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DS-08-1022Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Project Address 10538 NE 4 Avenue Miami Shores, FL 33138- 1122310130200 Block: Lot JOHN KURACK Owner Information JOHN KURACK Approved: Yes Comments: Date Approved: 6/4/2008: Yes Date Denied: Type of Work: SIDEWALK Bond Retum : Address Fees Due Amount CCF $1.20 Education Surcharge $0.40 Notary Fee $5.00 Permit Fee $100.00 Scanning Fee $6.00 Technology Fee $2.50 Total: $115.10 Building Department Copy Expiration: 12 /06/2008 Parcel Number 10538 NE 4 Avenue MIAMI SHORES FL 33138 -2014 Additional Info: CONCRETE Classification: Residential Valuation: Total Sq Feet: Authorized Signature: Owner / Applicant / Contractor / Agent Phone Total Amt Paid Amt Due J $ o.00 $ o.00 $ 0.00 Payment Type: ,U1 W1 1 8 PAID Applicant Available Inspections: Cell Inspection Type: Sidewalk Foundation Landscaping Final 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 responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. June 09, 2008 Date Monday, June 9, 2008 1 VF6\01krfb BUILDING PERMIT APPLICATION FBC 2004 FOLIO / PARCEL # Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Is Building Historically Designated YES NO 4 �dlf Permit No. OS MOW Job Address (where the work is being done) 4,6 g - /o 44 A/6-°: City Miami Shores Village County Miami -Dade Zip '3 313e Master Permit No. Permit Type (circle): Building / Roofing Owner's Name (Fee Simple Titleholder) 2)h PI kvr L Phone # gas 7 O 96-10 Owner's Address la515T `125 ./t/ c= 4 i - e City #74/m i State /� Zip 31 .3r Tenant/Lessee Name Phone # Contractor's Company Name 0 -/7 —V Phone # Contractor's Address City / State Zip Qualifier Name r"r f �L i' //Z-e-// Phone # 78 a-�� h V� State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ /570 42 Square / Linear Footage Of Work: cl S '.--- 50 e,,._.- Type of Work: ['Addition ❑Alteration !►, ew ❑ Repair/Replace ❑ Demolition Describe Work: rnST -/e C0i7 Cs Agglip .5i' /e /i /e41 Ovid a roack• * * * * * * * * * * * * * * * ** x ***************** **** F �x�x�x�x�x�x�x�x�x*: x�x�x *�x**** * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ b 06e- CCF $ () 40 CO /CC mm Notary $ J• 2 Fee $ 0 •10 Technology Feel $ i )O Scanning $ (Q '00 Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ I Structural Review. $ Total Fee Now Due $ ) MO See Reverse side -* Bonding Company's Name (if applicable) . Bonding Company's Address 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 rei spection fee will be charged. (Revised 07/10/07) Signature ; Signature - N 1 TARY PUBLIC: Sign: Print: My Commission Expires: Own -r or Agent The for�g�oing instrument was a wledgenore me is I The foregoing instrument was acknowledged before me this day of JU� , 20 J0, byl /.. _ , day of , 20 _ , by is personally known to me or who has produced who is personally known to me or who has produced As identification and who did tak►' Bath. as identification and who did take an oath. t0C 1ti ti`� NOTARY PUBLIC: Cd' „. 9� G �`� Sign: e APPLICATION APPROVED BY: Print: My Commission Expires: Contractor Plans Examiner Engineer Zoning RCM NM RADIAL NR BENCH WRY CALOAA7W COME OM D6a'OR - = - ORILDOE for RAMBO R NEDFL OR FpEO FOND MORI LIWIEVAaTSS AOTTOSCAWE OFFICIAL OMAR MOWN ft PENINNET PAGE PAYHLBlflf RATEOOF AOMOF POMP PONTORL•E FONTCFaIV RINTOF CUM POTTOP ROOF NasvaewY WORM( TVHSII RTaT Certified to: John Kura Teresa Ku • vo Property Ad 10538 It 10 Miami Sho - Survey Num NOTE INCOMPLIANCE Wrai ERSEMEMIS OR ES REQUIRED, TMS TWO S OR BUI DNG #1� &#10540 0 u Plat of Boundary Survey LegalDesc tion: Lat5andPre S o u l s 1 NUot ,, Black 11, °Nazi AMNON PASADFVAPARK' lodeeplaflhereofasrecorded Raffia* 6, Page 8 2 the PI * R e o f A ri T m I D e d e CaunO;, LEGEND: FE WMFENCE Fit MR • war R REODAD R FED c CNCwATED a CLEAR Eras arRotosEN1 CEVIERLIAT ▪ CaeRETE PROPS TOWN COTAVE F1R. MONDRON KIP. FWWMOW RAV WIMP Mr IND MILSO6C Of MOW RE WIRY FD FOUND P RAT AMOS A97NLT DEL OIERR69 PP. PDA0P08 IX =MOM COW CANE REM WL[ MIERAETNA la Imo, • COVB4 ®ARRA RA 890910 C, CIORD RR AA RA CD a D3 R DN IDSr E91r EL FF. FAIL fPX LAE NR AIL OA ORE. PER PRA PR RR ROE PAC P.OL. RC PAC PL R ROE SW 8•a Y9,R T.OA Iva I) LEGAL OTHER 3) UNDERGROUND .y .8.41:1.71628611070 ARENO17OSE 5) ONLY WORE 8) AOWEAtTIRCA n DES • FEE a) ELEVATIONSIR 140 WARMS 11) IRS SURVEY 1k) NO NAVEEESVLOCA Na Sax NNE MOMENT MAW 05/30/2008 t Jr. 0.91' ress: N4TI - 1 WrrE.• • Fl01*1? 33138 • • r.Olt,51 . SET smut 15 �Id • b SEF1QLR • • • • •• • • • • • . . STATUES 6101741631 One 1FLLTCATWNOF A.WAH1F'RECORD, OTN8iTNAN TIDI ON T, P TO T • • • • ••• • • • • • • • • • •• • • AurPoarbaa • • • • • • Iv EAA8.8A84A 7 TE1}.0RE VTS • • • ISWZIMORANCES NOT MOWN ON Ili EPLAT. OF FOOTINGS, FOUADATNMSOR OMFR LNPXOVEte®v88 _ - mortocC768.. TO FACE Arta • ON a onftwazIE swam ARE PLAT t _ ; •�_., ,.� diNERISE GISMO • Nor •.- •• •• ARE AA , • Nave wads on SElNTt37 • TOLD ZN07688..& HER E FORMS A CL OSED OEONETRIC MM. FOR MIEEALSTALLA'TIO S OMER TTL MOM 4 OEM& IN CEN1t3O.DOF NE1Of1HSTREET PPE O3r"F.ASFOFONER SETifILR. 3.42' Padia62 S 89'53'51 E 107.28' ' C. &M. smolt P5111S112 C. &M. FOUNAVA060 ONEAST &OA4r, RTH W LLJI 3 W g W O O z FOR REFERENCE ONLY THIS SURVEY IS NOT VALID WITHOUT THE SIGNATURE AND THE ORIGINAL RAISED SEAL OFA FLORIDA LICENSED SURVEYOR AND MAPPER. PHOTOCOPYING FORBIDDEAL COPYRIGHTED MATERL4L SURVEYORS LRTIFICAT/ON: 178 T THLS'. ARY SURVEY ISA TRUEAAfDCORRECT OF{4 IIH AREDUAmER1MY(MECUM STATEOFFLORIDA L A ND S UR V E YO R& MAPPER NO. 3762 CENTRAL FLORIDA SURVEYING AND MADDIvrs nnncinu S OSO&IOz2,_ 0) c rn 0 0 v 0 m Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Owner's Name: JOHN KURACK Job Address: 10538 4 Avenue NE Miami Shores, FL 33138- Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 6/4/2008 : Yes Comments: o ' .t is6,, e Issue Date: Not Issued Contractor(s) Phone Primary Contractor HOME OWNER Yes Permit Na DS -6 -08 -1022 Expires: of issued Folio Number:1122310130200 Owner's Phone: Total Square Feet: 215 Total Job Valuation: $ 2,000.00 VILLAGE OF MIAMI SHORES OWNER BUILDER DISCLOSURE STATEMENT NAME: © u re-e, DATE: ADDRESS: /0 — Z as-4/ i C - t /44.4e. 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 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 hold title to the above property and I am planning on doing this construction Myself. Initial Initial 2. I understand that as an owner- builder I must abide by all zoning ordinances and building regulations in effect at the time of permit application. Inactive permits for a period of over 180 days will become null and void (expired) and a new permit will be required to be issued for reinstatement of the permit. 3. I have an understanding of the 2004 FBC -& FRC and understand that this department and its inspectors are there to help enforce and interpret the code. There is a copy of the code in this office for review. 4. I understand that the building official and inspectors are not there to design, alter or give advice on how to meet code — only if the structure meets t minimum code. Produced there License or Initial Initial 5. I understand that as an owner - builder, that any contractor disputes with sub- contractors and myself must be handled in a civil court with the advice of an attorney. The department will not mitigate any contract disputes. 6. I understand that if I compensate any person or company for work performed they are required to have a business license in the county. If for any reason they do not posses a business license I will be responsible and liable for any wrong doing from this unlicensed company or person. 