FW-09-134 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
I nspection Number: INSP - 123377 Permit Number: FW -1 -09 -134
Inspection Date: May 19, 2010 Permit Type: Fence/Wall
Inspector: Bruhn, Norman Inspection Type: Final
Owner: ESPINOSA, ALEXANDER Work Classification: Wood Fence
Job Address: 10659 NE 10 Place
Miami Shores, FL
Phone Number
Parcel Number 1122320280540
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
REPLACE 5FT HIGH WOOD FENCE (INCLUDING GATE)
ON NORTH FRONT SIDE OF PROPERTY
Inspector Comments
Passe AS REINSPECTION FOR INSP- 105260. Permit is expired NB
Failed EJ
Correction ❑
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
For Inspections please call: (305)762 -4949
May 19, 2010 Page 1 of 1
`5HRES Fjf' Miami Shores Village
10050 N.E. 2nd Avenue \ o \ Wt3rtcOlaSCar Wt>g>=a>r�Ce
Miami Shores, FL 33138 -0000 "
-�` \ �\ \
Phone: (305)795 -2204
t r
'
Expiration: 11/15 /2010
sz 1F Ispate /5�2Q
Project Address Parcel Number Applicant
10659 NE 10 Place 1122320280540
Miami Shores, FL Block: Lot: ALEXANDER ESPINOSA
Owner Information Address Phone Cell
ALEXANDER ESPINOSA 10659 NE 10 Place
MIAMI SHORES FL 33138 -2103
Contractor(s) Phone Cell Phone $ 1,000.00
HOME OWNER Valuation:
_.... ,, mm._...,_. _.... _.. _..._..._. Total Sq Feet: 0
Approved: Yes Available Inspections:
Comments:
Date Approved: 1/30/2009: Yes
Inspection Type:
Date Denied:
Foundation
Final
Type of Construction: Wood Fence Additional Info: 5 FEET MAX Final
Classification: Residential
Fees Due ]An Pay Date Pay Type Amt Paid Amt Due
CCF Invoice # FW -2 -09 -33843
Education Surcharge
Permit Fee -Wire &Wood 05/19/2010 Check #: 228 $ 159.20 $ 50.00
Permit Technology Fee 01/30/2009 Cash $ 50.00 $ 0.00
Scanning Fee Submittal Reversal Fee Work without Permit Fee Total:
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.
May 20, 2010
Authorized Signature: Owner / Applicant / Contractor / Agent ate
Building Department Copy
May 20, 2010 1
VV1
Miami Shores Village ; t z C
Building Department
13y .........
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING Permit No.
)tq O�'I
PERMIT APPLICATION Master Permit No.
FBC 2004
Permit Type (circle): (Building Roofing
Owner's Name (Fee Simple Titleholder)
— Phone #
Owner'sAddress AM C e-
, r7,
/ �) � C, re' � r i zip -5 5 / 3
City State
Tenant/Lessee Name Phone#
Job Address (where the work is being done) A/IEF / 6) ^7
City Miami Shores Village County Miami-Dade Zip -31
1-c -31
FOLIO/ PARCEL# Ala r Zc� 2-, 1 -
Is Building Historically Designated YES
Contractor's Company Name 40w — Phone 9
Contractor's Address
City State Zip
Qualifier Name Phone#
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone#
Value of Work For this Permit $ C' Square Linear Footage Of Work:
Type of Work: ❑Addition ❑Alteration ❑New Repair/Replace ❑ Demolition
Describe Work: C
Id
o- ' /' /_1
C! jj AZL11 LA' kycv-
A 0= A
JAN
Submittal Fee 50 - OD Permit Fee CCF $ 0(00
Notary $ Training/Education Fee $ 0.090 Technology Fee $ _S0
t
Scanning $ (4)-0D Radon $ DPBR $ Zoning $
Bond $ Code Enforcement $ ouble E Fee $ 1 40 ai
Structural Review. $ Tota� ee Now Due
See Reverse side
15c.
o
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 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 permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the ®tice of coiinmencement and construction lien law brochure will be delivered to the person
whose property is subject t chmAlso, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection w�tic occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be a r ed and a reinspecti6n fee will be charged.
