RC-12-1203Arlenis Silvera
From: Bryan Nugen <bryan @nugenlaw.com>
Sent: Thursday, March 07, 2013 5:08 PM
To: Arlenis Silvera
Subject: Permit Number RC -6 -12 -1203
If you would please terminate the above - referenced permit. I was unable to begin the project due to a hectic work
schedule. I intend to once again apply for the permit when time permits.
Thank you.
J. Bryan Nugen, JD
Licensed in Florida, Indiana, Ohio & Michigan
A PROFESSIONAL CORPORATION
221 South Main Street PO Box 6067 Auburn, Indiana 46706
12000 Biscayne Blvd Suite 206 Miami, Florida 33181
777 South Flagler Drive Suite 800 West Palm Beach, Florida 33401
433 Plaza Real Suite 275 Mizner Park Boca Raton, Florida 33432
PH: 866.795.8433
FX: 260.925.3757
bryan@nugenlaw.com
www.nugenlaw.com
Estate Planning, Estate Administration, Elder Law, and Business Transactions
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1
ql6e
Arlenis Silvers
From:
Sent:
To:
Subject:
Dear Arlene:
Bryan Nugen <bryan @nugenlaw.com>
Friday, January 04, 2013 3:55 PM
Arlenis Silvera
Permit Number: RC -6 -12 -1203
The above - referenced permit is due to expire tomorrow, January 5, 2013. My work is not complete and I would like to
respectfully request a nin
ety (90) day extension of the permit.
Thank you for your kind consideration.
John B. Nugen
375 NE 99th Street
Miami Shores
1
DING
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
PERMIT APPLICATION
Permit Type: BUILDING
JOB ADDRESS: 7.5 1 gort. 57 /'i'g-+-
City:
Folio/Parcel #:
c. tvrT I
JUN 2 9 2012
Y:
FBC 20
Permit No. r� P
Master Permit No.
ROOFING
Miami Shores
County: Miami Dade
zip: 13
Is the Building Historically Designated: Yes
NO Flood Zone: 0
OWNER: Name (Fee Sim ?le Titleholder): V� i) �/�(a„/ ai g Phone #: 716/C3 �%�'r�
Address: 3 7 s iv f e4q`A ---' '
City: t-1 a cti, 51c701--€)5 State: F" Zip: 73 i 3 U
Tenant/Les e Name: pp
Email: N(c N P% 0 ..-C VJ t. ow) I CU
CONTRACTOR: Company Name: 5,-f ( F
Address:
Phone#:
Phone #:
City:
Qualifier Name:
State Certification or Regi
Contact Phone #:
DESIGNER: Architect/E
Value of Work for this P
Type of Work: DAdditic
Description of NNork:
State: Zip:
Phone #:
tration #: Certificate of Competency #:
Email Address:
gineer: 5-c ' -F Phone #:
rmit: $ 5 oo Square/Linear Footage of Work: 411
n 1 ❑Alteration D
rew XRepair/Replace UDemolition
. 144 -'l / -e)(71. G,'t`, � 1 v `.^()° °
dr.;- j ate.
Color thru tile:
Submittal Fee $
Scanning Fee $
Notary $
Double Fee $
* x:* ****** ***** ********* Fees****** *** **** ** *** **:x*+x******* :******** *****
Permit Fee $ /inV CCF $ CO /CC $
Radon Fee $ DBPR $ Bond $
Training/Education Fee $ Technology Fee $
Structural Review $
TOTAL FEE NOW DUE $ Q lJ U' COO
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 inspectio •\ which s sev an (7) day er the building permit is issued. In the absence of such posted notice, the
inspection will not be a p proved and a re' 'sped' a ee will be charged.
Signature Signature
�y Contractor
The foregoing ins • was acknowledged before me this L1* The foregoing instrument was acknowledged before me this
day of , 20 _ y .rS1Ni , day of , 20 _, by
who is personally known to me or who has produced el—it 0 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:
0 r or Agent
Sign: -�-_
.'2.- % &.
' ' �� .0
islutitt
Print:
My Commission Expires:
APPROVED BY
Plans Examiner
Sign:
Print:
My Commission Expires:
Zoning
Structural Review Clerk
(Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)
NA
AD
Do hereby petitio
And I have read a
understand that I
State Law require
exemption allows
supervise the con
commercial buildi
occupancy. It ma
construction is co
an unlicensed per
law and by coun
supervision and
compensation for
buildings codes a
Please read an
1. l u
pe
co
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
k OWNER BUILDER DISCLOSURE STATEMENT
E: 0 tti 13-r)e \1/4),, f 41DATE: - a 4
RESS: / 7 5� �� ~ 51.0.1-e5 f-i --3(?
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).
d understood the following disclosure statement, which entitles me to work as my own contractor; I further
s the owner must appear in person to complete all applications.
construction to be done by a licensed contractor. You have applied for a permit under an exception to the law. The
ou, as the owner of your property, to act as your own contractor even though you do not have a license. You must
truction yourself. You may build or improve a one - family or two- family residence. You may also build or improve a
g at a cost of $25,000.00 or less (The new form states 75,000). The building must be for your own use and
not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the
plete, the law will presume that you built for sale or lease, which is a violation of this exemption. You may not hire
on as a contractor. It is your responsibility to make sure the people employed by you have licenses required by state
or municipal licensing ordinances. Any person working on your building who is not licensed must work under your
ust be employed by you, which means that you must deduct F.I.C.A and with - holdings tax and provide workers'
hat employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances,
d zoning regulations.
initial each paragraph.
derstand that state law requires construction to be done by a licensed contractor and have applied for an owner- builder
it under an exemption from the law. The exemption specifies that I, as the owner of the property listed, may act as my own
tractor with certain restrictions even though I do not have a license.
2. I u derstand that building permits are not required to be signed by a property owner unless he or she is
co struction and is not hiring a licensed contractor to assume responsibility:
3. l u
fro
na
pe
4. l u
a
not
my
im
derstand that as an owner builder, I am the responsible party of record on a permit. I understand that I btect myself
potential financial risk by hiring a licensed contractor and having the permit filed in his or her name stead of my own
e. I also understand that the contractor is required by law to be licensed in Florida and to list his or licen
and contracts. .4000,‘
Initial
derstand that I may build or improve a one family or two-family residence or a farm outbuilding. I may a ild or improve
mmercial building if the costs do not exceed $75,000. The building or residence must be for my use;. occupancy. It may
be built or substantially improved for sale or lease. If a building or residence that I have built or substantially improved
elf is sold or leased within 1 year after the construction is complete, the law will presume that I built o , < tially
roved it for sale or lease, which violates the exemption.
5. I u derstand that, as the owner- builder, I must provide direct, onsite supervision of the construction.
6. I u
res
mu
Initial
Initial
derstand that I may not hire an unlicensed person to act as my contractor or to supervise persons workin
dence. It is my responsibility to ensure that the persons whom I employ have the license required by law
icipal ordinance.
building or
my or
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 will 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 ''3'ot licenses to
perform the work being done. Any person working on my building who is not licensed must work under my irect 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 comp - nsation 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 abid
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.
all applicable
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 m.. contact the
Florida Construction Industry Licensing Board at 850.487.1395 or htt .: / /www.m oridalicense .com /db.r /.ro /cilb /ind
Initial
11. I am aware of, and consent to; an owner- builder building permit applied for in my name and understands tha ; ' the party
legally and fi ncially res sonsible for the proposed construction activity at the following address:
12. I agree
have p
s 4q*-
5/) Ft 3314Y
Initial
fy Miami Shores Village immediately of any additions, deletions, or changes to any of the i orma
ed on this disclosure.
Initial
Licensed contractors are regulated by laws designed to protect the public. If you contract with a person who de mot have a
license, the Constr4uction Industry Licensing Board and Department of Business and Professional Regulati • 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
returned 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 . , 20 1(2—
Br_at-44-1
�\.SC -+-) who was personally known
�.\\`'\\`1W1feP � o / i
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Produced there_,ense or
OWNER
to me or who has
as identification.
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