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FW-18-986Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Parcel Number Permit NO. FW-4-18-986 Permit Type: Fence!Wall Work Classification: Wood -Fence Permit Status: APPROVED ate 5t10/2018 Expiration: 11/06/2018 Applicant 10125 BISCAYNE Boulevard Miami Shores, FL 33138-2647 1132050190190 Block: Lot: BISCAYNE 10125 LLC Owner Information Address Phone Cell BISCAYNE 10125 LLC 10125 BISCAYNE Boulevard MIAMI SHORES FL 33138- (786)390-3177 10125 BISCAYNE Boulevard MIAMI SHORES FL 33138- Contractor(s) Phone JC DESIGN CONSTRUCTION OF FLOE (786)273-6866 Cell Phone Valuation: Total Sq Feet: $ 5,000.00 152.2 Approved: Comments: Date Approved: : Date Denied: Type of Construction: Wood Fence Classification: Residential Additional Info: NEW WOOD FENCE Scanning: 3 Fees Due CCF DBPR Fee DCA Fee Education Surcharge P&Z Review Fee Permit Fee - Wire & Wood Scanning Fee Technology Fee Total: Amount $3.00 $2.28 $2.00 $1.00 $35.00 $152.20 $9.00 $4.00 $208.48 Pay Date Pay Type Invoice # FW-4-18-67163 05/10/2018 Check* 9180 04/12/2018 Check #: 9122 Amt Paid Amt Due $ 158.48 $ 50.00 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Final Foundation Review Planning Review Building Review Building Review Building Review Public Works 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. Futher re, I authorize the above -named contractor to do the work stated. May 10, 2018 Auth ner / Applicant / Contractor //Agent ' Date Building i epartment Copy May 10, 2018 1 BUILDING PERMIT APPLICATION 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 FBC 20G.'� f Master Permit No. � i E & Sub Permit No. BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑EXTENSION ❑RENEWAL El PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: /0Ij-% City: Miami Shores County: Miami Dade Zip: 33/36 Folio/Parcel#: III 30O'S-` 019- °I gv Is the Building Historically Designated: Yes NO 'r Occupancy Type: Load: Construction Type: 1 Flood Zone: BFE: D(Q (6 l��j r`C • �r /� OWNER: Name (Fee Simple Titleholder): Cjad,' e JG.i) t, Phone#% Address: / ®/ / �V ' 29[ `` FFE: City: State: Pt- Zip: 3731 Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: j ��S/�� 67xSrSTa1.flo'9 aPF/ ' '°Phone#: a38-5s1%1 Address: 9,3OSu) t 7 21 City: J / State: FL Zip:.33/9y Qualifier Name: 24Fd6C- l2A/L,I/4 ,6 /4 Phone#: ---86 - a-38 - 88• f State Certification or Registration #: cs �e_. /S23 2 I Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ S o J Q Square/Linear Footage of Work: i SZ . 2 Type of Work: ❑ Addition ❑ Alteration'�El New ❑ Repair/Replace ❑ Demolition P4 el,) '7(�1n,e_o- U Si.) r !/ -e-A--f (t) oeet Description of Work: Specify color of color thru tile: Submittal Fee $ Permit Fee $ ) 5 2 • 2.0 CCF $ CO/CC $ Scanning Fee $ Radon Fee $ 2 • 249 DBPR $ 2.. Cal Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ ' tS • L' g pEt *3G.cA (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 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 approved and a reinspection fee will be charged. Signature WNER or AGENT The foregoing instrument was acknowledged before me this , 20 11 , by OAv ( , lYk ewho is personally known to me or who has produced as identification and who did take an oath. t0 day of Pe, NOTARY PUBLIC: Sign: Print: Seal: • rat if Ct LcJGeni4ioril Commission # GG141449 Expires: October 3, 2021 Bonded thru Aaron Notary **************************** APPROVED BY (Revised02/24/2014) CONTRACTOR The foregoing instrument was acknowledged before me this day of -A-p rf I , 20 / O , by PSA4A. aVi . -vvho is personally known to me or who has produced 4-61. °L Arra A-0 /41 as identification and who did .n o. h. NOTARiPUB s Print: Seal: Plans Examiner Structural Review Pvscu Lae 1 •!.7 d # UOISS!WWOJ .`ao��,,,, wwo3 IN sA ;`s; eppolj to awls - oilgnd bie2oN -, +,"' '_ llllll NINII:V3 ','any na;°?' / ? 4/ Zoning Clerk Property Search Application - Miami -Dade County Page 1 of 1 Summary Report Property Information Folio: 11-3205-019-0190 Property Address: 10125 BISCAYNE BLVD Miami Shores, FL 33138-2647 Owner BISCAYNE 10125 LLC Mailing Address 1680 MICHIGAN AVE 910 MIAMI BEACH, FL 33139 USA PA Primary Zone 1100 SGL FAMILY - 2301-2500 SQ Primary Land Use 0101 RESIDENTIAL - SINGLE FAMILY : 1 UNIT Beds I Baths I Half 2/2/0 Floors 1 Living Units 1 Actual Area 2,090 Sq.Ft Living Area 1,520 Sq.Ft Adjusted Area 1,801 Sq.Ft Lot Size 14,028 Sq.Ft Year Built 1957 Assessment Information Year 2017 2016 2015 Land Value $411,577 $383,496 $349,076 Building Value $125,350 $125,350 $125,350 XF Value $3,089 $3,133 $2,621 Market Value $540,016 $511,979 $477,047 Assessed Value $430,558 $511,979 $477,047 Benefits Information Benefit Type 2017 2016 2015 Non -Homestead Cap !Assessment Reduction $109,458 Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). Short Legal Description MIAMI SHORES SEC 8 REV PB 43-67 LOT 8 LESS BEG SW COR LOT 7 TH SWLY27.41FT NWLY120.59FT NELY52.35FT SELY128FT TO POB & LOT 9 LESS NWLYI2FT FOR R/W Generated On : 4/12/2018 Taxable Value Information 1 2017 2016j 2015 County Exemption Value $0 $0 $0 Taxable Value $430,558 $511,979 $477,047 School Board Exemption Value $0 $0 $0 Taxable Value $540,016 $511,979 $477,047 City Exemption Value $0 $0 $0 Taxable Value $430,558 $511,979 $477,047 Regional Exemption Value $0 $0 $0 Taxable Value $430,558 $511,979 $477,047 Sales Information Previous Sale Price OR Book - Pa 9e Qualification Description 10/24/2015 $496,000 30280-0036 Qual by exam of deed 05/12/2015 $480,000 29632-1960 Affiliated parties 08/26/2014 $365,100 29292-0162 Financial inst or "In Lieu of Forclosure" stated 05/01/2005 $550,000 23429-0866 Sales which are qualified 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: https://www.miamidade.gov/propertysearch/ 4/12/2018 Detail by Entity Name Page 1 of 2 Florida Department of State DIVISION Of CORPORAF ONS I (Ylr:,d )��S fj Department of State / Division of Corporations / Search Records / Detail By Document Number / Detail by Entity Name Florida Limited Liability Company -BISCAY NE'10125 LLC Filing Information Document Number L16000156453 FEI/EIN Number 81-3643459 Date Filed 08/22/2016 Effective Date 08/22/2016 State FL Status ACTIVE Principal Address 1680 MICHIGAN AVE SUITE 910 MIAMI BEACH, FL 33139 Mailing Address 1680 MICHIGAN AVE SUITE 910 MIAMI BEACH, FL 33139 Registered Agent Name & Address SUNNY HOUSES CONS LLC 1680 MICHIGAN AVE STE 910 MIAMI BEACH, FL 33139 Authorized Person(s) Detail Name & Address Title MGR BENEDETTI; CLAUDIO 1680 MICHIGAN AV STE 910 MIAMI BEACH, FL 33139 Title MGR SANTINI, ANDREA 1680 MICHIGAN AVE, SUITE 910 MIAMI BEACH, FL 33139 Annual Reports http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 4/ 12/2018 Detail by Entity Name Page 2 of 2 Report Year Filed Date 2017 03/18/2017 2018 01/02/2018 Document Images 01/02/2018 -- ANNUAL REPORT 03118/2017 -- ANNUAL. REPORT 08122/2016 --- Florida Limited Liability View image in PDF format View image in PDF format View image in PDF format ri. Kira ;:.:7.0 4 http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 4/ 12/2018 ACCORD CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 4/11/2018 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, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 4520 NW 7th St Miami, FL 33126 CONTACT NAME: a°No,Ext): (305) 649-5566 (A/C. jackiebatista 749@hotmail.com INSURER(S) AFFORDING COVERAGE FAX 649-5559 NAIC1 INSURER A: UNITED SPECIALTY INS COMP INSURED JC DESIGN CONSTRUCTION OF FLORIDA CORP. 930 SW 151 PL MIAMI, FL 33194 INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : CERTIFICATE NUMBER: REVISION 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 INSURANCE ADDL INSR SUER WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DDM'W) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMSESt(Ea occurrence) $ 50, 000 CLAIMS -MADE OCCUR MED EXP (Any one person) $ 5,000 SIII1004B209830 04/02/18 04/02/19 PERSONAL BADVINJURY $ 1, 000, 000 GENERAL AGGREGATE $ 1, 