Loading...
FW-11-356Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 156577 Permit Number: FW- 3- 11-356 Scheduled Inspection Date: September 28, 2011 Inspector: Bruhn, Norman Owner: FORMENT, ILEANA Job Address: 515 NE 95 Street Miami Shores, FL 33138- Project: <NONE> Contractor: HOME OWNER Permit Type: Fence/Wall Inspection Type: Final Work Classification: Wood Fence Phone Number Parcel Number 1132060140720 Building Department Comments BUILD 5' HIGH WOOD FENCE ON BACK OF HOUSE extension approved by nb. ok to extend permit 30 days. vc 8/29/11 Passed Failed Inspector Comments ,'1-...),-/i---- CC, 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 3 of 26 1 1 Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number ssue date: 314/2 od Fence Expiration: 08/3112011 Applicant 515 NE 95 Street Miami Shores, FL 33138- 1132060140720 Block: Lot: ILEANA FORMENT Owner Information Address Phone CeII ILEANA FORMENT 515NE95ST MIAMI SHORES FL 33138 -2731 Contractor(s) HOME OWNER Phone Cell Phone Valuation: Total Sq Feet: $ 750.00 80 1 Approved: Yes Comments: Date Approved: 3/3/2011: Yes Date Denied: Type of Construction: Wood Fence Classification: Residential Additional Info: 5 HIGH Scanning: 2 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee - Wire 8. Wood Scanning Fee Technology Fee Total: Amount $0.60 $2.00 $2.00 $0.20 $100.00 $8.00 $0.80 $111.60 Pay Date Pay Type Amt Paid Amt Due Invoice # FW -3 -11 -40205 03/07/2011 Credit Card $ 61.60 $ 50.00 03/02/2011 Check #: 1699 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Final 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. March 07, 2011 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date March 07, 2011 1 3f-' 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 G Permit No. r J*--' BUILDING PERMIT APPLICATION FBC 20 Permit Type: BUILDING OWNER: Name (Fee Simple Titleholder): Address: S City: MAR 022011 Master Permit No. ROOFIING g -eK/�@ Phone #: ��� y 7r -.c''3 State: Tenant/Lessee Name: Zip: Phone #: o �d Email: / fi /) % JOB ADDRESS: City: Miami Shores Folio/Parcel #: County: Miami Dade Is the Building Historically Designated: Yes CONTRACTOR: Company Name: Address: % t City: L f /Ii .1 to Re _ State: F Zip: NO Y Flood Zone: A/ 0 re O W /1/2i< S97: Phone #: 30S^ Y2��' Zip: Za Qualifier Name: Phone #: State Certification or Registration #: Certificate of Competency #: Contact Phone #: Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ 75-6 CO S are/Linear Footage of Work: - C C Type of Work: ❑Addition ❑; to tic ►� ew ❑Repair eplace ❑Demolition Description of Work: d 5' A // j t jj O . 0A) ******** * * * * * * * *x * * * * * * * * * * * * * * * * * * * * ** Fees************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ /4 0°4 CCF $ CO /CC $ Scanning Fee $ "' Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ (0 k 'e° 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 inspectio ; ' no + > app + • ed and a reinspection fee will be charged. wner or Agent The foreg6ing instrument was acknowledged befog day o(f L ' �2 �20 , by Signature Contractor The foregoing instrument was acknowledged before me this day of , 20 _, by lily known to me or who has produced �' .if" ' who is personally known to me or who has produced R.) LAs identification and who did take an oat 1. as identification and who did take an oath. Ar LIC: ' � • NOTARY PUBLIC: L, � i C , �N l My Commission Expires: APPROVED BY (Revised 07 /10 /07XRevised 06 /10 /2009)(Revised 3/15/09) Plans Examiner Structural Review Sign: Print: My Commission Expires: AO; Zoning Clerk 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: A SP �- d2�i pPri- DATE:to3_01- 2 o ) ADDRESS: a E (Ts --' I i S 11 D i2L°s 3 S% 38 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 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. Initial F 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. Initials P F 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. InitialZaA', 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. y� Initial" J ► Pt , T 5. I understand that, as the owner - builder, I must provide direct, onsite supervision of the construction. Initial /V, F 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 Ti h. F 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. �- Initial 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 \r, %Tr F 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 V a 13 • r 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 /prolcilbrindex.html Initial , a • F 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: ten 33/3.9 Initial + +A. f 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 T. R . F 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 Produ License or \ o -Q� v —who was personally known to me or who has 1 day o �1����, , 20 H r identification. OWNER I� J i NOTARY STATE OF (FLORIDA) COUNTY OF (DADE) Miami Shores Vivage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 SURVEY AFFIDAVIT -5 e P , Erefr e i does hereby attest that le3iR e) 1 Q kns-cti (Name of surveyor's comp y) SS it :mil _fa Pe)1 3/3 The undersigned Affiant, attached survey, performed by For address: Performed on f"'2- 89 f (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 Tess than seven (7) years old 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. ght. Property Owner Signature SWORN TO AND SUBSCRIBED before me this Affiant is personally known to me, Revised on 5/22/2009/ Revised on 6/12/09 day,of ( roduced i \ � Ly YO as identification. s AA Fpierit- Property Owner Print Name z ri.1c 1.VNIS 0. S Via % C,0 Z' k� 23 , 2Z - esbceu. e0.0 Notary z BOUNDARY SURVEY 24 SCALE- r' 22) 15' ALLEY. • cj' PAVEMENT t • MAW 0 2 2011 .E3 () 06 el‘) Fc1112"— LOT 14 F3LK . 54 RI 5LOC CORNER tD R4.112" , eos 100 Shores V' APPROVED ty W); ZONING DEP. BLDG DEPT SUBJECT Tq STATE AND C •15710 .01!:*: STORY. C.5.5. RE5 No'. 515 • 21.50' 1415' k•1 r--- cotvc. i 12.55.0 s Lae. ) ! 12. • 1415 i I i I ' 0 o I I 4 ; --•‘• 1.... T L E. 6 / .- „ \ ts•1 i \ \ i •,.., '2.3' -1 / 2 i ' .473 5 00' (fz 4 KA 51 oc.vvALK .... .._ .._ 1.55 24. F'F‹ K vv A; _ 20 p AV1 im C.-, PLIANOE WITH ALLFEDERAL TY RULES AND REGULATIONS e••■■•••••••••••••••■•■•■ EA5-1',112 LOT 1G -te- m •-• Miami Shores Village 10050 NE 2 "d Avenue Miami Shores, FL 33138 -0000 Attn: Planning and Zoning Department August 26, 2011 Re: Open Permit No. FW -3 -11 -356 Ileana Forment 515 NE 95th Street Miami Shores, FL 33138 Dear Building Inspector, - LS (-1-/ - ��.CJ The Permit referenced above is for the purpose of building a wooden fence in our back yard. We have substantially finished the project , the fence is built, but we are pending to build the gates. Due to circumstances beyond my control, we have been unable to finish project in the time stipulated by the Permit and as a result, I need some extra time. I would like to request that you grant me a 30 day extension to complete this project. Thank you for your consideration. S cerely, Ilea 'a Forment