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FW-10-232Project Address 230 107 Street Miami Shores, FL 33161- 1122310130670 Block: Lot: BENJELLOUN HASSAN Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Approved: Yes Comments: Date Approved: 2/17 /2010 : Yes Date Denied: Type of Construction: Wood Fence Classification: Residential Additional Info: 5 FEET HEIGHT MAX Fees Due CCF Education Surcharge Permit Fee - Wire & Wood Scanning Fee Technology Fee Total: Amount $0.60 $0.20 $100.00 $3.00 $0.80 $104.60 Building Department Copy February 19, 2010 ERO' Expiration: 08/18/2010 Parcel Number Invoice # Invoice Total Amt Paid Amt Due FW -2 -10 -37054 $104.60 $104.60 $0.00 Applicant For Inspections please call: (305)762 -4949 Available Inspections: Final Foundation Inspection Type: 1 Inspection Number: INSP - 149578 Permit Number: FW -2 -10 -232 Scheduled Inspection Date: August 12, 2010 Inspector: Bruhn, Norman Owner: HASSAN, BENJELLOUN Job Address: 230 NE 107 Street Project: <NONE> Miami Shores, FL 33161- Contractor: HOME OWNER Building Department Comments REPLACING EXISTING CHAIN LINK FENCE BY WOOD FENCE ON THE EAST SIDE OF THE PROPERTY Passed Failed Correction Needed Re- Inspection Fee el,F-7(ft No Additional Inspections can be scheduled until re- inspection fee is paid. August 11, 2010 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 eL For Inspections please call: (305)762 -4949 Permit Type: Fence/Wall Inspection Type: Final Work Classification: Wood Fence Phone Number Parcel Number 1122310130670 Inspector Comments CREATED AS REINSPECTION FOR INSP- 149445. Provide permit for fence at west side fence must be 5' maximum height NB Page 16 of 23 Email Job Address (where the work is being done) City Miami. Shores Vila ge County $ice- Dade ^ _kip FOLIO I PARCEL Is Building Historically Designated YES Contractor's Company Name Cimitractof's Address Value of Work For this Permit $ /Lit City State Zip Qualifier Name Phone 4t State: Certificate otRegigtration No. Contact Phone _ E. Type of Work C]Addition •121Altera!tiort. Describe Work: Ph one # Flood Zone Certificate of Competency No. . 1 ArthiteetIEnginetes Name (if applicable) ;. Phone # 1. ; • ,rte Notary. $ 0 ■ BUILDING PERMIT:APPLI ATION FBC20 .Iit i Shores Village • Building Department 10050 N.E 2n4 Avenue, Miami Shores, Florida 33138 Te1. (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 Pero* Type: BUILDING _ Owner's Name (Fee Simple Titleholder) 43E 3E- t ; . t fl C'' Phone # Owner ° s Address o ]J E t ci7 5 n , City . _ J t 5 State J? `� ' Zip 3 ` f Tenant/Lessee Name iI Permit No, 7 t 3 Master Permit No / Phone # Square I Linear Footage Of Work • New 0 Repair/Replace yeYt32tk*' k: 49rdevPokFt****dt***9r Fdr9c**$ *fit r9r c�t9r3t�' * aY9eds** aF *rok3rd *If . 9r*at*7k;Y*+k* ***** Submittal Fee .$ Permit Fee $.° F $ CO /CC $. TrainingtEducation Fee $ Technology Fee $ Scanning $' Radon $ DPBR $ Bond $ Double Fee .$ Violation date: Structural Review. Total Fee Now Due $ See Reverse side a Dcmolition k.� Bonding Company's Name (if applicable) Bonding Company's Address City : State Signature Signs: . .. . Print My Commission Expires: a et); s ^ - — a ` i e. .a!