FW-11-1717Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 170899 Permit Number: FW -9 -11 -1717
Scheduled Inspection Date: March 13, 2012
Inspector: Bruhn, Norman
Owner: MANION, COREY
Job Address: 138 NE 106 Street
Miami Shores, FL 33138-
Project <NONE>
Contractor: HOME OWNER
Permit Type: Fence/Wall
Inspection Type: Final
Work Classification: Wood Fence
Phone Number (305)607 -8334
Parcel Number 1121360050050
Building Department Comments
A SMALL GATE FENCE ON THE NORTH EAST CORNER
OF THE PROPERTY TO ENCLOSE SERVICE SIDE OF
THE HOUSE. TO LIMIT VIEW OF UNATTRACTIVE
PROPANE GAS TANK AND BLOCK ACCESS.
Passed ` ?j)?_
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
CREATED AS REINSPECTION FOR INSP- 164633. Each fence board
requires 2 fasteners at each connection.
Add a post a t wall or connect to wall. NB
March 12, 2012
For Inspections please call: (305)762 -4949
Page 13 of 18
tl'COLtY(
B ILDING
PERMIT APPLICATION
FBC 20
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
pe,mi,NO'Fik)
Master Permit No.
Permit Typ c UILDING ROOFINGG p
OWNER: Name (Fee imp - e older): G� R1'" t h & '�`
►,) Phone#: 7BC''' C' i 3' 2 5 6
Address: V3$ kJ l%'
City: /1/4'11 A.M1 i Jf v-os= -ej State: c L zip: t 3 6
Tenant/Lessee Name: <--(/a �" Phone #: — PP- --
Email: , O7L— tr-c:D43 € HO- ► L , C. cS A—.
JOB ADDRESS: rob N t 0 e
City: Miami Shores
Folio/Parcel #:
County: Miami Dade
Zip: ?j3%3
Is the Building Historically Designated: Yes
CONTRACTOR: Company Name:
Address:
.ate
kW&
Oc
Flood Zone: e
Phone #:
City: State: Zip:
Qualifier Name: Phone#:
State Certification or Registration #:
Contact Phone #: Email Address:
DESIGNER: Architect/Engineer: Phone #:
'Certificate of Competency #:
o
Value of Work for this Permit: $
Type of Work: ❑Addition OAlteration
Description of Work: 1 s} '6 0^1rZiL I1 _
Square/Linear Footage of Work:
Olfgew ORepair/Replace
CkVS4rePo c• 14∎4 r, 6t
Z - ate„ e. .)(A,gre_
¶b w- ate- JZ e,0 6.5- � ry e, ,
'644-
ODemolition
*********** ****x :******** * *+x************ Fees******+ x******+ x****** *************** **** *****
Submittal Fee $ Permit Fee $ /OO O' J
Scanning Fee $ Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CCF $ CO /CC $
DBPR $ Bond $
Technology Fee $
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 r be approved and a reinspection fee will be charge' d.
Signature — Signature
Owner or Agent Contractor
The f goin _ ins : , was . owledged . - fore this + The foregoing instrument was acknowledged before me this
day of . i. ..�i L : ,(' i b .1�lt � � . day of , 20 _, by
i
who is er' • naally known to me or who ha produced �L ho is personally known to me or who has produced
dentification and who did take an oath. as identification and who did take an oath.
NOT' TiTTi i.Y_
My Commission Expires:
A CUBt 3
,011 cVSS'et s 4'01
j„
* * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPROVED BY
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** *.. * * * * * * * * ** * ** * * * * * * * * * * * * **
Plans Examiner 3 // Zoning
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Structural Review Clerk
NAME:
ADDRESS:
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
`� DATE: l0 °Z1 ` `1
'ki (06 — S
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 2�
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 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
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:Uwww.mvfloridalicense.com /dbpr /pro /cilbfindex.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
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
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 Z
day of ®`71-0,i'20 If
who was personally known to me or who has
License or G '1 % • ' �: dentificatio
OWNER NOTARY
Lic.srXTY.o7 71, Cubillos
Vaire o S .23, 2011 .
