PW-18-3734Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Issue Date:12/27/2018
Parcel Number
241 NW 91ST ST, Miami Shores, FL 33150 1131010331340
Contacts
Permit NO.: PW-12-18-3734
Permit Type: Public Works
Work Classification: Public Works
Permit Status: Approved
Expiration: 06/18/2019
Lori Brandt Owner ONE STOP PAVING Contractor
241 NW 91 ST CARLOS M ACOSTA
1463 NE 173 ST, N MIAMI BEACH, FL 33162
Business: 7862991354 carlosmarcia@yahoo.com
Description: REMOVE AND REPLACE TWO 4"`CONCRETE Valuation: $ 1,600.00 Inspection Requests:
SIDEWALK SLABS. 305-762-4949
Total Sq Feet: 50.00
Fees
Amount
Education Surcharge
$0.40
Public Works Permit Fee
$100.00
Scanning Fee
$9.00
Technology Fee
$2.50
Total:
$111.90
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$111.90
Check # 2294
12/27/2018 $111.90
Amount Due:
$0.00
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 AF IDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating c truction a zoning. Futhermore, I authorize the above nam d contractor to do the work stated.
GUI & vt� CS f i n a
Authorized ignature: O er / Applicant / Contractor / Agent Dat
December 27, 2018 Page 2 of 2
DEC 2 0 2 1
C:1 Miami Shores Village
Public Works Department
Public works forms are available from the building department,1005Ci NE 2nd Ave., Miami Sh
ores, FL 33138
PUBLIC Permit Type: Work in the Right -of -Way j l on Miami Shores village or Miami -Dade Property
Permit#:2�� �-31 4
Name of Applicant (if utility see below): h c� t� gy -------------
Owner Off the follovA,ing desc 'bed property:
Legal Description: Lot 19 %�,��pgloci< / 3b
Folio /! 3 J e! G Subdivision-C,�,y„
Address. 30
-75
UTIUTY NAME:
Qualifier/Authorized Agent:
Address:
City: -
Telephone: State ZIP:
Email:
State Certification Or Regis*ratiion #:
Certificate of Competency
CONTRACTOR NAME: Ono 5-'D4 P,
Qualifier/Authorized Agent:
Address: 1 `-6" 3 !73
City: _
Telephone:�B� 299 /35 _Email: S to ZIP:
State Certification or Registration #:�c5c !S`/� 7!�/fr� , "'G � �
Certificate of Competency #:
Requests permission to install (describe vvork, attach separate page if necess
waY:ern ov.� f3 �, �:c� -� ryj in t e ad}Dining righto?
Type of Work: it Paving Q utility
(E] Landscape[] Antenna
Sidewalk 0- Electric 17 "irrigation
E] Other:
DESIGNER. Architect/Engineer:
Address:
City; State:
Telephone: ZIP:
Registration: Email:
Value Of Work for this Permit: S /, (pod
l!!I Square/Lineal Footage of Work: SD s
Perrlit Fee 100.00 r = Fees '1 +
Notary $ Training/Education 5 0.2o
Bond
. _______ (if required)
Technology Fee $ 0.80 Scanning
T otal Fee Now Due $
Bonding Company's mama (if applicable):
Bonding Company's Address:
City: State:
ZIP:
Application is hereby made to obtain a public works permit to do the work in the right of way and
installations as indicated. I certify that no work or installation has commenced prior to the issuance of -
permit and that all work will be performed to meet the standards of all laws, regulation construction in
this jurisdiction. I understand that separate permits must be secured for
APPLICANT'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be
done in compliance with applicable laws regulating construction and specifically construction in the
right-of-way.
"WARNING TO APPLICANT: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN
YOUR PAYING TWICE FOR IMPROVEMENTS TO THE RIGHT OF -WAY. 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 public works permit with an estimated value
exceeding $2,500, the applicant must promise in good faith that a co
PY of the notice and construction lien law brochure will be delivered to the person whose Property is subject to thement
attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job
site for the first inspection which occurs seven (7) days after the public works permit is issued, in the
absence of such posted notice, the inspection will not be approved and a reinspection will be charged.
