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PW-19-799Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Issue Date: Location Address Parcel Number 358 NE 104TH ST, Miami Shores, FL 33138 1121360130180 Contacts Pemwt NO.: PW44-19-799 Permit Type: Public Works Work Classification: Public Works Permit Status: Applied Expiration: 10/08/2019 ALFREDO PADILLA Owner MULTITECH CORP Contractor 358 NE 104 ST, MIAMI SHORES, FL 331382018 LEOPOLDO D'ESPAUX Other:3057561507 Description: IMPROVEMENT OF DRIVEWAY IN FRONT OF THE j Valuation: L$ 2,951.00 Inspection Re uests: HOUSE 305�2-49 TotaISq Feet: 590.00 Fees Amount Education Surcharge $0.60 Notary Fee $5.00 Public Works Permit Fee $100.00 Scanning Fee $9.00 Technology Fee $2.50 Total: $117.10 Building Department Copy Payments Date Paid Amt Paid Total Fees $117.10 Credit Card 04/19/2019 $117.10 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. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulati� construction and zoning. Futhermore, I authorize the above named contractor to do the work stated. Authorized Signature: Owner / Applicant / Contractor / Agent Date April 19, 2019 Page 2 of 2 \0� �'V(D oj,� Miami Shores Village \� v Public Works Department \ (305)795-2210 Public works forms are available from the building department, 10050 NE 2"d Ave., Miami Shores, FL 33138 PUBLIC WORKS PERMIT APPLICATION Permit Type: Work in the Right -of -Way on Miami Shores Village or Miami -Dade Property nn Permit#: Name of Applicant (if utility see below): \ t' r IL4o -` ' i_` ... \ ` 4� Owner off the followin described property: �./ 41 Legal Description: Lot 5.45 Block b Subdivision ��� ► `�0►'b1125 �•G S Folio #; ob -- ©� Q !2 Address: 3 TJ' •�p - 22� " �� ", UTILITY NAME: Qualifier/Authorized Agent: Address: City: State: _ Telephone: Email: State Certification or Registration #: CONTRACTOR NAME: l--V' ­Ve e_" Qualifier/Authorized Agent: %Nw Address: S90 . S� g" 1 City: PO %W& w► I State: _ Telephone: 3e 2AIR % Email: e3.a C' State Certification or.,Registration #:�� t's2t�i1 S Requests permission to install (de cribe wor , attach sepa way: Intl;jlL[) �kV � �Nl�� ZIP: Certificate of Competency # GCL c.? . �-- ZIP: opt CZ �'C,'C . 't. Zertificate of Competency #: ' ,a e,pa e ' neces ,,.fry ' t adjoi ing ri t of .y f ro,,? e �1ay �- Type of Work: Paving ❑'Utility ❑ Sidewalk ❑ Electric ❑ 'Irrigation ❑ Landscape ❑ Antenna ❑ Other: 'DESIGNER:"Architect%Engineer: , Address: City: Telephone: ' Registration #: ' State: Email: ZIP: Value of Work for this Permit: $ 3 o Square/Lineal Footage of Work: V S' *****Fees***** Permit Fee $ 100.00 Notary $ Training/Education $ 0.20 Technology Fee $ 0.80 Scanning $ 10 Bond $ (if required) Total Fee Now Due $ - Bonding Company's Name (if applicable): Bonding Company's Address: City: State: ZIP: Application'is hereby made to obtain a public works permit to do the work in the right of way 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, regulation construction in this,jurisdicticn: I understand that`separat6 permits must•be secured for APPLICANT,'S AFFIDAVIT:) eertifyJthaX all the foregoing information is aoWrate.and that all work will be done'in compliance with applicable' laws regulating con truc ion arpdspecifica(ly.copstruction -in the right-of-way. d ; 4 "WARNING TO APPLICANT: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO THE RIGHT-OF-WAY. 