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DS-07-34Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 2004 ipcmrwrzi JAN 0 9 2007 NaCk BY: Permit No. VS In- ` Master Permit No. Permit Type (circl Buildin Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) (V%/1%.041/In )i7 Phone # 3 G,- 011 S.)/-65- Owner's Address 1 aZ N� r `� City M /AM) V S%f1 Tenant/Lessee Name State Job Address (where the work is being done) City Miami Shores Village FOLIO / PARCEL # /1 A.7- 17117114 51- County . Miami -Dade Zip D3 /30 Is Building Historically Designated YES NO_, 1 Contractor's Company Name �bvne Contractor's Address „Phone # -3 a. / V _ Yd City State Qualifier Name State Certificate or Registration No. Zip Phone # Architect/Engineer's Name (if applicable) Value of Work For this Permit $ Certificate of Competency No. Phone # O0 Square / Linear Footage Of Work: Type of Work: ❑Addition Alteration [New Describe Work: a- e Attfr ❑ Repair/Replace ❑ Demolition * ***** * ***** ** * ******* * ** * * * * * * * **** Fees, * * * *** **** * * * ** * * * ** * * ** * * ** ***** * * * * * *** ** Submittal Fee $ Notary $ Scanning Bond $ Structural Review. $ Permit Fee $ Training/Education Fee $ /DD 6,- 2O CCF $ a (0 CJ co/cc Technology Fee $ CD Radon $ DPBR $ Zoning $ Code Enforcement $ Double Fee $ Total Fee Now Due $ 11( . See � r 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 AF'1'IDAVIT: 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 days :. er the building permit is issued. In the absence of such posted notice, the inspection will not be ap charged. ��ove' and a re �pection fee wi e charge �7" 4,1'/`'■ Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged fore me this 9 The foregoing instrument was acknowledged before me this I day of , 2(� by VI ALVA tkft, , day of , 20 , by who is personally known to me or who has produce,'. yo ' 5 Ll(vho is personally known to me or who has produced PI) '5Z' X3-1 °O As identification and who did take an oath. as identification and who diddtake an oath. NOTARY P IC: NOTARY PUBLIC: Sign: Print: My Commission Expires: * * * * * * * * * * * * * * * * * * * * ** Sign: Print: My Commission Expires: ******************************************* * *** * * * * * ** * * **** * ** * ** * * * * ** ** APPLICATION APPROVED BY: (Revised 02/08/06) Plans Examiner Engineer Zoning VILLAGE OF MIAMI SHORES OWNER BUILDER DISCLOSURE STATEMENT NAME: Oil) in ,A;) 1 d 12 0 C • DATE: ADDRESS: 4,N qd.„ Ai6 � 71 S 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 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 constructi 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 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, alter or give advice on how to meet code —. only if the structure meets 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. 6. I understand that if I compensate any person or company for work 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. 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. 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. Was acknowledged before me this � day da of By Wham UtaUk, who was personally known to me or who has Produced there License or r < VTttl6' 5 1 %1(b TV - 63-1/0-0 (j-0 a identification. 20 = ttv r »l2 = ff-ig• . p MIAMI SHORES V!L For Driveways and/or Sidewal ! before final inspect d bon ° approved for rrfundti and and y� must be completed. 