FW-14-495s Miami Shores Village
Building Department M
AR Za1
f 10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
FBC 20
BUILDING Permit No.
PERMIT APPLICATION Master Permit No. ALU
Permit Type: BUILDING
ROOFING
JOB ADDRESS: 3 4 L j t[ \O A ST'S E ET
City: Miami Shores County: Miami Dade Zip: TL—
Foho/Parcel#:
Is the Building Historically Designated: Yes
OWNER: Name (Fee Simple Titleholder):,
NO Flood Zone:
Address: -'k 91 MV, l n 3 S'r4%=– r—T `
City: 't At.r3 i S)&oRS 5 state: �E Lo R i ISA zip: 3 3 1346
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: 40 e- o ua rfw�A tn,3, 8 t.L c hone#:
Address:
City: State: Zip:
Qualifier Name: Phone#:
State Certification or Registration #: Certificate of Competency #:
Contact Phone#: Email Address:
DESIGNER: Architect/Engineer: Phone#:
`J
Value of Work for this Permit: $ 2,�JO Square/Linear Footage of Work: -44 (a
Type of Work: ❑Addition DAlteration )A ew ORepair/Replace DDejnolition
Description of Work: �,kl ®ra a t = L o
Color thru tile:
Submittal Fee $ J V -0 y Permit Fee $ CCF $ CO/CC $
Scanning Fee $
Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $
Bonding Company's Name cif applicable)
Bonding Company's Address
City State
Mortgage Lender's Name (if applicable) _
Mortgage Lender's Address
City
State
zip
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. a
"WARNE14G • 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 $2509, 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 alrserrce of such posted notice, the
inspection will not be approved and a reinspectionfee ivill be eharged.
Signature Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this
day of1&h-, 20f� by LOL1 / Xae/-e ,
whois personally known to me or who has produc 6
M 6 �q�-7D As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Joanna M FeNciano
My Commission FF 082753
Exphres 01/1212018
APPROVED BY
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.
NOTARY PUBLIC:
' a
�
Sign:
I i lilt:
My Commission Expires:
Plans Examiner zoning
Structural Review Clerk
(Revised 5/2/2012)(Revised 3/12/2012) )(Revised 06/10/2009)(Revised 3/15/09XRevised 7/10/2007)
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: -0 S cDATE: 3 1 LV
ADDRESS: 'I91 N C �o 5fi l`t+Arty S�ot�,�S L 3 3 13 �,
Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, RS 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.CA 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.
I. 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 1, 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. 1 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. 1 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 --k:L—
4. 1 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 _
5. 1 understand that, as the owner -builder, I must provide direct, onsite supervision of the construction.
Initial
6. 1 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
S
7. 1 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=fes
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
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 odes, and zoning regulations.
Initial
10. 1 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 httoJAwww myfloridalicense.comldbodproicilbfindex.html
Initial.=
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:
34 t ts� E k,o R Si"
Initial
12. 1 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 WO --( C U , 20 _
By
who was personally known to me or who has
Produced there License or �,*��6 6�J�`I z?G� as identification.
Boy
U.P.
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7 ht rA q�fr i� 0.18'
A-�
15' ALLEY 9' PAVEMENT
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41.0'
C4 I
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ONE STY. C.B.S.
RES. No.391
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SWK.
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•'`• F.R.01/2'
NO ID.
35
R=25.00'
^ A=39.14'
' X89'41'51
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5
STA'T'E ANo cCUN i y r7U ES FME�
AND REGULq 1IONS
PROPERTY ADDRESS: 391 NE. 103rd STREET, MIAMI SHORES, FLORIDA 33138
LEGAL DESCRIPTION
THE EAST 25 FEET OF LOT 23 AND ALL OF LOT 24, IN BLOCK 118, OF
AMENDED PLAT OF SECTION No. 5 OF MIAMI SHORES, ACCORDING TO
THE PLAT THEREOF, AS RECORDED IN PLAT BOOK 10, AT PAGE 47, OF
THE PUBLIC RECORDS OF MIAMI-DADE COUNTY, FLORIDA.
