PLC-18-1664Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
�m it
Permit NO. PLC-6-' 8-1664
Permit Type: Plumbing - Commercial
Work Classification: Septic
Permit Status: APPROVED
Issue Date:..8123/2018
Expiration: 02/19/2019
Parcel Number
Applicant
9636 NE 2 Avenue
Miami Shores, FL 33138-
1132060132500
Block: Lot:
PALAZZO LEONI LLC
Owner Information
Address
Phone
Cell
PO BOX 381703
MIAMI FL 33238-
Contractor(s) Phone CeII Phone
EDWARD ROJAS PLUMBING CORP (305)944-6788
Valuation:
Total Sq Feet:
$ 1,200.00
0
Type of Work: SEPTIC TANK ABANDONMENT
Type of Piping:
Additional Info: SEPTIC TANK ABANDONMENT
Classification: Commercial
Scanning: 1
Fees Due
CCF
Change of Contractor Fee
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$1.20
$110.00
$2.25
$2.00
$0.40
$150.00
$3.00
$1.60
$270.45
Pay Date
Invoice #
06/18/2018
08/23/2018
Pay Type
PLC-6-18-67962
Credit Card
Credit Card
Amt Paid Amt Due
$ 50.00 $ 220.45
$ 220.45 $ 0.00
Available Inspections:
Inspection Type:
HRS Approval
Final
Review Plumbing
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, PLUINGIIECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify 1e foregoing informa 'on is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. F er re, I authorize the above a ed c99tractor t./do t - ork stated.
Authorized Signature: Owner / Applicant / Contractor / Agent
August 23, 2018
Date
Building Department Copy
August 23, 2018 1
((3?\\� 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 20 I�
BUILDING Master Permit No. 'LC i%4122`-k
PERMIT APPLICATION Sub Permit No. PIC t f 1 Qloq
RECEIVED
JUL 12 2013
Of
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 3 6 /v t 2/' /TM
City: Miami Shores County: Miami Dade Zip: 33/3413
Folio/Parcel#: 1132 a b — a 13 -- 2-50 o Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Patekru.„2 , LL CC Phone#: 306' 15b- \ al )(1.0
Address: VC) it ( 34?)1 O3
City:; 0•41--�
State:
Tenant/Lessee Name: Phone#:
Email: R0 e. 1—R-oA1 Co •
Zip:
33z3%
Lt A
CONTRACTOR: Company Name: SQO42A4c 3/la5- iv hi' vki Phone#: • AA'S - \ Uyb
Address: is “3 111 St
City: Q iSc01Rue\�-
Qualifier Name: .,c)'J0.r1CojG-s ti Phone#:... �. '\`\' . q�`'0b
State Certification or Registration #: QEC— °k`A3` Certificate of Competency #: ..
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
/
Value of Work for this Permit: $ "`' )� Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration
State: �- Zip: 33\b\
❑ New
Description of Work: Q\ri A\C-' G`Ofr- y i(
❑ Repair/Replace I I Demolition
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ ( C - ''i CCF $ CO/CC $
Scanning Fee $ Radon Fee $ 2 ' C� DBPR $ . Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
DANCE Q,p(47(2„ke--de,: I (O - G b TOTAL FEE NOW DUE $ 2 2 0 . 'TG
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
e '
Mortgage Lender's Address
City State Zip
•
NIt.
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 beNapproved and a reinspection fee will be charged.
Signature
OWNER or AGENT
The foregoing instrument was acknowledged before /O meOthis
.�7� r n day of �� , 20 , by
1 vDN jDb"/ , who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
11
Sign:
Print:
Seal:
0 ANDREW VOGEL
MY COMMISSION # FF919683
EXPIRES: November 25, 2019
**************** *
APPROVED BY
Signature
The foregoing instrument was acknowledged beforemethis
f t day of /7 , 20 lO , by
�!/a/t �s-4f , who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
Actrefry
e/
ANDREW VOGEL
MY COMMISSION # FF919683
EXPIRES: November 25, 2019
************************************************ *****************
a Plans Examiner
Zoning
Structural Review Clerk
(Revised02/24/2014)
STATE O FLORIDA
DEPART2dT OF HEALTH
ONSITE t; WAGE TREATMENT AND DISPOSAL
SYSTEM
CONSTRUCTION PERMIT FOR: OSTDS Abandonment
APPLICANT: (Palazzo Leo.1 LLC)
PERMIT # :13-SC-1852005
APPLICATION #: AP1347807
DATE PAID:
FEE PAID:
RECEIPT #•
DOCUMENT #: PR1119681
PROPERTY ADDRESS: 963NE 2 Ave
LOT: 1267
PROPERTY ID #:
Miami, FL 33138
BLOK: 19 SUBDIVISION:
11-3206113-2500
[SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
[OR TAX ID NUMBER]
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION
381.0065, F.S., AND HAPTER 64E-6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE
SATISFACTORY PERFORMANiE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS,
WHICH SERVED AS A PSIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE
PERMIT APPLICATION. ijSUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID.
