RC-09-20-2219, 162 NW 108th StMiami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address Parcel Number
162 NW 108TH ST, Miami Shores, FL 33168 1121360100060
Contacts
Jovens Degage Owner ANOTHER CREATION HOME INC Contractor
162 NW 108 ST, Miami Shores, 33168 1 NATHANIEL CURRY
Mobile: 3058499102 JOVENS.DEGAGE@YAHOO.COM 1535 NW 180 TER, MIAMI, FL 33169
Business:6782494730 NATECURRY@ANOTHERCREATIONHOM
ES.COM
Description: 410 sq ft addition to the side and rear of the Valuation: $ 60,000.00 Inspection Requests
home, the space will be used for a new master bedroom, y�
bath and closet . Total Sq Feet: 410.00� z
Fees
Amount
Application Fee - Other
$200.00
CCF
$24.60
Certificte of Completion for Single Fam
$50.00
and Duplex
Change of Contractor
$110.00
DBPR Fee
$18.45
DCA Fee
$12.30
Education Surcharge
$8.20
Permit Fee
$1,030.00
Planning and Zoning Review Fee
$35.00
Scanning Fee
$36.00
Structural Review ($45)
$60.00
Structural Review ($90)
$90.00
Structural Review ($90)
$90.00
Technology Fee
$30.75
Total:
$1,795.30
Payments
Date Paid
Amt Paid
Total Fees
$1,795.30
Credit Card
03/31/2021
$1,485.30
Cash
09/30/2020
$200.00
Credit Card
06/16/2021
$110.00
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
regulating construction and zoning. Futhermore, I authorize j..0e abgve named contractor to do the work stated.
Authorized Signature: Owner / Applicant /
Contractor / Agent
Date
June 16, 2021 Page 2 of 2
Miami Shores Village�EcF�rVED
Building Department d .
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20-14 ���✓✓✓
BUILDING Master Permit No. RC-09-20-2219
PERMIT APPLICATION Sub Permit No.
QBUILDING ❑ ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS 0 CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 162 NW 108 Street
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#:11-2136-010-0060 Is the Building Historically Designated: Yes NO X
Occupancy Type: Res. Load: Construction Type: CBS Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): covens Degage Phone#: (305)849-9102
Address:162 NW 108 Street
City: Miami Shores state: Florida Zip: 33168
Tenant/Lessee Name: Phone#:
Email: Jovens.degage@yahoo.com
CONTRACTOR: Company Name: Another Creation Homes, Inc. Phone#: (888)591-8291
Address: 8203 SW 27th Court
City: Davie state: Florida Zip: 33328
Qualifier Name: Nathaniel Curry II Phone#: (678)249-4730
State Certification or Registration #: CGC1519372 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 60,000.00 Square/Linear Footage of Work: 420 sf
Type of Work: ❑f1• Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of work: New Master Bedroom Addition
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ . 1
(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
M
WIL
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
G-tk day of 114 20 �by
Soye�h S OeGC'GE, , who is personally known to
me or who has produced—perSo,cJLy kIKo1,V\. as
identification and who did take an oath.
NOTARY PUBLIC:
Print: 2
Seal: ip4W ft- Notary Public State of Florida
Ruth Thomas
y c. My Commission GG 156700
~?wa Expires 11/12/2021
******************************* ****
APPROVED BY (P'.14
Signaturr—
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of _ AA G� , 20 cLA , by
C L rr- who is personally known to
me or who has produced alL %U -G3$ 2a-0g1-as
identification and who did take an oath.
