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FW-18-3681Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Issue Date:12/13/2018 Parcel Number 1284 NE 94TH ST, Miami Shores, FL 33138 1132050100140 Contacts Permit NO.: FW-12-18-3681 Permit Type: Fence/Wall Work Classification: Wood Fence Permit Status: Approved Expiration: 06/11/2019 Suzanne Jacobs Owner HOME OWNER Contractor 1284 NE 94 ST, Miami Shores, 33138 HOME OWNER Description: REPLACE EXISTING FENCE WOOD AND INSTALL Valuation: $ 200.00 Requests: Inspection 305-4949 HORIZONTALLY RATHER THAN VERTICAL Total Scl 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 12/13/2018 $156.30 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 regulating construction and zoning. Futhermore, I authorize the above named contractor to do the work stated. er , / Applicant / Contractor / December 13, Page 2 of 2 BUILDING PERMIT APPLICATION Miami Shores Village Building Department i°,ECEIVEU 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 JUN 0 4 201 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 I �Y FBC 201"l � Master Permit No. FW-12-18-3681 ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS JOB ADDRESS: 1284 NE. 94th St. Sub Permit No. ❑ REVISION rN-] EXTENSION ❑RENEWAL CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS City: Miami Shores County: Miami Dade Zip: 33138 Folio/Parcel#: 11-3205-010-0140 Is the Building Historically Designated: Yes NO X Occupancy Type: SFR Load: Construction Type: CBS Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Suzanne J. Giller f/k/a Suzanne Jacobs Address: 1284 NE. 94th St. City: Miami Shores Tenant/Lessee Name. N/A Email: Phone#:305-754-4482 state: FL Zip: 33138 CONTRACTOR: Company Name: Owner Phone#: Address: City: State: Zip: Qualifier Name: Phone#: State Certification or Registration M Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ® Repair/Replace ❑ Demolition Description of Work: Extend existing wood fence permit Specify color of color thru tile: Submittal Fee $ Scanning Fee $ Permit Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ _ CCF $ DBPR $ CO/CC $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ C S (Revised02/24/2014) Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City N/A N/A 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 Signature OWNERorA NT CONTRACTOR The foregoing instrument was �acknowledged before me this day of 20 - I by Suzanne J. Gille who is personally known to me or who has produced FL Driver's License as identification and who did take an oath. NOTARY PUBLIC: pa-sal, t11Sign:S � •ay,ISSf ♦ � Print: i Seal: _ C-) i •�'4Ry 1 T • Q�� nrrY, •� APPROVED BY (Revised02/24/2014) 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 +++s+++*s+*ssss+**ssss+*s+++s+*****++*+++++++++++**** miner Structural Review Zoning Clerk Arlenis Silvera From: b <b@giller.net> Sent: Tuesday, June 04, 2019 10:37 AM To: Arlenis Silvera Subject: Re: 1284 NE 94TH St. On behalf of Suzy Giller, Please extend the fence permit per the application submitted. thank you BRIAN GILLER, Authorized Agent Miami Shores Village PtCEIVED Building Department DEC 13 2018 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 T 1 INSPECTION LINE PHONE NUMBER: (305) 762-4949 4C 2`0 BUILDING Master Permit No.� ` I PERMIT APPLICATION Sub Permit No. E�BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: / Z g r lv&-z n) Y- r ' City: Miami Shores County: Miami Dade Zip: 3 � l31�- Folio/Parcel#: t ( ^ ? l9 �Lq Is the Building Historically Designated: Yes NO Occupancy Type: S�t-C Load: Construction Type: C / Flood Zone: BFE: FFE: /� S" as viwlf OWNER: Name (Fee Simple Titleholder): ��2qyl h� (� .Q r r/4/c- Phone#:Z— Address: 50� Vh 1�— City: Tenant/Lessee Name: Email: State: CONTRACTOR: Company Name: a2w ytf Phone#: Address: p: City: State: Zip: Qualifier Name: Phone#: State Certification or Registration #: Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ 0� Square/Linear Footage of Work: `Z—S l Type of Work: ❑ Addition ❑ Alteration /J❑ New / I Repair/Replace ❑/ Demolition Description of Work: gt�'yl q(,e PZU S �►�c/ -(�Q T6 rd oo( l�(�$ �a !�1 p Y t� 2d �l ( k ( y t �1 � Cr ��ot VA V? r f `l 4e' / Specify color of color thru tile: Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ CCF $ DBPR $ CO/CC $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ _ (Revised02/24/2014) 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 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 711�Signature Fnt ER or A E CONTRACTOR The foregoing instrumas ackno�i edged before me this The foregoing instrument was acknowledged before me this 'y day of I t L , 20 1 � by Sv 2 4WA t, ry; 0 -ty who is personally known to me or who has produced P- L, L e-- as identification and who djqLt�ajr ►at P •., MAHARAI K. GONZALEZ NOTARY PUBLIC: MY COMMISSION # GG 114112 * ;o EXPIRES: November 2. 