FW-17-2619Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit
Parcel Number
Permit NO. FW -11-17-2619
Penni( Type: Fence/Wall
Work Classification: Wood Fence
Permit Status: APPROVED
Issue Date: 11121/2017
Expiration: 05/20/2018
Applicant
Owner Information
Address
1060 NE 92 Street
MIAMI SHORES FL 33138-
Phone
Cell
Contractor(s)
HENRY'S FENCE INC
Phone Cell Phone
(305) 669-0180
Valuation:
$ 2,400.00
Total Sq Feet: 163
Approved:
Comments:
Date Approved: :
Date Denied:
Type of Construction: Wood Fence
Classification: Residential
Additional Info: 6' HIGH WOOD FENCE
Scanning: 3
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee - Wire & Wood
Scanning Fee
Technology Fee
Total:
Amount
$1.80
$2.45
$2.00
$0.60
$163.00
$9.00
$2.40
$181.25
Pay Date Pay Type
Invoice # FW -11-17-65542
11/21/2017 Check #: 1066 $ 131.25 $ 50.00
11/02/2017 Check #: 1056 $ 50.00 $ 0.00
Amt Paid Amt Due
Available Inspections:
Inspection Type:
Final
Foundation
Review Building
Review Building
Review Planning
Review Planning
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: certify at: •II t foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoni ize the above-named contractor to do the work stated.
Authorized • nature: Owner / Applicant /
Buildin v' epartment Copy
Contractor / Agent
November 21, 2017
Date
November 21, 2017
1
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC
❑PLUMBING ❑ MECHANICAL
JOB ADDRESS:
City:
Folio/Parcel#:
Miami 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
❑ ROOFING
RECEIVED
NOV 0 ? 2017
FBC 20145
Master Permit No. -) t
Sub Permit No.
❑ REVISION ❑ EXTENSION ❑RENEWAL
El PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
iDuo tz9z4___
Miami Shores County:
Miami Dade
Zip: 0►
I- 2-t.-5--- ti f3 .-Ob D Is the Building Historically Designated: Yes NO
Occupancy Type: Load:
Construction Type:
OWNER: Name (Fee Simple Titleholder):
Address:
City:
Tenant/Lessee Name: Phone#:
Email: V�
Flood Zone: BFE: FFE:
State:
Phone#:V)51: (?r 4 two
CONTRACTOR: Company Name:
Address:
City:
Qualifier Name: Phone#: / M
State Certification or Registration #: Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City:
Value of Work for this Permit: $ 24_ Square/Linear Footage of Work:
State: Zip:
I tt
Type of Work: El Addition 'Alteration
1
Description of Work:
\e‘ tccr0
❑ Repair/Replace ❑ Demolition
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $ —I
Technology Fee $ 2 440 . Training/Education Fee $ 0 • 6o
Structural Reviews $
Permit Fee $
1b3
CCF $ • Bo coicc
Radon Fee $ 2. 7 DBPR $ Z . 4.S Notary $
(Revised02/24/2014)
Double Fee $
Bond $
TOTAL FEE NOW DUE $ t \ 2S
r ti
'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.
WNER or/ ENT
Th - fore oing instrent was a nnowlleddgged before me this
• da 1/.�C/ , 20 1.3 , by
who is person. y known
me or who has produced
identification and who did take an oath.
NO ARY PUBLIC:
\\1111111
as
The foregoing instrument was acknowledged before me this
day of rn , 20 1 , by
o is persona
me or who has
identification and who did take an oath.
NOTARY P BLIC:
\�\\\\11111111111J/11��
*
Sign:
Print:
Seal: `*• �•"
• fiFF 9845
****************4we*ua*# *****************************
//,-4/8LIC, BIPWc"
"111/11111110H�
Sign:
Print:
Seal:
s* • �op ••�
• #F 984571
#,E -e*******************
\\\\\
APPROVED BY
(Revised02/24/2014)
Plans Examiner
Zoning
Structural Review Clerk
STATE OF (FLORIDA)
COUNTY OF (DADE)
The undersigned Affian
Miami Shores Village
Building Department
SURVEY AFFIDAVIT
W141 geal
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
es hereby attest that
(P operty owner) �
The attached survey, performed byj)X2cT',4 L2rGI �
(Name if surve or's company) t �Q l
For address: / 0 f �Zkmody 1 _n�V 1 3�
Performed on 1 ( 13 I 1-1 (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 inspect • s as applicable to this or other permits.
