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DS-12-1525Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 177263 Scheduled Inspection Date: December 03, 2012 Inspector: Bruhn, Norman Owner: PUFF, MARTIN Job Address: 1208 NE 98 Street Miami Shores, FL 33138- Project: <NONE> Contractor: HOME OWNER Permit Number: DS -8 -12 -1525 Permit Type: Driveways/Sidewalks/Slabs Inspection Type. Work Classification: Addition /Alteration Phone Number (786)553 -7400 Parcel Number 1132050090360 Building Department Comments BACK PATIO PAVERS ON SAND Inspector Comments Passed Failed /„Z7/42- Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. November 30, 2012 For Inspections please call: (305)762 -4949 Page 5 of 29 2 PERMIT# it` 1525 CONTRACTOR: "' � (9ct)VQ4" SUBMITTAL DATE: 6 1,01,12--) ADDRESS: l j 10 NAME: 0 kY1 WY\ V RESUBMITAL DATES: 11 1 j )7° PROJECT TYPE: 111P ill 4Pair -a 6110 • 1.4 ZONING-- --- 2 )------' FIRE STRUCTURAL IMPACT FEES ELECTRICAL HRSIDERM PLUMBING NOC 'MECHANICAL d nI V:Yi...)0, BLDG �' " It 1 142 ����� . BLJIL�DING �u/ PERMIT APPLICATION 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 Permit Type: BUILDING JOB ADDRESS: 4020cr 'eM City: Miami Shores County: Folio/Parcel#: Is the Bantling Historically: Yes r / 4 AUG AUG 2:Z62 d 3 6�. p . rues .om ®oem000evovoo� FBC 20 Permit No. O )� Master Permit No. ROWING Miami Dade ,gyp: � / P Flood Zone :; - /OLD OWNER: Name (Fee Simple Titleholder): .r7<r�ji,.r /'e,� Address: /20/ ®(,o- 91/4 J/4ei ' )'hone#: !phi City: ,/'`7r /-vrr ' iL7-e -• State: Zip: Z ?X Tenant/Lessee Name: Phonet Email: CONTRACTOR: Company Name: Phone#: Address: City: State: Qualifier Name: Phone#: State Certification or Registration #: Certificate of Competency #: Contact Phone#: Email Address: DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ 20C1C, F c90 Squ ear Footage of Work: Type of Work: OAddition Alteration °New ORepair/Replace ODemolition Description of Work: rer- Color thru tile: 11k,(90 . ********* * * * * * * * ** * * * * * *** ******* * *** * *p ******* �**** ************ * **** ** **** * * * * ****** Submittal Fee $ Permit Fee $ . ti3O CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fes $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 1110 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 pennit 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 pent must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDmONERS,-HTC 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 YOtJ 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 Own . r Agent The fore oing instrument was acknop f� Y before day of '1 .� , 20 ,, by who is 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: y known to me or who has produced, ntification and who did take an oath. NOTA ' Y PUBLIC: Sign: Print My Commission Expires. Sign: Print My Commission Expires: ******************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPROVED BY ** * * * * * * ** * * * ** * * * * * * * * ** ' / /Plans Examiner Zoning Structural Review (Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06/10/2009)(Revised 3/15/09) Clerk Miami Shores Village Budding Department 10050 N.E.2nd Avenue Miami °Shores Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 OWNER BUILDER DISCLOSURE STATEMENT NAME: i "T "/ 4.) 11%/7/..4 ) DATE: trfro //Z. ADDRESS: I Of' /067 9 f ' 17/4"-Pd jams' 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 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 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 foamy 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 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, maybe 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. 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 htta:// www. mvfloridalicense :conddbpr /arolcilblindex.html 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: /20e /t ✓9''d'/i .r); Initial 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 ) 0 day of 34 20 ) BY I A. Produced there License or � Z ID 1 • '2012—Ns identification. who was personally known to me or who has o'WIER CLA ®TA of Florida ,PUb<',' Notary Public - Sta a 23. 2015 .7"1 My Comm. Expires Sep a* �►. : y 128810 a`c mission # EE : °o` Bonded Through National Notary Assn. Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 RECEIPT PERMIT #: t 1 g, 1 J�S DATE: gs) 141" 1 V °14 I - 19(At(11_ Contractor ' J3wner ❑ Architect Pic up 2 sets of plans an Address: (o 1a V& g O From the building department on this date in order to have corrections done to plans And /or get County stamps. I understand thdt the plans need to be brought back to Miami Shores Village Building Depient to continue permitting process. Acknowledged by: PERMIT CLERK INITIAL: RESUBMITTED DATE: 11 I� PERMIT CLERK INITIAL: • Rick Scott Governor John H. Armstrong, MD, FACS State Surgeon General November 07, 2012 (Martin Puff & Veronica Arcila) 1208 NE 98 Street Miami, FL 33138 RE: Contingency Letter Application Document No: AP 1087150 Centrax Permit Number: 13 -SC- 1437406 OSTDS Number: 1208 NE 98 St Miami, FL 33138 Mg -1525 Lot:10 Block: 3 Subdivision: Earleton Shores Dear Applicant: This will acknowledge receipt of an application dated 10/29/2012 for a permit to use an existing onsite sewage treatment and disposal system located on the above referenced property. pT,c:r. -.7 v7 BY: ommoe°aoe- oe - -a- _ From a review of your completed application, it has been determined that your existing system is adequate for the proposed use (Terrace construction). If you have any questions on this matter, please call our office at (305) 623 -3500. Enclosures cc: Sincerely, Josep er, Engineer Specialist 11 Miami -Dade County Health Department 1725 NW 167 St, Opa Locka, FL 33056 Phone: (305) 623 -3500 . Fax: (305) 623 -3645 . http: / /www.MyFloridaEH.com Rick Scott Governor John H. Armstrong, MD, FACS State Surgeon General November 07, 2012 (Martin Puff & Veronica Arcila) 1208 NE 98 Street Miami, FL 33138 RE: Contingency Letter Application Document No: API087150 Centrax Permit Number: 13 -SC- 1437406 OSTDS Number: 1208 NE 98 St Miami, FL 33138 Lot:10 Block:3 Subdivision: Earleton Shores Dear Applicant: This will acknowledge receipt of an application dated 10/29/2012 for a permit to use an existing onsite sewage treatment and disposal system located on the above referenced property. From a review of your completed application, it has been determined that your existing system is adequate for the proposed use (Terrace construction). If you have any questions on this matter, please call our office at (305) 623 -3500. Enclosures cc: Sincerely, Jos Specialist II Miami -Dade County Health Department 1725 NW 167 St, Opa Locka, FL 33056 Phone: (305) 623 -3500 . Fax: (305) 623 -3645 . http: / /www.MyFloridbEH.com BOUNDARY SURVEY SCALE: 1° = 20' et" . • . t a' PAWL • 015X 12c, cer-z4 Elef 9481 BY: - ................ • 96th STREET 2 A" ASMALT GO' TOTAL PW rn a 15' ONE STORY C.B.5. E5# /208 ELEV.= /2.39' GARAGE= 9.761 . • • • • • • as 4- 0 44 Ti CM WALL ki ■ 1 I 1 :111-11 R BLOCK- 3 ti F... LOT-9 In • . • 8 Property Address: /208 N.E. 96th 57REET MIAMI 5HC Legal Description: LOT /0 BLOCK 3 SUBDIVICION FASalabL2j ACCORDING TO THE FIAT THEREOF A5 =OR= IN FIAT BOOK 43 OP RC PUBLIC RECORDS OF MIAMI DADS LOCATION MAP N.T.S. N.E. 98th 57REET :**5' A), / ///: 5 .9 . 7 6 5 4 , 3 I I 12 13 14 0 15 16 / 7 . /8 A • • • • • • • •••• • •• • • •• ...... •••• • • • • •• • OW 1 a • *• .• • • • ea* le Ore •• •0 • • ••••• • • ..... it • • • V* •• • to • • • •••• •••• • • • 00 • • • •• • 111.8C(Mot(M) BLOCK- 3 LOT- I F. 1/10 LP. • •• • • • • 00 BLOCK- 3 LOT- /2 • N.E. 97th STREET !LED ON me FLOEID =URA= RATE MAP OF THE RCM. BERGEICY ANDY REVISEC DISCRMED PROPERTY 113 SITUATE:1VMM • • * • ZONE X-500. BASE FLOOD ELEV. _ha_ whammy NumBERJ.201152. PANEL NEM LEGAL NOBS • SURVEYDOEB NOT RERECT OR DETERNINED OWNERBIEP. EXAMINATION OF THENDIERACr 0 DETERIBM RECORDED INEGRUMENTS, IF ANY. AFFECTING THE PROPERTY. THE SURVEY M SEEM REERRICEONS. REBERVATIOPM OR EMIEMENTIT OF RECORDB. LEGAL DEBORIPTION PROVIDED BYO M LOBED TO THE COST OF 1HE SURVEY. UNDERGROUND ENCROACHMEED, ANY. ARE NOT MOP TO LOCATE FOOTING AND1OR FOUNDATIONS ANDER UNDERGROUND IMPROVEMENTS OF ANY NATE REFEREED TO AN ARMED MERIDIAN. IF MOWN G.EVATIONS ME REFERRED TO NEV.D. OF WEL • SURVEY t8 ABOVE 1: IBM THIS SURVEY II3 NOT DITBETED FOR NEMER DESIGN NOR CONSTRIETE PURPOSES A TOPOGRAPHIC SURVEY 11:1 REBATED. CERTIFIED TO: ThEODORft dontmur IZATE OFFIELD REVISED OM I HERFEW CERTIFY 1141 DESCRIBED HERE WM AND THE SAME MEER nexus= SET PORI Permit No: 12 -1525 Job Name: August 14, 2012 Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Building Critique Sheet 1) Provide approval from Miami Dade County Health Dept. (DOH /HRS) 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