MC-19-1217Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Permit NO.: MC-05-19-1217
ely-� 0. Permit Type: Mechanical - Residential
P
L Work Classification: A/C Replacement
Permit Status: Approved
Issue Date: 06/04/2019 1 Expiration: 12/02/2019
Location Address Parcel Number
373 NE 91ST ST, Miami Shores, FL 33138 1132060136530
Contacts
ARCA INTERNATIONAL GROUP Owner COMFORT AIR CONDITIONING, INC Contractor
373 NE 91 ST, MIAMI SHORES, FL 33138 NELSON RODRIGUEZ
Home: 3057737064
Business: 7862824396
Description: IR CONDITIONING REPLACEMENT. Valuation: $ 5,000.00 Inspection Requests:
TotalSq Feet: 0.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$3.00
DBPR Fee
$2.63
DCA Fee
$2.00
Education Surcharge
$1.00
Permit Fee
$125.00
Scanning Fee
$9.00
Technology Fee
$4.38
Total:
$197.01
Payments
Date Paid Amt Paid
Total Fees
$197.01
Credit Card
06/04/2019 $147.01
Credit Card
05/28/2019 $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: that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating construcpo jfnd 460g. Futhermore, I authorize the above named contractor to do the work stated.
Authorized
/ Applicant / Contractor / Agent
Date
June 04, 2019 Page 2 of 2
(".OMF(11iT AIR ("'ON )ITI\T(i
CA(;-1 It 17 3 7 9
DATE: �) 12, 1 n
STATE OF:
COUNTRY OF:
personally appeared ��-Spn ��)2" �eZ
Before me this Day
p y pp .who, being duly sworn, deposes and
says:
That he or she will be person working on the project located at:
Sft(ys
Contractor Signatu
Sworn to ( or affirmed) and subscribed before me this 3 day of C)lD 20
By V �-
�t':siyr YESENIARIVEROTUCKER
MY COMMISSION # GG 013439
EXPIRES: August 7, 2020
Thm Nowy Pubic underwriters
Personally know:
Or Produced Identification: D. L - V— 3102. — 02 U — (0(0— 3�—b
Type of Identification Produced: J1 uz k.dPk- -jDUe2 L.h,e�1SL
BUILDING
PERMIT APPLICATION
❑BUILDING
❑PLUMBING
JOB ADDRESS:
❑ ELECTRIC
MECHANICAL
Miami Shores Village RECEIVED
g MA 2 s
p ot9
BuildingDe artment
� BY:
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949 �� [,
FBC 201 �
Master Permit No. (PVC QS - 19
Sub Permit No.
❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
[:]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
City: Miami Shores County: Miami Dade Zip: 3 3 l30
Folio/Parcel#: it -3,lok03- 653 Q Is the Building Historically Designated: Yes NO X
Occupancy Type: Load: `� �J�.Construction Type: Flood Zone: BFE: FIFE:r'7Yc OWNER: Name (Fee Simple Titleholder): A &7-T—V IARM � �CGtpU(5 Phone#:
Address: -3 33 sE, 1 Av sr� 25-30
City: /)')lL} n f State: f! Zip..
Tenant/Lessee Name:
Email
CONTRACTOR: Company Name: 60/N,4:0p1- 40 (0d(Idlj2/0/(//i(/G _ , 7XIC. Phone#: 79&— oc9.z — 739(o
Address: 417 7/ AIN 177 . Yji�
City: /YIL4g-?� State: rC Zip: 3345�
Qualifier Name: �,(/ �i/✓f')//
State Certification or Registration #:
DESIGNER: Architect/Engineer:
Address:
Value of Work for this Perm. :
Type of Work: ❑ Addi 'on
Description of Work: ma
[PAP"
Certificate of Competency #:
State: Zip:
Square/Linear FOOt2ge of Work:
Alteration ❑ New �j7Repair/Replace
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
0�3 Permit Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
❑ Demolition
CCF $ CO/CC $
DBPR $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $
(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 inspect' n which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not b a rov d a reinspection fee will be charged.
Atom)
Signature Signature
R or AGENT CONTRA OR
The foregoing instr ment as acknowledged before me this The foregoing instr en as acknowledged before me this
d�<Z)
of 20 19 by G�L--da of 20 lC by
1 I^I o who is personally known to �`-'P ho is Personally known to
me or who has produced
identification and who did take an oath.
