FW-16-1581 IN
Miami Shores Village M #Pe1=enct�l1
10050 N.E.2nd Avenue NE � � All
Wd. "14
Miami Shores,FL 33138-0000ROVE® �
Phone: (305)795-2204
fit° Expiration: 01/03/2017
Project Address Parcel Number Applicant
10417 NE 2 Avenue 1121360130530
Miami Shores, FL 33138-2058 Block: Lot: LUCKY 13 HOME INVESTMENTS
Owner Information Address Phone Cell
LUCKY 13 HOME INVESTMENTS 8004 NW 154 Street (305)219-8267
MIAMI LAKES FL 33016-
8004 NW 154 Street
MIAMI LAKES FL 33016-
Contractor(s) Phone Cell Phone Valuation: $ 1,200.00
APC ENGINEERING ENTERPRISES IN (305)219-8267
Total Sq Feet: 335
Approved: Available Inspections:
Comments: Inspection Type:
Date Approved:
Final
Date Denied: Foundation
Type of Construction:Wood Fence Additional Info:6'FEET WOOD FENCE Review Planning
Classification:Residential Scanning:3 Review Building
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.20 Invoice# FW-6-16-60103
DBPR Fee $5.03 07/07/2016 Credit Card $357.26 $0.00
DCA Fee $5.03
Education Surcharge $0.40
Permit Fee-Wire&Wood $335.00
Scanning Fee $9.00
Technology Fee $1.60
Total: $357.26
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
construction an uthelm e,I authorize the above-named contractor to do the work stated.
"r"W07, 2016
Authod ignature: ner / Applicant / Contractor / Agent Date
Building Department Copy
July 07,2016 1
AFFIDAVIT
1, David M Dipuglia,will be the only person working on the project at 10417 NE 2"d Ave Miami
Shores, FL 33138-2058.
David M Dipuglia
(305)219-8267
daviddapc@gmaii.com
Signature:
The foregoing instrument was acknowledged before me this jday of 20
BY who is personally known tome or who has produced
AS identification and who did take an oath.
NOTARY PUBLIC:
Signatur . _
Print: w ,.,,,,,._,
SANDY ROMERO
fttWy Public 1(a MY •State of FIWW&
CM086ion#FF 915706
COM,Expires Sep r,2019
APG Engineering Enterprises,Inc.
2150 West 1 Avenue Hialeah,FL 330757 Pipe:r3_06)80-5371«FAX:(305)X5073 a epcengirteeting g auxom
Page 1 of I
Miami Shores Village RECEIVED
Building Department UN 07 2016
10050 N.E.2nd Avenue,Miami Shores, Florida 33138 BY, 14
Tel:(305)795-2204 Fax:(305)756-8972 114
INSPECTION LINE PHONE NUMBER:(305)762-4949 _
FBC 20t
BUILDING Master Permit No.Fy� 5118
PERMIT APPLICATION Sub Permit No.
BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL E:]PUBLICWORKS [:] CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 1041-7 PC .20J4. -
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): L_"Ck`j /.3 Zn✓t°Sl-ME'A * Phone#:
Address:/O Y/7 /✓ •F_ dg Ndave
City: M lei'm t S h o 2 pf State: Zip: -??O3
Tenant/Lessee Name: Phone#: 3 DS— +Z -�
Email: /� c //
CONTRACTOR:Company Name: APc F_yJ 41`6 Pe C(n f' Phone#: 3 OS-21 - Z 6
Address: 21(X0 W • /8 *'' Ave—
city: 4"AI-e h State: F6, Zipa330(y
Qualifier Name: b!✓l ;1 'D<ee 1 edz' Phone#:
State Certification or Registration#: /rf 7e7 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: (-2-03 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration 1:1 New E:1 Repaiirr-/Replace [:1 Demolition
Description of Work: 1p �!�C .P /+�i f T/� W YTp Q L 0c 7
1
TICE V_�4
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ � ' �� CCF$ Z0 CO/CC$
Scanning Fee$ b Radon Fee$ ®3 DBPR$ Notary$
Technology Fee$l '60 Training/Education Fee$ a ` Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(Revised02/24/2014)
A
'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: 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.
