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DS-08-2010Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 100197 Permit Number: DS -11 -08 -2010 Scheduled Inspection Date: September 24, 2009 Inspector: Bruhn, Norman Owner: CRUTCHFIELD, TIMOTHY Job Address: 69 NE 99 Street Miami Shores, FL 33138- Project: <NONE> Contractor: HOME OWNER Permit Type: Driveways /Sidewalks /Slabs Inspection Type: Final Work Classification: Repair Phone Number Parcel Number 1132060131300 Building Department Comments EXTENDING DRIVEWAY 12" SO THAT IT REACHES STREET, AS NOW REQUIRED BY VILLAGE (APPROACH) STOP ORDER ISSUED DUE TO BOUNCE CHECK PENDING TO BE PAID. Pass >901>ocf..69 Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Cnninmh•r 9R lnna For Inspections please call: (305)762 -4949 Dann 1 of 17 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 2004 Permit Type (circle): ( Building 1 Roofing Owner's Name (Fee Simple Titleholder) Owner's Address Permit No. Fi orV 1 v 2 . Master Permit No. Phone # 4� 2_5-22 city /l ; ' A4 State et_ Zip 33 5r Tenant/Lessee Name Phone # Job Address (where the work is being done) 6 I 1" t 7: City Miami Shores Village County Miami -Dade Zip 33131 FOLIO / PARCEL # Is Building Historically Designated YES NO & Contractor's Company Name ikt Phone # Contractor's Address City State Zip Qualifier Name Phone # State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name (if applicable) ✓1/ .4 Phone # Value of Work For this Permit $ 10y Type of Work: Describe Work: 0 [Addition ElAlteration Square / Linear Footage Of Work: 12t9 if :II,. ❑New /2/ ❑ RepairlReplace ❑ Demolition * * * * * * * * * * * * * * * * * * * * * * * * *:x**** * *** ** * ** Fees:** **** * *** * * *** * ***** :�x *:x*** *�x: * ** *** ** * *** /69 Permit Fee $ CCF $ CO /CC Notary $ Training/Education Fee $ Technology Fee $ Subniittit l e J • Scanning $ Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ See Reverse side --* FS�*' - C O7 ! 11802 v._..i aa'vG - 13 Li _ 9 %.rf 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 Signature ' Signature The for:,_oing day of who 'fpersonally known to me or who has l"``' 1 VCAs identification and who did to an %ath. c ..********************************44** Owner or Agent ent was acknow NO IIA ' Y PUBLIC: o , I1 I I Sign: � _1 Print: My Commission Expires: APPLICATION APPROVED BY: (Revised 07/10/07) 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: ************************************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning Miami Shores Village Building Department •.. 10050 N.E.2nd Avenue Miami Shores, to a 33138 Tel:T3 5) Fax: (305) 756.8972 PermitN 'Y0%90 ( . Job'Name BUILDING CRITIQUE SHEET • ".•) rill :11 Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 Fax: (305)756-8972 .1 a Pennit NO. DS-11-08-2010i elm Issue Date: Not Issued Work :41.wri, • on Re Expires:Not Issued Folio Number:1132060131300 Owner's Name: TIMOTHY CRUTCHFIELD Job Address: 69 99 Street NE Miami Shores, FL 33138- Owner's Phone: Total Square Feet: 0 Total Job Valuation: $ 1,000.00 Contractor(s) Phone Primary Contractor •• •• •• •• •• •• •• HOME OWNER Yes •• •• •• •• •• •• •• •• •• •• Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 11/19/2008 : Yes Comments: VILLAGE OF MIAMI SHORES —O�WNER BUILDER DISCLOSURE STATEMENT � NAME: (�!t'1 ����C z DATE: f/` ADDRESS: 4/- 7� S � /`1 Nr7 �i �p z .3/3,�i 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. �— Initial 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 4. I 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 minimum code. Initial 5. 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 6. I understand that if I compensate any person or company for work performed they are requited 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. Initial 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 day of NtOMW, 20 (Ar who was personally known to me or who has Produced there License or OWNER )1- lq-aola as identification. TAW �� o ��ti3 ��+�° cyz. s 0114 M a ti 4 3 z I%/ ■ i. 901.114 „„, r�.