DEMO-16-33 Miami Shores Villas
Building Department JZ72
10060 N.E2nd Avenue,Miami Shores,Florida 33138 BY:
Tel:(305)795-22Q4 Favc(305)756-8972 -7
IN9PE;t10N UNERMENUMBER(305)762,4949
FBC20$ I
BUILDING Muer Permit nbz 103
PBW IT APRJCA11CN Sib Permit Ib.
"twLIING ❑ REMRIC ❑ RaORNG ❑ RBASON ❑ BUIMON ❑RENEWAL
❑R11MENIG ❑MEHANIM ❑PUEJCWORICS pGANGE OF ❑OVCEL TION ❑ SiOP
OOM'RACTOR DRAWINGS
JOBADDREEs �7� !U� tO2�"� S�•
Miami ewes Miami Dade
FonotPerosi#: Isthe Building Hstorically Designated:Yes NO
Occupancy Type: Load: Construction Type: Rood Zone: BFB FFE
OWNER Name(Fee Simple Titleholder):LVtr Cf > U?A F'hon :
Address 70( NS I tl ihy S -P
City' 4CIWKy 3 605 sate: Alp: 331, -----
Tenant/Lessee Noe: phone#:
Fjnail:
OONTwiwt Company Name: 373 Ym hn;e_ C e o lat To- I n G phone#:3y6,866. 1 e I
Address 4-0L VF, 07i"9 S��-
aty: 1460 wu Ske lr e 3 A Stater > Ap: - �a
Qualifier Name. `I Pie;
State 03nification or Fisgistraltion GO I Certificate of Competency#:
y
DIMIGNE3 Architect/Engineer: a Rhone#:
Address aty: State: Ap:
Value of Work for this Permit:$ a Square/Linear FbotageofWork: Z(.
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Fir/Phplaoe I]nmlition
Description of Work:' DLMO c& 3 6w-- v(06v"5 - lc..,' Cj%Q to
Specify color of color thru tile:
Stibmittal Fee$ Permit Fee$ 100 'CyO CCF$ cofoc$
Sunning Fee$ Fhdon Fee$ DEPR$ Notary$
Technology Fee$ Training(Rkioation Fee$ Double Fee$
Structural F bWows$ BDnd$
TOTALFEENC W DUE$
(ReNlsadW24/2M)
i
BxUng Obmpan00Name(if applicable)
Bbr17ng Cbmpan00A0�eQl
City State Ap
Mor[OW LwElsr'OName(if applicable)
MoQage LenOer'OAO]em
City state ap
Application is hereby made to obtain a permit to do the work and insulations 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 BLIC(RICS HJJMBINQ S" POOLE!
FUMACEIS BOIL9F&HE ATS TANKS AIROONDITICNffF ETC....
CG NERS 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.
"0 ARNING TO OD NEFO YOUR FAIWFE TO FEMFD A NOTICE OF CCVIMEVCEMENT MAY
REEJLT IN YOUR PAYING TWICE FOR IM PROVEVI ENT5TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN RNANCING, 0ONSULT WITH YOUR LENDERORAN ATTORNEYS SING
10JR NOTICEOF COM M ENCENI ENT."
Notice to Applicant: As a condition to the issuance of a building permit with an.estimated value eQoseding$2500;the applicant must
promise in good faith that a copy of the notice of commencement and corutnxtion lien law brochure will be delivered to the person
whose property iss4ect to attachment. Also,a certified copy of the recorded notice of commencement must tie posted at the job site
for the first inspection which occurs seven m days atter the building permit is iswed. In the absence of such posted notice, the
inspection will rot be approved and a reinspection fee will be charged.
Sgnature � Sgriature
O WNERor AGENT CONTRAMOR
The foregoing instrument wasadmowledgedbefore methis The foregoing instrument wasaadmowledgedbefore methis
(O+A^ day 20 [ by �(r"_ day of t�ot,rt� .2D. G .by
L n
rally know o Vi n 1f. who is p song wn to
me or who has produced as me or who hasproduced as
identification and who did take an oath. identification and who did take an oath.
NOTARYR BIJQ NCTfARYR)SUC
�
Ste; 9 gn.
Phint: QWWA Print: L Ar
Ste: =(&mn'DA �: QUIDA JACOBS MY COMMISSION q FF43855 EXPIRES:August 14,2017AAA^PVVVVVVVVW
xxxxx####x#x##x#xxxxx###xxxxxxx####xxxxxx####xxxx#######xxx#####xxxx+t#x####x##xxxxxx##x##x#xxx#####xxxx###x#
APPFDV®BY (0 Hans 6carniner ping
Structural Fbview Clerk
(Fk isedW2412m4)
Johnnie C. Cope
479 NE 102 St, Miami Shores, FL 33138
Phone: (305)866-8617 Ceii:(305) 710-9565 FAX:786.369.0419
License:CG-CO60174
January 7,2016
State of FL
County of Miami-Dade
Before me this day personally appeared Johnnie C Cope who,being duly sworn, deposes and
says:
That he will be the only person working on the project located at 479 NE 102nd St, Miami
Shores, FL.,33138.
Sworn to and subscribed before me this 7t'day of January, 2016, by Johnnie C Cope.
