RC-10-20-2487Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address Parcel Number
8953 NE 4TH AVENUE RD 8953, Miami Shores, FL 33138 1132060460420
offasum
Contacts
SHAWN CLARK Owner HOME OWNER Contractor
8953 NE 4 AVE, MIAMI SHORES, FL 33138 HOME OWNER
shawn@miami.edu
markacampbellarchitect33138@gmai
Isom
Inspection Requests:
Description: REPLACE KITCHEN CABINETS, EXTEND COUNTER Valuation:
$ 6,000.00
TOP, REPAIR SOME DRYWALL, RELOCATE BATHROOM DOOR .
305 762-4949
REPLACED 13-576 1 £ Total Sq Feet:
0.00
Fees Amount
Payments
Date Paid
Amt Paid
100% Permit Renewal Fee $180.00
Total Fees
$180.00
Total: $180.00
Credit Card
11/03/2020
$180.00
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 regyired for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
d zoning. Futhermore, I authorize the above named contractor to do the work stated.
Authorized Signature: Owner
/ Applicant / Contractor / Agent
Date
November 03, 2020 Page 2 of 2
Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address Parcel Number
8953 NE 4TH AVENUE RD 8953, Miami Shores, FL 33138 NNMAs= Wsu
Contacts
SHAWN CLARK Owner HOME OWNER Contractor
8953 NE 4 AVE, MIAMI SHORES, FL 33138 HOME OWNER
Shawn@miami.edu
markacampbellarchitect33138@gmai
Isom
� w���m�ov�ewvvvvvvvwvvvvovvv� " ��
Description: REPLACE KITCHEN CABINETS, EXTEND COUNTER
Inspection Requests:
=
Valuation: $ 6,000.00
TOP, REPAIR SOME DRYWALL, RELOCATE BATHROOM DOOR
. l
305 762 4949
REPLACED 13-576
'Total Sq Feet: 0.00
Fees Amount
Payments Date Paid
Amt Paid
100% Permit Renewal Fee $180.00
Total Fees
$180.00
Credit Card 11/03/2020
$180.00
Total: $180.00
Amount Due:
$0.00
Applicant Copy
For Inspections, Call (305) 762-4949 or Log on at https://bidg.miamishoresvillage.com/cap/.
Requests must be received by 3pm for following day inspections.
NOTICE: In addition to the requirements of this permit, there may be AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER
additional restrictions applicable to this property that may be found in the GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS,
public records of this county. STATE AGENCIES, OR FEDERAL AGENCIES.
November 03, 2020 Page 1 of 2
BUILDING
PERMIT APPLICATION
Miami Shores Villageaz.EcEIvED
Building Department OCT 2 8 2o2o
10050 N.E.2nd Avenue, Miami Shores, Florida 3313ft,,;
Tel: (305) 795-2204 Fax: (305) 756-8972 .__,,_�
INSPECTION LINE PHONE NUMBER: (305) 762-4949 41.
I"v
FBC 20)4
Master Permit No. _Ic- `O" 2�0
Sub Permit No.
UILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION 05RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
C,i CONTRACTOR DRAWINGS
��l" JOB ADDRESS: � %�� ( � �� 4�
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: % l 06v :�416 &Y L--0 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder):
Address:�� !�
City:, ( J
Tenant/Lessee Name:
Email
CONTRACTOR: Company Name:
Address:
Phone#: q 76 7 Fy olz�
State: d''—( Zip: 53 f!
Phone#:
Phone#:
City: State:
Qualifier Name: Phone#:
/
State Certification or Registration #: i 107t- <_' 41 49i4rfi e of Competency #: _
Zip:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $��>c e' O Square/Linear Footage of Work: z uy
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Technology Fee $
Structural Reviews $
Permit Fee $ CCF $_
Radon Fee $ DBPR $
Training/Education Fee $
CO/CC $
Notary $
Double Fee $ _
Bond $
(Revised02/24/2014)
TOTAL FEE NOW DUE $ 180' <!B0
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
E.
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 i_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
11 day of t`�'��b� r 20, by day of 20 , by
A�UW0 Z)0n0'fQLn Cjff� ,who is personally known to who is personally known to
me or who has produced 'EL bL as me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Sign:
Print:
Print:
Seal:
SELENA ARAN AD
Seal:
u�
iPt�::�' •`t
MY COMMISSION # GG202405
EXPIRES: March 22,
"rs cP�ed..
