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DS-16-3180Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 1189 NE 102 Street Miami Shores, FL 33138-2615 Owner Information Permit NO. DS -11-16-3180 Pe m Permit Type: Driveways/Sidewalks/Slabs' Work Classification: Repair Pennit Status: APPROVED Issue Date: 1/5/2017 Expiration: 07/04/2017 Address Parcel Number 1132050190100 Block: Lot: Applicant GEORGE GLADDING Phone Cell GEORGE GLADDING 1189 NE 102 ST MIAMI SHORES FL 33138-2615 Contractor(s) Phone Cell Phone ONE STOP PAVING INC 786-299-1354 Valuation: $ 1,800.00 Total Sq Feet: 500 Approved: In Review Comments: Date Approved:: In Review Date Denied: Type of Work: ASPHALT RESURFACING OVER EXISTING Bond Return : Scanning: 3 Additional Info: ASPHALT RESURFACING OVER EX Classification: Residential Fees Due Bond Type - Contractors Bond CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $500.00 $1.20 $2.00 $2.00 $0.40 $100.00 $9.00 $1.60 $616.20 Pay Date Pay Type Invoice # DS -11-16-62135 11/21/2016 Credit Card 01/05/2017 Check #: 1628 Bond #: 3294 Amt Paid Amt Due $ 50.00 $ 566.20 $ 566.20 $ 0.00 Available Inspections: Inspection Type: Final Foundation Review Planning Review Planning Review Planning Review Building Review Building Review Building 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; erti construction and zonin I the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating uthorize the above-named contractor to do the work stated. Authorized Signature: Owner / Applicant / Building Department Copy January 05, 2017 Agent Date January 05, 2017 1 cpxos PdOb\1° \c),V0V)' csk95 BUILDING PERMIT APPLICATION 'UILDING ❑ ELECTRIC ❑PLUMBING ❑ MECHANICAL JOB ADDRESS: 1 \ ‘8°‘ City: Miami Shores Folio/Parcel#: 11 3 20 S Occupancy Type: Load: Ua Miami Shores Village 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 ❑ ROOFING ❑PUBLIC WORKS 102 si Master Permit No. RECEIVED NOV 211016 CAN)— FBC 20N Sub Permit No. 0 REVISION 0 EXTENSION ❑ RENEWAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS County: Olq OIO6 Miami Dade zip: 3 3 138 Is the Building Historically Designated: Yes NO Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): 6eor i e C 141.1J -col 8°( 1J & 102 sf Address: Phone#: 33C7 r 61 0 6)23/ City: Stest, S State: Tenant/Lessee Name: Phone#: Email: Ca CZ (aciGivi e G/(. C0 CONTRACTOR: Company Name: 014 e S -tor POL/1''l 7 .1-0.-aAddress: '[4 3 NL' 173 s 7' 1 City: iJ . M . %}-L 4 CII i State: -TL Qualifier Name: C l (a S a" Stet Zip: 3 '> t3 �) Phone#: 786' 29'/ /35q zip: 33/hz Phone#: id( 2Ry /)$1 State Certification or Registration #: Certificate of Competency #: ' 2 3 (S-00 . DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ /800. 00 Square/Linear Footage of Work: 504 s Type of Work: 0 Addition ❑ Alteration ❑ New Description of Work: / �f 5f,17ta /7 4.cci4 G. 1;4 2 /` 0 SW,iv/'' o , .D pr f 7 • P.7) Specify color of color thru tile: / Submittal Fee $45) ' 0 Permit Fee $ 1 00 CCF $ ' • 20 Scanning Fee $ I Radon Fee $ Z Z. DBP^^R,^$ Z • Om Technology Fee $ 1 • 6 0 Training/Education Fee $ 0.40 Structural Reviews $ [Repair/Replace ❑ Demolition (Revised02/24/2014) CO/CC $ Notary $ l� Double Fee $ Bond $ TOTAL FEE NOW DUE $ C) 5(6•zo 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 • ov_• and a reinspection fee will be