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DGT-10-21-2775 � 2 \ ,���� � � �� �,�� ��'��� �� �� � �.�� , .,� � . ���� � ���°,� Miami Shc�res Vill�ge ��`���� � � � � � �� � �� � � � � �� � zooso r��z.��e �� �` �� ` ��� � � �: � ��� �� ,� ��. � a� Pefiami Shores Fl.3313� �: � ` . �` : ����� ���3������'�'�,���: � F 305-795-2244 w µ �ir. �� � ; ��'��'������ ��' y .4� .� \ ����.+��� `�`l gvq-� Jp „ �.,1., . ,: ��R0.6�4��P� � t. . .<... : "�. .. ........ ....... . . .... �.:.. ������ ��������� ��prra�o�: a�jzzjzoz� ....�.: .c� 1 \ \. .�,.. .. .�.. i.ocat�ran Address P�re�l�Eumber � ������m���..����,..�,_�____ �...... ....,....._ � .. �__._ _�._�. � �� a.�.._ _r.._. �_.._.. �� . ., �...�_ m n..� .�,._ _...,, r .�,e��. � 65 IVW 1Q5T9�S1",Mi�e�i Shor�s,FL 3315{� 22213�t3050270 . � 4 �. . .>��a�, �,,aa ��ntacts � I�inda Samsoe � Owner 1N1EC C�t�STRUCTION,lLC Coa�tract�r 1 65 105 ERfC SCQTT FINKELS�CEIN ; 560 NW 39 AVE,COCONUT CRE�K,Fl 33066 i ��asiness:95441Q4695 TC3UCN�$@BELLSC}UTN.N£T ��� � __._._ _�__ � �, ...�......�.. a��.�re �w_� _�._�m_,,_m,.� � ���w ��nkv�,...K�,.�._„. . . ...,m.,.__...._�..� � C}�scriph�n.DECK AS P�R�PPRQVED P�ANS � Valuat�or�: $ 5,�00.00 � Ins eet�on 6ie uests: : ���������. � ; TatalSq Feet; 160.40 <,... � 1 =. � � � F�es Am�unt Rayments ��te P�id Amt Faid Application Fee-Other $SO.QO Tatal Fees $27�.13 CCF $3.00 Credit Card 10/26/2021 $�pep� DePR Fee $2.00 Credit Card 12f22/2QZ1 $22$.13 QC�Fee $2.Q0 Deck Fee $125.04 AtYt�unt Du�: $0.�0 Educatian SurcMarge $5,0� Planning and Ze�ning Review�ee $35.Q0 Scanning Fee $12.Q0 Structural Review($45) $45.00 TechnologyFee $3.13 1"�tal� $278.23 11 IEi tl� In cansideration �f the issuanc� ta me of this permit, I �gree to perfarm the w�rk cavered h�reunder in campli�nce with alI ardinances and regulatians p�rtaining �hereto and in strict �anformify with the plar��, drawings, statemer�ts ar s�ecifications submitted to th� proper autharities of Miami Shor�s ViEl�ge. In accepting thi� p�rmit I assume responsibility for alI work done by ei r myself, my ag�nt, servants, ae�mploy�s. P understand that�eparate permits are r�quired for�L��TFtICAL, �LU�BIPtG, IVlECNR�tIC�,�,WIND S, D RS, RQC3F[NG and SWI�MING PC�Ct�work. ] 1 � C}WN�RS A�F}DAVIT: ( eerti�}r th�t all Ehe foregoing information i ccurate �lid that ai! wr �k i(! b� don� in ccsmpiiance wi4h a(I applicable I�ws � reguiating construction and zoning. Futhermore, I authorize t pr to do e w k sfiated. Flutharized Signature: C?wner / Applicant/ Contrac / Rgent C�at� �ece�raber 22,2022 Pa��Z�f 2 �-� , :, �� � , l� T� � �-� ������ i i h r s i I I� � %,l �� ��- 'E �_; � �� �;, � � i �j� �,� �� � � ,o�� 1i� E ��� � �f� �� ��a�t���t ' ;j� Et.; � � ����i � �; M � �- a � , _ 10QS0 N.E.Zr�d,Avenue, Miami Shores, FEorida 33138 �re�: {���)7s�-zzo��aX:(�a�}75�-s47z ��1`` '�� '�.�._ IiVSPECTIE?N LtNE PHC?NE NUMBER:(305}762-4949 ..�'` °��� F � ���� E ��.�E Master Perm�t No.����" ��- � �� €�� PERMIT APPLICATI N su�P���►�t ��. BUIL[�ING � ELECTRIC (� RQUFING ❑ R�VISIQN � EXTENSIC3N ❑RENEWAL �P�UMBING � IVlECHARlI�AI �PUE�LIC WC}RKS � CNANGE QF � CANCEI.