FW-03-22-575Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address Parcel Number
80 NW 93RD ST, Miami Shores, FL 33150 1131010170020
Contacts
MILTON MIZELL Owner HOME OWNER Contractor
80 NW 93 ST, MIAMI SHORES, FL 331502233 HOME OWNER
Other: 3057581836 MILTONMIZELL@AOL.COM
Inspection Requests
Description: FENCE REPAIR - REMOVING VERTICAL PICKETS ON Valuation: �400.00
garAPPROXIMATELY 18 FEET OF FENCE. AND REPLACING WITHTotal Sq Feet: EEr`Ei ? ;l
PRESSURE TREATED PINE HORIZONTAL BOARDS.
Fees
Amount
Application Fee - Other
$50.00
CCF
$0.60
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.20
Planning and Zoning Review Fee
$35.00
Scanning Fee
$9.00
Structural Review ($45)
$45.00
Technology Fee
$2.50
Wire and Wood Fence Fee
$50.00
Total:
$196.30
Payments
Date Paid Amt Paid
Total Fees
$196.30
Credit Card
03/30/2022 $196.30
Amount Due:
$0.00
IAt L V
A-licant`Copy
For Inspections, Call (305) 762-4949 or Log on at https://bldg.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.
March 30, 2022 Page 1 of 2
Miami 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
BUILDING
PERMIT APPLICATION
OBUILDING ❑ ELECTRIC ❑ ROOFING
Master Permit
Sub Permit No.
'W Tj&Rj&D
M* 0 3 AW
gV1
2-69��
FBC 20?k
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
80 NW 93 ST
JOB ADDRESS:
City: Miami Shores County: Miami Dade Zip:
11-3101-017-0020
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FIFE:
OWNER: Name (Fee Simple Titleholder): MILTON MIZELL Phone#: (305) 494-5222
80 NW 93 ST
Address:
MIAMI SHORES FL 33150
City: State: Zip:
Tenant/Lessee Name: Phone#:
miltonmizell@aol.com
Email:
CONTRACTOR: Company Name: By Owner
Address:
City:
Qualifier Name:
State Certification or Registration #:
DESIGNER: Architect/Engineer:
hone#:
State: Zip:
Phone#:
Certificate of Competency #: _
Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 400 Square/Linear footage of Work: \>/
Type of Work: ❑ Addition ❑ Alteration ❑ New 0 Repair/Replace ❑ Demolition
Description of Work: Fence repair - Removing vertical pickets on approximately 18 liner feet of fence
and replacing with pressure treated pine horizontal boards.
Specify color of color thru tile:.
Submittal Fee $
Scanning Fee $
Technology Fee $_
Structural Reviews $
(Revised02/24/2014)
Permit Fee $
Radon Fee $
Training/Education Fee $
CCF $
DBPR $
CO/Cc $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ l (e yJ
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 L*XVWLSignature
W ERorAGENT CONTRACTOR
The foregoing instrument was acknowledged before me this
day of (f 1"� ��- 20 L by
" r2 is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:_
Print:
The foregoing instrument was acknowledged before me this
day of , 20 , by
as me or who has produced
who is personally known to
identification and who did take an oath.
NOTARY PUBLIC:
Sign:_
Print:
Seal: °*_ MY COMMISSION # GG 950A77 Seal:
EXPIRES: March 6, 2Q?4
''�goF 00 Banded Thru Notary Public Un`!-T!lters
as
***************************************Q*********************************************************************
APPROVED BY 3� r Plans Examiner ��----__� Zoning
ALao kl/
Structural Review Clerk
1.
(Revised02/24/2014)
Ah;: li a Village
illage
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
OWNER BUILDER DISCLOSURE STATEMENT
NAME: tAk uTC) (V �..�, L DA7 E -----
ADDRESS: 00 WW 93.__ST "lAtA\ rivAO(2_SS , F_LISS1_50
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 entities 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 art 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 Taw. 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.
k7iti'I
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 understa d that I may protect myself from potential
financial risk by hiring a licensed contractor and having the permit filed in his or her name instead of my own name. I also understand that the
contractor is required bylaw to be licensed in Florida and to list his or license numbers on permits and c tracts.
initia
4. 1 understand that I may build or improve a one family or two-family residence or a farm outbuilrg. y 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.
initi
5. 1 understand that, as the owner -builder, 1 must provide direct, onsite supervision of the construct n.
