DS-08-876Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Date: 06/19/2008
Inspector: Grande, Claudio
Owner: STOCK, MICHAEL
Job Address: 268 102 Street NE
Miami Shores, FL 33138-
Project: <NONE>
Contractor: HOME OWNER
Permit Type: Driveways /Sidewalks /Slabs
Inspection Type: Final
Work Classification: New
Phone Number
(40.00.00.
Parcel Number 1132060134720
Lot:
Building Department Comments
REMOVE EXISTING GRAS AND CONCRETE RIBBONS
IN DRIVE WAY AND INSTALL NEW BRICK PAVERS
OVER A 4" ROCK BASE AND 1" OF BEDDED SAND.
REPLACE WALKWAY TO FRONT DOOR WITH BRICK
SURVEYS OUT FOR HRS APPR V • L. 5/ /08. MLD
;6Q►`® Q
Passed
Inspector Comments
6/4/08 Broken sidewalk on west end of property to be replaced by final
inspection. CG
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid .
until
Wednesday, June 18, 2008
Page 2of2
tit \u`c 4-
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING RE En /ED Permit No. flS OS enb
PERMIT APPLICATION MAY 14 2008 r: ter Permit No.
FBC 2004 _'
Permit Type (circle): adding R�oorfmg
v
Owner's Name (Fee Simple Titleholder) V ` e.,( «� Ce/L Phone #
Owner's Address c g ! 0a- 5
City M S t1 ®re S State r �°
5' 717 S-24
Zip
/3 g
Tenant/Lessee Name Phone #
Job Address (where the;work is being done) 9 6V t' /0
City Miami Shores Village County Miami -Dade Zip 3 3 / 3
FOLIO / PARCEL # 1`32- °013 -9710
Is Building Historically Designated YES NO
Contractor's Company Name f O CU-rte 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) Phone #
00
Value of Work For this Permit $ 4pl00
Type of Work:
Describe Work:
sc,-.d
['Addition ['Alteration
alma e 1)(%
Square / Linear Footage Of Work:
❑New
53-1j'
❑ Repair/Replace ❑ Demolition
it
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L/h` roc
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Amy
aecf
14ce._ co vi It,
alc0,"" k,
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Submittal Fee $ Permit Fee $
Notary $
Scanning $
Bond $ iwCD.'
Training/Education Fee $ 2'SS
Radon $
Code Enforcement $ = ' Double>Fee $
) ,�� = �. Q�;,�
To Now Due $ V' ) -
MAY 2 8 2008
CCU 65 142?
jgY
€+ c
DPBR $
CCF $ 5.00 CO /CC
Technology Fee $ •) Ji-°
Zoning $
Structural Review. $
See Reverse side -*
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.
•
Signature Signature
Owner or Agent
The foregoing instrument was acknowledged before me this ZS
day of I,k
Contractor
The foregoing instrument was acknowledged before me this
,200! , by
ttlLINte S�'lal�l 31-4 day of , 20 _, by
who is personally known to me or who has produced ff. -3)17,4141-(e. who is personally known to me or who has produced
As identification and who did take an oath.. . as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
APPLICATION APPROVED BY:
(Revised 07/10/07)
NOTARY PUBLIC:
Sign:
Print
My Commission Expires:
,J 2
Plans Examiner
Engineer
Zoning
NAME:
VILLAGE OF MIAMI SHORES
MAY 2063
OWNER BUILDER DISCLOSURE STATEMENT
/1/l t cGt a &f DATE: s / /� /�'
ADDRESS: t% g
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.
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 M 5
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.
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 44
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.
Initial S-
-
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.
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.
Initial
Was acknowledged before me this J,0 day of /in , 20 a
By 1/46 d, 1,ttAoltt 51bU- who was personally known to me or who has
Produced there License or a Dtivis Lc, 513210 as identification.
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APPROVED BY DATE
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SUBJECT TO COMP
1 STATE AND COUNTY RULES AND REGULATIONS
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A3AUflS AuvaNnoe JO H313)IS
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Miami Shores Village
10050 Northeast Second Avenue
Miami Shores, Florida 33138 -2382
Telephone: (305) 795 -2207
Fax: (305) 756 -8972
www.miamishoresvillage.com
AFFIDAVIT
STATE OF FLORIDA
COUNTY OF DADE
ECECVE D
MAY 4 2008
The undersigned Affiant / 1Tci/gT` S'roc K , does here by attest that the
attached survey, performed by
performed on , is an accurate representation of the existing conditions and locations of all
Structures on the property as of this date.
The purpose of the 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 may now 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 effect final inspections as
applicable to this or other permits.
Further, Affiant sayeth naught.
Witness (sign and print)
Aff ant/Property Owner
Witness (sign and print)
SWORN TO AND SUBSCRIBED before me this /4114 day of /fry Z6o5' .
Affiant is nickel personally known to me, produced Ft -Pitv¢it3 S7?,Z1. as identification.
® I ®i,
S ores V �, age
Ncrilbensi Sid Avenue
oies, F'llolida33338 -2382
TA,- in one: (305) 795 -2207
Fax: (305) 756 -8972
WSVSV
tfi0 oil�' -`tn
ag cc
RE EGVED
MAY 4 2008
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
WHEREAS, /Me /MIL $TccK
(owner)
described property: 5"" AfE /0.2
ST�EEr
Legal description/folio#: J/- 32U6, - 0/3 -V/A0
Lot 3 &J
Tax Folio #: ,11- 3 .204 -0/3 - y7.2,0
, hereinafter referred to as the Owner of the following
/1 rriff .r 5/4 -mei , 46e ,oxr4 33 / 3r
Block 3 $ Subdivision
Requests permission to install:
[Asphalt, concrete(brick pavers
❑ Landscaping
❑ Other
Within the public road right of way of ' ,/£ /OA. STerfi T f Mt.q _5%1,71Z! 5 /.(J#9.
(address)
33133'
IN CONSIDERATION of the approval of this permit by the Village, the owner agrees as follows:
1. 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 obligations 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
SIGN El/ SEALED, AND DE 11 iii t - wesence
Permit 11
Folio a // - 3 a & -CV 3 - V 7,20
NOTICE OF COMMENCEMENT
The undersigned hereby gives notice that improvement will be made to certain real
property and in accordance with Chapter 713, Florida Statutes. the following Information
is provided In this Notice of Commencement
Legal Description of Property:
Street Address if available:
2. General description of Improvement :
3. a. Owner name and address:
h. Interest in property:
Name and address of fee simple
titleholder (if other than Owner):
c.
4. a. Contractor name and address:
b. Contractor's phone number:
5, a. Surety name and address:
b. Surety's phone number:
e. Amount of bond:
G. a. Lender name and address:
h. Lender's phone number:
,his space reaenad ree recedes
Lot 3d. `i Block 55 Unit fl Bldg OLengthy legal attacked
Subdivision /Condominium: g $S r T f3 y2. rl'JT i 5110140 fie` f As.e�! f�' /O`X'19s
4/R it 46-1- try* /l's 4.. Y //S .fi meos o'l
024? A/t /OA ST Mr'.folz 1id04t,f /A 53/55
/71.0e##.4 .vs?
