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FW-12-1085Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 174798 Permit Number: FW -6 -12 -1085 Scheduled Inspection Date: June 27, 2012 Inspector: Bruhn, Norman Owner: BROWN, JAY Job Address: 302 NE 97 Street Miami Shores, FL Project: <NONE> Contractor: HOME OWNER Permit Type: FenceMlall Inspection Type: Final Work Classification: Wood Fence Phone Number Parcel Number 1132060135870 Building Department Comments INSTALLATION OF PEDESTRIAN GATE ON THE SIDE OF THE HOUSE Inspector Comments Passed ;, 6Ya -AL Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. June 26, 2012 For Inspections please call: (305)762 -4949 Page 18 of 36 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 faNt BUILDING PERMIT APPLICATION Permit Type: BUILDING JOB ADDRESS: BD 9— S City: Miami Shores County: Folio/Parcel#: Is the Building Historically Dated: Yes NO ` E WF i . - N 1 try►t iili 2 FBC2O Permit No..---tO 12 1 OAS Master Permit No. ROOFING Miami Dade zip: 031 3 e OWNER: Name (Fee Simple Titleholder): �—Jf Ay 0416 Address: 3 c� ti `Z i - "� 0 City: CAL k kik& State: F Tenant/Lessee Name; Email: :L1 6 6-to M c C_) - Flood Zone: Phone: i'-6 0 7tp 4149 Zip: 3 31 Phone#: CONTRACTOR: Company Name: Address: 4OA.0 Cusf m Phone#: 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: $ 207 J Square/Linear Footage of Work: Type of Work: DAddition DAlteration Whew DRepair/Replace Description of Work: I t, (A-LL e k 11 ODemolition Color thru tile: Submittal Fee $ Permit Fee $ / ()©od 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 not be approved and a reinspection fee will be charged Owner or Agent The foregoing instrument was acknowledged before me this I day ofJtU 1,0 , 20ta , by --ph r42.- is pe onally known toCCe or who has produced I I 11 ( `l identification and who did take an oath. NOTA Sign: Print: My Commission Ex P LIC: APPROVED BY 1 pZI. B • , ■ • . .. ` P ��ii :z °�.-�►5�: Notary Public -State of Florida My Comm. Expires ep o Commission # EE 128810 =. : .'0's Bonded Through National Notary Assn. 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: 6j6-41-- Plans Examiner /t'72z Zoning Structural Review (Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Clerk 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. 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 /dbpr /pro /cilb/iindex.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: 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 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 3 day of e , 20 By Produced there License or -0 who was personally known to me or who has e99--4---"0 b-24-Zil ifcation. NOTARY OWNER so.'4K VA Uq I CLAUDIA V. CUBILLOS B �a °' ". - Notary Public - State of Florida _� * ,` °- My Comm. Expires Sep 23, 2015 %. -:^ po-� $ Commission # EE 128810 i �0iiu Bonded Through National Notary Assn. 