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FW-16-3257 Permit FW1111326? �sN°.aeso�i Miami Shores Village P&!mit Tj� "nCea11 10050 N.E.2nd Avenue NE Work0es itication4Wo'od FenCa Miami Shores,FL 33138-0000 h 'ag Phone: (305)795-2204 3"Inst®bstteAW61206 Expiration: 06/14/20 7 Project Address Parcel Number Applicant 164 NE 105 Street 1121360130660 GLENN FORD CATHERINE HABI Miami Shores, FL 33138-2033 Block: Lot: Owner Information Address Phone Cell GLENN FORD CATHERINE 164 NE 105 Street ----- MIAMI SHORES FL 33138- 164 NE 105 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 500.00 , HOME OWNER ... .. Total Sq Feet: 20 Approved: Available Inspections: Comments: Inspection Type: Date Approved: Final Date Denied: Foundation Type of Construction:Wood Fence Additional Info: Review Planning Classification:Residential Scanning:3 Review Planning Review Building Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 Invoice# FW-11-16-62220 DBPR Fee $2.00 12/16/2016 Credit Card $ 119.60 $0.00 DCA Fee $2.00 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 ce ify that I t foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction an er T orize the above-named contractor to do the work stated. December 16, 2016 4 Auth d Signature:Ow r / Applicant / Contractor / Agent Date uilding Dep ent Copy December 16,2016 1 Miami Shores Village �, ,� Building Department NOV 3 A ?016 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 � INSPECTION LINE PHONE NUMBER:(305)7624949 _ FBC 201` BUILDING Master Permit No. Fyj I(o— 32S�- PERMIT APPLICATION Sub Permit No. OBUILDING ❑ ELECTRIC ROOFING REVISION EXTENSION RENEWAL PLUMBING ❑ MECHANICAL PUBLIC WORKS CHANGE OF CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 164 NE 105th St City: Miami Shores County: Miami Dade Zip: Folio/Parcel#:11-2136-013-0660 Is the Building Historically Designated:Yes NO X Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder):Glen Ford Phone#:9548494287 Address:164 NE 105th St City: Miami Shores State: FL Zip: 33138 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: Phone#: Address: City: State Zip: Qualifier Name: Phone#: State Certification or Registration#: Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$500 Square/Linear Footage of Work: ZO Type of Work: ❑ Addition ❑ Alteration ❑ New Q Repair/Replace ❑ Demolition Description of Work: Repaired part of the fence and gates. Specify color of c for thru tile: Submittal Fee �� Permit Fee$ CCF$ CO/CC$ //yy Scanning Fee$ "l Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ • (Revised02/24/2014) 11/2/2016 Screen Shot 2016-09-28 at 20.39.26.png(1422x1052) x �n y tk Awl vlii� uiE eEi �x.i �x g file:///Users/NRIFirePhotos/PicturesBMX/Clint's%20parcel/Clints%20pics/Screen%2OShot%202016-09-28%20at%2020.39.26.png 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 Signature 6-\4V\ OWNERorAGENT CONTRACTOR The foregoing instrument�acknovyledged before me this The foregoing instrument was acknowledged before me this day of pCrr--��`"'�� 20 ,by day of .20 by �h lJJ who is personally known to ,who is personally known to me or who has produced Loo- as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign Sign: Print: N Pr' t: Notary Public,State of Flartd� Seal: Commission#FF 987414 a I: My comm.expre9 May 14,2020 ******************************* ***** ********************************************************************** APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) 