DS-19-474Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Permit NO.: DS-03-19-474
Permit Type: Driveways/Sidewalks/Slabs
Work Classification: Addition/Akeration
Permit Status: Approved
Issue Date:05/30/2019 1 Expiration: 11/26/2019
Parcel Number
78 NW 99TH ST, Miami Shores, FL 33150 1131010330070
Contacts
OSVALDO GOMEZ Owner
78 NW 99 ST, MIAMI SHORES, FL 33150
Home: 7862620901 OZZI E 1633 @COMCAST. N ET
HOME OWNER Contractor
HOME OWNER
Description: REMOVE AND REPLACE CONCRETE STRIPS.
REMOVE WALKWAY, REPLACE 15 FT OF CRACKED SIDEWALKS,
INSTALL TRAVERTINE DRIVEWAY AND WALKWAY ON WEST
SIDE OF HOME, INSTALL MATCHING TRAVERTINE PORCH
FLOOR
TRAVERTINE 6X12 X 3CM COUNTRY CLASSIC
Fees
Amount
Application Fee - Other
$50.00
CCF
$1.80
Concrete/asphalt/pavers, slabs, dways,
$100.00
swalks
DBPR Fee
$2.25
DCA Fee
$2.00
Education Surcharge
$0.60
Planning and Zoning Review Fee
$35.00
Scanning Fee
$9.00
Technology Fee
$3.75
Total
$204.40
Valuation: $ 2,300.00 Inspection Requests:
305-762-4949
Total Sq Feet: 1,200.00
Payments
Date Paid Amt Paid
Total Fees
$204.40
Credit Card
05/30/2019 $204.40
Amount Due:
$0.00
Building Department Copy
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 anhis
'ict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores
Village. In acceptinrmit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate
permits are requiredCTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFF I . I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating con r n and zoning. Futhermore, I authorize the above named contractor to do the work stated.
Authorized
/ Applicant / Contractor / Agent
Date
May 30, 2019 Page 2 of 2
Miami Shores Village
C EIVED
Building Department
MVRO2019
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
BY:
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20 i-7
BUILDING
Master Permit No._I"�__
- I Q
PERMIT APPLICATION
Sub Permit No.
%fBUILDING ❑ ELECTRIC
❑ ROOFING ❑ REVISION ❑ EXTENSION
❑ RENEWAL
❑PLUMBING ❑ MECHANICAL
❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION
❑ SHOP
CONTRACTOR
DRAWINGS
"�
/ JOB ADDRESS: 8 N W
q q J`T� FC�
City: Miami Shores
County: Miami Dade Zip:
3 / 570
Folio/Parcel#: / / /b / D 33 OCR �10 Is the Building Historically Designated: Yes
NO
Occupancy Type: Load:
Construction Type: Flood Zone: BFE:
FFE:
OWNER: Name (Fee Simple Titleholder):
/�
�S VA- L AO I2 ` G-9 'V_LZ Phone#: � ' - 2- dqo/
Address: ill uj
City: l fi yl 1 I 1.4 o 2 S
State: r C- Zip:
3
Tenant/Lessee Name:
Phone#:
Email: OlL2 /f✓ !(0 33 @ GO�N&+67", NE!
CONTRACTOR: Company Name:
�y111tQ �W1��Y Phone#:
Address:
City:
State: Zip:
Qualifier Name:
Phone#:
State Certification or Registration #:
Certificate of Competency #:
DESIGNER: Architect/Engineer:
Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 2 3 w Square/Linear Footage of Work: / _-� b 0 S F
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: Otm0yE A+ak-ING, 00AJC:+e6-�i_S7-RIi�S, QENL)Ve wALKio/-V
/3 AID w A-L IC G a!i n Al WE;S T 5 / O F 1 f'm Ei ZNSyra LL /►il A 7-GN /NCj T�� Specify color color of color thru tile: TP AV��'r/A1,9 (a X I Z Y- 3 0IM eoyN+ tt1 C L-A-ss/c.
Submittal Fee $ Permit Fee $ CCF $_ _ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $.
Structural Reviews $
Training/Education Fee $
Double Fee $
Bond $ -160
TOTAL FEE NOW DUE $
(Revised02/24/2014)
701.40
P1712-►Ud 0-002
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 oc fur seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved nd a einspection fee will be charged.
Signature
WNER or T
The foregoing instrument was qcknowledged before me this
TA
S d y of QYC 20 l -1 . by
S who is personally known to
me or who has produc Y,V�V lkgrff `fas
identificati n an who id take an ath.
NOTARY P BLIC:
Print:
Seal:
P ' •. \-J YmADY PRIETO
MY COMMISSION # FF 214031
EXPIRES: March 25. 2019
APPROVED BY
(Revised02/24/2014)
9
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of , 20 , by
who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:_
Print:
Seal:
as
Plans Examiner 7 Zoning
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: AVA-(,-6 0 (_-T70-DATE:
ADDRESS: 7 !� A) "E T2'&7_-T 11 1A 1111n I S fy�u5, F-1- 3315-0
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 ortwo-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 safe 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 m own contractor with certain
restrictions even though i do not have alicense.
Initial
2. 1 understand that building permits are not required to be signed by a property owner unless he or she is r sponsibie 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 c tracts.
Initial
4. 1 understand that 1 may build or improve a one family or two-family residence or a farm outbuilding. I ma 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 i Id or leased within 1 year after the
construction is complete, the law will presume that I built or substantially improved it for sale or leas h ch 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 king 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 co my or municipal ordinance.
Initial
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. 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 a ware of the limits of my insurance
coverage for injuries to workers on my property. A
Initial vl�
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 n erstand that my failure to follow
these may subject to serious financial risk.
