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DS-17-1198�, cyNORES r'I Y Miami Shores Village 10050 N.E. 2nd Avenue NW Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit NO. DS-5-17-1198 Pe Permit Type: Driveways/Sidewalks/Slabs r� it Work Classification: Addition/Alteration Permit Status: APPROVED Issue Date: 6/29/2017 1 Expiration: 12/26/2017 Project Address Parcel Number Applicant 104 NW 102 Street 1131010220130 ALFREDO R PATINO Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone cell ALFREDO R PATINO 104 NW 102 Street MIAMI SHORES FL 33138- 104 NW 102 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone HOME OWNER In Review Valuation: $ 100.00 Total Sq Feet: 800 mments: to Approved:: In Review to Denied: )e of Work: 4 CONCRETE PAVER PATIO IN BACK YAF Additional Info: 4 CONCRETE PAVER PATIO IN BAC nd Return : Classification: Residential anning: 1 Fees Due Amount CCF $0.60 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.20 Notary Fee $5.00 Permit Fee $125.00 Scanning Fee $3.00 Technology Fee $0.80 Total: $138.60 Pay Date Pay Type Amt Paid Amt Due Invoice # DS-5-17-63874 06/29/2017 Credit Card $ 138.60 $ 0.00 ravanaoie Inspection Type: Final Foundation Review Planning Review Planning Review Building Review Building 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:�rtify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoniA4 u hermore, I authorize the above -named contractor to do the work stated. June 29, 2017 Authorized Building De June 29, 2017 Owner / Applicant / Contractor / Agent ;ment Copy Miami Shores Village RECEIVED R Building Department MAY -2 201 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 20 IL� BUILDING Master Permit No. Rat PERMIT APPLICATION Sub Permit No. DS I ` I IC1 BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑ PLUMBING ❑ MECHANICAL [:]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 1Ok 1 o Z -g� City: Miami Shores County: Miami Dade zip: 33i� Folio/Parcel#: Is the Building Historically Designated: Yes NO _ Occupancy Type: Load: Construction Type: CL.?2) Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder):�� ` IZ � �� *J b Phone#: I C)._7 � � ��� Address:1: ,, ',�01-n^A ,' � � �� � -d 2Kck City: P�"�a t �C�!� State: Zip: 331 Tenant/Lessee Name: Email: hone#: CONTRACTOR: Company Name: fi t & Vw'`•' Phone#: Address: City: State: Zip: Qualifier Name: State Certification or Registration #: DESIGNER: Architect/Engineer: Certificate of Competency #: Address: City: State: Zip: Value of Work for this Permit: $ Square/Linear Footage of Work: 900 Type of Work: ❑ Addition ❑ Alteration New ❑ Repair/Replace ❑ Demolition Description of Work: y u C0NGQ&'T[5 jA-NVl ,S . ?1P-71O (k 'QV, '-{PLOD i& Specify color of color thru tile: Submittal Fee $ Permit Fee $ ll �'� (7AJ CCF $ Q .�0 CO/CC $ Scanning Fee $3 - G7 Radon Fee $ 2 DBPR $ v`D Notary$� Technology Fee $, Structural Reviews $ 0 w _ Training/Education Fee $ a - Zd Double Fee $ Bond $ c�� h TOTAL FEE NOW DUE $ �J GO (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 Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this e day of M a 20 [ '�- by day of , 20 by Anedo P (Z?ho is personally known to who is personally known to Q — 01 �I3-213 '0me me or who has produced fSn 0 or who has produced as identification and who did take an oath. 4�-i0nc� identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: MAHARAI K.GONZAL Print: ", o ? Seal: ' :FqF. oar' EXPIRES: November 2, 2020 Bonded Thru Notary public Underwriters Seal: APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) A Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 OWNRR BUILDER DISCLOSURE STATEMENT NAME: VZ'O - - -- DATF2 ADDRESS: I CM 1) UJI t O Z CWk "Lk% 'rb V r,)m& r t—L-331GV 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 personas 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 lJ � 3. 1 understand that, as an owner builder, I am the responsible party of record on a permit. I understand th 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 a 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 presum,: that I built or substantially improved it for sale or lea a hich violates the exemption. Initial S. I understand that, as the owner -builder, I 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 wo king on my building or residence. It is my responsibi!?ty to ensure that the persons whom I employ have the license required by law and by county or municipal ordinance. Initial 40 A, 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. 