Personally known QUIDA JACOBS
MY COMMISSION#FF43855
EXPIRES:AugW 14,2017
Quid > * 1
...� Miami shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305)795.2204
Fax: (305)756.8972
Notice to Owner- Workers$ Com ensation Insurance Exem tion
Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of
P the Florida ria
allows corporate officers in the construction industry to exempt themselves from this Mutes. Fla.p Stat. § prior t
obtaining a building permit. pursuant to the Florida Division of Workers'Compensation Employer Facts Bron any ction project prior to
An employer in the construction industry who employs one or more part-time or full-time
employees,includingthe owner,must ust
. . , obtain workers compensation coverage.erage. Co orate o
I mem Corpora fficers
members of a
limited liability �
ty company (I LC) in the construction in
exempt if: industry may elect to be
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 h
day labor,part-time employees or subcontractors for your project.The contractor has provided an affidavit stating that he e or she will not use
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 A �+nnnnN
QUIDA JACOBS
State of Florida MY COMMISSION it FF43955
EXPIRES.August 14,2017
County of Miami Dade
The foregoing was acknowledge before me this,=day of. 120 L_(.
By i/i t� i a V L ��,,t�. who' Wally known me or has produced
as i cation.
Notary:
SEAL:
i
001747
Local Business Tax Receipt
Miami-Dade County, State of Florida
-THIS IS NOTA BILL - DO NOT PAY
5735163 LBT
susuuess NAIwWU C^-noN RECEWr No. EXPIRES
JOHNNIE C COPE JR INC �. SEPTEMBER 30, 2016
479 NE 102 ST 419=56
MIAMI SHORES FL 33138 Must be displayed at place of business
Pursuant to County Code
Chapter 8A-Art.9&10
OWNER SEC.TYPE OF Busmass
JOHNNIE C COPE JR INC 196 GENERAL BUILDING CONTRACTOR PAYMM RECEIVED
CGC=174 BY TAX COIJ.ECTOR
Workerts) 2 $45.00 07/28/2015
CHECK21-15-106737
This Local Badness Tax Receipt only com%,t&paymentoldto Local Busisass Tax.The Receipt is sots Reason
pennit,are certification of the kolgiar,
'sPWor ao�o►'ennne 1 atouY taws a ��io',t0 do fns Voider m s�toomply wb6 any 9w+emmemal
rMntrHOeBewhich apply to the business
The RECOF r N0.above now be diaptaysd as all commercial w Niles-Ntami-Dade CWe Sea ..
Fortswa�,
JEFFATWATER
CHIEF - 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#W the hxlivkkmi Hated below has elected to be exempt from Florft Workers'Compermmtbn law.
EFFECTIVE DATE: 9/14/2015 EXPIRATION DATE: 9/13/2017
PERSON: COPE JOHNNIE C JR
FEIN: 20251W75
BUSINESS NAME AND ADDRESS:
JOHNNIE C COPE JR INC
479 NE 102ND ST
MIAMI SHORES FL 33138
SCOPES OF BUSINESS OR TRADE:
LICENSED GENERAL
CONTRACTOR
Pur�d�o( 440.�(14y,F.B.,en ager ara ar�n Mroate�e mcwrn Gram ftme tlmptm pyffinB a e ori un�rgue a
meYltOtfec�iat un�tlds P�estmMloaa�r440.�(1�.F.8..Cm�tesdeiectlonfobewcm�t... ypity
w9h4�tlrescapeoTHiOptr��tlplMed �beaxpnpt.PlceuOMto 4�.05(13).F.S..NatkaO�eF cr ns�a tobe
�B PBBOa 118f1p1 @tBp� @ �bet0(8�A7C8dpli(B<e11yfLI100&� OitllO 1pl�Ce p910ORU10C�CeD9,
ntea>a 61e repApnp�a�@ds 1 rp(ssueaca Of a per.Tha raYOke a
DMr2.OWC-252 CERnFICATE OF BBCTION TO BE EST REVISM 08.13 0U8M1M S?(850$13.1W9
i
P Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-254015 Permit Number: DEMO-1-16-33
Inspection Date: March 08,2016 Permit Type: Demolition
Inspector: Rodriguez,Jorge Inspection Type: Final
Owner: SOUZA, HENRIQUE Work Classification: Building
Job Address:479 NE 102 Street
Miami Shores, FL Phone Number (646)320-4171
Parcel Number 1132060170840
Project: <NONE>
Contractor: JOHNNIE C COPE JR INC Phone: (305)866-8617
Building Department Comments
DEMO OF 3 BATHROOMS&KITCHEN Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-250535. Work not completed.
need to remove tiles from the bathroom walls and Aub area.
Need to properly cap off the sewer line at the old bathroom on the rear east
room, Plumbing inspection is required.
Failed Remove rotten wood, if structural provide engineer detail and specifications.
Correction
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
For Inspections please call: (305)762-4949
March 07,2016 Page 1 of 1
1 L 4 ) { t
Miami Shores Village
10050 N.E.2nd Avenue NE
• Miami Shores,FL 33138-0000 '
Phone: (305)795-2204 � N
Expiration:07/17/2016
Project Address Parcel Number Applicant
479 NE 102 Street 1132060170840
HENRIQUE SOUZA
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
HENRIQUE SOUZA 479 NE 102 Street (646)320-4171
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 2,500.00
JOHNNIE C COPE JR INC (305)866-8617 (305)710-9565 Total Sq Feet: 265
Type of Demo:Building Available Inspections:
Additional Info:DEMO OF 3 BATHROOMS&KITCHEN Inspection Type:
Classification:Residential Final
Scanning:3 Review Electrical
Review Electrical
Review Electrical
Review Plumbing
Review Plumbing
Review Building
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.80 Invoice# DEMO-1-1658252
DBPR Fee $2.00 01/07/2016 Check#:2867 $50.00 $67.80
DCA Fee $2.00
Education Surcharge $0.60 01/19/2016 Check#:2882 $67.80 $0.00
Permit Fee $100.00
Scanning Fee $9.00
Technology Fee $2.40
Total: $117.80
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 for o g information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore, thoabove-named contractor to do the work stated.
January 19, 2016
Authorized Signature:Ownero / Applicant / Contractor / Agent Date
Building Department Copy
January 19,2016 1