DS-17-1702 Pormit No CSS-S-174,702
Miami Shores Village
PG'RfT1t Tjlj3e I1laWs� `�>� C )ICB � .
10050 N.E.2nd Avenue NW
�fild�tlfiiltttratli?It
Miami Shores,FL 33138-0000 Wol�f O S tI`l Cfl .•,
Phone: (305)795-2204 APPROYir�
' issue,Date:7/6/201V Expiration: 01/02/2018
Project Address Parcel Number Applicant
79 NW 97 Street 1131010330260
Miami Shores, FL 33150- Block: Lot: GORDON&RISA BLAIR
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: $ 1,200.00
HOME OWNER
_...__..... _ . ._.. _.... _._....... Total Sq Feet: 170
Approved:In Review Available Inspections:
Comments: Inspection Type:
Date Approved::In Review
Final
Date Denied: Foundation
Type of Work:BRICK PAVERS Additional Info:BRICK PAVERS Review Planning
Bond Return:BRICK PAVERS Classification:Residential Review Building
Scanning:3
Fees Due jAmn �Date Pay Type Amt Paid Amt Due
CCF
Invoice# DS-6-17-64457
DBPR Fee 07/06/2017 Credit Card $ 116.20 $0.00
DCA FeeEducation Surcharge Permit Fee Scanning Fee Technology Fee Total:
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 re ponsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUM ING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS : I certify that foreg ' g information is accurate and that all work will be done in compliance with all applicable laws regulating
constructs and zonj, g. Futh or ,Jt ri the above-named contractor to do the work stated.
c+-r / July 06, 2017
Authorized STg-natuCtj Owner / Applicant / Contractor / Agent Date
Building Department Copy
July 06,2017 1
Miami Shores Village RECEIVED
Building Department JUN 3 0 2017
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 201 —1
BUILDING Master Permit No.
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLICWORKS�/❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
ACTOR
JOB ADDRESS: 99 /V/ 11-) � 7 1 r/ �Tr e P— DRAWINGS
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 3 1 6 33 -0 2 60 Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: I Flood Zone: BFE: FFFE: /
OWNER:Name(Fee Simple Titleholder): I' Phone#:
Address: q Az IA/ 9 .117Ty S 6Z e
City: AA 14 >M I, , O PS State: f— /0 r ( �i Zip: -3� .3 /S
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: L n" a-® +-u k^• Phone#:
Address:
City: State Zip:
Qualifier Name: Phone#:
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip: L
Value of Work for this Permit:$ 1 -Z ®c Square/Linear Footage of Work: 1 9 0 SZ
Type of Work: ❑ Addition ❑ 1Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: 1, I 4L Ccy e rS
Specify color of color thru tile:
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$
(Revised02/24/2014)
Bonding Company's Name(if applicable)
r
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 roved and a reinspection fee will be charged.
2 Signatur Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
0 day of v 1 w 20 by day of 20 ,by
who is personally known to who is personally known to
me or who has produced^B U (D() -M d—!�-1 aJ•PS;� Re who has produced as
identification and who did take an oath. 1 COof N a identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: nm7ALEZ Sign:
MA #GG 044
Print: .•'� jw° ., YCOMMISSION 2020 Print:
Seal: p;= gonded1hru ry Seal:
############################ ### ## ########################################################################
APPROVED BY ��. Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
Miami-Dade Official Records -Print Document Page 1 of 2
,, , - i 111111 IIIII 11111 IIIII IIIII Illli Illli Illi it
CFN 2.:00CP11,.J4_^:2023
OR Bk 26927 Fes 2731 - 2732; (2w
RECORDED 07/06/2009 10:53:43
DEED DOC TAX 900,00
HARVEY RUVIN, CLERK OF COURT
MIAMI-DADE'COUNTYr FLORIDA
qrV
Ik�ase Re ur To:
Shepard & Laskar, P A.
Prepared By
Allette Richard 100 NW 70th Ave.
Buyer's Title,Inc
100 NW 70th Avenuep'®rpt®tIorsq FI
Plantation,FL,33317
incidental to the issuance of a title insurance policy.
File Number:
OS-2019a
Parcel M#:11-3101-033-0260
79,NW 97 Street,Muni Shores,Florida 33150
SPECIAL WARRANTY DEED
s (CORPORATE)
This SPECIAL WARRANTY DEED, dated#4!r6WA 2009 by LaSalle Bank National Association as Trustee for Merrill Lyric]
Mortgage Investors Trust 2007-3,Mortgagh,Loan Asset Backed Certificates,Series 2007-3,by Hone Loan Services,Inc.,as
Attorney-in-Fact whose post office address is:135 South LaSalle Street,Suite-1511,Chicago,IL 60603 hereinafter called the
GRANTOR,to Gordon Bleb and Rise Blair,husband and wife whose post office address is:79 NW 97 Street,Miami Shores,
Florida 33150 hereinafter called the GRANTEE:
(Wherever used herein the terms"GRANTOR"and"GRANTEE"include all the parties to this instrument and the heirs,legal
representatives and assigns of individuals,and the successors and assigns of corporations.)
WITNESSETH: That the GRANTOR,for and in consideration of the sum of$10.00 and other valuable considerations,receipt
whereof is hereby acknowledged,hereby grants,bargains,sella,aliens,remises,releases,conveys and confirms unto the GRANTEE
all that certain land situate in Miami-Dade County,Florida,viz:
Lo�16 and 17,Block 129,MIAMI SHORES SECTION 6,according to the plat thereof,as recorded in Plat Book 10
Page`39,of the Public Records of Miami-Dade County,Florida.
SUBJECT TO covenants,conditions,restrictions,reservations,limitations,easements and agreements of record,if any;taxes and
assessments for the year 2009 and subsequent years;and to all applicable zoning ordinances and/or restrictions and prohibitions
imposed by governmental authorities,if any,
TOGETHER with all the tenements,hereditaments and appurtenances thereto belonging or in anywise appertaining.
TO HAVE AND TO HOLD,the same in fee simple forever.
AND THE GRANTOR hereby covenants with said GRANTEE that it is lawfully seized of said land in fee simple;that it has good,
right and lawful authority to sell and convey said land;that it hereby fully warrants the title to said land and will defend the same
against the lawful claims of all persons claiming by,through or under the said GRANTOR.
Book26927/Page2731 CFN#20090482823 Page 1 of 2
https://www2.miami-dadeclerk.com/officialrecords/PrintDocument.aspx?QS=YaoUfOzxry... 6/30/2017
Miami-Dade Official Records - Print Document Page 2 of 2
OF-, BK
LAST PAGE:
IN WITNESS WHEREOF,GRANTOR has signed and sealed these presents the date set forth above.
SIGNED IN THE PRESENCE OF THE FOLLOWING WITNESSES:
LaSalle Bank National Association as Trustee for Merrill
Lynch M ge vestors Trust 2007-3,Mortgage Loan
/� Asset acked cafes,Se es 7-3
Signature:� tj h�
Print N �'c o ,,&.c ke 7 By: as
of Home Loan Services,Inc-as Attorney-in-Fact
Signature:
Print Name:: c� NaVARAW Wlik
State of Pennsylvania
County of Allegheny
Eileen Peparieila
THE FOREGOING INSTRUMENT was sworn and acknowledged before me on _L�2009 by
of Home Loan Services,Inc.,as Attorney-in-Fact for LaSalle Bank NationaM11,cia on as rus ee
for Merrill Lynch Mortgage Investors Trust 2007-3,Mortgage Loan Asset-Backed Certificates,Series 2007-3 on behalf of the
corporation. He/She is personally known to me or who has produced a driver's license as identif 'on.
Notary Seal Signature:
Print Name:
CONOl10NWEALTH�,PE�iN YLVI�NU►
Ameba sera.NAY Publ�
crty of Pte.Apeplau�fr CauMy
a canm+asla�r .len. ,zots
Manber.Penn n� ada�an of oteriea
SWD-:79 NW 97 Street,Miami Shores,Florida 33150
Book26927/Page2732 CFN#20090482823 Page 2 of 2
https://www2.miami-dadeclerk.com/officialrecords/PrintDocument.aspx?QS=YaoUfOzxry... 6/30/2017
11
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
�R Miami Shores, Florida 33138
Tel:(305)795.2204
Fax:(305)756.8972
OWNER BUILDER DISCLOSURE STATEMENT '7NAME: e� V` TO� Q 1 (P'- DATE: ''I E. , 00 /
ADDRESS:-t-! 9 /\(
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. I 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. ,l�
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 a cont cts.
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 leas ic�tes the exemption.
Initial
5. 1 understand that,as the owner-builder,l must provide direct,onsite supervision of the construction.
