DEMO-17-2383Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
9801 NE 1 Avenue
Miami Shores, FL
Owner Information
Permit
Permit NO. DEMO -1'0-17-2383
Permit Type: Demolition
Work Classification: Building
Permit Status: APPROVED
Issue Date: 10/13/2017
Expiration: 04/11/2018
Parcel Number
Applicant
ADELMO AND MARTA GIUSTI
Address
1132060132290
Block: Lot:
9801 NE 1 AVE
MIAMI FL 33138-2306
ADELMO AND MARTA GIUSTI
Phone
Cell
Contractor(s)
HOME OWNER
Valuation:
Total Sq Feet:
$ 500.00
220
Type of Demo: Building
Additional Info: DEMOLITION OF EXISTING WOOD DECK
Classification: Residential
Scanning: 3
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Notary Fee
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$0.60
$2.00
$2.00
$0.20
$5.00
$100.00
$9.00
$0.80
$119.60
Pay Date Pay Type Amt Paid Amt Due
Invoice # DEMO -10-17-65250
10/13/2017 Credit Card $ 69.60 $ 50.00
10/05/2017 Credit Card $ 50.00 $ 0.00
Available Inspections:
Inspection Type:
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 for ;f ork done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL, PLUMB! MECHA L, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AF
construction
DAV : I
nd ing.
rtify tha - II e f
uther = e, u •�
ng information is accurate and that all work will be done in compliance with all applicable laws regulating
the above-named contractor to do the work stated.
u horized Signature: Owner / Applicant / Contractor / Agent
Bu ding Department Copy
October 13, 2017
Date
October 13, 2017 1
BUILDING
PERMIT APPLICATION
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
❑BUILDING ❑ ELECTRIC ❑ ROOFING
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS
JOB ADDRESS: 1/6/ NN`E. `5 r AVE,
Master Permit No.
Sub Permit No.
❑ EXTENSION ❑ RENEWAL
❑ REVISION
❑ CHANGE OF
CONTRACTOR
RECEIVED
OCT 057017
C4-4(1
k1
FBC201LI
Or(
❑ CANCELLATION ❑ SHOP
DRAWINGS
City: Miami Shores County: Miami Dade
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood
: Flood Zone:
OWNER: Name (Fee Simple Titleholder): AD F /. /Y1 a 6—r l t t Phone#:�. 757 r080
Address: 9 / . GST 4VVC .
zip:3� t 3 8
BFE: FFE:
City:/'fi*i f(; 5'6/0 oS State: tf.1 •
Tenant/Lessee Name: Phone#:
Email:
Zip: 33 (3 6
CONTRACTOR: Company Name: ay ( w
Phone# 757 Wee-)
Address:96Ol/JE /ST' Tt V
City:/.' Z/ S(64070S State: Zip: 33 (3
Qualifier Name:
Phone#:
State Certification or Registration #: Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 6-00 Square/Linear Footage of Work: 2_2-c' 2 -
Type
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace I, Demolition
Description of Work: 7i./n Oi-/ T c9X)
>e(51"; oA✓a. E_c
Specify color of color thru tile:
Submittal Fee $ 5 6 `CfC/� Permit Fee $ l Jb . co CCF $ 0 - GT) CO/CC $ 9
Scanning Fee $ ci - q Radon Fee $ Z- - DBPR $ 2 Notary $ ES - C.. -
Technology
Technology Fee $ 6 1 W Training/Education Fee $
Structural Reviews $
(Revised02/24/2014)
D - 2-d Double Fee $
Bond $ /
TOTAL FEE NOW DUE $/ 00
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 a er the building permit is issued. In the absence of such posted notice, the
inspection will not be: •roved and_:.raz: pecti. fee 111 be charged.
