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REV-19-972! I to
iq&wt-o h
q
gX,(0 Miami Shores Village
�M\,\ Vw) I BuildingDe artment RECE; LED
i�\,.`' p MAY 0 3� � 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 2 1019
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949 Cp
04
FBC 20i-4
BUILDING Master Permit No.
PERMIT APPLICATION Sub Permit No. 12C.-os-ICl-QCeq
❑X BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
(aEv--
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP C� �2
CONTRACTOR DRAWINGS
JOB ADDRESS:
1191 NE 103RD ST
City: Miami Shores County: Miami Dade Zip: 33138
Folio/Parcel#: 11-2232-031-0050 Is the Building Historically Designated: Yes NO X
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): COBIA LLC
Address: 8045 NW 155 ST
City: MIAMI LAKES
ne#:
State: FL Zip
Tenant/Lessee Name: Phone#:
Email:
33016
CONTRACTOR: Company Name: TOP CHOICE RENOVATION Phone#: 786-399-0886
Address:
2301 SW 16TH AVE
City: MIAMI State: FL Zip: 33145
Qualifier Name: SEBASTIAN TARALLO
State Certification or Registration #: CGC 1519665
hone#: 786-399-0886
Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 2 7o Square/Linear Footage of Work: 32o s�
Type of Work: ❑ Addition ❑ Alteration ❑ New ® Repair/Replace ❑ Demolition
Description of Work: REPLACE SHEETROCK IN KITCHEN AND BATHROOMS WALLS REPLACE ELCTRICAL PANEL *SAME LOCATION*
INSTALL 2 EXHAUST FAN IN BATHROOMS,ADD 6 RECESSED LED LIGHTS IN KITCHEN,CANCEL EXISTING WATER PIPES IN GARAGE AREA
ADD 6 RECESSED LED LIGHTS IN LIVING ROOM,INSTALL NEW 240V LINE FOR LAUNDRY,REPAIR SMALL CRACKS AND HOLES IN EXTERIOR
STUCCO
Specify color of color thru tile:
Submittal Fee $_ Permit Fee $ �00 • OZ3 CCF $ CO/CC $
Scanning Fee $ G ( prnrn Radon fee $ 2 W DBPR $ 2 - d0 Notary $
Technology Fee $ Training/Education Fee $ G 6C'� Double Fee $
Structural Reviews $ Uzi Bond $ _
TOTAL FEE NOW DUE $ a
(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
Zi
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.
Signature R Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this
day of i'��" 1 20 by
who is p rsbnally known o
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Signal
Print:
The foregoing instrument was acknowledged before me this
2 Vs day of 20 X q by
TGtnl'(AI 10who is sonally kno n to
me or who has produced as
identification and who did take an oath.
NOTARY P
Sign:_
Print:
Notary ruv1- -
Seal: , 0AN Camila grred0ndo Seal:
• MY Commission 22 262400
Expuas o9�281
a
************* ************* ***** *** *************************
APPROVED BY Plans Examiner
l{% / Structural Review
Off",(r _ Notary Public $fate of Florida
• � Cemila Arredondo
MY Commission GG 262408
q Expires 09/26/2022
Zoning
Clerk
(Revised02/24/2014)
ACORE) CERTIFICATE OF LIABILITY INSURANCE
DATE(MMIDDIYYYY)
lla.�
04/03/2019
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER
NT CT
NAM MARTA ALONSO
Florida Bankers Insurance
FAX
PHONE 305 266-6493 Alc No): 305 262-0679
6874 SW 8 St
MDAIL marts flohdabankersinsurance.com
INSURERS AFFORDING COVERAGE
NAIC #
Miami, FL 33144
INSURERA: INTERSTATE FIRE & CASUALTY INSURANCE CO
INSURED
INSURER B :
INSURERC:
TOP CHOICE RENOVATION CORP
INSURER D :
5750 COLLINS AVE APT, 15 H
INSURER E :
INSURERF:
MIAMI BEACH, FL 33140 305 970-15
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR
TYPE OF INSURANCE
POLICY NUMBER
MM/DD
MWDD XP
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE Q OCCUR
N
N
MXC07014920
04/06/2019
04/06/2020
EACH OCCURRENCE
$ 1,000,000.00
r
$ 50,000.00
MED EXP (Any one arson
$ 5,000.00
PERSONAL & ADV INJURY
$ 1,000,000.00
GENERAL AGGRFGATE
$ 2,000,000.00
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY PRO LOC
PRODUCTS - COMP/OP AGG
$ 2,000,000.00
$
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
NON -OWNED
HIRED AUTOS AUTOS
COMBINED SINGLE IMIT
a
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
P A
(Per accident)
$
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
_
$
DED I I RETENTION $
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE ❑
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
If yyes describe under
DESCRIPTION OF OPERATIONS below
NIA
I WC STATU- OTH-
E.L. EACH ACCIDENT
$
E.L DISEASF - F.A EMPLOYE
$
E.L. DISEASE - POLICY LIMIT
$
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required)
TOP CHOICE RENOVATION I CGC1519665
CERTIFICATE HOLDE
MIAMI SHORES VILLAGE BLDG DEPT
10050 NE 2ND AVE
MIAMI SHORES, FL 33138
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
ACORD 25 (2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
oR
_ 9
JIMMY PATRONIS
CHIEF FINANICAL OFFICER STATE OF FLORIDA
DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS' COMPENSATION
* * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * *
CONSTRUCTION INDUSTRY EXEMPTION
This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law.
