DEMO-19-1156Location Address
Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Ch=;tr�irii�
Issue Date,
Parcel Number
410 NE 94TH ST, Miami Shores, FL 33138 1132060140360
Contacts
Permit No.: DEMO -05-19-1156
Permit Type: Demolition
Work Classification: Residential
Permit Status: Approved
Expiration: 12/04/2019
DANIEL CUBES Owner HOME OWNER Contractor
410 NE 94 ST HOME OWNER
Mobile: 9176125104 DANIELCUBES@MAC.COM
Description: DEMOLITION OF SHED Valuation: $ 1,500.00 Inspection Requests:
4949
Total Sq Feet: 69.00
Fees
Amount
Application Fee - Other
$50.00
Building Demoloition Fee
$50.00
CCF
$1.20
DBPR Fee
$3.75
DCA Fee
$2.50
Education Surcharge
$0.40
Notary Fee
$5.00
Scanning Fee
$9.00
Technology Fee
$6.25
Total:
$128.10
Payments
Date Paid Amt Paid
Total Fees
$128.10
Credit Card
06/07/2019 $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 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. Futhermore, I authorize the above named contractor to do the work stated.
Authorized Signature: Owner / Applicant / Contractor / Agent Date
June 07, 2019 Page 2 of 2
C
Miami Shores Village
�, � ,
Building Department 1 MAY
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 2017 u+h
BUILDING Master Permit Nol.
PERMIT APPLICATION Sub Permit No.
WBUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
F-1 PLUMBING [-]MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 41O Nig qT '�' qr
Citv: Miami Shores Countv: Miami Dade zip: 33136
Folio/Parcel#: Is the Building Historically Designated: Yes NO X_
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): ���Z ct) P)455 Phone#: 1 I I- v1 z'- S 1 o 4
Address: 'qr
City: 1404 S X 1 5 State: �� Zip: 331%26
Tenant/Lessee Name: NA_ Phone#: ql +- 612-yoo
Email
CONTRACTOR: Company Name:
Address: Q�3 A/iI
city:
Qualifier Name: C+r�lbs
State Certificat2itect/=Engifneer:.
DESIGNER:
A'Ci. CM.
IV
�
r-900
Phone#:
Zip: 551qk
hone#: 'W�_ �%- �I00
#: T J 5 D03 ( I\ Certificate of Competency #:
hone#:
Address: f/E .� City: \� State: Zip:
Value of Work for this Permit: $ Square/Linear Fo6tage of Work: 1
• •••,��- ,rff.
Type of Work: Addition ❑ Alteration ID ; + `,, ; ,'+ ;.Repair/Replace 9�Demolition
Description of Work: ,Aj�.00 f -i Dee
,4.
Specify color of color thru tile:
..•,r,,+art r.
Submittal Fee $ Permit Fee $ CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $ S
Technology Fee
Structural Reviews $
(Revised02/24/2014)
Training/Education Fee $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ ( 7_
Bonding Company's Name (if applicable)
Bonding Company's Address
City State
Mortgage Lender's Name (if applicable) M
Zip
Mortgage Lender's Address 4452 15 IQ( 0-44 ' Jlly wo
City W is*l flew State _DC, Zip ZC9006-
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 reinspection fee will be charged.
a
Signature_ -4j Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
Vt,\ day of Ma 20 10 by day of , 20 , by
�fti who is personally known to who is personally known to
me or wKhas produced I�i`e►' �I �Q11� as me or who has produced as
identifi atio a d wh did take an oath.
OTA PUB I
Sign:
Print: V -V 64
Seal:
identification and who did take an oath.
NOTARY PUBLIC:
nt:
Seal:
APPROVED BY 3 L� Plans Examiner �I" I Zoning
Structural Review Clerk
(Revised02/24/2014)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
OWNER BUILDER DISCLOSURE STATEMENT
NAME: ' " '61 � I� � PV -5 DATE: Or- 20 -;W11
ADDRESS: A/ 0 A;� RV m"I 540P5 1 -f-b 3313
Tel: (305) 795.2204
Fax: (305) 756.8972
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. 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.
