FW-12-1927Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 179991 Permit Number: FW -10 -12 -1927
Scheduled Inspection Date: November 13, 2012
Inspector: Rodriguez, Jorge
Owner: ROMERO, JOAN LUIS
Job Address: 73 NW 108 Street
Miami Shores, FL
Project: <NONE>
Contractor: HOME OWNER
Permit Type: Fence/Wall
Inspection Type: Final
Work Classification: Wood Fence
Phone Number (786)231 -9297
Parcel Number 1121360110260
Building Department Comments
REPLACE CHAIN LINK FENCE IN A WOOD FENCE
Infractlo Passed Comments
INSPECTOR COMMENTS
False
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
November 09, 2012
For Inspections please call: (305)762 -4949
Page 19 of 36
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
-E.cEIV
OCT 152012
\C4 Ia- FBC20l0
BUILDING Permit No. PLi-7 12 - 1 q 2-q--
PERMIT APPLICATION Master Permit No.
Permit Type: BUILDING ROOFING
JOB ADDRESS: 43 Nii '110g 5+
City: Miami Shores
County: Miami Dade
Folio/Parcel #: 1
Is the Building Historically Designated: Yes O J
OWNER: Name (Fee Simple Titleholder): NO4 +) 1)-V.13 e V lZO
Address: 73 MW tog S1
City: %G' G.' $1 o,?S
Zip: 33jI P
Flood Zone:
Phone #:
State: -t-Lo i 0+
Zip: 33%i
Tenant/Lessee Name: Phone #:
Email:
CONTRACTOR: Company Name: (2.�L- Phone #:
Address:
City: State: Zip:
Qualifier Name: Phone #:
State Certification or Registration #: Certificate of Competency #:
Contact Phone#: Email Address:
DESIGNER: Architect/Engineer: Phone #:
$ Square/Linear Footage of Work:
Value of Work for this Permit:
Type of Work: °Addition
a
eta
Description of Work:
°Alter�attioon
- (.l e(.421�
® °New
i(. 'L t' a-
Repair/Replace °Demolition
- 14,vr.ve
Color thru tile:
******** * * * * * * * * * * * * * * * * * * * * * * * * * * ***** Fees **** x************** ********* * *** ********* * **
Submittal Fee $ Permit Fee $ 03 •(--)
Scanning Fee $ Radon Fee $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
CCF $ CO /CC $
DBPR $ Bond $
TOTAL FEE NOW DUE $
r
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, 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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the abse of such posted notice, the
inspection will not be approve and a reinspection fee will be charged.
Ownr or Agent
The foregoing instrument was acknowledged before me this /IS The foregoing instrument was c� owledged before me this
day of f? : 7/ °� , 20 I, by 3J /20n°1
who is personally known to me or who has produced 41 ° who is personally known to me or who has produced
As identification and who did tak$■l .ial ]t�ii��i as identification and who did take an oath.
1
"'% "•S '� NOTARY PUBLIC:
vo �oSS�•1�
0
NOTARY PUBLIC:
Sign:
Print:
OPP
Wit_
My Commission Expires:
:34) , :print:
eaat0:0 My Commission Expires:
************************************************** ***** ********* ** ** *** ** ****$n** ** ***** *** * * * * ** * *********
APPROVED BY
Plans Examiner
/6
7;'-Zoning
Structural Review Clerk
(Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
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: jA-1111 D ilEqcz o DATE: IV/ °/-
ADDRESS: 73 NW (t r
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,) 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 1, 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 2.
3. I understand that, as an owner builder, I am the responsible party of record on a permit. 1 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. r
Initial J .
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 *Se
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.
Initial Sg.
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 3g.
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 V
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 SiZ
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 htto : / /www.myforidalicense.com/dbor /pro /cilb/iindex.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 3-4,
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
retumed to the local permitting agency responsible for issuing the permit. A copy of the property owners 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 et/s/ , 20 (Z-
By
Produced there License or
who was personally known to me or who has
0;a,151,entification.
•
�=v ‘\����� \�
nnr
III
8
75.00
LOCATI ON MAP
7
75.00'
Scale: 1° = 120'
6
75.00'
75.00
gi 9
75.00'
75.00
11
75.00
5
12
75.00
4
75.00'
3
75.00
2
75.00'
74.69
15' ALLEY
75.00
Si 13
75.00'
75.00
14
75.W
1fl8th ST.
75.00'
15
75.00
74.69'
Fv 16 €;
74.73'
LEGAL DESCRIPTION
Lot 10, Block 214, DUNNINGS MIAMI SHORES EXTENSION No. 7, according to the plat thereof, as
recorded in Plat Book 52, at Page 33, of the Public Records of Miami -Dade County, Florida.
Property Address : 73 N.W. 108th Street, Miami Shores, Florida 33168.
