DS-06-23-1496Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Permit No.: DS-06-23-1496
Permit Type: Driveways/Walkways/Slabs
work Classification: Addition/Alteration
Permit Status: Approved
Issue Date: 08/01/2023 Expiration: 02/01/2024
Location Address Parcel Number
305 NE 91ST ST, Miami Shores, FL 33138 1132060136490
Contacts
ALFRED DOWSON Owner OWNER Contractor
305 NE 91 ST, MIAMI SHORES, FL 331383129 Owner OWNER
Home: 7865564086 mcddcs@gmail.com
Description: AFT TILE OVER EXISTING FRONT PORCH & Valuation: $ 2,500.00
WALKWAY & FRONT STEPS ---
Total Sq Feet: 4g6.00-
Fees
Amount
Application Fee - Other
$50.00
CCF
$1.80
Concrete/asphalt/pavers, slabs, dways,
$50.00
swalks
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.90
Planning and Zoning Review Fee
$70.00
Scanning Fee
$3.00
Technology Fee
$10.00
Work without Permit Fee
$100.00
Work Without Permit Fee- Plus $100
$100.00
Total:
$389.70
Ins action Re uests:
Payments Date Paid Amt Paid
Total Fees $389.70
Check# 5084 08/01/2023 $389.70
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. Futhennore ulhorize the above named contractor to do the work stated. , ,
mature: Owner / Applicant / Contractor / Agent Date
August 01, 2023 Page 2 of 2
1
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Miami Shores Village PInCEIVEL)
Building Department JUN 12 2023
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY:9it
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 2020
BUILDING Master Permit No.& —06— 23-Lg96
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION DRENEWAL
❑PLUMBING ❑ MECHANICAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
^` CONTRACTOR / � DRAWINGS
JOB ADDRESS: �%� /[� / 1/5 Y
CCU: Miami Shores County: Miami Dade Zip: 3'2 3
Folio/Parcel#: // — 41,2� —01.5 - / Y y 19 Is the Building Historically Designated: Yes NO --L
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
Tenant/Lessee Name: Phone#:
RNM;
CONTRACTOR: Company Name:
Address:
Email:
Qualifier Name:
State Certification or Registration #:
DESIGNER: Architect/Engineer: _
of Competency #:
Aaaress: City: State: Zip:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: ❑ Addition E+ Alteration ❑ New ❑ Repair/Replace ❑ emolition
/ c
Description of Work:
Specify color of color thru tile:
Submittal Fee $ • A7 Permit Fee $ CCF $ • $O CO/CC $
Scanning Fee $ .3 ' DCA Fee $ DBPR $ 00 Notary
Technology Fee $ 10 - CO Training/Education Fee $ ' Q0 Double Fee $,
Structural Reviews $ P&Z Review $ 7 O' CXJ Bond $
�
2
(Revised04/05/2022)
TOTAL FEE NOW DUE $ .99 R • 70
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
OWNS orA ENT
The foregoing instrument was acknowledged before me this
t
4 day // �lof �� 20 �3 by
W ✓)/O'U`St'n , who its personally known to
me or who has produced 1 /l I as
identification and who did take an oath.
NOTARY PUBLIC:
Sign: y¢ &-;o-7ZZ
Print:
S`YpRPeSeal: CHRISTOPHE.KEY
k Commission#GG950755
�A< Expires May 21,2024
'�'op ft`' aab,A7luuauEpel Noteryaxvkea
CONTRACTOR
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
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APPROVED BY �T Plans Examiner A0,0699"jl f' 1�71// Zoning
T� a- 06 /Zol�z
Structural Review Clerk
(Rev1sed04/05/2022)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
OWNER BUILDER SCLOSURE STATEMENT
NAME:
ADDRESS: —
Do hereby petition the ViI age of Idiami Shores :c Ec a_ -c . actor pursuant to the laws of the State of Florida, F.S 489.103(7 . And I have
read and understood the following disclosure staten-e' enbtics me to work as my own contractor; I further understand that I as the owner
most appear in person to complete all applications.
State Law requires construction to be done by a license- 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-famil\ residence. You may a!sc build or improve a commercial building at a
cost of 525,000.00 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 a, :ease a 7- long i,o_ have built Yourself", :r r one yez :he construct¢ - __ .riete, the law will presume that you built
for sale or lease... . ; _ _ -.,s 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. ' - son working on
Your building - ce-sed r-_s _.. _ -_ -_ -- - ;educt F.I.C.A and
with -holdings ta) ... c ,oe We'KE Zce : c y with all
applicable laws, ordinances, buildings ID:, : _ -•g regulations.