Moires .mac®.,
mop A� ��
Name:Q�DT P�"
1
Planning and Zoning Criteria
Permit NO. FW -9 -11 -1717
0
Expires:Not Issued
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax (305)758 -8972
Issue Date: Not Issued
Folio Number:1121360050050
Owner's Name: DARRIN/ CHANTAL KAGELE/ COLLIER
Job Address: 138 106 Street
Miami Shores, FL 33138-
Owner's Phone:
Total Square Feet:
Total Job Valuation:
(305)607 -8334
8
$ 300.00
Contractor(s)
HOME OWNER
Phone
Primary Contractor
Yes
Planning and Zoning Criteria and Comments
Approved: Yes Date Approved: 9/23/2011: Yes
Comments:
Miami Shores Village
'APPROVED
BY
TZD
DATE
1'}3
ZONING DEPT
BLDG DEPT
r°
Ftdi#e/(
r
FEDE �
typ
SUBJECT TO )MPLIANCE WITH ALL
STATE AND ClatTY RULES AND REGULATIfO3PAg
d).61P'SZ6 (W).lr tZU
75.00' TOTAL R/W
M.90.OZ•OON
.z5n'
.17RV
13 k
2m St
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(d).PS= ad/ST n° i : 3.90,
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CERTIFIED TO:
RAPID TITLE SERVICES COMPANY; COMMONWEALTH LAND TITLE INSURANCE
COMPANY; COREY ADAM MANION AND HA THIEN NGUYEN; NATIONSTAR
MORTGAGE LLC, ITS SUCCESSORS AND /OR ASSIGN, AS THEIR INTEREST MAY
APPEAR.
FLOOD ZONE: X
MAP & PANEL= 12086C0302
COMMUNITY No.: 120652
SUI=FIX L
DATE OF FIRM: 9-11 -09
BASE ELEV.= N/A
PRQPERT *.OF COREYIADAM MANION
AND .0 J�' E11INt vEN
13frN I44STYO6th: TREET
MIAMI S RES, FLORIDA 33138 ,
NOT VAUD WITHOUT THE SIGNATURE AND THE
ORIGINAL RAISED SEAL OF A FLORIDA UCENSED
SURVEYOR AND MAPPER.
A BOUNDARY SURVEY
I HEREBY CERTIFY THAT THE SURVEY
REPRESENTED HEREON MEETS THE MINIMUM
TECHNICAL STANDARDS SET FORTH BY THE
FLORIDA BOARD OF LAND SURVEYORS IN CHAPTER
61G17-6, FLORIDA ADMINISTRATIVE CODE
PURSUANT TO SECTION 472 -027, FLORIDA
STATUTES, THERE ARE NO ENCROACHMENTS,
OVERLAPS, EASEMENTS APPEARING ON THE PLAT,
OTHER THAN AS SHOWN HERETO.
FRANCISCO F. FAJARDO #4767
LOCATION SKETCH
NOT TO SCALE
NE 106th STREET
90 -ZOt06 "-
NE 105th 5TRE-ET
( .4g141 .:71 i :.14: e.::
LEGAL DESCRIPTION:
• LOT 5, BLOCK 201, "DUNNING'S MIAMI SHORES-EXTENSION N° 1", ACCORDING TO
THE PLAT THEREOF, AS RECORDED IN PLAT BOOK 41, PAGE 51, OF THE PUBLIC
RECORDS OF MIAMI -DADE COUNTY, FLORIDA.
SURVEYOR'S NOTES:
.1) NOT VAUD UNLESS SIGNATURE IS EMBOSSED WITH THE REGISTERED LAND SURVEYOR'S SEAL.
2) LEGAL DESCRIPTION PROVIDED BY OTHERS.
