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RC-17-1350 NORC4Z' 4350 e HaR s L Miami Shores Village FBrmit Type:Rt�(t 0i construction 10050 N.E.2nd Avenue NW r",M I +ork` Lass atian.A ditionAertadon Miami Shores,FL 33138-0000 ' It enr7t Slants'AP11W Phone: (305)795-2204 F[a0NA Issue torte:513012017 Expiration: 11/ 612017 Project Address Parcel Number Applicant 79 NW 97 Street 1131010330260 GORDON 8<RISA BLAIR Miami Shores, FL 33150- Block: Lot: Owner Information Address Phone Cell GORDON$RISA BLAIR 79 NW 97 Street (786)458-7799 MAIAMI SHORES FL 33150- 79 NW 97 Street MAIAMI SHORES FL 33150- Contractor(s) Phone Cell Phone Valuation: $ 2,300.00 HOME OWNER _..... .... ...._... Total Sq Feet: 0 Approved:In Review Available Inspections: Comments: Inspection Type: Date Approved::In Review Drywall Date Denied: Miscellaneous Type of Construction:FRONT ENTRY AND STAIRS/STEP Occupancy:Single Family Window Door Attachment Stories: Exterior: Tie Beam Front Setback: Rear Setback: Final Left Setback: Right Setback: Framing Bedrooms: Bathrooms: Insulation Plans Submitted:Yes Certificate Status: Final PE Certification Certificate Date: Additional Info:FRONT ENTRY AND STAIRS/STEPS Truss Insp Columns Bond Retum: Classification:Residential Foundation Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Window and Door Buck CCF $1.80 Fill Cells Columns DBPR Fee $2.00 Invoice# RC-5-17-64043 Wire Lathe DCA Fee $2.00 05/17/2017 Credit Card $50.00 $72.80 F.Termite Letter Education Surcharge $0.60 05/30/2017 Credit Card $72.80 $0.00 F.Elevation Certificate Notary Fee $5.00 Review Mechanical Permit Fee $100.00 Review Structural Scanning Fee $9.00 Review Electrical Technology Fee $2.40 Review Planning Total: $122.80 Review Building Declaration of Use Review Plumbing In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conform with the plans,drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume respon ibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECT LUMBING, ECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS FIDAVIT*- certify that I the fore oing info a ion is accurate and that all work will be done in compliance with all applicable laws regulating constru 'on and zoni g. Futhermor ,I authori a he bo -named contractor to do the work stated. ;-7 01 May 30,2017 u Si re:Owner / A nt / Contractor / Agent Date Building Department Copy May 30, 2017 1 Miami Shores Village RECEIVED -�� Building Department MAY 17 2017 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(30S)762-4949 S i—\ q FBC 20 BUILDING Master Permit No. 650 PERMIT APPLICATION Sub Permit No. BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: Qs-1 City: Miami Shores County: Miami Dade Zip: 331 Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: a- FFE: OWNER:Name(Fee Simple Titleholder): tAb�'� e)(aw Phone#: 3®5 q00— `SIG Address: 3R ow q A"— 9 2 City: 5('zV' 2e State: l✓ Zip: 7� ' Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: Phone#: Address: City: State: Zip: Qualifier Name: Phone#: State Certification or Registration-#: Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$'T 0D< Dn Square/Linear Footage of Work: Type of Work: El Addition El Alteration L❑ New ❑ Repair/Replace ElDemolition Description of Work: (� 11\ A2N( &.A (as L""' , bp-y�16,0 UA.k4k 4i 0S 117- Specify 17.Specify color of color thru tile: Submittal Fee$ Permit Fee$ 100 CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (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 X Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this _ day of 120 I by day of 20 by who is personally known to ` who is personally known to me or who has produced 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: U"", �A�s Sign: Print: �� t"�� Print: Seal: Seal: :►� PATRICIA FEBLES MY COMMISSION#GGW9157 APPROVED BY H Plans Examiner C17)i 7 ning Structural Review Clerk (Revised02/24/2014) SNoREs Gi << Miami shores Village soon googol" Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 �ZORIDp' Tel: (305) 795.2204 Fax: (305) 756.8972 SURVEY AFFIDAVIT STATE OF(FLORIDA) COUNTY OF(DADE) The undersigned Affiant, U-�A rJ16-966,r ,does hereby attest that (Property owner) The attached survey, performed by (Name of surveyor's company) For address: 1.Ju) , Performed on 2 0 (date of survey)is an accurate representation of the existing conditions and locations of all structures on the property as of this date. The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the property without first providing a survey less than seven (7) years old old. The Affiant, as property owner, further agrees to remove or obtain permits for any structures which now may exist on the property which are not permitted or which may violate zoning or building code regulations. The Affiant further understands that the existence of any such structures may affect final inspections as applicable to this or other permits. Further an y eth naught. Property Owner Signature Property Owner Print Name SWORN TO AND SUBSCRIBED before me this 10 day of r'4q. 2017 Affiant is ✓ personally known to me, produced as identification. ,,•►"'ry PATRICIA FEBLES MY COMMISSION#0000915 EXPIRES July 06,2020 Notary Revised on 5122/2099/Revised on 6/12/09 ,y .s 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:C.'n"J® `'P ` r' DATE: i ` a ADDRESS: L l Al ` ( N� i /)/) `' 1 14eS/ 3 3 Iso 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 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. InitiI A 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 d con . Initi 4. I 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, 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 1 t 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 1 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 plion'�_ /,s ' Ini 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/ClibAndex.html Initia 11. 1 am aware of,and co sent to;an wrier-builder building permit applied for In my name and understands that I am the party lega ancially re onsibl a pr osed construction activity at the following address: 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. Initia 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 3� day of �' a 20 1 -1 By Gj(Z_CK�5v who was personally known to me or who has ��111111111111/�� ge\\X-\a wvloN * 0,6 Produ there Livens or 'vim as identifica o a OWNE NOTARY C11TY •.• .. • . •• . GO: rt' . •• . Y. 0 0 00 • • • • • . • • • • ••• • !1• *00 X ¢ (az)Rrse XsC�p,5'�f` C�1 � ���t✓pdNS-s ��''t �S �ii jCttj �'rAlP. -4"'G' ptAcf XN �sJ�� yvq-L to ir�Ap A dA RS E /3 d IT .41-r DECEIVED A ! JJ MAY q's�AT A"-. Miami Shoes Village APPRO`vED BY DATE ZONING DEPT J 7 BLDG DEPT F Its SUBJECTTO CUIPLLANCE WTTH ALL FEDERAL CI STATE AND CCUC f RUES 41D REGULATIONS . . ... . . . ... •. •. . . . .. .. . . . ... . . . . ... ... ... MAY //C)//7 . . ... . ... . .. . . . •• ••• RNA ME.. „r. 4?A4,LJ e Z" 4,95-s TRA �� To V— .311 /fir,(- q''c[.ER FZ. jp/c/<E7-s' p,��ET -7Lxll IV��-7A- Z- (rr-A . moi, q n X e4 ILII A-44 -THORES /etz.4 �33/57-C3 . . ... . . . ... .. .. . . . .. .. . . . ... . . . . ... . ... . ... . ... . ... . . . . .. • 01VE+ ���c fe�1 • S'/D C NG ATE CsE� �� STA,2 AT N7-P-vy CSE- br-r) CIaC . &,<I 4- su✓k ENTRY (3, ??ISERS 6>� EXN • 1L/1 �lSc2@5� 12- R,:�=PL A C-6- AWA NJ ro S s f Rocs: ,4DD2�.�S ----------------------------------- ------------------------------------— I I 1 J O O O ! C F- I ------------------------------------------- I I A' FRONT VIEW Ld sic"s -�,(ell +0 � s ",, Ale o s 0000 vi w "-------------------------------------------- • ••• c� p • • • •••.•• • CT---------------------------------------------------------------------------------- ---------------------� i]S•s•� ----------------------- --------------- H HO � � EQ NO � � � 00.00• '•: ••�•g I 1 0•00•9. E - L----------------------------------------L-------------------------�--------- -----= 77 ---- ��,. •.Z- • •0 0 • •••• REAR VIEW NEW ACCORDION • SHUTTER TO BE � •�• •.0• INSTALL FL 12549-R5. •o 0 ••• • • • a .