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 public works permit with an estimated value exceeding $2,500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochureMill be delivgred;to'the porson'who�e.Vroperty is subject to the attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which'oteurs's'even (,7)� days°after.t�ie:pu)ilic"works{permit is`issued Aln the absence of such posted notice, the inspection wllj1not be approved and a r'einspectAion'will be charged. ,.+1?e• l - "gyp ...... 2 M . ..,,� r» ... : HNC ` �'.R• �, .;�. r i e.'�. .l.J :o,�' n .�..+ ...+ �''+.- w: :» a . •s .,,. r » .. ...... Signature Signature Applicant or Authorized Agent Company/Utility Agent The fore oing instrumen as ark wledged before The forego' 'nstrumen was 5c wledge b re me his �'�df 2 t by ern this ' iayof 20� py •�VhO Z► �s`.S• ,i.A 'f `�wh• is personally known to me or who has produced is personally known to me or who has produced as as identification. NOTARY PUBLIC: w Sign: AIDA MIRTHA VALLEJO Print: :°°�� MY COMMISSION #FF984883 SEAL: EXPIRES: APR 21, 2020 °►^d� Bonded through 1st State Insurance identification. NOTARY PUBLIC: - Sign: AIDA MIRTHA VALLEJO Print: : MY COMMISSION #17198M SEAL: EXPIRES: APR U-,2W- Bonded through 1st State Insurance APPROVED BY:= ANAkO\ Public Works Director, or Designee 2017-04-15 4/8/2019 Property Search Application - Miami -Dade County OFFICE OF THE PROPERTY APPRAISER Summary Report Property Information Folio: 11-2136-013-0180 Property Address: 358 NE 104 ST Miami Shores, FL 33138-2018 Owner ALFREDO S PADILLA &W BEATRIZ Mailing Address 358 NE 104 ST MIAMI SHORES, FL 33138-2018 PA Primary Zone 1000 SGL FAMILY - 2101-2300 SQ Primary Land Use 0101 RESIDENTIAL -SINGLE FAMILY: 1 UNIT Beds / Baths / Half 2/1/0 Floors 1 Living Units 1 Actual Area 1,380 Sq.Ft Living Area 1,086 Sq.Ft Adjusted Area 1,232 Sq.Ft Lot Size 9,225 Sq.Ft Year Built 1948 Assessment Information Year 2018 2017 2016 Land Value $230,638 $230,638 $198,007 Building Value $85,747 $85,747 $85,747 XF Value $548 $549 $550 Market Value $316,933 $316,934 $284,304 Assessed Value $103,325 $101,200 $99,119 Benefits Information Benefit Type 2018 2017 2016 Save Our Homes Cap Assessment Reduction $213,608 $215,734 $185,185 Homestead Exemption $25,000 $25,000 $25,000 Second Homestead Exemption $25,000 $25,0001 $25,000 Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). Short Legal Description MIAMI SHORES SEC 5 PB 10-47 LOT 4 & E1/2 LOT 5 BLK 118 LOT SIZE 75.000 X 123 OR 14309-1923 1089 1 Generated On : 4/8/2019 Taxable Value Information 2018 2017 2016 County Exemption Value $50,000 $50,000 $50,000 Taxable Value $53,325 $51,2001 $49,119 School Board Exemption Value $25,000 $25,000 $25,000 Taxable Value $78,325 $76,200 $74,119 City Exemption Value $50,000 $50,000 $50,000 Taxable Value 1 $53,325 $51,200 $49,119 Regional Exemption Value 1 $50,000 $50,000 $50,000 Taxable Value $53,325 $51,200 $49,119 Sales Information Previous Sale Price OR Book -Page Qualification Description 10/01/1989 $75,000 14309-1923 Sales which are qualified 01/01/1973 $34,000 00000-00000 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/disclaimer.asp Version: Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 COVENANT OF CONSTRUCTION NTHIN RIGHT OF WAY Whereas, (owner) ;nRe,� 6 • qd l /-? hereinafter referred to as the owner oft following describe property (address): E 10X 5X-R(4m1 <Sho)Qes m Legal Description: Lot Block Subdivision i'» 4 r Folio # Je ineK4 Requests permission to install (describe work) eel CFN 20183R0437211D OR BK 31067 Ps 1922 (1F'3s) RECORDED 07i20i2018 10:52:1,;12 HARVEY RUVINt CLERK. OF COURT 7IAiI-DALE COUNT'Yt FLORIDA OF FLORIDA, COUNTY OF DADS ; Y CERT7 FY f hi ° fhi; is a true copy of ft ¢ax flied hi this office_or rkW of A ' _, AD. 2Q CLER art d County Courts .G. 40 W S ° s1�` er o6g( le aJaI4?)