41111
Signature . / Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this
The foregoing instrument was acknowledged before me this
5 day of 00- , 20 l , by day of , 20 , by
'41 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:
AtKpmeoi
Prin
Seal:
* -,•
,*: MY COMMISSION # GG 044602
. EXPIRES: November 2, 2020
Q� ;o; Bonded Thru Notary Public Underwriters
********************************
APPROVED BY
(Revised02/24/2014)
*
Sign:
Print:
Seal:
***************************************************************
Plans Examiner Zoning
Structural Review Clerk
NAME:
OWNER BUILDER DISCLOSURE STATEMENT
DT C f l0 C rd ,g7'L
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
DATE: //7 17
ADDRESS: / I - G Sr/41V-e- 5646kez L 1,
Do hereby petition the Village cf 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. I 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 A
C.Z,
3. I 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 OR C�
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 n
5. 1 understand that, as the owner -builder, I must provide direct, onsite supervision of the construction.
Initial
6. I 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. /ry
Initial , 6-
.
v.
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 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 A. �•
8. I 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 m ust 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. I 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 /-CQQ
G..
10. I 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/cilb/index.html
Initial
11. I 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:
'SO(/UF. ! r1q✓r', S SS 33( 8
Initial /71-6-
12. I 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 C--.
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
By Ns.irm h� USS
Produced
OWNER
day of OL -k- , 20
who was personally known to me or who has
as identification.
NOTAR
•...... "••. MAHARAI K. GONZALEZ
MY COMMISSION # GG 044602
EXPIRES: November 2, 2020
tsfr tito Bonded 'Mu Notary Public Underwriters
MAP OF BOUNDARY SURVEY
253
Miami Shcres Village
APPSROVED
BY
DATE
ZON UG DEPT
BLDG DEPT
(d
SUB,=CT 10 CCMPLIANCE WITH ALL FE RAL
STAT = ANL) ( IJN-IY aULES AND REUULATONS
7
<ECEIVED
OCT 0 5 2017
4(
SCALE : 1"=20'
60' TOTAL R/W
•
•
• . .
.. .
.
....
• .
....
. .
• .
• ..
.. •
•
.
....
•
•
.
•
• .
• •••
. • •
•
•
.
.
•
• .
•
•
•
ELECTRIC UNE
25.40'
NO• CAP)
l—CN UNE
4.95'
14.70'
►S1
EPS -
C
0
8.00'
2 STEP
ONE STORY
RES, #9801 NE 1 AVE.
MIAMI, FL 33138
8.00
on
m
of;
10•
=25.0 t'
=39.29
90'03'20"
S
Lti
A
.9
r qs,4
—0.50' CL
F.I.P. 1/2'
(NO CAP
I P,' 1/2"
�. jt3n rAo) •
SIiEWAL
23.40' PARKWAY
7
BASIS OF BEARING. SYSTEM WHEN. SHOWN REFER TO:
TYPE OF SURVEY; BOUNDARY
SCALE: 1 " = 20'
PROPERTY ADDRESS: 9801 NE 1st AVE., MIAMI, FLORIDA 33138
SOURCE OF LEGAL DESCRIPTION -
LEGAL DESCRIPTION
LOT 15 AND THE WEST 1/2 OF LOT 16 BLOCK 17
SUBDIVISION AN AMENDED PLAT OF MIAMI SHORES SECTION No. 1
ACCORDING TO THE PLAT. THEREOF AS RECORDED IN PLAN" BOOK :•11j• ALP.Q,GE_
OF THE PUBLIC RECORDS OF MIAMI—DADE COUNTY, FLORIN. • ••
••
z
t N.E. 99th S
55.90'
50.00'
13'
50.00'
15'
50.00'
120
O
50.00'
50.00'
11
L L E 50.00'
0
54.00'
10Q
50.00'
50.00'
0
92
50.00'
•
. • •
• . .
• .
••••
.•..
• • . .•
..•• .. •
••.
• .
• •
• . .
.• •
FLOOD ZONE INFORMATION
LOCATION SKETCH
• •••..
