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FW-14-1594Miami Shores Village Building Department �\ 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 �0�4 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 __-... FFBC20 d� BUILDING Master Permit No.J_�� PERMIT APPLICATION Sub Permit No. ,BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF [:]CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: d3�) 6 N F- q � P � S1. , Folio/Parcel#: 11-3ax)C, M-6-- CQZ40 Is the Building Historically Designated: Yes NO _ Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Address: `� �` is City: �"A &/Oil State: � L Zip: ) Tenant/Lessee Name: Phone#� Email: e—v ion (Ct ( i crrn V `CONTRACTOR: Company Name: �`7`�jj��'ei SSP Phone#: Address: City: Qualifier Name: State Certification or Registration M Certificate of Competency #: DESIGNER: Archit neer: I u l Phone#: Ams: City: State: Zip: Value of Work for this Permit: $ 6 L Square/Linear Footage of Work: 2�z 2 6 , Type of Work: ❑ Addition ❑ Alteration F-1New ORrRn Repair/Replace ❑ Demolition Description of Work: Specify color of color thru tile: Submittal Fee $ Permit Fee $ Scanning Fee $ Technology Fee $ Radon Fee $ Training/Education Fee $ CCF $ CO/CC $ DBPR $ Notary $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ �! (Revised02/24/2014) 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 Zi 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 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. I Signature L�4()W NER or AGENT Signature CdiL�>i.7_tytil;3 The foregoing instrument was acknowledged beforemethis The foregoing instrument was acknowledged before me this day of U V� 20 V \ , by day of 20 by glk-xu -IA who is personally known to who is personally known to me or who has produced ® ,w t— as me or who has produced as identification and who did take an\identification and who did take an oath. NOTARY PUBLIC: .�`5?i1�er.... �. NOTARY PUBLIC: . �.> -•. '�, Sign: _t,,% `c = Sign: Print: '� cds���� • ^�` Print: Seal: %ATSeal: `1iE �0, APPROVED BY V Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) 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: DATCD 4+o� e .� ADDRESS: 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 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.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 — A- 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 ancontracts. 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 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 leas which violates the exemption. Initial I understand that, as the owner -builder, I must provide direct, onsite supervision of the constructi Initial I understand that I may not hire an unlicensed person to act as my contractor or to supervise persons working on my building or residence. Is my responsibility to ensure that the persons whom I employ have the license required by law and by ounty or 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 m aware of the limits of my insurance coverage for injuries to workers on my property. Initial 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 —<a 9. 1 agree that, as the party legally and financially responsible for this proposed Construction activity, l w 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 !PW 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 http://www.mvfloridalicense.com/dbpr/pro/cllb/index.html Initial 11. 1 am aware of, and consent to; an owner -builder building permit applied for in my name and underst s that I am the party legally and financially responsible for the proposed construction activity at the following address: 7 Initial 12. 