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RF-16-739
Miami Shores Village f�� 21 2016 Building Department 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 No`P ��' l� 1 PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ZROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP 1 t �n CONTRACTOR DRAWINGS i JOB ADDRESS: 1 0 S®`1 rJ W Z 4A . City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: �� -z 136r OOZ_d 1d Is the Building Historically Designated:Yes NO Occupancy Type: Load: //Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): A Q A 6\ 0 a e,C.` Phone#: (Z 1 _XCIS Addressp 141 '1 � ��- City: fit OA 0- 't bo y C�^ ' State' ' ' Zip: 3� Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: C__-08'r, Phone#: 36S Address: City: �'��� �Q_N State.� Zip: Qualifier Name: Q I� 1 6" d p 1 6 S G a Phone#:IB6 State Certification or Registration#: �• 7a6 6 �- Certificate of Competency#: DESIGNER:Architect/Engineer: ccs /,30 , Phone#: Address: City: State: Zip: Value of Work for this Permit:$ �/ Square/Linear Footage of Work: Type of Work: El Addition lJ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: e, 1 C__ k ®�' G r,- Specify color of color thru tile: Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (Revised02/24/2014) r 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 n t be ap ro ed and a einspection fee will be charged. Signatu Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this y(// L� day of U� `�'� 2016 by / A day of IV ��" d ,20/6 ,by e,7 e ed?o,4 who i personallyy nizTnwto U��✓�� � a o 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: Sign: Print: Print: �S R COX .` r. Seal: :+= MY COMMISSK?N#1 GG011522 Seal: ,,,. EXPIRES July 13,2020 " EXPIRES July 13,2020 (ao 3830153 Fl AlMotu cm 4077 399-0153 corn G APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) November 18,2016 Miami Shores Village Building Department 10050 NE 2nd Ave, Miami Shores, FL 33138 To whom it may concern: RE:PERMIT#RF13-16-731q We hereby request that permit#RF13-16-731 for address 10804 NW 2nd Ave, Miami Shores, be cancelled due to a change in the required scope of works. Thanks in advance. #Roof INSPECTION RECORD p POST ON SITE • Sy�jOas h�t Miami Shores Village Permit NO. RF-3-1 6-739 7n 10050 N.E.2nd Avenue -... Miami Shores,FL 33138-0000 h" o° Phone: (305)795-2204 Fax (305)756-8972 FtORtOp' I ue X4/612016 Expires: 10/03/2016 INSPECTION REQUESTS: (305)762-4949 REQUESTS ARE ACCEPTED DURING 8:30AM-3:30P.M IftR`!3H FOLL`f� B � DAY Roof' . `' Parcel#:1121360020140 Owner's Name:ANGELA M HENAO Owner's Phone: (305)793-2495 Job Address: 10804 NW 2 Avenue - Total Square Feet: 1700 Miami Shores, FL 33168- Bond Number: 3048 Total Job Valuation: $ 17,000.00 WORK IS ALLOWED MONDAY THROUGH SATURDAY, Contractors) Phone Primary Contractor 7:30AM-6:00PM.NO WORK IS ALLOWED ON SUNDAY OR HOLIDAYS. CODA ROOFING, INC 305-681-1060 Yes BUILDING INSPECTIONS ARE DONE MONDAY THROUGH THURSDAY. ROOFING INSPECTIONS ARE DONE MONDAY THROUGH FRIDAY. NO BUILDING INSPECTIONS DONE ON FRIDAY. COLOR THROUGH CONCRETE TILE OR SOLID CLAY TILE REQUIRED. NO INSPECTION WILL BE MADE UNLESS THE PERMIT CARD IS DISPLAYED AND HAS BEEN APPROVED. PLANS ARE READLY AVAILABLE. IT IS 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 REQUIRED TO ALLOW INSPECTION. 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. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. 