# : `6V . // n • . �� ., 0 A.... .. sr r* *** , * ** * * * * * art: ** * * * * * *.sr*********Urowmtok** *'******** * * *** ** r***** **** *** *fir * * * **ar ** as * *. r* x* r** * * ** APPROVED BY .JJ— fv Plans ;Examner #!d L l G Zoning (Revised 07 /10 /07)(Revised 06/10/2009) My Commission Expires: Engineer Clerk checked Mortgage Lender's Name (if applicable) Mortgage Lender's Address City. State 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 be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNERS AFFIDAVIT: 1 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 - approved and a reinspection fee will be charged. Signature eror Agent .. Contractor The forego' - , struniei t was acknowledged before me this The foregoing instrument was acknowledged before me this day . o'f . i .'�" ,. 201L—_), by. tkor-,A-ip,...N Via 0.44 . day of , 20. _, : . �, by who is personally known to the or who has produced 19 who is personally known to me or who has prroduced As identification and who did take an oath. as identification and Who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: E- o o ': t� = Print; Planning and Zoning Criteria Job Address: 230 107 Street Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Owner's Name: BENJELLOUN HASSAN Miami Shores, FL 33161- Contractor(s) HOME OWNER Phone Primary Contractor Yes 1 Planning and Zoning Criteria and Comments Approved: Yes Comments: 4/19/10 NEW PLAN OK Date Approved: 4/19/2010 : Yes 8/4/10 THIS IS 3RD REVISION. 4/19/10 WAS FOR A SMALL FENCE ON REAR LOT LINE. THIS IS FOR AN ADDITIONAL FENCE ON THE WEST SIDE. Folio Number:1122310130670 Owner's Phone: Total Square Feet: Total Job Valuation: 68 $ 1,000.00 FOUND IRON PIPE (NO ID.) PIN M N 0 CHAIN LINK FENCE 0.30' EAST (CL.) w 0.05' NORTH (CL.) IC ) • Amor 1 1 19.3' I J2 , - 0.3' � + CONC. SLAB 9 02:6 11l N) -o 0 0 1 m 0 26.2' crjN 22.7' 1 o 0 E IS IN 0 C/1 z z 0mZ 0 11 -�I Z 2 -n r- mz rr 0 m m z m .9 z + co m z 13' WOOD GATE ti \ /t v m 000 m v ° m3 / 0 26.2' N 22.7' f 4C-1 NOTE: THERE ARE NO PERTINENT FEATURES ON SUBJECT /ADJACENT PROPERTIES AND ACROSS THE STREET THAT MAY AFFECT THE SYSTEM INSTALLATION II 0 p CO 0) 1 0) 1 Co N �O I 0 0 N 'w V, MI' O 0 rM -p O 0 CD (3) + W 9 r N 5' MIN CHAIN I N CHAIN LINK FENCE LOT 10 - BLOCK 15 & WOOD FENCE P.B 6 - PG. 82 0.50' EAST (CL.) ° i i t `.i.io'If„�' 0 2.35' 4.55' 7.65' 01 7.60' O 500 DRAIN FIELD 25' to N 01 w NO2 °44'30' W 125.00' 12.6' GRASS PARKWAY 14.75' ASPHALT PAVEMENT �c T_ NO2 °44'30"W w O + 22.45' H.E.2nd COURT (40' RNV) 0 + 0 Z N z r cn r m a � zZ �\ m 33.60' - n Z W 2 O bj 0 0 • �m M 03 rc tn a v � Z 0 0 >< abr) N N is fV 01 O Cs z o 0 3.45' O 4.40' 0.4'1 3.75' t Ac 1 • CONCRETE °- DRIVEWAY -D t 0 • 23.0' 27.4' 3' WALKWAY 22.7' -Co Lc) N 32.5' 13.5' I T 7.7 Q• v O 0 z z Oz Pr - . Z o rn 0 0) r 0 C w 2 ia Z z 0) D 0 o m = w 01 - O 9 77 01 m z 0 -1 0 0 S 0 ' c� 71 8 Z r RESIDENCE 230 NE 107TH ST MIAMI SHORES, FL 33161 APPLICABLE CODES: FLORIDA BUILDING CODE - RESIDENTIAL. 2007 EDITION NFPA 101 - LIFE SAFETY CODE. 2006 EDITION SCOPE OF WORK ALTERATION LEVEL 1 - ADD NEW MASTER BATHROOM AND WALK IN CLOSET. — ADD NEW LIVING ROOM — EXISTING HOME TO REMAIN. DO NOT DISTURB. COVER SHEEET C-1 LOCATION PLAN STRUCTURAL S-1 FLOOR PLAN S-2 ROOF PLAN S3 STRUCTURAL ELEVATION DETAILS S-4 DETAILS 8-5 NOTES ELECTRICAL E -1 ELECTRICAL PLAN, DETAILS, NOTES DATE .' % C0 I IY RULES AND REGULATIONS S T 0 SCALE: 1 /8" = 1'- ••• • • • • . L JECT i D CUMPI.IANOE WITH ALL FEDERAL •• •• • • • . •• • • • ••• • • • • • • • • • • ••• • • • • • •z • • • • • •• •• ••• • • • • • • • • • • • • • •• • • •• • C.A.y26942 9330 NW 13 ST. DORAL FL 33172 PHONE 305 - 594 -2382 FAX 305 - 594 -2366 DATE(S) r,"/" ne c ee g de a r�oanstnitin ?4 PERMIT SET ©2049. MEP FNONFFRINE nFS2C n HEREBY RESERVE THEIR COPYRIGHTS TO THE IDEAS AND DRAWINGS SHOWN. THESE DRAWINGS ARE TO BE USED FOR THE PROJECT STATED ONLY AND SHALL NOT BE USED OR REPRODUCED FOR ANY 01000 PURPOSE TMATSOEVET THE 1 E%PRESSED WRITTEN CONSENT. 