DS-04-22-923Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Permit NO.: DS-04-22-923
Permit Type: Driveways/Walkways/Slabs
Work Clossijfcotion: Addition/Alteration
Permit5tatus: Approved
Issue Date:05/10/2022 Expiration: 11/10/2022
Location Address
Parcel Number
99 NE 103RD ST Miami Shores, FL 33138
1121360130990
Contacts
PUJA LAKH LAN
Owner
Arco Construction Corporation Contractor
99 NE 103 ST, Miami Shores, FL 33138
LESTER JENSEN
puja.lakhlani@gmail.com
1665 NE 137 TER, MIAMI, FL 33181
Business: 3058926507 arcoconstruction@aol.com
Other: 3058926507
Valuation: $ 5,600.00 InspectRe qu
Description: NEW CONC, SLABS DRIVEWAY
i
�
305-762-4949
Total Sq Feet: 504.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$3.60
Concrete/asphalt/pavers, slabs, dways,
$75.00
swalks
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$1.20
Notary Fee
$5.00
Planning and Zoning Review Fee
$35.00
Scanning Fee
$9.00
Technology Fee
$3.13
Total:
$185.93
Payments
Date Paid
Amt Paid
Total Fees
$185.93
Check N226
05/10/2022
$135.93
Check N 144
04/11/2022
$50.00
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. Futher,rmore, I authorize the above named contractor to do the work stated.
Authorized Signature: Owner / Applicant / Contractor / Agent Dake /
May 10, 2022 Page 2 of 2
Miami Shores Village
ENTERED
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
QBUILDING ❑ ELECTRIC ❑ ROOFING
APR 11 ZUZZ
BY: '
FBC 20�
Master Permit No. -Ds -0 (,-2?-C71-3
Sub Permit
❑ REVISION ❑ EXTENSION RENEWAL
❑PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: "I -t OF, IO'? 6 1
City: Miami Shores County: Miami Dade Zio: �"aI
Folio/Parcel#: I k-ZI36` 0 i 3 -C 1 k) Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): ?unA I-AKI-1LA-M'% Phone#:
Address: qq Nr 10?2 ,7 '
City: M I FMI State: IF- L- Zip: 3313B
Tenant/Lessee Name: Phone#:
Email: ' U AIKi )Actll i e(ILOI I f �8f/i'1
CONTRACTOR: Company Name:tti LAB �Ol a i� l OIU (� r1�. Phone#: 42 ge-2
Address: l2.QQ IW/LrD4,
i 1�IState: Zip:
Qualifier Name:
State Certification or Registration
of Competency #:
DESIGNER: Architect/Engineer: /\I / A Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 5' i /c>y Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New c❑ Repair/Replace ❑ Demolition
Description of Work: N e�-,W 60/J C . mil A -A S DCA t ) r-, IA9 A% :(
Specify color of color thru tile:
Submittal Fee $ 51D CD PPermit Fee $
Scanning Fee $ L. CO Radon Fee $
Technology Fee $ 3 13
stroji-al Reviews $ 35 - W
?S.",
.00
CCF$
DBPR $ u
CO/CC $
Notary $ 5- 6'
Training/Education Fee $ I zle, Double Fee $
Bond $
(Revised02/2412014)
TOTAL FEE NOW DUE $ 135- Y3
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 reinspection fee will be charged.
Signature P -
OWNER orAGENT
The foregoing instrument was acknowledged before me this
3 1 dayof MaretN 20 22- by
W R 4 tl�L{ti �Lir� , who is personally known to
me or who has produced L e rs t? c csw s as
identification and who did take an oath.
NOTARY PUBLIC:
Print:�. tM 11/�t�1► i.
JESSICAAAMONS
Notary Public . Stab of I
Commission 9 HN 07,
Signat
V C R
The foregoing instrumentwledged before me this
day of A-P rq ( 20 2Z by
L2.54--� _ Len, s.-_,rn who is personally known to
me or who has produced ri_ J? ✓t ✓evS Zak as
identification and who did take an oath.
NOTARY PUBLIC:
Sign: V1 !`_'�" Lfz -
Print: V 1 V 1.2✓1 rim "( CCL)
`.SPPr'P1a, vmenne tau
Seal: __;• :el Comm.0222410
' .� Expires: Jan. 31, 2026
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il .
k"N1°I„o�O Notary Public -State of Florida
rrsrsrsrssssss+rsssssssssssssessssssssssrssrrrrrrrssss
APPROVED BY rr !v�2� Plans Examiner `ZZ Zoning
Structural Review Clerk
(RevisedO2/24/2014)
Propert Search Application - Miami -Dade County Page 1 of 1
THE PROPERTY APPRAISER
aFF�cEaF
Summary Report
Property Information
Folio:
11-2136-013-0990
Property Address:
99 NE 103 ST
Miami Shores, FL 33138-2326
Owner
PUJA LAKHLANI
DAVID MCLENNAN
Mailing Address
99 NE 103 ST
MIAMI SHORES, FL 33138 USA
PA Primary Zone
1000 SGL FAMILY - 2101-2300 SQ
Primary Land Use
0101 RESIDENTIAL -SINGLE
FAMILY: 1 UNIT
Beds I Baths I Half
3/2/0
Floors
1
Living Units
1
Actual Area
2,622 Sq.Ft
Living Area
2,216 Sq.Ft
Adjusted Area
2,249 Sq.Ft
Lot Size
9,889.2 Sq.Ft
Year Built
Multiple (See Building Info.)