as `me or who has produced
identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sig Sign:
Print: cN _ c'114� Print:
Seal:IL
OF
APPROVED BY
(Revised02/24/2014)
as
Seal: _
REj1ECAFONT-ROMERO
MY COMMISSION # GG 216112
NPnsof garbed Notw y Public Um writers
Examiner Zoning
Structural Review
Clerk
Property Search Application - Miami -Dade County Page 1 of 1
! 1D. OFFICE OF THE PROPERTY APPRAISER
Summary Report
Property Information
Folio:
11-3206-013-6530
Property Address:
373 NE 91 ST
Miami Shores, FL 33138-3129
Owner
ARCA INTERNATIONAL GROUP
LLC
Mailing Address
333 SE 2 AVE STE 2530
MIAMI, FL 33131 USA
PA Primary Zone
1000 SGL FAMILY - 2101-2300 SQ
Primary Land Use
0101 RESIDENTIAL -SINGLE
FAMILY: 1 UNIT
Beds / Baths / Half
3/2/0
Floors
1
Living Units
1
Actual Area
3,209 Sq.Ft
Living Area
2,169 Sq.Ft
Adjusted Area
2,609 Sq.Ft
Lot Size
12,800 Sq.Ft
Year Built
1955
Assessment Information
Year
2018
2017
2016
Land Value
$383,743
$383,743
$320,290
Building Value
$181,586
$181,586
$181,586
XF Value
$650
$660
$670
Market Value
1 $565,979
$565,989
$502,546
Assessed Value
1 $565,979
$552,8001
$502,546
Benefits Information
Benefit
Type
2018
2017
2016
Non -Homestead Cap
Assessment Reduction
1
$13,189
Note: Not all benefits are applicable to all Taxable Values (i.e. County,
School Board, City, Regional).
Short Legal Description
MIAMI SHORES SEC 1 AMD PS 10-70
LOTS 21 & 22 BLK 48
LOT SIZE 100.000 X 128
OR 21217-1334 0403 1
COC 23888-0815 09 2005 1
Generated On: 5/28/2019
Taxable Value Information
2018
2017
2016
County
Exemption Value
$0
$0
$0
Taxable Value
$565,979
$552,800
$502,546
School Board
Exemption Value
$0
$0
$0
Taxable Value
$565,979
$565,989
$502,546
City
Exemption Value
$0
$0
$0
Taxable Value
1 $565,979
$552,800
$502,546
Regional
Exemption Value
$0
$0
$0
Taxable Value
1 $565,979
$552,800
$502,546
Sales Information
Previous
OR Book -
Price
Qualification Description
Sale
Page
31325-
Federal, state or local government
02/07/2019
$493,100
1093
agency
23888
09/01/2005
$535,000
Sales which are qualified
0815
22525-
Sales which are disqualified as a result
07/01/2004
$0
2455
of examination of the deed
22112
[02/01/2004
$4101000
Sales which are qualified
4690
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 hftp:/twww.miamidade.gov/info/disclaimer.asp
Version:
https://www8.miamidade.gov/Apps/PA/propertysearch/ 5/28/2019
Detail by Entity Name
Page 1 of 2
Florida Department of State,
jffOros
�_✓ r c r
Department of State / Division of Corporations / Search Records / Detail By Document Number /
Detail by Entity Name
Florida Limited Liability Company
ARCA INTERNATIONAL GROUP, LLC
Filing Information
Document Number
L14000152212
FEI/EIN Number
47-2316519
Date Filed
09/29/2014
State
FL
Status
ACTIVE
Last Event
LC AMENDMENT
Event Date Filed
11/05/2014
Event Effective Date NONE
Principal Address
333 SE 2 AVE SUITE 2530
MIAMI, FL 33131
Changed: 03/05/2018
Mailinq Address
333 SE 2 AVE SUITE 2530
MIAMI, FL 33131
Registered Agent Name & Address
ANTELO, EMILIO
333 SE 2 AVE SUITE 2530
MIAMI, FL 33131
Name Changed: 03/05/2018
Authorized Person(s) Detail
Name & Address
Title Authorized Member
Gonzalez Ocque, Miguel A
333 SE 2 AVE SUITE 2530
MIAMI, FL 33131
Title Authorized Member
ANTELO, EMILIO
DIVISION OF GORPORRTIONS
http://search. sunbiz.org/Inquiry/CorporationSearchISearchResultDetail?inquirytype=Entity... 5/24/2019
VA. ,i
Notice to Owner — Workers' Corn
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:
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 al wed to work on your project. In these circumstances, Miami Shores Village does not require verification of
workers' compensate n insurance coverage from the contractor's company for day labor, part-time employees or subcontractors.
BY SIGNING Bf OM ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS
CONTENTS.
Signature:
State of Florida
County of Miami -Dade
The foregoing was acknowledge before me this Zg day of a , 20
ci
a ' ,✓1 who is personally known to me or has produced
By I 1 t
/ as identification.
Notary:J
SEAL:
Via: ► ., RPECAFONT-ROMERO
MY COMMISSION # GG 2W72
Balled 71uu Notar!' Public Underwkers