ACT-16-2788Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
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Permit NO. ACT -10-16-2788
Permit Type: Avvrtings/Canopies/Tents
Work Classification.: Repair
Permit Status: APPROVED
Issue Date: 10/19/2016
Expiration: 04/17/2017
Parcel Number
Applicant
270 NE 104 Street
Miami Shores, FL 33138-2016
1121360130320
Block: Lot:
JOESPH BASSETT
Owner Information
Address
270 NE 104 Street
MIAMI SHORES FL 33138-
270 NE 104 Street
MIAMI SHORES FL 33138 -
Phone
Cell
Valuation:
Total Sq Feet:
$ 1,250.00
0
Approved: In Review
Comments:
Date Approved:: In Review
Date Denied:
Type of Work: RE-COVER AWNING IN FLORIDA ROOM
Classification: Residential
Code Comments: :
Code Denied:
Additional Info: RE-COVER AWNING IN FLORIDA R(
Color Approved: In Review: In Review
Code Approved: : In Review
Scanning: 3
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Notary Fee
Permit Fee
Scanning Fee
Technology Fee
Amount
$1.20
$2.00
$2.00
$0.40
$5.00
$100.00
$9.00
$1.60
Total: $121.20
Pay Date Pay Type Amt Paid Amt Due
Invoice # ACT -10-16-61651
10/19/2016 Credit Card $ 71.20 $ 50.00
10/14/2016 Credit Card $ 50.00 $ 0.00
Available Inspections:
Inspection Type:
Final
Review Planning
Review Planning
Review Planning
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 all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for LECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS A
construction
[DAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
d -,'Hing. _ uth e, I authorize the above-named contractor to do the work stated.
October 19, 2016
Auth • • ed Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
Date
October 19, 2016
1
Ac* WZ2M
q ea /6/46
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
OCT 14 2016
5
FBC 2o11/44
Master Permit No. AO- 1(o • 29-33
Sub Permit No.
'BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 2 .o N \o �l
City: Miami Shores
County:
Miami Dade Zip:
Folio/Parcel#: 11 Z t 3(' 0 1 303 ZC. Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): "To S Phone#: o S - 9. $ (- hS Zfi
Address: "?...9-0 tJ`Z._ lo'4 S`t
City: .a. • S 1104--41 S State: 'FL Zip: 3 "? ( 3
Tenant/Lessee Name: • A . Phone#:
Email: T'4 '�,45•S�i%� Gw. ��L_. Cry v"�
CONTRACTOR: Company Name: iu . / -. 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: $ (,1 -CO Square/Linear Footage of Work: S 2�
Type of Work: ❑ Addition ❑ Alteration
❑ New ® Repair/Replace ❑ Demolition
Description of Work: t) Z f•- t'. IJ\ - cu.-) 1 'FiGAA DA acuu"
Specify color of color thru tile: -Mwva-w � -"A AMC' SOO SC A-1----. 6 -n -Ey So (a
Submittal Fee $ Permit Fee $ L 03 • C3 CCF $ I . 2-0 CO/CC $ P
Scanning Fee $ 1 Radon Fee $ vZ • 0,,SS DBPR $ a ' Notary $ S - 0
6
Technology Fee $ ;( .d Training/Education Fee $ 0 • (4 0 Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ T( ` ZO
(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 n t be approved and a reinspection fee will be charged.
Signature j ► _ Signature
OWNER or AGENT CONTRACTOR
The foregoing ins? ument was acknowledged before me this The foregoing instrument was acknowledged before me this
l day of Jo) r, 20 I 6 , by day of , 20 , by
765'zpi-( 7 --6pSScr'Sho is personally known to , who is personally known to
me or who has producedt-L .DONN-e- L.0.04Stas me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY; BLIC:
Sign:
Print: SI
Seal:
'00 •
Y PO4, Notary Public State of Florida
Sindia Alvarez
My Commission FF 156750
Expires 09/03/2018
orf%
*
*
* ** * *
NOTARY PUBLIC:
Sign:
Print:
Seal:
**************************************************************
APPROVED BY Plans Examiner/00Zoning
Structural Review Clerk
(Revised02/24/2014)
-ems G6 r .c1P9r---'kruo 1,
ld`RV-•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:—So%1_(?a SSS c\ DATE: to - I - - 1(0
ADDRESS: 20 iv `c ►e�l� Si
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. 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 5 •
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 •
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 J' •
5. I understand that, as the owner -builder, I must provide direct, onsite supervision of the construction.
Initial c� .7S'
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.
Initial '3
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
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 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.
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 "-S•
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.myfloridalicense.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:
Z90 N L 1OA Sri , vy'4311/211 'C3 L 33 3$
Initial 2 •
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
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 ( 6
By UGSI`P{-k- R _BP SST
who was personally known to me or who has
Pr.duced there License or F -1---12)2t-42- L-ICJCNSE/
as identification.
