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DEMO-16-2979 MIZk R 3� Miami Shores VillageW., PeIT#1 1�riractll�n 10050 N.E.2nd Avenue NE I/1/oIt*0CBitort Miami Shores,FL 33138-0000 Phone: (305)795-2204 r t q Pert /its aR * 00"", Expiration: 05/02017 Project Address Parcel Number Applicant 123 NE 97 Street 1132060132440 Miami Shores, FL 33138-2332 Block: Lot: JUAN R. DEL RIO Owner Information Address Phone Celt JUAN R.DEL RIO 123 NE 97 Street MIAMI SHORES FL 33138-2332 123 NE 97 Street MIAMI SHORES FL 33138-2332 Contractor(s) Phone Cell Phone Valuation: $ 215.00 HOME OWNER .. _.w. . ..:..... _._.__.... _.m._„n__. Total Sq Feet: 176 Type of Demo:Building Available Inspections: Additional Info:CAR PORT DEMOLITION Inspection Type: Classification:Residential Final Scanning:3 Review Building Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 Invoice# DEMO-11-16-61866 DBPR Fee $2.00 11/01/2016 Credit Card $50.00 $64.60 DCA Fee $2.00 Education Surcharge $0.20 11/02/2016 Credit Card $64.60 $0.00 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 certifyApt at all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating constructio nd zory'ng. Fut e,I auth 'ze above-named contractor to do the work stated. November 02, 2016 Authorized Signat-dPardwner / Applicant / Contractor / Agent Date Building Department Copy November 02,2016 1 4 v 1 CEIV D Miami Shores Village NOV 012016 Building Department BY: 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 201 � BUILDING Master Permit No. �LmQ %I — b—Z 1 * I PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [—]RENEWAL ❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP ACONTRACTOR DRAWINGS , JOB ADDRESS: /V City: Miami Shores �,� County: Miami Dade Zip: L3� Folio/Parcel#: -,3906 — 013—dL L1`,o Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): � V aAJ �'� / Phone#:K3 01 ,y V-0? 0 Address: l' I: City: lrI Q m/ 0/,Ys State: �` �� Zip: 34)1.3 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: Ott)A)- Phone#: Address: City: State Zip: Qualifier Name: Phone#: State Certification or Registration M Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ 09 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteratio liw` ❑ New ❑ Repair/Replace CA Demolition Description of Work: ue d 17 J rue Specify color of color thru tile: Submittal Fee$ Q% Permit Fee$ tW-LO CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ s (Revised02/24/2014) ti 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 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 —6&OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day C& dV'e MiCr2 r 20 Lb ,by day of 20 by lXa�n ���D trek wh its personally known to who is personally known to me or who has produced �C��Pe Y l 1 C�eng-c as me or who has produced as identification and who did take an o identification and who did take an oath. NOTARY P U NOTARY PUBLIC: Sign Sign: Print: p Print: ziY ei YANADY PRIETO Seal: = �= NIYCOMMISSION#FF214031 Seal: =m EXPIRES:March 25,2019 Bonded Thru Wt"Public Undenxrlters �x�**rix**r�**�*�***�•��x**�xws�e�**pix x�*x�* *�*®wx��x**�*��*+kx��r**x�***�x**��r�r***mx�s�***��x�x�*a�**��x****aux*�***a�*+k**x�*�x� �K APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) stns Miami Shores Village pm Building Department 10050 N.E.2nd Avenue Ri Miami Shores, Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 OWNER BUILDER DISCLOSURE STATEMENT / f NAME: iq k• di + 4" DATE: ADDRESS:�d► ' A/9 j'7��-5 tr't le �!