�A,TIQf� � SHOP CONTRACTC�R DRAWINGS JOB ADDFtESS: � �P (� � � � � �� � Citv: fYiami Shcares Countv: Miami Dade 2ir�: � �` � � Foliof Parcet#� ts the Building Historically Designated:Yes NQ Occupancy Type: �oad; Construction Type: Flaad Zone: BFE: FFE: OWNER: Name(Fee Simple Titlehoid�r}: ����� � �� � �",,��"�. Rhone#: ���� ���� � �� � Address: � �� f � �� Gty. � ��`� Stat�: �,I Zi�. �.,�. �.._._... TenantJlessee Name. Phone#: Email: a � � � � �� CC�NTRACTQR:Company(Vame: � �' � � �. �� ��s �'�` � �' :� '� Phone#: � � ��� Address: �� � ���� � �.� � , � City: 4��� ���"�� � State: Zip: �'��,� Qualifier N�me: ���� '� {� � Phone#: ���� �'� � � � State Certificati�n ar Re�istration#: ���� � Certificate of Competency#: DESIGNER:ArchitectJEn�ineer: Phone#: Address: City: State: �ip: �,c. Vatue of Work for this Permit:$ � SquareJCinear Foot�ge af Work:I f�� �' � Ty�ae of Work: ❑ Additi�an ❑ Alteratian � New ❑ RepairJRepiace ❑ Demolition Description af Work: � � �� >,,� � �� �.. Specify eolor of color thru tit�: Submitcal Fee$ �'�� ° �.� Perm'st Fee$ CCF$ CQjGG$ Scanning Fee$ Radan Fee$ D�PR$ Notary$ Technology Fee$ TrainingjEducation Fee$ Doub€e Fee$ Structural Reviews$ Bond$ TQTAL FEE lVOW�UE$ �� • � (Reu�seaa212a/�os�} �onding Campany's Name(if applicable) Banding Company's Address �_ City State Zip Mortgage�ender's Name(if applicable} Mc�rtgage Lender's Address � City State Zip ,Application is hereby made to ok��ain a permit to do the work and installations as indicated. 1 certify that no work or instailation has commeneed prior to the issuanee of a permit and th�t aIl work wiH be perfarmed to meet the standards of all laws regulating construction in this jurisdietic�n. ! understand that a separat� permit must kae secured for ELECTRkC, P�UMBING, SIGNS, POQ�S, FURf�ACES, BOILERS, HEATERS,TANKS,AIR CONDITIC?NERS, ETC..... AWNER'S ,4FFPDAVIT: I c�rtify that al! the foregoing informaticrn is accurate �nd that all work will be don� in compli�nce with all applieable laws re�ufating construction and zoning. "WARNING TC� t)WNER: YOUR FAILURE TU RECQRD A NQTICE C}F CQMMENCEMENT MAY RESULT IN YQUR PAYINta tCE Ft?R IMPRQVEMEIVTS 7C) YC1UR PRC}PERTY. IF Y�U INTENQ TtJ QBTAIN FtNANC1NG, �C?NSU�T WITH YO�UR LENDER QR AN ATfCJRNEY �EF4RE RECQRDING Y�UR NC?TtCE OF GAiVIN1EN�E�11EN1".,, t�otlee ta Appfieanc: As a eonditlon tc�ihe issuance of a bur`Iding permit�vith an estimated va(ue exeeedr`ng$25Q0, the applicar�t must promise /n�ood faith that a co�y af t9�e notice of carnrrrencemer�t and construction lien Iaw brochure wilt be delivered to the peesan whase property is subjeet to attachr»ent. Also,a certified capy of the recarded notice of eommencement must be posted at the job site fcar the first inspection which oceurs seven (7J days after the buitding permit is issued. In the absenee caf such pc�sted notice, the inspectron will not be approved and a reinspectian fee wil!be charged. iw � Signatu Signature �� � OWlVER or AGENT CQNTRACTOR The foregain�instrument was acknowledged before me this The foregoing instrument was acknowled��d befare me this day of ,� �-� ,20 �` � , by �� day of ��--� 20 �� �, bY � t �"'i.