RC-15-2286 Permit NO. R.C-9-15-2" 86_
Miami Shores Village „€ FffT77lf ly# :RS( EttlxtnSttttcon
�.� 10050 N.E.2nd Avenue NW
y}rorkc 0a$Sfflr tivrl: ._
Miami Shores,FL 33138-0000
Phone: (305)795-2204
F1 ',�DROVED
�toRmA Expiration: 0712016
Issues Not Isstt�d p
Project Address Parcel Number Applicant
119 NW 110 Street 1121360030550
Miami Shores, FL 33168-4320 Block: Lot: 2620 ACQUISITIONS LLC
Owner Information Address Phone Cell
2620 ACQUISITIONS LLC 600 BRICKELL Avenue
MIAMI FL 33131-
600 BRICKELL Avenue
MIAMI FL 33131-
Contractor(s) Phone Cell Phone Valuation: $ 2,000.00
KIS CONSTRUCTION SERVICES LLC (786)975-5750 Total Sq Feet: 1658
Approved:In Review Available Inspections:
Comments: Inspection Type:
Date Approved::In Review Final
Date Denied:
Review Building
Type of Construction:stucco redue on the entire house.o Occupancy:
Stories: Exterior:
Front Setback: Rear Setback:
Left Setback: Right Setback:
Bedrooms: Bathrooms:
Plans Submitted: Certificate Status:
Certificate Date: Additional Info:
Bond Return: Classification:Residential
Fees Due LAnt Pay Date Pay Type Amt Paid Amt Due
CCF ,20
DBPR Fee Invoice# RC-9-15-57018
.00 09/24/2015 Credit Card $ 116.20 $0.00
DCA Fee .00Education Surcharge .40Permit Fee .00Scanning Fee .00Technology Fee .60Total: 20
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 caon�oji�w* he plans,drawings,statements or specificationssubmitted to the proper authorities of Miami Shores Village. In
accepting this permit I suraeor all wIn
ne by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELE TRIC PLUANICAL, DOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERSAFF VI I certifregoing iation is accurate and that all work will be done in compliance with all applicable laws regulating
construction a z ni g. Futhee the abarrr€d contractor to do the work stated.
September 24, 2015
Authoriz d r :Owner / Applicant / Contractor / Agent Date
Bu' ng Deparrtment Copy
September 24,Y0515 1
Miami Shores Village Building Permit
10050 NE 2nd Avenue
Phone: 305-795-2204 Permit Number: BP2005-1254
Printed:10/6/2005 Page 1 of 1
Applicant: OSMEL LOPEZ
Owner: GERVE ACHILLE
JOB ADDRESS: 119 NW 110 ST
Contractor Contractor's Address:
Local Phone:
Parcel # 1121360030550 Legal Description: 36 52 41 MIAMI SHORES EXT PB 43-40 LOT 23 BLK 220 LOT SIZE
Fees: Description Amount
FEE2005-13227 Building Painting Fee $60.00
FEE2005-13228 CCF $1.20 Total Fees: $67.90
FEE2005-13229 Notary Fee $5.00 Total Receipts: $0.00
FEE2005-13230 Training and Education Fee $0.20
FEE2005-13231 Technology Fee $1.50
Total Fees: $67.90
Permit Status: APPROVED Permit Expiration: 2/19/2006 Construction Value: $2,000.00
Work: REDO THE STOCCO WORK ON THE ENTIRE HOUSE, OUTSIDE PAINTING THE ENTIRE HOUSE
Signed: (INSPECTOR)
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 responisibility for all work
done by either myself,my agent,servants or employes.
F Dpi;
Signed: (Contractor or Builder) BY:
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-243069 Permit Number: RC-9-15-2286
Scheduled Inspection Date: October 07,2015 Permit Type: Residential Construction
Inspector: Rodriguez,Jorge
Inspection Type: Final
Owner: , Work Classification: Repair
Job Address: 119 NW 110 Street
Miami Shores, FL 33168-4320 Phone Number
Parcel Number 1121360030550
Project: <NONE>
Contractor: KIS CONSTRUCTION SERVICES LLC Phone: (786)975-5750
Building Department Comments
stucco redue on the entire house. outside paint entire house. Infractio Passed Comments
TO CLOSE PERMIT#BP-2005-1254 INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
October 06,2015 For Inspections please call: (305)762-4949 Page 20 of 60
Miami Shores Village `
BuildingDepartmentA 2015
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20 IQ
BUILDING Master Permit No.-V . 2---�y)b
PERMIT APPLICATION Sub Permit No.