NE. 104th STREET
8
7
6
5
4
118
3
2
1
mmnm0� .
NE. 103rd STREET
LOCATION SKETCH
N.T.S.
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-OLD REPUBLIC NAnCNM nTLE INSURANM� COYPANr
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NOTES
THE D•ECTm Il9E OF THE LANA Asn •rom,• IN THE Im,IDDURI IEONHICAL STANDARDS
t (81017-SFACj L4 IMSOM I.'. THE MCOOIII RELATIVE DISTANCE ACCURAOY FOR THIS TYPE
F Bp1N0ARY 91RVEY IS 1 FOOT w 7AW FEET. THE A=RACY CSTAOED BY MEAS3i10RT ago*
AND CAL=Al= OF A EASED SEOM@1RIC FIGURE WAS FOUED TO EXCEED THIS REQUITEMENT. •
-YELL M MIM FEATURES AS DEPICTED ON TICS SIIETW WERE YEASIRED TO AND 0FRUATED • • 0000
• 555777tttttt •
HOR=WAL POSOONAL ACC1"CY OF 0.1 FEET. •
-LANDS SHOWN HEREON ARE NOT ABSTRACTED, THEREFORE DCS SURVEY A SUBJWT TO FID"TION wFURATM
�
° ° IL °
EASEMDITBSEARCH ON MILE ID THE�SUB.EDI' LANDS MATTERS WOM MtONT BE REFLECTED w A pA� OF FtlOMs 09-1i" 1�i9y�'
-NO ATTEMPT WAS MADE 10 LOCATE UNDS ORMRD FWWM OF ANY STRUC(MRE. • 12O6bZ
•
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NA D Mew SUHWY w T�CER7�TM At D D THE SNOT Dt mONTODA ANY�iDONAMED PPARTY.• i'Y'i Y302 affm L
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N/A • °
1 ANTONIO FIORE PSM'
•UD COTES 6
A7Osl910
LAND SURVEYOR LAND PL"4ftlgV
•••
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1842 SW. 124th Place, Miami, Florida 33175 • • •
•••••
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Phone (305) 221-3040 Fmc (305) 221-9d" • •
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1 HERMNY CDTOY DIAT THIS 80140ARY SUMRY OF TIM PROPFR'1Y 0 • • • • •
• •
HEREON S WE AND OOMECT W THE OW OF MY NMOMEDW NO BMW AS
IIECMRLY swwFD Aw CUM Mum MY SURRMSNIL THIS 51RHEY COINIB ATOM0 FWW
wa DM ON" TECHIML ISDOOAIISS SET FLRCI OT TI• 100BOARD W PR�ONAL SURVEYOR AND MAPPER 1�.Q1004•
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LAND C � SOULFO ROMA ApOM81RATRe SLATE a I�ICDA
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SCALE 1'=20' DRAIMR By. F.aL RESFRFMCE [PECO 13-02
DATE 03-f13E-i3..
•
6 ft. x 8 ft. Pressure -Treated Pine Heavy Duty Stockade Fence Panel -0307050 at The Ho... Page 1 of 2
Your Store.
Dade County #277 (change)
PRODUCT OVERVIEW
PRO Site 1 Tool & Truck Rental 11 Installation Services and Repair I Clift Cards ( Help
6 ft. x 8 ft. Pressure -Tres Pine Heavy
Duty Stockade Fence Pai iel
Model # 0307050 Store SKU # 641184
-A e, (1) Write Review
$39.97 / each
69 in Stock at Dade County #277
(change pick up store)
PRODUCT SOLD : In StoreOnly
The pre-bullt 6 ft. x 8 ft. Wood 3 -Rail Stockade -Style Fence Panel allows for faster installation, whether you are constructing a large or a small fence. This ornamental panel is
manufactured from Southern pine. The unfinished wood can be stained or painted to blend with your outdoor decor. The 1/2 t n. x 4 in. pickets, 24 in all, are Pressure -Treated for
protection against fungal decay, rot and termites.
