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DEMO-17-1774Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Perms Parcel Number ■ r Permit NO. DEMO-7=17-1774 Permit Type:, Demolition Work Classification: Building Pennit Status: APPROVED Issue date: 7118/2017 Expiration: 01/14/2018 Applicant 1090 NE 104 Street Miami Shores, FL 33138- 1122320290190 Block: Lot: RICHARD E MELLETT Owner Information Address Phone Cell RICHARD E MELLETT 1090 NE 104 MIAMI SHORES FL 33138- (305)984-7069 1090 NE 104 MIAMI SHORES FL 33138- Contractor(s) HOME OWNER Phone Cell Phone Valuation: Total Sq Feet: $ 500.00 400 Type of Demo: Building Additional Info: DEMO EXISTING WALLS IN THE EXISTING Classification: Residential Scanning: 4 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Notary Fee Penalty Fee Permit Fee Scanning Fee Technology Fee Work without Permit Fee Total: Amount $0.60 $2.00 $2.00 $0.20 $5.00 $100.00 $100.00 $12.00 $0.80 $100.00 $322.60 Pay Date Invoice # 07/11/2017 07/18/2017 Pay Type Amt Paid Amt Due DEMO-7-17-64547 Check #: 4294 $ 50.00 $ 272.60 Check #: 440 $ 272.60 $ 0.00 Available Inspections: Inspection Type: Final Review Electrical Review Electrical 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 all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zonin• F ermore, I authorize the above -named contractor to do the work stated. July 18, 2017 Authorized Signature: S'' ner / Applicant / Contractor / Agent Date Building Department Copy July 18, 2017 1 -4\140 ,:f2S4A -A\\ BUILDING PERMIT APPLICATION 'BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION (RENEWAL 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 FBC 20111 tn' Master Permit No.)l() I -Pr r 11 t 14 Sub Permit No. JU 1 2017 nPLUMBING ❑ MECHANICAL I 'PUBLIC WORKS ❑ CHANGE OF (J CANCELLATION n SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 1 vq o Mt. /d (•(D 5 t6-7 City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: ( �23Z- '029' • 0le, v Is the Building Historically Designated: Yes NO W Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Nam� e (Fee Simple Titleholder): `4`'ic- 6AI w''i Phone#: 30S L'4-� q Address: 10? 0 iU,j (cik ?'1 S,''-%j�Z1~T- J City: V1 % be' ( c iti . y�,-'i State: Zip:33 1'34) Tenant/Lessee Name: Phone#: Email: PeAtPt-t— Fa." ((I- Gv GI MA-c . CONTRACTOR: Company Name: 4-4.om V tir f' Phone#: Address: Qualifier Name: City: State: Zip: State Certification or Registration #: Phone#: Certificate of Competency #: DESIGNER rchitec /Engineer: tke,0-43.41 !i"(PK_46.,.CAW / 3 (A --Phone#: Address: 3% Nk 5 2 4 City: �-S ' State: N- . Zip: Ili) E' Value of Work for this Permit: $ cap Square/Linear Footage of Work: C0 Type of Work: ❑ Addition ❑ Alteration (1 New ❑ Repair/Replace n Demolition Description of Work: D r 0 rt ,j}7 4' (&)11-1'‘- j / ,v TktE- - ? a-z 4 AfiAt-t.e-e- OdA/tx wj'7N-fzc.,1—ACOC'1.'4 rr-- Specify color of color thru tile: Submittal Fee $ VV PC{ d Permit Fee $ C ,COCCF $ ' CO/CC $ Scanning Fee $ •-C)Cif Radon Fee $ oc • 03 DBPR $ * °D Notary $ 5 co Technology Fee $ O - Training/Education Fee $ 0 ' 0 Double Fee $ / • Ii Structural Reviews $ 52,Bond $ NA.L ' (CO, W TOTAL FEE NOW DUE $IR 2 ' 6o (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 herebymade 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 reinspecticn fee will be charged. Signature z� OWNER or AGENT The foregoing instrument was acknowledged before me this 7T1r day of jDL 1 , 20 1 7 , by 5t1A A- JZ 7\"`1 , who is personally known to me or who has produced identification and who did take an oath. NOTARY P CHASE CAMPBELL MY COMMISSION # FF 200055 , EXury ;,R••` BondedPIRES: Thru NotaryFebrPublic aUnderwriters17, 2019 Print: C;(-I- r C P/S F t_,L Seal: APPROVED BY (Revised02/24/2014) * as * Signature CONTRACTOR The foregoing instrument was acknowledged before me this day of ,20 ,by who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: ************************************************** Plans