-sle4 �./td�re /,q F s S.✓ .0.?Z�� 9 �ito�r iJ.9��teerk�
GL 5 r *, K
Qw.fE R
68 .vE /a). ST7fti /17 -ns frra
�.7b! �'5
647 !JIM' - ti- 1_Ne r te' d"tcF•4,
141
_
7 a Persons within the State of Florida designated by Owner upon w
by Section 713.13(1)(a)7., Florida Statutes:
Name:
Address:
b. Phone number:
1
om notices or other documents may be served as provided
1.1. a. In addition to himself or herself. the Owner designates
to receive a copy of 1-tenor's Notice per Section 713.13(124 Florida
b. Phone number of person or entity designated by owner
9. Expiration date of notice of commencement :
(Ihe expiration date Is 1 year from the date of recording unless a different date is SiSesSessffl4
WARNING TO OWNER: ANY PAYMENTS MADE 13Y THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1. SECTION 713.13,
FLORIDA STATUTES. AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY, A
NOTICE OF COMMENCEMENT MUST 13E RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING. CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Signature(s) of Owners) or Ownor(s)'lA thorized Officer /Director /Partner /Manage
fly
oy
U.e.1 Name chef-0 A. coi.I; r
rin Name
Title/Office TltleIOffice
STATE OF FLORIDA
COUNTY OF tI IAMI-bAbE 11
Lly
Tile foregoing instrru/ment was acknowledc�fled before me this /0 day of
ndividually, or 0 as
11 Personally known, or 0 produced the following typo of Identification:
in
vC
(or
Signature of Notary Public:
Print Name:
(SEAL)
VERIFICATION PURSUANT TO SECTION 92.525. FLORIDA STATUTES
Under penalties of perjury. I declare that 1 have read the foregoing and
Ih :rt the facts stated in it are true. to the boar nr ...., v..,.. ,_a__ _._ -.. •• •
NOTAR FL
Y PVBLIC$TATE OF ORIDA
, "�.•,, Scott Williams
ii : Commission # DD727296
,, .''' Expires: FEB. 03, 2012
Charlie Crist
Govemor
Michael Stock 0
268 NE 102 St
MIAMI, FL 33138
RE: Contingency Letter
Application Document No: AP859384
Centrax Permit Number: 13 -SG- 917347
OSTDS Number:
268 NE 102 St
MIAMI, FL 33138
Lot: 3 & Block: 35 Subdivision:
Ana M. Viamonte Ros, M.D., M.P.H.
State Surgeon General
May 16, 2008
Dear Applicant:
This will acknowledge receipt of an application dated 05/15/2008 for a permit to use an existing
onsite sewage treatment and disposal system located on the above referenced property.
1. -There is no increase in sewage flow, change in characteristics or compromise the integrity or
function of the system installation.
2. -This project entails :" Construction of a Driveway. "
From a review of your completed application, it has been determined your existing system is
adequate for the proposed use : " APPROVED ".
If you have any questions on this matter ,please call our office at ( 305) 513 -3459
Sincerely,
, Engineer II.
If you have any questions on this matter, please call our office at (305) 513 -3459.
Sincerely,
v.1
Dade
NW 1725 167th St
OPA LOCKA, FL 33056
305 513 -3459
Fax 305 513 -3472
Miami Shores Village
10050 NE. 2nd Avenue
Miami Shores, FL 33138-0000
Phone: (305)795-2204 Fax: (305)756-8972
Pennit NO. DS-5-08-876
Ofatriikitidfi:
Issue Date : Not Issued
Expires:1/1/2999
Folio Number:1132060134720
Owner's Name:
Owner's Phone:
••
••
••
••
.„,
.,,
Job Address: 268 102 Street NE Total Square Feet: 537
.•
••
.•
••
••
••
Miami Shores, FL 33138- ••
••
Total Job Valuation: $ 4,700.00
Contractor(s) Phone Primary Contractor
••
••
••
• •
••••
• •
• •
HOME OWNER Yes ••
••
••
••
••
••
••
••
••
Planning and Zoning Criteria and Comments
Approved: Yes Date Approved: 5/21/2008 : Yes
Comments: THE DRIVEWAY FLARES CAN NOT EXCEED 2 FEET IN WIDTH.
Miami Shores Village
Building Department
10050 .NE 2 Ave, Miami Shores, Fl 33138
Tel: (305)795 -2204 - Fax; (305)756 -8972
RECEIPT
PERMIT #; --DS 08- Z.-IL DATE: 5114103
I, M Lk U STUCK
❑ Cpntractor
Owner
❑ Architect
Picked up sets of s and (other) Soft/(9. j 11)
Address:
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: 0/26/01r
PERMIT CLEARK INITIAL: