SENC-09-481 oRSS ;,.
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10050 N.E. 2nd Avenue
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Miami Shores -
FL 3313 -
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Project Address Parcel Number Applicant
10357 6 Avenue 1122310120200
ESTELA MENDIETA
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
........... ... ......... ......... ............
ESTELA MENDIETA 10357 NE 6 AVE
MIAMI SHORES FL 33138 -2047
Contractor(s) Phone Cell Phone
$1 ,000.00 ......... - --
HOMEOWNER - Valuation:
................. _..,. ........ ........................ Total Sq Feet: 545
Approved: Yes m - Available Inspections:
Comments:
Date Approved: 3/26/2009 : Yes
Inspection Type:
Date Denied:
Final
Type of Work: REPAIR Additional Info: EXISTING ENCLOSURE
Classification: Residential
Fees Due Amount Invoice # Total Amt Paid Amt Due
CCF $0.60 SENC -3 -09- 34355 $ 114.30 $ 64.30
Education Surcharge $0.20
Notary Fee $5.00 SENC -3 09.34355 $ 114.30 $ 114.30 $ 0.00
Permit Fee $100.00 Check #: 3121
Scanning Fee $6.00
Submittal Fee $50.00
Submittal Reversal Fee ($50.00)
Technology Fee $2.50
Total: $114.30
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.
April 20, 2009
Authorized Signature: Owner / Applicant ! Contract(,- / Agent Date
Building Department Copy
April 20, 2009 1
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
W W WMIAMISHORESVILLAGE.COM
BUILDING �ED Permit No. 3E C o -0
PERMIT APPLICATIO MA 2 2009 Master Permit No.
FBC 20
Permit Type (circle): Building mg
Owner's Name (Fee Simple Titleholder) r �•^ MJ ~ 'c+ Phone #
Owner's dress � S
t 1 '�^
City State Zip
Tenant/Lessee Name Phone #
w
Email (h, tom"
l
Job Address (where the work is being done) _ W
City Miami Shores Village County Miami -Dade Zip
FOLIO / PARCEL #
Is Building Historically Designated YES NO Flood Zone
Contractor's Company Name —�rwt, MAX& J Phone
Contractor's Address
City State Zip
Qualifier Name Phone #
State Certificate or Registration No. Certificate of Competency No.
Contact Phone E -mail
Architect/Engineer's Name (if applicable) Phone #
500 Value of Work For this Permit $ Square / Linear Footage Of Work:
Type of Work: ❑Addition ❑Alteration ❑New ❑ Repair/Replace ❑ Demolition
Describe Work: ~ 4A Q CI`E y1�
* * * * * * * *eD * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee s � � 3 / Fee $ /�a � CCF $ � •IJGQ CO / ems
Notary $ �.lJ� Training/Education Fee $ Technology Fee $
Scanning Radon $ DPBR $ Zoning $
Bond $ Code Enforcement $ Double Fee $
Structural Review. $ Total Fee Now Due $
See Reverse side
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address "`"
City State
Z
Application is hereby made to obtain a permit to dib #he-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 j urisdiction. .1 understa" separate permit must ured�ior ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FCIRI�I�EES OILERS�;1 J S an&AIR aftDIMNERS, ETC.....
OWNER'S AFFIDAVIT: I certify that all the foregoing" idformation=is &-xurate and that All work will bedops coni trance with all
applicable laws regulating constntetioii an(t zo ng. _ t
"WARNING TO OWNER: YOUR FAILURE TO RECORD A O OF C
TICE d rE PJCMEINT NAY-RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YEd> , PR( ERT , & 'jo INTEND ° Td OBTAIN FINANCING,
CONSULT WITH YOUR •Lk� DER OR' AN AfiTURNEY 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.
r
Signatu a Signature
wner or Agent Contractor
The foregoing instrument was acknowledged before me this U The foregoing instrument was acknowledged before me this
day of Nam , 20� , by z IC��� Ha icU
day of ' 20 _, by
who is personally known tome or who has
p roduc e d ` !`�tW5
P who is personally known to me or who has produced
As identification and who did take an oath... as identification and who did take an oath.
NOTARY PUBLIC:
NOTARY PUBLIC:
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Sign: pvpp�5 (,
Sign:
Print: .r C4M�}�ct��`a Print:
ARNO
My Commission Expires
4
My Commitssion
,
xRires:
APPLICATION APPROVED BY
— flans examiner Zoning.
Engineer Clerk checked
(Revised 07/10/07)
_
VILLAGE OF MIAMI S11101? S MAR 2 4 % = 1 . dw
6 2009
OWNER 13UILDER DISCLOSURE STAT +INTENT
" 'NAME: �, tk y" - DATE: 0 Z Zoo
ADDRESS: 3 7 Pie 0 hk du �J
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
�i 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 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 hold title to the above property and I am planning on doing this construction
Myself.
Initial
2. I understand that as an owner- builder I must abide by all zoning ordinances and
building "regulations in effect at the time of permit application. Inactive
permits for a period of over 180 days will become null and void (expired)
and a new permit will be required to be issued for reinstatement of the
permit. �--�} �
Initial C►�"1
3. I have an understanding of the 2004 FBC & FRC and understand that this
department and its inspectors are there to help enforce and interpret the code.
