DS-13-1212Miami Shores Village���
1� Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 =_
�" Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S P'BIOS) 762.4949
FBC 20 LO
BUILDING y Permit No.
PERMIT APPLICA ON Master Permit No.�
Permit Type: BUILDING ROOFING
JOB ADDRESS: 53 +) W 13 -4,555
City: Miami Shores County: Miami Dade Zip: V
Folio/Parcel#:
Is the Building 11istorically Designated: Yes NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): L JV Phone#: ^ F` f qQo
Address:
City: State: Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: i4ow,' dyar Phone#:
Address:
City: State: Zip:
Qualifier Name: Phone#:
State Certification or Registration #: Certificate of Competency #:
Contact Phone#: Email Address:
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit:$_ ,l Square/Linear Footage of Work:
1�
Type of Work: ❑Addition ❑Alteration ew ❑Reuair/Renlace ❑D molition
Submittal Fee
Scanning Fee $
Color thru tile:
Permit Fee $
Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CCF $ CO/CC $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $ u CSO
Bonding Company's Name (if 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.
"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.
Signature l Signature
Owner or Went Contractor
The for of nstrume as a owl e e ore m this The foregoing instrument was acknowledged before me this
41
day of , 20 _, by day of .20 by ,
v his per�onal �kngvA to me or who has produced who is personally known to me or who has produced
V'® V I I u" lv 'l Al's identification and who did take an 2a.
NOTAR P IC: - v. 'ovu0� otida
_ tate 2015
Sign: m EE 12
Print: rou9� Na
n go
My Commission Expires:
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
APPROVED BY '`� Plans Examiner `9 6� l a/ Zoning
Structural Review Clerk
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
592 NW 7th STREET SUITE 202
,
MIAMI, 28 Nava
Aurtirnors
Jur,
SURVEY No, 03-5062
TELEPHONE:ONE: (3 (305)5) 220-3171
FAX (305): 284-0229
DRAW BY: JAIME LAND , SURVEY®RS SHEET No. 2 OF 2
B®uN $ QRVEY SCALE=1":20'
-4 LOT -5 I
BOK-6 I BLsp { 'a
LOT -6
BLOCK -•5
P 20
I
P 1/2" — _ 5 UE _ 58.00' 3' CLF F.I.P 1/2"
SP 9006' 0 5.UE 89° 3'10'" N —
_ —0.50' -------- —C/S ( E-----
NCR
CL 0.35'
C, e•
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LOT -17 0
BLOCK -6
3I
z F.I.P 1/2"
L
— — NO CAP
F.I.P 1/2 249.00
NO CAP
fi —' E R MT .
Miami Flores Village
APPROVED
BY D
ZONING DEPT
`
BLDG DEPT
SUBJECT 1"0 CC NfP1 L010E WITH All FE
STATE ANS t�tv,
C r riUL AND REGULA"T NS
two
58.00'
�.
Z', 15' PWY
hl
SURVEYORS NOTE:
THERE MAY BE EASEMENTS RECORDED IN THE PUBLIC RECORDS NOT SHOWN ON THIS SURVEY
THE PURPOSE OF THIS SURVEY IS FOR USEiINT OBTAINING TITLE INSURANCE AND FINANCING AND
SHOULD NOT BE USED FOR CONSTRUCTION PURPOSES
21.30'
I
c�•1.
5.30'
$ LOT -15
N
BLOCK-6
UT
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In Com.cyr
25.80'
LOT -1 6 Ln
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BLOCK -6 M
ONE STORY!
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RESIDENCE
#'663-666
41.80'
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(
°6. ,�
1/2"
NO CAP
58.00'
�.
