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PL-12-762Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 172902 Permit Number: PL -4 -12 -762 Scheduled Inspection Date: August 06, 2012 Inspector: Hernandez, Rafael Owner: DAVITAN, GEORGE Job Address: 85 NW 102 Street Miami Shores, FL Project: <NONE> Contractor: HOME OWNER Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Sprinkler System Phone Number Parcel Number 1131010180080 Building Department Comments NEW SPRINKLER SYSTEM INSTALLATION Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments August 03, 2012 For Inspections please call: (305)762 -4949 Page 13 of 61 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 APPLICATION FBC 20 mmcmEwmr- gt I� APR 3 0,2912 �J B Y: Permit No. r 12.----Kop, Master Permit No. Permit Type: PLUMBING OWNER: Name (Fee Simple Titleholder): Gi D / J 1417i / /�/'/ Phone #:305 ,2t2h �4 Address: gS— City: N/A-A/ / $,4f f V/LI 4State: /, . Zip: 33/S O Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: 35- %I/k/ /02_ 5 a City: Miami Shores County: Miami Dade Zip: 3 3/ 50 Folio/Parcel #: // � 3/D /- ° doge Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: Address: City: State: Zip: Qualifier Name: Phone #: State Certification or Registration #: Certificate of Competency #: Contact Phone #: Email Address: DESIGNER: Architect/Engineer: Phone#: Phone #: Value of Work for this Permit: $ 7SY). ®® ° ; g$guare/Lipear Footage of Work: Type of Work: °Address °Alteration Description of Work: _ PR/4/fr2Asie_< ew :; DRepair/Replace S00 3_F °Demolition ***************************************F * **F * * ** x*+ x****+ x** *+ x****** ********************** Submittal Fee $ Permit Fee $ /S—C3---- CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ t+ • Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) /1/®/V 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 CONDPTIONERS, 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 't be approve !_�nd a reinspection fee will be charged. Signature! Signature Owner or Agent Contractor The fore going ins ment was acknowledged before me this Z9 The foregoing instrument was acknowledged before me this day o , 20 le b ' - r aeri,guday of , 20 _, by / / who has produced _ who is personally known to me or who has produced L As ideritif atyn_AnKLw]2p didiak an oath.. • as identification and who did take an oath. NOTARY PUBLIC: .`i Y P4e«�'. MUHAMMAD MOINUDDIN 4, 01. s. Notary Public - State of Florida �1 a, My Comm. Expires Jul 6, 2015 Sign: %'�'� /•s ���; "�' `Commission • EE 109561 Sign: s Print:��� � �-A Print: My Commission Expires: d.(jl S My Commission Expires: NOTARY PUBLIC: **** x *,xa:,x,x*s,+x+s+x**** *** ** *** x*** ** ******** ** ** say***************,************** * ****** *****,x******* *** **** *** APPROVED BY Plans Examiner Structural Review (Revised 07 /10/07)(Revised 06 /10/2009)(Revised 3/15/09) Zoning Clerk NAME: 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 i�7 ATE: 4A/2_ ADDRESS: Sc r /it) /,0 2 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 wn 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 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. 4. I understand that I may build or improve.a,one family or two- family residence or a farm outbuilding. I may also wild 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 i ..roved myself is sold or leased within 1 year after the construction is complete, the law will presume that I built orAo., o .ntially improved it for sale or lease, which violates the exemption. / Initial Alr 5. I understand that, as the owner - builder, I must provide direct, onsite supervision of the construction. 