ISSUANCE OF THIS PETIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL,
STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY.
SYSTEM DESIGN AND SPECIFICATIONS
T [ ] GALLONS ;'GPD CAPACITY
A [ ] GALLONS ij GPD CAPACITY
N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ ] GALLONS DOING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 BRS #Pumps [ ]
D [ J SQUARE FEES' SYSTEM
R [ ] SQUARE FEE;' SYSTEM
A TYPE SYSTEM: [ isE STANDARD ( ) FILLED [ 1 MOUND [ ]
1 CONFIGURATION: [ )1 TRENCH [ ] BED [ ]
g
N
F LOCATION OF BENCHMARK,,
I ELEVATION OF PROPOSSDf SYSTEM SITE [ ][
E BOTTOM OF DRAINFIELD BE [ ][
L ¢#
D FILL REQUIRED: [ OE00 ] INCHES
0
T
H
/ ] [ ABOVE/ 3ELOW )BENCHMARK/REFERENCE POINT
/ ] [ ABOVE / BELCW ] BENCHMARK/REFERENCE POINT
EXCAVATION RE UIRED: [ ] INCHES
Have the tank abandoned in accordance with the following procedures:(a) The tank shall be pumped out.(b) The bottom of
the tank shall be opened or ruptured, or the entire tank collapsed so as to prevent the tank from retaining water, and(c) The
tank shall befilled with cle,n sand or other suitable material, and completely covered with soil.Have the system inspected
by the health department after it has been pumped , ruptured and filled with sand and covered.
SPECIFICATIONS BY: TITLE:
APPROVED BY: ff TITLE: Engineering Specialist II Dade CHD
LP ni s X vo
DATE ISSUED: 06104/2018 EXPIRATION DATE: 09/02/2018
DH 4016, 08/09 (Obsolets all previous editions which may not be used)
Incorporated: 64E-6.003, FAC
Page 1 of 3
EDWARD ROJAS
PLUMBING SERVICE
880 NE 111 TH ST
BISCAYNE PARK, MIAMI FL 33161
SEWER AND DRAIN SPECIALISTS
My phone 786-443-9846
305-944-6788 my office
LICENSED -BONDED -INSURED
CC-CFC 049431
Date: g - Z 2 - ) J
State of Flo erC76
Country of rD �pl
Before me this day personally appeared
duly sworn,
( I 2a q
Q/C,f / who, being
That he or she will be the only person working on the project located at:
!�0 36 ill -fir 2 "d Aue
Contractor Signature
Sworn to (or affirmed ) and subscribed before me this d day of
By L1) (N�. / � /2 S
v
Personally Know
OR Produced Identification
2018
Type of identification Produced
Print Type or Stamp Name of Notary
A1ND EW VOGEL
MY COMMISSION # FF919683
EXPIRES: November25,2019
-h
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:
()JL.
Owner
State of Florida
County of Miami -Dade
The foregoing was acknowledge before me this
day of
� I t L60
By _ � � � � who is personally known to me or has produced
1
Notary:
SEAL:
0,,p
as identification.
ANDREW VOGEL
MY COMMISSION # FF919683
EXPIRES: November 25, 2019
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.
Signature:
Owner
State of Florida
County of Miami -Dade
The foregoing was acknowledge before me this
By 11)OO &w)
Notary:
SEAL
ANDREW VOGEL
MY COMMISSION # FF919683
EXPIRES: November 25, 2019
IT
day of
the ,20i.
who is personally known to me or has produced
as identification.
