DS-15-446 \ \
Miami Shores Village
'01110050 N.E.2nd Avenue NW `
.... *+
Miami Shores,FL 33138-0000
4�RVYEQ Phone: (305)795-2204
oft
Expiration: 02/29/2016
\ \\
Project Address Parcel Number Applicant
3 NW 92 Street 1131010170090 GABRIEL GUTIERREZ ELIZABE-
Miami Shores, FL 33150- Block: Lot:
Owner Information Address Phone Cell
GABRIEL GUTIERREZ ELIZABETH 3 NW 92 Street (305)756-7361 (786)250-5659
- -- MIAMI SHORES FL 33150-2226
Contractor(s) Phone Cell Phone ( Valuation: $ 300.00
HOME OWNER
Total Sq Feet: 294
Approved:In Review Available Inspections:
Comments:
Inspection Type:
Date Approved: : In Review Final
Date Denied: Foundation
Type of Work:PAVER WALKWAY Additional Info: Review Planning
Bond Return : Classification:Residential Review Planning
Scanning:3 Review Building
Review Building
Review Building
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60
Invoice# DS-2-15-54636
D13PR Fee $2.00 09/02/2015 Cash $ 114.60 $0.00
DCA Fee $2.00
Education Surcharge $0.20
Permit Fee $100.00
Scanning Fee $9.00
Technology Fee $0.80
Total: $114.60
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT, I ce ' that _fpregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and z the ihofize the above-named contractor to do the work stated.
September 02, 2015
o ur . er / Applicant / Contractor / Agent Date
Building Department Copy
September 02,2015 1
Miami Shores Villageti ����- P -.
Building Department FEB 2 201
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
�✓ Tel:(305)795-2204 Fax:(305)756-8972 -
li' INSPECTION LINE PHONE NUMBER:(305)762-4949
iF�BC 20 1 C)
BUILDING Master Permit No. � '
PERMIT APPLICATION Sub Permit No.
BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
[--]PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
St CONTRACTOR DRAWINGS
JOB ADDRESS: � NX 91
City: Miami Shores County: Fl//
y Miami Dade Zip: �� S
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): Phone#: NQS,6!1) 06
Address: _Ah,e /2
-Af
City: &1/16100E State: Zip:
Tenant/Lessee Name: Phone#: Jos- K113 —7q4�
Email: - P
CONTRACTOR:Company Name: C � )-- Phone#:
Address:
City: State: Zip:
Qualifier Name: Phone#:
State Certification or Registration#: Certificate of Competency M
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
nn
Value of Work for this Permit:$ A Square/Linear Footage of Work. a
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
",' R P
Description of Work: �; C
Specify color of color thru tile:
Submittal Fee Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ I
(Revised02/24/2014)
Bonding Company's Name(if applicable)
Bonding Company's Address _
City State Zip
Mortgage Lender's Name(if applicable)
Mortgage Lender's Address
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 c occ seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be a 'a inspection fee will be charged.
Signature Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of`-, 20 /5 by day of 20 by
��f— 7 �rroho is personally known to ,who is personally known to
me or who has produced 0�"Z-f as me or who has produced as
identification and who did take an oa*011'11i� � identification and who did take an oath.
NOTARY PUBLIC: v ' NOTARY PUBLIC:
0
Sign: i "�= Sign:
Print: 'c, ; Print:
S,'{ �..
Seal: I'll"00<� »������` Seal:
APPROVED 0YPlans 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: �O_wt�e11
lett DATE: 2?
ADDRESS:3_ N W) Qa S� M�Qm 1 X315
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-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. -r
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.
Initial6
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 bylaw any coun y 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. ♦�
8. 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
9. 1 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
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.myfloridaIicense.com/dbpr/pro/ciIb/index.htmI
Initial L2
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 th roposed 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 that I have provided on
this disclosure. �
Initial t� �.
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.
G
Was acknowledged before me this / day of , 20
By L COU Ti��t">✓� who was personally known to me or who has
Produced the is se r as identification.
OWNER OTA
Q �
♦ - 4 k
Rick Scott
V'Jssion:
Governor
(c,protect,promote&improve the health
of all people in Florida through integrated 7
state,county&community efforts. u,,� ��, � , John H.Armstrong, MD, FACS
j��T 1 State Surgeon General&Secretary
Vision:To be the Healthiest State in the Nation
July 06,'2015
Irinardo Duarte
3 NW 92 Street
Miami, FL 33150
RE: Modification to a Single Family Residence - No Bedroc,-n Addition
Application Document Number: AP1184050
Centrax Permit Number: 13-SC-1599042
3 NW 92 Street
Miami, FL 33150
Lot: 9 Block: na Subdivision: t
Dear Applicant,
i
This will acknowledge receipt of a floor plan and site plan on 04J09/2015 for the use of the existing
onsite sewage treatment and disposal system located on the alraove referenced property. No objection.
Reviewed by Y.Martin on 07/06/2015 for walkway.
i
This office has reviewed and verified the floor plan and site plar you submitted, for the proposed
remodeling addition or modification to your single-family home. Based on the information you provided,
the Health Department concludes that the proposed remodeling addition or modification is not adding a
bedroom and'tbat it does not appear to cover any part of the e,listing system or encroach on the
required setback or unobstructed area. No existing system inspection or evaluation and assessment,
or modification, replacement, or upgrade authorization is required. y
Because an inspection or evaluation of the existing septic systgsn was not conducted, the Department
cannot attest to the existing system's current condition, size, or adequacy to serve the proposed use.
You may request a voluntary inspection and assessment of yo!...r system from a licensed septic tank
contractor or plumber, or a person certified under section 381.0101, Florida Statutes.
If you have any questions, please call our office at (305)ArE
233;
in
Engine;ring Specialist 11
Departrent of Health in Dade County
Florida Department of Health www.floridahealth.gov
in Dade County- •,Florida TWITTER:HeafthyFLA
PHONE: (305)623-35GO FACEBOOK:FLDepartmentofHealth
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c N4 1
I
• � •: 0TOTALR1W)
x' ® IAVENUE (PER PLAT)
ABBREVIATIONS: . .
—{ SVW=SIDEWALK,CBS-CONCRETE BLOCK STRUCTURE,CLF=CHAIN LINK FENCE.PL=PROPERTY LINE,DUE=DRAINAGEUTiLr7YEASEMENT,IP=IRO
F=FOUND,AIC=AIR CONDITIONER PAD,PIC=PROPERTY CORNER,DIH=DRILLED HOLE,W/F=WOODEN FENCE,RES=RESIDENCE,CL-CLEAR,RB=1
UE=UTILITY EASEMENT. CONC=CONCRETE SLAB. RAWRIGHT OF.WAY, DE=DRAINAGE EASEMENT, C/L=CENTER LINE, O=DIAMTER,TYP=T
M=MEASURED.R=RECORDED,ENCR=ENCROACHMENT,COMP=COMPUTER,ASH=ASPHALT,NID=NAIL&DISC.S=SET,FEE=FINISH FLOOR ELEF
OIS=OFFSETP/P=POWER POLE,OHP=OVERHEAD POWERLINE,IAM=MTER METER
. ,_..lgCGDFENCE..
1 MASONRYWALL ELEVATION BASED ON LOC. # 3100 SW
CONCRETE .l:.I-.•::1.,:. •I,.•<••t -::'.••I....l.•:.
NOT VALID UNLESS EMBOSSED WITH- MAINTENANCE a DRAINAGE EASEMENT=M BD.E. CBM# N-568 ELV.9.65 r TYPE OF SURVEY:BOUNI
SURVEYOit'S SEp L
"L SURVEYOR'S NOTES: 1) OWNERSHIP SUBJECT TO OPINION OF TITLE. 2)NOT VALID WITHOUT THE SIGNAL
�;_.' AND RAISED SEAL OF_A FLORIDA LICENSED SURVEYOR AND MAPPER. 3) THE SURVEY DEPICTED HERE IS
-t-- COVERED BY PROF SIONAL LIABILITY INSURANCE. 4) LEGAL DESCRIPTION PROVIDED BY CLIENT
Aft UNDERGROUND EN OACHMENTS NOT LOCATED. 6) ELEVATIONS ARE BASED ON NATIONAL GEOC
OEM
VERTICAL DATUM OF').929.. 7) OWNERSHIP OF FENCES ARE UNKNOWN, 8) THERE MAY BE ADDITIC
qmw RESTRICTIONS NOT SHOWN ON THIS SURVEY THAT MAY BE FOUND IN THE PUBLIC RECORDS OF THIS COUNT
CONTACT THE APPROPRIATE AUTHORITY 'PRIOR TO ANY DESIGN WORK FOR BUILDING AND ZOi
INFORMATION. 10 EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO
EX
BE MADE TO DETERMINE RECOF
REVISED: INSTRUMENTS,IF ANY;AFFECTING THIS PROPERTY:
Additions or deletions to survey maps or reports by other than the signing party or parties is prohibitec
without written consent of the signing party or parties.
41
'BEARINGS WHEN SHOWN ARE REFERRED TO AN ASSUMED VALUE-OF SAID PB PAGE 1
LOCATION SKETCH
SCALE: NTS
CL
00
NORTH MIAMI AVENUE
CERTIFIED TO: GABRIEL GUTIERREZ
PROPERTY ADDRESS: 3 N.W. 92ND ST. , MIAMI SHORES, FL. 33150.
..LEGAL DESCF IPTION: LOT 9 BLOCK
OF CANADAY EXTENSION
SUBDIVISION
ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 4I AT PAGE 71
OF THE PUBLIC RECORDS MIAMI—DADE COUNTY, FLORIDA
URVEY I HEREBY CERTIFY That the survey represented SINCE 1987
theteon meets the minimum technical requirements BLANGO SURVEYORS INC.
adopted by.the STATE OF FLORIDA Board of Land
Surveyors pursuant to Section 472,027 Florida Engineers•Land Surveyors•Planners-LB#0007059
Statutes.
There are no encroachments, overlaps, easements 555 NORTH SHORE DRIVE
appearing on the plat or visible easements other than MIAMI BEACH,FL 33141
as shown hereon. 30 865_1200 Email:biancosurve orsinc
( } Y Oa yahoo.cam Fax: (305)565-7810
skz
" FLOOD ZONE: X SUFFIY,: L DATE: �11/Q9 BASE:N/A T
ADIS N.NUNEZ PANEL: 0302 1COMMUN(Ty# 120652
REGISTERED LAND SURVEYOR DAT `. SCALE: OWN.BY: Ing No
STATE OF FLORIDA#5924 3614 1^=20' F.Blanco 14-233