Z', 15' PWY
hl
SURVEYORS NOTE:
THERE MAY BE EASEMENTS RECORDED IN THE PUBLIC RECORDS NOT SHOWN ON THIS SURVEY
THE PURPOSE OF THIS SURVEY IS FOR USEiINT OBTAINING TITLE INSURANCE AND FINANCING AND
SHOULD NOT BE USED FOR CONSTRUCTION PURPOSES
I
AMN.W. 7th STREET SUITE 202 � V v �� ��• SURVEY No - O O 0 5 0 6 2
AMI, FLORIDA 33126
:LEPHONE: (305) 220-3171
4X (305): 264-0229
LAND SUR�IEYORS SHEET No. 1 OF 2
SAW RYA JAIME
Survey of Lot: 16 Block: 6
Subdivision: WEST SHORES
According to the Plat thereof as recorded in the Plat Book No. 42
at Page No. 18 of the public records of MIAMI-DADE County, Florida.
Property Address: 553-55 NW 113 ST, MIAMI, FL 33168
For: PAUL JOSEPH
LOCATION SKETCH Scale 1"= NT.S.
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PG.- PAGE.
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A/S= ALUMINIUM SHED.
FNIP.- FEDERAL NATIONAL
PWY- PARKWAY.
-pH- OVERHEAD UTILITY LINES
ASPH - ASPHALT.
INSURANCE
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MONUMENT.
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H.- HIGH (HEIGHT)
P.L.S.- PROFESSIONAL LAND
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IN.&EG.- INGRESS AND EGRESS
EASEMENT.
SURVEYOR,
R.- RECORDED DISTANCE.
!S
/7! /d I /9 I /4 I /9 9
LP- LIGHT POLE.
RR.- RAIL ROAD.
C.B- CATCH BASIN. LF.E.- LOWEST FLOOR ELEVATION. RES.- RESIDENCE.
MAINTENANCE EASEMENT R/W- RIGHT-OF-WAY.
Q
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Date: 04/30/2003
B' 0
Ilk
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F.N.D.- FOUND NAIL & DISK
CURVE
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FR- FRAME.
P.B.= PLAT BOOK.
A/R- ALUMINIUM ROOF.
FT- FEET.
PG.- PAGE.
-0--0- IF -IRON FENCE
A/S= ALUMINIUM SHED.
FNIP.- FEDERAL NATIONAL
PWY- PARKWAY.
-pH- OVERHEAD UTILITY LINES
ASPH - ASPHALT.
INSURANCE
PRM- PERMANENT REFERENCE
F-57---- -- -
B.C.- BLOCK CORNER.
I
MONUMENT.
I 1
BLDG.- BUILDING.
H.- HIGH (HEIGHT)
P.L.S.- PROFESSIONAL LAND
-0-00 m EXISTING ELEVATIONS.
00' '57 A
A= ARC
M E LAKE
F.F.E.= FINISHED FLUUH 6LLVA"un.
r.mu.= ruin ur ,mvmma
-_,X CLF -CHAIN LINK FENGt
A/C- AIR CONDITIONER PAD.
F.N.D.- FOUND NAIL & DISK
CURVE
Zal C.B.S. WALL (CBW)
A.E.= ANCHOR EASEMENT.
FR- FRAME.
P.B.= PLAT BOOK.
A/R- ALUMINIUM ROOF.
FT- FEET.
PG.- PAGE.
-0--0- IF -IRON FENCE
A/S= ALUMINIUM SHED.
FNIP.- FEDERAL NATIONAL
PWY- PARKWAY.
-pH- OVERHEAD UTILITY LINES
ASPH - ASPHALT.
INSURANCE
PRM- PERMANENT REFERENCE
-44-0 WP -WOOD FENCE
B.C.- BLOCK CORNER.
F.N.- FOUND NAIL.
MONUMENT.
BLDG.- BUILDING.
H.- HIGH (HEIGHT)
P.L.S.- PROFESSIONAL LAND
-0-00 m EXISTING ELEVATIONS.
B.M.- BENCH MARK
IN.&EG.- INGRESS AND EGRESS
EASEMENT.
SURVEYOR,
R.- RECORDED DISTANCE.
® m PROPOSED ELEVATIONS.
B.O.B.- BASIS OF BEARINGS.
C- CALCULATED
LP- LIGHT POLE.
RR.- RAIL ROAD.
C.B- CATCH BASIN. LF.E.- LOWEST FLOOR ELEVATION. RES.- RESIDENCE.