• Q C - ------- T�______________T] C - DESIGN BY:E.F. 9kI IIIIII ❑❑ j� \ Ij DRAWN BY:E.F. UERTIBESHTTO © 1 C II C-'--'� j 1 --- FL 12549-R5,- ---------------J RIGHT VIEW LEFT VIEW EXISTING ELEVATIONS DATE:12-20-2018 SCALE: 1/8" = l'-O" SCALE:AS SHG NOTE THIS PLAN IS NGT CONSIDERED COMPLETED UNTIL SIGNED AND SEALED BY THE ENGINEER OE RECORDS MID REVIEWEDAND APPROVED BY THE CORRESPONDMO PERMITTMG AGENCIES SHEET: 24 REAR VIEW -- - ---------rT-I NEW ACCORDION SHUTTER TO © O BE INSTALL FL 12549-R5. I I Ir-----iii o ~ it== =- ==={__;i M ' w W II II I �LJJ J Li IIINfl _`_ _---- �� ------- __ -__;—_ ---7I Lv n N � •••• N W Zn Elf w > jre O II O O O O I O O �"'•Me • •••••• •� YI •�f• J BEDROOM I I rr•f f••• •• • �. •g • • ¢ II II II •••••• �••n 0000 ••••••• < • JE I • I I I BEDROOM I BATH I w f 0--o•••• • •.r• (L ---- ----- --1-- --JI •• •• EGRESS f••••• • �,Z ��l.. I10 B OI 00.00• ..... -1L=====__ - - O- - =====1J FRONT VIEW ••0 • +� 6�.� •s • ••• • V 6 • • a EXISTING FLOOR PLAN W a SCALE: 1/8" = 1'-V DESIGN BY:E.F. GENERAL NOTES: DIiAVIN BY:E.F. 1. THESE PLANS ARE PREPARED EXCLUSIVELY FOR THE SELECTION OF NEW DOORS OR WINDOWS. INSTALLATION SHALL BE CARRIED OUT FOLLOWING THE CORRESPONDING PRODUCT CONTROL APPROVALS FROM MIAMI-DADE COUNTY. ANY MODIFICATION TO THE ORIGINAL STRUCTURE REQUIRED FOR THE DOOR/WINDOW INSTALLATION IS NOT COVERED BY THESE PLANS. A SEPARATE PERMIT WITH CORRESPONDING DESIGN PLANS MUST BE OBTAINED IF MODIFICATIONS ARE REQUIRED FOR THE INSTALLATION . 2. THESE PLANS ARE NOT CONSIDERED COMPLETE UNTIL SIGNED AND SEALED BY THE ENGINEER AND REVIEWED AND APPROVED BY THE CORRESPONDING PERMITTING AGENCIES 3. ALL DIMENSIONS SHOWN ON THESE DRAWINGS HAVE BEEN OBTAINED, IN PART, BASED UPON INFORMATION FURNISHED BY OTHERS AND/OR BY ROUGH MEASUREMENTS FOR THE PURPOSE OF PROVIDING A SPACE PROPORTION TO THE USER. WHILE THIS INFORMATION IS BELIEVED TO BE RELIABLE, THE ENGINEER RECORDS ASSUMES NO RESPONSIBILITY FOR THE ACCURACY OF THIS DIMENSIONS OR FOR ANY ERRORS OR OMISSIONS THAT MAY HAVE BEEN INCORPORATED INTO IT AS A RESULT OF INCORRECT INFORMATION PROVIDED TO THE ENGINEER. THOSE RELYING ON THIS PLAN ARE ADVISED TO OBTAIN INDEPENDENT VERIFICATION OF ITS ACCURACY. 4. DO NOT SCALE FROM PLANS DATE:12-20-20113 SCALE:AS SHOWN NOTE THIS RAN IS NOT CONSIDERED COMPLETED UNTIL SIGNED AND SEALED BY THE ENGINEER OF RECORDS MID REVIEWED AND APPROVEDBY THE CORRESPONDING PERM'..- SHEET: 14 • ••• • ••• • ••• • • ♦ • • n •• ♦ ••• •IL 0 CRASS ••• • cZ $ a •� .•1 00'•ASW ALT41MVEVERT o ui'. • • • • ►• • • • • • • ROOtl10�P • FIP 34'0 g FIP Ire NO l o NOB! 05 c ^ ti 2' 2' t) N c CRASS !" Cm i Y a15 a � 17.70' 8 r7j' g J a 132W 04.00' el dr6. M Lid a3 •. ys C B 1250' 31.80' ONE STORY g al RESIDENCE ® 0 17.7 ' # 79 1, 34.40' •'p` 23.10' w 70' �-L c NORTH � ( Gr J SCALE: 1/20 'Po -�CRASSfin/tl NO`S � e 0 FlP 34•e�C' No 0 yu??• ��1� FW we NO 10 NOW taco.o4>.''.' •1QDAOd��PdcM "••.'.•.'.'.'. .$.fl0' CONC•SWK. ... . . . .'. .'. .$ ►i i� eoNcGRASS •.'.'.'.'.'. . .'.'.'.'.'.'.'.'.'.'.'.'.'.'. . . oaass $ OASS ........... ......GRASS 37.00A, . .. . 59.Q0' . .. . 1.6'b . 4.00 18.00' ASPHALT PAVEMENT (+ NW 97 STREET i 3 i 3 Property Address: NOotes: 79 N.W.97 STREET, MIAMI SHORES FLORIDA 33150 ff2Q7RVEYOR'8-CER$AEtRSAT7ON.;I NEREB"/CERTIFY4HAT TH(S'EOIiNOARYSURVEY'i8 ATRUE AN1A CORR@CT REPRESPNYATIOQI OP A SUR9Y@Y PR@PARPD9JNDER LAY®IRECi'ION.731�CIXdW9E8 V�6TN 7HE N.HIMUNTECMN4CALSTAFIOAR .ASSETPORM BY78d SWH OF F LORMABOARO OF PROFESS(Ck L'LAND O'fQtT.Q RLORM'AO6UNt'bTR9i1LEC OW PItRfl AW TO'`n.W.FLORIDA MIGUEL ESPINOSA LAND 2a,Opp+ , SURVEYING,INC. . 10665 SW 190TH Street Suite 3110 93GNmFOR MIAMI, FL 33157 .. PHONE:(305)740-3319 MIG5STAATT��D14 ,.- PSdtd MD. FAX#:(305)669-3190 LB#6463 rsxraaLmx�n-�rmda�xantcesc�st�aoNans�'npaanf+Ea'rEa , �s5n�a�vsrs 7WIS MAPS aOr49WOWiTMW THG96114R#E AMTM0R0KMWMWM&CWA=MW6t0a VM Accepted By ana rAaP . Survey: A-6354 PAGE 1 OF 2