RC-18-497 (2) ?01L
Permit 1 0. RC_248-497
fs�;O1Q-js of Miami Shores Village -02 ON P,P Aft Permit Type:Residential Construction
n�+� 10050 N.E.2nd Avenue NE 1NQtic Classification:Addition
Miami Shores,FL 33138-0000 "tt
Phone: (305)795-2204
Pena t Status.APPROVED
N
F[ORtDp'
issue Bates 3/112018 Expiration: 08/28/2018
Project Address Parcel Number Applicant
841 NE 95 Street 1132060142940
Miami Shores, FL Block: Lot: ARTURO CADILLA
Owner Information Address Phone Cell
ARTURO CADILLA 841 NE 95 Street
MIAMI SHORES FL 33318-
841 NE 95 Street
MIAMI SHORES FL 33318-
Contractor(s) Phone Cell Phone
Valuation: $ 12,250.00
HOME OWNER
s
Total Sq Feet: 300
Approved:In Review Available Inspections:
Comments: Inspection Type:
Date Approved::In Review Tie Beam Bond Beam
Date Denied: Window Door Attachment
Type of Construction:COVERED TERRACE ADDITION Occupancy:Single Family Slab
Stories: Exterior: Termite Letter
Front Setback: Rear Setback: Framing
LeftSetback: Right Setback: Insulation
Bedrooms:2 Bathrooms:2 Drywall Screw
Plans Submitted:Yes Certificate Status: Final Building
Certificate Date: Additional Info: Final PE Certification
Bond Return: Classification:Residential Trusses Plan Submittal
Roof Sheathing
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Spot Survey
CCF $0.00 Wall Sheathing
DBPR Fee Invoice# RC-2-18-66589 Rake Beam
$0.00 03/01/2018 Credit Card $ 141.75 $50.00
DCA Fee $0.00 Footing
Education Surcharge $0.00 02/27/2018 Credit Card $50.00 $0.00 Window and Door Buck
Notary Fee $5.00 Roof Trusses
Permit Fee $183.75 Density
Scanning Fee $3.00 Fill Cells Columns
Technology Fee $0.00 Wire Lathe
Total: $191.75 Review Building
Review Planning
Review Structural
Review Mechanical
Review Electrical
Declaration of Use
Review Plumbing
Building Department Copy
March 01, 2018 2
A Pei it',No., RC-2-18-497
snO1 S h� Miami Shores VillagePenrrit TypE�Residential,Construction
e 10050 N.E.2nd Avenue NE
Miami Shores,FL 33138-0000
$• � � Per , It oiic C/assifrcation:Addition
Phone: (305)795-2204 Permit Status:APPROVED
FC°R'DA Expiration:,08/28/2018
Issue nate;3/1/201$
Project Address Parcel Number AFiplicant
841 NE 95 Street 1132060142940 1 11
Miami Shores, FL Block: Lot: ARTURO CADILLA
Owner Information Address Phone Cell
ARTURO CADILLA 841 NE 95 Street
MIAMI SHORES FL 33318-
841 NE 95 Street
MIAMI SHORES FL 33318-
Contractor(s) Phone Cell Phone
Valuation: $ 12,250.00
HOME OWNER
Total Sq Feet: 300
Approved: In Review Available Inspections:
Comments: Inspection Type:
Date Approved: :In Review
� Tie Beam Bond Beam
Date Denied: Window Door Attachment
I _
Type of Construction:COVERED TERRACE ADDITION Occupancy:Single Family Slab
Stories: Exterior: Termite Letter
Front Setback: Rear Setback: Framing
Left Setback: Right Setback: Insulation
Bedrooms:2 Bathrooms:2 Drywall Screw
Plans Submitted:Yes Certificate Status: Final Building`
Certificate Date:
Additional Info: Final PE Certification
Bond Return: Classification:Residential Trusses Plan SubmittalRoof Sheathing
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Spot Survey_Wall Sheathing
CCF $0.00
D13k Fee $0.00 Invoice# RC-2-18-66589 Rake Beam
DCA Fee $0.00 03/01/2018 Credit Card $ 141.75 $50.00 Footing
Education Surcharge $0.00 02/27/2018 Credit Card $50.00 $0.00 Window and Door Buck
Notary Fee $5.00 Roof Trusses
Permit Fee $183.75 Density
Scanning Fee $3.00 Fill Cells Columns
Technology Fee $0.00 Wire Lathe
r
Total: $191.75 Review Building
Reiview Planning
Review Structural
Review Mechanical
Review Electrical
Declaration of Use
Review Plumbing
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 uriderstand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. i
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 thoriz he above-named contractor to do the work stated.