� °'� ���� ���,who is personally known ta ����� � �7 �� �� 1�who is personally knawn to me or wha has produced as me or who has produeed as identification and wh�did tak c�ath. identifieation and who did take an aath. NOTARY F BL�C: NOTIARY PUBIIC: � Sign: � Sign: Print: e�e' ���'�` � �� Print: ��� � � i�'�+�E�5;�t�o�Fi�ri�a Seal: Seal: , {.�ur���r€ey � � �'� - ��' tvty�.�rnmi �GCa 2�t3Q35 hcat&try Puttkic Si�B��t Florid� �- ��;��ca'� �xpir��43I16t2t�2� a w ��Ut�F�fl�y ��+ �Y�ammi�i��,�29f�t3 �**����� �n �ak a����r�R6� ��*� �� *����a:*���*****�*�*��****�*�������*��s��*�*������m�*�*�:*���:**�**�**� APPft{�VED�Y ���� Flans �xamin�r �i� ���� Zoning �1�� �- Structural Review Clerk (Revised02j24/2014) Pro��z-ty �earch 1�p�li�atic�zz- Miami-L>�de C�unt� Fage 1 a� 1 �� ��n�?�� �i2 ����� ���� ,..'<�� , , ��,��: ��1�'1�'1�C� ���}(�I°� �en�r�ted Or�: 1Q126l�d21 Pro�s�rty Enf�rmatian F�lio: ;11-2136-Q05-0270 Properky Addres�: ;65 NW 105 ST �tVii�mi Shores,F� 33150-1241 a , � �_...W. �...�, �m�_�._�.__..�....�_���.�__.__._...� .�_�_� Uwn�e �LIND,A G SAt�SOE �� � ��,_�.����_._. �__ � '65 NW 1d5 ST Mailing�ddr��� �MIAN1k SHORES,Ft�33150-1241 � �____.�� _� ___.._._______� _. ��_.___�_�____._. _.______ _a__ �PA F�rirr�aty Z�n� (0$40 SGt�F�lN11LY-1701-190Q SQ :z; ��:,r;x ,: �_.___ __ _�. —.— � _ _._�_�m,__.�.�_..__ � i01Q1 RESI�E[�1TIF�l�-SING�E � �' „� , Pri�ary�and U�e � iFRfNl�Y: 1 UNIT ____n__�_..__�e_________.._ ______.�.�._.��___�_.�_____._ � ._.._............__._.�__..__. Bed�1 Baths J Hal� i 2/1 1 Q _�_`� _� '�_ ��_____ _ �Floors (1 __�____. _ .k___._._.w� �___��__ t�iving Ur�its ____,�.� ___�.._.._. � \ � Actual Ar�a ��1,175 Sq,Ft � ,�� � _ __.� _ �_ _� _._. , �____Mm__..__�______.._ Livfng Area ;857 Sq.Ft _.___�.�__e� � �_._�.�.._....�...e��__.��_ .___��.__��___-._-___._- Adjusted,Area i1,Q34 Sq.Ft __m T�xa�l��alu�It���rrna�tion �_.����__��___mm___.�_._._�____�__�...��,..��_._____..�.._____ �c�t�ize i 9,150�q,Ft � : � ��_m__j___�� �.�_�� � 20�1� �Q20� 20`�9 Y�ar�uilt `1939 �_ ____��_�_____.___�� ���.__._m__.�__.__�_ ��__ �.__.__�__._ ' Ct�ur�ty __._�_�_________.__________________�....__._._._.__�.._.����.__..__..._..._____.___�_��__ A���ssm�nt tnf� a�ie�n Ex�mption Vaiu� � ��II,537� $87,3151 �85,352 �__._�_ ._._ __._.__.______......._�_..____. __ __ ;__.._..__.__�....._.._..._._.� __�_._ t ' Tax�k�Ie Value ' �4� $0� $0 Year � 2021 2020? 2019 __...__._.._......,.�....._...._____.__.._..__...._..............�.J._...,._.._.,_._.___._......�_.�..____.......__.._..�_.__.__...._.i_..........__......_____....__..._._.... ...a�.m......�___-.___���k�� w_�._._m____�_._�_�_��_�.�. ..____.__...___._..._._�_� Lane�Valu� � 5227;119 �2Q6,472� $2�6,472 School��a€d ____m.�._.___�_�.�_.�.��_�����_�4 ___�____��.._� _ �.__._� � �__ .� _ _ ______ _____ .�_�_ �uiic�ie� Vatue � $71,966 �T1,966���������������___�71,966 �xemption Va(ue �25,OQ0' $25,000; $25,000 9 � �M�_� ___.�.. � _ , _� � � �__ � �_� �� _.__.__.__._....__.� �.��____�__._..�_ �~ Ta�cable Value ? �63 537i �62,315� $60 352 _._ XF Valu� � �Q �Q� �Q _.���_____._._.�_, L�_�.�_.____� ___�__.