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: ,I -AY Q-C tk) DATE: 1?-1 2-- ADDRESS: 3o2- t1/41.(41.Lk -R 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. 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. sr Initial a► 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. 5. I understand that, as the owner - builder, I must provide direct, onsite supervision of the construction. Initial 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 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:1132060135870 Owner's Name: JAY BROWN Job Address: 302 97 Street Miami Shores, FL Owner's Phone: Total Square Feet: Total Job Valuation: 0 $ 400.00 Contractor(s) HOME OWNER -, Phone Primary Contractor Yes Planning and Zoning Criteria and Comments Approved: Yes Comments: Date Approved: 6/18/2012 : Yes S 2 of 21Surveyr Related Data) - See Sheet 1 of 2 for Legal Description, Certifications, Property and other Survey related data. SURVEY IS NOT COMPLETE WITHOUT BOTH SHEETS SCALE: I' 1 0 • JUN 252 1:- E. -97ih STREET 18' ASPHALT ROADWAY - (75 RIGHT-OF -WAY) j gig! -1 kelleligi 'vf AID UREisc§ oloo.14- Q rn 2 16 W 0, R =25.00' CA =90.14'48' L =39.38111 CH =35.43'(?) 23.5' PARKWAY 73.001? *PA) NO 1.D. 5 CONC. WALK F1P 1/2' N01.D. 10...39' 0.4'W. 25.31' \VCV\ (ka CTAI ()u -10.20 - 0.2' E. FC = 0.1' W. 02'N. Miami Shores t a APPROVED BY RP 10.5' A51i1ALT 90°00'001 1° N :• ROAD - (15' PLATTED ALLEY) NO I.D. ZONING DEPT IDT 13 mock 43 BLDG DEPT SUBJECT TO COMPLIANCE WITH ALL FEDERAL STATE AND COUNTY RULES AND RFCiIJL.ATIONS I' Fr3C.E PlArtrnnE Its.) rfHt LAW REWROTE Sf+BJECTFROPERTYB BYP1 UTRlfa Arse •Pieseratethefativic PIS SURVEYS APPROVED FOR COISTRUC 10,4BYLANDTEc (SURVEYING, •A a SadhProce4 . -Rue dosses EatiRapatyllre. LeathStmitg offal olio . t : the Slab ofRaata.Raase refer baawe> sww.laridtedtaveyme for upto date lntamab about our loin aadcoveragearea. Tit stray Ire been lazed trite tolbangLa1 ahSuneytgtake: 1500 N.W. 62nd Street, Suite 511 Fort Lauderdale, Florida 33309 Office: (954) 776 -6766 Fax: (954) 776-4660 www.LandtechSurvey.com baits take: 01-57812 Dtawn By: C. Felrma Dated Feld Wak:1 11 Revco: Rave: Providing °NSt..8 / cu e! Sheet 1 of 2 (Survey Related Data) — See Sheet 2 of 2 for Sketch of Survey. SURVEY IS NOT COMPLETE WITHOUT BOTH SHEETS LEGAL DESCRIPTION 43, MIAMI SHORES SECTION ONE AMENDED, ACCORDING TO THE PLAT THEREOF PUBLIC RECORDS OF MIAMI -DADE COUNTY, FLORIDA. . THE WEST 1/2 OF LOT 11 AND ALL OF LOT 12, BLOCK AS RECORDED IN PLAT BOOK 10, PAGE(S) 70, OF THE PROPERTY ADDRESS 302 NE 97TH STREET MIAMI SHORES, FL 33138 INVOICE NUMBER 01 -57612 DATE OF FIELD WORK 10/05 /2011 CERTIFIED TO JAY BROWN FLOOD ZONE X - 120652 - 0302 - L BYAUiNORIrrGRANTEDPER81G17- 8. O13( 3)( G) FLORIDAADMIMSTRATIVECODE :FCRMORTf3AG1ETRANSACTIO , LAFD TEcHM EREBYAUMORZEStEM =ITTLEA00118SIOWNI€REONTOA DAW LE=93 CERNICATTOMWEY DEEM FIE RYTOCOMPLETESAID7RA: C ION. ANY OTHER ALTERATIONS t3HALL VOID THIS suavet PLEASE ENTER ADDMONAL CERTIFICATION(S) BELOW: Genes Notes: 1. THIS SURVEY IS BASED UPON RECORD INFORMATION PROVIDED BY CLIENT. NO SPECIFIC SEARCH OF THE PUBLIC RECORD HAS BEEN MADE BY THIS OFFICE UNLESS OTHERWISE NOTED. 