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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 Retum to Search ® 1997-2019, Grant Street Group. All rights reserved. wl Print this bill Help - Contact us - Terms of service - Tax Collector home 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.