1, 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 m 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 (FICAI and must. orovide wnrkers rmmnansation for the employee. I understand that my failure to follow these may subject to serious financial risk. Initial It h 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 regulation 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: mk uw 102 %� Wo,,s�r, rt 331Z Initial 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. Initial Licensed contractors are regulated by laws designed to protect the public. if you contract with a per n 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 (t-JO , 20 [ 1'11 1 ByTI� �, �o Vgii n o who was personally known to me or who has Produced ther L tense r � o, � �CQ - � as`it1'entification. o N CO 3 it C)g IiJig R NO ARY O N 11 Property Information Folio: 11-3101-022-0130 Property Address: 104 NW 102 ST Miami Shores, FL 33150-1232 Owner ALFREDO R PATINO Mailing Address 104NW102ST MIAMI SHORES, FL 33150 USA PA Primary Zone 0800 SGL FAMILY - 1701-1900 SQ Primary Land Use 0101 RESIDENTIAL -SINGLE FAMILY: 1 UNIT Beds / Baths / Half 3/2/0 Floors 1 Living Units 1 Actual Area Sq.Ft Living Area Sq.Ft Adjusted Area 1,630 Sq.Ft Lot Size 9,209.16 Sq.Ft Year Built 1947 Assessment Information Year 2017 2016 2015 Land Value $202,827 $202,827 $149,815 Building Value $90,954 $113,448 $113,448 XF Value $912 $924 $749 Market Value $294,693 $317,199 $264,012 Assessed Value $294,693 $317,199 $264,012 Benefits Information Benefit Type 2017 2016 2015 Homestead Exemption $25,000 Second Homestead Exemption $25,000 Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). Short Legal Description GOLD CREST A SUB PB 21-56 E1/2 OF LOT 5 BILK 2 AND LOT 6 LOT SIZE 85.270 X 108 OR 15259-3293 1191 4 Generated On : 6/27/2017 Taxable Value Information 2017 2016 2015 County Exemption Value $50,000 $0 $0 Taxable Value $244,693 $317,199 $264,012 School Board Exemption Value $25,000 $0 $0 Taxable Value $269,693 $317,1991 $264,012 City Exemption Value $50,000 $0 $0 Taxable Value $244,693 $317,199 $264,012 Regional Exemption Value $50,000 $0 $0 Taxable Value $244,693 $317,199 $264,012 Sales Information Previous OR Book - Price Qualification Description Sale Page 01/29/2016 $305,000 29950-0504 Qual by exam of deed Financial inst or "In Lieu of 08/18/2015 $230,300 29772-1383 Forclosure" stated Financial inst or "In Lieu of 02/04/2015 $275,100 29496 0280 Forclosure" stated Corrective, tax or QCD; min 05/27/2011 $0 27758-3989 consideration The Office of the Property Appraiser is continually editing and updating the tax roll. This website may not reflect the most current information on record. The Property Appraiser and Miami -Dade County assumes no liability, see full disclaimer and User Agreement at http://www.miamidade.gov/info/disclaimer.asp Version: http://www.miamidade.gov/propertysearch/ 6/27/2017 " N. n� T RI Y GC __... ` ... r .. EDGE OF PAVEMENT - 2 PARKWA t — RI OF i r R)0. 'p �;GRac.Dwgtx 5 ., ? ,. •':$fj �• . ,fF� 4- NO LID. �ECEIVIED ` COI WA B6 R MAY - 2 2g17 ' PORCH ,.s:.. Od 4.9. G y N;•' 2le L07--5 I 1 STORY RES. , BLOCK-2 LOT-S ` No. 104 SLOCK-2 Q F.F.E.=12.24' I Q 11 &D' 25 G0' EAST o N 112 a 1M '9 :r NO LD. IRR FENCE /D. `LOT 1- 4. R M I T #: Miami Shores Villa e _ APPROVED BY DATE ZONING DEPT SUBJE t'O CC,h!Pt:;: G� R.,W, 4.a.•.F..i lL 1 AL, L-ZS AND 6 ' ` oN3 I C VAY R "_ ... N C4 : 1 'AY LINE R P 'f() P.0 ' 70 S 25.0 9 I M P-25.00 N L=38. 12 �+ a=os•asse• . NTER 23.36 I 11 I1 J P T. Oi86' tt.7 `ti - -,o: i.27'(R&M) a NO LOT-7 BLOCK-2 (NOT TO SCALE) —q_ • • •� �m • • • • 4 ' •• •yy�y� Lc a• b •• :1 • N • • ' S s o „ z •• • • • • •••• • d6if c1 t5,add�`La�r • w •� • Graphic Scale • • • • • f = y rd r—_ .y...• 42 �w, • �xd so • • I .�LJ'.¢••.a •• LEGAL DESCRIPTION: •� } w< Lot 6 the East 1/2 Lot 5, in a �" and of Block 2, of GOLD CREST, according 3 to the plat thereof, as recorded in Plat Book 21, at Page 56. of the Public Records of Miami Dade County, Florida. g a< m 'LOOD ZONE WITHIN ZONE. % ORDER NOV: M•10636 PROPERTY ADRESS: ELEVATION: 41A FIELD BOOK: 'FILE' 104 N.W. 102nd Street COMMUNITY. 