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PAINT-19-2191Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Ave, Miami Shores, Florida 33138 Tel: 305-795-2204 Fax: 305-756-8972 Inspection Number: INSP-010216-2019 Permit Number: PAINT -09-19-2191 Scheduled Inspection Date: October 16, 2019 Permit Type: Paint Inspector: Naranjo, Ismael Inspection Type: Building Final Owner: CASA FAWAZ LLC Work Classification: Paint Address: 1335 NE 105TH ST Phone Number: Miami Shores, FL 33138 Parcel Number: 1122320270070 Project: Contractor: Florida Painting Services Phone Number: 954-749-8886 Gerardo Herrera Building Department Comments EXTERIOR PAINTING Checklist Item Passed Comments General Comments False October 16, 2019 For Inspections please call: 305-762-4949 Page 1 of 1 Inspector Comments Passed si Failed Correction Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. October 16, 2019 For Inspections please call: 305-762-4949 Page 1 of 1 Location Address Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Issue Date: Parcel Number 1335 NE 105TH ST, Miami Shores, FL 33138 1122320270070 Contacts Permit No.: PAINT -09-19-219'1 Permit Type: Paint Work Classfffcation. Paint Permit status: Approved Expiration: 03/31/2020 CASA FAWAZ LLC Owner Florida Painting Services Contractor 16748 NW 8 ST, Pembroke Pines, FL 33028 Gerardo Herrera 169 S STATE RD 7, MARGATE, FL 33068 Business: 954-749-8886 pherrera@florida-painting.com Mobile: 9542262756 Inspection Requests: Description: EXTERIOR PAINTING Valuation: $ 2,200.00 3105-7s12 4949 Total Sq Feet: 0.00 Fees Amount CCF $1.80 DBPR Fee $2.00 Education Surcharge $0.60 Permit Fee (Manual) $100.00 Scanning Fee $3.00 Total: $107.40 Building Department Copy Payments Date Paid Amt Paid Total Fees $107.40 Credit Card 10/03/2019 $107.40 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 foregoirii ormation is accurate and that all work will be done in co `pliaice w7ll aapplicable laws regulating construction and zoning. Futhermore, I au ori a the above named contractor to do the work stated. �� / . A, Authorized Signature: Owner October 03, 2019 Page 2 of 2 SW707l GRAY SCREEN HGSW1467 PAINT COLOR APPROVAL AND AGREEMENT All elements on the site must be listed and indicate the color to be painted DIRECTIONS: Please circle corresponding number to appropriate color sample. Walls: 1:�tr� iC%� ( 2 3 4 Fascia: 1 2 A 4 Drip edge: 1 2 3 4 Soffit: 1 2 3 4 Roof: 1 2 3 4 Flower Bins: 1 2 3 4 Shutters: 1 2 3 4 Awnings: 1 2 3 4 Chimney: 1 2 3 4 Doors & Jambs:1 2 3 4 Garage Doors: 1 2 3 4 Railings: 1 2 3 4 Fences: 1 2 3 4 All Brick: 1 2 3 4 Stucco Bands: 1 2 3 4 Other Stucco Feature: 1 2 3 4 Accessory Bldg: 1 2 3 4 OWNER'S AFFIDAVIT: I certify that all the foregoing information is accur applicable laws regulating construction and zoning. Signature: - Signature Owner or Agent The foregoing instrument was acknowledged before me this j/ day of_, 20 1_�, by ( -I{ ,<:_. �._r.{f ..,t L who is personally known to me or who has produced �- {t ✓e¢ - cti s c As identification and who did take an oath. NOTARY PUBLIC: The foregoingiinstrument was acknowledged before me this-Al- day his day of I 20, by ���1�[/�i� IYQ�`('I who is personally known to me or who has produced�� -7i,iliw/L046- as identification and who did take an oath. 1` a►RY PUB LIANA MA TiNE2 Print: L _ (y)r !! T n f+° ''•uv roMMISSION # GG032161 M Commission Expires: N� °� EXPIRES: September 20, 2020 My on p �lFUF F`pP Bonded Thru Budget Notary Services NOTARY PUBLIC: Sign: Print' My Commission Exp' APPROVED BY: Notary Public - State of Florida Commission p GG 285339 My Comm. Expires Dec 18, 2022 Code Official Preservation Board Miami Shores Village I ED g EP 2 0 019 Building Department BY: y� BUILDING Permit No. 1 v � ul—'I —1 �I— I PERMIT APPLICATION FBC 20 10050 N.E.2nd Avenue, Miami Shores, Flori da 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 NE105th ST City: Master Permit No. Permit Type: PAINT OWNER: Name (Fee Simple Titleholder): Casa Fawaz LLC Phone#:305 610 6064 Address- 1335 Miami Shores State: FL zip: 33138 Tenant/Lessee Name: Email JOB ADDRESS: 1335 NE 105th st City: Miami Shores County Folio/Parcel#: 11-2232-027-0070 Is the Building Historically Designated: Yes 33138 Permit Fee $ 100 CCF $ 1 •8 0 Notary $� Training/Education Fee $ Technology Fee $ Double Fee $ ��� TOTAL FEE NOW DUE $ 0b 4-(-/0 NO X Flood Zone: CONTRACTOR: Company Name: Florida Painting Services Phone#: 954-749-8886 Address: 169 S STRD 7 City: Margate State: FL Qualifier Name: Gerardo Herrera Phone#: State Cert ification or Registration #: Contact Phone#: 954-226-2756 Value of Work for this Permit: $ Z7_00 33068 954-865-3030 Certifi cate of Competency #: CCO210343PU Email Address: pherrera@florida-painting.com Miami Dade Zip: Square/Linear Footage of Work: 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS an Description of Work: Exterior Painting d AIR CONDITIONERS, ETC..... "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 att achment. 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 an inspection fee will be charged. Property Search Application - Miami -Dade County Page 1 of 1 .'OPERTY APPRAISER @,...,,OFFICE yR Summary Report Property Information Folio: 11-2232-027-0070 Property Address: 1335 NE 105 ST Miami Shores, FL 33138-2135 Owner CASA FAWAZ LLC Mailing Address 16748 NW 8 ST PEMBROKE PINES, FL 33028 USA PA Primary Zone 3000 MULTI -FAMILY - GENERAL Primary Land Use 0803 MULTIFAMILY 2-9 UNITS: MULTIFAMILY 3 OR MORE UNITS Beds / Baths / Half 6/6/0 Floors 2 Living Units 4 Actual Area Sq.Ft Living Area Sq.Ft Adjusted Area 4,002 Sq.Ft Lot Size 8,000 Sq.Ft Year Built 1959 Assessment Information Year 2019 2018 2017 Land Value $160,000 $128,000 $124,000 Building Value $310,322 $342,322 $295,475 XF Value $0 $0 $0 Market Value $470,322 $470,322 $419,475 Assessed Value $470,3221 $320,6691 $295,158 Benefits Information Previous 2019= 2018 Benefit Type 2019 2018 2017 Save Our Homes Cap Assessment Reduction $65,832 $54,184 Non -Homestead Cap Assessment Reduction $83,821 $70,133 Homestead Exemption $25,000 $25,000 Second Homestead 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 32 52 42 ANCO SUB PB 53-54 E60FT LOT 6-A 7 W20FT OF LOT 7-A LOT SIZE 8000 SQ FT Generated On : 9/19/2019 Taxable Value Information Previous 2019= 2018 2017 ___............_..... . .................................... _ County Exemption Value $0 $50,000 $50,000 Taxable Value $470,3221 $270,6691 $245,158 School Board Exemption Value $0 $25,000 $25,000 Taxable Value $470,322 $379,490 $340,291 City Exemption Value $0 $50,000 $50,000 Taxable Value 1 $470,322 $270,6691 $245,158 Regional Exemption Value $0 $50,000 $50,000 Taxable Valu 1 $470,322 $270,669 $245,158 Sales Information Previous OR Book- PricePa Qualification Description Sale 9e 06/30/2018 $690,000 31113-0239 Qual by exam of deed Deeds that include more than one 01/01/2005 $515,000 23006-4179 parcel Deeds that include more than one 09/01/2000 $255,000 19345-4954 parcel Deeds that include more than one 12/01/1983 $150,000 12003-3014 parcel 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 hfp:/twww.miamidade.gov/info/disclaimer.asp Version: https://www8.miarnidade.gov/Apps/PA/propertysearch/ 9/19/2019 2019 FLORIDA LIMITED LIABILITY COMPANY ANNUAL REPORT DOCUNIENT# L18000142887 Entity Name: CASA FAWAZ, LLC Current Principal Place of Business: 16748 NW 8TH STREET PEMBROKE PINES, FL 33028 Current Mailing Address: 16748 NW 8TH STREET PEMBROKE PINES, FL 33028 FEI Number: NOT APPLICABLE Name and Address of Current Registered Agent: FAWAZ, JOSEPH 16748 NW 8TH STREET PEMBROKE PINES, FL 33028 US FILED Apr 09, 2019 Secretary of State 8512726062CC Certificate of Status Desired: Yes The above named entity submits this statement for the purpose of changing its registered office or registered agent, or both, in the State of Florida. SIGNATURE: Electronic Signature of Registered Agent Date Authorized Person(s) Detail Title MGRM Name FAWAZ, JOSEPH Address 16748 NW 8TH STREET City -State -Zip: PEMBROKE PINES FL 33028 Title MGRM Name FAWAZ, GEORGES Address 16748 NW 8TH STREET City -State -Zip: PEMBROKE PINES FL 33028 Title MGRM Name FAWAZ, GABRIEL Address 16748 NW 8TH STREET City -State -Zip: PEMBROKE PINES FL 33028 I hereby certify that the information indicated on this report or supplemental report is true and accurate and that my electronic signature shall have the same legal effect as if made under oath; that 1 am a managing member or manager of the limited liability company or the receiver or trustee empowered to execute this report as required by Chapter 605, Florida Statutes; and that my name appears above, or on an attachment with all other like empowered. SIGNATURE: JOSEPH FAWAZ MGRM 04/09/2019 Electronic Signature of Signing Authorized Person(s) Detail Date 9/16/19 State of Florida County of Broward Before me this day personally appeared Gerardo Herrera who, being duly sworn, being duly sworn deposes and says: That he will be the only person working on the project located at: 1335 NE 105TH ST MIAMI cunorc ri 30100 Sworn.Jo (or affirmed) and subscribed before me this daylkoof SWteMbt,60 %'l By 4__SS (C b 1 - ca Iden L,rcA Personally know OR Produced Identification Type of Identification Print, Type or Stamp Name rortary v'i s.• .= S;ICA ROBLES•GOLDEN `?4 Nc sr . Public State of Florida v `¢; Car mission # GG 285339 My Carom. Expires Dec 18, 2022 Bonded thr ;,.h National Notary Assn. Print, Type or Stamp Name rortary Notice to Owner — Workers' Com Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 nsation Insurance Exemation 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 CONTF.NTfi Signature: Owner State of Florida County of Miami -Dade The foregoing was acknowledge before me this , day of �dC�� , 20 vl By fvV C1 2 who is personally known to me or has produced as identification. rr Notary:S*jv a� •., JESSICA ROBLES•GO Notary Public - State of Florica SEAL: _� Commission # GG 285339 ''? My Comm. Expires Dec 18, 2022 Bonded through National Notary Assn.