11/2/2016 Screen Shot 2016-09-28 at 20.39.18.png(1364x1046) r ti tea,, M d 4 i- N #wf,. VdiY e file:///Users/NRIFirePhotos/Pictures/BMX/ClinVs%20parcel/Clints%20pics/Screen%2OShot%202016-09-28%20at%2O2O.39.18.png T/I. 8 � gtt�° Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 OWNER BUILDER DISCLOSURE STATEMENT NAME: 714 ef'%I DATE: t I L ADDRESS:-1 ,61-4 eve 1� S-r, i . Z � I F 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.R 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 vrorkers'compensation for that employee,all as prescribed by taw.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 1,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. Initi 3. 1 understand that,as an owner builder,I am the responsible party of record on a permit.I under 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 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 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 S. 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 co ty or municipal ordinance. Initial 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 Of 11. 1 am aware of,and consent to;an owner-builder building permit applied for in my name and unders ds that I am the party legally and financially responsible for the proposed construction activity at the following address: Initial- 12. nitial12. 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 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 2-1`o day of i� , 2016 By��FOOD who was personally known to me or who has sl EP� Produced there License or �i�FY /Y� ��2_ as identifi •SioN '••. 6,20 xO�9': o We •® a Q. AFF 054 �� Pm;'4C OWNER NOTARY %,�'pj°.�•,� a��.�;�o��v w' NEAP OF BOUNDARY SURVEY aG ria � �mrcAte a,un�urow,uo-na �„ ,,.,._'�"� _�.. �� .•tea. _._ - P s4Jaraz aurverying 84 msPP1r'tg. Ino. $OB;• °00 BFJRCSU6H°MAIM( 16190 SW 1381h Street,Suite 20,Miami,Florida 33186 -! - asluGEo _- 19ASPHht 1VV 105th STREET Tel:305 696.1799 Fez:oyin8.1888 www.suarersurve Yin9•oom F�AV6A1ER1T_ K >�V ui.�l C { - + T5'R!W� CO a PLATUSAGE., N07 TO SCALE NORTH SCALE: 1'=20- Ei, N„ =:=.EASEMENT C1 E,iep1• f-fOS 9T DAY•dtNE•M'AY yy ®•ELECT<✓C eGf �y� Ei n FIR 11r pFy��± NO ID 6 swK N 90°00'00"E 100.00". 00 00 ""1600 �EEvaTlDnp tO K n� 135.OD' BLOCK b'L9 EI T R E E T CORNER ' . FNDv FOUND NAaa Z •�~ Zl+ll PIP3I4v (SO.09) B' FIR i PPL•P1.GiDAPOIYERSLNHT Tp0. OPMBRPAO �e 1 NO/D ° LOT LOTS �f0� u�.w•r EAmer -ID N�s TREET 841 K 121 I BLOCK 121 I W •° D ej eRxxereasm,DE cowry v R4 = L� PROPERYA 184 NEIOSTHSTREET,MW SHOWS,FLORIDA 53138 PTLEOAL.DESC�PTfON:SPLABCCK S PPC CP•PERMUT�RTCOHTgpL POBtf LOTS 8 E 7,BLOCK 121,OF WAW SHORES SEnON FIVE.ACCORDING TO THE PLAT DS OF F.AS RECORDED IN PLAT BOOK 10. PAGE 47. OF THE PUBLIC p� PE•POO.SQUIP IENTPAID RECORDS OF WAW-DADE COUNTY.FLORIDA AfW w:PvaD`G9 mTP>r�IwN FLOOD ZONE INFORMATION: � PL-PLANTER BASED ON THE FLOOD INSURANCE RATE MAP OF THE FEDERAL EMERGENCY b1 .fib V PaB•PCar�erxTeaWRO MANAGEMENT AGENCY REVISED ON 08/11/09 AND INDEX MAP REVISED ON 15_� 0.15' ^ tZ�� _ i••�..�\9, � ^ Poc.PopR�000a@NC�IT 09/11/08 THE GRAWZ"Y DEPICTED IMI DINGS) SHDMN ON THIS MAP OF ``7, 14.4 las• 14.a' ,r1 `�I PRG.POMr OFREYEPBECURNATI� WRVE'IS WITHIN ZONE a BASE FLOOD ELEVATION 9(9 COMMUNITY NAME 7.3' .4 g0'• �(('�\� 1,19.: Ar(^� Y u 1 PRM•PE�PtNM M•ADffM NUMBER WAW.++DP�'e_1fp9g2 MAP p PANEL NUMBER 12OBSCO302 SUFFIX L y y �q 2 PT.PO .TAN�HiC1• 0.19 1`it't19 a ^ Afn 9 a RADIUS RECORD GBTANCE SURVEYORS NOTES., at)•RECO 1. VAnFL�WN REFER ro 1828 NAnoNAL GEODETIC vERnGL RAM-FUG TWAAT• DAIUN(NOVO 1829). LOT B tV . 