N NatarY Public olervml l
I�
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
OWNER BUILDE DISCLOSUR TATEMENT
NAME: �ZC,12_0
DATE:
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
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.
fnitial___`����7`\
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,
11090-7
Initi
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 l within 1 year after the
construction is complete, the law will presume that I built or substantially improved it for sale or lease, vdUCLy.%erates the exemption.
Initial !�<
5. 1 understand that, as the owner -builder, I must provide direct, onsite supervision of the constructio
Initial
6. !understand that I may not hire an unlicensed person to act as my contractor or to supervise person ing on my building or residence. It
is my responsibility to ensure that the persons whom I employ have the license required by law and county r nicipal ordinance.
Initial
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.
Initial-
B. 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 m on the Florida Construction Industry
Licensing Board at 850.487.1395 or http://www.myfloridalicense.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 i n 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 dvho 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 OC--f1Dbff , 20 Zee
By��)VUW i) DOntV0W) Clarkwho was personally known tome or who has
Produced there License or _FL- _D as identification.
OWNER
NOTARY
SELENA ARANDA
y, W COMMISSION # GG 971705
EXPIRES: March a `V'
Bonded ihru c `2''
Miami Shores Village �iAk 2,Z 2013
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
FB C 210
BUILDING Permit No.J
PERMIT APPLICATION Master Permit No.
Permit Type: BUILDIN ROOFING
JOB ADDRESS: P-53 V E yj-4 AVe R-oa c
City: Miami Shores County: Miami Dade Zip: 33 l 3 Q'
Folio/Parcel#:
Is the Building Historically Designated: Yes
NO X Flood Zone:
OWNER: Name (Fee Simple Titleholder):s�2ht 4"2 Phone#: 30S 767
Address: 10795-3 WE S!AI- IA'e 'm'O'k
City: 2htKMI 'S401rL5 State: rL Zip: 33
Tenant/LesseeName: Phone#:
Email: ig & (2 ye'-"6 4- ; C6m_
CONTRACTOR: Company Name:;�t.,t�i��t f2— Phone#:
Address:
City: State: Zip:
Qualifier Name:
State Certification or Registration #:
Phone#:
Certificate of Competency #:
Contact Phone#: Email Address:
DESIGNER: Architect/Engineer: :5_4 /OGi% z�V-, -A i �f'c /5 Phone#:
Value of Work for this Permit: $ 60w oe, Square/Linear Footage of Work: Zoo se FX91
-
Type of Work: ❑Addition ❑Alteration ❑New XRepair/Replace ❑Demolition
Description of Work:
i&os►%v- Avtw
Cl�C A 10- Aff-" r I, AAV',edt-&CJe,'S C11-. /nC.
Submittal Fee $ Permit Fee $ aJ CCF $ CO/CC $
Scanning Fee $
Notary $
Radon Fee $
Training/Education Fee $
DBPR $ Bond $,
Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $!573
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
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 ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 pennit 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 rein spection.fee will be charged.
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this
day of 20 1—,
who is personally known to me or who has produced"'
As identification and c id,take an oa(k
NOTARY PUBLIC:
Sign: O
Print:
Si
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:
Sign:
Print:
My Commission Expires: f +'1/'rJ H f '����� My Commission Expires:
•�:�:��:••T:x�:�:�*�*�:�:�������*�:x:• �:: �x����x:xx�*��x��x�*�x��>K�x*:x�x�*�:xa;�x�:��:*:xa::;:x���x�*:x:xr��*�x*�x�x*:xx�:x�:�x��:�*x�x��xx��x:*x:�:x:��x�::x��x��:
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
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: JIevg Ale- L DATE: -J)tC •
ADDRESS: We VA AVe 11b . fA\Au^ �\ s%S, ri- 3-3
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. I 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. TM
Initial IDC/
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 3w,'
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 ,vc_'
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.
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 by county 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 c3,yc,
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 Svc,
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 JAB./
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 y C,
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. �1 '
Initial J v
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 ZA 20 j2
By
who was personally known to me "or1W49 has
Ml
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. CL(" - � ' � SITAX FOLIO NO. II - - ?" " 04 1!,
STATE OF FLORIDA:
COUNTY OF MIAMI-DADE:
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real
property, and in accordance with Chapter 713, Florida Statutes, the following information
is provided in this Notice of Commencement.
1. Legal description of property and street/address: jhe
L)AJbi V ` ql t7ca fn � ir, Ldtald yt,:4,
2. Description.of improvement: UibAwJ-e- o loe,,-ic.z l
CHIN 2013RO287968
OR Bk 28580 Ps i 271 a (1 t:+s )
RECORDED 04/12r"2013 15:27<:1
HARVEY RUbINY CLERK OF COURT
MIAMI-DADE COUNT`trr FLORIDA
LAST PAGE
Space above reserved for use of recording office
3. Owner(s) name and address: -1e" t loon i)" 0 I,�Iyf; K1153 WC- 4*" &y't � f (Y1ip' l 5 aUfVt ,g i
Interest in property: 0tuflp A �T 3
Name and address of fee simple titleholder:
4. Contractor's name, address and phone number:
�ja� v � ram_ ✓v�rk C . ! yZb i sii i Z�z
5. Surety: (Payment bond required by owner from contractor, if any) '
Name, address and phone number:
Amount of bond $
6. Lender's name and address:
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by
Section 713.13(1)(a)7., Florida Statutes,
Name, address and phone number:
--31.38�-
8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section
713.13(1)(b), Florida Statutes. / ,-. Q
Name, address and phone number: c�7 4s�wh t� 1 r/�7�/� �q S� PG � AVe (24 c?% 62-1
9. Expiration date of this Notice of Commencement:
(the expiration date is 1 year from the date of recording unless a different date is specified)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT RE CONSIDERED
IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AN ,Q�TE 0`
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUHINW CGU
OR RECORDING YOUR NOTICE OF COMMENCEMENT. I HEREBY CERTIFY that is a title
I filed ' th' o y of �.
Signature(s) of Owner(s Owner( ' Authorized Officer/Director/Partner/Man cs
Prepared By Prepared By
Print Name 17a k-- Print Name WR14E55my a' l`Mt+
Title/Office O Title/Office�ui�,
STATE OF FLORIDA-,--.--
COU OF MIAMI-DA `� - �pnr u�c NANCYCaOLDRNVG
Th o oin in ument a ackno a ed b o me this day of L� MY COMMISSION # EE aso780
gy EXPIRES: February 15, 2017
❑ Individually, or, ❑ as for '9TFtoT od` UMCIN frortl UWget Notary Services
�nally
known, or ❑ produced the following type of identific ' n,
Signature of Notary Public:
Print Name: T J')
(SEAL)
VERIFICATION PURSUANT TO SECTION 92.525, FLORIDA STATUTES
Under penalties of perjury, I declare that I have read the foregoing and
that the facts stated in it are true, to the best of my knowledge and belief.
Signature(s) of wner(s) or Owner )'s Authorized Officer/Director/Partner/Manager who signed above:
By ���� By
71
123.01-52 PAGE 3/10
PERMIT #
CONTRACTOR:
SUBMITTAL DATE:
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ADDRESS:
NAME:
RESUBMITAL DATES:
PROJECT TYPE:
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STRUCTURAL
IMPACT FEES
ELECTRICAL
HRSIDERM
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MECHANICAL
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ADO SMOKE/CARBON MONOXIDE DETECTORS.
ANY AND ALL CLOTH AND RUBBER
INSULATED CONDUCTORS TO BE REPIL_ACED.
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UNTY RULES AND RECjUL.ATIONS
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LEGAL DESCRIPTION
SHORES VILLAS CONDO BLDG B UNIT 8953,
UNDIV. Yae% INT. IN COMMON ELEMENTS. AS
RECORDED IN CLERKS FILE: 74R-185949 &
74 R-263202
SITE PLAN
N.T.S.
TNOTH
CLARK RESIDENCE
KITCHEN -BATH REMODEL
sago
architects
MARCH 21, 2013
APR 08 � 013 I
EXISTING FLOOR PLAN
scale: 1 /4"=1$-0"
t LARK RESIDENCE
R y,, KITCHEN —BATH REMODEL
-7� SALOW
t a rc h i tects
APRIL 4, 2013
•
uN
CLOSET
2' L-E
iu
EXIST.UTILITY ROOM
EXISTING LIVING ROOM I
EXIST. HROOM
17'-1 N
o EX. ELECTRIC PANEL
I I
�A� FIG
L D/� ' J Um O
I
SINK STOVE/OVEN
o
E]l
RTITION WALL
o
EXISTING ENTRY
O
g
1'
2' ll'-4' (V,I,F.)
