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FW-05-1231Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 163708 Scheduled Inspection Date: August 25, 2011 Inspector: Bruhn, Norman Owner: BIENSTOCK, JENNIFER Job Address: 275 NE 105 Street Miami Shores, FL 33138- Project: Permit Number: FW -12 -05 -1231 <NONE> Contractor: HOME OWNER Permit Type: Fence/Wall Inspection Type: Final Work Classification: Wood Fence Phone Number Parcel Number 1122310130520 Building Department Comments A 5' WOOD FENCE TO BE INSTALLED AROUND THE PERIMETER OF THE PROPERTY Passe J � 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- 163647. CREATED AS REINSPECTION FOR INSP -2957. Provide plans and access. No dogs for inspection. NB Cc_ August 24, 2011 For Inspections please call: (305)762 -4949 Page 15 of 18 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 BUILDING PERMIT APPLICATION FBC 20 Permit Type: BUILDING 1 �,�� J OWNER: Name (Fee Simple Titleholder): i G 6t% �'� Phone #: Address: 2'6 t. 41 ROOFING RECEIVED AUG19 111 BY•� Permit No.c-c-OLJS • 12D Master Permit No. Do-Z(7 --E-'2! City: V t 't t 56'frj �/ Tenant/Lessee Name: (J I� T Email: TCST IUD S'%G 7 gJ State: (4Y 4 Zip: 331 3X Phone #: 40C. C, rYI JOB ADDRESS: IS i g i oS S beak- State: "" " City: Folio/Parcel #: Miami Shores County: Miami Dade Zip: 33 /35 Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: / V Phone #: Address: City: State: Zip: Qualifier Name: Phone #: State Certification or Registration #: Certificate of Competency #: Contact Phone #: Email Address: DESIGNER: Architect/Engineer: Phone #: Z t'7 0, 0 Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑Addition 41teration ONew ORepair/Replace ODemolition � r S 1 4. (A - cc Ll g S — Description of Work: * * * * ** :* ******************* a: *+ x+ x******** Fees*** **+ x******* ***** ***+x******* * * ** ********* ** Submittal Fee ', j Permit Fee $ CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ (� TOTAL FEE NOW DUE $ 'J-;.16, I I °ffi Ilr't�' rinetw4 r" 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature wner or Agent Contractor The for ' oing instrume was a owledge�d /� be e m l foregoing instrument was acknowledged before me this day of , 20 , by l , .l y of , 20 _, by who is person ly known to me or who has produced who is personally known to me or who has produced Signature As identificat NO ' • Y ' UBLIC: Sin: 'hit Print: My Commission Expires: and wh did take an oath. as identification and who did take an oath. OD lot 2. My Commission Expires: ***********************************************+ x*x+**** ********* * ****** *+xx:****:x**x:**** mix**** * *:x************** APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) Miami Shores Village Building Department 1 0050 N.E.2nd Avenue, Miami Shores, Florida 33138 BUILDING PERMIT APPLICATIO FBC 2001 Permit Type (circle): Building Tel: (305) 795.2204 Fax: (305) 756.8972 E I ` E A 525 Electrical Permit No. f W°1t 17 1 Master Permit No. Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) ) not r C 1§Iensizeic Phone # 186-.267 -L22J Owner's Address .275 NE /DSO ..51ree-t City /Maim Shores State FiOr /cfa Tenant/Lessee Name Zip 33/38 Phone # AVA- Job Address (where the work is being done) .27$ Ne /O51 sY r€ t City Miami Shores Villa e County Miami -Dade Is Building Historically Designated YES NO, Contractor's Company Name IA W ASS • Contractor's Address Phone # Zip 33/3e City State Qualifier Zip State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # $ Value of Work For this Permit # 2,0°400 Square Footage Of Work: .2 94011-4r fet Type of Work: DAddition DAlteration NNew [1 R air/Re ep lace p ❑Demolition Describe Work: A 41ve fiat- wood eAce. tii, 64. pls- 61.1/ed mound perrnnefer, of ,¢,.loreper- Submittal Fee $ Permit Fee $ Notary $ Training/Education Fee $ 2.0 CCF $ CO /CC. Technology Fee $ Scanning $ Radon $ Zoning Bond $ Code Enforcement $ Total Fee Now Due $ Structural Plan Review. $ (Continued on opposite side) 4-14_2,413 .1c�ni� 04e +W .J Rye t �f t� 104 '1;ic r T:) fir- J 1•! y. 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is f.'s ed. In the absence of such posted notice, the inspection will not be approved and a reinspecctionnffee will be charged Signature Signature er or Agent � Contractor The foregoing instrument was acknowledged before me this 1'r8' The foregoing instrument was acknowledged before me this day of /,�_r , 200$ by , day of , 20 , by who is personally known to me or who has produced who is personally known to me or who has produced kOOLU01 As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: Sign: .Q <ZCr %, 20G 2� n NOTARY PUBL Sign: GwvLQ& Print E v f M o ��s A_ N O Print: Eva- t-10 Pt- P.% My Commission Expires: 1 g-J /c/o r********,******** **** * * * * * * * ** * * ** * * * * ** * ** * * * ** My Commission Expires: / - / /S /& *********************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * * * ** * * ** ** * * * * * * * * * * ** * * * * * * * * * * * * * * * * * ** f Gfi ii ` ` Plans Examiner Engineer Zoning APPLICATION APPROVED BY: ohc 05/13103 U / DI �T'N�'',a EVA M. FASANO ° Widow Ptak - State of Florida •IMyCannmkbrit tesDec152006 Commission • OD 399917 t . SondedByNationalNotaryAsm. •— _. ►♦ c) • 41•1 . 20 SKETCH OF BOUNDARY SURVEY SCALE ln= • 4.,Lufge, fetuce, Lar 5,50' 5 119 • II fR1 5/84 0 CENED 2%5 Mb 00 0,Za. GL, • 4. F 12,o' poOd 3.343' /12,0' /2.0toof -Q Q 0. zve e9.rofzi? 43 a 00 ■ /115 N ere.4 3---rp,otuog LaN6 S at13 to. PaLe Lt1 fie oc) 4,'■ Ito too' or_ 'MEM -4 10* 40N • sil.bs • • • C006 Vg.1 lig 6,5f1" Of^ 01. gitorer2- tqi :• i5paiacawf LA ugratz 0 Hr' t el pi, 410 • I 05"rit "7W( lrLT pAutmeor- 1 5 41 Pd or) BEARINGS HEREON (IF ANY) ARE REFERRED TO AN ASSUMED VALUE OF FOR THE SAID BEARING IS IDENTICAL WITH THE PLAT OF RECORD ACCORDING TO THE N.F.I.P. THE SUBJECT PROPERTY FALLS WITHIN FLOOD ZONE: X w LEGAL DESCRIPTION fbFLor. h t 2 SUBDIVISION: L V A0Q to 10.) o P+0. 40 • ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK OF THE PUBLIC RECORDS OF 14111141- 9A326 LOCATION SKETCH SCALE 1 gv� 1.16, 2"P ASE. 19 ZD SURVEY CERTIFY TO a N PAR Co BLOCK 14- AT PAGE 62 COUNTY, FLORIDA. NIA 105rN Imo{ +t ,c ► 5 �4-oFe , L , 3313$ . �C, e►EU � . 