PW-19-1592Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue :De: 107/12/2019
Location Address Parcel Number
1000 NE 91ST TER, Miami Shores, FL 33138 1132050010290
Contacts
Permit NO.: PW -07-19-1692
Permit Type: Public Works
Work Clossification: Public Works
Permit Status, Approved
Expiration: 01/08/2020
Description: REMOVE AND REPAIR SIDEWALK Valuation: $ 2,400.00 Inspection Requests:
130�4�2-4949
Total Sq Feet: 75.00
Fees
CHRISTOPHER KING Owner
1000 NE 91 TER
ONE STOP PAVING Contractor
CARLOS M ACOSTA
1463 NE 173 ST, N MIAMI BEACH, FL 33162
Business: 7862991354 carlosmarcia@yahoo.com
$0.60
Public Works Permit Fee
$100.00
Description: REMOVE AND REPAIR SIDEWALK Valuation: $ 2,400.00 Inspection Requests:
130�4�2-4949
Total Sq Feet: 75.00
Fees
Amount
Education Surcharge
$0.60
Public Works Permit Fee
$100.00
Scanning Fee
$9.00
Technology Fee
$2.50
Total:
$112.10
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$112.10
Check # 2560
07/12/2019 $112.10
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. Futhermore, I authorize the above named contractfr to do the w#rk stated.
niLt.U-0—
Authorized Signature: Owner / Applicant / Contractor / Agent
Date
July 12, 2019 Page 2 of 2
A
1
JUL 1 1 20'19
Miami shores Village '�/ItI
Public Works Department BY: [
Public works forms are available from the building departments 0050 NE 2 d Ave., Miami Shores, FL 33338
PUBLIC WORKS PERMIT APPLICATION
Permit Type: Work in the Right -of -Way on Miami Shores Village Qr Miami -Dade Property
j Permit#.- 7-1
�hT;s �-6 Phi r
Name of Applicant (if utilitysee below): '
��
�CLU
LJr
Owner off the following d scribed property -
Legal Description: Lot j 5151:7r7 -Block Z Su
Folio#; II 3aos bo pada s bdivision IiV 0r54[�
Address: /J `'t l e v:- 4icxry1' pQreS F(_ 33138
UTILITY NAME: —
Qualifier/Authorized Agent:
Address:
City:
Telephone: State: ZIP:
Email:
State Certification or Registration #:
Certificate of Competency #
CONTRACTOR NAME: � �'�" V L 0
Qualifier/Authorized Agent: n�
Address:—L4&3 IU E I ?j 5
City: P . .
Telephone: (p �}'ei U� —Y S ate: --P
_ ZIP: 3 3 C-1;21
State Certification or Registration #: Email. QYA; �SYv! c i^ a • C41 ✓ 1
Certificate of mpetency #:
Requests permission to install (describe
way: c�V'e— � r�
j ype of Work: ❑ paving ❑ Utility/
attach se rate page if necessary) in the adjoining right of
❑ Landscape ❑ Antenna
DESIGNER: Architect/Engineer:
Address:
City:
Telephone: State:
Email:
Registration #:
UT"Sidewalk ❑ Electric ❑ lrrigation
❑ Other:
Zip:
Value of Work for this Permit: �{pp,
Square/Lineal Footage of Work:
Fees x
rm It t ee $ 100.00
Notary
$ _ _Training/Education $ 0.20 Technology Fee $ 0-80 Scannin$
Elond < (if required)
Total t=ee Now Due $ g_ !—
Fol
Bonding Company's Flame (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 a
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 const- ion and specifically construction in the
right-of-way.
"WARNING TO APPLICANT. YOUR FAILURE TO RECORD A NO— ICE OF COivti>f ENCEK/IEAIT MAY RESULT IN
YOUR PAYING TWICE FOR IMPROVEMENTS TO THE RIGHT-OF_t,✓,IAY. IF YOU INTEND TO O$TA111
FINANCING, CONSULT WITH YOUR LENDER OR AAI A T TOURNEY BEFORE RECORDING YOUR NOTICE OF
CON1V?ENCEIVIENT"
Notice to Applicant: As a condition to the issuance of a public worics perrnit with an estimated value
exceeding $2,500; the applicant must promise in good faith that a cop,, Of ;tie notice of Commencement
and corstruction lien law brochure will be delivered to the person whose property is subject to the
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 afterthe public iivorks permit is issued. lit the
absence of such posted notice, the inspection will not be approved and a reinspection will be charged.