charged. Signature ER or AGENT The foregoing instrument as acknowledged before me this /0 day of PO t/ ,20 / ,by Goo," 4, c( 7V 7 , who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLI 4117 Sign: Print: Seal: BARBARO SOBRINO MY COMMISSION # FF 195634 EXPIRES: February 3, 2019 3 Dandcd Thru Notary Plc Caderwrib r; fn ****************************al APPROVED BY (Revised02/24/2014) Signature CONTRACTOR The foregoing instrument was acknowledged before me this 11)/ day of e✓ ,20 /10 ,by CoT%s c /` , who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: ins Examiner Structural Review MY COMMISSION # FF 195634 EXPIRES: February 3, 2019 ej EPbnded Thru Naar; Public Underwriters 1//Zoning • Clerk la OFFICE OF THE PROPERTY APPRAISER Summary Report Property Information Folio: 11-3205-019-0100 Property Address: 1189 NE 102 ST Miami Shores, FL 33138-2615 Owner GEORGE H GLADDING Mailing Address 1189 NE 102 ST MIAMI SHORES, FL 33138-2615 Primary Zone 1100 SGL FAMILY - 2301-2500 SQ Primary Land Use 0101 RESIDENTIAL - SINGLE FAMILY : 1 UNIT Beds / Baths / Half 2/2 / 0 Floors 1 Living Units 1 Actual Area Sq.Ft Living Area Sq.Ft Adjusted Area 2,394 Sq.Ft Lot Size 11,120 Sq.Ft Year Built 1950 Assessment Information Year 2016 2015 2014 Land Value $372,562 $339,519 $299,867 Building Value $166,622 $166,622 $162,313 XF Value $770 $616 $616 Market Value $539,954 $506,757 $462,796 Assessed Value $285,475 $283,491 $281,242 Benefits Information Benefit Type 2016 2015 2014 Save Our Homes Cap Assessment Reduction $254,479 $223,266 $181,554 Homestead Exemption $25,000 $25,000 $25,000 Second Homestead Exemption are applicable to all $25,000 $25,000 $25,000 Note: Not all benefits School Board, City, Regional). Taxable Values (i.e. County, Short Legal Description MIAMI SHORES SEC 8 REV PB 43-67 LOT 10 BLK 175 LOT SIZE IRREGULAR OR 20043-3809 11 2001 4 Generated On : 11/19/2016 Taxable Value Information Previous 2016 2015 2014 County Exemption Value $50,000 $50,000 $50,000 Taxable Value $235,475 $233,491 $231,242 School Board Exemption Value $25,000 $25,000 $25,000 Taxable Value $260,475 $258,491 $256,242 City Exemption Value $50,000 $50,000 $50,000 Taxable Value $235,475 $233,491 $231,242 Regional Exemption Value $50,000 $50,000 $50,000 Taxable Value $235,475 $233,491 $231,242 Sales Information Previous PriceSale OR Book- Page Qualification Description 11/01/2001 $U 20043- Sales which are disqualified as a result 3809 of examination of the deed 05/01/2000 $250,000 19113- Sales which are qualified 3125 06/01/1999 $0 18677- Sales which are disqualified as a result 3385 of examination of the deed 05/01/1998 $0 18458- Sales which are disqualified as a result 1254 of examination of the 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 Property Appraiser and Miami -Dade County assumes no liability, see full disclaimer and User Agreement at http://www.miamidade.gov/info/disdaimer.asp Version: Paving Inc. CONTRACT TO GEORGE GADDING 1189 NE 102 ST MIAMI SHORES, FL 33138 305-610-6231 GGLADGUY@GMAIL.COM DATE: NOVEMBER 2, 2016 PROJECT:OVERLAY ASPHALT QTY DESCRIPTION UNE TOTAL 500'SQF ASPHALT OVERLAY $1,500.00 1 PULLING PERMIT $300.00 SUBTOTAL TOTAL $ $1,800.00 ✓ Permit pulling $300 (Miami), $400 (Broward),$350 (Coral Gables) [DOES NOT INCLUDE CITY FEES] 1n Payment Upon Contract Acceptance I nd { 2. Payment=After;FINALIN$PECTION(I 4,v/ It applies)::` One Paving Inc. TO: akp44 SAilASS V 11-I.4 PROJECT: NAME: NAME: ADDRESS: PHONE: FAX: ADDRESS: JAS )h. u•-2 z Lsh Sl�l DATE //7/O// t34/ ,{ Me 441-s. 4.7 'so •-1 c /4 a„eo,.c .