FW-10-2127Inspection Number: INSP- 153863 Permit Number: FW -12 -10 -2127
Scheduled Inspection Date: December 28, 2010
Inspector: Bruhn, Norman
Owner: COLEMAN, BRIDGET
Job Address: 118 NW 103 Street
Miami Shores, FL 33150-
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
December 27, 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: Fence/Wall
Inspection Type: Final
Work Classification: Wood Fence
Phone Number
Parcel Number 1131010220030
INSTSALLATION OF 5' HIGH SHADOW BOX WOODEN
FENCE ON THE BACK OF THE HOUSE IN
REPLACEMENT OF BROKEN WALL
Passe / / 6ze 6
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
Page 4 of 10
1 -1 "IP 40 i\fL
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: BUILDING
OWNER: Name (Fee Simple Titleholder):
Address: % 0 c")`
City: State:
Tenant/Lessee Name: Phone #:
Email:
JOB ADDRESS: ®a , tJ>,, °�7 j fir'
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #:
Is the Building Historically Designated: Yes
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 #:
Value of Work for this Permit: $
Type of Work: ❑Address CIAlteration
Description of Work:
Miami Shores Village leCTOW
Building Department
1 LOW
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972 --p4pp9
INSPECTION'S PHONE NUMBER: (305) 762.4949
Permit No. F) 0
Master Permit No.
Phone #: p S- /y1�/�pS� �l / ■/ /�J
� • V • 3 �4 V 5
Zip: �®
NO Flood Zone:
Phone #:
Square/Linear Footage of Work:
UNew URepair/Replace
❑Demolition
N
COLOR THROUGH ROOF TILE IS REQUIRED acknowledged by:
******* * * ** * * * * * * * * * * * * * * * * * * * * * *,r * ** F * *** * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $ Permit Fee $ /',g 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 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 approved and a reinspection fee will be charged.
NOTARY PUBLIC:
Signature _ 1'� Signature
Owner or Agent Contractor
The foregoin instrument was acknowledged before me this t The foregoing instrument was acknowledged before me this
day of 1 , 20 IDby t3(V0®, -4p1 kft, ,`� , day of , 20 , by
who is personally known to me or who has produced lD who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
As identification and who did take an oath.
Sign:
Print: \ ��,�
. . ' t om ''
S TAB '6k \ .\\
My Commission Expires:
APPROVED BY
l/� /f?
(Revised 07 /10 /07)(Revised 06110 /2009)(Revised 3/15/09)(rev6/4/10)
Sign:
Print:
My Commission Expires:
Plans Examiner � 1 d' 1 ( ((Q Zoning
Structural Review Clerk
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: rtur,u-, ` DATE: 1.1 25\
ADDRESS: °%
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.
Initial A- t_
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 "'L.
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.
Initial Q L.
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 ��
5. I understand that, as the owner - builder, I must provide direct, onsite supervision of the construction.
Initial 2.1
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.
Initial 2 -�
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.
Initial Q
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.mvfloridalicense.comldbpr /pro /cilbfindex.html
Initial 1?)•L
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.
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
returned 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 L day of _0 _ , 20 tl�
By who was personally known to me or who has
Produced there License or 1 6 06 '4 G �O (P as id entificatiQO,urrru,, ,,, ����
�,e \very ' %�, t. iotimillino
Initial %I"
Initial
Initial °�
May 2009
\ )L. Shadow Box
o Vertical Picket
o Board on Board
WOOD FENCE DETAIL
4x4 Post Spacing
Fences <= 5' high posts spaced at 5' on center maximum
Fences <= 4' high posts spaced at Won center maximum
Fence must not exceed 5' in height
4x4 pressure treated
posts embedded 2'lnto
concrete footing 10"
diameter x 2'deep
M iami Shores Vuiiage
Building Department
ALL wood must be pressure treated
All fasteners must be corrosion resistant
No lees than two fasteners in any connection
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
1x pickets fastened
with two corrosion
resistant fasteners per
connection
2x4 horizontal
pressure treated
wood members
with two corrosion
resistant fasteners
per connection
Revised on 5/22/2009
Permit application must be accompanied by:
iami Shores Vinage
Building Department
REQUIREMENTS FOR FENCE PERMIT
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
❑ 2 copies of your survey (not older than 7 years).
❑ If survey is older than 7 years fill out Survey Affidavit form.
❑ If owner is doing the job, owner must fill and notarize Owner Builders
Disclosure form (This form must be signed and notarized in the building
department only).
❑ Show the proposed size on survey including, required 40 sq ft of garbage
area, location of gates if any, and height (can not exceed 5' ft height).
❑ Include wood or chain link specs form (one with each survey).
❑ $50.00 submittal fee when submitting your permit.
NOTICE:
ALL OTHER TYPES OF FENCES WHICH DO NOT COMPLY WITH ESPECIFICATIONS
MENTIONED ABOVE, MUST PROVIDE 2 SIGNED AND SEALED ARCHITECTURAL OR
ENGINEERING DESIGNED DRAWINGS, OR MIAMI DADE COUNTY PRODUCT APPROVALS.
STATE OF (FLORIDA)
COUNTY OF (DADE)
The undersigned Affian oes hereby attest that
(Property owner)
The attached survey, performed by .
(Name of surveyor's company)
For address: \' is _1 , \ -; NO , -; ,
Performed on 1 ''Z10. -AD (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 Tess than seven (7) years old 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 say eth naught.
Property Owner Print Name
SWORN TO AND SUBSCRIBED before me this 1 day of (2 ( 2"D/ C)
Property Owner Signature
Affiant is personally known to me, produced as identification.
ROTARY PUBLIC lotry
Commission #
cP ® Q'��
Revised on 5/22/2009/ Revised on 6/12/09
SURVEY AFFIDAVIT
M iami Shores Voiage
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Miami
Shores Village
1 BY
DATE
APPROVED
ZONING DEPT q
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BLDG (DEPT
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WITH AU.
RULES AND REGULATIONS
w/„Zy®
FEDERAL
SUBJECT TO COMPLIANCE
STATE AND COUNTY
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FOR: G�� � 4- 6, r
• T. L RIGGS
PROFESSIONAL LAND SURVEYOF
P. O. BOX 330403
MIAMI, FL 33233 -0403
TEL. (305) 448 -9032
•
BOUNDARY SURVEY
•
Lots 7, 8 and 9, Block 1, GOLD CREST recorded in Plat.Bdok 21 at Page 56.
of the Public Records of Dade County, Florida.
Order #951 F.B. #34 -3 January 267 1 • •••• '
I HEREBY CERTIFY: That the survey represented hereon meets technical
standards set forth by the Florida State Board of Land Surveyors and
is correct to the best of my knowledge and belief.
•
• ..
T.L. Riggs
Registered Land Surveyor #2349
STATE OF FLORIDA
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FOR: G�� � 4- 6, r
• T. L RIGGS
PROFESSIONAL LAND SURVEYOF
P. O. BOX 330403
MIAMI, FL 33233 -0403
TEL. (305) 448 -9032
•
BOUNDARY SURVEY
•
Lots 7, 8 and 9, Block 1, GOLD CREST recorded in Plat.Bdok 21 at Page 56.
of the Public Records of Dade County, Florida.
Order #951 F.B. #34 -3 January 267 1 • •••• '
I HEREBY CERTIFY: That the survey represented hereon meets technical
standards set forth by the Florida State Board of Land Surveyors and
is correct to the best of my knowledge and belief.
•
• ..
T.L. Riggs
Registered Land Surveyor #2349
STATE OF FLORIDA
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