DS-19-1993Location Address
Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Permit No.: DS -08-19-1993
ftVLn%
Permit Type. Driveways/Sidewalks/Slabs Work Clossi ftcutfon. Addition/A{teration
Issue Date:
Parcel Number
1301 NE 101ST ST, Miami Shores, FL 33138 1132050230090
Contacts
Permit Status: Appr*Ved
Expiration: 03/04/2020
Description: REPLACING EXISTING ASPHALT DRIVEWAY WITH Valuation: $ 6,600.00 Inspection Requests:
BRICKS PAVERS ON SAND BASE. (DRIVEWAY) AND NEW 305-76-2-049
PATHWAY Total Sq Feet: 0.0011 71
Fees
Daisy Solis Owner
1301 NE 101 ST, MIAMI SHORES, FL 33138
HOME OWNER Contractor
HOME OWNER
$200.00
swalks
09/06/2019 $305.00
Description: REPLACING EXISTING ASPHALT DRIVEWAY WITH Valuation: $ 6,600.00 Inspection Requests:
BRICKS PAVERS ON SAND BASE. (DRIVEWAY) AND NEW 305-76-2-049
PATHWAY Total Sq Feet: 0.0011 71
Fees
Amount
Concrete/asphalt/pavers, slabs, dways,
$200.00
swalks
09/06/2019 $305.00
Lost Plans Review Fee
$100.00
Notary Fee
$5.00
Total:
$305.00
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$305.00
Check # 130
09/06/2019 $305.00
Amount Due:
$0.00
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 zo ing. uthermore, I authorize the above named contractor to do the work stated.
Owner / Applicant / Contractor / Agent
Date
September 06, 2019 Page 2 of 2
\YA Miami Shores Village
�� Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
J Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING
PERMIT APPLICATION
BUILDING ❑ ELECTRIC ❑ ROOFING
RECEI V ED
AUG 2 71019
l�
&4Jl
`�FcBC 2011 G�
Master Permit NoD (y* 4 -135
Sub Permit No.
❑ REVISION ❑ EXTENSION ENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS [:]CHANGE OF ❑ CANCELLATION ❑ SHOP
� (CONTRACTOR DRAWINGS
J /P�JOB ADDRESS: j /J�
City: Miami Shores County: Miami Dade Zip:/
Folio/Parcel#: Is the Building Historically Designated: Yes NO
G r
Occupancy Type: r Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Ja /sJ 56 6-5- Phone#: )V W�
Address:
City: ��l / L�/!� i S Gl O/PS State: Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name:. 0—(& Phone#:
Address:
City:
Qualifier Name:
State Certification or Registration #:
DESIGNER: Architect/Engineer:
Zip:
Phone#:
Certificate of Competency #:
Phone#:
Address: City: State: Zip:
Value of Work for this Permit: U Square/linear Footage of Work: i D0 '� • S Q
Type of Work: ❑ Addition ❑ Alteration New Repair/Replace ❑ Demolition
Description of Work: t?k PI &C, Y) S CX 15 Fill) j P� P via ll- 0 Y w o l.(Ja(j S (t' I4/ \
r) C k- 1)0 VJ KS C) n SOYA d lS
Specify color of F015.rthru tile:
Submittal Fee $ Permit Fee $ Q` 0 CCF $
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
(Revised02/24/2014)
DBPR $
' IVP G� �l
CO/CC $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ 26G; • Cb
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City f
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 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
-Cj�-
aER or AGENT
The foregoing instrument was acknowledged before me this
day of'-�' 20 by
who is personally known to
me or who has produced 3TC l ���f J �--� as
identification and who did take an
(Revised02/24/2014)
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
(� Plans Examiner Zoning
Structural Review
Clerk
OWNER BUILDER DISCLOSURE STATEMENT
NAME: DATE:
ADDRESS:
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
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 sate 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
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, I 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
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. 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
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.myfloridalicense.com/dbpr/pro/ciIb/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
12. i agree to notify Miami Shores V-diage 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 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
who was personally known to me or who has
Produced there License or as identification.
eViEW.-
NOTARY
Work Class: Addition/Alteration
Status: Expired
Issue Date: 10/20/2015 Parcel 1132050230090
Expiration Date: 06/01/2016
IVR Number: 609828
Address: 1301 NE 101 ST
Miami Shores, FL
Subdivision: 113205023
Scheduled Actual Reinspection
Date Start Date Inspection Type Inspection No. Inspection Status Primary Inspector Required? Complete
09/10/2015 09/17/2015 Review Building INSP-243158 Re -inspection Ismael Naranjo No Complete
required
Reinspection of INSP-131606
Checklist Item COMMENTS Approved
General Comments PLAN REVIEW COMMENTS - Health Department approvs No
is required.