7. I understand that if any person gets injured on my construction project—they are entitled to workmen's compensation. And if they do not posses a workmen's policy I could be held liable for all doctor and related cost which could include loss of wages during recovery from injury. Initial 8. I understand that under state and local laws I can not do any Electrical, Plumbing, Heating, Air & Roof work on my property with out first obtaining the proper permits by licensed contractors. Was acknowledged before me this 04- day of ,Q,Q,P'e/ , 20 who was personally known to me or who has as identification. NOTARY j I* 44....,,„? Affiant is personally known to me, . produced 'STATE OF FLORIDA) COUNTY OF DARE) The undersigned Affiant, 'O A v t ! � , does hereby attest that the (property owner) Z attached survey, performed by ee� � � t sp,JYv (na a of surveyor's company) performed on v6 0 d& is an accurate representation of the existing conditions and (i .too urvey) 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 less than six (6) months 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, Affiant sayeth naught. Witness(sign and print) Witness(sign and print) SWORN TO AND SUBSCRIBED before me this t day o k/ . a 1 identifica tp g 4 ; 1 OA Tax Folio #: requests permission to install: SIGNED. SEALED AND DELIVERED in the presence of: • iccmi Shope� ( 10050 N.E. SECOND AVE. MIAMI SHORES. FLORIDA 33138 Telephone (305) 795 -2207 Fax: l3Q51755- 8972 COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY WHEREAS, i roc, hereinafter referred to as the Owner of the (owner) following described property: Legal description�/foollio #: Lot 5 ,/ A Block L / Subdivision [ ] Asphalt, concrete, rick pavers [ ] Landscaping [ ] Other -- within the public road right of way of (.0 sr (L7 s--yo /v /f7 4 (address) 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. I f 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 obligation 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 04 day of 2 WiQ /0O ,p 4 '. 1,096 'fi‘ ��Anes� INSTALL CONCRETE SIDEWALK AND APPROACH 0 g O Passed Inspector Comments CREATED AS REINSPECTION FOR INSP- 86221. CC Needs sod q=4 - D ? Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until • Inspection Date: 09/04/2008 Inspector: Grande, Claudio Owner: KURACK, JOHN Job Address: 10538 4 Avenue NE Miami Shores, FL 33138- Project: <NONE> Contractor: HOME OWNER Building Department Comments Wednesday, September 3, 2008 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: New Block: Parcel Number 1122310130200 Lot: Page 1 of 2 INSTALL CONCRETE SIDEWALK AND APPROACH ' / ( 0 't'" N7 Passed Y Inspector Comments cc � Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid . until • Inspection Date: 06/26/2008 Inspector: Grande, Claudio Owner: KURACK, JOHN Job Address: 10538 4 Avenue NE Project: <NONE> Miami Shores, FL 33138- Contractor: HOME OWNER Buildinct Department Comments Wednesday, June 25, 2008 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: Foundation Work Classification: New Block: Phone Number Parcel Number 1122310130200 Lot: Page 2 of 2 INSTALL CONCRETE SIDEWALK AND APPROACH Passed Inspector Comments CC , 7'l� ® p !" Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid . until E Inspection Date: 07/01/2008 Inspector: Rodriguez, Jorge Owner: KURACK, JOHN Job Address: 10538 4 Avenue NE Miami Shores, FL 33138- Project: <NONE> Contractor: HOME OWNER Buildin De Comments Monday, June 30, 2008 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 JUL 0 2 Block: ?': Phone Number Lot: Permit Type: Driveways /Sidewalks /Slabs Inspection Type: Final Work Classification: New Parcel Number 1122310130200 Page 1 of 2