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DS-09-2Project Address Owner Information L MADELEINE ROMANELLO Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795 -2204 Address 29 N. E. 96 ST. Expiration: 07/12/200 Parcel Number 29 NE 96 Street Miami Shores Village, FL 33138- 1132060130830 Block: Lot: MADELEINE ROMANELLO Contractor(s) HOME OWNER Phone CeII Phone Phone Valuation: Total Sq Feet: Approved: Yes Comments: CAN NOT PLACE PATIO/PAVERS IN FRONT YARD Date Approved: 1/9/2009 : Yes Date Denied: 1/5/2009 Type of Work: PATIO Bond Retum : Additional Info: CONCRETE PAVERS Classification: Residential Fees Due CCF Education Surcharge Notary Fee Permit Fee Scanning Fee Submittal Fee Technology Fee Work withqut Permit Fee Totalt) I Amount $6.00 $2.00 $5.00 $125.00 $3.00 ($50.00) $2.90 $125.00 $218.90 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy January 13. 2009 Invoice # Total Amt Paid Amt Due DS-1 -09 -33596 $ 218.90 $ 218.90 $ 0.00 Applicant January 13, 2009 Date CeII $ 10,000.00 820 Available Inspections: Inspection Type: Final Sidewalk Landscaping Foundation 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. 305 ,E BUILDING PERMIT APPLICATION FBC 20 Permit Type: BUILDING Owner's Name (Fee Simple Titieholder) Owner's Address 2 t . . 94 5 City 4fli ,J /f0_ State : Pr-..- Tenant/Lessee Name Email Value of Work For this Type of Work: Describe Work: .. Job Address (where the work is being done) - plat- City Miami Shores Village County .. Miami -Dade Zip FOLIO 1 PARCEL # Is Building Historically Designated YES NO i■' Flood Zone Contractor's Cotnpany Name Contractor's Address City Architect/Engineer's Name (if app 4, am Shores Village Building Department 1 D050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 7952204 Fax: (3`05) 756.8972 INSPECTION'S .PHONE NDMl3EII :. (30S) 762.4949 Phone # 305 : 7/D Pnco Submittal Fee $ Permit Fee $ State gAlteration Notary . .'$ Scanning Radon $ Double Fee $ Structural Review:: $ TranungfEd ucatien Fee E-mail Master Permit No Zip. 3 9/.34' .... ONew 0 . Repair/Replace DPBR $ Violation date: • **************W******** 9. A * **** ,kitr9r:ik*** **Fees** *fir** *** *fit** *** *iF*** ZaERVED JUN z i zoo n Permit No. 0-;?- Phone # "Phone Square / Linear Footage Of Work: Zip Qualifier Nance Phone State Certificate or Registration No Certificate of Competency No. .. Contact Phone Phone #.... ti 32 ❑ Demolition CCF Total Fee Now Due $ - 31 • CO1CC $ Technology Fee $ Bond $ See Reverse side -+ APPROVED BY Sign: Print My Commission Expires; .0 (Revised 07 /10 /07)(Revised 06/10/2009) * * * * ** * * ** * * ** * * *** Zoning 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 bas 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 CON]ITIONERS, ETC..... OWNER'S Alit WAVIT: 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 CONNCEMENT 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 certified copy of the recorded notice of commencement must be posted at the job site for the first inspection whit . c s • • • J days of er the building permit is issued. in the absence of such posted notice, the ;. inspection will not be appr. 'rid' ✓on fee will be charged.. Owner or Agent The for going instrument was ac owledged efore me this o� 1 The foregoing instrument was. acknowledged before me this day of,� , ;z �, 20 1 (3, by i ..J A ) ' 0 Ace), (t_day of , 20 , by who ' personally known to me or who has produce who is personally known to me or who has produced 13 NO " YPUBLIC: 9 identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: r0. fi 'pi' Y" ya %?R G a 4 r * * * * * * * * * * * * * * * * * ** * *** Irmo *:fr9r3i9t9r,F*it3e*** **** * ** • Plans Examiner Engineer Contractor Signature 26.80' ONE STORY RESIDENCE 1. # 29 15.90' CONC - `i ffj/ 12.90' 5.00' CONC SWK 7.00' GRASS PKWY vo ! 