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DS-12-1903Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 179800 Permit Number: DS -10 -12 -1903 Scheduled Inspection Date: December 27, 2012 Inspector: Bruhn, Norman Owner: MARTELLY, LEANDRA Job Address: 149 NW 99 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 1131010230380 Building Department Comments EXTENSION OF EXISTING DRIVEWAY AND INSTALLATION OF A NEW CIRCULAR STAMPED CONCRETE ON WIRE MESH. Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. December 27, 2012 For Inspections please call: (305)762 -4949 Page 2 of 17 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 l 291_ °Z-- 1-4A-01-46 INSPECT 10) i 12 -- O His -Lt? BU LDING PERMIT APPLICATION Permit Type: Permit No. Q, OCT 1i`62 g BY: o ©.o...e ----- o....ma Master Permit No. BUILDING ROOFING JOB ADDRESS: I41;k . Ciat �T City: Miami Shores County: Miami Dade ✓ Zip: 35t6to Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: t ) OWNER: Name (Fee Simple Titleholder): t $SL°f l ie rt'fi Phone # 3 o 759- Z% 5 4. Zip: '53 i5 ra Phone #: �3bS,'1� -315 ut p_ hptn i. 1. Coin Address: ( i 1\3 NA) . cia( ST. City: 41 Ava ^ ir s State: Vt,.. Tenant/Lessee Name: S E. L d ,92� Email: tas 1 to arts kl e. a Noo . Crm, `eooncirct a wsar CONTRACTOR: Company Name: Address: City: State: Zip: Qualifier Name: State Certification or Registration #: Certificate of Competency #: Contact Phone #: Email Address: DESIGNER: Architect/Engineer: Phone#: 14)wr) OWIAD/{"-- Phone #: Phone #: 2_0. V V • Square/Linear Footage of Wor Type of Work: ❑Addition DAlteration New ❑ epair/Replace • Demoli n �ti e d� oAY'. • 1�5if Descripti ' l of Work: a. Value of Work for this Permit: $ Color thru tile: ***** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ********* * * * * * * * * * * * * * * * * * * * * * * * *** * **** Submittal Fee $ Permit Fee $ ) SO 00 CCF $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ CO /CC $ Bond $ TOTAL FEE NOW DUE Were Bonding Company's Name (if applicable) Bonding Company's Address ity 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, BOWERS, HEATERS, TANKS and AIR CONDITIONERS, ETC DWNER'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 FENANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE CORDING 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. Owner or Agent Signature Contractor e for of g tkn.s.1.zuilent was a' i owl ged before , e The foregoing instrument was acknowledged before me this ay of K1, 20 1 9; by day of , 20 _, by ho is •1 llp sonally known to me or who has produce s - `� who is personally known to me or who has produced '31 4Mentification and who did take an oath. as identification and who did take an oath. NOTA ' UBLIC: NOTARY PUBLIC: Sign: Fint: y Commission Expires: * * * * * * * * * * * * * * * * * * * * * * * * ** APPROVED BY Sign: Print: My Commission Expires: *********** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** **** * *** ** ****** ** *** * * * * *** (d /a, /2-Zoning Structural Review Clerk Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Miami Shores Village Btuiiding Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 OWNER BUILDER DISCLOSURE STATEMENT NAME: �'s� ,� ,�!..�`� ! J e1 f DATE: , 39 ADDRESS: 14 i'vcs PL.) q 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,entities 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 properly listed, may act as my own contractor with certain restrictions even though I do not have a license. lnitiaL 1 understand that building permits are not required` to be signed by a proper) construction and is not hiring a ; Ilcensed contractor to assume responsibility:, °Wrier 'infest he, or the is responsible for the Initial 1 understand that, as an owner builder, I. am the responsible party of record on a permit. I understand that 1 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.) 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: initial . ' 4. I understand that l 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. P Initial 5. I understand that, as the owner - builder, I must provide direct, onsite supervision of the construction. Initial -a 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. Inftialv.L�` 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 requiting 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 .,G '/ 10. I understand that l 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 htro://www.mvfloridalicense.com/dbprforokilbrindex.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 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 i," 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 statementmusrt 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 i I da y of aylochek \Any-clit who was personally known to me or who has Produced there License or T C.> 1i to 5'13. identification. 