DS-08-1249Project Address
101 NW 106 Street
Miami Shores, FL 33150 -1247
Owner Information
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204
Valuation:
Total Sq Feet:
$ 3,000.00
1000
ANDRE DORMUS
Approved: No
Comments: DRIVEWAY CAN NOT EXCEED 10 FEET IN WIDTH WITH2 FOOT FLARES, CONNECTION TO
Date Approved: : No
Date Denied: 7/11/2008
Type of Work: DRIVEWAY
Bond Retum :
Additional Info: CONCRETE
Classification: Residential
Fees Due
Bond Type - Owners Bond
CCF
Education Surcharge
Notary Fee
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$300.00
$1.80
$0.60
$5.00
$125.00
$6.00
$3.13
$441.53
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.
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
Address
PPR V
Expiration: 01/18/2009
Parcel Number
1121360080320
Block: Lot
101 NW 106 Street
MIAMI SHORES FL 33150 -1247
U � 14� MOP
MIAMI SHORES VILLAGE
Phone
(305)756 -7530
Applicant
ANDRE DORMUS
Available Inspections:
July 22, 2008
Date
Cell
Sidewalk
Inspection Type:
Final
Foundation
Landscaping
Tuesday, July 22, 2008 1
1I15la �.
BUILDING
PERMIT APPLICATION
FBC 2004
Permit Type (circle):
Contractor's Company Name
Contractor's Address
Ay bei
wide IAA% r, bet m esh,
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
RECEIVED
Roofmg
J L a 2008
O.
Master Permit No.
Owner's Name (Fee Simple Titleholder)4 N D R E ¶O tT A £' iW.Sc e #(305)150 747.3 v
Owner's Address / 0/ ,4I Gt) /f7 (a y+ ee t
City Pil j4M ( abre..S State FL O PI Zip 3 3 5O
Tenant/Lessee Name Phone #
Job Address (where the work is being done) /0 / NCO /0 C. S
City Miami Shores Village County Miami -Dade
FOLIO /PARCEL# l (-- /3 -00 9-0,3.2.0
Is Building Historically Designated YES NO
JUL 2 5 2ooe
Cry 144
MIAMI SHORES VILLAGE
Phone #
Permit No. RID 6
zi 33 / vr-
City State Zip
Qualifier Name Phone #
State Certificate or Registration No. Certificate of Competency No
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ J., `l ® Square / Linear Footage Of Work: /.
Type of Work: ['Addition ['Alteration ®New
Describe Work: / / A r . n c reZ e i vcw Pt - " o ee - . ' eel'
❑ Repair/Replace ❑ Demolition
******* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** F *********** * ** * * ** * * * * * * * * * * * * ** * * * * * * * * **
Submittal Fee $ Permit Fee $ A
/ S
r/ . CCF $ CO /CC
Notary $ Training/Education Fee $ Technology Fee $
Scanning $ i Radon $ DPBR $ Zoning $
Bond $ ly . 113` Code b,� A e . , • i t ,,max , II Double Fee $
Structural Review. $ Total Fee Now Due $ 41 t •
See Reverse side -4
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 Al l l )AVIT: 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 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 # proved and a reinspection fee will be charged.
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this lb The foregoing instrument was acknowledged before me this
day of
Signature
, 200t, by AM6■t '" DtOt .a) , day of , 20 _, by
who is personally known to me or who has produced T`,1�ratIS who is personally known to me or who has produced
3 1.013t.
As identification and who did take an oath.
NOTARY PUBL _ :
as identification and who did take an oath.
NOTARY PUBLIC:
/ ter 0140Pt° \SS O Dq�g r
Sign: ii
tier /.5 � + ice � �A�S'. �,�unaere" E Sign:
Print: / ,t .
1 Print:
My Commission Ex s: My Commission Expires:
** ***ox** **** ******* **• x***:****************** : ****************** * ********* *********** * : * * * * *:x**:x********* * **
APPLICATION APPROVED BY:
(Revised 07/10/07)
,lor
Plans Examiner
Engineer
Zoning
STATE OF FLORIDA)
COUNTY OF DADE)
The undersigned Affiant,4N6 ,t11 mu 0J does hereby attest that
(property owner)
The attached survey, performed by
(name of surveyor's compatjy)
for address: /D/ cv 1 0 co s7hecY �� /� -1 /� 1^cS FZ3 3 /S•6,
performed on (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.
