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DS-10-1536Inspection Number: INSP - 150497 Permit Number: DS -8 -10 -1536 Scheduled Inspection Date: March 29, 2011 Inspector: Bruhn, Norman Owner: CARMONA, SERGIO Job Address: 9402 NW 2 Court Project: <NONE> Miami Shores, FL 33150- Contractor: HOME OWNER Building Department Comments Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Type: Driveways /Sidewalks /Slabs Inspection Type: Final Work Classification: Addition /Alteration Phone Number (305)751 -9697 Parcel Number 1131010150130 PAVE APPROACH RE4PALCE DRIVEWAY AND ACCESS CONCRETE Passed Failed Correction Needed Re- Inspection Fee March 28, 2011 4.?•72q--, No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments For Inspections please call: (305)762 -4949 Page 2 of 11 1 ° 912 G State Permit Fee $ 0 CCF $ CO/CC $ TraintnglEducation"Fee $ Technology Fee $ Radon $ DPBR $ Bond $ See Reverse side Competency No. Total Fee Now Due $ APPLICATION BULL] ss (where the work is being do Miami Shores Village PARCEL # Historically Des ctor's Company Name tor's Address Submittal Fee $ $ Scanning $ Double Fee $ Structural Review. $ w iami Shores Village wilding Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER.. (305) 762.4949 C Certificate or Registration No. Certificate o 30 5 7671 hitect/Engineer's Name (if applicable) Phone # alue of Work For this Permit $ 4 15 0 Square / Linear Footage Of Work: 350 .6 ° ype of Work: °Additions , [ Alteration New Repair/Replace Q Demolition Describe Work: Fits / PR0Ac R� ? L —Ac D New j Ae e . BUILDT PERIVIT C 20 Permit Typ Owner's Name (Fee Simple Titleholder) Owner's Address '314 o l'\ IA) City AM Tenant/Lessee Name Email G Pizm t.4 Job Addr City FOLIO / Is Buildin Contra Contra City ialifier State ontact Phone Bonding Conipaity"aName- (ifapplicable) • ..••DOOding.CeMpanY"aAddreSalli • NOTARYPUBLIC4,:.• • • ..". • • • • • .• • • MY • 7 •.. Engineer Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip on tall has lication is hereby made to -obtain a perinit to do the work and installations as indicated. I certify that no work or in s ati s commenced, prior to the issuance of a permit and that all work will be petfonned to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit nuist be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and .AIR CO fsIDITIONERS, ETC.... OWNER'S AFFIDAVIT: 1 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, Me 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 P osted notice the inspection will not be approved and a rei spection fee will be charged. Signature .., - , ..... _„t„. Signature .,0 0 er or A:, -rit Contractor , Tile foregoing rumen was aclais)wledged before me this . The foregoing instrument was acknowledged before me this , 20,1U i\ , by e.--/ t..ii,v , i i.,, ,.. 4. - V „ ,,, , 011.) 1.it-it (IN- , day of , 20 , by , A o who is per rfilly known to me or who has produced - ) i L who is personally known to me or who has prcidticeti l As identification and who did take an oath, as identification and who did take an oath. NOTARY PUBLIC* My Commission Expires: 1 ‘s, - - - *******************it********1:** * 4 ****************** ******************b/e******* ************************ 2 APPROVED - BY 7 Plans Examiner Zoning - Clerk checked • 5. I understand that, as the owner- builder, I must provide direct, onsite supervision of the construction. 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: 5&»b C/1/2-M00 DATE: 2/2 2/10i / ADDRESS: ` Uo 211/4)1) L% e M 571 47lr✓S 3,W1 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. 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. I 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. I 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 5L6, 4. I 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. G Initial Initial 6. I 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 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. 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 am aware of the limits of my insurance coverage for injuries to workers on my property. 8. 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. 9. I 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. 