FW-17-204 Permit No. FWA-17-204
�s+`OaEs h Miami Shores Village Permit Type: Fence/Wal
10050 N.E.2nd Avenue NE Work ClassifiCafibiw Wood Fence
Miami Shores,FL 33138-0000 �Per I
'
Permit Status:APPROVED
Phone: (305)795-2204
�ORIDp
Issue Date: 1/31/2017 Expiration: 07/30/2017
Project Address Parcel Number Applicant
53 NE 102 Street 1132060131660
Miami Shores, FL 33138- Block: Lot: LYDIA AMADOR
Owner Information Address Phone Cell
LYDIA AMADOR 53 NE 102 Street
MIAMI SHORES FL 33138-2322
Contractor(s) Phone Cell Phone Valuation: $ 550.00
HOME OWNER
... ,m._.,.., w Total Sq Feet: 28
Approved: Available Inspections:
Comments: Inspection Type:
Date Approved:: Final
Date Denied: Foundation
Type of Construction:Wood Fence Additional Info:BACKYARD FENCE Review Planning
Classification:Residential Scanning:3 Review Building
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60
DBPR Fee Invoice# FW-1-17-62730
$2.00
DCA Fee $2.00 01/31/2017 Credit Card $ 119.60 $0.00
Education Surcharge $0.20
Notary Fee $5.00
Permit Fee-Wire&Wood $100.00
Scanning Fee $9.00
Technology Fee $0.80
Total: $119.60
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 and zoning. Futhermore, I a horize the above-named contractor to do the work stated.
January 31, 2017
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
January 31,2017 1
Miami Shores Village 7 ,t FWED
Building Department JAN 26 2017
S7.J
10050 N.E.2nd Avenue,Miami Shores, Florida 33138 ------
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FFBC 20 r Q
BUILDING Master Permit No. p- " 20�
PERMIT APPLICATION Sub Permit No.
IM BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOBADDRESS: 53 I1/C-- 10a S-1--
City:
fCity: Miami Shores County: Miami Dade zip:
Folio/Parcel#: //"(3322-06 - O/3 - I&(a D Is the Building Historically Designated:Yes NO
Occupancy Type: V Load: Construction Type:mASFlood Zone: ND BFE: FFE:
OWNER:Name(Fee Simple Titleholder): (!S1 L R _Phone#: -%S--j6k'�o10�f
Address: 53 N E 10 cL &f
City: M1 a&C-711 sl10r- c state: _ R-, zip: 331 g
Tenant/Lessee Name: Phone#:
a
Email: d!: I J2C'JS D.4 S'e IAO/_ , G CsA
ClrcAdSC{"s QQa(, cry n•,
CONTRACTOR:Company Name: spdp Phone#: 3 OS I V R I Zd y
Address: e- As A P, O L)
City: — State: Zip: '"—
Qualifier Name: Phone#:
State Certification or Registration M Certificate of Competency M
DESIGNER:Architect/Engineer: Phone#: _
Address: City: — State: '— Zip:
Value of Work for this Permit:$ c550, ° Square/Linear Footage of Work: L$�
Type of Work: ❑ Addition ❑ Alteration New ❑ Repair/Replace ❑ Demolition
Description of Work:_'Roe-jC-gja*-d - �C 2r r''_ •
Specify color of color thru tile: Wood j - ✓ "
Submittal Fee$ 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$ f •
(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.
Signature �y�-Sz- �.1/Lt D�/�J�-- Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
20 day of 1 ar ,20 1= by day of 20 , by
iC a MOM ho personally know:t�3 who is personally known to
me or who has produced A!5,s 3'-mc � as me or who has produced as
identification and who did take an oath. *Aondq identification and who did take an oath.
NOTARY PUBLIC: awive r5 NOTARY PUBLIC:
Sign: Sign:
Print: MY COMMISSION#GG 044602 Print:
_.NF2 1000
Seal: lB,,;,� BondedThruNo"PubllcUmilte
nders Seal:
lll�APPROVED BY Plans Examiner A117 Zoning
Structural Review Clerk
(Revised02/24/2014)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
.3�R Miami Shores,Florida 33138
Tel:(305)795.2204
Fax:(305)756.8972
OWNER BUILDER DISCLOSURE STATEMENT
NAME: (1MENDO[.A DATE: 14 2q-
11-7
ADDRESS: S NET O a S-1: m
Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida,F.S 489.103(7).And I have
read and understood the following disclosure statement,which entitles me to work as my own contractor;I further understand that I as the owner
must appear in person to complete all applications.
