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DS-12-807Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Mnspection Number: INSP - 175220 Permit Number: DS -5 -12 -807 Inspection Date: July 10, 2012 Inspector: Bruhn, Norman Owner: CAMACHO, FEDERICA Job Address: 11016 NW 2 Avenue Miami Shores, FL 33138- Project: <NONE> Contractor: HOME OWNER Permit Type: Driveways /Sidewalks /Slabs Inspection Type: Final Work Classification: New Phone Number (786)973 -2263 Parcel Number 1121360020250 Building Department Comments DRIVWAY INSTALLATION USING EXISTING CONCRETE SLAB AND ADDING CONCRETE PAVERS ABOVE. Inspector Comments Passe • CREATED AS REINSPECTION FOR INSP- 174855. CREATED AS 7—A REINSPECTION FOR INSP- 174684. CREATED AS REINSPECTION FOR INSP- 173188. Note: A village property must be restored. This includes ,-/ sidewalks, swale and asphalt on NW 2nd Ave. Failed This includes where material and equipment were stored at 11004 NW 2nd Ave. All restoration must be completed to Miami Shores standards. NB Correction Not Ready- idewalk must be replaced where broken at 11016 and 11004 NW Needed 2nd Ave. Asphalt must be repaired to village standards this include cutting pavement from curb to curb by a licensed contractor. The contractor must register with the Village prior to starting repair. SEE NORM BRUHN Sod swale at 11004 NW 2nd Ave. This is in progress but not complete. Re- Inspection Sidewalk at 11004 NW 2nd Ave have not been replaced. Fee Asphalt repair is not done to Miami Shores standards. NB No Additional Inspections can be scheduled until Same comments. NB re- inspection fee is paid. (41� For Inspections please call: (305)762 -4949 July 16, 2012 Page 1 of 1 sI II2 B ILDIN PERMIT APPLICATION Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CA INSPECTION'S PHONE NUMBER: (305) 762.4949 Permit Type: BUILDING JOB ADDRESS: I I -a nut- Permit No. Master Permit No. .O MCMgcsdiff-il HAY 0 7 :5"i2 BY: ....V.:, 'seo. ROOFING City: Miami Shores County: Miami Dade Folio/Parcel #: Is the Building Historically Designated: Yes Zip: NO Flood Zone: OWNER: Name ``( // ` (Fee Simple Titleholder): +? ( b moor P Address: 110 )((c I uJ D City: (I 1 am / 9 lc i es State: Zip: 2a �° Tenant/Lessee Name: Phone #: U Email: (� can CONTRACTOR: Company Name: /4007-) 0,..St V 1111 Phone #: Address: 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: $ 1)9e0 " 1 Square/Linear Footage of Work: /6 fd_ Type of Work: ❑Additi pescri n of Work ❑Alteration n New I' epair/Replac 4. 11.1 A, A ce, / f 14 ( . ' 1 • 1, AC A i as. YA/D1 ODemoli on .yYte YD c04..±e,- ******* * * * * * ** * * * * * * * * * * * * * * * *„* * * * * ** ees *, *.* , * *, ** , * * * *, *, * *, * *.**, *. * *, * *,* Submittal Fee $ Permit Fee $ Q CCF $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ �j r\ - TOTAL FEE NOW DUE $ 1 m ` 6 CO /CC $ Bond $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) c ll rerun i. C V - t 1 Mortgage Lender's Address A 'Quo City ( 1./ Urn 9 State Obi Cka_ Zip l n. 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 3..'feet to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first i . n which occurs en (7) days after the building permit is issued. In the absence of such posted notice, the inspecti►n "wil approved andction fee will be charged. s pecti not b Signature 4O 1 0 1. A Signature er or Agent Contractor The forego' g instrument was acknow edged before s' i 's The foregoing instrument was acknowledged before me this day of ;.J L , 20 1 by l` 1 L dIlifi of �w�ho is p onally?.! own to me or who has produced 21111 ' ho is personally known to me or who has produced � ,20,by NOT Sign: Print: dentification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: PUBLIC: My Commission Expires: * * * * * * * * * * * * * * * * * * * * * * * ** APPROVED BY Sign: Print: My Commission Expires: ******************************* * * * ** * *** *** *** * ***** *** * **** ** 101- Plans Examiner . J,,/'/c172- Zoning Structural Review (Revised 3 /12 /2012)(Revised 07 /10 /07XRevised 06/10/2009XRevised 3/15/09) 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: P(JeJICQ ( f. IT) DATE: 5I -1 ,-y a ADDRESS: 1 ID 110 IOW 3r7111 111A 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, m.; :ct 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 construction and is not hiring a licensed contractor to assume responsibility. Initial sible for the 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 i .'ead of my own name. I also understand that the contractor is required by law to be licensed in Florida and to list his or li e 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 substa Ily improved myself is sold or leased within 1 year after the construction is complete, the law will presume that I bui 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 Initi 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 ensue 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. 