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RC-19-459Miami 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 Q 4-1 BUILDING PERMIT APPLICATION UILDING ❑ ELECTRIC ❑ ROOFING MAR .01 2019 FBC 20 11 Master Permit No. Sub Permit No. ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS [:]CHANGE OF ❑ CANCELLATION ❑ SHOP ,� /_ - / 2 CONTRACTOR DRAWINGS JOB ADDRESS: 149 dam S-I" W `'4 VC_ , City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): /y ' " ,Phone#: �- 25 ���3Z Address: " to -,o�(� " 2 Ile City: Nd tW1-hO�State: /lam/ �� Zip: I �� Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: /V I" WO' Cb a—C-0tv Phone#: Address: v _5-0 4 ve- City: '. Stage: Zip: 7 �b Qualifier Name: Jl/O CD— �� /e'7'k2 t2 �'� / Phone#: T 62 Ze ` State Certification or Registration #: %7`a yiie Certificate of Competency #: DESIGNER: Architect/Engineer: hh Phone#: - Address: City: State Value of Work for this Permit: $ _�� Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace Description of Work: M ❑ Demolition Specify color of color thru_tile: Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $_ Structural Reviews $. Training/Education Fee $ 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 nature6'�� OWNER or AGENT CONTRACTOR The f egoing instrument was acknowledged before me this dayof(�/�'!�f/Gt 20 by Casa 0.20 — �sonall known to P Y i me or who has produced L�O��AL�(1i7 identification and w156did to iu Print: Seal: a4 0 Notary Public State of Florida 4Karen I Duarte r . My Commission GG 194420 �i c." ill Expires 06/17/2022 APPROVED BY The foregoing instrument' wzs acknowledged before me this day of ��� 20 1 % - , by 1 x w is personally known to me or who has produced identification -aad-wbo take an th. NOTA P I Sign: Print: Seal I Plans Examiner Structural Review R Notary Public State of Florida Karen I Duarte ap EMY xpires OW17 2 GG 194420 Zoning Clerk (Revised02/24/2014) j tY t 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 NAME: IL49 /I- N DATE: d` O� a ADDRESS: 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 1, 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 �Cr' 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 $75,060. 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 lewhich violates the exemption. Initial leas 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. 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. 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 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 htttp://www.mvfloridalicense.com/dbpr/pro/cilb/index.html 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. 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 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 , lc��11 By �Y �,Yl�� who was personally known to me or who has a rn x rn 2 v -ZA. Z,rmg3� Produced ther L cense or as identification. 0 o Qua NG)nNZ C N C, o rn N fD OWNER NOTARY N Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address 10504 NW 2ND AVE, Miami Shores, FL 33150 Cnntaetc Permit o.: RC-03-19-459 Permit Type: Wilding (Residential) �.. if L 9 Work Classifica#ona Add tion/Akeratton Permit status: Approved Issue Date:03/21/2019 1 Expiration: 08/28/2019 Parcel Number 1121360020010 NORMA CHACON Owner HOME OWNER Contractor 10504 NW 2 AVE, MIAMI SHORES, FL 33150 HOME OWNER Other:7862522232 Description: INTERIOR RENOVATION NEW DRYWALL WORK / Valuation: $ 2,000.00 Ins ection Requests: LEGALIZE KITCHEN AND BATH TO REPLACE RC 17-286 §b5-762-4449 TotalSq Feet: 150.00 Fees Amount 100% Permit Renewal Fee $50.00 Application Fee - Other $50.00 Total: $100.00 Building Department Copy Payments Date Paid Amt Paid Total Fees $100.00 Credit Card 03/01/2019 $50.00 Credit Card 03/21/2019 $50.00 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 zoning. Futhermore, I authorize the above named contractor to do the work stated. Signature: C(vner / Applicant / Contractor / Agent Date March 21, 2019 Page 2 of 2 3/1/2019 Property Search Application - Miami -Dade County 1=�,x�OFFICE THE PROPERTY APPRAISER OF Summary Report Property Information Folio: 11-2136-002-0010 Property Address: 10504 NW 2 AVE Miami Shores, FL 33150-1227 Owner NORMA CHACON Mailing Address 10504 NW 2 AVE MIAMI SHORES, FL 33150 USA PA Primary Zone 0800 SG 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 2,127 Sq.Ft Living Area 1,472 Sq.Ft Adjusted Area 1,964 Sq.Ft Lot Size 8,987.5 Sq.Ft Year Built 1944 Assessment Information Year 2018 2017 2016 Land Value $193,411 $193,411 $161,775 Building Value $125,119 $125,276 $125,433 XF Value $2,304 $2,304 $2,304 Market Value 1 $320,834 $320,991 $289,512 Assessed Value 1 $257,658 $252,359 $247,169 Benefits Information Benefit Type 2018 2017 2016 Save Our Homes Cap Assessment Reduction $63,176 $68,632 $42,343 Homestead Exemption $25,000 $25,000 $25,000 Second Homestead Exemption $25,000 $25,000 $25,000 Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). Short Legal Description SHORELAND HGTS PB 43-85 LOT 1 LOT SIZE 71.900 X 125 COC 23740-0934 08 2005 1 Generated On : 3/1/2019 Taxable Value Information 2018 2017 2016 County Exemption Value $50,0001 $50,000 $50,000 Taxable Value $207,658 $202,359 $197,169 School Board Exemption Value 1 $25,000 $25,000 $25,000 Taxable Value 1 $232,658 $227,359 $222,169 City Exemption Value 1 $50,000 $50,000 $50,000 Taxable Value $207,658 $202,359 $197,169 Regional Exemption Value $50,000 $50,000 $50,000 Taxable Value $207,658 $202,359 $197,169 Sales Information Previous Price O Book- Qualification Description Sale e Page 11/05/2014 $315,000 29384-5017 Qual by exam of deed Financial inst or "In Lieu of Forclosure" 07/30/2012 $156,000 28213-4849 stated Financial inst or "In Lieu of Forclosure" 06/08/2012 $0 28202-1478 stated Financial inst or "In Lieu of Forclosure" 03/29/2012 $0 28202-1477 stated The Office of the Property Appraiser is continually editing and updating the tax roll. 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