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DS-10-535`� ��,� J)O BUILDING PERMIT APPLICATION FBC 20 Permit Type: BUILDING ROOFING Owner's Name (Fee Simple Titleholder) t,,1 „ F ,,kR,,,, , mn Phone # 3n e :r9 • 4 ■ • 42 41 Owner's Address Z ., ; 2 e City Mp A6\Bl SA,, State FL Zip g g M) Tenant/Lessee Name Email 0 = noe;r9 Miami Shores Village Building 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 Job Address (where the work is being done) 9 City Miami Shores Village County Miami -Dade FOLIO / PARCEL # Is Building Historically Designated YES Contractor's Company Name Contractor's Address City State Contact Phone Value of Work For this Permit $ v BOO ° Structural Review. $ NO lkoyi Ouw E -mail Type of Work: ❑Addition ❑Alteration :New Describe Work: CC,b0 : <� 1 I�1 9 1� 1 ` =�.�JV 1� %�D� I5 �� \' -1 �� Permit No.DS I O —5 3S Master Permit No. Phone # Phone # Zip Qualifier Name Phone # State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # Square / Linear Footage Of Work: 240 4 'f ❑ Repair/Replace ❑ Demolition CsintAiSt. 1 ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** F * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ aJ Dd CCF $ -tD t.J � Notary $ Training/Education Fee $ 0 " Q -D Scanning $ & 00 Radon $ DPBR $ Double Fee $ Violation date: Total Fee Now Due $ Bond $ 17 C T W C oT ILS !pi l MAR 3 0 2010 B Y: Flood Zone 14 See Reverse side CO /CC $ Technology Fee $ 1 0 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 ANNIUAVIT: 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. \sj Signature p .3 '� ^v1,en G --- -iv i , Signature Contractor The foregoing instrument was acknowledged before me this 30 The foregoing instrument was acknowledged before me this day of ems, 2010 , by ° 1) \` 1�� �, , 'C.t is r.13, day of , 20 , by who is personally known to me 14 4 '44.- (D who is personally known to me or who has produced As ideptif 0 9 it Slke an oath. as identification and who did take an oath. NOTARY PUBLIC: °11]8/111 A1dlON = NOTARY PUBLIC: t jotisoieo Print: i My Commission Expires: Owner or Agent ************ *********************** ********* * * * * * * * * * * ** * ** * * * * * * * * * * * * * * * . * ** * * * * * * * * * * * * * * * ** * * * * * ** APPROVED BY Plans Examiner 11 D / � / a Zoning (Revised 07 /10 /07)(Revised 06/10/2009) Sign: Print: My Commission Expires: Engineer Clerk checked Scheduled Inspection Date: August 26, 2010 Inspector: Bruhn, Norman Owner: FRUCIANO, DANIEL Job Address: 236 NE 91 Street Project: <NONE> Miami Shores, FL 33138- Contractor: HOME OWNER Building Department Comments August 25, 2010 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 139370 Permit Number: DS -3 -10 -535 Permit Type: Driveways /Sidewalks /Slabs Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132060190440 CONNECT AN EXISTING 22' X 22' CONCRETE PAD TO HOUSE BY ADDING AN ADDITIONAL 240SQ FT OF CONCRETE ON THE BACK YARD TO PICK UP: READY Passedioi Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments For Inspections please call: (305)762 -4949 Page 3 of 22 OWNER BUILDER DISCLOSURE STATEMENT NAME: t'41t• . DATE: ✓' ° ADDRESS: e '61 VA t4i'kM 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 ©f4e5 , FL Do hereby petition thellage 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_ 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. 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 iY 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. 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. Initial 7) ° 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 govem 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 l 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 .comldbor /prolcilbliindex.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: 23 if S, FL 3313h Initial 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. u 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 fine 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 day of 'Y\ 1 , 20 By TbAN 1 L( Pi ( who was personally known to me or who has Produced there License or ! E WNER fv' ° Initial Initial Initial Permit No: 10 Job Name exi , 2010 Building Critique Sheet 4//es 40,,,..../ Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Norman Bruhn CBO 305 - 795 -2204 M iami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 \ � v2 r � i : h / /z \ • JOB :09 -7149 IJ 35 /2 /3 i sr /4 /35' LOCATION SKETCH r SCALE 1 " ='1 O IM AL D SCRIPTION:Lots 8 and 9,Block 3,EL PORTAL,according to the Plat thereof as recorded in Plat Book 9,Page 101 of the Public Records of Miami Dade County,Florida. - 1) 3) 4) 5) 6) OWNERSHIP IS SUBJECT TO OPINION OF TITLE. 2) EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED INSTRUMENTS, IF ANY, AFFECTING THIS PROPERTY. (2.22) DENOTES THOSE ELEVATIONS REFERRED TO N/A DATUM. LOCATION AND IDENTIFICATION OF UTILITIES ON ANDIOR ADJACENT TO THE PROPERTY WERE NOT SECURED AS SUCH INFORMATION WAS NOT REQUESTED. THIS PROPERTY IS WITHIN THE Lows OF THE FLOOD ZONE X NO UNDERGROUND LOCATIONS WERE DONE BY THIS COMPANY. CERTD TO: Law Office of Ilona Anne Wiss,P.A. ,Attorneys Title DATE: Insurance Fund.,inc.,Daniel Fruciano and Paul A. Thrussell P.F.G. Loans,Inc.ISAOA /ATIMA SURVEYING, INC LB. NO. 3333 6187 NW 167 STREET, H5 MIAMI, FLORIDA 33015 305/512 -4940 GENERAL NOTES APPLICABLE ZONING, UNDERGROUND, ZONING AND BUILDING SET BACKS, MUST BE CHECKED BY OWNER, . ARCHITECT OR BUILDER BEFORE DESIGN OR CONSTRUCTION BEGINS ON THIS PROPERTY. I HAY CERTIFY: That the a of above gibed property is true and correct to the best of my knowledge, Irrtorrrr onnn bete art feetfil sditgyed and platted under my dhuction, also that there are not above -gfo {l r titan those shown. This survey meets the minhuum technical standards set forth by fire Board of Land Surveyors pursuant to Chapter 61G17-6, Florida Awe dna, SectIoll$724tr, Roilla Statues. NOT VALID UNLESS SEALED WITH AN EMBOSS • • •• • • • • • • • •• • • ... arui • Grate No. 3590 • • Ficwra... THIS IS A BOUNDARY SURVEY ; • •„ • • • EQ' S�lt$V�lt�$t 8AL April 15,2009 • • m C) AS 0 V • PLAN OF SURVEY 11 .4s' •• ••• • • • • • •• • • • •• t it • •• • • • •• Vat �-� c.,2_ 00.00 lZ % Urces •. • • ••• , . • • - f0.1 • • • ••• ••• • . e E . J 1 SC Cael Vex, SCALE 1" = 20' A....ARC DISTANCE AfC..MR counnIONMK4 CBS...00NcRETE BLOCK STRUCTURE O.UL..OVERHEAD UT1IJTY LINE CL—CLEAR C/L—CEMIER LINE RAD...RADIAL • • •ENC...E NtSRc .ovM • • _ RAN—RIGHT OF WAY... FRP...FOUND IRON PIPE O.H...OVER HEAD W.M.—WATER METER C.LL..CHORD A. p1L ..PROPEfl1 Y .. c'c CON�OREm F H FIRE HYDRANT UP—UTILITY POLE R .RADIUS u E UTUJ1Y EASEMENT A .CENTRAL ANG :1-- AQ • '1.....TANGENT C.U.....CATCH BASIN MH.„..MANHOLE CLF. CHAIN LINK FENCE W.F..—WOOD FENCE \ \\ i(2 /7 6 0 /8 5 /9 4 20 ai I • svi -81 - /5 tt JOB :09 -7149 IJ 35 /2 /3 i sr /4 /35' LOCATION SKETCH r SCALE 1 " ='1 O IM AL D SCRIPTION:Lots 8 and 9,Block 3,EL PORTAL,according to the Plat thereof as recorded in Plat Book 9,Page 101 of the Public Records of Miami Dade County,Florida. - 1) 3) 4) 5) 6) OWNERSHIP IS SUBJECT TO OPINION OF TITLE. 2) EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED INSTRUMENTS, IF ANY, AFFECTING THIS PROPERTY. (2.22) DENOTES THOSE ELEVATIONS REFERRED TO N/A DATUM. LOCATION AND IDENTIFICATION OF UTILITIES ON ANDIOR ADJACENT TO THE PROPERTY WERE NOT SECURED AS SUCH INFORMATION WAS NOT REQUESTED. THIS PROPERTY IS WITHIN THE Lows OF THE FLOOD ZONE X NO UNDERGROUND LOCATIONS WERE DONE BY THIS COMPANY. CERTD TO: Law Office of Ilona Anne Wiss,P.A. ,Attorneys Title DATE: Insurance Fund.,inc.,Daniel Fruciano and Paul A. Thrussell P.F.G. Loans,Inc.ISAOA /ATIMA SURVEYING, INC LB. NO. 3333 6187 NW 167 STREET, H5 MIAMI, FLORIDA 33015 305/512 -4940 GENERAL NOTES APPLICABLE ZONING, UNDERGROUND, ZONING AND BUILDING SET BACKS, MUST BE CHECKED BY OWNER, . ARCHITECT OR BUILDER BEFORE DESIGN OR CONSTRUCTION BEGINS ON THIS PROPERTY. I HAY CERTIFY: That the a of above gibed property is true and correct to the best of my knowledge, Irrtorrrr onnn bete art feetfil sditgyed and platted under my dhuction, also that there are not above -gfo {l r titan those shown. This survey meets the minhuum technical standards set forth by fire Board of Land Surveyors pursuant to Chapter 61G17-6, Florida Awe dna, SectIoll$724tr, Roilla Statues. NOT VALID UNLESS SEALED WITH AN EMBOSS • • •• • • • • • • • •• • • ... arui • Grate No. 3590 • • Ficwra... THIS IS A BOUNDARY SURVEY ; • •„ • • • EQ' S�lt$V�lt�$t 8AL April 15,2009 • • m C) AS 0 V • PLAN OF SURVEY 11 .4s' •• ••• • • • • • •• • • • •• t it • •• • • • •• Vat �-� c.,2_ 00.00 lZ % Urces •. • • ••• , . • • - f0.1 • • • ••• ••• • . e E . J 1 SC Cael Vex, SCALE 1" = 20' A....ARC DISTANCE AfC..MR counnIONMK4 CBS...00NcRETE BLOCK STRUCTURE O.UL..OVERHEAD UT1IJTY LINE CL—CLEAR C/L—CEMIER LINE RAD...RADIAL • • •ENC...E NtSRc .ovM • • _ RAN—RIGHT OF WAY... FRP...FOUND IRON PIPE O.H...OVER HEAD W.M.—WATER METER C.LL..CHORD A. p1L ..PROPEfl1 Y .. c'c CON�OREm F H FIRE HYDRANT UP—UTILITY POLE R .RADIUS u E UTUJ1Y EASEMENT A .CENTRAL ANG :1-- AQ • '1.....TANGENT C.U.....CATCH BASIN MH.„..MANHOLE CLF. CHAIN LINK FENCE W.F..—WOOD FENCE