09/14/2015 Review Planning INSP-243159 Passed DAVID DACQUISTO No Complete
Reinspection of INSP-131606
Checklist Item COMMENTS Approved
General Comments PLAN REVIEW COMMENTS Yes
10/15/2015 10/19/2015 Review Building INSP-243702 Passed Ismael Naranjo Yes Complete
Reinspection of INSP-243158
Checklist Item COMMENTS Approved
General Comments PLAN REVIEW COMMENTS No
11/03/2015 11/03/2015 Foundation INSP-243160 Re -inspection Ismael Naranjo No Complete
required
Reinspection of INSP-131606
Checklist Item COMMENTS Approved
General Comments INSPECTOR COMMENTS No
11/05/2015 11/05/2015 Foundation INSP-247200 Passed Ismael Naranjo Yes Complete
Reinspection of INSP-243160
Checklist Item COMMENTS Approved
General Comments INSPECTOR COMMENTS No
12/04/2015 12/07/2015 Building Final INSP-243157 Re -inspection Ismael Naranjo No Complete
required
Reinspection of INSP-131606
Checklist Item COMMENTS Approved
General Comments INSPECTOR COMMENTS - 1. Need to replace sections o No
damage sidewalk in front and on side of property.
2. Need to finish the landscaping.
September 06, 2019 10050 NE 2 Ave Miami Shores FL 33138 Page 1 of 1
Permit Type: Driveways/Sidewalks/Slabs Application Date: 09/10/2015 Owner: DAISY SOLIS
Work Class: Addition/Alteration Issue Date: 10/20/2015 Parcel 1132050230090
Status: Expired Expiration Date: 06/01/2016 Address: 1301 NE 101 ST
Miami Shores, FL
IVR Number: 609828 Subdivision: 113205023
Scheduled Actual Inspection Type Inspection No. Inspection Status PrimaInspector Reinspection Complete
Date Start Date Primary Required?
09/10/2015 09/17/2015 Review Building INSP-243158 Re -inspection Ismael Naranjo No Complete
required
Reinspection of INSP-131606
Checklist Item COMMENTS Approved
General Comments PLAN REVIEW COMMENTS - Health Department approve No
is required.
09/14/2015 Review Planning INSP-243159 Passed DAVID DACQUISTO No Complete
Reinspection of INSP-131606
Checklist Item COMMENTS Approved
General Comments PLAN REVIEW COMMENTS Yes
10/15/2015 10/19/2015 Review Building INSP-243702 Passed Ismael Naranjo Yes Complete
Reinspection of INSP-243158
Checklist Item COMMENTS Approved
General Comments PLAN REVIEW COMMENTS No
11/03/2015 11/03/2015 Foundation INSP-243160 Re -inspection Ismael Naranjo No Complete
required
Reinspection of INSP-131606
Checklist Item COMMENTS Approved
General Comments INSPECTOR COMMENTS No
11/05/2015 11/05/2015 Foundation INSP-247200 Passed Ismael Naranjo Yes Complete
Reinspection of INSP-243160
Checklist Item COMMENTS Approved
General Comments INSPECTOR COMMENTS No
12/04/2015 12/07/2015 Building Final INSP-243157 Re -inspection Ismael Naranjo No Complete
required
Reinspection of INSP-131606
Checklist Item COMMENTS Approved
General Comments INSPECTOR COMMENTS - 1. Need to replace sections oNo
damage sidewalk in front and on side of property.
2. Need to finish the landscaping.
September 06, 2019 10050 NE 2 Ave Miami Shores FL 33138 Page 1 of 1
i MAP OF,BOUNDARY SURVEY f �!
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'THE PUBLIC RECORDS OF �� COUNTY, FLORIDA.
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ABBREVIATIONS d LEGENOa
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• C[ . CCNCR[TE SLAB . H • NEIOMT P•m7 PC 09 . PONT OF CUWQuPE SEC' SECTION • �""�F • • • • • •
tR� I lot valid without the signature and the original raised seal of a Florida licenced surveyor and mapper.. :0.00 0
�s-l°I -1, -��► p�M T � g
_ ......
Eli:�d Z- P N I kaminalfon of the abstract of title wi1P • • •
� J! f�' VI k ave to be made to determine recorded Instruments, if _ • • •
ny affecting the property. Location and Identification of utilities on and/or adjacent to the
Miami Sh res Villag 22 loperty were not secured as such Information was not requested. Ownership Is subject to PSM NO. ��� �' �'�Z
e► a/ r r pinion or ctle. Underground to
and utllftles not located. The survey depicted here is
-�APPROVED r G�� f �I pt COVs:'rd by professional liability Insurance. STATE OF FLORIDA
:• TE I -til DATE: \ _.
ZONING DEPT '` '711 /� �.' ppTE: DATE OF FIELD �,,5-200p �
��/ a, DATE: SURVEY
BLDG DEPTQ DATE'
TYPE Of
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dAJ u/4fHLE•,� ,�/p,�J ��,`, �, SS PROFESSIONAL SURVEYOR SUITE 263
� �3 '4'�' 63 ANDMAPPER MIAMI, FL 33155 ORDER NO. 70•,4374"/A
�'[7Rfi1ULES AND REGULATIONS SCALE: 1^= � • CERTIFICATE NUMBER LS 2798 PH. (305) 267-9016