FW-12-935Miami 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
VIZ E 3 AVIV
5 1 ate) I°Z-- FBC 20
BUIL ING Permit No. CU.) 12 -- C1 ` bS
PERMIT APPLICATION Master Permit No.
Permit Type: BUILDING ROOFING
JOB ADDRESS: ea, ,' N L l 03 •
City: Miami Shores County: Miami Dade Zip: 3 3 (3 8
Folio/Parcel #: \ \ ` (cl ®l 334I-40
Is the Building Historically Designated: Yes NO Flood Zone: \\.)
OWNER: Name (Fee Simple Titleholder): IA C� Y- ` 3u j a
Address: 2SS 1V E 103
City: 4— l v,,- . Ir e S State: L— Zip: 3
Tenant/Lessee Name: ,i ■ Phone #:
Email: `a vz ek ex r S Q�
CONTRACTOR: Company Name: 601.4■1&•4L— V O144(' Phone #:
Address:
City: State: Zip:
Qualifier Name: Phone #:
State Certification or Registration #: Certificate of Competency #:
Contact Phone #:
DESIGNER: Architect/Engineer: Phone #:
Email Address:
Value of Work for this Permit: $ n J • 0 0 Square/Linear Footage of Work: ='''i
Type of Work: Addition ❑Alteration UNew
Description of Work: R 0 V e- vx e -P e Y' - -r f Q_ r 4/ 1i A e,
ORepair/Replace " '' ❑Demolition
Color thru tile:
Submittal Fee $ Permit Fee $ /00 CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $ ( ,.
TOTAL FEE NOW DUE $ `°
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 approved and a reinspection fee will be charged.
Sign
Owner or Agent �e�,
trument was acknowledged before me this [�
T -
day of , 20 (t by Jt.J�%1. (2■e4Pt ,
who is personally known to me or who has produw1
As identification and keeen,o 4
Z
_ (0
_
- __ o, .a.
-azo_ ,:; 4 )
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
1.4 irn
c r„_
-., •
APPROVED BY
Signature
Contractor
The foregoing instrument was acknowledged before me this
day of , 20 , by
who is personally known to me or who has produced
as identification and who did take an oath.
$02P /4 Plans Examiner
Structural Review
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
(Revised 5 /2 /2012)(Revised 3 /12 /2012XRevised 07 /10 /07XRevised 06 /10 /2009)(Revised 3/15/09)
* * * * * * * * * * * * * * * * **
.23//Z Zoning
Clerk
Planning and Zoning Grit ria
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Folio NumLero1121360130440
Owner's Name: JULIA RANDLE
Job Address: 285 103 Street
Miami Shores, FL 33138 -2430
Owner's Phone:
Total Square Feet:
Total Job Valuation:
97
$ 1,780.00
Contractor(s)
ALL ABOUT FENCING CONTRACTOR INC
Phone
Primary Contractor
Yes
Planning nd Z
Approved: Yes
Comments:
ning Criteria and Comments
Date Approved: 5/23/2012 : Yes
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: C 1� -� O� r�L DATE: 5 (13/ \ Z
ADDRESS: -2_%
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. !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._
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.
Initial
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.
5. I understand that, as the owner- builder, I must provide direct, onsite supervision of the construction.
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
k/a2-1(4fn
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_sm
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.
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 http:// www. myforidalicense .com /dbpr /prolcilb /index.html
Initial C i�
11. 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:
2-SS tO ,
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 contractors workers compensation coverage.
Before a building permit can be issued, this disclosure statement must be completed and signed by the property owner and
returned to the local permitting agency responsible for issuing the permit. A copy of the property owners 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 __t day of nkt , 20
By Jls4 121Ac.... who was personally known to me or who has
Produced there License or
U4UU
F.I.P 4°
37.50• NO CP.