�t, , JOB NO.: 95 -9 -222 DATE: July 19, 1995 L.a.!„.4rion/ to6.8c'67') (H) —P :Se•,4 LE /a =Zoo' LEGAL DESCRIPTION: Lots 19, 20 and 21 in Block 9 of AN AMENDED PLAT OF MIAMI SHORES SECTION NO. 1, according to the Plat :hereof as recorded in Plat Book 10 at Page 70 of the Public Records of Dade County, Florida. Property Street Address: 69 N.E. 99th. St.., Miami Shores, Dade County, Florida. This Survey is Certified to: Timothy H. Crutchfield Haley, Sinagra & Perez, P.A. Attorney's Title Insurance Fund, Inc., and Prime Mortgage Investors, Inc. L>smmm apeClaar O/B.Off Set rttc..Encroaat CaVc.- concrete . Line -ry Line of Way Vocamentad Line Lirk FOAM N.Y.S..tist To Scala W.F..Wendet Renee A/C.Air (bdttfaner • S.X.P..Set.j"isco Pipe .S.11.60..Set trail and Disc F.D.ILe antd trill Hole P.X.P.-)i6 r Iran Pipe F.14.&D..9Etmd Nall and Disc F.W.•Found Hail. N.G.V.D..Natimal: Geographical Vertical Datum 0.61.0.C..0mhead Utility Cables u.E..tttilitS tit PL..Planter D.C.B.M..Dade Countr•bench Nark L.F.EL. 7onart•Finer Elevation C.B.S..concEete Block. Structure P.C.P..Petwneat Control Point P.R.M..Pereaceatt Reference ltnment • (P):As per accorded Plat (MIS (C)=0:itputed (L.0.1. As per legal. Description P.C. Point of Curvatta+e 421- c...)/7 VG y WOOD r - SGr.4LE /rr� 24,1 *gtge- • 1,701 l >rile • 40 lappgamarriumr 1 FLOOD INFORMATION: F(.00DZONE= X • FLOOD INSURANCE RATE MAP= 120652 -0093 J (3/2/1994). Notes: l': -Not valid unlms Imprinted with an embossed Surveyor's Seal 2.- Elevations shown thus ' refer to N.G.V. Datum (1929) 3.= This is nj an Surrey 4.Feire o p assumed ai coding to the position of • its •elerrents, (.enless otheniise noted I 5.North Arrow shown is as per Plat Book 10 at Page 70, Dade County Public Records. v11ERfADY corn fY: That the attached PLAN OP SURVEY of the above described pm is tore and correct to the best of my lutowledge and belief as tcccntly surveyed and platted under my direction; *an that thane are not above - iund encroachments other than those shown. I further cent that•this survey meets the:Minimum Technical Standards set forth by the - Florida Board of Professional Land Surveyors pursuant to ion •' 7, Ft • }Ida Statutes and Chapter 21 -HH1, Florida A ndnis rathrc 'flAR1fIErimf P.S.M. Professional Surveyor and Ma Registration No.2263 State, of Florida..; Mailing Address: P.O.BOX 55 -7152, Miami, F1. 33255 -7152 A -1 LAND SURVEYING CO., Inc. LAND PLANNERS, SURVEYORS 4811• H.W. 79 Ave. Suite 1 5, Miami, F1. 33166 PM. 305-7164696 17.X1 305- 669 -1189 t=t APIO' °0old WALL, t i, vat; r W, 111 „\J V) Mk �/� W' • o 13,11 1 MErAf. 4i{:BD t/G • -e i le' 5xfrt 58.231 7P* 13.3 m te'l', m PLANTER MART kg, h'i t4 0't 1' /4.7 I ` L:LE AD *Mr hN • 1-4 to r- 5, eerie: -‘.isswatw. • • • ' • •l 2Z.1 PA- Y. a .7o • 439s, L9. .•'• • 1 . , � •; gyp' �� � �' �: v1 vrvi .co,c ore - .zr7' ..+1atT ::_:aver . tkeeo STREET. 99D1 Fir mr-zil-PIF7 trj 1,8 21B BY: ----- ------------ PERMIT #:1DS DX-DOD Miami Shores Villa e ZONING DEPT BLDG DEPT SUBJECT TO COMPUANCE WITH ALL FEDERAL STATE AND COUNTY RULES AND REGULATIONS STATE OF FLORIDA) COUNTY OF DADE) Ilteame Siotce4 ti a14 Vowdwice 10050 NE 2nd Ave Miami Shores, Fl 33138 Phone 305-795-2204; Fax 305-756-8972 www.miamishoresvillage.com AFFIDAVIT The undersigned Affiant, li,�, 6,„ 7� �f,�Z�� , does hereby attest that (property ow)ier) The attached survey, performed by 4 ( h44ye Au - 4 -2/'c (n. e of surveyor's compan for address: performed on 7 (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. r Property Owner Signature Property Owner Print Name SWORN TO AND SUBSCRIBED before me this 1 day of N-10\) Affiant is \4 personally known to me, produced as identification. �v ' �� Notary Public State of Florida Yuswny Border My Commission DD436629 Expires 06102 09