1,
Si g nature #I Signature
Owner or nt r� Contractor
The fore n instrument as acknowled ed before me this T The foregoing instrument was acknowledged before me this
g g g
day of �U , , 20 D�, by day of 20 _, by ,
who is personally known to me or who has produced X 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:
I
Sign Sign:
a`P tw MY COMMISSION
Print: z, �� #DD775288 Print:
EXPIRES: A
My Commission Expires: " I Bonded through 1st State Insurance My Commission Expires:
APPLICATION APPROVED BY: Plans Examiner
Engineer
1
Zoning
(Revised 07/10/07)
VILLAGE OF MIAMI SHORES
OWNER BUILDER DISCLOSURE STATEMENT
NAME: `,- ..f < DATE:
ADDRESS: 1' 4_� �_ �.
�C0 7 cr e
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 40.103(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 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 Qf this exemption. You cnay not hire
an unlicensed person as it 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 con ction
Myself.
Initial
2. I understand that as an owner- builder I must abide by all zoni 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 reinstateme of the
permit.
Initial
3. I have an understanding of the 2004 FBC & FRC and unde tand 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,
alter or give advice on how to meet code — only if the structure me s the
minimum code.
Initial
5. 1 understand that as an owner - builder, that any contractor disput 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
6. I understand that if I compensate any person or company for wor performed
they are required 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 ny Electrical,
Plumbing, Heating, Air & Roof work on my property with out first btaining
the proper permits by licensed contractors.
Initial
Was acknowledged before me this day o , 20
By who was personally known to me or who has
Produced ther . nse or- " identification.
1� ti
0 R NOTARYy
aa���`4'4c�
Miami Shores Village
10050 Northeast Second Avenue
Miami Shores, Florida 33138 -2382
Telephone: (305) 795 -2207
Fax: (305) 756-8972
www.miamishoresvillage.com
AFFIDAVIT
STATE OF FLORIDA
COUNTY OF DADE
The undersigned Affiant, does here by attest that the
attached survey, performed by C /'Ct `_t '5S T�17 C
performed on 4 1 — G is an accurate representation of the existing conditions and locations of all
Structures on the property as of this date.
The purpose of the Affidavit is to induce Miami Shores Village to issue a building permit for the property without first
providing a survey less than six (6) months old. The Affiant, as property owner, further agrees to remove or obtain permits
for any structures which may now 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 effect final inspections as
applicable to this or other permits.'
Further, Affiant sayeth naught.
A ant/ roperty Owner
Witness (sign and print) , Wtness (sign and print)
i
SWORN TO AND SUBSCRIBED before me this °�' day of iULlL1 lr
Affiant is ersonally known to me, produced as identification.
Notary
.01 BELKYS CASTILLO
' y1M MY COMMISSION #00775288
Or" G
EXPIRES: APR 06, 2012
} Bonded through 1 st State Insurance
Miami Shores Village
Permit No. FWA -09-134
10050 N.E. 2nd Avenue .............. .......... .......................
............ .......... ........ .... — .. ...
... ................... .. .
. ..........
.....................
........ .....
..........
........... ..............
Miami Shores, FL 33138-0000
.......... ...... ..... .......................
. .......... ................ ............ ........... ...................
.................... — -
........... .. .......
------ .... ..........................
.................
.................. ......
Phone: (305)795-2204 Fax: (305)756-897 - ---- ..................... .........
2 --- ::�: � � � I I I I I I I � I � I I ..........
. ............. ............ ........................... ......
- Issue .. Da te: . Not Issued Expires:Not Issued
........................ ..........
...... .... . . . ...............
Folio Number) 122320280540
Owner's Name: ALEXANDER ESPINOSA Owner's Phone:
Job Address: 1065910Place
Total Square Feet: 0
X
Miami Shores, FL
Total Job Valuation: $ 1,000.00
. ...................
.... ... .......................................................... ................................ .............................................................................. --- ....................... . .....................
Contractor(s)
Phone Primary Contractor
HOMEOWNER Yes
Planning and Zoning Criteria and Comments
Approved: Yes Date Approved: 1/30/2009 Yes
Comments:
WOOD FENCES
i
. i
Wed post...
Wood Posts
2" X - V Wood roll 4' -0" High or Less = 6' -0" O.C.
Owner's Side 5' -0' High or Less = 5' -0" O.C.
