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DS-11-1194r Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 161592 Permit Number: DS -7 -11 -1194 Scheduled Inspection Date: January 10, 2012 Inspector: Bruhn, Norman Owner: BEST, JEAN CLAUDE Job Address: 571 NW 112 Street Miami Shores, FL 33138- Project <NONE> Contractor: WPH CONSTRUCTION COMPANY Permit Type: Driveways /Sidewalks /Slabs Inspection Type: Final Work Classification: New Phone Number Parcel Number 3021360210940 Phone: (305)244 -2392 Building Department Comments CONCRETE DRIVEWAY ON THE FRONT OF THE HOUSE Passed�,� / Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments a- January 09, 2012 For Inspections please call: (305)762 -4949 Page 2 of 25 ),, �� 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 AUG 042011 BY: .. Permit No. \ - -/V7 Master Permit No. Permit Type: BUILDING ROOFING OWNER: Name (Fee Simple Title C " lder): Ak, )%1A- Phone#: Address: 1 VAlt‘)."\rrOkk City: ''1 \%eN'\\ State: Fl Zip:`33)C Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: S 11 1� �1 1 1 2S,r City: Miami Shores County: Miami Dade Zip: Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: Phone#: t) c OZ 4 t42,3 / B CONTRACTOR: Company Name: VU 7O e-st 4'00 19' /,t; 4444 ,' State: �.! l5 oh e/ ilz9A/ Address: City: Qualifier Name: Zip: 33 /6.0 Phone#: Z 4r�Z3 Z State Certification or Registration #: aft Ca l../ 6.534-6 Certificate of Competency #: Contact Phone #:30 r Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ C /6 G D + ®tom Square/Linear Footage of Work: Type of Work: OAddition 4Alteration ONew pair/Replace ODemolition Description of Work: 7Z2./t? D r %Qa/ ©/4/ ejle%p/ +x** ** * * * * * * **** * * **+x************* ** *** Fees******** *** **+u **+x*+x ******** ** ********* * * *** Submittal Fee $ Permit Fee $ /SO° v CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE lr 'ia 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 Owner or Agent Contractor The foregoing instrument was ac ',owl • ged before me this 1 The fore oing ' ment w s ackn 1 fore �this� day of , 20 , b , day of `�'• Afit. 1 , 201, by 1�- U i r y l y� Y who is personally known to me 7 ho has produced ho iss p so ally kno j to me or who has produced eL l� N 0 4A 3 As identification and who did take an oath. L`U �J 1 "5. i tification and who did take an oath. NOTAR ' UBLIC: N 1 TA ' PUBLIC: wc1�•.ti Sign: Sign: Print: My Commission Expires: NOTARY PUBLIC -STATE OFFLORmA eon w.,,, Fritz Mathurin e , ��„ Commission #DD897929 . BONDED 'MU tgLS: nc u' iDI�NG+CO „1NC. APPROVED BY .. d” c f/0 - q Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /1012009)(Revised 3/15/09) My Commission Expires: liL ")t2gVDi+ c�P e,j (' : v23 v1 03/i/ Zoning Clerk Miami Shores Viiiage Building Department 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) (�v 1-P t the following described property (address): 51) P V \! \ 11 her inafter referred to as the owner of Legal Description Lot Folio # Requests permission to install (describe work): Block Subdivision Within the public right of way of (address) 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). Owner or Agent The foregoing instrument was acknowledged before me this , 20 il, by 2 who is personally known to me or who has produced , _ "-01 tification and who did take an oath. NOTARY PUBLIC: Sign: Print: ligleAr P op p is 1 �y ::!+.3 op 's 1 °per :. 7.1.1x3 BPy�yFC,� �..a�} My Commission Expires: 2 Rick Scott Governor H. Frank Farmer, Jr., M.D., Ph.D. State Surgeon General August 11, 2011 Wilson Henry 571 NW 112 St Miami, FL 33175 RE: Contingency Letter Application Document No:AP1044048 Centrax Permit Number: 13 -SC- 1363655 OSTDS Number: 571 NW 112 St Miami, FL 33175 Lot:18 Block:5 Subdivision: Dear Applicant: This will acknowledge receipt of an application dated 08/10/2011 for a permit to use an existing onsite sewage treatment and disposal system located on the above referenced From a review of your completed application, it has been determined that your existing system is adequate for the proposed use (concrete driveway repair). If you have any questions on this matter, please call our office at (305) 623 -3500. Sincerely, Enclosures cc: eph Piverger, Engineer Specialist II Miami -Dade County Health