RF-19-823iRf --04- P-82- 3
4,01Gli Y
Location Address Parcel Number
515 GRAND CONC, Miami Shores, FL 33138 1132060171340
Contacts
GREGORY PALMER Owner HOME OWNER Contractor
HOME OWNER
Other: 3052207663
j Description: INSTALLING GUTTERS Valuation: $ 2,000.00 Inspection Requests3€15M76i2-4�4
Total Sq Feet: 509.00,
Fees
Amount
Application Fee - Other
$50.00
CCF
$1.20
DBPR Fee
$3.75
DCA Fee
$2.50
Education Surcharge
$0.40
Notary Fee
$5.00
Roofing Fee
$50.00
Scanning Fee
$9.00
Technology Fee
$6.25
Total:
$128.10
Payments
Date Paid Amt Paid
Total Fees
$128.10
Credit Card
04/18/2019 $128.10
Amount Due:
$0.00
Building Department Copy
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 AFf IDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulg[lag_constructiio and zoning. Futhermore, I authorize the above named contractor to do the work stated.
C
Authorized Signature: Owner
/ Applicant / Contractor / Agent
Date
April 18, 2019 Page 2 of 2
Miami Shores Village -
�� Building Department 016 2019
�• ' 10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972 (v1
INSPECTION LINE PHONE NUMBER: (305) 762-4949
,(FBC 201---A
BUILDING Master Permit No. V
PERMIT APPLICATION Sub Permit No.
F--] BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑ PLUMBING ❑ MECHANICAL ❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
/� / CONTRACTOR DRAWINGS
JOB ADDRESS: C l � `i^-�t 1. P'c. J k S --
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FIFE:
/ t
OWNER: Name (Fee Simple Titleholder): G Q C'a r -1 Q ` M e -'r- Phone#:
Address: 'S (� �� t r -d N Co , AS e—
City: /,,,Ar��Ai SkLA t1--�f State: ( ____Zip: y�
Tenant/Lessee Name: Phone#:
Email it ` �
CONTRACTOR: Company Name: �" M�CL'lu Phone#:
Address: ` L,-4
Pr( r' Co 2pe /�, 2 �?
City: !" 4 S•1C2£ t State: [ <— Zip: l ) 360
Qualifier Name: Phone#:
State Certification or Registration #: Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
op
Value of Work for this Permit: $ loop_ Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: i k S I k� C 6 a< S
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Technology Fee $
Structural Reviews $
(Revised02/24/2014)
Permit Fee $
Radon Fee $
Training/Education Fee $
CCF $_
DBPR $
CO/CC $
Notary $
Double Fee $
Bond $ 1
TOTAL FEE NOW DUE $ ��
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
M
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 on 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
The foregoing instrument was acknowledged before me this
W day of "Yl 20 , by
Ye l 1 1virh� known to
me or w o has produced i as
identification and who did take an oath.
NOTARY P LIC:
�� K. GONZALEZ
Print: "CPv MAH;.;; ,:
o" MYC0R,:; i'.DS1)N I UG 044662
Seal: =* ' EXPIRI'c6: November 2,2020
Bonded 70M iVotary Public Underwriters
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of
me or who has produced
20 , by
who is personally known to
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
as
APPROVED BY r �l Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
4/16/2019 Property Search Application - Miami -Dade County
k
-OFFICE OF THE PROPERTY APPRAISER
Summary Report
Property Information
Folio:
11-3206-017-1340
Property Address:
515 GRAND CONC
Miami Shores, FL 33138-2464
Owner
GREGORY M PALMER &W
KIMBERLY E JORDAN
Mailing Address
515 GRAND CONCOURSE
MIAMI SHORES, FL 33138-2464
PA Primary Zone
1300 SGL FAMILY - 2801-3000 SQ
Primary Land Use
0101 RESIDENTIAL -SINGLE
FAMILY: 1 UNIT
Beds/Baths/Half
5/3/0
Floors
1
Living Units
1
Actual Area
4,423 Sq.Ft
Living Area
3,342 Sq. Ft
Adjusted Area
3,815 Sq. Ft
Lot Size
13,429 Sq. Ft
Year Built
Multiple (See Building Info.)
Assessment Information
Year
2018 2017
2016
Land Value
$472,624 $472,624
$429,658
Building Value
$203,046 $202,238
$203,806
XF Value
$5,723 $5,790
$5,857
Market Value
$681,393 $680,652
$639,321
Assessed Value
$251,173 $246,007
$240,948
Benefits Information
2018
Benefit
Type
2018
2017
2016
Save Our Homes
Cap
Assessment
Reduction
$430,220
$434,645
$398,373
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
MIAMI SHORES SEC 4 AMD PB 15-14
LOT 21 & 22 BLK 96
LOT SIZE 103.300 X 130
OR 16932-0017 TO 25 0795 4
COC 26255-0231 02 2008 1
Generated On : 4/16/2019
Taxable Value Information
2018
2017
2016
County
Exemption Value
$50,000
$50,000
$50,000
Taxable Value
$201,173
$196,007
$190,948
School Board
Exemption Value
$25,000 $25,000
$25,000
Taxable Value
$226,173 $221,007
$215,948
City
Exemption Value $50,000
$50,000 $50,000
Taxable Value $201,173
$196,007 $190,948
Regional
Exemption Value $50,000
$50,000
$50,000
Taxable Value 1 $201,173
$196,007
$190,948
Sales Information
OR
Previous
Price
Book-
Qualification Description
Sale
Page
02/01/2008
$825,000
26255-
Sales which are qualified
0231
09/01/2003
$465,000
21671
Sales which are qualified
4702
00000-
Sales which are disqualified as a result of
07/01/1995
$0
00000
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:
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: S I'^e DATE: L fs j S
ADDRESS: Gra ^ (d N Coy,, 2S C
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 tie 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. 1 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. ( I '
Initial
2. 1 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. 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. 1 understand that, as the owner -builder, 1 must provide direct, onsite supervision of the construction.
Initial
6. 1 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.
t .l l_ n
Initial
7. 1 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 t "
8. l 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. 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
Construction must comply with all applicable laws, ordinances, building codes, and zoning regulations.
Initial_
10. 1 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.htmi
Initial
11. 1 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 /1-411
12. 1 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. V/l
• 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
1 day of , 20 l�
ByMCAY 1h
who was personally known to me or who has
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W
Produced th a Licens o
as identification.
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In event it becomes necessary for Gutterman's Services, Inc. to employ the services of an attorney to effect collection of the
amount or balance due, under this contract, purchaser agrees to pay seller's reasonable attorney's fees and all expenses
incident thereto. When executed and signed by both parties, this proposal becomes a contract.
Gutterman's Services, Inc., will honor a five year guarantee upon completion of installation of your continuous gutters
system. This guarantee covers the installation and materials. Our suppliers guarantees the baked on enamel finish for
twenty years against cracking, chipping or peeling. We will repair or replace any part necessary if it is a direct result of faulty
materials. We do not cover damage due to neglect or lack of proper maintenance. We do not cover damages that have
occurred from abuse or acts of nature. )�!`� To,,� voi rc -4z t ,.t�1 iL•� �. �/�
i COLOR THIS ETIMATES IS VALID FOR AONE MONTH
6" GUTTERS
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DOWNSPOUTS
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TOTAL FEET
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AMOUNT
DEPOSIT
TOTAL
CUSTOMER GUTTERMAN'S SERVICES, INC.
www.rainguttersmiami.net
e-mail: info@rainguttersmiami.net
930 S.W 149 Court - Miami -Florida - 33194