2020 ' ,rFOP ��o?� Bonded Thru Notary Public Underwriters Print: a r 1 1 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: Seal: as APPROVED BY Plans Examiner ' �3 �0 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 OWNER BUILDER DISCLOSURE STATEMENT J NAME: ��Zi49'11 / / DATE: Z 12 / ADDRESS: ' 2 92,4 1 �t 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 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 bylaw to be licensed in Florida and to list his or license numbers on permits and o ra s. 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 lea c iolates the exemption. Initial 5. 1 understand that, as the owner -builder, 1 must provide direct, onsite supervision of the constructio . 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 b nV 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 w o 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 ppr osed construction activity at the following address: 12. 1 agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of�infgrm ation that I have provided on this disclosure. //ff 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 &2 day of Kam-— 20 BySU -C GM t &I k � el( who was personally known to me or who has ration. y%�ys* a 0n ZNEn v o se x v M Z 0 c v U 0 �Gz s �ND N o pAf �V O p fD a Miami shores Village Building Department SURVEY AFFIDAVIT STATE OF (FLORIDA) COUNTY OF (DADE) 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 The undersigned Affiant, �U Z 01 U k i 61 114 ✓, does hereby attest that (Property owner) The attached survey, performed by ,, � ti� L � k e, � S k f S G ' � G (Name of surveyor's company) For address: Z g 4 �� �/ -k Sf , Performed on v 7-3 f 144(date of survey) is an accurate representation of the existing conditions and locations of all structures on the property as of this date. The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the property without first providing a survey less than seven (7) years old old. The Affiant, as property owner, further agrees to remove or obtain permits for any structures which now may exist on the property which are not permitted or which may violate zoning or building code regulations. The Affiant further understands that the existence of any such structures may affect final inspections as applicable to this or other permits. F her, Affiant say et h n ugh Tc,zPNA� Property ner Signat re Property Owner Print Name SWORN TO AND SUBSCRIBED before me this _day of i-t c-- 2-.o! k Affiant is personally known to me, ---produced 11—G D it . Q ,- as identification. K GONZALE MY COMMISSION # GG 044602 ber2,2020 :*= IRES: Novem * :a Bonded Not rypublicundenr�1e� Notary p, BOnded 1:11N Revised on 5/22/20091 Revised on 6/12/09 1 .� ,~ RECEIVED -, DEC 13 2018 [ J 1 f LO cli o4 - Pipc 75 F-RNIT #: ` .,� s �lr� jiT, a� r 1 •�yF. o DATE 1 "�' • .'�' -DG DEFT +' SUBJECT i'0 CGMPLIFN E WITH AU. E_DERAL. 1(�(1/�� 3 s•. r ~''� STATE ANJ CCUN N RUI =S AND REC ILATIONS IILLJ- //�� TT G00 supc,.. d a �0 .. ThP v . al ,ice ' h_ zOr. ' ' •,. FJ 'r rr_m a. _'B. or of t.-,e r �t on •^f F t n f'i tie �= kt {hG i In ?nd the f�-,5 - .� ..�r ' ,• ,a'-i J Ot or an, abutnnn nryhi-ot`way. �' +hy1 Jlr ,. ing l FeKcc prrt U� t 1 Wd 511 a a0 ? } 5ty, C9Cv 128A ............ 0.0 V N 16 000 15 14 I 620 ' 25 2S Scaic:l'100' 20, � Q. Z 0� / r O 2� . W O Fh C%j 30 } N m SKETCH OF SURVEY 19.T Pkway •� Plpc 1004 WWI m.: 3' cc 294S' lo.ia' LP d' I Sty. CBS. O Cli N ac . 128A G Q.10' plpc • Cnntr.. I:Qn� Lot 16, MIAMI SHORES BAY VIEW, according to the platthereof, as recorded in Plat Boole 40 at Page 16 of the Public Records of Dade County, Florida. Order No. 80462 Date: August 23rd, 1966 F.B. No. 1395/48 Scales Shown HEREBY CERTIFY: That the attached "SKETCH OF SURVEY" of tht auove descrloed iroperty is true and correct to the best of my knowledge and belief as eecent- .y surveyed and platted under my direction. SCHWEBKE-SHTSKIN AND ASSOCIATES, INC. Regis tereo iUpa turve,Vor M `•'7.7 Stitt nT:Fjorlok. :' : ..• R E V I S I 0 N S__ •� �� ��� Order No. Date Field Book T S�oature o rl�a--sas-AeydfT-... ":ftA6-uz--.Fla. eB1 -Ub-d-Sur_.e 'i rr`5t8tS-�YT-Fla. -7'•T7`�1"'-• a P�e�or e oF�'Ia. .•• . • . ..• . . 1 H r L CA. vvf N C= 9 �ts�- S� K 4iCL- P-4 r+ L I r - , • •,, tA (h Y, c"Ov c f W4� • era ►n .. . . • r�� 6�t sta ►�T i� �1 has+ nor 5�S �'�:• G�.wrd5Lo►►.' : v� 2✓ S h Ito .......... ............ .......... . owv\t,lp- i Su Zu�,. e (/AQ-ef