RC-06-19-1272, 9353 NE 9th AveMiami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
9353 NE 9TH AVE, Miami Shores, FL 33138
Contacts
Permit NO.: RC-06-19-1272
Permit Type: Building (Residential)
Work Classification: Alteration
Permit Status: Approved
Issue Date: 04/13/2020 Expiration: 10/12/2020
Parcel Number
1132060010040
9353 FLORIDA LLC Owner BANANAS GROUP INC Contractor
9353 NE 9TH AVE, Miami Shores, FL 33138 RAFAEL LEYVA
27501 S DIXIE HIGHWAY 403, NARANIA, FL 33032
Home: 3052571000 eallen.bananas@gmail.com
Inspection Requests:
Description. BATHROOM RENOVATION 1 BATH TOP 1 SINK ON I. Valuation: $ 25,000.00 305 762-4949
F FIRST FLOOR, SECOND FLOOR, 1 SHOWER 1 SINK
Total Scl Feet: 0.00 5V
Fees
Amount
Application Fee - Other
$50.00
CCF
$15.00
Certificte of Completion for Single Fam
$50.00
and Duplex
DBPR Fee
$11.25
DCA Fee
$7.50
Education Surcharge
$5.00
Permit Fee
$700.00
Scanning Fee
$9.00
Structural Review ($90)
$90.00
Structural Review ($90)
$90.00
Technology Fee
$18.75
Work Without Permit Fee
$750.00
Work Without Permit Fee
$100.00
Total:
$1,896.50
COV I D 19
Applicant Copy
Payments
Date Paid Amt Paid
Total Fees
$1,896.50
Credit Card
04/13/2020 $1,846.50
Credit Card
06/04/2019 $50.00
Amount Due:
$0.00
For Inspections, Call (305) 762-4949 or Log on at hops://bidg.miamishoresvillage.com/cap/.
Requests must be received by 3pm for following day inspections.
NOTICE: In addition to the requirements of this permit, there may be AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER
additional restrictions applicable to this property that may be found in the GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS,
public records of this county. STATE AGENCIES, OR FEDERAL AGENCIES.
April 13, 2020 Page 1 of 2
Mad i fiolwzv
�v
BUILDING
PERMIT APPLICATION
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
RECEIVED
Iti
FBC 20 to
Master Permit Nolec—(06- jq I
Sub Permit No.
BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
��,,ee
CONTRACTOR DRAWINGS
a
JOB ADDRESS: 1 Pw f-
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): r'X CY°i / LC— Phone#:
Address: 8460 5T r /
7'!
City: � JrQ ly1 State: Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name:
Address: ;.750( 15,
City: bi
Qualifier Name:
P�wG lrw-P --Tr�
4
State Certification or Registration #:
DESIGNER: Architect/Engineer:
ne#: 30 5JG-7kaDD
rL, Zip: 55652-
Phone#: 147r— tOW
Certificate of Competency #: _
Phone#:
Address: y City:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Zip:
Type of Work: ❑ Addition ❑ Alteration ❑ New ® Repair/Replace ❑ Demolition
//��
I
Description of Work: ,)6A X 4Y O v M 4 Y-O � ` S 0 �^
/ors f /9i61 ,Sr_ �r� rlo o -" % sAaa-"ems
Specify color of color thru tile:
Submittal Fee $�')V ' Permit Fee $ CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $
Structural Reviews $
Double Fee $
Bond $
TOTAL FEE NOW DUE $
(Revised02/24/2014) I & q / a e;o
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspectiaafee will be charged.
Signature �� "---�-�� Signatu
OWNER or AGENT
The foregoing instrument was acknowledged before me this
J 5 day ofro— brvart4lby
44—,Ir4seL &rd,er[/L who s personally own to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:_
Print:
Seal: expW$ Wfdf 08, 2021
---------------
APPROVED BY _
CONTRACTOR
The foregoing instrument was acknowledged before me this
day off " by
o is persDnawn to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
rians Examiner
Notary PUWIG Stet* of Florida
Elston Allen
My Cormissicn GO 222380 .
Zoning
3/i)1L1 Structural Review Clerk
(Revised02/24/2014) �!
2/14/2019 Miami -Dade Official Records - Print Document
CFN: 20190070039 BOOK 31313 PAGE 2826
DATE:02/05/2019 08:54:07AM
RIETURN TV. DEED DOC 2,052.00
7RAW"ATE WILE Wi LWANCE AOENCY,.I LC
HARVEY RUVIN, CLERK OF COURT, MIA-DADE CTY
1B2" aftegym Bhrd.. Sm
Averftrrik FIL 33160
THIS INDENTURE, executed on the —LiL of January 2019, bergriestt tket aft JL LOW. hued 00 v WW1
by WW �h�I�rogram of Daft Mthe fGbOW FlorkdeLLC, a , 93 Streat MWW Shur" . PwW of
the second pan.
The Patsy of the fast pert, pus to the Order of the Ckeuil C%t for Dade COUtly. Flo W dated .ktNltawety 6, 2019, Md
in coniikWation of'the aum of $10.00 aid o6w good artd volluabie mwl dsnWih In hand paid, grwft
86eet6, M%1546, retereeae, t9trrrYl O. end CWOM" her htMrast 1110the party of the Eaco(W pit. feY heh and
assigns fir, in the read prnpwW in ti+heni4)ada Coto*, Ftc> 4o described a6:
Lot 4 of UMLYN � HEltiFil`s(oM�:4r,���c��plat fdl" to dw pwwf, ret� d ed it Plot Book 41, d Pap 8, of tre
Rnords of WWeCoartty, t-
AAA 9i5i3 tali: 9 Av/a�ru/�, VtwW Setutae, FL 33138
Su*d to meat WIHRi hme for 2019 wW YMiiasquarg yasm
TOGETHER with ae and singuk it the Wwrtertka, her apputtainrnes6 belon g or In anywise apP042161011I
to that real pny.
