DS-16-2670Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit NO. DS►-9-16-2670
' ermi
Permit Type: Driveways/Sidewalks/Slabs
Work Classification: AdditionlAiteration
P
Permit Status: APPROVED
Issue Date: 2/23/2017
Expiration: 08/22/2017
Parcel Number
Applicant
1263 NE 92 Street
Miami Shores, FL 33138-
1132050270270
Block: Lot:
MARTA J PACHECO BOBONIS
Owner Information
Address
Phone
Cell
CHRISTOS TZAVARAS
1263 NE 92 Street
MIAMI SHORES FL 33138-
(787)233-3606
1263 NE 92 Street
MIAMI SHORES FL 33138-
Contractor(s)
Phone
CeII Phone
ORINOCO BUILDING LLC
(786)531-9479
Valuation:
Total Sq Feet:
$ 19,654.14
2140
Approved: In Review
Comments:
Date Approved: : In Review
Date Denied:
Type of Work: REPLACE DRIVEWAY AND POOL PATIO.
Bond Return :
Scanning: 3
Additional Info:
Classification: Residential
Fees Due
Bond Type - Owners Bond
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$500.00
$12.00
$3.00
$3.00
$4.00
$200.00
$9.00
$16.00
$747.00
Pay Date Pay Type
Invoice # DS-9-16-61511
02/23/2017 Check #: 226
02/23/2017 Check #: 228
Bond #: 3318
Amt Paid Amt Due
$ 500.00 $ 247.00
$ 247.00 $ 0.00
Available Inspections:
Inspection Type:
Final
Foundation
Review Planning
Review Building
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 certify4hat all th
construction and ning:7 herm
horize
rmation is accurate and that all work will be done in compliance with all applicable laws regulating
above -named contractor to do the work stated.
February 23, 2017
Authofized Signatur• Owner / Applicant / Contractor / Agent
Date
Building Department Copy
February 23, 2017 1
BUILDING
PERMIT APPLICATION
•BUILDING ❑ ELECTRIC
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
'c"w'(-FTVED
S P 2 9 2016
FBC 201 y tta
Master Permit No. ( (0, 2 C0.°
Sub Permit No.
❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 1263 NE 92nd Street
City: Miami Shores
County:
Miami Dade Zip:
Folio/Parcel#: 11-3205-027-0270
Occupancy Type: Load:
Is the Building Historically Designated: Yes
Construction Type: Flood Zone:
OWNER: Name (Fee Simple Titleholder): Marta Pacheco
Address: 1263 NE 92ns Street
BFE:
NO X
FFE:
Phone#: (787) 233-3606
City: Miami Shores State: FL
Tenant/Lessee Name: NA
Email:
Phone#:
Zip: 33138
CONTRACTOR: Company Name: Orinoco Building LLC
Address: 9620 NE 2nd Ave, Suite 207
Phone#: (786)531-9479
City: Miami Shores
Qualifier Name: Eloy Paredes
State: FL
Zip: 33138
Phone#: (305)333-3169
State Certification or Registration #: CGC 152 3919 Certificate of Competency #:
DESIGNER: Architect/Engineer: NA Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 19,654.14 Square/Linear Footage of Work: 2,140.00
Type of Work: ❑ Addition ❑ Alteration ❑ New .❑ Repair/Replace ❑ Demolition
Description of Work: Replace driveway and pool patio
Specify color of color thru tile:
Submittal Fee $ Permit Fee $
Scanning Fee $ Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
CCF $ CO/CC $
DBPR $ Notary $
0
Double Fee $
Bond $
(Revised02/24/2014)
TOTAL FEE NOW DUE $ 2. 1 .