55100. CONTRACTORS SHALL VERIFY ALL 5tENSI4N5 AND SHALL NOT RELY ON SCALED DIMENSIONS. NOTIFY THE ENGINEER OF ANY DISCREPANCIES PRIOR TO COMMENCING WORK BUILDING PERMIT APPLICATION FBC 20 Permit Type: BUILDING ROOFING Owner's Name (Fee Simple Titleholder) I1 4S 60 1 °, L0(.4 # 7z 6 — 2 S ('-01 3 (! Owner's Address 2 3 0 iv e 4- 0 S free City M r a m 5 P res State F L Zip 331 5 9 Tenant/Lessee Name Email Job Address (where the work is being done) 7-30 t i 0 - S'-f- rrce �} City Miami Shores Village County Miami -Dade Zip 3 31 Sff FOLIO / PARCEL # Is Building Historically Designated YES NO Flood Zone Contractor's Company Name /o 06-) C A _ 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 a . plicable) Phone # Su bmittal: PV Notary $ Scanning $ Double Fee $ Structural Review. $ Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 Training/Education Fee $ Radon $ d \ 2i Permit No. Fit) 1® — 2 3 2 Master Permit No. Phone # Value of Work For thi a 50.40 Square / Linear Footage Of Work: /9 e e t Type of Work: ,�� a w yp ❑Alteration t New [L]- Repair/Replace 0 Demolition I Describe Work: ; � C � 5 - 170 rl to T tno col GQr ne'r DoS°f ( .5O J-* Fcu - cnv01 -fi r5 '� ' ,4 k -- N''occ` 19C( o4- C1lC Vl W'r'y -k1 `LUOOd fce, Permit Fee $ So CCF $ CO /CC $ Technology Fee $ DPBR $ Bond $ Violation date: 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 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 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. 1 j he absence of such posted notice, the inspection will not be approved and a reinspection fee Signature Signature Owner or Agent The foregoing instrument was acknowledged before me this The fore •o'� day of , 20 _, by , day of *A who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: APPROVED BY (Revised 07 /10 /07XRevised 06/10/2009) Plans Examiner Engineer NOTARY PUBLIC: Sign: Print: My Commission Expires: actor trument wasacknow edged before me , who is personally known to me or who has produced as identification and who did take an oath. (7 /(a Zoning Clerk checked IrIvin - ricin A DRAFTING SERVICES CORPORATION ENGINEERING 1 ARCHITECTURAL 1 SURVEYING PRESIDENT: DIEGO HERRERA 18090 COLLINS AVENUE, SUITE T -1790 SUNNY ISLES BEACH, FL 33160 MAIN LINE: (305) 216 -9302 / OFFICE: (305) 682 -1513 BOUNDARY SURVEY GP PLAN SCALE: 1 " =20' • • • By: / == • ••• • Rafael I':T`'era, P.S.M. Profes .: na Surveyor and Mapper Number 5665 :• State of Florida. NOTICE: Not valid without the signature and original r sed seal of a Florida licensed Surveyor and Mapper. Additio s deletions to Sketch of Survey are prohibited without the written consent of the signing party. • • • • • •• ••• • • • • • •• • • • • •• ••• •• • • • •• ••• • ••• • • • • • • • •• • • •• • • •• • • • • • • • • • • • • • • •• • • ••• • • • • • • • • • • • • • •• • • TIKI FENCE & WOOD FENCE 0.50' EAST (CL.) FOUND CUTNAI FOUND IRON PIPE (NO ID.) • • • • • TIKI FENCE 0.30' EAST (CL.) 0.05' NORTH (CL.) FOUND IRON PIPE (NO ID.) wPP b N 1/4,, CO N m a ' CO M 1— 4 o z 4.4' 4.3' 0 cp 0 u7 10.31' 1 7 // z a N '9 20.0' C.B.S. WALL 2.25'x1.0' C.B.S. 29.80' WALL 4'x0.7' 0 Lo r) In 10.30' 7.00' 11.60' N� 23.6' A/C 3'x3' • -. NEW C.B.S. ADDIT ION 2 (UNDER CONSTRUCTION) F.F.E.: 11.78 LOT _9- EL: P.B. } I = L 23.6' --- 6.3' --- (WOOD DECK) DECORATIVE ROOFED WOOD DECK B.B.Q. 5'x5' TILE 14.3' in r7 (60' RNV) NI. 101M STREET 21.5' ASPHALT PAVEMENT 9' ASPHALT 47' N 1 0 07 N C.B.S. WAL4 4.10' 3.