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EL-05-83
2 Miami Shores Village Bung Department "APPLICAT N.E.2nd Avenue,Miami Shores,Florida 33138 Tel: (305)795.2204 Fax: (305)756.8972 BUILD Permit No. E los-93 PERMIN Master Permit No. FBC 2001 Permit Type(circle): Building Electrical Plumbing / Mechanical Roofing Owner's Name(Fee Simple Titleholder) �� -S u Aiione# x Owner's Address city i'w�c'(�` (IS�S State �- Zip Tenant/Lessee Name Phone# ,, 3 Job Address(where the work is being done) _0 D /A+ City Miami Shores Village County Miami-Dade Zip Is Building Historically Designated YES NO _ Contractor's Company Name u S FdUme— _<�e&u 04 (�Os)Phone 0 87 -$4�5 S Contractor's Address !r/�P D PV U) CityState Zip 33/-79 `G,"er Amhitect/Engineer's Name(if applicable) :Phone# — ---� $Value of Work For this Permit �� Square Footage Of Work: Type of Work: ❑Additi Alteration ❑New E Repair/Replace Demolition Describe Work: 't &Arm �'/�� xxxxxxxxxxxxxxxxxxxxxxxxxxxxF�Sxxxxxxxxxxxxxxxxx*xxxxx*xxsxxx Submittal`Iree$ V Permit Fee$ _1,0,oP'" b CCF$ r "� CO/CC Notary$- _ Training/Education Fee$ ' Technology Fee$ Scanning$ Radon$ Zoning Bond$ Code Enforcement$ Structural Plan Review.$ Total Fee Now Due$ (Continued on opposite side) 1 Bonding Company's Name(if applicable) — Bonding Company's Address City State Zip , Mortgage Lender's Name(if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING, SIGNS, WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS and AIR CONDITIONERS,ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant. As a condition to the issuance of a building permit with an estimated value exceeding$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law 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 ins ection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspect' of be approved and a reinspection fee will be charged. Si Signature Own or Agent a Contractor The foregoing instrument was ackno ledged before m s - The foregoing instrument was acknowle ged bef e th - day of—� 20,1Z,by D day of ftli 20 by who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as i cation and who did take an oath. NOTARY P NOTARY PUBLIC: P Barbara H Corzo 34C` r' v*� 05 D3 Barbara A.Corzo Sign: r i4 t o mission D Sign. �` rcuk D305340 Print: ,,�,�a s Ma Print: %or r4d Expires March 30,2001+ My Comiussion Expires: My Co ssion Expires: (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. APPLICATION APPROVED BY - 5,f Plans Examiner Engineer Chc 12/15/03 Zoning Certificate of Insurance S CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON YOU THE CERTIFICATE HOLDER. THIS CERTIFICATE IS T AN INSURANCE POLICYAND DOES NOT AMEND,EXTEND,OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW. This is to Certify that BRINK'S HOME SECURITY,INC. 8880 ESTERS BOULEVARD Name and " IRVING,TX�75063 — address of �'`� 1 Libe"- -� Insured. mutug7M at the issue date of this certificate, insured by the Company under the policy(ies) listed below. The insurance afforded by the listed policy(les)is subject to all their terms, fusions and conditions and is not altered by any requirement,term or condition of any contract or other document with respect to which this certificate may be issued. EXP.DATE nCONTINUOUS LIMIT OF LIABILITY . TYPE OF POLICY ❑EXTENDED POLICY NUMBER COVERAGE AFFORDED UNDER WC ®POLICY TERM LAW OF THE FOLLOWING STATES: WORKERS 1/1/2006 WC7-611-004177-015 ID,KS,OR,WI EMPLOYERS LIABILITY COMPENSATION WA7-61D-004177-295 AL,AK,AZ,AR,CA,CO,CT,DE, BodlyI jury By Accident DC,FL,GA,HI,IL,IN,IA,KY,LA, $1,000,000 Each Accident ME,MD,MA,MINKIVIS,MO,MT, Bodily Injury By Disease NE,NV,NH,NJ,NM,NY,NC, 00 ,Policy $1,000,0 OK,PA,RI,SC,SD,TN,TX,UT, Limit VA Bodily Injury By Disease $1,000,000 Each Person GENERAL LIABILITY N/A General Aggregate-Omer man Pro ucts omp ete perahons Products/CompletedOperations Aggregate OCCURRENCE CLAIMS MADE Bodily Injury and Property Damage Liability Per Occurrence Personal Injury Per Person/ RETRO DATE Organization Other Other UTOMOBILE LIABILITY N/A Each Accident-Single Limit B.I.and P.D.Combined 7 OWNED Each Person Each Accident or Occurrence X NON-OWNED HIRED i I Each Accidentor Occurrence FX THER DDITIONAL COMMENTS VI operations of the insured and all of its whollyowned subsidiaries It the certificate expiration date is continuous or extended term,you will be notified if ccverage is terminated or reduced before the certificate expiration date. ,PECIAL NOTICE-OHIO: ANY PERSON WHO, WITH INTENT TO DEFRAUD OR KNOWING THAT HE IS FACILITATINGA FRAUD AGAINST AN INSURER.SUBMITS N APPLICATIONOR FILES A CLAIMCO NTAINING A FALSE OR DEC EPTIVESTATEMENT IS GUILTY OF INSURANCEF RAUD. Llbefty MU1UaI UPORTANTNOTICETOFLORIDA POLICYHOLDERSANDCERTIFICATEHOLOERS IN THE EVENTYOUHAVEANYOUESTIONSORNEED INFORMATION BOUTTHISCERTIFICATEFORANY RSCAN,PLEASEFCASE NTACTYOUR OPRIALOCAL SALES SALESO PRODUCER, CEMAIL OSENAME E AND TELSOBEOBTANEEDBYCALLNGTHSTHE Insurance Group O .OWER RIGHT HANDC RNEROFT ;OTICE OF CANCELLATION: (NOT APPLICABLE UNLESS A UMBER. NUMBER OF DAYS IS ENTERED BELOW.) BEFORE THE STATED EXPIRATION DATE THE COMPANY I VILLNOT CANCELORREDUCETHEINSURANCEAFFORDEDUNDERTHE A13OVEPOLICIES UNTILATLEAST 30 DAYS CITY OF MIAMISHORES _ Christine Merline ERTFICATE OLDER 10050 NE 2 AVE. AUTHORIZED REPRESENTATIVE Weston,MA (781)891-8900 1/1/2005 L MIAMISHORES,FL 33138 OFFICE PHONE NUMBER DATE ISSUED 'his certificateis executedby LIBERTY MUTUAL INSURANCE GROUP as respects such insurance as is affordedby Those Companies BS 772A R11 'A 31� � Ce �, �� � � Certificate of Insurance S CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON YOU THE CERTIFICATE HOLDER. THIS CERTIFICATE IS T AN INSURANGE POLICYAND DOES NOT AMEND,EXTEND,OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW. This is to Certify that BRINK'S HOME SECURITY,INC. 8880 ESTERS BOULEVARD Name and "• address of Libertm IRVING,TX 75063 ,— '�' Insured. mutui1lm L� 3t the issue date of this certificate, insured by the Company under the policy(ies) listed below. The insurance afforded by the listed policy(ies)is subject to all their terms, iusions and conditions and is not altered by any requirement,term or condition of any contract or other document with respect to which this certificate may be issued. EXP.DATE LIMIT OF LIABILITY . CONTINUOUS TYPE OF POLICY ❑EXTENDED POLICY NUMBER COVERAGE AFFORDED UNDER WC ®POLICYTERM LAW OF THE FOLLOWING STATES: WORKERS 1/1/2006 WC7-611-004177-015 ID,KS,OR,WI EMPLOYERS LIABILITY COMPENSATION WA7-61D-004177-295 AL,AK,AZ,AR,CA,CO,CT,DE, Bodily Injury By Accident DC,FL,GA,HI,IL,IN,IA,KY,LA, $1,000,000 Each Accident ME,MD,MA,MI,MN,MS,MO,MT, BodilylnjuryByDisease NE,NV,NH,NJ,NM,NY,NC, $1,000,000 ,Policy OK,PA,RI,SC,SD,TN,TX,UT, Limit VA Bodily Injury By Disease $1,000,000 Each Person GENERAL LIABILITY N/A ener ggregate-O erthan ro ucts/ omplete perations Products/CompletedOperations Aggregate OCCURRENCE CLAIMS MADE BodilyInjury and Property Damage Liability Per Occurrence Personal Injury Per Person/ RETRO DATE Organization Other Other UTOMOBILE LIABILITY N/A Each Accident-Single Limit B.I.and P.D.Combined OWNED Each Person Each Accident or Occurrence I NON-OWNED 0 HIRED i i Each Accident orOccurrence THER ,DDITIONAL COMMENTS all operations of the insured and all of its wholly owned subsidiaries It the certificate expiration date is continuous or extended tens,you will be notified if coverage is terminated or reduced before the certificate expiration date. SPECIAL NOTICE-OHIO: ANY PERSON WHO, WITH INTENT TO DEFRAUD OR KNOWING THAT HE IS FACILITATINGA FRAUD AGAINST AN INSURER.SUBMITS .N APPLICATIONOR FILES A CLAIMCONTAININGA FALSE OR ISNPORTANTNOTICET FLORIDAPOLIICYHOL ERSANDCERTIIFICATEHOLDERS DECEPTIVESTATEMENT INTHE EVENTOYOUHA EANYOINSURANCEFUESDTIONSORNEEDINFORMATION Liberty Mutual ,BOUTTHIS CERTIF ICATEFOR ANY REASON,PLEAS ECONTACTYOUR LOCAL SALES PRODUCER, WHOSENAME AND TELEPHONENUMBER APPEARSIN THE Insurance Group OWER RIGHT HANDCORNEROF THIS CERTIFICATE,THE APPROPRIATELOCALSALESOFFICE MAILINGADDRESSMAY ALSO BE OBTAINEDBY CALLINGTHIS IUMBEER. lOTICE OF CANCELLATION: (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW.) BEFORE DAYSSTATED EXPIRATION DATE THE COMPANY VILL NOT CANCELORREDUCETHEINSURANCEAFFOROEDUNDERTHE ABOVE POUCIESUNTILATLEAST 30 9 • CITY OF MIAMISHORES Christine Merline K-0-a—z"_4 ERTIFICATE OLDER 10050 NE 2 AVE. AUTHORIZED REPRESENTATIVE Weston,MA (781)891-8900 1/1/2005 ' AMISHORES,FL 33138 OFFICE PHONE NUMBER DATE ISSUED I his certificat MIs executedby LIBERTY MUTUAL INSURANCE GROUP as respects such insurance as is afforded by Those Companies BS 772A R11 Miami Shores Village Electrical Permit 10050 NE 2nd Avenue Phone: 305-795-2204 Permit Number: EL2005-83 Printed:3/9/2005 Page 1 of 1 Applicant: JAVAN THOMPSON 0 Owner: THOMPSON JAVAN JOB ADDRESS: 30 NE 97 ST Contractor BRINKS HOME SECURITY INC Contractor's Address: 9960 N. W. 116TH WAY, SUITE 12 Local Phone: 305-887-8455 Parcel # 1132060130790 Legal Description: MIAMI SHORES SEC 1 AMD PB 10-70W1/2 LOT 8& LOT 9 BLK 6 LOT SIZE Fees: Description Amount FEE2005-3069 Building Fee $100.00 Total Fees: $56.30 FEE2005-3070 CCF $0.60 Total Receipts: $0.00 FEE2005-3071 Training and Education Fee $0.20 FEE2005-3072 Scanning Fee $3.00 FEE2005-3073 Submittal Fee ($50.00) FEE2005-3074 Technology Fee $2.50 Total Fees: $56.30 Permit Status: APPROVED Permit Expiration: 8/30/2005 Construction Value: $300.00 A Work: BURGLAR ALARM MASTER (1)AND (8) DEVICES MAR 1 0 PAID Signed: (INSPECTOR) 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 responisibility for all work done by either myself,my agent,servants or employes. Signed: (Contractor or Builder) BY: Miami-Dade My Home-Text Page 1 of 2 n• y _ Y I �I'f�`• � i �` My Home M1, Show Me: Go to property map Print friendly version ropey n orma ion- ex , Search By: Summary Details: Folio No.: 11-3206-013-0790 @ U e ec em Property: 30 NE 97 ST Mailing Address: JAVAN THOMPSON J 30 NE 97 ST MIAMI SHORES FL IA Address earc 33138-2331 - 'Enter the address and click Property Information: "LOCATE". Use the Tab key to Primary Zone: 1100 SINGLE FAMILY RESIDENCE switch between fields or click using the mouse. CLUC: 0001 RESIDENTIAL-SINGLE FAMILY Beds/Baths: 3/3 House Number: 30 Floors: 1 Living Units: 1 Direction: Adj Sq Footage: 1,926 Street Name: 97 Lot Size: 8,625 SQ FT Year Built: 1938 Street Type: Legal Description: MIAMI SH RES SEC 1 AMD PB 10-70 W1/2 LOT 8&LOT 9 BL _-____.__._..._......... Unit(opt): 6 LOT SIZE 75.000 X 115 OR 16861-1733 0795 1 Zip Code(opt): 33138 Sale Information: Sale O/R: 16861-1733 Sale Date: 7/1995 Sale Amount: 99,000 Assessment Information: Year: 2004 2003 Land Value: 116,343 $89,467 Building Value: $111,551 Market Value: $230,829 $201,018 Assessed Value: $98,028 Homestead Exemption: $25,000 $25,000 Total Exemptions: $25,000 $25,000 Taxable Value: 77,891 $73,028 We appreciate your feedback,please take a minute to complete oursurvey. My Home I Property Information I Property Taxes I My Neighborhood I Property Appraiser Home I Using Our Site I About I Phone Directory I Privacy I Disclaimer kE If you experience technical difficulties with the Property Information application, please click here to let us know. E-mail your comments,questions and suggestions to Webmaster Web Site ©2002 Miami-Dade County. http://gisims2.miamidade.gov/myhome/proptext.asp?app=none&bytool=ADDR&cmd=FINDAD 1/30/05