March 0,1, 2018
Authorized Signature:Owner / Applicant / Contractor / Agent Date
March 01, 2018 1
k o Miami Shores Village FEB 27
�(6 2\ Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
A INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20
' BUILDING Master Permit No. 9 C 8 -�cl1
PERMIT APPLICATION Sub Permit No.
n BUILDING F-� ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [-]RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: I N S S-f
City: Miami Shores ' I Countv: Miami Dade Zip:
Folio/Parcel#: ( 1 -3106(31 ZCl Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder): T f (LDAf2,0 (IR-D I L- - Phone#: �� Z. ;z -8 03
Address:
City: State: Zip:
jenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: Phone#:
Address:
City: State: Zip:
'Qualifier Name: Phone#:
State Certification or Registration#: Certificate of Competency#:r
DESIGNER:Architect/Engineer: t Phone#: t
Address: a;:.'*.;�•. 4� �, ;; .(
City: 'State: Zip:
o�
Value of Work for this Permit:$ 1 a , S(D Square/Linear Footage of Work: i
Type of Work: ❑ Addition ❑ Alteration ❑ New
(� ❑ Repair/Replalce ❑ Demolition
Description of Work:
Specify color of color thru tile:
Submittal Fee$ -45&C-r%18 Permit Fee$ 16-3 .-IS — CCF$ CO/CC$ Q I
Scanning Fee$ 6 Radon Fee$ DBPR$ �, Notary$
Technology Fee$ Training/Education Fee$ i Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ ( J
(Revised02/24/2014)
,i
Bonding Company s Name(if applicable)
O
Bonding Company's Address
City State Zip
Mortgage Lender's Name(if applicable)
Mortgage Lender's Address
City t ' + - t'. ' —) "'f 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 accurateandthat 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 approved and a reinspection fee will be charged.
Signature Signature
OWNER or AGENT CONTRACTOR
The foregoing instrum nt was acknowledged before me this The foregoing instrument was acknowledged before me this
2-1 day of 20-A by day of 20 , by
who Q personally known to who is personally known to
me or who has produced hrl vnc 1mm as me or who has produced as
identification ]who did to ath. identification and who did take an oath.
NOTARY PU LIC: NOTARY PUBLIC:
Sign: Sign:
Print: Ol r' Print:
Seal: ; '"gay ADYPRI Seal:
MY MISSION% 0 FF 214MI
EXPIRE>3;Mach26,2oae
I
s ** *' s* s*sr*ss**s**sssi*#"sss*:sssssssssss*s*sssss*rs***s**ss`s*sss*s*sssssrssr
APPROVED BY, `` " - Plans Examiner Zoning
�#
a
4,. Structural Review Clerk
(Revised02/24/2014)
Exterminators,
4035 S.W. 98th Avenue, Miami, Florida 33165 NO 8444
P.O. Box 650213/ Miami, Florida 33165-0213
+ Tel. (305) 552-0141 / 1-800 782-9284
Fax (305) 227-1797
{ Web Page: www.alflexexterminators.com/ Email: alflex@bellsouth.net
t
-t-v Partial Treatment Notice
Project Name: Property Address:
Lot Block Model: �L
FL
Service order by:--���-us
7 _ Permit#: i
Date: % Time: Applicator:
Product Used:
o/ni/9i0Chemical Used: !--7n?lj
(active ingredietff)
A
Number of Gallons applied : 2 Percent Concentration:
Area Treated : Z..rC7/rizontal/Interior
Tamp: Linear feet Treated
Stage of Treatment : H Vertical
Add,," /0"J
i
This is not valid without a company seal
p Y " �NATpR
?. . .........,� %S
1. The above noted structure has received the first of two or more required treatmets for the preve �.,Potiod'F'••,:
subterranean termites.
