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RC-11-23-2896Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Expiration: 05/29/2024 Location Address Parcel Number 135 NW 109TH ST, Miami Shores, FL 33168 1121360030210 Contacts ENRIQUE EVINS Owner EVINS CONSTRUCTION LLC Contractor 135 NW 109 ST, Miami Shores, FL 33168-4316 ENRIQUE EVINS evainse@bellsouth.net 135 NW 109 ST, MIAMI, FL 331684316 Mobile:3059629003 enriquee@evinsconstructionllc.com Description: REFINISHING EXISTING WOOD FLOORS, Valuation: $ 15,000.00 Inspection Requests: . 3057762-4949 j REPLACING BASEBOARDS AT WOOD FLOOR LOCATION AND Tota 15q Feet: 780.00 REPLACING ALL INTERIOR DOORS AND CLOSE BYPASS DOORS. NEW TRIM Fees Amount Application Fee - Other $50.00 CCF $9.00 DBPR Fee $6.75 DCA Fee $4.50 Education Surcharge $4.50 Permit Fee $400.00 Scanning Fee $9.00 Technology Fee $45.00 Total: $528.75 Payments Date Paid Amt Paid Total Fees $528.75 Credit Card 11/29/2023 $478.75 Credit Card 11/16/2023 $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 erti that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating co c ion an i g:...Futhermore, I authorize the above named contractor to do the work stated. Author ed ature: Owner / Applicant / Contractor / Agent Date November 29, 2023 Page 2 of 2 BUII PER ING IT APPLICATION Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (30S) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 [3BUILDING Cl ELECTRIC ® ROOFING opt JOB A' City: Folio/ ;'y t"� FBC 20,9�) Master Permit No. Sub Permit No. 13REVISION ® EXTENSION ©RENEWAL WING r3 MECHANICAL ® CHANGE OF [3CANCELLATION [3SHOP CONTRACTOR DRAWINGS 135 NW 109 Street Miami Shores County Miami Dade Zip: 33168 rcel# 112136003021 O Is the Building Historically Designated: Yes NO X cy Type: Res Load: Construction Type: Flood Zone: BFE: FFE: _ Name (Fee Simple Titleholder): Enrique Evi nS Phone#: 305-962-9003 135 NW 109 St. City: iami Shores state: florida Zip: 33168 Tenant Lessee Name: N/A Phone#: -- Email: Email: evinse@bellsouth.net Evros Construction LLC 305-962-9003 CONT CTOR: Company Name: Phone#: Address: 135 NW 109 St. Miami Shores, Florida 33168 Email: ;vinsconstructionllc@gmail.com Enrique Evins Phone#• 305-962-9003 Qualifi r Name: State CI rtification or Registration #: CGC1526461 Certificate of Competency #: DESIGNER: Architect/Engineer: Phoriey#: Addres : City: State: Zip: 780 Valueof Work for this Permit: $ $15000.00 Square/Linear Footage of Work: Type & Work: D Addition EB Alteration ® New 13Repair/Replace ®Demolition Description of Work: Refinishing exisitng wood floors, replacing baseboards at wood floor location and replacing all i �terior doors and close bypass doors. New Trim color of color thru tile: Specfy Submittal Fee $ Permit Fee $ CCF $ CO/CC $ ScanniI rg Fee $ DCA Fee $ DBPR $ Notary $ Technglogy Fee $ Training/Education Fee S Double Fee $ Structural Reviews $ P&Z Review $ Bond $ TOTAL FEE NOW DUE $ (Revised04/05/2022) Bonding Company's Name (if applicable) Bonding ompany's Address City State Mortgag� Lender's Name (if applicable) Mortgage Lender's Address City State Zip E. Applicati n 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' AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicably laws regulating construction and zoning. "WAR ING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESUL 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 i 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 fi-st inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspectio p will not be approved and a rei ction fee will be charged. I Signature 61 Signat