Furthe Affiant/.y eth nau
Pr, serty Ow •r Signa,�re 1 _ Property Owner Printne
SWORN TO AND SU RIBED before me this 4 day of PJiV'2.niki2.X 2�' T—
I?l( Aiue. RrAuel�
Affiant isrsonally known to me, produced
011111111/���
NN esS ROD .z.---fr.r,As!2O20
:*
71'
y #FF 984527�:a��` '•'`7ye0°did 5b��.'
�� 1/111 IS1111\\\\\\
Revised on 5122120091 Revised on 6/12/09
as identification.
IVliami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Notice to Owner — Workers' Compensation Insurance Exemption
Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05
allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to
obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure:
An employer in the construction industry who employs one or more part-time or full-time
employees, including the owner, must obtain workers' compensation coverage. Corporate officers
or members of a limited liability company (LLC) in the construction industry may elect to be
exempt if:
1. The officer owns at least 10 percent of the stock of the corporation, or in the case of
an LLC, a statement attesting to the minimum 10 percent ownership;
2. The officer is listed as an officer of the corporation in the records of the Florida
Department of State, Division of Corporations; and
3. The corporation is registered and listed as active with the Florida Department of
State, Division of Corporations.
No more than three corporate officers per corporation or limited liability company members are
allowed to be exempt. Construction exemptions are valid for a period of two years or until a
voluntary revocation is filed or the exemption is revoked by the Division.
Your contractor is requesting a permit under this workers' compensation exemption and has acknowledge that he or she will not use
day labor, part-time employees or subcontractors for your project. The contractor has provided an affidavit stating that he or she will
be the only person allowed to work on your project. In these circumstances, Miami Shores Village does not require verification of
workers' compensation insurance coverage from the contractor's company for day labor, part-time employees or subcontractors.
BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS
CONTENTS.
Signature:
Owner
State of Florida
County of Miami -Dade
The foregoing was uaclrn '
By 00•,
efore me this
►111110/0,
who is °fug 4 ,me or has produced
as identifica#�r�•• 1-20
day of
Joqjno_0_.
•
* •• �•� :zt _
ti #FF 984527•
i0•`
•°tea eo tb�`•„l�
,/perI, S l�
III
Henry's Fence Inc.
Miami Shores Village
10050 NE 2nd Ave
Miami Shores, FL 33138
Job Address: 1060 NE 92ND Street
Miami Shores, FL 33138
October 25, 2017
I, Henry P. Villoch, president of Henry's Fence Inc, will be the only person installing and
working on this fence project. Should you need any further information, feel free to contact me.
Sincerely,
}f e vu'y P. Vat°,ly
,011111111//1/4,
\\\�� GikpS RODR/G,�t�i//�
fir; 0.• fit=
;#FF 984527
9PyS bldc Unarm•
4%. -c
A° • ..... • 0.0\:,.
\\az I1-
PREPARED BY:
Land Surveyors, Inc.
www.exactaland.com
Toll Free 866-735-1916 • F 866-744-2882
PROPERTY ADDRESS: 1060 NE 92ND STREET MIAMI SHORES, FLORIDA 33138
FIELD WORK DATE: 7/13/2017 REVISION DATE(S): (REV 0 7/14/2017)
1707100
BOUNDARY SURVEY
MIAMI-DADE COUNTY
TABLE:
'0'• COOP, Vet
1/2" FIR
NO ID
L1 S 0'00'00" E 25.00' (P)
S 000'00" E 25.00' (M)
L2 S 8945'00" W 54.33' (M)
LOT 3
1 2" FIR
NO ID
P.R.M.
irDb ,-
001:q 0
Cric0
0:
00
b.9
00 M
b0
0b
(110
0.10 ON
0.8' OFF
rum x cur
•-zs
"
-;‘
failitwirri51
0.