Examiner Zoning Structural Review Clerk Property Search Application - Miami -Dade County Page 1 of 1 Summary Report Property Information Folio: 11-2232-029-0190 Property Address: 1090 NE 104 ST Miami Shores, FL 33138-2656 Owner RICHARD E MELLETT JTRS ERIKA BATEY JTRS Mailing Address 1090 NE 104 STREET MIAMI SHORES, FL 33138 USA PA Primary Zone 1100 SGL FAMILY - 2301-2500 SQ Primary Land Use 0101 RESIDENTIAL - SINGLE FAMILY : 1 UNIT Beds/Baths/Half 3/2/0 Floors 1 Living Units 1 Actual Area 2,208 Sq.Ft Living Area 1,672 Sq.Ft Adjusted Area 1,931 Sq.Ft Lot Size 8,250 Sq.Ft Year Built 1951 Assessment Information Year 2017 2016 2015 Land Value $288,964 $288,964 $251,303 Building Value $120,494 $120,494 $120,494 XF Value $1,507 $1,522 $1,314 Market Value $410,965 $410,980 $373,111 Assessed Value $383,612 $375,722 $373,111 Benefits Information Benefit Type 2017 2016 2015 Save Our Homes Cap Assessment Reduction $27,353 $35,258 Homestead Exemption $25,000 $25,000 $25,000 Second Homestead Exemption $25,000 $25,000 $25,000 Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). Short Legal Description EVENINGSIDE PB 44-53 LOT 5 BLK 2 LOT SIZE 75.000 X 110 OR 20377-1291 04 2002 1 Generated On : 7/11/2017 Taxable Value Information 20172016 2015 County Exemption Value $50,000 $50,000 $50,000 Taxable Value $333,612 $325,722 $323,111 School Board Exemption Value $25,000 $25,000 $25,000 Taxable Value i $358,612 $350,722 $348,111 City Exemption Value j $50,000 $50,000 $50,000 Taxable Value $333,612 $325,722 $323,111 Regional Exemption Value l $50,000 $50,000 $50,000 Taxable Value $333,612 $325,722 $323,111 Sales Information Previous Sale Price OR Book - Pa 9a Qualification Description 01/17/2014 $430,000 29018 2251 Qual by exam of deed 04/01/2002 $206,000 20377- 1291 Sales which are qualified 09/01/2000 $150,000 19312 3116 Sales which are qualified 01/01/1994 $0 16261- 1865 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.gov/propertysearch/ 7/11/2017 • 4 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: .0 DATE: 7• I i • I r7 ADDRESS: it og 0 f d `1 Sni.cj i 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 co racts. Initial 4. 1 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 constructi 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. 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. ---j6Initial �'-C 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 C�J 9. 1 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 i:-; 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 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: ICI o uI©i Si• Initial 12. I agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the infor ation 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 By i Ci--1-'r i. Produced there License or I 1 day of q-C/A , 20 t �` who was personally known to me or who r1V'-Cv rRS'`i 4� v. r}. ;,;:f^YPRIETO ' ' � , { ; ,:;i�j�i # FF 214031 *: h7;� . c A t:K1-1HLS: Mar;r, 25, 2019 Bonded Thru rva0,y �Ui;,n: Undenxriters _asi.d.entification. OWNER t NOTARY... •''''4 YANADY PRIETO *'�' ;_ MY COMMISSION # FF 214031 ° ' EXPIRES: March 25, 2019 �• 0Public Underwriters �' oa �.� Bonded Thru Notary EXISTING • DRIVEWAY TO REMAIN � � LL r✓ � � Pt iEl ( b60 �C I(D9b NC I oLL Si��C� 141 I N\ I S dt 02L3 . EXISTING GARAGE DOOR TO REMAIN A1. -- --- .YY —- — -- �M1F-1 ` `IY IY y) O EXISTING GARAGE D 1./ 1,— EX GARAGE DOOR OPENER TO REMAIN EX WALLS TO BE REMOVED -1r \ EX DOOR TO \ BE REMOVED 1- _D L141 o L i "it oNi ri LEI • • • • • •• • • • • • • 1 • • • •• •• • • • • • • • • • • •• • 1 • • • • • • • Is ••• • ,• • • • • • • • • • • ••• • ••• • • • •• • .• • • 000000 • • DR► LIJKI: (o-5-(1 PJ t_ EI iT(c-ic- Lac L cte-.a sue: Ec_13,o0 2.035 I -S5 S €(SLA'I,JC gi_oo et_zh, Nt 1"4(AM► CL- 33181 rc�2 PP6-y S f I o 1'n I.s� I Oq.,14- / K o-rOr X.-4 C 1 RDT 455K1MEcKHA1 i e M,CS10PI , F,v'oo99a S Efi 1 oh1. / EXPIRES: February 12, 2019 ovti