EL-19-994Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
1350 NE 1015T ST, Miami Shores, FL 33138
r—t.r+c
Issue Date: 05/09/2019
Parcel Number
1132050230020
Permit Ao.: EL-05-19-994
Perm, it Type: BectriCal - Residential
Work Classification: Alteration
Permit Status: Approved
Expiration: 11/05/2019
ELIZABETH & DIRK PETERSON Owner ANAMIK ELECTRIC CORP Contractor
MIGUEL MENDEZ
Mobile: 3053339955 lisavp2003@yahoo.com
Business: 7863956931
Other:3052823168
Inspection Requests:
Description: RUN NEW 230 VOLT CIRCUIT FOR GARAGE AIR Valuation: $ 850.00 Inspec ion Re
49
CONDITIONER
Total Sq Feet: 0.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$0.60
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.20
Permit Fee
$50.00
Scanning Fee
$9.00
Technology Fee
$2.50
Total:
$116.30
Payments
Date Paid Amt Paid
Total Fees
$116.30
Credit Card
05/03/2019 $50.00
Credit Card
05/09/2019 $66.30
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 a and that all work will be done in compliance with all applicable laws
regulating construction and zoning. Futhermore, I authorize the aboveR&ned 6ontractor to 6qPeork stated.
Authorized Signature: Owner / Applicant / Contractor / Agent
Date
May 09, 2019 Page 2 of 2
L,,,,O RESflfl�La
Miami shores 1� illage
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
NP-ticevto Owner Workers' Com-pensation Insurance Exemption �I
a._.:..! .�;. i� �'ii�t'+i•nt�:j7Y}'��.S.�.t-'�++.. �w.a •_.,."^w.^"!.•-,a"` i. 5' �1�, 'J'3,s sr.* �.`� -Jr<:' . .- ._ 1
Florida
allows
obtaini
Your• a
day lab
be the (
worker
I BY SI
i CONTI
Sigrtatt
w requires Workers' Compensation insurance coverage`under Chapter 440 of tltc Florida Statutes. Fla. Stat,1 -4-I0.05
)orate officers in the construction industry to exempt themselves from this requirement fur am construction prO.iect prior to
building, permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts C3roc11ure:
An employer in the construction industry Moo employs one or more part-time or toll -Limo
employees, including the owner, must obtain workers' compensation coverage. Corporate officers
or members of a limited liability company (LLC) in the construction industry nmy elect to be
exempt it':
I . The ofticcr owns at least 10 percent of the stock of the corporation. or in the case of
an LLC, a slatenient attesting to the minimum 10 percent o��nership:
2. The officer is listed as an officer of the corporation in'thc records of the Florida
Department of State. Division ofCorporatioils: and
3. The corporation is registered and listed as active \\ith the Florida Deparnnent of
State. Division of Corporations.
No more than three corporate officers per corporation or limited liabilitx company members are
allowed to he exempt. Construction exemptions are valid for a period of two \ears or until a
voluntary revocation is f ited or the exemption is revoked by the Division.
Tractor is requesting a permit under this workers' compensation exemption and has acknow 1�d,;e that he or she %till not. use
r part-time entpiuyees or subcontractors for your project. •I'he contractor has provided an affidavit stating that Ire or she will
lv person allowed to work on your project. In those circumstances. Miami Shores Village flocs not require veriflcation of
compensation insurance coverage from (lie contractor's company for day labor. part-tinie employees or subcontractors.
N1NG BELOW YOU ACKNOWLEDGE: THAT YOU HAVE READ "1111S NOTICE AND I.fNDERSTAND ITS
lTS. —
Owner
State 011,10rida
County miami-Dade
The for going was acknowledge before me this - clay of 4 .20
13v S,who is personally known to me of -has produced
as identification.
No4try
YR CHRISTOPHERJ. OMPILIO
SLAL; ; 0,in.
p w` MY COMMISSION J 2, 2021�73
Miami Shores Village
RECEIVED
Building Department MAY 03 2019
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 } p
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20(_�k
BUILDING Master Permit No. MC -OQ p -U�-�
PERMIT APPLICATION Sub Permit No. f; I - IDS - Roc "1
❑BUILDING ❑■ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION DRENEWAL
PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 1350 NE 101 ST
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#:11-3205-023-0020 Is the Building Historically Designated: Yes NO
t
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): DIRK PETERSON Phone#:
Address:1350 NE 101 ST
City: Miami Shores State: FL Zip: 33138
Tenant/Lessee Name: Phone#:
Email:
t/ �j 305 - 28 3l�3
CONTRACTOR: Company Name:
nn 17�i ��.1 `c, glee-74"_1, C&Me_ Phone#:
Address:
City: ��cil State: )5z• Zip:'7 ?J'�
Qualifier Name: �t�t M�VLC Phone#:
State Certification or Registration #: �� /3�b5 n Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration New L ❑ Repair/Replace ❑ }Demolition
Description of Work:, ��� 2 3� Vu �� G17 GU i l" 1 yii r �� LZ rIGtJt �✓i
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Technology Fee $_
Structural Reviews $,
Permit Fee $
Radon Fee $
Training/Education Fee $
CCF $_
DBPR $
CO/CC $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ 60
(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
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 absencq of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this
7 day of 14VVr r 20 19 by
13�no9 P{� who is personally known to
-� _ ►�
me or who
has produced �—� �� ` '+C— as
The foregoing instrument was acknowledged before me this
day of �, 20 19 by
�tV
-`� ►' llv� who is personally known to
me or who has produced
identification and who did take an oath. identification and who did take an oath.
