RC-18-838Miami Shores Village
10050 N.E. 2nd Avenue NW
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Pe
mit
Permit NO. RC-3-18-838
Permit Type: Residential Construction
Work Classification: Alteration
Permit Status: APPROVED
Issue Date: 4/18/2018
Expiration: 10/15/2018
Parcel Number
Applicant
53 NW 99 Street
Miami Shores, FL
1131010180500
Block: Lot:
DENISE DELGADO
Owner Information
Address
Phone
Cell
DENISE DELGADO
53 NW 99 Street
MIAMI SHORES FL 33150-
(646)573-2213
53 NW 99 Street
MIAMI SHORES FL 33150-
Contractor(s)
HOME OWNER
Phone
Cell Phone
Valuation:
Total Sq Feet:
$ 950.00
72
Approved: In Review
Comments:
Date Approved: : In Review
Date Denied:
Type of Construction: LEGALIZATION OF 12 X 6 PATIO C
Stories:
Front Setback:
Left Setback:
Bedrooms:
Plans Submitted: No
Certificate Date:
Bond Return :
Occupancy: Single Family
Exterior:
Rear Setback:
Right Setback:
Bathrooms:
Certificate Status:
Additional Info:
Classification: Residential
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$0.60
$2.00
$2.00
$0.20
$100.00
$3.00
$0.80
$108.60
Pay Date Pay Type Amt Paid Amt Due
Invoice # RC-3-18-66993
04/18/2018 Credit Card $ 58.60 $ 50.00
03/30/2018 Credit Card $ 50.00 $ 0.00
Available Inspections:
Inspection Type:
Window Door Attachment
Framing
Insulation
Drywall Screw
Final PE Certification
Window and Door Buck
Fill Cells Columns
Review Building
Review Planning
Review Electrical
Review Plumbing
Review Structural
Review Mechanical
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 all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhe more, I authorize the above -named contractor to do the work stated.
rized ig atu-7 -1- - i' / Applicant / Contractor / Agent
April 18, 2018
Date
Building Department Copy
April 18, 2018
1
Submittal Fee $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ 4 Double Fee $
Structural Reviews $ Bond $
BUILDING
PERMIT APPLICATION
Ej BUILDING ❑ ELECTRIC
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
Master Permit No.
Sub Permit No.
❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
RECEIVED
MAR 30101
S
FBC 2o\u
2C- t 8"83S
❑ PLUMBING ❑ MECHANICAL ❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
JOB ADDRESS: W 941 Sweet -
City: Miami Shores
County:
CONTRACTOR DRAWINGS
Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO i(
Occupancy Type:
Load:
Construction Type: Flood Zone:
BFE: FFE:
OWNER: Name (Fee Simple Titleholder): JL`til ) is /IVO Phone#: 646 Gel3 ZZ 13
Address: S3 NU - °1 9 �j
City: 1 W i�YO ( s State: �� Zip: 7:)Lc
Tenant/Lessee Name: Phone#:
Email:
D NI.SWM(DELi 0 6--A4 Os -Yin
CONTRACTOR: Company Name: 1 /l-e-Ow7ltE4 • 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: $ Square/Linear Footage of Work:
Type of Work: ❑ Addition . ❑ Alteration
Description of Work:
❑ New Repair/Replace
'Demolition
Specify color of color thru tile:
Permit Fee $ 00 ' CxD CCF $ CO/CC $
TOTAL FEE NOW DUE $ e
CO
(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. , t
"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
OWNER or AGENT
/,,
Signature
CONTRACTOR
Thforegoirig instrument was acknowledged before a this The foregoing instrument was acknowledged before me this
day of • C 20 _! by day of , 20 , by
S"e M �G ' is personally known to , who is personally known to
11T \ COrn ZS ' "as me or who has produced as
me or who has produced
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign:
Print:
Seal:
Sign:
Print:
Seal:
************************************s**********************************************************************
APPROVED BY LI ! 2 Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
OWNER BUILDER DISCLOSURE STATEMENT
NAME: vtjfa-7IM1 QI.IfU
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
DATE: Sl36IIS
ADDRESS: .g3 N N G141 ST22ET I 0.1. rVl \ $' '12S,'FE- 3 31 S-0
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 mustwork 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
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
buildfng,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.
Initia
5. I understand that, as the owner -builder, I must provide direct, onsite supervision of the construction.
Initia
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 a .. . ,p y or municipal ordinance.
f
Inif
1
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 labbr 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.
InitialP 7
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 workei.s compensation for the empl'oyee. I understand that my failure to follow
these may subject to serious financial risk.
t
d
�-5
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.
Initia�/�
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:
N W qA STQiztr RAL KWIL 1tta12e51 F3L.�1)
Initial
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.
Initia
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 4P'9-( ' , 20 I
By Donl mi who was personally known to me or who has
p Y
Produced the
as identification.
NOTARY
Miami Shores Village
Building Department
10050 NE 2 Ave, Miami Shores, FL 33138
Tel: (305)795-2204 • Fax; (305)756-8972
2/2/2018
To: Current Owner
53 NW 99 Street
Miami Shores, FL 33150
Permit: RC-6-17-1480
Address: 53 NW 99 Street Miami Shores FL 33150
Dear Sir or Madam,
Our records indicate that the above referenced permit has expired without obtaining the
proper final inspection. In order to serve you better, we need to keep our files up to date.
As per section 105.4.1 of the Florida Building Code, "Every permit issued shall become invalid
(expired) unless the work -authorized -by -such -permit -is -commenced within six -months -after its
issuance, or if the work authorized by such permit is suspended or abandoned for a period of
six months after the work is commenced, or completed without obtaining the final inspection
of the work performed."
Please be advised that open permits will hinder your ability to obtain new permits, refinance or
sell this property.
Please contact the Building Department, within 15 days of receipt of this letter in order to take
care of this matter.
Sincerely,
Wf
Ismael Naranjo (CBO)
Building Director