8b
z
I hereby certify
been made un
a true and
Practice set
Chapter 5J-17
1/2"
NO ID
hereon described properly has
"'my knowledge and belief, it is
meets the Standards of
. NOTES:
OIlaISu'verrs & MaPPers in LOT APPEARS TO 8E SERVICED BY CITY WATER AND SEWER
5876
WATERSEDGE SUBDIVISION
P.B. 9, PG 141
/2" F1R
NO ID
WILLIAM E. LUCAS
State of Florida Professional Surveyor and Mapper
License No. 5782
LOT 5
3
FENCE OWNERSHIP Ng; DETERMINED 0 15 .30
GRAPHIC SCALE (In Feet)
1 inch = 30' ft.
Use of This Survey for Purposes other than Intended, Without Written Verification, will be at the User's Sole Risk and Without Liability to the Surveyor.
Nothing hereon shall be Construed to Give ANY Rights or Benefits to Anyone Other than those Certified.
FLOOD INFORMATION:
BY PERFORMING A SEARCH WITH THE LOCAL GOVERNING
MUNICIPALITY OR VVVVW.FEMA.GOV, THE PROPERTY APPEARS TO BE
LOCATED IN ZONE X SHADED. THIS PROPERTY WAS FOUND IN THE
VILLAGE OF MIAMI SHORES, COMMUNITY NUMBER 120652, DATED
09/11/09.
CLIENT NUMBER: 17-1304
DATE: 7/14/2017
BUYER: MANUEL SEBASTIEN REVEIZ AND PAULA ANDREA QUEVEDO
SELLER: ALKAY INVESTMENTS LLC
POINTS OF INTEREST
1. 3' CHAIN LINK FENCE (TYP.) OVER 5' EASEMENT
CERTIFIED TO: MANUEL SEBASTIEN REVEIZ AND PAULA ANDREA DUEVEDO; s
BROKERS TITLE GROUP, LLC; OLD REPUBLIC NATIONAL TITLE
COMPANY; ADVANCIAL FEDERAL CREDIT UNION
This is page 1 of 2 and is not valid without all pages.
Florida Land
F LTA Title Association
AFFILIATE
MEMBERS
zzik C T A
-d Surveyors, Inc
www.exactaland.com
P.066-735-1916 F.866-744-2882
LB* 7337 11940 Fairway Lakes Drive, Suite 1.75. Myers, FL 33913
REPORT OF SURVEY FL1707.1000
This is page 2 of 2 and is not valid without all pages. 1
.-
LEGAL DESCRIPTION:
LOT 4, PLAT OF REPPENHAGEN'S "Cr, ACCORDING TO THE MAP OR PLAT THEREOF, AS RECORDED IN PLAT BOOK 41, PAGE(S) 100, OF THE
PUBLIC RECORDS OF MIAMI-DADE COUNTY, FLORIDA
JOB SPECIFIC SURVEYOR NOTES:
THE ASSUMED BEARING REFERENCE OF SOUTH 00 DEGREES 00 MINUTES 00 SECONDS WEST IS BASED ON THE EASTERLY PROPERTY LINE
OF LOT 4, LOCATED WITHIN PLAT OF REPPENHAGEN'S ACCORDING TO THE PLAT THEREOF, AS RECORDED IN PLAT BOOK 41, PAGE 100
OF THE PUBLIC RECORDS OF MIAMI-DADE COUNTY, FLORIDA.
GENERAL SURVEYOR NOTES:
1. The Legal Description used to perform this survey was supplied by others. This survey does not determine or imply ownership.
2. This survey only shows improvements found above ground. Underground footings, utilities and encroachments are not located on this survey map.
3. If there is a septic tank, or drain field shown on this survey, the location is approximate as the location was either shown to Exacta by a third party or 1,t was estimated by metal detection,
probing rods, and visual above ground inspection only. No excavation was performed in order to determine the exact and accurate location.
