RC-17-872 Permit No, RC-3-17-872
Miami Shores Village M Pelt Type:Residentat Construction
10050 N.E.2nd Avenue workCiassfffbation:Alteration
Miami Shores,FL 33138-0000
hrP � Phone: (305)795 2204
Permit Status:APPROVED
�'CORNF'
#41201 7 Expiration: 10/01/2017
Project Address Parcel Number Applicant
533 GRAND CONCOURSE 1132060171350
DONNA HURTAK
Miami Shores, FL 33138-2464 Block: Lot:
Owner Information Address Phone Cell
DONNA HURTAK 533 GRAND CONCOURSE
MIAMI SHORES FL 33138-2464
Contractor(s) Phone Cell Phone _. $ 3,570.00
Valuation:
ORINOCO BUILDING LLC (786)531-9479
Total Sq Feet: 82
Approved:In Review Available Inspections:
Comments: Inspection Type:
Date Approved::In Review
Window Door Attachment
Date Denied: Framing
Type of Construction:CHANGE THE OLD TILE IN THE EN Occupancy:Single Family Insulation
Stories: Exterior: Drywall Screw
Front Setback: Rear Setback: Final PE Certification
Left Setback: Right Setback: Window and Door Buck
Bedrooms: Bathrooms: Fill Cells Columns
Plans Submitted:Yes Certificate Status: Review Building
Certificate Date: Additional Info: Review Planning
Review Electrical
Bond Return: Classification:Residential Review Plumbing
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Review Structural
CCF $2.40 Review Mechanical
Invoice# RC-3-17-63507
DBPR Fee $2.00
DCA Fee $2.00 04/04/2017 Credit Card $76.50 $50.00
Education Surcharge $0.80 03/30/2017 Credit Card $50.00 $0.00
Permit Fee $107.10
Scanning Fee $9.00
Technology Fee $3.20
Total: $126.50
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,PLUMB ,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I ce ify t II the for going information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Fut r authoriz the above-named contractor to do the work stated.
April 04,2017
Authorized Signature:Own r / Ap licant / Contractor / Agent Date
Building Department Copy
April 04,2017 1
Orinoco
Building Co
CGC # 152 3919
State of Florida
County of Miami-Dade
Before me this day personally appeared Eloy Paredes who,being duly sworn,
deposes and says:
That he will be the only person working on the project located at
533 Grand Concourse,Miami Shores,FL 33138
Sworn to (or affirmed) and subscribed before me this 09) day of
2017,by 'aai
Personally know
OR Produced Identification
Type of Identification Produced
Print,Type or Stamp of Notary
Ja1PRY Pf,®� LEONARDO RA IRE
Notary Public-state of Florida
N91 in POP; My Comm.Expires Mar 17,2098
I •.eorvVo,, Commission sy FF 102787
9620 NE 2nd Ave, Suite 207, Miami Shores, Fl, 33138 Ph (786) 531-9479
MiamishoresVillage
00ei Qin
Building Department
�R 10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305)795.2204
Fax: (305)756.8972
Notice to Owner -• Workers' Compensation Insurance Exemption
y= r
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. n
Signature:
O ner
State of Florida
County of Miami-Dade ,'ll II
The foregoing was acknowledge before me this V*day of
By „NAM � � l�U����� who is personally known to me of4d
as identification.
Notary: i � MOREIRA
ulllil
ic,Stege of Fladda
Commisslon#FF06467b
SEAL: My Commission Expires Oct 20,2017
Miami Shores Village
Building Department
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 d
BUILDING Master Permit No. 2Z j
PERMIT APPLICATION Sub Permit No.
�UILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 533 qeA m 9 wico 1 F'(i�K$C � mA Scor eA
City: Miami Shores County: Miami Dade Zip: 33 438
Folio/Parcel#: Is the Building Historically Designated:Yes' NO
Occupancy Type: Load: Construction Type: ''Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): J¢j01A11q R Te7h%2. 'C 04AK Phone#: 30� $92 -680
Address: 533 ('d1�Clrh1 J>�2 t
City: K6OL.t, 514-tP4 State: L Zip:
33439
Tenant/Lessee Name: n Phone#:
Email: 1 h V N'f& iG (� w�Qye l°OWtpu1 a. eow&
CONTRACTOR:Company Name: A0 k(W 0w rj y(C.P(^meq Phone#: 705 313 3( 6T
Address: U2h N�C sulte 4 204'1
City: MOAAZ Ski. t a State: _!�L Zip: 33138
qualifier Name: FC 0,f ?'f—IDS ` "Ll Phone#;(3b3' 733 DO
State Certification or Registration#: 152 31 4Q Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: yy�� City: State: Zip:rr
Value of Work for this Permit:$ 3 i 5 Ty.oo Square/Linear Footage of Work: 82 S'Q T'_
Type of Work: ❑ Addition ❑ Alteration pp1❑ New , / Repair/Replace ❑ Demolition
� 1_
Description of Work: � 1L &�A L`kL t(M ;VA4 jAAj VQ.W42,. (J►�.i%' B�- V Y�61�t/1 .
Specify color of color thru tile:
Submittal Fee$ Q` Permit Fee$. I V CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$ 0
TOTAL FEE NOW DUE$ —4G- S�O
(Revised02/24/2014)
Bonding Company's Name(if applicable) &J
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.
Signature ` Signature
OWNER or AGENT 011TRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrumen was acknowledged before me this
17 �In day of as 20 177 7by day of M 20 by
q* 1 who is personally known to ELOY T�� ?, .who is personally known to
me as C"or who has produced ��OUM tea500l as
identification and who did take an oath. identification and who did take ath.
NOTARY PUB Q NOTARY PUB
Sign: pwl+ Sign:
Print: J-e N by Print:
Seal: Seal: .`c Notary Public-State of Florida
SERGIO MOREIRA My Comm.Expires Mar 17,2018
o .....
Notary Pudic,State of Flodde '•h,;FO'„OpeCommission FF 102787
oxuu
Commission#FFOt39878
APPROVED BY s r, Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
Orinoco
Building Co
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Orinoco
Building Co
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Miami Shores, November 30, 2016
Dear Donna:
Thank you for giving us the opportunity to offer you an estimate for the
reconstruction of the porch of your house.
Considering the cracks of the tile, it seems necessary to demolish the whole
structure of the stair and reconstruct it.
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9620 NE 2nd Ave,Suite 207,Miami Shores FL,33138 (305)333-3169
eiov.paredes.jr@orinocobuilding.com www.orinocobuilding.com