Signature
Ap cant or Aut' ized fi� nt
The foreggo-in7g instrument w.fas clrnowleugeu before
mem this _ '1j3 J 70 205_ by
e j�tt�IL 6m, "mho
is personally known to me or v„ho has produced
identification.
Sign: _
Print:
DEAL:
as
Signature
Company/Utility Agent
i ne romgoing instrument in nr s r,owledged ' r
F atkoefo e
met is
whG
45 persOnakly ICI o4vn tp �Zie ar wh0 i7a5
produced
identification.
Sign:
MY COMMISSION # GG 29614p
EXPIRES: February 3, 2023
Bonded Thru Notary Public Underwriters
as
APPROVED BY:
_AR:: Public Works Director, or Designee
2017 -04 -IS
MY COMMISSION 9 Ga 2>:,". 68
—WIRES: February 3, 20.-23
Bonded Thru NotaryRibiic I la;x• a iters
Miami bores i!!a e
9
Building Department
10050 N.E.2nd .Avera! to
Miami Shores, Florida 33138
Tet: (305) 795.2204
Far.: (305) 756.8972
..v`.v� L%R yVVJJVJ — rvyenGllS %-#umpensallon insurance txemotion
Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.0
allows corporate officers in the construction industry to exempt themselves from this requirement for any consi.ction 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 Iiability company (LLC) in the construction industry may elect to be
exempt if:
1. The officer owns at least I0 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 -tune 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: _
Ory r
State of Florida
County of Miami -Dade
The forevoing was acknowledge before me this _ _1_0 day of J -(J .20 1-1
B3 lJ'N I S 6 6ker K(al who is personally known to me or has produced
—__ as identification.
Notarv:_ BARBARO SOBRINO
„ MY COMMISSION # GG 296168
SEAL: p =' EXPIRES: February 3 2023
Y� '•FOF F�-�� Bpnded Thru Notary Public Underwriters
One
Paving Inc.
TO: PROJECT:
NAME: NAME:
ADDRESS: ADDRESS:
PHONE:
FAX: DATE
;7
c�
il! s
OW CA -11 4o
7b/ DATE:
c4 4
BARBARO SOBRINO
MY COMMISSION 9 GG 296168
Bonded Thru Notary Public Underwriters
EXPIRES: February 3, 2023
OFFICE OF THE PROPERTY APPRAISER.
Summary Report
Property Information
Folio:
Property Address:
Owner
Mailing Address
11-3205-001-0290
1000 NE 91 TER
Miami Shores, FL 33138-3402
CHRISTOPHER DAVID KING
NATASHA KING
1000 NE 91 TER
MIAMI SHORES, FL 33138 USA
PA Primary Zone
1100 SGL FAMILY - 2301-2500 SQ
Primary Land Use
0101 RESIDENTIAL - SINGLE
FAMILY: 1 UNIT
Beds / Baths / Half
3/210
Floors
1
Living Units
1
Actual Area
2,740 Sq.Ft
Living Area
1,800 Sq.Ft
Adjusted Area
2,127 Sq.Ft
Lot Size
10,625 Sq.Ft
Year Built
1959
Assessment Information
Year
2019
2018
2017
Land Value
$402,050
$382,500
$382,500
Building Value
$167,501
$168,831
$157,908
XF Value
$19,047
$19,079
$19,111
Market Value
$588,598
$570,410
$559,519
Assessed Value
$588,598
$570,410
$559,519
Benefits Information
Benefit Type 2019 2018 2017
Note: Not all benefits are applicable to all Taxable Values (i.e. County, School
Board, City, Regional).