EXIST. KITCHEN 4' 2'-6'
Z
o
J
N
F-
(n
X
W
X. SIDE/DOOR
FLOOR PLAN
scale: "1/4 ="I —U
CLARK RESIDENCE
1, KITCHEN —BATH REMODEL
SAI n
a. rc h i te(ts
`a I MARCH 21, 2013
LIGHTING —ELECTRICAL PLAN
scale: 1 /4"=1 ' —0"
CLARK RESIDENCE
KITCHEN —BATH REMODEL
ALQ
1
rc h i tuts
APRIL 4, 2013
Folio
11-3206-046-0420
Property Address
8953 NE 4 AVE RD 8953
Owner Name(s)
JENIFER DAY CLARK
Mailing Address
8953 NE 4 AVE ROAD
MIAMI SHORES FL
33138
Primary Zone
3000 MULTI -FAMILY - GENERAL
Use Code
0007 CONDOMINIUM - RESIDENTIAL
Beds/Baths/Half
2/2/0
Floors
0
Living Units
1
Adj. Sq. Footage
954
Lot Size
0
Year Built
1974
Legal Description
SHORES VILLAS CONDO BLDG B
UNIT 8953
UNDIV 1/88% INT IN COMMON
ELEMENTS
CLERKS FILE 74R-185949 &
74R-263202
Current Previous
Year 2012 2011
Land Value $0 $0
Building Value $0 $0
Market Value $64,050 $85,400
Assessed Value $53,8951 $52,326
Current Previous
Year
2012
2011
Homestead
$25,000
$25,000
2nd Homestead
$3,895
$2,326
Senior
$0
$0
Veteran Disability
$0
Civilian Disability
$0
$0
Widow(er)
$0
$0
Disclaimer
MIAMI-DADE COUNTY
OFFICE OF THE PROPERTY APPRAISER
PROPERTY SEARCH SUMMARY REPORT
Carlos Lopez-Cantera
Property Appraiser
i►e
A Aerial Photography 2012
N
I Current Previous I
Year 2012 2011
Exemption/Taxable Exemption/Taxable
County $28,895 / $25,000 $27,326 / $25,000
School Board $25,000 / $28,895 $25,000 / $27,326
City $28,895 / $25,000 $27,326 / $25,000
Regional $28,895 / $25,000 $27,326 / $25,000
Sale Infoffnatlan-
Date Amount Recording Qualification Code
2/2012
$60,000
28110-0711
Sales qualified as a result of
examination of the deed
5/1987
$45,000
13300-1357
Sales which are qualified
4/1980
$52,000
10721-2088
Sales which are qualified
4/1976
$40,500
00000-0000
Sales which are qualified
The Office of the Property Appraiser and Miami -Dade County are continually editing and updating the tax roll and GIS data to reflect the latest property information
and GIS positional accuracy. No warranties, expressed or implied, are provided for data and the positional or thematic accuracy of the data herein, its use, or its
interpretation. Although this website is periodically updated, this information may not reflect the data currently on file at Miami -Dade County's systems of record.
The Property Appraiser and Miami -Dade County assumes no liability either for any errors, omissions, or inaccuracies in the information provided regardless of the
cause of such or for any decision made, action taken, or action not taken by the user in reliance upon any information provided herein. See Miami -Dade County full
disclaimer and User Agreement at http://www.miamidade.gov/info/disclaimer.asp.
Property information inquiries, comments, and suggestions email: pawebmail@miamidade.gov
GIS inquiries, comments, and suggestions email: gis@miamidade.gov Generated on: Friday, March 22, 2013
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
March 27, 2013
Permit No: RC13-576
Building Critique
The plan shows to remove an existing wall. Where is the wall being removed
from. Show the existing layout. Identify all interior bearing walls supporting the
second floor. The wall that separates the kitchen from living is bearing.
Norman Bruhn CBO
305-762-4859
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.