111 rl r F1 /2P W /a 0 /D Iii 144.0 4-71. Yrrer0,? P#1+.t'�!.: ( q ak16460 GfZl K P4 Co " I ?S 8.00' ASPHALT PAVEMENT 100.00' P&M 100.00' P&M 1 . •• • 0.5E_ , L il p YE-0 ) 'Cjvis 9.9rf s Al) i; S flit ? -f'&. F1 /2P w/NO/lo 6819 5a4< 6.5vt 7)CL 1 c Diir C W/?74 EfOffili S 2.20 v...;3.5# U a O O co E-- 0 Legal Descr Lot 15+16,1 MIAMI SH the plat there 70, of the P Florida. NORTH ).CALF: 1/20 Certified To: MADELEINE $ AND KOLSK N COMPANY, ( SUCCESSOR APPEAR. c\) 2 Atp,77nA/ 377IV 12)1tc? �,TC1'1y 7/a.) .E 7XCV GO / ✓G C 4LL Si9F f 9c� C®ve" - inD /N PEJ2 1.i /,4/1/ S/ vDST�Y� ill i ?7P ',-g ) Cave" = L4`!7 b vr2 Mr Q /,ZAflT E76-4'09-2 Ml l- /l /1 s /7 , Pt_ 33/g k /L77 xis Is -#4, - • • • • • •• • • • • • • •••• •••• • • . •• • • • •• • • • •• • • • • s • • • • • • Permit No: 310 Job Name 6_ 3 , 2010 4 ci / «d 4. /77 J o' L " ✓ e) ..r4 dtG't_ Norman Bruhn CBO 305 - 795 -2204 Building Critique Sheet �L ♦ rv 1/ M iami Shores Vivage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 •S • .t e r /.€ sag' 41cJ1 64 .�.c Page 1 of 1 C7. 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. Planning and Zoning Criteria Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Owner's Name: MADELEINE ROMANELLO Job Address: 29 96 Street Miami Shores, FL 33138- Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 6/25/2010 : Yes Comments: CAN NOT PLACE PATIO /PAVERS IN FRONT YARD Issue Date: 1/13/2009 Contractor(s) HOME OWNER Phone Primary Contractor Yes 1 CAN NOT PLACE PATIO /PAVERS IN SIDE YARD WITHIN 10 FEET OF SIDE LOT LINE. 1/9/09 MUST MAINTAIN 10 FOOT SIDE YARD ON EAST SIDE OF LOT. 6/21/10 PLEASE CLEARLY IDENTIFY SCOPE OF WORK ON THE PLANS 6/25/10 OWNER STATED THAT THE PATIO WOULD BE 12 FEET FROM THE SIDE LOT LINE, PLAN OK Permit NO. DS- 1 -09 -2 Expires:1 /13/2009 Owner's Phone: Total Square Feet: 820 Total Job Valuation: $ 10,000.00 Folio Number:1132060130830 Planning and Zoning Criteria Owner's Name: MADELEINE ROMANELLO Job Address: 29 96 Street Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Miami Shores, FL 33138- Contractor(s) Phone Primary Contractor HOME OWNER Yes 1 Planning and Zoning Criteria and Comments Approved: No Comments: CAN NOT PLACE PATIO /PAVERS IN FRONT YARD Date Denied: 1/5/2009 CAN NOT PLACE PATIO /PAVERS IN SIDE YARD WITHIN 10 FEET OF SIDE LOT LINE. 1/9/09 MUST MAINTAIN 10 FOOT SIDE YARD ON EAST SIDE OF LOT. 6/21/10 PLEASECLEARLY IDENTIFY SCOPE OF WORK ON THE PLANS Folio Number:1132060130830 Owner's Phone: Total Square Feet: 820 Total Job Valuation: $ 10,000.00 Planning and Zoning Criteria Owner's Name: MADELEINE ROMANELLO Job Address: 29 96 Street Planning and Zoning Criteria and Comments Approved: No Comments: CAN NOT PLACE PATIO /PAVERS IN FRONT YARD 1/9/09 MUST MAINTAIN 10 FOOT SIDE YARD ON EAST SIDE OF LOT. 6/21/10 Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Miami Shores, FL 33138- Contractor(s) HOME OWNER Issue Date: 1/13/2009 Phone CAN NOT PLACE PATIO /PAVERS IN SIDE YARD WITHIN 10 FEET OF SIDE LOT LINE. NS Permit NO. DS- 1 -09 -2 Folio Number:1132060130830 Owner's Phone: Total Square Feet: 820 Total Job Valuation: $ 10,000.00 Primary Contractor Yes Date Denied: 1/5/2009 Permit No: I& 9 -2 Job Name ?3 , 2010 Norman Bruhn CBO 305 - 795 -2204 Miami Shores Vivage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 Building Critique Sheet / � ,tom 6e z/',t e #f©1 :;t47 /j.gr