State Law requires construction to be done by a licensed contractor.You have applied for a permit under an exception to the law.The exemption
allows you,as the owner of your property,to act as your own contractor even though you do not have a license.You must supervise the
construction yourself.You may build or improve a one-family or two-family residence.You may also build or improve a commercial building at a
cost of$25,000.00 or less(The new form states 75,000).The building must be for your own use and occupancy.It may not be built for sale or
lease.If you sell or lease a building you have built yourself within one year after the construction is complete,the law will presume that you built
for sale or lease,which is a violation of this exemption.You may not hire an unlicensed person as a contractor.It is your responsibility to make
sure the people employed by you have I:censes required by state law and by county or municipal licensing ordinances.Any person working on
your building who is not licensed must work under your supervision and must be employed by you,which means that you must deduct F.I.C.A and
with-holdings tax and provide workers'compensation for that employee,all as prescribed by law.Your construction must comply with all
applicable laws,ordinances,buildings codes and zoning regulations.
Please read and initial each paragraph.
1. 1 understand that state law requires construction to be done by a licensed contractor and have applied for an owner-builder permit under an
exemption from the law.The exemption specifies that I,as the owner of the property listed,may act as my own contractor with certain
restrictions even though I do not have a license.
Initial
2. 1 understand that building permits are not required to be signed by a property owner unless he or she is responsible for the construction and
is not hiring a licensed contractor to assume responsibility.
Initial
3. 1 understand that,as an owner builder,I am the responsible party of record on a permit.I understand that I may protect myself from potential
financial risk by hiring a licensed contractor and having the permit filed in his or her name instead of my own name.I also understand that the
contractor is required by law to be licensed in Florida and to list his or license numbers on permits and contracts.
Initial_ L
4. 1 understand that I may build or improve a one family or two-family residence or a farm outbuilding.I may also build or improve a commercial
building if the costs do not exceed$75,000.The building or residence must be for my use o;occupancy.It may not be built or substantially
improved for sale or lease.If a building or residence that I have built or substantially improved myself is sold or leased within 1 year after the
construction is complete,the law will presume that I built or substantially improved it for sale or lease,which violates the exemption.
Initial ,
5. I understand that,as the owner-builder,I must provide direct,onsite supervision of the construction.
Initial
6. 1 understand that I may not hire an unlicensed person to act as my contractor or to supervise persons working on my building or residence.It
is my responsibility to ensure that the persons whom I employ have the license required by law and by county or municipal ordinance.
Initial
U. r
7. 1 understand that it is frequent practices of unlicensed persons to have the property owner obtain an owner-builder permit that erroneously
implies that the property owner is providing his or her own labor and materials.1,as an owner-builder,may be held liable and subjected to
serious financial risk for any injuries sustained by an unlicensed person or his or employees while working on my property.My homeowner's
insurance may not provide coverage for those injuries.I am willfully acting as an owner-builder and am aware of the limits of my insurance
coverage for injuries to workers on my property.
Initial
8. 1 understand that I may not delegate the responsibility for supervising work to be a licensed contractor who is not licenses to perform the
work being done.Any person working on my building who is not licensed must work under my direct supervision and must be employed by
me,which means that I must comply with laws requiring the withholding of federal income tax and social security contributions under the
Federal Insurance Contributions Act(FICA)and must provide workers compensation for the employee.I understand that my failure to follow
these may subject to serious financial risk.
Initial_
9. 1 agree that,as the party legally and financially responsible for this proposed Construction activity,I will abide by all applicable laws and
requirement that govern owner-builders as well as employers.I also understand that the
Construction must comply with all applicable laws,ordinances,building codes, and zoning regulations.
