PL-18-1549Miami Shores Village
10050 N.E. 2nd Avenue NW
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
■
erm
Issue Date: 6G
Permit NO. PL--18-1549
Permit Type: Plumbing - Residential
Work Classification: Septic
Permit Status: APPROVED
2018
Expiration: 12/05/2018
Parcel Number
Applicant
19 NW 99 Street
Miami Shores, FL
1131010180530
Block: Lot:
LATONIA JOHNSON
Owner Information
Address
Phone
Cell
LATONIA JOHNSON
19 NW 99 Street
MIAMI SHORES FL 33150-
(305)372-2746
19 NW 99 Street
MIAMI SHORES FL 33150-
Contractor(s) Phone
A SUPER SEPTIC & DRAIN FIELD INC
CeII Phone
Valuation:
Total Sq Feet:
$ 6,500.00
300
Type of Work: SEPTIC TANK AND DRAINFIELD REPLACEM
Type of Piping:
Additional Info: SEPTIC TANK AND DRAINFIELD REPLACEM
Bond Return :
Classification: Residential
Scanning: 3
'Fees Due
Bond Type - Owners Bond
CCF
DBPR Fee
DCA Fee
Education Surcharge
Notary Fee
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$500.00
$4.20
$4.50
$3.00
$1.40
$5.00
$300.00
$9.00
$5.60
$832.70
Pay Date
Invoice #
06/08/2018
06/06/2018
06/08/2018
Bond #: 3792
Pay Type
PL-6-18-67822
Check #: 882
Check #: 880
Check #: 883
Amt Paid Amt Due
$ 282.70 $ 550.00
$ 50.00 $ 500.00
$ 500.00 $ 0.00
Available Inspections:
Inspection Type:
HRS Approval
Final
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 understand that separate permits are
required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
AFFIDAVIT: c ify that all the foregoing information is accurate avid that all work will be done in compliance with all applicable laws regulating
n and zonin . F hermore, I authorize the above -named contractor to do the work stated.
uthorized Siture: Owner / Applicant / Contractor / Agent
June 08, 2018
Date
Bui ding Department Copy
June 08, 2018 1
BUILDING
PERMIT APPLICATION
El BUILDING ❑ ELECTRIC
i7 PLUMBING ❑ MECHANICAL
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
Master Permit No.
❑ ROOFING ❑ REVISION
Sub Permit No.
RECEIVED
JUN 0 61018
FBC 20f4.
PI 18-«uP
❑ EXTENSION 0 RENEWAL
PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: /9 /7/ (.1/ / 7 / s rfieQ7
Miami Shores County: Par(e Miami Dade
City:
Zip: 331.E
Folio/Parcel#: //- 3/0/-6/8, 0.61_50 Is the Building Historically Designated: Yes NO
Occupancy Type: 1 .9- Load: Construction Type: Flood Zone: ' BFE: FFE:
OWNER: Name (Fee Simple Titleholder): `T -TD n/ jA �/ �! //v7 o r J
Address: (r /?%.v. 9 9 77,- ,e 7-
City: /99//4 Mf ' -1/7M)E-5
Tenant/Lessee Name:
•
Email:
State:
Phone#:
Zip: .334-1-r)
Phone#: l'
CONTRACTOR: Company Name rz _ �°of� n C 9i2, vl �i o!U % l� + Phone#: f
Address: I/ D/ lr/. /h/3,2 °—
City: /-7/A AP i /77 State: //.
Qualifier Name: /fT ate/ .oQd, /-4?”.(4-7
State Certification or Re istration #:
-
Zip: 3�oi V
Zip:
Phone#: s3r2 '- a •Y O// 3
�/ (/'% 'la
of Competency #: -sdi D/ (o/ %,2••.
DESIGNER: Architect/Engineer: Phone#: �-
Address:
Value of Work for this Permit: $ �,c ��d• -
Type of Work: ❑ Addition ❑ Alteration
Description of Work: (:)`e p 't T a 4 K.
City: Stater Zip: ---
Square/Linear Footage of Work: geVO
n❑ New
Repair/Replace ❑ Demolition
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ 300 — CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $ S`-'O�
TOTAL FEE NOW DUE$ 2 01
RBZ,�_
(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 • t be approved and a reinspection fee will be charged.
Sign
OWN
AGENT
The foregoing instrument was acknowledged before e this
�' day of vl`�� 20 ,by
1Q �' I,Q (��'\ is ersonally kry�wn to
me or who has produced fl I' 1 C V
identification and who did take an oath.
NO PUBLI
Si
Print:
Seal:
MAHARAI K. GONZALEZ
Signature
The foregoing instrument was acknowledged before e this
L.` day of (� , 20 , by
Y 0 , who is personally known to
as me or who has produced ' ` (Ca l j as
identification and who did take an oath.
NOTARY PUBLIC:
ah MY UUMMIS IUN 4 GG 1744602
EXPIRES: November 2, 2020
FoF Fi,o;•' Bonded Thru Notary Public Underwriters
Sig
Print:
Seal:
.... Pu"Bv MAHARAI K. GONZALEZ
., z* MY COMMISSION # Gr. naaag2
EXPIRES: November 2, 2020
Bonded Thru Notary Public Underwriters
************************************************************************************************************
APPROVED BY
Plans Examiner
Zoning
(Revised02/24/2014)
Structural Review
Clerk
By
Not.
SEAL:
Miami Shores Village
Building Department
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 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.
2
Signatur
Owner
State of Florida
County of Miami -Dade
The foregoing was acknowledge before me this day of 3-UM. , 20b.
who is personally known to me or has produced
as identification.
MAHARAI K. GONZALEZ
MY COMMISSION # GG 044602
EXPIRES: November 2, 2020
Bonded Thru Notary Public Underwriters
A SUPER SEPTIC & DRAIN FIELD INC.
CC: SR0161772
PHONE: 305-364-0113
7701 WEST 18 LANE
HIALEAH, FLORIDA 33014
Licensed and Insured
E—MAIL: ASUPERSEPTIC@GMAIL.COM
WWW.ASUPERSEPTIC.COM
DATE: 6-y- /if
STATE OF FLORIDA
COUNTY OF MIAMI-DADE
BEFORE ME THIS DAY PERSONALLY APPEARED,
BEING DULY SWORN, DEPOSES AND SAYS:
FAX: 305-364-0349
THAT HE OR SHE WILL BE THE ONLY PERSON WORKING ON THE PROJECT AT:
tU Nu3 °tq S-1--
Contractor Signature: 3,V/4
SWORN TO (OR AFFIRMED) AND SUBSCRIBED TO ME THIS -'\ DAY OF
, 2018, BY: 1::Y 1 0 n
?o:Yeys ,- MAHARAI K. GONZALEZ
d� MY COMMISSION # GG 044602
°' EXPIRES: November 2, 2020
4 o F‘,$' Bonded Thru Notary Public Underwriters
PERSONALLY KNOWN
OR PRODUCED IDENTIFICATION
WHO
TYPE OF INFORMATION PRODUCED 6 I t am,
PRINT, TYPE, OR STAMP NAME OF NOTARY
Page 1 of 1
Property Search Application - Miami -Dade County
FT
Summary Report
Property Information
Folio:
11-3101-018-0530
Property Address:
Owner
Mailing Address
PA Primary Zone
0800 SGL FAMILY - 1701-1900 SQ
Primary Land Use
0101 RESIDENTIAL - SINGLE
FAMILY : 1 UNIT
Beds / Baths / Half
3/2/0
Floors
1
Living Units
1
Actual Area
1,996 Sq.Ft
Living Area
1,732 Sq.Ft
Adjusted Area
1,858 Sq.Ft
Lot Size
5,400 Sq.Ft
Year Built
1965
Assessment Information
Year
2018
2017
2016
Land Value
$118,932
$118,932
$118,932
Building Value
$160,252
$149,792
$150,870
XF Value
$1,896
$1,911
$1,924
Market Value
$281,080
$270,635
$271,726
Assessed Value
$218,642
$214,145
$209,741
Benefits Information
Benefit
Type
2018
2017
2016
Save Our Homes
Cap
Assessment
Reduction
$62,438
$56,490
$61,985
Homestead
Exemption
$25,000
$25,000
$25,000
Second Homestead
Exemption
$25,000
$25,000
$25,000
Note: Not all benefits are applicable to all Taxable Values (i.e. County,
School Board, City, Regional).
Short Legal Description
NAVARRO SUB PB 12-59
LOT 24 BLK 5
LOT SIZE IRREGULAR
OR 18962-4739 01 2000 1
Generated On : 6/4/2018
Taxable Value Information
2018 2017
2016
County
Exemption Value
$50,000
$50,000
$50,000
Taxable Value
$168,642
$164,145
$159,741
School Board
Exemption Value
$25,000
$25,000
$25,000
Taxable Value
$193,642
$189,145
$184,741
City
Exemption Value
$50,000
$50,000
$50,000
Taxable Value
$168,642
$164,145
$159,741
Regional
Exemption Value 1
Taxable Value
$50,000
$50,000!
$50,000
$159,741
$168,642
$164,145.
Sales Information
Previous
Sale
Price
OR Book -
Pa a
9
Qualification Description
04/14/2011
$285,000
27677
0723
Qual by exam of deed
01/01/2000
$102,000
18962
4739
Sales which are qualified
01/01/1996
$0
00000-
00000
Sales which are disqualified as a result
of examination of the deed
07/01/1987
$80,000
13342
3241
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/
6/4/2018
Miami -Dade Official Records - Print Document Page 1 of 2
11111111111111111111111111111111111111111111
THIS INSTRUMENT PREPARED BY AND RETURN TO:
STEPHEN J. STRALEY, ESQ.
STRALEY & OTTO P.A.
2699 STIRLING ROAD, SUITE C-207
FT. LAUDERDALE, FLORIDA 33312 1— — --
Property Appraisers Parcel Identification (Folio) Numbers: l 1.31010180530Es -
SPACE ABOVE THIS LINE FOR RECORDING L)ATA
C F1•I 2ID11R0292112
OR Bk 27677 Pes 0723 - 724; (2Pss
RECORDED 05/04/2011 16:09:08
DEED DOC TAX 1,710.00
HARVEY RUVIN, CLERK OF COURT"
t1IAMI-DADE COUNTY, FLORIDA
THIS WARRANTY DEED made the t9 day of April, 2011 by KEENAN W. BAIN and EUGENIA M. BAIN, HIS WIFE,
herein called the grantors, to;LATONIA JOHNSON,,A SINGLE WOMAN whose post office address isr19-N:W. 99TH STREET, 4
MIAMI SHORES; FL 33150, hereinafter called the Grantee:
(Wherever'used herein the 'terms "grantor" and 'grantee" include all the parties to this instrument and the heirs. legal representatives and assigns of
individuals. and the successors and assigns of corporations)
W I T N E S S E T H: That the grantors, for and in consideration of the sum of TEN AND 00/100'S ($10.00) Dollars and other valuable
considerations, receipt whereof is hereby acknowledged, hereby grants, bargains, sells, aliens, remises, releases, conveys and confirms
unto the grantee all that certain land situate in BROWARD County, State of Florida, viz.:
LOT 24, BLOCK 5, NAVARRO SUBDIVISION, ACCORDING TO THE PLAT THEREOF, RECORDED IN PLAT BOOK
12, PAGE 59, OF THE PUBLIC RECORDS OF MIAMI-DADE COUNTY, FLORIDA
TOGETHER, with all the tenements, hereditaments and appurtenances thereto belonging or in anywise appertaining.
TO HAVE AND TO HOLD, the same in fee simple forever.
AND, the grantors hereby covenant with said grantee that the grantors are lawfully seized of said land in fee simple; that the grantors have
good right and lawful authority to sell and convey said land, and hereby warrant the title to said land and will defend the same against the
lawful claims of all persons whomsoever; and that said land is free of all encumbrances, except taxes accruing subsequent to December
31,2010.
IN WITNESS WHEREOF, thesaid grantors have signedand sealed these presents the day and year first above written.
Signed, sealed and del'�• ed i e presence of:
Witness #1 naturer/i
Witne • 1 Printed Name
es .r Signature
Witness #2-Printed Name
STATE OF Florida
COUNTY OF BROWARD
KEENAN W. B'AIN
19 N . 99TH STREET, MIAMI S/HOO�R�ES, FL"--. 33150
EUG IA M. BAIN
19 N.W. 99T1 1 STREET, MIAMI SHORES, FL 33150
The foregoing instrument was acknowledged before me this44 day of April, 2011 by KEENAN . ' IN and EUGENIA M. BAIN
who are personally known to me or have produced 1t.. arc J�+li h �. s._ as identificati
SEAL
My Commission Expires:
STEPHEN J. BTRALEY
MY COMMISSION 0 DO 772201
EXPIRES: July 11, 2012
9oMW T n Notary Pablo Undenu une
otary S'
Book27677/Page723 CFN#20110292112
ary Signature
Page 1 of 2
https://www2.miami-dadeclerk.com/OfficialRecords/PrintDocument. aspx?Q S=YaoUfOzxr... 6/4/2018
Miami -Dade Official Records - Print Document Page 2 of 2
OR B k 27677 PG 0724
LAST PAGE
MIAMI SHORES VILLAGE
Building Department
10050 NE 2 Ave, Miami Shores FI, 33138
Tel: 305-795-2204. Fax: 305-756-8972
Permit No. REOC-4-11-594
Certificate of Re -Occupancy
Address: 19 NW 99 Street
City: Miami Shores Village
State: Florida
Zip: 33138
This certificate verifies that the reference property has been inspected by Miami Shores
Village and has been determined to presently comply with schedule of regulations of
Miami Shores Land and Development Code pertaining solely to the requirement that
each one -family dwelling is used and intended to be used for a one -family dwelling
purpose only; however, this certificate does not constitute any representation or
warranty as to the condition of the dwelling or other structures on the premises
described herein, or any aspect of such condition, and interested persons are advised
and encouraged to make their own inspections of the premises in order to determine the
condition thereof.
Building Officials Approval:
Oararur-ri.JJu ,n,. CBO
Book27677/Page724 CFN#20110292112 Page 2 of 2
https://www2.miami-dadeclerk.com/OfficialRecords/PrintDocument.aspx?Q S=YaoUfOzxr... 6/4/2018
ORLANDO GRANDAL PSM.
PROFESSIONAL. LAND SURVEYORS AND MAPPER
5839 SW 17th STREET
MIAMI. FL. 33155
PHONE:(786) 553-4658 OgrandalOyahoo.com
PAGE 2 OF 2
NOT VALID WITHOUT PAGE 1 OF 2
SKETCH SURVEY
RECEIVED
JUN 0 6 2018
a(4"\
LOT 5
BLOCK 5
F.I.P. 1 /2" ,,.- „ F.I.P. 1 /2"
NO ID. 50.00 I NO ID.
pp
0.73'. " 0.38'
" 11.83' p. op 9.27' 1
r 28.90' "
4' CHAIN_A
LINK FENCE I
LOT 23
BLOCK 5
6' WOOD
FENCE —
NCONC.
L ) CI I •.
PI
i A/CC
CODC
1.12SL6B
9 4 • -10'
F.I.P. 1/2"
NO ID.
ONE STORY
RES. No. 19
28.90'
10.00'
"1IL
LOT 28
BLOCK 5
1
O
L
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JJ.
.1
8.9'
TILE
—ON
I LINE
LOT 28
BLOCK 5
LOT 28,
BLOCK 5 f:
LOT 28
BLOCK 5
•
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��9.
F.I.P. 1/2" 105.86'
® NO ID. _ -0
BLOCK
CORNER
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16' PARKWAY
ASPHALT PAVEMENT::
PERMiT #:
Miarni Shires Village
APPROVED
GRAPHIC SC.ALEING DEPT
a
VIIANI AVENUE
DATE
41741
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( IN FEET ) SUBJECT 10 CCMIPLIANCE W111-1 ALL. FEDERAL
1 Inch= 20 t
STATE ANv CC,UNIY riLLES ANC REGULATIONS