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DS-12-814Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 173243 Permit Number: DS -5 -12 -814 Scheduled Inspection Date: July 26, 2012 Inspector: Rodriguez, Jorge Owner: LEROY, PIERRE Job Address: 9301 NW 2 Court Miami Shores, FL 33150- Project: <NONE> Contractor: HOME OWNER Permit Type: Driveways /Sidewalks /Slabs Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1131010150400 Building Department Comments NEW PAVER DRIVEWAY AND COVER EXSITNG FRONT DOOR STEPS AND WALKWAY Inspector Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. July 25, 2012 For Inspections please call: (305)762 -4949 Page 3 of 26 i- Miami Shores Village A � 1 lift_ 5 uildin De p artment 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 5i PERMIT APPLICA ION FBC 200 Permit Type: BUILDING ROOFING . / OWNER: Name (Fee dimple Titleholder): ,. P 1. E rr cosi Phone.: (q �/ Ll. Address: 3o d ill Lt/ 2 °"" City: Oe r cS ;o1-P.'s State: RECEIVED MAY 082012 Permit No. Master Permit No 5 l `2-- all PC, Zip: 2 3 /S0,_ Tenant/Lessee Name Phone#: Email: JOB ADDRESS: q 3 ® cu City: Miami Shores County: Folio/Parcel#:' ' f " 3/ ®/ _, I r ` 6,4100 Is the,13uilding Historically Designated;. Yes. Miami Dade Zip: 3 ` / cp CONTRACTOR: Company' Name: Address: /(//24- City: AU44 Qualifier Name: State Certification or Registration #: Contact Phone#: DESIGNER: Arehitect/Engineer. Flood Zone: ' 0 ) 4rie._. Phone*: WA State: Al/A- Zip: AI Phone#: "1../7 Certificate of Competency #: 'v/A Email Address: 41 Phone#: A//4 , .. Value of Work for this Permit: $ ` 2 / es-0 Square/Linear Footage of Work: Type of Work: °Addition °Alteration XtNew °Repair/Replace °Demolition Description of Works DP 11.1e e/ P Veil-- a- (V t.A1'4. w-1 % �✓4 ! , 4� t Covey e ,- ,S! % ,,9 F- r �®ov ('tens Lett+ A'acu vat,- k 900 * * ******* 00* * ********* *********** ***** ************* ****** **** ********************* Submittal Fee $ to Permit Fee $ i 2S. CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding Company's Address City /11/4 State /4/ /4 Zip ,t//4 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. Signature Signature Owner or Agent ¢' Contractor The foregoing instrument was acknowledged before me this 0 / The foregoing instrument was acknowledged before me this day of r t * 20 I Z by P 2fi. , day of , 20 ___, by who is personally known to me or w has prod lu '/ 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. ,`a1►11I i,4,, o ` tale ,�: , ' - � /- • .•% Sign: 'X'•_o•` Print .6/4 - Print: cv ` My Commission Expires: . `:ee, f l/ ' i My Commission Expires: *�R+ ********** ** * *** ****** ** (( fl{I H , I `1 ** ** A *** *** R** ***** *# ffi * *## * * *** ***** 6 * lei_ Plans Examiner s/ / A , Zoning NOTARY PUBLIC: APPROVED BY Structural Review Clerk (Revised 07 /10/07)(Revised 06/10/2009)(Revised 3 /15/09) NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE J08 SITE AT TIME OF FIRST JNSPECi1ON PERMIT NO. TAX FOLIO NO. i®- 3169 -Btu nziow STATE OF FLORIDA COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements wifi be made to certain real property, and In accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement 1111111111111111111111 I11l11I111111111111 1111 CFN 2012R032231!5 OR Bk 28100 Ps 35921 (1Ps) RECORDED 05/07/2012 13 :53230 HARVEY RUVIH, CLERK OF COURT I1IAIII -DADS COUNTY, FLORIDA LAST PAGE Space above reserved for use of recevang .office 1. Legal description of property and street/address: CI 342if N ?Ai CT. A4,;: n7.. .SITOk eS P/ ?S /To ®1>e// ?4*,0,- 473q1-6-7 lord, &BX 3 G'7 tine PG�eC,v/1 '*v 2. Description of improvement: tier, pmv0„. fl-e7 , 44,.442( -4 f .9q J N2 /PJ 3. Owner(s) name and address: ?M.Oy q3 6> Ale, 2» CT' Mio,,.,: d'/rat")- r2: i 31fo Interest in property: gxvne'- Name and