-- 5.10 .0 . CONC.? o ri 9.30' rd ONE STORY C.B.S. BUILDING HIGHEST FLOOR ELEVATION: 13.23 LOWEST FLOOR ELEVATION: 11.81 27.50' 27.49' 42.8' POOL 42.8 CO M POOL DECK N87 °24'10 "E 115.00' LOT 7 - BLOCK 15 P.B. 6 - PG. 82 30.00' 10.2' GRASS N87 °24'10 "E 115.00' 22.85' 22.68' x x 25.7' <I CO + r + —WOOD FRAME 1 0 (UNDER CONSTRUCTION) L..' T t> - r, Co 16.43' N 19.25' PARKWAY FOUND NAIL & DISC (NO ID. + 25.6' (NI TIKI FENCE ON -LINE 0 0 0 M TIKI FENCE ON -L' • • • • ••■ • • • •• ti • Efil + 0Q • O • • • X Isr TIKI FENCE, • •• /�"' 0.25' WEST (CL.)_.- 0.29' NORTH (CL.) FOUND IRQN .. PIPE:NOIg.) : X • • • • •• •• . • • • • ••• •A • • • • • • •• • • • • • • • • • • • • - • . • •• •••. •4 . t f • ••• • 'L t • • • t i ' • • • • • ••• • • • • 16N _ - sue SIGN 20.00' ro" • • • •• 16' l GRASS • ••• • • • • • • • 00 • s _ 0 too CIC CD N� SHEET: 20F2 NOT VALID WITHOUT SHEET 1 OF 2 r ©In9 APR 1 ( 0 201n ti �� �7r1 P . - "I: �7� ��~ Miami Shores Village SUBJECT iD CCMP .IANCE WITH ALL FEDERAL STATE AND CCUN RULES AND REGULATIONS • °°°° • °° ° • • • • • K • 11 * o ° o ° o ° o ° • • • °° °° °° • °°°° °° • • • 0 °° • • °° • • • • • ° ~~ ° ° • • • • • • • • • ° ° • • • °° ° = °° • ^ • °�° ° °° °� w°° • • • • °°° • • • • • • ° o °~ • • • • °° ~ ~ ~ ~ • • • • • °° • °° • • • 0 • • °° • • • ° °°°° ° ° °°°~ • • • ° °° • • � • • • • • °��� � • • • • • • • • • • • • °° • • • °°• Owner's Name: BENJELLOUN HASSAN Job Address: 230 107 Street Miami Shores, FL 33161- ri Zoning Criteria Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 4/19/2010 : Yes Comments: 4/19/10 NEW PLAN OK Permit NO. FW -2 -10 -232 Owner's Phone: Total Square Feet: Total Job Valuation: Contractor(s) HOME OWNER Phone Primary Contractor Yes ka ': d Fence Expires:2/19/2010 Folio Number:1122310130670 BUILDING PERMIT APPLICATION FBC 20('n Permit Type: ': UILDING ROOFING Owner's Name (Fee i older) 144ss 66-taSeft0010 Phone # 7k — J 5 1 --• of 3 Owner's Address es* t> /J E lo S{-4 City TT, A.wi cleat Gs State fLod i e7 Tenant/Lessee Name Email Job Address (where the work is being done) City Miami Shores Village FOLIO / PARCEL # NO x 4WD (W Is Building Historically Designated YES Contractor's Company Name Contractor's Address City State Zip Qualifier Name Phone # State Certificate or Registration No. Certificate of Competency No. 'Contact Phone Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ Ieo0 Type of Work: ['Addition ['Alteration JNew ❑ Repair/Replace Describe Work: Re-14-64'r, eo , mi eIJ Notary $ Structural Review. $ Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 a30 ■t loi County Miami -Dade Zip E -mail ye_ 4 k G✓J het, oje Fees Submittal Fee $ gp•CO Permit Fee $ /6 ©ci Training/Education Fee $ Scanning $ Radon $ DPBR $ Double Fee $ Violation date: Permit No. Master Permit No. Zip _33 6 Phone # Phone # Square / Linear Footage Of Work: 6g a 6. CCF $ Gd Total Fee Now Due $ .3 C FEB 17 2010 II BY:---- . --- Flood Zone I.) 4 ❑ Demolition CO /CC .$ Technology Fee $ Bond $ See Reverse side -a 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 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 a roved and a reinspection fee will be charged.. Signature 1I 1 ■ 1.