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FW-16-2587 Miami Shores Village �'���`'"� SEP 2.0 2016 Building Department BY: 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 2014 BUILDING Master Permit No. T w 9 — i PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLICWORKS F-] CHANGEOF F-] CANCELLATION [--] SHOP /� CONTRACTOR DRAWINGS JOB ADDRESS: I �.� 1 L�`Q' City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: AAConstruction Type: Flood Zone: BFE: c/( / FBF/E:Q 2 OWNER: Name(Fee Simple TitlXhIder): 1� Phone#:Address: ��� 1r� 1.e City: t-4 ( 6 0-1 ( C--Al 6Ir PS State: �' Zip: Tenant/Lessee Name: Phone#: Email: R,:1)zou t' C.O[ V3 S CONTRACTOR:Company Name: Phone#: Address: City: State: Zip: Qualifier Name: Phone#: State Certification or Registration#: Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: r/ City: State: /Z_ip: Value of Work for this Permit:$ 1�- Square/Linear Footage of Work: �"6 Type of Work: ❑ Additiol ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: � �e A-0w ops �C? �(o e`� �t.,� L Specify color of color thru tile: wnac� w Y 2 ao Submittal Fee$ Permit Fee$ CCF$ 3 • CO/CC$ et Scanning Fee$ Radon Fee$ 2 . 49 DBPR$ 2- 40)/ Notary$ Technology Fee$ CPU Training/Ed u cation Fee$ Double Fee$ Structural Reviews$ Bond$ QQ[� (] TOTAL FEE NOW DUE$ I V 1 �-t S (RPvi,;Pdm/?4/?M 41 r _ r 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 f hat a copy of e notice of commencement and construction lien law brochure will be delivered to the person whose property is ubje to achmet Also,a certi d copy of the recorded notice of commencement must be posted at the job site for the first ins ction is occurs se en (7) days r the building permit is issued. In the absence of such posted notice, the inspection will no be app ove and are spection fee it be charged. Signature G Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before e this The foregoing instrument was acknowledged before me this n�\ A dayofc )*- z Z rn+ �,20 b by day of . 20 by 'V i C0 _(1 Oft P*Cf17A who is personally known to ,who is personally known to me or who has produced T�rV*ety (,'Q,11 s`R as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUB IC: NOTARY PUBLIC: Sign: _( Sign: Print: Print: Seal: YANADYPRIETO Seal: :.: MY COMMISSION#FF 214031 EXPIRES:March 25,2019 ': pF fid' Bonded Thru Notay Pub!!c Undenv�lers APPROVED BY Plans Examiner Zoning Structural Review Clerk loc4-4n)/)n/)nl A M �5N°RFS yMiami Shores Village all. ' Building Department 10050 N.E.2nd Avenue 0 Miami Shores, Florida 33138 Tel: (305)795.2204 Fax: (305) 756.8972 O ER BUILDER DISCLOSURE STATEMENT i NAME: �1 CA 4S QJ�t� DATE: ADDRESS: �Z�L L �` 4u,A 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 licenses 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 ontractor 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 re onsible 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 o 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 cot cts. Initi 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 or 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 s d 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, Viviolates the exemption. Initial, — 1 5. 