Flood Zone: °X° Community Panel No: 120653-0302
Base Rood Elevation: N/A Map Revised: Semtember 11th, 2009
FOR THE BENEFIT OF: JOAN LLUIS ROMERO RIAMBAU and UUAN VIEIRA LIMA
KIM & LOWMAN, LLP
OLD REPUBLIC NATIONAL TITLE INSURANCE COMPANY
HOME LOAN CENTER INC. DBA Lending Tree Loans
11111111
ttii,
MARIO PRAT'S JR. 8z ASSOCIATES, INC.
1111111
SIJRN/EYORS — MAPPERS — PLANNERS
52 S.W. 81ST Avenue - Miami - Florida 33144
Voice(305) 551-6000- Fax(305)265 -9480
E-mail: docsepratssurvey.com Certificate of Authorization No.:4249
The above 'BOUNDARY SURVEY', represent the herein described properly and M was completed under my supervision
and or direction, to the best of my knowledge and bellet and M also meets the Minimum Technical Standard set forth by
The Flortda Board of Land Surveyors and Mappers, pursuant to Section 61G17 -9.003, Florida Statutes and Implementing
Rules, Florida Board Administrative Cade.
SURVEYOR'S NOTES:
1) The above capttoned Property was surveyed and described based on the above Legal Description furnished by
Ghent.
2) This Certitcatton Is only for the lands as described. M Is not as certification of Tide. Zoning. Easements. or Freedom of
Encumbrances, ABSTRACT NOT REVIEWED.
3) mere may be additional Restrtcttore not shown on this survey that may be found In the Public Records of this
County. Examination of ABSTRACT OF TITLE will have to be made to detem**, recorded Instruments. M any affecting
tNs property.
4) Ownership subject to OPINION OF TITLE.
5) Type of Survey: BOUNDARY SURVEY.
6) Location and Identification of LJtilites and or adjacent to the property were not secured as Such Informatron was
not requested.
7) Unktss otherwise noted, this Firm has not attempted to locate Footings and/or Faundattcns (underground).
8) This PLAN OF SURVEY, has been prepared for the excfufive use of the entfites named hereon. The Certificate does
not extend to any unnamed party.
9) M Bearings shown they are based an Centerline of N.W. 108th Street being N917001;0981
10) Predston do aosure 1:7500 Suburban Class Surrey
jLEVATIONS NOTES' (RF REQUESTED AND SHOWN)
1) 0.0' Indicates existing Elevations
2) Elevations are referred to the National Geodetic Vertical Datum.
3) BENCHMARK (Used B.M. No. Elevation : _Feet
EVISIONS• won'
R
J.N.: 25763 fie. 08/13/2010
J.N.: Date:
J.N.: Date:
THIS NOT A VALID CERTIFICATION
WITHOUT THE SURVEYOR'S ORIGINAL
SIGNATURE AND RAISED EMBOSSED
SEAL PRESENT.
ABBREVIATIONS
S.M. =Bench Mark
Cale.. Calcdated
Meas. • Measured
Centerline
M/L= Monument Una
Nor North
S• • South
E °East
W. • West
P.R.M.. PenrianerdRererate Mannmrd
P.C.P. =Permanent Cared Pohl
W.E. =woad Fence
C.L.F. • chain Uric Fence
Rea =Rene
R= Ramie
• Delta
Tangent
P.T. - Point of Tangacy
P.O.S -Paint of Seg5 Wg
P.C.. Pahl of CuvaIue
PRC • Paint of Reverse Cuvarve
CAS. ° Cmarete.Eodr-Stnphre
PPN RIgtdgrWay
SEC. =Section
ROE. • Range
1WP •TOVUdVp
&cr. = Encroanrgrd
F.F. • Wtltr Roar
C • Canaltlaner
Concrete
Sue • Sidewalk
STY- Stay
,. • Elewlkn
C.A.D. File:
T:Surveys \24420
Original date:
05/21/08
Tar Updates see REt/IEOIG)
Field date:
05/20/08
Sheet 1 of 1
Original J.N.:
24420
PLAN OF SURVEY
Scale: 1 ° = 20'
TT pUNNINGS MIAMI SHORES EXTENSION No. 7 TT
( P.B. 52 • PG. 33)
( Lot 7, Block 214)
.5' Asphalt Area
i:;!.
reia
ntfliliilllilllllillllr'•
O
Z
0
N
W
N
V �(03.
=N
O ci
m
<a
Z erioob
Z itgro
L
Fbtnd 5/8°
Iron Pipe
No Id. 0.60
15' ALLEY;;:
.............. .... ...............................
:.214139° : 57`42 "E 75.00`
�•:: Asphalt Area •::....
• }:iC:G..:B:•WGip•i::•: i:•r:•
Found 5/8" _
Iron Pipe Pi
No Id.
( Lot 9, Block 214 )
LL
U
NOO °07'40 "W
Found 5/8"
Iron Pipe -\
No Id.
volo
Found 5/8°
Iron Pipe
No Id.
Parkway
N.
CO
c
bl
Found Nall
105.00'