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WS-04-22-947
Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address 114 NE 109TH ST, Miami Shores, FL 33161 rnntaets Permit NO.: WS-04-22-947 Permit Type: Windows/Shutters Work Clossii ication: Window/Door Replacement Permit Stotta: Approved Issue Date: 04/25/2022 1 Expiration:10/25/2022 Parcel Number 1121360090150 RUBEN FARACH Owner SOUTH POINT DEVELOPMENT INC Contractor 114 NE 109 ST MARCIAL RODRIGUEZ 5941 NW 173 DR, MIAMI, FL 33015 Business: 3055577900 Other: 3055572900 I Description: RETROFIT TRUSSES Valuation: $ 1,500.00 ns ection Reg uests:- Total Sq Feet: 2,877.00 Fees Amount Application Fee - Other $50.00 CCF $1.20 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.40 Permit Fee (Manual) $50.00 Scanning Fee $9.00 Technology Fee 52.75 Total: $117.35 Building Department Copy Payments Date Paid Amt Paid Total Fees $117.35 Check# 10806 04/25/2022 $67.35 Check# 10786 04/14/2022 $50.00 Amount Due: $0.00 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 FI AVIT: I cert' that all the foregoing info Lion is accurate and that all work will be done in compliance with all applicable laws requlati0 ns ucti n nin . Futhennore, I authorizebove named contractor to do the work stated. Applicant / Contractor / Agent Date April 25, 2022 Page 2 of 2 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 BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC ❑ ROOFING APR 14 1 FBC 20 Master Permit No. Lr o N - 22 - G9�y Sub Permit No. REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP 1 CONTRACTOR DRAWINGS JOB ADDRESS: I Jy r-V E Ili 1 City: Miami Shores County: Miami Dade 2j 33 /fP 1 Folio/Parcel#: 11—d J34 - 005- 0/.50 Is the Building Historically Designated: Yes _ NO Occupancy Type: Load: �/Consstructio�n�fTyyp7e: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titlehcld;r):' IA�'/�,&n rl r�Lf �(� Phone#: aJ12S1-7-7 0 Address: I I Li Of- Ifl , V.. City: - f-I "II Tenant/Lessee Name: Email: CONTRACTOR: Company Name: Address: _ 2 %3o W •7Ac City:_ HI GIP G Qualifier Name: P16LTc6,f /' 2111(1& State Certification or Registration #: L� (P C /5 DESIGNER: Architect/Engineer: Address: Value of Work for this Permit: uW bQ Type of Work: ❑ Addition ❑ Alteration Description of Work: State: "EL .331101 Zip: 1-'P-V2toI f)6 • Phone#:304SS3-54,?5 - --rL zip: g5 a of Competency #: Square/Linear Footage of Work: ❑ New ❑ Repair/Replace Specify color of color thru tile: Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ (Revised02/24/2014) S57- k Zip: ❑ Demolition CCF$ CO/CC$ DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding Company's Address City Mortgage Lender's Name (if Mortgage Lender's Address City State 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 $1500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien low 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 Bence of such pasted notice, the inspection will not be approved and a reinspection fee will be charged. ---- -----------.._� Signature Signature _ OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this day Of riff I 20 by r•� n J�'af4 Chyho is personally known to me or who has produced PL b epnX as identification and who did take an oath. NOTARY PUBLIC: The foregoing instrument as acknowledged before me this �-2 day of A -,l 20 0? by N� rc f �•1 w GN (tI Z who is personate known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: i��ryt4.i Print: Seal: Notary Public State of Florida Paola M Lora My Commission B Exp ititSno25 APPROVED BY Plans Examiner Zonin Structural Review Clerk (Revlsed02/24/2014) 1 MIA 1_ , 1 11 I 1. 1 11113 Summary Report Property Information Folio: 11-213"09-0150 Property Address: 114 NE 109 ST Miami Shores, FL 33161-7042 Owner RUBEN M FARACH Mailing Address 114 NE 109 ST MIAMI SHORES, FL 33161 USA PA Primary Zone 1000 SGL FAMILY - 2101-2300 SO Primary Land Use 0101 RESIDENTIAL -SINGLE FAMILY: 1 UNIT Beds I Baths / Half 3 / 2 / 0 Floors 1 Living Units 1 Actual Area 2,394 Sq.Ft Living Area 2,000 Sq.Ft Adjusted Area 2,197 Sq.Ft Lot Size 9,300 Sq.Ft Year Built Multiple (See Building Info.) Assessment Information Year 2021 2020 2019 Land Value $267,742 $232,690 $232,690 Building Value $172,025 $173,300 $172,826 XF Value $44,004 $44,461 $44,917 Market Value $483,771 $450,451 $450,433 Assessed Value $456,757 $450,451 $446,332 Benefits Information Benefit Type 2021 2020 2019 Save Our Homes Cap Assessment Reduction $27.014 $4,101 Homestead Exemption $25,0001 $25.0001 $25,000 Second Homestead Exemption 1 $25,0001 $25,0001 $25,000 Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). Short Legal Description WINNINGS MIAMI SHORES EXT NO 5 PB 48-21 LOT 7 BLK 216 LOT SIZE 75.000 X 124 OR 18704-4534 07 1999 1 Generated On: 4/6/2022 Taxable Value Information 2021 2020 2019 County Exemption Value $50,000 $50,0001 $50,000 Taxable Value 1 $406.7571 $400,4511 $396.332 School Board Exemption Value $25,000 $25,000 $25,000 Taxable Value 1 $431.7571 $425,4511 $421,332 city Exemption Value $50,0001 $50,0001 $50.000 Taxable Value 1 $406,7571 $400,451 $396,332 Regional Exemption Value 1 $50,0001 $50,0001 $50,000 Taxable Valu 1 $406,757 $400,451 $396,332 Sales Information Previous Price OR Book- Qualification Description Sale Page 02/16/2022 $100 33041-1483 Corrective, tax or QCD; min consideration 12/12/2016 $193,000 30383-2909 Corrective, tax or QCD; min consideration 12112/2016 $193,000 30382-2728 Corrective, tax or QCD; min consideration 05/15/2015 J$493,0001 29669-0158 lQual by exam of deed 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:/Aw .miamidade.gov/info/disclaimer.asp Version: ACORDr CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDlYYYY) 411.1� 4/14/2022 THIS CERTIFICATE IS 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. If the certificate holder is an ADDITIONAL INSURED, the pollcy(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). PRODUCER Serrod Insurance Agency, LLC 2151 So. LeJeu�}e Road CONTACT NAME: Anthony Mayor PHOQc.NE (305) 445-6441 No): (3051145-6469 A-D""DARESS: amayor@ serrodinsagency. . com Suite 302 Coral Gables FL 33134 ENSURERS AFFORDING COVERAGE NAIC III INSURER A: Evanston Insurance Com an INSURED Southpoint Development Inc. 2730 West 76th Street INSURER 8 : INSURER C : INSURERD: INSURER E : Hialeah FL 33016 COVERAGES INSURER F : CERTIFICATE NUM BER:CL2183104600 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE PdUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MlpO MMIDD LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE �X OCCUR DAMAGE O RENTED PREMISES- Me occurrence $ 100,000 3AJ 501449 8/26/2021 8/26/2022 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER: D PRO- GENERAL AGGREGATE $ 2 , 000 , 000 PRODUCTS - COMP/OP AGG S 2,000,000 POLICY JECT LOC OfiH ER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO ccident BODILY INJURY (Per person) S ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NEO A HIRED AUTOS AUTOS AUTOS PROPERTY DAMAGE $ Per accident) S UMBRELLA LIAR OCCUR EXCESS LIAR EACH OCCURRENCE $ CLAIMS -MADE AGGREGATE $ DED I I RETENTION S WORKERS COMPENSATION $ AND EMPLOYERS' LIABILITY PTE'TE OTH- ATI ANY PROPRIETOR/PARTNER/EXECUTIVE Y I N ER OFFICER/MEMBER EXCLUDED? ❑ NIA E.L. EACH ACCIDENT $ (Mandatory in NH) If yes, describe under E.L. DISEASE - EA EMPLOYEE $ DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT S DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached U move space is required) CGC1508392 CERTIFICATE HOLDER CANCELLATION Miami Shores Village Building Department 10050 NE 2 Ave Miami Shores, FL 33138 ACORD 25 (2014/01) INS025 (201401) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Melissa Cruz/MVC ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD JIMMY PATROPATRONS0 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 the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 3/11/2022 PERSON: MARCIAL RODRIGUEZ FEIN: 320087044 BUSINESS NAME AND ADDRESS: SOUTH POINT DEVELOPMENT INC. 2730 W 78 ST HIALEAH, FL 33016 SCOPE OF BUSINESS OR TRADE: EXPIRATION DATE: 3/10/2024 EMAIL: PLORA@FRTROOF.COM Masonry NOC Concrete Construction NOC Concrete Work Incidental To Carpentry NOC The Construction Of Private Residence 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 E01467739 QUESTIONS? (850) 413-1609 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 Exem Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. y 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: bp Owner State of Florida County of Miami -Dade i The(ffoo�reegoJing was acknowledge before me this �.� day of PG < 20 as . By Yl U` "(2i( e C i--% who is personally known to me or has produced FL,- ride! //l & Se_, as identification. Notary Public State of Florida Paola M Lora Notary: , My Commission llu HH 2O5623 SEAL: E x p. t 2M 5no25 Print, Type of Stamp Name of Notary FLORIDA ROOF -TECH ROOFING DONE RIGHT GUARANTEED 04/25/2022 State of C County of 0 1 &r ll Before me this day personally appeared 04(e1 c- (�JOI 1 'L who, being duly sworn, deposes and says: That he or she will be the only person working o7 the project located at: Co Sworn to (or affir ) ja d subscribed before me this 95 day of Q ++ l 20 as , by !mil - r 1 �'L Personally know ./ OR Produced Identification Type of Identification Produced �y State License No. CCC 052460 ' NotarLZ y Public State of Florida Paola M Lora MYHN 2058Y3ion 111 Exp.1211512025 2730 West 78 Street, Hialeah, Florida 33016 ' Phone: (305) 557-9685 ' Fax: (305) 558-4883 CIVIL Renleh Engineering Corp. CITY (Consulting Engineer) ��Mi Southwest 317 Avenue Miami, Florida 33175-1174 ENGINEER Fax:305-823-3300 Tel: 305-823-8008 / 305-397-6414 LOOPY February 22, 2022 Florida Roof -Tech 2730 West 78 Street BY. Hialeah, Florida 33016 Project: Visual Roof Strap Inspection Residential Home 114 Northeast 109 Street Miami Shores, Florida Miami Shores Village Buil 'ng Department Zoning Dept. Date Building Dept. Date Subject to comp "a with all Federal, State and County rules a d regulatlons, Permit# —2 2 — Project Number: 22-0350 ..... (Testing Laboratory Certificate # 16-0602.01) .... ...... .... Dear Sirs; ....% .... . ..... In accordance with your request and authorization, on February 21, 2022, a re• teSdntativ6 bf Reileh Engineering Corporation performed a visual roof inspection for the slope iprc*pf at xbe above ... referenced project. This inspection was performed persuant to Section 553i844•Florid'n Stafutes - .. . *' Roof -to -wall connections for site -built single family residential structures, lV rr6ris K. disual ' observations and conducting field examination, to examine the strapping of the roof trusses slung the roof perimeter of the structure. Access into the attic space was limited. Based on our field observations, the anchorage of the inspected rooftrusses is not in compliance with the requirements mentioned above. We recommend that the strapping be repaired as per the requirement in Section 201.3.6 Prescriptive method for hip roofs on a masonry wall. The hip rafter, the hip girder and the rafters/trusses adjacent to the hip girder that are not anchored with a strap having at least four fasteners on each end, shall be connected to the top plate below using strap or a right angle gusset bracket having a minimum uplift capacity of 500 lbs. Adding fasteners to existing straps shall be allowed in lieu of adding a new strap provided the strap is manufactured to accommodate at least four fasteners at each end. When the straps or right angle gusset brackets are attached to a wood sill, the sill plate shall be anchored to the concrete masonry wall below. This anchorage shall be accomplished by installing 1/4-in diameter masonry screws, each with supplementary 1/4-inch washer, having sufficient length to develop a 2- 1/2 inch embedment into the concrete and masonry. These screws shall be installed within 4-inches of the truss or rafter on both sides of each interior rafter or truss and on the accessible wall side of the gable end truss or rafter. As per Section 201.3, Roof to wall connections shall not be required unless evaluation and installation of connections at gable ends or all corners can be completed for 15% of the cost of roof replacement. Attached are field taken photos for your review. Reileh Engineering Corporation appreciates the opportunity of assisting you in this project. Please review the result reported and if you have any questions or if we may be of further assistance, please do not hesitate to contact the undersigned. Respectfully submitted; Reileh Engineering Corporation •' ohamad Sonny Salleh, P.E.49014 ...... • •: • ...... " " " :••••: Project Manager .... Project: Visual Roof Strut) Immeetion •••„• „•, „:„' Residential Home 114 Northeast 109 Street .. .. .•.. ... Miami Shores, Florida .•. : • • • • • . .• • ...... Project Number: 22-0350 • •' (Testing Laboratory Certificate N 16-0602.01) • • w .ti