BUILDING ELECTRIC ROOFING REVISION EXTENSION RENEWAL
r
PLUMBING ❑ MECHANICAL PUBLIC WORKS [:] CHANGE OF ❑CANCELLATION [] SHOP
d CONTRACTOR DRAWINGS
JOB ADDRESS: //47 /V
City: Miami Shores b� County: Miami Dade ZIQ: '33 13
Folio/Parcel#:�/ /rj(z- �C°�� ® Is the Building Historically Designated:Yes NO X
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): ► i)0Y)5 Ph'
`� �• `�'<
Address: 9U0 syy 27 A per
City: 1-1/�b`i l l State: E A i o q
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: [?s!i„�i t°�!r✓ 1j)IJ Se✓V .5 phone
Address: ggK0 S V1/
City: /`ol 14 A4 i State: -��oe 104 Zip: S313 113
Qualifier Name: AI A epu i 1 Phone#: 26 561iM6
State Certification or Registration#: C &C 1-511413 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ Square/Linear Footage of Work:
Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace ❑ Demolition
De cription of Work: e ke 0A1 -j7j 1,Lj e9 SiD�
/✓ �' ,re
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$ f2 -2402
(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 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: 1 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 c&/fled copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occur even (7) d s a r the building permit is issued. In the absence of such posted notice, the
inspection will not be app ved a reinspe 'o fee 11 be charged.
Signature �
g Signature
r CONTRACTOR
The foregoi4dayo
ment was acknowledged before me this The foregoing instrument was acknowledged before me this
51_ "�S� 20_ 15- ,by A 8 day of �L2S� 20 15 ,by
who is personally known to -Solf,i K • S.zryJ who is personally known to
Coor who has produced as /fie�r who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
A
Sign: Sign:
_A
Print: i � Print: vA4l- I
Seal: , ,' WAA HERNANDEZ Seal ,, "¢li • MYLAI HERNAND
MY CON6191SSION 5 EE 221249 ;x MY COMMISSION A EE 221249
EXPIRES:December 1 2016 Qi EXPIRES:December 1,2016
Bonded Th,Nagy Public Uc de"rwft m sonded'rhru No"Public Unde+writers
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
Property Search Application- Miami-Dade County Page 1 of 1
� E a E
s y ' THE R
p :
Summary Report
Generated On:9/9/2015
Property Information
Folio: 11-2136-003-0550
Property Address: 119 NW 110 ST
Owner 2620 ACQUISITIONS LLC
Mailing Address
600 BRICKELL AVE#1750 -
�„� r s�
MIAMI,FL 33131a
Primary Zone 0800 SGL FAMILY-1701-1900 SQ
0101 RESIDENTIAL-SINGLE
Primary Land Use
FAMILY: 1 UNIT
Beds I Baths/Half 3/2/0
f �"
Floors 1
Living Units 1
Actual Area 2,016 Sq.Ft f 3
Living Area 1,185 Sq.Ft ! -
Adjusted Area 1,630 Sq.Ft
Lot Size 9,150 Sq.Ft Taxable Value Information
Year Built 1940 2015 2014 2013
Assessment Information County
Year 2015 2014 2013 Exemption Value $0 $0 $0
Land Value $164,440 $98,074 $44,981 Taxable Value $119,693 $108,812 $98,920
School Board
Building Value $55,641 $53,892 $53,939
XF Value $0 $0 $0 Exemption Value $0 $0 $0
- - - Taxable Value 1 $220,081 $151,966 $98,920
Market Value $220,081 $151,966 $98,920 City
Assessed Value $119,693 $108,812 $98,920
Exemption Value $0 $0 $0
Benefits Information Taxable Value $119,693 $108,812 $98,920
Benefit Type 2015 2014 2013 Regional
Assessment Exemption Value $0 $0 $0
Reduction
Non-Homestead Cap $100,388 $43,154 Taxable Value $119,693 $108,812 $98,920
Note:Not all benefits are applicable to all Taxable Values(i.e.County,
School Board,City,Regional). Sales Information
Previous Price OR Book- Qualification Description
Short Legal Description Sale Page
36 52 41 11/19/2012 $100,000 28368-4705 Qua[by exam of deed
MIAMI SHORES EXT PB 43-40 08/01/2005 $350,000 23685-2514 2008 and prior year sales;Qual by
LOT 23 BLK 220 exam of deed
LOT SIZE 75.000 X 122
75R 184001
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 hftp://www.miamidade.gov/info/disclaimer.asp
Version:
http://www.miamidade.gov/propertysearch/ 9/9/2015
Miami Shores Village
Building Department
` 10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795.2204 Fag: (305)756.8972
BUILDING PermitNo.
PERMIT APPLICATION Master Permit No.
FBC 2001
Permit Type(circle): Building Electrical Plumbing Mechanical Roofing
Owner's Name(Fee Simple Titleholder) oC, L Phone# (o —904�
Owner's Address 31k2-c� S w -2-3 +L rr
City 1--y em ( State Zip 314
S
Tenant/Lessee Name Phone# (3o S Lt6 t- Zq l.S
T
Job Address(where the work is being done) NQJ )C® S
City Miami Shores Village County Miami-Dade Zip
Is Building Historically Designated YES NOle
Contractor's Company Name k) p" Phone#
Contractor's Address
City State Zip
Qualifier ,, CC �y
State Certificate or Registration No. Iv (r' Certificate of Competency No. 1J JA
Architect/Engineer's Name(if applicable) Phone# A-
3 $Value of Work For this Permit '2-0d:15' a b Square Footage Of Work: ` (c S on
Type of Work: ❑Addition ❑Alteration ❑New [ Repair/Replace ❑Demolition
Describe Work: 14_10 f- -kkc O C D cS-g- IL_ �-
b LAel I c,:Q . X70._;.VQ1 e k
Submittal Fee$ 000" Permit Fee$ CCF$ ®. G d CO/CC
Notary$ Training/Education Fee$ 0.20 Technology Fee$ 1 -i5o
Scanning$ Radon$ Zoning Bond$
Code Enforcement$ Structural Plan Review.$
Total Fee Now Due$ 6-7 -10
(Continued on opposite side)
Bonding Company's Name(if applicable)
Bonding Company's Address
} n ,
City State Zip
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 ELECTRICAL WORK,PLUMBING, SIGNS,
WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS and 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
fo�the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will n be approved and a r inspection fee will be charged
Signa Signature
Owne Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day ofAU C1 ,2&_Jr—,by en YCLa, ' , day of .20 by
who is personally known to me or who has produced who is personally known to me or who has produced '
As identification and who did,taNe aA, oath. as identification and who did take an oath.
NOTARY PUB IC: ""°�<, °�° �`R''. NOTARY PUBLIC:
Sign: �� �vJ� Jet Sign:
Print: =G�' rt��+�;r� v Print:
My Commissio xpires: My Commission Expires:
APPLICATION APPROVED BY: Plans Examiner
Engineer
Zoning
chc 05/13/03
VILLAGE OF MIAMI SHORES
BUILDING DEPARTMENT
OWNER BUILDER DISCLOSURE .STATEMENT
Ilf Dw? L �cpt:F-z_ being the legal property owner, for the property
Located at: It cl N l,J
Legally described as
Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the
State of Florida,F.S.489.103(7),-;nd I have read and understand the following disclosure
Statement, which entitles me td aisrork as my own contractor, I further understand that I as the owner
must appear in person to complete all applications.
DISCLOSURE STATEMENT
State law requires construction to be done by licensed contractors. You have applied for a permit under an
exemption to that law. The exemption allows you, as the owner of your property, to act as your own contractor
even though you do not have a license. You must supervise the construction yourself. You may build or
improve a one-family or two-family residence or a farm out-building. 'You may also build or improve a
commercial building at a cost of$25,000.00 or less.The building must be for.your own use and occupancy.It
may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the
construction is completed, the law will presume that you built it for sale or lease, which is a violation of this
exemption. You may not hire an unlicensed person as your contractor.It is your responsibility to make sure
that people employed by you have licenses required by state law and by county or municipal Iicensing
ordinances. Any person working on your building who is not licensed must work under your supervision
and must be employed by you, which means that you must deduct F.I.C.A. and with-holding tax and
provide workers' compensation for that employee, all as prescn-bed by law. Your construction must comply
with all applicable laws, ordinances,building codes and zoning regulations.
Proof of ownership provided( ) initial of reviewing clerk Tlie foregoing instrument
Was acknowledged before me this day of 20
By En J/I%A Q, I(JY who is personally known to me or who has
Produced as identific ion an who did take an oath.
Owner
-�': ,✓^u.,r�r i; P.A.. • .
CXPI Fes
Ogler Ronded lYlf '
ktlantic Bondin C'+=. Oto,
Miami Shores village apps, 2S�
Paint Color Approval and Agreement
Date
Owner's Name e
�� �� Phone# B(v� g 6—21® Z
Owner's Address
City_`41VI/ State Zip f°tV
`,CI 0 W N�Z
.lob Address(where the work is being done) 3-6 t(09
City_ Miami Shores Village County Miami-Dade Zip
Is Building Historically Designated YES NO
Contractor's Company Name(if applicable) Phone#
All elements on the site must be listed and indicate the color to be painted
Walls 9/ l
Fascia
Drip Cap/drip Edge/ OCT
3 2
IT
Soffit V Roof
Flower bins Color Samples
With Numbers
Shutters
Awnings r
Chimney_ \
Doors and door jams
Garage doors
Railings
Fences
Decorative metal
All brick(simulated or regular)
Stucco banding
Any other stucco features
Accessory Buildings
Other
OWNER'S AFFIDAVIT: I certify that all th n oregoing information is accurate and that all work will be done in compliance with all
applicable law ting construction and zo
Date
Signator —
Owner or Agent
D (� �+P rDate
!0P:I-_kTl9T A..DR..VE'. B� '. c�3c 611R1Q'
4'L Ofsi:.ma_
-47
i
Venus,
OOYY 65/10. . i
miaini Shores village
paint Color approval and greemnn'�E? 1.4
r��
Date
Owner's Name ^
Phone'" 's 717
Owner's Address
Citv
State_ �_ Zip
Job Address(where the work is being done) /]1 .110
County Miami-Dade Zip '-
City Miami Shores Village ty
Is Building Historically Designated YES NO
SEP 2 7 2935
Phon
Name
Contractor's Company Nae(if applicable) -
All elements on the site must be Iisted and indicate the color to be painted
Walls
Fascia
Drip Cap/drip Edge Z
Soffit Var,
Roof__X)1111
Flower bins
Ready-Mix White
Shutters
Awnings
Chimnev
Doors and door jams �-
Garage doors
Railings -
Fences
Decorative metal
All brick(simulated or regular) 014-
Stucco banding
Any other stucco features A)17
Accessory Buildings ,
Other S vh
OWNER'S AFFIDAVIT: I certify that all the foregoing informatio�is �ur ��that all work will be done in com fiance with all
ting construction d zoning.
applicable laws r J
Signature Date
Owner or A ent
e
tPp'_I'—_A:TIOh DD O CETBY: Date
cnc 6/18/0:'
Miami Shores Village
Paint Color Approval and Agreement
Date z
Owner's Name
� Phone# � p(o- �g(o-ZIyZ
Owner's Address 34 L S
City M t g M 1 State L— Zip 3 I `'�S�
Job Address(where the work is being done)
City Miami Shores Village County Miami-Dade Zip
Is Building Historically Designated YES N0�_
/
Contractor's Company Name(if applicable) ,4 Phone#
All elements on the site must be listed and indicate the color to be painted
Walls
Fascia it
Drip Cap/drip Edge
Soffit
e
Roof
Flower bins Attach Color Samples
With Numbers
Shutters
Awnings
Chimney
Doors and door jams
Garage doors c�
Railings
Fences �� `�'
Decorative metal --file !
All brick(simulated or regular) ����
Stucco banding
Any other stucco features
Accessory Buildings EX7 -A 01A Ile- 6 f 11-3.9 6 C-
Other �3 y�vy 35
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.
Date 551 L Ll ,a
Signature
Owner or Agent
APPLICATION APPROVED BY: Date
P&Z Officialchc 6/18/03
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