1) 1AA
Signatur Signature l
OWNER or AGENT CON ACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument Jw-as acknowledged before me this
_ da of 20 /b ,by 14 day o//f�� ,,�� 20/jo by
�2D1 ` vim who i ersonall know o who personally know
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:
Sig Si n•
Print: Print:
Seal: ,a SANDY ROMERO Seal: ,o.w' SANDY ROMERO
= Notary Public.gists of Florida Notary Public-State of Florida
Commission#t FF 91570 ag Commission#t FF 915708
My Comm.E fres Sep 7, 01 r�'•.,p.� ,.•`� My Comm.Expires Sep 7,2019
APPROVED BY Plans Examiner y Zoning
Structural Review Clerk
(Revised02/24/2014)
Detail by Entity Name Page 1 of 2
E 33
i
E
E (3 If•
Detail by Entity
Florida Profit Corporation
LUCKY 13 HOME INVESTMENTS, INC
Filing Information
Document Number P04000167141
FEI/EIN Number 20-2009716
Date Filed 12/14/2004
Effective Date 12/13/2004
State FL
Status ACTIVE
Last Event REINSTATEMENT
Event Date Filed 11/16/2015
Principal Address
8004 N.W. 154TH ST., STE 217
MIAMI LAKES, FL 33016
Changed: 01/29/2013
Mailing Address
8004 N.W. 154TH ST., STE 217
MIAMI LAKES, FL 33016
Changed: 01/29/2013
Registered Agent Name &Address
RONCA, PAUL
7850 NW 146TH STREET
SUITE 513
MIAMI LAKES, FL 33016
Name Changed: 11/16/2015
Address Changed: 04/01/2009
Officer/Director Detail
Name &Address
Title P
HECTOR, RICHARD A
http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 6/7/2016
Detail by Entity Name Page 2 of 2
8004 N.W. 154TH ST., STE 217
MIAMI LAKES, FL 33016
Title VP
HECTOR, CRISTINA M
8004 N.W. 154TH ST., STE 217
MIAMI LAKES, FL 33016
Annual Reports
Report Year Filed Date
2014 01/12/2014
2015 11/16/2015
2016 04/29/2016
Document Images
04/29/2016 ANNUAL REPORT —View image in PDF format
.11/16/2015 REINSTATEMENT F—View image in PDF To7rm7a—t--7
01/12/2014 ANNUAL REPORT F—View image in PDF format --]
01/29/2013 REINSTATEMENT F—View image in PDF format
05/23/2011 Dom/For AR View image in PDF format
05/24/2010 ADDRESS CHANGE View image in PDF form—at
04/12/2010 ANNUAL REPORT F—View image in PDF format-7
04/01/2009 ANNUAL REPORT [—View image in PDF format--7
04/28/2008 ANNUAL REPORT F—View image in PDF format---]
01/16/2008 ANNUAL REPORT F—View image in PDF format
03/21/2007 ANNUAL REPORT F——View image in PDF format----]
03/15/2006 ANNUAL REPORT F—View image in PDF fo—rm—a-F--�
04/12/2005 ANNUAL REPORT F—View image in PDF format
12/14/2004 Domestic Profit 17--view image in PDF format
Copyright and Privacy Poli cle
State of Florida,Department of State
http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquiry-type=Entity... 6/7/2016
♦S C.I Li
s� Miami shores Village
Building Department
10050 N.E.2nd Avenue
�IORNp' Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
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:
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,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: Q '
/Z
O ger
State of Florida
County of Miami-Dade
The foregoing was acknowledge before me this ZZ- day of 3U N(__ ,20� .
By MCP S? `I' 2 who is personally known to me or has produced
as identification.
Notary:
SEA t�� ' '�"'°" State of Florida
�� r' 't'CPg_!VXez
Gommissi�r,FF 156750
° �Fpd Expires 09/0312018
r
6 -- a c=A
SKETCH OF BOUNDARY SURVEY _== ' 1401-011
; POt6 LUCKY I3 HOMEINVESTMENTS.WC. OOBNO
I 1 FlFLD DATE:01-08-2016
SC�� %-20' _ ! J,� /• tl PBOP.ADD: 10417 N.E.2nd AVENUE,MIAMI SHORES.
FL 33135
' RECEIVED '=-_ ' - -- I I
q LUCKY 13 HOME INVESTMENTS,INC.
�y
J N / 2 16 1 CF WITH AlL FL Df fIAl_ STERS TITLE,INC.
FIDELITY NATIONAL TITLE INSURANCE COMPANY.
s BY.
Conc. LOT 11 BLOCK 120 M LEGAL DESMPTTOA
AN AMENDED PLAT OF
TraPole b J U W J 6'C.L.F. LOT:12&N23'of Lot 13 BLOCI4 120 SUBDNDBON:SECTION NQ.5 OF MIAMI SHORES
Pole � 130.00' v c
40.00' 5.50 &Wood F. PLAT BOON: 10 PAtiPa 47 Op: MIAMI-0ADE COUNTY,FLORIDA.
