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REV-18-1162BUILDING 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 y� t I VrF- AY 2208 I FBC 20110"" Master Permit No. 9-6 - (o- ) G' 1-7 -7 3 PERMIT APPLICATION Sub Permit No. Ylty k% -11ia2 BUILDING \N:l ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑RENEWAL ]PLUMBING t MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 4' 2 d lU G 10 3 -� r City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): D•Agly ✓ n/NtSM Phone#: G 3e - Dot `4123 Address: Q Z -4- N If 1 a"-5 41" City: m t '4"l !!2 140" S State: �/' Zip: Tenant/Lessee Name: Phone#: Email: � N `�}/4/LS CONTRACTOR: Company Name: zo rF/z tj A-r,tf"( A4A5 .w Pzw/ w,S t Phone#: Address: 1 4-01 26 t City: . pi 4 �-4' State: FL, Zip: 3 3) y 6 qualifier Name: Phone#: -7 6,0 - 3 3377 8 U State Certification or Registration #: Certificate of Competency #: ! GQ a 3 G ✓ DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ •�� Za' Square/Linear Footage of Work: S F Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace ❑ Demolition _ Description of Work: ?�c V 1S i Or -�Q /',✓ re12 j a/z w oyz le //I //, r3.e off ri iCAI a Specify color of color thru tile: ( Submittal Fee $ Permit Fee $ ��`�f ' � CCF $ c7t`lJ CO/CC $ Scanning Fee $ Radon Fee $ �r DBPR $ • a Notary $ Technology Fee $ Training/Education Fee $ `' �) Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ cD 5? • (Revised02/24/2014) (11 �,N Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) _ Mortgage Lender's Address City State Zip 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 f4bpro ven (7) days aft r the building permit is issued. In the absence of such posted notice, the inspectioinspection fee wi be charged. SignatSignature ENT CONTRACTOR The foregoing instrument was acknowledged before me this The for instrument was acknowledged beforemethis 2 day of 20 �� by \/� Z day of I 20 5 by �S wh�ispV�anally nown to '' `i`el ii who isjpersonally known to me o ho has produced r1• as me o ho has produced .1J�C►V`QY \U SAP_ as identificati an o did t7anoa identificati an ho ntakean NOTARY BLIC: NOT RY P BLIC: Sign: Sign: Print: %AAV\AatA O Print: Seal: YA . YPRIEM Seal: pYANADYP 0 r 'y'gy 1 = Ml' COMMISSION # FF 214031 = M COMMISSION # FF 214031 o= EXP!P.ES: March 25, 2019J,.'a EXPIRES: March 25, 2019 f S�' Th u Noty Pubic Undrwril s F• n rwe m pE k Bonded rY OF i�' Bended Thru Notary Pub' c U Je APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 IVouce to UWner — WorKers' Lonlpensation insurance tXen'lmon Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees, including the owner, must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if: 1. The officer owns at least 10 percent of the stock of the corporation, or in the case of an LLC, a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State, Division of Corporations; and 3. The corporation is registered and listed as active with the Florida Department of State, Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption and has acknowledge that he or she will not use day labor, part-time employees or subcontractors for your project. The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project. In these circumstances, Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company for day labor, part-time employees or subcontractors. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: caner State of Florida County of Miami -Dade The foregoing was acknowledge before me this h� day of �`� A `Q\, , 20. By 61TOX (w"S nfRwSC� who is personally known to me or has produced _7)�_f-4AV k 1C*RM S%v, as identification. Notary: �� P�' • YANADY PRIEr0 MY COWISSION # FF 214031 SEAL: a= EXPIRES: March 25, 2019 ;ft'p' Bonded Thru Notery Pub':c Underwdtsrs INTEMATIONAL MIST88 DESIGNS AND PLANNERS LLC L t 5 ul --un, DIAZ-FUENk- I&GF r-.BHCHITBCT BLA.#0000635 GZMRAL IMINNERING # 1-20900 G MEBAL & ROOr- TIM CONTRACTOR * :_ 3B000305 7 1 r 5j l �i . 6 �rZ %DVS . .0 0 0 0. . . . . . 00 . . z Ga .. ... .. .. �° 37 G••t�OS:• .. . . . . �..•. . . . . . .•. .•. ••• .. . . . .... ... . . . . . . .. . ... .. . V -- K-1 1!