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DS-11-816Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 159464 Permit Number: DS -5 -11 -816 Scheduled Inspection Date: September 28, 2011 Inspector: Bruhn, Norman Owner: BITTNER, WARREN Job Address: 287 NE 96 Street Miami Shores, FL 33138- Project: <NONE> Contractor: HOME OWNER Permit Type: Driveways /Sidewalks /Slabs Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132060134140 Building Department Comments INSTALLATION OF CONCRETE APPROACH WITH WIRE MESH 6" THICK Inspector Comments Passed ,/g.-1.01 Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. September 27, 2011 For Inspections please call: (305)762 -4949 Page 6 of 26 1 Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Applicant 287 NE 96 Street Miami Shores, FL 33138- 1132060134140 Block: Lot: WARREN BITTNER Owner Information Address Phone CeII WARREN BITTNER 287 NE 96 Street MIAMI SHORES FL 33138 -2715 1 Contractor(s) HOME OWNER Phone Cell Phone Valuation: Total Sq Feet: $ 500.00 0 1 Approved: No Comments: PLEASE ACCURATELY IDENTIFY THE ALLEY PAVEMENT AND THE RELATIONSHIP OF THE PRi Date Approved: : No Date Denied: 5/12/2011 Type of Work: PAVERS OVER SAND BASE Additional Info: RIGHT OF WAY Bond Retum : Scanning: 2 Classification: Residential Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $0.60 $2.00 $2.00 $0.20 $100.00 $6.00 $0.80 $111.60 Pay Date Pay Type Invoice # DS -5-11 -40870 05/20/2011 Check #: 5059 05/06/2011 Check #: 5056 Amt Paid Amt Due $ 61.60 $ 50.00 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Final Sidewalk Landscaping Foundation 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. May 20, 2011 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date May 20, 2011 1 \\i\\ - tAA 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 No. 07) \ ---,81(P Master Permit No. BUILDING PERMIT APPLICATION FBC 20 Permit Type. UILDING OWNER: Name (Fee Simple Titleholder): Address: City: ROOFING tA) -er-) �Qaf F4 ?c't (94` . T\ct i h TCS State: PA,— Phone #: �.� s4. 3 ?, 3 DJ. Zip: � tt 6 t Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: City: Miami Shores County: Miami Dade Zip: 3 3 Folio/Parcel #: Is the Building Historically Designated: Yes CONTRACTOR: Company Name: Address: City: Qualifier Name: NO Flood Zone: Phone #: State: Zip: Phone #: State Certification or Registration #: Certificate of Competency #: Contact Phone #: Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ San ® 0 Square/Linear Footage of Work: Type of Work: ❑Addition ❑Alteration ❑New Repair/Replace ❑Demolition Description of Work: 161..5 Ag ��� ` dY f1 (1► �.� \ . c . r r�h b - - f�U4.s c�• e C � kr e, C �1 r Submittal Fee $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ Permit Fee $ CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ 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 whicl 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 Contractor The fore `ing i ment was a e owledge�l befo n-4 this The foregoing instrument was acknowledged before me this p yp day , 20 l , by 4 Ve ( o " \ 11110 , day of , 20 _, by who is personals y own to me or who has produced tj _ ---- who is personally known to me or who has produced J',J 1 L n'As,flidentification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: 0.) ) /1? , Sign: Print: My Commission Expires: APPROVED BY 060.0A, 3 NOTARY PUBLIC: Sign: Print: My Commission Expires: ** mix ****m * * *** * * *** * ** �`✓ �A /� �/ Plans Examiner 5 // / "Zoning Structural Review Clerk (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) yoo 7.∎11 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: T 1 rTh ; (- DATE: 5- 6,- 1 ADDRESS: ;Z CT L -el - - 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 1 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 muss 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 1, 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 2. 1 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. 