California residents: seeProposition 65 informationP
• Fence panel is constructed of Southern pine for a solid, Iong4asfing performance
• Unfinished wood is paintable and stainable
• Dog-ear pickets add an elegant and classic look to your yard
• Stockade -style construction can add privacy to your yard
• Pressure -Treated wood for protection against fungal decay, rot and termites
• Pre-bullt panel for hassle -free installation
• Screws (not included) are the recommended fastener
• Note: Product may vary by store.
SPECIFICATIONS
Actual backer rail length (in.) 96 Actual backer rail thickness (In.) 1.5
Actual backer rail width (in.) 3.5 Actual panel height (in.) 72
Actual panel thickness (in.)
4
Actual panel width (in.)
96
Assembled Depth (in.)
4 in
Assembled Height On.)
72 In
Assembled Width (in.)
96 in
Color Family
Brown
Commercial/Residendal Use
Residential
Contact Type Allowed
Above Ground
Fence Application
Privacy
Fencing Product Type
Wood Fens Panels
Manuracturer Warranty
15 Year Limited Warranty Against Rot,
Material
Wood
Decay, and Terrnites
Nominal backer rad length (in.)
8
Nominal backer rail thickness (in.)
2
No rval badcdl rad vtidth (•n.)
4
Nominal panel depth On.)
4
Norr?nal pl<d%A eigtfd Rt.) • • • i i • • •6 Nominal panel width (ft.) 8
• Number of pickets for panels 24 Number of rails for panels 3
one
0 0W
0 n.2 Treed• • •,. •0 Yes Product Weight (Ib.) 110
Structure type • • i • • • i • • • •Ohnamental only
••• • •
00: ::: : . . '.
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http://www.homedepot.com/p/Unbranded-6-ft-x-8-ft-Pressure-Treated-Pine-Heavy-Duty-S... 3/12/2014
Allure Aluminum Replacement Black Fence Gate Self Closing Hinges (2-Pack)-DT3248-... Page 1 of 1
Your Store:
Dade County #277 (change)
PRO Site i Tool & Truck Rental Installation Services and Repair Gift Cards = Help
Allure Aluminum Replacement Black
Fence Gate Self Closing Hinges (2 -Pack)
Model # DT3248-2-BL Internet # 100491524
(6) Write a Review
$34.99 f each
PRODUCT SOLD : Online Only
Item cannot be shipped to the following state(s): AK,GU,HI,PR,VI
PRODUCT OVERVIEW
Replacement patented self-closing gate hinges with an adjustable spring in a durable yet slim design ensures years of reliable gate closing. Hinges made from rust -free
aluminum. Easy to install.
Aluminum body does not rust
Durableteflon bearings
5/8 in. x 5/8 in. Square pickets
Adjustable tension
Replacement use only - hinges included when buying gate
SPECIFICATIONS
Assembled Depth (in.)
1.125 in
Assembled Height (in.)
5.75 in
Assembled Width (in.)
3 in
Assembled length (in.)
