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DS-15-719Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 Parcel Number Annlicant 9520 BISCAYNE Boulevard 1132060142870 Miami Shores, FL 33138- Block: Lot: JASON & GRETHEL FEVIG Owner Information Address Phone Cell JASON & GRETHEL FEVIG 9520 BISCAYNE Boulevard MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone HOME OWNER In Review Approved:: In Review Denied: of Work: REMOVE ASPHALT OF EXISTING DRIVEV\ Additional Info: Retum : Classification: Residential ning: 3 Fees Due Amount Bond Type - Owners Bond $500.00 CCF $1.80 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.60 Notary Fee $5.00 Permit Fee $125.00 Scanning Fee $9.00 Technology Fee $2.40 Total: $647.80 Valuation: $ 2,500.00 Total Sq Feet: 823 Pay Date Pay Type Amt Paid Amt Due Invoice # DS -3-15-54989 04/13/2015 Credit Card $ 597.80 $ 50.00 03/30/2015 Credit Card $ 50.00 $ 0.00 Bond #: 2669 AvauaDie Inspection Type: Final Foundation 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 info ation is accurat and that all work will be done in compliance with all applicable laws regulating construction and zoning. Fuths ore, I the abov named corit. to doe work stated. ,--y April 13, 2015 Authorized Signature: er / Applicant / Contract / Agent Date Building Department Copy April 13, 2015 1 Miami Shores e Villa g -� 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 MAR 3 0 2015 Master Permit No. F) S �'5 — 119 Sub Permit No. ❑ REVISION ❑ EXTENSION ❑ RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: City: Miami Shores ' County: 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): _:1,5o n 4 GrLj, T `d") �) Phone#: Address: 95-7-0 8 iS !E�_v City: i r'\ 4. o o°YZ S State: l_ V , c,� Zip: Tenant/Lessee�N�am�ej: iQ 1+ Phone#: N%/, "�� Email: M -L-L 1 2 q3 zo �' 1 9 Csa ✓Yl CONTRACTOR: Company Name: CDC . ),�'�m Phone#: Address: City: State: Qualifier Name: Phone#: State Certification or Registration #: DESIGNER: Architect/Engineer: Certificate of Competency #: one#: Address: City: State: Zip: Value of Work for this Permit: $ Z C) Square/Linear Footage of Work: j=1. Type of Work: ❑ Addition ❑ Alteration ❑ New [�epair/Replace ❑ Demolition Description of Work: (2 P 'y10V1e C 5b 6"R f X 1 S%1 �� ��� (�J��O i'n s �G• �_� ' D �'� rS Specify color of co/or'thru tile: Submittal Fee $ Scanning Fee $ Permit Fee $"M CCF $ CO/CC $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ (Revised02/24/2014) DBPR $ Notary $ Double Feemm($ Bond $ TOTAL FEE NOW DUE $ sq-� - 80 Bonding Company's Name (if applicable) Bonding Company's Address City State Zip j Mortgage Lender's Name (if applicable) K( //4 Mortgage Mortgage Lender's Address (A / City State Zip F 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 OWNER or AGENT The foregoing instrument was acknowledged before me this — day of MW32 , 20 Z 4—J by ?4f? who is personally known to me or who has produced_ identification and who did take an oath. NOT, 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: as Print: Print: �d oe, c lary Pubic Seal:®`� '�P na M Feliciano ommission cFOg2753 Seal:, , F 4`P 0 111 212018 ff ./ APPROVED BY (� Plans Examiner JI Zoning Structural Review Clerk (Revised02/24/2014) NAME: ADDRESS: 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 DATE: 6 ' ZA - I S Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, RS 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 Has 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. 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. 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 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_ r 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 G+� 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. C-74--- Initial- 9. -74---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.myfloddalicense.comidbpr/pro/Cilbrindex.html Initial(27 -r- 11. I 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: 615 ZO �isC�ynSL l �- �/1 -3 %3 ` 3 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. C Initial�-y'— 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 day of /P&MAI , 20 B�i' e.1O2L Fe vi who was personally known to me or who has t FC: 1 -F -Alk TITI-1: GROU "!C' now fffi fRF& r6 mua �. I 4 rw..��Q � NH � AE Malars t We need to take every► opportunity i'ssible to thank our , _ amazing clients NE QN5P e, ,, 4 fog-theirsupport... �BAEp YI' �r Than k YM u l l l tli�+eN rSM�.f�.E'AIYA4Se.� , SC -0 , vA- \^j 04< A419% t4- ;,j�tt f 2vm iD V #—,A . ®� frnv-PX5 w n 0. Z '� S 10' ASPHALT ALLEY ` CLD rx k� Sra ✓1 C 1i a 50.00 F M © \ar 44'� 4-0 ® �Gx✓�5 l i �4_ • ASPHALT . ���77� ONVEWAY CL) C\. C;.�� 27' 10.00' 21.$0 ON PL s.o P U 11.10 LUJ 20 m 4 3� 'n $ air` aC 2y C. J o `J I ONE STORY w m o RESIDENCE C7 #8520 ' %-U M M ` .0'� me 1 10.001 r210r F.LP.1/2" R BLOCK CORNER F.i P.1/a 1 ' IiB F.M 112" !i5 w.�.,r��� 'In�ae�ari': 75.0 PAI. •'`r.i'.�pxc.'.0 b.n S v r v� y .: : 8' PARKWA I2' r_r IUM"r MMAV eun fafrrro _ R By: Address: 9520 BISCAYNE BOULEVARD MIAMI SHORES, FL 33138 Survey:A-37914 M THE FIRM P.S K Ab. Not Client File #. FEV1030513 NOTES: NO NOTES M.E. Land Service, Inc. 10665 SW 190TH STREET SUITE 3110 MIAMI, FL 33157 PHONE: (305) 740-3319 FAX (305) 669-3190 -- -;Z__- LB#:6463 Page 1 of 3 Not valid without all pages. 61 Surveyors Legend PROPERTY UNE STRUCTURE FIND FDUND IRON PIPE / R.R. BEARING REFERENCE TEL TELEPHONE FACILITIES CONO. BLOCK WALL PIN AS NOTED ON PIAT A CENTRAL ANGLE OR DELTA U.P. UTILITY POLE —X—X— CHAIN-LINK FENCE OR WIRE FENCE Le# LICENSE # - BUSINESS R IWONS OR RADIAL B.U.& ELECTRIC UTILITY BOX --1/—/� Wow FENCE LS# LICENSE # - SURVEYOR RAO. RADIAL TD: SEP. SEPTIC TANK —a ---o-- IRON FENCE CALL CALCULATED POINT N.R. NON RADIAL D.F. GRAINFIELD ---- EASEMENT SET SET Pip 7YP. TYPICAL A/C AIR CONDITIONER — - — CENTER UNE ♦ CONTROL POINT I.R. IRON R00 $/W SIDEWALK ® WOOD DECK Ill CONCRETE MONUMENT I.P. IRON PIPE DWY DRIVEWAY ljo BENCHMARK N&D NAIL & DISK SCR. SCREEN O CONCRETE aw ELEVATION PK NAIL PARKER-1(ALON NAIL GAR GARAGE ®ASPHALT P.T. POINT OF TANGENCY D.H. DRILL HOLE ENOL ENCLOSURE P.C. POINT OF CURVATURE ® WELL N.T.S. NOT to SCALE SR= / TILE P.R.M. PERMANENT REFERENCE MONUMENT ® FIRE HYDRANT F.F. FINFffiNED FLOOR WATER P.C.C. POINT OF COMPOUND CURVATURE ® Y.H. MANHOLE T.O.B. TOP OF BANK P.R.C. POINT OF REVERSE CURVATURE O.H.L OVERHEAD LINES E.O.W. EDGE OF WATER APPROXIMATE EDGE OF WATER P.O.R. POINT OF BEGINNING TX TRANSFORMER E.O.P EDGE OF PAVEMENT ® COVERED AREA P.O.C. POINT OF COMMENCEMENT CATV CABLE TV RISER cv.G. CONCRETE VALLEY CUTTER P.C.P. PERMANENT CONTROL POINT W.Y. WATER METER S.S.L BUILDING SETBACX LINE Q TREE Y FIELD MEASURED P/E POOL EQUIPMENT S.T.L. SURVEY TIE LINE POWER POLE P PLATTED MEASUREMENT CONC. CONCRETE SLAB CENTER LINE ® CATCH BASIN D DEED ESMT EASEMENT R/w RKNNT-OF-WAY C.U.E. COUNTY UTILITY EASEMENT C CALCULATED D.E. DRAINAGE EASEMENTP.U.E. PUGLTC UTILITY EASEMENT I.E./E.E. INGRESS / EGRESS EASEMENT LM.E. LAKE OR LANDSCAPE MAINT. ESMT. L&E. LANDSCAPE BUFFER EASEMENT C.M.E. CANAL MAINTENANCE EASEMENT U.E. UTILITY EASEMENT R.O.E. ROOF OVERHANG EASEMENT I.A.E. LIMITED ACCESS EASEMENTA.E. ANCHOR EASEMENT Property Address: General Notes: 1. The Legal Description used to perform this survey was supplied by others. 9520 BISCAYNE BOULEVARD LEE T� survey does not determine or is not to Imply ownership. 2. This survey only shows above ground improvements. Underground utilities, MIAMI SHORES, FL footings, or encroachments are riot located on this survey map. 3. if there is a septic tank, well, or drain field on this survey, the location of such iters was shown to us by others and the Information was not verb. ns Information: 4. Examination of the abstract of M will have to be made to detemdee recorder Instruments, If any. ~ this property. The lands SM— herein were riot Community Number 120652 abstracted for easement or other recorded encumbrances not shown on the plat. 5. wail ties are done to the face of the wall. Panel Number. 12086CO306L B. Fence ownership Is not doWnYdned. Suffix: L 7. BeedW referenced to One noted B.R. a. Dimensions shown are plated and measured unless otherwise shown. Date of Firm Index: 9/11)2009 9. No Identification found on property comers unless Toted. Flood Zone: X 10. Not valid unless sealed with the signing surveyors embossedseal. 11. Boundary survey means a drawing and/or graphlorepresentation of the Base Flood Elevation: WA survey work performed M the field, could be drawn at a shown scale and/or not to scale. Date of Field Work 3/20/2013 72. Elevations K shown ere based upon NOYD 1828 unless otherwise noted. Date of Completion: 3121/2013 13. This is a BOUNDARY SURVEY unless otiorww noted. 14. This survey is exclusive for the use of the potties to whom it S cerdfled. The certifications do not extend to any unnamed parties. 15. This survey shall not be used for constructlon/permli ng purposes wit out witien consent from Miguel Espinosa. Legal Description: Please see the last page for long Legal Description. PRINTING INSTRUCTIONS: While viewing the survey In any Acrobat Reader, select the File Drop-down and select *Print' Select a color printer, If available, or at least one with 8.5' x 14' paper. Select ALL for Print Range, and the # of copies you would like to print out Under the "Page Scaling' please make sure you have selected 'None.' Do not check the 'AutoRotate and Center' button. Check the 'Choose Paper size by PDF'checkbox. Click OK to Print CHICAGO TITLE INSURANCE COMPANY; PROSPECT TGAGE LLC; . Its'successors and/or assigns as their interest may easements interests or dabns vkkh nmyeAW by mww of, orretkKded by, Me ors crown on O>e YpFapruedby a QQTL r sEvntosA coed LI—8 Jab # A,=14 M.E. Land Services, Inc. 10665 SW 190TH Street, Suite 3110 MIAMI, FL 33157 PHONE:(305) 740-3319 FAX #:(305) 669-3190 LB # 6463 WMAELANQSERVICES.COM Client File* FEV1030513 Page 2 of 3 Not valid without all pages. Legal Description: A PARCEL CONTAINED IN BLOCK 75, MIAMI SHORES SECTION THREE, ACCORDING TO THE PLAT THEREOF, AS RECORDED IN PLAT BOOK 10, PAGE 37, HAVING A FRONTAGE OF 75 FEET ALONG THE WESTERLY SIDE OF BISCAYNE BOULEVARD AND MORE FULLY DESCRIBED AS FOLLOWS: COMMENCE AT A POINT OF BISCAYNE BOULEVARD AT THE TERMINUS OF THE LINE SEPARATING LOT 2 AND LOT 3, AS AND FOR A POINT OF BEGINNING, THENCE PROCEED IN A SOUTHWESTERLY DIRECTION ALONG THE WESTERLY BORDER LINE OF SAID BISCAYNE BOULEVARD 75 FEET TO A POINT LYING AT THE MID -POINT OF THE BORDER OF LOT 3A AND BISCAYNE BOULEVARD; THENCE PROCEED AT AN ANGLE ALONG A STRAIGHT LINE IN A NORTHWESTERLY DIRECTION TO THE NORTHWESTERLY TERMINUS OF THE LINE SEPARATING SAID LOTS 3 AND 3A; THENCE PROCEED NORTHEASTERLY ALONG THE BORDER OF SAID LOT 3, A DISTANCE OF 50 FEET TO THE NORTHEASTERLY TERMINUS OF THE LINE SEPARATING LOTS 2 AND 3; THENCE PROCEED SOUTHEASTERLY TO THE POINT OF BEGINNING. viewing the survey In any Acrobat Reader, select the File sown and select"Print' a color printer, if available, or at least one with 8.5° x 14° lect ALL for Print Range, and the # of copies you would like print out ider the 'Page Scaling' please make sure you have selected not check the °AutoRotate and Center' button. ick the 'Choose Paper size by PDF°checkbox. :k OK to Print. M.E. Land Services, Inc. 10665 SW 190TH STREET SUITE 3110 MIAMI, FL 33157 PHONE: (305) 740-3319 FAX: (305) 869-3190 LBl#: 6463 ;m Survey:A-37914 Client File #. FEV1030513 Page 3 of 3 Not valid without all pages.