DS-16-3184 JOAN LMON 7/6 /1,7
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Miami Shores Village
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�Sr 10050 N.E.2nd Avenue NW Woli?t 0a tff,&afion1 AdditibnAfteraflon
Miami Shores,FL 33138-0000 .r.,eiAPPROVED
Phone: (305)795-2204
F�"COA1Dp' `
Issue bats-V14/267 Expiration: 0 13!2017
Project Address Parcel Number Applicant
167 NW 109 Street 1121360030180
Miami Shores, FL 33168-4316 Block: Lot: STEPHEN AND JOAN LUTTON
Owner Information Address Phone Cell
STEPHEN AND JOAN LUTTON 167 NW 109 Street
MIAMI SHORES FL 33168-4316
167 NW 109 Street
MIAMI FL 33168-4316
Contractor(s) Phone Cell Phone Valuation: $ 3,600.00
ORINOCO BUILDING LLC (786)531-9479
..... .: _:: _ _:... m.. Total Sq Feet: 520
Approved:In Review Available Inspections:
Comments: Inspection Type:
Date Approved::In Review Final
Date Denied: Foundation
Type of Work:NEW DRIVEWAY WALKWAY AND PATIO Additional Info: Review Planning
Bond Return: Classification:Residential Review Building
Scanning:3
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
Bond Type-Owners Bond $500.00
CCF Invoice# DS-11-16-62141
$2.40 02/14/2017 Check#:977 $599.40 $50.00
DBPR Fee $2.00
DCA Fee $2.00 11/21/2016 Check#:3353 $50.00 $0.00
Education Surcharge $0.80 Bond#:3315
Notary Fee $5.00
Permit Fee $125.00
Scanning Fee $9.00
Technology Fee $3.20
Total: $649.40
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: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
constry0ioo,and zoning. Futhermor ,I authorize the above-named contractor to do the work stated.
February 14, 2017
d1thorized Signatur . wner / App scant / Contractor / Agent Date
Building Department Copy
February 14, 2017 1
•
Miami Shores Village
Building Department ' NOV z pry
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 11
BUILDING Master Permit No.:)(5-1 �0_ �I
PERMIT APPLICATION Sub Permit No.
OBUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL
❑PLUMBING ❑ MECHANICAL ®PUBLIC WORKS ❑ CHANGE OF [:]CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 167 NW 109th St, 33168
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 11-2136-003-0180 Is the Building Historically Designated:Yes NO X
Occupancy Type: Load: Construction Type: CMS Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder):Joan Lutton Phone#:(305) 479-8557
Address: 167 NW 109th St
City: Miami Shores state: FL Zip: 33168
Tenant/Lessee Name: NA Phone#: NA
Email: Jdl59@aol.com
CONTRACTOR:Company Name: Orinoco Building LLC Phone#: 786)531-9479
Address: 9620 NE 2nd Ave, Suite 207
City. Miami Shores State: FL Zip: 33138
Qualifier Name: Eloy Paredes Paoli Phone#: 305)333-3169
State Certification or Registration#: CGC# 152 3919 Certificate of Competency#:
DESIGNER:Architect/Engineer: NA Phone#:
Address: City: State: Zip:
Value of Work for this Permit:-$ 5hac) Square/Linear Footage of Work: 20
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: New driveway, walkway and patio
Specify color of color thru tile:
Submittal Fee$�® Permit Fee$ 12. CCF$ 2• v CO/CC$
Scanning Fee$ Radon Fee$ DBPQR�$ Notary$
Technology Fee$ • 2 Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(Revised02/24/2014)
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a
Bonding Company's Name(if applicable) NA
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$2500, the applicant must
promise in goad faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment Also,a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of suc posted notice, the
inspection will not be approved and a reinspection fee will be charged. '
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Signa ` - Signatur
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The/fore oing instrument was acknowledged before
eesme this
�5 day of Au��$` 20 ` ' J by "l dav of 020 by
who is personally known to who i ersonally known
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: 1111111NOTARY PUBLIC:
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******************************* *** *** *************************** * e*** IRS +2 ** ******
APPROVED BY l J Plans Examiner Zoning
LZ
Structural Review Clerk
(Revised02/24/2014)
ORINOCO BUILDING LLC
Date: 9 q I ® 16
State of T OP k A
County of — DQE
Before me this day personally appeared � .� who,being duly sworn,deposes and
says:
That he or she will be the only person working on the project located at: r�excp
-:�;-H
Sworn to(or affirmed)and subscribed before me this W day of ri%J Gil — . 20 d 6, by
Personally know
OR Produced Identification
Type of Identification Produced
a000Y ryes Notary PUbdC State of Florida
Si,dia Al,,,,-,,
FF` any Commission FF 156750
GF FN:Coq Expires 00/03'2018
Print,Type or Stamp Name of Notary
,goal Miami shores Village
Building Department
�ZO)Pt1D�° 10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305)795.2204
Fax: (305)756.8972
Notice to Owner — Workers' Compensation Insurance Exemption
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
wrier
State of Florida
County of Miami-Dade
The foregoing was acknowledge before me this�° day of 4ULX.rt 20 .
By /1®4-" U 1 l®N who is personJy known to me or has produced
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Mission: Governor
` To protect,pra wte&inp-me the heats
of all people in Flaidathrough intevatsd da Ceissto MM^MD,MPH
state,=M&Wmv*eff0ftS, Rate Stugeon General and Seaetap'
HEALTH
Vision:To be the Fleaf tlest State in to Nation ;On y
February 07,2
Jose Castro 0py
15362 SW 36 Terrace
Miami, FL 33185
RE: Modification to a Single Family Residence-No Bedroom Addition
Application Document Number: API 274"2
Centrax Permit Number: 13-SC-1737636
167 NW 109 Street
Miami, FL 33168
Lot: 18 Block: 219 Subdivision:
Dear Applicant,
This will acknowledge receipt of a floor plan and site plan on 02/06/2017 for the use of the existing
onsite sewage treatment and disposal system located on the above referenced property. No Objection
for New pavers on the front and rear of the property having no impact on the existing septic or drain
field. By B.O
This office has reviewed and verified the floor plan and site plan you submitted,for the proposed
remodeling addition or modification to your single-family home. Based on the information you provided,
the Health Department concludes that the proposed remodeling addition or modification is not adding a
bedroom and that it does not appear to cover any part of the existing system or encroach on the
required setback or unobstructed area. No existing system inspection or evaluation and assessment,
or modification, replacement, or upgrade authorization is required.
Because an inspection or evaluation of the existing septic system was not conducted,the Department
cannot attest to the existing system's current condition, size,or adequacy to serve the proposed use.
You may request a voluntary inspection and assessment of your system from a licensed septic tank
contractor or plumber, or a person certified under section 381.0101, Florida Statutes.
If you have any questions, please call our office at(305)623-3500.
Sincerely,
,i�QQ4�
Betsy Olmino
Engineer II
Department of Health in Dade County
D"wbnsd of x sar
in Dade County- -,Florida TWITTER:HealthyFLA
PHONE: (305)623-3500 FACEBOOK:FLDepartmentofHealth
YOUTUBE:fldoh