Initial
(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 cont t the Florida Construction Industry
Licensing Board at 850.487,1395 or http://www.myfloridalicense.com/dbprlpro/cilb/index.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:
$ NGU S rk4E�
Initial
12. 1 agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of tTt
ation 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 b�day of Are
zo 1
By
1 1QA Corr)tz_
who was personally known to me or who has
1
I
Produced them is nse or r� v�Q r �1(`-e�as identification.
ER
NOTARY
YpNADY PRIET� ��t
COMMISSION it F1
EXPIRES;Mz►� j4
SKETCH OF SURVEY sc LE r - 2o,
' �// �J
LEGEND
NORTH ''
—OAd
-CENTER LINE
Aa% ft WPP - WOOD POWER POLE
d
�D , PLANTER PLANTER'l
9,95 12.4'0
�\ 31.2' 21,45'
oo j
�� —a N / ONE STORY i
A � 10
U � /�� RES. No.: 78' /ic`n•, a2j
Eu " 'n' a /9.2
`r' W m LYa 3. 3' , 17. 3' I x— 21.5 5' x `,
p A/C G ( 0.8'CL N ..�,
Nf<-13.7' I cx1sTINU toIs 9
. •..• . • _
•..�.i •
• • • • I . ih PAVERS j x 0.7'ENC
• I :00 SLAB E x
OVED:::4**lERHEAD WE T X2 CHAIN
AMI. c� CAMTY H[h1•ffi'UEPARTPi1Ca'M?TY LINE 20.0� OF L T 10 I LINK
RMI *;• I P•- k'4(Z0G-q--e... :00:00• A~ LOT 11, LO K 128' FENCE
I
1 �. ..:... Q$ 0. BLOCK 128 j
• .... FWNQ A"o 3.0'
.:.... .... IRQN PIPE I i TENT ON I �� r' 1.0'ENC
• sees
• • •' 0.4'CL CONC. TILES j C �(1x�x x-x-
------. TILES — 1.5'CL
: fig WPP J 75. O'(R&Meas) J WPP
in
6lOZ 4 t 8 d `� � ALLEY CLNIK o FOUND -a"0
FENCE IRON PIPE
-------------------- ------------------
ClaAllaDaZl
2022 W. Atlantic Blvd.
Pompano Beach, Florida 33069
Tel: 954-977-4876 Fax:954-977-4849
HUROK MARBLE LLC
TUMBLED TRAVERTINE 3cm PAVER
IVORY - NOCE - WALNUT - GOLD - SCABOSS - SILVER - PHILADELPHIA - LEONARDO - DAVINCI - TOSCANA -
ANTIQUE BLEND - PEACH BLEND - COUNTRY CLASSIC - ROMA CLASSIC - SUPER WHITE
Compressive Strength to ASTM-C 170
Item # Load - Lbs Stress - Lbs/In2
WET 1 2400 2,713
TRANSVERSE 2 4000 4,711
3 3000 3,263
4 2800 3,535
5 2400 2,437
Stress Average 3,332
Item # Load - Lbs Stress- Lbs/In2
WET LONG .... 6 3400 3,644
���••� •• ;7.••. 2000 2,402
......
• � � • • � � 1600 2,045
9:..: 4300 4,839
•••••• •••• 1e696• 5000 6,453
..... ... . ......
• •„4tress Average 3,877
. . .... ....
Item.-..Loid - Lbs Stress - Lbs/In2
...... .. .. ..
DitY : ' 11 .. 4500 5,183
•TRAMSVERSf•••„ 12 6000 6,524
•••• 13 6700 7,116
14 4500 4,722
15 4400 5,145
Stress Average 5,738
Item # Load - Lbs
Stress- Lbs/In2
DRY LONG 16
4900
5,937
17
3700
4,170
18
4500
4,835
19
3800
4,252
20
7500
7,816
Stress Average 5,402
Water Absorption & Density to ASTM-C 97
Water Absorption, % 2.979
Bulk Density 2.37
Freeze & Thaw to ASTM-C 666
Notes No cracks or deformation noted.
Results PASS
Dynamic Co -Efficient of Friction Analysis
Results per ANSI A137.1
**Dry Result 0.67
**Wet Result 0.68
Avg.
Min.
Max.
Dry
1
0.59
0.50
0.70
Dry
2
0.64
0.56
0.72
Dry
3
0.72
0.66
0.83
Dry
4
0.74
0.63
0.82
Wet
1
0.65
0.59
0.70
Wet
2
0.72
0.69
0.74
Wet
3
0.70
0.58
0.76
Wet
4
0.65
0.59
0.76
Spec: 42 minimum average
Acceptable per ANSI A137.1
ATSS/TS/Admin REV.5/11/2017
Ron DeSantis
Mlsdon: I (4) Governor
To protect, promote & improve the health
of all people in Florida through integrated o-ria
state, county & community efforts. HEALTH
Vhbon : To be the Healthiest State in the Nation
May 07, 2019
(Owner)
78 NW 99 Street
Miami, FL 33150
RE: Contingency Letter
Application Document No:AP1410369
Centrax Permit Number: 13-SC-1943553
OSTDS Number:
78 NW 99 St
Miami, FL 33150
Lot:
Block:
Subdivision:
Dear Applicant:
This will acknowledge receipt of an application dated 04/23/2019 for a permit to use an existing
onsite sewage treatment and disposal system located on the above referenced property.
Review on 5/07/2019 by Gerard Philizaire.
NO OBJECTION letter issued for 2 single driveway installation. No impact over the existing septic
system.
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 Phil' afire, Environmental Manager
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