111652 PANEL NO.' 0302 DATE MARCH ID 2015 UPDATE Miami Shores, FL. 33150 SUFFIX: L UPDATE: FOR: ALFREDO R. PAn&o DATE: 091IN2DO9 I HEREBY CER-Y THAT THIS DRAWING REPRESENTS THE RE— OF A yR STY OF THE THS SURVEY IS NOT VALID WTHOIIT THE WITHIN DESCRIBED MOPERTY AND THIS DRAWING AND SAID SURVEY WETS PREPARED, BY SIGNATURE A•C OR.ANAL RAISED SEAL OF A ARE NO ENCPO4CM^HY pR HE OR TAC WENTS I1IEESS SHOVR'HEflECN. THERE ME N FLORIDA LICENSED SURVEYOR AND HAFPER NOTBS • HIS SURVEY DOES NOT FELEC T CA DETERMINE 0W1,18R IF. • Ex AHINATION Q THE ABS-RACT OF TITLE WILL HAVE TO BE HALE TO DCTOMINE RECORDED INSTA—HTS. IF ANY, AFFECTING THE PROPERTY THIS SA&Y IS SLB:CC T TO DEDICATIONS. LIHITA*IONS, FESTRKTIONS, RLTINATIONS OR CASOHE VTS OF RCCDi03 • LEGAL OESCRIPTNNS PROVIDED BY CLIENT CA I , STING TIRE COMPANY. IWK' SO J. PAMBIEL A CHlBTI•I UAL LAND SUNVEYCR A MAPPER • UNLESS OTHERWISE NOTED THIS FIRM HAS NOT AN A'� . D TO LOCATE FOOTINGS W. ZT19 ' AND FDIMATIDS STATE OF FLORIDA • NOT VISIBLE ENCROACHMENTS WERE FDUND ON THE PRCFERTY, - L— SHOWN. • IF SHOWN ELEVATIOS ME REFE1iRED TO N. G. VD. 9n am • SUNSET DRNE • BENCH YARX USED ND. N-5A7. LOC4'CR —..1 EUCV1ION: 10.54 MIA M, FIL W143 TEL: (305) 5060988 S (306) 50fi-0990 E-MAIL �Un.ri31 3ntEP�IR�'+71i9v �ii.1FD wI(DR�iN' 12ock �Qiuer �oc�)' �L C 1(ow Mission: To protect, promote & inprm ethe health of all people in Florida through integated state, oaudy & aom unity d1brts. Drainmasters 19337 SW 24 Street Hollywood, FL 33029 { �or�a HEALTH Vision: To be the Healthiest State in the Nation June 19, 2017 RE: Modification to a Single Family Residence - No Bedroom Addition Application Document Number: AP1294256 Centrax Permit Number: 13-SC-1768839 104 NW 102 Street Miami, FL 33150 Lot:5 Block:2 Subdivision: Dear Applicant, Rick Scott Governor Celeste Philip, MD, MPH State Surgeon General and Sea-etary This will acknowledge receipt of a floor plan and site plan on 06/08/2017 for the use of the existing onsite sewage treatment and disposal system located on the above referenced property. New patio construction. No Objection Letter issue by Loanis Gonzalez on 06/19/2017 This office has reviewed and verified the floor plan and site plan you submitted, for the proposed remodeling addition or modification to your single-family home. Based on the information you provided, the Health Department concludes that the proposed remodeling addition or modification is not adding a bedroom and that it does not appear to cover any part of the existing system or encroach on the required setback or unobstructed area. No existing system inspection or evaluation and assessment, or modification, replacement, or upgrade authorization is required. Because an inspection or evaluation of the existing septic system was not conducted, the Department cannot attest to the existing system's current condition, size, or adequacy to serve the proposed use. You may request a voluntary inspection and assessment of your system from a licensed septic tank contractor or plumber, or a person certified under section 381.0101, Florida Statutes. If you have any questions, please call our office at (305) 623-3500. Sincer Loans (onzalez Engineer Specialist II Department of Health in Dade County Florida DaparNnoat of HeaM WWW.florida "woov in Dade County • • , Florida TWITTER:HealthyFLA PHONE: (305) 623-3500 FACEBOOK:FLDepartmentofHealth YOUTUBE: fldoh STATE OF FLORIDA DEPARTMENT OF HEALTH ' APPLICATION FOR CONSTRUCTION PERMIT Permit Application Number ---------------------------PART II - SITEPLAN--------------------------- AMEN s N MEN M■ rim ■ ■■eye MEN ■■■■■■fin\ .39 WMEM !� �..■M MM 11 e ■e■■�■■■L4■ ■■©...eW�e � ��■NO e.■e■e■■■■■�■�■■■■■■■■!■s.■oe� ■■■e■■�■■■■■■e�E■s�®e■�eEein MM ■■■■■■■■■■■■■■■■■■■■r■■■■■M■■■e ro ■■■�.::��.�■■■■■■■■■■■■■■■■■■ ■■■■�■■�■■■■■■■■■■■■SEEM■■■■■■ Notes: .-I S U 1J �� ✓1 t I r) . ccp ✓1 c, s -, rr 3 O o s c }� �� c Q�✓�. �✓1 k-D Cc, - f r cQ. Site Plan submitted by. Plan Approved Not Approved Date t z R` County Health Department ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT DH 4015. 08/09 (Obsotetes previous editions which may not be used) Incorporated: 64E-6.001, FAC Page 2 of 4 (Stock Number: 5744-002-4015-6)