MAINTENANCE EASEMENT R/W- RIGHT-OF-WAY.
4
A
C.B.S- CONCRETE BLOCK STRUCTURE- ' ,e MINUTES. RAD,- RADIUS OF RADIAL SURVEY 0 R S ' S N 0 T E S
CBW- CONCRETE BLOCK WALL
CH= CHORD. M.- MEASURED DISTANCE. R.P.- RADIUS POINT.
CH.B.- CHORD BEARING. M%H- MANHOLE. RGE.- RANGE. 1). IF SHOWN, BEARINGS ARE REFERRED TO AN ASSUMED
CL= CLEAR MA= MONUMENT LINE. SEC.- SECTION. MERIDIAN, BY SAID PLAT IN THE DESCRIPTION OF THE PROPERTY. IF NOT,
C.L.F.= CHAIN LINK FENCE. N.A.P.- NOT A PART OF. STY.- STORY. THEN BEARINGS ARE REFERRED TO COUNTY, TOWNSHIP MAPS.
C.M.E= CANAL MAINTENANCE NGVD- NATIONAL GEODETIC SWK.- SIDEWALK. 2), IF SHOWN , ELEVATIONS ARE REFERRED TO
EASEMENTS. VERTICAL DATUM. S.I.P.= SET IRON PIPE L.B.
CONIC.= CONCRETE. N.- NORTH. #6044. BMIq ELEV. FEET-
C.P.-
EET.C.P- CONC. PORCH. N.T.S.- NOT TO SCALE. S.- SOUTH. OF N.G.V.D. OF 1929.
C.S.= CONCRETE SLAB. #-NO.- NUMBER. '- SECONDS
D.E.- DRAINAGE EASEMENT . O/S- OFFSET. T- TANGENT. 3). THIS IS A SPECIFIC PURPOSE SURVEY.
D.M.E.= DRAINAGE MAINTENANCE O.H.- OVERHEAD #6044 TWP-TOWNSHIP.
EASEMENTS O.H.L- OVERHEAD UTILITY LINES UTIL.- UTILITY.
DRIVE= DRIVEWAY OVH- OVERHANG U.P.- UTILITY POLE. 4), THE CLOSURE IN THE BOUNDARY SURVEY IS
= DEGREES. PVMT,- PAVEMENT. W.M.- WATER METER. ABOVE 1:7500 FT.
E= EAST. PL,- PLgryTER, W.F.- WOOD FENCE. I HEREBY CERTIFY: THAT THIS 'BOUNDARY SURVEY"
E.T.P.- ELECTRIC TRANSFORMER PAD P/L- PROPERTY UNE. W.S.= WOOD SHED. OF THE PROPERTY DESCRIBED HEREON, AS
ELEV.= ELEVATION. P.C.C.- POINT OF COMPOUND CURVE W/R- WOOD ROOF. RECENTLY SURVEYED AND DRAWN UNDER MY
ENCR.= ENCROACHMENT. SUPERVISION, COMPLIES THE MINIMUM
F.H.- FIRE HYDRANT. P.C.- POINT OF CURVE. � =CENTRAL ANGLE. TECHINICAL STANDARDS ASS SET FORTH BY
PT.- POINT OF TANGENCY. q - CENTER UNE. THE FLORIDA BOARD OF PROFESIONAL LAND
F.I.P.- FOUND IRON PIPE. POC.- POINT OF COMMENCEMENT. � - ANGLE. SURVEYORS IN CHAPTER 61G17-6, FLORIDA
F.I.R.= FOUND IRON ROD. POB.- POINT OF BEGINNING. ADMINISTRATIVE CODE PURSUANT
TO 472.027, FLORIDA STATUTES.
