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FW-12-297Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 170215 Permit Number: FW -2 -12 -297 Scheduled Inspection Date: March 06, 2012 Inspector: Bruhn, Norman Owner: LIVINGSTONE, KERI Job Address: 1140 NE 100 Street Miami Shores, FL 33138- Project: <NONE> Contractor: HOME OWNER Permit Type: Fence/Wall Inspection Type: Final Work Classification: Wood Fence Phone Number (786)218 -0080 Parcel Number 1132050190430 Building Department Comments REPLACE FENCE WITH A 5'HIGH WOOD FENCE. Passed ig Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments March 05, 2012 For Inspections please call: (305)762 -4949 Page 13 of 20 Miami Shores Village Building Department RECEIVED FEB 222012 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PE PPLICATION FBC Permit Type: BUILDING ROOFING Permit No. V 2 . - 2 . - r Master Permit No. OWNER: Name (Fee Simple Titleholder): ��d Lr ✓,n 5slrvh -a-- Phone #: ifs >o L i r corn Address: City: it o ■N1; ,00 S }r' -ld.% SA6,rC.S Tenant/Lessee Name: Email: State: Zip: 33 i 3 St Phone #: ,v�ri cpd 5 n,l,.k n� . tA'JOB ADDRESS: 114o auc I Go S-.r e_e.r City: Miami Shores County: Miami Dade Zip: 3 313 (C . Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: a► >r, Phone#: Address: City: State: Zip: Qualifier Name: Phone #: (. 7 State Certification or Registration #: Certificate of Competency #: �Y Contact Phone #: Email Address: t DESIGNER: Architect/Engineer: Phone #: r S Value of Work for this Permit: $ 4 CO 6 Square/Linear Footage of Work: Type of Work: ❑Addition ❑Alteration New Repair/Replace Description of Work: j ref t� c ...,,,.<..�ar a c ,ru kcv.,. c4.- , �. 1... ∎-+. n-. .14.-J S t W J 81- F� cu.- / (a Dc.T10.- cr.", l04) c.,r aD ) �vr 1 c:n.dt ❑Demolition hA o O ('`tay J kso ***** ***** a::x** ** * *** *************** ****Fee six * * * ** x * *** * * ** * * ** * *** * * **** * * * * * * ** ** Submittal Fee $53 SA Permit Fee $ is / CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ �ti • t! 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 AFFIDAVI.T: 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 �� ---___ Signature Owner or Agent Contractor The foregoi instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of P1(6 , 20 , by YC�ry 1l LIVt: / A/, day of , 20 _, by who is personally known to me or who has produced A4 %, 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: i , .. 11111110, Ari Sign: . •. /I Sign: �.. ® s % %6�� ' Print: o , • Print: co �f m o0 �`m cp ? �. d�' - My Commission Expires: �y .` + ksIasksks la* skskskXsakH�akiksk�Issk�IsskskK ssk�3: *skaknk�F�kakaksksk*1;4 pP4 ifsjgHuNHs*** d* �kak�Iasksk: k�kakakaksp *sKik9kaksknknksknkakskik** *********** ***** • aksk�k *skak�Iaxksksk 1 ii, �!! U I III 111 N \ \ \\ APPROVED BY �����ls� Plans Examiner 2 12 /2-Zoning My Commission Expires: Structural Review Clerk (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) '( NAME: ADDRESS: M iami 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 5c1 DATE: 114 a 0-Pe l o o S ►.re estr un Ca net: Si ..s -T 3 313 Y 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 Y-4-/ 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 Iry 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 K.t. 