Initial
����1
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(w
s
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,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. 6
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.l 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 regulation
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.myfloridalicense.com/dbpr/pro/cilb/index.html
Initial
__k�
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:
�-
Initial
12. 1 agree to notify Miami Shores Village immediately of any additions,deletions,or changes to any of the informati 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 i lA 4 I!Lday of -30 , 20 1
.A.:tis:t ti
r
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y iG ` who was personally known to me or who has
�u (o0 - ZSSD - U - aSs ^ d 9g 'o
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Miami Shires Village
APPROVED BY DATE
ZONING DEPT e
a .
BLDG DEPT
Property Address: NO° �WCT (0 CcNIPLIANCE WITH ALL FEDERAL
79 NSW.97 STREET,
MIANII SHORES FLORIDA 33150 STATE ANO C( UN'i Y MULES AND REGULATIONS
RECEIVED
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r MIGUEL ESPIINOSA LAND
F, 4 SURVEYING,INC
10665 SW 190m Street
Suite 3110
SMNED 4 FOR 1WE FUM MIANII, FL 33157
FSFtAta . s
?$. PHONE:(305)740-3319
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Accepted By
Survey: A-6354 PAGE 1 OF 2
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NOT TO SCALE
Certified To:
GORDON BLAIR AND RISA BLAIR, 1) LEGALDESCIUMMPROVIDEDEWOTHERS.
BUYER'S TITLE INC, 2) EXAMINATION OFTHE AaSTRACTOFTITLE WILL HAVE TO K-MADE TO DEMM4E
RECORDED INSTRUMERM 6:AW.FIRST AMERICAN TITLE INSURANCE COMPANY, 3) t A�FOREASF TOROnWR
FIDELITY FUNDING MORTGAGE CORP, 4) TW OFTM FOR ogrA=jr,ME SSUR4NMAW
FTN4Nf1►GAND SHOULD NOTSE USED FOR CONSTRUCT oK PEFwrr;IG.DESA.
ORANYOniER PURPOSE WDIOUTTHEWRUTIEMCONSSPTTOFMUEL ESPOSOSA
Its'sucessors and/or assigns as their interest may APP5) UNDERGROUND PORTION OFF .FOUPM71ONSoRonM0541nvEMEM
WERE WI LOCA715R
b7 ONLY VIAND AWVEGROUND Et qTS LOCATED.
Community Number: 8) �Wr
Panel Number.-0260 9) wAwMREFEwm-roumwrwASB.R.
iM BOUNDARY SURVEY MEANS ADRAW=ANDfORoRaPtitcREPR MWATIONOFTHE
Suffix: T SMURVEY
WO TOPERFORMED IN TM FIELD.Cot"BE DRAWN AT ASH�II SCALE
AMMSQUE
Date of Firm Index:o7/17/1995 ") NOM134TU:=T=FDM IN'I P UY{X VOM W LESs NO7ED
Flood Zone: X U "�Y"� SEALED'AMiTW�°IIMSURVE"� �
13) DIM80ONS SHOW ARE RATAND MEASURM UNLESS 07HERVAMSHaM
Base Flood Elevation: 44) ELWAnONSIFSHOMARE BAS UPON&G.V.D.IM9 UWM 01MMISE W07ED.
1Q THISISA BQtAVDARI' /EYIn OTHERWW NOTED.
Date of Field Work:2/6/2009 1% nM 6OUN01WSURVEY HAS SIM4 PREPAFIEDFOR TIS EXCLUSIVE USE OFTW
Date of Completion: 2/8/2009 NAM H TW CWTI�ATI DO NOT WEND TO AM UNNAMED
AaRM.
al Description: LOT 16 AND 17,BLOCK 129,OF MIAMI SHORES SECTION 6 SUBDrMION
ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 10,PAGE 39,
OF THE PUBLIC RECORpS OF MIAMI DADE COUNTY,Fj ORIDA.
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Property Address:
9 N.W.97 STREET,
MIAMI SHORES FLORIDA 33150
ffiA ,W MIGUEL ESPINOSA LAM
SURVEYING,INC.
TOM=R=WA PUMAMU 10665 SW 190TH Street
Suite 3110
• AHAIVII,FL 33157
PHONE:(305)740-3319
+� FOR THE WRM FAX#:(305)669-3190
A&GULc Ps+ NO. 5101
LB#6463
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Accepted By
Survey: A-6354 PAGE 2 OF 2