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DS-13-2100Miami Shores Village Building Department 1MM NY -2W Avemie, Miami Sham% Had& 33138 Tel: (305) 795MM Fax: (305) 756.8972 INSPECTION'S PRONE NUMBER: OW 762.4949 BUILDING PERMIT APPLICATION PenWt Te. JOB ADDRESS: BUILDING 3S 44 +, SEP 112013 P=.. Permit No. Z ICO Master Patift No. ROOFING WyAw sJW . county+: Rpm 22n' _._.._._._ FOIiaJPa: h the B+p It EvArkwly Dedpdwh Yes NO X Plood ZM: OWNER: Name (Fee Simple Titleholder): ?_.� Ate; 3SS}- chr.__ nh.mw:, S�,.rea State: Fe pr. TiramoVt�ssm; Nanm: .._�Pa `�2�-Ee71Ar �4MCI ,lam CONTRACTOR: Company Name• '� E Afters: Srate: �Name� State Cadladon or Registration#: Catiflcat of C�tmpatamy +�:. WNIIMY. $ L.f J �•. --Email Aft=-. D 1 X11 D.�_ ■ _■ ■ Monet. Valve Of WOrk for fWs Permit: $ ®' 1jTC Worlu OAddidon OAlt ion allowp *ftplaoe ilD on Dpfian Of WOTI� ..,.,..,5 \ 1` v.� Aa w+�.�rr■rim. �r..�+r ®j'�Maw t�qi«�R#«tik•#i�Mr����iln1.�#�ktrnit#�i�ti��MWi���r1t41��M�M�k�t�ki��i�i�k1�#+Ir�CikMnk* • %bad l Fee $ Permit Fee $ CCF$ co= $. Sext�'ae $ Radoa Fee $ `DBrR 8 $ ?40b"$ Tt ainin Q%cad= Fee $ - Tabadou Fee $ Double Fee $ Straetord Revkw $ TOTAL FEL NOW DUE $ V'*3oxdh:g Company's Nam (if applicable) _t$"Company's Address city stab ZIP Mortgage Lendees Nam (if applicable) Mortgage Lender's Address _Stow zip, AppHcadon is hereby made to obtain a permit to do the work and insuWans as irAcated I certify the no work or bmtdiation has comamced prior to the issuance of a permit and that all work will be performed to mm the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WOW PLUMBING, SIGNS, WELLS, POOLS, FURNA�l MS� BqU..PRS, HEATERS, TANKS and AIR CONDMONIMS, ETC..... . , OWNER'S AffWAVrr: I certify that all the foregoing information is ==ate and that all work will be done In compliance with an applicable Imn mpbwg construction and zoning "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR DeROVEMENU, TO YOUR PROPERTY. IF YOU 6ftND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCENW.NT." Notice to A;WU=N.- As a condition to the issuance of a bm7ftg permit with an estimated value exceeding $2500, the applicant =a promise in good faith that a copy of the notice of commencement and consftdion lien law brochure will be delivered to the person whose property is subject to attachment. Also, a cert] copy of the recorded notice of commenconew 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 Wpecdon will not be approved and a reinspection fee will be charged. OwworAscan Contractor The, Instron W e4ged bOr me Will I The. Ibmsoing W=mt was aftowledged b*m me this ( J��a f brAoin-4 )#owl I 20 r day of d" of by 20 _--, by wbo' is kno to the ar who has vifia is'persotmlly known m use or who Inas - It•12? . -it 41& ( *21 if lu 45kindfieWilm and who did take ars ciA. u dentificifion and whb did to opdL NOTAR-4 "LIC: NOTARY PMUQ ' Sign: Sign: Notary pJbfic - S130of Florida Print: my commis "J EE Commission r My Com mission Exph": ........ Bonded Throvgh Nal.onal Notary Assn SUveltmil Review (RcviW 3/32012XPxdwd 07110V)0k%*W OVIOMMAUVWd 3/ISM ��21F Mlaml Shores Village Suiding Department 10050 N.E.2nd.Avenue Miami Shores, Florida 33138 Tel (305) 795.2204 Fax: (305) 756.8972 OWNER BUILDER DISCLOSURE STATEMENT NAME: V aeL,, DATE: °)10113 ADDRESS: 10S Do hereby petition the mage 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 unders(ood the following disclosure statement, which entity 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'mustbe lot yourown use and occupancy. It may not he built for sale or lease_If you sell or lease 'a building you have built yourself within' one year after the construction is, c ftlete, fti9w wll1paume that^you built lor-sale of lease, which We violation of this' extimption. 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 perm 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 fordnat employee, all as presdribed by law. Your construction must comply with all applicable laws, `ordinances, buildings codes and zoning roguiations. Please read and (nidal each paragraph. 1. 