Signature '
i can or Authorized Agent
The foregoing instrument was acknowledged before
me this o day of 201$
--by
14or1 rah w
is persona�l;nown to me or who has produced
ho
identification.
Sign:
Print: arCc.
SEAL:
APPROVED BY:
2017-04-x5
as
Signature
Company/Utility Agent
The foregoing instrument was acknowledged before
me wis day of
by
�� who
is personally known to me or who has produced
identification. as
Sign: I
Print: Y ) YLI�
SEAL:
BARBAN SOBRINO ail , OMWO SOBRINO
ryIY COMMISSION FF 19563� MY COMMISSION If FF 19M
EXPIRES: February 3, 2019 EXPIRES: February 3. 201t Bonded fhru Noary puy undN„�,,, Banded ihm Nowy Pubk n
b Public Works Director, or Designee
OFFICE OF THE PROPF.RTY APPRAISFR
Summary Report
Property Information
Folio:
Property Address:
Owner
Mailing Address
PA Primary Zone
Primary Land Use
11-3101-033-1340
241 NW 91 ST
Miami Shores, FL 33150-2258
LORI BRANDT
241 NW 91 ST
MIAMI SHORES, FL 33150 USA
0800 SGL FAMILY - 1701-1900 SQ
0101 RESIDENTIAL -SINGLE
FAMILY: 1 UNIT
Beds / Baths / Half
2/1/0
Floors
1
Living Units
1
Actual Area
1,152 Sq.Ft
Living Area
836 Sq.Ft
Adjusted Area
994 Sq.Ft
Lot Size
9,375 Sq.Ft
Year Built 11940
Assessment Information
Year
2018
2017
2016
Land Value
$206,250
$206,250
$206,250
Building Value
$55,465
$55,465
$69,182
XF Value
$971
$982
$994
Market Value
$262,686
$262,697
$276,426
Assessed Value
$144,9151
$141,935
$276,426
Benefits Information
Benefit
Type
2018
2017
2016
Save Our Homes Assessment
$117 771
Cap Reduction
Portability 'Assessment
$120,762
Reduction
Homestead Exemption
$25,000
$25,000
Second Homestead I Exemption
$25,000
$25,000
Note: Not all benefits are applicable to all Taxable Values (i.e. County,
School Board, City, Regional).
Short Legal Description
MIAMI SHORES SEC 6 PB 10-39
LOT 19 & W1/2 LOT 20 BLK 136
LOT SIZE 75.000 X 125
OR 19312-3529 09 2000 1
Generated On : 12/13/2018
Taxable Value Information
2018
2017
2016
County
Exemption Value
$50,000
$50,000
$0
Taxable Value
1
$94,915
$91,935
$276,426
School Board
Exemption Value
$25,000
$25,000
$0
Taxable Value
1
$119,915
$116,935
$276,426
City
Exemption Value
Taxable Value 1
Regional
Exemption Value 1
Taxable Value
$50,000.
$94,915
$50,000
$94,915
$50,000
$91,935
$50,000
$91,935
$0
$276,426
$0
$276,426
Sales Information
Previous Sale
Price
OR Book -Page
Qualification Description
12/28/2016
$315,300
30364-1570
Qual by exam of deed
05/13/2016
$298,000
30081-0274
Qual by exam of deed
09/01/2000
$100,000
19312-3529
Sales which are qualed
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:
STATE OF (FLORIDA)
COUNTY OF (DADE)
The undersigned Affiant,
Miami Shores Village
Building Department
10050 N.E2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
SURVEY AFFIDAVIT
Lori 51-a C! 1
does hereby attest that
(Property owner)
The attached survey, performed by U r v e I i V'+ >> u C
(Name of surveyor's company)
For address: 2 y , s
Performed on t2 I Z 1 (date of survey) is an accurate representation of the existing conditions and
locations of all structures on the property as of this date.