1 —2@ {5 <Jae 1k)eou(ZA04 i ft*UDI We,/ :''St '. Utcf6A4E C'F2p., evvcGEj iaS A.PD/432 A k L*, THE ATTACHED SKETCH OF BOUNDARY SURVEY OF THE ABOVE DESCRIBED PROPERTY IS A TRUE AND CORRECT REPRESENTATION OF A FIELD SURVEY MADE UNDER MY DIRECTION AND MEETS THE MINIMUM TECHNICAL STANDARDS AS SET FORTH BY THE FLORIDA BOARD OF PROFESSIONAL SURVEYORS AND MAPPERS IN CHAPTER 61017-6 1 _ FLORIDA CODE, PURSUANT TO SECTION 472.027, FLORIDA STATUTES. FOR: J10,130 ( JOB NUMBER 02 r/ 1 - S 4. DRAWN BY: L- c F.B. NO. CHECKED BY: 01 Y DATE OF THE FIELD SURVEY 1 — "G — REVISION DATE: SURVEYOR'S NOTES: LEGAL DESCRIPTION WAS FURNISHED BY CLIENT. NO UNDERGROUND INSTALLATIONS OR IMPROVEMENTS HAVE BEEN LOCATED, EXCEPT AS NOTED. THERE ME NO VISIBLE ENCROACHMENTS OTHER THAN THOSE SHOWN EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED INSTRUMENT, IF ANY AFFECTNG THIS PROPERTY . FENCE OWNERSHIP BY VISUAL MEANS ONLY OF ANY), LEGAL OWNERSHIP NOT DETERMINED. LEGAL DESCRIPTION SUBJECT. TO ANY DEDICATION, LIMITATIONS, RESTRICTIONS, RESERVATIONS OR EASEMENTS OF RECORDS. E. BELTRAN & ASSOCIATES, INC. 12533 S.W. 30th STREET MIAMI, FLORIDA 33175 PHONE: (305) 552 -7450 CERTIFICATE OF AUTHORIZATION NUMBER LB 5233 RAM C.L.F. W.F. RES. FJ.P. 8.R.8 CJL =CENTER LINE PPROPERTY LME =RIGHT-OF-WAY xHAN LNK FENCE =WOODEN FENCE zliESMENCE =FOLIO IRON PIPE SET RE-SAFI =CHORD BEARING MEAS =MEASURED S.N&D =SET NM. & DISC F.N. =POUND NAIL ABBREVIATIONS OF ANY APPLIED) CL =CLEAR U.E. ENC. MIYOROACHIAENt C.B.S. ATE BLOCK STRUCTURE 0 • MONCRETE =DIAMETER D.M.E. MRAINAGE MAIPTEVNNCE EASMT. 8.U? =SET IRON PIPE F.O.H. =FOUND DRILL HOLE ABC mA R CONOMO INO Leaf REC.. =RECORDED F.N.&D =POUND NAL DISC F.C.N. =FOUND CUT NAL =UTI.ITY EASEMENT W.M.E. =MLIAMIr. laCniaME EAST. th =MONUMENT LINE PROR COR =PROPERTY CORNER F.H. =FWE HYDRANT EASMC. =EASEMENT F.R.B. =FOUND RE-BM SAN. N. MET DRILL HOLE CALL. =QALNIXJSED F.S. =FOUND SPINE RAD =AV F. =F t8D (TM)mTYPICAL ERNESTO BEL PROFESSONAL • R & MAPPER NO. 4885 STATE OF FLORIDA DATE NOTE: THIS IS NOT A VALID SURVEY WITHOUT THE ORIGINAL RAISED SEAL AND SIGNATURE OF A FLORIDA LICENSED SURVEYOR AND MAPPER. j I4- 18 115' ., t5; 19 ZD SURVEY CERTIFY TO a N PAR Co BLOCK 14- AT PAGE 62 COUNTY, FLORIDA. NIA 105rN Imo{ +t ,c ► 5 �4-oFe , L , 3313$ . �C, e►EU � . 1 —2@ {5 <Jae 1k)eou(ZA04 i ft*UDI We,/ :''St '. Utcf6A4E C'F2p., evvcGEj iaS A.PD/432 A k L*, THE ATTACHED SKETCH OF BOUNDARY SURVEY OF THE ABOVE DESCRIBED PROPERTY IS A TRUE AND CORRECT REPRESENTATION OF A FIELD SURVEY MADE UNDER MY DIRECTION AND MEETS THE MINIMUM TECHNICAL STANDARDS AS SET FORTH BY THE FLORIDA BOARD OF PROFESSIONAL SURVEYORS AND MAPPERS IN CHAPTER 61017-6 1 _ FLORIDA CODE, PURSUANT TO SECTION 472.027, FLORIDA STATUTES. FOR: J10,130 ( JOB NUMBER 02 r/ 1 - S 4. DRAWN BY: L- c F.B. NO. CHECKED BY: 01 Y DATE OF THE FIELD SURVEY 1 — "G — REVISION DATE: SURVEYOR'S NOTES: LEGAL DESCRIPTION WAS FURNISHED BY CLIENT. NO UNDERGROUND INSTALLATIONS OR IMPROVEMENTS HAVE BEEN LOCATED, EXCEPT AS NOTED. THERE ME NO VISIBLE ENCROACHMENTS OTHER THAN THOSE SHOWN EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED INSTRUMENT, IF ANY AFFECTNG THIS PROPERTY . FENCE OWNERSHIP BY VISUAL MEANS ONLY OF ANY), LEGAL OWNERSHIP NOT DETERMINED. LEGAL DESCRIPTION SUBJECT. TO ANY DEDICATION, LIMITATIONS, RESTRICTIONS, RESERVATIONS OR EASEMENTS OF RECORDS. E. BELTRAN & ASSOCIATES, INC. 12533 S.W. 30th STREET MIAMI, FLORIDA 33175 PHONE: (305) 552 -7450 CERTIFICATE OF AUTHORIZATION NUMBER LB 5233 RAM C.L.F. W.F. RES. FJ.P. 8.R.8 CJL =CENTER LINE PPROPERTY LME =RIGHT-OF-WAY xHAN LNK FENCE =WOODEN FENCE zliESMENCE =FOLIO IRON PIPE SET RE-SAFI =CHORD BEARING MEAS =MEASURED S.N&D =SET NM. & DISC F.N. =POUND NAIL ABBREVIATIONS OF ANY APPLIED) CL =CLEAR U.E. ENC. MIYOROACHIAENt C.B.S. ATE BLOCK STRUCTURE 0 • MONCRETE =DIAMETER D.M.E. MRAINAGE MAIPTEVNNCE EASMT. 