Short Legal Description
5 53 42
WATERSEDGE PB 9-141
LOT 1 & W35FT OF LOT 2 BLK 2
LOT SIZE IRREGULAR
OR 18377-4977 1198 1
Generated On : 7/8/2019
Taxable Value Information
2019
2018
2017
County
Exemption Value $0
$0
$0
Taxable Value 1 $588,5981
$570,4101
$559,519
School Board
Exemption Value
$0
$0
$0
Taxable Value
$588,598
$570,410
$559,519
City
Exemption Value
$0
$0
$0
Taxable Value
1 $588,598
$570,410
$559,519
Regional
Exemption Value $0
$0
$0
Taxable Value $588,598
$570,4101
$559,519
Sales Information
Previous
OR Book -
Price
Description
Sale
PageQualification
1
28132
05/29/2012
$455,000
3
Qual by exam of deed
04
18377
11/01/1998
$169,000
Sales which are qualified
4977
Sales which are disqualified as a result
00000-
06/01/1990
$0
00000
of examination of the deed
09710-
06/01/1977
$61,000
Sales which are qualified
1859
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:/fwww.mismidade.govinfo/disclaimer.asp
Version:
S I N. I E OF (FLORIDA)
COUNTY OF (DADE)
Mr% I I
iami Ohores Willage
Building Department
SURVEY AFFIDAVIT
10050 N.E.2nd Avenue
PAiami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
The undersigned Affiant,r i 57 0 )ke_ V_does hereby attest that
(Property owner)
The attached survey, performed by
(Name
For address: t0100 NGT CiI Te r -C P
surveyor`s company)
I ani t '�5 116 re S (3313 &
Performed on (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 survey 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, Aff eth n ght.
Prop OwnerW nature Property Owner Print Name
SWORN TO AND SUBSCRIBED before me this i o day of zi (�_. ao 1 5
Affiant is personally known to me, produced as identification.
BARBARO SOBRINO
4L4
MY COMMISSION # GG 2
EXPIRES: February 3, 2023 tary
Bonded Thru Notary Public Underwriters
Revised on 5122120091 Revised on 6112109 ...I
Paving Inc. Proposal/Contract
CGC 1513719
TO: PROJECT: SIDEWALK RESTORATION
NAME: Mr crrs Kina r—A915 NAME:
ADDRESS: ADDRESS: 1000 NE 91 TERRACE
PHONE: MIAMI SHORES
FAX: DATE 6/5/2019
EMAIL
DESCRIPTION
WE PROPOSE PERFORM ALL MATERIALS, LABOR AND EQUIPMENT NECESSARY FOR THE FOLLOWIG SCOPE OF
WORK:
• REMOVE AND REPAIR 3 CONCRETE SLABS SIDEWALK
• Call 811 to located underground utilities
• Saw cut, remove and moving out existing cracked, uneven, and broken sidewalks.
• Saw cut and remove roots affecting sidewalks.
• Form new sidewalks, compact subgrade.
• Pour new 4" to 6" as necessary 3000 psi strength. 1' Ta C-o"A Pi-6re wc1(Ztic PR' c lZ Tb
• Provide light broom finish to sidewalks surface. -713 It I I "I
• Remove forms.
CWei S "To f." 'rHC- f&AZAt IT" r`c-F 'rrt�v
PERMIT FEES NOT INCLUDED (only process to get permit A PRLAA-J ^ /Abb""ci''w- FFA To r,
ON& STS' 4'AV
PAYMENTS $500.00 AS SIGNED CONTRACT TO PERMIT PROCESS (OWNER PROVIDE
SURVEY)
50% TO START PLUS PERMIT FEES # o`'F s^ncP To 001-1 r -a2 PC-iw �z
50% AS FINAL
The work and performed by the co may result in a hen 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 kable in hull amount of contract in the event owner cancels after work has started. The co shah 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 10
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 vartation results on
the odor select by Owner.
TOTAL PROPOSAL
SUBMITTED BY: Carlos Acosta, President.
$ 2,400.00
Acceptance of contract
The above prices, specifications and conditions are hereby accepted. You are to do the work as
specified payment will be mades outlined above.
XAPPROVED BY: DATE: % lit) Ill
1463 HE 173 ST N. MIAMI BCH FL 33162 PHONE: 786 299 1354 FAX: 305 947 3233
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