4. This survey is exclusively for the use of the parties to whom it is certified.
5. Additions or deletions to th0 survey map and report by other than the signing party or parties is prohibited without written consent of the signing party or parties.
6. Dimensions are in feet and decimals thereof.
7. Due to varying construction standards, house dimensions are approximate.
A Any FEMA Rood zone data contained on this survey is for informational purposes only. Research to obtain such data was performed at www.fema.gov.
9. All corners marked as set are at a minimum a Wdlameter, l8'iron rebar with a cap stamped L887337.
10. If you are reading this survey in an electronic format the information contained on this document is only valid if this document is electronically signed as specified in
Chapter 53-17.062 (3) of the Florida Administrative Code and Florida Statute 472025. The Electronic Signature File related to this document is prominently displayed on the invoice for this survey which is
sent under separate cover. Manually signed and sealed logs of all survey signature files are kept in the office of the performing surveyor. R this document is in paper format
it is not valid without the signature and original raised seal of a Florida Licensed Surveyor.
11. Unless otherwise noted, an examination of the abstract of title was NOT performed by the signing surveyor to determine which instruments, if any, are affecting this property.
12 The symbols reflected in the legend and on this survey may have been enlarged or reduced for darity.The symbols have been plotted at the center of the field
location, and may not represent the actual shape or size of the feature.
13. Points of Interest (POl's) are selected above -ground improvements which may be in conflict with boundary, building setback or easement lines,
as defined by the parameters of this survey.There may be additional POI's which are not shown, not called -out as POrs, or which are otherwise
unknown to the surveyor.These POI's may not represent all items of interest to the viewer.
14. Utilities shown on the subject property may or may not indicate the existence of recorded or unrecorded utility easements.
15. The information contained on this survey has been performed exclusively, and is the sole responsibility, of Exacta Surveyors. Additional logo or references to third party firms are for
informational purposes only.
16. Pursuant to F5.558.0035, an Individual employee or agent may not be held individually liable for negligence.
17. House measurements should not be used for new construction or planning. Measurements should be verified prior to such activity.
LEGEND:
SURVEYORS LEGEND
IJONVIT5, Y/ AICa•0a•n*M0 005119p0W MC MO=
r.
ELF EMIL TAIR
13REE= MX RI4p5[1.096a
•M,C0dePST NOTIESIANT
ne,
0aPx
I a ^R t
=MOM LSI WNW • ONENESS NYS SET NAL • PEE
WOOL • - BURVEYOR SEN. SNARE MET
OYMaI Ko 4R r0•?MA MOW. SLY w
u• M INASIELED ETV. SAW
SAVOR�nacmx
13X4 Cr WA= R GILIMIEL. .F. NEM MAN SIM 500.10
RON MSC! C Old! MIL MI WAWA SIE aeraveLt
CAM 1Y MEE ST. NOT IOWA! TEM ILIOOKALY MOYNE<
cm
04130115•D MI5
SLIMY TI Ile sum
lett arataywll.
•Ort 11162 cue come. on ROVE Er SAM, FARM SR OMIT 100ER
STEM OMER
COM CONCRETE SOM. ORS OFFICIAL MOM BOOR VOIC
Mel 113 i ev.c. CONCEEIL MILL Emil Clxy. OFFICIAL roZIMMVOLL•E Vin, .1.111i9t
ca. ca... uaa OM OVERALL WE MOMS MICE
3unanv tol•••1 ••••••a y ma• 05 OFFSET Mil mom ueransouc �
ISITYLT I/ / A emc.or hit...., a V.F..F MR
OMER I :1.. I°°:MP L> 1pe.FLL ,a
MAIM n mon F7A
DO_ 0.0.1£ AIM MINX EMMERT
9111130LS, sra.•ms
o Mai WOK OA BLOW INTER FLS PIONISOONAL v oa,esm
f assume me MEV F P.00110 my FLIJOXIL SL ORAIINOE MOMENT
SOL ORINACE MOuwmr0SM5.
