RC-11-73Miami 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
SSA.VFBC 20
Permit Type: BUILD
OWNER: Name (Fee S.
Address: /` 2- 7
City: AN i, S
Tenant/Lessee Name:
Email:
State:
Permit No. Val L7
Master Permit No.
77)/a
s.
Phone #: 305— 4/S' in n l I
Zip: 33/3
Phone #:
JOB ADDRESS: / E 7 7- 51
City:
Folio/Parcel #:
Miami Shores
County: ami Dade Zip: 3.3/3
Is the Building Historically Designated: Yes
CONTRACTOR: Company Name: l/ Lei Al t Ir
Address:
City: State: Zip:
NO Flood Zone:
Phone #:
Qualifier Name: Phone #:
State Certification or Registration #: ;y "h;. Certificate of Competency #:
Contact Phone #:
DESIGNER: Architect/En : �a v`5._ Phone #:
Value of ¢rkrf61 this ermit: $ 72/ 00 0 , 0 P Square/Linear Footage of Work:
Type of Work: DAddress DAlteratio/nn _ONew URepair/Replace DDemolition
Description Work: /1 C l if' & � / / 2 c (,cam- �v �i N l/4 e- ✓V-
/ 41er
COLOR THROUGH ROOF TILE IS REQUIRED acknowledged by:
******** * * * * * * * * * * * * * * * * * * * * * * * * * * + * * ** Fees ************ * * * * * * * * * * * * * * * * *** * * * * * * **** **
Submittal Fee $_ ( (3 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 A ddress
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature
er or Agent Contractor
The foregoing instrument was acknowledged before me this /3 The foregoing instrument was acknowledged before me this
day of ( , 201( , by _ (�/1LeA. —° 7Cj/. f_)LS , day of
who is personally known to me or who has produced A t �/ who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: / NOTARY PUBLIC:
`�eral nl
Sign: Sign:
Print: = ate., : x, c, .4 ®o ca _ Print:
My Commission- Fctpires��Q �$'J of:..-z:---
a My Commission Expires:
s
s`/,i ' ........ •� " \\.
, 20 , by
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised 07 /I0 /07)(Revised 06 /10 /2009)(Revised 3/15/09)(rev6/4/10)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
y— OWNER BUILDER DISCLOSURE STATEMENT
NAME: `e1; r uu�� Ta l r DATE: 1 /13 /11
�.J
ADDRESS: t 2.31. /V f 9 7s F
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 (*-7`--7
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 C71
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 C-11-1.-- 1-0
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.
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 �0
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
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.mylloridalicense.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:
J 2 7f ,V c7Z Ain; $ L 33 /3g-
Initial i�d
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. r —r�- --
Initial U�(
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 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
retumed 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 day of , 20 1. 1
By � 01(0k. ibukfl who was personally known to me or who has
Produced there License or PL 11T
as identification.
CUMULATIVE SUBSTANTIAL IMPROVEMENT
VERIFICATION WORK SHEET
In accordance with FEMA regulation and Miami Shores Village Flood Damage Prevention Ordinance the costs of all
improvements must be monitored. The costs of any improvements in the past 12 months and the costs of any proposed
improvements must be shown on the worksheet. The cost of improvements must include demolition, raw and finished
materials (include those donated), labor (including volunteer and self - performed), construction supervision and
management, and overhead and profit. A list of items the costs of which are to be included as well as those excluded is
attached for your reference. (A nt
Copy
of the Contract must be attached)
PROPERTY OWNER: —To ►�°' e, I o (e -
PERMIT # c '-1
ADDRESS: I ( / /L-' 9 7 S t, /Gill S4'ore R L 33/3 k
FOLIO NUMBER: FLOOD ZONE:
BASE FLOOD ELEVATION:
FREEBOARD: EAST OF FL.CCCL:
