RC-18-1772Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Pe
mit
Parcel Number
Issue Date:
Permit NO. RC-6-18-1772
Permit Type: Residential Construction
Work Classification: Alteration
Permit Status: APPROVED
612018
Expiration: 01/02/2019
Applicant
426 GRAND CONCOURSE
Miami Shores, FL
1132060170070
Block: Lot:
HERIBERTO CRUZ
Owner Information
Address
Phone
Cell
HERIBERTO CRUZ
1000 NE 96 Street
MIAMI SHORES FL 33138-
1000 NE 96 Street
MIAMI SHORES FL 33138-
Valuation:
Total Sq Feet:
$ 11,000.00
0
Approved: In Review
Comments:
Date Approved:: In Review
Date Denied:
Type of Construction:
Stories:
Front Setback:
Left Setback:
Bedrooms:
Plans Submitted: Yes
Certificate Date:
Bond Return :
Occupancy:
Exterior:
Rear Setback:
Right Setback:
Bathrooms:
Certificate Status:
Additional Info: replace kitchen cabinets and sink r
Classification: Residential
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
P&Z Review Fee
Permit Fee
Scanning Fee
Technology Fee
Amount
$0.00
$0.00
$0.00
$0.00
$0.00
$165.00
$0.00
$0.00
Total: $165.00
Pay Date Pay Type
Invoice # RC-6-18-68074
06/28/2018 Credit Card
07/06/2018 Credit Card
Amt Paid Amt Due
$ 50.00 $ 115.00
$ 115.00 $ 0.00
Available Inspections:
Inspection Type:
Window Door Attachment
Framing
Insulation
Drywall Screw
Final PE Certification
Window and Door Buck
Fill Cells Columns
Review Building
Review Planning
Review Electrical
Review Plumbing
Review Structural
Review Mechanical
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 resRonsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for .LECTRICUMBING, MECHANICAL, WIND• DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFID
construction an
rtify that all the foregoing i
uthermore, I a thorizjt the
Authorized 1. nature: Owner
accurate and that all work will be done in compliance with all applicable laws regulating
ontractor to do the work
cant / ',ntractor / Ag
July 06, 2018
Date
Building ' epartment Copy
July 06, 2018
1
BUILDING
PERMIT APPLICATION
BUILDING ❑ ELECTRIC
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
❑ ROOFING
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS
JOB ADDRESS:
City:
Miami Shores County:
Folio/Parcel#: l ( 32-0 le o 1 '1 Oo'? a
Master Permit No.
Sub Permit No.
❑ REVISION ❑ EXTENSION ❑ RENEWAL
RECEIVED
JUN 2 8 2018
FB 20�
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
Miami Dade
Is the Building Historically Designated: Yes
Occupancy Type: Load:Construction Type: Flood Zone:
OWNER: Name (Fee Simple Titleholder): TI]E - 6E
Address: 4 -6,S2
Zip: 33 / 3S
NO
BFE: FFE:
Phone#: g' 3
City: M) +94-.wc i S/ ,r+.¢.S State: ( Zip: 3313g
Tenant/Lessee Name: Phone#:
Eddie + V2_bc) 4 get 1. cow
Email:
CONTRACTOR: Company Name:
Phone#: $(... 3$j- as
Address:
City: State: Zip:
Qualifier Name: Phone#:
State Certification or Registration #: Certificate of Competency #:
DESIGNER: Architect/Engineer:
Address:
Value of Work for this Permit: $
it DOD
Type of Work: ❑ Addition ❑ Alteration
Description of Work: n '(2 pi .,ue.
Phone#:
City: State: Zip:
Square/Linear Footage of Work: 3S-2-
0 New ❑ Repair/Replace ❑ Demolition
Specify color of color thru tile:
Submittal Fee $ eCDPPAT Permit Fee $ l�r-.� CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $
(Revised02/24/2014)
Bonding Company's Name (if applicable) ¢ '`
Bonding Company's Address
3a
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 i11 not approved and a reinspection fee will be charged.
Signature
OWNER or AGENT
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
2' `• day of TU _ ; 20 (F) , by day of , 20 by
He_ r't b r j" o CiU `-who is personally known to , who is personally known to
me or who has produced f 1 1 CQ.r-- as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign:
Print:
Seal:
APPROVED BY
@gilded ThN Notary Public Underwriters
Sign:
Print:
Seal:
Plans Examiner
Zoning
(Revised02/24/2014)
Structural Review
Clerk
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: NERt ger:21h e R - — DATE: (P 2qI 8
ADDRESS: `c 26, o 0-0610-PtAC.
Do hereby petition the Village cf 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 foryour own use and occupancy. It may not tie 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 arcontractor. 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.
Initia
2. I understand that building permits are not required to be signed by a property owner unless hems d rl onsible for the construction and
is not hiring a licensed contractor to assume responsibility.
Initial
3. I understand that, as an owner builder, I am the responsible party of record on a permit. I understand aN'may protect myself from potential
financial risk by hiring a licensed contractor and having the permit filed in his or her name inste of 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 a c a ts.
Initi
4..a.l understand that I may build or improve a one family or two-family residence or a farm outbuilding. may also build or improve a commercial
buildingifihe 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 s s sold or leased within 1 year after the
construction is complete, the law will presume that 1 built or substantially improved it for sale or lea h' iolates the exemption.
Initi • ®►��,
5. I understand that, as the owner -builder, I must provide direct, onsite supervision of the constructs
Init
6. I understand that I may not hire an unlicensed person to act as my contractor or to supervise
Is my responsibility to ensure that the persons whom I employ have the license required by law an. �j.r municipal ordinance.
. Ini ial
ing on my building or residence. It
7. I 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.
Initi
8. I understand that I may not delegate the responsibility for supervising work to be a licensed contractor] ho 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_ nderstand that my failure to follow
these may subject to serious financial risk.
Initia
9. I agree that, as the party legally and financially responsible for this proposed Construction activity, I III ab• 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 regulate
.,Initia �i(�
10. I understand that I may obtain more information regarding my obligations as;an employer from the In • rnal 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.myfloridallcense.com/dbpr/pro/cilb/index.html
Initial
11. I am aware of, and consent to; an owner -builder building permit applied for in my name and understan
legally and financially responsible for the proposed construction activity at the following address:
12. I agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any
this disclosure.
m the party
on that I have provided on
Licensed contractors are regulated by laws designed to protect the public. If you contract with a perso 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 /CQ day of _ U - , 20
By t-kT TA per k0 ( ) who was personally known to me or who has
ced th
as identification.
OWNER '/ NOTARY,
� 1
GEOTEC�iNICAL I ENVIRONMENTAL I MATERIALS TESTING I ASBESTOS I ROOP TESTING I INSPECTION SERVICES I DRILLING SERVICES
DATE:
DEC DYNATECH ENGINEERING CORP.
W'W W.DYNATECHENGINEERING.COM
MOISTURE -DENSITY RELATIONS OF SOILS
PROCTOR COMPACTION TEST
March 5, 2018
CLIENT: MR. PAUL MATA
/ 4 7' 13
PROJECT: Proposed 2-Story Addition @
ADDRESS: 1213 Northeast 94th Street, Miami Shores, FL
CONTRACTOR: Mr. Paul Mata
MATERIAL DESCRIPTION: Tan sand w/rock
SAMPLED BY: WD
TESTED BY: WD
TEST RESULTS
Sample Number 1
The following compaction test was conducted in accordance with the Standard Methods for Moisture Density Relations of soil using a
10 lb. Hammer and an 18" drop ASTM D-1557.
% MOISTURE
3.0
4.4
6.3
11.9
DRY DENSITY
120
118
116
Optimum Moisture 8.8 Percent
100% Maximum Dry Density 118.4 lbs./cu.ft. 114
% Passing %" Sieve 83 Percent
112
110
Sampled By: WD
Tested By: WD
Checked By: WN
112.5
114.6
116.8
115.6
As a mutual protection to clients, the public and ourselves, all reports
are submitted as the confidential property of clients, and authorization' a No. 395
for use, publication of statements, conclusions or extracts from or regarding
our reports is reserved pending our written approval. • I/ ;
����tlllftiidAl!
730
STATE OF ; °r
r' ry .,%;
'-.NNAL eve
4 6 8 10 12 14
Respectively submitted,
1SSa1AA
Wissam Naa ani, P.E.
DYNATECH ENGINEERING CORP.
Florida Reg. No. 39584
Certificate of Authorization No.: CA 5491
D
R
Y
D
E
N
S
I
T
Y
GEOTECHNICAL 1 ENVIRONMENTAL. I MATERIALS TESTING I ASBESTOS 1 ROOF TESTING I INSPECTION SERVICES I DRILLING SERVICES
DATE:
-��DEC DYNATECH ENGINEERING CORP.
W W W.DYNATECHENGINEERING.COM
FIELD DENSITY TEST OF COMPACTED SOILS
March 5, 2018
CLIENT: MR. PAUL MATA
PROJECT: Proposed 2-Story Addition a,
ADDRESS: 1213 Northeast 94th Street, Miami Shores, FL
CONTRACTOR: Mr. Paul Mata
Test No. 1 Location: Center of northwest column footing pad
Test No. 2 Location: Center of west column footing pad
Test No. 3 Location: Center of north column footing pad
Test No. 4 Location: Center of east column footing pad
Test No. 5 Location: Center of southeast column footing pad
Description of Material: Tan sand w/rock
TEST NO.
1
2
3
4
5
DEPTH
12"
12"
12"
12"
12"
FIELD DENSITY
116.6
116.9
117.2
116.4
116.0
MOISTURE CONTENT %
7.6
8.2
8.4
7.9
8.0
MAX. DENSITY IN THE FIELD %
98.5
98.7
99.0
98.3
98.0
COMPACTION REQUIREMENTS
% OF MAXIMUM DENSITY
' 98%
98%
98%
98%
98%
100% MAXIMUM DENSITY (LAB)
118.4
118.4
118.4
118.4
118.4
REMARKS: ALL ABOVE TEST RESULTS COMPLY WITH COMPACTION REQUIREMENTS
Tested By: WD
Checked By: WN
•
No. 39584 ��
*A density test determines the degree of compaction of the tested layer of material only. In no wai shall a density test replace a soil bearing capacity determination a
soil boring test must be provided by client, prior to construction to verity 1subsoil'condltions. As a mu LI protection to the clients, the public and ourselves, all reports
are submitted as the confidential property of clients, and authorization3fOr, publ ittlY f3fatement nclusions or extracts from or regarding our reports is reserved
pending on our written approval.
ey
kS810NR�
L
t,",• ,�
Respectfully Submitted,
IAA
Wissam Naamani, P.E.
DYNATECH ENGINEERING CORP.
Florida Reg. No. 39584
Certificate of Authorization No.: CA 5491
GEOTECHIslICAL I ENVIRONMENTAL I MATERIALS TESTING I ASBESTOS 1 ROOF TESTING 1 INSPECTION SERVICES I DRILLING SERVICES
DATE:
_DEC DYNATECH ENGINEERING CORP.
W W W.DYNATECHENGINEERING.COM
FIELD DENSITY TEST OF COMPACTED SOILS
March 5, 2018
CLIENT: MR. PAUL MATA
PROJECT: Proposed 2-Story Addition @
ADDRESS: 1213 Northeast 94th Street, Miarni Shores, FL
CONTRACTOR: Mr. Paul Mata
Test No. 6 Location:
Test No. 7 Location:
Center of southwest column footing pad
Center of northeast column footing pad
Test No. 8 Location: Center of center column footing pad
Test No. Location:
Test No. Location:
Description of Material: Tan sand w/rock
TEST NO.
6
7
8
DEPTH
12"
12"
12"
FIELD DENSITY
117.4'
116.7
117.4
MOISTURE CONTENT %
8,0 ,
7.8
8.3
MAX. DENSITY IN THE FIELD %
99.1
98.6
99.1
COMPACTION REQUIREMENTS
% OF MAXIMUM DENSITY
98%
98%
98%
100% MAXIMUM DENSITY (LAB)
118.4
118.4
118.4
REMARKS: ALL ABOVE TEST RESULTS COMPLY WITH COMPACTION REQUIREMENTS
Tested By: WD
Checked By: WN
, 0 : 11 . 11,,
SAAD 4;»
/ No.39584 %,�d
*A density test determines the degree of compaction of the tested lays if mate FF' op In no wly shall a density test replace a soil bearing capacity determination a
soil boring test must be provided by client, prior to construction to vetfy`§ubsofl i5'rks. Asa tual protection to the clients, the public and ourselves, all reports
are submitted as the confidential property of clients, and authorizatioQ,%tviWation of atatGtfiefit,conclusions or extracts from or regarding our reports is reserved
pending on our written approval. ., OR1O ��'
C?
Respectfully Submitted,
tAA
3
Wissam aamani, P.E.
DYNATECH ENGINEERING CORP.
Florida Reg. No. 39584
Certificate of Authorization No.: CA 5491