rrPo/ 4-/77 • 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. • BUILDING PERMIT APPLICATI FBC 2004 Permit Type (circle): Building Type of Work: Describe Work: pp��A Submittal Fee $ 'a.! Permit Fee $ / Notary $ 5.0 Training/Ed ucation Fee $ Scanning $ 3' Bond $ Code Enforcement $ • Structural Review. $ Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fa (305) 756.8972 Roofing Job Address (where the work is being done) e 9C City Miami Shores Village County Miami -Dade FOLIO / PARCEL # / 1— 32 — 04 Is Building Historically Designated YES NO Value of Work For this Permit $ a 5 O 0 Square / Linear Footage Of Work: Permit No. L SYSOi Master Permit No. Owner's Name (Fee Simple Titleholder) J 09E— ®A. ACC Z Phone # �� V 0 q ng Owner's Address City 11 4 1 A-vvN . ' S 4Oe9tate _ �1._ Zip 3S /3 9, Tenant/Lessee Name Phone # Contractor's Company Name ® . C$ Uff . hone # Contractor's Address e l City State Zip Qualifier Name Phone # State Certificate or Registration No. Certificate of Competency No Architect/Engineer's Name (if applicable) Phone # Addition ;4Alteration ❑New ❑ Repair/Replace gDemolition �/ 3it 6.12$kss Geab, AW / cc Ne_2 PAu - P417b 5 ',w a 11C �^ ®v= s /y oR 6U FA X'/577/v 4 exyrDooe 864 PA 5Y J'rt ***************************************F s ******************************************** V � Technology Fee $ 910 Radon $ DPBR $ Zonmg $ a • Double Fee $ / Total Fee Now Due $ 6) -q - 10 Zip 33P3 CCF $ W '00 CO /CC Sep 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 subjec chment. ; s', a certified copy of the recorded notice of commencement must be posted at the job site for the first inspecti' which :ccurs ; 7) days after the building permit is issued. In the absence of such posted notice, the inspection will no '� a approz; ,' ; r/r ection fee will be charged. Signature The foregoing instrument acknowledged was acknowledge me this Z The foregoing instrument was acknowledged before me this day of �A, , 20 d GG =1, by pt Aria , day of , 20 _, by who is personally known to me or who has produced • l OS' who is personally known to me or who has produced NOTARY PUBLIC: Sign: Print: My Commission Expires: * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: (Revised 07/10/07) 1 Signature Owner or Agent Contractor As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: **************************************** ***** **** * * ******* **** ** * *** *** Plans Examiner Engineer Zoning Expires:Not issued Owner's Name: MADELEINE ROMANELLO Job Address: 29 96 Street NE Total Square Feet: 820 Miami Shores Village, FL 33138- Total Job Valuation: $ 10,000.00 • Contractor(s) Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 1/9/2009 : Yes Comments: CAN NOT PLACE PATIO/PAVERS IN FRONT YARD Issue Date: Not Issued Phone Primary Contractor CAN NOT PLACE PATIO /PAVERS IN SIDE YARD WITHIN 10 FEET OF SIDE LOT LINE. 1/9/09 MUST MAINTAIN 10 FOOT SIDE YARD ON EAST SIDE OF LOT. Permit NO. DS-1 -0 9 -2 Folio Number:1132060130830 Owner's Phone: .PM.. .4C — o Im Min 4. This Instriqient Prepared Name VW) - ;1 Address O 1 '-- STATE OF COUNTY OF THE UNDERSIGNED hereby gives notice that improvement wilt be made to certain real property, and in accordance with Chapter 713, Florida Statutes. the following information is provided in this Notice of Commencement. 1. Description of property: (legal description of property, and street address if available) c' Mi lm 46 re 1 � i 4� 1 cc � ri 0 c (! (.� 2!SArferardfe ` ri ' p-ti ' b � n PmprTtG�menl: V 3. Owner information (74„ • t 1 �" W/IJ�J b. Name and address:� I�/►1G1W11 S>n4r�S 3 v b. Interest in property: '�v c. Name and address of fe mp litleho o r than owner): (3l"---. 