EFFECTIVE DATE: 4/19/2019
PERSON: SEBASTIAN TARALLO
FEIN: 465648743
BUSINESS NAME AND ADDRESS:
TOP CHOICE RENOVATION CORP
2301 SW 16TH AVE
MIAMI, FL 33145
SCOPE OF BUSINESS OR TRADE:
Licensed General Contractor
EXPIRATION DATE: 4/18/2021
EMAIL: SEBANOB44@HOTMAIL.COM
IMPORTANT: Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under
this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt... apply
only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05(13), F.S., Notices of election to be
exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the
person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a
certificate at any time for failure of the person named on the certificate to meet the requirements of this section.
DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS? (850)413-1609
Proudly Serving
Iw .
sx A the Florida Real
ME LAND
ME LAND - Estate Community
L
!� for Over 20 Years
L° ek WWW.MELANDSERViCES.Com
• • •••• ••••••
•••••• •• • ••••••
•
•••• • •• •••••
-Z .........
N.E. 104th STREET :.. • • ' •.
50 RIGHT—OF—WAY BY PLAT):.:.: ::::......... ............:.... i > . �:......... ....... .' :.':::::20'f ASPHALT PAVEMENT ...:::' ::..::.....
........ r... •r. .....i:. ..
a 15.0' PARKWAY A= 98�
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F.1.P. 1/2 •99
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49.05'
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AC ONE STORY
3'X3' 6.05'oi
v RESIDENCE Q�
LOT 2 0 119 t 0.70' m
BLOCK 2 �' ri CBS WALL
a LOT 1
BLOCK 2 ! A,1 �! 0.
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NO 16 2 -A�, '
NO ID 21't ASPHALT PAVEMENT .... .. .
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N.E. 103rd STREET .:....:
Accepted By:
Property Address: Notes: NO NOTES
1191 N.E. 103 Street
Miami Shores, FLORIDA 33138
tURVEYOR'BCERT�ICATION:INERBY
THAT THIS BOUNDARY SURVEY 4 A TRUE AND
M.E. Land Surve m Inc.
y g,
-
aF
VWTHTHEMINFA NTEC
ED UNDER MY DIRECTION. THIS COMPLIES
FORTH BY THE STATE OF FLORIDA WARD
10665 SW 190th Street
PROFESSIONAL LAND I C
h THROUGH 6FD'-M FLORIDANND-
ADMNISTRATIVECOOI
@ Tula.
Suite 3110
-
SIGNED o
d FOR THE FIRM
Miami, FL 33157
ME L
EFRAIN LOP FLOR
A
Phone: (305) 740-3319
_
STATE OF FL 6112/
P.S.M. No. 6792
Fax: (305) 669-3190
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NOT VAUDWITHOUTAND
or
IC SIGNATURE AND AUTHENTICATED
LB#: 7989
ELECTRONIC SEAL ANDOORTHISMAP 18
VALID WRHOUTTHE SIiNATUREAND THE ORIGINAL
Survey #:B-40152 Client File #: 18-046 Page 1 of 2 Not valid without all pages
Surveyor's Legend
PROPERTY LINE
STRUCTURE
END FOUND IRON PIPEB.R. BEARING REFERENCE TEL TELEPHONE FACILITIES
/
® CONIC. BLOCK WALL
PIN AS NOTED ON PUT � CENTRAL ANGLE OR DELTA U.P. UTILITY POLE
—X—X— CHAIN -LINK FENCE OR WIRE FENCE
LBO LICENSE / - BUSINESS R RADIUS OR RADIAL E.U.B. ELECTRIC UTILITY BOX
WOOD FENCE
LSO LICENSE / - SURVEYOR RAD. RADIAL TIE SEP. SEPTIC TANK
—o---o— IRON FENCE
CALL CALCULATED POINT N.R. NON RADIAL D.F. DRAINFIELD
----- EASEMENT
SET SET PIN TYP, TYPICAL A/C AIR CONDITIONER
— - — CENTER LINE
A CONTROL POINT I.R. IRON ROD S/W SIDEWALK
MONUMENT I.P. IRON PIPE DWY DRIVEWAY
®CONCRETE
WOOD DECK
BENCHMARK HAD NAIL k DISK SCq, SCREEN
CONCRETE
ELEV ELEVATION PK NAIL PARKER-KALON NAIL GAR GARAGE
P.T. POINT OF TANGENCY D.H. DRILL HOLE ENCL ENCLOSURE
® ASPHALT
P.C. POINT OF CURVATURE ® WELL N.T.S. NOT TO SCALE
BRICK / TILE
P.R.M. PERMANENT REFERENCE MONUMENT ® FIRE HYDRANT F.F. Fj&'SAEO ILOOR
WATER
P.C.C. POINT OF COMPOUND CURVATURE ® M.H. MANHOLE • • •T.O.B. TOP Di! SANK • • • • •• •
•
• •
P.R.C. POINT OF REVERSE CURVATURE O.H.L OVERHEAD LINES E,O.W. Eple(r' VTER •
/lam- APPROXIMATE EDGE OF WATER
P.O.B. POINT OF BEGINNING TX TRANSFORMER • • • • E.O.P EDWOF PSVEMENT • • • • • •
P.O.C. POINT OF COMMENCEMENT CATV CABLE TV RISER • • • • • • )
C.V.G. CONCRETE VALLEY G1,411 • • •
COVERED AREA
P.C.P. PERMANENT CONTROL POINT W.M. WATER METER • • • • • B.5.4 It1L*C SETBACK LINE
�e TREE
M FIELD MEASURED • • • • SURVEY TIE LINE • • • • • •
P/E POOL EQUIPMENT S.T.L.