2. Upon completion of this treatment and payment of any balance due under this contract,AI-Fle 1v,�lviaseP wits
written confirmation that the treatment is completed and the associated limited warranty is in full V�ke �r�Q;
The limited warranty shall not be considered to be in effect until all required payment has been rrt j''•., FLO�,•� df
This form is for inspection or construction draw purposes only. The perimeter of the above structure 7?Wft t sratr "ated at final grade
accordance with pesticide label and Florida Statue.Warranty and treatment certification will be issued upon completion of final
treatment.
i
This form should not be accepted as proof of complete treatment for Certificate of Occupancy or Closing.
NOTICE TO BUILDER: It is the responsibility of the builder to notify AL-Flex Exterminators should treatment be required for patios,
driveways and entryways.AI-Flex Exterminators must be notified at final grade of structure so final treatment can be completed
I
arranty issued, and required paperwork for closing submitted.
THIS IS NOT A PROOF OF WARRANTY
r
1
n
�•N• « .� Miami sh&es Village
` Building Department
�4R11 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 anyconstruction project
prior to obtaining.a building permit. Pursuant to the Florida Division of Workers'Compensation Employer Facts Brochure:
r
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: k
1. The officer owns at Ieast.10 percent of the stock of the corporation,or in the case
of an LLC,a statement.attesting to the minimum 10 percent ownership;
1 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.In these circumstances,Miami Shores Village
does not.require verification of workers'compensation insurance coverage,from the contractor's company, Therefore,you may be
Personally liable for the worker compensation injuries of anyyperson allowed to work under this permit. Please check,with your
insurance carrier since most property insurance policies DO NOT cover this type of liability,
k
BI' SIGNING .BELOW YOU'ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS
CONTENTS.
Owner Contractor
,0paa0pfA
Print Name:&Y-bQroQ C�i1 a •
?� Name: Z GtF Z
��ii,, ll
Signature: t.Ml ,,���ainu�`� i attire: 'D
O� Rn�z
State of Florida} to lorda)
County of Miami-Dade) 3 e a 3 d
,8 „�m g ,o unty of Ivliami-Dade} o; -0Sworn to and subscribed before me this 2 o worn to and subscribed before me this N T. 2
+ day of lbeepr,�l g v- ,ZO��. y a of c N 0 m v,
m �+ y /�c�e/�b��Z0 o d
m m 0 �/p oo'1(y NW
By J T y y 22— Y C_- /�Z ��' N �l
A �^ O � G, C
} (SEAL) . Gia ^ SEAL
Type of Identification produced FL 1 ( , T entification produced,
i
Mission: <>' Rick Scott
To protect promote&improve the health Governor
of all people In Florida through integrated
state,county&community efforts. f r John H.Armstrong,MD, FACS
HEALTH
71_.7, State Surgeon General&Secretary
Vision:To be the Healthiest State in the Nation
August 28, 2014
William Plasencia R.A.
7700 N Kendall Drive, Suite 506
Miami, FL 33156
RE: Modification to a Single Family Residence- No Bedroom Addition
Application Document Number: AP1167115
Centrax Permit Number: 13-SC-1555506
841 NE 95 Street
Miami, FL 33138
Lot: 13 Block: 75 Subdivision: Miami Shores Sec 3
Dear Applicant,
This will acknowledge receipt of a floor plan and site plan on 08/18/2014 for the use of the existing,
onsite sewage treatment and disposal system located on the above referenced property. No objection.
Covered terrace'addition. Reviewed by Y.Martin on 8/28/2014.
i
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 (305iEngine
'I
i
itin
g Specialist II
Department of Health in Dade County
Florida Department of Health www.FloridesHealth.com
in Dade County• •,Florida TWITTER:HeafthyFLA
PHONE: (305)623-3500 FACEBOOK:FLDepartmentotHealth
YOUTUBE:ftdoh
- I Illfil IIIII!1111 ill11 111!111!{1111!1{{il Illi
c GF14 20 1 2R02€'8022
1' OR Bk 28083 P'as 2346 - 23474 (2p9s)
RECORDED 04/23/2012 15:53:33
DEED DOC TAX 2x094.00
HARVEY RUUINx CLERK- OF COURT
Empared by and return to; MIAMI-DADE COUNTYx FLORIDA
Vivian R Roca
Attorney at Law
Roca Gonzalez,P.A.