\ Signature er or Agent Contractor The forego' s trument was ac owledged befor me this The foregoing instrument was acknowledged before me this day of t i� , 20 10, by 1 '4 , : y of , 20 _, by personally known tome or who has produced` a e who is personally known to me or has produced take an oath. who is as identification and who did take an oath. NOTARY PUBLIC: Sign: 4\ 2 °,b *x ,* * ,r�r , **�e,,,r x *,+fix ° ,x ,* ****** x *,u,,�,r�c ** x* **** �r�r,�,�. , r�rxx** x, * ********** * **** *,r* xx Print: My Commission Expires: APPROVED BY (Revised 07 /10 /07)(Revised 06/10/2009) 0 . /D • Plans Examiner Engineer NOTARY PUBLIC: Sign: Print: My Commission Expires: (C Zoning Clerk checked 8arm nd Zoning Criteria Owner's Name: BENJELLOUN HASSAN Job Address: 230 107 Street Miami Shores, FL 33161- HOME OWNER Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)758 -8972 Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 2/17 /2010: Yes Comments: Permit NO. FIN -2 -10 -232 Issue Date: Not Issued Expires: Contractor(s) Phone Primary Contractor Folio Number:1122310130670 Owner's Phone: Total Square Feet: 68 Total Job Valuation: $ 1,000.00 Yes ADDRESS: J 3o IV E /07 Si; 17 a*; cif (t 43 5. I understand that, as the owner- builder, I must provide direct, onsite supervision of the construction. 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: lliSSI$,J /501/413/ /bQIJ DATE: C2 "11" i/0 Co 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 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. I 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 ilk 3. I 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. Infial 4. I 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 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 Initial 6. I 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. 7. 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, may be 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 8. I 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 'I 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. I 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. I 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 the Florida Construction Industry Licensing Board at 850 .487.1395 or htto:/rWww.mvfloridaticense.com/dbor/oro/cilblindex.html Initial 11.1 am aware of, and consent to; an owner- builder building permit applied for in my name and understands that 1 am the party Malty and financially responsible for the proposed construction activity at the following address: Initial 12. I agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of 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 may be 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 properly 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 retumed to the local permitting agency responsible for issuing the permit A copy of the properly owner's driver license, the notarized signature of the property owner, or other type of verification acceptable to the local permitting agency is required when the permit is issued. ) Was acknowledged befog me this day of .�'! C,I , 2010 By \ C ( Y ' ) & who was personally known to me or who has Produced there License or G' O 42.44011 4:904) identification. NOTARY v F..TBL1C-1311, �u ; iYa NOTAR >- ` #1))7 , .. s ,.: SAP 23, Initial_ 2. I 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. 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: P4 I EJ1o,Jk) DATE: 0 4- if —Jo ADDRESS: -230 p6i / b7 S /i % < 1 c4-5 / 7 f .`i 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. I 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. 5. I understand that, as the owner- builder, I must provide direct, onsite supervision of the construction. Initial Initial Initial 3. I 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. 4. I 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 6. I 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. 