1, 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 e .loyees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am wil ;Jj cling 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 a 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 CD 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.mvforidalicense.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 inform 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 -1 day of who was personally known to me or who has d there Li �� godentification. CLAUDIA V. CUBI oLO Florida Notary Public - 2g ri a c My Comm. Expires Sep • ; Commission # LE 128810 Bonded Through National Notary Assn. MEECMEWMIffi MAY 072` °2 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY Whereas, (owner) hereinafter referred to as the owner of the following described property (address): 11016 NW 2nd Avenue, Miami Shores - FL 33150 Legal Description Shoreland Hgts Folio # 11- 2136 -002 -0250 Lot 65.690x125 Block 22 Subdivision PB 43-85 Requests permission to install (describe work): driveway of concrete pavers Within the public right of way of (address) 11016 NW 2nd Avenue, Miami Shores - FL 33150 IN CONSIDERATION of the approval of this permit by the Village, the owner agrees as follows: 1. To maintain and repair, when necessary, the above - mentioned item(s) installed within the dedicated right of way. If it becomes necessary for Miami Shores Village or Dade County to make repairs or maintain said items within public right of way including restoration of street by reason of the Owner's failure to do so, such expense shall be paid by the Owner or shall constitute a lien against the above described property until paid. 2. The owner does hereby agree to indemnify and hold Miami Shores Village or Dade County harmless from any and all liability, which may rise by virtue of permitting the installation of these items within the public right of way. 1 3. The Owner does hereby agree to remove or relocate their facilities at their own expense, within 60 days notice by the Village to do so. Failure to comply with this notice will result in the Village causing the item(s) to be removed and a lien being placed on the property and /or assessed against the Owner for all costs incurred in the removal and disposal of the item(s). 4. The undersigned further agrees that these conditions shall be deemed a covenant running with the land and shall remain in full force and effect and be binding on the undersigned, their heirs and assigns, until such time as this obligations has been canceled by an affidavit filed in the Public Records of Dade County, Florida by the Village Manager of Miami Shores Village (or his fully authorized representative). SIGNED, SEALED, EXECUTED AND ACKNOWLEDGE on this SIGNED, SEALED, AND DELIVERED in the presence of: 2 day of , 201 (Owner's Signature ) 1 0 r- WEST MIAMI SHORES SEC D (PB 46- PG.53) LIMIT OF PLAT (N.A.P.) 6' W.F.65.64' C.L.F. .LP 1/2" 0 CAP wok 0.20' APPROVED BLDG DEPT SUBJECT TO COMPLIANCE WITH ALL FEDER STATE AND (BOUNTY RULES AND REGULATIO: CL 4' C.B.W. vett-1V 1-6 Vitt N LOT -21 :^ (C) 5' ENCR. LOT -23 0.33' CL P 4' W.F. BAD CONDITION F.I.P 1!2" NO CAP Proposed Location for Final Driveway PS.: Pavers will be installed on top of existing concrete slab. The areas without concrete will be excavated and prepared with 6" lime rocks ( compacted), 2" sand (compacted) and pavers on top to match with the rest. F.I.P 1/2° NO CAP ENCROACHMENT NOTES: (A) East side ofthe Subject Property Concrete Return Encroaching into the Right of Way of W. 2nd Avenue. B.C. F.I.P 1/ NO CAI i Planning and Zoning Criteria Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)758 -8972 Folio Number:1121360020250 Owner's Name: Job Address: 11016 2 Avenue Miami Shores, FL 33138- Owner's Phone: Total Square Feet: Total Job Valuation: 0 $ 1,900.00 Contractor(s) HOME OWNER Phone Primary Contractor Yes Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 5/18/2012 : Yes Comments: A LANDSCAPE STRIP OF NOT LESS THAN 5 FEET MUST BE LEFT BETWEEN THE HOUSE AND THE END OF THE DRIVEWAY. 5/18/12 NEW PLANS OK Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 RECEIPT PERMIT Mpg, 2:1-r) DATE: 5 J b )® OdUTP o Contractor la-Owner o Architect 1 Picked up 2 sets of plans and (other) •°'S Address: 110I10 141,-J 9-MU From the building department on this date in order to have corrections done to plans And /or get County stamps. I understand that the plans need to be brought back to Miami Shores Village Building Department to continue permitting process. Acknowledged by: rri,4 /fir PERMIT CLERK INITIAL: RESUBMITTED DATE: 5 ) Cp. PERMIT CLERK INITIAL: