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DS-17-2654Miami Shores Village 10050 N.E. 2nd Avenue NW Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Permit NO. DS-11-17-2654 la PePermit Type: Driveways/Sidewalks/Slabs rm! WorkClassification: Addition/Alteration Permit Status: APPROVED Issue Date: 11/20/2011 Expiration: 05/19/2018 Parcel Number Applicant 49 NW 98 Street Miami Shores, FL 1131010330140 Block: Lot: BRADLEY & KELLY SOUTHARD Owner Information Address Phone Cell BRADLEY & KELLY SOUTHARD 49 NW 98 Street MIAMI SHORES FL 33150- (305)218-0119 49 NW 98 Street MIAMI SHORES FL 33150- Contractor(s) TRUE STAMP CONCRETE LLC Phone (305)494-4465 CeII Phone Valuation: Total Sq Feet: $ 1,400.00 448 Approved: In Review Comments: Date Approved: : In Review Date Denied: Type of Work: REPLACE EXISTING ASPHALT APPROAC Bond Return : Scanning: 3 Additional Info: REPLACE EXISTING ASPHALT APP Classification: Residential Fees Due Bond Type - Contractors Bond CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $500.00 $1.20 $2.00 $2.00 $0.40 $100.00 $9.00 $1.60 $616.20 Pay Date Invoice # 11/20/2017 11/07/2017 Bond #: 3562 Pay Type DS-11-17-65588 Credit Card Credit Card Amt Paid Amt Due $ 566.20 $ 50.00 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Final Foundation Review Building Review Building Review Planning 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 constructioh and zoning. Futhermore, I authorize the above -named contractor to do the work stated. L November 20, 2017 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date November 20, 2017 1 • \(„SN Miami Shores Village Building Department BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑ PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION CONTRACTOR JOB ADDRESS: (f /V(4/ q j 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 RECEI VEb NOVIO 71017 5h FBC 20i Master Permit No.DS R "21.0C JH Sub Permit No. City: Miami Shores Folio/Parcel#: (/ `5(c7 / ©? 30 / cry Occupancy Type: Load: County: Miami Dade RENEWAL SHOP DRAWINGS Zip: "7 3 /-rb Is the Building Historically Designated: Yes Construction Type: _ Flood Zone: BFE: NO l/ FFE: OWNER: Name (Fee Simple Titleholder): /(e C(./- S ? (y ?4,9/C.o) Phone#: Address: 47-`1 /tom f / q IT S ? City: 4--1-1 ,' ' 1 c" /6,4 e State: zip: -3 Tenant/Lessee Name: Phone#: Email: Address: CONTRACTOR: Company Name: (/ez (• CZ e /e p 0 3 ZQJ S -3 s--7-/ City: y"1 , State: Qualifier Name: V7( 67.4- Phone#: - "S 5/%C/ /9'6 Zip: —53 /S Phone#: 3 0 $ ci �%C7 //Cl4 State Certification or Registration #: , O 7 00 %C/ f Certificate of Competency #: s DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ -/r (f V is Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New gcLI ❑ Repair/Replace ❑ Demolition Description of Work: &pp co e ,c < C r Ac 4.,Q / � ite c p S 4 e'ern c�.e /T : Specify color of color thru=tile: Submittal Fee $ 5C • �� , Permit Fee $ (03. CZ CCF. $ • (.., 2S;) ..• ._ . ""'`Co/CC $"' Radon Fee $ 2 •03 DBPR $ 2 Scanning Fee $ [ . Technology Fee $ I . (� 0 Training/Education Fee $ b Structural Reviews $ (Revised02/24/2014) • co f Notary $ ,17 Double Fee $ Bond $ TOTAL FEE NOW DUE $ ("CO f l , 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 arged. Signature OWor AGENT The foregoing instrument was acknowledged before me this day of c9 L1 , 20 (7 , by f4,,G y Sd�%�j�}1101 , who is personally known to me or who has produced A ( «SP as identification and who did take an oath. NOTARY PUBLIC: Sign: . , Print: Seal: 4,-t,ki�S' r "• + ARANEUS GONZALEZ MY COMMISSION # FF 913306 1 EXPIRES: September 18, 2019 �Bf `' Bonded ru Notary Publc Underwriters %crn 14, (e ********************** APPROVED BY Signature CONTRACTOR The foregoing instrument was acknowledged before me this 2 day of D Cr- , 20 "7 , who is or who has produced identification and who did take an oath. • NOTARY PUBLIC: Print: Seal: Plans Examiner Structural Review by ersonally known to ic(�� ARANEUS GONZALEZ MY COMMISSION # FF 913306 J EXPIRES: September 18, 2019 Bonded Thru Notary Public Underwriters as Zoning Clerk (Revised02/24/2014) 11/2/2017 Property Search Application - Miami -Dade County Summary Report Property Information Folio: 11-3101-033-0140 Property Address: 49 NW 98 ST Miami Shores, FL 33150-1736 Owner BRADLEY I SOUTHARD KELLY SOUTHARD Mailing Address 49 NW 98 ST MIAMI SHORES, FL 33150 USA 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 1,711 Sq.Ft Living Area 1,299 Sq.Ft Adjusted Area 1,505 Sq.Ft Lot Size 7,650 Sq.Ft Year Built 1953 Assessment Information Year 2017 2016 2015 Land Value $168,558 $168,558 $124,474 Building Value $146,647 $104,748 $104748 XF Value $16,535 $16,538 $11,203 Market Value $331,740 $289,844 $240,425 Assessed Value $172,763 $125,903 $125,028 Benefits Information Benefit Type 2017 2016 2015 Save Our Homes Cap Assessment Reduction $163,941 $115,397 Portability Assessment Reduction $158,977 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 (.e. County, School Board, City, Regional). Short Legal Description MIAMI SHORES SEC 6 PB 10-39 LOT 20 & W1/2 LOT 21 BLK 128 LOT SIZE 75.000 X 102 OR 18388-2326 1298 1 S Generated On : 11/2/2017 Taxable Value Information 2017 2016 2015 County Exemption Value $50,000 $50,000 $50,000 Taxable Value $122,763 $75,903 $75,028 School Board Exemption Value $25,000 $25,000 $25,000 Taxable Value $147,763 $100,903 $100,028 City Exemption Value $50,000 $50,000 $50,000 Taxable Value $122,763 $75,903 $75,028 Regional Exemption Value $50,000 $50,000 $50,000 Taxable Value $122,763 $75,903 $75,028 Sales Information Previous Sale Price OR Book- Page Qualification Description 12/29/2016 $405,000 30368- 3745 Qual by exam of deed 12/01/1998 $114,000 18388 2326 Sales which are qualified 12/01/1995 $0 17156- 1767 Sales which are disqualified as a result of examination of the deed 10/01/1990 $85,000 14734 1711 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: lami Shores Vi llage 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 CONTENT. Signatur e State of Florida County of Miami -Dade The foregoing was acknowledge before me this oz9 day of 0 6.74-- By C Sr) ii7A'- c .D C ce_„ 4Q Notary: SEAL: ,20/7. who is personally known to me or has produced as identification. i ARANEUS GONZALEZ 3t' . : •, :,: MY COMMISSION # FF 913306 •.���:g EXPIRES: September 18, 2019 of h Bonded Thru Notary Public Underwriters ST4 True Stamped Concrete LLC. Date: od-2 (/ ZD (7 State of: -(to A, t 24 County of: •Z��/C Before me this day personally appeared (Lilt ' deposes and says: who, being duly sworn, That he or she will be the only person working on the project located at: "7 w‘c/ F S Sworn to (or affirmed) and subscribe before me this 2°t day of 0 G% 20 / 7 by: 62IC6 'Cl%;2--- Affiant Signature: :y'�.,; ARANEUS GONZALEZ ' '' = MY COMMISSION # FF 913306 •g EXPIRES: September 18, 2019 „RA , F. ' Bonded Thru Notary Public Underwriters Personally Known: Or Produced Identification: Type of Identification Produced: Print, Type or Stamp Name of Notary STATE OF (FLORIDA) COUNTY OF (DADE) For address: Miami Shores Vivage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 SURVEY AFFIDAVIT The undersigned Affiant, (e cog,/ , does hereby attest that (Property owner) The attached survey, performed by g�D freti y,e Nai 61,t,d cb/..zvt/o/1- (Name of surveyor's company) (i% AA/ c7 `'r «4.,IY 3 3/cQ Performed on /2 `2'/-2o% (date of survey) is an accurate representation of the existing conditions and locations of all structures on the property as of this date. The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the property without first providing a survey Tess than seven (7) years old old. The Affiant, as property owner, further agrees to remove or obtain permits for any structures which now may exist on the property which are not permitted or which may violate zoning or building code regulations. The Affiant further understands that the existence of any such structures may affect final inspections as applicable to this or other permits. Fi4ther, Affiant y eth n., •ht. Property Owne ignature i<2c,0 74, A.,) Property Owner Print Name SWORN TO AND SUBSCRIBED before me this 2- °% day of p G 74- . z.9 /7 Affiant is personally known to me, produced /7 e as identification. Revised on 5/22/2009/ Revised on 6/12/09 L.S.c.43::.4‘.'1...*%,. ARANEUS GONZ.ALEZ MY COMMISSION M FF 913306 W. EXPIRES: September 18, 2019 Bonded Thru Notary Pubic Underwriters Notary D I 2A0S1/4f ••• LOT - BLOCK.; 1 5, LOT- 19 BLOCK -128 4C.L.F. %NI 0 0.35CL 0)0_1 verAily ,q/1.1 Wiwi( OVe ed4tesicrel e mcit 1(eal, : art,d ta-misz4N41If y 4 A/0) .F.I RECEIVED NOV 6 ma_ LOT - 7 BLOCK - 128 VNI °"1 Miami Shores Village APPROVED TONING DC PT DEPT COMP'CE WITH P4PTE-C6-1KL BLOCK- 12$ 7,0l INTY Ill II. CS AND REellil_ATIONS AND LOT - 20 ONE STORY BLOCK- 128 RES. # 49 11 1? 01 774.15-. . 'Lr brgra' • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • (.4 REMAINDER LOT - 21 BLOCK - 128 (N.A.P.) 0 CAP • . • ' • • • • • • • • • • B.C. • • F lP 3/4" NO CAP w;i• < N- I— ", 0 LOT-8 BLOCK- 128 6,0ro sed. /,q ve/L d4t-( veto, A, JiWit°,a( Ov.QiL b" e11 comp d cis e Satz Fi t(e & anal I `'-rith*044 A/ F.I 3/4" 7ac_ar� LAWRairt,s ' RECEIVED NOV 0 71017 . o BLOCK - 128 L BLO • • • • • • 9• • 1 • .y ••.• • • • •.• ••} 1•r•• • • ••N REMAIMAR •� •.O. • L•091-21• ••• BLOCK- 4B8 • .. • (N.A.P•) • • • • • • • •• • • • ••• • • 0.55'CL • • • •• • • • • • • • • • • • • B.C. ' F 1 P 3/4" NO CAP b.64 ?ia31 s� ti. 0C). Q