1 agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of 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 o 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 day of ��1 , 20 By `�`�`���-�1�� who wasersonall known to me or who has p Y Produced there License or as identification. OWNER - °'`+, SST P�������` Prepared by and return to: Balzli & Associates Mark D. Balzli, Esq. 1111 Lincoln Road, Suite #400 Miami Beach, FL 33139 (305)538-1765 File No.: 1441 WARRANTY DEED This indenture made on July J, 2014, by Donald P. Shockey, a single man whose address is: 95 NW 41st Street , Miami, FL 33127 hereinafter called "Grantor", to Jennifer Donya Litowitz, a single woman and Elizabeth Cowen, a single woman, as joint tenants with rights of survivorship whose address is: 321 NE 93rd Street, Miami Shores, FL 33138 hereinafter called "Grantee": (Which terms "Grantor" and "Grantee" shall include singular or plural, corporation or individual, and either sex, and shall include heirs, legal representatives, successors and assigns of the same) Witnesseth, that Grantor, for and in consideration of the sum of Ten Dollars, ($10.00) and other valuable consideration, receipt whereof is hereby acknowledged, hereby grants, bargains, sells, aliens, remises, releases, conveys and confirms unto Grantee, all that certain land situate in Miami -Dade County, Florida, to -wit: Lot 18 and the west %z of Lot 19, Block 46, MIAMI SHORES SECTION 1 AMENDED, according to the plat thereof, as recorded in Plat Book 10, Page(s) 70, of the Public Records of Miami -Dade County, Florida. Parcel Identification Number: 11-3206-013-6240 Subject to all reservations, covenants, conditions, restrictions and easements of record and to all applicable zoning ordinances and/or restrictions imposed by governmental authorities, if any. Together with all the tenements, hereditaments and appurtenances thereto belonging or in any way appertaining. To Have and to Hold, the same in fee simple forever And Grantor hereby covenants with said Grantee that Grantor is lawfully seized of said land in fee simple; that Grantor has good right and lawful authority to sell and convey said land; that Grantor hereby fully warrants the title to said land and will defend the same against the lawful claims of all persons whomsoever; and that said land is free of all encumbrances except taxes accruing subsequent to December 31, 2013. FL FA DEED -Warranty Individual Join By Spouse Rev. July 10, 2014 Page 1 of 2 File No.: 1441 .rw�r ORDERED BY: MARKOWITZ RINGEL TRUSTY HARTOG 65w st PROPERTY DRESS: 321 NE 93RD STREET MIAMI SHORES, FLORIDA 33138 FIELD WORK DATE: 617/2014 REVISION DATE(S): (REv.o 6/12/2o14) FL 1406.0782 BOUNDARYSURVEY MMMOADE COUW DIG Orr —b N z [.a OFF— LOT 17 vj BLK 4G r 3t PND. NAIL NO 10 @ B.C. 225, N 90000'00' I hereby ON#& desaftdpaip and to the bat and accurate it mininwar 16chn of Professional the Florida Adh Sff F direabn, 'tis a hue numb the Fladds Board DIVIrSUI-17of KEITH A. STEPHENSON Stft of FWda 1`110ftWoned Swv"w eta MMM LICMM NO. 6521 I SURVEY NUMBER: FL1 406.0782 1 9 C.L.F. 0.2' OFF FF1 io q �"g LOT /a SLK 46 I (NOT INCLUDED) ail T 37.a LU N Cn 1 STY. LU in RES #321 Ma 9Lu Lu + 4t0nN LINE t LL -j 28.2' f -t 13.9"0 THE W 1/2 OF 3: LU i LOT 19 BLK 4G ib 25.9V (D,' 0 C L Z. > 0 in .2 Tn. NOTES: '01040104140 • LOT APPEARS TO BE SERVICED BY CITY WAVftft840EiVER 0 FENCE OWNERSHIP NOT DETERMINED sees a •a :0000 • : 0 a : • 0 0 1010•• a 00 :.0060 30 0 1 1 00OJ30 1010•• 1010• • 1010•• 1010 1010 ; GRAPHIC SCALE (In fVA.I: I inch = 30' ft! N • - Use ofThIs Survey for Purposes other than Intended, Without Written Verification, will beat the Users Sole Risk and Without Liability to the Surveyor. Nothing hereon shall be Construed to Give ANY Rights or Benefits to Anyone Other than those Certified. FLOOD INFORMATION: POINTS OF INTEREST BY PERFORMING A SEARCH WITH THE LOCAL GOVERNING NONE VISIBLE MUNICIPALITY OR WWW.FEMA.GOV, THE PROPERTY APPEARS TO BE LOCATED IN ZONE X. THIS PROPERTY WAS FOUND IN THE VILLAGE OF MIAMI SHORES, COMMUNITY NUMBER 120652, DATED 09/11/09. Thomas Ringel Special Thanks CLIENT NUMBER. 14-M23R / LITOwi [DATE: 6/1/2014 �2 i COWEN 305.670.5000 / trmge1@=th1awcomM Two Datran Center, Suite 1800 BUYER: JENNIFER DONYA UTowrrZ AND ELIZABETH COWEN 9130 S. Daddand Blvd. Miami, FL 33 156 SELLER: DONALD SHOCKEY - -=- CERTIFIED TO: JENNIFER DONYA LITOWITZ AND ELIZABETH COWEN; MARKOWITZ, RINGEL, TRUSTY & HARTOG, PA; OLD REPUBLIC NATIONAL TITLE INSURANCE COMPAN' �RME Urry MORTGAGE ITISANjRS IPNC-; ITS E CTA SUCC SSO /0 S S9 I T S Y E RSAND R ASTHEOIR N ERE A EAR qWm Land Surveyors, Inc. PM6-73.5-1916 FM&744-2= This is page 1 of 2 and is not valid without all pages. 11940 FaInsayLain DflmSufte I- FL Myers, FL33913,. 77= " 17 7-777 7 7, 7 7 7,777 77 77 N est W92Ws PROPERTY DRESS: 321 NE 93RD STREET MIAMI SHORES, FLORIDA 33138 FIELD WORK DATE: 617/2014 REVISION DATE(S): (REv.o 6/12/2o14) FL 1406.0782 BOUNDARYSURVEY MMMOADE COUW DIG Orr —b N z [.a OFF— LOT 17 vj BLK 4G r 3t PND. NAIL NO 10 @ B.C. 225, N 90000'00' I hereby ON#& desaftdpaip and to the bat and accurate it mininwar 16chn of Professional the Florida Adh Sff F direabn, 'tis a hue numb the Fladds Board DIVIrSUI-17of KEITH A. STEPHENSON Stft of FWda 1`110ftWoned Swv"w eta MMM LICMM NO. 6521 I SURVEY NUMBER: FL1 406.0782 1 9 C.L.F. 0.2' OFF FF1 io q �"g LOT /a SLK 46 I (NOT INCLUDED) ail T 37.a LU N Cn 1 STY. LU in RES #321 Ma 9Lu Lu + 4t0nN LINE t LL -j 28.2' f -t 13.9"0 THE W 1/2 OF 3: LU i LOT 19 BLK 4G ib 25.9V (D,' 0 C L Z. > 0 in .2 Tn. NOTES: '01040104140 • LOT APPEARS TO BE SERVICED BY CITY WAVftft840EiVER 0 FENCE OWNERSHIP NOT DETERMINED sees a •a :0000 • : 0 a : • 0 0 1010•• a 00 :.0060 30 0 1 1 00OJ30 1010•• 1010• • 1010•• 1010 1010 ; GRAPHIC SCALE (In fVA.I: I inch = 30' ft! N • - Use ofThIs Survey for Purposes other than Intended, Without Written Verification, will beat the Users Sole Risk and Without Liability to the Surveyor. Nothing hereon shall be Construed to Give ANY Rights or Benefits to Anyone Other than those Certified. FLOOD INFORMATION: POINTS OF INTEREST BY PERFORMING A SEARCH WITH THE LOCAL GOVERNING NONE VISIBLE MUNICIPALITY OR WWW.FEMA.GOV, THE PROPERTY APPEARS TO BE LOCATED IN ZONE X. THIS PROPERTY WAS FOUND IN THE VILLAGE OF MIAMI SHORES, COMMUNITY NUMBER 120652, DATED 09/11/09. Thomas Ringel Special Thanks CLIENT NUMBER. 14-M23R / LITOwi [DATE: 6/1/2014 �2 i COWEN 305.670.5000 / trmge1@=th1awcomM Two Datran Center, Suite 1800 BUYER: JENNIFER DONYA UTowrrZ AND ELIZABETH COWEN 9130 S. Daddand Blvd. Miami, FL 33 156 SELLER: DONALD SHOCKEY - -=- CERTIFIED TO: JENNIFER DONYA LITOWITZ AND ELIZABETH COWEN; MARKOWITZ, RINGEL, TRUSTY & HARTOG, PA; OLD REPUBLIC NATIONAL TITLE INSURANCE COMPAN' �RME Urry MORTGAGE ITISANjRS IPNC-; ITS E CTA SUCC SSO /0 S S9 I T S Y E RSAND R ASTHEOIR N ERE A EAR qWm Land Surveyors, Inc. PM6-73.5-1916 FM&744-2= This is page 1 of 2 and is not valid without all pages. 11940 FaInsayLain DflmSufte I- FL Myers, FL33913,. 77= " 17 7-777 7 7, 7 7 7,777 77 77