Ob
00
Bonding Company's Name (if applicable) NA
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature 1 Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this
12 I day of S 2) evYl 1002.i2 , 20 1 , by Z. 1 day of SC0 VIA be , 20 l (o by
ftl,t2Ac 7 Pc chec.c1. , who is personally known to
The foregoing instrument was acknowledged before me this
c 10k-1 N,I-}Oru o 'Qat\p who is personally known to
me or who has produced as me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: OSM0,111A Z >710CLte�
Seal:
Notary Public State of Florida
Osmara Zamora
•.t . o` My Commission FF 905588
********* 40 at**Ocp N. c ******** ******s***************
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: OS
1'
I1ck m 0n_9\
-Seal: -
APPROVED BY
Plans Examiner
Structural Review
et" h% Notary Public State of Florida
. Osmara Zamora.
*; `* 4* lsigawiiMignkFi*$ $dt***
or fro Expires 09/11/2019
**********
Zoning
Clerk
(Revised02/24/2014)
Orinoco Building LLC
CGC # 152 3919
State of Florida
County of Miami -Dade
Before me this day personally appeared Eloy Paredes who, being duly sworn,
deposes and says:
That he will be the only person working on the project located at 1263 NE 92nd St,
Miami Shores, FL 33138.
Sworn to or affirmed) and subscribed before me this 29 day of -tQ-,
2016,by (Lot-
-PA -t€S .
Personally know
OR Produced Identification
Type of Identification Produced 'FL.TDO.VE2—
Notary Public State of Florida
Sindia Alvarez
'r My Commission FF 156750
Expires 09/0312018
Print, Type or Stamp of Notary
9620 NE 2nd Ave, Suite 207, Miami Shores, FL 33138 p (305) 333 31 69
•
Miami Shores Viiiage
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 insu ance coverage from the contractor's company for day labor, part-time employees or subcontractors.
BY SIGNI G BELOW ftOU CKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS
CONTENT
Signature:
Ordner
State of Florida
County of Miami -Dade
The foregoing was acknowledge before me this day of SerCrh 3e.r1 , 20 1 $o .
By 1, iL rcL 5. Poi _ReQ b
Notary: 05YYla
SEAL:
who is personally known to me or has produced
as identification.
o,P" °Ve^- Notary Public State of Florida
Osmara Zamora
'.• v. . :. A` N y commission FF 905588
'of r,o`' Expires 09/11/2019
Mission:
To protect, promote & irrp rowthe health
of all people In Ronda through Integrated
state, ootrty&con-randy efforts.
Vision: To be the Healthiest State In the Nation
Rick Scott
Golemor
Cohost* Philip, MD, MPH
Sate Surgeon General and Seaetary
December 13, 2016
Jose Castro
15362 SW 36 Terrace
Miami, FL 33185
RE: Modification to a Single Family Residence - No Bedroom Addition
Application Document Number: AP1266834
Centrax Permit Number: 13-SC-1725865
1263 NE 92 Street
Miami, FL 33138
Lot: 16 Block: 2 Subdivision:
Dear Applicant,
This will acknowledge receipt of a floor plan and site plan on 12/12/2016 for the use of the existing
onsite sewage treatment and disposal system located on the above referenced property. No Objection
issue by B.Olmino for pavers in the back and front of the property,no impact on septic tank and drain
field.
This office has reviewed and verified the floor plan and site plan you submitted, for the proposed
remodeling addition or modification to your single-family home. Based on the information you provided,
the Health Department concludes that the proposed remodeling addition or modification is not adding a
bedroom and that it does not appear to cover any part of the existing system or encroach on the
required setback or unobstructed area. No existing system inspection or evaluation and assessment,
or modification, replacement, or upgrade authorization is required.
Because an inspection or evaluation of the existing septic system was not conducted, the Department
cannot attest to the existing system's current condition, size, or adequacy to serve the proposed use.
You may request a voluntary inspection and assessment of your system from a licensed septic tank
contractor or plumber, or a person certified under section 381.0101, Florida Statutes.
If you have any questions, please call our office at (305) 623-3500.
Sincerely,
Betsy Olmino
�•• ••: � pginrecli•••
•• • • • QeQaltant gf Health in Dade County
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•• ••• •• • • • ••
• ••• • ••• •• •• •••
•• • • • • • •
fledia Da► s .af •f Nadia
in Dade County• • , Florida
PHONE: (305) 623-3500
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TWITTER:HealthyFLA
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