DS-10-2069Scheduled Inspection Date: December 13, 2010
Inspector: Bruhn, Norman
Owner: BURKHALTER, LAWRENCE
Job Address: 185 NE 105 Street
Miami Shores, FL 33138 -2032
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
December 10, 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- 153560 Permit Number: DS -11 -10 -2069
For Inspections please call: (305)762 -4949
Permit Type: Driveways /Sidewalks /Slabs
Inspection Type: Final
Work Classification: New
Phone Number 305 -494 -8858
Parcel Number 1121360050160
pavers for pathway leading from side yard to garbage area:
leave 2ft setback to property line. connect to existing pool
deck
Passed
zrt
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
Page 10 of 17
BUILDING
PERMIT APPLICATION
FBC 20
Folio/Parcel #:
Miami Shores Village rOVVISI
Building Department
JOB ADDRESS:
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
Permit Type: BUILDING
OWNER: Name (Fee Simple Titleholder): La 'JYCL V - '\L - \NUL — t YL, Phone #: ? J o5 9 4 "'/ 93
Address: 1 s c C , 1 O' Sa
City: ■ 0-AN.A SA p -- A State: Zip:
Tenant/Lessee Name: Phone #:
Email: \ O` U V.-Pt N PNo..ar f,`e s, L.9
City: Miami Shores County: Miami Dade
Master Permit No.
Permit No. Q .- 20609
Zip: "53\
Is the Building Historically Designated: Yes NO ✓ Flood Zone:
CONTRACTOR: Company Name: t Phone #:
Address:
City: State: Zip:
Qualifier Name: Phone #:
State Certification or Registration #: Certificate of Competency #:
Contact Phone #: Email Address:
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $ — l. 0 0 t t 0 Square/Linear F of Work: 5 S h
C9
Type of Work: ❑Address ❑Alteration New Repair/Replace ❑Demolition
Description of Work: ?o-vei, 5 cc 1R_- ()AA* \-e.--ex.. P swl. Si t rv-rA__
i._y—_ . C ..ek '\Z-D --z--_i S"Cl
COLOR THROUGH ROOF TILE IS REQUIRED acknowledged by:
******** * * * * * * * * *,* * * * * * * * * * * * * * * * * * * ** F * * * * * * * * * * * * * * * * * * * * * * * * * * *** ** * **
Submittal Fee $ O ' Permit Fee $ /®o" a CCF $ CO /CC$ $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $
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 pennit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be annroved and a reinspection fee will be charged.
NOT
Signatur Signature
Owner or Agent
The foregoing i ment was aPknowledged
day of ,1 ti , 20 lQby
wh is per nally known to me r who has produced
C b 4 ji r 94 ation and who did take an oath.
APPROVED BY
UBLIC:
Sign:
Print:
My Commission Expires:
'� : Commission Expires:
0
,'2 I Plans Examiner
(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)(rev6/4/10)
Contractor
e foregoing instrument was acknowledged before me this
day of , 20 , by
wbo is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
it/75/(d
Zoning
Structural Review Clerk
CER17F1ED TQ
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LEGAL' DE
LOT 16, BLOCK 20'1, DUNN!NbS MIAMI SHORE EXTENSION NO. 1,
ACCORDING TO THE PLAT THEREOF, RECORDED IN PLAT BOOK 41, PAGE
51 OF THE PUBLIC R, EQRD$ OF MIAMI —DADE COUNTY, FLORIDA
,.) liwD
13L/R1jvJfE,
n O
1,) n n
1. LAWRENCE BURKHALTER AND LAURA BURKHALTER
2. ATTORNEYS' TITLE INSU ICE FUND
3. HARK & BURKHALTER, P.L. Miami Shores Viitage
01
',PPPO"ED BY
) N!F'L' fEPT
JG DEPT L_
LIFCT TO cOtRUPXCE WITH ALL FEDERAL
n rE AND COUN'{YR1LES AND REGULATIONS
LB #0006933
PREPARED F0Tt
BURKHALTER
185 NORTHEAST 105th STREET
MIAMI SHORES, FL
33138
1.
�l
3850 NW BOCA RATON BLVD SUITE 3
BOCA RATON, FLORIDA 33431
PHONE: 561 -620 -8722
FAX: 561- 620 -8724
FLOOD ZONE / BASE FLOOD FLEV,
MIOIUNRY PANEL NUMBER
120652- 0093 -J
MTE OF FJ INDEX
03/02/94
• • • •h A SSU .4ED`8e ME: $I@ • SOUTH LINE OF THIS PLAT BEARS
• • ta AND ALL BEAD DEPICTED HEREON ARE RELATIVE THERETO.
2. LEGAL te3cFsProm PROVIDED BY CUENt.
3. THE LANDS SHOWN HEREON WERE NOT ABSTRACTED BY THIS OFFICE FOR EASEMENTS, RIGHT -OF-WAYS,
OWNERSHIP OR OTHER INSTRUMENTS OF RECORD.
