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RC-15-1004 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-239932 Permit Number: RC-4-15-1004 Scheduled Inspection Date: July 27, 2015 Permit Type: Residential Construction Inspector: Rodriguez,Jorge Inspection Type: Final Building Owner: , Work Classification: Alteration Job Address: 1111 NE 91 Terrace Miami Shores, FL 33138- Phone Number (707)451-8111 Parcel Number 1132050010120 Project: <NONE> Contractor: ALES GROUP GENERAL CONTRACTORS Phone: (786)223-6096 Building Department Comments REPLACE EXISTING KITCHEN CABINETS WITH NEW Infractio Passed Comments CABINETS( SAME LAYOUT) INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. July 27,2015 For Inspections please call: (305)762-4949 Page 25 of 30 [y Y `yNOREs L,` "to I Miami Shores Village 1 � 1Ctt r N 10050 N.E.2nd Avenue NE ` �' Miami Shores,FL 33138-0000 Phone: (305)795-2204 4 Expiration: 1212112015 Project Address Parcel Number Applicant 1111 NE 91 Terrace 1132050010120 � Miami Shores, FL 33138- Block: Lot: POLYMATHIC PROPERTIES INC Owner Information Address Phone Cell POLYMATHIC PROPERTIES INC 1111 NE 91 Street (707)451-8111 MIAMI SHORES FL 33138- 707 ALDRIDGE Road VACAVIL CA 95688- Contractor(s) Phone Cell Phone Valuation: $ 1,500.00 ALES GROUP GENERAL CONTRACT( (786)223-6096 Total Sq Feet: 150 Approved: In Review Available Inspections: Comments: Inspection Type.- Date Approved:: In Review Final PE Certification Date Denied: Window Door Attachment Type of Construction: REPLACE EXISTING KITCHEN CAB Occupancy: Framing Stories: Exterior: Insulation Front Setback: Rear Setback: Drywall Screw Left Setback: Right Setback: Fill Cells Columns Bedrooms: Bathrooms: Window and Door Buck Plans Submitted: Certificate Status: Review Planning Certificate Date: Additional Info: Review Electrical Bond Return: Classification:Residential Review Electrical Review Building Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Review Building CCF $1.20 Review Plumbing DBPR Fee Invoice# RC 4-15-55349 Review Plumbing $2.00 04/28/2015 Check#: 1034 $50.00 $66.20 DCA Fee 82.00 Review Structural Education Surcharge $0.40 06/26/2015 Credit Card $66.20 $0.00 Review Mechanical Permit Fee $100.00 Scanning Fee $9.00 Technology Fee $1.60 Total: $116.20 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: rtify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zo uthermore, I authorize the above-named contractor to do the work stated. June 26, 2015 Au o zed Signature:Owner / Applicant / Contractor / Agent Date Build' g Department Copy June 26, 2015 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-239460 Permit Number: EL-4-15-1005 Scheduled Inspection Date: July 21, 2015 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: , Work Classification: Alteration Job Address: 1111 NE 91 Terrace Miami Shores, FL 33138- Phone Number (707)451-8111 Parcel Number 1132050010120 Project: <NONE> Contractor: ALES GROUP ELECTRICAL CONTRACTORS Phone: (786)244-0004 Building Department Comments REPLACE EXISTING GFI RECEPTACLE WITH NEW Infractio Passed Comments RECEPTACLES, SAME LOCATION AND CONNECT TO INSPECTOR COMMENTS False EXISTING WIRING SYSTEM Inspector Comments Passed Failed Correction -� Needed Re-inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. July 20, 2015 For Inspections please call: (305)762-4949 Page 34 of 39 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-239578 Permit Number: PL-5-15-1110 