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1, 0 0 0 , 0 0 0 POLICY X PROT i JEC LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANYAUTO BODILY INJURY (Per person) $ — ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ — HIRED AUTOS — AUT SWNED OP �PeraE de `DAMAGE $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED RETENTION S $ WORKERS COMPENSATION WC STATU- TORY LIMITS OTH- ER AND EMPLOYERS' LIABILITY YtN ANY PROPRIETOR/PARTNERJEXECUTIVE E.L. EACH ACCIDENT $ OFFICEmMEMDER EXCLUDED? (Mandatory in NH) N/A E.L. DISEASE - EA EMPLOYEE $ IF yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 'DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule. if more space is required) ***GENERAL CONTRACTOR*** CERTIFICATE HOLDER CANCELLATION Miami Shores Village Building Department 10050 NE 2nd AVE MAIMI SHORES,FL 33138. TEL:3057952204,FAX:3057568972 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRA ION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANC WITH THE POLICY PROVISIONS. AUTHORIZED R PRf-ENTATIVE 1988-2010 ACORD CORPORATION. All rights reserved. ACORD25(2010/05) The ACORD name and logo are registered marks of ACORD JIMMY PATRONIS CHIEF FINANICAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 6/10/2017 EXPIRATION DATE: 6/10/2019 PERSON: PARRA RAFAEL SR FEIN: 473319172 BUSINESS NAME AND ADDRESS: JC DESIGN CONSTRUCTION OF FLORIDA CORP 930 SW 151 PL MIAMI FL 33194 SCOPE OF BUSINESS OR TRADE: Licensed General Contractor Contractor -Project Manager, Construction Executive, Construction Manager or Construction Superintendent IMPORTANT: Pursuant to Chapter 440.05(1'4), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS? (850)413-1609 Notice to Owner — Workers' Com p Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 ensation 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 insurance coverage from the contractor's company for day labor, part-time employees or subcontractors. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: State of Florida County of Miami -Dade The for oing was acknowledge before me this 1 Cr J• day of � t , 20 I . By ao to Notary: SEAL: who is personally known to me or has produced as identification. Lorena Rivera • ■% •= Commission I GG141449 R - Bonded thru Aaron Notary JC DESIGN CONSTRUCTION OF FL CORP Date: // qC r ? State of r-67/wpA County of /1, Before me this day personally appeared ArA PAY-' deposes and says: who, being duly sworn, That he or she will be the only person working on the pr ject located at: 2 Contractor Signature Sworn to (or affirmed) and subscribed me this 19 day of AfC ►) .20 nv Qe9. rra CARMIN TILLIT Notary Public - State of Florida My Comm. Expires Jun 26, 2018 Commission # FF 098617 Personally know Or Produced Identification Type of Identification Print, Type or Sump Name of Notary RESPONSE TO COMMENTS 1. Detail for wood fence was provided. The slats will be placed horizontally. The Fence will be 6' high. This is not a pool barrier. 2. No changes submitted. Survey submitted is marked where the fence will be installed. Fences Good Side Out. The veri+cal and horizontal supporting members of a fence shall face the interior of the plot on which the fence is located and the finished side shall face the adjoining , lot or any abutting right-of-way. _._J! • . • .... • .• •. • • .... • • •.• . • . .. . • • .. •. • • • • • • .• •. • . •••• . • •... .. . • .. •. . • t ►• MAW :rr ....w 1 r �. .__. .._ ._ .. r • 1 . 1w r =I ! t•I 1;1 t=1 ty� I•r �.' �( sr € i 7 � f ` • •f •,s••• .i' .fa• • s • • • • • • D FO1' FEN ' 5 LAT ' . t L t))00.1) Tt S,50 -rearco 40R,370AITAL SLQ, �3)J Fences Good Side Out. The vertical and horizor supporting mt ;',ers of a fence shall f, interior of the plot on which the fence is loca. and the finished s de shall face -the adjoini lot or any abutting r oht ct-way. • •••• • • • • • • • • • • • • • • • • • •J • • • • • • • • • • • • • • • • • • •• • • • , • J •• •• •• • • • • • • • • • •• • (SACK Fe • • • • •• ,••• • •• • �• • •• • • • • •• • • •