-7 oa-� oFSAe400�k. Within the public right of way of (address) /US7-gl% - t SAD ,FG 33%3 �. IN CONSIDERATION of the approval of this permit by the Village, the owner agrees as follows: 1. To maintain and repair, when necessary, the above -mentioned item(s) installed within the dedicated right of way. If it becomes necessary for Miami Shores Village or Dade County to make repairs or maintain said items within public right of way including restoration of street by reason of the Owner's failure to do so, such expense shall be paid by the Owner or shall constitute a lien against the above described property until paid. 2. The owner does hereby agree to indemnify and hold Miami Shores Village or Dade County harmless from any and all liability, which may rise by virtue of permitting the installation of these items within the public right of way. 3. The Owner does hereby agree to remove or relocate their facilities at their own expense, within 60 days notice by the Village to do so. Failure to comply with this notice will result in the Village causing the item(s) to be removed and a lien being placed on the property and/or assessed against the Owner for all costs incurred in the removal and disposal of the item(s). 4. The undersigned further agrees that these conditions shall be deemed a covenant running with the land and shall remain in full force and effect and be binding on the undersigned, their heirs and assigns, until such time as this obligations has been canceled by an affidavit filed in the Public Records of Dade County, Florida by the Village Manager of Miami Shores Village (or his fully au .J�orized representative). Signature Owner or Agent State of Florida County of Miami Dade The foregoing instrument was acknowledged before me this (8 day of lcuuJ , 20 �, by S U A who is personally known to me or who has produced X-� LkC:E-NKR identification. NOTAR UBLIC: Sign: Print: ( N6 I A h�.1✓� SEAL: Notary Public state of Florida "india Alvarez 'Ay Commission FF 156750 Expires09103 /2018 R a. a. 'k A -A, Notice to Owner - Workers' Com Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 nsation 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: I . 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. t Signature: l " ; Owner State of Florida County of Miami -Dade The foregoing was acknowledge before met is day of , 20A__ l� . whois personally known to me or has produced r Y 9- N � as identification. Notary SEAL: --------- p SINDIA ALVAREZ MY COMMISSION # GG 238273 Bonded Thru Notary public UnderwMers Multitech Corp ■ State of Florida General Contractors 5801 SW 89th PL, Miami, FL 33173 workdone@att.net (305)275-1229 PROPERTY: 358 NE 104th Street, Miami Shores, FL 33138 JOB: Driveway. State of Florida County of Miami Dade Date: 04/6/2019 Before me this day personally appeared Leopoldo D'Espaux Diaz who, being duly sworn deposes and says: That he will be the only person working on the project located at: 358 NE 104th Street, Miami Shores, FL 33138 I Cont ctor si nature Sworn to me and subscribed before me this 6th day of April 2019 by Leopoldo D'Espaux Diaz who is personally known to me. Notary 4 ,ti AIDA MIRTHA VALLEJO MY COMMISSION #Ft�9BM EXPIRES: APR 21, 2020 °r Bonded through 1st State Insurance -,rm,pko Al or- d eive (A) a DI FA-n�-oF6e AodYJ sc Lf -zrcG)es "-A1e/L coticRe� cfi�i v'eajV - Y IECENEJ nAll�. APR 11 919 `75.00 eQ P.rs -N AA cr, w cL. • 0 . 1 NL Shcrewage I'- APFPOVED BY DATE 4 BONING DE �91 r BI Dr-- DEPT SUB,;ECT fOC *�LJAN Wi" STATE AN� 4 7s: r LL FELER ` C LATIONS - 3 AFMMIP Witmu vwau c w-%Am cc= m