Initial
t
6., { understand that I may not hire an unlicensed person to aSt as my contractor or to supervise per ons working on my building or residence. it
is my responsibility to ensure that the persons whom I employ have the license required bylaw and by untyor municipal ordinance.
Initia
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 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
w�t_
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 1 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 title Florida Construction Industry
Licensing Board at 850.487.1395 or,http://www.mvfloridalicL-nse.coM/,Obor/pro/ci[blindex.html
Initial
11. I aril 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:
$O NVU 9S S i 'AwN k s%Ac?2qS
initial
12. 1 agree to notify Miami Shores Village. immediately of any additions, deletions; or changes to any cif 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 maybe 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 property 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 responsiblefor issuing the permit. A copy of the property owner's drive license, the notarized signature of the property
owner, or other type of verification acceptable to the local permitting agency is required wherl the permit is issued.
Was acknowledged before me this day of ` ��r� ,:20 12
BY \ '�� �' -z ? \ \ who was personally known to me or who has
Produced there License or !— L -D C-1 C_ as identification.
0 P%' Afton
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OiA I Y r MY CeiwilWw Expires 1229M
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Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
SURVEY AFFIDAVIT
STATE OF (FLORIDA)
COUNTY OF (DADE)
The undersigned Affiant, M LLTO N M BZ-E L=does hereby attest that
(Property owner)
The attached survey, performed by OK N P�,L E S W. CAM S URV EY l N Ca . L L C—
(Name of surveyor's company)
For address: go Q W 9�MiAtAk s 1Ao L FL 3 3,1 S®
Performed on 0 (date of survey) is an accurate representation of the existing conditions and
locations of all structures on the property as of this date.
The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the property
without first providing a survey less than seven (7) years old old. The Affiant, as property owner, further agrees to
remove or obtain permits for any structures which now may exist on the property which are not permitted or which
may violate zoning or building code regulations. The Affiant further understands that the existence of any such
structures may affect final inspections as applicable to this or other permits.
Further, Affia say eth naught.
MkZ
;jProperty 0 r Signature Property Owner Print Name
SWORN TO AND SUBSCRIBED before me this ��~ day of `��N� °'2—
Affiant is personally known to me, v`*" prod uced-f L— as identification.
Revised on 5/22/2009/ Revised on 6/12/09
ary
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SHEET 2 OF 2
038[ju ns W. CARR g'i?nvugrxxov x1mic.
MAIL TO: PHONE (305) 221-3416
9245 S.W. 441h St. FAX (305) 553-9903
MIAMI, FLORIDA 33165
SEE THE REPORT OF BOUNDARY SURVEY, LANDS DESCRIBED IN PLAT BOOK 41 AT
PAGE 71 . NuANII-DADS COUNTY, FLORIDA. THIS SURVEY MAP IS NOT VALIDWITHOUT
THE SIGNATURE AND ORIGINAL RAISED SEAL OF THE FLORIDA LICENSED SURVEYOR
AND MAPPER. THE SIGNATURE AND SEAL CAN BE FOUND AT THE END OF REPORT.