Please read and initial each paragraph.
i stanc ;s.a: <-tate av, ec-'es :oos:r_:nuc :c be ccle cy a _:e-,sec ccrcrac:r and have applied `or an owner -builder permi: under an
caem,tior `'o'r. the am T'.e er e^icao sae-'.`iei 'Jr a; as ttiE cr:^aer c` 7re- roper:y fisted, may act as my own contractor with certain
_-. .-.., s e%c': 110-E'.. C. _. a,C a i cC" se.
2 _-:_;._._
C..
a: bdpenTa z'e
C-- C :_ re rgrec -p in _,less he or she is responsible for the construction and
3. 1 understand that, as a^ owner builder, a. a a.„_,.sible ca,:, -e: o c o- a peg r-ii rroerstanc that I may protect myself from potential
financial risk by hiring a licensed conti-actearc -a,ag :he permit `.ec _ re ne, -.zr,c -rcad of mi :am name. I also understand that the
contractor is reTulred by law to be kcen.scc Fonda and to list his or ieersc • _mbecs on permits and ce-t'a^:
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 ieasec within "a year a'ter the
construction is complete, the law will presume that I built or substantially improved it for sale or lease,
which
violaIis the exemption.
Initial
_ _-a , -at. as the owner -builder, I most provide direct, onsite supervision of the constructior��
a:. ,z, 'ro. -e ar unlicensed person to act as my contractor or to supervise persons working on my building or residence. It
is my responsibility to ensure :`.a::he persons whom I employ have the license required by law and by.4ouIn municipal 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, m2y be held liable and subjected to
serious financia! risk for any injuries sustained by an unlicensed person or his or employees while working on my property. nay homeowner's
insurance may not provide coverage for those injuries. ! am willfully acting as an owner -builder and am aware- of the limits of my insurance
coverage for injuries to workers or my property.
Initial ` llI
8 understanc that i may not deieg2te 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 i2ws 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
S. I agree that, as the party legally ant financially responsible for this proposed Construction activity, I will abide by all app'�icable laws and
requirement that govern owner -builders as well as employers. 1 also understand that the
Construction must comply wit" a'! applicable laws, ordinances, building codes, and zoning regulations.
�? Z_
Initia
10. 1 understanc 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 Fiorida Construction Industry
Licensing Board at 850.487.1395 or httn://wkvw.mvfloridalicense.com/dbpr,/pro/cilb/index.html
i
Initial
11. I am aware of, and consent to; ar owner -builder building permit applied for in my name and understands that I am the party
legally ane financially responsible for the proposed construction activity at the following address:
05� i
In t�ai
12. 1 agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the informati that I have provided or
*n s t:sciclsure.
Initial
Licensed contractors are regulate&, by iaws designed to protect the pubiic. If you contract with a person who d6es not have a �icerse, the
Constr4uction Industry Licensing Board and Department of Business and Professional Regulation may be unable to assist you with any financial
loss t1-at you sustain as a result of contractor may be in civil court. It is also important for you to understand that, if ar unhcersed 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 hi•e a !icersed contractor, you will be responsible for verifying whether the contractor is properly licensed and the status of
the contractor's worker's compensation coverage.
Before a building permit can be issued, this disclosure statement must be completed and signed by the property owner and returnee 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 reeuired when the permit is issue&,.
Was acknowledged before me this
Produced there License or
day of , 20
who was personally known to me or who has
as identification.
OWNER
NOTARY
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- ALL ANGLES AND DISTANCES SHOWN HEREON ARE BOTH RECORD AND MEASURED UNLESS OTHERWISE NOTED
The survey map 6 report or the copies theraof are not valid without the digital signature
and seal of a Florida licensed surveyor and mapper
Date of Field Work.: 06-11-2022
Drawn By: Oleg
Order #: 181762 a
Last Revision Date: None Nf
3xnsua n'euvc oYiwzoocr
Boundary Survey prepared by: 1.68111 ` a"'vernissE°i
NexGen Surveying, LLC
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551-508-6272 EXGEN
SWEO`' aa+mA
1421 Oglethorpe Rd SUffif ING LLC. L^' -''•,, sw.p1�+"y`,•``
West Palm Beach, FL 33405