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DEMO-10-20-2381 (2)Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Parcel Number 9333 N MIAMI AVE, Miami Shores, FL 33150 _ 1132060130350 Contacts Patricia Pinicheiro Owner CDS2, CORP _ Contractor 9333 N Miami AVE WESLEY A CASTELLANOS 333 SE 2 AVE, MIAMI, FL 33131 Business:7862185335 WESLEY@CASTELLANOSDESIGN.COM Inspection Requests: Description: EXISTING FAMILY ROOM UNDER DEMOLITION ? Valuation: $ 20000.00 PERMIT TO REPLACE DEMO 09 19 2239 "N "j' Total Sq Feet: 500.00 ''�� Fees Amount Payments Date Paid Amt Paid 100% Permit Renewal Fee $250.00 Total Fees $295.00 Structural Review ($45) $45.00 Credit Card 12/03/2020 $295.00 Total: $295.00 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 the above named contractor to do the work stated. Authorized Signature: Owner / Applicant / Contractor / Date December 03, 2020 Page 2 of 2 Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Parcel Number 1333 N MIAMI AVE, Miami Shores, FL 33150 1132060130350 Dntacts Patricia Pinicheiro Owner CDS2, CORP Contractor 9333 N Miami AVE WESLEY A CASTELLANOS 333 SE 2 AVE, MIAMI, FL 33131 Business:7862185335 WESLEY@CASTELLANOSDESIGN.COM [ Description: EXISTING FAMILY ROOM UNDER DEMOLITION Valuation: $ 20,000.00 Inspection Requests PERMIT TO REPLACE DEMO 09-19-2239 30S 762 4949 ti Total Sq Feet: L 500.00 . Fees Amount Payments Date Paid Amt Paid 100% Permit Renewal Fee $250.00 Total Fees $295.00 Structural Review ($45) $45.00 Credit Card 12/03/2020 $295.00 Total: $295.00 Amount Due: $0.00 Applicant Copy For Inspections, Call (305) 762-4949 or Log on at https://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. December 03, 2020 Page 1 of 2 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 G INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 201-� BUILDING Master Permit No.ZEMO 0 9� PERMIT APPLICATION Sub Permit No.DF a)0 ' V - r Z-3&I ❑j` BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION FN RENEWAL [PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION Q SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 9333 North Miami Avenue City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 11 -3206-013-0350 Is the Building Historically Designated: Yes NO X Occupancy Type: R-3 Load: Construction Type: I I I Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Patricia N. Penicheir0 Phone#: 916-796-5773 Address: 9333 N. Miami Avenue City: Miami Shores State: FL zip: 33150 Tenant/Lessee Name: Email: Phone#: CONTRACTOR: Company Name: CDS2, Corp Phone#: 786-218-5335 Address: 333 SE 2nd Avenue, Suite 2000 City: Miami State: FL Zip: 33131 Qualifier Name: Wesley A. Castellanos Phone#.: 786-218-5335 State Certification or Registration #: CGC1523930 Certificate of Competency #: DESIGNER: Architect/Engineer: Wesley A. Castellanos Phone#: 786-218-5335 Address: 7300 Biscayne Blvd. Suite 200 City: Miami State: FL zip: 33138 Value of Work for this Permit: $ 20,000 Square/Linear Footage of Work: 500 s.f. Type of Work: W Addition ❑■ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of work: Existing Family Room under Demolition Permit (Demo 09-19-2239) to be renewed 500 s.f. of Family Room Specify color of color thru tile: Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Technology Fee $ Structural Reviews $ Training/Education Fee $ CCF $ CO/CC $ DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ D- c--1 ' 0 (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 WE 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 on 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 reinspeciion fee will be charged. Signature li ( 4 Signature. OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this day of J 1A 20 `V by ho is personally know me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: ' Print: as The foregoing instrument was acknowledged before me this day of 20 IZIJ' by roIJI 4 who is personally known to me or w o has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Se :, �a""4 : STEPHEN K. LOFFREDO Seal: JM OM M" �. .: a' MY COMMISSION # GG 770034 EXPIRES: July 4, 2024 i Commission+ I GG121935 ` 't . 27 2021 a` d Bonded Thru Notary Public unaerwitaa tlYu APPROVED BY "" Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) j 9LII�Kr3 LOT 9 I o 9 i ASPHALT PA I E"MENT.'; . 0 15 � ALLEY - � 41 33.50'.. FND. A L 66.9d' =� P. 112" 0.70' C.B. ux 4.0 ui 11.0 0,60' WALL 3 R 1, vi 1,21' rO LOT 10 o t - (IN) ' o BLOCK 3 at 20 POOL ON N ca 24,60' b 21'� (UT o PAVERS o 30.50' i g 20 o o R , � � p7�h 0• � 21` V mi YY 9.50' d 1 inch it �f• iM • •••• CONIC vi THEM TN 7f2i °' • ry N GAR.EL.=10.90 _ OF T 17 ar • • • W.. �F .- ✓^� z 7.5248s BL K3 •• ••r••� ....ate. g 11 O'� o • • U)%% 3 t0.50' o.v�l •• • r 01-4 9.0 • REM1fDER 4f LOT 11 -� SHE • •ad 9lrC1Cli 3 • o Q .' © 18 70 _ ONE STORY a p • • •f� • '• r .t ld TILE M RESIDENCE 10.90 1, I • • • � • .."1'. ��51' +t N M 9333 t7 40' _ o .. o # I M—cON4� • • • • -. N =r ; r; LF.F.E.=11.16 � • wr • •• • 0 F.F.E.=12.99 I 75. • r PLANTER—� AC n • • • • • • 9 99 .. its p C� Q 9.45' < n 21,40' 12.75', 7.15 ( 20.30' 9.95'L0880.70 o TiLE "� 6.3d' T) PLANTS PLANTER 6 M cV {� TILE o 189,00' a 0. ( (BASIS OF BEARING 1, y9 0 o ASSUMED) /p,2 .....Q3��i�' (R&M s CSW `d• " FIR NOTE 5f PARKWAY .,',B.M. SED # N-568 �...,. �., ELEV TION 9.65 8t1 RlGHr OF -WAY fBY PLAT 56f ASPHALT PAVEMENT,.,. :";-,,,VERTIPAL DATUM SHOWN (N.G.V.D. 1929) NORTH MIAMI AVENUE 44 AND WALKWAY CROSS LOT LINES. MAP OF BOUNDARY SURVEY Property Address: 9333 N MIAMI AVE MIAMI SHORES, FL 33150 15271 NW 60 AVE, Suite 206 Miami Lakes, FL 33014 www.O nlineLandSu rveyors. Com SURVEYOR'S CERTIFICATION' I HEREBY CERTIFY THAT THIS 'BOUNDARY SURVEY" IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY PREPARED UNDER MY DIRECTION THIS COMPLIES WITH THE MINI STANDARDS, AS SET FORTH BY THE STATE OF FLORIDA BOARD OF P - SIGNAL SU RS AND MAPPER IN CHAPTER _-17. 051, FLORIDA ADMINISTRATIVE CO P/U/pSUANT TO SEC U4.72.027, FLORIDA STATUTES. C / E4.Y Nn. 5:01 SIGNED ss FOR THE FIRM MIGUEL ESPINO P.S.M. No. 5101 STATE OF FLORIDA All r..ID NIIH 1[AN AI E- HII"'�FI. NI.'. SIGN 11RE AND AI H N:IG AIE) E! ONl SEAL. AN[ IDR FHISMAPiS ANDORIGINAL RAISED SEA[. GF A IJCENSE .Sl1R'YEYDR AND MAPPER. Survey Date:7/1/2019 Survey Code:0-52967 Page 1 of 2 Not valid without all pages. LOCATION MAP N.T.S. PROPERTY FRONT VIEW CERTIFIED TO: FLOOD INFORMATION: TICHA PENICHEIRO Community Number: VILLAGE OF MIAMI SHORES ITS'SUCCESSORS AND/OR ASSIGNS AS THEIR 120652 + • • • INTEREST MAY APPEAR. Panel Number: 12086C03029-• ' • • • •' Suffix: L • • • Date of Firm Index: 9/11/2009 • • • Flood Zone: X • Base Flood