FW-17-2173Project Address
Miami Shores Village
10050 N.E. 2nd Avenue N
Miami Shores, FL 33138-0000
Phone: (305)795-2204
9518 N MIAMI Avenue
Miami Shores, FL
Owner Information
MIGUEL TEMBLADERA
Address
Issue. Date: 8/2'
Parcel Number
1131010330460
Block: Lot:
9518 N MIAMI Avenue
MIAMI SHORES FL 33150-1717
620 SW 10 Street
MIAMI FL 33130-
Expiration: 02/25/2018
Applicant
MIGUEL TEMBLADERA
Phone
Valuation:
Total Sq Feet:
Approved:
Comments:
Date Approved: :
Date Denied:
Type of Construction: Wood Fence
Classification: Residential
Additional Info: REPLACING WOOD FENCE- HORIZ
Scanning: 3
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Notary Fee
Permit Fee - Wire & Wood
Scanning Fee
Technology Fee
Total:
Amount
$2.40
$2.55
$2.55
$0.80
$5.00
$170.00
$9.00
$3.20
$195.50
Pa
Inv
08/29/2017
08/29/2017
7
I,
Credit Card
Credit Card
Amt Paid Amt Due
$ 50.00 $ 145.50
$ 145.50 $ 0.00
Cell
Available Inspections:
Inspection Type:
Final
Foundation
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 ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that,ll the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. F lihermoxe, I authorize the above -named contractor to do the work stated.
re: Owner / Applicant / Contractor / Agent
August 29, 2017
Date
Building Department Copy
August 29, 2017 1
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
RECEIVED
AUG 2412017
FBC20 q
BUILDING Master Permit No. r-A) 7R3
PERMIT APPLICATION Sub Permit No.
BUILDING ❑ ELECTRIC ❑ ROOFING U REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 9 D (\) K(\) S' I -A OQ S - ‘ S t 7
City: Miami Shores County: Miami Dade Zip: 3 3 / S ()
Folio/Parcel#: 1 1 0 033 _ V 67 0 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): NI I G a t ` L 13 Phone#:
Address: g5iS r IM(FM 1 �.)
City: t "t %t' \ S t4 O Q State: Zip: 7 / Su
Tenant/Lessee Name: Phone#:
Email:
305 305 / iq
CONTRACTOR: Company Name: 11dmC 0t3ncr Phone#:
Address: �O
City: State: 1\00 Zip:
Qualifier Name: Phone#:
State Certification or Registration #:. Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: ,,_tux, City: State: Zip:
Value of Work for this Permit: $ X 1/ U Square/Linear Footage of Work: 1C / 9 0 ' J.
Type of Work: ❑ Addition i I Alteration Ti New ❑ Repair/Replace Ti Demolition
Description of Work:
ccpi061 wccd r-'ncr - t�2dA,i4l
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 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
Signature
OVGNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
pp 28 day of AOC(\U'?4 , 20 I-1 , by day of , 20 , by
M; u.€ t A . 1(1rb n'a((Q, who is personally known to , who is personally known to
me o? who has produced D (1V"Q( [ i C�Q 1'\S'-Q as me or who has produced as
identification and who did take ari i5kR:-- identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
}• 1 ADY PRIETO
_ MY ISSION # FF 214031
EXPIRES: March 25, 2019
.. .........Bonded Thru an/ Public Underwdbru
NOTARY PUBLIC:
Sign:
Print:
Seal:
**************************,ti.re**ekx>f>�***************************************************************
APPROVED BY ( 1/ ' Plans Examiner Zoning
(Revised02/24/2014)
Structural Review Clerk
•
I,
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 11
NAME: (v'\It2LEt T E1,`A (L(\ `iE?S DATE: 0 + ' �� � T
ADDRESS: -Is I s N MU A\ ` \ rvy ► 3 4 (2 FL- 1160
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 /
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 /" 1
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
5. I understand that, as the owner -builder, I must provide direct, onsite supervision of the construction. /�
Initial ► " i
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
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 ' 1
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
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:
Initial
1,4
12. '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 28" day of 20 \1
By N1 C. vcl TCmAAGdCrO
(
Produced there License or
ER
who was personally known to me or who has
76„ rev U Cie nS-�
as identification.
