FW-14-1164Miami Shores e
Villag
// Building Department
bG ` cll 1 C/ 10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING
PER/MIT APPLICATION
O
� ILDING ❑ ELECTRIC ❑ ROOFING
jUN A 6 20%
FBC 20 �G
Master Permit No. G
Sub Permit No.
❑ REVISION ❑ EXTENSION [-]RENEWAL
F-1 PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
SCONTRACTOR DRAWINGS
JOB ADDRESS: N --
0
Folio/Parcel#: Is the Building Historically Designated: Yes NO -
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple
��Titleholder):
Address: f, �(� lv� ��3
2A v '&)S- I
City�� clt/"� e g State: ��-- Zip:
">rs�
Tenant/Lessee Name: Phone#:
Email
,r �C
CONTRACTOR: Company Name: V �V �\ Phone#:
Address
City: State:
Qualifier Name:
State Certification or Registry Certificate of Competency #:
DESIGNER: Architet/Engineer: Phone#:
Addres • City: State: Zip:
Value of Work for this Permit: $ ® �— Square/Linear Footage of Work: leo`
f
Type of Work: ❑ Addition ❑ AlterationA-Ke-w ❑ Repair/Replace ❑ Demolition
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Technology Fee $_
Structural Reviews $
(Revised02/24/2014)
Permit Fee $
Radon Fee $
Training/Education Fee $
CCF $_
DBPR $
CO/CC $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ b9.66
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
Zip
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 ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES, BOILERS, HEATERS, TANKS, 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 seve (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a r nspection fee will be charged.
OWNER or AGENT
The foregoing instrument was acknowledged before me this
day ofyn -�_ . 20 J!? , by
2 o is personallomown
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
state of
F
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of
me or who has produced
20 , by
who is personally known to
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal: )' '`'ov�60' ExWnsol/12/2078 Is Seal:
as
APPROVED BY Plans Examiner ` Zoning
Structural Review Clerk
(Revised02/24/2014)
U
NAME:
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
DATE:
ADDRESS: i 4M N -3-e- c .OR SI -
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 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 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. 1 understand that state law requires construction to be done by a licensed contractor and have applied for an owner -build
permit under an exemption from the law. The exemption specifies that I, as the owner of the property listed, m y act as 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 e
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 myse
from potential financial risk by hiring a licensed contractor and having the permit filed in his or her name inste of my o n
name. I also understand that the contractor is required by law to be licensed in Florida and to list his or license numbe 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 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 imp ad
myself is sold or leased within 1 year after the construction is complete, the law will presume that I built or substa 'ally
improved it for sale or lease, which violates the exemption.
Initial
5. f 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 coun o
municipal ordinance.
Initial
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
A %
8. 1 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 e_
9. 1 agree that, as the party legally and financially responsible for this proposed Construction activity, I will abide by all appli ble
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, e
United States Small Business Administration, and the Florida Department of Revenues. I also understand that I ma Contac e
Florida Construction Industry Licensing Board at 850.487.1395 or htto://www.myfioddalicense.com/dbpr/Dro/Cilbrindex. tmI
Initial
11. 1 am aware of, and consent to; an owner -builder building permit applied for in my name and understands that I am the parhi
legally and financially responsible for the proposed construction activity at the following address:
Initial
12. 1 agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the information th 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
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 qday of , 20 /%
By kalk I/e/r� who spersonally known t me or who has
ProducedAhere License or / \ as identification.
ER
v no Notary Public Stets of Firma
a° Joanna M Feliciano
My Commission FF 082753
ovav Exp ires011121201
i
N
o Shadow Box
o Vertical Picket
o Board on Board
Miami shores Village
BOOM Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
WOOD FENCE DETAIL
4x4 Post Spacing
Fences <= 5' high posts spaced at Yon center maximum
Fences <= 4' high posts spaced at 6"on center maximum
Fence must not exceed S' in height
4x4 pressure treated ,
posts embedded Tinto
concrete footing 10"
diameter x 2'deep
LL wood must be pressure treated I
II fasteners must be corrosion resistant L
6 less than two fasteners in any connection
1x pickets fastened
with two corrosion
resistant-Ynteiaqs per
connection ...
C
,.�2x4horizonta
�..:
/�.rVj jure trel eel • • •
•
"' •
wood members
%VIII tiro corsosipri.
' • • • •
resistant fasteh-r?
• • • • • •
.p OUlinection •
.
11ti �
4' ALUMINUM
FENCE
O 112 P. m
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COLUMN
1&\�1,4Vx1.40`
SUN 0 2014
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N89' '39"E
A-52-NI(P)
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PERMIT:
Miami Shores Villa e
APPROVE® 13Y DATE
ZONING
SUEUECT TO
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Notes:
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- Septic Tank location as indicated by others
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li'OF
This property described as::00:0:
Monument
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s
Lot 20, Block 5,
"C"
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REPEAT OF TRACT MIAMI SHORES BAY
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PARK ESTATES, according to the Plat thereof as
"•
%�"NuMN5,
I♦I♦I♦I♦J♦I.
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recorded in Plat Book 64, Page 97, of the Public
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R = Radius
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Mark Llerena
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�.
2 (0%-& C'ClaVC .
Address:
pd"c2 _ s
1550 N.E. 103rd Street, Miami Shores, FL. 33138
6 �L��r` cr—
Easement
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E.B. =Electric BOX
11ti �
4' ALUMINUM
FENCE
O 112 P. m
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COLUMN
1&\�1,4Vx1.40`
SUN 0 2014
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N89' '39"E
A-52-NI(P)
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PERMIT:
Miami Shores Villa e
APPROVE® 13Y DATE
ZONING
SUEUECT TO
R=364.88'
A=168.18'
Tan=85.62'
L--26'24'38"
CHB=N4V05'43"E
CH=166.71'
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0
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6 �s "IS• 6•
LEGEND
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Notes:
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R' • • oeo•e' • ••••
- Septic Tank location as indicated by others
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This property described as::00:0:
Monument
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s
Lot 20, Block 5,
"C"
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REPEAT OF TRACT MIAMI SHORES BAY
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PARK ESTATES, according to the Plat thereof as
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recorded in Plat Book 64, Page 97, of the Public
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Records of Miami -Dade County, Florida
R = Radius
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Certified to:
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Mark Llerena
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2 (0%-& C'ClaVC .
Address:
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1550 N.E. 103rd Street, Miami Shores, FL. 33138
6 �L��r` cr—
Easement
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R=364.88'
A=168.18'
Tan=85.62'
L--26'24'38"
CHB=N4V05'43"E
CH=166.71'
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LEGEND
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ASPH =Asphalt
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BM Bench Mark
P.O.B. = Point of Beginning
P.O.C. = Point of Commencement
LL
BRG = Bearing
S
12 S
CAN =Cable TV
viol-
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CB = Catch basin
E 8 o c,
P.R.M.= Permanent Reference
CBS - Concrete Block Structure
8 c m
CH =Chord
Monument
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c 8 m
Chatty = Chattahoochee
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q. = Center Line
E
CLF = Chain Link Fence
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8 6 8 r� $ 8
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CL. = Clear
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CONC.= Concrete
R = Radius
so a ' to m
E
D = Delta
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= Diameter
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DH = Drill Hole
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DME - Drainage & Maintenance
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Easement
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E.B. =Electric BOX
m m N N W .pW
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Eno. = Encroachment
F.F. =Finish Floor
'0=-
$ W «e c'Co`
F.H. = Fire Hydrant
Emm m
F.I.R. = Found Iron Reber
a e 8 o c 8 v
B i$
FPL = Florida Power & Light
F.I.P. = Found Iron Pipe
CL `o 8 $
@ v = E E = c
F.N. = Found Nall
mE
W ? $m m
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L.P. = Light Pole
W $ z €
M = Measured
-
r $ c m
M.F. = Metal Fence
Z
o m o m m c
M.H. - Manhole
9 a o
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if = Monument Line
MON.
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N/A = Not Applicable
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N/D = Nall &Disc
8 m
+T = Denotes Spot
NTS - Not to Scale
O/S = Offset
° 5 S,
O.U.L. = Overhead Utility Lines
c E I
9 v
OH = Overhang
9
P - Plat
PB = Plat Book
'
PC = Point of Curvature
$ W c
P.C.C. = Point of Compound
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Curvature
=Permanent Control Point
$ °cPCP
$ ai o
PG = Page
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P.I. = Point of intersection
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@ = Property Line
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PL - Planter
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6
P o -t
P.O.B. = Point of Beginning
P.O.C. = Point of Commencement
S
12 S
P.P. = Power Pole
viol-
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P.R.M.= Permanent Reference
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s
8 W or
Monument
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P.R.C. = Point of Reverse
Curvature
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PT =Point of Tangency
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R = Radius
m
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a w = `d m E
g 02 o m
R/R = Railroad
PSM - Professional Surveyor
Mapper
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RNV = way
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SWK =Sidewalk
Sidewalk
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Seo. = Section
(1YP) =Typical
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8 "
= Tangent
in
mE
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U.E. - Utility Easement
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W.F. = Wood Fence
W.M. = Water Meter
W.V.= Water Valve
i=
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8mm
8 m
+T = Denotes Spot
IS SURVEY DEC RATIONISMEON THE FIELD TOPOGRAPHIC & BOUNDARY SURVEY.
DAT INDICATED, TO THE OWNER(S) LISTED. IT IS NO I HEREBY CERTIFY: that this survey meets the
T NSFERABL AL INSTITUTIO minimum technical standards as set forth by the
Bearing, if any, shown based on Plat Meridian (reference) NORTH R N89046'39"E SUBSEQUENT OWNER . FLORIDA BO ESSI SURVEYORS
AND MAPP RS in pter 5J-1 lorida Administrative
REVISIONS: ELEVATION NOTE: (IF APPLICABLE) Not valid unless Code, pursue o Sectio .027 Florida Statutes.
FLOOD ZONE COMM. No. PANEL No. SUFFIX: it bears the
VE 120652 0306 L L.F.Elev.= 9.0' (lowest habitable floor elevation). signature and the
Elevation shown hereon refer to N.G.V.D. 1929. original raised seal IVES 09/24/13
F.I.R.M.DATE F.I.R.M.INDIX BASE ELEV. Lowest adjacent grade elevation= �� . of Florida licensed
BM. # B -26 -RA (Miami -Dade Co.) Elev.=17.23' . Surveyor and PFO�FESS O SURVEYOR AND
c m W W c / Elevations Taken
a 3 o�
z m a o v m C
Alvarez, Aiguesvives and Associates, Inc.
Surveyors, Mappers and Land Planners
5701 S.W. 107th Avenue #204, Miami, FL 33173
Phone 305.385.0385 Fax 305.385.0623
L.B. No. 6867 / E-mail: fastsurvey@aol.com
Field Date Scale:Drawn by: Drwg. No.
09/19/13 1 1 "= 25' F.0 1 13-20212