2. NO ATTEMPT MAS MADE TO LOCATE FOOTDW/FOUNDATMNS. OR BLOCK 121 LO 1t 7 :, f1.T �p(}� 8NG•BET aAaa D18K R'q UNDERORCUND UTILITIES UNLESS OTHERWISE NOTE3. THE LANDS SHOWN HEON HAVE NOT . Lr2 CTED IN REGARDS TO 32.9 ® Lp y g(LvgWyYEYTE LR@ MATTERS OF INTEREST BYREOTHER PARTIES.�SUCHASEASEMENTS.RIGHTS OF N e+f co SYAtvSDEW'uK WAYS,RESERVATIONS,ETC.ONLY PLATTE EASEMENTS ARE SHOW ® I A CN1 I i=H 45 (TYPI.TYnca. 4. TRIS SURVEY WAS PREPARE FOR AND CERTIFIED TO THE PARTY(IES) P L••UT�ryBd( INDICATE HEREON AND IS NOT TRANSFERABLE OR ASSIGNABLE. $ ONE STORY �^Z + k _ F ev'o00 F5 S.ADDITIONS OR DELETIONS TO SURVEY MAPS OR REPORTS BY OTHER THAN THE B( Cw 71 ® ; 1, I T l NO PARTY OR PARTES IS PROMOTED WITHOUT WRITTEN CONSENT OF THE s F e �• i SGWSIGNING PARTY OR PARTES tdN RES.#�G4 ,r-,O - 'I;��"'4' C._. SYMBOLS: S.THIS IS A SURVEY OF A RESIDENTIAL PROPER",THE STANDARD ACCURACY S_ vCiNTERIOE D7•Te.EPHDNE RIMFOR THE CONTROLLNO DATA(BOUNDARY.CENTER.TRAVERSE AND SURVEY TE 1 j 1 ' ©•CAME rvRIBEROWEEE MITS THT USE 1s I FOOT 77•�FEET. IS SURVEY EXCEEDS THAT SO Q 18.9' b 13.3' nLLGI LLL ° 1 `' n �W CURBIMLETxam-EiBvpT FoNOTER l,Es IMPROVEMENTS flA°vE°NBE�EN� cMT HEARTM6EMEANEST T 10"OF 10 OF A FOOT.A 12.00' ,q 32.6' LL�.q�', `�� 8 h4 1 + ^ H T m01•aBGNAL LOTGSrA11IS a ALL,90UDDARr�WI71NDICATOrROWN�TRyE D LE! 71 W 1 9' O ���-� I •: 8.7K BOUNDAIRT LIMITS ESTASIMED ON 7HIS SURVET AR���0•0:'kRE d aU00 'b `t uLLtt �u i3g A'-- •IIOHTPGa 'm•UIRITYPO B LEGA0.FLEN•EESSODINIONSDI DOTED BY CUENT OR ITS REPRESENTATIVE. • 1 •OPANAOE YANIOIC 11.BEARIAOS WREN SHAb ONDI ARE MERIDIAN,THE CENTFJtL�E OF a5 •BS - DECA tttit"`o +, CATCH BARN ®•BEWERWNNIXE NE IOSTH STREET�IA_S BEEN ASS OF N BOVO'pp E � -- � - lift"Ct� I I 12.T1'�•♦>�IGIR'� � •••••• t BOUNDARY 4'a }{ L 20' d -•..( sItON FENCE • �`- 1 `d 75 •. • •••••• • • • tae•=�'� � �� 4.01 S v t.-.- .Ga9a LDx PeN� BLTrDTNa(AND GMD&@tD �yy+ •••••• Ltt�`� �4- e`d"''" �` SURFAQBS• �m� •••• • • • • BxwTKwwA6aerANPnmGK r[µL[�`(_` " t a- • • • SOm2 maeGTRt0V0E0YRX1)NT r 1 LL o ` I • • GTATEaR FTOP®AGEP.VGMWTtrOFH&,TN µ CERTAA �J PaI°fAPPIXYAOiNAB%1MzX.M 4 Ila' v® t�1•i d`98I_uL '- L tt A AL PAVERS 0.EN� l C�7HERB4E • ••••• _ t U F .F_F.`AC tt 1 • • • • (� ll 0.10' I 1CBS0 �� t t.Int ADDITJ TANK ONLY,NO LD WORK 6/22/15 • tt I^- TILES COVER •rL���� • J to' t Li.2 ELICCBtTIFfOATE: • • • • 94100:111, e. IVDIU (60.Ont d y,q• ® 50. nS(fIL7.."_ I REBY CERTIFY THAT THIS SURVEY IS TRUE AND CORRECT TO THE BEST OF MY KNOMAA 00• OA TE OF SURVEY: BE EF AS RECENTLY SURVEYED AND DRAWN UNDER MY DIRECn�I AND MUSTS THE MINIMUM!TECHNICAL •031�Y�91(/2��0It5 BT ARDS SET FORTH BY THE FLORIDA STATE BOARD OF SUR16YORS YID•APPERS IN CHAPTER JOg •1703Z� 6 ,1G,ASFHAL'T �j n 7 FLORIDA ADMINISTRATIVE CODE PURSUANT TO SECTION 472.j2iFLOR1iy STATUE. •••• $ 15ALtEY PAt s. C p Z Q 9 AON r>e�mMeNdgj �F -A-Ax-"-j rwl4 �! nr B c-158 a ENTIC COPIES OF THIS ASVaa 54 'uan A. T•O0'A-A PROJECT NAME: _51 SHALL BEAR THE DNawAxnA -.Nwm.PawPPm9m.nM SURVEYS 2015 8IGNATURE AND Juan A. aaTHE ��-��-��-�N- CAD F1L£(MJ:FORD a ems . pRE� P�A01 -A SHEET!OF 1 �-B�AND MAPPER Suarez mus BFA7E OP FLORAJA LIC.D8220 113a)7APIr 11/2/2016 Screen Shot 2016-09-28 at 20.38.48.png(1896x1214) 5 . .......... g, 'M OKA 51,71;", ,Klo 4� 'r7l Al A IN 4 N i. N, Y mr, ........ 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