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DS-06-2226Inspection Number: INSP -25703 Permit Number: DS -8-06 -2226 Inspection Date: 11/07/2006 Inspector: Grande, Claudio Owner: BLANCO, PHYLLIS Job Address: 533 91 Street NE Miami Shores Village, FL Project: <NONE> Contractor: HOME OWNE Building Department Comments Passed Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid. Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 1U 0 inspector Comments Permit Type: Driveways /Sidewalks /Slabs Inspection Type: Final Work Classification: New Block: Phone Number Parcel Number 1132060141230 Lot: Monday, November 6, 2006 Page 2 of 2 r READY MIX CONCRETE • PUMP SERVICE • SIX DAY DELIVERY Sales Person Date: Sold To: Delivery Address: P.O. # Truck # Quantity Ticket # Driver # Name: DESCRIPTION Price AMOUNT CU YDS. SLUMP THIS DELIVERY TOTAL OF YOUR ORDER FOR cu YDS. CUSTOMER OR HIS AGENT ASSUMES FULL RESPONSIBILITY FOR STRENGTH AND /OR PERFORMANCE OF ANY CONCRETE PLACED ABOVE DESIGN SLUMP OR WHEN WATER IS ADDED. ` WATER ADDED: ❑ YES ❑ NO GLS IME ARRIVED ON THIS JOB STARTED UNLOADING FINISHED UNLOADING LEAVING THE JOB TAX TOTAL 9150 N.W. 87th Avenue Medley, Florida 33178 Phone: (305) 887 -3250 Extension BUYER, OR HIS AGENT, AGREES TO ASSUME RESPONSIBILITY FOR CONCRETE, AND ANY PROPERTY DAMAGE RESULTING FROM TRUCK MAKING DELIVERY BEYOND CURB LINE. ALL CLAIMS MUST BE MADE AT TIME OF DELIVERY. IF IT BECOMES NECESSARY TO BRING ANY ACTION TO COLLECT AMOUNTS DUE ON THIS INVOICE PURCHASER SHALL BE RESPONSIBLE FOR REASONABLE ATTORNEYS FEES AND COURT COSTS INCURRED BY VENDOR IN SECURING COLLECTIONS. INTEREST SHALL ACCRUE AT 11/2% PER MONTH ON OUTSTANDING BALANCES. UNLOADING TIME RECEIVED BY .................... ................... .................... .................... lactic ...................... ...................... ...................... Inspection Date: 10/10/2006 Inspector: Grande, Claudio Owner: BLANCO, PHYLLIS Job Address: 533 91 Street NE Project: <NONE> Miami Shores Village, FL Contractor: HOME OWNER Building Department Comments Friday, October 6, 2006 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 1132060141230 Lot: Page 2 of 2 ow ✓ Passed 1 or Inspector Comments IM Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid . until .................... ................... .................... .................... lactic ...................... ...................... ...................... Inspection Date: 10/10/2006 Inspector: Grande, Claudio Owner: BLANCO, PHYLLIS Job Address: 533 91 Street NE Project: <NONE> Miami Shores Village, FL Contractor: HOME OWNER Building Department Comments Friday, October 6, 2006 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 1132060141230 Lot: Page 2 of 2 Date Thursday, September 21, 2006 09/21/2006 Check Receipt Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Number: DS -8 -06 -2226 Invoice Number: DS -8 -06 -26020 Applicant: PHYLLIS BLANCO Company Name: Owner Address: 533 NE 91 ST MIAMI SHORES, FL 33138 Job Address: 533 91 Street NE Miami Shores Village, FL Payment Type Check Number 1576 Amount $437.73 Change $0.00 Total Payment: $437.73 Page 1 of 1 BUILDING PERMIT APPLICATIO FBC 2004 ,441ft t j. Permit Type (circle): Building;' Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) )lyL ! tf C `j Phone # 8 ` ? J d+ ( ) 2 Owner's Address S - ki ' C - Q/S7 City J l / 044 �'t'i'e S. State I.._- Tenant/Lessee Name Phone # Job Address (where the work is being done) _5: E Q7 , , f / e f City Miami Shores Village County Miami -Dade Zip, ?,?/- ?e FOLIO / PARCEL # 3 :1. c /'// ;l.. (: Is Building Historically Designated YES Contractor's Company Name Contractor's Address City Qualifier Name State Certificate or Registration No. Architect/Engineer's Name (if applicable) Value of Work For this Permit $ J a ; 16a- ," 1 )D Square / Linear Footage Of Work:- Type of Work: Addition ❑Alteration [New Describe Work: L etf, Submittal Fee $ 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 mac =}i ,� * ******* ** **** * * * *,�,�* ,�* *, , * * * * * * * *, Fees * ** * *, * * *, **** * * ** ** * * * * * * * * * * * * * * *,* * * * * * *,* Permit Fee $ Notary $ Training/Education Fee $ Bond $ I , Code Enforcement $ Structural Review. $ Miami Shores Village Building Department 'I; 2 fri'_' C.) NO . / Scanning $ - Radon $ DPBR $ Double Fee $ Permit No. 9.