WS-19-1581Location Address
Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
700 NE 101ST ST, Miami Shores, FL 33138
Contacts
Issue state. 09/01/2019
Parcel Number
1132060172220
Permit No.: WS -07-19-1581
Permit Type: Windows/Shutters
Work Clanfication: Shutters
Permit Status: Approved
Expiration: 01/28/2020
OSCAR MIRANDA Owner SHUTTER DEPOT LLC Contractor
700 101 CHRISTY ABAY
Home: 7863299871
Business: 3058223575
Inspection Requests:
Description: SHUTTERS 10 OPENINGS TO REPLACE Valuation: $ 3,100.00 305.762 4949
WS -5-18-1470
Total Sq Feet: 0.00
Fees
Amount
Payments
Date Paid Amt Paid
100% Permit Renewal Fee
$200.00
Total Fees
$300.00
Lost Plans Review Fee
$100.00
Credit Card
08/01/2019 $300.00
Total:
$300.00
Amount Due:
$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.
AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
construction and zoning. Futhermore, I authorize the above named contractor to do the work stated.
Sig
/ Applicant / Contractor / Agent
Date
August 01, 2019 Page 2 of 2
BUILDING
PERMIT APPLICATION
UILDING ❑ ELECTRIC
Miami Shores Village
�L,,-�- vEIS
Building Department JUL 10 2019
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949n
FBC 2011
Master Permit No. VV S—o l 1 S�
Sub Permit No.
❑ ROOFING F-1 REVISION ❑EXTENSIONRENEWAL
F-1 PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
}�-- CONTRACTOR DRAWINGS
JOB ADDRESS: 70O A)C 10 / St
City: Miami Shores County Miami Dade
Folio/Parcel#:I 13-zo oc 17zzl-o Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simp'- Titleholder): Scor o-) I rU n 4G( Phone#:
Address: N % 1) 1 0 S F
City: rn) m / '1410 /cy State: f7 Zip:
Tenant/Lessee Name:
Email:
one#:
CONTRACTOR: Company Name: S1'1(r>"-Os ..IJ-wz) l Phone#: '5m;-3? J ►�
Address: ��1 (0
City:
Qualifier Name: C'h n
State Certification or Registration #:
DESIGNER: Architect/Engineer:
U9 150
Zip: �3—JZ% 2
i Phone#: � I� 1510q I -t)
Certificate of Competency #: 1912600 23 !f
Phone#:
City: State: Zip:
Value of Work for this Permit: $ ) oc) Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace
Description of Work:
Specify coltile:
Submittal Fee $= Permit Fee $
Scanning Fee $
Technology Fee $
Structural Reviews $
Radon Fee $
Training/Education Fee $
CCF $
DBPR $
❑ Demolition
CO/CC $ _
Notary $
Double Fee $ _
Bond $
TOTAL FEE NOW DUE $ 24�01 iD
(Revised02/24/2014)
0
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 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 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 posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signatre
OWNER or AGENT
The foregoing instrument was acknowledged beforee me this
I day of U, 20 � 1 by
r6ca M I ✓G( who is personally known to
me or who has produced ,V as
identification and who did take an oath.
Signature
CONTRACTOR
The foregoing instrumen was acknowledged befolree me this
I day of I� 20 1 I by
ChO' V, '�, who is personally known to
me or who has produced
identification and who did take an oath.
11
NOTARY PUB NOTAR U IC:
Sign: Sign:
Print: z��: Notary Public State of Florida print:
1d "or om
'� F M Comm. Expires Apr 18, 2023 ?°�`��`: Nota Pu
Seal: of�.. Y u •• •, Notary blit State of Florida
Seal' Commission x GG 325349
Bonded through National Notary Assn. y�
ort.: My Comm. Expires Apr 18, 2023
Bonded through National Notary Assn.
L
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
s►
LIU
'Local -Business
Tax Receipt
Miami -Dade County, State of Florida
-THIS is NOT A BILL - fit? NOT PAY
C
' 6466825
BUSINESS tvAMEILOCATION AE CEtt9T NC). EXPIRES
,
SHU17 S POT, LLC REN1! AL
SEPTEMBER 30,.Wi9
1776 W 41 ST S 735774 Moot be disptav'00 at place of business
HIALEAH FL 33013 Pursuant to County Coca
ftapter tit - Ara. 9 & 10
0
OWNE
pPRSL PAYMENT�RECEIVEDFRANCI TANGIBLEEONAPROP DLR OTAX. T
OR
Employee(s) t S45, 07/06/2018
FPPUOS 18--020577
This local Business Tax Receipt only confirms payment of the Local Business Tax, The Receipt is not a license,
the holds ,e to do business. Holder
permit, or s certification of uslificotions, must comply whit any governmental
.' 9r"Parggpyerpmental regulatory low nd iequirernonts which apply to tiro business.
A
The RECEIPT NO. above must be displayed on all commercial vehicles - Miami -Dade Code Ser -27&
For more information, visit '
1
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I0
LOI• • • < •
EFFECTIVE DATE. 4P3=DI9
PERSON, CHRISTY A13AY
FEIW. 4544379056
BUSINESS NAME AND ADDRESS--
SHUTTERS
DDRESS:SHUTTERS DEPOT, LLC
1776 W 41 STREET
HIALEAH, FL 33412
SCOPE OF BUSINESS OR TRAM
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an modm ffwy rat mcow bww4b w a' x &rdwtaxa c kvwt, z lt
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Y • Y ! F- 6 e • CrS • w ' .
SHUTTERS DEPOT, LLC
July 29, 2019
State of Florida
County of Dade
Before me this day personally appeared C;hy'/s OID6V who, being duly sworn,
deposes and says:
That he or she will be the only person working on the project located at:
70v OF 10i 3t Oilomi ft.
r Si'jz(iatu
Sworn to (or affirmed) and subscribed before me this I day of 2019.
Personally known
Produced Identification
Type of Identification
or Stamp Name of Notary
1776 W 41 ST. HIALEAH, FL 33012 1 TEL. 305.822.3575 1 FAX. 305.822.3731
EMAIL: SHUTTERSDEPOT2006@GMAIL.COM
ROEL LUCIANO
Notary Public - State of Florida
Commission 2 5349
My Comm. Expires Apr 18, 2023
Bonded through National Notary Assn.
or Stamp Name of Notary
1776 W 41 ST. HIALEAH, FL 33012 1 TEL. 305.822.3575 1 FAX. 305.822.3731
EMAIL: SHUTTERSDEPOT2006@GMAIL.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:
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.
Signatur
Owner
State of Florida
County of Miami -Dade
The foregoing was acknowledge before me this day of N L 120 .
By MOW M 4-()r)(*1 who is personally known to me or has produced
DL
SEAL
lan
enitcatWL LUCIANO
e��`: Notary Public - State of Florida
Commission # GG 325349
My Comm. Expires Apr 18, 2023
Bonded through National Notary Assr.