1 understand that, as an owner builder, I am the responsible party of record on a permit. I understand that 1 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 ovltn name. 1 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. rr�� Initial `°�'�J 4. I understand that I may build or improve a one family or two- family residence or a farm outbuilding. 1 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 leaself 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. !understand that, as the owner - builder, I must provide direct, onsite supervision of the construction. Initial `Z 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 44J 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 whije 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 L 44 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. Initial 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. Initial Cil4S 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.myfloridalicense.com /dbpr /pro /cilb /index.html Initial ( 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: 2e2- r4 c(6 ` - Initial 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 1� 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 contractors 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 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 B y Produced there Lic e or , 20 who was personally known to me or who has J:1) L as identification. NOT ol 11 C4t10 fAts ,0- • • • • • • • • • • • BOUNDA • eeeee • ••• • • a.2o • • • • • • •••p • ,44 / / //ct• go, ...4 v /6'3 • �y ��° (i e- ao, :zz -70' tK 701 _21.0•' .Q,•'iG-.it - 7 /f to' Pi ' 11 n k' 4: -y (� No. g-iii 0I0 1' 14.'4 L a' INJV a�• AA NOT VALID UNLESS EMBOSSED WrTH UN 9 0 AVW 7 - es .�' �aFPI CYr6 7'80'7;77 ; /w) 0--)\Q f, . = 9b #•' 'ez0 Afr w, 'o,/7 r �s Q=. ag• • ,0. so Arlie SNOW (1110314 ONV S3lnki ALNnOD QNV 3IVLS 11V HUM VONUndwtO of Iowans 1430 0018 1d30 ONINOZ 31da A9 03AOIJddV LEGEND • FIP= Found I •n Pipe S.P..C= SET 1/2" PIN & CAP LB47, 9 P' 6fra7s5/c 4 i S.PCP= SET PERMANENT CONTRA t ontwT 6B476fl c= CENTERLINE. P/1.= PROPERTY UNE. 0 /1= ON UNE Eteva;iors base M.H.= MANHOLE WM= WATER METER. PP= POWER POLE c3:` # F.C.= FENCE CORNER, R= RECORD, M= MEASURED Elev. N GV E CHAIN UNK OR WIRE FENCE= • _ W000 FENCES ;; / Locator Index MASONRY WALL= CONCRETE= ••,:. • • • ' " MINTENANCE & MENAGE EAS DE. NOTES: UNLESS OTHERWISE SHOWN. THE FOLLOWING NOTES APPLY. 1) Record and measured calls are in substantial agreement. 2) Bearings, if shown are based on Ph .hnu,n harann were not abstracted for Easements or other recorded emcumbrances not shown on Ott • • - -_ ..... nr other In rug 1M Miami Shores Village �f Building Department ay 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY Whereas, (owner) �\ ^�i° 1.■°41—n-e—kr PaC 1 V� 9 C, 41 S$ e hereinafter referred to as the owner of the following described property (address): Legal Description Lot Block Subdivision Folio # Requests permission to install (describe work): Within the public right of way of (address) .2 Nt t q GD a-, 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. 1 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 /9 day ofi�_ r 2 in the presence of: 044 Vy 17 '400,16. ocoe s Signature ) ,2016 1 1 Planning and Zoning Criteria Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit NO. DS -5 -11 -816 Permit Type.- Driv wa1� Addition /A1te;tatio Issue Date: Not Issued Explres:NOt Issued Folio Number:1132060134140 Owner's Name: WARREN BITTNER Job Address: 287 96 Street Miami Shores, FL 33138- Owner's Phone: Total Square Feet: Total Job Valuation: 0 $ 500.00 Contractor(s) HOME OWNER Phone Primary Contractor Yes Planning and Zoning Criteria and Comments Approved: No Date Denied: 5/12/2011 Comments: PLEASE ACCURATELY IDENTIFY THE ALLEY PAVEMENT AND THE RELATIONSHIP OF THE PROPOSED DRIVEWAY TO THE EXISTING ALLEY PAVEMENT. CAN NOT REMOVE THE ALLEY PAVEMENT WITHOUT THE PERMISSION OF THE PUBLIC WORKS DIRECTOR.