Property Owner Signature
Ma a S Tillage
R4 Dice
10050 NE 2nd Ave
Miami Shores, Fl 33138
Phone 305.795.2204; Fax 305-756-89727:;:c:;; 11 (74:
www.miamishoresvillage.com
AFFIDAVIT
SWORN TO AND SUBSCRIBED b e f o r e me this lb d a y of g o . , 7 AY .
Affiant is personally known to me, '- produced
T7116/ LiG 320 43D as identification.
Notary
9
,0 'Mi" MONICA LISSE li DIA'
MY COMMISSION # DD 46•
F . EXPIRES: October20, 2L
P „; Q Bo nded Thru Notary Public Underw-
os
FTC EGV/
VILLAGE OF MIAMI SHORES JUG 1 0 ma
OWNER BUILDER DISCLOSURE STATEME _ - - " ° - -
NAME: AA('p K € ‘r wt US. & J. Su 3` e' DATE: 0 7 // O /!� e
ADDRESS: / o / l'l Gt9 10 e Hi& C# SI ors F
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 at 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
understand that the building official and inspectors are not there to design,
alter or give advice on how to meet code — only if the structure meets the
'� : ,' riinimum code. h
PI 0 21;r.11 Initial J S
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 /7
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
By Al* J
/of*
day of
Initial /9: /J
Initial 11,-
who was personally known to me or who has
Produced there License or g � Ilt/di`j 6431' as identification.
attached survey, performed by
iami ShoNe6 (/iLLcc�e
Al FLDA ITT `
DS
RFC
occ.- 1246(
JUL
'STATE OF FLORIDA)
COUNTY OF DADE)
The undersigned Affiant,ANb E \) D Q r news t5� ubsvto s hereby attest that the
(property owner)
(name of surveyor's company)
performed on , is an accurate representation of the existing conditions and
(date of survey)
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.
Witness(sign and print) Witness(sign and print)
SWORN TO AND SUBSCRIBED before me this 0 day of py Z
Affiant is personally known to me, . *oduced ri. irti c.K3Zo43D as identification.
MONICALI D49
48399•`
�fihNN ffiNOPUbli20 d 0muter
Lot qg
requests permission to install:
!/i amj S e
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
p Dsoa 02�
– C(
2
WHEREAS, A•k(prt [� h, Js NlL&SEehereinafter referred to as the Owner of the
(owner)
following described property:
Legal description /folio✓*: `j- 2,434 aQ o
Block l {o subdivision
Tax Folio g: , - ea S -x3
10050 N.E. SECOND AVE.
MIAMI SHORES. FLORIDA 3313
Telephone: (305) 795 -2207
Fax. (3051756 78972
Aliithf41 sh/o .4- es
VI, Asphalt, C rete brick pavers
[ J Landscaping
[JOther
within the public road right of way of / (() 1 0 fp vi Mf l
(address)
IN CONSIDERATION of the approval of this permit by the Village, the Owner agrees as follows:
I • 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.
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 obligation has been canceled by an affidavit filed in the Public records of Dade County, Florida
by the Village Manager of Miami Shores Village (or his fully authorized representative).
SIGNED, SEALED, EXECUTED AND ACKNOWLEDGE on this 0 day of
(owner)
SIGNED. SEALED AND DELIVERED in-the presence of :J7, 7?n tu's LtG 32,0 430
es FL3 f So
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
Issue Date: Not Issued
Permit NO. DS -7 -08 -1249
Permit Type: Driveways /Sidewalks /Slabs
Work Classification: New
Expires:Not Issued
Folio Number:1121360080320
Owner's Name: ANDRE DORMUS
Job Address: 101 106 Street NW
Miami Shores, FL 33150 -1247
Owner's Phone: (305)756 -7530
Total Square Feet: 1000
Total Job Valuation: $ 3,000.00
Contractor(s)
HOME OWNER
Phone
Primary Contractor
Yes
1
Planning and Zoning Criteria and Comments
Approved: No Date Denied: 7/11/2008
Comments: DRIVEWAY CAN NOT EXCEED 10 FEET IN WIDTH WITH 2 FOOT FLARES, CONNECTION TO SIDEWALK
CAN NOT EXCEED 3 FEET IN WIDTH, DRIVEWAY SHOULD BE LOCATED FARTHER FROM CORNER
PERMIT #; a 7 C7 I Ia
��- / 67' DATE: 7- / 7- ar
1, b larky
❑ Corr tractor
wner
❑ Architect •
Picked up 2 sets of plans and (other)
Miami Shores Village
Building Department
10050 NE 2 Ave, Miami Shores, Fl 33138
Tel: (305)795 -2204 - Fax; (305)756 -8972
Address: (0 ( , U) / 06 S I P 33/CO
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.
