REV-16-626 Miami Shores Village CEEB
Building Department Ma.: 09 ?ops
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 $Y:
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20
BUILDING Master Permit NO. 0 1 23S
PERMIT APPLICATION Sub Permit No. Cyl�iyL�
'BUILDING ❑.ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
q CONTRACTOR DRAWINGS -,
JOB ADDRESS: 10'. 5
City:' Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO i
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FF E:
OWNER: Name(Fee Simple Titleholder):_ V-Z Phone#: 1305_546- 80&3
Address: 10 5S uy; 9 Sr
City: )I/A1'(l SHD2dS State: ��- iip: 33i38,
Tenant/Lessee Name: 2 -� Phone#:
Email: t?4_rr2jC.c? Qg3,�er(2 ho-TP41
CONTRACTOR:Company Name: N/'� Phone#:
Address:
1
City: _ State: Zip:
Qualifier Name: Phone#:
f •
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: + Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ sem Square/Linear Footage of Work:
Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: _1 X�A!_l.y G!O$6 DAF W Iil,l�S (KU it1 1.JAC L
Ald i"t A ca W i k)AoLas T
ev
Specify color of color thru tile: !\
Submittal Fee$ Permit Fee$ ( dam . CCF$Q • G' `° "'CO/CC$
Scanning Fee$ 01
`C�j Radon Fee$ a CQ DBPR$ a Notary$ ,—::; .00
G �J
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Ids - W Bond$
TOTAL FEE NOW DUE$ p3 '1 - GO
(Revised02/24/2014)
Bonding Company's Name(if applicable)
Bonding Company's Address 1
City - z-
�� State Zip "
Mortgage Lender's Name(if applicable)
Mortgage Lender's Address
City d 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. 0
"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.
R
Signature —� Signature
—OWNEWAGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of (��AdLI 20 (� " , by day of 20 by
:(�r (\jT Wois personally known to who is personally known to
me'or who has produced R- X--,fZt\?CJ2 UC.)t-0<71�-.:as me or who has produced { as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLI NOTARY PUBLIC:
Sign: ` Sign:
Print: (V�il� �W�Z' Print: A
Se
L%y(ille State of Florida Seal:
�O156750
�
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
4
5h°RFs Miami Shores Village
Building Department
10050 N.E.2nd Avenue
� 0 Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
OWNER BUILDER DISCLOSURE-_
IS�CLLOOSURE STATEMENT
Q Q�
t NAME: ?A1 2- C 3 ICU 1: ( DATE: �S' I - OC(J L�
ADDRESS: 105_5� M3 '3i z�-r, TIM)
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--�� _
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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
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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 c ntracts.
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,w i lates the exemption.
--,..:_.,.µ_.....,,_.. . ...._.Initial
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.5. 1 understand that,as the owner-builder,I must provide direct,onsite supervision of the construction.
Initial—�
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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 my 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. 1 understand that I may not rdelegate 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.('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 htta://www.mvfloridalicense.com/dbpr/oro/cilb/index.html
Initial
E
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:
1 o s`'S 1J d �iS ST- �lA4f� 51� irk-333 g
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
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 issuinghhe 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.
J .
Was acknowledged before me this day of YAQ01 , 20
a
By�A-�IQLly—la,_7 tq&t?�VT 'k)?J ho was personally known to me or who has
Produced there License or as identification.
?�,Pr oue, Notary Public State of Florid
O 4dR NOTARY MyCommissio?FF 156750
v OF F`OQ• Expires 09/03/2018
tat`-.
- 1
Miami Shores Village
APPROVED BY DATE
ZONING DEPT
BLDG DEPT 'Ll 3841 fes
_ AA26001388
• 1 3, FC r TO CC)MPLIAN ,E WITH AI_I_F_Dr i L ARa171ICTOR .BRUCE
AR-0017103
#5 DWLS. �31A1L AND COUNTY RULES AND RI-GIAAI IONS 370N.E.101stShet
® 24" O.C.
Miami Mores,Nodda
EXIST. BLOCK WALL NEW BLOCK WALL 33138
tel:305-310.5030
fax 1.877.106.8280
® ematl:
vbruee@ai•assocktes.net
RETROFIT FILL L FILLED '
CELL CELL
2 FILLED CELL .
.... ... .....
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SCALE: 3/4' = 1'
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09 2016 '
CLOSET A/C
SEE DETAIL
" GYP. BD. OVER _ I.