Woks
LOT -20
BLOCK - 119 sloe
123.41'
CL
o
r
3.84
!2 ° ›Den
119 /
0 4 }.50'
ONE STORY o
RES. # 285
F.F.E = 11.75 1'
LF.E.= 10.88
GARAGE ELEV.= 10.19'
10.60
NCR.
NCR
8.25.00
L=39.21
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•STAVYOR '1701%
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orris not shown on this Survey.
R 3 S Miami Shores Village
APPROVED
-a
DATE
ZONING DEPT
o
r
3.84
!2 ° ›Den
119 /
0 4 }.50'
ONE STORY o
RES. # 285
F.F.E = 11.75 1'
LF.E.= 10.88
GARAGE ELEV.= 10.19'
10.60
NCR.
NCR
8.25.00
L=39.21
• •• •
•
•
•S•••• •.•••:
• • • •
• • • • •
, '•
re } •rrid in :tiiio, Pu
• ..
• • •
•
•STAVYOR '1701%
• ,9 her may be•Ea1b'ine
•
00000
•
•
•
orris not shown on this Survey.
R 3 S Miami Shores Village
APPROVED
BY
DATE
ZONING DEPT
Alla
Sh 3 (2
BLDG DEPT
4...10
SUBJECT TO COMPLIANCE WITH ALL FEDERAL
STATE AND COUNTY RULES AND REGULATIONS
5582 N.W. 7th STREET SUITE 202
MIAMI, FLORIDA 33126
TELEPHONE: (305) 264-2660
FAX: (305) 264 -0229
DRAWN BY: T.D.
Xrrvtt uruPqurs Jnr.
LAND SURVEYORS
SURVEY No. 98- 0008576 -2
SHEET No. 2 OF 2
• •
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•
BOUNDARY SURVEY
SCALE' = 1" = 30'
LOT - 20
BLOCK -119
F.I.P
37.50' NO C
123.41'
ONE STORY g
RES. # 285 -
F.F.E = 11.75'
LF.E.= 10.88'
GARAGE ELEV.= 10.19'
•
•
•
••
10.60
NCR.
NCR.
.82
SURVEYOR'S NOTE:
- There may be Easements recorded in the Public Records not shown on this Survey.
6582 N.W. 7Th STREET, SUITE 202
MIAMI, FL 33128
TELEPHONE: (305) 264-2880
FAX: (305) 284-0229
DRAWN BY: TDD
Nova Surveyors, Inc.
LAND SURVEYORS
SURVEY NO 98- 0008576 -2
SHEET NO 1
OF 2
SURVEY OF LOT 21 -23, BLOCK 119, OF AN AMENDED PLAT OF SECTION NO. 5 OF MIAMI SHORES, ACCORDING TO THE PLAT THEREOF AS
RECORDED IN PLAT BOOK 10, PAGE 47, OF THE PUBLIC RECORDS OF MIAMI -DADE COUNTY, FLORIDA.
PROPERTY ADDRESS: 285 NE 103 ST, MIAMI SHORES, FL 33138
FOR: JULIE RANDLE
LOCATION SKETCH Scale 1" = NT.S.