Scheduled Inspection Date: July 23, 2015 Permit Type: Plumbing - Residential Inspector: Diaz, Osvaldo Inspection Type: Final Owner: , Work Classification: Addition/Alteration Job Address: 1111 NE 91 Terrace Miami Shores, FL 33138- Phone Number (707)451-8111 Parcel Number 1132050010120 Project: <NONE> Contractor: GMP CONTRACTORS Phone: (786)443-3548 Building Department Comments INSTALL NEW KITCHEN SINK REMOVE EXISTING Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-234465. P-TRAPS FOR SINK Ee SHALL NOT BE CORRUGATED SEPARATE STOPS FOR D/W Failed � (� 1 Correction � { Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. July 22,2015 For Inspections please call: (305)762-4949 Page 26 of 39 6A Miami Shores Village RECET JAPR2Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 2016 BUILDING Master Permit No. PERMIT APPLICATION Sub Permit No. BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 1111 NE 91st TERRACE, MIAMI SHORES, FLORIDA 33138 City: Miami Shores County: Miami Dade zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO X Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder):POLYMATHIC PROPERTIES INC. Phone#:707-451-8111 Address:707 Aldridge Rd Suite B City: VACAVILLE state: CALIFORNIA Zip: 95688 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: ,ti(�V�6/�ZeQe 6EA4S49-14L GbFl7/ZyfG Oa Phone#: 7,86 Address: R 16 ✓mak(/ 70 A16 // City:_ /T117+g State: FLc;.;Lo� Zip: Qualifier Name: 94,02(1 LclzF-4-4� Phone#: State Certification or Registration#:G�7G ¢137��Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ l i J QU) Square/Linear Footage of Work: 150 Type of Work: ❑ Addition ❑ Alteration ❑ New P6 Repair/Replace ❑ Demolition Description of Work: I20�>Z&E EY/S711-)67 /Z1TQ-1E,A1��� 4-,�&) 75 ZZ yat4T) Specify color of col�orrtthru tile: (� 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$ G• !V (Revised02/24/2014) 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 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. Signature Signature J OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this i'Yl� i'C C �►'C t l /_day of ,20 r � , by �_day of ,20 � J , by YQ..I10 n (5. D L0�/L�, r-) who is personally known to who is personally known to me or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: 1�)l kLL U-� r 'GL f'll����� Sign Print: 1 C)1 e 1 1 F'C�.�l l Z ZC�, Print: V lG1 l�.0 I.�GGv Seal: ».»..,..»........»--•-».................»...,.<..,_. Seal: ' ,, ADRIANAGIRARDI i ItRICHELLE P�lN)�^n *; ::= MYCOMMISSIOIN#EE 867174 '" '.,;., , of EXPIRES: January 22,2017 �' Commission N r� U `r i ,ice'} G. 98 <<.3 or k�Q`` Bonded T hru Notary Public Underwhiers Z .�' NOTARY PUBLIC-CAi_IFGRN(A ��,, My Comm.Expires JULY 16,2056 APPROVED BY _�) L� I J Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD The GENERAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS, Expiration date: AUG 31, 241E LGRENTE, RAMON ALES GROUP GENERAL CONTRACTOR 896, SW 70 AVENUE ■ MIAMI FL 33144 SISUEG IM2,12014 DISPLAY AS REQUIRED BY LAW SEo q L1408210001626 Local arsines Tax RecOlP Miami-Daae County, State o Frees -THIS IS NOT A 811.1 -- DO NOT PAY,,,',,,. 