`i 0 14-14 7 Master Permit No. Zip . ?..?/ , Phone # , State Zip Phone # Certificate of Competency No. Phone # Repair/Replace ❑ Demolition CCF $ CO /CC Technology Fee $ Zoning $ Total Fee Now Due $ See Reverse side -* 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 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 S2500, 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 persctz whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job ,it, 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 Owner or Agent The foregoing instrument was acknowledged / befof e me day of 4:7 ,20( ,by " �'ly/ r 4f who is personally known to me or who has produced_ As identification and who did tak NOTARY PUBLIC: Sign: Print: My Commission Expires: ******************************************* * * * * * * * * ** * ** * * * * * * * * * * * * * * * * ** * ** ' * * * * * * * * * * ** * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: (Revised 07/08/06) Zip 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: My Commission Expires: j{' Plans Examiner Engineer Zoning VILLAGE OF MIAMI SHORES OWNER BUILDER OTSCLOSURE STATEMENT NAME: ' (I LE i anC0 DATE: - ®C ADDRESS: 533 f e E 9/j IL 101/, Do hereby petition the Village of Miami. Shores.to act as my own contractor pursuant to the laws ofthe State of Florida, F.S 4$9.103(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 cornniercial building at a cost of.$25,000.00 or less. The building must be for yor own use and.occupancy. IIt 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 zbning regulations. Please read and initial each paragraph. I. I hold title to the above property and I am planning on doing this construction 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 Initial Initial 'S%zone rap 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. Initial 4. I understand that the building official and inspectors afe not there to design, alter or give advice on how to meet code —, only if the structure meets the minimum code. 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. initial 6. I understand that if I compensate any person or company for work performed they are required to. have a business license in the count 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 Initial I. understand that under state and focal 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. Initial Was acknowledged before me this go day of �//. U� , 20 6( BlAy.1113 6q4t(o who was personally known to me or who has Produced there License or Y ri ) Lie,;.? identification. mi l -, MONICA Due • # DD 483995 EXPIRES: October 20, 2009 r;orstd tfire Natal FAG undowritys STATE OF FLORIDA) COUNTY OF DADE) Property Owner Signature Mated S 43144 ti► eldg outwear 10050 NE 2 Ave Miami Shores, Fl 33138 Phone 305-795-2204; Fax 305 -756 -8972 www.miamishoresvillage.com AFFIDAVIT The undersigned Affiant, B h LAC® , does hereby attest that (property owner) The attached survey, performed by (`6 Qf //lcc Su vsk.yeA orS G • ame of surveyor's compdny) for address: $ 2 2 A) d E. c /S e performed on I - ? /- 64 (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 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. c LC 0 Property Owner Print Name SWORN TO AND SUBSCRIBED before me this , day of Affiant is personally known to me, f1 produced ,J r tj; iS identification. oJT PERMIT #: I, Tkii1 0a n C D ❑ Contractor downer ❑ Architect Picked up 2 sets of plans and (other) Acknowledged by: Miami Shores Village Building Department 10050 NE 2 Ave, Miami Shores, Fl 33138 Tel: (305)795 -2204 • Fax; (305)756 -8972 PERMIT CLEARK INITIAL: RESUBMITTED DATE: PERMIT CLEARK INITIAL: RECEIPT DATE: 9 " / D —-n S u dr t.;` cf S Address: 5 .? P12n 4-1 E From the building department on this date in order to have corrections done to plans And/or get County stamps. I understand that the plans need to be brought back to Miami Shores Village Building Department to continue permitting process. i HEREBY CERTIFY That the survey represented thereon meets the minimum technical requirements adopted by the STATE OF FLORIDA Board of Land Surveyors pursuant to Section 472.027 Florida Statutes. There are no encroachments, overlaps, easements appearing on the plat or visible easements other than as shown hereon. ADIS N. NUNEZ REGISTERED LAND SURVEYOR STATE OF FLORIDA #5924 (305) 865 -1200 FLOOD ZONE: X PANEL: 0093 DATE: SCALE: 7/31/06 1• =20' SINCE 1987 BLANCO SURVEYORS INC. Engineers • Land Surveyors • Planners • LB # 0007059 555 NORTH SHORE DRIVE MIAMI BEACH, FL 33141 Email: blancosurveyorsinc ©yahoo.com Fax: (305) 865 -7810 SUFFIX: j DATE: 7 / 17 /95 BASE: N/A COMMUNITY # 120652 DWN. BY: JOB No. F Blanco 06- 1374 34.60' 34.55' LOT 10 BLOCK 58 6.30' w 'v cn 16.05' PLANTER 30.60' • •� • • REVISED: \. • s- S • •• • • ••• ••0• • • • • •••• _ • • • • •••• •••• • • • • ••• •• • •• •• •. • • • �• • \ • • Y( • • •• ,�® 0000 • e •• • • • • • .• • •• • • • • •• • • • NOT VALID UNLESS EMBOSSED WITH SURVEYOR'S SEAL g sp y A (- T .o \ ABBREVIATIONS: SWK= SIDEWALK, CBS= CONCRETE BLOCK STRUCTURE, CLF =CHAIN LINK FENCE, PL= PROPERTY LINE, DUE = DRAINAGE UTILITY EASEMENT, IP =IRON PIPE, F= FOUND, A/C =AIR CONDITIONER PAD, P /C= PROPERTY CORNER, D/H= DRILLED HOLE, W/F= WOODEN FENCE, RES= RESIDENCE, CL- CLEAR, RB= REBAR, UE= UTILnY EASEMENT, CONC= CONCRETE SLAB, RN/ =RIGHT OF WAY, DE= DRAINAGE EASEMENT, C/L= CENTER LINE, o= DIAMETER. TYP= TYPICAL, M= MEASURED, R= RECORDED, ENCR = ENCROACHMENT, COMP = COMPUTER, ASPH = ASPHALT, N/D =NAIL & DISC, S =SET, FP E.= FINISH FLOOR ELEVATION, O /S= OFFSET, P/P =POWER POLE, OHP= OVERHEAD POWERLINE, WM =WATER METER WOOD FENCE= MASONRYWII -1 1 1 1 1 11 1 1 1 ELEVATION BASED ON LOC. # 3250 S.W. CONCRETE 1 '• _ '' �' "� '''� '''� '' '' `' I IOBM# N -603 ELV. 7 . 70 r TYPE OF SURVEY: BOUNDARY SURVEY MAINTENANCE 8 DRAINAGE EASEMENT = M 8 D.E. SURVEYOR'S NOTES: 1) OWNERSHIP SUBJECT TO OPINION OF TITLE. 2) NOT VALID WITHOUT THE SIGNATURE AND RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER. 3) THE SURVEY DEPICTED HERE IS NOT COVERED BY PROFESSIONAL LIABILITY INSURANCE. 4) LEGAL DESCRIPTION PROVIDED BY CLIENT. 5) UNDERGROUND ENCROACHMENTS NOT LOCATED. 6) ELEVATIONS ARE BASED ON NATIONAL GEODETIC VERTICAL DATUM OF 1929. 7) OWNERSHIP OF FENCES ARE UNKNOWN. 8) THERE MAY BE ADDITIONAL RESTRICTIONS NOT SHOWN ON THIS SURVEY THAT MAY BE FOUND IN THE PUBLIC RECORDS OF THIS COUNTY. 9) CONTACT THE APPROPRIATE AUTHORITY PRIOR TO ANY DESIGN WORK FOR BUILDING AND ZONING INFORMATION. 10) EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED INSTRUMENTS, IFANY, AFFECTING THIS PROPERTY. BEARINGS WHEN SHOWN ARE REFERRED TO AN ASSUMED VALUE OF SAID PB PAGE F a 70cl 1.50' 1.50 0.45 cl LOCATION SKETCH SCALE: NTS LEGAL DESCRIPTION: LOT 11 OF MIAMI SHORES SECTION NO. 2 ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK OF THE PUBLIC RECORDS MIAMI - DADE COUNTY, FLORIDA BLOCK 10 AT PAGE SURVEY FOR: PHYLLIS G. BLANCO, 533 N.E. 91ST ST., MIAMI SHORES, FL. 33138. 37 58 SUBDIVISION Issue Date: 9/12/2006 Owner's Name: PHYLLIS BLANCO Permit Type: Driveways /Sidewalks /Slabs Work Classification: New Job Address: 533 91 Street NE Miami Shores Village, FL Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Expires: 03/11/2007 Contractor(s) Phone Primary Contractor HOME OWNER Yes Comments: DRIVEWAY RESURFACING AND ADD A SECTION Additional Information Type of Work: DRIVEWAY Additional Info: Bond Return : Classification: Residential 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 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. Fees Due Amount Bond Type - Owners Bond $300.00 CCF $1.20 Education Surcharge $0.40 Notary Fee $5.00 Permit Fee $125.00 Scanning Fee $3.00 Technology Fee $3.13 Total: $437.73 Building Department File Copy Applicant Signature Parcel #: Block: Section: Permit Status: APPROVED Permit Number: DS -8 -06 -2226 Phone: 1132060141230 Lot: PB: Total Square Feet: 1000 Total Valuation: $ 1,500.00 Re ' uired Ins • ections Foundation Sidewalk Landscaping Final Invoice Number DS - 8 - 06 - 26020 Total: C. Amt Due $437.73 Amt Paid NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES.