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WS-16-139Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 BUILDING PERyIT APPLICATION UILDING ❑ ELECTRIC ❑ ROOFING PLUMBING ❑ MECHANICAL 0PUBLIC WORKS JOB ADDRESS: City: Master Permit No. Sub Permit No. ❑ EXTE ❑ REVISION ❑ CHANGE OF CONTRACTOR JAN 19 2016 BY: FBC 20 4/*E1212- CANCELLL Folio/Parcel#: Miami Shoe County: Miami Dade ❑ RENEWAL ❑ SHOP DRAWINGS Zip: 10 Occupancy Type: Is the Building Historically Designated: Yes NO/� Construction Type: Flood Zone: OWNER: Name (Fee Simple TitleholdeY)�h4-/ Z ''% 0 Address: /1/6 a 9 Sw / V s d' V9e0 BFE: FFE: Phone#:()g6% 3 - 370 City: (MI mState: Tenant/Lessee Name: Phone#: •Email: !M °len ° l m - 5 oG . oar/ Zip: 33/ 13�- CONTRACTOR: Company Name: Address: City: to 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: $ Square/Linear Footage of Work: Alteration ❑ New Erepair/Replace n Demolition d / Phone#: Type of Work: ❑ Addition ❑ •AP/a tc Description of Work: /M/aci 65 (,vinc/oas / S w,,; c% w s sW.�J;;if c>/ootil olt£ 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) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made tookbtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the iss nc1 of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdietior ' 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 rtify 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days ter the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee I be charged. OWNER or AGENT The foregoing instrument was acknowledged before me this day of✓/a/' voirci , 20 46 , by day of , 20 , by rip / e.t� zrr, klpersonally o is pally known to , who is personally known to O identification and who did take an oath. �� identification and who did take an oath. Signature CONTRACTOR The foregoing instrument was acknowledged before me this me or who has produced as me or who has produced as NOTARY PUBLIC: NOTARY PUBLIC: Sign: Print: Sea Afit Notary Public State of Florida Joanna Pvi Feliciano j My Commission FF 082753 +Cf PgpExpires 01/12/2018 APPROVED BY (Revised02/24/2014) Sign: Print: Seal: ************************************************************************ Plans Examiner Structural Review Zoning Clerk 9 • • ••• • • • ••• • • , • • • • • • P • • • • • • • w • • • • 4 • • • ••Y • • • • w • • • • a • • 0 w .. w • • • • • • CZASTAL /rximpct Windows ' ►;;$ervice, Inc_ .• • • • • • • ••• •• ••• 9114 NW 106 Street Medley Florida 33178 • •• .+ Office: 305-885-1256 Fax: 305-885-1280 •• luis@coastalwindows.org Company Name: Address: City: Phone: Fax #: • • • AM Ma. •' Date: Shipper: Address: Markings: Attn: 11/9/15 Salesperson: Luis Arrieta Job Name: BISCAYNE PARK MARK QUAN. WIDTH HEIGHT MODEL GLASS FINISH PRICE EXT. PRICE 18 37 38-3/8 %%/ HORIZONTAL FULL VIEW SERIES 60 GREY BRONZE 8 74 63 F4ORIZONTAL FULL VIEW SERIES 60 GREY BRONZE 5 74 50-5/8 Y/j-IORIZONTAL FULL VIEW SERIES 60 GREY BRONZE 2 74 26 V/HORIZONTAL FULL VIEW SERIES 60 OBSCURE BRONZE 2 60 38 V HORIZONTAL FULL VIEW SERIES 60 GREY BRONZE 4 55-1/2 63 FULL VIEW SERIES 60 GREY BRONZE 2 55-1/2 50-5/8 /HORIZONTAL Y/ HORIZONTAL FULL VIEW SERIES 60 GREY BRONZE 1 44 26 Y SINGLE HUNG FULL VIEW SERIES 50 OBSCURE BRONZE 2 37 38-3/8 /SINGLE HUNG FULL VIEW SERIES 50 "OBSCURE BRONZE 1 38 81 { FRENCH DOOR FULL VIEW @ GREY BRONZE 1 39 82 ✓ FRENCH DOOR FULL VIEW GREYBRONZE 1 26 83 ✓/ FRENCH DOOR FULL VIEW GREY'V BRONZE 1 33 86 �/ FRENCH DOOR FULL VIEW GREY t BRONZE 1 38 81 ✓ FRENCH DOOR FULL VIEW GREY BRONZE 5 96 807 SLIDING DOOR FULL VIEW GREY BRONZE 8 37 77 ii FIXED FULL VIEW GREY BRONZE 2 37 76 ', CASEMENT FULL VIEW GREY BRONZE 3 29 18PROJECTED FULL VIEW GREY BRONZE 8 37 63 V FIXED FULL VIEW GREY BRONZE 2 37 63 CASEMENT FULL VIEW GREY BRONZE 5 1X4X 63 MULLION WITH CLIPS BRONZE 5 1X4X 77 MULLION WITH CLIPS BRONZE ALL MATERIAL QUOTED ARE ECO IMPACT WINDOWS & DOORS PERMIT & ENGINEERING FEES ARE NOT INCLUDED STUCCO: DRYWALL REPAIRS OR PAINTING IS NOT INCLUDED PRICES VALID FOR 30 DAYS FROM DATE OF QUOTATION SUB TOTAL $38,030.84 LABOR $11,425.00 Tax $2,662.16 TOTAL $52,118.00 . 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: bee/ 0/20,t -C o DATE: ` /'J /5 ADDRESS: % /L /0 1:71 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 residen ou 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 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 , on.js complete, the law will presume that you built for sale or lease, which is a violation of this exemption. You may not hire an unlicense2.Fontractor. It is your responsibility to make sure the people employed by you have licenses required by state law and by county or licensing ordinances. Any person working on your building who is not licensed must work under your supervision and must be employed b o ch-rneans that you must deduct F.I.C.A and with -holdings tax and provide workers' compensation for that employee, all as prescribed by la Y r� nstruction 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 a my ow r) contractor with certain restrictions even though I do not have a license. Initial 2. I understand that building permits are not required to be signed by a property owner unless h . .e is resonsible for the construction and is not hiring a licensed contractor to assume responsibility. Initial 3. I understand that, as an owner builder, I am the responsible party of record on a permit. I understd that 1m ' protect myself from potential financial risk by hiring a licensed contractor and having the permit filed in his or her name in • ea. 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 per an. on ract Initial 4. I understand that I may build or improve a one family or twlJ Ifj esidence or a farm outbuildi g. I may also build or improve a commercial building if the costs do not exceed $75,000. The building or r e 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 b or substantially improved mys- is sold or I-ased within 1 year after the construction is complete, the law will presume that I built or substantially4ped it for sale or le vv Initial 5. I understand that, as the owner -builder, I must provide direct, onsite supervision of the construe Initial •ch iol: es the exemption. 6. I understand that I may not hire an unlicensed person to act as my contractor or to supervise lie . • working on my building or residence. It is my responsibility to ensure that the persons whom I employ have the license required by law a . by •unt or municipal ordinance. Initial 7. I 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 ''le working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an owner-bui coverage for injuries to workers on my property. am aware of the limits of my insurance 8. I understand that I may not delegate the responsibility for supervising work to be a licensed co 'tractor 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 ax and social security contributions under the Federal Insurance Contributions Act (FICA) and must provide workers compensation for the -m • oyee I under and that my failure to follow these may subject to serious financial risk. 9. I agree that, as the party legally and financially responsible for this proposed Construction 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 regu Ini ty, I will abide by all applicable laws and Initial 10. I understand that 1 may obtain more information regarding my obliga ns as an employer from the Internal Revenue Service, the United States Small Business Administration, and the Florida Department of Reve el.. Iso understand that I m. • ontact the Flori•a Construction Industry Licensing Board at 850.487.1395 or http://www.myfloridalicense.coj/&ilb/index.html 444141? � Initial 11. I am aware of, and consent to; an owner -builder building permit applied for in my r1and unders ands that I am the party legally and financially responsible for the proposed construction activity at the following address: 6 I A/C /or s ' Initia 12. I agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any •f h- ' orm::tion 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 d. -s 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 compl . • fhe property owner and returned to the local permitting agency responsible for issuing the permit. A copyof the property owner's, �h notarized signature of the property owner, or other type of verification acceptable to the local permitting agency is required w e p n) r,�sued. Was acknowledged before me this i ( day of / /dual , 20 6 pp/4' Til. By 2(C (V�,PS`• mMC-2 - was personally known to me or who has d a �o3- '3°'v . S N g N C. Nn Produced there License or �)t' as identification. -,..,-0,„ 0 — X5.51 cord a> p 0 o W I b co to -4O 'r. E1 w _ NOTAR Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Type: Windows/Shutt+ or;Replacem :APPROVED Parcel Number :10/26/2016 Expiration: 04/24/2017 Applicant 671 NE 105 Street Miami Shores, FL 33138-2053 1122310120100 Block: Lot: ROBERT MORENO C/O SASHA I Owner Information Address Phone Cell ROBERT MORENO CIO SASHA 1 NE 2 Avenue MIAMI FL 33132- 1 NE 2 Avenue MIAMI FL 33132- Contractor(s) Phone RM & ASSOCIATES CONSULTING INC (786)348-3903 CeII Phone Valuation: Total Sq Feet: $ 38,000.00 0 Type of Work: REPLACE WINDOWS AND DOORS WITH IMPA No of Openings: 75 Additional Info: Classification: Residential Scanning: 3 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Work without Permit Fee Work without Permit Fee Total: Amount $22.80 $12.75 $12.75 $7.60 $850.00 $9.00 $30.40 $100.00 $850.00 $1,895.30 Pay Date Pay Type Invoice # WS -8-16-61052 10/26/2016 Credit Card 08/19/2016 Credit Card Amt Paid Amt Due $ 1,845.30 $ 50.00 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Window Door Attachment Final Review Building , 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 forI work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRI AL, PLUMBING, MECHANIC L, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVI 1 cert that construction and zoni all the fo-eg in information is accurate and that all work will be done in compliance with all applicable laws regulating , I a hor e h above-named contractor to do the work stated. October 26, 2016 Authorized gnature: s, ner / Applicant / Contractor / Agent Building D • partment Copy Date October 26, 2016 1 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 11 INSPECTION LINE PHONE NUMBER: (305) 762-4949 b�C FBC 201 BUILDING Master Permit No. O((-2_346 PERMIT APPLICATION Sub Permit No. 1145 Vo.— 23 Lt) BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL RECETITF:1771 A.G192016 0PLUMBING ❑ MECHANICAL 0PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: C 7 / (- i0.575 T City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: f "� 2 61.3---0/00 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: OWNER: Name (Fee Simple Titleholder): ?> r" Address: / V6.2 9 _5' (0 (1 54 -II LC9 BFE: FFE: Phone#: 36S 341'18 - 3703 City: 4110 4-144 i State: it Tenant/Lessee Name: Phone#: Zip: 33( Email: CONTRACTOR: Company Name: f`1 6 iel 5 5o i A4res C..'01°-'5(--' / P� : Address: / 4/6 % .54-1..7 / Ot S -I *-(1 7S City: /tel P,—it4 ,� �State: f Zip: 3 3 d Qualifier Name: Rohe„---/--- J' '% re�®� Phone#: - 0X 3�P 370_3 State Certification or Registration #: �/ S Z0 G r �/ Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: / „ . -e. t Value of Work for this Permit: $ Type of Work: ❑ Addition❑ Repair/Replace Description of Work: r e 4-c -c LAO( &-,C0 o 5 4 po or•-- �i�1 oT.EeL �i1 (6- I3( Specify color of color thru tile: Submittal Fee $ 50 Permit Fee $ S CCF $ Z Z •- CO/CC $ -49'- Scanning Fee $�n _Radon Fee $ `Z . DBPR $ /Z �� . S Notary $ ® Technology Fee $ 30. y`® Training/Education Fee $ Double Fee $ Cr 5t) 305-3,1S-3(703 City: State: Zip: Square/Linear Footage of Work: `.//. ❑ Alteration ❑ New .❑ Dem Structural Reviews $ TOTAL FEE NOW DUE $ / a `l -5. so (Revised02/24/2014) Bond $ °"�` 4 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is . bject to attachment. Also, a certified copy of the recorded notice of commencement must be post- • at the job site for the first ins a i' n which occurs seven (7) ' , s after the building permit is is. ed; In the absence of such p' notice, the n t b. ppr'ved and a reinspectio ie will be charged. Signature Signature I inspection wil The foregoing instrument was acknowledged before me this 291 day of --I L -54--A , 20 KV , by -20k14.01,.(2)4.0 , who is personally known to me or who has produced Chiw iS identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: r as KLs l4a1 (S,-vrsa tiis4Y P.i%'••,, Marisol Quintana ?°'•,:, '=Commission#FF172378 �� .a.i�PlExpines: OCT 28, 2018 `'•;�'QFo'•'� Huron THRU ••••$ %S P 1ST FLORID i APPROVED BY (Revised02/24/2014) irrov The foregoing instrument was acknowledged before me this %-I day of _t1_YLS. , 20 4 , by IYLbY,/2_Vt_p , who is personally known to me or who has produced CIX IVVYQ as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: ,a��}Y �y Marisol Quintana :?' :Commission#FF172378 7z'"'` f ExP�s: OCT 28, 2018 . OFF`BONDED THRU 101 I YI CLP Plans Examiner Zoning Structural Review Clerk POWER OF ATTORNEY LIMITED TO THE CONSTRUCTION AND COMPLETION OF 671 NE 105 STREET MIAMI SHORES, FLORIDA 33138 I, Robert Moreno of Miami, Florida, appoint Albert Mendez of Angler Development of North Miami, Florida, as my attorney-in-fact to act on my behalf for the specific purpose(s) of: To manage the property located at 671 NE 105 Street, Miami Shores, Florida 33138. I am the owner of said property. This power further includes the right to carry on all actions and proceedings with the Village of Miami Shores in regards to all matters regarding the construction and completion of the above referenced property. This Power of Attorney will begin to be in full force and effect with the execution of my signature below. This Power of Attorney will be in full force and effect for one year from June 30th, 2016 or until the construction and completion of 671 NE 105 Street, Miami Shores, Florida 33138, whichever event comes sooner. I grant my attorney-in-fact full authority to act in a reasonable and necessary manner for the purpose of exercising the specific powers mention above and herein. I ratify all lawfully performed acts by my attorney-in-fact when exercising said powers. Any third party who receives a valid copy of this Power of Attorney can rely on and act under it. A third party who relies on the reasonable representations of my Agent as to a matter relating to the specific powers granted by this Power of Attorney will not incur any liability to the Principal as a result of permitting the Agent to exercise the authority granted by this Power of Attorney up to the point of revocation or the expiration of the one-year time period. Acknowledgment: I, Robert Moreno, Being the Principal named in this Power of Attorney hereby acknowledge: a. I have read and understand the nature and effect of this Power of Attorney. b. I am of legal age in the State of Florida to grant said Power of Attorney. c. I am voluntarily granting this Power of Attorney. Principal Signature: Robert otary Signa re 10 / Commission F0 Commission Number reno 0-1 lot zo Personally known [] Provided Identification ``"p i �� Ci1sta1 Martinez o $Ail-• Commirston#FF063286 ,,- p : Oct 27,2017 •n„°„,n.••` WWW.AMRONNOT RYsom