4. Contractor: a. Name and addres s: { /�y 7r� ` ti .,305c_ A cos. �. b. Phone number: V�' ) ( 3\N � 'l d on---it 2q Al r 6 s T 5. Surety a. Name and address: b. Amount of bond $ c. Phone number: 6. Lender a. Name and address: b. Phone number: 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes: a. Name and address: b. Phone number: B. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 7.13.13(1)(b), Florida Statutes: a. Name and address: b. Phone number. 9. Expiration date of notice of commencement (the expiration date Is 1 year from the date of recording unless a different date is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713. PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED THE •: SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WI YO - 'D OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF bOMMEN skorel rL g NOTICE OF COMMENCEMENT Th ip trument was acknowledged before me this / da (name of person) as authority, ...e.g. officer, trustee, attorney in fact) for behalf of whom Instrument was executed). NOTARY PUBLIC-STATE OF FLORIDA %, Claudia V. Cubillos • Commission # D D 3 2011 ••,4,,,„„ Expires: 1� o *wan` 1.1410. Verification Pursuant to Section 92.5 Personally Known _ or Produced Identification Si, "a ural Person Signing Above Tax Folio Nol1 er or Owner's Authorized Officer/Director anager . J © E A. co $i f .. Signatory's Ti . /Office ..�i Iftear) by (type of _(name of party on 61. SIg = ure o Notary Public - State of Florida Prin , Type, or Stamp Commissioned Name of Notary Public Commission Number • Under penalties of perjury, I declare that I have read the foregoing : nd ff cts stated in it are true to the best of my knowledge and belief. • • NAME: ADDRESS: VILLAGE OF MIAMI SHORES OWNER BUILDER DISCLOSURE STATEMENT t�2 A das-R4 DATE: 1 I 0 a( 0 9 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 2. I understand that as an owner- builder I must abide by all zoning ordinances and building regulations in effect it 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. Initial : 4. I understand that the building official and inspectors are not thereto 'dein, = = 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. 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 v - day of 'Ea."'" BY By 6-1) 115D Initial -- Initial ,le Initial , 20 b who was personally known to me or who has Produced there License or . 1.'" - S q D1ls �.It Gb 1 1 3 110 as identification. • • • •■ kA.r. *0 Contractor(s) Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 Fax: (305)756-8972 C 24 EV 1, ( /to t comer Issue Date: Not Issued Phone Planning and Zoning Criteria and Comments Approved: No Comments: CAN NOT PLACE PATIO/PAVERS IN FRONT YARD CAN NOT PLACE PATIO/PAVERS IN SIDE YARD WITHIN 10 FEET OF SIDE LOT LINE. Permit NO. DS-1 -09-2 Expires:Not issued Folio Number:1132060130830 :.• 820 Owner's Name: MADELEINE ROMANELLO Job Address: 29 96 Street Miami Shores Village, FL 33138- Total Job Valuation: $ 10,000.00 Owner's Phone: Total Square Feet: Primary Contractor Date Denied: 1/5/2009 BUILDING PERMIT APPLICATION FBC 20 Permit Type: BUILDING ROOFING Owner's Name (Fee Simple Titleholder) NI o S t4 Owner's Address 2 /V . P 37 City i?j/ ft-State P 6— Tenant/Lessee Name Job Address (where the work is being done) City Miami Shores Village FOLIO / PARCEL # Is Building Historically Designated YES Value of Work For this Permit $ Type of Work: Addition Describe Work: Miami Shores Village Building Department Email JA Pt �./07w 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 Permit No. 02)S °` (` 2-- Master Permit 1o. 