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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 ., 4 F Z i { 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.