DS-18-3730Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Permit NO : DS -12-18-3730
Q Permit Type: Driveways/Sidewalks/"Slams
Work ciassif?cation: A do Aftration
PemitStatus: Approved
Issue Date: 01/15/2019 1 Expiration: 06/18/2019
Location Address Parcel Number
440 GRAND CONC, Miami Shores, FL 33138 1132060170030
Contacts
EDUARDO & XIMENA CALLE Owner ROHI CONCRETE & FINISH CORP Contractor
440 GRAND CONC, MIAMI SHORES, FL 33138 HOMER VIRGILIO MURILLO
Other: 3057512707
Business: 7863126131
Description: REPLACE WALKWAY WITH CONCRETE SLABS. PLACE Valuation: $ 3,000.00 Inspection Requests:
CONCRETE RECTANGLE ON THE SIDE OF THE HOUSE ri"'062-4049
Total Sq Feet: 350.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$1.80
Concrete/asphalt/pavers, slabs, dways,
$50.00
swalks
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.60
Notary Fee
$5.00
Planning and Zoning Review Fee
$35.00
Scanning Fee
$9.00
Technology Fee
$2.50
Total:
$157.90
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$157.90
Credit Card
01/15/2019 $157.90
Amount Due:
$0.00
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
regulatirm construction and zoning. Futhermore, I authorize the above named contractor to do the work stated.
"-�T) —, �m"' my'6�W'A - C��' vk'�
Aut onze i n re: Owner 1 Applicant ! Contractor / Agent e
January 19 Page 2 of 2
PERMIT APPLICATION
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
D 2,0 202
BY: !7
FBC 201
Master Permit No. -DS (80 - 3�3b
Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
F-1 PLUMBING [-]MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
+' �n CONTRACTOR DRAWINGS
JOB ADDRESS: L44o 60yi doo fse
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: w le — () I _+ ` 00 �)(:Is the Building Historically Designated: Yes NO V—
Occupancy Type: Load: Construction Type: Flood Zone:
BFE: FFE: r''
OWNER: Name (Fee Simple Titleholder): Xl lyw fk Aw&ta w ' 1� Phone#: q (o �� Wo
`'
Address: LW(bot-00P.[�hGOtf (se—
City: �" � &V- t State: FL Zip: _3;'5M
Tenant/Lessee Name:
Email: X0,6+0
10
CONTRACTOR: Company Name: . . �Q►�(ft.I , E -►-1o1r1 I S Vl �)OfI Phone#: :2AZ30 6131
Address: 61-7 Nth _-2 q Co q r -t.
_
City: "" Q &A; State: f I Zip:
Qualifier Name: t4orne.-f �j iALI r'l to, Phone#: 7S(o 3 1a (-13
State Certification or Registration #:
Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 31000 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ['Repair/Replace ❑ Demolition
Description of Work: [lC iUL(A-(k VJY4ZAL y_')a A W'ILA COYI._Wk_ bL&U g --
Specify color of color thru tile:
Submittal Fee $,
Scanning Fee $
Permit Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $ _
(Revised02/24/2014)
CCF $ CO/CC $
DBPR $
Notary $
Double Fee $
Bond $ 5n
TOTAL FEE NOW DUE $
COSH , �o
Bonding Company's Name (if applicable) RcAl iCeloutYL PV -41 Yll 5 1' , Cos -P -
Bonding Company's Address b—t o2 p Dg r j.
City "Ig ivy; State Zip -33 7),
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 on 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 charaed.
Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
_ day of I-\(� GV S t 20by
n �c-,-TP>A1Or--,P, who is personally known to
me or who has producedlk Q��Nas
identification and who did take an oath.
NOTARY
Print:
Seal: ' rospWPy*.r• Notary Public State of Florida
Sindia Alvarox
' 'r My Commission FF 158750
vora41F Expires 0 810 312 01 8
APPROVED BY
(Revised02/24/2014)
Signature
CONTRACTOR
The foregoing instrument lwas acknowledged before me this
_ / day of � ( q 20 l e ' by
U%m0 (- U tion. �( C) , who is personally known to
me or who has produced FL D( M 6,q6 4 -)z -0 as
identification and who did take an oath.