Initial '1
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 J/
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, w ich violates the exemption.
Initial Jtl
1' ( 1 5. C +Iunderstand that, as the owner -builder, I must provide direct, onsite supervision of the construction.
Initial
v .,6. 1 understand that I may not hire an unlicensed person to act as my contractor or to supervise persons rking on my building or residence. It
47 is my rzsoonsibility to ensure that the persons whom I employ have the license required by law and by c unty or municipal ordinance.
"�` .. t�• a .+� cr e Initial
�5"��r4
f�e','f fe Sl hitt`;'
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 k
8. 1 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.m)tfloridalicense.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:
#to �� 4gr- NVrMI 6WA�7- ��j,,�
Initial JY
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. J
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 day of 20
By � 1)0 0 i \k I �,UY�'e s who was personally known to me or who has
Produced there License or
OWNER
►1 `t PR1EI. T0 ��///i
-\ pN VS
ration. $ : ;,2s,i•:
--c1
orwea
PA
Page 1 of 3
CM 20190251151 SOOK 31414 PAGE 648
DATE:04t24t2019 12:00:16 PM
DEED DOC 3,990,00
HARVEY RUVMN, CLERIC OF COURT, MIA-DA.0E C Y
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Qualifitif Thk Smites, LLC
MO NW i56 Steers Suite 209
Miami Lakes, FL33016
30S,557-85"
'Crams,%te TRW lummuct Agency, LLC
18205 $dsetym s Buss, Sant 2201:
Mentors. FL 33160
AbM MS`L. X FQ9 a `
War ran Deed.
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0 Maid Bravelon L Conrad, at skWe hetet as jest teaaot t with sight of savivorithip whow posh office awrm is +tits
NE 94 Ste, Mimi Shores, FIL 33138, .
(%dlrmm und butt* tine arms 'Few aw «gume wAtOA an panki to tis .mmuwm ad de ideas, ko tepmsequAim ad magas of
adwAak md ftutammm and XSMM aft a a 0d )
Wi , Hatt said graa9m, fear and is cansidesatm of the wean ofTr;N d414L3l+l€3a't00 DOLLARS ($10.100) and othew
pod md v rossra .yitti�ay � ywt�.o W grantor in hand paid by said S and
the t C whatof is ad kdpd,
has granted, -d , and scald w the said l� and s bei s aand - forever, dice f0flowin dnmiw ftudg
shuaft, lying and being,' in M ele County, d dda to -twit
Lot 1 t antd 12, IMoek 51, Mimai Shorts Section 2, according to the Plat tkere4 rttcstled In ghat
Book 10, Page 37, of the Public Records of Mbaaad-1tte & minty, Florida.
uAA 410 NE 94 Street, Misuai Sb orts, FL 33138
Panni (drothietfies Number, 11-3M"l4.030
Together with all die terlc wns, heteditanumu atnd appurtemmet brlaaagittg or in anywise apperadning.
To Have and to Hoo the sa m in Lan sintpte tnmtr.
And the pimor hmby covatmas with sw Vane rima the VaMW Is 14WWIY scmd of sari WO in Rae , the thea
rantor bass good rim alnd Lawful antes to sell and convey said lam the the SmaW bnvby fly 'wxr nta the. tine to said
Land and 'gill dv&W rite the: hwful claims of all peace wbomoover, sad deet said fmW m (w of all
cxvmbmxek vwqx Mus accming Subsequent to Deember 31, 2018.
In Witness Wht rmt g w!0rhas bdeunto wt ViAW1 hand and saai the day and d yeas fag above mitcm
https://onlineservices.miami-dadeclerk.com/officialrecordslCFNDetailsHTML5.aspx?QS=... 5/10/2019
del vend in our ice:
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Page 2 of 3
€FN; 2019M1151 BOOK 31414 PAGE 849
https://onlineservices.miami-dadeclerk.coni/officialrecordslCFNDetailsHTML5.aspx?QS=... 5/10/2019
Page 3 of 3
CFN- 20IM51151 HOOK 31414 PAGE 650
Notary 8k)ck
Stns: of Flerith
County ormimi-nem
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