The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the property
without first providing a surrey less than seven (7) years old old. The Affiant, as property owner, further agrees to
remove or obtain permits for any structures which now may exist on the property which are not permitted or which
may violate zoning or building code regulations. The Affiant further understands that the existence of any such
structures may affect final inspections as applicable to this or other permits.
Further, ffiant say eth naught. / �1
Property Owner Signature Property Owner Print Name
SWORN TO AND SUBSCRIBED before me this c?0 day of DAL aUl Y
Affiant is __personally known to me, produced as identification.
"r'i'N•,, BpRBARO SOSRINO Kota
COwSSION N FF 1950 ry
Revised on 5122120091 Revised on 6J12109 '-i%fi>IAES: Fern.3�' 3• �19
hk�ks, BoY,iOdli;iutnt7+lfubFGtJederwASef6
One
a
Paving Inc.
TO: �-t om ( Sn cye $ 0 ROJECT:
NAME: NAME:
ADDRESS: ADDRESS:
PHONE:
FAX: _ DATE
S 75,le- dLUncl¢
.,e me i�s wo '`,/ 0 �s
h o� hoSt� G Ham✓ S'a c/s;
7YIa7 Gjg W i (l 4�� �l�Q CI ✓► ( ��r �'v n Wl)��t ✓lcf � y ��,2
/n �r/� IDC!/72� GtT 2T( Nl�li L� S l / - G m♦ -SSW-Cs
ivy/
Flo C(I;t_
5 w 0 " k, ou" i U� 5 Zw/,,o 1-e
/fit - Z 2 3
DATE. �I
BUGopN
BARBARiSOBRINO�;,'' {ggR�SOiiNO
_. MY COMMISSION R FF 195634 = F. dMVSSIOPI ! FF 195634
{ ` EXPIRES: February 3, 2019 ° DES: February 3, 2019
• u Bonded ThN Notry Public UndaiwfOBq =a;� ihm Notary Pubic UndxwriM
.
�N`r
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 Iimited 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:
Ovyner
State of Florida
County of Miami -Dade
The foregoing was acknowledge before me this o7'0 day of Dee-- , ,20 l b _
By 6 r, 6 - who is personally known to me or has produced
as identification.
Notary:
SEAL: BARBARDSOBRINO
FAY comMISSION 8 FF IVAN
iF br EXPIP.t 3, 2019
T• . rd7tYY Pubic Uridwwftm,
One
Paving Inc.
CGC 1513719
Proposal/Contract
TO: TS ROOFING SYSTEM PROJECT: SIDEWALK REPAIR
NAME: Melissa Suarez NAME:
ADDRESS: Itltat Nw 2 •'Ut s,- Mio.rei, ADDRESS: 241 NW 91 ST
PHONE:
FAX: DATE 11 /20/2018
EMAIL msuarez@tsroofingSYSTEMS.com
DESCRIPTION
WE PROPOSE PERFORM ALL MATERIALS, LABOR AND EQUIPMENT NECESSARY FOR THE FOLLOWIG SCOPE OF
WORK:
• REMOVE AND REPLACE 2 CONCRETE SLAB, 3000 psi
• SAW CUT ROOTS AS NECESSARY
• PERMIT FEES NOT INCLUDED, ONLY PROCESS.
• NO LANDSCAPE WORK INCLUDED.
• PAYMENTS 50% AS SIGNED CONTRACT 50% AS FINAL.
The work and performed by the cc may result in a lien being placed on the premises described above, in case the owner or contractor default its in any
payment under this contract owner hereby agrees to accept full responsibility for all fences, sidewalks, all underground pipes, wires septic tanks, drain lines,
wells, etc. unless stated above. Owner is liable in full amount of contract in the event owner cancels after work has started. The co shall not be responsible
for damage or delays do to strikes, fires, accidents, or the others cause beyond its control, not for inherent defects in the premises on which work to be done.
