RC-18-1552Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit
Permit NO. RC--18-1552
Permit Type: Residential Construction
Work Classification: Alteration
Permit Status: APPROVED
Issue Date: 6/28/2018
Expiration: 12/25/2018
Parcel Number
Applicant
1084 NE 97 Street
Miami Shores, FL 33138-
1132050170190
Block: Lot:
1084 MIAMI SHORES LLC
Owner Information
Address
Phone
Cell
1084 MIAMI SHORES LLC
1084 NE 97 Street
MIAMI SHORES FL 33138-
(305)767-9693
1265 SABAL TRAIL
WESTON FL 33327-
Contractor(s)
GAVEN, LLC
Phone Cell Phone
(786)338-3367 (786)325-7470
Valuation:
Total Sq Feet:
$ 13,000.00
0
Approved: In Review
Comments:
Date Approved: : In Review
Date Denied:
Type of Construction: UPDATING KITCHEN AND BATHRC
Stories:
Front Setback:
Left Setback:
Bedrooms:
Plans Submitted: Yes
Certificate Date:
Bond Return :
Occupancy: Single Family
Exterior:
Rear Setback:
Right Setback:
Bathrooms:
Certificate Status:
Additional Info: UPDATING KITCHEN AND BATHRO
Classification: Residential
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
P&Z Review Fee
Penalty Fee
Permit Fee
Scanning Fee
Technology Fee
Work without Permit Fee
Amount
$7.80
$5.85
$3.90
$2.60
$0.00
$100.00
$390.00
$9.00
$10.40
$390.00
Total: $919.55
Pay Date Pay Type
Invoice # RC-6-18-67825
06/28/2018 Credit Card
06/06/2018 Credit Card
Amt Paid Amt Due
$ 869.55 $ 50.00
$ 50.00 $ 0.00
Available Inspections:
Inspection Type:
Final PE Certification
Window Door Attachment
Framing
Insulation
Drywall Screw
Fill Cells Columns
Window and Door Buck
Review Planning
Review Electrical
Review Electrical
Review Building
Review Mechanical
Review Plumbing
Review Structural
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 AFFIDAVI : 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 z
• ;
Auth: d ' ignature: Owner
uthermore, I auth rize the above -named contractor to do the work stated.
/ Applicant / Contractor / Agent
June 28, 2018
Date
Building Department Copy
June 28, 2018
1
BUILDING
PERMIT APPLICATION
BUILDING ❑ ELECTRIC
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
❑ ROOFING
El PLUMBING ❑ MECHANICAL PUBLIC WORKS
JOB ADDRESS: /O X7 Ve. '?c¢ • g? •
City: Miami Shores County: Miami Dade
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): /2 Y/ ' !% G(" S4/4' L_ L e_
Address: A -6, S__ __-. < _ ( /14.6.4-6
City: Ca'S ?45- State: r 6-
RECEIVED
JUN 06 2018
FBC 20 r4
Master Permit No. ' ` C t8 �S
Sub Permit No.
❑ REVISION ❑ EXTENSION El RENEWAL
CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
Zip: 3 3 13 2
Phone#:
Zip: ..33Z3 •
Tenant/Lessee Name: Phone#:
Email: ✓Li11.4e64 Q 5/14.(4..-(• 1�c
CONTRACTOR: Company Name: ai `l G LL� Phone#: 96t, - �-� 1400
Address:) Ifs IMP_ Arr ZtK
City: t't;Gtr
Qualifier Name:
State: ti' L_ Zip:
C'Aj CAntCt- .
Phone#..52__.)
State Certification or Registration #: t j'Z.I-{ .:a Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: : 1iSquare/Linear Footage of Work:
r '
Type of Work: Ell Addition l Alteration ❑ New ❑ Repair/Replace
Description of Work: (.,,GlC /1 f 1L . et44 & ,- p'"J
❑ Demolition
a, e.G..! -
Specify color of color thru tile:
Submittal Fee $ `,J . CO Permit Fee $ 37 • Os CCF $ - eC3 CO/CC $
Scanning Fee $ — I CO Radon Fee $
Technology Fee $ 1� ' `7 0 Training/Education Fee $ z- • 6 0 Double Fee $ ��(CS • co
Structural Reviews $ --
3.9-0 DBPR $ • 9,5
Notary $
Bond $
(Revised02/24/2014)
TOTAL FEE NOW DUE $
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: 1 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, • certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seve ) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a re spection fee will be charged.
