DS-10-1895Inspection Number: INSP - 152642
Scheduled Inspection Date: November 29, 2010
Inspector: Bruhn, Norman
Owner: LONGMAN, THOMAS
Job Address: 1200 NE 95 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
November 24, 2010
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
For Inspections please call: (305)762 -4949
Permit Number: DS -10 -10 -1895
Permit Type: Driveways /Sidewalks /Slabs
Inspection Type: Final
Work Classification: New
Phone Number (305)892 -8598
Parcel Number 1132060144110
EXISTING REAR CEMENT DRIVEWAY TO BE REPLACED
Passed /,/
r
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
Page 12 of 21
1(1 Li -Lr►
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: BUILDING
OWNER: Name (Fee Simple Titleholder): Phone#: 3a�S '? 5 7 - 5 7 /
Address: /!
City:
/I /1M % 2& State: Zip: t33/ ,r,r
/op_
Email: y � 7Qa gi 44
J; �� 4�ui-
Tenant/Lessee Name: /1)
JOB ADDRESS:
City: Miami Shores
Folio/Parcel #:
Is the Building Historically Designated: Yes
Type of Work: OAddress
Description of Work:
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
/#4,/ivy • ,7-7 1/4/
County: Miami Dade
NO Flood Zone:
OWyb.
Permit No.
Master Permit No. f Q 7
Phone#:
Phone#:
REVEM
OCT 6 2010
10'iP
Zip:
CONTRACTOR: Company Name:
Address:
City: State: Zip:
Qualifier Name: Phone#:
State Certification or Registration #: Certificate of Competency #:
Contact Phone#: Email Address:
DESIGNER: Architect/Engineer: Phone#:
3'
Value of Work for this Permit: $ ° Sgaare/Linear Footage of Work:
OAlteration ONew %Repair/Replace
ODemolition
COLOR THROUGH ROOF TILE IS REQUIRED acknowledged by:
******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** F * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $ Permit Fee $ /..(0 CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ 1 I
Bonding Company's Name (if applicable) /0)11
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable) P#
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 subj t to • hment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first i*pection hich ccurs seven (7) days after the building permit is issued In the absence of such posted notice, the
inspection will not be app ove and a reinspection fee will be charged
Signature ,% Signature
r
. . o Contractor
The foregoing ' i • , u. ` it was acknowledged before me this , - , 2t The foregoing instrument was acknowledged before me this
day of ocl v r , 201(3 , by / `tGms -/ Le e �/./ , day of , 20 , by ,
N is personally known to mebr who has produced who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC:
7
Sign: d wE�n -c:
Print:
My Commission Expires:
APPROVED BY
ROBERTA K. DZUBIN
NOTARY PUBLIC
STATE OF FLORIDA
Commit EE006645
Expires 8/1812014
(Revised 07 /10 /07)(Revised 08/10/2009)(Revised 3 /15/09Xrev6 /4/10)
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
Plans Examiner / r r' t 1( Zoning
Structural Review Clerk
Please read and initial each paragraph.
OWNER BUILDER DISCLOSURE STATEMENT
5. I understand that, as the owner - builder, I must provide direct, onsite supervision of the construction.
M iami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
NA E: J/4 L // '4 DAT
ADDRESS: 1 C C C� � " M 4 '? S M
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)! L_
And I have read and understood the following disclosure statement, which entitles me to work as my own contractor; I further 3 I� O
understand that I as the owner must appear in person to complete all applications. C /
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.
1. I understand that state law requires construction to be done by a licensed contractor and have applied for an owner -b
permit under an exemption from the law. The exemption specifies that I, as the owner of the property listed, may a
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 responsibl
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 mys
from potential financial risk by hiring a licensed contractor and having the permit filed in his or her name instead of m
name. I also understand that the contractor is required by law to be licensed in Florida and to list his or license nu
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. I
not be built or substantially improved for sale or lease. If a building or residence that I have built or substantially
myself is sold or leased within 1 year after the construction is complete, the law will presume that 1 built or
improved it for sale or lease, which violates the exemption.
Initial
Initial
ed
ally
6. I understand that I may not hire an unlicensed person to act as my contractor or to supervise persons working on my buildin
residence. It is my responsibility to ensure that the persons whom I employ have the license required by law and by co / m .�
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. I, as an owner - builder, may be
liable and subjected to serious financial risk for any injuries sustained by an unlicensed person or his or employ
working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully
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 -
social security contributions under the Federal Insurance Contributions Act (FICA) and must provide workers comps f ' 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 applica
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 I may obtain more information regarding my obligations as an employer from the Internal Revenue Service, th
United States Small Business Administration, and the Florida Department of Revenues. I also understand that I may conta
Florida Construction Industry Licensing Board at 850.487.1395 or http : / /www.mvfloridalicense.com/dbpr /pro /cilb/iindex.htm d
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:
-� 3 2 ` ,3 Initial
12. I agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the information th
have provided on this disclosure.
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
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 pC day ofc -%% 20 / (-)
Produced
No (ism
0 113 - 0 11 I
Initial
Initial
Initial
Initial
who was personally known to me or who has
" 20 entifi • tion.
OWNER - NOTARY
Initial
NOTARY FUNLIC -STATE OF FLORIIDA •
e" Claudia V. Cubith s
,�
Commission � �^312Ci1
,r E Expires:
D TigRET ATJ AI.TiC BONDING CO.,1
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
Whereas, (owner) I_ar • hereinafter referred to as the owner of
the following described property (address): _ • / t�, '
Pt 33 (
Legal Description Lot Block
Folio #
Requests permission to install (describe work):, \a� c� �1\ -��.
Within the public right of way of (address)
rn (oAl ,(, S e n) FL 3 l3
1
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Subdivision
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.
Signature
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 Ma ager of Miami Shores Village (or his fully authorized representative).
ner or Agent
The foregoing instrument was acknowledged before me this2 day of (1 ,, 20 L, b
who is personally known to me or who has produced `CC \ �. 1 ) • 11 � entification and who did take
an oath.
NOTARY PUBLIC:
� . fi
Sign:
Print:
My Commission Expires:
2
NOTARY PUBT IC .$TATS OF FLORIDA
", Claudia V. Cubiilos
` °� = Commission #DD717923
� . ` u.xli9:•Ps• SEP. 23, 2011
novena :i "] ATIANPlC BONDING CO., INC.
RECEIPT
PERMIT #: DS \v y ` 16 DATE: I t 1 2N 10
f �
Lcr9
❑ Contractor
owner
❑ Architect
Picked up 2 sets of plans and (other) A-k IZS ( i''t .—
Address: \` ,00 5 3T
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 Departm t to contin - permitting proces
Acknowledged by:
PERMIT CLERK INITIAL:
PERMIT CLERK INITIAL:
RESUBMITTED DATE:
M iami Shores Viiiage
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
REVISED:
NOT VALID UNLESS EMBOSSED WITH
SURVEYOR'S SEAL
F.I.P. 1/2"
(NO I.D.)
5.008
CONC. e d
WALK
L =33.63'
R =25.00'
=77'04'27"
•F.I.P. 1/2"
(NO I.D.)
:25' ..(
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
FLOOD ZONE: AE
PANEL: 0306
DATE:
SCALE:
1• =20'
DWN. BY:
F. Blanco
SUFFIX: L
C OMMUNITY #
DATE 9 /11/09 BASE: 8
120652
JOB No
10 -593
•
SCALE: 1 " =20'
F.I.P. 1/2"
(NO I.D.) W.P.P.
0
ar
GARAGE
23.25'
N.E. 95th STREET
31.00'
0
2.70' ( " 1 •
0
0
2.70'
27'± ASPHALT PAVEMENT
80' RIGHT —OF —WAY (BY PLAT)
21' PARKWAY
22.25'
co
7.30
° o ` 77LE
• PORCH
0
N
. . . *(80 5 � CONGyS/DP`i+NA,C(�s�� .
22.20'
a
��
< p V 10.18'
2.50 t ' ai
2.50' _
rei
2.80' CBS ONE STORY
RESIDENCE
# 1200
21.70 2.70'
106.10' (R &M) WOOD F. N
LOT 1
ui
4.00'
0
0
POOL
EQUIP.
1298'
10.00'
ON PL
13.05' _
;l e% ON PL
F.I.P. 1/2"
I z 2 (NO I.D.)
1 LOT 2
3250 S
ELEVATION BASED ON LOC. #
CBM# B -62 ELV. 8.74' TYPE OF SURVEY: BOUNDARY SURVEY
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, IF ANY, AFFECTING THIS PROPERTY.
BEARINGS WHEN SHOWN ARE REFERRED TO AN ASSUMED VALUE OF SAID PB PAGE
F.I.P. 1/2"
I MMEIIV�j�
BY:
LOT 16
BLOCK 85
OS 10
Miami Shores Village
APPROVED
ZONING DEPT
BLDG DEPT
SUBJECT TO COMPUANCE WITH ALL FEDERAL
STATE AND COUNTY RULES AND REGULATIONS
BB
SVVK'I
F =FO
UE=
M =M
0/S O
MASONRY V�
CONC
MAI
URE
N
RY
PRAi4A ASEMENT "M &D.E
LOCATION SKETCH
SCALE: NTS
1
LEGAL DESCRIPTION: LOT 17
OF MIAMI SHORES BEACH VIEW •
ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 10
OF THE PUBLIC RECORDS MIAMI —DADS COUNTY, FLORIDA
N.E. 95th STREET
17 16
15
1
APPROV
14
ONS
EVALKiC S =CONCRETE BLOCK STRUCTURF, I HAINUNK P 7 0 LNE.DUE=D i' GE UTILITY EASEM ENT, IP=I'G
A IR CONDITIONER PAD, P/C= PROPERTY CO = . RESIDENCE, CL-C =KEBAB,
E cONC=C RETE SLAB, R/W=RIGHT OF !MY, DE =D G EMENT, C/L LINE, O=DIAMTER, TYP=TYPICAL,
RRD
ECOED.,ENt COMP=
COMPUTER, COMPOMPUTER, ASH =ASPHALT, N/D=NAIL & DISC, S =SET,' FEE =FINISH FLOOR ELEVATION,
/P r, _ ., • kitie.COHFi=l0IIVERHEAD POV4ERLINE,VM =VATERMETER
13
85
- „ L
SURVEY FOR: TOM LONGMAN, 1200 N.E. 95TH ST., MIAMI SHORES, FLORIDA 33138.
BLOCK 85
SUBDIVISION
AT PAGE
37
SINCE 1987
BI..ANCO SURVEYORS ING.
Engineers • Land Surveyors • Planners • LB # 0007059
565 NORTH SHORE DRIVE
MIAMI BEACH, FL 33141
(305) 865 -1200 Email: blancosurveyorsinc@yahoo.com Fax: (305) 865 -7810