DEMO-19-79Location Address
Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
issue Fate: 02/15/9:019
Parcel Number
34 NW 96TH ST, Miami Shores, FL 33150 1131010330480
Contacts
Permit No.: DEMO -01 -19-79
Permit Type: Demolition
Work Classification: Residential
Permit Status: Approved
Expiration: 08/14/2019
JORGE BONAMINO Owner CONSTRUCTION DEVELOPER GROUP Contractor
34 NW 96 CORP
GUSTAVO ASMAN
20381 NE 30 AVE 414, AVENTURA, FL 33180
Business: 3052151988
Description: DEMOLITION OF WOOD PERGOLA BEHIND POOL Valuation: $ 500.00
Ins Requests:
TO CLOSE NOV18-3413
Z5-762-4949
Total Sq Feet: 70.00
Fees Amount
Application Fee - Other 50.00
Building Demoloition Fee 200.00
CCF 0.60
DBPR Fee 3.75
DCA Fee 2.50
Education Surcharge 0.20
Scanning Fee 9.00
Technology Fee 6.25
Work Without Permit 1st Offense 200.00
Work Without Permit 1st Offense 100.00
Total: 572.30
Building Department Copy
Payments Date Paid Amt Paid
Total Fees 572.30
Credit Card 02/15/2019 $522.30
Credit Card 01/14/2019 $50.00
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.
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.
Applicant / Contractor / Agent Date
15, 2019 Page 2 of 2
Miami Shores Village
IF2JEW, CEIVED
J N 14 2019
jv Building Department
ly
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972 }
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20 I
BUILDING Master PermitNo.Jv U1
PERMIT APPLICATION Sub Permit No.
BUILDING ELECTRIC ROOFING REVISION EXTENSION RENEWAL
PLUMBING [:]MECHANICAL [PUBLIC WORKS CHANGE OF CANCELLATION SHOP
Y,(
CONTRACTOR DRAWINGS
JOB ADDRESS:, /7 9w "'
Folio/Parcel#: fl 3,10,f ' 032 09-1 &V Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple/ Titleholder):
Address, 3 if Nt/, 5(O -'"
3oS Mir 2-3 16
City--/i;`%r l State: f .Olw&4 zip: 33 I -SCD
City:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: L U&T7`LV074*Y ARI NEPALI Phone#:205 04K 4d A
Address: 4?00
r
City: ,lj.Jy7t/G State: Al Zip:
Qualifier Name: 0a"I/0 '4 Phone#:, -?05
State Certification or Registration #: 0< C 'T49 I 9J Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#: -
Address: City: State
Value of Work for this Permit: $ 4X oz> Square/Linear Footage of Work: _
Type of Work: Additttiion,, Alteration ^
r
New Repair/Replace
Description of Work: ,4
Specify color o—fr/color thru tile:
Submittal Fee $ E;O, 00 Permit Fee $ 2-Q ` 01) CCF $
Scanning Fee $ _
Technology Fee $
Structural Reviews $
F715--NA(-l'`- ; / UCS. 60
10-4-4M In/9Mn
Radon Fee $
Training/Education Fee $
DBPR $
CO/CC $
Zip:
Demolition
Notary $
Double Fee $ 2(l - 0-D
Bond $
TOTAL FEE NOW DUE $,_
Bonding Company's Name (if applicable)
Bonding Company's Address
City State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
Zip
City State, 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 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 inspe/bion which occurs seven (7) days after the building permit is i ued. In the absence of such posted notice, the
inspection will noj be approved and a reinspection fee will be charged. f -
Sig
i l OWNER or AGENT
The foregoing instrument was acknowledged before me this
day of JA vwJ `r v 20 (G by
6r>6V%4 a who is personally known to
me or who has produced 7L as
identification and who did take an oath.
NOTARY PUBLIC: -
Signatu
CONTRACTOR
The foregoing instrument was acknowledged before me this
tq day of `_Ta KU0Q 20 by
who is personally known to
me or who has produced as
identification and who did take an oath,
NOTARY PU6LIC:
Sign:' V— A. Sign:.
Print: Print:Q ^ry Public State or Florida
Josefina Girek ose i a Uverez
Seal: My Commission GG 238740 _ Seal:
ora
My Commission GG 238740
j w Expires 09/30/2022 Expires 0913012022
o
APPROVED BY ( _ Plans Examiner Zoning
Structural Review Clerk
Revised02/24/2014)
Aniano J. Garcia, PLSM Ph (305) 856-45667210SW126thCourt, Fax (305) 595-1454 Record SurveyMiami, Florida 33183 Land Surveyor & Planner agarcia297@aol.com Scale 1'= 20'
Property Address: HIP — —
15' Wide Alley o
34 N W 96th Street, I 0j. : I
Miami Shores, Florida 33150 Ir! square 'g y
Legal Description: cut in,asphalt ! Asphalt Pavement
II
Lot 7 and the East 25 feet of Lot 8, I -15.o0'
iN 90°00'00" W 7_5.00'
Block 131, of "MIAMI SHORES 1 i -T FIP
SECTION NO 6", according to the ; — I — ti 01"
Plat thereof, as recorded in Plat I ; As. ea I o, I 0.1'
Book 10, at Page 39, of the Public I ;
0.1' ? N N Block 131 I L I CI
Records of Miami -Dade County,I i I CI I
Florida. 1 j 5000'
I
1iJtA
25.00'
o 'I Y
I ii I 14.5'x26'o I The E 25'
a
a
Swimming Pool ' o I n of Lot B. I
Flood Plane Information: I
13 ,
a I
dock 131
Flood Zone: X; Panel No: 1 i 110'
12086C0302L, Dated I i
September 11th, 2009; I
Woody X121
14.95' 7,aNv--
Community Name /No.: I ;
N '
Deck 1
Village of Miami Shores/ I ' \ , 16.4 6
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N 14 2019 — _ 1
15.00'
i, BOB I ':,
9000' "E
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85' Fl : N 90°00'00" E 75.00' Sidewalk
BY. 0
Curb & Gutter
o i Parkway
j
There may be easements o i
and/or other instruments ! Asphalt Pavement CIYVIaffectingthisproperty, AWOL
recorded in the Public i c nc certIt Am n ii
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 Exemotion
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
CONTENTS.
Signature:
Owner
State of Florida
County of Miami -Dade
The foregoing was acknowledge before me this 1 (4 day of WVt, 20ICJ .
ByJ'ckp0bf0t n0,rA- f'lC:) who is personally known to me or has produced
identification.
Notary:
state
qe_etz,
Wypow
SEAL: P Josefina Genz
MY Commisslw GG 238740
11 Expires 08/3 M22
CONSTRUCTION DEVELOPER GROUP.
20381 NE 30th Ave. #414, Aventura, FL 33180
PH: 305-878-4688 FAX: 786-265-6263
February 10, 2019
State of Florida
County of Miami Dade
Before me this day personally appeared Gustavo Asman who, being duly sworn,
Deposes and says:
That he or she will be the only person working on the project located at:
34 NW 96th Street street, Miami Shores, FL 33138
Cu-tavo Asman
Construction D vel roup - Owner
License Number: CGC1504895
Sworn (or affirmed) ano subscribed before me this 13 day of Ie6Vuo'(
7 .
2019
By VS V-0
Personally Know
Or produced Identification
Type of Identification
Notary Public State of Florida
a4 . Josefina Gerez
My Commission GG 238740
Expires 09130/2022
Name of Notary