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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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be annroved and a reinspection fee will be charged. NOT Signatur Signature Owner or Agent The foregoing i ment was aPknowledged day of ,1 ti , 20 lQby wh is per nally known to me r who has produced C b 4 ji r 94 ation and who did take an oath. APPROVED BY UBLIC: Sign: Print: My Commission Expires: '� : Commission Expires: 0 ,'2 I Plans Examiner (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)(rev6/4/10) Contractor e foregoing instrument was acknowledged before me this day of , 20 , by wbo is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: it/75/(d Zoning Structural Review Clerk CER17F1ED TQ • •••• •••• • • .. • • Bout46;R sLji Y ' • • .1 ..1; • opts •i • • • f • •L • n nn nn n t9 n nn nn O 1 n n 1 n 0 O 0 n '1 .1 0 n -, 1 0 n LEGAL' DE LOT 16, BLOCK 20'1, DUNN!NbS MIAMI SHORE EXTENSION NO. 1, ACCORDING TO THE PLAT THEREOF, RECORDED IN PLAT BOOK 41, PAGE 51 OF THE PUBLIC R, EQRD$ 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 •.1 I Ar rt ":" ▪ ROVW3W ORAL 925.2 ) ,' *. 0 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 •• • • • • • • • • • • • •• •• • • •••• •••• • •• • • • • • • 1 1 1 •••• • • • • • •• • • • • •• • • •••• • • • • • • • • • • • • • • • • • • • • • • • ` 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 u z w z0 tn w i n a ri7a/i0 � /��� 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.