LEGAL NOTES TO ACCOMPANY SKETCH OF SURVEY (SURVEY):
THERE MAY BE EASEMENTS RECORDED IN THE PUBLIC RECORDS NOT SHOWN ON THIS SURVEY "
THE U)RNOOSE OF THIS
OR CONIS FOR USEON IN PURPOSES
OBTAINING TITLE INSURANCE AND FINANCING AND
EXAMINATIONS OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED BY:
INSTRUMENTS, IF ANY, AFFECTING THE PROPERTY. THIS SURVEY IS SUBJECT TO DEDICATIONS, G IBARRA (DATE OF FELD WORK)
I
LIMITATIONS, RESTRICTIONS, RESERVATIONS OR EASEMENTS OF RECORD. LEGAL DESCRIPTIONS
PROVIDED BY CUENT OR ATTESTING TITLE COMPANY.
BOUNDARY SURVEY MEANS A DRAWING AND/ OR A GRAPHIC REPRESENTATION OF THE SURVEY WORK PROFESSIONAL LAND SURVEYOR NO.
PERFORMED IN THE FIELD, COULD BE DRAWN AT A SHOWN SCALE AND/OR NOT TO SCALE. STATE OF FLORIDA (VAUD COPIES OF THIS SURVEY WILL BEAR
EASEMENTS AS SHOWN ARE PER PLAT BOOK, UNLESS OTHERWISE SHOWN. THE EMBOSSED SEAL OF THE ATTESTING LAND SURVEYOR).
THE TERM 'ENCROACHMENT" MEANS VISIBLE AND ABOVE GROUND ENCROACHMENTS.
ARCHITECTS SHALL VERIFY ZONING REGULATIONS, RESTRICTIONS AND SETBACKS AND THEY WILL.
BE RESPONSIBLE OF SUBMITTING PLOT PLANS WITH THE CORRECT INFORMATION FOR THEIR REVISED ON:
APPROVAL FOR AUTHORIZATION TO AUTHORITIES IN A NEW CONSTRUCTIONS, UNLESS OTHERWISE
NOTED, THIS FIRM HAS NOT ATTEMPTED TO LOCATE FOOTING AND/OR FOUNDATIONS.
FENCE OWNERSHIP NOT DETERMINED. REVISED ON:
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 FNIP FLOOD MAPS HAVE DESIGNATED THE HEREIN DESCRIBED LAND TO BE
Situated in Zone: X Community/Panel/Suffix: 120635-0090-J
Date of Firm: 07/17/1995 Base Flood Elevation:
Certified to: PAUL JOSEPH AND MARIE JOSEPH
ASHLEY TITLE COMPANY
ATTORNEY'S TITLE INSURANCE FUND, INC.
GREENPOINT MORTGAGE FUNDING INC, ITS SUCCESSORS AND/OR
ASSIGNS,ATIMA
A
kL
11 Miami Shores Village
oo Building Department
p
°� � � 70050 N.E.2nd Avenue, Miami Shores, Florida 33l 38
6 Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (30S) 762.4949
BUILDING
PERMIT APPLICATION
Permit Type: BUILDING
JOB ADDRESS: 5 5 �) ` 5 5 ,� i) `) I
r R
"F g1
J,U;N ®3 201 !
LBY:
FBC 20
Permit No.
Master Permit No.
ROOFING
1-3S
City: Miami Shores County: Miami Dade Zip: 3
Foho/Parcel#:
Is the Building Historically Designated: Yes &O Flood Zone:
LL)LI OWNER: Name Tee Simple Titleholder): J PP
Phone#;�� C
--- re la id A p l B I -.;?, -_ A.
City: Rt 6i _61 f State: Zip-
Tenant/Lessee Name: Phone#:
Email:
�M6
CONTRACTOR: Company Name: omna'-r Phone#:
Address:
City. State: Zip:
Qualifier Name: Phbne#:
State Certification or Registration #: Certificate of Competency#:
Contact Phone#: Email Address:
DESIGNER: Architect/Engineer: Phone#:
'�+Valve of Work for this Permit: $itDDSquare/Linear Footage of Work: _ S
Type of Work: OAddition OAlteration . New I ORepair/Replace ODem lition
Description of Work: _U Y l V t, VJ kYN
Color thru tile: 2-1-90
Submittal Fee $ Permit Fee $ /—U CCF $ COXC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ e
Bonding Company's Name (if applicable)
Bonding Company's Address
City State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State
Zip
IV1C,
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.