� ��P _.._e� Market�alue �� � ��299 0 5 $278 438� $278 438 ��..�___.._...._� . .___.. __.___�.__. ___..___.�..M __w_�___ �� ._�_� � ____�__ � � . ____. �_ ._�� __.�__ Exemption Value �54,Q00� �54,4Q0� �50,400 Ass��sed Value �$8,537�����87,315j �86,352 — �___.�_.._ � _. �_„-.�_ Taxable Value j $38,637= �37,316� $35,35� �@Ptf.'�I�S�t1�OCRl��IOEl RE3�I0[t�E ~�� A ��� _>_______�_m__ � _ __.__�.._.._ _._ a_ Ex�m t�on Value �50 000 � __ $50,OOQ B�nefit �Type � 2029 202Q� 2019 p i ��O,OQO, �_�� N_�. __v_ _�.. �__ �� �._. _� w.�� �.�� ? ����_� T�x�b{eValue �_ �38,537` �_ $37,315� $35,352 S�u��ur Fl�mes 'Assessment i �21Q,54�� �191,1233 �193;Q86 �ap �Reductian � � � _ _��.__ _._______. �___�� �_e__ � .___ _�______e__�._�_�.__�_._�_.��_� ._ Ham�stead ��xemption $25,OfltJ $25,OflQ; �25,QQ0 ��les lnf�rm�t6on _.__-�-�. _.� __� _, .__._______ , � r��G��d Previous S�le ; Prieel OR Bc�ok-Page ; Qualific�tior�D�scriptiorr Homestead �Ex�mption � �25,000 �25,000� $25,Q00 E i € ��.�� �____.._.__.___.M��_-�____�._e___��.,__ �.___�_.�_� Senioe Narr�estead Exemptian ` $38,537; $3T,315� �35,352 _.,_.� �._._� � �_.._.w__�___m�� �_ �__�_�__._z_ �_�a__.._ w,_..___ Not�:Not all benefit�are appiicable to ali Taxable Vaiues{i.e. County, Schooi Ba�rd,City,Regi�na!}. ahort�e�aE De��ript�or� DUNNINGS iUtlAfVll SHt?RES EXT NO 1 PB 41-51 LC7l"11 BL.K 203 LQT SIZE 75.000 X 122 OR 135Q9-3442 1287 4 The(Jffice af 2he Property Appraiser is continualiy editing and updafing the tax rall.This website may e�at reflect the n�ost current infarmatian on record.The Property Appraiser and Miami-C�ade Gaunry assumes no iiability,see fuPi disclaimer and User Agreemen4 at httpJtwww.miamidade.govlinfaidisclaimer.asp https:/,'�vw�vv.�z���r�iidac�e.go����pps/�'�.lpz�ap�rtyse�rcl�/ 10/2�i/2021 � ��c.r�'� � .� i�r�i h�r�� �Ila � ew�. �.�R�� . . ��a�a �.�.��,a �ve�,�� �`�'��v,.��°�� Mi�mi �hor��, �forid� 331�� �� t T`�I: (3Q5) 795.2204 ��x: (305} 756.$972 � � STATE OF(FLORIDA) G�UNTY�F(DADE) ,� The undersign�d Affiant, �� �, does hereby��test that (Pro erty owner} � Th��fitachetl st�rvey, Perfarmed by �CM���� �� }�' ���� �� .� (Name of sunr�yor's camp�nY) For atldress: ° � �� �� � � ���' � ,�� Performed an � �� �� (date of survey) is an accurate representation�f th�existing conditi�ns and locatians of all structures on the praperty as�fi this d�te. The purpas� of this Affidavit is fo induc� (�iami Sh�r�s Vill�ge to issue a building permif f�r fhe property with�ut first praviding a survey less than seven (7} years old ald. The Affiant, as praperty owner, further agrees to remove or obt�in p�rmits f�r any sfructur�s �hich now may exis� on the prop�rEy which are not p�emi�t�d �r which may violate zoning or building eode regulations. The A,�ianf fiurther understands that the exisfienc� of any such steuctures may a�fect gnal inspections as applieabl�ta this or�ther permits. F er ffiant say et naught. ��� �„��- � �- � �- `;� Praper�y��rn�r Signa�ur� Property�wner Print Nam� SW�RN T�AND S�1�SCRI�ED before me thi ° °�� day of �,��. Affiant is personally known to me, produced as identifieatia . � � �,�'` � � ��;a�a�,���c sta���r r=io�E�� tdotary m �.