NOTARY PUBLIC:
Sign: � rr�?� -14�2
Print: I`LKyLA -a O ASS
Seal: iow Notary Public State of Florida
Ruth Thomas
My Commission GG 156700
q pd Expires 11/1212021
Plans Examiner Zoning
(Revised02/24/2014)
Structural Review Clerk
Permit Number: RC-0c1--a.0 _aalest
Owner's Name (Fee Simple Title Holder): 7-Novt,n5 Qeactiae Phone: (30 , z4ct-110�L
Owner's Address: Ida NW 10`6 S4reE+
City: /V lami State : r1ocloiG, Zip Code: 331C8
Job Address (where work is being done): Itvw i O`Z S�ree�
City: Miami Shores State: —Florida Zip Code: 331 C12�
Contractor's Company Name: AoA6—c- 6rec A',c v,. lIomF cPhone ZA!�j' 1
Address: Sa03 Sw AV'I C6L,r-t
City: - ()o•v ► E. State: r -- Zip Code: 333 -,-�g
Qualifier's Name : Noxfk viiEd Lic. Number: �GCtSl93 7�
Architect/ Engineer of Record Name:
Address:
City
State:
Describe Work: MclS+E�- tie-A-OavK &U, 41,o VA
Phone:
Zip Code:
I hereby certify that the work has been abandoned and/or the contractor/architect is unable
or unwilling to complete the contract. I hold the Building Official and the Miami Shores
harmless of all legal involvement.
Signature _cam _ Signature
Owner / Agent Contractor / Architect / Engineer
The foregoing instrument was aknowledged
before me this $day of IVl v ,20w, by
�Gvev�S (aaGe Who is personally
known to me or who has produced
A✓�A as indentification.
Notary Public:
Sign and Seal:
The foregoing instrument was aknowledged
before me this day of ,20 , by
Who is personally
known to me or who has produced
Notary Public:
Sign and Seal:
as indentification.
_dGT°N°sTMtr for Form Page 2 of 2
�o� My Conmmission GG 156700
?meads Expires 11/1212021
Miami shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
CONTRACTORS' REGISTRATION
IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR:
A. / COPY OF QUALIFIER'S STATE LICENCES
B. ✓ COPY OF LOCAL BUSINESS TAX RECEIPT
C. COPY OF LIABILITY INSURANCE*
D. COPY OF WORKERS COMPENSATION INSURANCE*
(Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit)
IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY:
A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER
B. COPY OF LOCAL BUSINESS TAX RECEIPT
C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL
CONTRACTOR'S TAX RECEIPT.
D. COPY OF LIABILITY INSURACE*
E. COPY OF WORKERS COMPENSATION INSURANCE*
(Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit)
*YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW:
Certificate Holder:
MIAMI SHORES VILLAGE BLDG DEPT
10050 NE 2ND AVE
MIAMI SHORES, FL 33138
Certificate must specify the description of operations or contractor license number.
.000..80...0.0.0000a00w0.0..00..0...0.II.800000
L.1.0....0...0.00000. 00 N N M 000000 E 0000 N 0...... 0 w6
BUSINESS NAME: AnACY Gtt+Gv� �UYvI �5, C�
BUSINESS ADDRESS: n 3 SV l kT�" (�oLACITY Dcw ie- STATE EL ZIP 33 _5 a�
BUSINESS PHONE: (O� ) .5 q t — Fck I FAX NUMBER ( )
CELL PHONE (G7$ ) o1LtR —4 73d QUALIFIER'S NAME: Ajot{" C-tyi'(J �rL& ry :a
QUALIFIER'S LIC NUMBER: C; GC l,51 9 3 r7 �), C C C 13 3 a373
.. .. . A
I A & . ■ A
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
11ULK;e uU vvvr>ler - vvyukers Cumpensativn insurance axemptivn
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
The foregoing was acknowledge before me this day of
Notary:
SEAL
120
who is personally known to me or has produced
as identification.
Ron Desantis, Governor Halsey Beshears, Secretary
c STATE OF FLORIDA Florida
x,* WE DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION. INDUSTRY- LICENSING BOARD
THE GENERAL CONTRACTOR HEREIN IS CERTIFIED UNDER THE
PROVISIONS OF CHAPTER 489.- _FLORIDA-STATUTES
ANOTHER CREATION HOMES, INC ;>.
8203 SV1/,27TH COURT=
DAV1EFL�3328
h .. K
EXPIRATION DATE: AUGUST 31, 2022
Always verify licenses online at MyFloridaLicense.com
Do not alter this document in any form.
%-eu
This is your license. It is unlawful for anyone other than the licensee to use this document.
BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT
115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000
VALID OCTOBER 1, 2020 THROUGH SEPTEMBER 30, 2021
DBA: OTHER CREATION HOMES INC
Business Name:
Owner Name: NATHANIEL CURRY II
Business Location: 8203 SW 27 CT
DAVIE
Business Phone:888-591-8291
Receipt #:GENER 8L CONTRACTOR
Business Type:GENERAL CONTRCATOR )
Business Opened:10/12/2017
State/County/Cert/Reg: CGC15193 72
Exemption Code:
Rooms Seats Employees Machines Professionals
1
For Vending Business Only
Number of Machines: Vendina Tvoe:
Tax Amount
Transfer Fee
NSF Fee
Penalty
Prior Years
Collection Cost
Total Paid
27.00
1 0.00
0.00
1 2.70
0.00
1 0.00
29.70
THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS
THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is
non -regulatory in nature. You must meet all County and/or Municipality planning
WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when
the business is sold, business name has changed or you have moved the
business location. This receipt does not indicate that the business is legal or that
it is in compliance with State or local laws and regulations.
Mailing Address:
ANOTHER CREATION HOMES INC Receipt #WWW-20-00003350
8203 SW 27 CT Paid 10/27/2020 29.70
DAVIE, FL 33328
�R CERTIFICATE OF LIABILITY INSURANCE ( Ql11C12121
MMR YYY)
T1413 CERTIFICATE 13 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS{ NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT; lithe certificate III~ is an ADDITIONAL INSUARD, the polk:y(les) MUM be sndor"d. ff SUSNO ATION 13 WA�1 0, subject to
the terms and conditions of free policy, certain policies may require an endon nnt, A statement on this certificate does not confer riphta to taw
certificate holder In Ileu of such aMoo►sement(4
PRODUCER j ANGELA DEHART GOMEZ
Morgan Insurance Group Inc 305) 222-A001 F
� Earh ( t� No _ (3011) 222.9008
13155 SW 42nd St 111107 SI tnpkt rnorli mnntirptorn
Miami, FL 33175 INSURER(SI AFFORDING COVERAGE i NAIC r
Phone (305) 222-OMI Fox -(305) 222-9008 j INSURER A I CERTAIN UNDERWRITERS AT LLOYDS
INSURED
i INSURER B I j
Another Creation Home Inc INSURER C : _
8203 SW 27th Court INSURER o ;
Davie, FL 33328 (878) 248.4730 INSURER B I
INSURER F
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER.
... YA i$ TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
ILTR i TYPE Of INSURANCE ADDLIIU
INSR WVD I PMAY NUMBER LIMITS
GENERAL UAIILITY
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
C_.
_ 1,0w,000,00
__...a
1 100,000,00
F N� cLAIMalAOE [ OCCUR
A
N
N
MP0041005002008
05/10/2021 0(5110/2022
MED EXP tAr'r aw 0erwni
s 5,000.00
PERSONAL 3 ADV INJURY
11,000-000,00
i
j
GENERAL AGGREGATE
i 2,000,000,00
GEN%AGGREGATE LUT APPLIES PER;
PRODUCTS - COM1301 AGO
s 2,000,000,00
j-� POLICY LOC
1
AUTOMOBILE LIABILITY
COMBS_ _ N®�INOLE LIMT
iBOOODILY
1
ANY AUTO
j
INJURY (Pat Win)
1
= ALL OWNED SCHEDULED
i I I AUTOS j p
BODILY INJURY (PeraeftVII
-
1
N�AMED
1 E_1 HIRED AUTOS IJ AUTOS
t>PE GE
s
-
UMBRELLA LIAR OCCUR
_
-
EACH OCCURRENCE
�
S
i � lXCESi LAB CLAIMS -MADE
� �
� AGGREGATE
0
�._.. _
I
AND EMPLOYBRF LIMILITY YIN
ANY PROPRIETORIPARTNEWEXECUTIVE .N I A
OFFICERIMEMBER EXCLUDED? _._;
(Mend0M In NMI
DredRIPTION & OPEMTIONS bww
IJ
E L. EACH ACCIDENT 1
E L 011EME - EA EMPLOYE S
E L DISEASE - POLICY LIMIT !-
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AV44h ACORD 101. AddWWW Rerloft $ 110dWe. If rare emm Is required)
CGC1519372
CCC1332373
CERTIFICATE HOLDER
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
10050 NE 2ND AVE
MIAMI SHORES, FL 33138
ACORD 25 (2010105) QF
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES YE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISION$.