I "X6`' III X611
WOOd PI&Ct
2915 Fences
2915.1 Wood fences, located on a property
that by zoning regulations they cannot be used
as a wall of a building, shal6 be constructed to
meet the following minimum specifications.
i u C01'IGrete (a) Fences not exceeding 5 feet in
height shall be constructed to meet
the following minimum
A o requirements: from nominal 4 inch
c
— G I I by 4 inch by $ feet -0 inch long
I posts spaced 5 fee 0 inches on
$ —' I I centers, having; a fiber stress of
Zt"O�� I -I I I I 1200 p.s.i. in bending, and shall be
embedded 2 feet -0 inches into a
. 5. concrete tooting 1 feot -0 inches in
diameter and 3'feet -0 inches deep.
1 = 1 ! Other components shall be
17-1 a a = I I designed to comply with the
III ) _l I I provisiogs of. this Chapter and
Chapter 23.
III =III _ (b) Fences not exceeding 5 feet and 4
f =III 1 =I III =III feet in height respectively shall be
i
I _ _ _ constructed as provided in
III —I i I III = I I = I I I_� I I paragraph 2915.1 (a) herein,
except that the spacing of posts
•„ may be ipcjea ;�d to 5 feet -0
• • •
:irretes f jnj ,feet -0 inches on
• •cgM,e j.fir:M4se1w1ghts.
:. . . . ••
/co4m 0
j • • • ♦ • • •• • •
e •
•• •
a
-C LEGEND
O 7th STR�� ` A = Central Angle
I 130.00' _ �0 AM
Q Z " . Q A/C = Air Conditioner
f o _
• u: ` ` �4' CLF 0_ c ASPH = Asphalt '
Z BB C B arbe c u e
= arbe e
j .50 42.00' 21 CB = CBS = Concrete Block Structure
c CH = Chord
U"26.75' I Chatta. =Chattahoochee
. 20 Center Line
5 34.00• N 04.60 CLF = Chain Link Fence
Cl. =Clear
=:
-
.,
Conc. = Concrete
55.90` D
i = Deed
N 2 19
o Z 0 = Diameter
WWD H = Drill Hole
26.00' - (� EME
= Drainage &Maintenance Easmt
10.00' _Q] Q asrutt =Easement
31.30' :'::::: ' 6.
47 o a y -C, F.H. -Encroachment
2. .70' 18 Eno. E
c W a = ire Hydrant
NG. Ii�ALK +
V_ CO O FIP =Found 1@' Iron Pipe
V_ r- FIR = Found 112' Iron Reber
l FPL = Florida Power & Light
$ Z' $ Roof W).:. I W 4 LLJ
17 ID = Identification N O O N 8.20' Z Z I.P. = Iron Pipe LB
= Licensed Business
3.10' °c Z v I LME = Lake Maintenance Easement = Land Surveyor
W 17.20' O 9.55' 5 16 nLA.S. = Measured
(� MAINT. = Maintenance
9.55' a ME = Maintenance Easement
° o •$ q M M = Monument Line
a. a 1 .00' 3.6 ' �� s 6 15 N/A Not um Ap p licable
2.00' 22.00' :..: N/D =Nall &Disc
25.00' as:::_ N' = Number
W r� N 3.7 8.40 n Z' 0 3.00
rn �, NTS = Not to Scale
3 .0
O ao:
c
s
Off
Z rn fn Location Sketch O.U.L. = Overhead Utility Lines
D _ 60' = 0 0.ao �, `�' NTS = Riei gook
o .0 = � PC = Point of Curvature
a a K ° LEGAL DESCRIPTION PCP = Permanent Control Point
PG . Page
The South 5 feet of Lot 2, all of Lot 3 and the North 57.5 feet of P .I . _ �t I ntersection
18.30' PO of
a 1 Lot 4, Block 4, MIAMI SHORES ESTATES, according to the Plat PKWY = Parkway
CL ° e = Property Line
thereof, as recorded in Plat Book 47 Page 58 of the Public
g , PL = Planter
0
l`..:.....: Records of MIAMI -DADE County, Florida. PLS = Professional Land Surveyor
P.O.S. - Point of Bnning
° v ` ° o PAC. = Point of Commencement
o ..:
E . Alexander Espinosa; Garcia & Baloyra; P. s Power Pole
5
Attome .1 CERTIFIED D TO' PAC = Point of Reverse curvature
I s Title Insurance Fund, Inc.; Washington Mutual Bank,
/^ PRM = Point of Reference Monument
� FA. PT = Point of Tangency
R Radius
00 66
PROPERTY OF. Espinosa, 10 9 N.E. 10 Place,
R . = Residen
d Land Surveyor
�1 Alexander Espin 65
_ Miami Shores, FL 33138 RNG =Range
R/R - Railroad
s RSM = Reg
istered Surveyor & Mapper
o 67 Encroachments: R/W = Rig or- -way
1. Portion of the asphalt drive is encroaching into the street sdwik = Sidewalk
� I p 9
r � S - section
CP
'
-of-Wa T c = Tangent
30.80
L: 25.0 = Surv Note:
0 y TwP = Township
U.E. = Utility Casement
" :ill ll According to the above referenced Plat and our field UTIL. = utility
-o o observations, the roadways shown on the attached survey have w.M. W.F. °woos Fence
= Water Meter
o o b (.. '.z .....: I _ all Maintenance Easement
e
•
e n dedicate or pu tc use wMs
.. •.. ,.