� CQf /o s c4.47 s �a , 4040 , -7-4,1 tie will 4e 7lie 17 DA' gore u/0Tj / a7 FL .9 i” /024 Ates Ys �p�PcT �OCG.��.ec� �` �, S vhsce �d e�� , 'e G�GIiOY✓� -� / CGrlof atllS / ct,ervr ,()' DV' zo1(P 47 ole ro.ses o 53(3$ 4'I % /(,) Jr" BARBARO SCBRINO MY COMMISSION # FF 195634 EXPIRES: Fed uary 3, 2019 Cunded Thru Notary Public Underwriters 1463 NE 173 ST N. MIAMI BCH. FL 33162 PHONE: 786 2991354 FAX: 305 947 3233 Irl iami Shores ViHage Building Department 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 ins e coverage from the contractor's company for day labor, part-time employees or subcontractors. BY SIGNING BELOW CONTENTS. �`4 ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS Signature: _ �t er State of Florida County of Miami -Dade The foregoing was acknowledge before me this /0. day of 4)0() ,201 . who is personally known to me or has produced as identification. SEAL: BARBARO SO6RINO MY COMMISSION # FE 195634 `I EXPIRES: Febri;ay 3, 2019 Banded Tnru Wan) Pubic; Underwriters--- Ip STATE OF (FLORIDA) COUNTY OF (DADE) Miami Shores Village Building Department SURVEY AFFIDAVIT 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 The undersigned Affiant, ec 7j does hereby attest that (Property owner) The attached survey, performed by 1/),-1c1& 5 v del i.r, el (Name of surveyor's company) For address: /189 A)6 /02 s f Performed on 10 /7S- / /k(date of survey) is an accurate representation of the existing conditions and locations of all structures on the property as of this date. The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the property without first providing a survey Tess than seven (7) years old old. The Affiant, as property owner, further agrees to remove or obtain permits for any structures which now may exist on the property which are not permitted or which may violate zoning or building code regulations. The Affiant further understands that the existence of any such structures FJ►� affect final inspections as applicable to this or other permits. Further�% ;4 say eth naught. 1411 aOcie -144�� Prope ' ' er Signature Property Owner Print Name SWORN TO AND SUBSCRIBED before me this /0 day of &)c' v' . 70/ (v Affiant is personally known to me, produced Revised on 5/22/2009/ Revised on 6/12/09 f d .__ MY COMMIS' ON # Fr 195634 .% ;.` EY,FIRES: February 3, 2019 I ..'...,°;;....,...4,...:4i.. '%,1e,: , ..Bonded Thru Notary Public Underwriter as ' . entificatio r 410 ri :r BARBAROBOBBIN°"dile Laabi Notary BOUNDARY SURVEY Y SER A FLORIDA COAST TO COAST OFF:(877)-894-8001. www.FlorldalandSurveying.com 12555 Biscayne Blvd / 934 North Miami, FL 33181 Ask('6It [s v0t tocreaS2 ►•-1 Stif- f -10V. t41 I1 c, 6.91' (R) <,vo, •tip LOT -10 BLOCK -17 19.20' ONE STORY • 00 ~ RES. #1169 4" F.F.E.=10.76' R -a 2430' 15.42' "►�,"� ST. h9.0 • i .. `aim LOCATION SKETCH Seal & 1 "= J iT. SCALE V:30' RECEIVED :30 - RECEIVED NOV 21 2016 FND 1/2" IRON PIPE NO/1D/ NOTE: BM USED: DADE CO. BM # B -26-R ELEV. = 10.09 (REDUCED TO: NGVD 1929) 13000' IV; iam- ml S res Village XI AMPIlALT PVMT. NE 102nd. ST. APPROVED ..