DS-17-2466Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Pe
Permit NO. DS -10-17-2466
rniPermit Type: Driveways/Sidewalks/Slabs
Issue Date: 12/5/2017
Work Classification: New
Permit Status: APPROVED
Expiration: 06/03/2018
Parcel Number
Applicant
1009 NE 104 Street
Miami Shores, FL 33138-2655
1122320290140
Block: Lot:
LENILAN INVESTMENT LLC
Owner Information
Address
Phone
Cell
LENILAN INVESTMENT LLC
1009 NE 104 Street
MIAMI FL 33138-
(305)608-9839
980 BELLE MEADE ISLAND Drive
MIAMI FL 33138-
Contractor(s) Phone
STAR ISLAND CONCRETE DESIGN C( (305)776-7916
Cell Phone
Valuation:
Total Sq Feet:
$ 2,400.00
430
Approved: In Review
Comments:
Date Approved: : In Review
Date Denied:
Type of Work: PLAIN CONCRETE PATIO (WALKWAY)
Bond Return :
Scanning: 3
Additional Info:
Classification: Residential
Fees Due
Bond Type - Owners Bond
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$500.00
$1.80
$2.00
$2.00
$0.60
$100.00
$9.00
$2.40
$617.80
Pay Date
Invoice #
12/05/2017
10/16/2017
Bond #: 3582
Pay Type
DS -10-17-65367
Check #: 1132
Credit Card
Amt Paid Amt Due
$ 567.80 $ 50.00
$ 50.00 $ 0.00
Available Inspections:
Inspection Type:
Final
Foundation
Review Building
Review Planning
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 1 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 ce at all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zor nc . F t er L re - thorize the above-named contractor to do the work stated.
Authorized / Applicant / Contractor / Agent
Building epartment Copy
December 05, 2017
Date
December 05, 2017 1
`2`
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
BUILDING
PERMIT APPLICATION
•BUILDING ❑ ELECTRIC ❑ ROOFING
ElPLUMBING ❑ MECHANICAL El PUBLIC WORKS
1009 NE 104TH ST
JOB ADDRESS:
R.ECE1VEI3
d T 1 6 017
BY.
FBC2OI4
Master Permit No. [1 ( ` G"-'
Sub Permit No.
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
City: Miami Shores County:
Miami Dade Zip:
+tolio/Pa l# 111 - ca -c — b 1 '4 () Is the Building Historically Designated: Yes
NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): LENILAN INVESTMENT LLC
225 N SHORE DR
Address:
MIAMI BEACH FL 33141
City: State: Zip:
Phone#:
305 608 9839
Tenant/Lessee Name: Phone#:
Email:
alainzenatti@me.com
STAR ISLAND CONCRETE 786 367 4712
CONTRACTOR: Company Name: Phone#:
1018NW41 ST
Address:
City: MIAMI FL
State:
MIGUEL CORPAS
Qualifier Name: Phone#:
33127
Zip:
E201903
State Certification or Registration #: Certificate of Competency #:•
DESIGNER: Architect/Engineer: Phone#:
Address:
o�
City: State:
Value of•Work for-this•Permit:.$ a 1.4 Ol7 Sf` quare/Linear_Footage of Work 30
Type of Work: ❑ Addition ❑ Alteration ■❑ New ❑ Repair/Replace ❑ Demolition
PLAIN CONCRETE PATION (WALKWAY)
Description of Work:
o,.znr. t tlQrti ^Y.� G,tn7 +
Specify color of •color thrirtile.
r
_ wvr
�lS..,r rr.,„6e4 23,?r? t=• 2 ,
Submittal Fee $ n • Permit Fee $ ( 00.(X) CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $ 560 <
TOTAL FEE NOWDUE$-4.90
f. r .•
(Revised02/24/2014)
SGS ' GO
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 ' curs sev: (7) days after the building permit is issued. In the absence ff . h posted tice, the
inspection will not be app . - , and a rei . ection fee will be charged. j
Signature / I Signature
rrVA
The foregoing instru -nt was ackn� ledged before me this
/I L1 day of i 20 ; I , by
A• ♦ -� �;:.1■ ,who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
APPROVED BY
(Revised02/24/2014)
CONTRAC
The foregoing i trument was ac
day of
atm
me or w' has produced as
identification and who did take an oath.
