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RC-15-821 (8). � r Miami Shores Village Building Department APR 092015 as 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 00"LTel:(305)795-2204 Fax:(305)756-8972 J10 INSPECTION UNE PHONE NUMBER:(305)762-4949 FBC 20 K) BUILDING Master Permit No. PERMIT APPLICATION Sub Permit No. 00 BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: /PS610 � City Miami Shores //�� County: Miami Dade Zip: Folio/Parcel#: /1- a�3 ^ O)3'-�SNU Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: SKP Tgs gQ 11C,r L OWNER:Name4Fee Simple Titleholder Phone#: asR SSl Address: 7�U/D G/e Et CVni',9Sr C-496 7t- R01 AA 2118 c City: LAV A4d2WL,-9 State: If& Zip: y Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: L S I U m IA-)UA9 Phone#: Address: D 1 W City: 1 A W Y A-1 10 A/ State: Zip: q Qualifier Name: a e a Phone#: 0 C; S 6 Jz' 1Z6 1 Sfate Certification or Registration#: [' � / 1y9--C !rti C mpetency#: DESIGNER:Architect/Engineer: Phone#: Address ty: State Zip: Value of Work for this Permit:$ �fl Square U r FootA e of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Rel air/Replace ❑ Demolition Description of Work: * ✓ /Ze of e,A,'), Specify color of color thru We: Submittal Fee$ Permit Fee$I r CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ (�G TOTAL FEE NOW DUE$ I - 1 . (Revised02/24/2014) w AL Bonding Company's Name(if applicable) Bonding Company's Address, City R w 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: 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$21500, 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 spE, fee will be charged. Signature Signature A,�'�� OWNER ENT CONTRA OR The foregoing instrument as acknowledged before me this The foregoing instrument was acknowledged before me this J day of 3 ,,220 75 ,by day of r- 20 1� ,by In rrc., ,� ,who is p� ers�rt one wn ho i personally knownto me or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: ` NOTARY PUBLIC: Sign: Q�`d-�UAD Sign: ° •e" PUM-Stme of Flotfda Print: Print: iivi&�qz 20 Seal: o��ar PU NADINE AUSTERFIELD Seal 'For CoanrNss�i►N FF 147132 eicr �ynn.ZM` Ilbn0adlAraigliffaellfiitAs Notary Public-State of Florida =°+ • My Comrrdssion Expires Nov 7,2017 Commissio #FF 55651 F OF f�� rf�---- APPROVED BY f Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) �■ Miami V Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 ANoff to Owner - Workers' Com nsation Insurance Exem tion Flofres Workers' Compensation hrsurance covoerage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allofficers in the construction hndtatry to exempt themschm from this requh meat for any construction project prior to obtaining a bij lding 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: I. The offices'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 contractc is requesting a permit under this workers'compensation exemption and has acknowledge that he or she will not use day labor,part 'me employees or subcontractors for your project.The contractor has provided an affidavit stating that lie or she will be the only per on allowed to work on your project,lin dose circumstances,Miami Shores Village does not require verification of workers'cam sation 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: State of Florida County of M' i-Dace The foregoing 4 as acknowledge before me this day of � ,20� By 4Lapa who is nal y has produced a8 identification. „uurq, . '` YP � s �`"R g"f, NADINE AUSTERFIELD Notary: ?a; a _. # Notary Public-State of Florida ° My Commission Expires Nov 7,2017 SEAL: -�4e SOF F��J,` Commission# ` FF 55651 Tony's Aluminum General Contractors I.ic.#CGC1512149 Screen Rooms* Accordion Shutters* Hurricane Storm Panels* Pavers* Stamped Concrete Driveways Fences Bathrooms*Kitchens*Interior and Exterior Home Remodeling Services March 26,2015 State of Florida County of Dade Before me this day personally appearedV'�Q'AIVwho being duly sworn,deposes and says: That he or she will be the only person working on the project located at: ' 10540 NE 2"d Place Miami Shores, FL Sworn to(affirmed)and subscribed before me thisday of�6& 2015,by 1 Personally Known Or Produced ID Type of Identification Produced Jp�►Rr a�e6• �` ROSA A.NOT Notary Pu(�•Stat111* of Flowa •:tdy COMM.Expires Nor ZT.Via Commission#�FF 14'132 00 NOWY AWL Print,Type or Stamp Name of Notary T 6231 SW 7 Cr Plantation,FL 33317 Dade:(305)SOS-78S4.Broward:(954)Stiff-6811 EMAIL:tonpguminum@aol.com..Website:www.tonysaluminum.com Detail by Entity Name Page 1 of 2 40 r Detail by Entity Name Forelan Limited Liability Company SRP TRS SUB, LLC Filing Information Document Number M12000004126 FEI/EIN Number N/A Date Filed 07/20/2012 State DE Status . ACTIVE Principal Address 1999 Harrison St _ Oakland, CA 94612 Changed: 03/17/2014 Mallina Address 1999 Harrison St Oakland, CA 94612 Changed: 03/17/2014 Registered Agent Name&Address Corporation Service