Initial
10. 1 understand that I may obtain more information regarding my obligations as an employer from the Internal Revenue Service,the United States
Small Business Administration,and the Florida Department of Revenues.I also understand that I may contact the Florida Construction Industry
Licensing Board at 850.487.1395 or http://www.mvfloridalicense.com/dbpr/pro/cilb/index.htmi
Initial A&L,
11. 1 am aware of,and consent to;an owner-builder building permit applied for in my name and understands that I am the party
legally and financially responsible for the proposed construction activity at the following address:
,'T-3l)�- /Oa "S+ Iotwr Shores
Initial
12. 1 agree to notify Miami Shores Village immediately of any additions,deletions,or changes to any of the information that I have provided on
this disclosure.
Initial_ L
Licensed contractors are regulated by laws designed to protect the public.if you contract with a person who does not have a license,the
Constr4uction Industry Licensing Board and Department of Business and Professional Regulation may be unable to assist you with any financial
loss that you sustain as a result of contractor may be in civil court.It is also important for you to understand that,if an unlicensed contractor or
employee of an individual or firm is injured while working on your property,you may be held liable for damages.If you obtain an owner-builder
permit and wish to hire a licensed contractor,you will be responsible for verifying whether the contractor is properly licensed and the status of
the contractor's workers compensation coverage.
Before a building permit can be issued,this disclosure statement must be completed and signed by the property owner and returned to the local
permitting agency responsible for issuing the permit.A copy of the property owner's driver license,the notarized signature of the property
owner,or other type of verification acceptable to the local permitting agency is required when the permit is issued.
Was acknowledged before me this _day of Q 20
By 6111&A P� mr°.n do a who was personally known to me or who has
Produced they License �5J —??,C) —SAO 3-4ide�fication.
✓ J OWNER NII. MAHARAI K.GONZALEZ
MY COMMISSION#GG 044502
:a= EXPIRES:November 2,2020
%!p..oto,".•'' Bonded Thru Notary Public Underwift-
Proudly Serving
1A:?< the Florida Real
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members of a fence shall face thee plot on which the fence is locatedished side shall face the adjoiningutting right-of-way, OT 6LOT 8
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.. ... . . • . . ••
. .. . . . . ... .
Accepted By: • • • • • • • • •
Property Address: Notes: FENCES ENCROACH OVER EAST LOT LINE.
53 N.E.102 Street Y
Miami Shores,FLORIDA 33138 • ••• . •• •••
a1RMEYOI'fOEpTiiCA71ON,IH919Y THATTH1G80INOAR•sUR%W*AM1J5AND•• E Lr SU 1 Inc.
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ADYa•B PROMM01ALECDOEFU § ON DA L.Y`
Suite 3110
SIGNED i FOR THE FIRM Miami,FL 33157 ME LAND
EFRAIN L SFTAT1 0 ••• • • • (305)7403319 CJ
STATE OF FL P.S.IIIIT No.d792 0 0• ax:(3055 669..90
NOTVAUDW THO0MANDAUTI C81WATUREAIDA ffX1E TM.f®• • • B#P7989 • •
ELECTRONIC SMAND 1TIISYAPS %#M WRHOUT THE SUMATUSE AN)iti0R1*1L• • •• ••
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Surveyor's Legend
PROVERTY LINE
STRUCTURE END FOUND IRON PPE/ BR. BiA411,0 FEFERENCE TEL. TELEPHONE FACILITIES
----=-_= CONIC.BLOCK WALL PIN AS NOTED ON PLAT r- CENTRAL ANGLE OR DELTA U.D. UTILITY POLE
—T <— CHAIN-LINK FENCE OR WIRE FENCE LBf LICENSE r-BUSINESS R RADIUS OR RADIA_ E.U.B. ELECTRIC UTILITY BOX
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^--— CENTER UNE A CONTROL PO!4T I.R. IRON ROD SIR SIDEWALK
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_ P.D.C. POINT OF COMMENCEMENT CATV CABLE TV RISER C.Y.G. CONCRETE VALLEY GUTTER
_- COVERED AREA P.C.P. PERMANENT CO.NTNOL MINT — SETBACK LINE
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Property Address: General Notes:
1.)The Legal Description used to perform this surveywas supplied by others.
53 N.E.102 Street This survey does not determine or is not to imply ownership
Miami Shores,FLORIDA 33138 2•)This survey only shows above ground improvements.
Underground utilities,footings,or encroachments are not located on this survey map
Flood Information: 3.)If there is a septic tank,well,or drain field on this survey.
the location of such items was shown to us by others andthe information was not verified.