A mn01.4l1122 057A ELECEEIC 0000 •r
2/7 0:11•,1011 woernr �w
• cnRlla POW
• COMMIE 1•3111.••31T
vete • M• UL WOMAN &PM MAT
wol reel M WPM
LYE era•tlde0uf.
HIOrXE
Cr rA mprwf ILASELNANCE owm.•xr
FIR FOUND P. ROD FT FONT OF WEND.
• no Qxr101.rr •w
C- ala•ee Olt/ MOR
0 WAN= MEE FOUNDS. MO MSC
e sea SILL EENVINA UNMAN(
S.M
®MEW FOAM MI MILS PSC SIMIEW
mu O....opp. LAE TOINOLOSIGIL LIMEY MN.
40500 lOR N01L 5..", ,•e u• uruwrwemar
OARAOE
M OAS WWI sot SOILS
ELECTRONIC SIGNATURE:
In complete accordance with Florida 5,amte 4020250nd Pursuant to
the Electronic Signature Act of 1996 or Florida Statute 1111,E 00010,
Chapter668, if ,his document was received electronically via PDF,
Then it has been lawfully Hecrmnk ly Signed. Therefore, 09 survey
1 PRINTING INSTRUCTIONS:
1. While viewing the survey in Adobe Reader, select the
"Print" button under the `Fie" tab.
OFFER VAUD ONLY FOR:
MANUEL SEBASTIEN REVEIZ AND PAULA
ANDREA QUEVEDO
PDF,taurhentichcornp49r4orfimland Insurable. In order to validate
POF surs sent vie Aver...nven.Ltars.cmt,
Me -Demonic Sigatue&y
hash free hash is for
2. Select a printer with legal sized paper.
3. Under"Print Range", dick select the "All" toggle.
_
E
I
you must use a calculator. A calculator available
dombadar
4. Under the "Page Handling" section, select the number
=AC
wwnr.+.eeaw...-, 0.900,",.---u."o"_..rutn s alcwaarx,all,."a
In orderro validate rhe Elecrroek Signature of any survey PDF sew Ma
wwwwneyyrtarscmr:
I Download me Hast Cakslaroravalade at
...dosaWgf' Ieayry9eaeMA1•e:akuMtw-xxI Mml
of espies that you would lie to prim.
k
5. Under the "Page Scaling" selection drop down menu,
select "None."
I
25%Off 'I
Survey 2.5ave me PDF onto your computer frm...survey...on)
wham the email sero from wwwwrwyslarscom.
3. Click Mcomer e square Browse button In the upper right hand coer of the
HadiCaku tato9rdaroslectthes,wd5,.,eyPDFkkxtoror.,arade
t eCOMPlflE button in the lowerngmt hMtlmnerofthe HashCakuIaror.
n,
orCooaredx40digt ming In the SHA -1 line to the AO digit
SHA -1 characters {or the survey inthepb file lnwzw.u.uysoncan which
is also printed on the invoice for that sury.
6. Un}heck the "Auto Rotate and Center"dtedkbox.
7. Check the 'Choose Paper size by PDF` chedkbox.I
8. Click OK to pnnt.
TO PRINT IN BACK* ITE
1. In the main print screen, choose 'Properties`.
I
(UP TOE500)
F U T U R E
SURVEYING SERVICES I
ON TI -IIS PROPERTY*
• Offer aid for rem aaeaM. res Wren to Ore eawMg muaurnOIr.
s. rrre4odgtstring ofSPN'I characters arc mealy the same onme invoice2.
thndex.wylka,wtcnvveSOlSgO imday aein sting cesotes tmaw,
Choose'Oualiry'from the options.
3. Change from "A,ttoColgror "Full Colorto
"Gray Scale".
1l
y
f 4
r
exacNisheFiswulwcdbeeoamperedMhanditsHwInotmatl,
eaady, then this PDF has been tampered sum 0011115 not authentic.
-.-.....-....-•-...-....--...-.....J
j� Exacta Land Surveyors. Inc. www.exactaland.com
p P.866-735-1916 • F.866-7442882
E C T A L68 7337 11940 Fairway Lakes Drive, Suite 1. Ft Myers, FL 33913