7164387 BUSINESS AE1�. tTT EXPIRES ALES GROUP GENERAL coNmcroRs RMEWAL, , SEPTSM699101 2015 696 S'J 74 AVE -14420 6 Mast tae displayed at ply business MIAMI EL 33144 Pursuant to" aunty Coo Chapter 8A-Art. ' 10 SEC.TYPE OF BUSINESS OWNER ` P�lYMEHIT R " ECEtV ALES GROUP GENERAL CONTRACTORS 96 GENERAL Bt31L�33�G CCtWTRA{�4R rax C(XLECTOR C/o ALES CROUP,iNC CC-0047373 175.00 09/30/2014 Worker(s) l REDITCARD-14-043542 This Local Business Tax Receipt Wift4ofirms payi�tent of the local Business Tax_The Re0jo is not a psis€t ore certlfioafion^of the hotdo squaliftcattans,to do business. Halter any gov or natigovernmentalMgUiatory laws and requirements wbteb apply to the httsi& f The RECEIPT NO,above rmst splayed Ian BPS otnatnerpial vehr€)"— r sYt -M for more information tisitt imidadetatYltefi49lLkt'�' ' DATE JDDNYYY) CERTIFICATE OF LIABILITY INSURANCE 1/14(/2015 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 j 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 endorsement(s). PRODUCER NAMEA ANDY RODRIGUEZ JR ANDYS ASSURANCE AGENCIES PHONE - _ _. ac No E,, (3 )5) 642-8407..______ LAic,N.)(305)643 5969 1441 W Flagler St e-MAIL - — - ADDRESS.andyj r@ andysassurance.com Miami, FL 33135 - _.__....... _._.. INSURER(S) AFFORDING COVERAGE NAIL N INSURER A:WESTERN HERITAGE INS CO _.. ........_..... _............._ _. — .INSURED ALES GROUP INC INSURER B: d/b/a PROLOCK & SAFE/ALES GROUP INSURER c: ..... ELECTRICAL CONT/ALES GROUP GC INSURER D: -- 896 S W 70 AVENUE _..----_..._.... INSURER E MIAMI, FL 33144 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. POCICY`EFF�O>_tCYEkP LTR TYPE OF INSURANCE INSD wvo POLICY NUMBER :(MM/UD/YYYY MMfDDlYYVY)'.. LIMITS X COMMERCIAL GENERAL LIABILITY ` EACH OCCURRENCE is 1,000,009 — DAM I fAGETO-RENTEO ` j CLAIMS-MADE Ex OCCUR ( PREMISES(Ea occurrence) is 100,000 f I MED EXP(Any one person) is 5 000 A ... SCP1507683-01 0103/15'01/03f16 Y rPERSONAL BADV INJURY �$ 1,000,000 _.. _....._ --.._. GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 X POLICY ECT LOC PRODUCTS-COMP/OPAGG $ 1,000,000PRO- j _ _ OTHER $ AUTOMOBILE LIABILITYUMBINED SINGLE i— Ea accidents $ ANYAUTO BODILY INJURY(Per person) $ ALL OWNED r—I SCHEDULED AUTOS AUTOS WI j BODILY INJURY(Per acaden)'$ HIRED AUTOS NON-ONED I PRO� f2TY DAMAGE---` $ - t� AUTOS ' (Per accident) _ $ UMBRELLA LIAR OCCURl +EACH OCCURRENCE $ - -.__ ...._. ...-- EXCESS LIAB CLAIMS-MAGE AGGREGATE $ . ....__--T— __ DED RETENTIONS $ WORKERS COMPENSATION OTH_ I AND EMPLOYERS'LIABILITY YIN STATUTE. ER . ..._._ ANY PROPRIETOR/PARTNER/EXECUTNE -- ' OFFI_ERIMEMBER EXCLUDED? CIINIA ' E.L.EACH ACCIDENT $ (Mandatory in NRI E.L.DISEASE-EA EMPLOYE s -Ify as .describe under .,_ i ESCRIPTION OF OPERATIONS below l E.L.DISEASE-POLICY LIMIT $ f I � 1 i DESCRIPTION OF OPERATIONS t LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) (Locksmith (14913) , Door & Window Installation (91746) , Alarm Installation (91127) , !Electrical Work (92478) , General Contractor (91580) & Subcontracted Work (91585) CERTIFICATE HOLDER CANCELLATION Miami Shores Village SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Building Department THE E PIRATION DATE THEREOF, TICE WILL BE DELIVERED IN 10050 NE 2 Avenue ACCOR ANCE WITH THE POLICY PROV NS, Miami Shores, F1 33138 AUTHORIJ O REPRESENTATIVE I L I f @0 988-2013 AC RD CORPO ION. All rights reserved. ACORD25(2013104) The ACORD name and logo are registered markiof ACORD t Ac R® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYW) i 3/20/2015 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(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 endorsement(s). PRODUCER SUNZ Insurance Solutions, LLC. ID: TLR NAME:CONTACT Aimee Gra c/o TLR of Bonita, Inc PHONE A/C No Ext): 727-520-7676 x 222 Mc No): 727-525-3862 700 