A .�. ,;.: t ,SURVEYORS SEAL : ROUN P� .
� t; , , • • , • • , • • • • I I Y: Y•S�IRVEY MOJARENA & ASSOCIATES, INC.
t, . • • "+ • ' • • • • " ~'' signature I HEREBY�OERTIiY: ha�t atf s was made
J
• • • r,.. +:; • . • Urlass it bears the g nature and un l a etlni6substanmeetsthe Land Survey & Map p ers
•!_ • s • R• a ;, • • • • ,,, a n tliY arig4lal raised seal of a i s�land� asldt ibrtlt 1 ly4he FLOWDA Certificate of Authorization No. 6698
ing
g d Rbilda tensed surveyor and BOARD OF taNO SURVEYORS in Chapter 61017 -6, Florda E 12925 S.W. 132nd Avenue
4 q this ma port iS for Administrative Ccde, pursuant to Section 472.02'7, Florida
=r g
. • maiJper, la on a
\ • ;` s '" — W e infatmational uses only and . StaGrtess There sue no enaoatd+men ovejl�ps easements 6 (305) 8 _ 2494
!tA' mi Fi 'd 3318 7
Note: •: e.,• y • • •; • • P Y • apbe811 on the plat 'Or J�sibiA easerheWA o sthan as
• `AN clearances and/or encroachments shown'hereon are of apparent nature. i Fenc�A�ne�, step s ; ; .•. s •.. _� is ^not v211d. «atrwr, r « s ' « • • •
b visual means. Legal ownership of fences no .d "e (mined. • • • • • • ' :• s s . ; ' • • FLOOD ZONE: BASE:
•
. . •�� s
G Encroachments Noted: 1 ' R
I � '6Vt SED.
$
Y 9 P t
Underground structures, if any, e$r t I
ocated. k N ELSON JARENA
• Bearings, if
r DATE: SCALE: DWN. BY JOB NO.
shown, are based on assumed meridian or Plat of Record.' s s s i s . ,. ,++. " • • z �
l Lands shown'herdon were not abstracted for ea�etxtents rent! /or right•of Whys of record.; ; ;: ,; �.�± ^ : : ;ft :gi�er�Q 5u o FM No. 5504 1 rr _ 20r
•
rid 05 -24 -01 - Mai 01 -0552
i
e
Y: -
i
I
°1 -134
APP ROVED Y D X TF •• • i v i i i i •• •• i i s i i i •!
�e� •• . . ..• • • ••• • • • ••
• • • • • • • e: • • •
y �, f��`T Tai r �a � tP* � i }-� �� �. � F � t ���kG • • • •• ,� • • • •s• • •!• •••
s
• t "- ! ••' • • ! • • • •••
y �
Miami Shores Village
Building Department
(0050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING Permit No.
PERMIT APPLICATION Master Permit No.