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 Jaw and j1 unty 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 employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully ting 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 compe sation 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. 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 ma contact the Florida Construction Industry Licensing Board at 850.487.1395 or http : / /www.myforidalicense.com /dbor /pro /cilb /ind .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 Dally 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 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 30 day of By ((ROT) ( 2t\i l Fin B V ut �/ who wa ,20 )9 me or who has Produced there License or _ gas identifica 'on. rWNER P, ,, CLAUDIA V. MAWS �( c''s Notary Public - State of Florida 4 My Comm. Expires Sep 23, 2015 %; ; °:�` Bonded Through National Notary Assn. Commission # EE NOTARY LlgoetttelJ'e.tN 1------------Northwest 103rd Street------ z 0 0) .< CD (D 16 15 14 13 12 11 10 9 8 7 6 5 4 3 2 1 rv� j7 � / 18 19 20 0 21 22 23 24 } PROPERTY ADDRESS: 85 Northwest 102nd Street Miami Shores, Florida 33150 gib z 0 0) 53 3, n C Northwest 102nd Street---------r1 SURVEYOR NOTES #1 Lands Shown Hereon were not abstracted for Easement and/or Right of Way Records. The Easement / Right of Way that are shown on survey are as per plat of record unless otherwise noted. #2 Benchmark: Miami -Dade County Public Works Dep. BM Loc. 3100; Name: N -567; Elev. +10.54' #3 Bearings as Shown hereon are Based upon Northwest 103rd Street, N90 °00'00 "E #4 Please See Abbreviations #5 Survey is incomplete Without Sheet 2 of 2 #6 Drawn By: A. Torres Date: 12 -16 -2009 #7 Complete Field Survey Date: 12 -15 -2009 #8 Disc No 2009, Station Sunning Scion #9 Last Revised: 810 Legal Description Furnished by client. #1 1 This Certification is only for the lands as described It is not a certification of Title, Zoning, Easements, or Freedom of Encumbrances. ABSTRACT NOT REVIEWED. #12 There may be additional Restrictions not shown on this survey that may be found in the Public Records of Miami -Dade County, examination of ABSTRACT - OF TITLE will have to be made to determine record instruments, if any affecting this property. #13 ACCURACY:The expected use of the land, as classified in the Minimum Technical Standard (61017- 6FAC), is "Residential ". The Minimum relative distance accuracy for this type of boundary survey is 1 foot in 10,000 feet The accuracy obtained by measurement and calculation of a closed geometric figure was found to exceed this requirement #14 Foundations and/or footings that may cross beyond the boundary lines of the parcel herein described are not shown hereon. #I5 Not Valid without one signature and the original raised seal of a Florida Licensed Surveyor and Mapper. Additions or deletions to Survey maps or reports by other than the signing party or parties is prohibited without written consent of the signing party or parties. #16 Contact the appropriate authority prior to any design work on information. #17 Underground utilities are not depicted hereon, contact the appropriate authority prior to any design work or construction on the property herein described. Surveyor shall be notified as to any deviation from utilities shown hereon. #18 Ownership Subject to OPINION OF TITLE. JOB # 09 -646 DATE 12 -16 -2009 PB 12 -59 ABBREVIATIONS A -ARC DISTANCE AVE. - AVENUE ASPH - ASPHALT A/C =AIR CONDmoNER BLDG - BUU.DINO B. COR. -BLOCK CORNER C.B. -CATCH BASIN CLF .CHAIN LINK PENCE CONC.