PL-19-48Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Issue Date: 01/09/2019
NO:: PL-01-19-48
Perm tt Type. Plumbing - Residential
Work Classification: Drainfield
PermitStattrs:A,pproved
Expiration: 07/08/2019
Parcel Number
1316 NE 105 ST, Miami Shores , FL 33138
1122320270150
Contacts
FLUS LLC
C/O GFB TAX SERVICE LLC
5210 SW TER, SOUTH WEST RANCHES, FL 33332
Other: 3056092522
Owner
JASON'S SEPTIC INC
JASON NESENMAN
13341 SW 88 AVE, MIAMI, FL 33176
Business: 3052521080
Contractor
FLUS LLC
C/O GFB TAX SERVICE LLC
5210 SW TER, SOUTH WEST RANCHES, FL 33332
Other: 3056092522
Applicant
Description: FIX DISCONNECTION BETWEEN EXISTING TANK TO
EXISTING DRAINFIELD TO REPLACE PERMIT#PL15-3184
1/12/2016 - RETURN CHECK FOR $885.10
TOTAL DUE NOW $ 885.10+ $44.26= $929.36.
Permit fees must be paid by 4:OOPM on January 13, 2016. If
not paid by date stipulated above we will charge double
permit fee for work without permits.
Fees
Amount
Application Fee - Other
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Returned Check Fee ($30)($51-$300)
Scanning Fee
Technology Fee •
Work Without Permit 1st Offense
Work Without Permit 1st Offense
Total:
$50.00
$0.60
$4.50
$3.00
$0.20
$250.00
$44.26
$3.00
$0.80
$300.00
$100.00
$756.36
Valuation: $ 950.00
Total Sq Feet: 36.00
Inspection Requests:
305-762-4949
Payments
Total Fees
Credit Card
Amount Due:
Date Paid
01/09/2019
Amt Paid
$756.36
$756.36
$0.00
Building Department Copy
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 's accurate and that all work will be done in compliance with all applicable laws
regulating construction and zoning. Futhermore, I authorize th- above na -d . ontractor to do the work stat
Authorized Signature: Owner / Applicant / Contractor
gent Date
January 09, 2019
Page 2 of 2
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
RECEIVED
JN 0 9. 2019
BY:
FBC 20
BUILDING Master Permit Nom. ✓s
PERMIT APPLICATION Sub Permit No. {?L- (cl - 49
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 131(O 14E. 1054 " S4.
City:
Miami Shores County:
Folio/Parcel#: t t a a3 a as 7 o Is°
Miami Dade
zip: 3.3 38
Is the Building Historically Designated: Yes NO
Occupancy Type: - Load: Construction Type: Flood Zone: BFE: �' L FFE:
OWNER: Name (Fee Simple Titleholder): 1U L__i _C Phone#: IQ5L 21C —6
Address: J/O G-F •"Tccr v IcG L.L . (3 I (p City: rniarii '? EE, State: rZip: 301 Ja�p
N". LOS-,
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name:, i (+S p+t C t )C Phone#: 3•.) r ) b 80
Address:l' (33k--1.' Ju3 (u Q_
City: LA% (At....A t
Qualifier Name: /\J'S€1) Jr Y I'l Phone#: Ala S ) OirC
State Certification or Registration #: S o03.( (_4(_{ LI Certificate of Competency#:
DESIGNER: Architect/Engineer: Phone#: —
Address: — City: ▪ State: Zip: —
Square/Linear Footage of Work:
State:
Value of Work for this Permit: $ /ZO0
00
Type of Work: ❑ Addition ❑ Alteration
❑ New
Description of Work x `_5: `,► aaFe i�',.��+'�1�'�•l�;ic ���� � :mow . pi)
Zip: 33 1-740
❑ Repair/Replace ® Demolition
1;d
Specify color` of.'colorthfru;tile:
Submittal Fee Permit —Fie--$ CCF $
K'y •
Scanning Fee $ Radon Fee $ DBPR $
Technology Fee $ Training/Education Fee $
Structural Reviews $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $
(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. . . I ,' ,
"WARNING'TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR`PROPERTYa IF YOU INTEND
TO OBTAIN FINANCING, CONSULT. WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING
YOUR NOTICE OF COMMENCEMENT."
, 1
Notice to Applicant: As a condition to the issuance of al evading pelmitwith' an estimated value exceeding $250t7, 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 tiie recorded notice of commencement mustb'e" 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 a approved and a reinspection fee will be charged.
