FW-18-325, 0140PECTION RECORD
4 gNOREs
Miami Shores Village
M 10050 N.E. 2nd Avenue
uu nu.�
Miami Shores, FL 33138-0000
yy� y Phone(305)795-2204 Fax: (305)758-8872
F�ORIDA
Permit No. FW-2-18-325
Issue Date: 2/8/20r I Expires: 08/07/2018 '
INSPECTION REQUESTS: (305)762-4949 or Log on at https://bidg.miamishoresvillage.com/cap
REQUESTS ARE ACCEPTED DURING 8:30AM - 3:30PM FOR THE FOLLOWING BUSINESS DAY.
Requests must be received by 3 pm for following day inspections.
Fence/Wall Parcel #:1121360040520
Owner's Name: REGINA PAVONE nOwner's Phone:
Job Address: 141 NE 10 Street I H113 Mud I UIL U, Total Square Feet: 85
Bond Number: MiammShorp.- FL33161- AE Total Job Valuation: $ 1,700,00
.re
WUKK 1:5 ALLUYYCU:
ellContractors Phone MONDAY THROUGH FRIDAY, 8:OOAM - 7:OOPM.
SATURDAY 8:00AM - 6:00PM.
HOME OWNER Rpm Yes NO WORK IS ALLOWED ON SUNDAY OR HOLIDAYS.
BUILDING AND ROOFING INSPECTIONS ARE DONE
MONDAY THROUGH FRIDAY.
NO INSPECTION WILL BE MADE UNLESS THE PERMIT CARD IS DISPLAYED AND HAS BEEN APPROVED, PLANS ARE READLY AVAILABLE. IT IS
THE PERMIT APPLICANTS RESPONSIBILITY TO ENSURE THAT WORK IS ACCESSJBLE AND EXPOSED FOR INSPECTION PURPOSES. NEITHER
THE BUILDING OFFICIAL NOR THE CITY SHALL BE LIABLE FOR EXPENSE ENTAILED IN THE REMOVAL OR REPLACEMENT OF ANY MATERIAL
REQUIRED TO ALLOW INSPECTION.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
. COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO : YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED
AND,, -POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU
pANTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF
'@OMMENCEMENT.
`ygort£s t,� Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
p-` Phone: (305)795-2204
FLOR lDA
en-lofiftit
Issue Date: 2/8/2018
Permit NO. FW-2-18-325
Permit Type: Fence/Wall
Work Classification: Wood Fence
Permit Status. APPROVED
Expiration: 08/07/2018
Project Address Parcel Number Applicant
141 NE 109 Street 1121360040520
Miami Shores, FL 33161- Block: Lot: REGINA PAVONE
Owner Information Address Phone Cell
REGINA PAVONE 541 NE 105 ST
MIAMI FL 33138-2044
Contractor(s) Phone Cell Phone
HOME OWNER
nents:
Approved:
Denied:
of Construction: Wood Fence
,ification: Residential
Fees Due
Amount
CCF
$1.20
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.40
Notary Fee
$5.00
Permit Fee - Wire & Wood
$100.00
Scanning Fee
$9.00
Technology Fee
$1.60
Total:
$121.20
Valuation: $ 1,700.00
Total Sq Feet: 85
Additional Info: EXISTING WOOD PANEL FENCE, T
Scanning: 3
Pay Date Pay Type Amt Paid Amt Due
Invoice # FW-2-18-66386
02/08/2018 Check #: 1179 $ 50.00 $ 71.20
02/08/2018 Credit Card $ 71.20 $ 0.00
Available Inspections:
Inspection Type:
Final
Foundation
Review Building
Review Planning
Review Planning
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 ce^ that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction aryl nipq. F
,AKermore, I authorize the above -named contractor to do the work stated.
February 08. 2018
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
February 08, 2018 1
Miami Shores Village iy , 'r�JvED
Building Department FEPos1s
10050 N.E.2nd Avenue, Miami Shore
Tel: (305) 795-2204 Fax: (305)
INSPECTION LINE PHONE NUMBER:
BUILDING
PERMIT APPLICATION
BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION
Florida 33138
i6-8972
05) 762-4949
f
F-
BC201V,"'
Permit No. Fw I R —.3ZS
Sub Permit No.
❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGEI OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 1 9( NE 1 C9` it, S
Folio/Parcel#: 11 ? 1 3 b" Q O y- D S Z C) Is the Building Historically Designated: Yes NO . X
Occupancy Type: S t) Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholde
Address: 1 Li( t'l E- : E
City:
Tenant/Lessee Name:
Email:
(0
rC".2 State:
I
ne#: 3 6S7 S-I G L( (
ne#:
ip: 33 t
CONTRACTOR: Company Name: fic cc)iC �JWnC"r Phone#: �d� • . 3,-c 1 y
Address: ILk k Nt— Joel S;
City: a 16! State: Ty Zip: (o
Qualifier Name: v ��- I) Phone#:
State Certification or Registration #: Certificate of Competency #:
DESIGNER: Architect/Engineer: I Phone#:
Address: City: I State: Zip:
Value of Work for this Permit: $ �C�� . Square/Line'ar Footage of Work: X
Type of Work: ❑ Addition ❑ Alteration ❑ New 0 Repair/Replace ❑ Demolition
Description of Work: 11G w
Specify color of color thru tile:
Submittal Fee $ 1 Permit Fee $
Scanning Fee $ Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
CCF $ CO/CC $
DBPR $ 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 UP--- Signature
W N E R cf AGE - CONTRACTOR
The foregoing instrument was acknowledged before me this
_ day of i'�b �20� � � , by
IZf�"✓11 hq PC\nrlSo i p� ersDnally known to
me or who has produced�o ,Y1 ' as
identification and who did take an oath.
NOTARY PUBLIC:
Ri
Print: MY COMMISSION # GG 044602
EXPIRES: November ,ZuZu
Seal: , �t, a Bonded Thru Notary Public Underwriters
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
*:�*:**rssss*s****.:.:**ss*********s**•**�:*:*::****..*�*.:::*:********* �W**Z*o*n*in**g
APPROVED BY Plans Examiner
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
Permit No: FW-2-18-325
Planning Critique
2/8/2018
NEEDS TO INDICATE ON PLANS MATERIAL AND HEIGHT
Travis Kendall
305-762-4864
Plan review is not complete, when all items above are corrected, we will do a complete
plan review.
If any sheets are voided, remove them from the plans and replace with new revised
sheets and include one set of voided sheets in the re -submittal drawings.
-
� i
-,,3 DEP-r
• ,1 7 a DEPT v --" 1 LOCATION SKETCH
NOT TO SCALE
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, XE ." LEGAL DESCRIPTION_
b
LOT 2t BLOCK 2 •COLLEGE HELGH THE PLAT THEREOF
IS '. ACCORDING TO E
1°v LCT - Po AS RECORDED IN PLAT SOON 42, PAGE B, OF THE PUBLIC RECORDS OF,
w hF. Paz-.,, 2 MIAMI-DADE COUNTY, FLORIDA.
LOT -zP
FLDi.'A - P q ''O5S V 'j tr
SLIT
RVEYOR'S NOTES:
o- o .:1 -
1 Yet' fJN S((3/i'y I) NOT VALJD Ur`Ii£SS SGNAii/hF � . MRJSSFD WITH THE REG!51EREU �S'D SURVEYO.R'n SEAL
R(: Sf1!ONCE ' Y; LEGAL DESCRfPTION PROVlOFO OTHERS
y, 3) f4WERTIES SHOWNHEREON WERE`DTABSTRACTED FOREASEMENTS OR.OTHER RECORDED
c'NCLWBRANCE:SNOT S] IOWNCN THE PROPERTY PLA 7OF RECORD.
CI MEASUREMENTS TO WOOD FENCES ARE TO OUTSIDE OF WOOD
S UNDERGROUND UfWTIES. FOUNDATION OR OTHER IAIPROV0WE":TS. !F AUY. WERE_ N-7
l,J N w a,p 7 rfN.. IT i w y LOCATED
+ N 1 �1'. u o b) ELEVA T1p15 IF SHOWN ARE EASED O! KORTW A.MEMCAN VERTMAL PATU44 198b
%r T FENCE Oi54FERSHIP NOT OFTERACNED UMESS 0 tHERMSE NOTED.
81 MEASIJREUENTS TO WIRE FENCES ARE TO CENTER OF WIRE..
V - I` `; 8) WALL MFASUREMENTSARE rpgRO!A FACE OF WALL
�,t? 'Y IM DRAWING LMSTANCL BETKLEN WALLS AM?TA: FENCES.4ND PRGPERP.'L/^JES MAYBE
\ vSC4 f.RJ a EXAGGERATED FOR CLAIUTY.
FFA1 V, I.F. r /R•�A' 3"so-IR) 11) HOOD ZONE INFORMAWN WAS DERIVED FROM FEDERAL EMERGEr'K'YMANAGFME.NT4GPNCY
\ A'D JD __ _I - �rAt f9. ::M_5� iMtr LOO[' MffORMA710N PA fE VAPS ..
_F
FFS % P tILOCA CCW".iR L BEARING^ IF ANY SHr Y'h ARE EASED ON ASSUMED PLAT MFRIONN A h T (RIGHT Of WAY
ti t y 'Wt::T i�.Ol1'(i28M} +JROA'ED7/'018 )NE, OF NL ,HLL.-IW'ESr} • ••••
9' S7 Y ) C'X+ \ 1. P RY' NF. r F J F l.'2'
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GAAL' ARF4 IJ:tr llf AiF YYF `i?kM4 P :,PAV Y r'LS Y.YC WMba i4+.7J.vJN11: Y.MJ •:i111A14;,
WY
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F1<)M lKYY1:.:RiMJi} S. PAt rE�a•YJAL JJM�.1Ha hK!YWr2+'`• •'th KYY t. Y•%1('y!
2!� Y. !S.f FiS i. rJ." h.:t/11fAy r1W A.""Atr' f /• JY4.K ✓k NAf-i: L lat YyiC�tfn • • •
{ liI fGAl yr wrrY F1A F� `4l�?V f.%,l h`f)H vcwr.I J' ,�rAxa+C7
k.f. �OL1J STfiEET Iv A�tFtt•++wttw .m rnx SYMM7L8 •
::tl GA.2TJAM19w L AR('.LT•.. i'4,: IYM rr �e r.�MJL<41YIll'ARolf
• •, L �s aYrAyrcre Re:Xxs7rne.^ic¢ my oNV k�1tlGNlr•r!-•�'�r•. {/CWFAA:J• �'1.^"2fs`.lrT.:• • • • • •
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�/ (icxYrt llp l.Wl.E t3 M.Cx :?. F•.:1�F.S5 �' NAL:YAi • ar:Hr anrxa.Lw� . • • • • •
•
CERTIFIED TO: • •
RAPID TITLE SERVICES COMPANY, a-Nrrrcarr.: NA:v Aarfr rAu.Rr.w learn:Ar :ri`ty tFarr -r s9:.••• ••� 1•AT-Rnt •
C.i.AN Apl"i tiA•YSNM "lXXTC YTkTv.Y Mll%bt. a. Sr. •.'Ar• • • �•f!DRTIM'difAIK L"i. L:SA7<K
OLD REPUBLIC NATIONAL 1171E INSUTLINCE COMPANY, - cnw:. c.HaT�Td Aoc' na>'w_*r'r<'wea.1' srn Arr;Rv.';ars • • • • * 'i7 "ayC+"r'Mi►'itt'i`•"'"x`�
REGlNAM. PAVONE. ^D :trlNaJi �+,1 Au+xrw srA UTYAIrr 11 N It'AlrPva..r • •
I B rFr:RK%) Nfg M;T f. r. AYrr I.uN
• • • • •
IMPAC MORTGAGE CORP. ITS SUCCSSORS AND/OR ASSIGNS eIr L F r.A•+Y <; 1rn n1k v Rr 'rt r:xY( T♦w's^'?
F_ • • ,k`P;tl=�>a •
AS THEIR INTERFSTMAYAPPEAR EfFR-A rFJ1yMDJr Tr,i?N<KRttC`'EnT:xFnCAT -;n �'. r-.r'ri 7 .w1a++ rr.aw:r Ltrti rlk w • •lS•sAM u3Weo
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nll•:NT.!'tX.fI:A?I:Jf/' 't:'. IYJR'�:. rKYfr31R:Iu rh'!. •
__ f,!I. 1r4 rrMYLwr /•.. ,: KY/Cr H'rn}IY'wmf:[MR'A1r W' I'll /R.•.t".- V, V F.j, LXJMAM:M(''v.W.'G9"nW
FLOOD ZONE: X PROPERTY OF.-REGINA M. PAVONE. A BOUNDARY SURVEY
14AP 8 PANEL= 12086CO139 1HERi9YC[ROFYMAT OdS801MMRYSURVEY
PITOFESS18NAL S.ftYjjrjAND /PW4
WASMAQOFRMYSUPEAYCOMMUNITY NO,: 120652 141 N.E. 109TH STREET srANDAVSOF:sAcrcESEFFOR7eY lHE
SUFFIXILANitS &GARC)A,:
MIAMI SHORES, FLORIDA 33161 Rr�•: •• • • •
DATE OF FIRM: 09-11-2009 MAPPFP-c IN CkAMR SETT oso THROUGH S. rr.as L(;t!��lr •
FLOR DA AD W AS nM THE CODE. "su1NT 10
BASF FLEV = N/A NOT %ALmW(THO ^ THE' SX NATURF;.IJD THE ,Ecnon 41 Lon. aoRoA STATUTES A+a THAT T- y rsr f FRANCISCO F. FAJARDG fSIV Y 4767 (QUALIFIER)
ORIGINAL RAISED SUL OF A R. CRlLLi _K1 LNSFD SA: .T H ILREON IS rRUF ArR9 CC4 RC r c 1F - f 27i%jj SW 37tlL AVENUE,
•--- ��_`_ -� SURVCYORAN) MAFPER NO!ES4,1 xN747NJNO At f DC+EAri:Be1 F .> �,.: ro w .�F/J MIAMI, FLORIDA33133
NO! _SAND h0?Al?iXR SHONiJ NFRF l7N
/ PH (305) 666-7909 FAX t305.)442-2530
DWG. No.::dU9286 _
kLS571XJA1::11hvCYGitAfA:MA•'3L-
- ------.---•-- - -u-Y .-• RE.,IS, c..nOr. rrc; aTsz � r• t t? DA Tr=:U:b28'R'16 SCALE I. _JU' ORAWNDKJONEUE DWG.No-.260928
s
❑ Shadow Box
V❑ yertical Picket
Board on Board
Fence Good Side
Out. The vertical
and horizontal
supporting
members of a
fence shall face
the interior of the
plot on which the
fence is located
and the finished
side shall face the
adjoining lot or
any abutting right-
of-way.
p6u
lw( PF-s-r
Miami shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
WOOD FENCE DETAIL
i
es < = 6' high posts spaced at 4' on center maximum
es < = 5' high posts spaced at 5' on center maximum
Fences < = 4' high posts spaced at 6' on center maximum
Fence must not exceed 6' in height
• •• ; ; • 041N4pFeSsuretreated
• • ••• • b �p�stsembedded 2'into
• • • + cencre9e footing 10"
�� 0 •diameterx2'deep
eve
••• A61-woodmustbeJpressuretreated I
• . . L
• • + All as �te� ens raustrbe corrosion resistant
•v• �• i j?4ess•thantw,o;s#eners in any connection
Revised ID4U J/2tr116AS • • • • v e • •
400 c 0 0 ••• 0 0
I pickets fastened
with two corrosion
resistant fasteners per
connection
2x4 horizontal
pressure treated
wood members
with two corrosion
resistant fasteners
per connection
A
4
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
OWNER BUI ER DISCLOSURE STATEMENT
NAME: IC- 11 FP,,J b to G DATE: (a — Z d 1 ?I
ADDRESS:
C L,,, �� _-� k � I
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 by law to be licensed in Florida and to list his or license numbers on permits and contr
Initial Ow
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.
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 by county or municipal ordinance.
Initial I
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.
InitialC�
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
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/cilb/index.html
Initial 12�_
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 a/t_
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 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 un!icensed 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 _ 4 h day ofC�JQjuC(r,20
By P)7M1YJ0j MG,, PCAVLff—who was personally known tome or who has
Produced there L' ense or 1-6v
L' f
OWNER
as identifi
YANADY PRIETO
MY COMMISSION # FF 214031
ff EXPIRES: March 25, 2019
'' RF Bonded Thru Notary Pubk Undennifers
NOTARY
0
Regina M. Pavone
141 NEI09th Street
Miami Shores Florida 33161
(305) 546-3414
Miami Shores Village Building Department
10050 NE 2"d Ave
Miami Shores, FL 33138
Re: Fence/Swimming Pool Safety Compliance
Dear Inspectors,
I am the property owner of the residence corresponding to the address above. I had an
inground pool constructed on my property, pending final code inspection. The job has
not passed final building inspection due to the wooden fence that runs along the east
side of the property. The 6' wooden fence belongs to my neighbors to the east, Eric
and Amy Knowles, 129 NE 109TH St. The fence currently is "good side out," relative to
my property. The Knowles have granted me permission to install matching vertical
wood moulded panels to the fence facing their property, allowing for pool safety
compliance for both fence sides. Additionally, several of the posts will need to be
replaced.
I am respectfully submitting this permit application with accompanying documents and
fee, including a recent survey (2 copies), although this is not a new installation, merely a
repair. I can be reached at the following contacts if needed:
reginapavone(a-att.net
(305 6-3414
Xegina Pavone
I (we) concur with the information provided in this letter.
Eric Knowles Amy Knowles Date
129 NE 109TH ST
Miami Shores, FL 33161
Cc: Garry Wiggins, Handyman (305) 979-7955