Department 1725 NW 167 St, Opa Locka, FL 33056 Phone: (305) 623 -3500 . Fax: (305) 623 -3645 . http: / /www.MyFloridaEH.com 1 t 1,� JUL 0 6 2011Ly �• . W COVICA-4C, dy vA-1A pcy• -„; -4maGthciA oft wkedlA • 0 F.N -x -x 0' GAP. -- LOT 19 C\„ a 6 58.0' (R)(M) —x -x -x -x x —r-x -x -x x - 5' U.E. G C 140.00' (R)(M) 0.50' CL. r I 6.1' „ay 23.50' c umm 4: METAL SHED / \ 21.20' ONE STORY RES. No 571 44.70' PLANTER a 0 SHEET 2 OF 2 APPROVE "I9 MIAMI -DADE COUNTY HEALTH DEPARTMENT XLx P.P F.N .i TM 1.00' CL. V $9� o k k k 4 la x � i 12� k +�Y k • k • ^]V x k O k O x O 1 xI 2.25' CL. ENCR. o k (1)A CLF ENCR. UP TO 0.6' M i INTO THE ADJ. PROP. N f CL1rj LOT 17 7.30' X- •X— X— X— X— X —X_X —X x —x_ J vt ON PL. c 11g "sr. Nw 112th sr 20' ASPHALT PAVEMENT Miami Shores Villa • e APPROVED ZONING DEPT BLDG DEPT DATE _ a • • • • • • • SURIFCT TO COMPLIANCE WITH ALL FEDERAL rAlT AND COUNTY RULES AND REGULATIONS • O. lj THOMAS J. KELL L.B # 6486 •' SURVEYORS- MAPPERS -LAN 8125 SW 120 STREET PINECRES (786) 242 -7692 DADE (9 (786) 242 -6494 DADE FAX (9 •••• • • ••.• ••• • • • • • • ..• • WD F DATE FIELD WORK 03/15/2008 SCALE 1"=20* SURVEY NO. 08 -0375 • . • •. • • • • • • 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 Folio Number:3021360210940 Owner's Name: JEAN CLAUDE BEST Job Address: 571 112 Street Miami Shores, FL 33138- Owner's Phone: Total Square Feet: Total Job Valuation: 0 $ 1,200.00 Contractor(s) HOME OWNER Phone Primary Contractor Yes Planning and Zoning Criteria and Comments Approved: No Date Denied: 8/4/2011 Comments: PLEASE CONFIRM WIDTH OF PROPOSED GARAGE. PLAN SEEMS TO INDICATE 12 FEET WIDE. SCALE ON PLAN INDICATES 14 OR 15 FEET WIDE. PLEASE INDICATE SETBACK BETWEEN PROPERTY LINE AND DRIVEWAY. DRIVEWAY FLARES CAN NOT EXCEED 2 FEET IN WIDTH. Miami Shores Viiiage Building Department RECEIPT PERMIT #PSAIi. 119 `i DATE: i > g i I, Jean C CIAL \❑ Contractor 1e Owner ❑ Ar Pick ets of plans and o - 1V re c> O f) 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 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 CLERK INITIAL: RESUBMITTED DATE: PERMIT CLERK INITIAL: Permit No: 11 -1194 Job Name: August 5, 2011 Miami Shores Vuiage Building Department Building Critique Sheet 1) Plans must be approved by HRS for the septic system. 2) Zoning approval is required first. 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 Plan review is not complete, when all items above are corrected, we will doa complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Norman Bruhn CBO 305 - 795 -2204 (SA 1 �� -�1.� 1 k..A0v Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 3313 Tel: (305) 795.2204 Fax: (305) 756.897 INSPECTION'S PHONE . B 762. BUILDING PERMIT APPLICATION FBC20 Permit Tvn? UILDING ¥NG JUL U 6 2011 ii -II94 Phone #(3as) 303 -qo3? OWNER: Name (Fee Simple Titleholder): i. t ! ! Address: /44o N W i Rl �t City: ,iftff+1 State: fl Zip: 331Q Tenant/Lessee Name: Phone #: Email: " JOB ADDRESS: J? I N A \, 2 -)T City: Miami Shores County: Miami Dade Folio/Parcel #: Is the Building Historically Designated: Ye CONTRACTOR: Company Name: Address: City: Zip: 33 J 38 Flood Zone: Phone#: Sta Qualifier Name: State Certification or Regis . tion #: Certificate of Competency #: Contact Phone #: ► Email Address: Zip: Phone #: DESIGNER: Architec gin . Phone #: Ids Value of Work for this Pe Type o ork: ❑Addi Descripgn Wor Square/LinearFo /otage of Work: ❑_ teration ❑New ®Rep t; ', ' eplace ❑De c lition ;L� **** ** *****+ x +x*+x+xs:+x **+x*+n**** ****x *** **** Fees**+x***+x***+x+x **+ say***** ** ****+x**+xw+x*********** Submittal Fee $ 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 $ 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 The forgo day of why is per O2 NOTA Owner or Agent /ignature "vs Contractor g instrument was ac owledg , 20 1 1, kno to me or who has produced AAA PUBLIC: Sign: Print: My Commission Expires: The foregoing instrument was acknowledged before me this day of 6 , 20 , by 0 ho is personally known to me or who has produced ification and who did take an oath. as identification and who did take an oath. • NOTARY PUBLIC: o Sign. `rte My Commission Expires: 't ************ **** x*+x***************** ** .... + x�xx�**** a�a�a�******** �xa�a�x��x�x******** x��xu��n�xx��xx� ****x��x+x+x�xa�x��x�x****** Sawn _,,.� t' Plans Examiner �� Zoning APPROVED BY Structural Review Clerk (Revised 07 /10 /07)(Revised 06/10/2009)(Revised 3/15/09) i' N 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: J. j r) dQ 3.st DATE: (c)/6 CPI ADDRESS: 571N N 11. 1 r 5k 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 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 my own contractor with certain restrictidns even though I do not have a license. Initial 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. Initial 1 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. Initial 4. I understand that I may build or improve a one family or two- family residence or a farm outbuilding. I may alsd'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 ' tantially improved it for sale or lease, which violates the exemption. 5. I understand that, as the owner- builder, I must provide direct, onsite supervision of the construction. Initial 6. I understand that I may not hire an unlicensed person to act as my contractor or to supervise persons working .' my building or residence. It is my responsibility to ensure that the persons whom I employ have the license required* law and by county or municipal ordinance. Initial 7. I understand that it is frequent practices of unlicensed persons to have the property owner obtain erroneously implies that the property owner is providing his or her own labor and materials. I, as liable and subjected to serious financial risk for any injuries sustained by an unli sed pers working on my property. My homeowner's insurance may not verage for th e injuri owner- builder and am aware of the limits of my irg;urance cov- P es to workers my p 8. I understand that I may no = legate the respons perform the work being done. ny person working and must be employed by me, ich means that I m social security contributions and • e Federal lnsur the employee. I understand that m -ilure to follow uilder permit that may be held ees while ng as an owner -bw or his or em! . I am willfully perty. for pervising work to a licensed contt cctor o is not r -nses to my b ding who is not li nsed must work der my di r= upenrision st com ' with laws r ng the withholding of f- ncome tax and ce Conti .' • . ICA) and must provide workers compensation for ese may subject to serious financial risk. ti 9. I agree that, as the party legally and financially ponyible 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. 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 .•ntact the Florida Construction Industry Licensing Board at 850.487.1395 or htto : //www.mvfloridalicense.com/dbor /pro /cilbfndex4 I Initia'ii /i 11. I am aware of, and consent to; an owner- builder building permit applied for in my name and understands that I a / the party Dally and financially responsible for the proposed construction activity at the following address: 12. I agree to notify Miami Shores Village immediately of any additions, deletions have provided on this disclosure. Licensed contractors are regulated by laws designed to protect the public. If you con license, the Constr4uction Industry Licensing Board and Departme f Business and P assist you with any financial loss that you sustain as a result of contra may be in civil c understand that, if an unlicensed contractor or employee of an individual rm is injured wh be held liable for damages. If you obtain an owne - - it and wish to • e a licens verifying whether the contractor is properly li M ' ed and the st • of the contr Initial e informa ion a/•t I Initial who does not have a egulation may be unable to Iso important for you to king on your property, you may actor, you will be responsible for is workers compensation coverage. Before a building permit can be issued, th' disclosure statement m ,t be completed d signed by the property owner and retumed to the local permitting agency r . ponsible for issuing the pe it. A copy of the property owner's driver license, the notarized signature of the property ow , or other type of verification cceptable to the local permitting agency is required when the permit is issued. Was acknowledged before me this day of lJ Produced there License or who was personally known to me or who has O7O 5, 2 X)2 as identification. NOTARY