FBC 2004
Permit Type (circle): Building ' Roofing
Owner's Name (Fee Simple Titleholder) A I , e ( 1 # - Sq' 3 ;2 Y Sko
Owner's Address ,9 q N E i o++ % pl
City State Zip 1
Tenant/Lessee Name Phone #
Job Address (where the work is being done)
City Miami Shores Villaee County Miami -Dade Zip 33 / .3
FOLIO / PARCEL #
Is Building Historically Designated YES NO
Contractor's Company Name Q U l L-FD Phone #
Contractor's Address
CiTy State Zip
Qualifier Name Phone #
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ ��(� . C�� Square / Linear Footage Of Work: I CJ
Type of Work: ❑Addition ❑Alteration ❑New Repair/Re lace ❑Demolition
Describe Work: Y"e } 4 (o e 4
it
Submittal Fee $ Permit Fee $ CCF $ CO /CC
Notary $ 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 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 Iaws 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 ' sua e of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a tchment. y of t" notice f commencement and construction lien law brochure will be delivered to the person
whose property is subject t a Also, a certied copy of the recorded notice of commencement must be posted at the job site
for the first inspection w i occurs seven ) days after the building permit is issued. In the absence of such posted notice, the
inspection wiilll not be a r d and a reins ction fee will be charged.
Signature Signature
Owner o gent Contractor
The foregoing ' strument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of , 20 _, by day of , 20 by ,
who is personally known to me or who has produced 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:
Sign: Sign:
Print: Print:
My Commission Expires: My Commission Expires:
APPLICATION APPROVED BY: Plans Examiner
Engineer
Zoning
(Revised 07/10/07)
;�P ik.
O ai- �
W ` b;, r - s fl i
� �
Bui lci i € 4 Department �__ ® ®F ®w_d
/005v N,9 , �: ane, Miami Shores, Florida 331-13 �Y" �.
I el: ' 7 ;5.2204 Fax: (305) 756.8972
BUILDING Permit No. Oq '
PERMIT APPLICATION A Aaster Permit No.
FBC 2004
Permit Type (circle):, Building : Not►sttg
Owner's Name (Fee Simple Titleholder) _,'�. �_ '�� �'; =_ Phone # __ z` -
Owner's Address - - - --
�
City .' –` State
'renant/Lessee
Job Address (where the work is being done)
City --- ____ -- Miam Shores Village -- t'oun y Miami -Dade _ — Zip --
r
FOLIO / PARCEL # ", , r, �,`' t , I - • x`
Is Building Historically Designated YES G"
f,
Contractor's Company Name Phone
Contractor's Address
Cit y----- - - - - -_ - - - - --
– - - - --
Stat., _ _ _— ._–- - - -
Qualifier Name _ _ Phone
State Certificate or Registration No. _ _ Certificate of Competency No._,_,__
Architect/Engineer's Name (if applicable) _ _ _ _Phone #
Value of Work For this Permit $ Square / Linear Footage Of Work:
Type of Work: ❑Addition ❑Al .c << >tion .,New Repair /Reel sce El De nolition
Describe Work: ' - _ : 411 = i .. C : -
- -- J A N t.
Submittal Fee $ LA–) ' W Permit Fee $ _ _ _ CCF $ CO /CG
Notary $ Training /Educatien Fee _ Technology Fee $ ,
Scanning $ Radon $ „ -_ —_ DPBR $ _ Zoning $_
Bond $ Code Enforcemert $ Double Fee $
Structural Review. $ Total Fee Now Due $._ —
See Reverse side ->
VILLAGE OF MIAMI SHORES
OWNER BUILDER DISCLOSURE STATEMENT
NAME: DATE: I
ADDRESS: "� �C' N C_1 0 4� Ce
N , P4 I 1 rig Y'"L 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 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
Initial h/
2. I understand that as an owner - builder I must abide by all zoning dinances and
building regulations in effect at the time of permit application
Initial
3. 1 have an understanding of the 2004 FBC & FRC and unders nd that this
department and its inspectors are there to help enforce and inte t 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 t 'r to design,
alter or give advice on how to meet code — only if the structu eets the
minimum code.
Initial
5. I 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
6. I understand that if I compensate any person or company for w k performed
they are required 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 y wrong
doing from this unlicensed company or person.
Initial
7. I understand that if any person gets injured on my construction proj ct 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 whit
loss of wages during recovery from injury.
Initial
8. I understand that under state and local laws I can not do
Plumbing, Heating, Air & Roof work an my property with o
the proper permits by licensed contractors.