�., rlrPT RIDGDEP 1- „ I _,j, i n' I t \1t LEGAL DESCRIPTION: LOT 10, BLOCK 175, OF "MIAMI SHORES SECTION 8 REVISED", ACCORDING TO THE PLAT THEREOF, AS RECORDED IN PLAT BOOK 43, PAGE 67. OF THE PUBLIC RECORDS OF MIAMi—DADE COUNTY, FLORIDA FLOOD INFO: Community. Miami Dada Co. 120652 Map & Panel j 1208600306 Suffix: L Flood Zone: X Base Flood Elevation: N/A CERTIFIED TO: GEORGE GLAGGING This Survey has been prepared for the exclusive use of the analog named herein and the Certitkatlon dose not extend to any unnamed party. SURVEYOR'S NOTES: 1 -OWNERSHIP IS SUBJECT 70 OPINION OF TITLE 2 -NO UNDERGROUND IMPROVEMENTS HERE LOCATED 3 -ELEVATIONS ARE REFERRED 70 NATIONAL GEODETIC VERTICAL DATUM OF 1929 (UNLESS ASSUMED). 4 -THERE MAY BE ADDITIONAL RESIRICJIONS NOT SHORN IN THIS SURVEY THAT MAY BE FOUND IN THE COUNTY PUBiJC RECORDS 5 -LEGAL DESCRIPAQN PRONDED BY -CLIENT 5 -UNLESS OVERUSE NOTED RECORDED AND MEASURED ARE THE SAME 7 -BEFORE ANY CONSTRUCTION THE SET BACKS MUST BE CHECKED 8 -ALL FIELD MEASUREMENTS TAKEN FOR TIi/S SURvEy WERE MADE 101H ELECTRONiC TRANSIT AND/OR STEEL TAPE W/ACCU. 1:7500 9 -THIS SURVEY 6 FOR USE AS PER REQUEST AND NOT FOR ANY OTHER PURPOSE 10- THIS SURVEY WAS PREPARED IW1HOUT THE BENEFIT OF A COMMRMENTS POR TITLE INSURANCE )1- DATE OF FIELD MORK 10/21/2016 L P r S.V.SEC. t CPP GV A SSAN. • OO OD PFS POLE FIRE HYDRANT SECTION CONC. POWER POLE_ GAAS�METEVR VE GGAS V. SANITARY MANHOLE DRAINAGE MANHOLE NOTE: THE FLOOD DATA PROVIDED 15 FOR INFORMATION PURPOSES ONLY, THE SURVEYOR MAKES NO GUARANTEES AS TO THE ACCURACY OF THE INFORMATION P*OVIDED THE LOCAL F.ENI.A. AGENCY SHOULD BE CONFACTED FOR VERIFICATION. BASIS OF BEARING BASE ADDRESS: 1189 NE 102nd ST.MIAMI SHORES FL. 33014 LEGEND: P•0•C•= Point of Commencing R. _ Ti. cm. P• - Point ofg��q�� ID. - Identification MAT.. Pavete ement MAI C/P - Concrete Porch g/M►.- Righ of Way FJ.P.= Found Iron Pipe M.s Wood Fence LR.C.- Iron• Rod and Cap w-.. Chain LinIt "PMt91' C = Center • % WC- Mr Conditioner* P.L. - Property this U►&+ 4UtMMty Ewe • P.O.L - Polon, 61? tine &'0.B.- Basle of Bearing IP - iron` M.. R.0J1 Roof Otpplpu i Swk - Sldewolc PL = pipnter Cone = �• & Gutter cos / C000let..JlockL= ferhead Wis tine canses gimes ligEL c albtlon RES = lq�dence• • • • • FH - Fire isge F.�t Fatah Roos Om WyR=Roof B.C. = Blodc Comer • �_ N= Parkways • • • Mita Encroachment V!B Ca a k 34+ t hied elOCENSe V. 1 No.5711 s09: CARL.OS HERNANDEZ PROFESSIONAL SURVEYOR AND MAPPER LB if 7619 10.232016 ELECT PILE CODE 111 1 SONE102STAISM Survey is not valid without the signature and raised/digitol sod of Registered Professional Land the and The boundarysurveyeonMower for accuracoromissions.eSubjjeect property opinion title and anyadedications, limitations. ccordance with the description estrictions or beasemmts of coy the client. No d. No of public ��� has been nddo u thiswere office located. lghdargrpmd improvements and/or utUties we 1 Hereby Certify. That the attached boundary survey of the property described below le to the best of my knowledge and belief accurate as recently swayed under m dlrection; also that them ore no above ground encroachments other than those shown. and that this survey meets the minimum technkal standards set by the Florida Board of Land Surwwrs os set forth Is Section 472.027 (F.S.1 Chooter 61017-6 of The Florida AminlstraUvs Code