PL-17-2875 r
t r
Permit IVO. PL-12-17-2875
sµO1 s y� Miami Shores Village ot Permit Type.Plumbing-Residential
� 10050 N.E.2nd Avenue NE - Per
IWork Classification:AdditionlAlteration r
Miami Shores,FL 33138-0000 Permit Status:APPROVED
Phone: (305)795-2204
F�RiDP'
issue date: 1V121/2017 Expiration: 06/19/2018
Project Address Parcel Number Applicant
186 NE 107 Street 1121360070170
Miami Shores, FL 33161- Block: Lot: 186 NE 107 ST. LLC
Owner Information Address Phone Cell
186 NE 107 ST. LLC 501 GRAND Concourse I
MIAMI SHORES FL 33138-
501 GRAND Concourse
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 4,800.00
INFINITY CONSTRUCTION SERVICES (786)443-9590
_...�.... �.__.. �. .W _.wM Total Sq Feet: 0
Type of Work:ONE BATHROOM,ONE KITCHEN CHANGE O Available Inspections:
Type of Piping: Inspection Type:
Additional Info:ONE BATHROOM,ONE KITCHEN CHANGE O Top Out
Bond Return: Final I
Classification:Residential Scanning: 1 Review Plumbing
Underground
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $3.00
DBPR Fee Invoice# PL-12-17-65831 ,
$2.25 12/06/2017 Credit Card $50.00 $ 190.25
DCA Fee $2.00
Education Surcharge $1.00 12/21/2017 Credit Card $ 190.25 $0.00
Permit Fee $225.00
Scanning Fee $3.00 l
Technology Fee $4.00
Total: $240.25
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
construction and zoning. Futhermore, I authorize the above-named contractor to do the work stated.
December 21, 2017
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
December 21, 2017 1
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4 F
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Miami Shores Village a- , r�% -' ,
DEC 2017
i Building Department '
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY: -
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(30S)762-4949
FBC 20'►`�
BUILDING Master Permit No. RnCI1' z1-
PERMIT APPLICATION Sub Permit No. 1'L �1 ' Z61-5
❑BUILDING ❑ ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION []RENEWAL
LUMBI NG ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: !Oc lv�f A2T
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: O -2136 -oco7— Q 17 Is the Building Historically Designated:Yes OccupancyType:9—Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): -d (o N 1'o-7 S'-�� LLQ Phone#:
Address: G / t-4
City: j-14wptt S - State: .. Zip: I?
-^ r
Tenant/Lessee Name: /J/� Phone#:
Email: LA�7��5�_ � USA,1\)e-7
CONTRACTOR:Company Name: cam- V it Phone#?9,6 q—3` l/
Address: 415-k)
r,� ,� ) 331 b S
City: 1 VK State: Zip:
a
Qualifier Name:: Phone#: ��
State Certification or Registration#: Certificate of Competency#:
5
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 ❑ Reypai /Replace ❑ emolition
Description of Work:
v �
Specify color of color thru tile: . ►r a+ n : aPax ,f3,�t
Submittal Fee$ 1 Permit Fee$ CCF$ ( CC
Scanning Fee$ Radon Fee$ '�� DBPR$ 2• Z Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ 1<:1O
(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
� r
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 4issued. he•absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature %� v'�"'L-� ( Signature . ♦ ,- t
•� OWNE or AGEN CONTRACTOR ;
The.foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
v `day`ofd` �O�E�'1I C-��t� 12 20 j: by ._,dayof �� . •"�, 20 17 by
PR? R I G 6C L; U ,wis personally kn wn to`' 8r �' 14LkhL1Jhho is personally kno n 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: Te k5o
Sign: ' �./"' Sign: a
Print: -'Lti w��1 .� Print: ANTONIO E.GOM€Z
aI CUMNIISSIOF'#FF913115
Seal: "--' Seal: �I EXPIRES:AUG 25,2019
FRANKLIN J WOLLMANN �« " Bonded through 1st State Insurance
;': MY COMMISSION#GGSWS56
EXPIRES My 06,2020
APPROVED BYn ' Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
11/20/2017 Property Search Application-Miami-Dade County
�y .4
-b
OFFICE OF THE PROPERTY
Summary Report
Generated On: 11/20/2017
Property Information 1`I'
Folio: 11-2136-007-0170
,_f a
Property Address: 186 NE 107 ST ,
Miami Shores,FL 33161-7032
Owner 186 NE 107 ST LLC l
Mailing Address 501 GRAND CONCOURSE F'► ).
MIAMI SHORES, FL 33161-7032 ;
PA Primary Zone 1000 SGL FAMILY-2101-2300 SQc
Primary Land Use 0101 RESIDENTIAL-SINGLE
FAMILY: 1 UNIT r A
Beds/Baths I Half 2/1 /0 s
Floors 1 c 1T
Living Units 1
Actual Area 1,722 Sq.Ft
Living Area 1,152 Sq.Ft
Adjusted Area 1,381 Sq.Ft
Lot Size 9,300 Sq.Ft Taxable Value Information
Year Built 1942 2017 2016 2015
County
Assessment Information
Exemption Value $0 $0 $0
Year 2017 2016 2015 Taxable Value 1 $233,845 $212,587 $193,261
Land Value $232,690 $199,874 $164,822 School Board
Building Value $96,118 $96,118 $96,118 Exemption Value $0 $0 $0
XF Value $1,784 $1,808 $1,415 Taxable Value 1 $330,592 $297,8001 $262,355
Market Value 1 $330,592 $297,800 $262,355 City
Assessed Value 1 $233,845 $212,587 $193,261 Exemption Value $0 $0 $0
Taxable Value 1 $233,845 $212,587 $193,261
Benefits Information
Regional
Benefit I Type 2017 2016 2015 Exemption Value $0 $0 $0
Non-Homestead Cap Assessment Reduction $96,747 $85,2131 $69,094 Taxable Value $233,845 $212,587 $193,261
Note:Not all benefits are applicable to all Taxable Values(i.e.County,School
Board,City,Regional). Sales Information
Short Legal Description Previous OR
Sale Price Book- Qualification Description
36 52 41 PB 42-33 Page
DUNNINGS MIAMI SHORES EXT NO 326256- Sales which are disqualified as a result of
03/01/2008 $0
LOT 1 BLK 208 1019 examination of the deed
LOT SIZE 75.000 X 124 02/01/1997 $67,500 17535- Other disqualified
OR 17535-3012 0297 6 1 i 3012
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:
INFINITY CONSTRACTION SERVICES
CFC 1428288
4156 sw 96 Ave
Miami FI 33165
Phone (786)443-9590
Nov 16, 2017
State Of Florida
County Of Miami Dade
Before me this p/ o ally appered AntonioLuvara eho, being dully sworn, deposes and says :To
Be of qualifayer/Infi ity Construction Services.
That he will a the my person working on the project located at 186 ne 107 st Miami Shore FI
33138
Swor o (o i d) and suscribed before me this- 1�00_day of 2dl
by 44 s0N <D ( r G1
Personally know
Or Produced Identification Type of Identification Produced
RAUL NAyARPO
"rsY:yB 4
MY comm,
#
20,202
2; E(PIRES'.MAFI
Staie
Bonded through lOSuf2flCe
gtiOR�S
Miami' Shares Village
" °"��� Building Department
A�OR'rop`
10056 N.E.2nd.Avenue
Miami Shores, Florida 33138
Tel; (305) 795.2204
Fax '(305)758.8972
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
obtainingr 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 ommer,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 11_C,a statement attesting to the minimum I Opercent 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'afiidavitstating`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 flay labor;part-time employees or subcontractors.
BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE- AND UNDERSTAND ITS
CONTENTS.
Signatutla__
____Owner
State of Florida
l
County of]Miami-Dade
The foregoingiwas acknowledge before me this day of_'N o r��•. 20 )
By ➢` ' ` ►` who is personally known to me or has produced
as identification.
Notary: ti
SEAL: dh
r p•y� USA CHRISTINA fLORES
Notary PWft-State of Florida
omm sa iFFT94t1T—
My Comm.Expires Jan 28,2019
" "�� Raided ough Natlartal
thNotary Assn.