4.)Examination of the abstract of title will have to be made to determine recorded instruments,if any,effect this prop
Community Number. 120652 erty.The lands shown herein were not abstracted for easement or other recorded encumbrances not shown on the pl
Panel Number. 12086CO302L at
SuffiX' L 6.)Wall des are done to the face of the wall.
6.)Fence ownership is not determined.
Date of Firm Index: 09/11/2009 T.)Beatings referenced to line noted BR
Flood torte• X 8.)Dimensions shown are platted and measured unless otherwise shown.
Base Flood Elevation: 9.►No identification found on property comers unless noted.
10.)Not valid unless sealed with the signing surveyors embossed seal.
Date of Field Work: 06/14/2016 11.)Boundary survey means a drawing and/or graphic representation of the survey work performed in the field,cold
Date of Completion: 08/1512016 d be drawn at a shown scale and/or riot to scale
12.)Elevations if shown are based upon NGVD 1929 unless otherwise noted
13.)This is a BOUNDARY SURVEY unless otherwise noted.
14.)This survey is exclusive for the use of the parties to whom it is certified.The certifications do not extend to any u
nnamed parties.
16.)This survey shall not be Used for construction"rnitting purposes without written consent from the land
IT surveyorwho has signed and sealed this survey.
Legal Description:
Lot 17 and the West 1/2 Lot 18,of Block 12,of MIAMI S 1 o rn o e7dn1a
rded in Plat S19e C7�LF` eke icaPanBook 10,Page 70,ofthe public records of Miami-Dade ��j� i g members of a fence shinterior of the plot on which the fencand the fir'shed side sha'I face th
lot or any abutting right-of-way.
Printing Instructions: Certified To:
While viewing the survey in any PDF Reader,select the File Lydia Amador
Drop-down and select"Print".Select a color printer,)f available: Allied Title and Trust,LLC
or at least one with 8.5"x 14"(legal)paper. North American Title Insurance Company
Select ALL for Print Range,and the#of copies you would like to New Penn Financial LLC
print out. its successors and/or assigns as their interest may appear.
Under the"Page Scaling"please make sure you have selected
•• ••• • • • • • ••
"None". • • • •
Do not check the"Auto-rotate and Center"bck, • ••0 prja9talapppy Below for policy preparation purposes only:
Check the"Choose Paper size by PDF"cheekbort,theroclisk SK TIDSpolricywoesnolinwre against bss ordemage by reason of Me f01104hp
to print. •• ••• •• &cep"Ant ithts easementri interests ordeims which may exiatby reason
of,or re bcfed by,the fodbwing facts shown on the survey prepared by_
EFRAIN LOPEZ dated 06/152016 Deena.lob u B-18159
• •r• • • gryrjFt ENOROACH OVER EAST LOT LINE.
M.E. Land Surveying, Inc. P�
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4LAND 1066% 1100th SM,Wit%;110.Miami•FL 33157 �-ME- �. - • • Phone: 06)7443349 • .
s : : F4 I(=669.3190 • i
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Accepted By:
Property Address: Notes: FENCES ENCROACH OVER EAST LOT LINE.
53 N.E. 102 Street
Miami Shores, FLORIDA 33138
•
KiRVIEVORMCOMMATM;IHERE1Y THAT THIS MUNDARYSURVEY ISATRUFANDM.E. Land Surveying,Inc.
C 0 R R E C T R EFPIPJ EM MEN ON OF UNDER MYDIREC7M.TH"OMPLES
WITH THFMINIMUM TEU 1 FORTH U(THESTATEOF FLORIDABOARD OF I W65 SW 190th Street
PROFESSION&LANDSUR FA R THROUGH 5J.17-OW,FLORIDA
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ADMINWRAT
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SIGNEF) SIAT U FOR THE FIRM Miami, FL 33157 1;7
ME J.P%N D
EFRAIN L FLO A Phone: (305)740-3319
STATE OF FLP.S.M. No.6792 Fax: (305)669-3190
NOT VAUD WITHOUT AND ALrrHEN.. 10 SIGNATURE AND AUTHENTCATED LB#:7989 •
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Survey i*B-18159 Client File#.16-099-R Page 1 of Z Not valid without all gages
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s
s 00
supporting
upporting members of a fence shall face the
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t t st
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