REV-18-2174BUILDING
PERMIT APPLICATION
L(UILDING
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 16 2018
FBC 20fR
Master Permit NoW I8- 189-S
Sub Permit No. -€ V (6-21-a`-',
ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION 111 RENEWAL
PLUMBING El MECHANICAL PUBLIC WORKS
JOB ADDRESS:
City:
Folio/Parcel#:
Occupancy Type:
4/ ( /f/1/r/ /o c) j/ree-74
Miami Shores County:
CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
Miami Dade Zip: 22Al0
Is the Building Historically Designated: Yes NO
Load:
Construction Type:
/(f.e
Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): U ( 4.1'6 7 Phone#: �- 2S'7-
Address: S a/Y) e
City: State: Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name:
Address:
City:
/7<)/71e
Phone#:
State: Zip:
Qualifier Name: Phone#:
State Certification or Registration #: Certificate of Competency #:
DESIGNER: Architect/Engineer:
Address: _ City:
Zr0°
Value of Work for this Permit: $
Phone#:
State: Zip:
Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration J I �'T eew1
Description of Work: gel/)d yo/1 /- GN ( C4 "/")
Repair/ Ijeplace
/L/! '
❑ Demolition
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ 14 I CCF $ ' ' 'r° CO/CC $
Scanning Fee $ 1 Radon Fee $ 2 -,-,-- DBPR $ 2 -- ;.. Notary $
Technology Fee $ Z • 1.0 Training/Education Fee $ 0 .4 o \ Double Fee $
4tw.ctuxal+Reviews $ 3 5
Bond $ t,
TOTAL FEE NOW DUE$ 193
(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 rein section fee will be charged.
Signature
Signature
OWNER or ENT CONTRACTOR
The foregoing instrument was acknowledged beforeAe this The foregoing instrument was acknowledged before me this
�� day of 20 1 V by day of , 20 by
1 , w �eTs6rla ly known to , who is personally known to
me or who has produced f 1 (Cs2)nas me or who has produced as
identification and who did take an oath.
NOTARY PUB
Si
Print:
Seal:
ovem.er
.... Bonded Thru Notary Public Underwriters
**************
APPROVED BY
•
***********
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
•*,k****************************************************************
Plans Examiner /• _,V t>� c�
Structural Review
Zoning
Clerk
(Revised02/24/2014)
NAME:
ADDRESS:
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
DATE:
/ byl)4)) j F/ 3 3/3-°
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. 1 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
5. I understand that, as the owner -builder, I must provide direct, onsite supervision of the construction.
Initial
C
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 pq 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
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.myfloridalicense.com/dbpr/pro/cilb/index.html 4 i
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:
g /VW /dJ f/Yee
ir//r d 33 ESL)
Initial
C
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 worker's 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 tie day of q , 20
By *" `� 1 `e , U o 6 (0 Jvho s
'�personally known to me or who has
Produced ther License .r as identification.
NOTARY
ME LAND
vy—
PERMIT #
Miami Shires Village
APPROVED
2
ONING DEPT
LDG PENT
BY
DATE
(&
LIBJECT i"O CCMIPI.IFNCE WITH All FEDERAL
TATE ANLJ Cr IJN, f tiL,L=S AND REGULATIONS
iltiolp Accepted By:
:mi., A
1¢➢Q 511✓M
•
••.s•
• ••
•
•
•
• • • •
• • ••
• •• • •
••••
• •
• • • • Proudly Se wing
• CIA • Ile F>klrida Real
• FAELANE• • • • •
• \P.,• Etstate Oomntunity
•••• • • for Over 2Bii' ars
W W W.MEIANDSERVICPS.COM
• •• •
•• • • • •
• • ••• • •
• •
• • •
• •
• • • ••
• • •
•
•••
• •
•�•
•• • • • •• • • • ••
•
•
• ••
•• • • • • • •
�La 1/2"o
NO CAP .g 16.20'
N.W. 100th STREET:: ( DUCAL_ROAD BY PLAT )
50 RIGHT —OF --WAY (er�PUT):..,..
-. J4 Aseg T PAY{M£LVT :...
2.50' 27.40
4' CHAIN LINK 0.70'
FENCE C.B.S
a.
v
LOT 10 $
BLOCK 5 1.