10. I 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.mvfloridalicense.com /dbpr /pro /cilbRndex.html Initial 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: 6 )472 AJw c7,M 00g6 ,4 3' 12. I 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 5 7 L 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 Toss 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 contractors workers compensation coverage. Before a building permit can be issued, this disclosure statement must be completed and signed by the property owner and retumed 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 a- day of `�`'�� , 20 41 CPMC IAGI who was personally known to me or who has o/ . Produced there Licen e or L V WNER Initial Initial G Initial 5 C 2 Initial �- STATE OF (FLORIDA) COUNTY OF (DADE) wn SWO' TO AND SUBSCRIBED before me this ure Revised on 5122/2009/ Revised on 6/12/09 SURVEY AFFIDAVIT The undersigned Affiant,11 o CA2MOA does hereby attest that (Property owner) The attached survey, performed by U -) % T E C _ 5 Z'J y1 N4 ► 13G (Name of surveyor's company) For address: ° 402 P c-T Affiant is personally known to me, produced �-- M iami Shores Viiiage Building Department Performed on 2/6. / 200 Z (date of survey) is an accurate representation of the existing conditions and locations of all structures on the property as of this date. The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the property without first providing a survey Tess than seven (7) years old old. The Affiant, as property owner, further agrees to remove or obtain permits for any structures which now may exist on the property which are not permitted or which may violate zoning or building code regulations. The Affiant further understands that the existence of any such structures may affect final inspections as applicable to this or other permits. Further, Affia t say eth . ught day of A 5� 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 5 --- ?6Ao CAi?t4.o4JA. Property Owner Print Name as identification����� O' 11►n,,,, ��� /' / . _ 1 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY Whereas, (owner) eA/OA/WA hereinafter referred to as the owner of the following described property (address): 4 r/ Lk) Z e J ,, MI 6 ijo? r:S _ 33 0 Legal Description Lot Block Subdivision Folio # Requests permission to install (describe work): S7 PLID Cz-ZticRe ' r're 7i Within the public right of way of (address) ( 3 1 /02- NIA.) Z Ajb c M S/t/2t5 33675 IN CONSIDERATION of the approval of this permit by the Village, the owner agrees as follows: 1. To maintain and repair, when necessary, the above - mentioned item(s) installed within the dedicated right of way. If it becomes necessary for Miami Shores Village or Dade County to make repairs or maintain said items within public right of way including restoration of street by reason of the Owner's failure to do so, such expense shall be paid by the Owner or shall constitute a lien against the above described property until paid. 2. The owner does hereby agree to indemnify and hold Miami Shores Village or Dade County harmless from any and all liability, which may rise by virtue of permitting the installation of these items within the public right of way. 3. The Owner does hereby agree to remove or relocate their facilities at their own expense, within 60 days notice by the Village to do so. Failure to comply with this notice will result in the Village causing the item(s) to be removed and a lien being placed on the property and/or assessed against the Owner for all costs incurred in the removal and disposal of the item(s). 4. The undersigned further agrees that these conditions shall be deemed a covenant running with the land and shall remain in full force and effect and be binding on the undersigned, their heirs and assigns, until such time as this obligations has been canceled by an affidavit filed in the Public Records of Dade County, Florida by the Village Manager of Miami Shores Village (or his fully authorized representative). SIGNED, SEALED, EXECUTED AND ACKNOWLEDGE on this SIG 2 ELI /ER n tf�: �?�' nce of: 4 40, 04 it ►� day of &f) , 2014 gnature ) Charlie Crist Govemor Maria Carmona 9402 NW 2 Ct Miami, FL 33150 RE: Contingency Letter Application Document No: AP979175 Centrax Permit Number: 13 -SC- 1279481 OSTDS Number: 9402 NW 2 Ct Miami, FL 33150 Lot: 5 Block: 2 Subdivision: 2. -This project entails : "STAMPED CONCRETE DRIVEWAY " G/P Enclosures cc: Sincerely, Miami -Dade County Health Department 1725 NW 167 St, Opa Locker FL 33056 Phone: (305) 623 -3500 Fax: (305) 623 -3645 Ana M. Viamonte Ros, M.D., M.P.H. State Surgeon General September 23, 2010 1[1 IzoiT,R7 FEB : 2 2011 BY:--- ....... --------- Dear Applicant: This will acknowledge receipt of an application dated 09/20/2010 for a permit to use an existing onsite sewage treatment and disposal system located on the above referenced property. 1. -There is no increase in sewage flow, change in characteristics compromising the integrity or function of the system installation. From a review of your completed application, it has been determined that your existing system is adequate for the proposed use : " APPROVED ". If you have any questions on this matter, please call our office at (305) 623 -3500. r, Engineer Specialist II Y% STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Permit Application Number Scale: Each block represents 10 feet and 1 inch = 40 feet. WWINISHIIIIIIMIIIIESI rraliffiliatt If -1 it • 111111111 111 - � 4(4 raz !"r iTiflr/s;I 11914 i C 4 X 4 W Notes: Site Plan submitted by: %L i — t .1 r i IJVAAk. &'7Z ` g4 Plan Approved s� o Approved Date By County Health Depart ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT DH 4015, 10/96 (Replaces HRS -H Form 4016 which may be used) (Stock Number. 5744-002- 4015 -6) PART II - SITEPLAN i1 Pagi IPA L O 0 r) 0 PLAN OF SURVEY c.3.S. _75.00 + 10_9 2/N.: 1% lc; Vt.\ J P41.1,1'5' 5 v i c 1 't F as • • • '1 15.75' A ■h0 m I jTORYC.&S_ 9402 ,J_V3- Z" ° CT M� or , ) ¶-- 1.331 ad N s' �c 091+. v � 5 TOO 1,0 10 e0 A S N 0 d 0 V SCALE I" �U LID le— Pe. Bae POLe • Sa l PAD c-cwc1 177 . 06*- ,r 7e-4)) A Pero* Ito u x M L DP Q �r IJe (AO w x 2� L / L I 1� tee? o ,,.7z1.v W x z4 L. I c°T eL .s e S Ccu.cze s ZO s i i j? zg i rvt) ¶-l.33160 Tit 41;1-eY Y Ata ET DSID ISZok 114 • • • • • • • • • • • • 0 0 0 • • • • • • Will • • • • • • • • • • • ------ •••••• • -- a rd e MUST BE ON ' JOB AT TIME OF rav,rs‘e'r° E1SPECTION -r ZONING DEPT BLDG DEPT SUBJECT TO COMPLIANCE WITH ALL FEDERAL STATE AND COUNTY RULES AND REGULATIONS JOG :02-7093 j LOCATION SKETCH SCALE ' = % A.t w 2 ' PL in N ( v ! 1 ti) . 3 •75‘ _ � 75 ,v s. ,s �`? i , 1 0 75 9 0 1 s 1 35' . 3 * 7 8 o ZZS.00' ti n 2 C7 0 14" _ LEGAL DESCRIPTION:Lot 5,Block 2,O MANORS,acco i 1, r .. the Plat Book 41,Page 57 of the Public Records of Dade County,F1 "ida. Plat thereof as recorded in •••• GENERAL NOTES • • 1) . IlMM11ERSHIP IS OOtI CT TO OPINION OF TITLE. • • 2).Ex4 ItNATIOMOFTHEABSTRACTOFTITLEWILL HAVE TO BE MADE TO DETERMINE RECORDED HVSTRUMENISS, IF Art, AFFECTING THIS PROPERTY. N/A DATUM. • • 3) (2.22) DENOP>a34148SE ELEVATIONS REFERRED TO 4) :EQCATION AI41.13EIJTIFICATION OF UTILITIES ON AND /OR ADJACENT TO THE PROPERTY WERE NOT • • 'SEC'U'RED AS6dC41•INFORMATION WAS NOT REQUESTED. X 5 TIIg I OPE 'WO 4 & HIN T}IE LIMITS OF FLOO I Z1 E _ . , • . • - -,I • II 41 •, • • • 1 • 1 1 • lI P.._ i 1 I 1 O. N or i erican 1 e ompany, ergio armona an • ' aria aceres armona, W T 1O' ; foal Ban - •r : i .1. ssigns DATE:February 06,2002 ' APPLICAIBLE•ZONINGI, UNIDERGROUND. ZONING AND BUILDING SET BACKS . MUST BE CHECKED BY OWNER. • ••• ii I RCHITgcc it R BUILt I B/FORE DESIGN OR CONSTRUCTION BEGINS ON THIS PROPERTY. CER I' 1 ; : 1 HEREBY CERTIFY: That the attached Plan of Survey of the above described property is true and correct to the best of my knowledge, information and belief, as recently surveyed and platted under my direction, also that there. are not above - ground encroachments other than those shown. This survey meets the minimum technical standards set forth by Florida • Board of Land Surveyors to Chapter 61G17- 6,Florida A i • trative pursuant SURVEYING,INC. Code,Section 472- 027,Florida Statutes.- , ���_ L.B. No. 3333 -����� 147 ALHAMBRA CIRCLE No. 241 LAZARO D. ALONSO CORAL GABLES, FLORIDA ,33134 PROFESSIONAL LAND SURVEYOR Phone` (305) 4411 -9488 TIiIS IS A BOUNDARY SURVEY CERTIFICATE NO. 3590 STATE OF FLORIDA NOT VALID UNLESS SEALED WITH AN EMBOSSED SURVEYOR'S SEAL