Signature Signature
Owner lAgent ?� Contractor
The fo oing instrume t was ac wledg b ore me 's V The foregoing instrument was acknowledged before me this_
day of /, 20'"Jy day of .20 _, by
who is , r9sonally kno to me or who has produced It I F \, _ vho is personally known to me or who has produced
" I� 1 I' • I s identification and who did take an oath. as identification and who did take an oath.
My Commislion Expires:
APPROVED BY b �� Plans Examiner
Structural Review
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
NOTARY PUBLIC:
My Commission Expires:
451211—? Zoning
Clerk
NAME:
ADDRE
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, KS 489.103(7).
And I have read and understood the following disclosure statement, which entities 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 "in 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. 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 s D o
2. 1 understand that building perrnits 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 o
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 JjZense numbers on
permits and contracts.
Initial.
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 lf 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 It or substantially
Improved it for sale or lease, which violates the exemption. '
Initial 1 I ®oT
5. 1 understand that, as the owner -builder, I must provide direct, onsite supervision of the construction.
Initialy '
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.
Init!
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 whiia
working on my property. My homeowners 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 V
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. b
`=
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 codes, and zoning regulations.
Initial V
10. 1 understand that I may obtain more information regarding my obligations as an employerfrom 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 h J/www.m floddalioense.com/db Irl ro/cilbAndex.html
Initial 1 6, T
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:
Inttiaiz , v
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 �� .0
Licensed contractors are regulated by Ian 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, 9 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 13
B ` Y who was personally known to me or who has pe Y
Produced there License or S V jidentification.
ry eP 23.
OWNER 'j,
Amy c12BB10
Commission # EE
=; •' � h National Notary Assn.
Bonded Throu9
5582 N.W. 7th STREET SUITE 202
MIAMI, FLORIDA 26 wr
TELEPHONE: (305)5) 220-3171 Purmeno"Iff�• SURVEY No, 03-5062
FAX (305):, 264-,F1229
DRAW BY: JAIME LAND SURVEYORS SHEET No. 2 OF 2
BOUNDARY SURVEY SCALE=1":20'
TyLOT4 LOT -5 -LOT
BLOCK -6 I BLOCK -6o
_
------ I— ------ --��
_ _F.LP 1/2" 5 UE _ 58.00' 3' CLF_ F.LP 1/2" _
NO P 90°6'50 — 5UE 89° 3'10' N C P
-----
0.50' C!g ENCR — — —
CL I 0.35'
-------- L� � V q
�ePs 3
FLIM P77IT
Vic
a &LASS Cont -c'.- t e- SUBJECT TO COMP ANCE VVITH ALL FERE L h
p'TATF AND CO IN RULFS AND FIF('UI
W00i
LOT -17 0
BLOCK -6
5.90'
W Y-'
q .90'
L 2.10'
x-
� I Vim'
■
F.I.P 1/2"
B/C NO CAP
F.I.P 1/2 249.00'
NO CAP
21.30'
SURVEYORS NOTE:
THERE MAY BE EASEMENTS RECORDED IN THE PUBLIC RECORDS NOT SHOWN ON THIS SURVEY
THE PURPOSE OF THIS SURVEY IS FOR USE INT OBTAINING TITLE INSURANCE AND FINANCING AND
SHOULD NOT BE USED FOR CONSTRUCTION PURPOSES
o LOT -15
!g BLOCK -6
COW
0A T16i ft�
CL
0.60'
F.I.P 1/2"
NO CAP
15, PWY
■.
25.80'
C/S•:
LOT -16 Ln
BLOCK -6 M
ONE STORY
N RESIDENCE
#553-555
41.80'
] 31
-
PL Com•
P
�
CONC.
Cry ,bR1vEwA
°5310"'
w
1
,6,.
-' 58.00'
SURVEYORS NOTE:
THERE MAY BE EASEMENTS RECORDED IN THE PUBLIC RECORDS NOT SHOWN ON THIS SURVEY
THE PURPOSE OF THIS SURVEY IS FOR USE INT OBTAINING TITLE INSURANCE AND FINANCING AND
SHOULD NOT BE USED FOR CONSTRUCTION PURPOSES
o LOT -15
!g BLOCK -6
COW
0A T16i ft�
CL
0.60'
F.I.P 1/2"
NO CAP
15, PWY
■.