NOTARY PUBLIC:
d before me this
20 (, by
who is personally known to
Sign:
Print:
Seal:
Plans Examiner
Zoning
Structural Review Clerk
Property Search Application - Miami -Dade County
Page 1 of 1
OFFJCE IF THE PROPERTY APPRAISER
Summary Report
Property Information
Folio:
11-2232-029-0140
Property Address:
1009 NE 104 ST
Miami Shores, FL 33138-2655
Owner
LENILAN INVESTMENT LLC
Mailing Address
980 BELLE MEADE ISLAND DR
MIAMI, FL 33138 USA
PA Primary Zone
1100 SGL FAMILY - 2301-2500 SQ
Primary Land Use
0101 RESIDENTIAL - SINGLE
FAMILY : 1 UNIT
Beds / Baths / Half
3/3/0
Floors
2
Living Units
2
Actual Area
4,796 Sq.Ft
Living Area
4,156 Sq.Ft
Adjusted Area
4,339 Sq.Ft
Lot Size
14,525 Sq.Ft
Year Built
2013
Assessment Information
Year
2017
2016
2015
Land Value
$508,375
$435,750
$399,438
Building Value
$695,969
$703,144
$710,320
XF Value ,
$58,162
$58,750
$0
Market Value
$1,262,506
$1,197,644
$1,109,758
Assessed Value
$1,262,506
$1,197,644
$1,109,758
Benefits Information
Benefit
Type
2017
2016
2015
Note: Not all benefits are applicable to all Taxable Values (i.e. County,
School Board, City, Regional).
Short Legal Description
EVENINGSIDE PB 44-53
LOT 15 BLK 1
LOT SIZE SITE VALUE
COC 22786-0550 10 2004 1
Generated On : 10/16/2017
Taxable Value Information
Previous
PriceSale
OR Book-
Page
Qualification Description
2017
2016
2015
County
02/03/2017
$1,960,000
Exemption Value
Qual by exam of deed
11/28/2015
$0
$0
$0
Taxable Value
$395,000
27833-3350
$1,262,506
$1,197,644
$1,109,758
School Board
Exemption Value
$0
$0
$0
Taxable Value
1
$1,262,506
$1,197,644
$1,109,758
City
Exemption Value
i
$0
$0
$0
Taxable Value
i
$1,262,506
$1,197,644
$1,109,758
Regional
Exemption Value
$0
I— $1,262,506
$0
$1,197,644
$0
$1,109,758
Taxable Value
Sales Information
Previous
PriceSale
OR Book-
Page
Qualification Description
02/03/2017
$100
30418-1661
Corrective, tax or QCD; min
consideration
02/03/2017
$1,960,000
30418-1657
Qual by exam of deed
11/28/2015
$258,400
29993-0145
Corrective, tax or QCD; min
consideration
09/09/2011
$395,000
27833-3350
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 Property Appraiser
and Miami -Dade County assumes no liability, see full disclaimer and User Agreement at http://www.miamidade.gov/info/disclaimer.asp
Version:
http://www.miamidade.gov/propertysearch/
10/16/2017
Detail by Entity Name
Page 1 of 2
D Si ON 4 F:orida Department of State
i'�4 i�OiiPQr:A'a,N
aft LK.fe+7 or 11
,0,4;
Department of State / Division of Corporations / Search Records / Detail By Document Number /
Detail by Entity Name
Florida Limited Liability Company
LENILANINVESTMENT_LLC
Filing Information
Document Number L09000041215
FEI/EIN Number 27-0385091
Date Filed 04/29/2009
Effective Date 04/27/2009
State FL
Status ACTIVE
Principal Address
225 NORTH SHORE DRIVE
MIAMI BEACH, FL 33141
Changed: 02/08/2010
Mailing Address
225 NORTH SHORE DRIVE
MIAMI BEACH, FL 33141
Changed: 02/08/2010
Registered Agent Name & Address
ZENATTI, ALAIN
225 NORTH SHORE DRIVE
MIAMI BEACH, FL 33141
Name Changed: 02/08/2010
Address Changed: 02/08/2010
Authorized Person(s) Detail
Name & Address
Title MGRM
ZENATTI, ALAIN
225 NORTH SHORE DRIVE
MIAMI BEACH, FL 33141
Annual Reports
Report Year Filed Date
http://search. sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entit... 10/16/2017
, Detail by Entity Name Page 2 of 2
2015 01/11/2015
2016 01/23/2016
2017 01/08/2017
Document Images
01/08/2017 -- ANNUAL REPORT
01/23/2016 -- ANNUAL. REPORT
01/11/2015 ANNUAL REPORT
02/11/2014 -- ANNUAL REPORT
04/14/2013..:.,.._ ANNUAL REPO)PT
01/11/2012 -- ANNUAL REPORT
01/06/2011 --ANNUAL REPORT
02/08/2010 ANNUAL REPORT
04/23//2009-- Florida Limited Liability
View image in PDF format
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Florins D
..ter _-w.
http://search. sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entit... 10/16/2017
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AcvRd° CERTIFICATE OF LIABILITY INSURANCE
`
DATE(MMIDELYYYY)
12/04/2017
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,
11 SUBROGATION IS WAIVED, subject to the terms and conditions
on this certificate does not confer rlahts to the certificate holer
the policy(les) must have ADDITIONAL INSURED provisions or be endorsed.
of the policy, certain policies may require an endorsement. A statement
in lieu of such endorsentent(s).