'County Miami- Dade NO State E -mail Radon $ DPBR $ Violation date: Contractor's Company Name Contractor's Address City titb pq C c Qualifier Name (/ State Certificate or Registration No. Certificate of Competency No. Contact Phone Phone # Zip L3( 3 8 Phone # Phone # ******** * * * * * * * * * * * * * * * * * * * * * * * * * * ** * ** *F * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ 126 zip 33/3Y Flood Zone Zip S3/5;_° 205 7R) 972 Architect/Engineer's Name (if applicable) Phone # Square / Linear Footage Of Work: [New ❑ Repair/Replace ❑ Demolition * * * * * * * * * * * * * * * * * ** CCF $ CO /CC $ Notary $ Training/Education Fee $ Scanning $ Double Fee $ Structural Review. $ Total Fee Now Due $ 125 .oZ Technology Fee $ Bond $ 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 AF1MIDAVIT: 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 subje' t� atta - ent. Also, a •rtified copy of the recorded notice of commencement must be posted at the job site for the first inspecti ys after the building permit is issued. In the absence of such posted notice, the inspection will not ' e apps; ed t a cti r fee will be charged. Signature Signature Owner or gent Contractor The foregoing instrument was acknowledged before me this CO ) The foregoing instrument was acknowledged before me this day of rL.., 2010, by �C� s k , day of , 20 _, by who is personally known to me or who has produced A-1 f 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: NOTARY PUBLIC: \\`` ���111 UU /,i,��� Sign: — ' : Sign: Print: — NOTARY PUBLIC • = Print: My Commission Expires:; Commission # My Commission Expires: U'f:'•.. DD165901: '@'' %, OF Ft- °No\ APPROVED BY Plans Examiner Zoning (Revised 07 /10 /07)(Revised 06/10/2009) Engineer Clerk checked OWNER BUILDER DISCLOSURE STATEMENT NAME: E A . 1F ' -sT - -DATE: f( / 24/() ADDRESS: 0 9 (V E --- PC S 7 If Ali M iami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Please read and initial each paragraph. 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. 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. 5. I understand that, as the owner - builder, I must provide direct, onsite supervision of the construction. Initial Initial Initial 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. 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 umbers on permits and contracts. 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 .stantially improved it for sale or lease, which violates the exemption. Initial A 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. 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. 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 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.mvforidalicense.com /dbpr /pro /cilb /inde .html 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: &-r'YL 12. I agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the information hat I have provided on this disclosure. Initial 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 U day of 3A\- , 20 By who was personally known to me or who has Initial Initial Initial Initial M20700 5. of AN AMENDED PLAT OF . CTION NO. 1, according to recorded in Plat Book 10, at Page Records of Miami -Dade County, nullity Number: N/A Number: 0093 J c ''rm Index: 3/2/1994 1 Gone: X Flood Elevation: N/A of Completion: 01/22/04 :rty Address: E. 96 STREET vII SHORES , FL 33138 A''TLLO, CATLIN, SAXON, EVANS, FINK , __.ST AMERICAN TITLE INSURANCE ANTY RESIDENTIAL LENDING, INC., ITS ) /OR ASSIGNS, AS THEIR INTEREST MAY iv SIGNED I 98 nS H O A E L A t•: D ..... • GENERAL NOTES: I HEREBY CERTIFY REPRESENTATION OF 1 N .. T THIS BOUND SURVEY PREP 94 r " MIGUEL ESPINOSA LAND SURVEYING, INC. 6494 S.W. 24 STREET ML4MI, FLORIDA 33155 PHONE: (305) 740 -3319 LB # 6463 :i T R�CT � H OSru L • V A P. D • • SIY.q.CT .• Cs '7477 „ I j :STREET 1) LEGAL DESCRIPTION PROVIDED BY OTHERS. 2) THE LANDS SHOWN HEREON WERE NOT ABSTRACTED FOR EASEMENT OR OTHER RECORDED ENCUMBERANCES NOT SHOWN ON THE PLAT. 3) UNDERGROUND PORTIONS OF FOOTINGS, FOUNDATIONS OR OTHER IMPROVEMENTS WERE NOT LOCATED. 4) ONLY VISIBLE ENCROACHMENTS LOCATED. 5) WALL TIES ARE TO THE FACE OF THE WALL. 6) BEARINGS REFERENCED TO LINE NOTED AS B.R. 7) NO IDENTIFICATION FOUND ON PROPERTY CORRNERS UNLESS NOTED. 8) NOT VALID UNLESS SEALED WITH THE SIGNING SURVEYORS EMBOSSE SEAL. 9) DIMENSIONS SHOW ARE PLAT AND MEASURED UNLESS OTHERWISE ' OWN. 10) ELEVATIONS IF SHOWN ARE B D UPON N.G.V.D. 1929 UNLESS 0 ► '1 RWISE NOTED. 111 THIS IS A BOUN ARYSURVEY $•O THERWISE NOTED. INOSA 01 ORIDA IS A TRUE 1 CORRECT MY DIRE N. FOR THE FIRM THIS SURVEY IS INTENDED FOR ORT AGE OR REFINANCE PURPOSE ONLY, EXCLUSIVELY FOR THIS USE BY ' OSE TO WHOM IT IS CERTIFIED. THIS SURVEY IS NOT TO BE USED FOR CONSTRUCTIO PERMITING, DESIGN OR ANY OTHER USE WITHOUT WRITTEN CONSENT OF MIGUEL ESPINOSA. g&I.]:;=. 9.00' 'f/ � 1.. , F1 W $ ,00'01.1. '41 P bl/g r 1.67 - k1 i:, CIAO LD &Z Ole& ik t; Our Doo ' I? F101/E PL % / 1 115.00' Pdt 1 h7 (3\ 1 rii LOT - 17 BLOCK BLOCK-.. 1,1 �lb x x RePz..4 cc 4.J ` C&W C 3 f P :" -/l.5 rt.-N; Ei �` / a 24.40' 26.80' o Y /:. CONC if. CONC ` Q / 12.90' o co ON E STORY RESIDENCE , . , ► r r►. #. 29 O 13.70' `J 16.' C 1 NIPil I r V_ rile 0 4.40' g _ *'0 G AQ - '' f / 0 c.74: 4� 1 9 5.00' CONC SWK 100.00' Pale 7.00' GRASS PKWY I 200' VALLEY GUTTER 0 F^FY1 DVe lC 7C (. , I1 10 /.4_2.11Lk.41 Ql=Pe.4ce. Of Cv9fc�iF°rePA II, NE 96 STREET /b'x2.i/x3;5 Mi,.. Shores Village p 2.00' G DROVED • , T�f'KWY • 100.00' Pahl t). Ls c ;T el 8.00' ASPHALT PAVEMENT NG DEPT DEPT ECT TO COMPUANC § AqA AVEM T 'ATE AND COUNTY RULES AND REGULATIONS Lot 15 +16, l MIAMI SH the plat then M k - 70 , of the P Florid .... Legal Descr NORTH SCALE 1/20 Certified To: MADELEINE AND KOLSK cS COMPANY, SUCCESSOR APPEAR. uutvJpg- V Hail • of 1 s nip . / uiQU.6vvsic.a.vuv ,,: a.. .- —.__.• ::1:146RE1 PA v M (36" Cas 7b/rJ /6" )C2 lm X.,5 11/28/2008 11:02 AM Inspection Number: INSP - 145202 Permit Number: DS- 1 -09 -2 Scheduled Inspection Date: July 13, 2010 Inspector: Bruhn, Norman Owner: ROMANELLO, MADELEINE Job Address: 29 NE 96 Street Miami Shores, FL 33138- Project: <NONE> Contractor: HOME OWNER Building Department Comments REMOVE CHICAGO BRICK IN THE BACK PATION AND REPLACE IT WITH CONCRETE PAVERS Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP- 103328. Plans and permit must be posted outside for inspection. Work exceeds permit. Provide permit for gates /fence, wall and BBQ. NB July 12, 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 Type: Driveways /Sidewalks /Slabs Inspection Type: Final Work Classification: New Phone Number Parcel Number 1132060130830 Page 9 of 17 August 02, 2010 Building Department Official Miami Shores Village Building Department 10050 NE 2" Ave. Miami Shores, FL 33138 Re: 1299 NE 104' Street Miami Shores, FL 33138 Dear Building Official: We would like to inform you that we have temporarily abandoned execution of permits: permit # Dock-3-07-470 for concrete boat dock and Permit # BP2005 -1289 for house painting. No work under these permits was done. ester Jensen