A_ inn'
1.COMMUNITY NUMBER”
120652
-2.PANEL NUMBER
093
3.SUFFIX
J
4.DATE OF FIRM
0717/95
5.FIRM- ZONE
X
6.BASE FLOOD ELEVATION
N/A
ABBREVIATIONS & LEGENDS
A - ARC DISTANCE CT.- COURT F.N.D.- FOUND NAL & DISC. O.V.FL- OVERHANG. RAA- RADIILL. U.E.- UTILITY E
AC - AIR CONDITIONER PAD CDH - CUT DRILL HOLE FR - FOUND RE -BAR O.W:- OVERHEAD WIRES. RB - RADIAL BEARING U.P. - U111.17Y 1
ASPH - ASPHALT D - DEED FRA - FRAME P - POUT RD.- ROAD. WILL - UTILITY
0 - BEARING DIST - DISTANCE FT- FEED PAYNE - PAVEMENT REC.- RECORD. W.- WEST
88 - BEARING E.- EAST H - IEIOIT (HI04). P.B.- PLAT BOOK. RES.- RESIDENCE. W/F- WDDD FE
BLDG.- M
am BUILDING
UILDI NARD EUV- - ELEVATION - HWY - HIGHWAY P.C.- POINT OF CURVATURE. ROE- RANGE. % - RIMIER E
BM- BDICIYARK ENG- ENCROACHLFE = LONEST FLOOR"E1EVAI,ON ROA- POINT OF BECBMtNG NW.-RK,HT OF WAY. VIRE- MARE Fp
U4.- LANE. P.O.C.- POINT OF COMPOUND Rk
C:- CUM ESMT.- EASEMENT MSI. - LEAN SEA LEVEL CURVE mum - CENTRAL A
CS.- CATCH BASIN ETP.- ELECTRIC MEAS.- MEASURE P.G.- PAGE. S - SOUTH
C.B.S - CONCCRETE BLOCK TRANSFORMER PAD Mop - MONUMENT PKWY.- PARKWAY. S P. SET � PIPE.
STRUCTURE F -FOUND. M/L- MONUMENT UNE PL-- PLACE S.N.D.- SET NAIL & DISC.
CO - CURB & GUTTER F.D.H - FOUND DRILL HOLE M/S.- METAL SHED. P/L - PROPERTY UDE SP - SREENED PORCH
qR - CHORD D DISTANCE F.F.E-ESN FLOOR ATIONN.- NORM PLA - PLANTER STY - SOY
CHB- CHORD BEARING FH- FIRE HYDRANT NGVD - NATIONAL GEODETIC PRM - PERMANENT REFERENCE 371K.- =EWAN
CL- CLEAR El P- FOUND IRON PIPE VERTICAL DATUM MONUMENT T.- TANGENT.
No.- NUMBER. PSM - PROFESSIONAL SURVEYOR TERR.- TERRACE
FOUND NAIL 26:: CENTER- UNE EN. -• - DIAMETER NTS - NOT TO SCALE &APPER TAP: T TYPICAL :
O.R.B.- OFFICIAL RECORDS BOCK. R - RAMS TYP - TYPICAL
CS - CONCRETE SLAB
NOT VALID. WITHOUT THE SIGNATURE. AND THE ORIGINAL RAISED SEAL OF A FLORIDA. LICENCED. SURVEYOR AND MA
Examination of the abstract of title will have to be made to determine recorded instruments, if
any affecting the property. Location and identification of utilities on and/or adjacent to the
property were- not secured as such information wasnot requested. ownership is subject to
opin on of title. Underground foundation and utilities not located. The survey depicted here le
not covered by professional liability Insurance.
PSM
STATE
DATE
%RVEY
NO. JOSE A. DIAZ 27E
OF- FLORIDA
OF FIELD
01/03/2006
cn
rn
x
DATE:
DATE
— --�
DATE:
c
FOR: ADELMO. GIUSTI and
DATE:
JOSE A. DIAZ
11865 SW 26th. ST.
PROFESSIONAL SURVEYOR BUILDING I
14
AND MAPPER MIjAMI, FL 33175
CERTIFICATE NUMBER LS 2798 PH.(305)267-9016
wife MARTA
ORDER
DRAW
NO 25-16247
BY. LA.N