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FW-15-1386i Miami Shores Village CCF 10050 N.E. 2nd Avenue NE DBPR Fee Miami Shores, FL 33138-0000 DCA Fee Phone: (305)795-2204 Project Address Parcel Number Applicant 1341 NE 103 Street 1132050300140 LISA RHODES Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell LISA RHODES 1341 NE 103 Street MIAMI SHORES FL 33138- 1341 NE 103 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone HOME OWNER Approved: Denied: of Construction: Wood Fence ;ification: Residential Fees Due Amount CCF $0.60 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.20 Permit Fee - Wire & Wood $100.00 Scanning Fee $9.00 Technology Fee $0.80 Total: $114.60 Valuation: E$600.00 Total Sq Feet:21 Additional Info: WOOD FENCE FOR POOL RENEWA Scanning: 3 Pay Date Pay Type Amt Paid Amt Due Invoice # FW -6-15-55886 06/08/2015 Credit Card $ 50.00 $ 64.60 06/15/2015 Credit Card $ 64.60 $ 0.00 Available Inspection Type: Final In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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 7Ao,ning. Futhermore, I a th above-named contractor to do the work stated. 111t_ June 15, 2015 Owner / Applicant / Building Department Copy June 15, 2015 1 0 Miami Shores Village Building Department 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 PERMIT APPLICATION BUILDING ❑ ELECTRIC ❑ ROOFING JUN 0 A 2015 FBC 20 16 Master Permit No���.��",� Sub Permit No.�W/_ 4 3 ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: l (/� J 4 l VU E I CV i5heed City: Miami Shores Countv: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): '�y v I D 4>�\� Phone#: Address: Ly City: M 1 ay -yl t L<;ticK-t? S State: 1P 1 tX- l &z"� Zip: 1 Tenant/Lessee Name: Phone#: Email: I Q 'j CONTRACTOR: Company Name: " LING, Phone#: ` 1g-33a--7s,� Address: YUr� City: 1 I Y�(Aryu �IO�(� State: �(., Zip: 331 Qualifier Name: Phone#: State Certification or Registration #: Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: tea, i Value of Work for this Permit: $®� ®(C� Square/Linear Footage of Work: ® �� Type of Work: ❑ Addition ❑`` Alteration El New ElRepair/Replace ❑ Demolition Description of Work: G)Gc� _. �/��ir/Cr' 107, Specify color of color thru tile: Submittal Fee $ !3/)-Q6 Permit Fee $`W ' � CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ to ' 0 O (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 City State OIL 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 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 &— IiQ Signature OWNER or AGENT The foregoing instr ment was acknowledged before me this day of 20 by who is personally known to I e me or who has produced Q_ I- as identification and who did take an oath. NOTARY PUBLIC: Seal: 'rte: Joennei M F811081 My Commisslan FF e..►d EX0690M21201® CONTRACTOR The foregoing instrument was acknowledged before me this day of , 20 , by , who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign:_ Print: Seal: as APPROVED BY G�671;77 Plans Examiner Zoning 11 7 - 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: �A- khb� DATE: 16 ADDRESS: I rue Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, FS 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 odes and zoning regulations. Please read and initial each paragraph. 