Assessment Information
Year
2021
2020
2019
Land Value
$284,211
$247,244
$2147 2244
Building Value
$154,233
$154,405
$154,578
XF Value
$2,892
$2,924
$2,957
Market Value
$441,336
$404,573
$404,779
Assessed Value
$441,336
$404,573
$404,779
Benefits Information
Benefit
(Type
20211
20201
2019
Homestead
Exemption
$25,000
Second Homestead
IExemption
$25,000
Note: Not all benefits are applicable to all Taxable Values (i.e. County,
School Board, City, Regional).
Short Legal Description
MIAMI SHORES SEC 5 PB 10-47
LOT 23 $ E1/2 LOT 22 BLK 123
LOT SIZE 80.400 X 123
OR 9682 1300
Generated On : 4/11/2022
Taxable Value Information
2021
2020
2019
County
Exemption Value
$50,000
$0
$0
Taxable Value
1 $391,3361
$404,5731
$404,779
School Board
Exemption Value
$25,000
$0
$0
Taxable Value
1 $416,3361
$404,5731
$404,779
city
Exemption Value
1 $50,000
$0
$0
Taxable Value
$391,336
$404,573
$404,779
Regional
Exemption Value
$50,000
$01
$O
Taxable Value
$391,336
$404.573
$404,779
Sales Information
Previous
Price
OR Book-
Qualification Description
Sale
Page
07/20 22020
$0
32027-4251
Trustees in bankruptcy, executors or
guardians
07/1512020
$100
32027-4225
Corrective, tax or QCD; min
consideration
07/15/2020
$505,000
32027-4223
Trustees in bankruptcy, executors or
guardians
04/30/2018
$100
30972-0197
Unable to process sale due to deed
errors
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, we full disclaimer and User Agreement at http:/Aw .miamidade.gov/infoldisclaimer.asp
Version:
https://www.miamidade.gov/Apps/PA/propertysearch/
4/11/2022
rmsswniyrS Nor VALm wmou1•AL4 PA6f5 PAGE30FA
Curve Table
Cun•e s
Length
Radius
Della
Chord
Bearing
Cl
39.21'
25.00'
1 89' 59' 32'
1 35.35'
1 N43' 14. WE
P= 30'
103YC,
- BYt-ram
'NEST HALF
OF LOT 22
810CK 123
GNOTINCLUOE
LOT 21
SLON 123
I ti
6Xl'5T (w (A CONC. Qt vmP'0 �` S _
To 'ief- P& P[ ou 6 9
Nc'w �QtvC--eft`( ToGotIoc-P
or
CoNC .
tfiCi l �C)NE
C� N GQZ.A'�. � i✓
�✓I.PcOiS 10 PiF� INSt Pcclk�C=�
DN Vnl b(L CfJ ri P/ -e 1% `F� 518' IR1
3605-
IN AN �kZTIFtCa A l_ Tuf2�
CITY
COPY
ALLEY
EAST HALF;
OF LOT 22
UNK123 1
(INCLUDED)
O.R.B 309121P 71
CG%
PATIO
42.7.
' A
510'
l
25.9' 10'2 .�.•
i
w
m
w I
22.4' w
7 - a 23.7' 9.6' �'PPIKT
TANG[
FN0 5,
wl
LOT 23
BLON 123
RESBF110E # 99
Zo' x Zs,2 NP
LOi'9Ptv6wA—
sl>rr�x FN0 518' IR
T03RD STR_ EET t _ _
15' RIONT-10P AY pp.yp'
ASPRALT ROMTNAY
Miami Shores Village Building Department
Zoning Dept. Date
Building Dept. Date�o
Subject to complia with all Federal, State
and County rules a regulations.
Permit#
75- b2-1 --71,5
M
SIGN
STREET I
SIGN
POINT OF
INTERSECTNIN
63G .S
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. Star. § 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 L day of#arr— 2022 .
By /�iw I/ I /J Zell) 6? / \ who is personally known to me or has produced
!ve / -e as identification.
Notary:
SEAL: RHEI
'
4
Arco Construction Corporation
April 11,2022
State of Florida
County of Miami Dade
Before me this day personally appeared Lester Jensen who, being duly sworn deposes and says:
That he will be the only person working on the project located at:
99 NE 103 Street, Miami Shores, FL 33138
Sworn to (or affirmed) and subscribed before me this 11 day of April , 2022 ,by
7 t 4�-O�
L�2 SAS+-r J.Qn�-e-v�
Personally know,
Or Produced Identification rL
Type of Identification Produced 5�t' - S�Zo , S--Li 1 `4 & - U
Y!xf V, I vi. I en nx Ya-<3
Print, Type or Stamp Name of Notary
Wivienne Yao
_�: •'�: Comm.:HH 222410
Expires: Jan. 31,2026
a0 Notary Public State of Florida
General Contractors/CGO505163/1665 N.E.137 * Terrace/N. Miami, FL 33181
305.892-6507