Signature
OWNER or AGENT
The foregoing instrument as ack owledged before me
C1 r
J day of cS 11 / , 201
`?w' ar iS M i'
, who is personally known
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
**********
1Y ��' •. GEORGE A. DEKKI ,
•?� ': Notary Public • State of Florida
7��Q. Commission # GG 227444
'0F SPY �Mv Comm. Expires Jun 11 2022)
**"¢.00n'aeeatnrou '"Itationai r o'ta`ryAssst.
by
0
Signatur
day of L'J f— • ' " ; 20
Trot\ itCSe WOCAnl, who is personally known to
CONTRACTOR
regoing instrument was acknowledged befdreme this
i • ,
by
as me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
•
Sign:w^`
Print:
Seal:
di"."‘, CATHERINE ELIZABETH NYLUNO
MY COMMISSION # GG023712
EXPIRES August 23, 2020
****************************************************
***********
APPROVED BY Plans Examiner _ Zoning
(Revised02/24/2014)
Structural Review
Clerk
2019 details - Business Tax Account JASONS SEPTIC INC - TaxSys - Miami -Dade Cou... Page 1 of 2
2018 Annual Tax Bills are scheduled to be mailed on October 31, 2018 and will be payable on November 1, 2018.
2018 3rd Quarter Tax Bills will be payable on December 1, 2018.
If paying delinquent real estate taxes (2017 and prior) by mail, acceptable forms of payment are: Cashier's Check,
Certified Funds or Money Order.
If paying delinquent real estate taxes (2017 and prior) in person, acceptable forms of payment are: Cashier's Check,
Certified Funds, Money Order, or Cash.
The information contained herein does not constitute a title search or property ownership. Amount due May be
subject to change without notice.
If you have a deed certified on your account, click the following link for sale
information httus://miamidade.realtdm.com/public/cases/list
2019 Details — Business Tax Account JASONS SEPTIC INC
prin„hre MO
Business Tax Account #5175567
Account details CB Account history
2019
2018
2017
2016
Paid
Account number:
Business start date: 10/01/2003
Physical business location: UNIN DADE COUNTY
Paid
5175567
Business address: JASONS SEPTIC INC
13341 SW 88TH AVE
MIAMI, FL 33176
Receipts And Occupations
Paid Paid
2010
Paid
Mailing address: JASONS SEPTIC INC
JASON NESENMAN PRES
13341 SW 88 AVE
MIAMI, FL 33176
Owner(s)
JASONS SEPTIC INC
13341 SW 88 AVE
MIAMI, FL 33176
Flags '' Home Business
Receipt 5409677
Contracting 10/01/2018-09/30/2019 NAICS code: 238220
SPECIALTY PLUMBING CONTRACTOR Units: 3
Documentation Required by Occupation: State/County License or Certificate
Document Received: SEP031444
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https://miamidade.county-taxes.com/public/business tax/accounts/5175567 1/9/2019
JAsot's SEPTIC INC.
'WE [ OVF YOUR STINXIN BUSINESS'
13341 SW 88 Ave, Miami, Florida 33176
November 13, 2018
State of Florida
County of Miami Dade
Before me this day personally appeared Brittnie Nesenman who, being duly sworn deposes and says:
That she will } the only person orkin
Florida 331
ctor Signature
on the project located at : 1316 N.E. 105 St. Miami Shores,
worn to (or affirmed) and subscribed re me this 13 day of November 2018
By CC.L
Sincerely,
Brittnie Nesenman
Owner
Telephone: (305)-252-1080
Jason's Septic, Inc.
SR00031444
Personally know
Or produced identification
Type of Identification Produced
Col 1-h h Q \\C I u.- bt of
Print, Type or Stamp Name of Notary
•';Ar.y CATHERINE ELIZABETH NYLUND
. MY COMMISSION # QG023712
",� ; ' EXPIRES August 23, 2020
"We Love Your Stinkin Business"
www.jasonseptics.com
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 O? day of ,,,JGt,h vAk t/ , 20 / .
who is personally known to me or has produced
By � 1 eh l A Ai j. Ya'i II 12 ,' S'
(r. L . D , L) -i-/-5-c1-16-9y-Videntification.
Notary:
SEAL:
GEORGE A. DEKKI
Notary Public State of Florida
" $ Commission # GG 227444
• My Comm. Expires Jun 11, 2022
Bonded through National Notary Assn.