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FW-12-1001Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 174338 Scheduled Inspection Date: June 14, 2012 Inspector. Bruhn, Norman Owner: SULLIVAN, ROBERT Job Address: 390 NE 93 Street Miami Shores, FL Permit Number: FVV -6 -12 -1001 Project: <NONE> Contractor: HOME OWNER Permit Type: Fence/Wall Inspection Type: Final Work Classification: Wood Fence Phone Number Parcel Number 1132060136310 Building Department Comments INSTALL WOOD FENCE Inspector Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. June 13, 2012 For Inspections please call: (305)762 -4949 Page 10 of 22 Z M.em-ei 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 No.V 1 CO PERMIT APPLICATION Master Permit No. FBC 20 Permit Type: BUILDING ROOFING OWNER: Name (Fee Simple Titleholder): O)) )4 -t) Address: 31 i) E g 7 4 0 S 7 City: fut titN'11 HD 1x'S Tenant/Lessee Name: Email: �- / ` • 4 11 Plr Phone#: 78'1:::► ".29 663 State: F-L- OA, 4 zip: 331' lii, rlc_-t"' Phone #: Li JOB ADDRESS: 390 Ai E. 93 ,e24( City: Miami Shores County: Miami Dade Zip: 3 3) 3 2' Folio/Parcel #: Is the Building Historically Designated: Yes NO /1( Flood Zone: CONTRACTOR: Company Name: Address: S, ill 0 Phone #: )x6,02984137 City: State: Zip: Qualifier Name: Phone #: State Certification or Registration #: Certificate of Competency #: Contact Phone*. Email Address: DESIGNER: Architect/Engineer: Phone#: � �' Value of Work for this Permit: $ ® Square/Linear Footage of Work: 8°®17 OAlteration ONew Repair/Replace ODemolition e Type of Work: OAddition . l ) Description of Work: )^ 1cc_, % �C od �'-ic° e 1 C_ '#1 i �( /01 *********** ** ********** ******* ** *** ****Fa? * ***** ** *** * ***** ** ** ** *r�r�*****,xa� *�x*** Submittal Fee $ Permit Fee $ /Q© CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTALFEENOWDUE$ I 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 Ali 'I II)AVIT: 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 wner or Agent The fo m strument as ac owl . „_ed bef day o, 20 --_by who is pe onal own to me or who has produced As identification and who did take an oath. NOTAR P : LIC: Sign: Print: My Commission Expires: Signature Contractor The foregoing instrument was acknowledged before me this day of , 20 _, by who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print My Commission Expires: ***** ********** ***+x*+x*x * ** x * ** ** * * *** six* * **** ** * *** *** ************* * „_: *** * * ****x k* ** x****** * ** **** APPROVED BY 6:G41---- Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Zoning Clerk 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: t %A-ic& 444.det DATE: 7 /i/ 0) ADDRESS: 5,0 iJh 73 a (5-i- ae,t, l -3 (38- 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 7 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 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 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. 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 govern 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.mvfloridalicense.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: 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 contractors 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 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 I day of Ve) , 20� a,UIAda QkdJ1( Produced there License or who was personally known to me or who has I O 10:1•14 as identificatiors. CLAUDIA V. CUBILLOS Notary Public - State of Florida My Comm. Expires Sep 23, 2015 Commission # EE 1288100 Bonded Through National Notary FIR'S KEY TITLE & ESCROW, INC, 11420 SW 88 STREET, SUITE 207 MIAMI, FL 33175 306.696.0301 Instrument Prepared By: CHRISTOPHER P. KELLEY, Esquire 11098 Biscayne Boulevard, Suite 205 Miami, Florida 33181 Folio No. 11- 3206 - 013 -6310 CF', : 27714 PAGE .L10 DATE:06108 /2011 08:20:11 AM DEED DOC 2,580.00 HARVEY RUVIN, CLERK OF COURT. MIA -DADE CTY WARRANTY DEED THIS INDENTURE) Made this J day of M- , 2011, Between ROBERT E. SULLIVAN, JR., and PAM M. SULLIVAN, husband and wife, GRANTORS, and DONALD SPRAGUE PENDER and LINDA JEAN PENDER, husband and wife, whose post office address is 390 NE 93 Street, Miami Shores, FL 33138, GRANTEES, WITNESSETH, That said GRANTORS, for and in consideration of the sum of Ten and NO /100 Dollars, and other good and valuable considerations to said GRANTORS in hand paid by said GRANTEES, the receipt whereof is hereby acknowledged, have granted, bargained and sold to the said GRANTEES, and GRANTEES' heirs and assigns forever, the following described land, situate, lying and being in Miami -Dade County, Florida to-wit: Lot 1 and E -112 of Lot 2, Block 47, AMENDED PLAT OF MIAMI SHORES, SECTION NO. 1, according to the Plat thereof, as recorded in Plat Book 10, Page 70, of the Public Records of Miami -Dade County, Florida SUBJECT TO: Applicable zoning and/or restrictions and prohibitions imposed by governmental authority; Conditions, Restrictions limitations, reservations, easements, and other matters appearing on records, if any; Utility easements of record, and taxes for the year 2011 and subsequent years. and said GRANTORS do hereby fully warrant the title to said land, and will defend the same against the lawful claims of all persons whomsoever. IN WITNESS WHEREOF, GRANTORS have hereunto set their hands and seals the day and year first above written. , sealed, and delivered in our p s Name a =Cf^- P �, M. SULLIVAN Grantor Print Name STATE OF FLORIDA ) COUNTY OF MIAMI -DADE ) I HEREBY CERTIFY that on this day, before me, an officer duly authorized in the State and County aforesaid to take acknowledgments, personally appeared ROBERT E. SULLIVAN, JR., and PAM M. SULLIVAN, husband and wife, who produced PO( and Fri respectively, as identification, and who executed the foregoing instrument and acknowledged before me that they executed the same. WffNESS my hand and official seal in the County d State lastafo this l day of ac'.yr .2011: My commission expires: NO C, Sta = FL• ' 'A at Large 9101990091101170114 EWA% May 21.2±1 k 01 401 41.■ REMA I WEN 4•4 WEST HALFJ LOT - 2 BLOCK - 4? ,f1v, fwv,4104-:41 •-, ,..qtolg, 4..t* APPRO tqk SUBJECT TO COMPUANCE WITH ALL FEDERAL STATE AND COI INN RULES AND REGULATIONS 00 Ca'4veLAt, #4(a,2$ ... 411Ca ^,ECL 10 co71i`iriVIICE Milli °a. r E '311- c +' f iLJ