6
Builders Hardware Product Type
Gate Hinge
Fasteners included
Yes
Finish
black
Finish Family
Black
Hinge type
Flush/full inset
Manufacturer Warranty
limited lifetime
Material
Aluminum
Package Quantity
2
Returnable
90 -Day
SHIPPING OPTIONS
Most orders process within 10 business days
Please allow 3 to 5 business days for Standard Shipping in addition to order processing time, which varies by product. Items deliver by
small parcel service. This item is also available for
• • • • • • • pick up In your local store
If,product is eligib(p fq: shjp(; p t4AJHI.AcMIUS Territories additional transit time and remote surcharges may apply. (FREE) within 4-7 business
dltys, plus o tier p•c•es•ingtinw. • •
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• • • • •• • • • • •
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http://www.homedepot.com/p/Allure-Aluminum-Replacement-Black-Fence-Gate-Self-Clo... 3/12/2014
4 in. x 4 in. x 4.5 ft. Solid Wood Finial Ready Deck Post -778459 at The Home Depot Page 1 of 1
4 . I
M"'=' your Store,
momDade County #277 (ctiwi ge€
PRO Site Toot & Truck Rental installation Services and Repair Gift Cards Help
4 in. x 4 in. x 4.5 ft. Solid Wood Finial
Ready Deck Post
Model # 778459 Store SKU # 778459
Write the First Review
$19.97 t each
8 in Stock at Dade County #277
Aisle 14 Bay 01
(change pick up store)
PRODUCT SOLD: In Store Only
PRODUCT OVERVIEW
Every piece meets the highest grad n sta sd�a s for s re 10 n s10a Phis Qumber is res ure treated in order to protect it from termites, fungal decay and rot. Ideal for a
variety of applications, including decks, play sets, landscaping, stair support, walkways and other outdoor projects where lumber is exposed to the elements. This lumber can be
painted or stained. When used properly, it is both safe and environmentally friendly.
California residents: seeProposition 65 infofmation�o
Every piece meets the highest grading standards for strength and appearance
Effective against termites, rot and fungal decay, both above -ground and in -ground
Can be primed and painted or stained
Used in building decks
No notch
SPECIFICATIONS
Actual post height (in.)
54
Actual post thickness (in.)
4
Actual post width (in.)
4
Assembled Depth (in.)
4 in
Assembled Height (in.)
54 in
Assembled Width (in.)
4 in
Cap/top included
No
Color Family
Brown
Commercial/Residential Use
Commercial / Residential
Contact Type Allowed
Above Ground
Manufacturer Warranty
None
Material
Wood
Nominal post height (ft.)
4.5
Nominal post thickness (in.)
4
Nominal post width (in.)
4
Number of posts included
1
Pressure Treated
Yes
Product Weight (lb.)
12
Shape
Square
Use
Any
SOPPIN13DOTIONS':
'.
Store Exclusive. This item is available for purchase in select stores only.
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http://www.homedepot.com/p/Unbranded-4-in-x-4-in-x-4-5 -ft-Solid-Wood-Finial-Ready-... 3/12/2014
o Shadow Box
0
Co Boar on Board
Miami hores Village
014 Building Department
artment
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tet: (305) 795.2204
Fax: (305) 756.8972
WOOD FENCE DETAIL
4x4 Post Spacing
Fences <= 5' high posts spaced at 5'on center maximum
Fences <= 4' high posts spaced aTon center maximum
Fence must not exceed 5' in height
III I.,21CI GIJ IIIUI L UC %-VI I VJIV11 IGJ1J tat R
••• • •
No=ess than two fasteners in any connection
tx pickets fastened
with two corrosion
resistant fasteners per
connection
2x4 horizontal
pressure treated
wood members
with two corrosion
resistant fasteners
per connection
•
•••
• •
T:O.
•
•
••
•• •• . •
May 2009
Miami hores Village
014 Building Department
artment
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tet: (305) 795.2204
Fax: (305) 756.8972
WOOD FENCE DETAIL
4x4 Post Spacing
Fences <= 5' high posts spaced at 5'on center maximum
Fences <= 4' high posts spaced aTon center maximum
Fence must not exceed 5' in height
III I.,21CI GIJ IIIUI L UC %-VI I VJIV11 IGJ1J tat R
••• • •
No=ess than two fasteners in any connection
tx pickets fastened
with two corrosion
resistant fasteners per
connection
2x4 horizontal
pressure treated
wood members
with two corrosion
resistant fasteners
per connection