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ABBREVIATION AND MEANING
A =ARC
A/C = AIR CONDITIONER PAD
AE. = ANCHOR EASEMENT
A/R = ALUMINIUM ROOF
A/S = ALUMINIUM SHED
ASPH. = ASPHALT
B.C. = BLOCK CORNER
B.C.R. = BROWARD COUNTY RECORDS
B.M. = BENCH MARK
B.O.B. = BASIS OF BEARINGS
C = CALCULATED
C.B. = CATCH BASIN
C.B.W. = CONCRETE BLOCK WALL
CH = CHORD
CH.B. = CHORD BEARING
CL = CLEAR
C.LF. = CHAIN LINK FENCE
C.M.E. = CANAL MAINTENANCE
EASEMENTS
CONC. = CONCRETE
C.P. = CONCRETE PORCH
C.S. = CONCRETE SLAB
D.E. = DRAINAGE EASEMENT
D.M.E. = DRAINAGE MAINTENANCE
EASEMENTS
DRIVE = DRIVEWAY
ENCR. = ENCROACHMENT
E.T.P. = ELECTRIC TRANSFORMER PAD
F.F.E. = FINISHED FLOOR ELEVATION
F.H. = FIRE HYDRANT
F.I.P. = FOUND IRON PIPE
F.I.R. = FOUND IRON ROD
F.N. = FOUND NAIL
F.N.D. = FOUND NAIL & DISK
FNIP. = FEDERAL NATIONAL INSURANCE
PROGRAM
IN. &EG. = INGRESS AND EGRESS
EASEMENT
L.F.E. = LOWEST FLOOR ELEVATION
L.M.E. = LAKE MAINTENANCE EASEMENT
L.P. = LIGHT POLE
M. = MEASURED DISTANCE
M/14= MANHOLE
N.A.P. = NOT A PART OF
NGVD = NATIONAL GEODETIC VERTICAL
DATUM
N.T.S. _ NOT TO SCALE
O.H.L. = OVERHEAD UTILITY LINES
O.R.B. = OFFICIAL RECORD BOOK
O/S = OFFSET
OVH.= OVERHANG
P.B. = PLAT BOOK
P.C. = POINT OF CURVE
P.C.C. = POINT OF COMPOUND CURVE
PL. = PLANTER
P.L.S. = PROFESSIONAL LAND
SURVEYOR
P.O.B.. = POINT OF BEGINNING
P.O.C.. = POINT OF COMMENCEMENT
P.P. = POWER POLE
P.P.S.. = POOL PUMP SLAB
P.R.C. = POINT OF REVERSE CURVE
PRM = PERMANENT REFERENCE
MONUMENT
PT. = POINT OF TANGENCY
PVMT. = PAVEMENT
PWY =PARKWAY
R. = RECORD DISTANCE
RAD. = RADIUS OF RADIAL
RGE. = RANGE
R.P. = RADIUS POINT
R.O.E. = ROOF OVERHANG
EASEMENT
RAN = RIGHT -OF -WAY
SEC. = SECTION
S.I.P. = SET IRON PIPE L.B. #6044
SWK. = SIDEWALK
T = TANGENT
TWP = TOWNSHIP
U.E. = UTILITY EASEMENT
U.P. = UTILITY POLE
W.M. = WATER METER
W.R. = WOOD ROOF
W.S. = WOOD SHED
= ANGLE
A = CENTRAL ANGLE
= CENTER LINE
= MONUMENT LINE
}.EGAL NOTES TO ACCOMPANY SKETCH OF SURVEY ( "SURVEY");
- THERE MAY BE EASEMENTS RECORDED IN THE PUBLIC RECORDS NOT SHOWN ON THIS SURVEY.
- THE PURPOSE OF THIS SURVEY IS FOR USE IN OBTAINING TITLE INSURANCE AND FINANCING, AND SHOULD NOT BE
USED FOR CONSTRUCTION PURPOSES.
- EXAMINATIONS OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED INSTRUMENTS, IF ANY,
AFFECTING THE PROPERTY. THIS SURVEY IS SUBJECT TO DEDICATIONS, LIMITATIONS, RESTRICTIONS, RESERVATIONS
OR EASEMENTS OF RECORD, AND LEGAL DESCRIPTIONS PROVIDED BY CLIENT OR ATTESTING TITLE COMPANY.
BOUNDARY SURVEY MEANS A DRAWING AND / OR A GRAPHIC REPRESENTATION OF THE SURVEY WORK PERFORMED IN
- THE FIELD, COULD BE DRAWN AT A SHOWN SCALE AND / OR NOT TO SCALE.
EASEMENTS AS SHOWN ARE PER PLAT BOOK, UNLESS OTHERWISE SHOWN.
- THE TERM "ENCROACHMENT" MEANS VISIBLE AND ABOVE GROUND ENCROACHMENTS.