1 wWorstand that state law requires construction to be done by a Hoonsed contractor and have applied for an owner -builder permit under an exemption from the law. The exemption specifies that I, as the ower of the property listed, may act as my own contractor with certain restrictions even though I do not have a Ilcense. lniflal_ ?-4tk 2. 1 understand that building permits are not required to be s1l;Ined by a property owner unless he or she Is rseporwlble for the construction and is not hiring a loom contractor to assume responsibility. Initial % 3. I understand that, an curet binder, i am the respotnsible party of mord on a pemdt i urldetstand that i may protect myself from potetrtial financial risk .by hiring a ltotwed contractor and hauling the permit titecl fi � or tmr name instead of my own name. I abo understand that the contractor k required by law to be Iicrerreed in Fbrida and to �t his or numbers on permits and co *a*. lrnitial RRAtt� 4. 1 understand that 1 may build or iniprove a one family or two-family residence or a fans outbuilding. I may also build or improve a commercial bolding if the cosi do not exosed $75,000. The building or residence must be folmy use or ncy. ft may not be bolt or substantially improved for sale or lease. If a building or residence that I have built or subsfantialy Improved myself Is sold or leased within 1 year after the construction is complete, the law will presume #0j bull or substantially improved it for sale or lease, which violates the exemption. . lrnitici 5. 1 understand that, as the Iur der, I must provide direct onsite supervision of the construction. 1niUal �� 6. 1 understand that I may not hire an unlicensed person to act as my co *Ww orto supenvbe perms working on my building or residence. it Is my responsibility to ensure that the poisons whom I employ have the Boarnse required by law and by county or municipal oMnanoe. Inibsl ±�� 7. 1 understand that it is frequent practices of unlicensed persons to have the properly owner obtain an owner -builder permit that erroneo�ly implW that the property owner Is providing his or her own labor and materials. I, es an dw wr-Iwlldbrr.may be. heid liable and subjected to serious financial risk for any injuries sustained by an unlicensed person or his of ern {—o hNe working on my property. My homeowner's insurance may not provide coverage for those injuries. I em willfully acting as an ownet builder and am aware of the limps of my insurance coverage for injuries to workers on my property. Initml �1� 8. 1 understand that I may not delegate the responsibility for supervising work to be a libersaf contractor who Is not licenses to perform the workbeing done. Any person n working on my buildhhg who not,lic$red must work under my direct supervision and must be employed by me, which rri�afklfiat I must comply hs+ith laws *uiniig the withholding of federal Income tax and social sem* 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 P Aur I agree that, as the party legally and financially responsible for this proposed Construction adivity, I will abide by all applicable lws and requiremand that govern owner4)uHders as was as employers. I also understand that'the Construction mist comply with all applicable laws, ordlnances, building lode, ° and zoning regulations. initial - ��t 10. 1 understand that i. may obtain more information regarding my obligations as an employer from the Internal Revenue saMce, the United states Snag Business Administration, and the Florida Deperhnent of Revenues. I also understand that l may c onmct the Florida Construction Industry Licensing .Board at 850.487.1395 or httol* w.mvfiorWdmnse.c omlobmbmJ-* rnimc.htmI initial "A- 11. 1 am aware of, and consent to; an owner4wilder building permit applied for in my name and understands fiat I am the party lega0y and tjnwndally responsible for the proposed construction activity at the following address: Is% we AA tnitml � � 12. 1 agree to notify Marl Shores Village immediately of any additions, deletions, or charges to any of the Information that i have provided on ftvs disclosure. initial k!L Licensed contractors are regulated by laws designed to protect the public. If you contract with a person who does not have a license, the Corstr4uction Industry Licensing Board and Department of Business and Professional Regulation may be unable to assist you withh any finendei loss that you sustain as a result of contractor may be int 614 court. it Is also Important for you to understand that If an unlicensed contractor or employee of an individuel or firm Is injured while working bn your property, you may be held liable for damages. B you obtain an owner -builder permit and wish to hire a licensed contractor, you will be responsible for verifying Whether the contractor Is property 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 IssuiM the permit. A copy of the property ownaes driver license, the notarized signature of the property owner, or other type of verification acceptable to the last pen .0% agency is required when the permit Is issued. was acknowledged before me this �� day of 201 gy C�� who was personally known to me or who has Produced there License or d JOA + • 4"' as identrf'ication. .� CUBI�L�s State of fiotid;5 OWNERN�� , YUbFxPi�es $e �2g81O MN m�ss1on * EE Notary Assn• = Com National ®ondedThtough Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY Whereas, (owner) Q 1 f`'(XS jb Q/1 �L' C_� (L�l F—t C Fe U ICXhereinafter referred to as the owner of the following described property (address): 35,g lie ( oS A S T R,l'ai S)n bas, FL 3313 R Legal Description Lot Block Subdivision Folio # Requests permission to install (describe work):,GU cn wZr c� ` D� CzI^p Within the public right of way of (address) ' C) 1 +" IN CONSIDERATION of the approval of this permit by the Village, the owner agrees as follows: 1. To maintain and repair, when necessary, the above-mentioned item(s) installed within the dedicated right of way. If it becomes necessary for Miami Shores Village or Dade County to make repairs or maintain said items within public right of way including restoration of street by reason of the Owner's failure to do so, such expense shall be paid by the Owner or shall constitute a lien against the above described property until paid. 2. The owner does hereby agree to indemnify and hold Miami Shores Village or Dade County harmless from any and all liability, which may rise by virtue of permitting the installation of these items within the public right of way. 3. The Owner does hereby agree to remove or relocate their facilities at their own expense, within 60 days notice by the Village to do so. Failure to comply with this notice will result in the Village causing the Item(s) to be removed and a lien being placed on the property and/or assessed against the Owner for all costs incurred in the removal and disposal of the item(s). 4. The undersigned further agrees that these conditions shall be deemed a covenant running with the land and shall remain in full force and effect and be binding on the undersigned, their heirs and assigns, until such time as this obligations has been canceled by an affidavit filed in the Public Records of Dade County, Florida by the Village Manager of Miami Shores Village (or his fully authorized representative). SIGNED, SEALED, EXECUTED AND ACKNOWLEDGE on this / _� day of , 2013. SIGNED, SEAL , A f��s6.11fqnnthe presence of: b 2 (Owner's Signature) Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 nCOVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY Whereas, (owner) V� l~ Q� (� �e_cl l i n He- f -'e Al Q- hereinafter referred to as the owner of the following described property (address): 35$ i�%� 0SW1 I blah t 41.1)r2i- FL _33/_)8 Legal Description Lot Block Subdivision Folio # f % Requests permission to install (describe work):Jmucre-] d-riyewu an FI -s w al t Within the public right of way of (address) IN CONSIDERATION of the approval of this permit by the Village, the owner agrees as follows: 1. To maintain and repair, when necessary, the above-mentioned item(s) installed within the dedicated right of way. If it becomes necessary for Miami Shores Village or Dade County to make repairs or maintain said items within public right