NOTARY PUBLIC:
Sign: nn _
Print-- . m � M K�
L/r Plans Examiner
Structural Review
ARMINDA D DARNA
State of Florida -Notary Publi
Commission # GG 223524
My Commission Expires
June 15, 2022
***************
4 Zoning
Clerk
ROHI CONCRETE & FINISH CORP
817 NW 24TH CT
MIAMI FL 33125
DATE: DECEMBER 11, 2018
STATE OF: FLORIDA
COUNTY OF: MIAMI DADE
Before me this day personally appeared, HOMER V MURILLO, who being duly
sworn, deposes and says:
That he will be the only person working at the project located at: 440 grand
concourse, Miami shores FI 33138.
i o rAV � ) Mx --1V1 -
ctor signature
Subscribed and sworn to (affirmed) before this 11 day of DECEMBER, 2018
BY: HOMER V MURILLO
PERSONALLY KNOW
OR PRODUCED IDENTIFICATION
TYPE OF IDENTIFICATION PRODUCED: Florida driver license M640-338-71-4700
DILCIA F. BACA
•'`' G•c= MY COMMISSION 8 FF 945417
PRINT, TYPE OR STAMP NAME OF NOTARY EXPIRES: December 21, 2019
aF' Bonded Thru Notary Public Underwriters
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' 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:
caner
State of Florida
County of Miami -Dade ,�,� I
The foregoing was acknowledge before me this i day of EmgQ& 9 , 2041-1-
By // MEN& P_4:�f1 LA GA who is personally known to me or has produced
U u.CkP1.S as identification.
Notary:
SEAL:
SINDIA ALVAREZ
MY COMMISSION # GG 22A273
EXPIRES. September 3, 2022
Bonded TAm Notary Ptlic Undenrrt .
Ron DeSantis
Mission: Governor
To protect, promote & improve the health
of all people in Florida through integrated Or
4la
state, county & community efforts. HEALTH
Vision: To be the Healthiest State in the Nation
January 10, 2019
(Eduardo luan Calle & Ximena Asiralaga)
440 Gran Concoursr
Miami, FL 33138
RE: Contingency Letter
Application Document No: AP1389635
Centrax Permit Number: 13 -SC -1911672
OSTDS Number:
440 Grand Course
Miami, FL 33138
Lot:5 6 Block:86 Subdivision: Miami Shores Sec 4
Dear Applicant:
This will acknowledge receipt of an application dated 12/26/2018 for a permit to use an existing
onsite sewage treatment and disposal system located on the above referenced property.
NO OBJECTION letter issued by Gerard Philizaire.
MODIFY CURVE ENTRANCE TO A STRAIGHT LINE WITH CEMENT BLOCS AND AT THE
RIGHT SIDE A RECTANGLE SURFACE ONLY.
From a review of your completed application, it has been determined that your existing system
appears to meet the minimum standards of F.A.C. 64E-6 for the proposed use. It is approved for
use with the plans submitted to this office. If this system should fail, causing an unsanitary
condition to exist, steps must be taken to bring the system into compliance immediately.
Department approval of the system does not guarantee satisfactory performance for any specific
period of time. Any change in material facts which served as a basis for issuance of this approval
requires the applicant to modify the permit application. Such modification may result in this
approval being made null and void. Issuance of this approval does not exempt the applicant from
compliance with other Federal, State, or Local Permitting required for development of this
property.
If you have any questions on this matter, please call our office at (305) 623-3500.
Sincerely,
Gerard Philizaire, Engineering Specialist II
Florida Department of Health www.FloridasHealth.com
in DADE COUNTY TWITTER:HealthyFLA
1725 NW 167 St, Opa Locka, FL 33056 FACEBOOK:FLDepartmentofHealth
PHONE: (305) 623-3500. FAX: (305) 623-3645 1 YOUTUBE: fldoh
N.E. 5TH AVENUE
SCALE: P = 20'
SKETCH NO.: 15-0545
DRAWN BY: Q.D.I.