5582 N.W. 7th STREET SUITE 202
MIAMI,
TELEPHONOE: (305)1220-3171 gfvva uru���a'r�c Jur. SURVEY No - O C 0 5 0 62
FAX (305): 264-0229
DRAW BY: JAIME LAND SURVEYORS SHEET No. 1 OF 2
Survey of Lot: 16 Block: 6
Subdivision: WEST SHORES
According to the Plat thereof as recorded in the Plat Book No. 42
at Page No. 18 of the public records of MIAMI-DADE County, -,Florida.
Property Address: 553-55 NW 113 ST, MIAMI, FL 33168
For: PAUL JOSEPH Aatii�:-04/370/2003
LOCATION SKETCH Scale 1"= NT.S.
A- ARC
F.F.E.• FINISHED FLOOR ELEVATION.
ItPRN
A/C- AIR CONDITIONER PAD.
F.N.D.= FOUND NAIL & DISK .
CURVE
AO'
e /4•J
407M T aB
1 mmm.W'
-O-
Vw
am
x
e°
ASPH.- ASPHALT.
/
0
B.C.- BLOCK CORNER.
F.N.- FOUND NAIL.
MONUMENT,
BLDG.= BUILDING.
7
B.M.- BENCH MARK
IN.&EG.- INGRESS AND EGRESS
'
;
`F 80 � /9
/B
I M
u
RR.- RAIL ROAD.
I
LF.E.- LOWEST FLOOR ELEVATION.
ne
T r
CBW CONCRETE BLOCK WALL
'- MINUTES.
RAD.- RADIUS OF RADIAL
I
M. MEASURED DISTANCE.
R.P.- RADIUS POINT.
v4 i %
J 1 9 /O //
/P ;
20 I
/9 /C
/7 /9 /f /9 r'P I
•//
N.A.P.- NOT A PART OF,
STY.- STORY.
aL
NGVD= NATIONAL GEODETIC
SWK.- SIDEWALK.
EASEMENTS •
VERTICAL DATUM.
S.I.P.- SET IRON PIPE L.B.
CNC.- CONCRETE
N.- NORTH.
#60".
C.P.= CNC. PORCH.
N.T.S.- NOT TO SCALE
S.- SOUTH.
SUBJECT
#•-•NO.- NUMBER.
"- SECONDS
a
0/S= OFFSET.
N. w
�6� ��' 11.3
a
PROPER
EASEMENTS
DRIVE= DRIVEWAY
.a b .
s
. = DEGREES.
e
U.P.- UTILITY POLE.
E- EAST.
PVMT.- PAVEMENT.
W.M.- WATER METER.
E.T.P.= ELECTRIC TRANSFORMER PAD P L- PLANTER.
/L= PROPERTY UNE.
W.F.- WOOD FENCE.
W.S.- WOOD SHED.
-it
/
a
20 '' /9 /B
I i
/7 /6 /9 /.i
/9 `
/� CENTRAL ANGLE.
6
F.H.• FIRE HYDRANT.
PT.- POINT OF TANGENCY.
=
= CENTER UNE.
"
POC.- POINT OF COMMENCEMENT.
�C -ANGLE.
— — --
V�
Q
r
'1
l 7
9
N ¢
J,
-rw
�mea� JET
A B B R E V I A T I O N
A N D M E A N I N G
L E G E N D T Y P I C A L
A- ARC
F.F.E.• FINISHED FLOOR ELEVATION.
P.R.C.- POINT OF REVERSE
A/C- AIR CONDITIONER PAD.
F.N.D.= FOUND NAIL & DISK .
CURVE
A.E.- ANCHOR EASEMENT.
FR- FRAME.
P
9
4
PG.- PAGE.
A/S- ALUMINIUM SHED.
FNIP.- FEDERAL NATIONAL
PWY- PARKWAY,
ASPH.- ASPHALT.