Signatur
NER or AGENT
The foregoing instrument was acknowledged before me this
'Tyne_ ,20 (8 ,by
Jose" f-urGdO u'Pwho is personally known to
me or who has produced 14- tt C1-11 443(o -81-13y-D as
identification and who did take an oath.
NOTARY PUBLIC:
S day of
Sign:
Print:
Seal:
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
�
w ,15 day of J , 20 IbO, by
l bS (TUC\ , who is personally known to
me or who has produced °DC• (0 2 S 0 8 / "o} °as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
�:RY?iie.: Astrid Camacho
•.Lc, --;COMMISSION#FF141883
*************stilt*
APPROVED BY
PicYna
(Amato
�►gC*ye Astrid Camacho
•o`,COMMISSION#FF141883
5,' . �� EXPIRES; JUL 15, 2018
:ea EXPIRES; JUL 15, 2018 ""mac pF ,oQ•' BONDED THRU
1st FLORIDA NOTARY, LLC
Plans Examiner Zoning
(Revised02/24/2014)
Structural Review Clerk
Property Search Application - Miami -Dade County
6/6/2018
Summary Report
Property Information
Folio:
11-3205-017-0190
Property Address:
1084 NE 97 ST
Miami Shores, FL 33138-2556
Owner
1084 MIAMI SHORES LLC
Mailing Address
1265 SABAL TRAIL
WESTON, FL 33327 USA
PA Primary Zone
1400 SGL FAMILY - 3001-3250 SQ
Primary Land Use
0101 RESIDENTIAL - SINGLE
FAMILY: 1 UNIT
Beds / Baths / Half
3/2/1
Floors
1
Living Units
1
Actual Area
2,424 Sq.Ft
Living Area
1,803 Sq.Ft
Adjusted Area
2,113 Sq.Ft
Lot Size
7,950 Sq.Ft
Year Built
1950
Assessment Information
Year
2018
2017
2016
Land Value
$286,036
$286,036
$266,033
Building Value
$158,475
$147,065
$147,065
XF Value
$0
$0
$0
Market Value
$444,511
$433,101
$413,098
Assessed Value
$444,511
$433,101
$413,098
Benefits Information
Benefit
Type
20183 2017
2016
Note: Not all benefits are applicable to all Taxable Values (i.e. County, School
Board, City, Regional).
Short Legal Description
REV PL MIAMI SHORES SEC 8
PB 43-51
LOT 7 BLK 181
LOT SIZE 75.000 X 106
OR 16196-1589 1293 1
Generated On : 6/6/2018
Taxable Value Information
I 2018
2017
2016
County
Exemption Value
$0
$0
$0
Taxable Value
$444,511
$433,101
$413,098
School Board
Exemption Value
$0
B $0
$0
Taxable Value
$444,511
$433,101
$413,098
City
Exemption Value
$0
$0
$0
Taxable Value
$444,511
$433,101
$413,098
Regional
Exemption Value
$0
$0
$0
Taxable Value
$444,511,
$433,101
$413,098
Sales Information
Previous Sale
Price
OR Book -Page
Qualification Description
11/09/2015
$525,000
29856-3542
Qual by exam of deed
12/01/1993
$150,000
16196-1589
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:
6/6/2018 Detail by Entity Name
Department State / Division of CQ!pora. c?ns / Search Records / Detail lay_Docome t. Number /
Detail by Entity Name
Florida Limited Liability Company
1084 MIAMI SHORES, LLC
Filing Information
Document Number L15000176983
FEI/EIN Number NONE
Date Filed 10/19/2015
Effective Date 10/16/2015
State FL
Status INACTIVE
Last Event PENDING
REINSTATEMENT
Event Date Filed 03/12/2018
Principal Address
1265 SABAL TRL
WESTON, FL 33327
Changed: 12/11/2015
Mailing Address
1265 SABAL TRL
WESTON, FL 33327
Changed: 12/11/2015
Registered Agent Name & Address
CILIBERTO, JOSE R
19355 TURNBERRY WAY
11J
AVENTURA, FL 33180
Authorized Person(s) Detail
Name & Address
Title MGR
CILIBERTO, JOSE RICARDO
1265 SABAL TRL
WESTON, FL 33327
Title MGR
http://search.sunbiz.ore/Inquiry/CorporationSearch/SearchResultDetail?i nqui rytype=EntityNam e&directionType= Initial&searchN ameOrder=1084M IAM ISH OR.. 1/2
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 ACKNOW ` )GE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS
CONTENTS.
