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FW-10-992Project Address Owner Information Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fees Due CCF Education Surcharge Permit Fee - Wire & Wood Scanning Fee Technology Fee Total: Amount $0.60 $0.20 $203.00 $6.00 $0.80 $210.60 Building Department Copy Address Parcel Number Contractor(s) HOME OWNER Phone Cell Phone Phone Approved: Yes Comments: Date Approved: 6/1/2010: Yes Date Denied: Type of Construction: Wood Fence Classification: Residential Additional Info: 5 FEET HIGH MAX Scanning: 2 Authorized Signature: Owner / Applicant / Contractor / Agent Pay Date Pay Type Invoice # FW -5 -10 -38046 06/17/2010 Check #: 1658 05/28/2010 Check #: 1652 Amt Paid Amt Due $ 160.60 $ 50.00 $ 50.00 $ 0.00 Date Applicant 166 NW 103 Street Miami Shores, FL 33150- 1131010230030 Block: Lot: JACQUELINE SMALL 1 C JACQUELINE SMALL 166 NW 103 Street MIAMI SHORES FL 33150 -1236 1 Valuation: Total Sq Feet: $ 1,000.00 278 1 Available Inspections: Inspection Type: Final Foundation 1 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. June 17, 2010 June 17, 2010 1 Scheduled Inspection Date: July 13, 2010 Inspector: Bruhn, Norman Owner: SMALL, JACQUELINE Job Address: 166 NW 103 Street Miami Shores, FL 33150- Project: <NONE> Contractor: HOME OWNER Building Department Comments July 12, 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- 148016 Permit Number: FW -5 -10 -992 For Inspections please call: (305)762 -4949 Permit Type: Fence/Wall Inspection Type: Final Work Classification: Wood Fence Phone Number Parcel Number 1131010230030 WOODEN FENCE AROUND THE HOUSE 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- 144775. Fence post spacing must be 5' Maximum Page 12 of 17 BUILDING PERMIT APPLICATION FBC 20 Miami Shores Village Building Department 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 ROOFING Owner's Name (Fee Simple Titleholder) ( L� lIJ r G Phone # Owner's Address 1 � C� )Ut.) /03 ded 6fiste.4 City NAJO,yvvi State Tenant/Lessee Name Email , J c 2, / (` VQ(,, l`ol'l°➢ Job Address (where the work is being done) / , /() 03rd r City Miami Shores Village County Miami -Dade FOLIO / PARCEL # 1 / g 0 /0 3 - o® 3z5 Is Building Historically Designated YES NO )e Contact Phone Submittal Fee $ Permit Fee $ E -mail Permit No. L) 1 U f - I "V ar Master Permit No. Zip 23/5o Phone # Zip Contractor's Company Name J a t i,p1 i�ihc Contractor's Address W 10 City &t (r).4„.4 t, t .5 r l.o Y e State Icy. Zip `Z ) S Qualifier Name Phone # State Certificate or Registration No. Certificate of Competency No. Value of Work For this Permit $ c r � �zf?��L�l. AIJIJA Type of Work: DAddition Alteration s �" eta • 34(4,3 cwA esag� a 3 av Describe Work: P # 731 T7 1 / 31."3 Architect/Engineer's Name (if applicable) Phone # *• * * * * * * * * * * * * * * * *** ** * * * * *• * * * * * • * ** Fee * * * * * * * * * * * * * * * * * * * * * * * * * * ** * *• ** • * ** * * * ** 7A7 /4,/ r3Z? Flood Zone rt-O' Notary $ Training/Education Fee $ 90) Scanning $ CQ .( . J Radon $ DPBR $ Bon $ Double Fee $ Violation date: Structural Review. $ Total Fee Now Due $ ` J , (g0 See Reverse side - CCF $ `J CO /CC $ Technology Fee $O. Bonding Company's Name (if applicable) Bonding Company's Address City Mortgage Lender's Name (if applicable) ( e(? / frc,-er, Mortgage Lender's Address f a 57 y7/(..) Cit p 0.;- (1P a State 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. Owner or Agent The fore = sing . I, ent was acknowledged before me this �� day of Mai , 20/0 , by .IaCv K t. I tr)e - rr i'v .QQ , who is personally known to me or who has produced or(cO9, n "vert!,eo.re As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: ****************************** ******************* * * * * * * * * * * * * * * * * * * * * * ** * * * * * * ** * * * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner %/A Zoning APPROVED BY (Revised 07 /I0 /07XRevised 06/10/2009) State Zip zip We-D.? e-/- y7/0 Signature Contractor The foregoing instrument was acknowledged before me this day of ,20_,by who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: Engineer Clerk checked Plannln 2 1 . 1 7 , m Owner's Name: JACQUELINE SMALL Job Address: 166 103 Street Miami Shores, FL 33150- Contractor(s) HOME OWNER n. Zoning Criteria 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: 6/1/2010: Yes Comments: Issue Date: Not Issued Phone Permit NO. FW -5 -10 -992 Expires:Not Issued 1 Folio Number:1131010230030 Owner's Phone: Total Square Feet: Total Job Valuation: Primary Contractor Yes 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 ai - AJ % ...371/1-111, DATE: i 7 fli(C�.' e=90(0 ADDRESS: 61040 lllo 1 a'rci ( 5,4- ildro,.1c Mrs l `-- 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. 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. 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. 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 27id 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.mvfloridalicense.com /dbpr /pro /cilbTndex.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: 16 /((tO (6,4_ ja C 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 retumed 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 a day of Q j , 2010 V Produced there License or Initial Initial Initial Initial S ma - who was personally known to me or who has "\ 01(09,-1 1.-p..-aoral identification. C Initial /7/ NOTARY 030 111G9 r �r 7ob� SIT c.S , INC. ;? X� i:t" rce.0 ©rtnc�toco., gONUh:D 'CL'R�1 h'C1" Mav ?.O(19 eShadow Box ; R ° 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 6" on center maximum Fence must not exceed 5'in height M iami Shores Viiiage Building Department 4x4 pressure treated posts embedded 2' into concrete footing 10" diameter x 2'deep ALL wood must be pressure treated All fasteners must be corrosion resistant No Tess than two fasteners in any connection 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 ix pickets fastened with two corrosion resistant fasteners per connection 2x4 horizontal pressure treated wood members with two corrosion resistant fasteners per connection ,. 0 t PROPERTY OF: / 0 / i02.54 4 G 4 3 g. T • 70 To t,4c- RAJ. NOT VALID MRNOUT ME =NATURE AND THE oRRUNAL RAISED SEAL OF FLORIDA • LICDIEED SURVEYOR NW MAPPER 7 2� /4 l8 Is /9 2a • • PORell c - Plc 0 c oil c • r1 b � A BOUNDARY SURVEY 1 hereby certify that the survey represented ,.Ihereop meats the nihilism (aclndeal standards set forth by the hoard of Land Striviiyors In chapter 210174 Florida b dmtnistraltve Code pursuant to Section 472.027 Fla. Statutes. There are no encroach +i ^it}s. overlaps, easements appearing on ths other than as shown hereto 10 FL. PROP. SURVEYOR AND MAPPER NO. 5 29 ONE 57"0/2./ Aae S /L)EA/CE .5476' This property described as: Lots:7, 8 and 9, Block 1 BONMAR PARK ADDITION, according to the Plat thereof, as recorded in Plat Book 24, Page 71 of the Public Records of Miami -Dade County', Flor,idd I,�Iaml ,o es APPROVED .. BY ail ZONING DEPT RI_ DG DEPT SUBJECT 1 CCMPLIANCE STA I E AND eti.,UN .Y RUI V ' 2 04)0 0 . * 0 /00.EO( /4) a Q 9 7�e *0 416HtCEN 0 rho 72 FENCE /A/ S C,E .EE'A/ED o Nrr.- L ?U-E, a/o/k: C a/7C STEPS L 07 0 G� > b. 1 X 4.44 50' um2 E / FENCE FIELD DATE SCALE DRAWN 8 07 / /yoB �t ►_2d, ) G Page 1 of 2 -- qLL FEDERAL ES AND REGULATI� ^:S 3 LANNES AND GARCIA, INC. L.B. #2098 Surveyors- Mappers -Land Planners BEALE SMITH. PSM 15238 I ! a 5 r BY DRAWING NO 150834 lb V,t/O o o • ON PROP. GOP-NE I:2 4 D.) Small ,...Jacqueline M. 166 N.W. 103rd Street, Miami Shores, Florida Office Address: 359 Alcazar Ave, Coral Gables, FL 33134 (305) 888 -7909 (954) 523-8663