ACT-8-1393Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 162713 Permit Number: ACT -8 -11 -1393
Scheduled Inspection Date: February 23, 2012
Inspector: Rodriguez, Jorge
Owner: VARONA, BELKIS & DANNY
Job Address: 517 NE 91 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: HOME OWNER
Permit Type: Awnings /Canopies/Tents
Inspection Type: Final
Work Classification: New
Phone Number
Parcel Number 1132060141220
Building Department Comments
REPLACE RIPPED FABRIC IN EXISTING FRAME OVER
BACKYARD LEADING DOORS, NEW FRAME AWNING
FOR FRONT ENTRY DOOR
Inspector Comments
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
February 22, 2012
For Inspections please call: (305)762 -4949
Page 4 of 34
614, kon
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 No.AC r OCV)
Master Permit No.
Permit Type: BUILDING ROOFING
OWNER: Name (Fee Simple Titleholder): ID Ist 1J1 1- BEL K l S VAROiJA Phone #:(30 `) 336 0777
Address: .611-7 A • E.
City: M (A'■ l S 1- L O RE S. State: ( Zip: 3' 13 8
Tenant/Lessee Name: Phone #:
Email: ciAKt H y V A tZ®I.! A ®A1'-'o 7V
JOB ADDRESS: 5 1 7 i 5-iVOEE1
City: Miami Shores County: Miami Dade Zip: 33138
Folio/Parcel #:
Is the Building Historically Designated: Yes NO ? Flood Zone: A)
CONTRACTOR: Company Name: Q (33 14-11- B u l L l7 Phone #: ()5-) 33 0 0777
Address: f% M E". • 9 5� f
City: M /A 4: S1-f deLf 5 State: F L zip: 33 )3S
Qualifier Name: Phone #:
State Certification or Registration #: Certificate of Competency #:
Contact Phone #: Email Address:
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $ q00 Square/Linear Footage of Work:
Type of Work: ❑Addition ❑Alteration / pilslew Atepair/Replace ❑Demolition
Description of Work: RE? /A c / 2 . J pip . (7 L 4 p 4 B/6 c /A--) E k C. f 5f,
FaAwtz. 0v -/2 84ch YAK.) LEA rit, Poo'?s) Ted ,&Ew
V-4 E 1 TO Art &-,J-1 4- O c
**+ x****** **** ***********a:**+n*********** Fees •************a: ******* *********** * *** u** * * ***
/�
Submittal Fee $ Permit Fee $ /00 CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ // C J Training/Education Fee $ Technology Fee $
Double Fee $ /O 0 Structural Review $
TOTAL FEE NOW DUE $
c1
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 andp reinspection fee will be charged.
Signature \ . , Signature
wner or Agent Contractor
The for . ing in tru ent was a owledged bef .re a this The foregoing instrument was acknowledged before me this
day of �;� 20 , by FM a(, 61 '• day of , 20 , by
r
who has p oduced ��L f 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.
My Commission Expires:
*+xx:x�a��x*** * *** * **** x *+xu�** **x��ux�a�x:** ***4(:* + x******** *********** ********* �xx��x�xx:* �xx�+ xx�* +x�xx:x� *x�a�a�a�+x *x��x** **�x� ***mix ****
�. r Lour t.
Plans Examiner k■
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
APPROVED BY L %��J c��
Zoning
Structural Review Clerk
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
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 '371-1—r
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
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 htto : /lwww.mvitoridalicense.com /dbor /pro /cilbfindex.htfml
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:
3 /T% 10, F. q( s/. Aelfr f 34rr S TC. 33/38
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 1.74""-
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 Toss 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 contractor's workers compensation coverage.
Before a building permit can be issued, this disclosure statement must be completed and signed by the property owner and
returned to the local permitting agency responsible for issuing the permit. A copy of the property owners 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 a day of
By Ozn 'UT& Q
Produced - License or
who was personally known to me or who has
) identification.
I �
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: 1-_)A1.)0, V- 1\12.0i<J DATE: 8/2`1/
ADDRESS: l % /U . E. 9/ cSJ/Zt.E1 - 1/1 M / COI ES
33/33
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 as my own
contractor with certain restrictions 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 —S7c5-'
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. l
Initial(
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.
Initial
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 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 -y V
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REGISTERED
APPLICATION
CONCERN No.
F -06901
e �liegigt
ISSUED BY
HERCULITE PRODUCTS, INC.
PO BOX 435
EMIGSVILLE PA 17318
Date Work Performed
4/27/11
—000 -0000
This is to certify that the materials described on the reverse side hereof have been flame -
retardant treated (or are inherently nonflamable).
FOR TRI VANTAGE? LLC AT 2937 WEST 25th STREET
CITY CLEVELAND STATE OHIO 44113
Certification is hereby made that: (Check "a" or "b ")
(a) The articles described at the bottom of this Certificate have been treated with a flame-
retardant chemical approved and registered by the State Fire Marshal and that the application
of said chemical was done in conformance with the law of the State of California and the
Rules and Regulations of the State Fire Marshal.
Name of chemical used Chem. Reg. No
X
Method of application
(b) The articles described at the bottom hereof are made from a flame - resistant fabric or material
registered and approved by the State Fire Marshal for such use.
Trade name of flame- resistant fabric or material used ACRYLIC FABRIC Reg. Na F—O6941
The flame Retardant Process Used WILL NOT Be Removed By Washing
(will or will not)
PETER COHEN
By STEPHANIE MUMMERT, 4 C MANAGER
Name of Production Superintendent Title
RINTA1 aJtPUK177 11M11,17117 ;Ct1tT1,tISTFP,,C 7111Wkr
A `TI.!; PMCI a J.0 ::.11tT x1)L11t�JtT1
We hereby certify this to be a true copy of the original "CERTIFICATE OF FLAME RESISTANCE" issued to us,
"original copy" of which has been filed with the California State Fire Marshal.
TRI VANTAGE, LLC
By ale
Control/lot # Quantity 20. 250 YD
UAN CARLOS WEBLON GP2BB7 -62
Customer order Description
39 9043 £ 57 87
Tri Vantage, LLC Invoice Product Code
PARADISE AWNINGS CORP. INC.
7850 NW 64TH STREET
MIAMI FL 33166
a
LOCATION SKETCH
SCALE: NTS
N.E. 5th AVENUE
r=20'
35.00'
AUGu ' &11
34.70'
66.60'
ELEV. = 9.40'
5.50' 37.75'
. )1-1393
3' CONC. WALK
5.60'
18.05'
34.65'
25.00'
Ar
35.00'
ABBREVIATIONS;
SWK= SIDEW' LK CBS= CONCRETE BLOCK STRUCTURE, CLF =CHAIN UNKFENCE, PL= PROPERTY LINE, DUE =DRAINAGE UTILITY EASEM ENT, IP =IRON PIPE,
F= FOUND, NC=AIR CONDmONER PAD, P /C= PROPERTY CORNER. D/H=DRILLED HOLE, WF =WOODEN FENCE, RES =RESIDENCE, CL- FLEAR. RB=REBAR,
UE=UTILITY EASEMENT, CONC- -CONCRETE SLAB. RIW RIGHT OF WAY, DE =DRAINAGE EASEMENT, C/L= CENTER LINE, �DIAM.ER, TYPICAL,
_ M- MEASURED, R= RECORDED, ENCR =ENCROACHMENT, COMP= COMPUTER, ASH-ASPHALT, N/D =NAIL & DISC. S=SET, FEE FINISH FLOO ELEVATION,
NOT VAUD UNLESS EMBOSSED WITH O /S= OFFSET,P/P =POWER POLE, OHP=OVERHEAD POWERLINE, WA=WATER METER
SURVEYOR'S SEAL WOOD FENCE=
WALL=
CONCRETE=
MAINTENANCE & DRAINAGE EASEMENT= M & D.E.
REVISED:
i�a1•aaafaaal�ai 1
SURVEY FOR: DANNY VARONA, 517 N.E. 91ST ST., EIAMI SHORES, FL. 33138.
LEGAL DESCRIPTION: LOTS 9 AND 10
OF MIAMI SHORES SECTION NO. 2
ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK
OF THE PUBLIC RECORDS MraKr —DADS COUNTY, FLORIDA
BLOCK 58
SUBDIVISION
10 AT PAGE 37
ELEVATION BASED ON LOC. # 3250 SW
CBM# N -603 ELV. 7.70'TYPE OF SURVEY: BOUNDARY SURVEY
SURVEYORS NOTES: 1) OWNERSHIP SUBJECT TO OPINION OF TITLE. 2) NOT VALID WITHOUT THE SIGNATURE
AND RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER. 3) THE SURVEY DEPICTED HERE IS NOT
COVERED BY PROFESSIONAL LIABILITY INSURANCE. 4) LEGAL DESCRIPTION PROVIDED BY CLIENT. 5)
UNDERGROUND ENCROACHMENTS NOT LOCATED. 6) ELEVATIONS ARE BASED ON NATIONAL GEODETIC
VERTICAL DATUM OF 1929. 7) OWNERSHIP OF FENCES ARE UNKNOWN. 8) THERE MAY BE ADDITIONAL
RESTRICTIONS NOT SHOWN ON THIS SURVEY THAT MAY BE FOUND IN THE PUBLIC RECORDS OF THIS COUNTY. 9)
CONTACT THE APPROPRIATE AUTHORITY PRIOR TO ANY DESIGN WORK FOR BUILDING AND ZONING
INFORMATION. 10) EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED
INSTRUMENTS, IF ANY, AFFECTING THIS PROPERTY.
BEARINGS WHEN SHOWN ARE REFERRED TO AN ASSUMED VALUE OF SAID PB PAGE
3. HEREBY CERTIFY That the survey represented
thereon meets the minimum technical requirements
adopted by the STATE OF FLORIDA Board of Land
Surveyors pursuant to Section 472.027 Florida
Statutes.
There are no encroachments, overlaps, easements
appearing on the plat or visible easements other than
as shown hereon.
ADIS N. NUNEZ
REGISTERED LAND SURVEYOR
STATE OF FLORIDA #5924
SINCE 9987
BL.ANGO S
Engineers • Land Surveyo P - e
555 NORTH SFf "EI RBI E
MIAMI BEACH FL 33141,
(305) 865 -1200 Small: blancosurvey• si
FLOOD ZONE: X
PANEL: 0306
DATE:
11/16/10
. ( 5) 865 -7810
BASE: N A
SCALE:
1 ° =20'
4
11
SIDE VIEW
42"
15"
1.25011 WELDED GALVANIZED TUBING
15"
6"
I
El
u u
FRONT VIEW
/
/
54"
54"
19
22"
TOP VIEW
42"
22"
FRONT DOOR AWNING DIMENSIONS
DANNY & BELKIS VARONA
517 N.E. 91 STREET MIAMI SHORES FL 33138
LOTS 9 AND 10 BLOCK 58 OF MIAMI SHORES SECTION NO2 PLAT BOOK 10 AT PAGE 37