3) PROPERTIES SHOWY HEREON WERE NOT ABSTRACTED FOREASF_MENTS OR OTHER RECORDED
ENCUMBRANCES NOT SHOWN ON THE PRTYPLAT OF RECORD.
4) MEASUREMENTS TO WOOD FENCES ARE TO OUTSIDE OF WOOD.
5) UNDERGROUND UTILITIES, FOUNDATIONS, OR OTHER IMPROVEMENTS, IF ANY, WERE NOT
LOCATED.
6) ELEVATIONS, IF SHOWN ARE BASED ON NATIONAL GEODETIC VERTICAL DATUM 1929.
7) FEND OWNERSHIP NOT DETERMINED UNLESS OTHERWISE NOTED.
8) MEASUREMENTS TO WIRE FENCES ARE TO CENTER OF WIRE.
9) WALL MEASUREMENTS ARE TO/FROMFACE OF WALL
10) DRAWING DISTANCE BETWEEN WALLS ANDIOR FENCES AND PROPERTYUNES MAYBE
EXAGGERATED FOR CLARITY.
11) FLOOD ZONE INFORMATION WAS DERIVED FROM FEDERAL EMERGENCY MANAGEMENT AGENCY
FLOOD INFORMATION RATE MAPS
12) BEARINGS IF ANY SHOWN ARE BASED ON ASSUMED MER/DLANAT CENTERLINE NE 106th STREET=
N90°0000`E
LEGEND
PCB:
POC:
fR)
D.U.E.:
PRM:
PCP:
END:
CL:
(C)
W.U.P.
INDICATES CONCRETE
INDICATES OVERHEAD LINES
INDICATES W/REFENCE
INDICATES WOOD FENCE
INDICATES PROPERTY CORNER
INDICATES POINT OFBEG!NNNNG
INDICATES POINT OF COMMENCEMENT
INDICATES PROPERTY LINE
OVDICATES RECORD ASEASUREME V T
INDICATES DRAINAGE & U77L/TYEASEMENT
INDICATES UT7LITYEASEMF_NT
INDICATES P E R M A N E N T R E F E R E N C E MONUMENT
INDICATES PERMANENT CONTROL POINT
INDICATES FOUND
INDICATES CLEAR
I ND I CA T ES REAM/RED CALCULATED
INDICATES WOOD UTILITY
L IK INDICATES LAKE MAINTENANCE
CL: INDICATES CLEAR
BNCR: INDICATES ENCROACHMENT
FIR INDICATES FOUND IRON PIPE
FRB: INDICATES FOUND REBAR
SRB: INDICATES SET lirom METER REBAR
TYP.: INDICATES TYPICAL
R/W: INDICATES RIGHT-OF-WAY
ORB: INDICATES OFFICML RECORD BOOK
t
INDICATES MORE ORLESS
F.F. ELEV.: INDICATES FINISHED FLOOR ELEVATION
N.T.S.: INDICATES NOT TO SCALE
N INDICATES NORTH
S INDICATES SOUTH
INDICATESCENTBiUNE
(M) INDICATES FIELD MEASUREMENTS
CONC.: INDICATES CONCRETE
ON1PL• /ND/CATESONPROPFRTYUNE
O.U.L. INDICATES OVERHEAD UTIUTY LINES
PROFESSIONAL SURVEYING AND MAPPING
LANNES & GARCIA, INC.
LB # 2098
FRANCISCO F. FAJARDO PSM # 4767
385 ALHAMBRA CIRCLE - SUITE C,
CORAL GABLES, FLORIDA 33134
PH (305) 666 -7909 FAX (305) 559 -3002
FLORIDA PROFESSIONAL SURVEYOR AND MAPPER
REG. NO. 4767. FIELD DATE 03-03 -2011
SCALE: 1" = 20' I DRAWN BY M. PIO 1 DWG. No.: 221379