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DS-19-2289Location Address Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Permit NO.: DS -09-19-2289 Permit Type: Driveways/Sidewalks/Slabs F—I(IP [Xul-u Work Ctassifcaffo New Permit Status: Approved Usue Date: 10/07/2019 1 Expiration: 04/06/2020 Parcel Number 30 NE 93RD ST, Miami Shores, FL 33138 1132060130200 Contacts Jude Faccidomo Owner HOME OWNER Contractor 30 NE 93 ST, Miami Shores, FL 33138 HOME OWNER Business: 3057257598 Description: PLAIN CONCRETE DRIVEWAY TO REPLACE PERMIT#DS-01-19-128 REPLACED DS -01-19-128 Please take a look at the approved plans. Make sure slab Fees Amount 50% Renewal Fee $25.00 Application Fee - Other $50.00 Total: $75.00 Valuation: $ 5,000.00 Inspection Reuests:rTS--762-4,9491 Total Sq Feet: 10500.00 Payments Date Paid Amt Paid Total Fees $75.00 Check # 1608 10/07/2019 $25.00 Credit Card 09/30/2019 $50.00 Amount Due: $0.00 Building Department Copy In consideration of the issuance to me of thisp , I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the ans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepti this permit I assume respons' ility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are requj d r ELECTRICAL, PLUMBIN ,MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNER I certify that all a foregoing information is accurate and that all work will be done in compliance with all applicable laws regulatin nstruc on and zoning. F ermore, I authorize the above named contractor to do the work stated. Authorized Signafgre: Owner / Applicant / Contractor / Agent October 07, Date Page 2 of 2 Miami Shores Village "T Building Buildin Department g p 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 F --]BUILDING ❑ ELECTRIC ❑ ROOFING Master Permit No Sub Permit No. RECEIVED SE I A-�' ✓ k'r\ FBC 201`4 - ❑ REVISION ❑ EXTENSION [—]RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP /� / CONTRACTOR DRAWINGS JOB ADDRESS: 16 ' `� 9 � j City: Miami Shores County: Miami Dade Zip: ) -j / J (I Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): j 61 t Grn C (� 1 lil I U '�Phone#: 7 Zf 7 V Gj Address: 11 U P( % _I 3 k }, City: I i✓►f) I J h E /J-) State: 1 l.- Zip: 7ty Tenant/Lessee Name: Email: rjJ I) � R CONTRACTOR: Company Name: Address: City: Qualifier Name: W V/ one#: Phone#: Phone#: State Certification or Registration #: Certificate of Competency #: DESIGNER: Architect/Engineer: one#: Zip: Address: City: State: Zip: Value of Work for this Permit: $ art%Linearfootra$e. of work: -41% � � o Type of Work: El Addition El Alteration ^ Ne 0 Ri pair/Replace ❑ Demolition rincrrin4inn n4 \A/nr4• 'Y 1 / 1 i I i 1 I /� , 1 0 ;ad Specify color of color thru tile:� �•, `' S' Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Technology Fee $ Structural Reviews $ (Revised02/24/2014) Radon Fee $ Training/Education Fee $ DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $2 J� Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip 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 i --k - 1. 0 R or AGENT The foregoin instrument was acknowledged before me this J4tl' day o((f�� l�� �' 120 1 1 , , by 1 •'tGICC 'd0 m0 who is personally known to m or who has produced ��- as identific ion nd o take an oath\\`\\`\�N����Y OTARY PUBLI �� AN:: ••••.F� ! �� • • 1 vov v� GH 25, �O�• Sign: Print: V"VIXp *GG2!<T268 Wed %V Seal: //�_/rjl/-GC unde STAiE?F 1%\0 � Signature CONTRACTOR The foregoing instrument was acknowledged before me this day of , 20, by who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: =Sign: Print: Seal: **�************ss:**:********:s* **sass****�**sssss�*******:ssssss*s*s***s**s*ss**ss**ss:*sss****** �� : �� APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Miami Shores Village Building Department OWNER BUILDER DISCLOSURE STATEMENT NAME: _Ci'DATE:) ADDRESS: 30 K) F_ 1� J _S 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 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 s 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 heo s e is r ponsible 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 understa d that I may protect myself from potential financial risk by hiring a licensed contractor and having the permit filed in his or her name instefofyname. I also understand that the contractor is required by law to be licensed in Florida and to list his or license numbers on permicts. Initial 4. 1 understand that I may build or improve a one family or two-family residence or a farm outbuilso build or improve a commercial building if the costs do not exceed $75,000. The building or residence must be for my use or o ay not be built or substantially improved for sale or lease. If a building or residence that I have built or substantially improved myleased within 1 year after the construction is complete, the law will presume that I built or substantially improved it for sale or leolates the exemption. 41� tsiii;rH�r►f>j Initial Ito I Ivri &std'nd that, as the owner -builder, I must provide direct, onsite supervision of the constructio Initial 6' ' "I undersfiA that I may not hire an unlicensed person to act as my contractor or to supervise pers w ing on my building or residence. It R is imy r'dsponsibility to ensure that the persons whom I employ have the license required by law and un or municipal ordinance. ,��h �" 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 ad 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 contra or 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 employ . I u erstand 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, ill 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 regulapernal Initial 10. 1 understand that I may obtain more information regarding my obligations as an employer from thvenue Service, the United States Small Business Administration, and the Florida Department of Revenues. I also understand that I may n the Florida Construction Industry Licensing Board at 850.487.1395 or http://www.mvfloridalicense.com/dbpr/pro/­cilb/index.htmi Initial 11. 1 am aware of, and consent to; an owner -builder building permit applied for in my name and underst nds that I am the party legally and financially res ionsible for the proposed construction activity at the following address: 12. !agree to notify Miami Shores village immediately of any additions, deletions, or changes to any of ff e i r ation that I have provided on this disclosure. 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 tk 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 3O day of 20 By �YA�C� �� mp who was personally known to me or who has Produced there License or a) 1, s identification OTARY Y PRI •���ii ...,, FT0 �i* • cc,H � �i GH 23,?0 .rpF y #GG 261264 0 i 'A • O7, #. :A the ��c� �• Okc Unds pTA� i •...••••F \` STAISID XR . . 0000.. 0000•• • • • • • • L • • 0000• 0000. .••..• 0000.. • 0.000. I i I 14t ,02=.t 131tl3S j 1S 98E6 3N 0E St S3a ANO1S-1 _" —" � -•-- --- -- -- —... � — /._1/121f1S !0 H713iIS � _ _ _. T 'Ino -, / =APIV Ln THOod/fi `n`>d 3NO3 n z Of 0k dIJ SI _/- to � 1 +13 00'SL LSd3 -mamoN. .S'Ol 10 S'( 11J� ,-n1 r►rl d(.i _ s D "'AE' i J11-- I `lJ se - Li S 8E i' t•zE �' 011adro L J3 (S I! J-13 m I( � m c I SE ut ooNO w o i I 100d a SStl�N � � l;>j �'0 J'13 � r 0000 .• . • . • . • • • n•.••. • 0000.• 0000 0000 V •J•rt3wdZn03 I, Mod - i 0000.• , •. as • 0000•t .•••C1 N i w .*Ln C . , O/v - 13 Ql ON\di i SE'EZ r—A N— -M a'M- i S"'D'CS VIII . E� ; V E'LI S JOON 1N13WM Lr) 011tld N -a JN03 a ti u S9'9 N ro '1J 'S380HS IwvtwLJ j 1S 98E6 3N 0E St S3a ANO1S-1 O � D ' H 9'9 e'tE T N Ln THOod/fi 3NO3 111PUBL C WORKS REVIEW. S . -civ .-. L� . - �— Florida Health Miami -Dade C my ol _.� Application No.: 1 L Date: i14 CT TO CO^.1PL ANCE U;' FH FALL FFCERAL v ^ '� - u ,TONs� Scanned by CamScanner Jr Mlsslon: Tn protect, promote & improve the health All people in Florida through integrated state, county & community efforts. ori a HEALTH Vision: To be the Healthiest State in the Nation January 10, 2019 (Maria de Brusos) 1250 NE 204 Terrace Miami, FL 33179 RE: Contingency Letter Application Document No: AP1388714 Centrax Permit Number: 13 -SC -1910385 OSTDS Number: 30 NE 93 St Miami, FL 33138 Lot:8 9 Block:2 Subdivision: Dear Applicant: This will acknowledge receipt of an application dated 12/18/2018 for a permit to use an existing onsite sewage treatment and disposal system located on the above referenced property. Ron DeSantis Governor NO OBJECTION letter issued by Gerard Philizaire for a DRIVE WAY INSTALLATION ONLY. From a review of your completed application, it has been determined that your existing system appears to meet the minimum standards of F.A.C. 64E-6 for the proposed use. It is approved for use with the plans submitted to this office. If this system should fail, causing an unsanitary condition to exist, steps must be taken to bring the system into compliance immediately. Department approval of the system does not guarantee satisfactory performance for any specific period of time. Any change in material facts which served as a basis for issuance of this approval requires the applicant to modify the permit application. Such modification may result in this approval being made null and void. Issuance of this approval does not exempt the applicant from compliance with other Federal, State, or Local Permitting required for development of this property. If you have any questions on this matter, please call our office at (305) 623-3500. Sincerely, Gerard Philizairri, Engineering Specialist II Florida Department of Health www.FloridasHealth.com in DADE COUNTY TWITTER:HealthyFLA 1725 NW 167 St, Opa Locka, FL 33056 FACEBOOK:FLDepartmentofHealth PHONE: (305) 623-3500. FAX: (305) 623-3645 1 YOUTUBE: fldoh 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 an am aware of the limits of my insurance coverage for injuries to workers on my property. (� n In 8. 1 understand that I may not delegate the responsibility for supervising work to be a licensed contc or who is not licenses to perform the work being done. Any person working on my building who is not licensed must work under my di c supervision and must be employed by me, which means that I must comply with laws requiring the withholding of federal income tax an ocial security contributions under the Federal Insurance Contributions Act (FICA) and must provide workers compensation for the employ . I understand that my failure to follow these may subject to serious financial risk. 1-1') Initia 9. 1 agree that, as the party legally and financially responsible for this proposed Construction actin 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 regul 10. 1 understand that I may obtain more information regarding my obligations as an employer from t Small Business Administration, and the Florida Department of Revenues. I also understand that I Licensing Board at 850.487.1395 or http://www.mvfloridalicense.com/dbpr/­pro/cilb/­index.html Initia 11. 1 am aware of, and consent to; an owner -builder building permit applied for in my name and legally and financially responsible for tosed construction activity at the following address: r`13' --i7 12. 1 agree to notify Miami Shores viiiage immediately of any additions, deletions, or changes to any this disclosure. II abide by all applicable laws and *nal Revenue Service, the United States ,ntact the Florida Construction Industry Is that I am the party (1? pf&rjnation that I have provided on Licensed contractors are regulated bylaws 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 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 3Oti) day of S4e � , 20 l ° BAy_ f 6,(C%66t R�Ywho was personally known to me or who has ration. `, �oR/Fr0 �i/''�i •. Gµ25,?�� d fIGG 28120 Pc�o; 40 C i l �•�''% BpndedSec'I CS Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 p ++ OWNER BUILDER DISCLOSURE STATEMENT J NAME: , � 4/ ��,C,l. o •,, DATE: _q/30111 rol o j -- ADDRESS: 3U � 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, marshe wn contractor with certain restrictions even though I do not have a license. Initial2. 1 understand that building permits are not required to be signed by a property owner unless heponsible for the construction and is not hiring a licensed contractor to assume responsibility. Initia 3. 1 understand that, as an owner builder, I am the responsible party of record on a permit. I undenj that I may protect myself from potential financial risk by hiring a licensed contractor and having the permit filed in his or her name inste o my own name. I also understand that the contractor is required bylaw to be licensed in Florida and to list his or license numbers on permits a d cprytracts. 4. 1 understand that I may build or improve a one family or two-family residence or a farm outbuildi* 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 mys f 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 lea is violates the exemption. Initial 5!`�t?I uricJdrstand that, as the owner -builder, I must provide direct, onsite supervision of the constructi ae k` r,4'C� �'' ''• Initial I understand that I may not hire an unlicensed person to act as my contractor or to supervise pers s wor ng on my building or residence. It .is fny responsibility to ensure that the persons whom I employ have the license required by law an y u ty or municipal ordinance. Z. Initial ifr►tis:i