40 _BO i rDARY SURVEY ........................... L c59/9"- -N-02 s, an be d work F1P.3 /4 " --- No I.D. NE. CORNER LOT 3, BLOCK 85 21' PARKWAY 5' SIDEWALK 7500' L FOP. 112" No I.D. ti 1C SHORES VILLAGE Driveways and/or Sidewalks, final insptian and bond can-be ved for ref i; all sod and yard work 0.31 usage completed. 1 B�IA/C = AIR BENCHMARK (C) = CALCULATED C = CENTER UNE CH = CHORD C&G = CONC. & GUTTER CONC. = CONCRETE D =DELTA D.E. = DRAINAGE EASEMENT EXT. EXTENSION F..# = FROM .1OW FFE = FINISH FLOOR ELEOTION F.N&D. = FOUND NAIL & DISC. F.N&T. = FOUND NAIL & TAB F.D \H. = FOUND DRILL HOLE F.PK.N = FOUND PARKER KALON NAIL INT. = INTERSECTION L.A.E. L = LENGTH UNITED ACCESS EASEMENT L.M.E. = LAKE. MAINTENANCE EASEMENT (M) = MEASURE o/s = OFFSET (P) = PLAT A& PLANTER OF BEAMING P.O.C. = POINT OF COWENCEMENT P .C.P. = PERMANENT CONTROL•POINT P.RM. _ PERMANENT REFERENCE MONUMENT PA:E. = PARTYVNATL EASEMENT R = RADIUS (R) =RECORD RA = RIGHT OFWAY R.E.E. = ROOF ENCROACHMENT EASEMENT S/F.N. = SET OR FOUND NAIL S/FIP. = SET / FOUND IRON PIPE S/FIR = SET / FOUND IRON ROD U.E = UTDJTY EASEMENT V&G = VALLEY & GUTTER 7) I,M.F = ZERO LOT LINE MAINTENANCE EASEMENT x0.00 = EXISTING ELEVATION 82.12' i pimcmz77E1 JAN 0 9 2001 gi BY: IIOA1CC( • • • • ALL THAT PART OF LOTS 1 AND 2 , Ytot'lC 85, 11F.4114MI SHORT,$' SECTION NO. 3 , ACCORDINC TO ?ND •P THEREOF A$ RECORDED* IN PLAT BOOK 10, AT PACE 37, 0E41= •PUBLIC RECORDS • DADE COUNTY, FLORIDA. LYING WEST•Q.LTHE FO WINO DESCRIBED LINE; FROM A POINT IN TW! . WORTJI OF LaT 1, 1 DISTANCE OF 75.0 FEET EAST OF MB 'NORTHWE$7'017RNER'(P • • • SAID LOT 1, RUN SOUTH 100.2 FEET *TA J. POINT ON •THE $WJ 1i • LINE OF LOT 2, LYING 82.12 FEET fere8F THE •INTHWES ' CORNER OF SAID LOT 2. • • • • • • • •••• • • • • •••• • • • CiERPIFIdATIoN OF BOUND. ' § Mitt •; I HEREBY CERTIFY THAT THIS SURVEY WAS MADE UNDER MY RESPONSIBLE CHARGE AND TO THE BEST .OF AlT .KNOWLEDGE AND BELIEF; THIS SURVEY MEETS THE MINIMUM TECHNICAL STANDARDS AS SET FORTH HY THE BOARD OF PROFESSIONAL LAND .y RVEYORS IN CHAPTER 81017 -6 FLORIDA ADMINISTRATIVE' CODs' "' ANT TO SECTION 472.027. FLORIDA STATUTES. • &4RNERA(' N©?r.B,S: 1) BASIS OF BEARING: AS PER PLAT 2) ELEVATIONS SHOWN HEREON ARE RELATIVE TO NATIONAL GEODETIC VERTICAL DATUM(N.C.V.D ) 3) LOCATION AND IDENTIFICATION OF UTILITIES ON AND /OR ADJACENTTO THE PROPERTY WERE NOT SECURE AS SUCH INFORMATION WAS NOT REQUESTED. 4) NOT VALID WITHOUT THE SIGNATURE AND THE ORIGINAL RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER 5) THIS SURVEY 13 NOT INTENDED FOR CONSTRUCTION _ - PURPOSES 8) ENCROACHMENTS AND VIOLATIONS ON SURVEY(IF ANT): COMMUNITY .NUMBER 120652 PANEL NUMBER 0093 SUFFIX DATE OF FD01 INDEX 7/17/95 FIRI! ZONE BASE FLOQD ELEVATION IO CATCH BASIN VATETY 'METER FIB HYDRANT BOX - = ELE( -sT OC Bak OMERNEW tik (OH) x — CHAIN uNK FENCE (CIF) — // — 1910=L FENCE &ON 1-1,44r1 JIHAD 3: PITA, 2P7 PROn 0NAL` .�•r`".. '.r' 1J&J ,gin VI 57 STATE or "mum VEYOR JSP SURV EY() MNd LAND D'uiw. LB 6371 7805 CORAL WAY. ,S'T'LITZ 118A MIAMI, FLORIDA 38156 PHONE (305) 262 -2404 =cliON: 32- 54 -41. OOUMa'Y: DADE o TOWILLIAM POI-RIVET & CARLOS VAZQUEZ LAW OFFICES 3 TITLE�.r�E FUND. INC. ALL STAR .MOR7Y AGE FINANCIAL CORP., ISAOA /ATIMA 1292 NE 95 STRET , MIAMI SHORES FL 33138 D 8/6/08 T 06 -06 -08 „ DW GL9428