2. IF THIS SURVEY HAS BEEN PREPARED FOR THE PURPOSES OF A MORTGAGE TRANSACTION, ITS SCOPE IS LIMITED TO THE DETERMINATION OF TITLE DEFICIENCIES. NO FUTURE CONSTRUCTION SHALL BE BASED UPON THIS SURVEY WITHOUT FIRST OBTAINING APPROVAL AND/OR UPDATES FROM LANDTECH SURVEYING. LANDTECH SURVEYING ASSUMES NO RESPONSIBILITY FOR ERRORS RESULTING FROM FAILURE TO ADHERE TO THIS CLAUSE. 3. ANY FENCES SHOWN HEREON ARE ILLUSTRATIVE OF THEIR GENERAL POSITION ONLY. FENCE TIES SHOWN ARE TO GENERAL CENTERLINE OF FENCE. THIS OFFICE WILL NOT BE RESPONSIBLE FOR DAMAGES RESULTING FROM THE REMOVAL OF, OR CHANGES MADE TO, ANY FENCES UNLESS WE HAVE PROVIDED A SURVEY SPECIFICALLY LOCATING SAID FENCES FOR SUCH PURPOSES. DETERMINATION OF FENCE POSITIONS SHOULD BE BASED SOLELY ON THEIR PHYSICAL RELATIONSHIP TO THE MONUMENTED BOUNDARY LINES. 4. GRAPHIC REPRESENTATIONS MAY HAVE BEEN EXAGGERATED TO MORE CLEARLY ILLUSTRATE MEASURED RELATIONSHIPS - DIMENSIONS SHALL HAVE PRECEDENCE OVER SCALED POSITIONS. 5. UNDERGROUND IMPROVEMENTS HAVE NOT BEEN LOCATED EXCEPT AS SPECIFICALLY SHOWN. 6. ELEVATIONS ARE BASED UPON NATIONAL GEODETIC VERTICAL DATUM (N.G.V.D.1929) UNLESS OTHERWISE SHOWN. 7. AU. BOUNDARY AND CONTROL DIMENS 0NS SHOWN ARE FIELD MEASURED AND CORRESPOND TO RECORD INFORMATION UNLESS SPECIFICALLY NOTED OTHERWISE. 8. CORNERS SHOWN AS ARE IDENTIFIED WITH A CAP MARKED LB (LICENSED BUSINESS) # 6799. HEREBY CERTIFY THAT THIS BOLBWARY SURVEY MEETS T}8: SWUM TECHNICAL STANDARDS FoR SURVEYS. AS SET FORTH BY THE FLORIDA BOARD OF SURVEYORS AND MAPPERS INCHAPTEt I31G174 OF THE FLORIDA ADM MSTRATNE CODE, PUR,SUANTTO SECTION V2.027, FLORIDA STATUTES. Al 4...--4. - / . DATE: 10/05/2011 Legend/Abbreviadons: EOW = Edge of Water P = Per Plat RfW = Right - of-Way A = Arc Length FF = Finished Floor P/L = Property Line TR = Telephone Riser CA = Central Angle FIP = Found Iron Pipe PC = Point of Curvature UE = Utility Easement CIL = Centerline FIR = Found Iron Rod PCC = Pont of Compound WM = Water Meter CF = Computed from Field Measure FN = Found Nail Curvature UP = Utility Pole CR = Computed from Record data L = Per Legal Description PK = Parker Kahl Nail CAN = Cable TV Riser M = Measured POB = Point of Beginning DE = Drainage Easement OHC = Overhead Cable POC = Point of Commencement Ease = Easement ORB = Offilai Records Book PRC = Poini of Reverse Curvature "'1v� f $ U ___ F '?l E ' Provkting Fasts A aura l =f a r i eda -••'� AAVREW SNY DER -PROFE SIONALSURVEYOR ANDMAPPER FLORIDA REDASTRATIONAb .5639NOT VALID WIINOUT TIE SI ATIREAADME ORIONAL RAISED SEAL O R ELECTRONIC S E A L OF77EFLOAlll4 L ED SURVEYOR AA71 S4PPERSHOWNABMVE1