Company 1201 Hays St Tallahassee, FL 32301 Name Changed: 03/17/2014 Address Changed: 01/21/2015 Authorized Person(s) Detail Name&Address Title Member SRP TRS Sub Inc. 1999 Harrison St Oakland, CA 94612 Title President Beasley, Gary http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 4/9/2015 Detail by Entity Name Page 2 of 2 1999 Harrison St Oakland, CA 94612 Title Vice President/Treasurer Tran, Nina 1999 Harrison St Oakland, CA 94612 Title Vice PresidenUSecretary Browne, Tamra 1999 Harrison St Oakland, CA 94612 Annual Reports Report Year Filed Date 2013 07/09/2013 2014 03/17/2014 2015 01/21/2015 Document Imaees 01/21/2015—ANNUAL REPORT View irrmge in PDF farrnat 03/17/2014—ANNUAL REPORT View image in PDF format 07/09/2013—ANNUAL REPORT View image in PDF format 07/20/2012— Foreign Limited View Image in PDF format Copyriaht©and Privacy Poiicfes State of Florida,Department of State http://semh.simbiz.org/Inquiry/CoTorationSemh/Se=bResWtI)etail?inquftyVpe=Entity... 4/9/2015 INSTR # 112912902 Page 1 of 2, Recorded 04/08/2015 at 10:22 AM Broward County Commission, Deputy Clerk ERECORD SRP TRS SUB,LLC CERTIFICATE AS TO ADOPTION OF COWANY RESOLUTION November 11,2014 The undersigned, Ding a duly authorized.officer of SRP TRS Sub, LLC, a Delaware limited liability company (the `�, does hereby certify that the fallowing resolutions have been duly adopted by the Company, in accordance with the provisions of the Company's Certificate of Formation and Limited Liability Company Agreement: RESOLVED, that each of the persons set forth on Exhibit A attached hereto shall be designated as Authorized Agent for the Company;and FURTHER RESOLVED, that each Authorized Agent, individually, be, and hereby is, airthorized and empowered,on behalf of the Company,to execute and deliver contracts,deeds, closing statements, and other documents nay, including but not limited to Affidavits of Title and Franchise Tax Indemnity Agreements,to settle and close on the purchase,sale or lease of real estate(such documents,the"Real Estate Documents')on behalf of the Company,and to take such Bother action as may be necessary to accomplish such settlement or closing(any such Authorized Agent's approval of the form, consent or necessity of any such Real Estate Document to be conclusively evidenced by such Authorized Agent's execution and delivery thereof for and on behalf and in the name of the Company). I hereby y that the foregoing resolutions have been duly adopted and remain in full force and effect on the date hereof. IN WITNESS WHEREOF,the undersigned,intending to be legally bound hereby,have duly executed this certificate as of the date first set forth above. By: T wne Secretary Miami Shores Village ,4 10 Building Department JA os 2016 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 )-"4" Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC20 ( `-4 BUILDING Master Permit No. 1'�zoo q --�sc� PERMIT APPLICATION Sub Permit No. BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL [__j PLUMBING [:] MECHANICAL ❑PUBLIC WORKS [:] CHANGE OF dCANCELLATION ❑ SHOP � ``� CONTRACTOR DRAWINGS JOB ADDRESS: City: Miami Shores Countv: Miami Dade Zia: ' _ 226 Folio/Parcel#: �,�7�.V -1-��" . ) Is the Building Historically Designated:Yes NO Occupancy Type:_5� N' Load: y Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder MW 1NO -Ac �� Phone#: L" JQ Ki 02 Address: 3gs City: tA)n �'S State: Zip: 33A Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: Phone#: Address: iz City: State: I Zip: Qualifier Name: Phone#: State Certification or Registration M Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ Square/Unear Footage of work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: —R15P(-A �1> S "P I lu G �( �• 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$ (Wsed02/24/2014) 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 AFFIDAVrr: 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 ///Ia� A Si OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before i , 'The foregoing instrument was acknowledged before me this Q10 day of/ 20� y day of .20 ,by I i`V A `who is personally known to ,who is personally known to mei r who has produced as me or who has produced as ideJJntification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: ✓ Sign: Print: �' - V \ Ae -PJ('Gl' Print: Seal: yil Seal: C01110t11sioe 0 IF84M E QI�Inb�15,2019 APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Monika Abels & Jacques Polynice 348 NE 103`d Street Miami Shores, Florida 33138 January 6,2016 RE: Cancellation of Permit to Replace stepping Stone in front of Garage door. To whom it may concern, By this letter we wish to cancel any outstanding permit filed in 2004 to replace the stepping stone in front of our garage located at 348 NE 103`d Street, Miami Shores, Florida 33138 Monika Abels Jacqup's Poly ice Yoft HUM Coauttb" # RS43846 . E>i � nb�15,2019 -0( � fdtls 4e . uuv Am X