Size 12,500 Sq.Ft Taxable Value Information
Year Built 1959 2014 2013 2012
County
Assessment Information Exemption Value $50,000 $50,000 $50,000
Year 2014 2013 2012 Taxable Value $470,363 $368,738 $361,739
Land Value $338,000 $228,000 $216,000
School Board
Building Value $152,762 $193,311 $220,715 Exemption Value $25,000 $25,000 $25,000
XF Value $29,601 $29,601 $37,700 Taxable Value $495,363 $393,738 $386,739
Market Value $520,363 $450,912 $474,415 City
Assessed Value 1 $520,363 $418,738 $411,739 Exemption Value $50,000 $50,000 $50,000
Taxable Value $470,363 $368,738 $361,739
Benefits Information
Regional
Benefit Type 2014 2013 2012 Exemption Value $50,000 $50,000 $50,000
Save Our Homes Cap Assessment Reduction $32,174 $62,676 Taxable Value $470,363 $368,738 $361,739
Homestead Exemption $25,000 $25,000 $25,000
Second Homestead Exemption $25,000 $25,000 $25,000 Sales Information
Note:Not all benefits are applicable to all Taxable Values(i.e.County, Previous OR Book-
School Board,City,Regional). Sale Price Page Qualification Description
01/22/2013 $605,000 28474-1002 Qual by exam of deed
Short Legal Description
11/01/2001 $361,000 200643613 2008 and prior year sales;Qual by exam
5 53 42 of deed
BAY LURE PB 44-63 12/01/1998 $215,000 18415-684 2008 and prior year sales;Qual by exam
W50FT OF LOT 18&E50FT OF LOT of deed
19 BLK 2 01/01/1995 $0 16661-3403 1 Qual by exam of deed
LOT SIZE IRREGULAR
The Office of the Property Appraiser is continually editing and updating the tax roll.This website may not reflect the most current information on record.The Property Appraiser
and Miami-Dade County assumes no liability,see full disclaimer and User Agreement at http://www.miamidade.govfinfo/disdaimer.asp
Version:
115 S.Andrews Ave., Rrn. A-100, Ft Lauderdale, FL 33301-1895—954-$31-4000 �
VALID OCTOBER 1,2014 .THROUGH SEPTEMBER 30,2.015
DBA:
Business Name:ROSS SERVICES F>eCelpti�:GYRAL CONTRACTOR
Business Type:
Y±'
1
Owner Name:GRIEPER, BMRX S Business Opened:12/02/2010
i Business Location;5325 ivw ias x.AIQE State/County/CerUReg•CGe15p7522
CORAL SPRXNGS l;
Business Code:
Phone:
Rooms Seats Employees Machines Professionals
For Vendln
' g gusinesa Only
Number of Machines: Vending Type; I
Tax Amount Transfer Fee NSF Fee on ''•
Penalty Prior Years CollectiCost Total Paid k
27.00 3.00 0:0;0' D•00 : { D.Dq 0.00 30.00 3
..l r,!
THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS
THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is ='
+' non-regulatory In nature.You must meet all County and/or Municipality planning
WHEN VALIDATED and zoning requirements.This Business Tax Receipt must be transferred when
h the business Is sold, business name has changed or you have moved the IN.
business location.This receipt does not indicate that the business is legal or that j:2.
s
it is in compliant:e with State or local taws and regulations.
Mailing Address: Y.,
BARRY GRIEPER Receipt #03B-13-00008571
5325 NW 709 LANE Paid 07/07/2014 30.00
I CORAL SPRINGS, FL 33076
U.S.A. i
a
�t
st
2014 - 2015
RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY
STATE OF FLORIDA
DEPARTMENT O"USIIVESS AND PROFESSIONAL REGULATION
6ONSTRUCTION:INDUSTRY.LICENSING BOARD I
( •GGC1_'507522• �
kt The.GENFRAL'CONTR'ACTOR .' .... .... - .. �I
f Named °? t
•below.IS..CERTIFIED- -
[ Ubelbr'the-provisio'ns'of-Chapter 489 E.S....'.'