address of fee simple titleholder. ,I/4 4. Contractor's name, address and phone number: jr/ /fl Cdr - 5. Surety: (Payment bond required by owner from contractor, if any) Name, address and phone number: A/41 Amount of bond $ i9/ %A 6. Lender's name and address: 4/4 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1j(a)7., Rorida Statutes, Name, address and phone number: /I/ /4 8. In addition to himself, Owners designates the following person(s) to rive a copy of the Uenor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name, address and phone number: ■WA 9. Expiration date of this Notice of Commencement .- We' t. -"-a®,.. 1 wTT ee ve d ,Ak Ohs expiration date is 1 year from the date d recardtng unless a different date is specified) WARNING TO OWNS t ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. • Signature(s) of Prepared By Print Name Title/Office CUvn. e.- STATE OF FLORIDA COUNTY OF MIAMI -DADE er(s)' Authorized Officer/Director/Partner/Manager Prepared By Print Name Title/Office The foregoing instriirnptt was acknowledged More me this 17 r &.4 P er- dividually, or O as tr for ,1 J.Personaily known, or O produced the following type of !dentin Signature of Notary Public: Print Name: (SEAL) dayof A49Y IFICATION VER Pt1RStJAun' TO ECTION 5. FL.ORtee STATUS Under penaltiesof perjury, I declare that I have read the foregoing and that the facts stated In it are true, to the best of my knowledge and belief. • STATE OF FLORIDA, COUNTY OF DADE 1 HEREBY CERTIFY that this Is a true copy of the orlQ* el Bled in this QtJ ae on ..day o1 AD. 20 WITNESS my hand end Official Seat, CLERK. of Circuit 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: Xoer 2 DATE: 5/ (t % 2__. ADDRESS: 94W/12L4--) "i/ 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 --7Z*". 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 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 nor bers 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. 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 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.mvfioridalicense.com /dbpr /pro /cilbfinde xhtml 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 1i 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 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 / t day of P 4? , 20 / 2- who was personally known to me or who has Produced there License or `? i 2�.. Cr vy' OWNER as ideny iii$' "'v /06/2016': • ug,t z- a9 f 11305g „••••• F) OW\vx `\ 1 Rick Scott Govemor John H. Armstrong, MD State Surgeon General May 29, 2012 Pierre Leroy 9301 NW 2 Ct Miami, FL 33150 RE: Contingency Letter Application Document No: API 072737 Centrax Permit Number: 13 -SC- 1411305 OSTDS Number: 9301 NW 2 Ct Miami, FL 33150 Lot:57 Block:16 Subdivision: Odell Manors Dear Applicant: This will acknowledge receipt of an application dated 05/22/2012 for a permit to use an existing onsite sewage treatment and disposal system located on the above referenced property. Proposed paver driveway and walkway, septic system at the back of the house. There is not increase in sewage flow, change sewage characteristic, or any alteration that change the conditions under which the system was approved. From a review of your completed application, it has been determined your existing system is adequate for the proposed use. If you have any questions on this matter, please call our office at (305) 623 -3500. Enclosures cc: Miami -Dade County Health Department 1725 NW 167 St, Opa Locka, FL 33056 Phone: (305) 623 -3500 . Fax: (305) 623 -3645 . http: / /www.MyFloridaF,H.com P 44a • y LOT 5 BLOCK 3 25.00' 4.'60' 1 0.80' L =39.2 R =25.00' 6= 89'55'40" NOT VALID UNLESS EMBOSSED WITH SURVEYOR'S SEAL REVISED: 25.55' 1' ENC. o° ,.z c x f �.. w�. r ,;x 11 APPROVED Permit n©.4' rate: Mini- d "'SIe B 