Initial
Was acknowledged before me this day of , 20
By who was personally known to me or who has
Produced there Lice o as identification.
0 R NOTARY
a
� o ( LEGEND
J
U
E 0 = Central Angie
LL 130.00' �a cLF o N F_
07th Ste_ _ A =Arc
s.oa' — — A/C = Air conditioner
37.t)0' 42.00' a ASPH = Asphalt
(90. 4.50 Z BBQ = Barbecue
p .�
?�•� 21 CB =Catch Basin
�v1 WA =Not Applicable
0 26.75' I CBS = Concrete Block Structure
CH = Chad
1 Chatta. = Chattahoochee
Go
t 5• 34.00' N 0 4.60 20 I = Center Line
32.00' > I CL = Chain Link Fence
.. 55.g0' N .� .O
C = r
a r c = Concre LLI
o o i $ C3 I 2 19 D = Deed
o
U _ C1 . • Z 0 = Diameter
" C $ t� DH = Drill Hole
W
26.00'
70 , U > DME = Drainage b Maintenance Easm't
31.30 cr N O I Q - sement
- q Easm't Ea
..-
E nc. Encroachment
O nt
= __ Hyd rant
> ° O r FIP = Found 12' root Pipe
FIR = Found 12' Iron Reber
G. c ID = Identification r O l 4 FPL = Florida Power 3 Light
0 Ld
C0 z
3.70' c ° v Z Z I.P. =Iron Pipe
9.55' r LB = Licensed Business
3 4
LjI
17.2(Y + LME = Lake Maintenance Easement L.S. =
O (
! 5 Land Surveyor
yor
9.55 16 M -
- Measured
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_ 0 MAI
o -
NT. - Maintenance
gl:
�
::..:.:= s s o
,J m rn k - ' ME = Maintenance Easement
CL N C 11.00 3. tZ: 6 M = Monument Line
O Mon. = Monument
T
: ' ' 52 00' 22.00 :- :- ut:....- 15
25.00'
o
- :�:�- ::., :`�.:> - o � 3.7 0 � o ��0 3.00" - : : -. - : N!D = Nail &Disc C4 ' ' =
6 0' rri
C" 3. 8.40 0 r : Co N' S Number
._.:.
� U +• ++ W GRE I NT = Not to Scale
a �3 3 ois =Offset
N7 w
CD � 0 o.::: .___ _ Location Sketch O.U.L. = Overhead Utility Lines
s €'s3s:a:€ $ O (� = b P =Plat
Q ,
NTS PB = Plat Book
O
Q 4 PC = Point of Curvature
xv° LEGAL DESCRIPTION: PCP =Permanent Control Point
18.30'
"' I The South 5 feet of Lot 2 all of Lot`3 and the o f PG = Page
= Point of Intersection
- - = a _ e N orth 57.5 feet of
Lot 4, Block 4, MIAMI SHORES ESTATES, according o the Plat PKWY = Parkway
g e = Property Line
thereof, as recorded in Plat Book 47, Page 58, of the Public
PL
= Planter
Records of MIAMI -DADE County, Florida. PLS = Professional Land Surve or
o
.:: � Y
. r3r ^ i ? P.O.B. =Point of Beginning
'-' - - •; . , r-• P.O.C. =Point of Commencement
CERTIFIED TO: Alexander Espinosa; Garcia Belo ra; P.P. = Power Pole
P
5.1 4 meys' Title Insurance Fun Inc.; Washington Mutual Bank PRC =Point of Reverse Curvature
Atto d
- -. - -- - / PRM =Point of Reference Monument
To. -.
PT = Point of Tangency
a R = Radius
= Residence
.' t , PROPERTY OF: Alexander Espinosa, 10659 N.E. 10 Place, R.L.S. = Registered Land Surveyor
P Miami Shores, FL 33138 RNG = Range
FUR R = Railroad
a 0 RSM = Registered Surveyor 8 Mapper
:.