*11 - - 1-7 q a M. 0 �- �L vv� ��� �►5 _t.' I yl t •�r1 i I � Yy e + � � I j � A I c � ' j I i . w. • . /u ... rr. At Al. ir j- i I !nr... + I�' I 1 •I ' 1 .....fj:;:` I i I I .aLer�z. f�.,.�Jirtl�• GGGG A ,- C•FaM. IkN .N J••t• • • • ' 1 �• .Ar. �rr li I •Yl• hI N r �.:••n 1 I' '�," °.'cx� �.�•'e' y� • • , �•.( I 1. i,i '� �•♦finrL .lYl�n *�•rw. w. � � I I � � 1 ( N • • • • • • • • • • • • • 111 I t._._ _ I � � is y`i C•aa��4•�••••• ,� • •••••00 • N!O- MW�1' i I "'�:.• .. • ,wp . ..... i I ! ... n.,„.•. • I IA.• /' h'• , Art.• 1. ._ 1fq• � rot.• �t••'� �.• .. n.' � t+.• t. • • • • • • • � • r . }T I i I ' ••.w:..;^'.' � I 4 n.l. I I rtx•. � r at. � •.. • : . r_) 7 . 461• .. - . 7=1" 64.1 i A p. �'6ro+J,fw. �. 1 tr .._�I.1 _ / x•.a•.a•... AP' F�. ^. cfii'.fj w'�. m. _.. ..�' ..�.. '•'. aw H. I TTT 8 ?ate �• / r wry.. .OI TR/CiC• /17tt50-01 �_ 0/.JlA.M G• irv, ,t r /++. ✓�• x%. •IIt)'!r d. eASCIxx LKI/J� tiro n<•. l a• sr.. � 9J PROPERTY ADDRESS: 424 NE 103rd Street Miami Shores, Florida 33138-2457 LEGAL DESCRIPTION: Lots 9 & 10, Block 92, of "AMENDED PLAT OF MIAMI SHORES SECTION NO. 4, according to the Plat thereof as recorded in Plot Book 15, Page 14 of the - Public Records of Miami -Dade County, Florido FOLIO NUMBER: 11 3206 017 0750 (Miami -Dade County Public Records/Property Appraiser's Office) SURVEYOR'S NOTES: All distances as shown are based on the US Survey foot. The Notional Flood Insurance Rote Map for Florida, Community Panel No. 120652 (Village of Miami Shores) 12086 C, 0302 L, FIRM Dote 09/11/2009 and Revised with an effective date of 09/11/2009, published by the United States Department of Housing and Urban Development, delineates the herein described land to be situated outside the Special Flood Hazard Area designated by the Federal Emergency Management Agency (FEMA). Subject property lies within Zone 'X areas determined to be outside the 0.2% annual chance floodplain. Survey done by occupation, physical evidence, the recovery of existing property comers, field measurements, calculations, adjacent plots and legal description provided to the surveyor and also from the Miami -Dade County Public Records/ Property Appraiser Office and no claims as to ownership are made or implied. The legal ownership of the fences and/or walls as shown hereon was not determined, and the locations as shown are based on the recovered boundary monumentation. CERTIFIED TO: ,Oar'yl L Unnosch and Nora De Freitas Unnash Wells Fargo Bank, N.A., ISAOA, ATIMA Chicago Title Insurance Company The Herskowitz Law Firm GENERAL SURVEYOR'S NOTES: 1)-This survey was conducted for the purpose of a 'Boundary Survey" only and is not intended to delineate the regulatory jurisdiction of any federal, state, regional or local agency, board, commission or other entity. 2)-The accuracy obtained by measurements and colculations on this survey, meets and exceeds the Minimum Technical Standards requirements for a suburban area (I foot in 7.500 feet) as specified in Chapter 5J-17, Florida Administrative Code. 3)-This Survey does not reflect or determine ownership. • • • • • +Legal Description subject to any dedications, limitations, retractions reservations or easements of record. • • •' • • ' • "' 5)-Examination of the Abstract of Title will have to be made to determine recorded instruments, if any affecting t%e property, segrtITDt Public Records not performed by this office. • • • .. • • • • oboe 6)-No effort was made by this office to locate any underground utilities and/or structures within or abutting the gipAt.property. . • 7)-This Survey has been prepared for the exclusive use the entities named hereon only and certifications hereon do rgt•gxtend to.gpy unnamed • • • parties. . . • • • • • 8)-This Survey was prepared for a Mortgage Transaction only, not to be used for design and/or construction purposes without the •con%epj, of this.:. office. •••••' 9)-Utility facilities within Utility Easements not noted as violations. •be• • • 14)-Driveways or portions thereof within Roadways not noted as violations or encroachments. ****a* • 1i)-Foundations and/or footings underneath the ground surface that may cross beyond the boundary lines of the hsreinedescr'ibed :qrge42ire not • • • shown. . . . • 12)-Fence ownership determines by visual means only (if any): Legal ownership not determined. •..' : • 13)-No search records was made by this firm beside the record plat; therefore we do not imply or accept responsibility for any Easement, Zedication or Limitation for which information was not furnished. 