5' U.E. County Health Department No LOT 1 74- BLOCK 3 0o 25' ENC. 5' LE. 1,.95 CL .F.L:P.. 1/2".. (NO LD.) 100.00' (R &M) 19' PARKWAY 62.50' RIGHT —OF —WAY (BY PLAT) ABBREVIATIONS; S M(= StDEWILK CBS =CONCRETE BLOCK STRUCTURE, CLF =CHAIN UNKFENCE, PL =PROPERTYUNE, DUE =DRAINAGE UTILrrYEASEM ENT, IP =IRON PIPE, F =FOUND, NC =AIR CONDmONER PAD, P/C =PROPERTY CORNER. O!H= DRILLED HOLE, VztWFF =V ODEN FENCE, RES =RESIDENCE, CL- CLEAR. RB =REBAR, UE =UTILITY EASEMENT, CONC =CONCRETE SLAB. RNWRIGHT OF W'Y, DE =DRAINAGE EASEMENT, CA-=CENTER LINE, 0 =DIAMTER, TYP =TYPICAL, M= MEASURED. R =RECORDED, ENCR =ENCROACHMENT, COMP=COMPUTER, ASH=ASPHALT, WD= NAIL & DISC, S =SET, FEE =FINISH FLOOR ELEVATION, O /S= OFFSET, PIP= POV.ER POLE, OHP=OVERHEAD POVvERLINE, W4I" ITERMETER WOOD FENCE= MASONRY l , I 1 I 1 I , , t ELEVATION BASED ON LOC. # ASONRYNO� L= CONCRETE= V. —• :• ••s }� •t..4 •t;.:•• ;•:.•3 :• •I MAINTENANCE& DRAINAGE EASEMENT= M &D.E. CBM# ELV. TYPE OF SURVEY: BOUNDARY SURVEY SURVEYOR'S NOTES: 1) OWNERSHIP SUBJECT TO OPINION OF TITLE. 2) NOT VALID WITHOUT THE SIGNATURE AND RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER. 3) THE SURVEY DEPICTED HERE IS NOT COVERED BY PROFESSIONAL LIABILITY INSURANCE. 4) LEGAL DESCRIPTION PROVIDED BY CLIENT. 5) UNDERGROUND ENCROACHMENTS NOT LOCATED. 6) ELEVATIONS ARE BASED ON NATIONAL. GEODETIC VERTICAL DATUM OF 1929. 7) OWNERSHIP OF FENCES ARE UNKNOWN. 8) THERE MAY BE ADDITIONAL RESTRICTIONS NOT SHOWN ON THIS SURVEY THAT MAY BE FOUND IN THE PUBLIC RECORDS OF THIS COUNTY. 9) CONTACT THE APPROPRIATE AUTHORITY PRIOR TO ANY DESIGN WORK FOR BUILDING AND ZONING INFORMATION. 10) EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED INSTRUMENTS, IF ANY, AFFECTING THIS PROPERTY. -- • —•• • — ... .,,.., . nr ncccoocn Tn Aw ACCI IMFn t /AI 1 IF (IF CAIn PR PAGE N.W. 93rd STREET 16'.t ASPHALT PAVEMENT S19 LOCATION SKETCH SCALE: NTS APPROV. ZONING C.-.L BLDG DE SUBJECT To STATE ANf) r,s Shores Village D 5//-1-1- uI IlAL U C 2 SCALE 1 " =20' SURVEY FOR: PIERRE LEROY, 9301 N.W. 2ND CT. MIAMI SHORES, FLORIDA 33150. LEGAL DESCRIPTION: LOT 16 OFODELL MANORS ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 41 OF THE PUBLIC RECORDS MIAMI —DADE COUNTY, FLORIDA BLOCK SUBDIVISION AT PAGE 57 3 i HEREBY CERTIFY That the survey represented thereon meets the minimum technical requirements adopted by the STATE OF FLORIDA Board of Land Surveyors pursuant to Section 472.027 Florida Statutes. There are no encroachments, overlaps, easements appearing on the plat or visible easements other than as shown hereon. SINCE 1987 BLANGO SURVEYORS ING. Engineers • Land Surveyors • Planners • LB # 0007059 555 NORTH SHORE DRIVE MIAMI BEACH, FL 33141 Email: blancosurveyorsInc@yahoo.com Fax: (305) 865 -7810 z ADIS N. NUNEZ REGISTERED LAND SURVEYOR STATE OF FLORIDA #5924 (305) 865 -1200 FLOOD ZONE: $ PANEL: 0093 SCALE: 1 " =20' DATE: 11 6 08 DWN. BY: F. Blanca PERMIT #: \'2 I, Contractor wner o rchitect Miami Shores Village Building Department RECEIPT DATE: 5 Leao Picked up 2 sets of plans and (other) Address: — I c l 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 tting process. 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Acknowledged by: PERMIT CLERK INITIAL: RESUBMITTED DATE: PERMIT CLERK INITIAL: M iami Shores Viiiage Building Department 10050 N.E2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY. Whereas, (owner) Pi. e 4,frevji the following described property (address): cl• SO/ Nco E CT /4/0,"; f 3 3 /SD hereinafter referred to as the owner of Legal Description r�1ot (6 Block `1 Subdivision Folio# ?I-310/ °'t5 -09,90 desc be T01 to 002 saduKt 440 sc Nsla gaitioe a nee NMI 3 af3 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 of d L , 201 Z SIGNED, SEALED 2 DELIVERED in the presence of: (Owner's igna 're