Acknowledged by:
PERMIT CLEARK INITIAL:
RESUBMITTED DATE:
RECEIPT
ga rn (& .4i
MO'
PERMIT CLEARK INITIAL: (917Z
CIRCULAR CONCRETE DRIVEWAY6" DEEP BY 12'
FEET WIDE WITH FIBERMESH
SI
Passed 11'11/1(-
Inspector Comments
CREATED AS REINSPECTION
REINSPECTION
MUST HAVE SOD
8/13/08
Need copy of fibermesh
M. t ���
C,52dig
FOR INSP- 91565. CREATED AS
FOR INSP- 89553. cc
AROUND DRIVEWAY. JR 08/04/08
concrete ticket for final inspection. CG
Oiz-
Failed I
,_ .
=
;��u!j
Correction
Needed
d&` a
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid .
until
[ 7. af,{ FSx} �v ;::;s;:;:::r,:;ar�:::::x;:;; {� M'i %;x•:wK:�:!wa:•>:•:
Inspection Date: 09/03/2008
Inspector: Rodriguez, Jorge
Owner: DORMUS, ANDRE
Job Address: 101 106 Street NW
Miami Shores, FL 33150 -1247
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
Tuesday, September 2, 2008
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: Final
Work Classification: New
Block:
Phone Number (305)756 -7530
Parcel Number 1121360080320
Lot:
Page 1 of 2
CIRCULAR CONCRETE DRIVEWAY 6" DEEP BY 12'
FEET WIDE WITH FIBERMESH
Passed
�j
Inspector Comments
CREATED AS REINSPECTION FOR INSP- 89553. cc
MUST HAVE SOD AROUND DRIVEWAY. R 08/04/08
il
c
�
�
O
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Inspection Date: 08/13/2008
Inspector: Grande, Claudio
Owner: DORMUS, ANDRE
Job Address: 101 106 Street NW
Miami Shores, FL 33150 -1247
Project: <NONE>
Contractor: HOME OWNER
Buildin
Department Comments
Tuesday, August 12, 2008
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit Type: Driveways /Sidewalks /Slabs
Inspection Type: Final
Work Classification: New
Block:
Phone Number (305)756 -7530
Parcel Number 1121360080320
Lot:
Page 2 of 2
CIRCULAR CONCRETE DRIVEWAY 6" DEEP BY 12'
FEET WIDE WITH FIBERMESH
Passed
Inspector Comments
` / L w J 5 r o f. t
//
5--o$
4--/e0 br iiJ
Failed 4-kt
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Inspection Date: 08/04/2008
Inspector: Rodriguez, Jorge
Owner: DORMUS, ANDRE
Job Address: 101 106 Street NW
Miami Shores, FL 33150 -1247
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
Friday, August 1, 2008
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: Final
Work Classification: New
Block:
Phone Number (305)756 -7530
Parcel Number 1121360080320
Lot:
Page 1 of 2
CIRCULAR CONCRETE DRIVEWAYS" DEEP
FEET WIDE WITH FIBERMESH
BY 12'
g
Passed
nspector Comments
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid .
until
Inspection Date: 07/28/2008
Inspector: Grande, Claudio
Owner: DORMUS, ANDRE
Job Address: 101 106 Street NW
Miami Shores, FL 33150 -1247
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
Friday, July 25, 2008
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 (305)756 -7530
Parcel Number 1121360080320
Lot:
Page 2 of 2