Central Ave, Suite 500 E-MAIL St. Petersburg, FL 33701 ADDRESS: INSURER(S)AFFORDING COVERAGE _NAIC# INSURERA: SUNZ Insurance Company 34762 INSURED INSURER B: Aspen Re-London-Best Rating"A" TLR of Bonita, Inc dba EnterpriseHR Encore Business Solutions, Inc INsuRERc: Catlin Syndicate Lloyds-Best Rating"A" and its Subsidiaries INSURER D: Brit Syndicate-Lloyds-Best Rating"A" 700 Central Ave, Suite 500 INSURER E: St. Petersburg FL 33701 — INSURER F COVERAGES CERTIFICATE NUMBER: 23881918 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. INSR TYPE OF INSURANCE ADDLISUBR POLICY EFF POLICY EXP LTR POLICY NUMBER MM/DD/YYYYI (MM/DDrfYYYl LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ - CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ _ 1 ,_GEN'L N'L AGGREG_ATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY _�� PRO- LOC PRODUCTS-COMP/OP AGG $ OTHER. $ AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT $ _) Ea accident _ ANY AUTOBODILY INJURY(Per person) $ ALL OWNED 1 SCHEDULED BODILY INJURY(Per accident) $ r l AUTOS AUTOS NON-OWNED ! PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ _ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION !WCPE0000000110 6/1/2014 6/1/2015 �/ STATUTE ROTH AND EMPLOYERS'LIABILITY Y/N — 'ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ NIA E.L.EACH ACCIDENT $ 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$ 1,000,000 B ,Workers Compensation This is for informational purposes C 'Excess Coverage and nothing shall create any right D under such reinsurance. DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Coverage Provided for all leased employees but not subcontractors of:Ales Group,Inc. Client Effective:6/20/2014 dbaAles Group General Contractor CERTIFICATE HOLDER CANCELLATION 7790 Miami Shores Village Bldg Dept. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami h r 2nd Ave g p THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores FL 33138 AUTHORIZED REPRESENTATIVE J Glen J Distefano ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD CERT NC.: 23881918 Aimee Gray 3/20/2015 9:01:32 AM (CDT) Page 1 of 1 i State of California Secretary of State CERTIFICATE OF STATUS I ENTITY NAME: POLYMATHIC PROPERTIES, INC FILE NUMBER: C3366341 FORMATION DATE: 04/07/2011 TYPE:. DOMESTIC CORPORATION JURISDICTION: CALIFORNIA STATUS: ACTIVE (GOOD STANDING) i I, DEBRA BOWEN, Secretary of State of the State of California, j hereby certify: i The records of this office indicate the entity is authorized to exercise all of its powers, rights and privileges in the State of 1 California. No information is available from this office regarding the financial condition, business activities or practices of the entity. S�Pu 4F Ty �P 'GU•R[Ka' F� I IN WITNESS WHEREOF, I execute this certificate and affix the Great Seal of the State of { '^ California this day of August 16, 2012. W x o t DEBRA ROWEN'4.t f tFo'R�XA Secretary of State NP-25(REV 1/2007) JNG i .3 3 b.'6:3 4 #Il{ � It - 66B8s5 Stag of California Secretary of State FILED " in the office of the Secretary of State of the Slate of California STATEMENT OF INFORMATION41 (Domestic Stock and Agricultural Cooperative Corporations) APR 2 9 2011 FEES(Filing and Disclosure): $2uo. if amendment,see Instructions. IMPORTANT—READ INSTRUCTIONS BEFORE COMPLETING THIS FORM I This Space for Filing Use Only 1. CORPORATE NAME (Please do not alter if name Is preprinled.) S Polymathic Properties, Inc f I II 'i I DUE DATE: JUL 0 7 209 COMPLETE ADDRESSES FOR THE FOLLOWING (Do not abbreviate the name of the city. Items 2 and 3 cannot be P.O.Boxes.) 