\r�l`� Miami Shores Village
(o���\ 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
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
FBC 201i Li"
Master Permit No. '1'o % _` L 6A
Sub Permit No. + i_1 ( 9— (22't
PLUMBING ❑ MECHANICAL ❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: q4o.3 6 4/6 Z "i' /4-utz
City: Miami Shores County: Miami Dade Zip: 33(3 6
Folio/Parcel#: //'3Z0,6 "D /3 —2vSfr' Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE:/Uiek FFE:
OWNER: Name (Fee Simple Titleholder): Pahl- Z v LtAovs; LL( Phone#: SO5 .56
Address:
L b ' 3i 13-03
City: r It C.cifY\ State: Fc—
Zip: 33 2-3$
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: n
Address:
�[1S 4J rS`k \NYC
Phone#:
etc cr.P-(
City: /,a t kes_Li„ i/(4 State: -R (. Zip: 3 G e_
i
Qualifier Name: Cci kUQ_A & 0 \�Ci 0,11 ,p) Phone#: r d �tCt q e' E
State Certification or Registration #: S f_ _ OD (O (5R..6 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State:
,fit Zip:
Value of Work for this Permit: $� 1 Z00-0-0 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace n Demolition
Description of Work: f } , Z 6-.6C„Aj o -
Specify color of -color thru tile:
Submittal Fee $ Soctid Permit Fee $ //w r CCF $ CO/CC $
Scanning Fee $ Radon Fee $ b DBPR $2 • 2_5 Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $ TLC. ( E5 122V
TOTAL FEE NOW DUE $ I 0 • ‘i 5
(Revised02/24/2014)
'l..j_ a "4
Bonding Company's Name (if applicable) t `-
Bonding Company's Address
City
State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
n h d
City ll;- .- € " r ' f State Zip
ter•; •,,, t• L
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
„L,
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'oe approved and a reinspection fee will be charged.
e - .
Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
7' ` dayof� , 20 /e , by
��of�
"f/ , who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUB
Sign:
Print:
Seal:
*****************
APPROVED BY
e.
(Revised02/24/2014)
ANDREW VOGEL
MY COMMISSION # FF919683
EXPIRES: November 25, 2019
Signature
CONTRACTOR
The foregoing instrumentwasacknowledged before me this
/-� day of i/�� , 20 /f , by
YUl �lerp'O Q UB/I"S , who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
*****************************
d1'w
Plans Examiner
Structural Review
ANDREW VOGEL'
MY COMMISSION # FF919683
EXPIRES: November 25, 2019
**
Zoning
Clerk
STATE O FLORIDA
DEPART/01. T OF HEALTH
ONSITE $SWAGE TREATMENT AND DISPOSAL
SYSTEM
CONSTRUCTION PERMIT FOR: OSTDS Abandonment
APPLICANT: (Palazzo Leafi LLC)
PERMIT #: 13-SC-1852005
APPLICATION #: AP1347807
DATE PAID:
FEE PAID:
RECEIPT #`
DOCUMENT #: PR1119681
PROPERTY ADDRESS: 9636 NE 2 Ave
LOT: 1 2 6 7
Miami, FL 33138
BLOCK: 19 SUBDIVISION:
PROPERTY ID #: 11-3206=13-2500
[SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
[OR TAX ID NUMBER]
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION
381.0065, F.S., ANDHAPTER 64E-6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE
SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS,
WHICH SERVED AS A ISIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE
PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID.
ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL,
STATE, OR LOCAL PERMITTIRG REQUIRED FOR DEVELOPMENT OF THIS PROPERTY.
SYSTEM DESIGN AND SPECIFICATIONS
T [
A [
N [
K
1 GALLONS i GPD CAPACITY
o
] GALLONS / GPD CAPACITY
] GALLONS GE{#ASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS)
] GALLONS DOSING TANK CAPACITY ( 'GALLONS @( ]DOSES PER 24 HRS #Pumps [ ]
li
D [ ] SQUARE FEE SYSTEM
R [ ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [ 1 STANDARD ( ] FILLED ( ) MOUND ( ]
I CONFIGURATION: [ 1 TRENCH [ ] BED 1 1
N
F LOCATION OF BENCHMARI0t
I ELEVATION OF PROPOSED4SYSTEM SITE
E BOTTOM OF DRAINFIELD s'0 8E
L
D FILL REQUIRED:
0
T
H
E
R
SPECIFICATIONS BY:
APPROVED BY:
11
[ CLOO] INCHES EXCAVATION REQUIRED: [ ] INCHES
Have the tank abandoned1n accordance with the following procedures:(a) The tank shall be pumped out.(b) The bottom of
the tank shall be opened o ruptured, or the entire tank collapsed so as to prevent the tank from retaining water, and(c) The
tank shall be filled with cl n sand or other suitable material. and completely covered with soil.Have the system inspected
by the health department after it has been pumped , ruptured and filled with sand and covered.
