DS-12-1120Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 174953 Permit Number: DS -6 -12 -1120
Scheduled Inspection Date: August 23, 2012
Inspector: Rodriguez, Jorge
Owner: BYNDLOSS, KEVIN & SARAH
Job Address: 87 NE 92 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: HOME OWNER
Permit Type: Driveways /Sidewalks /Slabs
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1132060130290
Building Department Comments
REPLACE EXISTING CONCRETE PATH WITH PAVERS
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
August 23, 2012
For Inspections please call: (305)762 -4949
Page 8 of 31
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
BIIIL�ING ���
PERMIT APPLICATION
Permit Type: BUILDING
RECEIVED
JUN 2 g 02
FBC20to
Permit No. ID 51 A '` l 1
Master Permit No.
ROOFING
JOB ADDRESS: g 9 Air 92 sr
City: Miami Shores County: Miami Dade
Zip: 33/35
Folio/Parcel #:
Is the Building Historically Designated: Yes
NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): X(///4 O/NBGOS5 Phone #: `"l '° 21 133Y
Address: 87 /tic q2 sr
City: /4/4M/ SNok'cS
State:
zip :33,35
Tenant/Lessee Name: Phone #:
6y,vDc.oss e 40441L, ca/''
Email:
CONTRACTOR: Company Name: `a- 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: $ .1p 173 XX Square/Linear Footage of Work: '/CD 47—
Type of Work: DAdditiion XiAlteration New ORepair/Replace ODemolition
Description of Work: g(/'LACC ix /ST /'JG colveifere //•l`raL®CK/AK fiiv IS
Color thru tile:
******* * * * * *** * * * * * * * * ******* ***** **** es�************ *******o*** ************* *** ** **
Submittal Fee $ °� Permit Fee $ 1S +Vl J CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ ( 1 ��
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, BOTI FRS, 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 e'c� Signature
Owner or Agent Contractor
r
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of 3 ` ; 201 , by 'J 1N1 f' N3 b4---C/S,- day of , 20 _, by
who is personally known to me or who has produced P---1 ® 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.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
s 5ilvetc;
1. '1°1°1
APPROVED BY f� /7 .67/ 7/ Z. Plans Examiner
Structural Review
(Revised 3 /12 /2012)(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
7//7/2 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: Kiv 1'`i + • YIA NOS--C' DATE: - ZO • 1 Z
ADDRESS: � N� 61 2 51. V-M I st tES IA./ 3I3("
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 kib
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 .g
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. p,�
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 VA,
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
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 FX5
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.mvforidalicense.com /dbpr /pro /cilb/iindex.html
Initial 49
11. I am aware of, and consent to; an owner - builder building permit applied for in my name and understancWthat I am the party
legally and financially responsible for the proposed construction activity at the following address:
Rq N gaea sr. in oin/ cs'fl®eI S' 33/3r
Initial KO
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 -e
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 () day of �-- , 20 0--
By f` fEjj 1 r— } 3`r
Produced there License or
OWNER
•
S who was personally known to me or who has
011 Mt%
•���. Jientificatet3
•
co
et:*
:4441:21\
•
size OF p A u x:134.0 x 3 7 4 " Loor a `o P A i r ` 2 " coN( ' I — /Pc -
r1zo ea' or t mNit-1
ctlr..ft ,ar i r- pm -vE -.-
�-� �► +Ditnois
4 O'er' S at.
W.U.P.
j4A
PAV ra-5
C1
R= 25.00'
L= 39.33'
Miami Shores TR
0.10
O.U.L.
1424 g 4. ri2-
im-kt '07777
(.1Slo)2— 9 6) 4(09
60.00' TOTAL R /I4
W.U.P.
5' HOG -W /RE
FENCE
(DAMAGED)
APPROVED
BY C 54QATB f
WIRE
ENCE
ONING DEPT
LOG DEPT
?/z 5 "/ z
UBJECT TO COMPLIANCE WITH AU. FEDERAL,
LOT -2I
TATS AND COUNTY RULES AND REGULATIE - 2
APFF OVER
- 7 / /t //
M aral- rad, :, C t
T- eaitn Depar ne
Permit no
Date:
F.� : l
N
al
0
tit
a Pa
5' WIRE
FENCE
CK
ELECTRIC METER
SUPPORT
b.75x0.75'
5.5'x7' CONC.