Encroachments: RAW = Right-of-Way ay
�J 2. Sdwk = Sidewalk
? 1. Portion of the asphalt drive is encroaching into the street
Sec. = Section 5 �, 30.80' on I? Right -of -Way. T = Tangent
T (L a , 130 00 4' CONC WALL Surveyors' Note: Tw = Township
— U.E
A Utility E
c asement o t ccording to the above referenced Plat and our field UTIL. = Utility
I " "' ' • ` " • • • o !: I obsWat ops,.the joadyW % §hown on the attached survey have W =Wood Fence
W.M. =Water Meter
LL
Z • ' ' • ' ' • ci ? been beliidathdfdr Usei WME = Wall Maintenance Easement
•`� rat ' i i ' •' 0" 0 • � � . .. '
fEY
SURVEYOR'S S EAL BOtlN ®AERY sv Rk •• MOJARENA & ASSOCIATES, INC.
D88 It bears the 51 nature and I HEREBY CERTIFY: That the attached survey was made
Land Surveyors & Mappers
• • • • • �- • • • • • S under my res charge and substantial meets the N
• • E • • • • xiginai raised seal of a
:Y '� • • - • • ` s mintmury ('e�hn ttanda • • s��orth OEilbq
Certificate of Authorization No. 6698
• • •, • • " • • ida licensed surveyor and BOARD OFIAND SURVEYORS in Chapter 61617 -6f F*Wa 12925 S.W. 132nd Avenue
• '
• t • , • • • • Adminisllatite t Se, paiFsu�rg to %,ct§n 37 2 ,pZr. F*dt
NOte: i } • `' j ' • • • �! • rper, this ma is for
Statutes - iherwarsm encrouchmesits, overlaps, easements
• All clearances and/or encroachments shown hereon are of apparent .nature. Fen efisftip , - mational purposes only and w e Miami, Florida 33186 (305) 278 -2494
by visual means. Legal ownership of fences not determined. ;,
)t valid sr
appearing on the plat or visible easements other lion as
• Encroachments Noted: 1 �' : *4 ,- :' FLOOD ZONE: AE BASE: 8
• Unde round structures, San , not located. • ' • * "+ VISED:
r9 Y . , . • .
• Bearings, if shown, are based on assumed meridian or Plat of Record. • • • • • • • • • • • O •
g • • • • • • • • Registeled Sa & & Mapoer Nd. SW
not abstracted for easements and/or right-of-ways of record. DATE: SCALE: DWN. BY JOB NO.
• Lands shown hereon were
State of Florida 05 -24 -01 1 " 20' MR 1 01-0552
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- J LEGEND
X
a
STREET 0 = Central Angle
- Z 130 :00' �_ r 44' CLF __ _53. --- — a 1�1 •E• 107th ac = a conditioner
37.00' '
42.00' a I ASPH = Asphalt
BS• — 0 4.50 z ( BBQ = Barbecue
Y� r to
and 21 CB = Catch Basin
:::a::'.:: ?�• 3 c
C � a o� 26.75' + CH _ BS = Concrete Block Structure
J 1
.: :: � � � • 1 - Chord
oki Chatta. = Chattahoochee
t 5
34.00' b 0 4.60 20 = Center Line
32.00 r > - - I I CLF =Chain Link Fence
55.90' - r . .. CG =Clear
on
= Concrete
19 Z D Deed
o I
2
Z 0 = Diameter
Q
26.00' U . .. W W DH = Drill Hole
N co DME = Drainage i4 Maintenance Easmi
10.00' Easm t = Easement
U
31.30 iv . _ 70' I Q
LO
Enc. = Encroachment
CL I 18 +L, F.H- = Fire Hydrant
Il
FIP =Found 12' Iron Pipe
Rppf T_ FIR = Found 12• Iron Reber
4
0 FPL = Florida Power 3 Light
N ; , O` N 8.20' • W 17 W ID = Identification
3.70' p Z Z Z I -P. =Iron Pipe
Q? LB = Licensed Business
9
.5'
5 en
..:.:..
I LME -Lake Maintenance Easement
W 17.20
O - ! 5 L S. =land Surveyor
U
r
I -
9.55' 16 M - Measured
0
MAINT. Maintenance ME = Maintenance Easement
:.:.:.::: .: >::_:. °:'.:. a 11.00 3. v j Z ...... M = Monument Line
O v �- 6
O := ;g:;;;:= Mon. = Monument
' S� 52.00' 15
22.00 :::::alt::::::::
25.00' I N/A = Not Applicable
>.•.
