RC-19-677Permit NO.: RC-03-19-677
Miami Shores Village Permit Type: Building (Residential)
10050 NE 2 Ave
Miami Shores FL 33138 Work Classification: Alteration
305-795-2204 Permit Status: Approved
Issue Date:04/09/2019 Expiration: 10/07/2019
Location Address Parcel Number
1060 NE 104TH ST, Miami Shores, FL 33138 1122320290220
Contacts
ERIC WOODLING Owner Arco Construction Corporation Contractor
1060 NE 104 ST, MIAMI SHORES, FL 33138 LESTER 1ENSEN
Other: 7275600539 1665 NE 137 TER, MIAMI, FL 33181
Business: 3058926507 arcoconstruction@aol.com
Other: 3058926507
Re
Description: STUCCO BANDS AROUND WINDOWS AND DOORS Valuation: $ 2,300.00 quests:
5-76 Inspection on Re
4 1/2" 6" GARAGE DOOR SEE ATTACHED FOR LOCATION SITE
PLAN Total sq Feet: 240.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$1.80
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.60
Permit Fee
$50.00
Scanning Fee
$9.00
Technology Fee
$2.50
Total:
$117.90
Payments
Date Paid Amt Paid
Total Fees
$117.90
Check # 9641
04/09/2019 $67.90
Check # 9627
03/29/2019 $50.00
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.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
�egulatia onesT
uction aan zoning. Futhermore, I authorize the above named contractor to do the work stated.
.•./gs�
Auffio—rized Signature: Owner / Applicant / Contractor / Agent Date
April 09, 2019 Page 2 of 2
Miami Shores Village
Building Department RECEIVE®
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 MAR 2 9 20;9
Tel: (305) 795-2204 Fax: (305) 756-8972 /��
INSPECTION LINE PHONE NUMBER: (305) 762-4949 kcn 0
BUILDING Master Permit No. P-r,-C) c--(P-�
PER T APPLICATION Sub Permit No.
BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION EXTENSION ❑RENEWAL
PLUMBING MECHANICAL PUBLIC WORKS CHANGE OF CANCELLATION SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: , v(O C) T o —1 J
Citv: Miami Shores Countv: Miami Dade Zio: 22 --3 /1
Folio/Parcel#: 11 Zz 3 2-D2-9 �( Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple
/ ,.,%/ c..
City: tA� A w( 9/ `U r C S State:
Tenant/Lessee Name:
Email: Lt-6 V\ k f-
CONTRACTORr: Company Name: r i
Address: l al `� N
City: -_
Qualifier Name: LcsA-e1� :J 6hcSe-ND Phone4-:3csVIL <�V�
State Certification or Registration kf6 c I S vJ f (0 3 Certificate of Competency #:
DESIGNER: Architect/Engineer: 4 Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 2-3 0 b Square/LineaarF000tage of Work: q 0 � .--F
Type of Work: ❑ Addition f El Alteration ❑ New )9:CRepair/Replace ❑ Demolition
Description of Work: S �t✓G G(1 5 A e—o CJ a 6 Lo(l_C� 0 UJ5
-a+a
p;3-2> t
3Cn $iz�s-o']
I Ai,_4 � 5�,
r`
i
Specify color of color thru the:
Submittal Fee $
Scanning Fee $
Technology Fee $_
Structural Reviews $
C
Permit Fee $ FCFS_
Radon F�� DBPR $
_ Training/Education Fee $
33t3'
V
CO/CC $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $
(Revised02/24/2014)
$onding 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.
Signature Sign
OWNER or AGENT
The foregoing instruPar-7
was a'ledged before me this T regoing instrume acknowled d before his
c� day of 20 by day of, by
�-- / ` (C b-)IDd C I/)L 2who is y known to P� Ct'15 who is personally known to
me or who has produced as me or who has produced as
identification and who did take an oath.
NOTARY
6;V4-4,C4--
Seal
APPROVED BY
(Revised02/24/2014)
identification and who did take an oath.