- ARCHITECTS SHALL VERIFY ZONING REGULATIONS, RESTRICTIONS AND SETBACKS, AND THEY WILL BE RESPONSIBLE
- FOR SUBMITTING PLOT PLANS WITH THE CORRECT INFORMATION FOR THEIR APPROVAL FOR AUTHORIZATION TO
AUTHORITIES IN NEW CONSTRUCTIONS, UNLESS OTHERWISE NOTED. THIS FIRM HAS NOT ATTEMPTED TO LOCATE
FOOTING AND /OR FOUNDATIONS.
FENCE OWNERSHIP NOT DETERMINED.
- THIS PLAN OF SURVEY HAS BEEN PREPARED FOR THE EXCLUSIVE USE OF THE ENTITIES NAMED.
- HEREON, THE CERTIFICATE DOES NOT EXTEND TO ANY UNNAMED PARTY.
- THE SURVEYOR MAKES NO GUARANTEES AS TO THE ACCURACY OF THE INFORMATION BELOW. THE LOCAL F.E.MA
- AGENT SHOULD BE CONTACTED FOR VERIFICATION. THE FNIP FLOOD MAPS HAVE DESIGNATED THE HEREIN DESCRIBED
LAND TO BE SITUATED IN ZONE: X COMMUNITY/PANELISUFFIX 120852 0302 L DATE OF FIRM: 09/11/2009
BASE FLOOD ELEVATION: N/A.
CERTIFIED TO: JULIE RANDLE
LEGEND TYPICAL
—01I— OVERHEAD UTILITY LINES
CBS = WALL (CBW)
- 4—x C.LF. = CHAIN LINK FENCE
-fl-0 I.F. = IRON FENCE
i•-sr W.F. = WOOD FENCE
• 0.00 = EXISTING ELEVATIONS
SURVEYOR'S NOTES
1) IF SHOWN, BEARINGS ARE REFERRED TO AN ASSUMED
MERIDIAN, BY SAID PLAT IN THE DESCRIPTION OF THE
PROPERTY. IF NOT, THEN BEARINGS ARE REFERRED TO
COUNTY, TOWNSHIP MAPS.
2) THIS IS A SPECIFIC PURPOSE SURVEY.
3) THE CLOSURE IN THE BOUNDARY SURVEY IS ABOVE
1:7500 FT.
4) IF SHOWN, ELEVATIONS ARE REFERRED TO
MIAMI-DADE COUNTY. • • •
ALL ELEVATIONS SH WN ARIiREFERRED TO • •
NATIONAL GL!C1bgTI VERTICAL DATUM OF 1929. •
MIAMI- DADCCOUNRY BENCH IlAdWels567 • • • 0 . 0
LOCATED @ 3100; • • •
ELEVATION •0.54gEFJ OF N.G.V.D. $F 1929 • •
•0.000 •0000•
•• •
SURVEYO • , ti'§ TIFICMIOI • • • • • •
00000
•
1 HEREBY CERTIFY ;VAT THIS 18OUND Y SURVEY" OF •
THE PROPER? DESCRIBED H r�I ¥RECEN I 0 0 0 0
SURVEYED AN %BRA N UNDEP'MY SUPERVISION •
COMPLIES WITH TISANIMUM TECHNICAL STANDARDS
AS SET FORTH 14•*LORIDA BARD QF •• • •
•
PROFESSIONPL�PNDSURVEYOS rNCHAPTER 61 G17-6•o
FLORIDA ADMINISTRATV COD BRURtlP<T
TO 472.027, •
FLORIDA STATU!LOS • • 0 0.0 •
•.• • .00••
• 03 -2/ -/1L
BY:
ROBERT IBARRA
PROFESSIONAL LAND SURVEYOR NO. 6437
STATE OF FLORIDA (VALID COPIES OF THIS SURVEY WILL
BEAR THE EMBOSSED SEAL OF THE ATTESTING LAND
SURVEYOR).
REVISED ON:
REVISED ON:
SURVEYORS SEAL