1 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 workhig 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 co y r municipal ordinance. Initial .f 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. I,as an owner-builder,m y be held liable and subjected to serious financial risk for any injuries sustained by an unlicensed person or his or employees while working n my property.My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an owner-builder and am a are of the limits of my insurance coverage for injuries to workers on my property. Initial "' "'1 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 supervi on and must be employed by me,which means that I must comply with laws requiring the withholding of federal income tax and social se ity contributions under the Federal Insurance Contributions Act(FICA)and must provide workers compensation for the employee.I and tand 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 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 lievenue Service,the United States Small Business Administration,and the Florida Department of Revenues.I also understand that I may cont he Florida Construction Industry Licensing Board at 850.487.1395 or http://www.myfloridalicense.com/dbpr/pro/cilb/index.html Initia 11. 1 am aware of,and consent to;an owner-builder building permit applied for in my name and understands thI am the party legally and financially responsible f r the propo d construction activity at the following address: 12kF_ IHS ,We ;F - Initial 12. 1 agree to notify Miami Shores Village immediately of any additions,deletions,or changes to any of the inf r ati n that I have provided on this disclosure. Initial 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 ofer 20 By NY\CO 7,0 who was personally known to me or who has Produced t ere Li e e or0-V)nV-tr Ui as iden 'fication. { Y'.dye4c =rch25 MY CO14031 EXPI2019Bonded Terwriters OWNER NOTARY ♦SNORES pr Miami shores Village logo Building Department ��''FNr °yam 10050 N.E.2nd Avenue ��ORIDp` Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 WOOD FENCE DETAIL ❑ Shadow Box ❑ Vertical Picket ❑ Board on Board Fences < = 6' high posts spaced at 4' on center maximum Fences < = 5' high posts spaced at 5' on center maximum Fences < =4' high posts spaced at 6' on center maximum Fence must not exceed 6' in height lx pickets fastened with two corrosion resistant fasteners per connection 2x4 horizontal pressure treated wood members with two corrosion resistant fasteners per connection 4x4 pressure treated posts embedded 2'into concrete footing 10" diameter x 2'deep ALL wood must be pressure treated All fasteners must be corrosion resistant No less than two fasteners in any connection Revised 06/22/2015 Permit NO. FW-9-16-2587 °R s y� Miami Shores VillageM ` Permit Type: FencelWall 10050 N.E.2nd Avenue NE I Work Classification:Wood Fence Miami Shores,FL 33138-0000 Pen Pemait Status:APPROVED Phone: (305)795-2204 - FCORtDp` Issue Date:912012016 Expiration: 03/19/2017 Project Address Parcel Number Applicant 12 NE 111 Street 1121360040020 Miami Shores, FL 33161-7047 Block: Lot: DILCIA HADDAD PENZO NICOL) Owner Information Address Phone Cell DILCIA HADDAD PENZO NICOLAS 12 NE 111 Street (786)399-6979 --- -- -- MIAMI SHORES FL 33161- 12 NE 111 Street MIAMI SHORES FL 33161- Contractor(s) Phone Cell Phone Valuation: $ 5,000.00 HOME OWNER Total Scl Feet: 166 Approved: Available Inspections: Comments: Inspection Type: Date Approved: Final Date Denied: Foundation