:#L :::::::::: :::::::: o ° 0 0 0 0 3.Q0' :. ss6:::::a: N/D = Nail 8 Disc
� N 6 0 , ui 3.7 3. , 8.40 0 �c :: ::::: N' = Number to
to N m c a I NTS = Not to Scale
::::::>z •::::: �� a 3 3 :: - as = offset
M �' 0 ` : = Overhead Utility Lines
_ a� o I fl Location Sketch O.U.L. Overhead N = c P = Plat
:::: NTS PB = Plat Book
}
4 * O PC = Point of Curvature
Q O
- 0 c} LEGAL DESCRIPTION: PCP = Permanent Control Point
a
18.3 "' The South 5 feet of Lot 2, all of Lot 3 and the North 57.5 feet of
PG = po t of Intersection
a 1 : of 4. Block 4, MIAMI SHORES ESTATES, according to the Plat PKWY = Parkway
a = Propert line
thereof, a� recorded in Plat Book 47, Page 58, of the Public PL
i
- = Planter
' ° d f C Flo PLS = Professional Land Surveyor
" � � O o � � R e cor ds O MIAMI DADE - County, F On
o I t N ; H P.OB. = Point of Beginning
P.O.C. Point of Commencement
. C
CERTIFIED TO: Alexander Espinosa; Garcia 8k Baloyra P.P. = Power Pole
I i tti 5.1 m ys'Ttl i e nsurance und I F -
�- , Inc.; Washington Mutual Bank = M onument
Point of Reverse PR v C urvature
urvature
AttO e
PRM Point of Reference M
PT =P f Ta oint o en
FA. T a n g en
:s
_ PROPERTY OF: Alexander Espinosa, 10659 N.E. 10 Place, R dt
_ R egiaen�
- .. _.: Reg.
R.L.S. Registered Land Surveyor
° Miami Shores, FL 33138 wvG = Range
RrR = Railroad
p p i RSM = Registered Surveyor 8 Mapper
• ,��c - Encroachments: RM = Ri -of -way
1. P of the asphalt drive is encroaching into the street _ Si dewal k
5.W 30.80' on Right -of -Way. T = Tangent
a 130 00'` 4• CONC WALL I Surveyors' Note Ep = u
I = i Easement
According to the above referenced Plat and our field UTIL. = Utilit
U. beast de8itaatild2& 1tlblic UL WME = Wail Ma in ten ance e
.. • I shown on the attached s urvey have . -. = I to Easem
o the wadWag; sho w F wood Fence
b I b�ervatwn$, . W M Water Meter
Z • •' • • • • • • _ '- I : - ?
• ••• • • • • •-
;_ 3uRVEYOR's SEAL •8 ®uNDARY•SURhdEI;• MOJARENA &ASSOCIATES, INC.
' - I HEREBY CERTIFY: That the attached survey was made
i98 it bears the signature s Land Surveyors & Mars
:
• • • • 0 • • a under qry resp�nsiGle a� bstant�ally e y p�
xiginai raised seal of a minimumtea,nieal as coma, She mee th FI► Pj
stan3ars se by Certificate of Authorization No. 6698
• • • • • • Ida licensed surveyor and Bo l�D VF LAND SURVCYOR9in ChapteA61G
9W -6 *Fonda 12925 S.W. 132nd Avenue
• • • • y per, this map/report is for
Nate: A 41VIpti�itat We' lwisyant W 473.027 da
�• = statutes- Theaeere no enrtoadments, ove4aps, easements Miami, Florida 33186 (305) 278 -2494
• All clearances and/or encroachments shown hereon are of apparegt nature. Fence ownersf�l mationai purposes only and appearing on the plat or visible easements other than as
by visual means. Legal ownership of fences not determined. n valid. shown
• Encroachments Noted:
• Underg structures, if any not located. • : V, VISED: • • / • • FLOOD ZONE: AE BASE: $
• Bearings, if shown, are based on assumed meridian or Plat of Record. • ; • s ,• ,. ; • S4N " JAR A;
• Lands shown hereon were not abstracted for easements and/or right -of -ways of record. R egi>;tered'SdrUyor$ Mlpper'Nd'. 5504 DATE: SCALE: DWN. BY JOB NO.
State of Florida 05 -24 -01 1" = 20' 1 MR 1 01-0552
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