2601 South Bayshore Drive Suite 725
Miami,FL 33133
305-859-6050
File Number: Crousi.120015
Parcel Identification No.11-3206-014-2940
[Space Above This Line For Recording Data]
Warranty Deed
(STATUTORY FORM-SECTION 689.02,F.S.)
This Indent re made this 8th day of April, 2012 between Cesar Christian Crousillat and Christine A. Crousillat,
husband and wife whose--post office address is'c/o RGPA, 2601 S. Bayshore Dr., STE 725, Miami, FL 33133 of the
County of Miami-DaderState of Florida,grantor*, and Arturo J. Cadilla, a single man whose post office address is 841
NE 95 St.,MiamiQShores,FL 33138 of the County of Miami-Dade,State of Florida,grantee*,
Witnesseth that said grantor, for and in consideration of the sum of TEN AND N0/100 DOLLARS ($10.00) and other
good and valuable considerations'to said grantor in hand paid by said grantee,the receipt whereof is hereby acknowledged,
has granted, bargained, and sold to the said grantee, and grantee's heirs and assigns forever, the following described land,
situate,lying and being in Miami-Dade County,Florida,to-wit:
Lot 13 of the West 1/2 of Lot 14,Block 75,MIAMI SHORES SECTION NO.THREE,according to
the Plat thereof, recorded in Plat Book 10, Page 37,of the Public Records of Miami-Dade County,
Florida.
,l
Subject to taxes for 2012 and,subsequent years; covenants, conditions, restrictions, easements,
reservations and limitations of record,if any.
The Grantors hereby warrant that the property described herein was acquired by them,during their
marriage and they have remained married without interruption through the date of this conveyance.
f
and said grantor does hereby fully warrant the title to said land,and will defend the same against lawful claims of all persons
whomsoever. '
""Grantor"and"Grantee"are used for singular or plural,as context requires.
' 1n Witness Whereof,grantor has hereunto set grantor's hand and seal the day and year first above written.
r
r
( DoubleTirnee
OR BK 28083, PG 347
LAST PAGE * r
Signed,sealed and delivered in our presence:
eal) P
C2�4&��e: Cesar 'stun Cr sillat
� (Seal)
to Name: istin A.Crousillat
State of Florida tr
County of Miami-Dade
The foregoing instrument was as0owledged before me this day of April, 2012 by Cesar Christian.Crousillat and
Christine A.Crousillat,who e p or[X}have driver's licens tification.
[Notary Seal] 1 ON
erg,
Printed Name:
icy •
` My Commission Exsi
�(!0•STAe01`
r
r
t
i.
e
i
t L
I ..
`
DoubleTlmeo
Warranty Deed(Statutory Form)-Page 2
4
is
1
.., y
Mission: - >'< , Rick Scott
Governor
To protect promote&improve the health i
of all people In Florida through Integrated
state,county&community efforts. John H.Armstrong,MD, FACS
HEALTH
State Surgeon General&Secretary
Vision:To be the Healthiest State in the Nation
I
August 28, 2014
William Plasencia R.A.
7700 N Kendall Drive, Suite 506 ,
Miami, FL 33156
• f
RE: Modification to a Single Family Residence-No Bedroom Addition
Application Document Number: AP1167115
Centrax Permit Number: 13-SC-1555506
841 NE 95 Street
Miami, FL 33138
Lot: 13 Block: 75 Subdivision: Miami Shores Sec 3
Dear Applicant,
This will acknowledge receipt of a floor plan and site plan on 08/18/2014 for the use of the existing
onsite sewage treatment and disposal system located on the above referenced property. No objection.
Covered terrace addition. Reviewed by Y.Maitin on 8/28/2014.
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) 623-3 00.
i
Si c
u _...__arin
Engine ring Specialist II
Department of Health in Dade County
Florida Department of Health www.FloridesHealth.com
in Dade County• •,Florida r TWITTER:HeilthyFl-k
PHONE: (305)623-3500 FACE130OULDepartmentotHealth
YOUTUBE:Bdoh r.