Elevation: N/A Date of Survey: 7/1/2019 "•' ' ' LEGAL DESCRIPTION: LOT 10 AND THE NORTH 1/2 OF LOT 11, BLOCK 3, OF AMENDED PLAT"F•W6AM1 SH";?,FS, • SECTION ONE, ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 10, PAGE �0.119f P IE PUBLIC • • RECORDS OF MIAMI-DADE COUNTY, FLORIDA ••SIR•• • — PROPERTY LINE STRUCTURE CONC. BLOCK WALL X— CHAIN-UNK ar WRE FENCE WOOD FENCE a - o IRON FENCE — — — — EASEMENT CENTER LINE ® WOW DECK CONCRETE ASPHALT BRICK/TILE / WATER --./-� APPROXIMATE EDGE OF WATER ® COVERED AREA Surveyor's Legend TREE A.P. POKER POLE ®CB. CATCH 8ASN C.U.E. CWNTY UTILITY ESMT: LE.A-E, INGRESS/ EGRESS ESMT. u.E, UTILITY EASEMENT FEW. OR F FOUND IRON PIPE/ PIN AS NOTED ON PLAT LB/ LICENSE # - BUSINESS LS# LICENSE # - S R YOR CALC CALCULATED POINT SET SET MONUMENT A CONTROL POINT ■ CONCRETE MONUMENT ELEV ELEVATION P.T. POINT OF TANGENCY P.C. POINT OF CURVATURE P.R.M. PERMANENT REFERENCE MONUMENT P.C.C. POINT OF C POUNO CURVATURE P.R.G POINT OF REVERSE CURVATURE P.O.B. POINT OF BEGINNING P.O.C. POINT OF COMMENCEMENT P.C.P. PERMANENT CONTROL POINT M FIELD ME RED P PUTTED MEASURMENT D DEED C CALCULATED j 1) LEGAL DESCRIPTION PROVIDED BY OTHERS. 2) EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED INSTRUMENTS, IF ANY, AFFECTING PROPERTY. 3) THE LANDS SHOWN HEREON WERE NOT ABSTRACTED FOR EASEMENT OR OTHER RECORDED ENCUMBERANCES NOT SHOWN ON THE PLAT 4) THE PURPOSE OF THIS SURVEY IS FOR USE IN OBTAINING TITLE INSURANCE AND FINANCING AND SHOULD NOT BE USED FOR CONSTRUCTION, PERMITTING DESIGN, OR ANY OTHER PURPOSE WITHOUT THE WRITTEN CONSENT OF ONLINE LAND SURVEYORS INC. 5) UNDERGROUND PORTIONS OF FOOTINGS, FOUNDATIONS OR OTHER IMPROVEMENTS WERE NOTLOCATED. 6) ONLY VISIBLE AND ABOVE GROUND ENCROACHMENTS LOCATED. 7) FENCE OWNERSHIP NOTDETERMINED. 6) WALL TIES ARE TO THE FACE OF THE WALL. 9) BEARINGS ARE BASE ON AN ASSUMED MERIDIAN. 10) BOUNDARY SURVEY MEANS A DRAWING ANDAJR GRAPHIC REPRESENTA TI0N OF THE SURVEY WORK PERFORMED IN THE FIELD, COULD BE DRAWN AT A SHOWN SCALE AND/OR NOT TO SCALE. 11) NO IDENTIFICATION FOUND ON PROPERTY CORNERS UNLESS NOTED. 12) NOT VALID UNLESS SEALED WITH THE SIGNING SURVEYORS EMBOSSED OR ELECTRONIC SEAL. 13) DIMENSIONS SHOWN ARE PLAT AND MEASURED UNLESS OTHERWISE SHOWN. 14) ELEVATIONS IF SHOWN ARE BASED UPON N.G. V.D. 1929 UNLESS OTHERWISE NOTED. 15) THIS IS A BOUNDARY SURVEY UNLESS OTHERWISE NOTED. 16) THIS BOUNDARY SURVEY HAS BEEN PREPARED FOR THE EXCLUSIVE USE OF THE ENTITIES NAMED HEREON, THE CERTIFICATIONS DO NOT EXTEND TO ANY UNNAMED PARTIES. • f qn ti •* L..M.f LAKE - LANDSCAPE MAINT. ESMT. R.O.E. ROOF OVERHANG EASEMENT P.P. POOL PUMP PL PLANTER OR PROPERTY LINE I.D. IDENTIFICATION B.C. BLOCK CORNER B.R. BEARING REFERENCE o CENTRAL ANGLE "r DELTA R RECORD OR RADIUS RAD. RADIAL NR. NON RADIAL TYP. TYPICAL I.R. IRON ROD I.P. IRON PIPE NaD NAIL @ DISK PK NAIL PARKER-KALON NAIL D.H. DRILL HOLE ® WELL TY FIRE HYDRANT 44 M.H. MAN HOLE O.H.L OVERHEAD LINES TX TRANSFORMER CAN CABLE TV. RISER W.M. WATER METER P/E POOL EQUIPMENT CON , CONCRETE SUB • • • * *1 •• • • a ESMT. EASEMENT D.E. DRAINAGE EASEMENT LS.E. LANDSCAPE BUFTER CFM;. L.A.E. LIMITED ACCESS EASEMENT TEL TELEPHONE FACILITIES U.P. UTILITY POLE E.U.B. ELECTRIC UTILITY BOX SEP. SEPTIC TANK IDS DRAIN FIELD AC AIR CONDITIONER CSW CONIC SIDEWALK DWY DRIVEWAY SCR. SCREEN