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PL-11-20-2638, 488 NE 101st StMiami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Parcel Number 488 NE 101ST ST, Miami Shores, FL 33138 1132060170440 Contacts MIRYAM COLE Owner DIMANY CONTRACTOR & FLOORING, INC. Contractor 94 NE 102 ST, miami shores, FL 33138 ERNESTO SANCHEZ Other: 7865462447 miryamsvz100@gmail.com Business: 7865742010 Ins section Re c uests: Description: MASTER BATH TO BE REMODELED Valuation: $ 1,800.00 BATH 2 TO BE REMOLED Total Sq Feet: 0.00 „ r Fees Amount Application Fee - Other $50.00 CCF $1.20 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.40 Permit Fee $50.00 Scanning Fee $30.00 Technology Fee $2.50 Total: $138.10 Payments Date Paid Amt Paid Total Fees $138.10 Check # 2933 01/21/2021 $138.10 Amount Due: $0.00 Building Department Copy In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulong construction and zoning. Futhermore, I authorize the above named contractor to do the work stated. sUnature: Owner / Applicant / Contractor / Agent -- v'- I Date January 21, 2021 Page 2 of 2 Miami Shores Village R�Ec JI Building Department NOV 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY; Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 20t)- �- BUILDING ��FBC Master Permit No. ' C' ��- 'L-u 3(P PERMIT APPLICATION Sub Permit No.? L,'" 11 -20 - 2(Q� ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 14 8$ Ng.. ,j i O I City: Miami Shores County: Miami Dade Zip: 3 3� Folio/Parcel#: It- / Z0 b ^ OL N - 0` -CO Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Wn "'^^ Co Lk Phone#:� 5'y� 02�1 Address: I -1 j j t T �UC W04-0 City: NUtZT 0 .M 1/4,- i State: Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: Address: Vty /3VJ or I. 1Ciro ne#: (4WSH-2010 City: �Qcwr�,; c �µii State: ' I . Zip: S3 0 t 8 Qualifier Name: jl:r S ° G 7��-("'ti Phone#: C� a6I f `i - LOl State Certification or Registration #: �� C 1K 2cgo (6J Certificate of Competency #: 1 DESIGNER: Architect/Engineer: � � 1C _ `� f� t'� `�o "� `` ` . F- . Phone#: 4 tic, 2. 5�5 to Address: to�) (�• SW i3 `� G"'f� City: PA State: Fl Zip: OR Value of Work for this Permit: $ / Square/Linear Footage of Work: Type of Work: ❑ Addition Description of Work: 4(A ❑ Alteration ❑L New Repair/Replace ❑ Demolition -Y 644� �+ "IV ►LL 1K! M+oI-W% 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 $ (Revised02/24/2014) TOTAL FEE NOW DUE $ 1,3 a ` 1� 0 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 reinsoection fee will be charaed. Signature k WNER or AGENT The foregoing instrument was acknowledged before me this 16 day of 1U4)V, M i5 rrt 20 2 `i by dLI i Ayam ( LG , who is personally known to me or who has produced identification and who did take an oath. NNl�ll�lla♦N NOTARY PUBLIC:AF o J ti 7, p� �o�x-� Sign: Print: EN g rt..e C = ��y OGG07460400dg:s Seal: ��P� jD�blic Una�� /C. STASE '11%\\ ***************************** Signatureti� CONTRACTOR The foregoing instrume t was acknowledged before me this day off 0 U'P/(/!') 20 "X by r who is personally known to as me or who has produced identification and who did take an oath. NOTARY Sign: Print: G CY-1, Notary Public Stale of Florida Michael Torres MY 08/m 02/2024 HH 028563 OF APPROVED BY g::� Ji � /k Plans Examiner as **************** Zoning Structural Review (Revised02/24/2014) Clerk 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: i Owner State of Florida County of Miami -Dade The foregoing was acknowledge before me this _ ) --�- day of NOVt�,A6 , 20 Q0. By who is as iae. Notary: SEAL: to me or has produced o\\N 1TCNFZ''�ii�� 2 : y #GG 074604 O;;k :°a 6a .�e`g .per: ?'d ONO ob/idcunde�'.0�� Dimany Contractor & Flooring, Inc. 8765 NW 168 St. — Miami Lakes, FL 33018 Phone: (786) 514-2010 November 17, 2020 State of EL o vt i PR County of '"i�Nl . 10 W 0t Before me this day personally appeared Ernesto C. Sanchez who, being duly sworn, deposes and says: That he or she will be the only person working on the project located at: 488 NE 101 Street, Miami Shores FL 33138 E2r�� . s,�•x-ate Con"a or ignature Sworn to (or affirmed) and subscribed before me this _17_ day of November 2020. Personally know OR Produced Identification Type of Identification Produced F#4-- - Print, Type or Stamp Name of Notary `\\��' �tAITCHF4��/ 0 ION y #GG 074604 �2 0`•�_ i 'i�'f'y ublic Undet�,.•\p \�� 841 tl l l 11 off\ \\\\\ Ron DeSands, Governor Halsey Beshears, Secretary Florida STATE OF FLORIDA Df d a-- r EPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTIO THE PLUMBING CO'I PROVISION5�►F NSING BOARD 1�1717IED UNDER THE ? :�ATUTES EXPIRATION DATE: AUGUST 31, 2022 Always verify licenses online at MyFloridaLicense.com a Do not alter this document in any form. This is your license. It is unlawful for anyone other than the licensee to use this document. a Local Busi nms Tax Pecei pt Miami -Dade County, State of Florida THIS IS NOT A BILL - DO NOT PAY 7171779 RECEIPT NO. RENEWAL BUSINESS NAM E/LOCATION 7450682' DIMANY CONTRACTOR & FLOORING INC LBT EXPIRES SEPTEMBER 30, 2020 8765 NW 1G8TM ST Must be displayed at place of business MIAMI LAKES, FL 33018 Pursuant County Code Chapter 8A - Art. 9 8 10 r OWNER SEC. TYPE OF BUSINESS PAYMENT RECEIVED DIMANY CONTRACTOR & FLOORING 196 PLUMBING BY TAX COLLECTOR INC CONTRACTOR 45.00 09/06/2019 r10.RANr.HF7 FRNFRTO Worker(s) 1 CFC1429063 0206-19-007539 This Local Business Tax Recel pt only con"mtis payment of the Local Business Tax. The lacei pt is not a license, permit, or a certi "cation d the hd der's quali"cations, to do business. Hdder mist oortp y with arty governmental or nongmwmmental regulatory laws and requirements which apply to the busi ness. The FEMPTNOabove must bedisplayed onall commercialvehicles -Mlard-Dade CadeSecBa-276. MUkm � For more irdarmation, visit www.miarddadegov/taucdlactor