4 t t INSPECTION RECORD PLUMBINGSTRUCTURAL ZONING INSPECTION DATE INSP INSPECTION DATE INSPI INSPECTION DATE INSP Foundation Zoning Final Stemwall ZONING COMMENTS Rough Slab Water Service Columns 1 st Lift 2rtd Rough Columns 2nd Lift Top Out Tie Beam Fire Sprinklers Truss/Rafters Septic Tank Roof Sheathing- Sewer Hook-up Bucks Roof Drains Windows/Doors ELECTRICAL Gas Interior Framing INSPECTION -DWMI-INWI LP Tank Insulation TemporaryPole Well Ceiling Grid, 30 Day Temporary Lawn Sprinklers Drywall Pool Bonding Main Drain Firewall Pool Deck Bonding Pool Piping Wire Lath Pool Wet Niche Backfiow Prevento Pool Steel Underground Interceptor Pool Deck Footer Ground Catch Basins Final Pool Slab lCondensate Drains Final Fence Wall Rough HRS Final Screen Enclosure Ceiling Rough Driveway Rough PLUMBING COMMENTS Driveway Base Telephone Rough Tin Cap- Telephone Final Roof in Progress TV Rough Mop in Progress TV Final Final Roof Cable Rough Shutters Attachment Cable Final Final ShuttiDo Intercom Rough Rails and Gdrails Intercom Final MECHANICAL ADA com e Alarm Rough INSPECTION DATE INSP Alarm Final Underground Pipe CUMENTS Fire Alarm Rough Soil BearingCert Fire Alarm Final Rough Soil Treatment Cert Service Work With Floor Elevation SurveyVentilation Rough Reinf Unit Mas Cert ELECTRICAL COMMENTS Hood Rough Insulation Certificate Pressure Test Spot Survey Final Hood Final Survey Final Vbntilation Truss Certification Final Pool Heater STRUCTURAL COMMENTS Final Vacuum r2 MECHANICAL COMMENTS INSPECTION DATE INSP Final Sprinkler Final Alarm • �� CODAR-1 OP ID:NG CERTIFICATE OF LIABILITY INSURANCE DA121291201TE Y) `....,�' 12/29/2015 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 CONTACT Workers Compensation Group Workers Compensation Group HONE FAX P O Box 410 c E •561.392-3300 Arc N.I:661-361-1132 Boca Raton,FL 33429-0410 Kirby Industries,Inc. ADDRESS: rkersCOmpgroup.com INSURERS AFFORDING COVERAGE MAIC 0 INSURER A:Bridgefield Employers Ins 10701 INSURED Coda Roofing,Inc. INSURER 8: 4678 East 10th Lane Hialeah,FL 33013 INSURER C: INSURER D; INSURER E: 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. NOTIMTHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. RwLr POLICY EFF POLICY EXP INSR LTR TYPE OF INSURANCE POLICY NUMBER M/DDIYYYY MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAUE TO RENTED CLAIMS-MADE LIOCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ POLICY JET LOC PRODUCTS-COMP/OPAGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ a clden ANYAUTO BODILY INJURY(Per person) $ ALL CWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Par cc $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION R AND EMPLOYERS'LIABILITY SEA LITE ER A ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N 830-43636 01/01/2016 01/01/2017 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? ElNIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,00 If yes describe under DESCRIPTION OF OPERATIONS glow E.L.DISEASE-POLICY LIMIT $ 1,00(),000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Coda Roofing Lic#1326045 CERTIFICATE HOLDER CANCELLATION MIAMIS3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Village of Miami Shores THE EXPIRATION DATE THEREOF, NOTICE 1MLL BE DELIVERED IN g ACCORDANCE WITH THE POLICY PROVISIONS. Building Department 10050 NE 2nd Ave. Miami Shores,FL 33138 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014101) The ACORD name and logo are registered marks of ACORD Miami Shores Village Building Department MAR 2226 6 ` 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 B,� Tel:(305)795-2204 Fax:(305)756-8972 ---------- �\ INSPECTION LINE PHONE NUMBER:(305)762-4949 5 FBC 20 tq BUILDING Master Permit No. 2F- 16- -4311 PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC EKOOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS [] CHANGE OF ❑ CANCELLATION ❑ SHOP � CONTRACTOR DRAWINGS JOB ADDRESS: /0 8-059r AlUl Z /Vy6 City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: //-Z/Ja-UOZ - C71449 Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: �/® OWNER:Name(Fee Simple Titleholder): ; u ����� Phone#: all — �9�7 1T Address: /OZ2 City: /Cth'7/ GrS 06State: Zip:-3316 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: 6OD'09 �L'C���hq -SAO' Phone#: Address: '?67 K 4�f- /0 //7 City: /c/ liezll State: 1 Zip: jrj U�3 Qualifier Name: 1 a," z0 O Phone#: ��G��—1060 State Certification or Registration#: CCG 1, ?26vq'S Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ 1_ DO 0 s Square/Linear Footage of Work: / I P® .5F.Type of Work: El Addition El Alteration ❑ New LI Repair/Replace ❑ Demolition Description of Work: �o - -r1f cz� �f�T 6-i'P//ctw 7-e,39cl Specify color of color thru tile: `� P/� Submittal Fee$ _ �tS() -� Permit Fee$ � `S•� CCF$ 1�[J�' CO/CC$ Scanning Fee$ 'GJ ` Radon Fee$� _% 13 DBPR$ T m I Notary$ Technology Fee$ 13• C(3 Training/Education Fee$ ° '-4(3 Double Fee$ Structural Reviews$ Bond$ F0 cz TOTAL FEE NOW DUE$.31,E�) • 14 G (Revised02/24/2014) � �e--- Bonding Company's Name(if applicable) BoVJ-ng Company's Addrbss 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. in the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature La Signature WNER or AGENT CONT CT The foregoing instrument was acknowledged before me this The foregoing instrument was CT before me this �-1 day of 20 �0 ,by Zk day of r -knit Gk 20 J(a by a'D - ,who is per ally nown to l�-�,o,. � �""' ,who is per ally known to me o ho has produced as me or who has prod ed as identification and who id ke an oath. identification and who d take an oath. NOTARY PUBLIC, NOTARY PUBLIC: Sign. HERNANDEZ Sign: .ot .$we of a <�'°�e'o RAMO ED0 HERNANDEZ Print: ° ��= 17 2016 Print: tate Seal: 'afar po- Commission#EE 216934 Seal: ""� "Qc My Comm.Expires Jul 17,2016 R �f O. '"el 1% �f��FOFF��P�- Commission#EE 216934 **************************** ******************************************************************************* APPROVED BY l Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Miami Shores Village ' , h . Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 r Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 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: City: Miami Shores County: 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): Phone#: Address: City: State: Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: Phone#: Address: City: State: Zip: Qualifier Name: Phone#: State Certification or Registration#: Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description.of Work. Specify color of color thru tile: Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (Revised02/24/2014) Miami Shores Village Ing Building Department 4h .•,� 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 OWNERS'S AFFIDAVIT OF EXEMPTION ROOF TO WALL CONNECTION HURRICANE MITIGATION RETROFIT FOR EXISTING SITE- BUILT SINGLE FAMILY RESIDENTIAL STRUCTURES PERSUANT TO SECTION 553.844 F.S. To: Miami Shores Village Building Department Date: 10050 NE 2nd Ave Miami Shores, A 33138 Re: Owner's Name: '4,? Lelo Q o a C) Property Address: 0 a'D 4 yuj o7 �9U� Roofing Permit Number: Dear/�uilding Official: I �s-fd�G /y /�'�a��cry • certify that I am not required to retrofit the roof to wall connections of my building because: \i The just valuation for the structure for purpose of ad valorem taxation is less than$300,000.00. Please attach proof of ad valorem taxation. The building was constructed in compliance with the provisions of the Florida Building Code (FBC)or with the provisions of 1994 editi 0 o0he Pouth F lorida Building Code(1994 SFBC) of Signatui/e 4 Print Name State of Florida County of Dade The undersigned, being the first duly sworn,deposes and says t h (rrieiifGl: mentioned. tau° �'' • Rl HERNANDEZ Sworn to and subscribed before me this da ofN-tarTPu-� blic-State of Florida My Comm.Expires Jul 17,2016 Commission#EE 216934 Notary Public, Sate of Florida at Large • When the just valuation of the structure for purpose of ad valoremtion Is equal to or more than$300,000.00,and the building was not constructed with FBC nor a 1994 SFBC.Then you must provide a building application from a General r the Roof to Wall connection Hurricane Mitigation. Revised on 5121/2009 Property,Search Application-Miami-Dade County Page 1 of 5 0 F F I C" E Oul F T H E P"Hs" UO"F"E R T"Y" A Fm 0 OF'Hw*'An I S"' E R Y� • �.