THORMW REPRESENTATIVE
AA
Agela Veda Nootl
01948-2010 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are mghltasd marks of ACORO
JIMMY PATRONIS
CHIEF FINANCIAL OFFICER STATE OF FLORIDA
DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS' COMPENSATION
* * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * *
CONSTRUCTION INDUSTRY EXEMPTION
This certifies that theindividual listed below has elected to be exempt from Florida Workers' Compensation law.
EFFECTIVE DATE: 5!7/2021
PERSON: NATHANIEL T CURRY II
FEIN: 261713455
BUSINESS NAME AND ADDRESS:
ANOTHER CREATION HOMES, INC.
8203 SW 27TH CT
FORT LAUDERDALE, FL 33328
SCOPE OF BUSINESS OR TRADE:
Contractor -Project Manager,
Construction Executive,
Construction Manager or
Construction Superintendent
EXPIRATION DATE: 5/7/2023
EMAIL: NATECURRY@ANOTHERCREATIONHOMES.COM
IMPORTANT: Pursuant to subsection 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under
this section may not recover benefits or compensation under this chapter. Pursuant to subsection 440.05(12), F.S., Certificates of election to be exempt issued
under subsection (3) shall apply only to the corporate officer named on the notice of election to be exempt and apply only within the scope of the business or
trade listed on the notice of election to be exempt. Pursuant to subsection 440.05(13), F.S., notices of election to be exempt and certificates of election to be
exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate
no longer meets the requirements of this section for Issuance of a certificate. The department shall revoke a certificate at any time for failure of the person
named on the certificate to meet the requirements of this section.
DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 E01340398 QUESTIONS? (850) 413-1609
Date: MC"Y (�' aO�l
State of Flor t do,
County of QUdel
Before me this day personally appeared t 1 otka"%IE1 (:�S"wl/Twho, being duly sworn,
deposes and says:
That he or she will be the only person working on the project located at:
1 Gc_'), NW I0'Z .5+ree}T � �wt xN
Contractor Signature
Sworn to (or affirmed) and subscribed before me this G day of �-c.-t4 20�,
by a kr C r JL _-L
Personally known
OR Produced Identification,V/_
Type of Identification Produced LCGOG -Ca38
Print, Type or Stamp Name of Notary
EKE
tate of Florida
n GG 156700
021
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 staring 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
The foregoing was acknowledge before me this fa+� day of / 20 a�
By obv ey, S ®Gq C&C.tE-, who is p_ ersonally known to me or has produced
as identification.
Notary:
_ 't Ruth Thomas
SEAL: My Commission GG 156700
~wR Expires 11/1212021
Agreement Between: Owner and Contractor
Contract Type: Addition
Date of Contract Agreement April 27, 2021
Owner:
Jovens Degage
162 NW 108 Street
Miami Shores, Florida 33168
Contractor:
Another Creation Homes, Inc.
8203 SW 27 h Court
Davie, Florida 33328
#CGC 1519372
#CCC1332373
For valuable consideration the parties do hereby agree as follows:
I. SCOPE OF WORK:
Another Creation Homes, Inc. proposes to perform the scope of work specified in the
plans listed below, provided to us by the Owner of the property. The proposal is for
the lump sum price of Seventy Nine Thousand and Zero Cents ($79,000.00); it
includes all labor, material, delivery, coordination, licensing, permitting, and
insurances.
Page
Dated
Notes:
Cover
9/1/20
- Tile allowances based on a $2/sf for indoor tile
Al
1/20/18
- Owner to provide all plumbing fixtures
Erosion
11/19/20
- Owner to pay master permit fee
A2
9/1/20
A3
3/9/21
A4
3/9/21
E1
3/9/21
P 1
3/9/21
M 1
3/9/21
S 1
9/1/20
S2
3/9/21
3/9/21
�%C AS3
2 of 2
II. TIME OF COMMENCEMENT & COMPLETION:
Upon receipt and clearance of initial funds to the Contractor, the Contractor will begin the
permit process and start procuring necessary items to begin construction. Within five(5)
business days of receiving the permit, the Contractor will provide the Owner with a
proposed work schedule, including the completion date. Once work commences it will
continue in a timely manner, as per the schedule provided, with scheduled payments.