of way including restoration of street by reason of the Owner's failure to do so, such expense shall be paid by the Owner or shall constitute a lien against the above described property until paid. 2. The owner does hereby agree to indemnify and hold Miami Shores Village or Dade County harmless from any and all liability, which may rise by virtue of permitting the installation of these items within the public right of way. 3. The Owner does hereby agree to remove or relocate their facilities at their own expense, within 60 days notice by the Village to do so. Failure to comply with this notice will result in the Village causing the item(s) to be removed and a lien being placed on the property and/or assessed against the Owner for all costs incurred in the removal and disposal of the item(s). 4. The undersigned further agrees that these conditions shall be deemed a covenant running with the land and shall remain in full force and effect and be binding on the undersigned, their heirs and assigns, until such time as this obligations has been canceled by an affidavit filed in the Public Records of Dade County, Florida by the Village Manager of Miami Shores Village (or his fully authorized representative). SIGNED, SEALED, EXECUTED AND ACKNOWLEDGE on this 1 -?411 day of Seb kw5nw--, 2013 &4 % (Owner's Signature) SIGN1, 41�E , A LI E th presenc t �1P�GG�e�o�F °tZp�S G W\C . S geP 23 �0 ,,,,p H,•. Notary ,.� Ex4`�e� Et 128 PSSA• w Gym Soo tNo�a`1 ' My mm�s �ai�ooa _ k � ; ' = Go �taogh s ' oe= W ep0 2 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 RECEIPT PERMIT* 1%5 �� DATE: 1 -3v -J3 &X,4'/(,a 14tr�:4-, a ,-I Crher ctor o Architect Picked up 2 sets of plans and (other) �[ Address: 3-5� From the building department on this date in order to have corrections done to plans And/or get County stamps. I understand that the plans need to be brought back to Miami Shores Village Building Department to continue permitting process. Acknowledged by: PERMIT CLERK INITIAL: RESUBMITTED DATE: 10 115) /-� PERMIT CLERK INR Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 September 19, 2013 Permit No: DS 13-2100 Building Critique Review 1. PROVIDE DETAIL AND SPECIFICATIONS FOR THE PAVER DRIVEWAY. PAVERS SHOULD BE SET OVER 2" OF COMPACTED LEVELING SAND, OVER 6" COMPACTED LIMEROCK. 2. PROVIDE COVENANT FOR PAVER APPROACH. Ismael Naranjo Building Official Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re -submittal drawings. SEP I iu13 _ N.E. 105th STREET r i����.L® �1�� 75' R/WY'S iA91fI.�SEtDVCi��r (18' ASPHALT) tbm Q� reU h.A SAd o��-P10v a 4�1m,V VV84 old C� 75.00'(R) �R. 8CO 93 ... ets 1l1 74.93'(M) 77.05' PnU) _ • . s. ; �" "LK. ••. 77.17 F.I.P. 3/4' — — — — — "r- (25.00') 5.00')-- NO I.D. `'. •(50.00 ' FNO. D.H l n x N < for I O W IWmI \o z I, n Ido LOT 7 I ul °D 1s.7 as ao BLOCK 117 i 10.3' vl 29.0• _p m J iP UJ p o.2' 1a.e' I LOT 5 BLOCK 117 d i I V) z l e. (INCLUDED) I o = _ o z 0 r,.. N W M 10.6' N RESIDENCE M 'u U O A 7C] #358 #358 14.4• � L CIR SURVEY NOTES f I c . F z -ASPHALT DRIVE CROSSING THE l ,r .Z� 1 10.8' ( [,� 9.4' C f W W NORTH SIDE OF LOT. ILL_ 29.4' " A/C -PAVERS WALK CROSSING THE Y NORTH SIDE OF LOT. I U' W t j -THERE ARE FENCES NEAR THE Q O_ BOUNDARY OF THE PROPERTY. I m W 6. OPEN PA 0 CO C14 0.4• 11.0' 17.4• � O IQ I W 0.7' I o —L (25_00') 00 (25 —10 C,0-3 R ; F.I.P. 1/2 T CORNER w 15; .A 75:0 LEY R�W NO 1.0. 9 TREE 9' ASPHALT •( I I I I I I I I i I I 0 r PAGE 2 OF 2 PAGES 0 " N BOUNDARY SURVEY 00UNTIES 4y{•RS t F C C4 t ♦ ( T � It0.28M ` SURVEYORS CERTIFICATESIHEREBYCERTJFYTNAT7HISBOUNOARYSURVEYIS A TRUE AND CORRECT REPRESENTATION OFA SURVEYPREPAREDUNDERMYDIRECTION.$TAUOFNOTVAUDV47HO,rANAUME">�'TEDELECTRONI`SE��GALLFLORI �y+tL O R t 9 P v SIGNATUREANDAUTNENTICATEDELtECJ�➢ and by CI de c eal „ R v s gle+p assED SEAL AND sr = C{ McNeal, C = US (� Y� 6250 N. MILITARY TRAIL, SUITE 102 Date: 2012.05.23 15:35:29 - WEST PALM BEACH, FL 33407 c:5�r---/'�'M c N e a I 04'00' PHONE (561) 840-4800 FACSIMILE (56(SIGNED) _ _ STATEWIDE PHONEi (800) 226.4807 CLYDE O. MCNEAL, PROFESSIONAL SURVEYOR AND MAPPER MM3 STATEWIDE FACSIMILE (800) 741-0576