Sign
Owner
State of Florida
County of Miami -Dade The foregoing was acknowledge before me this 5 day of We. , 20 1?
.
By 3OSI `k(Joy blAbeiio
pL tk. C4 -' - g l- PA-0
Notary: fs' 1&k (Arraoko
SEAL:
Astrid Camacho
=x�• ,., 6*-COMMISSION#FF141883
. Sit • a< EXPIRES' JUL 15 2018
• . •'pQ'.' BONDED THRU
OF F�•,.'' 1st FLORIDA NOTARY, LLC
who is personally known to me or has produced
as identification.
OR Produced Identification
Type of Identification Produced
GAVEN, LLC
260 NW 109 AVE #218 Miami FL 33172
Date: June 1st, 2018
State of Florida
Miami Dade County
Before me this day personally appeared Ca toS &cvrC.1\
deposes and says:
That he or she will be the only person working on the project located at:
1084 NE 97th St. Miami Shores FL 33138
who, being duly sworn,
Contractor Signature
Sworn to (or affirmed) and subscribed before me this S day of LW, , . 20 I?,
by COdt() S &arm1 bk,
Personally know
_ DL Sto2S-► s-
Print, Type or Stamp Name of Notary
•
r44i. COMMISSON#macho 883
F.
.� .... Q; EXPIRES: JUL 15, 2018
•' BONDEDTHARRU
,,O�1st FLORIDANOTY, LLC
Detail by Entity Name
Page 1 of 2
Ici'isi_!)t�g;3rl!tieni Qf_51ele
Department of State / Division erf Corporations / Search Records / Search by Entity Name /
D!vIaioN OF CORPORATKN$
Detail by Entity Name
Florida Limited Liability Company
1084 MIAMI SHORES, LLC
Filing Information
Document Number L15000176983
FEI/EIN Number 47-5357821
Date Filed 10/19/2015
Effective Date 10/16/2015
State FL
Status ACTIVE
Last Event REINSTATEMENT
Event Date Filed 03/12/2018
Principal Address
1265 SABAL TRL
WESTON, FL 33327
Changed: 12/11/2015
Mailing Address
1265 SABAL TRL
WESTON, FL 33327
Changed: 12/11/2015
Registered Agent Name & Address
CILIBERTO, JOSE R
19355 TURNBERRY WAY
11J
AVENTURA, FL 33180
Name Changed: 03/12/2018
Authorized Person(s) Detail
Name & Address
Title MGR
CILIBERTO, JOSE RICARDO
1265 SABAL TRL
WESTON, FL 33327
Title MGR
http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 7/ 12/2018
Detail by Entity Name Page 2 of 2
HRLIC, PHILIP
UNIT 62804
MIAMI, FL 33129
Annual Reports
Report Year Filed Date
2016 03/12/2018
2017 03/12/2018
2018 03/12/2018
Document Images
03/12/2018 -- REINSTATEMENT
12111/2015 -- LC Amendment
10/19/2015 -- Florida Limited liability
View image in PDF format
View image in PDF format
View image in PDF format
-.-r:.3 [:era: :mom
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