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DOCK-12-23-3172Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Parcel Number 1301 NE 104TH ST, Miami Shores, FL 33138 1122320300040 Contacts Dion Sena Owner HOME OWNER Contractor 1301 104 HOME OWNER cathy@ltcbusiness.com Mobile: 3057739559 mikeperez2987@gmail.com Inspection Requests: Description: TO REPLACE DOCK-06-23-1480 - REPLACE PLANKS Valuation: $ 0.00 , s N� ON DOCK WITH WOOD COMPOSITE (BROWN) € Total Sq Feet: 0.00 g, Amt Paid Payments Date Paid Fees Amount 25% Renewal Fee $25.00 Total Fees $25.00 Credit Card 12/21/2023 $25.00 Total: $25.00 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 required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS=AF%iT rtify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulatingn oning. �hermore, I authorize the above named contractor to do the work stated. Authorized Signature: Owner / Applicant / Contractor / Agent Date December 21, 2023 Page 2 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 FBC 20 BUILDING Master Permit No._7�0G14- a.1- dt3- I'leo PERMIT APPLICATION Sub Permit No. ®BUILDING ® ELECTRIC ® ROOFING ® REVISION ® EXTENSION 06E EWAL O PLUMBING ®MECHANICAL ® CHANGE OF ® CANCELLATION ® SHOP / % CONTRACTOR DRAWINGS JOB ADDRESS: // 3 O / /� Z2-7/ a �a�Z City: Miami Shores County: Miami Dade Zip: z l Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Title h`older) : / C"2 Phone#: Address: City: Tenant/Lessee Name: Email: CONTRACTOR: Company Name: Address: > �A �t Email: Qualifier Name: State Certification or Registration #: DESIGNER: Architect/Engineer: Address: Value of Work for this Permit: $ Type of Work: ® Addition ®/ Alterati 6 State: �— /,\- /V? 'c� IL/' _,z_1[1p7 0 Phone#: Phone#: Phone#: Certificate of Competency #: _ Phone#: City: Square/Linear Footage of Work: ❑❑ New Repair/Replace l Description of Work: / K242 f G/`/ l Specify color of color thru tile: Submittal Fee $ Scanning Fee $ Technology Fee $_ Structural Reviews $ Permit Fee $ DCA Fee $ Training/Education Fee $ CCF $_ DBPR $ P&Z Review $ State: Zip: ❑❑ Demolition CO/CC $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ S' (Revi5ed04/05/2022) 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: �-Z5 n 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 most 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 — 411 4-/151 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 an ontracts. Initial 4. 1 understand that I may build or improve a one family or two-family residence or a farm outbuilding. I may also build or improve a commercial building if the costs do not exceed $75,000. The building or residence must be for my use or occupancy. It may not be built or substantially improved for sale or lease. If a building or residence that I have built or substantially improved myself is sold or leased within 1 year after the construction is complete, the law will presume that I built or substantially improved it for sale or lease h" violates the exemption. w 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 o y or municipal ordinance. Initia Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Parcel Number 1301 NE 104TH ST, Miami Shores, FL 33138 1122320300040 Contacts Dion Sena Owner HOME OWNER Contractor 