2. STREET ADDRESS OF PRINCIPAL EXECUTIVE OFFICE CITY STATE ZIP CODE 525 Curtola Parkway Vallejo CA 94590 3. STREET ADDRESS OF PRINCIPAL BUSINESS OFFICE IN CALIFORNIA,IF ANY CITY STATE ZIP CODE 525 Curtola Parkway Vallejo 94590 4. MAILING ADDRESS OF THE CORPORATION,IF DIFFERENT THAN ITEM 2 CITY STATE ZIP CODE i NAMES AND COMPLETE ADDRESSES OF THE FOLLOWING OFFICERS (The corporation muss have those thfee ol6cers. A comparable(ilia _ for the specific officer tray be added•however,The preprinted titles on this form must not be altered.) '1 5. CHIEF EXECUTIVE OFFICE!! ADDRESS CITY STATE ZIP CODE Stanley Cheng 525 Curtola 'Parkway Vallejo CA 94590 S. SECRETARY/ ADDRESS CRY STATE ZIP CODE Dean Luca Krause 525 Curtola Parkway Vallejo CA 94590 DE T. CHIEF FINANCIAL OFFICER/ ADDRESS CITY STATE ZIP Barry Needleman 525 Curtola Parkway Vallejo CA 944 5590 NAMES AND COMPLETE ADDRESSES OF ALL DIRECTORS,INCLUDING DIRECTORS WHO ARE ALSO OFFICERS (The corporation must have at least one director. Attach additional pages,if necessary. 8. NAME ADDRESS CITY STATE ZIP CODE Stanley Chen 525 Curtola Parkway Vallejo CA 94590 0. NAME ADDRESS CITY STATE ZIP CODE Dean Luca Krause 525 Curtola Parkway Vallejo CA 94'590 10. NAME ADDRESS CITY STATE ZIP CODE Barry Needleman 525 Curtola Parkway Vallejo CA 94590 11. NUMBER OF VACANCIES ON THE BOARD OF DIRECTORS,IF ANY: AGENT FOR SERVICE OF PROCESS (If the agent is an Individual,ilio agent must reside in CeiifOrnis and Item 13 must be completed With a California street address(a P,O,Box address Is not acceptable). If the agent Is another corporalion,the agent must have on rile with the California Secretary of Stale a certificate pursuant to Corporations Code section 1505 and Item 13 must be left blank.) 12. NAME OF AGENT FOR SERVICE OF PROCESS Dean Luca Krause 13. STREET ADDRESS O AGENT FOR SERVICE OF PROCESS IN CALIFORNIA,IF AN INDIVIDUAL CITY STATE ZIP CODE 525 Curtola Parkway Vallejo CA 94590 TYPE OF BUSINESS 14. DESCRIBE THE TYPE OF BUSINESS OF THE CORPORATION Real Estate Investment IS. BY SUBMITTING THIS STATEMENT OF INFORMATION TO THE CALIFORNIA SECRETARY 00 STATE. THE CORPORATION CERTIFIG!?THE INFORMATION CONTAINED HEREIN,INCLUDING ANY ATTACHMENTS,is TRUE AND CORRECT. //////� 4-28-2011 Dean Luca Krause Secretary DATE TYPElPRINT NAME OF PERSON COMPLETING FORM TITLEA t/ fGNATURE PPROVED BY SECRETARY OF STATE 91.200 C(REV 0112.006) A f I Names and Complete Addresses of All Directors, Including Directors Who Are Also Officers Additional Dh—ectw- Christina Pan 525 Curtola Parkway, Vallejo, CA 94590 I i I i i POLYMATHIC PROPERTIES, INC. 525 CURTOLA PARKWAY*VALLEJO,CA 94590 9707-551-2752 •Barry@meyer.com To: Village of Miami Shores Building Department Subject: Permit application Property: 1111 NE 915'Terrace,Miami Shores, FL To whom it may concern: My name is Barry Needleman, Chief Financial Officer of Polymathic Properties,Inc. ("PMP"). PMP is the owner of the property located at 1111 NE 91 11 Terrace, Miami Shores,FL("Subject Property"). I hereby confirm that the Master Service Agreement dated as of April 26,2011 by and between PMP and Blue Mountain Enterprises,LLC(`BME")authorizes Gregory Scott Owen as CEO of BME to execute routine documents in connection with the purchase,reconstruction,leasing and sale of certain residential real estate