4. SUBSURFACE IMPROVEMENTS. FOOTINGS OR FOUNDATIONS HAVE NOT BEEN LOCATED.
5. ELEVATIONS ARE BASED ON THE NATIONAL GEODETIC VERTICAL DATUM OF 1929.
6. IN SOME INSTANCES GRAPHIC REPRESENTATIONS HAVE BEEN EXAGGERATED TO MORE CLEARLY ILLUSTRATE
THE RELATIONSHIP BETWEEN PHYSICAL IMPROVEMENTS AND/OR LOT LINES IN ALL CASES DIMENSIONS SHALL
CONTROL THE LOCATION OF THE IMPROVEMENTS OVER SCALED POSRIONS.
7. THE 0/T ENSIONS AND DIRECTIONS SHOWN HEREON ARE IN SUBSTANTIAL AGREEMENT WITH RECORD VALUES
UNLESS OTHERWISE NOTED.
BY . ---.'° A"g DATE 08/26/07
B. BURNS PROFESSIONAL LAND SURVEYOR FLORIDA CERTIFICATION N0. 5090
DATE
c''
SURVEYORS cERTIEcaION
I HEREBY CERTIFY THAT THE SKETCH OF SURVEY SHOWN HEREON MEETS THE MINIMUM TECHNICAL
STANDARDS FOR LAND SURVEYS AS SET FORTH IN CHAPTER 61017 -6 OF THE FLORIDA ADMINISTRATNE
CODE FOR THE BOARD OF PROFESSIONAL SURVEYORS AND MAPPERS PURSUANT TO SECTION 472.027
OF THE FLORIDA STATUTES.
NOT VALID WITHOUT THE SIGNATURE AND THE ORIGINAL RAISED SEAL OF A FLORIDA UCENSED SURVEYOR
AND MAPPER.
LEGEND
•1. ) :?.. +$ -„A 3 CONCRETE
CORNER
- , — , — , — r —, —,- OVERHEAD WIRES
W000 FENCE
�.— r — a — s —R — CHAIN UNK FENCE
POUND V2'
stoN NOD
30
Scale 1 "
c DpOic°
Bl.OiGYC�
WALT.
WALL
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ORAL
925.2 )
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OPEN ASPHALT ALLEYWAY
75.00'
LOT 16
BLOCK 201
37.2LT
ONE STORY
C.B.S.
RESIDENCE
(Has)
25.76'
49.82' WOOD PO•FR
AXE
CINCH t3tskY
MAW PAYMENT
(75 400
NORTHEAST 105th SWEET
30
A
1440'
romp
= 30'
t.Y R54. Tr
1 , .v
FOUND IRON PIi E
13.0'
h
60
40.00
NOM
PO•P
POLE
90
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` A DUNNINGS MIAMI SHORES EXT
NO 1 PB 4 I -5 I LOT I G BLIC 20 I
LOT SIZE 75.000 X 124 OR.
2 1 407 - 1 705 0G2003 G COC
23728 -38GG 07 2005 4
1
Y'Oi\
5' TRASH AREA
1 2' —G"
39I -5'
DRAINFIELD
ELEC.
METER
INFIELD
SEPTIC
TANK
0
RESIDENCE
ELEV= 10.65'
0 ELEC.
PANEL
49.82'
FB - 2004 R4 •I 7.I . 3
CHILD FENCE PERIMETER: I I G'
CHILD FENCE MUST BE PLACED NO LESS THAN.
20" FROM WATER EDGE
NOTE: ONE POST SET PERMANENTLY
SEE POOL SAFETY DEVICES(SHEET 2)
N.E. 1 O5T1 STREET
(CHILD FENCE BY OTHERS
0
e
L- 39.45'
w
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tn
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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. 1, 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.mvfioridalicense.com /dbpr /pro /cilb /index.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:
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.
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
returned to the local permitting agency responsible for issuing the permit. A copy of the property owners 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 AL, 20
B .)4 . 6(4011
Produced there License or T \
-Dr
OWNER
Initial
Initial ✓ y
Initial
who was personally known to me or who has
Kc-olg-0S.aoi
a
identificati
NOTARY
NOTA;4YP BLIC- °" 7.76O WJEDA
,n9:t:,,` Ctau ; V Cub MOS
m Comrsl sion4DIY /1 /' ,x ° 63
t ;EF. 23 2t'11
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
OWNER BUILDER DISCLOSURE STATEMENT
NAME: 'IZs4 t V DATE: L \ Z 2°' ) C)
ADDRESS: 1'Z S 2_, 1
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.
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.
5. I understand that, as the owner - builder, I must provide direct, onsite supervision of the construction.
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.
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.
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: LAWRENCE BURKHALTER
Job Address: 185 105 Street
Miami Shores, FL 33138 -2032
Planning and Zoning Criteria and Comments
Approved: Yes Date Approved: 11/23/2010 : Yes
Comments: SIDEWALK NOT TO EXCEED 3 FEET IN WIDTH.
Folio Number:1121360050160
Owner's Phone:
Total Square Feet:
Total Job Valuation:
Contractor(s)
HOME OWNER
Phone
Primary Contractor
Yes
1
305 -494 -8858
0
$ 1,400.00
Permit No: 1000
Job Name
/( -f /( „_?2, , 2010
/ Building Critique Sheet
0 / P� L ®c/ >/
Norman Bruhn CBO
305 - 795 -2204
M iami Shores Viiiage
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Page 1 of 1
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.