Co.. a.TeA
$ 53.10'
c- LOT 12 BLOCK 120 so SURVEYORS NOTES:
N Oi e L 1.)THE 3URVEYOF THE PROPERTY SHOWN HEREON IS M ACCORDANCE WITH THE
r \ LL DESCRIPTION FURNISHED SY CLIENT.
Lu 2)IRIIESSACONPARISCN ISSHOWN.ALL SEARING.ANGLES AND DLSTANCESSHOWN
2 7.19' m$ �� i THE=SHSHOTHE SAME OW'NNHH�CAI�W'ERE NOT ABSTRACTED FOR EASEMENTS OR OTHER
m 17.30' .n; }} RECQCDED ENCUNSEWWCES NOT SHOWN ON THE PLAT AND THE SAME.IF ANY MAY
>U" OT BE SHOWN ON THE SKETCH,
W e d W 4.)NUNDERBRAUND PORTIONS OF FOOTHNGS,FUNDATIONS OR OTHER IMPROVEMENT
WERE NOT LOCATED.
_ L. N OZ 3'TIIe 5.FENCES TPS ARE TO THE CENTER LINE OF THE SOME.
F $ g —/}V`PL N Cc 7-d 24.00' 7. LEVAT IWALL TIES TO THE FACE OF IKE SAME
WHEN SHOWN ARE ePBED ON NATN)NAL OEODETC VERTICAL DATUM
Tile LuW h ` �' &)THEERE RD ABOVE DEENNCROACHNENTS OTHER THAN THOSE SHOWN.
6' -�^LIOC g Tile Concrete P,TFBS SURVEYIS FOR MORTOAOE PURPOSES Ow.Y,ROT TO eP USED FOR
.00' 8.35' 0' ` ^ a e&TRucrroRPURPOSFS
LLI 29.89' 8.65'
Z -------- --------�,--------------- �
(FLOOD ZONE INFORMATION)
�I, g
g AIC b ZONE:X COMM:120652 PANEL:12086CM SUFFIX L DATE:9-11-2009 BASE:N/A
u7 ct PL g ` NOTE:DETERMINATION OF FLOOD ZONE UNES WERE BASED ON SCAUNG OF FEMA MAP LISTED ABOVE.
29WThe North 23 Feet J
Lot 13 Block 120 ei NOTE)ALL BEARING HEREON ARE BASED TO THE PLAT BEARING OP NIA
eo
29.91' 4 90e a 0, ON T119 CENTER LIN!OF NIA PROPORY LINE.
of-oo
j& 8.00' r� EASEMENTVIOLATION& ElYES KNO
8'W F. APPARENT VISDU ENCROACHMENTS: ❑YES K NO
40,00' J 130.00' J COMENT&
o V oO 4C.L.F. o 0 0
Remainder Lot 13 z ASIRREVIA17ONS:
BLOCK 120 Pm LIR&� �i mm Chain�Fear,
`r AIG AirC-MI..Pd,PlC= Camer.plHv Dr�9ed H.W.
WWIF-WOW
W,CONE RES-ReeNemwm,OL Clear.IR-E Reoar.UEv UBM
CJLv Cwaer Lk C'0CDwm6W..TYP<TYW�•N Neasur R.4W,
NR-Elmoatluna4 COMP=Compaer -Aap wNad&DHo.
U fk5
Sv Bel,FFt wP Fbar.Wm-n.
m OHPo0 Poaer5rre.WNv Water Neter,WPP-Wood PwmPON,
•• ••• • • •
,p EN.v Ne,N#�F Mo F.,DM
MkftMEetE=EN.E. 104th STREET LM
D+LrS • • •• • ME.v Nr>hV Eeamnen4 B.CEBNck Comm,
• •• • • • 'C� FNDvFwM.N010=NO ldantlficetlon.
""�Ddp r � ENSIONS INC. °"`
qboos�" eUe el �f� • Land Surveying Urvicps p fav(0 new
oZ f p(e e "`o C ••i orlid : : : : : DAVID L.FLITCH
PO S n �/e • �47T0 MW 43A WAY,• •• • • REGISTERED LAND SURVEYOR 94e43
�. P/L 1`Ti •• MU:NI�fIFtLL-'3�185! • • • STATE OF FLORIDA
PHONE: Nw5)5?24225 •• • LB IIIWM74
FAX:(305)5124914 N0�'Vigess
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