6.74'
COLUMN
L4 'x1.0'
4'+I # e 0.20,
Pkr
1.5' DIAMETER
UNDERGROUND
PROPANE TANK
FND. DRILL
HOLE
5' CONC. WALK
giCONC Z
BS UT /CITY
;; SHEDIa
< 3.65'x3',1;
I ''4'z 9.0
66.52'
FND. %2' I.R.
NO ID.
FND. %2' I.R.
NO ID.
t =S90 °00'00 "W r/06.601(M) 106.65'(R) „w
ti
24.00' PARKWAY
tom,_
JUL 19 2012
CERTIFIED TO: BY:
KEVIN BYNDLOSS AND SARAH G. BYNDL • .
RE
RECERTIFIED, CERTIFIED T(
CERTIFIED, (FIELD WORK COMPLETED), CERTIFIED TO & FLOOD
FLOOD ZONE: x
MAP & PANEL= 12086C0302
COMMUNITY No.: 120652
SUFFIX: L
DATE OF FIRM: 9 -11-09
BASE ELEV.= N/A
PROPERTY OF: KEVIN BYNDLOSS AND
SARAH G. ' BYNDLOSS
87 NORTHEAST 92nd STREET
MIAMI SHORES, FLORIDA 33138
NOT VALID WITHOUT THE &GNAT
ORIGINAL RAISED SEAL OF A FLOF
SURVEYOR AND MAPP
Miami
Shores
Viiiage
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
RECEIPT
PERMIT #: DATE:
—2c� f-
b
At2_A.4
o Contractor
wner
o Architect
Picked up 2 sets of plans and (other)
Address:
ST
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 t tp continue permitting process.
Acknowledged by:
PERMIT CLERK INITIAL:
RESUBMITTED DATE: 1
PERMIT CLERK INITIAL: l
Permit o: 12 -1120
Job Name:
June 22, 2012
Miami Shores Village
Building Department
Building Critique Sheet
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
1) Provide approval from Miami Dade County Health Dept. (DOH /HRS)
2) Provide corrections for zoning.
Page 1 of 1
Plan review is not complete, when all items above are corrected, we will do a complete plan
review.
If any sheets are voided, remove them from the plans and replace with new revised sheets and
include one set of voided sheets in the re- submittal drawings.
Norman Bruhn CBO
305 - 762 -4859
1
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:1132O6O13O29O
Owner's Name: KEVIN & SARAH BYNDLOSS
Job Address: 87 92 Street
Miami Shores, FL 33138-
Owner's Phone:
Total Square Feet: 800
Total Job Valuation: $ 4,793.00
Contractor(s)
HOME OWNER
Phone
Primary Contractor
Yes
Planning and Zoning Criteria and Comments
Approved: No
Comments: FRONT PATIO NOT PERMITTED.
Date Denied: 6/20/2012
FRONT SIDEWALK CAN NOT EXCEED 3 FEET IN WIDTH OR WIDTH OF EXISTING SIDEWALK
NEW PAVING IN SIDETARD CAN NOT EXCEED 3 FEET IN WIDTH WITHIN 10 FOOT SIDE YARD SETBACK
Rick Scott
Govemor
John H. Armstrong, MD
State Surgeon General
July 11,2012
Kevin Byndloss
87 NE 92 St
Miami, FL 33138
RE: Contingency Letter
Application Document No: API076694
Centrax Permit Number: 13 -SC- 1418768
OSTDS Number:
87 NE 92 St
Miami, FL 33138
Lot:22 23 Block:2 Subdivision:
Dear Applicant:
This will acknowledge receipt of an application dated 07/03/2012 for a permit to use an
existing onsite sewage treatment and disposal system located on the above referenced
property.
Proposed replace of concrete pad by pavers at east side of the property.
There is not increase in sewage flow, change sewage characteristic, or any alteration that
change the conditions under which the system was approve.