COST OF PAST IMPROVEMENTS (12 MONTHS):
COST OF PROPOSED IMPROVEMENTS:
(ATTACH COPY OF CONTRACT)
44/2, 000 oa (2-,,ffint,44
TOTAL CUMULATIVE COST OF IMPROVEMENTS (past and proposed): ` ,1 `d 4 0 . Od
VALUE OF PRINCIPAL STRUCTURE (attach appraisal):
OWNERS SIGNATURE: DATE: ,,7/3///
PLANREVIEWER:
PLAN REVIEWER SIGNATURE: DATE:
Created on June 2009
SUBSTANTIAL IMPROVEMENT / DAMAGE LIST
(NOTE: THIS LIST IS INTENDED FOR GUIDANCE ONLY, AND IS NOT ALL INCLUSIVE)
ITEMS TO BE INCLUDED
ALL STRUCTUAL ELEMENTS,
INCLUDING
Foundations including;
Spread footing, Continuous footing,
isolated footing, piles and pile caps
Slabs including; Monolithic, floating,
elevated
Walls including; Exterior walls, Bearing
walls, Shear walls
Beams, Tie Beams, Columns and Posts
Wood decking, Floor and Roof Sheathing
Trusses, Joist
Windows /Doors
ALL BUILDING ELEMENTS, INCLUDING
Interior Partitions, Walls, Columns
Drywall, Ceilings,
Built in Furniture, Cabinets, Vanities
All Fixtures
Flooring, Tile, Carpet, Stone, Linoleum,
ect.
All Finishes including Drywall, Paint,
Stucco Plaster, Paneling, Tile, Marble,
and Moldings
Roofing Material
ALL HARDWARE
ALL UTILITY and SERVICE
EQUIPMENT
HVAC
Electrical System and Equipment
Plumbing System and Equipment
Security System and Equipment
Central Vacuum System
Plumbing Fixtures
Lighting Fixtures and Ceiling Fans
Water Systems including
Softeners /Filtration
Created on June 2009
ALSO:
All Labor and other Costs associated with
Demolition, Removing, Replacing,
Installing Building or Altering Building
Components
Construction. Management / Supervision
Overhead and Profit
Equivalent cost for:
Donated Materials
Volunteer Labor (including owners and
friends)
Any Improvements Beyond Pre - damaged
Condition, including;
Utility Upgrades
Code Upgrades
ITEMS TO BE EXCLUDED
Plans and Specifications
Survey Costs
Elevation Certificate Costs
Permit fees
Debris Removal
Items not considered to be REAL Property
Rugs, Furniture, Refrigerator,
Appliances not Built -in
Outside Improvements, Including;
Landscaping
Sidewalks
Patios
Fences
Yard lights
Sheds
Gazebos
Irrigation
Pool
Permit No: 11 -73
Job Name:
January 21, 2011
Miami Shores Vivage
Building Department
Building Critique Sheet
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Page 1 of 1
1) The addition includes wood exterior walls which are not permitted in Miami Shores per
Ordinance. This review is a courtesy review for items not affected by the design of wood
walls. When resubmitted with masonry wallsa complete review will be done.
2) Plans must be approved by HRS for the septic system.
3) Provide receipt from Miami Dade planning and Zoning for impact fees.
4) Demolition permit applications are required.
5) The plans must identify the level of alteration per the FBC EX.
6) Provide a survey and an elevation certificate.
7) Provide the footing details for the existing foundation in the area of addition.
8) Identify the configuration of W1, are these multiple units?
9) Product approvals must be reviewed and signed approved by the designer of record.
10) Provide and identify the secondary means of escape from the master bed.
11) Energy calculations must be recalculated aftermasonry design. Method C is no longer
an acceptable form per FBC Ch 13.
STOPPED REVIEW.
Plan review is not complete, when all items above are corrected, we will do a 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
-FAx : 3(-- 5as- .39ace,
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:1132050090440
Owner's Name: JORGE & MAGALYS TOLEDO
Job Address: 1279 97 Street
Miami Shores, FL 33138 -2559
Owner's Phone:
Total Square Feet: 354
Total Job Valuation: $ 19,000.00
Contractor(s)
HOME OWNER
Phone
Primary Contractor
Yes
1
Planning and Zoning Criteria and Comments
Approved: No
Comments: WOOD CONSTRUTION IS NOT PERMITTED
Date Denied: 1/13/2011