PRODUCER
ALL INSURANCE SVCS CORP
1548 W 37 ST
H IAL EAR FL 33012
78Y5D
CONTACT
NAME
PHONE FAX
(we. No, Ext). (A/C( No).
E-MAIL
ADDRESS:
INS URER(S) AFFORDING COVERAGE
NIC f
INSURER A:FLORIDA W.C. JUA
561320
INSURED
STAR ISLAND CONCRETE DESIGN
CORP
1018 NW 47 ST
MIAMI FL 33127
NJSURER B:
INSURER C.
EACH OCCURRENCE
' URER'D:
DAMAGE TO RENTED
PREMISES iE a asurm eLJ
INSURERE:
INSURER F
COVERAGES
CERTIFICATE 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,
INSR
LTR
TYPE OF WSURANCE
ADDL.
INSD
SUaR
WVD
POLICY NUMBER
POLICY EFF
IMWODPIYYY)
POUCY EXP
)MWODTYYYY)
LIMITS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$
DAMAGE TO RENTED
PREMISES iE a asurm eLJ
CLANS -MADE .00CUR
MED EXP(Any :mepenal
S
PERSONAL &ADV INJURY
$
GENt
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AGGREGATE
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LIMIT APPLIES PER.
PROJECT O LOC
GENERAL AGGREGATE
$
PRODUCTS - COMM(' AGO
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AUTOMOBILE
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LIABILITY
ANY AUTO
OWNED AUTOS
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FgRFD AUTOS
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SCHEDULED
AUTOS
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COMBINED SINGLE LIMIT
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BODILY INJURYPer person)
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BODILY INJURY (Per aeddenl)
$
PROPERTY DAMAGE
POT A:cIOen0
—
UMBRELLA UAB
EXCESS UAB
OCCUR.
CLAIMS -MADE
EACH OCCURRENCE
AGGREGATE
DEDI RETENTION 5
A
WORKERS COMPENSATION
AND EMPLOYERS'LIADLITY
ANY PROPRIETOR/PARTNER)EXECUTIVE
OFFICER/MEMBER EXCLUDED? Y/
(Mandelory In NH) y
0 yes. describe undo
DESCRIPTION OF OPERATIONS Poleax
WA
t3
(6FR13UB-6644060-0-17)
11-05-17
11-05-18
PER OTH"
X STATUTE IEA
E.L. EACH ACCIDENT
$ 1 , 000, 000
E L.DIscASE -EA EMPLOYEE
4 1,000,000
E.L. DISEASE - POLICY LIMIT
$ 1, 000, 000,
DESCRIPTION OF OPE.RATI0NSrtOCATIONSVEHICLES (ACORD 101, AdddonY Remoras Schedule, may be attached
LICENSE #E201903
N more space M required)
1CATE HOLDER
CANCELLATION
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
M10050ZAMI SHORES
AMI SE 2 AVE
FL 33138
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE
POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
f
ACORD 25 (2013)
1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
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Scanned by CamScanner
Mission:
To protect, promote & improve the health
of all people in Florida through integrated
state, panty & mrntnity efforts.
HEALTH
Vision: To be the Healthiest State in the Nation
Rick Scott
Governor
Celeste Philip, MD, MPH
State Surgeon Generd and Seaetary
November 20, 2017
Maria De Bruzos
1009 NE 104 Street
Miami, FL 33138
RE: Modification to a Single Family Residence - No Bedroom Addition
Application Document Number: AP1312059
Centrax Permit Number: 13 -SC -1797389
1009 NE 104 Street
Miami, FL 33138
Lot: 15 Block: 1 Subdivision: Eveningside
Dear Applicant,
This will acknowledge receipt of a floor plan and site plan on 10/23/2017 for the use of the existing
onsite sewage treatment and disposal system located on the above referenced property. No
Objection: addition of concrete walkway. Issued by E. Omisca on 11/20/2017.
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.
Florida Heal`
,.). „ oade County
O.S•T.L•Well Program
j� "�
Sincerely,
Erlande Omisca
Engineering Specialist II
Department of Health in Dade County
Florida Department of Health
in Dade County • • , Florida
PHONE: (305) 623-3500
www.florldahaalth.gov
TWITTER: HealthyFLA
FAC EBOOK: FLDepartmentofHealth
YOUTUBE: fldoh