THE NIAP AND REPORT ARE NOT COMPLETE WITHOUT THE OTHER. FenceoSi --
su de vut. Tha VE rlic
f�pG(1i11g rnari UErs v! cl dG, h� LLOiIt ; inter"or Of the p1�t 0.1 C� s, I
a ter � a
8i1\ cll—
l(ie flliiSfi@� Sl�e S.ldii lie i6,1CQ IS IGGiitdu
N.W. 93 STREET _ _ I(" `�i cliq boutt(,iy u�c the aJ
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15 1 14 a
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N.W. 92 STREET
LEGEND & SYMBOLS
A - ARC LENGTH
BNI - BENCH NLARK
R -- RADIUS
PWRTRA\ - POWER TRANSFORMER
T - TANGE\7
WV -- WATER VALVE
C -- CHORD
W-NI - WATER METER
- DELTAICENTRALANGLE,
P&T -- POWER&TELEPHO`:ELMS
NIEAS - MEASURED
\IH - MANHOLE LID
CAL',- - CALCULATED
CB - CATCH BASIN
PCP .- PER,IANEN7CONTR0L
CO _ CLE:\N-01-7CC\'ER
POENT
-
1_L -- CENTERLINE
PRNI - PERNNENTEN REFERCE
W
CBS- CONCRETE BLOCKSTRL,"7-RE
MONUMENT
,yP - CONCRETE LIFE POLE
PC - PO(NF OF CURVE
CONC. - CONCRETE
R-«' -RIGHT OF WAY
FPL -- FLORIDA POWER & LIGHT I
BNI -- BENCH MAR -I:
EL -- ELEVATION BASED ON 1929'.G:E'
END IP - FOUND IRON PIPE
FND IR -- FOOD IRO`: RCD
CLR - CLEAR
ENCRO -- ENCROACHMENT �
C L F - CHAIN LINK FENCE
W'\1F .. WIRE MESH FENCE
TYP •- TYPICAL (FOR SE\"ERAL,
DH •- DRILL HOLE
NA - NOT APPLICABLE
N. D _ NAIL & DISC j
P-J B. - POINT OF BEGENNING
M NIOV -- C.OUNT\' )10\UNIENT
P.O.C"-POIN7OF COMMENCEMENT
PKC SP - PARKING SPACE
C NI -CONCRETE NIONI:ME''T
i{5'D -- FIRE Hl'DRA.`.-`
S.AN SWR - S--\\MARY SE\),'ER
H C PK6 -- i1ANDIC.AP PARKING
%V M - WATER MAIN
1; E -- LTILTTI' EASEMENT
WE -. WOOD FENCE
LOCATED IN:
VILLAGE OF MIANII SHORES.
MIAMI—DADE COUNTY. FLORIDA .
LOCATION SKETCH
SCALE: 1 INCH = 150 FEET
40 1 W
a
w
LOT DETAILS
SCALE: I INCH = 15 FEET
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MAIL TO:
9245 S.W. 44 h ST.
MIAMI, FL 33165
MAP OF BOUNDARY SURVEY FOR:
PRONE (305) 221-3416
FAX (305) 553-9903
SEE THE MAP OF BOUNDARY SURVEY, LANDS DESCRIBED IN PLAT BOOK 41 AT PAGE 71 , MIAMI-DADE COUNTY, FLC
REPORT AND MAP IS NOT VALID WITHOUT THE SIGNATURE AND ORIGINAL RAISED SEAL OF THE FLORIDA LICENSED SURV
THE SIGNATURE AND SEAL CAN BE FOUND AT THE END OF THIS REPORT. THE MAP AND REPORT ARE NOT COMPLETE WITH(
LEGAL DESCRIPTION:
LOT 2 , SUBDIVISION" CANADAY EXTENSION ".ACCORDING TO THE PLAT THEREOF AS RECORDED PLAT
PAGE 71 ,OF THE PUBLIC RECORDS OF MIAMI-DADE COUNTY, FLORIDA.
CERTIFIED TO:
MILTON A. MIZELL
PROPERTY ADDRESS:
80 N.W. 93RD STREET
MIAMI SHORES, FLORIDA 33138
DATE OF FIELD SURVEY: DECEMBER 30TH2004.
ACCURACY:
THE EXPECTED USE OF THE LAND: AS CLASSIFIED IN THE MINHvIUM TECHNICAL
STANDARDS (61G17-6 FAC). IS "SINGLE FAMILY RESIDENTIAL". THE MINIMUM
RELATIVE DISTANCE ACCURACY FOR THIS TYPE OF SURVEY IS 1 FOOT IN 7500 FEET.
THE ACCURACY OBTAINED BY MEASUREMENT WITH A SOKKIA T IEODILITE AND A
SOKKIA 200 FOOT STEEL TAPE AND CALCULATION OF A CLOSED GEOMETRIC FIGURE
WAS FOUND TO EXCEED THIS REQUIREMENT.
DATA SOURCES:
THE LEGAL DESCRIPTION WAS FURNISHED BY MARK A. CAMPBELL ARCHITECTS 373
N.E. 92ND STREET MIAMI SHORES, FLORIDA 33138.
EASEMENTS:
THE RECORD PLAT DOES NOT INDICATE ANY EASEMENTS ON SUBJECT PROPERTY.
SURVEYOR AND P
CHARGE:
RECERTIFIED: April 27t.h, 2009 CHARLES W. CARR..
SIGNED:
REPORT OF BOUNDARY SURVEY
LANDS DESCRIBED IN
PLAT BOOK 41 , AT PAGE 71
NHANH-DADE COUNTY, FLORIDA
SHEET 1 OF 2
SURVEY NUMBER:04-12-130
SURVEY NOTES
1. THE SURVEY HEREON REPRESENTS A PERRVIETER BOUNDARY SURVEY WITH
EXISTING ABOVE GROUND IMPROVEMENTS LOCATED. NO UNDERGROUND FOOTINGS
WERE LOCATED UNLESS OTHERWISE SHOWN.
THIS SURVEY 2. NO ENCROACHMENTS WERE NOTED BY THIS SURVEY UNLESS SHOWN.
AND MAPPER. 3. ANY NOTORIOUS EVIDENCE OF OCCUPATION AND/OR USE OF THE DESCRIBED PARCEL
-IE OTHER. FOR' RIGHTS -OF -WAY, INGRESS OR EGRESS IS SHOWN ON THIS SURVEY DRAWING.
HOWEVER THIS SURVEY DOES NOT PURPORT TO REFLECT ANY RECORDED
.INSTRUN NTS OR RIGHTS -OF WAY OTHER THAN SHOWN ON THE RECORDED PLAT OR
STATED IN THE LEGAL DESCRIPTION AS IT APPEARS ON THIS DRAWING. THIS SURVEY
'K 41 AT DOES NOT CERTIFY THAT SUCH INSTRUMENTS DO EXIST AND LANDS SHOWN HEREON
WERE NOT ABSTRACTED FOR EASEMENTS AND/OR RIGHTS OF WAY OF RECORD,
4. THIS SURVEYOR DID NOT RESEARCH THE PARTICULAR SETBACKS AS REQUIRED BY
THE ZONING OF THE DESCRIBED PARCEL, NOR DOES THIS SURVEY CERTIFY THAT ANY
OF THE IMPROVEMENTS SHOWN ARE IN COMPLIANCE WITH THESE ZONING REGULATIONS.
5. THE NORTH ARROW AND BEARINGS AS SHOWN ARE DERIVED FROM THE ASSUMED
MERIDIAN ON THE RECORDED PLAT; THE LEGAL DESCRIPTION THEREON IF SAID
DESCRIPTION IS A METES AND BOUNDS AND/OR A FRACTIONAL DESCRIPTION THE
BEARINGS ARE DERIVED FROM COUNTY SECTION MAPS AND THE BASE LINES ARE
SHOWN ON THE LOCATION SKETCH.
6. THE FLORIDA INSURANCE RATE MAP PANEL 0093 i DATED 7-17-95 , INDEX DATE 3-
2-94, COMMUNITY No. 120652 NATIONAL FLOOD INSURANCE PROGRAM DELINEATES THE
HEREIN DESCRIBED LAND TO BE WITHIN ZONE "X " . ELEVATION N/A FEET.
THIS IS NOT A FLOOD HAZARD ZONE.
7. ELEVATIONS ARE BASED UPON NATIONAL GEODETIC VERTICAL DATUM AND BENCH
MARKS ARE CITY, COUNTY, STATE OR GEODETIC VERTICAL REFERENCE MONUMENTS,
8. THIS IS A LAND SURVEY AND WAS PREPARED IN ACCORDANCE WITH FLORIDA
STATUTE 472 AND THIS SURVEY COMPLIES WITH THE MINIMUM TECHNICAL STANDARDS
ADOPTED BY THE FLORIDA STATE BOARD OF PROFESSIONAL LAND SURVEYORS
PURSUANT TO CHAPTER61G17-6 FLORIDA ADMINISTRATIVE CODE AND MEETS THE
REQUIREMENTS OF THE FLORII)A LAND TITLE ASSOCIATION.
ER IN RESPONSIBLE
>E NUMBER LS 1060,
OF FLORIDA.
f� S