OWNER or AGENT ONTRACTOR I The fo egoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this .1 day of LokYl�_ 20 3 , by day of No-'(�., 20 9 _ by yi n S who is personally known to S who is personally known to me or o ha prf oduc i C as me or wh hasp d ed as identifiICation and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: I i Sign: - Sign:— -� Print: Print:andaftom '17 �. ;: 11 KRISTINE KEPPLE YAO Seal: c"tu 'TINE f" Seal: i o :. `r er Notary Pof FlYAO oridallotary Public State of Florida ;o��.;:_ �..Commission # HH 452227 -�� Comm452227My Comm. Expires Oct 8, 2027oMy Comct 8, 2027ded through National Notary Assn. 3onded throuotary Assn. APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 04/05/2022) Generated On: 11/16/2023 v Summary Report Folio 11-2136-003-0210 Property Address 135 NW 149 ST MIAMI SHORES, FL 33168-4316 Owner ENRIQUE EVINS Mailing Address 135 NW'109 ST MIAMI SHORES, FL 33168-4316 Primary Zone 0800 SGL FAMILY - 1701-1900 SQ Primary Land Use 0101 RESIDENTIAL -SINGLE FAMILY: 1 UNIT Beds / Baths'/Half 3/1/0 Floors 1 Living Units 1 Actual Area > 1,485 Sq.Ft Living Area 1,188Sq. Ft Adjusted Area 1,296 Sq.Ft LVI JILl7 y, IJV 04.rL Year Built Multiple (See Building Info.) 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 httD://www.t-niamidade.ciov/info/disclaii-ner.asi) I I I I I I I I I I I I I I I I I I I .I I I I I I I .T i r rr 1---------------------- - --- �' I � M' I D 1 G214 f I � kn I i O °\ W o I I j EXIST. WASHER ANb\ I DRYER TO REMAIN I I 1 I z 3W ' Z EXIST I ST, EXIST. STUDY EXIST. u MW ly i tV EXIST, EX15T. EXIST. EXIST. WOOD DECK TO REMAIN EXIT. GONG. FOOTING TO REMAIN-t EXIT. EL. PNL TO REMAIN p WALL EXIST. USE EXIST. lc, vvI 000 Long- ��A I IGAL A-J� Section 110.1 Construction or work shall remain exposed and vided with access for inspection purposes until approved. COON1 EXIST TOAERNAIN EXIST, WINDOW TYPICAL�� 5T. EXIST. ® o ® EXIST. SK O O �^( E> IST. I EXIST EXIST. `z REP EXIST. I I CLOSET 0 EX15T. I .G. EXIST. f I 1 EXIST, EXIST. LW'7 q'egV1tCA At IN VJA* 60W41 I\f,vj �OOrtl� CLOSET EXIST. EXIST. i EXIST. EXIST. BosC4- I�plGc�cQ. EXIST L II,, U'VV0 fUP0i 4 yle,,,,J fI60" j w RAW EXIST Q�. O N LU I i i1 i i i CD _0 LLO Z � N H E I O i C� � i W oC to +' C7 Q LV LLI N I J 0 0 a °° c 4 V/ cu ti N Ln L W CO t r, Ll. C a"i LL Q. r1Q LL Qs, l ' • r �.� � ,r � � � N p LLJ IT LL LLI A > LU Lu Z w O c Z N j a, W �% u 0 w a - •L , Q .N cc 0 W H till" R1 nk" y L�l Hi� 0� 0 Local Business Tax Receipt Miami -Dade County, State of Florida -THIS IS NOT A BILL -DO NOT PAY 7349831 BUSINESS NAME/LOCATION EVINS CONSTRUCTION LLC 135 NW 109TH ST MIAMI SHORES, FL 33168-4316 OWNER EVINS CONSTRUCTION LLC C/O ENRIQUE EVINS QUALIFIER Worker(s) RECEIPT NO. RENEWAL 7643479 LBT EXPIRES SEPTEMBER 30, 2024 Must be displayed at place of business Pursuant to County Code Chapter BA - Art. 9 & 10 SEC. TYPE OF BUSINESS 196 GENERAL BUILDING CONTRACTOR CGC1526461 PAYMENT RECEIVED BY TAX COLLECTOR 45.00 07/07/2023 CHECK21-23-033126 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit, or a certification of the holders qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT NO. above must be displayed on all commercial vehicles - Miami -Dade Code Sao ga-276. ®s For more information, visit ACORN® CERTIFICATE OF LIABILITY INSURANCE `� DATE (MM/DD/YYYY) 1 09/13/2023 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 policy(ies) must have ADDITIONAL INSURED provisions or 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 endorsements . PRODUCER CONTACT Lucia Estrella NAME: PHONE (305) 226-8727 ac No): (305) 226-8767 ACCURATE GROUP