GAR. GARAGE ENCL ENCLOSURE M.T.S. NOT TO SCALE F.F. FINISHED FLOOR T.O.B. TOP OF BANK E.O.W. EDGE OF WATER E/P OR E.O.P. EDGE OF PAVEMENT C.Y.C. CONCRETE VALLEY GUTTER B.S.L. BUILDING SETBACK LINE S.T.L SURVEY TIE LINE Ii CENTER LINE R/W RIGHT OF WAY R.O.G. PUBUO UTILITY EASEMENT C,kILL CANAL MAINTENANCE EAKMEN'I' A.E. ANCHOR EASEMENT Printing to Scale: Fr:,ersr,.T"� 4 ; 1. Select`None" from Page Scaling-•-- 2. DeselectAuto-Rotate and Can Ter' 3. Select"Choose paper source by `;oa.nesxrrLFn xsn PDF page size' ELD WORK: 6/26/2019 O,Ep1; t'I r, f ?AWN BY. N.B. 1ECKED BY. M.E. VAL REVISION: 0710112019 4u. 5 LT i sTnrr: ° cORi OAw fYat suavEr� 904 )MPLETED: 71112019 :ALE.' 1' = 20" IRVEY CODE.' 1 0-52967 15271 NW 60 AVE, Suite 206 Miami Lakes, FL 33014 Phone: (305) 910-0123 Fax: (305) 675-0999 www.OnlineLandSurveyors.Com Survey Date:7/1/2019 Survey Code:0-52967 Page 2 of 2 Not valid without all pages. Miami Shores Village C I Building Department EP 5 20 100SO N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 BY: BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS �FBC 20 Master Permit Noj)-�: � _. 22 ' f Sub Permit No. ❑ REVISION ❑ EXTENSION ❑ RENEWAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 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): ) �'�1�I C F(471[20 Phone#: q, r Address: R2� f'i:l ��, L1 City: &P .Alzi , Tenant/Lessee Name: Email State: /- I -- Phone#: Zip: CONTRACTOR: Company Name: 6ik),S-Ty-0criD' %/mac Phone#: Address: %� �Z �S Lk.) - City: tbs /' c S -ILO O Qualifier Name: <-�f ,�7�� ; )/ 3 el hone#: - L / State Certification or Registration #: ��, Z�01�51 Certificate of Competency #: _ DESIGNER: Architect/Engineer: Phone#: J Address: City: State: Zip: Value of Work for this Permit: $ � f S �I-- Square/Linear Footage of Work: �;-00 ' VT .� Type of Work: ❑ Addition 119Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: -z) 1Lz� 22L 1 Z /- t% %Z(r ri Specify color of color t hru tile: Submittal Fee $ d Permit Fee $ 2�' CCF $ Scanning Fee $ Technology Fee $ Structural Reviews $ Radon Fee $ Training/Education Fee $ DBPR $ CO/CC $ Notary $ Double Fee $ _.=D SO' 00 Bond $ (Revised02/24/2014) TOTAL FEE NOW DUE $ 1 S'4 • --?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 whic occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will no apprqlveid and a reinspection fee will be charged. Signatu The foreg fng instrument was acl owledged before a this day of 20 by s who is personally known to me or who has produced as identification and who did take an oath. NOT Sign Print Signature CONT ACTOR The foregoing instrument was acknowledged before me this day of , 20 0), by who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: Print: I P as Seal: Seal: r°�;�-41': / OE)ALYS C. HURTADO -'N� ODALYS C. HURTADO MY COMMISSION II EE 067937 ? :.: * " * * MY COMMISSION f EE 091937 EXPIRES: May 12, 2020m &Ww Ttuu Bade mm EXPIRES: May 12, 2020 l4rfUF F<<R `y APPROVED BY Plans Examiner Zoning Structural Review Clerk (RevisedO2/24/2014) DATE(MM/DONY" CERTIFICATE OF LIABILITY INSURANCE 9/13/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES INOT AFFIF:MATIVELY 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: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). RODUCER CONTACT NAME: ADVANTAGE INSURANCE OF AMERICA PHONE 305) 649-5566 ) 4520 NW 7th St (AI., No. (A/D,No): (305 649-5559 ADDRESS: Marta@advantageinsuranceofamerica.com Miami, FL 33126 NSURED DOYON CONSTRUCTION INC 15625 SW 260 ST HOMESTEAD, FL 33032 INSURER(S) AFFORDING COVERAGE NAIC* INSURER A : INTERSTATE FIRE & CASUALTY INSURER B : INSURER C : INSURER D: INSURER E ;OVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 4SR _TR TYPE OF INSURANCE ADDL INSR BUBR WVD POLICY NUMBER POLICY EFF (MWDD/YYYY) POLICY EXP (MWDDNYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 0 0 O 0 0 0 X COMMERCIAL GENERAL LIABILITY currence)$ PRE. SES (E ToEa occurrence) 100 000 CLAIMS -MADE 1 x I OCCUR MED EXP (Any one person) $ 5,000 MXC070 07/14/19 07/14/20 PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 X PE POLICY RO LOC JCT $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE (Per accident) S S UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DIED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN WC STATU- OTH- TORY LIMITS ER ANY PROPRIETOPJPARTNERIEXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? NIA E.L. EACH ACCIDENT $ (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) GENERAL CONTRACTOR TE HOLDER MIAMI SHORES VILLAGE BUILDING DEPARTMENT 10050 NE 2ND AVENUE MIAMI SHORES, FL, 33138 SHOU D ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE I XPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. r° ©1988-2010ACORD CORPORATION. All rights reserved. ACORD25(2010/05) The ACORD name and logo are registered marks of ACORD 000-h11'&2M( r�ma TRAVIS RENOALL Planning & Zoning Director DEVELOPMENT ORDER 10050 N.E. SECOND AVENUE MIAMI SHORES, FLORIDA 33138-2382 TELEPHONE: (3051 795-2207 FAX: (305) 756-8972 File Number: Admin-000053-2019 Property. Address: 9333 N. Miami Avenue, Miami Shores, FL 33138 Owner/Applicant: Patricia Pencheiro Address: 9333 N. Miami Avenue, Miami Shores, FL 33138 Whereas, the applicant Patricia Pencheiro (Owner), has filed an application for site plan review Planning and Zoning Staff on the above property. The applicant sought approval as follows: Pursuant to Articles IV, V and VI of Appendix A Zoning, Sec. 400 Schedule of Regulations and Sec. 600. Administrative Site plan review and approval required for an exterior renovation. Whereas, a Site Plan Review was conducted on September 24, 2019 After having considered the application and after reviewing the evidence submitted, finds: 1. The application was made in a manner consistent with the requirements of the Land Development Code of Miami Shores Village. 2. The conditions on the property and the plans merit consideration and are consistent with the requirements of the Land Development Code. This approval requires that all further development of the property shall be performed in a manner consistent with the site plan, drawings, and conditions. 1) Approval is granted as shown on the plans submitted and made a part of this approval. 2) Applicant to apply for and obtain all required building permits from the Building Department before beginning work. 3) Applicant to apply for and obtain all necessary permits and approvals from outside agencies. 4) Applicant to obtain all required permits and approvals from the Miami -Dade Department of Regulatory and Economic Resources, Environmental Plan Page 1 of 2 DO-ADMIN-000053-2019_Penicheiro VISIT US j www.miamishoresvilfage.com Review Division (DRER, EPRD) and the Miami -Dade Department of Health (DOHlHRS) as required. 