1. 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 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` 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_ 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. r ,� Initial V-- 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 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 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,1 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 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 h ://www.m oddalicense.com/dbpr/ ro/cilbfindex.ht I 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 party legally and financially responsible for the proposed construction activity at the following address: ILII 103(4 . 0414mi Shoe �L 33,39 Initial 12. 1 agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the informationat 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 contractors 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 owners 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 e , 20Z__<�:::� By Z ,czij �L^ �,- who was personally known to me or who has a Produced there License or as identification. OWNER T--7 �\-3 14 -4N Miami Shores Village APPROVED BY DATE ",-ONING DEPT cowwectors that are used lw € EPT I( q, , �V �,)f T�O nCQCQ,PLIANH AI. �EDERAL FeKa.s. Fewces "t exceedi.i w%wd speed or go wLph (40 two o of Fe vac es %K height from grade mm. be desLgwed f secowd gust. WDOol we - wood fevze des%gw shaLL be as specs feed bd the code. Rwces < eft. loci, — 57 ft. Caw ceKker :Fewce, -4= 4 -E. Kcjh - Cp -f�. ow Uwter 2x4 HorizowtaL wood members wticLe I / Nails, bolts awd other metal cowwectors that are used lw I( LocatLows exposed to the weather shaLL be gaWaKtzed or otherwise corrostoK resLrtawt. in geKeraL wails shaLL pewetrate the seeoKd wi. Kaer a dtstaKce equal to the thieiewess of the mewtiber bdv.0 wailed •� • thereto. There shaLL be Kot Less thaw two KaUs tK aK� o, cowKectioK. u_ Qn NatL sizes: =/Z" Low 2" Lowg s Sd: 2-1/2" Lowg 1.00i: 31 Lowg /w �) :.7A: —1/2p ioKO 41 Lono NomLKaL 4x4x8 posts No. 2 etrade or better evKbedded 2 feet twto a coKarete footiwg :Lo twohes iw olLaw-eter aKd 2 feet deep. ALL posts, poles aKd coLuwi.Ks embedded tw cowarete which is tw cowtaat with grok" awd supporttKg permamKt POR RaV OF *RIVER R4 PARA' ALIDITIaNr (40-72) Take this are of decking out Pool to Replaster and tiled decking to be placed on existing concrete new 4 ft fence with self closing gate 54" above grade CERTIFIED TO: RAPID TITLE SERVICES COMPANY; COMMONWEALTH LAND TITLE INSURANCE COMPANY, • LISA RHODES; WELLS MARGO BANK, N.A., ITS SUCCESSORS ANMR ASSIGNS AS THEIR INTEREST MAY APPEAR. >Amz-- VL�P _ — "�, of—j�,'_ 292. qffM L TIE r© PC F. /, P 11Z' NO /D- t7,CD. Yr' 1.P. -J .