��9_Z n�'jl Detailed Report Generated On:3/18/2016 Property Information s $ Folio: 11-2136-002-0140 t Property Address: 10804 NW 2 AVE Miami Shores,FL 33168-4302 Owner ANGELA M HENAO Mailing Address 10804 NW 2 AVE MIAMI SHORES,FL 33168 USA & ;a Primary Zone 0800 SGL FAMILY-1701-1900 SQ sw/e Primary Land Use 0101 RESIDENTIAL-SINGLE ; FAMILY:1 UNIT y, Beds/Baths/Half 3/2/0 Floors 1 - z Living Units 1 t` Actual Area 1,677 Sq.Ft d P Living Area 1,677 Sq.Ft Adjusted Area 1,496 Sq.Ft Taxable Value Information Lot Size 12,123.75 Sq.Ft Year Built 1944 2015 2014 2013--- -- County Assessment Information Exemption Value 1 $50,000 $50,000 $50,000 Year 2015 2014 2013 Taxable Value 1 $52,1401 $51,3301 $49,833 Land Value $218,228 $129,967 $60,134 School Board Building Value $104,122 $101,429 $101,429 Exemption Value $25,000 $25,000 $25,000 XF Value $635 $643 $651 Taxable Value 1 $77,140 $76,330 $74,833 Market Value $322,985 $232,039 $162,214 City Assessed Value $102,140 $101,330 $99,833 Exemption Value $50,000 $50,000 $50,000 Taxable Value 1 $52,140 $51,330 $49,833 Benefits Information Regional Benefit Type 2015 2014 2013 Exemption Value 1 $50,000 1 $50,000 $50,000 Save Our Homes Assessment Taxable Value $52,140 $51,330 $49,833 Cap Reduction $220,845 $130,709 $62,381 Homestead Exemption $25,000 $25,000 $25,000 .. ., Second Exemption $25,000 $25,000 $25,000 Homestead MAR 2 2 2016 Note:Not all benefits are applicable to all Taxable Values(i.e.County, School Board,City,Regional). •• *00 • • . • i '--_ The Office of the Property Appraiser is continually editing and updating the tax roll.This website may not reflectthe mosPcuRen!inio,11%tiernoh record.The Property Appraiser and Miami-Dade County assumes no liability,see full disclaimer and User Agreement at http:lhvww.miamidads.Sovflmf•/risdaNier.asp : : •• Version: • ••• ••• ••• • • •• • • • • • • • • • •• • • • • • • • ••• • • • • ••• • • • • • • • • • • • • • •• •• • • • •• •• ••• • • • ••• • • http://www.miamidade.gov/propertysearch/ 3/18/2016 P•opert'y,5earch Application-Miami-Dade County Page 2 of 5 1 44`77' 0 F THE F'h 5'0*' w&E 0%Ts # A w&w&r% A I&%E RU L PHUF H Y PFKA SR a � Generated On:3/18/2016 Property Information Folio:11-2136-002-0140 Property Address: 10804 NW 2 AVE Roll Year 2015 Land, Building and Extra-Feature Details Land Information Land Use Muni Zone PA Zone Unit Type Units Calc Value GENERAL R-14.25,R-15 0800 Front Ft. 96.98 $218,228 Building Information Building Number Sub Area Year Built Actual Sq.Ft Living Sq.Ft Adj Sq.Ft. Calc Value 1 1 1944 1,353 1,353 1,280 $89,088 1 2 1952 324 324 216 $15,034 Extra Features Description Year Built Unitsi Calc Value Chain-link Fence 4-5 ft high 1977 100 $520 Patio-Brick,Tile,Flagstone 1945 24 $115 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 httpJ/www.miamidade.govAnfoidisdalmor.asp Version: •• ••• • • • • • •• • •• • • • • ••• • •• ••• •• • • • •• • ••• ••• ••• • • • • • • •• • • • •• • • • • • • • • •• • • • • • • • ••• • • • • ••• • • • • • • • • • • • • • •• •• • • • •• •• ••• • • • ••• • • http://www.miamidade.gov/propertysearch/ 3/18/2016 Property,Search Application-Miami-Dade County Page 3 of 5 OFFICO'hE OF T " PERT"Y" APPO"" Ho"kAls"ER Generated On:3/18/2016 Property Information Folio:11-2136-002-0140 Property Address: 10804 NW 2 AVE Roll Year 2014 Land, Building and Extra-Feature Details Land Information Land Use Muni Zone PA Zone Unit Type Units Catc Value GENERAL R-14.25,R-15 0800 Front Ft. +_96.991 $129,967 Building Information Building Number Sub Area Year Built Actual Sq.Ft.I Living Sq.Ft Adj Sq.Ft. Calc Value 1 1 1944 1,3531 1,353 1,280 $86,784 1 2 1952 3241 324 216 $14,645 Extra Features Description Year Built Units Calc Value Chain-link Fence 4-5 ft high 1977 100 $528 Patio-Brick,Tile,Flagstone 1945 24 $115 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 Properly Appraiser and Miami-Dade County assumes no liability,see full disdaimer and User Agreement at http:/Avww.miamidade.govfirTfoldisdalmer.asp Version: •• ••• • • • • • •• • •• • • • • ••• • •• ••• ON: • • • •• • ••• ••• ••• • • • • • • • • • • • •• • • • • • • • ••• • • • • ••• • • • • • • • • • • • • • •• •• • • • •• •• ••• • • • ••• • • http://www.miamidade.gov/propertysearch/ 3/18/2016 -Property Search Application-Miami-Dade County Page 4 of 5 OF"Flu"'I OW T'H"' E PROPERTY" APO""RAISER7 Generated On:3/18/2016 Property Information Folio:11-2136-002-0140 Property Address: 10804 NW 2 AVE Miami Shores,FL 33168-4302 Roll Year 2013 Land, Building and Extra-Feature Details Land Information Land Use Muni Zone PA Zone Unit Type Units Calc Value GENERAL R-14.25,R-15 0800 Front Ft. 196.991 $60,134 Building Information Building Number Sub Area Year Built Actual Sq.Ft. Living Sq.Ft Adj Sq.Ft. Calc Value 1 1 1944 1,353 1,3531,280 $86,784 2 1952 324 324 216 $14,645 Extra Features Description Year Built Units Calc Value Chain-link Fence 4-5 ft high 1977 100 $536 Patio-Brick,Tile,Flagstone 1945 24 $115 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 httpJAvww.miamidade.govfinfo/disdaimer.asp Version: •• ••• •• • • • of • ••• ••• ••• • • • • • • • • • • •• • • • • • • • • • •• • • • • • • • so ••• • • • • ••• • • • • • • • • • • • • • •• •• • • • •• •• ••• • • • ••• • • http://www.miamidade.gov/propertysearch/ 3/18/2016 Property„Search Application-Miami-Dade County Page 5 of 5 0 u U "" PERT"' A`PRA104hER Flal " F THE PHU Y .ems Generated On:3/18/2016 Property Information Folio:11-2136-002-0140 Property Address: 10804 NW 2 AVE Full Legal Description 36 52 41 SHORELAND HGTS PB 43-85 LOT 13&N25FT OF TH PORT NW 108TH ST LYG BETW LOTS 12&13 LOT SIZE 96.990 X 125 OR 11472-1048 0682 5 Sales Information Previous Sale Price OR Book-Page Qualification Description 11/25/2015 $220,000 29883-4582 Qual by exam of deed 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 Properly Appraiser and Miami-Dade County assumes no liability,see full disclaimer and User Agreement at http.//www.miamidade.govAnfo/disdaimer.asp Version: •• ••• • • • • • •• • •• • • • • ••• • •• ••• •• • • • •• • ••• ••• ••• • • • • • • • • • • • •• • • • • • • • 00 • • • • • • • • • • • •• •• ••• ••• •• ••• • • ••• • • http://www.miamidade.gov/propertysearch/ 3/18/2016 CODAR-1 OP ID:NG ACORO" CERTIFICATE OF LIABILITY INSURANCE DATE(M9120 6 • 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 CONTA T Workers Compensation Group PHONE Workers Compensation Group P O Box 410 FAX .561-392-3300 ANO 1 561-361-1132 Boca Raton,FL 33429-0410 A oRe Kirby Industries,Inc. ss:ce rkerscompgroup.com INSURER(S)AFFORDING COVERAGE NAIC i INSURER A:Brid efield Employers Ins 10701 INSURED Coda Roofing,Inc. INSURER B: 4678'East 10th Lane Hialeah,FL 33013 INSURER C: INSURER D: INSURER E: INSURER P: 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. I SRPAJULrXK1 POLICY FFF POLICY EXP LTR TYPE OF INSURANCE INSD D POLICY NUMBER MMID MMfDD LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ -0AMAZrT0-RW ED CLAIMS-MADE FIOCCUR PREMISES Me occurrence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑JET LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per parson) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIREDAUTOS AUTO->S MED FRrrP91dant DAMAGE $ UMBRELLA UAB OCCUR I EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER O AND EMPLOYERS'LIABILITY STATUTE ER A ANY PROPRIETORIPARTNERlEXECUTIVE Y/ YIN 01/01/2016 01/01/2017 E.L.EACH ACCIDENT $ 1,000,000 OFFICERIM EMBER EXCLUDED? NIA (Mandatory In NH) EL.DISEASE-EA EMPLOYE $ 1,000,000 If yes describe under DtSdRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 11000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached N more space is required) Coda Roofing Lic#1326045 CERTIFICATE HOLDER CANCELLATION MIAMIS3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Village of Miami Shores THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Building Department 10050 NE 2nd Ave. Miami Shores,FL 33138 '- AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD nam and logo are registered marks of ACORD