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RC-04-22-869Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Permit NO.: RC-04-22-869 Permit Type: Building (Residential) Work Classification: Alteration Permit Status: Approved Issue Date:05/12/2022 Expiration: 11/14/2022 Location Address Parcel Number 9329 NE 9TH AVE, Miami Shores, FL 33138 1132060010060 Contacts AIMEE GREEN Owner SLUYTER CONSTRUCTION Contractor 9329 NE 9 AVE, MIAMI SHORES, FL 331382903 GREG ALLEN SLUYTER 237 NE 102 ST, MIAMI SHORES, FL 33138 Business: 9703799730 sluyterconstruction@gmail.com Description: BATHROOM RENOVATION ALL FIXTURES SAME Valuation: $ 18,000.00 Ins ection 49 nests: LOCATION ALL NEW TILE FIXTURES 305-762-4949 Total Sq Feet: 0.00 Fees Amount Application Fee - Other $50.00 CCF $10.80 Cenificte of Completion for Single Fam $50.00 and Duplex DBPR Fee $8.10 DCA Fee $5.40 Education Surcharge $3.60 Permit Fee $490.00 Scanning Fee $12.00 Technology Fee $13.50 Total: $643.40 Payments Date Paid Amt Paid Total Fees $643.40 Credit Card 04/05/2022 $50.00 Credit Card 05/12/2022 $593.40 Amount Due: $0.00 i-HIS MUST BE ON JOB AT TIME OF INSPECTION 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. OWNERA AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regula' co r ti and zoning. uthermore, I authorize the above named contractor to do the work stated. Authorize Sign re: O er / Applicant / Contractor / Agent Date May 12, 2022 Page 2 of 2 Miami Shores Village 1D050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address 9329 NE 9TH AVE, Miami Shores, FL 33138 Contacts Permit NO.: RC-04-22-869 Permit Type: Building (Residential) Work Classification: Alteration Permit Status: Approved Issue Date:05/12/2022 Expiration: 11/14/2022 Parcel Number 1132060010060 AIMEE GREEN Owner SLUYTER CONSTRUCTION Contractor 9329 NE 9 AVE, MIAMI SHORES, FL 331382903 GREG ALLEN SLUYTER 237 NE 102 ST, MIAMI SHORES, FL 33138 Business: 9703799730 sluyterconstruction@gmail.com Ins ection Requests: Description: BATHROOM RENOVATION ALL FIXTURES SAME Valuation: $ 18,000.00 LOCATION ALL NEW TILE FIXTURES 305-762-4949 Total Sq Feet: 0.00 Fees Amount Application Fee - Other $50.00 CCF $10.80 Certificte of Completion for Single Earn $50.00 and Duplex DBPR Fee $8.10 DCA Fee $5.40 Education Surcharge $3.60 Permit Fee $490.00 Scanning Fee $12.00 Technology Fee $13.50 Total: $643.40 Payments Date Paid Amt Paid Total Fees $643.40 Credit Card 04/05/2022 $50.00 Credit Card 05/12/2022 $593.40 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. May 12, 2022 Page 1 of 2 Miami Shores Village trjP T 0 d T Building Department o 2022 D10050 N.E.2nd Avenue, Miami Shores, Florida 33138Tel:(305)795-2204 Fax:(305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20ZO BUILDING Master Permit No. re-0--6-2L' c�w1 PERMIT APPLICATION Sub Permit No. BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [—]RENEWAL ❑PLUMBING MMECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS Folio/Parcel#: It 3 Z D t0 " Fi b % �%� Is the Building Historically Designated: Yes NO Occupancy Type:s � ;Am Load: Construction Type: c Flood Zone: BFE: FFE: OWNER: Name (Fee Simple City: /"L.*il.i 5NQ/e3 State: i-'C___ Zip: Tenant/Lessee Name: Phone#:_ Email: 106 CONTRACTOR: Company Name: Address: QED 37 Q' i73c7 City: /I.b, 14,-\ ; S ff'41�5 State: i[ Qualifier Name: e"7 ^-Q S( " ^^ Phone#: State Certification or Registration #: C(l_ .33 / l /3� Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State:Zip: Value of Work for this Permit: $ (�. f�iR. i)T Square/Unear Footage of Work: Type of Work: ❑ Add/dition�jl��-'I Alteration ///� �❑ New g Repair/Replace ❑1 Demolition Description of Work: /,�� 'f%�%�% /L-L� A LiVAt%ram a -.. ..