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 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 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.myfloridalicense.com/dbpdpro/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: 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 bvt� 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 day of Fi3 , 20 ) Z By icRall Uvs04 J7c9 Produced there License or who was personally known to me or who has as identpatldiK!rrr%/ S ..... ' ,0. • ue 6131M "".. s• 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 Expires:Not Issued Folio Number:1132050190430 Owner's Name: KERI LIVINGSTONE Job Address: 1140 100 Street Miami Shores, FL 33138- Owner's Phone: (786)218 -0080 Total Square Feet: 156 Total Job Valuation: $ 1,500.00 Contractor(s) HOME OWNER Phone Primary Contractor Yes Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 2/22/2012 : Yes Comments: & W oN /300.1 -D § c SI 440D At k,1W FEB 2 x23;2 27..80' 4 C.LF. 119.12° ..M =a #: RA) 12 — 21,- APPROVED Mari Shores Village BY DATE ZONING DEFT BLDG DEPT ale �F SUBJECT 10 CCNIR LANCE WITH ALL FEDERAL STATE ANU eCIJN Y HUES AND REGULATIONS F VALID U' .11130 # t SURVEYbitS SEAL REVISED 10/18/06 z NORETE BLOCK STRUCTURE.. CLF=CHAINBLINK FENCE. PLCPROPERIY LINE. DUE=DIMINAGE UTILITY E SEVlENkT. PIPE, F- FOUND. AJC=AIR CONDITIONER PAD. PIC=PROPERTY CORNER, DIN=D ILLED HOLE, W!F=WOODEN FEPNGE, RES=RESIDENCE. t . RB=REBAR, UE =UTILITY EASEMENT, CONC.-CONCRETE SLAB. RNV =RIt ft OF WAX DE- DRAINAGE EASEMENT. CIL=CENTER LINE, O =OIF TYP .TYPICAL, EASUURED = RECORDED. ENCR=ENCROACHMENT COMP=COMPUTER,.ASFH :ASP}IALT, NCI. & DISC, S=SET,'F.F.E. R ELEVATION, OM:OFFSET, P/P=POWER POLE, O P OVERHEAD POWERLINE W WATERMETER ' E_ " ELEVATION BASE! ON L # 3250 S ETE ' x =a,s :•` •i`..•. •k,'+ *s #; e A .a1 01,131V1# i2 ELV 8.741 lYPE3A swam: e j MRINTENANCE& FAIWAGEEASEMENT=M SURVVEYOR'S NOTES; 1) OWNERSHIP SUBJECT TO OPINION OF TITLE. 2) NOT VALID-WITHOUT THE SIGIO AND RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER, 3). THE SURVEY DEPICTED HERE I COVERED BY PROFESSIONAL LIABILITY INSURANCE. 4) LEGAL DESCRIPTION PROVIDED BY CLIEN UNDERGROUND ENCROACHMENTS NOT LOCATED. 6) ELEVATIONS ARE EASEL' ON NATIONAL GEOI VERTICAL DATUM OF 1929. 7) OWNERSHIP OF FENCES ARE UNKNOWN. S) THERE MAY BE ADDITI RESTRICTIONS NOT SHOWN ON THIS SURVEY THAT MAY BE FOUND IN THE PUBLIC RECORDS OF THIS COUN CONTACT THE APPROPRIATE AUTHORITY PRIOR TO ANY DESIGN WORK FOR BUILDING AND ZC INFORMATION. 10) EXAMINATION OF THE ABSTRACT STRACT OF TITLE WILLI-IAVE TO BE MADE TO DETERMINE WILL FIAVE TO BE MADETO DETERMINE MCO INSTRUMENTS ,IFANY,AFFECTINGTHISPROPERTY. BEARINGS WHEN SHOWN ARE REFERRED TO AN ASSUMED VALUE OF SAID LOCATION SKETCH SCALE: W 19 119.12' (RIM) 1191; sU8VrY FOR: ,RAYtd€MO SAE: &RB , 1140 14.E. %%, 33L38. LEGAL DESCRIPTION' Lift OF KAA11 $RO SEM ACCORDING T 111E <P!AT NE NE AS REC'DR. DE:IN PLAT 13001( _1 OPINE PUBLIC RECQRO A z iNs 7 FL 1 LOC. 8.74' tYPIt VpALI0�WW1 AYE i 1 1014 PROV11107' + n/may.0vgd.:w Ett�G°1V4ATTII GE0ET 11,x,,,,! IP ' I AR4 KI40 i HERE !.?+. AD ... N476'X71'IVVMi:� ON N'Rn'�T liY�$i't"' Q:'T1- RF orrtva OUNTY ' TI4E l41ME A Th0RFf 0 iat€Y DESIGN WORK FOR MUALM O.FfD me g, 907:. 'IV E7EAt11NATY074OR: k AE8 0F' T%IEW40.0AtEb08E t AD1410DE 1 WdER GS Ef s.IFA`Y aFREG tutfaSHi&moPon Y. ..aii.d^fAaw 1Y'®0R11FY 7?l 11P a 4 44 em astn@ , r BitHimea�ce9in ftANc 3 8F61n4Dts Land'8i 85.4200 RWP STET Thee & t fls -cEH3a #v':n Pn'9