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FW-17-1003 1 ,-1 003 �sNOR-V°,i Miami Shores VillagePeftnit Type.Fence/Wall �c 10050 N.E.2nd Avenue NW fNbikClassifiication:Wood Fence Miami Shores,FL 3313&0000 Pe' r it, y`- a Pe mit Status:APPROVED Ph Rone: (305)795 2204 Y issue rwte:,4111/201'7 Expiration: 1 /08/2017 Project Address Parcel Number Applicant 262 NW 111 Terrace 1121360010610 Miami Shores, FL 33168- Block: Lot: RODRIGUE AND CHARITABLE C Owner Information Address Phone Cell [.!RO�DRIGUE AND CHARITABLE 262 NW 111 Terrace MIAMI SHORES FL 33168-3325 I 262 NW 111 Terrace MIAMI SHORES FL 33168-3325 Contractor(s) Phone Cell Phone Valuation: $ 600.00 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:REPAIR 2-45"GATES AND FENCE Review Planning Classification:Residential Scanning:3 Review Building Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 Invoice# FW-4-17-63660 DBPR Fee $2.00 04/11/2017 Check#:222 $69.60 $50.00 DCA Fee $2.00 Education Surcharge $0.20 04/11/2017 Check#:221 $50.00 $0.00 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 authorize the above-named contractor to do the work stated. go d 3�9,�������- April 11,2017 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy April 11,2017 1 I V Miami Shores Village • Building Department w 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FIIBC 201 `/ BUILDING Master Permit No._ A) i 3 PERMIT APPLICATION Sub Permit No. TABUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION. ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS:-2-(a Z N W 111 Iff r a Gam. b City: Miami Shores County Miami Dade zip: 331(p p Folio/Parcel#: Is the Building Historically Designated:Yes NO_X Occupancy Type: Load: Construction Type: ,r CrFlood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): 1kod d Ga V•I'_,-N lbornrYl Phone#:-7 D(p- -LISEg Address:_ 2(P2- NVV 111 Ttrrg ,e city: Mi am l State: -ftoi a Zip:_W 1 O Tenant/Lessee Name: h/1 Pr Phone#: n//A Email: CONTRACTOR:Company Name: kf Q(Y1 C Ow V\-tel. K- 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:$ to 00 •0 0 Square/Linear Footage of Work: 2y Type of Work: ❑ Addition ❑ Alteration ❑ New X Repair/Replace ❑ Demolition Description of Work: &,IDQ'Ir 2 - 45" Gtl-C Qrd -'C,Y1 1 pCQ+CgA t)h y-i(;Ih+ S 1Gf`Q. o-� Prcpty4 ,. Y Wa06fly) QrkkQhd nCf' l-►eight Ul+ Specify color ��ogqfcolor thru tile: Submittal Fee$ 7D"C�) Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ •W Technology Feg$ 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 ge ee Z c 0 [/ �� Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 1 ( day of �\r I 1 ,20 17Z by day of 20 by PN f ihb s per known to � who is personally known to me or who has produced �—Q(4-2 me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: d MAHARAI K GONZALEZ Si Sign: EXPIRES:November 2,2020 Print: F o":•` Print: Seal: Seal: APPROVED BY r1 1 Plans Examiner j ( Zoning Structural Review Clerk (Revised02/24/2014) 0 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: Y1GUQ _ fi� O ADDRESS: Z(_®Z -Tex vase, Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida,F.5 489.103(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 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 I D 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—P Ji '✓ 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 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 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. 9 1 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. 1 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/dbor/oro/cilb/index.htmi Initial t� 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: 2(o2 WVV ) II Ifrrace, 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 ./ 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 20 By C r r Was personally known tome or who has Produced th r License o _�u �Js ZO - �-1 �-1 +Z®�as identification. OWNER NO ARY MAHARAI K.GONZALEZ MY COMMISSION#GG 044802 = ` EXPIRES:November 2,2020 '•.�odd,°.• Bonded Thru Notary Public Undem b m ♦ RES Gi �c Miami shores Village NINE Building Department 10050 N.E.2nd Avenue R,�A Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 SURVEY AFFIDAVIT STATE OF(FLORIDA) COUNTY OF(DADE) The undersigned Affiant, 90 C�Y 1 0►l,� �� does hereby attest that (Property owner) The attached survey, performed by (Name of surveyor's company) For address: Z(D2 NW I 1 1 -Ttr wa, Performed on (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,Affiant say eth naught. Property Owner Signature Property Owner Print Name SWORN TO AND SUBSCRIBED before me this ay of r Affiant is personally known to me, roduced Q 'b�_ O p y p�®� as identification. ►�C No a Revised on 5/22120091 Revised on 6112109 •;��► •.,, MAHARAI K.GONZALEZ MY COMMISSION#GG 044602 EXPIRES:November 2,2020 ':! P ••,Eos Flo.•' Bonded Thru Notary Public Underwriters Qgdric�i�, `Del�ornrri-e,• fi=�'h��;1 W111 Ter►-� c ooh S de,ins c� �c>, V cat �,s� irg w cod -GnC�, a� gG+-es '=-�' ZAP • e )) ,�f i^c. Zr—L 3 r1 n „e nn rdhtic-1 ttie^` F'� at aq PYO r+ Q M i arni S ho 5, rhe 1� 0h2N(lp�l ri floc of hed side ,\Ore r1�e. i nis Y r-of- cr (4 elof 1,7 A40 I i — - I .. -- --------—M t. 3 ;i it lJl r,T 1 O �,C P.IPI IANCE WITH ALL FEDERAL A��, 1,�\'I ", i:) t i)'„ 'TY FMLFS AND M—GHI ATIONS `� � �SNORES Gid s� Miami shores Village Bull NJ� Building Department �LpRxpA Fences Good Side Out. The vertical and I or s, Florida Avenue 1�1f'�Pf���'� ores, Flor33138 supporting members of a fence shall face the Tel: (305) 795.2204 interior of the plot on which the fence is located ax: (305) 756.8972 and the finished side shall face the adjoining_ lot or any abuitinq right-of-way WOOD FENCE DETAIL ❑ Shadow Box X 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 Fence Good Side Out.The vertical 1 x pickets fastened and horizontal :E with two corrosion resistant fasteners per supporting connection members of a fence shall face the interior of the plot on which the 2x4 horizontal fence is located pressure treated and the finished wood members side shall face the 7 with two corrosion adjoining lot or resistant fasteners any abutting right- per connection of-way. 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 10/14/2016AS r � • ` • rN MA ALL E aw ttt T.