.a
NOTARY
: i� t4 YANADY PRIETO
• les MY COMMISSION # FF 214031
$ A d EXPIRES: Bonded Thru Notary Public Underwr ers
Miami Shores Village
Building Department
SURVEY AFFIDAVIT
STATE OF (FLORIDA)
COUNTY OF (DADE)
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
The undersigned Affiant, Ell LA Otil,ftloes hereby attest that
(Property owner)
The attached survey, performed by
(Name of surveyor's company)
For address: �S Sc tJ t-Itheil l awl i 5 t-1 DAIS 3
Performed on II J2Ejl3s (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,, iant swath naught.
4/
Propert 1'Owner Signature
SWORN TO AND SUBSCRIBED before me this 2S rv' day of
Affiant is personally known to me, V produced•riv`Pv 1i v1S as identification.
1v04, l ernb\adra
Revised (6/25/12)Revised on 5/22/2009/ Revised on 6/12/09
Property Owner Print Name
Notary
;..+Y'PG.., YANADY PRIETO
,, 4; MY COMMISSION # FF 214031
EXPIRES: March 25, 2019
�: a °'' Bonded Thru Notary Public Underwriters
Property Search Application - Miami -Dade County
Summary Report
Property Information
Folio:
11-3101-033-0460
Property Address:
9518 N MIAMI AVE
Miami Shores, FL 33150-1717
Owner
MIGUEL TEMBLADERA
Mailing Address
620 SW 10 ST 404
MIAMI, FL 33130 USA
PA Primary Zone
1000 SGL FAMILY - 2101-2300 SQ
Primary Land Use
0101 RESIDENTIAL - SINGLE
FAMILY : 1 UNIT
Beds / Baths / Half
3/1/0
Floors
1
Living Units
1
Actual Area
Sq.Ft
Living Area
Sq.Ft
Adjusted Area
1,109 Sq.Ft
Lot Size
9,750 Sq.Ft
Year Built
1937
Assessment Information
Year
2017
2016
2015
Land Value
$204,057
$204,057
$150,699
Building Value
$73,327
$73,327
$73,327
XF Value
$750
$760
$616
Market Value
$278,134
$278,144
$224,642
Assessed Value
$81,896
$80,212
$79,655
Benefits Information
Benefit
Type
2017
2016
2015
Save Our Homes
Cap
Assessment
Reduction
$196,238
$197,932
$144,987
Homestead
Exemption
$25,000
$25,000
$25,000
Second
Homestead
Exemption
$25,000
$25,000
$25,000
Civilian Disability
Exemption
$500
$500
$500
Note: Not all benefits are applicable to all Taxable Values (i.e. County,
School Board, City, Regional).
Short Legal Description
MIAMI SHORES SEC 6 PB 10-39
LOT 4 & N1/2 OF LOT 5 BLK 131
LOT SIZE 75.000 X 130
COC 23761-4496 09 2005 6
Page 1 of 1
Generated On : 8/28/2017
Taxable Value Information
2017
2016
2015
County
Exemption Value
$50,500
$50,500
$50,500
Taxable Value
$31,396
$29,712
$29,155
School Board
Exemption Value
$25,500
$25,500
$25,500
Taxable Value
$56,396
$54,712
$54,155
City
Exemption Value
$50,500
$50,500
$50,500
Taxable Value
$31,396
$29,712
$29,155
Regional
Exemption Value
$50,500
$50,500
$50,500
Taxable Value
$31,396
$29,712
$29,155
Sales Information
Previous
Sale
Price
OR Book -
Pa a
9
Qualification Description
05/11/2017
$262,300
30533-
4076
Federal, state or local government
agency
12/14/2007
$37,400
27419-
1088
Sales which are disqualified as a result
of examination of the deed
09/01 /2005
$57,341
23761
4496
Other disqualified
03/01/2005
$0
23171-
4974
Sales which are disqualified as a result
of examination of the deed
The Office of the Property Appraiser is continually editing and updating the tax roll. This website may not reflect the most current information on record. The Property Appraiser
and Miami -Dade County assumes no liability, see full disclaimer and User Agreement at http://www.miamidade.gov/info/disclaimer.asp
Version:
http://www.miamidade.goy/propertysearch/
8/28/2017