14)-Contoct the appropriote authorities prior to any design work on the hereon -described parcel for Building and Zoning information. 15)-In some instances graphic representations have been exaggerated to more clearly illustrate the relationship between physical improvements and/or lot lines. In all cases dimensions sholl control the location of the improvements over scaled positions. 16)-The dimensions and directions shown hereon are in substontial agreement with record and calculated values unless otherwise noted. 17)- Obstructed corners are witnessed by improvements JORGE L.. CABRERA PROFESSIONAL. SURVEYOR 8r MAPPER Phone- 3M-M-2522 2952 S.W.149th Place, Mend, Floods 33185 Fax 305-207-9537 This is to certify to the above named firm and or persons that the SKETCH OF BOUNDARY SURVEY'of the herein described property is true and correct to the best of my knowledge and belief as recently surveyed under my direction, also there are no visible encroachments other than those show Owner or his representative furnished the legal description contained herein. Other recorded instruments may affect this property. Surveyor has of examined the abstract of title. Locations of utilities on or adjacent to the property were not secured unless specifically requested by owner. I fu hlr`- certify that this map or plot meets the Minimum Technical Standard Requirements, adopted by the Board of Professional Surveyors and Mappers, �- pursuant to Chapter 472,027 Florido Statutes, as set forth in Chapter 5J-17, Florida Administrative Code, under Sections 5J-17.051 and 5J-17.05 on is a 'BOUNDARY SURVEY'as defined in Section 5J--17.050. - JORGE L. CABRE Date of Field Work 001/2018 Joe # 16-3512 Such # 4231 PIDftatOndl Surveyor d, Mapper, 8487 t>d.e1o,N,pkYrpoq,ly0flayLC•MM.Prdhwb lu,v%w&M WR@pm&,fin.dlM.6woftmnotaMLUiMGbrdwdiertlyaftemaArt Sht6ssofFbft I N ME 102nd St LOCATION MAP SCALE: (KT.S) CL. = Clear = Center Line CONC. = Concrete A = Delta ENC. = Encroachment F.F.EL. = Finish Floor Elevation F.I.P. = Found Iron Pipe F.I.R. = Found Iron Rod F.N. = Found Nail F.N&D. = Found Nail & Disc I.D. = Identification L = Length (M) = Measured O/L = On Line (P) = Plat P.C. = Point of Curvature P.B. = Plat Book PG. = Page R = Radius (R) = Record U.E. = Utility Easement D.M.E.= DRAINAGE MAINTENANCE Utility Easement (N.R.)= NOT RADIAL = MONUMENT LINE ME 102ra St ME it 100.00' (M)I ©----- f----- BLOCK CORNER FOUND %-0 IRON PIPE 90'23'49"(M) 89'54'4 SKETCH OF BOUNDARY SURVEY SCAL.E:1` =,V. ME 103rd STREET (75' TOTAL R/W by PLAT) . ... .. . - - - 24' ASPHALT PAVEMENT. 35.0' - M ASPHALT 20' PARKWAY M LIGHT POLE 100.00' (M)(R) 5' SIDEWALK ° °d ° ®W, :° --A' FOUND 34" 0.1 .0 FOUND 4"fb IRON PIPE IRON PIPE v } rn ( OZ o N PL �;� PIL I PL 89' m ° 10.90' 0.40' 22.3 � i 15.25 I PORCH 0.40 PIL M PL I - ONE-STORY ON PL 25.75' RESIDENCE # 424 66 I I LOT 10 ( LOT 9 � LOT 8 BL O;�K 92 (BLOCK 92 I ® BLOCK 92 LOT 11 37.80' I C14 �L OCK 92 11.05' 25.8' 4 00 i I 00 �I BRICK I 00 o� Y I � I � j CF I I m 14.7' POOL I I I 6' W. F. I o 5"(C) I I \--6'W.F. 90'05' I BRICK I FOUND %4"0 I IRON PIPE ( FOUND -Y4"0 ON PL 6'VI.F. I IRON PIPE — J — — — 1.0' — — — — — — — 100.00' (M)(R). wPP10 9' PAVEMENT 15 ALLEY . 36'11"(M) •• SYMBOLS AIR CONDITIONER ® POOL PUMP ® WATER HEATER ® CABLE TV ® C/B CATCH BASIN ®WM WATER METER `d CONCRETE POLE *WPP WOOD POLE W FIRE HYDRANT 1 5"(C) 0% EXISTING ELEVATION CQ., UTILITY POLE O MANHOLE ® ELECTRIC BOX COVERED AREA — — — —•--- CHAIN LINK FENCE (C.L.F.) —a--0 — METAL FENCE (M.F.) —^��—�—^— OVERHEAD LINES —�a PLASTIC FENCE (P.F.) — — WOOD FENCE (W.F.) — — WIRE FENCE (WR.F.)