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PL-18-3753Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Issue Date:12/27/2018 Location Address Parcel Number Permit NO.: PL-12-18-3753' Permit Type: Plumbing- Residential Work Classification: Alteration Permit Status: Approved Expiration: 06/19/2019 1600 NE 103RD ST, Miami Shores, FL 33138 1132050310120� Contacts NORTON & MARGARET BARCHAN Owner MIAMI PLUMBING & SOLAR HEATING Contractor 1600 NE 103 ST, MIAMI SHORES, FL 331382672 GEORGE KITZMILLER 2170 NW 95 ST, MIAMI, FL 33147 Business: 3058358008 Description: existing gas flue pipe Valuation: $ 100.00 Inspection Requests: 305-762-4949 Total Sq Feet: 0.00 Elm Fees Amount Application Fee - Other $50.00 CCF $0.60 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.20 Permit Fee $50.00 Scanning Fee $9.00 Technology Fee $2.50 Total: $116.30 Building Department Copy Payments Date Paid Amt Paid Total Fees $116.30 Cash 12/27/2018 $116.30 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 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` IF thermor�,�authorize the above named contractor to do the work stated. n �1 Authorized SigKature: Ow4r v / Applicant � Contractor / Agent Date December 27, 2018 Page 2 of 2 �.� Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 J?, Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 Y-BC 20 V 7 BUILDING Master Permit No. PERMIT APPLICATION Sub Permit No.'t' u '�- — ✓—i5� [—]BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL YMBING ❑MECHANICAL ❑PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ElSHOP CONTRACTOR DRAWINGS jj JOB ADDRESS: I \L3 Cc) City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: fConstruction Type: Flood Zone: BFE: FIFE: Q OWNER: Name (Fee Simple Titleholder): Address: , Q City: / /!9 (�r %/% State: Zip: Tenant/Lessee Name: Phone#: Email CONTRACTOR: Company Name://f !a & rry'��/1'! r A�'�d 1%GQ'% ��' r �Iyl Phone#: �P;5 E-3 O — aQs Address: i, G Zap Zf& "G 6�F / r City: /'-,/ �O Qualifier Name:( State Certification or R State: �� Zip: 11 all Phone#: n #: (/r—V acYEEC71 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: Value of Work for this Permit: $ t Square/Linear Footage of Work: Type of Work: El Addition El Alteration El New u Kepair/Replace Description of Work: L ZK 1 f �J�� �Q� S /C./ Specify color of color thru tile: Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ CCF $ DBPR $ State: Zip: ❑ Demolition CO/CC $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ (Revised02/24/2014) Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip 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 on 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 sted notice, the inspection will not be approved and a reinspection fee will be charged. ` 1 Signature Signature OWNER or AGENT CONTR CTOR Th egoing inst �ments acknowledged be a this 17/0 day of by &21"Q7/(/% / GI who is personally known to me or who has produced as identification and CHRISTY GOGA Notary Public - State of Florida Commission N GG 102127 My Comm. Expires May 19, 2021 Bondcd Ihtough Nallonal Notary Assn. Print: The foregoing instrument was acknowledged before me this • n day of , 20 by �t � Zi'Y1-'IL1L ; tAho is n to personal) i�141`f'f�t�� me or who has produced— �21K * b*�ii ���,�• Q�RES identification and who : J . •�� o N.y`� ; o = v' ¢= NOTARY PUBLIC: •� cn . S2 r: Sign: — �� •.;gW _ - • Q /V,10/1/Iti w� Print: Seal: Seal: APPROVED BY%ulans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Property Search Application - Miami -Dade County Page 1 of 2 OFFICE OF THE PROPERTY APPRAISER Summary Report Property Information Folio: 11-3205-031-0120 Property Address: 1600 NE 103 ST Miami Shores, FL 33138-2672 Owner NORTON L BARCHAN &W MARGARET BARCHAN Mailing Address __.._-_....... _.�.._.._—...._.....__._._.._.._�__... PA Primary Zone .......... 1600 NE 103 ST MIAMI SHORES, FL 33138-2672 _ _ ___........... ..___ 1400 SGL FAMILY - 3001-3250 SO Primary Land Use 0101 RESIDENTIAL -SINGLE FAMILY: 1 UNIT Beds / Baths / Half 5/6/2 Floors 2 Living Units 1 Actual Area 8,263 Sq.Ft Living Area 6,540 Sq.Ft Adjusted Area 6,733 Sq.Ft Lot Size 20,534 Sq.Ft Year Built 1959 Assessment Information Year Land Value 2018 $2,486,051 2017i $2,616,853 2016 $2,616,853 . _....... __._................_...........__...__....__.. Building Value _..__ $864,122t _ $873,000 ....._... _ ........_........__. $881,877 XF Value $28,524, $28,666 $28,806 Market Value $3,378,697i $3,518,519 $3,527,536 Assessed Value $2,027,520, $1,985,818 $1,944,974 Benefits Information Benefit __._ _._. Type �_.._......_._ 2018 2017 2016 Save Our Homes Assessment _..._._._..........._....... .....— _.._..._... _ Cap Reduction $1,351,177 $1,532,701 $1,582,562 Homestead ................... _.. Exemption $25,000 $25,000 $25,000 Second Homestead Exemption $25,000 $25,000 $25,000 Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). Short Legal Description 5 53 42 RE -PLAT OF TR C MIAMI SHORES BAY PARK ESTS PB 64-97 LOT 21 LESS BEG WLY COR SELY30FT NELY33.60FT NWLY45.05FT TO POB Generated On 12/21/2018 Taxable Value Information 2018 2017i 2016 County Exemption Value $50,000 $50,000 $50,000 Taxable Value $1,977,520 $1,935,8181 $1,894,974 School Board Exemption Value $25,000 ... __.._._...._.......... _ _—__._........._.. ....... ._. Taxable Value $2,002,520 $25,000 _._._.._._.._.._.._......... ...._..... $1,960,818 $25,000 .._..__._........... _........... _..... _..... _.... $1,919,974 City Exemption Value $50,000 $50,000 $50,000 Taxable Value _.____............._$1,977,520 ^V— $1,935,818 $1,894,974 ............ ... Regional Exemption Value j $50,000 _ _........ Taxable Value $1 977,520 $50,000 $1,935,818 $50,000 ___.. _._ $1,894,974 Sales Information Previous Sale j Price OR Book -Page Qualification Description 05/01/2004 =', $2,500,000 22327-2753 Sales which are qualified 01/01/1995 $800,000 16646-2556 Sales which are qualified 09/01/1987 ( $477,500 13419-2010 Sales which are qualified 08/01/1982 $400,000 11535 0845 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 Countv assumes no liabilitv. see full disclaimer and User Aoreement at htto://www.miamidade.aov/info/disclaimer.aso https://www.miamidade.gov/propertysearch/ 12/21 /2018 /�) i,q 47 /' �- /'� f �? e ( '/ A/, Y'/ "s -C� 1'r41- Ilev t" .�7 Date: / e " Z 7 ! ? Cr, State of County of Before me this day personally appeared )�G 1. , �Vvwho, being duly sworn, deposes and says: U That he or she will be the only p�-F't rson working on the project located at: &Z 02 of L ri Con ractor Sig ature worn to (or fffirrnecl) ano subscribed before me this Persona know OR Produced Identification Type dentificati roduced ..rL . � \A- O Print, Qype or Stamp Tame of Notary y •�;.:�y'%=March ETO t FF 21g431 25. 2019 gip•lic Unden�n Z�th day of 20 `�,, by Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Uwner - vvorKers' Gompensation 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: I . 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: Own State of Florida County of Miami -Dade The foregoing was acknowledge before me this day of eve,*201LI--- By who is personally known to me or has produced as identification. Notary: SEAL: i iQy::►.,: RICHARD JONES :.: MY COMMISSION # GG 126515 EXPIRES: September 3, 2021 Bonded Tin Notary R bkc Lk4w iers