NO'
Sigr
Prir
CATHERINE A. DUFFIN Sea
t Notary Public - State of Florida
• Commission # GG 104296
My Comm. Expires May 14, 2021
el J
Plans Examiner
Structural Review
**
Zoning
Clerk
3/29/2019 Property Search Application - Miami -Dade Countv
OFFICE OF THE PROPERTY APPRAISER
Summary Report
Property Information
Folio:
11-2232-029-0220
Property Address:
1060 NE 104 ST
Miami Shores, FL 33138-2656
Owner
ASHLEY OBENOUR
ERIC M WOODLING
Mailing Address
1060 NE 104 ST
MIAMI SHORES, FL 33138 USA
PA Primary Zone
1100 SG FAMILY - 2301-2500 SQ
Primary Land Use
0101 RESIDENTIAL -SINGLE
FAMILY: 1 UNIT
Beds / Baths / Half
3/2/0
Floors
1
Living Units
1
Actual Area
3,107 Sq.Ft
Living Area
2,049 Sq.Ft
Adjusted Area
2,483 Sq.Ft
Lot Size
9,900 Sq.Ft
Year Built
Multiple (See Building Info.)
Assessment Information
Year
2018
2017
2016
Land Value
$346,757
$346,757
$346,757
Building Value
$251,271
$251,767
$78,243
XF Value
$4,402
$4,453
$0
Market Value
1 $602,430
$602,977
$425,000
Assessed Value
1 $443,037
$433,925
$425,000
Benefits Information
Benefit
Type
2018
2017
2016
Save Our Homes Cap
Assessment Reduction
$159,393
$169,052
Homestead
Exemption
$25,000
$25,000
$25,000
Second Homestead
1 Exemption
$25,000
$25,000
$25,000
Note: Not all benefits are applicable to all Taxable Values (i.e. County, School
Board, City, Regional).
Short Legal Description
32 52 42
EVENINGSIDE PB 44-53
LOT 8 & E15FT LOT 9 BLK 2
LOT SIZE 90.000 X 110
OR 19411-1026 12 2000 1
Generated On : 3/29/2019
Taxable Value Information
2018
2017
2016
County
Exemption Value
$50, 100
$50,000
$50,000
Taxable Value
1 $393,037
$383,925
$375,000
School Board
Exemption Value
$25,000
$25,000
$25,000
Taxable Value
1 $418,037
$408,925
$400,000
City
Exemption Value
$50,000
$50,000
$50,000
Taxable Value
1 $393,037
$383,925
$375,000
Regional
Exemption Value
1 $50,000
$50,000
$50,000
Taxable Value
1 $393,037
$383,925
$375,000
Sales Information
OR
Previous
Price
Book-
Qualification Description
Sale
Page
29206-
Non -market financing or assumption of
06/24/2014
$455,000
3856
lease
24452-
Sales which are disqualified as a result of
04/01/2006
$0
4127
examination of the deed
12/01/2000
$188,000
19411
Sales which are qualified
1026
18218-
Sales which are disqualified as a result of
07/01/1998
$0
1449
examination of the deed
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://www.miamidade.gov/info/disclaimerasp
Version
Arco Construction Corporation
March 27, 2019
State of Florida
County of Miami Dade
Before me this day personally appeared Lester Jensen who, being duly sworn, deposes and
says:
That he will be the only person working on the project located at:
1060 NE 104 Street.
Sworn to (or affirmed) and subscribed before me this 27 day of March, 2019 ,by
Personally know / Cs--f e r le c, .5 GfU
Or Produced Identification
Type of Identification Produced
Print, Type or Stamp Name of Notary
I,, ••.,,
CATHERINE A. DUFFIN
Notary Public - State of Florida
Commission # GG 104296
oYi
My Comm. Expires May 14, 2021
ISond&I through National Notary Assn.
General ContractorsXG050516311665 N.E.137' Terrace -IN. Miami, FL 33181
305.892-6507
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.
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: �" ' _
O er
State of Florida
County of Miami -Dade
The foregoing was acknowledge before me this 1 of
B
y who is personally known to me or has produced
as identification.
Notary:
SEAL:
Notary Public - State of Florida
Commission N GG 104296
My Comm. Expires May 14, 2021
bonded through National Notary Assn.
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