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FW-19-2454Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 ft Ff - W -al n issue Date: 10/25/20'19 Location Address Parcel Number 123 NW 102ND ST, Miami Shores, FL 33150 1131010220070 Contacts Permwt o.: -10-18 2454 Permit Type: Fence/Wall Work Classification: Wood Fence Permit Status: Approved Expiration: 04/22/2020 OCTAVIO GODOY Owner HOME OWNER Contractor 123 NW 102 ST, MIAMI SHORES, FL 33150 HOME OWNER Other: 7864937296 Description: REPLACING CHAIN LINK FENCE WITH WOOD Valuation: $ 800.00 Inspection Requests: 305 762 FENCE 6' HEIGHT 4949 Total Sq Feet: 0.00 Fees Amount Application Fee - Other $50.00 CCF $0.60 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.20 Notary Fee $5.00 Planning and Zoning Review Fee $35.00 Scanning Fee $9.00 Technology Fee $2.50 Wire and Wood Fence Fee $50.00 Total: $156.30 Payments Date Paid Amt Paid Total Fees $156.30 Credit Card 10/17/2019 $50.00 Credit Card 10/25/2019 $106.30 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 regulati ion and zo ' . ther e, I authorize the above named contractor to do the work stated. Authorized Signatu�aner / Applicant / Contractor / Agent Date October 25, 2019 Page 2 of 2 BUILDING PERMIT APPLICATION F-IBUILDING ❑ ELECTRIC 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 ❑ ROOFING F-IPLUMBING ❑ MECHANICAL PUBLIC WORKS JOB ADDRESS: City: Folio/Parcel#:� Occupancy Type: OWNER: Name (Fee Simpl Address City: FBC 201q Master Permit No.�w—1 —i 1 -As 4 Sub Permit No. ❑ REVISION ❑ EXTENSION [:]RENEWAL ❑ CHANGE OF CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS Load: Count y: Miami Dade Zip: Is the Building Historically Designated: Yes NO Construction Type: Flood Zone: BFE: FFE: Ider : Phone#:'& State: Zip: Tenant/Lessee Name: Phone#: Email: 6-7A CONTRACTOR: Company Name: Phone#: Address: City: Qualifier Name: State Certification or Registration #: DESIGNER: Architect/Engineer: one#: Certificate of Competency #: one#: Zip: Address: x ,� City: State: 73ip: ` �_ Value of Work for this Permit: $ Square/Linear�,l:F'6. age of Work: '� O Type of Work: ❑ Addition ❑ Alteratio J/ W111 New �j /" epair%Replace ❑ Demolition f Work: � le /7�/ , Description • • Specify color of color thru tile: Submittal Fee $ 't-�'� I��I Permit Fee $ 0 CCF $ �'y CO/CC $ v Scanning Fee $ Radon Fee $ o� • DBPR $ a• �O Notary$J h J. � Technology Fee $ A50 Training/Education Fee $ 0.90 Double Fee $ Structural Reviews $ Bond $ XJ,, TOTAL FEE NOW DUE $ 01r•3O (Revised02/24/2014) t'BondingFCompany's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip WE 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. 1,z—b ;4 Sign atur WNER or AGENT The foregoing instrument was acknowledged before me this 1 �1 day of C� 20 by �NI-nki i0 L Q Jj QU) who is personally known to me or who has produced DL as entifi tion a who d 01— an oath. t � TAR PUBLIC \���OY PRIErO %� • GN 201a+' Sign: A' Print: �IV�(� ria *•:.z2112 Signature CONTRACTOR The foregoing instrument was acknowledged before me this day of 20 , by , who is personally known to me or who has produced identification and who.did take an oath. NOTARY PUBLIC: g3ign: S -Print: Seal: //��iy/y�BLICeSjP�`��� ``` Seal: as 7') *jt; *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 ER BU ER DISCLOSURE STATEMENT � �j 9 NAME: Z2;�r;;_7a�w DATE: ADDRESS: / 9:y ///,�7 6ezaX- 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 62j_ 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 an tracts. 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 leas ich violates the exemption. Initial 2Z S:.. I 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. It is my responsibility to ensure that the persons whom I employ have the license required bylaw and by o ty 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 60 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—' I 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 con ct the Florida Construction Industry Licensing Board at 850.487.1395 or http://www.mvfloridalicense.com/dbpr/pro/cilb/index.html 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 annancially responsible for the proposed construction activity at the following address: Initial 6- `I 12. 1 agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any ofthe i r 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. h Was acknowledged before me this fi day of 04 , 20 f By Dd-oyi© L Cluj � who was personally known to me or who has Produced there License or t-- as identification. tiV e�OK NER TARY ��� 14770 SW 43rd WAY, sme 1"=20' JOB NO: 1303-035 331185. PHONE. (M) TYPE OF PROJECT: DT NlENSIONS INCE FIELD DATE: 02-17-2014 Lan Surveying Services FA: (306) 612-1914 BOUNDARY SURVEY FOS CTAVIO GODOY LEGAL DESCR/PflON: PROF. 123 N.W.102nd STREET, MIAMI SHORES, FL 33150 LOT: 16 & E 1/2 of Lot 17BLOCK: 1 SUBDIVISION: GOLD CREST PLAT BOOK: 21 PAGE: 56 op MIAMI-DADE COUNTY, FLORIDA. l � I Lot 4 I Lot 5 I Lot 6 o I Block 1 Block 1 Block 1� —' ( W.P.P. 0 7500' FND.I.P.1/Z" x I x 5' C.L.F x x x ° FND.I.P.1/2" (NO ID) �oj 54.00 1g, 0936 (NO ID) C IV ID r $ n OCT 1 7 201 0.40 W Concrete PL CL L I - BY: ) 10.00' 41.00' �o cb, b� 4, Draina a Field Note: Septic Tank, 0 0 EL:.0.000 <3 Drainage FieldOand CIS. 0 , , , • J Q g00 Gal °r' of Tank dndibebtion as , • • • showned 1p t Fyv,Oer. • cv Septic •••• •••• { Tank •••••• • • Cone r •••• • 17.00 • • ••••i`• �■ •.•• • M•••r E.M I co Lot16•000 ••••• Re cinder Lot 17'�� 11.30' �' 10.63 �"' BCock 10' • • • • • Block 1 0 10.36' 19.20' f 17.75' f j 0000.. , x Cone. I A/C 000:0 0000 . I HIVE STORY CBS �s�p, � i //_��• :00 • • o RESIDENCE # 123 4.10' 10.77'• N li' r • F.F.E.=11.00' ,., /V o I-�fT 0.35' I o ��� o f �! n W I� d- to CL 18.80 $ <- L 12.70` d 18.35 - 10251: 540' .16 " O 0 13.00 w I . r I N N Ull-� �� �� 454 !p!4 �g3 499°gfl2s"Lt 9 10.00' 30.00' 10.00' t Cl) FNID01P.1/2" 5' Conc.Walk 75.00' ❑ FND.CP.1/7" B. oIr o ID)LL L bo Concrete 10Parkway Concreet \ LU LLI uicc �o3d 20' Asphalt �p LO;� U N.W. 102nd STREET 50.00' Total RMf z z CERTIFIED T0: l 2 0 rp I LU w OCTAVIO GODOY. b , O Q l LU SURVEYOR'S NOTES: , O I L z Q 1.) THE SURVEY OF THE PROPERTY SHOWN HEREON IS IN ACCORDANCE WITH THE i 0- O J Q DESCRIPTION FURNISHED BY CLIENT. �_ . Q N D� U 2.) UNLESS A COMPARISON IS SHOWN, ALL BEARING, ANGLES AND DISTANCES SHOWN ARE THE SAME AS PLAT VALUES. ABBREV/AflONS: 3.) THE LANDS SHOWN HEREON WERE NOT ABSTRACTED FOR EASEMENTS OR OTHER SWK= Ik, CBS= Concrete Block Structure, CLF= Chain Link Fence, RECORDED ENCUMBERANCES NOT SHOWN ON THE PLAT AND THE SAME, IF ANY MAY qP1r . PL= P Llne, DllE=Drainage Utllny Easement, IP= Iron Pipe, NOT BE SHOWN ON THE SKETCH. r A/C= Alr ondltloner Pad, PI C= rope�y Comer, DIH=Drilled Hole, 4.) UNDERGRAUND PORTIONS OF FOOTINGS, FUNDATIONS OR OTHER IMPROVEMENT ' 'j °: <;ig WIF=Wood Fence, REs= Residence, CL=Clear, IR=Iron Rabat, a E=usury WERE NOT LOCATED. J` Easement, CONC- Conc. Slab, R1W- Right of Way, DE= Drainage Easement, 5.) FENCES TIES ARE TO THE CENTER LINE OF THE SAME CIL= Center tine, 0= Diameter, TYP= Typical, M= Measured, R= Recorded, 6. WALL TIES TO THE FACE C THE SAME. ENCR= Encroachment, COMP= Computer, ASPH= Asphalt, NID= Nail 8 Disc., 7.)ELEVATION WHEN SHOWN ARE BASED ON NATIONAL GEODETIC VERTICAL DATUM S= Set, FTE= Finish a ft , M =j O1S=eter,Offset, PIP= Poorer Pole, (1929) UNLESS OTHERWISE NOTED. OHP=WarheadteriM.- YVM=WaterMeter,WPP=WoodPowerPale, 8.) THERE NO ABOVE GROUND ENCROACHMENTS OTHER THAN THOSE SHOWN. E.M tetanic Meter, nt, CNatal Fence, P.F: Phtsde Fence, nt,O.L. =Drainage Maintenance Easement, C.M.E.-Canal =Cartaf Maintenance Easement, L.M.E: lake Malntenence Easement, M.E M Zenenee Easement, B.0 =Bloc'x Comer, P.C.=Point of Curvature, FND=Found, NO ID=No Iderdiflcation. (FLOOD ZONE INFORMATION) i `mea s That the as RTI attached "BOUNDARY SURVEY" of the ianda ahaam hereon Ie frac end carraot to the L 9-11-20098RSE / beat army knoMsdy+ andhdtevas r, fy+uwayad amid eam under my ,am. and ZONE: X COMM:_124 2_PANEL:120$6C0302S'OFF1X: HATE N A Frdt�la� A-jodfP lonatSumayyooreaandMap orsaso�i� a nChaapptds odo��n� nada NOTE: D ERMINATION OF FLOOD ZONE LINES WERE BASED ON SCALING OF FEMA MAP LISTED ABOVE. amnt +a a,twr+uant t� M r4r�071 FloTdashtwa. NOTE: AL BEARING HEREON ARE BASED TO THE PLAT BEARING OF N/A -�d! ON THE ENTER LINE OF N/A PROPERTY LINE. EASEME T VIOLATIONS: ❑ YES N NO REGDIS�TEREDD LAND SL. URVEYOR # 4843 APPARE T VISIBLE ENCROACHMENTS: ❑ YES ® NO STATE OF FLORIDA LB # 0006874 COMENT V NOTE:NOTVALtDUNLESS SHEET 1 OF 1 � � 3 45 i iTw eArW. vi r L -