�UFs���f{��f Revised on 5122f2(1Q9!Revised on 6112fQ9 P�sy C�rnmi��i���29C1035 ��� Expit�s t�3lt&t2Q23 � � t��n D�S�r��is> ver��� H�Is�y E3�sh��r��5��r���ry �.. �� ����it�c� ' � �� p� �. ������� , T �T 1 E ,A FE�S1 �L 1 1 1 7° L1� SI T°h!E �E�E � ����' �1"�� F�E�E�I� fS �E��'�FIE� IJ�J�E�T'i�� II � L T ' �! 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C?F�-F2-C?VVC-?5�G�621`(FiG�T�C1F��.��T'(C}E�E TfJ E3����flAf�T'F2�tfl��F?0�-1� �013C�4672 Cdt3��T`!t]IV�?{�6C�)4'43-160� � ,� C3��� � re��.as�� � i�rr�i h�re� ilfag� .�.� M�«�.� . � � �� 1Q05Q N.�.2nd Rvenue ��������� Miami �hc�res, ��C� � �" Flc�rida 33138 T`�I: (305} 795.2204 Fax: (305} 756.8972 1 �` � �` �" ' 1 � �°` 1 Florida L,a��� r�quires W�z�kers' Cor�zpensa�ion insur�nc� eov��r�ge �tndcr Cha�ater �40 af the Ftoricia Statutes. Fla. Stat. � 4�0��15 allows cc�rpo�•ate of#icers if�th�cc�slst��uctian iudustry to exem�at tll�mseiv=es fi�Qrn this require�nen�far a.�2y eox�st-uetio��praject�rior to ol�taifling a building��r•mit. PuFs�i�n�ta Ehe Florida L?i�=ision�f��%ork�rs' C�����pez�saEia�l Ei2�ployer Paets Br€��hlu-e: A� ern�(oyer in ttic cpnsti�uction indtastr-y wi�o employ�s one or tt2ore part-time or full-time e�7lployees;includir��the o•,�=ner,znust e�btaizx work�rs' cam�ensatic�71 caver��c. Corparate officers o�- members of a limit�d liabil�ry Gon��aany (LL�.} in th� cc�nstrtzctio�� ii�dustry n�ay elect Eo be exe��pt if: I. T�e oftice�-ou�t�s at Ieast t E� �ez-cetlt af"the stock of tlze eorporatzaz�,ar in the case of an LLC,a statement�tfesting to the nlinin�unl 10 percent owt�ership; 2, The of�ic�r is Sisted as ai� oi�e�r af tlle eorporatioil in tl�e ree�rds oF t}�e Florida Departrnent of State,Divisian c�f{`orporations; ar�d 3� The co��p�zatia�� is registcred asld list�d as �cti�e with the Fl�arida Depart��ent c�f State,Division af Cor�aat-atior�s. Na n�oee tl��ri th�-ee co€por�zte offic�r-s }�er cor�arati�rl or liznited lia�ility con�panv �n�mbets are allowed to be exer���t. Construction exemptions are valid fo� � ��eriod of two yeass c�r uriul a voluz�taz-y°revocation is filed or t�e ex�nxptic���is revok�d by the Division. Yot�r corltractc�r is requesti��g a per�nit unde�-this v�arkeis' co�n�ensati�n�x��nptiar��t�d h��s acknav��l�dge that he or�1Te��ill not use dav labar;�ar-t-time en-�plQy=ees ar subc c�ntractors for yo��r pt-o,j�et."1�he catltraceor has pi-ovided an affidavie statin�th�t he or sh�w�ill be the only person 4lllowed to wc�rk ozl you�-�raject. In these ciz-cucnstazlc�s,&1iaz�rz Shores Village does t�ot require��e�-ificaEion of wc�rkers' cQmpensation insur-az�ce coti�era�c frc�r��tlae coi�tractor's co�npany for day labor, �art-tit��e employees or suE�cot�ti-actors� BY �IGNi��'G �ELC?�G' Xf�U ACKi�T���%L_�DGE '1�HA�l� YOU I-[AVE READ T[-ITS Nt�TiCE ,�NL} C;N[�ERSTANI� iTS ('(aNTENT�. Signatur : � �vner State c�f Fl�rzda County of Mianli-I�ade T17e fore�ainb��as acknow�letige befoz�e m�thi-s_ �•�_day af__� �` ,2Cl� � . _ �------ —__ By �-� �t �� �� � �` � � wl�o is personatiy kr�otkn to n�e or 17as�rodtteed _ — ��S iC��E1�IfICc��lOE1. 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