/ ][ ABOVE;/ BELOW ]BENCHMARK/REFERENCE POINT
](ABOVE/ BELCW]BENCHMARK/REFERENCE POINT
TITLE:
TITLE: Engineering Specialist II
Dade CHD
Ilkimis X Gor.#al-dz
DATE ISSUED: 004/2018 EXPIRATION DATE: 09/02/2018
DH 4016, 08/09 (Obsole+ ies all previous editions which may not be used)
oi
Incorporated: 64E-6.0t3, FAC
Page 1 of 3
Page 1 of 1
Property Search Application - Miami -Dade County
1
4Z
Summary Report
Property Information
Folio:
11-3206-013-2500
Property Address:
9636 NE 2 AVE
Miami Shores, FL 33138-2722
Owner
PALAZZO LEONI LLC
Mailing Address
PO BOX 381703
MIAMI, FL 33238 USA
PA Primary Zone
6400 COMMERCIAL - CENTRAL
Primary Land Use
2413 INSURANCE COMPANY :
OFFICE BUILDING
Beds / Baths / Half
0/0/0
Floors
1
Living Units
0
Actual Area
Sq.Ft
Living Area
Sq.Ft
Adjusted Area
11,065 Sq.Ft
Lot Size
23,850 Sq.Ft
Year Built
1936
Assessment Information
Year
2017
2016
2015
Land Value
$579,850
$524,700
$484,450
Building Value
$820,150
$621,495
$621,495
XF Value
$0
$0
$0
Market Value
$1,400,000
$1,146,195
$1,105,945
Assessed Value
$1,168,684
$1,062,440
$965,855
Benefits Information
Benefit
Type
2017
2016
2015
Non -Homestead
Cap
Assessment
Reduction
$231,316
$83,755
$140,090
Note: Not all benefits are applicable to all Taxable Values (i.e. County,
School Board, City, Regional).
Short Legal Description
1 53 41 6 53 42
MIAMI SHORES SEC 1 AMD PB 10-70
LOTS 1-2 & 6-7 BLK 19
LOT SIZE IRREGULAR
COC 23732-4546 08 2005 4 (CD)
Generated On : 6/18/2018
Taxable Value Information
2017
2016
2015
County
Exemption Value $0
$0
$0
t
Taxable Value fj $1,168,684
$1,062,440
$965,855
School Board
Exemption Value
$0
$0
$0
Taxable Value
$1,400,000
$1,146,195
$1,105,945
City
Exemption Value
$0
$0
$0
Taxable Value
$1,168,684
$1,062,440
$965,855
Regional
Exemption Value
$0
$0
$0
Taxable Value
$1,168,684
$1,062,440
$965,855
Sales Information
Previous
Sale
Price
OR Book -
Pa 9e
Qualification Description
12/18/2013
$2,425,000
28971
3673
Qual on DOS, multi -parcel sale
03/24/2011
$3,084,000
27638-
1734
Financial inst or "In Lieu of Forclosure"
stated
08/01/2005
$0
23732-
4546
Sales which are disqualified as a result
of examination of the deed
07/01/2005
$4,500,000
23628-
2089
Deeds that include more than one
parcel
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/
6/18/2018
2018 FLORIDA LIMITED LIABILITY COMPANY ANNUAL REPORT FILED
DOCUMENT# L13000150548 Mar 28, 2018
Entity Name: PALAZZO LEONI LLC Secretary of State
CC3572668885
Current Principal Place of Business:
9600 NE 2 AVE
MIAMI, FL 33138
Current Mailing Address:
PO BOX 381703
MIAMI, 33238 AF
FEI Number: 46-4350354
Name and Address of Current Registered Agent:
LEONI, TODD
9600 NE 2 AVE
MIAMI, FL 33138 US
Certificate of Status Desired: No
The above named entity submits this statement for the purpose of changing its registered office or registered agent, or both, in the State of Florida.
SIGNATURE:
Electronic Signature of Registered Agent
Authorized Person(s) Detail :
Title MGRM
Name LEONI, TODD
Address 9600 NE 2 AVE
City -State -Zip: MIAMI FL 33238
Date
I hereby certify that the information indicated on this report or supplemental report is true and accurate and that my electronic signature shall have the same legal effect as if made under
oath; that I am a managing member or manager of the limited liability company or the receiver or trustee empowered to execute this report as required by Chapter 605, Florida Statutes; and
that my name appears above, or on an attachment with all other like empowered.
SIGNATURE: TODD LEONI MANAGING MEMBER
03/28/2018
Electronic Signature of Signing Authorized Person(s) Detail Date