- 12086C0306 PROPERTY OF: NO.: 120652 LISA RHODES ?M: 09-11-09 1341 NE 103RD STREET = +nno Air, Vn f �9-0 MIAMI SHORES, FLORIDA 33138 NOT VALID WITHOUT THE SIGNATURE AND THE 7RIGINAL RAISED SEAL of A FLOrJDA I..IC'ENSEE SURVEYOR AND MAPPER. -Fw 1q-49 A BOUNDARY SURVEY I HEREBY CERTPY THAT THE SURVEY REPRESENTED HEREON MEETS THE "NO" TECHNICAL STANDARDS SET FORTH BY THE FLORIDA BOARD OF LAND SURVEYORS IN CHAPTER 61G17-4 FLO18'DA ADWKSTRATIVE CODE PLARSUANT TO SECTWN47 -027, FLORMA STATUTES. THERE ARE NO ENCROACHMENTS, OVERLAPS, EASEMENTS APPEAROVIS ON THE PLA T. OTHER THAN AS SHOKW HERETO. FRANCISCO F. FAJAR60 #47'67 FLORADA PROFESSIONAL SURVEYOR ANO MAPPER REG, NO. 4767, LOCATION SKETCH NOT TO SCALE A4040EA r o#m rAzAer B IfIFA W 4 WOA V0 J QAY' AA. 1f.. dfJTAr&F J LEGAL DESCRIPTION: LOT 5, BLOCK 6, "REPLAT OF TRACT B MIAMI SHORES BAY PARK ESTATES", ACCORDING TO THE PLAT THEREOF, AS RECORDED IN PLAT BOOK 63, PAGE 17, OF THE PUBLIC RECORDS OF MIAMADADE COUNTY, FLORIDA. SURVEYOR'S NOTES: 1) NOT VALID UNLESS SIGNATURE IS EMBOSSED WITH THE REGISTUaRED LAND SURVEYOR -S SEAT 2) LEGAL DESCRW71O1!MPROVIDEDBYOTHERS- 3) TH RS.3) PROPERTIES SW)WW HEREON WERE NOT ABSTRACED FOR EASEMENTS OR 07HER REOM)ED ,ENCL44"NCES NOT SHOWN ON TW PROPERTY PLAT OF RECORD, 4) UE&SUREMENTS TO WOW FENCES ARE TO OUTSAD€ OF WOOD. 5) UNDERGROUND UTILITIES, FOUN (MTiON4 OR OTHER #APROVEMENTS, IF ANY, WERE NOT LOCATED. 6) ELEVATIONS, IF SHOWN ARE BASED ON NATIONAL GEODETIC VERTICAL DATU1W 1929. 7) FENCE OWNERSHIP NOT DETERMINED WiLESS OTHERWISE NOTED. 8) MEASUREMENTS TO WIRE FENCES ARE TO CENTER OF WW 9) WALL MEASUREMENTS ARG TO/FROM FACE OF WALL 10) DRAMNG DISTANCE BETWEEN WALLS ANLVOR FENCES AND PROPERTY LINES MAY BE EXAGGERATED FOR CLARITY. 11) FLOOD ZONE INFORIWATION WAS DERIVED FRO)Ud FU:OERAL EMERaENCY U4NAGEMENT AGIENCY FLOOD YFORMATION RATE MAPS 12) BEARINGS IF ANY SHOWN ARE BASED ON PLAT MERIDIAN AT: CENTERLINE OF ME 10M STREET N8D'5D'64'E J'aOB: POC: i I� PYd6R PCT' FAD - Ct., (C) W.U.P. ArMAM C004CRUE occATES OMR SW LM4rS fiWrG 1M MWFFWE AAWA7E51M1000 FEA C -C #aCATFSMOPERTY CORNER MCA TEsPOAVTOFSEavV &4 *VXA7ES POhEVFOF mrCAW PR0PERTYI.ffW #tDOCATA3,SREL.1f WAAM WEAAi7VT PfiNrATEV DRAMC401EA Mrrr 9496WNT NWCAM$UrkRYfASEA9W #RNC:A7ES PEANAMENT A LVF 4101MWW A4IDIGAAIV& psFmA4q&w r caWmm PANT AAUYC'ATESFOUAV ^04AIMCLEAR #00K'SATES AAEABt.RED CALCKAM-0 AGr-4 TF$ NVO0 UTRliYPULE CL; NUM24IESCIAM ENC¢ HWWCA7ES EA1CIROA0h%MWT r p; #xp--4 7ES -9&U llO WON POPE FRU.' MUC47USFOUAW7REHAR SRR: N04A WS SFT li7 MAAWMR RSW 7YP.: MILNCATES TY MAL RM" W0t0ATE$RC44r-CF-WAr ORO MBNCATESOFFACW RMOR09" t AMo v" WF &0W aR LESS F.F. ELE W AMD;CA7ES FAASfA'D FLOOR FLEVA IR AMDICAV9N0rWSCALE AY WLMCATES POORTH s +urvrcA�Essc3unw' AiJDu1G'i47E9C0FTFW AVZ (AA) AMA TES FW AM4SUREWNTS CONC': MICA TFSCOAMETE CN1Bi°L: ffAP=4?V8 NA'ROV&W"LMAE O.U.L. MOICA TES 0WRHEAUUTHRYLMS PROFESSIONAL SURVEYING AND MAPPING LANNES & GARCIA, INC. LB # 2098 FRANCISCO F. FAJARDO PSM # 4767 385 ALHAMBRA CIRCLE - SUITE C, CORAL GABLES, FLORIDA 33934 PH (305) 666-7909 FAX (305) 559-3002 DATE.01.25.201-1SCALE: 1"= 20' _ I DRA WN BY.- A MEREL 1 DVYYs. No.. 221231