However, the Contractor shall not be penalized for Acts of God, strikes, shortages of
critical materials and other delays beyond his control.
III. PAYMENT SCHEDULE:
Fifteen percent (15%) of contract sum is due within five (5) business days of contract
signing. Remaining payments will be made by the Owner based upon work that is in
place, which will be presented to the Owner by the Contractor. The Contractor will
submit a request for paymentt to the Owner. The Owner will have five (5) business days to
submit payment. Construction phase amounts will be listed on the provided schedule,
therefore allowing for the Owner to plan for future payments. Any delays in payments will
delay construction.
IV. INSURANCE: Contractor shall maintain general liability and workers compensation
insurance to insure against risks covered by such insurance.
V. CHANGES TO SCOPE OF WORK: Any changes to the scope of work will come by
way of change order. Change orders can come directly from the Owner to the Contractor;
however, any cost differences that occur due to the change order will be discussed and
settled before the work is done.
VI. WARRANTY: Contractor's warranty shall be limited to defects in workmanship within
the scope of work performed by Contractor and which arise and become known within one
(1) year from the date thereof. All said defects arising after one (l) year and defects in
material are not warranted by Contractor. Contractor hereby assigns to Owner all
warranties on materials as provided by the manufacturer thereof.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the day and
year first above written.
Owner: Jovens Degage
Print
Contractor: Nathaniel Curry II
Print
Signature
Signature
Jd
Property Search Application - Miami -Dade County Page 1 of 1
o
OFFICE Of THE PROPERTY
Summary Report
Property Information
Folio:
11-2136-010-0060
Property Address:
162 NW 108 ST
Miami Shores, FL 33168-4313
Owner
JOVENS DEGAGE
LUCNY LOUIS
Mailing Address
162 NW 108 ST
MIAMI SHORES, FL 33168 USA
PA Primary Zone
0800 SGL FAMILY - 1701-1900 SQ
Primary Land Use
0101 RESIDENTIAL -SINGLE
FAMILY: 1 UNIT
Beds I Baths / Half
2/1/0
Floors
1
Living Units
1
Actual Area
1,615 Sq.Ft
Living Area
1,225 Sq.Ft
Adjusted Area
1,337 Sq.Ft
Lot Size
9,150 Sq.Ft
Year Built
1951
Assessment Information
Year
2020
2019
2018
Land Value
$206,472
$206,472
$196,886
Building Value
$94,606
$95,382
$96,157
XF Value
$3,463
$3,512
$3,649
Market Value
$304,541
$305,366
$296,692
Assessed Value
$303,497
$305,366
$296,692
Benefits Information
Benefit
Type
2020
2019
2018
Portability
Assessment Reduction
$1,044
Homestead
Exemption
$25,000
Second Homestead
Exemption
$25,000
Note: Not all benefits are applicable to all Taxable Values (i.e. County,
School Board, City, Regional).
Short Legal Description
DUNNINGS MIAMI SHORES EXT 6
PB 51-31
LOT 6 BLK 212
LOT SIZE 75.000 X 122
OR 19833-3962 07 2001 1
Generated On : 5/17/2021
Taxable Value Information
2020
2019
2018
County
Exemption Value
$50,000
$0
$0
Taxable Value
$253,497
$305,366
$296,692
School Board
Exemption Value
$25,000
$0
$0
Taxable Value
$278,4971
$296,692
City- ~
Exemption Value
$50,000
$0
$0
Taxable Value
$253,497
$305,366
$296,692
Regional
Exemption Value $50,000 $0 $0
Taxable Value
$253,497
$305,366
$296,692
Sales Information
Previous Sale
Price OR Book -Page
Qualification Description
12/13/2017
$374,000 30819-4840
Qual by exam of deed
07/01/2001
$158,000 19833-3962
Sales which are qualified
12/01/2000
$119,500 19408-0674
Sales which are qualified
06/01/1994
$73,000 16401-0836
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
https://www.miamidade.gov/Apps/PA/propertysearcli/ 5/17/2021