In the event of any default of this contract by owner -owner agrees to pay all cost and reasonable attorneys fees incurred by One Stop Paving, Inc. as a result
of said default All materials are guaranteed to be as specified. All work to be completed in a workman like manner according to standard practices. Any
alteration or deviation from above specifications involving extra cost will be executed only upon written orders and will become an extra charge over and
above the estimate. This proposal subject to acceptance within_ days and Is void thereafter at the option of the under signed work shall begin within 1 a
days of this contract being signed by all parties here and return to the co. On stamp concrete work contractor will not be responsible for variation results on
the color select by Owner.
TOTAL PROPOSAL $ 1,600.00
SUBMITTED BY: Carlos Acosta, President.
The above prices, sp
specified payment wi
APPROVED BY:
Acceptance of contract
accepted. You are to do the work as
DATE:
1463 NE 173 ST N. MIA10 BCH FL 33162 PHONE: 786 299 1354 FAX: 305 947 3233
EC I ED
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ccepted BY:
operty Address: Notes: NO NOTES
1 N.W. 91 Street
ami Shores, FLORIDA 33150
a
Surveyor's Legend
PROPERTY LINE
STRU'CTUR[
FND IOU IRON P;PE B.R. BEAiM'G REFERENCE TEL. TELEPHONE FACILITIES
/
CONC. BLOCK WALL
PIN AS NOTED ON PUT _ CENTRAL ANGLE OR DELTA U.P. UTILITY POLE
—v—�— CHAIN -LINK FENCE OR WIRE FENCE
LBj LICENSE j - IUSMESS R RADIUS OR RAO— EU,B. ELECTRIC UTILITY BOK
,. ,. WOOD FENCE
FE4CE
LSO LXENSC j - SURVEYOR RAO. RADIAL TIE SEP, SEPTIC TANK
CALC CALCULATED POINT
o- IRON
._R. NCN RADIAL D.F. CRAINFIELO
SET SET PIN TYP -PICAL A/C uR CONDITIONER
-- CENTER LINE
CONTROL POINT I.R. IRON RICO S/w SICEYVALK • •
fWOOD DECK
CONCRETE NONUVEW. I,P. IRON PIPE DWY • CR.EW • • • • •
•
--•'-•.. -- �
1 B[ACHYARK Na0 NAIL 8 DISK SCR. • SC-RL•N •
_1 CONCRETi
ELEv ELEvAT:ON •• • •• •
PK NAIL PARKER-KAION NA`I. GAR WRAC[
• •
D.T. POINT OF TANGERCY O.N. OR HOLC ENCL• "'! �� • • •
ASPNALT
URE c!t • COMO3ALE
P.C. POINT OF CURVATwEEL N.is
V . •
fit'' r ERICK / T LE
P.R.Y. PERMANENT REFERENCE MONUMENT FIRE NYDRAAT (.F. eri`V16C FLOOR
_. �.
P.C.C. POINT OF COMPOU40 CURVATURE ® Y N —.01E T.0.9• To OF PINK • •
WATER
•
P.R.C. POINT OF REVERSE CURVATURE D • • • • •
C.H.L. OVERHEAD LINES E.O.W. EDGE OF WATER
APPROXIMATE EDGE OF WATER
P-O-B- POINT OF BEGINNING TT TRANSFORMER E.O. • •WE & TAYEMEW • • • e
•
_
P.O.C. PORT OF COMME40EMENT CAN CABLE N RISER C.Y.G� •CO�FRTE VALLEY GUTiAS • • •
COVERED AREA
_ --
P.C.P. PERMANENT CONTROL PO:"' w.M. WATER METER B.S.L11 •8♦IeIV4SETRACK UVf •
TREE
Y FIELD MEASURED P/[ FOUL EQUIPMENT S.T-V SULEY;.E UNE • •
POWER POLE
P PUTTED MEASUREMENT CONC- CONCRETE SLAB CENTERUNE • • • • •
• •
�. �,: CATCH BASIN
D GEED - R/W RIC+T_p`-n'AY
C CALCULATED • • • • e •
Property Address:
General Nobs:
1.) The legal Description used to perform this survey was supplied by others.
241 N.W. 91 Street
This survey does not determine or is not to Imply ownership
Miami Shores, FLORIDA 33150
2.) This survey p only shows above ground Imovements.
underground utilities, footings, or encmadiments are root located on this survey map
&) If More Is a septic tw*, well, or drain netd on lids survey,
Flood Irtforrrtation:
the location of such items Was shown to us by others and the Wormation was not verified.
4.) Examhnatiort of the abstract of title win have to be made to dletemdne recorded Instruments, 9 any, effect this prop
Community Number. 120640
erty.The tangs shown herein were not abstracted for easement or omen recorded enEamtxances rot shown on the pi
Panel Number. 12086C0302L
at
5.) wall ties are dome to the lace of the wall.
Suffix' L
B.) Fence ownership is not determined.
Dab of Firm Index: 09/11/2009
7.) Bearings reieranced to line noted B.R
Flood Zone: X
a) Dimenslons shown are platted and measured unless otherwise shown.
Flood Elevation
Base10.)
9.) No identification found on property corners unless noted-
Not valid urdess sealed with the signing surveyors embossed seat.
Dab of Field Work: 12/12/2016
11.) Boundary survey means a drawing andlar gng"creprowdaUm of the survey work performed in the field, owl
Dab of Completion: 12/122016
(1 be drawn at a shown scale ardhor not to scale
M) Elevations If shown are Dared upon NGVD 1929 unless otherwise noted
13.) This is a BOUNDARY SURVEY urdess otherwise noted.
14.) This survey is exclusive for the use of Be parties to whom R is certirled. The C•rtifidatiOns do not extsrdd to any u
married parties.
11k) This survey steal not be used for constnxtionlperrnil irg purposes without written consent from the land
surveyor who has signed and sealed this si v .
Legal Description:
Lot 19 and the West 112 of Lot 20,
Block 136, Miami Shores Section No. 6, according to the plat thereof, as
recorded in Plat Book 10, Page 39, Public Records of Miami -Dade County, Florida.
Printing Instructions:
Certified To:
While viewing the survey in any PDF Reader, select the File
Lori Brandt
Drop -down and select "Print. Select a
dolor printer, if available;
Kellerman Vanla PL
or at least one with 8.5" x 14" (legal) paper.
Old Republic National Title Insurance Policy Issued Through
Select ALL for Print Range, and the # of copies you would like to
Attorneys' Title Fund Services, LLC.
print out,
its successors and/or assigns as their interest may appear.
Under the "Page Scaling" please make sure you have selected
Please copy below for policy preparation purposes only:
"None".
Do not check the "Auto -rotate and Center' box.
rids po&y roes not insure against roan or damage by reason of" rdhowing
Check the "Choose Paper size by PDF" chedrbox, then dick OK
axoept 1" Arryrights, onsements, intareaM ordains wtridd mayoxlat by reason
d, or reflected by, the ralow ng facts ahown an fine surveyPrepared by_
to print.
EFRAW LOPEZ dated 12/12/2016 bearing Job x 8-23306 :
a. NO NOTES
M.E. Land Surveying, Inc.
-
ME LAND
10665 SW 190th Street, Suite 3110 Miami, FL 33157 E —
ME LAND
Phone: (305) 740-3319-
F v
Fax: (305) 669-3190
LB#: 7989
Survey #.B-23306 Client File*. 2016-06 Page 2 of 2 Not valid without all Inges