8.U? =SET IRON PIPE F.O.H. =FOUND DRILL HOLE ABC mA R CONOMO INO Leaf REC.. =RECORDED F.N.&D =POUND NAL DISC F.C.N. =FOUND CUT NAL =UTI.ITY EASEMENT W.M.E. =MLIAMIr. laCniaME EAST. th =MONUMENT LINE PROR COR =PROPERTY CORNER F.H. =FWE HYDRANT EASMC. =EASEMENT F.R.B. =FOUND RE-BM SAN. N. MET DRILL HOLE CALL. =QALNIXJSED F.S. =FOUND SPINE RAD =AV F. =F t8D (TM)mTYPICAL ERNESTO BEL PROFESSONAL • R & MAPPER NO. 4885 STATE OF FLORIDA DATE NOTE: THIS IS NOT A VALID SURVEY WITHOUT THE ORIGINAL RAISED SEAL AND SIGNATURE OF A FLORIDA LICENSED SURVEYOR AND MAPPER. VILLAGE OF MIAMI SHORES BUILDING DEPARTMENT OWNER BUILDER DISCLOSURE .STATEMENT I ehn;7CY C . 81O1S fief< being the legal property owner, for the property Located at: a75 /J /0$"t $fie€& Miami. Shores, Fe. 33/39 Legally described as 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),.Ind 1 have read and understand the following disclosure Statement, which entitles me to *ork as my own contractor, T further understand that 1 as the owner must appear in person to complete all applications. DISCLOSURE STATEMENT State law requires construction to be done by licensed contractors. You have applied for a permit under an exemption to that 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 or a farm out - building. You may also build or improve a commercial building at a cost of $25,000.00 or less. The building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the construction is completed, the law will presume that you built it for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as your contractor. It is your responsibility to make sure that people employed by you have licenses required by state law and by county or municipal Iicensing ordinances. Any person working on your building who is not licensed must work under your supervision and must be employed by you, which means that you must deduct F.LC.A. and witb- holding tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances, building codes and zoning regulations. Proof of ownership provided ( ) initial of reviewing clerk. Tlie foregoing instrument Was acknowledged before me this /0' day of beami,or, 20 ©,S' By ' h1ik- C. Slept' le size d< who is personally known to me or who has Produced Honda driw:rs /u gse. as identification and who did take an oath. !t/ V�! M- f4- N omosomisoworrowbosnodhedsollowasillodhlir et, ✓"a,.,, EVA M. FASANO Wow ,Wow Pdkec - of Fbdda n• . 8goiesDec 18 2o3B Commission # OD 379917 44 �•.. ;x , 4. BondsdOcNalondNalar . v1 f (ommisslt »• cup, i- - 1►(I0S7 SIior =STATE OF FLORIDA) COUNTY OF DADE) The undersigned Affiant, y1yI1 iGI' c R /an$i eic , does hereby attest that the attached survey, performed by (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. Affiant/Property owner Witness(sign and print) Witness(sign and print) J ij Th SWORN TO AND SUBSCRIBED before me this / 7 day of 19' t Affiant is /personally known to me, produced as identification. i laztte- N°tarY ft/0 MN (oMmrsion ••o.+ ' N,, EVA M. FASANO ,Notwy Po c • State of Ftodda I :, • t?amnt�bn6lolesDac 152006 r�� • DD 379917 Sordid Naked Me. t