There is a copy of the code in this office for review.
Initial
4. I understand that the building official and inspectors are not there to design,
alte or give advice on how to meet code – only if the structure meets the
minimum code. /'�,�
Initiat P)k
5. 1- understand. that'as an owner - builder, that any contractor disputes with sub-
contractors and myself must be handled in a civil court with the advice of an
attorney. The department will not mitigate any contract disputes.
Initial G _.-
6. I understand that if I compensate any person or company for work performed
they are requited to have a business license in the county. If for any reason they
do not posses a business license I will be responsible and liable for any wrong
doing from this unlicensed company or person.
Initial
7. I understand that if any person gets injured on my construction project –they are
entitled to workmen's compensation. And if they do not posses a workmen's
policy I could be held liable for all doctor and related cost which could .include
loss of wages during recovery from injury.
Initial
8. I understand that under state and local laws I can not do any Electrical,
Plumbing, Heating, Air & Roof work on my property with out first obtaining
the proper permits by licensed contractors.
Initial
Was acknowledged before me this day of k — , 20
By. \u ClUw�k who was personally known to me or who has
Produced there License (� as identification.
OWNER � 99 N ARY
MA \G 0* *
pMM pc\ob��oy�a�
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f / Miami Shores Village Permit NO S E N C 3 09 481
�e 10050 N.E. 2nd Avenue
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{ ce 1= losl�ce
Miami Shores, FL 33138 -0000 "
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Phone: (305)795 -2204 Fax: (305)756 -8972
``-- -�' Issue Date: Not Issued
Expires:
Folio Number :1122310120200
Owner's Name: ESTELA MENDIETA Owner's Phone:
Job Address: 10357 6 Avenue Total Square Feet: 545
Miami Shores, FL
Total Job Valuation: $ 1,000.00
. ........ . ......... .........
Contractor(s) Pho ne Primary Contractor
HOMEOWNER Yes
Planning and Zoning Criteria and Comments
Approved: Yes Date Approved: 3/26/2009 Yes
Comments:
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33 Pl AVENUE
CORAL. GABLES, FL. 33134 SURVEY No. 97'027
I D ADE: (305) 779- 3288 4 THOMAS .J. KELLY, INC. SHEET 1 0 2
FAX:' (305) 441 -6494 LAND SURVEYOR --
SURVEY OF LOT _ -22 _.._ -._ ._� _ _ BLOCK
SUBDIVISION GOLF VIEW FSTATFS - - -'
ACCORDING TO THE PLAT THEREOF AS RECORDED IN Pl_AT BOOK NO. 41 AT PAGE NI.J.
PUBLIC RECORDS OF DADE._. _____ OUNTY. F' ,RIDA
DATE: 3o /97 FOR: R ICAR DO ME NDIETA MID ESTELA M ENDIETA
LOCATION SKETCH SCALE 1 " =tir 10357 NE _6 AVE
MIAMI SFbRES, FU. 33138
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I'- COMMUNITY PANEL NO. _120652_. _ . _
a PANEL NO.. — �3 ....- _ SUFFIX: __._yL .. DATE OF FIRM: 3J2 1_94 _
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NOTE: UNDERGROUND ENCROACH Mc,J'I:,, .F ANY, NOT LOCATED. ENCROACHMENTS NOTED: A-/U/V /
I hereby certity that this sketch of survey of the above described property is true and correct to the best of my knowledge and belief as surveyed and
platted under my direction. I further certify that this survey meets the minimum requirements adopted by the Society of Professional Land Surveyors
an the Florida Land Title Association and also CH -61G17 F.A. code. There are no encroachments, except as shown,
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1/3 NOTES:
1. IF SHOWN, BEARINGS ARE TO AN ASSUMED MERIDIAN (BY PLAT)
OSE A. PEREA (DATE OF FIELDWORK) 2. IF SHOWN, ELEVATIONS ARE REFERRED N.G.V. DATUM 1929
PROFESSIONAL SURVEYOR AND MAPPER # 485E 3. THIS IS A LAND SURVEY
STATE OF FLORIDA CLOSURE ABOVE 1 7500
o . (NOTVALID UNLESS IMPRINTED WITH AN EMBOSSED SURVEYOR'S SEAL) SCALE: 1
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X33 Palermo Avenu THOMAS 97 -0271
CORAL GABLES, FLA. 3313 J . KELLY INC. SURVEY NO.
BRWD' (305) 779 -3288 LAND SURVEYOR SHEET 2 OF 2
FAX ? ( 305) 441-6494
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.. Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 109706 Pe rmit Number: S ENC -3 -0 - 481
Scheduled Inspection Date: July 23, 2009 Permit Type: Screen Enclosures
Inspector: Bruhn, Norman
Inspection Type: Final
Owner: MENDIETA, ESTELA Work Classification: Repair
Job Address: 10357 NE 6 Avenue
Miami Shores, FL Phone Number
Parcel Number 112231012020
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
TO REPAIR EXISTING SCREEN
PLEASE CALL ESTELLA: 305.606.8065
Inspector Comments
Passed
Failed
Correction
Needed I�
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
July 22, 2009 For Inspections please call: (305)762 -4949 Page 2 of 14