10 PT WD. STRIPS NEW 8" CONCRETE
® 16" O.C. & R-5.0 BLOCK WALL
WALL INSULATION
OFFICE FILLED CELL
W/ 1 #5 o.r
Robinet-Gagnon
NEW WINDOW, SEE Wldence
atl alteration
WINDOW VENDOR 10.55 NE 96th Sheol
INFORMATION Wad Slates,rlal0o 33138
0310-robinet•gagnon
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Floor plan &
detail
FLOOR PLAN _
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associates
AA26001388
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VICTOR I BRUCE
AR-0017103
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370 N1 101d Street
Miami Shores,Rorida
33138
tet 305410.5030
fmc 1477408-M
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EXISTING CONC. •'•••• •
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INSIDE FILLED CELL,
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#5 INSIDE FULLY GROUTED
CELL, BOTH JAMBS
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#8 LADDER-TYPE HOR. REINF.
EVERY SECOND BLOCK COURSE.
m EXTEND 4" INTO CONC. FILLED CELL
EXISTING RAISED `
WOOD FLOOR I I DRILL J" DIA.x6" INTO
EXIST. FTG. & TIE-BEAM J
& SET 3'-0" DOWELS IN
EPDXY GROUT, TYP. 5
GRADE
III— E(ISTING MASONRY
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EXISTING CONC.
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Wall section
WALL SECTION
SCALE: 3/4' = 1'-0' NOR WINW.
A-2
1. GENERAL 3. STEEL 4. CONCRETE MASONRY
A. ALL MATERIALS AND A. REINFORCING STEEL SHALL BE A. ALL CONCRETE MASONRY
CONSTRUCTION SHALL COMPLY DETAILED & PLACED IN WALLS ARE DESIGNED AS LOAD
WITH THE FLORIDA BUILDING ACCORDANCE WITH ACI 318-02. BEARING'WALLS.
CODE 2014, ASCE 7-10 MIN. B. REINFORCING STEEL SHALL BE B. ALL CONCRETE MASONRY associates
DESIGN LOADS FOR BUILDINGS, DEFORMED BARS CONFORMING WALLS (CMU) SHALL CONFORM AAM13M
ACI 318-08 BUILDING CODE, TO ASTM A 615-94 (SI) GRADE TO ASTM C 90, 'STANDARD
AND ALL APPLICABLE FEDERAL, 60 SPECIFICATIONS FOR HOLLOW VICTORIUME
STATE, AND LOCAL ORDINANCES. C. ALL WELDED WIRE FABRIC LOAD BEARING CONCRETE AR-MI7103
B. ,THE CONTRACTOR SHALL SHALL CONFORM TO ASTM A MASONRY UNITS' & ACI 530-08 370 N1 1010SIreet
VERIFY ALL CONDITIONS OF 185-94. C. MORTAR SHALL CONFORM TO NOW Shom,Roddc
EXISTING STRUCTURES AFFECTING D. REINFORCING SHALL BE HELD ASTM C 270, TYPE 'M', WITH A 331M
NEW CONSTRUCTION BEFORE SECURELY IN POSITION WITH MINIMUM AVERAGE STRENGTH OF M305-310•5030
COMMENCING ANY WORK. STANDARD ACCESSORIES DURING 2500 PSI. for 1-877408-M
C. GENERAL CONTRACTOR SHALL PLACING OF CONCRETE. D. CONCRETE MASONRY e"
BE SOLELY RESPONSIBLE FOR E. AL TOP REINFORCING SHALL �"1C°�
ALL EXCAVATION PROCEDURES TERMINATE WITH STANDARD STRENGTH Fm, SHALL BE A
MINIMUM OF 1500 PSI. •••
INCLUDING LAGGING, SHORING, •
HOOKS AT DISCONTINUOUS E. VERTICAL REINFpRCING IN •.;.. ...,..
AND PROTECTION OF ADJANCENT EDGES OR ENDS. CONCRETE MASONR'(., 'E4S • ••
PROPERTY, STRUCTURES, STREET, F. ALL BOTTOM BARS SHALL SHALL BE SPLICED WITH 48 BMR • •
AND UTILITIES IN ACCORDANCE BEAR 6" MINIMUM OVER • •
WITH THE LOCAL BUILDING SUPPORTS. • ••••••
DIAMETER LAP * * PROVIDE' •
DEPARTMENT. •
CLEAN OUT HOLLESESA AT �aSE OF �
G. ALL REINFORCING BARS FILLED CELLS FOR EAP• •••• •�•��•
• •
D. `BACKFILL AROUND THE MARKED CONTINUOUS SHALL BE INSPECTION & VERIti WG•THAT •.... ..,..
EXTERIOR PERIMETER OF WALLS LAPPED 30 DIA. AT SPLICES AND THE CELLS HAVE QFF,tj FILLED • •
SHALL NOT BE PLACED UNTIL CORNERS UNLESS OTHERWISE
AFTER THE WALLS ARE NOTED. LAP CONTINUOUS BARS SOLID WITH GROUT. •F. FILLED CELLS S'I-rALL BI :•���
E
SUPPORTED BY THE COMPLETION AT CENTER BETWEEN SUPPORTS FILLED WITH 3000•1*11• OUT AS • ••
OF INTERIOR FLOOR SYSTEMS. AS REQUIRED. TERMINATE PER ACI 530-08 AND AW :000:
.••• :•
DO NO PROCEED WITH BACKFILL CONTINUOUS BARS AT 530.1-05. FILLING*OF CELLS :
UNTIL A MINIMUM OF (7) DAYS NON—CONTINUOUS ENDS WITH SHALL BE DONE IM.F.&I FOOT • �••••�
AFTER COMPLETION OF INTERIOR STANDARD HOOKS. FLITS WITH A MAXIMUM POUR OFA••�
FLOOR SYSTEM UNLESS WALLS H. MINIMUM CONCRETE COVER 12 FEET. USE MECHANICAL '•
ARE ADEQUATELY BRACED. FOR REINFORCEMENT: VIBRATION TO ACHIEVE GROUT
BACKFILL SHALL NOT BE PLACED i. CONCRETE CAST AGAINST & FILLED SOLID CELLS.
UNTIL AFTER COMPLETION AND PERMANENTLY EXPOSED TO G. GROUT SHALL CONFORM TO
INSPECTION OF WATERPROOFING EARTH = 3" ASTM C476. SLUMP SHALL BE
IF REQUIRED. ii.CONCRETE EXPOSED TO EARTH BETWEEN 8"AND 11".
E. GENERAL CONTRACTOR SHALL OR WEATHER: H. ALL CMU WALLS SHALL BE
BE,RESPONSIBLE FOR THE #6 BARS & LARGER = 2" HORIZONTALLY REINFORCED WITH
DISPOSAL OF ALL ACCUMULATED #5 BARS AND SMALLER = STANDARD NO. 9 LADDER—TYPE
WATER FROM EXCAVATIONS AND 1-1/2" GALVANIZED STEEL REINFORCING
DEWATERING OPERATIONS IN iii. CONCRETE NOT EXPOSED TO EVERY SECOND COURSE. EXTEND
SUCH A WAY AS NOT TO CAUSE T WEATHER OR IN CONTACT WITH REINFORCING A MINIMUM OF 4"
INCONVENIENCE TTHE WORK EARTH: INTO TIE—COLUMNS OR FILLED
AND DAMAGE TO THE SLAB & WALLS = 3 4
STRUCTURAL ELEMENTS. / " CELLS.
F. WIND: ASCE 7-10. V: 175 BEAMS & COLUMNS = 1-1/2" 5• WELDING
MPH, EXPOSURE C. 1:1.0. Kd:1 A. WELDING SHALL BE DONE
ENCLOSED BUILDING, WITH E-70 ELECTRODES.
2. CONCRETE B. WELDERS SHALL BE
A. ALL CONCRETE WORK SHALL AWS—CERTIFIED
CONFORM TO ALL REQUIREMENTS
OF ACI 318-08, 'SPECIFICATIONS s
FOR STRUCTURAL CONCRETE FOR
BUILDINGS'
B. CONCRETE COMPRESSIVE:
STRENGTH AT 28 DAYS SHALL BE
3000 PSI.
C. FORMWORK SHALL COMPLY
WITH ACI 347-86,
'RECOMMENDED PRACTICE FOR
CONCRETE WORK'.
11 sties pmal 003-01-Ip
D. NO WATER SHALL BE ADDED °iog11n D&
TO THE CONCRETE AT THE RobhlMaytwn
JOBSITE. Residence
E. TRANSPORTING, PLACING, WallaReratton
CURING, AND DEPOSITING 1055NE?&hDftt
CONCRETE SHALL COMPLY WITH 'Noni9m Paft319B
ACI 301-96. FM
o3wroeY�e1-paynoo
I Structural
4 notes
STRUCTURAL NOTES
scaLE: NTs
A-3