Loading...
DS-13-569,I91sI ►3 iZ'f(3- BUILDING 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: JOB ADDRESS: FBC 2010 Permit No. 13 --54: Master Permit No. BUILDING ROOFING lDo st- City: Miami Shores Folio/Parcel #: 1 t 3 2O6 0 i 311430 Is the Building Historically Designated: Yes County: Miami Dade Zip: 33138 NO Flood Zone: V J F'L -O.2D 2) /VC OWNER: Name (Fee Simple Titleholder): T i IK / F2. i.m lv £ Poi, 2 ,4 2JJ Phone #: 417— 3/4 6 4'3 2 Address: OD > fi City: 1`.1.1 (3Yt ( S H-c R.1-) State: PL Tenant/Lessee Name: e, Email: r c..n k l r +r tes y p h :fi' c, i 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 #: ©tin14„ez...„. zip: 3 3 ► 38 7 J Phone #:. "So S1_ -7-7'9 3.. ZS 7-G /) Phone #: Value of Work for this Permit: $ Type of Work: [B`Addition OAlteration Description of Work: ■ Square/Linear Footage of Work: ONew ORepair/Replace ❑Demolition 1.0 0„r n fi 1-0 tilt_ (001 (.Ad :io r- 3 c3ncref.V r1Qnt" f:, ''fie p %t' Col ©r thru tile: I ^i C.) re.'k.. (0, 4 4) ..e.totta 3�4 r cur- **************************************F aY, **** fir ********* **t*** *** *sir ***gtr****gir t **** *** Submittal F ee $ 'd Permit Fee $ Scanning Fee $ VIA14 �QC Radon Fee $ CCF $ CO /CC $ DBPR $ Bond $ Training/Education Fee $ Technology Fee $ d� Structural Review $ r,, ++ TOTAL FEE NOW DUE $ (6. f �f Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) (f• p t i- l 0 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 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 s ) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and, reinsp; ction fee will be charged. Signature / rcc �,� G Signature Owner or A;ent Contractor The foregoing instrument was acknowledged before me this lOtte The foregoing instrument was acknowledged before me this day of 3o,nci.,r7, 20 l 3, by 1-12,46.4.51 ka ry , day of , 20 , by who is personally known to me or who has produced (7-4-4 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: APPROVED BY ey0 prlen�s s , ork, //a,vezu � NOTARY PUBLIC: Sign: Print: My Commission Expires: Plans Examiner �� f //i 3 Zoning Structural Review Clerk (Revised 5/2/2012)(Revised 3/12/2012) )(Revised 06 /10 /2009XRevised 3 /15 /09)(Revised 7/10/2007) f- 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: P. L..- 2/t2A- D2JL DATE: Ti ( ) 10, "731 3 ADDRESS: �`' ,1� i �� �'r M t /� M► S H-D its,) , F L. 3) 13g 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 asy 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. 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 • •,:rs on 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 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 or st tially 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. 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 nty 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 ac 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 compenntion 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 may cont t the Florida Construction Industry Licensing Board at 850.487.1395 or h •: /lwww.m oridalicense .comIdb•r/.ro /cilbfindex 11. I am aware of, and consent legally and financially r Initial / owner- builder building permit applied for in my name and understands that I am the party e 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 t 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 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 1( day of —S—Ps-Ni , 20 I 'T1) By ' $'C. 1-44A-J " who was personally known to me or who has Produced there _ ense or as identification. OWJ1ER 41111111 '91‘ F� Jo .:**)\) -;;"7. s /p4 /c� Miami Shores Viiiage Building Department RECEIPT PERMIT #: 1 "-"'S DATE: zer-v--e ❑ Contractor , r Owner ❑ Architect. Picked up 2 sets of plans and (other) -t—t rLS 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 �on ac( ao(3 Address:7) , c ( � 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:' 95 PERMIT CLERK INITIAL: a Rick Scott Governor John H. Armstrong, MD, FACS Surgeon General & Secretary February 25, 2013 Pol Zazadre 77 NE 100 Street Miami, FL 33138 RE: Contingency Letter Application Document No: API 095845 Centrax Permit Number: 13 -SC- 1452878 OSTDS Number: 77 NE 100 St Miami, FL 33138 Lot:19 Block:10 Subdivision: Dear Applicant: This will acknowledge receipt of an application dated 01/30/2013 for a permit to use an existing onsite sewage treatment and disposal system located on the above referenced property. Proposed concrete slabs pieces beside pool. 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 (786) 315 -4444. 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.MyFloridaEH.com JAN 1 0 1013 =-- x a2' 90'6'20° 1'.75' n— rr- -n —n—� WATER PUMP' 1.3116' 3.45' 0,11.05 1 -STORY RESI 77 F.F.E= +13.05' WATER L.{ CONDITIONER 1.7'X3' FIP. 1/2' No 1.D. 12.59 wsa Eirlidi MO t .canr ea' mrr ossea S`al a..•� aji�irmw.. !s ., I N Anrr%ue --r �°1i�'�i n Infoli ttiiriics sr i rrrrrrac irai,ia r rr n A UM iririra�r�'ritawlailMl• r••rrim 'ER-, at><arrilai saarrirtfrliMR. iiiri�t10l Lrrirwrrrrrir=-- .---- .-- .._ —.-• �r� rrr�1 r� ii Z KaYiia\r Mee iiiia;4 h. irrrriy =rr . - - -= rr� Mai Wva sriar wrw i i V I. ! 1.1111011 ~,1 -0. W.1/2 LOT -21 BLOCK -10 25.0' 90'6'20° RP. 1/2' •L13/ �. -5' OEVA(J( 1/2' s,./1I1aae No D. MOrr�>s 1"i Er�� xellkaMBIRAMME 114iitairtM Rr!lrrl 1. M l %t UIift �ir11tral■ Rria11rr iriing all i.r:rr It> rrirc•� NNE 4.4114•111.1100. �sMOM 1111111th'!{ /IMAM 414 MUMMA. 1t( TAP. 141rtatl�lt ..741..l•41114•1tr TONS Permit Number: DS- 1 -13 -56 I Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 !Inspection Number: INSP - 184033 Inspection Date: March 15, 2013 Inspector: Bruhn, Norman Owner: FRANKLIN, TRACY Job Address: 77 NE 100 Street Miami Shores, FL 33138- Project: <NONE> Contractor: HOME OWNER Permit Type: Driveways /Sidewalks/Slabs Inspection Type: Final Work Classification: Addition /Alteration Phone Number (917)826 -6492 Parcel Number 1132060131430 Building Department Comments CONCRETE SLABS 3 X 4 AND 3 X 3 SLABS Infractio Passed Comments INSPECTOR COMMENTS False Passed Inspector Comments 3/ Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until March 15, 2013 For Inspections please call: (305)762 -4949 Page 1 of 1