�i POWER POLE
P PLATTED MEASUREMENT • • • • • • • • • • • • • • •
CONC. CONCRETE SLAB (1fNTER LING
® CATCH BASIN
• • • •
D DEED • • • • • • • • • •
ESMT EASEMENT R/W RIGHT-OF-WAY •
•
C.U.E. COUNTY UTILITY EASEMENT
C CALCULATED D.E. DRAINAGE EASEMENT , •
• • O.U.E. PUBLIC UTILITY EASEMENT •
• • • • ••••••
I.E./E.E. INGRESS / EGRESS EASEMENT
L.M.E. LAKE OR LANDSCAPE MAINT. ESMT. 4B E LANDSCAPE PUFFER EASEMENT C•0%0 OMWENANCE ;ASEMENT•
C.M.E.
U.E. UTILITY EASEMENT
R.O.E. ROOF OVERHANG EASEMENT L.A.E. UNITED ACCESS EASEMRNT • J.• E, ANCHOR EASEMENT • • • • • •
Property Address:
General Notes:
1.) The Legal Description used to perform this survey was supplied by others.
1191 N.E. 103 Street
This survey does not determine or is not to imply ownership
Miami Shores, FLORIDA 33138
2•) This survey only shows above ground improvements.
Underground utilities, footings, or encroachments are not located on this survey map
3.) If there is a septic tank, well, or drain field on this survey,
Flood Information'
the location of such items was shown to us by others and the information was not verified.
4.) Examination of the abstract of title will have to be made to determine recorded instruments, if any, effect this prop
Community Number: 120652
erty.The lands shown herein were not abstracted for easement or other recorded encumbrances not shown on the pl
Panel Number: 12086CO306L
at
5.) Wall ties are done to the face of the wall.
Suffix: L
6.) Fence ownership is not determined.
Date of Firm Index: 09/11/2009
7.) Bearings referenced to line noted B.R
Flood Zone: X
8.) Dimensions shown are platted and measured unless otherwise shown.
Base Flood Elevation:
9•) No identification found on property corners unless noted.
10.) Not valid unless sealed with the signing surveyors embossed seal.
Date of Field Work: 04/10/2018
11.) Boundary survey means a drawing and/or graphic representation of the survey work performed in the field, coul
Date of Completion: 04/11/2018
d be drawn at a shown scale and/or not to scale
12.) Elevations if shown are based upon NGVD 1929 unless otherwise noted
13.) This is a BOUNDARY SURVEY unless otherwise noted.
14.) This survey is exclusive for the use of the parties to whom it is certified. The certifications do not extend to any u
nnamed parties.
15.) This survey shall not be used for construction/permitting purposes without written consent from the land
surveyor who has signed and sealed this survey.
Legal Description:
Lot 1, of Block 2, of BISCAYNE RIVER
HEIGHTS, according to the plat thereof, as recorded in Plat Book 43, Page 73, of the public
records of Miami -Dade County, FLORIDA
Printing Instructions:
Certified To:
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Cobia, LLC , A Florida limited liability company
Drop -down and select "Print". Select a
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Torrens Law Firm, LLC
or at least one with 8.5" x 14" (legal) paper.
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Select ALL for Print Range, and the # of copies you would like to
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print out.
its successors and/or assigns as their interest may appear.
Under the "Page Scaling" please make
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Please copy below for policy preparation purposes only:
"None".
Do not check the "Auto -rotate and Center" box.
This policy does not insure against loss or damage by reason of the following
Check the "Choose Paper size by PDF"
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exceptions: Any rights, easements, interests, or claims which may exist by reason
of, or reflected by, the following facts shown on the survey prepared by Efrain
t0 print.
Lopez dated 0411112018 bearing .lob # B-40152 :
a. NO NOTES
M.E. Land Surveying, Inc.
� \
10665 SW 190th Street, Suite 3110 Miami, FL 33157
E LAND
ME LAN
ME LAND
Phone: (305) 740-3319 �
Fax: (305) 669-3190
LB#: 7989
Survey #:B-40152 Client File #: 18-046 Page 2 of 2 Not valid without all pages