5) Applicant to meet all applicable code provisions at the time of permitting. 6) This zoning permit will lapse and become invalid unless the work for which it was approved is started within one (1) year of the signing of the development order by the board chair, or if the work authorized by it is suspended or abandoned for a period of at least one (1) year. Additionally, the applicant must, satisfy all applicable Miami Shores Village Codes, Miami -Dade County Codes, the applicable building and life safety codes required for development, and provide a copy of the development order to the Building Dept. The application with conditions was approved this 24th day of September, 2019 by the Planning and Zoning Board as follows: Approved Administratively by Planning and Zoning Director. �/S Date Page 2 of 2 DO-ADMIN-000053-2019 Penicheiro September 13, 2019 To Whom It May Concern: My name is Patricia Penicheiro, resident in 9333 N. Miami Av. I am writing this letter to authorize the company DOYON CONSTRUCTION INC. to request permission to demolish the area of Florida room which will be remodeled ro"O ;�&,� ODALYs C. HURTADO * MY COMMISSION t EE 097937 * t EXPIRE : May 12, 202 mrq'p��l&�o i B4 W/® Thank you 9333 N Miami Av Miami Shores FI 33150 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: l . 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. ' q Signature• Owner State of Florida County of Miami -Dade �,y �^ The foregom was acknowledge before me this '(� day of _rl�� 20� By Zli �2 �''�.�a —who is personallynown to me or has produced -- - as identification. Notary-� SEAL: ?0�1;`:•:��i� ODALYSC.HURTADO * MY COMMISSION i EE 007937 * EXPIRES: May 12, 2020 s �� �._..a tMart Nauru Services Detail by Entity Name Page I of 2 Florida Department of State .om Depar merit of State / Division of Corporations / Search Records / Detail By Document Number / DIVISION OF CORPORA -IONS http://search. sunbiz.org/Inquiry/CorporationSearch/SearchResultDetaiI?inquirytype=Entity... 4/3 0/2020 Detail by Entity Name ,tea_ S 5 C=j,e• • C Page 2 of 2 2633 S HELEN ST SIOUX CITY, IA 51106 Title S SORIANO PEDRO 15625 S.W. 260 STREET HOMESTEAD, FL 33032 Annual Reports Report Year Filed Date 2018 01/28/2018 2019 03/31 /2019 2020 01/20/2020 Document Images 01/2012020.-- ANNUAL REPORT View image in PDF format 03/31/2019 -- ANNUAL_REPORT View image in PDF format 01/28/2018 -- ANNUAL REPORT View image in PDF format 04_/0412017 --ANNUAL. REPORT View image in PDF format 04/16/2016 -- ANNUAL REPORT View image in PDF formal 03/O1/2015 -- ANNUAL REPORT View image in PDF format 04/27/2014 -- ANNUAL_REPORT View image in PDF format ] 03/07/2013 -- ANNUAL REPORT View image in PDF format 02/21/2012 : ANNUAL_REPORT View image in PDF format 08/26/2011 - Amendment View image in PDF format 04/19/2011 --_ANNUAL REPORT_ I View image in PDF format 09/2212010 -- Amendment View image in PDF format 02/24/2010 -- ANNUAL REPORT View image in PDF format 10/29/2009 -- REINSTATEMENT View image in PDF format 01/05/2008 -- ANNUAL REPORT View image in PDF format 04/12/2007 - =ANNUAL REPORT View image in PDF format 01/18/2006 -- ANNUAL_REPORT View image in PDF format 04/02/2005 -- ANNUAL REPORT View image