�._ w_ n n_ 1. r Specify color of color thru tile: Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary Technology Fee $ Training/Education Fee $ Structural Reviews $ Double Fee $ Bond $ 1 ` TOTAL FEE NOW DUE $ L (Revised02/24/2014) Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State 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 Signature OWNER or AGENT CONTRACTOR The fore oing instrument was acknowledged before me this day of 20 Da —'by 446i_ pp W+r is personally known to i o ha?produced 0) as identification and who did take an oath. NOTARY PUBLIC: Print: —kz'A L- uh AAS& f Seal: '.•. MYCOMMISSIONAHH053232 ;vT__;•11 po EXPIRES: December 30, 2024 The ing instrument was acknowledged before me this day of 20, A Y what ersonall own tg e or h prodU as identification and who did take an oath. NOTARY PUBLIC: Print: •rr*******r*r**rr*r*rrrrrrrrrr****r*******r**rr****r* APPROVED BY Ok— £ P. ¢" 1 '� Plans Examiner Structural Review Zoning Clerk (Revised02/24/2014) Property Search Application - Miami -Dade County Page 1 of 1 @ OFFICE OF THE PROPERTY APPRAISER Summary Report Property Information Folio: '�. 11-3206-001-0060 9329 NE 9 AVE Miami Shores, FL 33138-2903 Property Address: Owner SCOTT M BLUMSTEIN &W AIMEE Mailing Address 9329 NE 9 AVE MIAMI SHORES, FL 33138-2903 PA Primary Zone 1400 SGL FAMILY - 3001-3250 SO Primary Land Use 0101 RESIDENTIAL -SINGLE FAMILY: 1 UNIT Beds I Baths I Half 4/3/1 Floors 2 Living Units 1 Actual Area 3,326 Sq.Ft Living Area 3,146 Sq.Ft Adjusted Area 2,863 Sq.Ft Lot Size 9,600 Sq.Ft Year Built Multiple (See Building Info.) Assessment Information Year Land Value 2021 2020 2019 $307,448 $259,102 $259,102 Building Value $229,982 $231,349 $232,715 XF Value $32,102 $32,459 $32,816 Market Value $569,532 $522,910 $524.633 Assessed Value 1 $316,756 $312,383 $305,360 Benefits Information Benefit Type 2021 2020 2019 Save Our Homes Assessment $252,776 $210,527 $219,273 Cap Reduction Homestead Exemption $25.000 $25,000 $25,000 Second Exemption $25,000 $25,000 $25,000 Homestead Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). Short Legal Description 5342 ARILYN HGTS PB 41-8 f SIZE 75.000 X 128 20261-4614 05 2001 5 Generated On : 4/5/2022 Taxable Value Information 2021� 2020 2019 County Exemption Value $50,000 $50,0001 $50,000 Taxable Value 1 $266,7561 $262.3831 $255,360 School Board Exemption Value 1 $25,000 $25,000 $25,000 Taxable Value 1 $291,7561 $287,3831 $280,360 City Exemption Value 1 $50,000 $50,000 $50,000 Taxable Value 1 $266,7561 $262,3831 $255,360 Regional Exemption Value 1 $50,000 $50,000 $50,000 Taxable Value $266,756 $262,383 $255,36.0 Sales Information Previous Price O Book -Qualification Description Prev Page 9 20261- Sales which are disqualified as a result 05I01I2001 $0 4614 of examination of the deed 16420 06/01/1994 $115,000 Sales which are qualified 3721 15150- Sales which are disqualified as a result 05/01/1991 $0 1354 of examination of the deed 12561 05/01/1985 $85,000 Sales which are qualified 0036 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 hap://www.miamidade.gov/info/disclaimer.asp Version: https://www.rniamidade.gov/Apps/PA/propertysearch/ 4/5/2022 [3c.�t�brn�, plfi�f Miami Shores Village Building Dep rtment Zoning Dept. Date Building Dept. Date Subject to corn nce with all Federal, State and County rules and regulations. Permit# ELECTRICAL REVIEW APPROVEDDATE. R 7D MECHANICAL REVIEW APPROVED DATE T0f d0 T APR 0 6 2022 Kr+c4,un UU-1e.&t. . . .. . .... ....:. ...... . ... .... .. . ..... CITY COPY S to G R, 0000 0 0 000000 0000 O 0 p 0 0 0 0 0000 O 00 0 0 000000 0000 000000 0 O O 0 000000 000000 0 0 0000 0000 O O O 0 00000 0000 0000 O 0 00000 0000 000000 0 0 0 0 0 000000 O 00 00 00 O 0 O 000000 0 0 O 0 000000 0 00 0 0 0 0 0 0 0 00 0 0 0 000000 0 0 0 0 0 0 00 0 00 0 0 0 00 0 0000 0 0 000000 0000 0 0 0 0 0 0 0 0000 0 00 0 0 000000 0000 000900 0 0 0 0 000000 000000 0 0 0000 0000 0 0 0 0 00000 0000 0000 0 0 00000 0000 000000 0 0 v 0 0 000000 0 00 00 00 0 0 0 000000 0 0 0 0 000000 0 00 0 0 0 0 0 0 0 00 0 0 0 000000 0 0 0 0 0 0 0• 0 00 0 0 0 00 0 0000so 0 0 v 000000 0 v 00000v 0 0 ovo00 0 0 00000 000000 0 0 0 000000 0 0 00-0co0 0 0 0000 0 0 0000 0 0 0 0 0 0000 0 00 0 0000 000000 0 0 00voo0 0000 0060 0 0 0 0 0000 0000 0000 000000 0 0 0 0 0 0 00 00 to 0 000000 0 0 0 0 oe o 0 0 0 0 00 v 0 0 v 0 0 0 00 0 00 0 0 0 00 0 BATHROOM RECEPTACLE ON 20 AMP CKI AND G.FI PROTECTED ELECTRICAL REVIEW APPROVEe�DATE r/� L 000000 1 0 O 000000 0 0 000000 0 0 00000 0 0 00000 000000 0 0 0 000000 0 0 000000 0 0 0 0 0 C 0 0 0000 0 0 O O O 0000 0 00 0 0000 000000 0 0 o0o000 0000 0000 0 0 0 0 0000 000o 0000 000000 0 0 0 0 0 0 00- 00 00 0 000000 0 0 0 0 0o 0 0 0 0 0 00 0 0 0 0 0 0 0 00 0 00 0 0 ip 90 0 SLUY CONSTRUCTION, LLC. M Date:5/5/2022 State of Florida County of Dade Greg Sluyter, Owner 970-379-9730 SluyterConstrucfion@gmail.com Before me this day personally appeared —Greg Sluyter who, being duly sworn, deposes and says: That he or she will be the only person worldng on the project located at:_ �% 9 N L' ry 6U 1 q i �jL f reS FL, ?31 8 Sworn to (or affirmed) and subscribed before me this l day of-A�4 LA 20ZZby �2r�Co S I-(—( FrZ Personally lmow Or Produced Identification Type of Identification Produced Type or Stamp Name of Notary Licensed and Insured Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address 9329 NE 9TH AVE, Miami Shores, FL 33138 Contacts Issue Date: 05/25/2022 Parcel Number EE633tIYQrFDLIYt] Permit NO.: PL-04-22-871 Permit Type: Plumbing - Residential Work Classification: Alteration Permit Status: Approved Expiration: 11/28/2022 r AIMEE GREEN Owner MOTZ PLUMBING LLC Contractor 9329 NE 9 AVE, MIAMI SHORES, FL 331382903 LEE MICHAEL MOTZ 820 NE 23 ST, NORTH MIAMI, FL 33161 Business: 3059924223 Inspection Requests: [RENOVATION. n: NEW COPPER WATER LINES TIE INTO EXISTING Valuation: $ 1,600.00 305-762-4949 LL FIXTURES SAME LOCATION BATHROOM Total Sq Feet: 0.00 Fees Amount Application Fee - Other $50.00 CCF $1.20 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.40 Permit Fee $50.00 Scanning Fee $3.00 Technology Fee 52.50 Total: $111.10 Payments Date Paid Amt Paid Total Fees $111.10 Credit Card 05/25/2022 $111.10 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 regulating constru ion and zo ' Fut�rmore, I author ri�� above I`� a co [tractor do the work stated. C /2Z� Authorized Signature: PVer / /"Applicant / May 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 01T9� TI 1 I AAR 0 5 2A22 D FBC 20 6 � TA4 BUILDING Master Permit No. PERMIT APPLICATION Sub Permit No. FL-Uq— GZ G�I BUILDING ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION [-]RENEWAL [ZPLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF []CANCELLATION ❑ SHOP q z q CONTRACTOR DRAWINGS JOB ADDRESS: I J 2 't City Miami Shores �Clounty: Miami Dade Zip: 33 l 3 CLl Folio/Parcel#: I (�- 3zD6^ � 1 1 DV > 1! Is the Building Historically Designated: Yes NO x Occupancy Type:'fi oad: Construction Type: Car= Flood Zone: BFE: FFE: OWNER: Name ((Fee Simple Q 4rlrlrocc• 1 ?Ct City: / W , AA4 - S�H t' f o) State: Fe— . Zip: ,�-312 i'-) Tenant/Lessee Name: Phone#: Email: L%ZboC7 C�"t4..C/ r nQ CONTRACTOR: Com any Name: V Address: (K City: Qualifier Name: �4 r State Certification or Registration #: ne#: - � (Z 2- -( G.Z3 of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State:Zip: Value of Work for this Permit: $ Square/UnearrF/Footage of Work: Type of Work: ❑ Addition ❑ Alteration 4,�N7 I 12 Repair/Replace El Demolition Descriotion of Work: 001,41 J� f D ft&R � &,1 Y 'GS iy S. 4 0) It I n h> e/Q ,5I �S+ Specify color of color thru tile: Submittal Fee $ Permit Fee $ Scanning Fee $ Technology Fee Structural Reviews $ Radon Fee $ Training/Education Fee $ CCF $_ DBPR $ CO/CC $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ �(7TS•" I U (Revised02124/2014) Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State 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 OWNER or AGENT The foregoing instrument was acknowledged before me this 19 ay of ^ 201�Ci\, by `"ri.e 1 1 who is personally known to me or who has produced _ as identification and who did take an oath. NOTARY PUBLIC: Signaturg, CONTRACTOR The foregoing instrument was acknowledged before me this day of L. 20 aa"'6y who is personally known to me or who has produced rf/ ( _ as identification and who did take an oath. NOTARY PUBLIC: Seal: MY COMMISSION# HH 053232 %• �d EXPIRES: December 30.2024 '•:oo�ffl°e: Bonded Thm Nolery Public underwritei rrrrrwrrrrrrrrrrrrr+++++++++++++++++++++r+++++++++++++++rrrrrrrrrrrrrrwrrrrrrrrrrr+rrr+rrrrrrrrrrrrrrrr+r++ APPROVED BY K�f_ Su2 — Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) 305-992-4223 license# CFC1429581 MOTZ PLUMBING LLC May 18th 2022 State of Florida Village of Miami Shores Before me this day personally appeared Lee Motz who, being duly sworn, deposes and says: That he will be the only person working o the project located at: 9329 ne 9th ave "v "C 'V " ' ractor signature L� Sworn to (or affirmed) and subscribed before me this I day of KAAf-20-Za by (✓e.e I-�(chtn<I �ni2 Personally know Produced id Type of id FL n/ivor u r-ef -A' xint type or stamp name of notary Notary Public State of Florida Luis Javier Lavelle My Commiaslon 1111 HX 188781 Exp. 1/1/2026 s:lU.: i HH 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 § 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 lose 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 subcommclors 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 insuuanee coverage from the contractor's company for day labor, pan -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 C-;�,5day 1 ' l of a 20_aa By :5 who is rr! lino to me or has produced as identification ^�/1n LESLIE RACKL Notary: �rCAfl _ 1 LL^ `-C`/` My COMMISSION M HH 084960 EXPIRES: March 13, 2025 4y Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address 9329 NE 9TH AVE, Miami Shores, FL 33138 Contacts Permit NO.: EL-04-22-872 Permit Type: Electrical - Residential Work Classification: Alteration Permit Status: Approved Issue Date:05/25/2022 Expiration:11/28/2022 Parcel Number 1132060010060 AIMEE GREEN Owner ZAP ELECTRIC, INC. Contractor 9329 NE 9 AVE, MIAMI SHORES, FL 331382903 ANDRES BARROSO 3890 W 4 AVE, HIALEH, FL 33012 Business: 78639213 Description: 2 Valuation: $ 700.00 BATHROOM RENOVATION . ELECTRICAL WORK Ins ection Requests: Desc HIGH HATS, SINK, GFI, LIGHT AND NEW TAN. 305-762-4949 Ai Total Sq Feet: 0.00 g Fees Amount Application Fee - Other $50.00 CCF $0.60 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.20 Permit Fee $50.00 Scanning Fee $3.00 Technology Fee 52.50 Total: $110.30 Payments Date Paid Amt Paid Total Fees $110.30 Credit Card 05/25/2022 $110.30 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 regulatin nstru a zoning. Futhermore uthorize the named contractor to do the work stated. above Authorize natur : OwWer / Applicant CLOtractor / Agent Date May 25, 2022 Page 2 of 2 0 � 9 � a Miami Shores Village PR 05 2022 L Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 y Tel: (305) 795-2204 Fax: (305) 756-8972 TIl�-( INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 21 10 � BUILDING Master Permit No.1��LC- 6`t-,. Z7- 301 PERMIT APPLICATION Sub Permit No.� Uri'//— 22—@- Z ❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS JOB ADDRESS: ` j 2 7 Q ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS City: Miami zzShores County, Miami Dade Zip: 4 9/ > Folio/Parcel#: i /- lreL ' Dt>l — I)'b 6 D Is the Building Historically Designated: Yes NO 'le_ Occupancy Type: S }'f Load: Construction Type:6 65 Flood Zone: BFE: FFE: OWNER: Tenant/Lessee Name: Phone#: Email: u Z n c `c Y6 CONTRACTOR: Company Name: �w d-l-ez' Phone#: 7 3 3 Address: t� " 4i` ' u%4V'C, city: Qualifier Name: p, ,} 3 aiL -2,e� • 3V23 r93D State Certification or Registration #: i6C / 3 a/ 0 3:1 7 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $� �f7�ii Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑�• 1NNew // Repair/Replace ❑ Demolition Description ofWgrk: /11/�1y-tW /�/�6�/2t . 61yryr ie.4-L U)i�f� Specify color of color thru Submittal Fee $ Permit Fee $ Scanning Fee $ Technology Fee Structural Reviews $ Radon Fee $ Training/Education Fee $ CCF $ CO/Cc $ DBPR $ Notary $ Double Fee $ Bond $ TOTALFEENOWDUE$ (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 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 v Signature OWNERor AGENT CONTRACTOR The fo egoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of 20 , by {� day of�T^ 20 '-a �-- by ,,yy ��FF_�� /J is personally known to 1[V t0.K�� 1 Jt/tS�� . w Jois personally known to m1'ot�i6h p1o�uu6 �i1r as me or who has produced Vl1 as identification and who did take an oath. NOTARY PUBLIC: Print: &A hkk9rUF7 Seal: 'g• '; MY COMMISSION 4 HH 053232 '`- EXPIRES: December 30, 2024 `•'•.feVi?e'' BendedTNu Nolery PuNkUMewiters identification and who did take an oath. NOTARY PUBLIC: Print: Seal: -" T. MY COMMISSION# HH 053232 `•.•} b; EXPIRES: December 30, 2024 °•;ro«,o?:' Bonded Thm Notary Public Undermilei Mi#i#####iiiiiiiiiii#i#i##k###M####iid•YYt�SriM1iiiiiiiiiiitY###. APPROVED BY � //�i f-_Z Z. Plans Examiner Structural Review •+Y+k#ii•#vM##Y•k t#Mi#Y####i•##iitiititiiiiii Zoning Clerk (Revised02/24/2014( 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 r 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 Fads Brochure: An employer in the construction industry who employs one or more part-time or full-time employees, including the owner, mast obtain workers' compensation coverage. Corporate officers or members of a limited liability comparry (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, ances, Miami Shorts Village does not require verification of workers' compensation insurance coverage from the contractor's actor's company for day labor, parHime 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 tthis0� day of Q 20�� By 30D I 1 B i,t Y l f_ 1 who 4 Wally kno to me or has produced as identification. , ,:;p'.Mi'!aQ;., LEISSI RACKL Notary:_ /�:�liC� ((� �4 C ( My HOUM0 ";id:` EXPIRES; March 13, 2025 SEAL �r� Bonded rnroNotary A ZAP ELECTRIC, INC. 3890 W 4T" AVE, HIALEAH, FL 33012 (786) 343-8930 May 24th, 2022 State of Florida Village of Miami Shores Before me this day personally appeared Andres Barroso who, being duty sworn, Deposes and says: That he will be the only person working on the project located at: 9329 N 91h Ave Andres Barroso (Contractor) Sworn to (or affirmed) and subscribed before me this 24th day of May, 2022. By Andres Barroso Personally Known Notary Signature SUSSYANGUERA #. . • MY COMMISSION # HN 044M EXPIRES: September 21, 2024 �' .°f WO Bo xW 11vU Notary Pnb5C WW&wrtkwa Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-22D4 Location Address 9329 NE 9TH AVE, Miami Shores, FL 33138 Contacts Permit NO.: MC-04-22-870 Permit Type: Mechanical - Residential Work Classification: Alteration Permit Status: Approved Issue Date:05/12/2022 Expiration: 10/03/2022 Parcel Number 1132060010060 AIMEE GREEN Owner 9329 NE 9 AVE, MIAMI SHORES, FL 331382903 SANITY'S AIR CONDITIONING & Contractor REFRIGERATION INC PABLO DE ARMAS 7531 NW 70 ST, MIAMI, FL 33166 Business: 3058845333 Description: REPLACE EXISTING FAN AT BATHROOM Valuation: $ 600.00 Ins ection Requests: 305-762-4949 Total Sq Feet: 0.00 Fees Amount Application Fee - Other $50.00 CCF $0.60 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.20 Permit Fee $50.00 Scanning Fee $3.00 Technology Fee $2.50 Total: $220.30 Payments Date Paid Amt Paid Total Fees $110.30 Credit Card 05/12/2022 $110.30 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 POOLwork. OWNERS AFFIDAVIT: I certify tbgt all the foregoing information is accurate and that all work will be done in compliance with all applicable laws reaulatina r`&. nstruL`l2n gird zonin uthernore. I authorize the above named contractor to do the work stated. Authorized Siffmature: Owner / Applicant / Contractor / Agent Date May 12, 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 ❑PLUMBING E<MECHANICAL ❑PUBLICWORKS JOBADDRESS: ` Folio/Parcel#: I I' ) J•01o" Occupancy Type: -�Load:_ OWNER: Name (Fee Simple Addn City: qA EPR 0 5 202Z FBC 20 � Master Permit No.�-qq - nz—&j ` Sub Permit No me -a L- 'zz-?J� ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS ')ti6'p Is the Building Historically Designated: Yes NO Construction Type: C 6,�Flood Zone: BFE: FFFE: A (Aim GI`P.eA Phone#: 3t7-�- 3 (Q--Q Li j, Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: S o -Y11211 5 X I, i G 47-LU IU)5 Phone#: Address: 531 l J� ST City: p(C kcx.vy�.k State: l'lI Zip: 53i(do' Qualifier Name: Pabl(D Qp H/MGS �r Phone#: C3) E raq-53�� State Certification or Registration #: O/C, D S % 3 D'5 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: _ Zip: Value of Work for this Permit: $ Square/Linear Fo tage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Re Ice ❑ Demolition Description of Work: X -�L- 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 $ (Revised02/24/2014) Bondk Company's Name (if applicable) bonding Company's Address City State Mortgage Lender's Name (if applicable) 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 $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 minspection fee will be charged. Signature OWNER or AGENT The /foregoing instrument was acknowledged before me this day of NY-j .20 3( by eF h! QA—V'Q��ho is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Print: L_ Seal: ••':yt;• CLARISSAARODRIGUEZ MY COMMISSIONIf HH 053232 ;• ?q EXPIRES: December 30, 2024 Bonded Tlw Notary Public Underwrite, APPROVED BY Signature �C, CONTRACTOR The foregoing instrument was acknowledged before me this day of as me or who has produced 20 .by who is personally known to as identification and who did take an oath. NOTARY PUBLIC: Sign: " Print: Seal: QV I Plans Examiner SANDRA UGALDE o,.utr - State of Florida Expires May 6, 2022 (Revised02/24/2014) Structural Review Clerk