41 # OP , rammurffitti 03' mss: _1. j f- 0s. IIIIIII■i NotaiN Com • My om s Sep 23.2015 • •��G� Commission # EE 128810 Bonded Through National Notary Assn a IVI iami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 RECEIPT PERMIT #:M2' \C103 DATE: 16 11 '117_, I, .Dig/iY7 /6 ❑ Contractor ❑ Owner ❑ Architect Picked up 2 sets of plans and (other) +I f Address: 149. KILO g r i 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 permitting process. Acknowledged by: PERMIT CLERK INITIAL: RESUBMITTED DATE: PERMIT CLERK INITIAL: 06 Rick Scott Govemor John H. Armstrong, MD, FACS State Surgeon General November 15, 2012 Lesly Martelly 149 NW 99 Street Miami, FL 33150 RE: Contingency Letter Application Document No: API 087777 Centrax Permit Number: 13- SC- 1438549 OSTDS Number: 149 NW 99 St Miami, FL 33150 Lot:13 Block:5 Subdivision: Dear Applicant: This will acknowledge receipt of an application dated 11/05/2012 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 (driveway construction). If you have any questions on this matter, please call our office at (305) 623 -3500. Enclosures cc: Sincerely, Joseph ecialist II 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 4 Scale 1"=20' ,...,,,,,__ vi ,....'" 11\ APPROVED ZONING DEPT LDG DEPT oil 0 BE LOT 11 BLOCK 5 BONMAR PARK ADDITION OE OE 0.3'CL LOT 12 BLOCK 5 BONMAR PARK ADDITION • oE 75.46 &R) 2.0' E P {h in 10.3' 3.4' ONC 3x4" AC es SUBJECT TO COMPLIANCE WITH ALL FEDERW 0 STATE AND CO(1NTY RULES AND REGULATICKIS w nl Os Z— l903 z J Nowaag madd a OE .4'CL V 90 3 0.8'CL X15.0' 0.4 L 1.36 1. .2'CL ound Nall w/ DISC (No I.D.) BLOCK CORNER 1.36x1.35 — COLUMN TYP. Found Nall w/ DISC (No 1.13.) LOT 12 BLOCK 5 BONMAR PARK ADDITION OE NW 99th STREET (60' PUBLIC:: RIGHT -OF -WAY) 6.5' ASPHALT PAVEMENT t, iAMI -DADS COUNTY HEALTH GPRRTAAEt.'. 777? R/W LINE PROPERTY ADDRESS: 149 NW 99th St., Miami Shores, FI. 33160 ( FOLIO No. 11 - 3101 - 023 - 0380 ) DESCRIPTION Lot 13 & W/2 of Lot 14, Block 6 of " BONMAR PARK ADDITION A RESUBDMSION OF AKRON SECTION 1 " according to the Plat thereof as recorded In Plat Book 24 at Page 71 of the Public Records of Miami -Dade County, Florida. There may be legal restrictions on the subject property that are not shown on the Map of Surrey that may be found In the PubNc Records of Miami -Dade County, or the records of any other public and private entities as their Jurisdictions may appear. The Map of Survey Is intended to be displayed at the stated graphic scale In English units of measurement. Attention is brought to the fact that said drawing may be altered in scale by the reproduction process. This Survey was conducted for the purpose of a BOUNDARY SURVEY only and Is not intended to delineate the regulatory Jurisdiction of any federal, state, regional or local agency board, commission or other entity. , Legal description was furnished by the client. The elevations of well - Identified features as depicted on this survey and map were measured to an estimated vertical positional accuracy of 1/10 foot for natural ground surfaces and 1/100 foot for hardscape surfaces, including pavements, curbs and other man -made features as may exist. Well-Identified features as depicted on this survey and map were measured to an estimated horizontal positional accuracy of 1/10 foot unless otherwise shown. Legal Description subject to any dedications, limitations, restrictions, reservations or recorded easements. LIST OF POSSIBLE ENCROACHMENT: N%A BENCH MARK USED TBM, Elevation = 10.27' converted to NGVD 1929. g.,1* I.01 1 , 4AM/009 37 nom MOE MEW ,1 MEM LINIENCINiv LOCATION MAP (NOT To SCALE) AERIAL MAP (NOT TO SCALE) LJ FLOOD ZONE INFORMATION: Community No 120652 Panel No. 0090 Suffix: J FIRM Date: 03 -02 -1994 Flood Zone: X If shown elevations are referred to N.G.V.D. of 1929 The surveyor makes no representation as to ownership, possession or occupation of the subject property by any entity or individual. Subsurface Improvements and/or encroachments within, upon, across, abutting or adjacent to the subject property were not located and are not shown. Not valid without the signature and original raised seal of a Florida Licensed Surveyor and Mapper. Additions and deletions to this Map of Surrey by other than the signing party are prohibited without the written consent of the signing party. This Map of Survey has been prepared for the exclusive use of the entitles named herein and the certification does not extend to any unnamed party. CERTIFY TO: Lesly Martelly and w/ Leandra C. Martelly. SURVEYORS CERTIFICATION: 1 hereby certify: That this "BOUNDARY SURVEY" and the Map of Survey resulting there from was performed under my direction and is true and correct to the best of my knowledge and belief and further, that said "BOUNDARY SURVEY" meets the Intent of the "Minimum Technical Standards for Land Surveying in the State of Florida ", pursuant to Rule 61G17-6 of the Florida Administrative Code and its implementing Rule, Chapter 472.027 of the Florida Statutes. 06-23 -2009 Nerclso Ramirez, P.L.S. Registered Surveyor and Mapper No. 2779 State of Florida. Survey is not covered by Proffeslonal Liability Insurance. ORIGINAL 06-23 -2009 FIELD DATE REVISIONS: JOB NO. 08- 179-09 DRAWN A.V.I. NARCISO RAMIREZ Land Surveyors & Mapper 8567 Coral Way # 425,MIAMI, FLORIDA 33155 PHONE: (786) 290 -4184 FAX: (305) 262 -1039 SHEET 1/1