as
NOTARY PUBLIC: NOTARY P IC: l
Sign: Sign: l
Print: IRA DE LER Print:
Seal: My comm. expires May 0 , 2023 Seal: ,• CHRISTOPHER J. POMPILIO
No. GG 313153 �, MY COMMISSION # GG 078673
Bonded thru 1lshton Agency, Inc. (80051 4854 ,.: og EXPIRES: Jury 2, 2021
•X
•� °!,(�.°p•• Banded Thru Notary Public UW6rwritm
############################################################## # ################
APPROVED BY S Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
Anamik Electric Corp.
Florida License # EC13005900
15060 Bristol Lane - Davie, FL 33331
305-282-3168
4/23/2019
State of Florida
County of Broward
Before me this day personally appeared %tA\gk `Q- ` Oe(\6JL- who, being duly sworn,
deposes and says:
That he or she will be the only person working on the project located at:
1350 N.E. 101 Street Miami Shores, FL 33138
Contractor's Signature
Sworn o (or af--firrn ed) and psubscri ed before me this 23 day of April, 2019 by
Personally known
OR Produced Identification
Type of identification produced
ruq`o
AILYN AMENEZ
�otts��
MYCOMMWONAFF98M
* *
��lFOFF1.�\o`
Dcpmi" 21, 2=
SOIMIdThNBidgtNOYf:__- 11
Print, Type or Stamp of Notary
5/3/2019
Property Search Application - Miami -Dade County
r� �a
'A.
OF
THE
PROPERTY
APPRAISER
OFFICE
Summary Report
Property Information
Folio:
11-3205-023-0020
Property Address:
1350 NE 101 ST
Miami Shores, FL 33138-2611
Owner
DIRK PETERSON
ELIZABETH PETERSON
Mailing Address
1350 NE 101 ST
MIAMI SHORES, FL 33138 USA
PA Primary Zone
1600 SG FAMILY- 3501-4000 SQ
Primary Land Use
0101 RESIDENTIAL - SINGLE
FAMILY: 1 UNIT
Beds / Baths / Half
3/2/0
Floors
1
Living Units
1
Actual Area
3,418 Sq.Ft
Living Area
2,522 Sq.Ft
Adjusted Area
2,869 Sq.Ft
Lot Size
14,720.86 Sq.Ft
Year Built
Multiple (See Building Info.)
Assessment Information
Year
2018
2017
2016
Land Value
$1,782,145
$1,876,058
$1,876,058
Building Value
$295,030
$297,258
$299,486
XF Value
$41,247
$41,638
$42,029
Market Value
$2,118,422
$2,214,954
$2,217,573
Assessed Value
1 $1,118,736
$1,095,726
$1,073,190
Benefits Information
Benefit
Type
2018
2017
2016
Save Our Homes
Assessment
$999,686
$1,119,228
$1,144,383
Cap
Reduction
Homestead
Exemption
$25,000
$25,000
$25,000
Second
Exemption
L!!,000
$25,000
Homestead
Note: Not all benefits are applicable to all Taxable Values (i.e. County, School
Board, City, Regional).
Short Legal Description I
5 53 42
M SHORES BAY PK ESTS PB 55-83
LOT 2 BLK 1
LOT SIZE 93.170 X 158
OR 20247-0593 03 2002 1
Generated On : 5/3/2019
Taxable Value Information
2018
2017
2016
County
Exemption Value
$50,000
$50,000
$50,000
Taxable Value
$1,068,736
$1,045,726
$1,023,190
School Board
Exemption Value
$25,000
$25,000
$25,000
Taxable Value
1 $1,093,736
$1,070,726
$1,048,190
City
Exemption Value
$50,000
$50,000
$50,000
Taxable Value
$1,068,736
$1,045,726
$1,023,190
Regional
Exemption Value
1 $50,000
$50,000
$50,000
Taxable Value
1 $1,068,736
$1,045,726
$1,023,190
Sales Information
Previous Sale
Price
OR Book -Page
Qualification Description
11/29/2011
$1,292,500
27946-3238
Qual by exam of deed
03/01/2002
$805,000
20247-0593
Sales which are qualified
11/01/1998
$485,000
1 18368-2503
Sales which are qualified
01/01/1997
$395,000
17514-3151
1 Sales which are qualified
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/disciaimer.asp
Version