on behalf PMP. I further confirm that Mr. Owen is authorized to order permits or other related documents of the Subject Property pursuant to the agreement referenced above. We disclaim any obligation to inform you of any status changes regarding the agreement and authorization abovementioned. However,please do not hesitate to contact me if you have any questions. Kindly Barry Nee leman Chief Fin cial Officer cc: Greg Owen Dean Luca Krause Daniel Badiali WCMELLE PAN VA Commission No. 19M83 " NOTARY PUBIGCALIFOWMA 8OLANO COUNTY My Comm.EWn JULY it 20114 UNANIMOUS WRITTEN CONSENT OF BOARD OF DIRECTORS OF POLYMATHIC PROPERTIES, INC. a California corporation Acting in Lieu of Board of Directors Meetings The undersigned, being the directors of Polymathic Properties, Inc. a California corporation ("Corporation"), consent by this writing to take the following actions to adopt the following resolutions, and to transact the following business of the Corporation pursuant to the authority of Section 307(a)(8)(b)of California Corporations Code: The Corporation hereby certifies that the resolution dated as of June 20, 2011 is still in force and has not been revoked. The Board of Directors hereby confirms authorization for Gregory Scott Owen of Blue Mountain Enterprises, LLC to execute routine documents in connections with the purchase, reconstruction, leasing and sale of these properties pursuant to that certain Master Service Agreement, dated April 26, 2011 by and among Polymathic Properties, Inc. and Blue Mountain Enterprises, LLC. For avoidance of doubt, aforementioned documents include but are not limited to the following: purchase agreements; sale agreements; listing agreements; city approvals; final maps; 2-10 warranty forms; permits; grant deeds; estimated settlement statements; acknowledgment of receipt of prelim title report; Cal FRPTA (State withholding form; Fed FRPTA (Fed withholding form); 593C for State withholding; 10995; verification of broker commission; escrow instructions; seller's affidavit of non-foreign status; and instructions for disbursement of proceeds. The undersigned have executed this Unanimous Written Consent of the Board of Directors effective as of March 13, 2014. Stanley Cheng Dean Luca Krause Barry 7Neleman Christina U Jima Certification of Corporate Resolution Authorizing Deed The undersigned hereby certifies that the undersigned is the Secretary of Polymathic Properties, Inc., a corporation organized under the laws of the State of California ("Corporation"). That in lieu of a meeting of the Board of Directors of said Corporation, and in accordance with and in compliance with said Corporation's by-laws, a resolution was unanimously adopted by the directors on March 13, 2014 ("UWC")to sell properties owned by the Corporation, which includes the property described on Exhibit"A" attached hereto("Property"). That it was further resolved under the UWC that Gregory Scott Owen of Blue Mountain Enterprises, LLC is authorized and directed to execute and deliver the necessary deed and all other documents to effectuate such sale on behalf of the Corporation, pursuant to a Master Service Agreement as described on the attached Resolution dated as of March 13, 2014. That said resolution remains in full force and effect, has not been revoked or modified in any manner, and may be relied upon by the purchaser and its title insurer for the facts recited herein. D �^ v ated 32014 Secret y