E-MAIL accurate.certificates@gmall.com ADDRESS: Cg 8300 West Fla ler, Suite 114 9 INSURERS AFFORDING COVERAGE NAIC # INSURER A: EVANSTON INSURANCE COMPANY 35378 Miami FL 33144 INSURED INSURER B INSURER C : Evins Construction LLC INSURER D : 135 NW 109 St INSURER E : INSURERF: Miami Shores FL 33168- COVERAGES 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. INSR LT TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/ D POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR A AGE ToNTIE PREM SES EaEocc. ence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 A 3AA594788 09/25/2023 09/25/2024 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY ❑ JECT LOC PRODUCTS -COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea ..ident $ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY PAUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OTH- STATUTE I ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED' ❑ N / A (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Qualifier Enrique Evins CGC1526461 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores Village Building Dept 10050 NE 2nd Ave AUTHORIZED REPRESENTATIVE Miami Shores, FI 33138 O_Wwr ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 26 (2016/03) The ACORD name and logo are registered marks of ACORD F � •��we• JIMMY PATRONIS 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: 5/2/2022 PERSON: ENRIQUE EVINS FEIN: 825389741 BUSINESS NAME AND ADDRESS: EVINS CONSTRUCTION LLC 135 NW 109 ST. MIAMI, FL 33168 SCOPE OF BUSINESS OR TRADE: EXPIRATION DATE: 5/1/2024 EMAIL: EVINSE@BELLSOUTH.NET Masonry NOC Concrete Construction NOC Concrete or Cement Work - Contractor -Project Manager, Floors, Driveways, Yards, or Construction Executive, Sidewalks and Drivers Construction Manager or Construction Superintendent 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 E01490173 QUESTIONS? (850) 413-1609 Miami Shores Village - BUILDING DEPARTMENT 10050 NE 2 Ave Miami Shores, FL 33138 305-795-2204 www.msvfl.gov 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: 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; The officer is listed as an officer of the corporation in the records of the Florida Department of State, Division of Corporations; and 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: �Vi,4S CMC�%J LX 11Ci is rerniestinn n nermit und(-r this wnrkPrs' 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 subcontra BY SIGNING BELOVj ,MU AQ/NQ LEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Address: State of Florida County of Miami -Dade /.30- /1 4J I -el, swiss The foregoing was acknowledge before me this day of ROV@ AbL 202. C4 c�LJE � n s - By who is personally known to me or has produce _-C. as identification. Notary: e SEAL: Zoni_ na; Revl KRISTINE KEPPLE YAO Notary Public . State of Florida Commission # Hsi 452227 My Comm, Expires Oct 8, 2027 rd through National Notary Assn. Notice to Owner Paae 1 of 1 EVINS RONSTRUITION lie Enrique Evins 135 NW 109 St. Miami Shores, Florida 33168 CGC 1526461 Date: Z4 State of Florida Dade County Before me this day personally appeared Enrique Evins who, being duly sworn, deposes and says: That he will be the only person working on the project located at: 135 NW 109 St. Miami Shores, Florida nni cn Sworn to (or affirmed) and subscribed before me this / (P day of .20_ By EWCJQy� EV 117S roduced Type of Print, Type or Stamp Name of Notary ;ti��'P�e,, KRISTINE KEPPLE YAO =o . ��', Notary Public - State of Florida ��o commission N HH 452227 `'� oa rti° ' My Comm. Expires Oct S, 2027 Bonded through National Notary Assn.