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.MyFloridaFH.com
1 11 1111 1 1111 11111 11 11111111 11 111 11 111 1111 11 11
CFN 2012R0574779
OR Bk 28229 Ps 30961 (1ps)
RECORDED 08/15/2012 1302:38
NOTIC HARVEY RUVIN, CLERK OF COURT
E OF COMMENCEMEW A RECORDED C T INS MIAMI-DADE COUNTY FLORIDA
WWRSPEC
LAST PAGE
PERMIT NO.I.V./C FOLIO
STATE OF FLORIDA:
COUNTY OF MIAM1-DADE:
THE LINDERSIEINED head* glyasixitidatat improvements will be made to certain real -
propane and in accordance with Chapter 713, Florida Statutes, the following infamation
is provided in Mkt Notice of Commencement..
.egai description of property and street/address: 5-7 /v6-- 92 61- Rovidi
Space above reserved oftveonling office
Description of improvement 6t/e
(1410-
in pro
ante and address of feb simple Titleholder:
nante, address Etnd phone further.: actrilo 3 vmDt...e)SC g7 iM* 9? 44#114? S 6i9-ES 3VM
l7/
5. Surety: (Payment bond required by owner from contractor, If any)
None, address and phone number:
Amount et pond S,
76: pLe4LierS*Ikirthnatij ttiap1"44; 01 fittila."- designated by Own- er upon whom notices or other documents may be served as Provided by
Section 713 13(1)(a)7„ Florida Staudt*, •
Nati, itTddross ahohttht,b et
8 In additian"tO hlinOkOWneridealjnates the foliairing person(s) to receive a copy of the tie/f,reNclice:-#q,prqvidoff In Section
713.13(i)0: IFIO4da Stahltek
. .
None; egiCiress and phOne
9. Expiration date of-this Notice of Commencement:
. ; (the tvelratIon date li 1 year from " the dale 01 recording die tolFiicffiesq
WARNINOTO_OWNEWANyeo,MENTS MADE arms OWNER AFTER THE pKpIRATioNOE THE fiditqs OF pptd.ltdswpodettr AkE CONSIDERED
PAYMENTS WOO CHAPTER 713, PART 1, SECTION 713.13. FLORIDA STATUTEGAND CAN ., X. • T IN YOUR PAYING TWICE FOR
IMPROVEMENTS TDWi,tiFf PROPERTY. A NOTIcEOF COMMENCEMENT MUST HE RECORDED. AND POSTED ON'THEVOMsrrEBEFoRE THE
VI SiINSOtertok. IF YOU INTEND TO OBTAIN FiNAtiddge, CONSULT viqrti YouRt*NpErt OR AN AITORNEY OgfORE,COMMENCING WORK
A 7 RECORDING YOUR NOTICE OF COMMENCEMENT.
kSIgdature(s) °frog .,or gyretlar Authored OffibetYPirectOr/Fartner/Manager
Prepared By j_..;;7-7.,. Prepared By , -•
Print Na* *- yikiirN.O.55 . s - .1 ' Print Name - ,• •
Title/06de • . Title/Office
STATE OF FLORIDA • - -
COUNTY OF MIAMI:bAct i
." •
The • acknowlesigaii before Me this day of -/ . .
— ' - -
s \vie A
Indhirditaki, or as for
VERIFICATION PURSUANT TO SECTION 92.525. FLORIDA STATUTES
Under penalties of perjury, 1 declare that I have read the foregoing and
known, or apiOOdotio the fog' ' type of identificatio
_
*94litre:a Notilly Rain:
Print Name:
(SEAL)
,
\V
s,
that the facts stated in it are true, to the best of my knowledge and belief.
Signature(s) of Owner(s) or Owner(sys Authorized Officer/Director/Partner/Manager who signed abov/1/1111/11TIAIII"1";‘'‘‘‘‘
By
.
°
-
By SIATECEELORIDA„-COUNU-QS-DADE
129.0142 PAGE 3 W10 I HEREBY CERTIFY that this Is e true copy of the
e fileritlimace clay of
CM IL A.D. 20
WITNESS rny hand and Official Seal.
V Y R N. CLERK, of Circulf and County Cowls
D.C.