►'�P a r�s. I � 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. 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 under nd 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 outbuil . elmay 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 s d 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,w h violates the exemption. Initial 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 roqg on my building or residence.It is my responsibility to ensure that the persons whom I employ have the license required bylaw and by co n 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.1,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. 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 9. I agree that,as the party legally and financially responsible for this proposed Construction activity,I wil 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.mvfloridalicense.com/dbpr/pro/cilbAndex.html 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: 12. 1 agree to notify Miami Shores Village immediately of any additions,deletions,or changes to any of the in rmation 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 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 Sk day of 110"v-etmb-er , 20 By r )UCkn 9CSSY---zk1do 64k R;o who was personally known to me or who has Produced there License or as Iden ati 4r MY COMMISSION WY rF 214031 EXPIRES:March 25,2019 Bonded Thru Notery Public Undenwitem -CrWNER N 129 N.*..et 97th; 8Y DATE ZOMNS DEP BLDG DEPT S UBJECT 10 CG, ,IPI.IV`1`ICE W1 r1 ALL F E AL 10 STa,TE ANL)UU.11Y _ _t Te PROPERTY FRONT VIEW CERTIFIED TO: FLOOD INFORMATION: JUAN ROSBALDO DEL RIO Community Number: VILLAGE OF MIAMI SHORES FIDELITY NATIONAL TITLE INSURANCE COMPANY 120652 COLUMBUS CAPITAL LENDER LLC Panel Number: 12086CO302L ITS'SUCCESSORS AND/OR ASSIGNS AS THEIR Suffix: L INTEREST MAY APPEAR. Date of Firm Index: 9/11/2009 Flood Zone: X Base Flood Elevation: N/A Date of Survey: 8/16/2016 LEGAL DESCRIPTION: LOT 17, LESS THE WEST 6.7 FEET THEREOF,AND ALL OF LOT 18, BLOCK 18,AN AMENDED PLAT OF MIAMI SHORES SECTION NO. 1,ACCORDING TO THE MAP OR PLAT THEREOF,AS RECORDED IN PLAT BOOK 10, PAGE 70, OF THE PUBLIC RECORDS OF MIAMI-DADE COUNTY, FLORIDA. PROPERTY LINE Surveyor's Legend ;•••;• STRUCTURE CONK.BLOCK WALL Esq 4.TREE L.M.E. LAKE or LANDSCAPE MAINT.ESMT. ••ENT• EA Iwi • ••• • X— CNNN—LWK or FENCE i P.P. POWER POLE R.O.E. �OVERP.P. EASEMENT •• • 000•• PUMPLAE. LANDSCAPE BUFFERTESMT. •• WOOD FENCE ®C.e. CATCH BASIN PL PLANTER OR PROPERTY LINE ••G • LIMITED ACCESS EASEMEN? • C.U.E. COUNTY UTILITY ESMT. I.D. I�ITIFICATOXV •$�,• TEI.FPt -F�CUIES ;*see; o- �— Di01d FENCE LE./EE. INGRESS/EGRESS lA/T• B.C. BLOCK CORNER • U_.FT. • UTDIZY • U.E. UTILITY EASEMENT •IL" ELEC7fW@ FAM BOX ••••• — ——— EASEMENT FPD).OR F FOUND IRON PIPE/ BA BEARING REFERENCE SFP71C TANK • • CENTER UNE PMI AS NOTED ON PLAT CENTRAL ANGLE or DELTA SEP.••S P•. • ••••• LBO LASE _BUSI NESS R RECORD OR RADIUS fIIA�I��'y A1 LSB LICENSE B-SURVEYOR RAD. RADIAL •• • e A •••••• ® WAD DECK CALL CALKXlLAlEO POINT ICR. NON SET SET MONUME14T TRP. TYPICAL RADIAL ;•SOLIKW*• SCR E N • •• CONCRETE ♦ COMROL POINT LR. IRON ROI) • @ ; SCREEN • •••••• ■ CONCRETE MONUMENT I.P. IRON PIPE ELEV ELEVATION N&D NAD'&DISK • •• • • :. ASPHALT P.T. POINT OF TANGENCY PK NAD. PARKER-KALON NAE. • 6, • NOT SCALE •••••• rf�� P.C. POINT OF CURVATURE D.H. DRILL HOEWEL •i F. • FlNT41t�1F7 i • • T.O.B. TOP40F BANK AN HOLE E/P OR E.O.P. EOPAVEMENT BRICK/TILE P.R.M. PERMANENT REFERENCE MONUMENT W FOE HYDRANT E.O.W. EDGE&'•WA" P.C.C. POINT OF COMPOUND CURVATURE M PRC. POINT OF REVERSE CURVATURE O M.N. MAN WATER QHL OVERHEAD LINES C.V.D. CONCRETE E VALLEY LITTER P.O.B. POINT OF BEGINNM TX TRANSFORMER B.S.L. BUILDING SETBACK UNE P.O.C. PMT OF COMMENCEMENT CATV CABLE TV.RISER S.T.L. SURVEY TIE LINE APPROXBAAIE EDGE WATER PM.C.P. PERMAN CONTROL POINT W.M. WATER METER FIELD MEASURED P/E POOL EQUIPMENT Rq CENTER 1 WAY P PLATTED MEASURMENT CCNC CONCRETE SLAB R.O.E. PUBLIC UTILITY EASEMENT ® COVERED AREA D D® C.M.E. CANAL MAINTENANCE EASEMENT C CALCULATED AZ ANCHOR EASEMENT GENERAL NOTES: , !) 1) LEGAL DESCRIPTION PROVIDED BY OTHERS. j 2) EXAMINATION OF THE ABSTRACT OF TITLE IMLL HAVE TO BE MADE TO DETERMINE RECORDED INSTRUMENTS,IF ANY,AFFECTING PROPERTY. 3) THE LANDS SHOWN HEREON WERE NOT ABSTRACTED FOR EASEMENT OR — OTHER RECORDED ENCUMBERANCES NOT SHOWN ON THE PLAT. 4) THE PURPOSE OF THIS SURVEY IS FOR USE IN OBTAINING TITLE INSURANCE AND FINANCING AND SHOULD NOT BE USED FOR CONSTRUCTION,PERMITTING PepeHmft DESIGN,OR ANY OTHER PURPOSE WITHOUT THE WRITTEN CONSENT OF Printing to Scale: 5a+M I c ❑col. ONLINE LAND SURVEYORS INC. 5) UNDERGROUND PORTIONS OF FOOTINGS,FOUNDA77ONS OR 077-IER 1, Sefect'None'lrom Page Scaling T IMPROVEMENTSWERENOTLOCATED. 2, Deselect Auto-Rotate and Center` @MW&Aamfe&mTCmW 6) ONLY VISIBLE AND ABOVE GROUND ENCROACHMENTS LOCATED. 3. SelectChoose paper source by 7) FENCE OWNERSHIP NOT DETERMINED. @07 by PDF pwft 8) WALL TIES ARE TO THE FACE OF 774E WALL. PDF page size" U.—t..PBPB 9FC n'hCl h-edetl 9) BEARINGS ARE BASE ON AN ASSUMED MERIDIAN. 10) BOUNDARY SURVEYMEANS A DRAWING AND/OR GRAPHIC REPRESENTATION OF THE SURVEY WORK PERFORMED IN THE FIELD,COULD BE DRAWN ATA IELD WORK 811512016 SHOWN SCALE AND/OR NOT TO SCALE. 11) NO IDENTIFICATION FOUND ON PROPERTY CORNERS UNLESS NOTED. �WN BY. V P 12) NOT VALID UNLESS SEALED IMTH THE SIGNING SURVEYORS EMBOSSED OR 4�ptt vl C F ELECTONIC SEAL. NECKED BY: M.E 13) DIMENSIONS SHOWN ARE PLAT AND MEASURED UNLESS OTHERWISE SHOWN. 14) ELEVATIONS IF SHOWN ARE BASED UPON N.G.V.D.1928 UNLESS OTHERWISE NOTED. lNAL REVISION: 0811612016 II,. s101 16) THIS IS A BOUNDARY SURVEY UNLESS OTHERWISE NOTED. 16) THIS BOUNDARY SURVEY HAS BEEN PREPARED FOR THE EXCLUSIVE USE OF OMPLETED: 811612016 THE ENTITIES NAMED HEREON,THE CERTIFICATIONS DO NOT EXTEND TO A �s coRt Dp e UNNAMED PARTIES �, 1"=20' s�°fit sulrAtYDR VENCOD I i'II 0-28105 904 15271 NW 60 AVE,Suite 206 Miami Lakes,91 33014 -0123 Phone:(305)910-0123 SURVEYORS,INC. Fax:(305)675-0999 www.OnlineLandSurveyors.Com Survey Date:8/16/2016 Survey Code:0-2810 Page 2 of 2 Not valid without all pages. LOT 13 LOT 12 j LOT 11 LOT 10 BLOCK 18 BLOCK 18 BLOCK 18 BLOCK 18 : ..... ....... •9'f ASPHALT PARKWAY'.•.•.•.'.•.•-•-•- :.::'.'.'.0.'.0.0.'.0. $ .:.':...:.:.:.:. .. :.:...:......9�. ®� �R&MJ...............°. ....ALLEY.. :::::: . F.LP. 1/2� 11.50' o• rq F.I.P. 1/2" — e ? o E 43.30' OF COMMON WALL �' LOT 18 LOT 18 a LOCK 18 BLOCK 18 N a 2ua3 0.07' ®ri b C ( b 3.0' n Iq 0 In 0' 10' 20• fJPi PL C. 13.50' N 0.42' 1 inch = 20' ft. 50 r- CONC 9°70' n 00 4' 3.0 REMAINDER OF "0•83c 4 v �15.ao' N LOT 19 LOT 17 0 11.50' Q�' ONE STORY O BLOCK 18 BLOCK 18 p I RESIDENCE 0.70 Q , 3'. 2 — # 123 6.40' A ? 22.90' g 2 .40' 3.10' I ...... 0.84' 4.0 in N • o •• • • .• • 0000• • cis": 0000•• C C 15.50' • • • • N .fg g• 9.20 0000 •0000•• �. • • C o CONC 0000 ••.• 00000 Lf] • • P'! 00.00• • 00000 0 • •0••• ¢ � � •• •• e 0000•• d N 0000•• to • •• (BASIS OF BEARING) Q ' • • ib • ••••+• 11270' 82 I Ii •0• a��o 0000• • • •00.0• S.C. Ft.P. 1/2A ?5' dil .:.�.93.310 (R&M)®� ' ' e � ;e � •,�1.P, 1/2-a F.1.R 1/2p CONC P�IVE 22.0' PARKWAY - :':°:'::':.':':':':':':': ':":'...'.'.:':.'..:.:.'75' RIGHT—OF—WAY(BY PLAT).'.:':'.':.'.'.':.•..-•.•-- :.............. •22'f ASPHAL T PA VEMENT...............:.......:. :......... :.':.':.:' .'.'' .....: -.....:...:...'..:. 4. :::......—..:.'.................'....-.-......----------- ::::::::.::::::::::::::::::::::::::':'::::::::::.:::::::::::: N.E. 9'7th STREET...:::::.::•:::. :::::::::::: ::::::::::::::::::::::::: .................'.......................................................'....'............................ ........................................................................................................... INT O NTEREST: ONC DRIVE CROSSES LOT LIN�E..•� /� �/SURVEY a+r®`�Cv MAP OF BOUNDAR 1 SU i/G i 1 HEOF A SURVEY THAT THIS BOUNDARY SURVEY'1S A TRUE AND CORRECT REPRESENTATION OF A SURVEY PREPARED UNDER MY DIRECTION-THIS COMPLIES WITH THE M1Nl STANDARDS,AS SET FORTH BY THE STATE OF FLORIDA BOARD OF SIONAL S S AND MAPPER IN CHAPTER 5.I-17.051,FLORIDA Prgmrty Address: ADMINISTRATIVECo UANT TO SE 472027,FLORIDA STATUTES. 123 NE 97 ST RSIF 1 ` e MIAMI SHORES, FL 33138 No. 5101 ®® STATE 0 �4 l®O ■eLand �l^ FCORI O.P. QQ SIGNED `�'S. � FOR THE FIRM MIGUEL ESPWO sup P.S.M.No.5101 SURVEYORS,INC. STATE OF FLORIDA 15271 NW 60 AVE,Suite 206 NOT VALID WITHOUT AN AUTHENTIC ELECTRONIC SIGNATURE AND AUTHENTICATED Miami Lakes,FL 33014 ELECTRONIC SEAL AND/OR THIS MAP IS NOT VALID WITHOUT THE SIGNATURE AND ORIGINAL RAISED SEAL OF A LICENSE SURVEYOR AND MAPPER. wwwr.OnfineLandSurveyors.Com Survey Date:8/16/2016 Survey Code:0-28105 Page 1 of 2 Not valid without all pages.