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RC-16-1083 (3) Miami Shores Village `N\ �� BuildingDepartment 1 015 p ��� \Q, 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 V Tel:(305)795-2204 Fax:(305)756-8972 $�• INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20Iti Ski BUILDING Master Permit No.egc to - ICB3 PERMIT APPLICATION Sub Permit No. [�rgUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP �} CONTRACTOR DRAWINGS JOB ADDRESS: I&5 AI u -!a a 5 t 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): 'kie IIi/VhA047" LLG Phone#: Address: l't4V AW !}zw- !� RV/!2 City: State: Zip: Tenant/Lessee Name: Phone#: Email: yy- CONTRACTOR:Company Name: L57G Vn/j,,71t4j�f 7.1!'1e_ Phone#: (�5).2sa 7313 Address: `75-5v -5� /13 C_z City: M i State: F4.-- Zip: 3 317'3 Qualifier Name: C pilo S 01V Phone#• State Certification or Registration M e6c 0351,/4140 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address• City: State: Zip: Value of Work for this Permit:$16, Square/Linear Footage of Work: k40J-cXN Type of Work: ❑ Addition ❑ Altera 'o ❑ New ,. y � El Demolition Description of Work: _17 ��2^� -L' '�� �7 i�!c �j etr kv all el /'Je���C✓� {,%' 6 /73 0C 7 amt X 119 S' Spedkcolor of color thru tile: Submittal Fee$ Permlt Fee$ CCF$ 'l CO/CC$ o Scanning Fee$ Radon Fee$ DBPR$_ 6-:T�� Notary$ 66 Technology Fee$ Training/Education Fee$ J OZ) Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ � (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: 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. D � SignatureQSignature OWNER r_oAGE4 CONTRA OR The foregoing instrument was acknowledged before me this The foregoing instrument�w�was acknowledged before me this =Ptd day of 20 MP by o/��a day of �/k- ��i. ,20 1& by dLl� /7'3aDLl�7� who is personally known to UZI� ZO el0 .who is personally known to 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 UBLIC: NOTARY PUBLIC: / INIIpI JORGEIIJANGO otary Public-State of Florida Sign: ,•��� Sig i esNOV ,2016 NGO ?'. _ �l�tary Public_ Commission # EE 848847 Pri "* State of xpires Nov 1,2016 Se ; $ j; C0171missian#EE 848847 ############################################################################################################ APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Electronic Artic�l�es of Organization L15000082859 FILED 8:00 AM Florida Limited Liability Company May oz's ate smmason Article I The name of the Limited Liability Company is: WE BUY MIAMI, LLC Article II The street address of the principal office of the Limited Liability Company is: 5409 CORTO DRIVE GRANBURY, TX. US 76049 The mailing address of the Limited Liability Company is: 5409 CORTO DRIVE GRANBURY, TX. US 76049 Article III The name and Florida street address of the registered agent is: UNITED STATES CORPORATION AGENTS, INC. 13302 WINDING OAK COURT A TAMPA, FL. 33612 Having been named as registered agent and to accept service of process for the above stated limited liability company at the place designated in this certificate, I hereby accept the appointment as registered agent and agree to act in this capacity. I further agree to comply with the provisions of all statutes relating to the proper and complete performance of my duties, and I am familiar with and accept the obligations of my position as registered agent. Registered Agent Signature: CHEYENNE MOSELEY, US CORP. AGENTS Article IV L15000082859 The name and address ofperson(s) authorized to manage LLC: FILED 8:00 AM May 11 2015 Title: AMBR Sec. Of State DAVID M SEYMOUR smmason 5409 CORTO DRIVE GRANBURY, TX. 76049 US Signature of member or an authorized representative Electronic Signature: CHEYENNE MOSELEY, US CORP. AGENTS I am the member or authorized representative submitting these Articles of Organization and affirm that the facts stated herein are true. I am aware that false information submitted in a document to the Department of State constitutes a third degree felony as provided for in s.817.155, F.S. I understand the requirement to file an annual report between January 1 st and May 1 st in the calendar year following formation of the LLC and every year thereafter to maintain "active" status. ORjt,r Y93J lists usnom Miamishores 'aVillage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel- (305)795.2204 Fax: (305)756.8972 Notice to Owner - Workers' Compensation Insurance Exem tion IR 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: I. 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'compensationexemptiop 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 CONTENTS. THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS Signature: �z 6 e�vn r�— State of Florida County of Miami-Dade The foregoing was acknowledge before me this a:?nd day of InWc t. 20.&, By ,�,Wa V,— who is personally known to me or has roduced as identification. ,J,o`P�r a`9a , JORGE LUANGO Notary Public-State of Florida Notary .�» .oQ My Comm.Expires Nov 1,2016 ': uar�",•° Commission#EE 848847 SEAL: E.T.C. UNLIMITED, INC C.G.C.#035966 7554 SW 113 Ct MIAMI,FL 33130 (305)282-7313 March 28 2016 State of Florida County of Miami-Dade Before me this day personally appeared Carlos A. Otero who, being duly sworn, deposes and says: That he will be the only person working on the project located at: 165 NW 92 St SWORN TO AND SUBSCRIBED before me this 28`x' day of March, 2016 by A�� Carlos A. Ofero ERE RGE LUANGOlic-State of FloridaPersonall known ►"y Expires Nov 1,ion 2016EE 848847 SEAL Jo u o