TO t wVE AND To HOLD D the aamnte to the party of the so=W patt, hkAw~ sew, In he simple tcrevar:
ANO the party of tilts fW paint does coxan nt to and wittt Ow party oiltts second park, fui Aodth* traex that
in aA to and hr and about thin o nrsyance. dre omdertt of the rvimleed am and the lawns of Fbida
have been i� quid corgpft i wtth M1 aA respectsViiat ttte party of do brat pact ks W&** ao%2amF of the prgl"
catveyed hftvby in f®e a 6 ante has good 6QW and tswhmt atttiW* to "I end convoy said fond, and hereby warranft.
tote We gwaft wO wiN defend the scene spMet the kawM da ns of a8 parsons whomsoew.
IN WTHESS ttf£REOF, JIM pointy Of the IM part, HaurtetM I UAW. tne"wAiNed *W4% far mb by and thm+eug, ben
"d an
sal ufW Guwdwwt J Progrw of Dada County, , tin 00 da haraf and veal an kite day AM year first abom
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Stowe C. Hft. Generae Courmal
do R tarcptann of Daft Ccuvly. I=
OW tM 53 Sbeet; 'Suits 402
Warot, FL 33160
BEFORE me tiffs day petaonWiy appeared Stave C: Nw. wlw OW being der Sworn. says OW he 6 G+Mla W
GaunW for t3t)ARt iHAOMIP PROGRAM OF t?ADE COLWY. tNG, Guardian of the Prape ft of tiariiHette J. Lessor who
lrtecxNed the foreguling b abtunad, who is peraonaly known to me, anct admwWdpd ttedor 1 ins shah he *n=4ad the
of walltiWTNESS my stand atrrd all in tits County and Sbft arereeald saris #' day of ytMWN#1jfflrte._
Sf evs C Ham, Attareey bar Guard m, Notary ftft
�opramrs Of Dade Cow".tnc. n Ewa
& MCI NW 53rd S't eet, State 4W $ a9tt a
ktrratnt,Fk7tide 33168 •. .___.,
https:ltwww2.m iami-dadeclerk.com/0fficialrecords/Pri rttDocument.aspx?QS=YaoUfOzxryl h9ufN EEQ5eOBfgdgYaeQDEGa3uB%2bn5Abj6FCEH BKAgmTAFdN... 1/1
Electronic Articles of Organization
For
Florida Limited Liability Company
Article I
The name of the Limited Liability Company is:
9353 FLORIDA, LLC
L19000010426
FILED 8:00 AM
January 08 2019
Sec. Of State
vherring
Article II
The street address of the principal office of the Limited Liability Company is:
9353 NE 9TH AVE.
MIAMI SHORES, FL. 33138
The mailing address of the Limited Liability Company is:
560 NE 93RD STREET
MIAMI SHORES, FL. 33138
Article III
The name and Florida street address of the registered agent is:
GARY A BODZIN
18205 BISCAYNE BLVD SUITE 2201
AVENTURA, FL. 33160
Having been named as registered agent and to accept service of process for the above stated limited
liability company at the place designated in this certificate, I hereby accept the appointment as registered
agent and agree to act in this capacity. I further agree to comply with the provisions of all statutes
relating to the proper and complete performance of my duties, and I am familiar with and accept the
obligations of my position as registered agent.
Registered Agent Signature: GARY A. BODZIN
Article IV L19000010426
The name and address of person(s) s authorized to manage LLC: FILED 8:00 AM
p O g January 08 2019
Title: AMBR Sec. Of Stale
TERESA CARDENAS vherring
560 NE 93RD STREET
MIAMI SHORES, FL. 33138
Signature of member or an authorized representative
Electronic Signature: TERESA CARDENAS
I am the member or authorized representative submitting these Articles of Organization and affirm that the
facts stated herein are true. I am aware that false information submitted in a document to the Department
of State constitutes a third degree felony as provided for in s.817.155, F.S. I understand the requirement to
file an annual report between January 1 st and May 1 st in the calendar year following formation of the LLC
and every year thereafter to maintain "active" status.
4
License #: CGC1527091 CFC1430157 CCC1331744
27501 S. DIXIE HWY., SUITE 403, NARANIA, FL 33032 Office #: 305-257-1000
Date:, --
State of Florida
County of Miami Dade
Before me this day personally appea red '�AF� �0,, VA
Deposes and says:
That he will be the only person working on the project located at:
q 353 N C q Avg
Contractor Signature
Fdo,
Sworn to (or affirmed) and subscribed before on this i day of -
Personally known
Stamp and Sign
�hNotary Public Stets of Florida
Elston Allen
My Commission C3G 222380
Expires OS262022
who, being duly sworn,
WIN
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:
Owner
State of Florida
County of Miami -Dade yy yy
The foregoing was acknowledge before me this day of t; 20 .
By 6 P eCc IV/ Cfi 5 who is p rsonally known to me or has produced
as identification.
Notary: Z
YC
SEAL: -'•.,,,., EXPIRES March 06, 2021