OWNER
NOTARY
Of Poe` Notary Public State of Florida
Sindia Alvarez
c My Commission FF 156750
'oi #' Expires 09/03/2018
N.E. 104th STREET
75.0' R/W •
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BLOCK 119 POOL
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15.0' ALLEY (P)
(IMPROVED)
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ETV S
OCT 142016
LBY:
152.05' (P)
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FOUND 1/2"
IRON PIPE
BLOCK CORNER
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$URVEY NOTES
CONCRETE WALK CROSSING
PROPERTY BOUNDARY ON
NORTHERLY SIDE OF LOT
THERE ARE FENCES &
CBS WALLS NEAR THE
BOUNDARY OF THE PROPERTY
d FOUND 1/2"
IRON PIPE
A1= 90'12'15" (P)
A2= 89'47'45" (P)
A3= 90'14'30" (P)
A4= 89'45'30" (P)
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(SIGNED)
PAGE 2 OF 2 PAGES
BOUNDARY SURVEY
SURVEYORS CERTIFICATE
I HEREBY CERTIFY THAT THIS BOUNDARY SURVEY
IS A TRUE AND CORRECT REPRESENTATION OFA
SURVEY PREPARED UNDER MY DIRECTION.
NOT VALID WITHOUT AN AUTHENTICATED ELECTRONIC
SIGNATURE AND AUTHENTICATED ELECTRONIC SEAL,
OR A RAISED EMBOSSED SEAL AND SIGNATURE.
I.* coned by Gybe O.
Clyde OCCN . Clyde �,
McNealSurveying0.5.2015.0061205:42-04.00
CLYDE 0. McNEAL, PROFESSIONAL SURVEYOR AND MAPPER #2883
LB #7893
TARGET
SURVEYING, LLC
SERVING ALL FLORIDA COUNTIES
6250 N. MILITARY TRAIL, SUITE 102
WEST PALM BEACH, FL 33407
PHONE (561) 640-4800
FACSIMILE (561) 640-0576
STATEWIDE PHONE (800) 226-4807
STATEWIDE FACSIMILE (800) 741-0576
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LIc.#07BS01223
',CPI 1799
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E.11 Ave. Hialeah, FL 33010
O. 305-681-7727
1 N G Fax: 305-888-0882
Professional Quality & Service
www.megaawning.com t
Guaranteed E-mail: info@megaawning.com Date: ,' r r --1 ; / /
Proposal Submitted To: '..--
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Address
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acceptance of Vroposai
The above prices, Specifications and conditions are satisfactory and are Signature
hereby accepted. You are authorized to do the work as specified.
Payments will be made as outlined above. Sales Representative
Date of Acceptance Signature
Buyer or Buyer's Authorized Agent
Patio 500®
Description:
Weight:
Width:
Transparency:
Abrasion Resistance:
Dimensional Stability:
Flexibility:
Flame Resistance:
Specifications
Vinyl laminated on a woven synthetic fabric.
17.5 oz. per lineal yard
61 inches / 154.94 centimeters
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Meets California State Fire Marshall Title 19, NFPA-701-"
99 (Large Scale) ASTM E84 -81A Flame Spread Rating
Class A (15)
Mildew Resistance: Excellent
Chemical Resistance: Excellent
Water Repellency: Excellent - Water Proof
Oil Resistance: Excellent
Sewability: Excellent
Heat Sealability: Excellent. Can be sealed by hot air weg welder or radio
frequency bar type.
,<HERCULITE'
Powered by Innovation • Proven by Performance
P.O. Box 435, Emigsville, PA 17318 USA
717-764-1192 800-772-0036 Fax: 717-764-5211
www.herculite.com EMAIL: customercare@herculite.com
Lic. # 076501223
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Professional Quality & Service
www.megaawning.com
Guaranteed E-mail: info@megaawning.com Date:
Proposal Submitted To:
Fabric Number
Color
Address
Valance Style
Length
Binding Color
Aplique
Ph:
Cell:
Fax:
PRICE
We hereby submit specifications and estimates for:
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RCCeptaure of Vropo at
The above prices, Specifications and conditions are satisfactory and are Signature
hereby accepted. You are authorized to do the work as specified.
Payments will be made as outlined above. Sales Representative
Date of Acceptance Signature
Buyer or Buyer's Authorized Agent
TERMS AND CONDITIONS
1. The signature of purchaser to MEGA AWNING the original (white copy with appropriate
50% deposit constitutes acceptance and convergence of this estimate into a contract.
2. Where goods, after delivery, are destroyed by fire, theft or accident or other causes, the
purchaser agrees to insure the goods set forth in this order for the benefit of the vendor
as his interest may appear.
3. This order constitutes the entire agreement between the purchaser and vendor, no
representations or agreements have been made other than as herein stated.
4. The purchaser agrees to pay all costs incurred for collection including reasonable
attorney fees.
5. Goods sold manufactured, and/or delivered to the purchaser named in this order,shall
remain the property of the vendor MEGA AWNING until the specified contract price has
been paid in full the said vendor reserves the right to respossess the goods stipulated
herein upon default of payment of any portion of this contract.
6. Contract price is due in full upon completion of work, thereafter, interest on any unpaid
balance will accrue at the rate of 1 1/2% per month.
7. This material is specially manufactured and ordered for the purchaser:this order is not
subject to changes unless by written agreement between the purchaser and vendor.
8. All work is subject to strikes,accidents,and other delays beyond the vendor's control.
9. The purchaser has agreed to obtain the permits for said products stated herein and has
agreed to execute his/her rights as an owner -builder unless specifically charged
separatelyfor.
10. This order shall not be binding upon MEGA AWNING until accepted by its president, or
other authorized officer hereof.
11. It is understood and agree that responsibility for corrections, and/or adjustments
ceases with MEGA AWNING following 30 days after the date of completion of its work.
12. Prices quoted are guaranteed for 30 days.
13. MEGA AWNING agrees to have product(s) described herein ready for delivery and or
installation within; from date your particular choice in color of
material arrives at our shop.
Thanks for selecting MEGA AWNING for your awning needs