INSURANCE
PRM- PERMANENT REFERENCE
B.C.- BLOCK CORNER.
F.N.- FOUND NAIL.
MONUMENT,
BLDG.= BUILDING.
H.- HIGH (HEIGHT)
P.L.S.- PROFESSIONAL LAND
B.M.- BENCH MARK
IN.&EG.- INGRESS AND EGRESS
'
d
`F 80 � /9
/B
I M
� /6 � /9 /•C i /9 � /2 � //
I I
RR.- RAIL ROAD.
I
LF.E.- LOWEST FLOOR ELEVATION.
RES.- RESIDENCE.
A- ARC
F.F.E.• FINISHED FLOOR ELEVATION.
P.R.C.- POINT OF REVERSE
A/C- AIR CONDITIONER PAD.
F.N.D.= FOUND NAIL & DISK .
CURVE
A.E.- ANCHOR EASEMENT.
FR- FRAME.
P.B.= PLAT BOOK.
A/R- ALUMINIUM ROOF,
FT- FEET.
PG.- PAGE.
A/S- ALUMINIUM SHED.
FNIP.- FEDERAL NATIONAL
PWY- PARKWAY,
ASPH.- ASPHALT.
INSURANCE
PRM- PERMANENT REFERENCE
B.C.- BLOCK CORNER.
F.N.- FOUND NAIL.
MONUMENT,
BLDG.= BUILDING.
H.- HIGH (HEIGHT)
P.L.S.- PROFESSIONAL LAND
B.M.- BENCH MARK
IN.&EG.- INGRESS AND EGRESS
SURVEYOR.
B.O.B.- BASIS OF BEARINGS.
EASEMENT.
R.- RECORDED DISTANCE.
C- CALCULATED
LP= LIGHT POLE.
RR.- RAIL ROAD.
C.B= CATCH BASIN.
LF.E.- LOWEST FLOOR ELEVATION.
RES.- RESIDENCE.
C.B.S- CONCRETE BLOCK STRUCTURELM.E.- LAKE MAINTENANCE EASEMENT R/W RIGHT-OF-WAY.
CBW CONCRETE BLOCK WALL
'- MINUTES.
RAD.- RADIUS OF RADIAL
CH- CHORD.
M. MEASURED DISTANCE.
R.P.- RADIUS POINT.
CH.B.- CHORD BEARING.
M/H= MANHOLE.
RGE.- RANGE.
CL- CLEAR
MA= MONUMENT UNE.
SEC.- SECTION.
C.L.F.- CHAIN LINK FENCE.
N.A.P.- NOT A PART OF,
STY.- STORY.
C.M.E= CANAL MAINTENANCE
NGVD= NATIONAL GEODETIC
SWK.- SIDEWALK.
EASEMENTS •
VERTICAL DATUM.
S.I.P.- SET IRON PIPE L.B.
CNC.- CONCRETE
N.- NORTH.
#60".
C.P.= CNC. PORCH.
N.T.S.- NOT TO SCALE
S.- SOUTH.
C.S.= CONCRETE SLAB.
#•-•NO.- NUMBER.
"- SECONDS
D.E.= DRAINAGE EASEMENT .
0/S= OFFSET.
T- TANGENT.
D.M.E.- DRAINAGE MAINTENANCE
O.H.- OVERHEAD X6044
TRP -TOWNSHIP.
EASEMENTS
DRIVE= DRIVEWAY
O.H.L.- OVERHEAD UTILITY LINES
UTIL= UTILITY.
. = DEGREES.
OVH= OVERHANG
U.P.- UTILITY POLE.
E- EAST.
PVMT.- PAVEMENT.
W.M.- WATER METER.
E.T.P.= ELECTRIC TRANSFORMER PAD P L- PLANTER.
/L= PROPERTY UNE.
W.F.- WOOD FENCE.
W.S.- WOOD SHED.
ELEV.= ELEVATION.
P.C.C.- POINT OF COMPOUND CURVE
- WOOD ROOF.
ENCR.- ENCROACHMENT.
P.C.= POINT OF CURVE.
/� CENTRAL ANGLE.
6
F.H.• FIRE HYDRANT.
PT.- POINT OF TANGENCY.
=
= CENTER UNE.
F.I.P.- FOUND IRON PIPE
POC.- POINT OF COMMENCEMENT.
�C -ANGLE.
F.I.R.= FOUND IRON ROD.
POB.- POINT OF BEGINNING.
LEGAL NOTES TO ACCOMPANY SKETCH OF SURVEY (SURVEY):
THERE MAY BE EASEMENTS RECORDED IN THE PUBLIC RECORDS NOT SHOWN N THIS SURVEY
THE PURPOSE OF THIS SURVEY IS FOR USE INT OBTAINING TITLE INSURANCE AND FINANCING AND
SHOULD NOT BE USED FOR CONSTRUCTION PURPOSES
EXAMINATIONS OF THE ABSTRACT OF TITLE WALL 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. LEGAL DESCRIPTIONS
PROVIDED BY CLIENT OR ATTESTING TILE COMPANY.
BOUNDARY SURVEY MEANS A DRAWING AND/ N 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 "ENCRoACHMENr MEANS VISIBLE AND ABOVE GROUND ENCROACHMENTS.
ARCHITECTS SHALL VERIFY ZONING REGULATIONS. RESTRICTIONS AND SETBACKS AND THEY WILL
BE RESPONSIBLE OF SUBMITTING PLOT PLANS WITH THE CORRECT INFORMATION FOR THOR
APPROVAL FOR AUTHORIZATION TO AUTHON71ES IN A NEW CNSTRUCTION% UNLESS OTHERWISE
NOTE). THIS FIRM HAS NOT ATTEMPTED TO LOCATE FOOTING AND/OR FOUNDATIN$.
FENCE OWNERSHIP NOT DETERMINE).
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 FNIP FLOOD MAPS HAVE DESIGNATED THE HEREIN DESCRIBED LAND TO BE
_x_* CLF- CHAIN LINK FENCE
2� C.B.S. WALL (CBW)
-0-0- IF -IRON FENCE
-O H- OVERHEAD UTILITY LINES
#f /f WF -WOOD FENCE
"0-00 m EXISTING ELEVATIONS.
O. ] -PROPOSED ELEVATIONS.
S U R V E Y 0 R S' S N 0 T E S:
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). IF SHOWN . ELEVATIONS ARE REFERRED TO
BMIq EFW. FEET.
OF N.G.V.O. OF 1929.
3). THIS IS A SPECIFIC PURPOSE SURVEY.
4). THE CLOSURE IN THE BOUNDARY SURVEY IS
ABOVE 1:7500 FT.
I HEREBY CERTIFY: THAT THIS "BOUNDARY SURVEY"
OF THE PROPERTY DESCRIBED HEREON, AS
RECENTLY SURVEYED AND DRAWN UNDER MY
SUPERVISION, COMPLIES WITH THE MINIMUM
TECHINICAL STANDARDS AS SET FORTH BY
THE FLORIDA BOARD OF PROFESIONAL LAND
SURVEYORS IN CHAPTER 61G17-6, FLORIDA
ADMINISTRATIVE CODE PURSUANT
TO 472.027, FLORIDA STATUTES.
BY:
G ISARRA (DATE OFFIELDWORK)
PROFESSIONAL LAND SURVEYOR NO. *253 f
STATE OF FLORIDA (VAUD COPIES OF THIS SURVEY WILL BEAR
THE EMBOSSED SEAL OF THE ATTESTING LAND SURVEYOR).
REVISED N:
REVISED ON:
Situated in Zone: X Community/Panel/Suffix: 120635-0090-J
Date of Firm: 07/17/1995 Base Flood Elevation:
Certified to: PAUL JOSEPH AND MARIE JOSEPH
ASHLEY TITLE COMPANY
ATTORNEY'S TITLE INSURANCE FUND, INC.
GREENPOINT MORTGAGE FUNDING INC, ITS SUCCESSORS AND/OR
ASSIGNS,ATIMA
E
SEAL