Type of Construction:Wood Fence Additional Info:CHANGE THE CHAINLINK TO WOO[ Review Planning Classification:Residential Scanning:2 Review Building Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $3.00 Invoice# FW-9-16-61397 DBPR Fee $2.49 DCA Fee $2.49 09/20/2016 Credit Card $ 189.98 $0.00 Education Surcharge $1.00 Notary Fee, $5.00 Permit Fee'-Wire&Wood $166.00 Scanning Fee $6.00 Technology Fee $4.00 Total: $189.98 a ~"Y 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 a ume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for EAoniC. L PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. Y OWNERS AI ify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction re,I orize the above-named contractor to do the work stated. September 20, 2016 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy September 20, 2016 1 NORTHEAST 111th STREET QtUIIt — Pen gatO must Open Shu i gIMPROVED) 22' PAVED away fr m the pool area, 2416 be self•CIo •x'41--Se111cking, P S� devic locatl on "''"''` •dpi ail. of me gate 1 ' : . ••• .... .. ... loca�QI n `.I@SS.' ar127j�ARKWAY 3:, ;7 •• • • b •• from otto: ©f;; e. :�� :.: ...... • FBC 1424._';1. ,. a•.. • F..;., .. ... 90 BLOCK 104.2T(P) rF''`7J.00"; FOUND�1fi; •• • .�' ]RON"IeLb i ••• • CORNER i,�••• • FOUND 1/2"--/`- ;"• 0000•• 0000 N • • IRON PIPE 90'02'35° :J':'.:.:..•'..3" 89i 57'25" •••••• • . II ••9 9 0000 090 00 •Q 009060 • 9 FbaL REQUIREMENTS. CONC. 9 . SELF-LCIOSIN WALK N N e 0 • G/ SELF-LOCKI fi� ..,.,. •... ... F TES R l CE: 4� EQUJREDij K e PLANTER 1 •0 ••I 9• i09 HIGH (MIN. c �: k .A' PLANTER cD�5" 15 4' 1 • z F NEIL NON-CLIMBABI_F , t Q 0 WALL, ORS REMOVE I--- U,v. TI E: M g NER MUST REPL 154.5' A 4' FENCE ON ts.s' �, W 09/ ER'S PROPERTY a Cr io j n c, v LOT 1 BUILDING 14.2' 0.3' m BLOCK 1 N °' #12 rl 12.7' N LO C4 C6 �QK1 3' - 1j�CONC. 4.1' �• � A/C LOT 2 ! .; 2 BLOCK i o � Q ~' 0 L N 127- TILE ' U In a In f;,.--„� 12.6' f,' 17.6' A '.CONC..; ;.� EASTERLY LINE I DRIVE-. = POOL N LOT 3 BLOCK 1� Ir. FOUND 1/2" 0.2' 90'01'55T• ;;: ~a. .5 1 0 i. 89'58'05" 0.1' IRON PIPE QA 75'(P)_75.1O'(M) SET 1/2" IRON ROD 3' .75.001 %-- OUND 1 2" IRON AND CAP "LB# 7893- 15' ALLEY - 10' PAVED:' F�nC2S.G08O W&. he vertical and horizon 1 SURVEY NOT --- t all face m ers of a fence shall 1) CONCRETE DRIVE CROSSING OVER PROPERTY LINE ON THE NORTHERLY IML31,0F c tfle plot e, which the fence is ace t 2) THERE ARE FENCES NEAR THE BOUNDARY OF THE PROPERTY. and the finish ed sidp hqll fn— +k- PAGE 2 OF 2 PAGES 10t or any abutting right-of-way. In II FMeq `�� T9 BOUNDARY SURVEY LB#7893 Na 20B3 f TARGET � SURVEYORS CERTIFICATE a f HEREBY CER77FY THA T THIS BOUNDARYSURVEY SUR ♦E,b N , LLC IS A TRUEAND CORRECT REPRESENTATION OFA r SURVEY PREPARED UNDER MYDIRECTION. 'rl�4 STTE 9 F P NOT VALID WITHOUTANAUTHENTIC4 TED ELECTRONIC 0 SIGMA TUREANDAUTHENTICArEDELEC7RoNjCSEAL, SERVING ALL FLORIDA COUNTIES L s u R v e ORA RAISED EMBOSSED SEAL AND SIGNATURE. 6250 N.MILITARY TRAIL,SUITE 102 Clyde O. WEST PALM BEACH,FL 33407 McNeal °ww�9an»as PHONE (561)640-4800 (SIGNED) FACSIMILE (561)640-0576 STATEWIDE PHONE (800)226-4807 CLYDE O.McNEAL,PROFESSIONAL SURVEYORANDMAPPER#2883 STATEWIDE FACSIMILE (800)741-0576 Lot Z.Block 1,COLLEGE HEIGHTS according to the Plat thereof,as recorded in Plat Book 42,Page 8,of the Public Records of MIAMI-DADE County,Florida. l Community Number:120652 Panel;0139 Suffix.L Flood Zone:X Field Work:91212014 Certified To: DILCIA HADDAD;KAHANE&ASSOCIATES,P.A.;FIDELITY NATIONAL TITLE INSURANCE COMPANY;HOMEBRIDGE FINANCIAL SERVICE,INC.,DBA REAL ESTATE MORTGAGE NETWORK,ISAOA .w.. Property Address: P00U GATE REQUIREMENTS: '. • : '••• • 12 NE 111 STREET • •• • t en poutward •••••• MIAMI,FL 33161 Access gates must o ••••. away from the p001 area, ••••'• •••• • Survey Number 212633 be self-closing/self-locking, '•••• •• • :000 ' device located on pool side of the gate ••" •• 00.0 and located no less than 54" .....• •••• from bottom of gate. 00 000. •••• FBC 424.2.17,1.3 • • . ...... ..... POOL REOLIMEMENTS: • .. . .... •.... SELF-CLOSING/ SELF-LOCKING • GATES REQUIRED FENCE: 4' HIGH (MIN.) AND NON-CLIMBABLE IF NEIGHBORS REMOVE FENCE/ WALL, OWNER MUST REPLACE WITH A 4' FENCE ON OWNER'S PROPERTY Fences Good Side Out. The vertical and horizontal supporting members of a fence shall face the interior of the plot on which the fence is located and the finished side shall face the adjoining lot or any abutting right-of-way, vEND.' AC AIRCOND-7XW6'R �Y�y L.AI.E LAKE.414WTE,YW_-EASEWW R9Y R1Gh?rGI`sYAr B.R BEi1R6VG REFERENCE 59 fIwSigw tZ om OR.B OFfr fAL Ire(GYWDR. OFFICW 9 3001r SPR &-r/RaV ROD 4 CAP F{P. FL1UN lRaV!'IPf Uf CMLFTYEAS5WNT T.f7& TOP OF CENTERLd4 Ft), FU(!YD + •, , K) C=,LCLXAAM P-G.r? fiERU4,V"STC0ITRtK POIA7 WAf WATER METER CATV CA&ERISER Kei P-R1d FcRStA'Vtr7R:FfRt"ACE+11CklilA/.NT AG. PAGE CD. CATOiB45N WC. WITNESS CMVER T.Sf1.. TE400RARYawHmAw fP) PLAT DW LIRLUHOLCE FP.K TAVNOPARKER-XALCCVNAAt Tft. ';L'LF.A�rL FFACP.1R_ES PO.. A4A7$00i f.C.IA AOUNDCaAP_-RETEAfONtfWAPT P.O'& PooircFeEGANIuW UP UTI1rTY'POCi� O•E. DR4 AGEEASfi1fENT F.T.R FO'VAV#?OVRL70 P.O.0 PO,7J7oFC03SirENCEA#ENT {L.fJ !X'JY DKrt iAY L LENGTH P. POK�AL)F^�OCUr?VAlURE PELlIdIcASURED d CSV M4A&a&DaTA LAE LhtItTEARC�fCSEk.SEd#ANT P.C. PO4-0OF-=OAT(IRE A,E ANCtJC Z4SEVENr C,V C WCRErE 0,H.4. ti'WR##FAD4MtlTY"y5S A.R. D`EDrGCK 4fEYT ML: If.AINrE;"%CFEASEiimr PRC. POMITOFRr-vERSECVVtATURE R PR(7PERTYLtNE AL/t AOUA-D E n r. POGYT OF UN.SEAVY CH a0w D. 94SE?I?TK7NO.4t� F,N. NAA$Di$C * PROPERTY CCIWER E5A/r E'ASf31F.VT Nab NA,t d L7CSC � COi'EREAARF-A COY/ EDGCOFIVATER NR, NCNRAa/gL RO.F R�FOV£Rk4VOrASeMEAIr c^-r� CO,CALITE NT.S. NorroscAtr R. RAE?`lus(RADMI - xtWFEyPC ,rte 4IET44 FENCE Gi=N,ER&1VOTrs' LEGAL DESCRIPTION AND CERTIFICATION .) tEf�Vtr6&XF77aVPROy.`aW5yOTzjERS LB#7893 7! if#ELANmSHat1'NkFREON('.ER6moTA9SIRACTs"DFQREfiSfAt7IT90R0iftER RECORDEDENCct S'?AW_rsAtOt&WVNo,Y7HEPW. TAR GET 3; LN'XRGROL W PURTIAYS DFF0O.TAr,S F0UAG4 n0VS 0R OrHER IA#PRQJE c-vTS NERF ; Nor LOCATED. 4) WAU U$ARE TO WFACror rhr WALL,4,yFj me Nor ro a-:mo rozcm,$mxr / �p� +'99�� LLC� SOVA`DARYZAV$S S VEymp, LL R 01%yWSSLEEhC'h04CHMEATSLOCA iEO. 6) iyAI-ENSOVSSA"VVARE FYArAvoArEASfJRfDL;vLE'SgorfiFjMI$E$H0"' SERVING ALL FLORIDA COUNTIES , rI F&W-OW% R_gW)VOTDErFFruNEa EtEVATIOHSU CgTL�pyERfL�ygRfRYFELrA/�pDEC4ytALSREfflL�MCEDT0N,0VCt IM 6250 N.MILITARY TRAIL,SUITE 102 �) M1SOVE'WSTAWCi:SC-RAPvLCPXM5Ep+rArtDws1AYE TED70MORE WEST PALM BEACH,FL 33407 CL EARVAUIS7P47FREtAJ"&-0APS8EriWZNPRYSICALANFRDVEa1FNjY.•LA&IORLOTL45`ES. PHONE (561)640-4800 IA'4(LCASES, D,7,rr')IWYSSNAUCOpdTRG+£rHEi3GifAWOFr1+E74{PR("/ESlEWr5OVER FACSIMILE (561)640-0576 SG4LfDA?STTKxY$' STATEWIDE PHONE (600)226-4807 STATEWIDE FACSIMILE (800)741-0576