in PDF format 02/04/2004=- ANNUAL REPORT View image in PDF format 04/04/2003 -- ANNUAL REPORTJView image in PDF forma 01 /30/2002 -- ANNUAL REPORT View image in PDF format 04/02/2001_-- ANNUAL REPORT I View image in PDF format _ANNUAL REPORT+ View image in PDF format =ANNUAL REPORT View image in PDF format __ANNUAL REPORT View image in PDF format _ANNUAL REPORT View image in PDF format -- ANNUAL_REPORT I -- ANNUAL REPORTI View image in PDF format View image in PDF format Flo ntla Depa'T�Ient of State, Division of Coy PC axons http://search. sunbiz.org/Inquiry/CorporationSearchISearchResultDetail?inquirytype=Entity... 4/3 0/2020 5H°RFS Miami Shores Village Building Department 10050 NE 2"d Ave. <oRti p Miami Shores, FL 33138 305-795-2204 / Fax 305-756-8972 NOTICE TO MIAMI SHORES BUILDING DEPARTMENT OF EMPLOYMENT AS SPECIAL INSPECTOR UNDER THE FLORIDA BUILDING CODE. I (We) have been retained by to perform special inspector services under the Florida Building Code 6th Edition (2017) and Miami Dade County Administrative Code at the project on the below listed structure as of (date). I am a registered arch itect/profession aI engineer licensed in the State of Florida. Process Number: k 1 �` d, di Special Inspector for Reinforced Masonry, Section 2122.4 of the FBC 6th Edition (2017) iami Dade County Administrative Code, Article II Section 8-22 Special Inspector for Trusses > 35 ft. long or 6 ft. high _ Steel Framing and Connections welded or bolted Soil Compaction Precast Attachments Roofing Applications, Lt. Weight. Insul.Conc. Other Note: Only the marked boxes apply. The following individual(s) employed by this firm or me is authorized representative to perform inspection* 1. 3. 2. 4. *Special inspectors utilizing authorized representatives shall insure the authorized representative is qualified by education or licensure to perform the duties assign by Special Inspector. The qualifications shall include licensure as a professional engineer or architect: graduation from an engineering education program in civil or structural engineering; graduation from an architectural education program; successful completion of the NCEES Fundamentals Examination; or registration as building inspector or general contractor. I (we) will notify the Miami Shores Building Department of any changes regarding authorized personnel performing inspection services. I (we), understand that a Special Inspector inspection log for each building must be displayed in a convenient location on the site for reference by the Miami Shores Building Department Inspector. All mandatory inspections, as required by the Florida Building Code, must be performed by the Miami Shores Building Department .Inspections performed by the Special Inspector hired by the owner are in addition to the mandatory inspections performed by the department. Further, upon completion of work under each Building Permit, I will submit to the Building Inspector at the time of the final inspection the completed inspection log form and a sealed statement indicating that, to the best of my knowledge, belief and professional judgment those portions of the project outlined above meet the intent of the Florida Building Code and are in substantial accordance with the approval plans. Engineer/Architect Name Signed and Sealed Print Date: Address