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DEMO-16-1473 EMID 4%mo I 1-, - '� �' � rn�?�' ' Miami Shores Village g RECEIVED Building Department MAR 13 2017 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 2019SIL BUILDING Master Permit No.am O ��" 1 113 PERMIT APPLICATION Sub Permit No. F-JBUILDING ❑ ELECTRIC ❑ ROOFING REVISION EXTENSION RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 2 2 13 OSS 414 6\45 OkA Q City: Miami Shores County: Miami Dade Zip: 31 3 Folio/Parcel#: 1 1 s -3 9Z C M 6 - 65 10 Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): K \J ' N ci )— Phone#: (3-cy✓ 213 •aO a7 Address": `J la15 �3 c i�g TN STi•R�e T- City: Cv - J`n, fi M I 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: TO CSCE L. PB-9 M iT n 16 S Specify color o olor 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) 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature +L Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before -mme this The foregoing instrument was acknowledged before me this }` day of 1 ' 1ny1�' 1 ,20 1 C by day of 20 by M O N11 1,who is personally known to ,who is personally known to me or who has produced go -Q&-�i5- rPe or who has produced as identification and who did take an oath.-F-40'rd(:7k identification and who did take an oath. NOTARY PUBLIC: t ICe� NOTARY PUBLIC: S' n. Sign: Print: ""Y Print: my COMMISSION#GO 044602 Seal: Pyr EXPIRES:November2,2020 Seal: ''•$P; °•'' Bonded Thru Notary Public Underwriters APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) March 13, 2017 I would like to cancel the permit that was obtained for demolition work. The work was never done. A tenant who was being evicted, made false statements and when she was put out by the Courts,the property was inspected and found that the statements that she had made were false and she had f made statements that were fraud. I did not have to do the work and would like the permit to be canceled. I am the owner of this property and I Kevin O'Neil state that these facts are true and correct. g I& 13 0�F Kevin O'Neil -�n-, Al fi l 3 N .. 04, -a-' Miami Shores Village `' y �it Tjr , temQ n 10050 N.E.2nd Avenue NES Miami Shores,FL 33138-0000Af , Phone: (305)795-2204y n j 6 'I2 16 Expiration: 12/0412016 Project Address Parcel Number Applicant 8813 NE 4 Avenue Road 1132060460510 KEVIN ONEIL Miami Shores, FL Block: Lot: Owner Information Address Phone Cell KEVIN ONEIL 8813 NE 4 AVE RD MIAMI SHORES FL 33138-3177 Contractor(s) Phone Cell Phone Valuation: $ 2,054.00 SLUYTER CONSTRUCTION (970)379-9730 Total Sq Feet: 7.8 Type of Demo:Building Available Inspections: Additional Info:DEMO DRYWALL AT WATER DAMAGE AREA Inspection Type: Classification:Residential Final Scanning:3 Review Building Review Building Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.80 Invoice# DEMO-5-16-59956 DBPR Fee $2.00 05/26/2016 Credit Card $50.00 $72.80 DCA Fee $2.00 Education Surcharge $0.60 06/07/2016 Credit Card $72.80 $0.00 Notary Fee $5.00 Permit Fee $100.00 Scanning Fee $9.00 Technology Fee $2.40 Total: $122.80 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 AFFIDAVI : 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 zo Futhermore,I the abPve-named contractor to do the work stated. June 07,2016 Authbrized ignaturOwne / Appli nt / ontractor / Agent Date Building Department Copy June 07,2016 1 � • Miami Shores Village - ) MAY j6 281� 3 � 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 ly BUILDING ' Master Permit No. - 1973 PERMIT A L CATION Sub Permit No. '-J�BUILDING ❑ ELECTRIC R I��VISION EXTENSION DRENEWAL F-IPLUMBING EJPUBLICWORKSCHANGE OF'' L01 Ti SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 5?G )3 1-4- 1= AO AO City: Miami Shores County: Miami Dade Zip: 35138 Folio/Parcel#: 1( - 3'aO&- 0 q&' O51 O Is the Building Historically Designated:Yes NO_ C Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): 10E1t I nl 6 NI=1 L Phone#: (305�) 893 --44Z17 Address: 525 N3= t3,9" STRF-f-T City: rA_ M%Am State: 'FL Zip: 3;316 1 Tenant/LesseeName: VF_I._g;r4E T)A6MiNS Phone#&I (V SL�� & 3-3 0 4'3 Email: KO G PR a 0, y kYIard • cc m CONTRACTOR:Company Name: C Phone#: 7 Address: ( !� 5 City: �Q7_ °"��.l'k, State /g=:7 Zip: 3313 Qualifier Name: ® Phone#: State Certification or Registr ion#: �/?(--- 1 3 3 d t U 9 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 ❑ w ❑ Repair/Replace Demolition ®� Description of Work: N7' 0 Specify color of color,thru file Submittal Fee$ ! Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ 00 Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ V (Revised02/24/2014) f ,t Bonding Company's Name(if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) Mortgage Lender's Address �f •y City State Zip x Application is hereby made to obtain a permit to do the work a }� 4nstalla�ipns as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all w� ilk b TZ rf ed,to meet the standards of all laws regulating Lf � l ,t rf ' construction in this juri� cti'on. t iderstand that a separate permit tn�st`be`secured for ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES,BOILERS,HEA-QRS,TAI K5,�11iL'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. e Signature Signature OWNER or AGENT VONTRACTOFK The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 1'2- qday of M{��1 20 J b by ^�day of 20 ((o by VtEj INl"I I JC �)I N o is personally known to l �A �L"A-Qx- who is personally known to me or who has produced ��\Q- �� s 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: nl ` ` Sign: Print: 1 V U L -LaPrint: ��- n Seal: Seal: `�� ���� ,,�� Heatther Mulroney e o4Y pub Notary public State of Florida _ I CIMISSION#FF12V27 Sindia Alvarez - ` 4 nny; emission=F 1567x0 :��a,� 0(P�RES. MW 21, 2016 � APPROVED BY V7 Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) OR.93s Miami Shores Village logo Building Department 10050 N.E.2nd Avenue ORiDp' Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner— Workers' Compensation ensation Insurance Exemption t tv 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. 1. 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; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State,Division of Corporations;and 3. 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 and has acknowledge that he or she will not use day labor,part-time employees or subcontractors for your project.The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project.In these circumstances,Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company for day labor,part-time employees or subcontractors. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: 1.41 Owner State of Florida County of Miami-Dade The foregoing was acknowledge before me this 'L day of By 491 N �e Q.l-(Q� U I�E1 L who is personally known to me or has produced �L 121 U kKE:e, L6N SF as identification. Notary: SEAL S(e v�((� `\� � c6p01 PL®, Notary�',lnlic State of Florid® r Sindia Alvarez a Pfly Commisslon FF 158750 v 9/031208 May 12, 2016 To whom it may concern: I authorize Sluyter Construction Company to remove and repair water damaged dry wall. I am the owner of the property located at 8813 N.E. 4th Avenue Road, Miami Shores, FL 33138. Kevin O'Neil - Owner The foregoing instrument was acknowledged before me this 12th Day of May,2016,by- Kevin O'Neil , who is personally known tome or who has produced (Q - as identification and who did take an oath. NOTARY UBLIC: Sign: Print: ��(�►�« �Ly Q�� Notary Public State of Florida $ ^ Sindia Alvarez �Q My Commission FF 156750 Seal: moi OF FVo4 Expires 09/03,12018 tri 3�7 9 -9'736 Greg Sluyter, Owner r SLUYTER_--. 970-379-9730 -' CONSTRUCTION,LLC. SluyterConstruction@gmail.com To Miami Shores Building Dept: Sluyter Construction will commence demolition at 8813 NE.4thAve rd.Miami Shores,Fl. 33138 on June 6th,2016. )43Z r State of Florida) County of Miami Dade) Sworn to and subscribed before me this 2-W-`- Day of 20,E a � Heather Mulroney By ;�= COMMISSION#FF125227 EXPIRES: May 21, tots (SEAL) �''n;;; � ��``� WWW.AARONNOTARY.COM Type of Identification produced Licensed and Insured