Expkatioii date: AUG 3^(,•201:6•
r- bRII=PER u,-I R1'' '.,,. 0 0
F �`°T.:,M i��.,1�1,VY�'VF/rr'N •.ti:Al�+.r L'." Q:. .'�•�'' � ,. 1 � ~yY•-. �
i.°,,.�. ,CQ�I'iL•`�SPR'FN.� "F�L"33078 ' -. - -`�'. ~c 4 "'� �,.�i,,•,•�' `�, -',�t ,,`'',l
w r ,-..r-'�:����"-.�w-.:`"a••v�`e,• w roe.",.. '•� "+.'' -,•r .. F-���'t�1,� �';y ti- • ',`I
M..d!..,,�.,. C'�.C:,-n•..,,,..r `"r'" .y��:...+.���...�--..,-; 'a�y ' ..• '�`!jl?i�_. �•`.���'. ` r\` 5 •i,i *,'' 'may 1,\:':�� I
ISSUED, 05/29/2014 DISPLAY AS REQUIRED BY LAIN SEQ# L140529OW20$2
09/17/2014 17:17 9549560555 COVER ALL INSURANCE PAGE 01101
ACORD, 'CERTIFICATE OF LIABILITY INSURANCEDATE(MINDDIYYYYI
09!0712014
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
COVERALL INSURANCE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
5$00 W.ATLANTIC BLVD, ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
MARGATE FL 33063
PH 54 9564006 Fat 954 956-0555 INSURERS AFFORDING COVERAGE MAIC#
INSURED INSURER A: WILSHIRE INSURANCE COMPANY
ROSS MANAGEMENT SERVICES INC DBA ROSS SERVICES INSURER a: OLD REPUBLIC SURETY COMPANY
5325 NW 909 LANE INSURER C:
CORAL SPRINGS FL 33076 INSURER D:
INSURER E
COVERAGM
THEPOLICIES OF INSURANCE LI$TED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTMTHSTANDING
ANY REQUARMENT, 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 CONDITION$ OF SVCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED aY PAID CLAIMS,
NSR001
POLICY NUMBER POLICY EFFECTIVE LI4`Y EXPIRATION LIMITS
GENERAL LIABILITY EACH OCCURRENCE $1000"o
AX COMMERCIAL GENERAL LIABILITY CL00182370 08122@014 0913012014 DAMAGE TO RE TEED 1��Q
�y� ftEMt$AAjEo M=noee $
�,, CLAIMS MADE LJ OCCUR MED EXP An one ereon $5,000
PERSONAL 8 ADV INJURY $1,M,000
GENERAL AGGREGATE $1,00,000
GERL AGGREGATE LIMIT APPLIES PER; PRODUCTS-COMPIOP AGG S 1,0K000
X POLICY PRO- LOC
AUTOMOBILE LIARILITY COMBINED SINGLE LIMIT $
ANY AUTO (Ea 606d")
ALL OWNED AUTOS
BODILY INJURY B
SCHEDULED AUTOS (Per person)
MIRED AUTOS BODILY INJURY S
NQN•gWNED AUTOS
(Per eloddenl)
PRDPERTYDAMAGE $
(Per aetwem)
GARAGE LIABILITY AUTQ ONLY-EA ACC IOENT
ANY AUTO OTHER THAN EA ACC S
AUTO ONLY, AGG $.
EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE S
OCCUR 7 CLAIMS MADE AGGREGATE
S
DEDUCTIBLE $
RETENTION i $
VMMRS COMPENSATION AND WC STATU• 0TH-
rR
EMPLOYERS'LIABILITY
E.L.EACH ACCIDENT #
ANY PROPRIETORIPARTNEWEXECUTNE
OFFICERIMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE
'P
s deacrlbe ander
E.L DISEASE•POLICY LIMIT I S
OTHER
B BUND OFL-0595152 000612014 04/0612015 BOND LIMIT $100,000
CESOP01>N OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
SWIMMING POOL INSTALLATION,REPAIR,AND SERVICE INCLUDING POOL POPPING COVERAGE
CERTIFICATE HOLDER CANCELLAt1ON
SHOULDANYOFTHEA RIBEDPOraS ELLED B"19 THE EXPIRATION
MIAMI SHORES BUILDING DEPT DATE THEREOF,THE 0+N LLEDZR;� 10 DAYS WRITTEN
10050 NE 2ND AVENUE NOTICETOTHEC TIFICA HOLDER T FAILURE t0 DO 90 SHALL
MIAMI SHORES FL 331318 MtPOSE NO oB TION OR BILITY OF ATHE INSURER,ITS AGENTS OR
REPRESENTATIVESAyTNPRQED RE!PRESENTATNE
FAX:954.597.6331
ACORD 25(2001108) 0 ACORD CORPORATION 1988
Report Viewer
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-F
JEFF ATWATER `�O,R✓-
j CFOEF FtNANcwL OFFICER STATE OF FLORIDA
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 erected to be exempt Born Florida Workers Compensation law,
EFFECTIVE DATE: 7/25/2014 EXPIRATION DATE: 1/2512016
PERSON: GRIEPER
S BARRY
FEIN: 262372977
BUSINESS NAME AND ADDRESS:
ROSS MANAGEMENT SERVICES INC
ROSS SERVICES
5325 NW 109 LANE
CORAL SPRINGS FL 33076
SCOPES OF BUSINESS OR TRADE:
LICENSED GENERAL
CONTRACTOR
Pursuant b Chapter 4aDA5(7<},F.S.,an oKiter of a rnrporatron was tlegs exemptron from this chapter byy Rang a cedifiwte otelachon under tnis sedron
may not recover benerds or mmpensation uMer mrs Maphr Qurauam b Chapter 1",00
F 5.,Cerafitates a electit*N,.
ae exempt ej th Dray
wean MB scope o/the business m trade fated on the notice 0feteGion to be eXempt Pursuant to Chaptef 64D.05(13),FT.NOUces o/ereawn b tre
exempt and 8md 0n t of election to be exempt shall be subject fo revoranon it.ai any lime afterthe!ting of the rronce or the issuance of Me certifroate.
the person named on tlra notice or certificate nc bnger meets the requhements of dm section f.,__of a cemficate.The
department shat!rewke a
DFS-F2-0VY6252 CERTIFICATE OF ELECTION TO BE EXEMPT RE>ASEI)07-12
( QUESTIONS?(850)413-1609
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littps://apps8.fldfs.com/crreportviewer/reportViewer.aspx?data=kdvpginc9D7Q3gH6TER6... 1/30/2014