1301 104 HOME OWNER cathy@ltcbusiness.com Inspection Requests: Description: REPLACE PLANKS ON DOCK WITH WOOD ValuLe : $ 0.00 r COMPOSITE (BROWN) d+ r t� j3rv�' Totaet: 0.00 � „ . .. Fees Amount Application Fee - Other $50.00 DBPR Fee $2.00 DCA Fee $2.00 Permit Fee $50.00 Planning and Zoning Review Fee $70.00 Technology Fee $10.00 Total: $184.00 Payments Date Paid Amt Paid Total Fees $184.00 Credit Card 06/20/2023 $134.00 Check # 665 06/09/2023 $50.00 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 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. / Applicant / Contractor / Agent June 20, 2023 Page 2 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 �UILDING ❑ ELECTRIC ❑ ROOFING � R 9 R 0 T R JUN 0 9 2023 By FBC 202D Master Permit Nokcy-t(0-�3-k4e6b. Sub Permit No. ❑ REVISION ❑ EXTENSION ❑ RENEWAL ❑PLUMBING ❑ MECHANICAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: GO I Iy E 10 s l• City: Miami Shores County: Miami Dade Zip: 331318 Folio/Parcel#: - 223 2- 0 31c) - oo `7 a Is theBuildingHistorically Designated: Yes N0 YI Occupancy Type: Bern. Load: Construction Type: C p5 Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): I)I oiler}—t Cathy Se n ci Phone#: ,305- 9Q 6 - A077Q , Address: 13t0 l N.E. 104 l City: M i aev% 1 J ho r If 5 State: F Zip: 3313 8 Tenant/Lessee Name: IJ I a Phone#: Email: I-1 CoIds1-%!e-, r- @_aol. epryn ea- kSj 0.LTGb05r nesS.COpn CONTRACTOR: Company Name: Phone#: Address: Email: Qualifier Name: Phone#: State Certification or Registration #: Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ :�, DOd Square/Linear Footage of Work: %os — Type of Work: ❑ Addition El Alteration ❑ New Repair/Replace ❑ Demolition Description of Work: 9zp1QCe pl ak) Ls nh d0de— U) 177111 Wond ,e'(,Zmp'o'sl 7e_ Specify color of color thru tile: 10 rout 1q. Submittal Fee $ Igt�to . Permit Fee $ CCF $ CO/CC $ Scanning Fee $ DCA Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ P&Z Review $ Bond $ TOTAL FEE NOW DUE $ `"✓'T'� (Revised04/05/2022 ) WN �J 9 ZO2a OWNER BUILDER DISCLOSURE STATEMENT Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 NAME: V On SeVW DATE: Cl vZ3 ADDRESS: 13O1 N C_ (O `t �j�. H i Ct ✓Yl,l 5 S. FL 3 313 0 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 (`` 5S 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 CJ l 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 CS S 5. 1 understand that, as the owner -builder, I must provide direct, onsite supervision of the construction. Initial C 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 SntJ V' UN V V— T�� 11 v�. �0; 08F-1301-92-509 4747 HOLLYWOOD BLVD.. STE 105, HOLLYWOOD, FL 33021 PHONE (954) 241-3000 LICENSED BUSINESS# 7326 FOR: SENA ADDRESS: 1301 NE 104TH STREET, MIAMI SHORES, FLORIDA 33138 DATE:0&13.2D08 LE_.GAL DESCRIPTION: LOT 5 AND THE WEST 25,00 FEET OF LOT 5 AND THAT CERTAIN 25,00 FEET STRIP LYING BETWEEN LQT5 4 AND 5. IN BLOCK I. OF -RIVER BAY PARK^, ACCORDING TO THE PLAT THEREOF, AS RECORDED IN' PLAT BOOK 41. PAGE 55, OF THE PUBLIC RECORDS OF MIAMbDADE COUNTY, FLORIDA. FLOOD ZONE: AS 8.0' — COMMUNITY NUMBER: 120652 — FIRM INDEX NUMBER: 12026CO093J CERTIFIED TO- - DION R. SENA AND LATHY SENA BOUNDARY SURVEY CNA O/S 2.98'S 0.37'E LEGEND & ABBREVIATIONS: A/C............ AIR CONDITIONER BM..............BENCHMARK 0. .............CALCULATED CITY C.G............CURB CONCRETE GU GUTTER OR VALLEYEp GUTTER C 8 G,.....,,,CURB b GUTTER CH .............. CHORD CHSRG.....,,CHORD BEARING C.M.E....,,,,,CANAL MAINTENANCE EASEMENT OKA............ CORNER NOT ACCESSIBLE CONC,.......,CONCR(C E 0.................DILTARAIN (CENTRAL ANGLE) D.B..............DRAINAGE EASEMENT EOP............EDGE OF PAVEMENT COPY FC...............FENCE CORNER FOH..........IOUND DRILL HOLE FE...............FENCE ENDS .F..............FINI9HED FLOOR T 1 FIPlFIR,....,,FOUND IRON P1PElROp -" 4 FN...............FOUND NAIL — FNbD.......... FOUND NAIL AND DISC F,Pk,N.....,...FOUND PARKER KALON NAIL I-D.............. 4URVEYOR'S IDENTIFICATION L.................. LENGTH LA.E,.......... LIMITED ACCESS EASEMENT L.M.E..... ,..LAKE MAINTENANCE EASEMENT (M)..............MEA9URE OIS..............OFFSET (P)............... PLAT PB...............PLAT BOOK P.C...,..-.....,POINT OF CURVATURE P,C.C,,,,,,,;.,POINT OF COMPOUND CURVATURE PG—- PAGE P.I.......POINT OF INTEPSECTION P.O,B,.....,,.,POINT OF BEGINNING P-O,C , ,.,,,,POINT OF COMMENCEMENT P,R.0.......... POINT OF REVERSE CURVATURE (/ .R,M,.,.,,,,,PERMANENT REFERENCE MONUMENT v P.T........... _POINT OF TANGENCY R................. RADIUS RNV.............l WAY S / SIR..............SET SET tl7* IRON ROD SNO........ ... SETNAIL AND DISC Q / (TYP,),......... TWICAL �o U...............UTILITY EASEMENT ` W.E. ............ WATERS EDGE <cr OVERHEAD CASLES(OH) pOLYVINYLCHLORIDE FENCE (PVCF) WIRE OR CHAIN LINK FENCE"(CLF) �� 361.85' (P)(M) E WOOD FENCE (WF) / P. �.4 — _ . ._ _./� — FIP M AL FENCE (MP) FIR 1 /2" MASONRY OR CONCRETE BLOCK WALL CONCRETE CONCRETE PAVERS OVERtHANG(O/H) OR ROOF Q COMMUNICATIONS BOX % CENTER LINE I0 GAS METER CATCH BASIN (CB) R PROPERTY LINE AIR CONDITIONER iI SEWER MANHOLE ® SEWER CLEANOUT la �i UTILITY POLE (UP) CABLE BOX (CA Tv.) INDICATES DIMENSION LIGHT POLE (LP) IS NOT TO SCALE METER (EM) E WATER METER (WM) Z WATER VALVE RISER UTILITY ANCHOR ELECTRIC BOX (FPL) Q BOUNDARY CORNER FIRE HYDRANT (FH) HANDICAP PARKING (HCP) ELEVATION �i PLANTER OR PLANTED 0 POINT OF ELEVATION NOT A VALID SURVEY WITHOUT THE SIGNATURE AND ORIGINAL NOTE: RAISED S A FLO LICENSED SURVEYOR b MAPPER THIS IS A COPYRIGHT DOCUMENT CONTA4NWO, PROPRIETARY INFORMATION AND 15 NOT WARRANTED BY PROFESSIONAL SURVEYORS, 9NC. OR THE 91GNING SURVEYOR WHEN COPIED BY OTHERS. UNLUS OTHariaE SHOWN HEREON, THE FOLLOWING NOTES APPLY: SURSTAN ��J _ THERECDLANOSSHOWN ON WERE: NAND MEASUM CALLS AREOTABBTRACTaoFOREASE`M&MOROTHERRECORDEDE(CUM ISRMICESNOT _ SHOWN ON THE PLAT AND THE SAME, IF ANY MAY NOT BE SHOWN ON TINS SKETCH. VNWJWRDUND PORTS OF FOOTINGS, FOUNDATIONS OR OTHER IWROVEME�NTS WERE NAT =AM. ELEVATWN9 ARE BASED ON NATIOPM GEODETIC VERTICAL DATUM IGn (N.G.V.D. IMI. LouIE P. JoHNsro THE OWNERSHIP OF TS ARE TOHE CENTERLINE FRAN'Y) IS NOT OETETERNINED. Of FLQ L SURVEYOR MAPPER ND.2173 WALL TIES ARE TO THE FACE OF THE WALL PROFESSIONAL b BA51S OF BEARINGS, IF ANY, ARE AWUWM PER PLAT AN VOR LEGAL DESORPTION.STATE OF IOftIDA THIS SLRVEY HAS BEEN PREPAMO MR THE EXCLUSIVE PURFPQSE FOR USE AS AN AID IN OBTAIINING A BUILDING PERMIT ON THE HEAEDN M121 M POIOPERTY. NO A=YX*IAL WAmmnAFs p"ca=w a,..'.u-_ 25' EASE (PER ti&W 76e!� 0.45'E