4' CHAIN LINK I
FENCE
F.I.P. I/2"
O•
NO ID n "
LOT 19
BLOCK 5
LOT 20
BLOCK 5
18.0' PARKWAY
120.00' (P)
BLOCK 5
NO CAP r Fry
F.I.P. 1/2
7,‘ ac
235.79 (P) F.I.P. 1/2"
NO ID
0.70' C.B.S
WALL
au'
REMINDER OF
LOT 7
BLOCK 5
CHAIN LINK
FENCE
0.
F..I.P. 1/2"
NO 1D
LOT 22
-BLOCK 5
a„), /ink / 6/64 `�' 0434
(20 A % 1/
z
Property Address:
48 N.W. 100 Street
Miami Shores, FLORIDA 33150
Notes: FENCE ENCROACHES ALONG WEST LOT LINE.
SURVEYOR'S CERTIFICATION: I HEROY THAT THIS ECUNOMYSURVEY ISATRUE AND
CORRECT REPRESS TATK7N OF �{���. UNDER MY DIRECTION. THECOMFIFS
WITH THE MINIMUM TECH HR BYTHESULTECE B04RDa
PROFESSIONAL LANDEUTHROUGH 5EnT�FO:RIDA
ADMINISTRATIVE CODE WTUES.
SIGNED
EFRAIN LO
STATE OF FLO
FOR THE FIRM
P.S.M. No. 6792
NOT VAUDWTMOUT AND AUTH- � T IC SIGNATURE AND AUTHENTICATED
ELECTROOC SEALANDAR THE MAP E VAW WITHOUT THE SIGNATURE AND THE ORIGINAL
RAISED SEAL OF A LICENSED SURVEYOR AND MAPPER.
M.E. Land Surveying, Inc.
10665 SW 190th Street
Suite 3110
Miami, FL 33157
Phone: (305) 740-3319
Fax: (305) 669-3190
LB#: 7989
ME LAND
Survey #:B-41195 Client File #: 18-308
Page I of 2 Not valid without all pages
e44
• • •
.. ..
•
• .
• •
• .
• • .
• • • . ...
• . .. .. .
• . •• . . •.
... • • •
• . . . •
• . •
. . .. .
. •.. •
.... ..• • . • .•
• . .• . • .. . • .
• . .• . . . • • • • .
• . •. •• . •. • • . .
Miami S hoses Village
... . .. ... ..
.
• ......... .
••Budding"airtment
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
CHAIN LINK FENCE DESIGN DETAIL
(ACCORDING TO THE F.B.C. SECTION R4408.11)
TABLE R4408.11
CHAIN LINK FENCE MINIMUM REQUEREMENTS
Fence
Height (ft)
Terminal Post
Dimensions
(in inches)
(o.d. X wall thickness)
Line Post Dimensions
(in inches)
(o.d. X wall thickness)
Terminal Post
Concrete
Foundation Size
(diameter X depth)
(in inches)
Line Post Concrete
Foundation Size
(diameter X depth)
(in inches)
Up to 4.
2 3/8 x 0.042
1 5/8 x 0.047
10 x 24
8 x 24
Over 4to6
23/8x0.042
17/8x0.055
10x24
8x24
For SI: 1 inch = 25.4 mm.
NOTES:
1. This table is applicable only to fences with unrestricted airflow.
2. Fabric: 12 % gauge minimum, Black or Green.
3. Tension bands: Use one less than the height of the fence in feet evenly spaced.
4. Fabric Ties: Must minimum the same gauge of the fabric.
5. Fabric Tie Spacing on the Top Rail: Five ties between posts evenly spaced.
6. Fabric Tie Spacing on Line Posts: One less than height of the fence in feet, evenly spaced.
7. Either top rail or top tension wire shall be used.
8. Braces must be used at Terminal Posts if top tension wire is used instead of Top Rail.
9. Post Spacing: 10 foot (3m) on center maximum.
10. Post shall be embedded to within 6 inches (152 mm) from bottom of the foundation.
11. In order to follow the contour of the land, the bottom of the fence may clear the contour of the ground by up to 5 inch
(127 mm) without increasing table values to the next higher limit.
NOTICE TO PROPERTIES WITH POOLS:
If the fence is to meet the criteria"as a pool barrier, the fence shall not be climbable and all rails must be placed facing
the inside of the property. Pedestrian gates shall have self -closing and latching devices installed at the minimum of 54"
above ground. For further details see Section R4401.7.1 of FBC.
CONCURRED
Created on 5/22/2009 MLDV;06/22/2015