SIDE 2 OF 2
CONCRETE BLOCK WALLS ONLY
LOCATION OF SEPTIC TANK
BLOCK
PER OWNER NOT VERIFIED
(TO PROPOSED POUR LINE
MARKED ON WALL)
••
4' CHAIN WALL
• •
• ••
CORNER
LINK FENCE0.8'w
0000• •.
POWER
.
• •
0 �1
•• •
FOUND 3/4"
! •
0000
• •.
0000•
ryJ�
000/
.•••
FOUND
IRON PIPE
.• 06
0000
60D NAIL
00.609
/
•
O
O
2.85'
0,30'(W)
0 0
000000
.z,
00
o
Voso:
w
LOT 4
1
I
�
o
FOUND 1/2"
a
BLOCK 8E
1
o�
ee�
F-
J
SITE B.M.'
IRON PIPE
2 ,
\
Q
SET NAIL ..
�.
I
n 3
o/s 0.04'(S)
TIC
LOT
z
m O "
All
BLOCK 86 O un�n
,.. 6�.
ELEV.=8.59°
-
0.04'(E)
LINES°(J
`O
a
130.00'
9• _
50.00'
— — —
O
29.
C)
Q -' <C
0- '
LOT6
s� S BLOCK 86
LIGHT
45.27
90,
^O/ N
POLE
IQkl
I
�0 • ui
A/C
32.97'
X//////407,7777777—,,,
10.1'
00
N 7.9:
'.- . -.,'
W
D
o
to
1
O
p
Uhl. ./ 20
U
.
F'".
O
O
7.7'
15.82.,
r
Lo
2.95'
CHATT
1
-
O
Op
STORY C.B.S.
Z
of
a ..
C7
Z.
e?
o
�� �; 2.92 RESIDENCE X440
Q
T 1
'`V
_
®
.p
—
00 C.B.S.
-
n FINISH FLOOR ELEV=11.88'
O
�•J
°
_�
�, .
U
�=
WALL
4.7
'12.12'
/N GARAGE FLOOR ELEV=10.35'
(TYP.)
O
0
r
30.03'
30.57r '/
11
SCALE: P = 20'
SKETCH NO.: 15-0545
DRAWN BY: Q.D.I.
SIDE 2 OF 2
PROPOSED ADDITION
(UNDER CONSTRUCTION)
NOTE:
CONCRETE BLOCK WALLS ONLY
LOCATION OF SEPTIC TANK
FINISH FLOOR ELEV=11.71'
PER OWNER NOT VERIFIED
(TO PROPOSED POUR LINE
MARKED ON WALL)
••
4' CHAIN WALL
• •
• ••
LINK FENCE0.8'w
0000• •.
POWER
.
• •
0 �1
•• •
•0000•
! •
0000
• •.
0000•
ryJ�
000/
.•••
FOUND
.• 06
0000
60D NAIL
00.609
/
•
o/s 0.65'(N)
2.85'
0,30'(W)
0 0
000000
.z,
00
__
32.32' 24.49'
Voso:
w
00 0
1
I
�
a
1
o�
-
F-
J
a6
2 ,
Q
24.52'
I
n 3
TIC
LOT
m O "
All
BLOCK 86 O un�n
-
LINES°(J
.
— — —
O
C)
Q -' <C
0- '
LOT6
s� S BLOCK 86
45.27
0000..
• •
•
0000••
t6
••
001.6•
• •
• ••
000000
0000• •.
.
• •
0000
•• •
•0000•
! •
0000
• •.
0000•
•.••.0
.•••
• 0
0.000
.• 06
0000
00.000
00.609
•
•
• •
0 0
000000
•..60•
00
Voso:
00 0
. • •