7. I understand that it is frequent practices of unlicensed persons to have the properly 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 be 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/ 8. I 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 I 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. I agree that, as the party legally and financially responsible for this proposed Construction activity, I will abide by all applicable laws and requirement that govem owner - builders as well as employers. I also understand that the Construction must comply with all applicable laws, ordinances, building codes, and zoning regulations. 10. I 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 the Florida Construction Industry Licensing Board at 850.487.1395 or http:// www. mvfloridalicense .corn/dbpr /pro/cilb/iindex.html Initial (c- 1 1. I am 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: 12. I agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of 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 may be 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 properly 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 retumed 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 required when the permit is issued. Was acknowledged before me this day of 2 , 20 / o dran \ftr who was personally known to me or who has Produced ere License or as ide f C? Initial_ Initial Ajb NOTARY ?SALA. - V. Cut Iles ,1,3111Corarniasiou DD717923 rt.s: SEN. 23, 2011 ®vrror+ " o 'WV ATLA*TPICBONDINGCO.,INC. NORTH SCALE: 1/20 4 PAGE 1 OF 2 Property Address: 230 N.E. 107 STREET MIAMI, FL 33147 glafflagrSSEUELERBOAt EMMY CERTIFY 'MAT TEES BOUNDARY SURVEY IS A TRUE AND CORRIRT REPRESENTATKA: OF A SURVEY PREPARED EWER MY DIRECTOR RES COMBIES BITE TETE WORN TECHNICAL STA..BLARCN RET ma.= BY WE STATE QT &CRUM WARD OF PROFESSIONAL LAND SURVEY 1017-5. EMMA AIINSNISTRATESE CODE PUESE/ANT TO 472.R2 L Etativ• spa+ • NA • suri SIGNED FOR THE FIRM MIGUEL MIMOSA P.SM No. MI Sr.47E OF FLORIDA 22.00' ASPHALT PAVElaN SO.CO' TOTAL npl Raft NE 107 STREET 14A4 3 1 2006 1OE3 Lep, 3' POOL GATE REQUIREK' TITS Access gztes nlust open oakard away f r z Oie pool are be seLt- cicising/self-lockin ice c pool side of t e and .o.::.ate0 no less than from bottom of gate. FaC 424„2j., , 1 1 115.0f• p LOT - 7 nom- 15 19.00 miss PK Eff Nigsg_NRIAMS a °Co T.: • Accepted By: 2000 rT, MIGUEL ESPINOSA LAND SURVEYING, INC 6494&W. 24 STREET MIAMI, FLORIDA 33155 PIIONE: (305) 740-3319 FAX (305) 669-3190 L13# 6463 zi 1 a moo' • NORTH SCALE: 1/2D SIGNED nett wiNDAD MIGUEL ESPINOSA STATE OF HONDA ....maposposn. elsksems■AlisLItibm.ladaw PAGE 1 OF 2 Property Address: 230 N.E. 107 STREET MIAMI, FL 33147 SLINVEYDICS CERTLFICATION:f HERESY MIDI' MAT THIS ISCRE4DARY =VEY' IS A TRUE AND CORRECT RFAILESENTATKA: Of 14 RUMMY PREPARED tRgTOR !AY DIRECITOD. TIM COMPLIFS Vitt 11;E MINIMUM lat LW:AL sio,Nacatas S ream ay us srmre ce Moira sP_ARE) eY PROFESSIONAL LAND SURVEY 13174. IFLOIRDA ADNEDLIEFRATPRE MIX PUESELANI TO 472 V47, :WAWA STAT. 22.00 ASPHALT PAVEWN 40.00' TOTAL II" • NE 107 STREET ciCalrir I MAO 3 1 2006 a' WRAC, F3 .;! .... FOR THE FIRM 11 r- H ONE STORY RESIDENCE # 230 27-5Gr 42.95' 116.00' POI 1,SOf• Pat LOT - 7 BLOCK 15 19.O 7:/-SS Pit 67 ...yr mama wale. ear ittl% 3' POOL GA:FE REQU EIVE Access fiz!tes must open out*ard away frm pool are be se!•`-csn..„ dE:qice 1:Dcat : :n pool side of t e iptg id kterj no less than 5.4 from bottom of gate. Ff.; 4242 Notes- NO NOTES OCo s Accepted By: MIGUEL ESPINOSA LAN)) SURVEYING, INC. 6494 .S.W. 24 STREET MIAMI FLORIDA 33155 ° PHONE: (305) 740-3319 FAX #: (305) 669-3190 LB if 6463 •