- CONCRETE COL -.COLUMN C.U.P. - CONCRETE UTILITY POLE C.L.P. - CONCRETEUGHTPOLE CBS ..CONCRETE BLOCK CMl.-- CANALL MAINTENANCE EASEMENT D - DntGCfONN D/W - DRIVEWAY D.M.E. - DRAINAGE&. MAINTENANCE EASEMENT ENC. - ENCROACHMENT E.T.P.-ELECTRIC TRANSFORMER PAD F.P.L - FLORIDA POWER AND LIGHT F.H. -FIRE HYDRANT F.I.P. -FOUND IRON PIPE F.R. - FINISH FLOOR F.D.H.-FOUND DRILL HOLE F.R. -FOUND RaBAR FN -ROUND DISC FIN -FOUND NAIL OF -IRON FENCE L - LENGTH L.P. -LIGHT POLE MEAS.- MEASURED M.H. -MAN HOLE N.O.V.D - NATIONAL GEODETIC VERTICAL DATUM N.T.S. -NOT TO SCALE O.E. - OVERHEAD ELECTRIC LINE 0/t. -ON LINE P.C.P.-PERMANENT CONTROL POINT A.C. -POINT OF CURVATURE R - RADIUS RES - RESIDENCE SDWLK - SIDEWALK T - TANGENT U.E. - UTILITY EASEMENT W/F -W00D PENCE W.V. -WATER VALVE W.U.P. -WOOD UTILITY POLE -- �� ----- IRON FENCE .CHAIN LINK FENCE -M`— WOOD FENCE -CBs WALL - OVERHEAD ELEC. - CENTER LINE - EASEMENT RILIEL - DENOTES ELEVATIONS ..BUILDING - DISTANCE .. - --_. AFA Company, In ELEVATION INFORMATION National Flood Insurance Program FEMA Elev. Reference to NGVD 1929 Comm Panel 120652 Panel # 0302 Find Zone: "X" Date of Firm: 039 -11 -2009 Base Flood Elev. N/A F.Floor Elev. 11.50' Garage Elev. N/A Suffix: Elev. Reference to NVGD 1929 CERTIFIED ONLY TO: Hmayak Intoyan LEGAL DESCRIPTION: Lot 17 and the West 15.00' feet of Lot 18, Block 1 of: "NAVARRO" according to the Plat Thereof as Recorded in Plat Book 12, Page 59 of the . Public Records of Miami -Dade County, Florida. L 811 Pro fessional Surveyors & Mappers LB 7498 13050 SM. 133rd Court Miami Florida, 33186 Ph. # (305) 234 -0588 Fax # (305) 234 -0423 This certifies that the survey of the property described hereon was made under my super- vision & that the survey meets the minimum technical standards set forth by the Florida Board of Professional Land Surveyors & Mappers in Chapter 6IG17 -6 of Florida Administrative Code, pursum to Section 472.027, Florida Statutes. & That the Sketch huraon is a true and accurate representation thereof to the best of my knowledge and Belief, subject to notes and notations shown hereon. /11164...APINO*' Armaada F. Alvaro; ofess 'nalSurveyor & Mapper # 5326 Stale•ofFlorida Not !Valid unless Signed & Stamped with EmbassedSeal .4 ..................... Boundary Survey 25.00 S8739'56'W_ N901'00'00'E 70.00 1 CBS Wall f SI hi Cot 2 Y2' FIP No Id o.e• g Y2' FIP No Id 0.e. — 4' CLF NI 0 1.15' x CL'' West 15.00' le _Da 1 /15.001 ,_,_ 22.21' .......... ...... '25.05 8 25.05 22 08' .... ........ • •••••• L -39.12 R -25.00 D-8939'56" Tan -24.54V- F/N • Conc.. ,Walk onc. Stripe 1.43' CLF A • :9 • • :. :F�nt : :::,:�",,, ..,,.", : rv�aoaro�• ."...... ; 94:s 5, • ... ,. ;. ;..... ;. ...:. •;. ;..... • • .'.$0r. Dedicated 'R /W'Al •F'er•'P912 -59' Midmi-Dacte'Couniy, : FIorkta:•' ........... ............................. • 1/2" FIP No Id W/V 0 FiN N (700'00'E 1705' Parkway 45.15' ® W/M Y' FIP No Id w g$ '16:00 "•Aeptaalt•'t'avernent 4 , , . , .. , , , llki ::iiy was# id •re::......... ;.r. •�•, •. L Survey or Notes• Survey is Incomplete without sheet 1 of 2 Scale of Drawing 1 =20' Drawn By: A. Torres Date: 12 -16 -2009 Completed Field Survey Date: 12 -15 -2009 A FA A. nnii sr, A 11111 rns... 13(-3( LL2k/ The sketch hereon is a true and Accurate representation thereof to the best of my knowledge and belief, Subject to notes and Notations shown hereon.