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FW-13-466Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 187009 Permit Number: FW -3- 13-466 Scheduled Inspection Date: April 11, 2013 Inspector: Rodriguez, Jorge Owner: CRILLY, NEIL & ANDREA Job Address: 39 NW 100 Street Miami Shores, FL 33150- Project: <NONE> Contractor: HOME OWNER Permit Type: FenceIWall Inspection Type: Final Work Classification: Wood Fence Phone Number 305/793 -5700 Parcel Number 1131010180391 Building Department Comments WOOD FENCE INSTALLATION ALONG OF DRIVEWAY AND POOL TO EXISTING FRONT WALL. REMOVE 15' SECTION FRONT WALL AND REMOVE EXISTING CHAIN LINK FENCE Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Jgo Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. April 10, 2013 For Inspections please call: (305)762 -4949 Page 11 of 29 PERM IT # CONT SUBM RACTOR: ITTAL DATE: ADDR ESS: NAME: RESUBMITAL DATES: 4r), amvs-ri � f4w ioo Gr�lli STRUCTURAL IMPACT FEES ELECTRICAL HRSIDERM PLUMBING MECHANICAL NOC LOT 2 8LIC 4 11674 "! 1.10' SUBJECT TOOOKCOLIANCE WITH ALL FEDERAL STATE AND CO11 MP 11 11y��p RE(' UST- - tsi .75' CBSWaU .7‘ 1 • Coc‘ I=. 18' Parkway LEGEND; A .ARC B.M. wuacmcat Ewa** asps. ...ASPHALT SUL =BLOCK PA BOA MAIM mac L Qt =CENTER UNE C.S. =CONCRETE KOCK CON. BLOCK STRUCTURE C.L.P. .CHAN UM FENCE CONC. =CONCRETE D.E. =ORAMAGE EASEMENT COUNTY RECORDS Ol 1 14' Aspksk ter NW 100 STREET ON =DRILLED HOLE =ELEVATION INATER EP =EWE Ear .-°" FB =RELO BOOK MD. =FOUND FOAL =FLORIDA POWER & Law LP. N LR =IRON ROD L.B. LS. =LICENSED SURVEYOR Y KR AUK HOLE AMOS EVA Use) IN THIS SUFIVEY ARE BASED ON ARE TIVE TO1LQ.v.D. OF 1921/. D , FND.I.P.117 fro °ions° '._.L =255.00' J • L=39.35' / OI 7ND.I.P.1/7 FND.I.P.1/7 No 13) ate. .aamosaaace EASEMENT WT 4404. a DISK O.H =OVERHANG P O.R.B. .OFFICIAL BOOK 3 PARE P8 .PALM BEACH CLAIM Peconix; PBO R • P.C. =POINT CIF CURVA P.T. =POINT OF TANCOMoy PO.B, =POOF aeasoma P.O.C. =POINT OFCOMPRENCOMENT P.P. =POWER POLE PRY. =PERMANENT REFERENCE SION PAVYI: =PAVEMENT R.P. =RADIUS poen nav sat =SOUTHERN BELL TELEPHONE ger SET 1 p LB � CAP NWT =SET MO SAN *SEE TS *TOP OFgnat W.O. =WORMS COMER WA3 op Face WLF. =WIRE • =C NENTRAL ANGLE ORTH ARROW ORIENTATION FIELD DETERMINED RJ( MITERED LAND 0.8111R31% p, YAUD WITHOUT THE SIGNATURE AND THE ORIGINAL RAISED SEAL OF A FLORIDA IM ��MAPPERNo. SURVEYOR 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 BUILDING PERMIT APPLICATION Permit Type: BUILD I NG JOB ADDRESS: g NUJ. I(Dcf) sr, �j, 7,i J ihi b b ''gy�pp 1J FBC 20 tJ Permit No.1 ,O) D, Master Permit No. ROOFING City: Miami Shores County: Miami Dade Zip: g 1 S © , Folio/Parcel #: Is the Building Historically Designated: Yes NO � Flood Zone: OWNER: Name (Fee Simple Titleholder): Iv L. fl v C&\ LLy Phone #: .?0 '.--°3`..g 391 1 Address: `% L- lc' Sc City: M \ A\ \ S i---1 ( S State: -et Zip: 33 ) SO Tenant/Lessee Name: Phone #: Email: N'E- Ca_ k L_ t f -. CONTRACTOR: Company Name: Address: City: Ao Om(' Phone #: 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: $ "Z-000 ,°' Square/Linear Footage of Work: g 0 i p Type of Work: DAddition OAlteration ONew )iRepair/Replace ODemolition Description of Work: W ° Or". C C-.E G S 0 }= 37a v 1 1 E_}< 1 s-s'\ G- rf1-o / �i of /_ , CZJ\®'�._ tic ' S E_�n ®� 0 f �1 L✓ t,c 2.Ge1\x-®vE_ J' cwt P l&.. , Color thru tile: ******** * * * * * * * ** * * * * * * * * * * * * * * * * * * * * ** Fees *** * * * * * * * * * * * * * * * * * ** * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ 76 to CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 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 iss ce 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 c rtify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating cons ction and zoning. "WARNING TO WNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMEN 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 con ition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a c y of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to att chment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which ccurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved nd a reinspection fee will be charged. Signature v " "" � V� Signature Owner o Agent Contractor The foreg ing ' trument was a owl fore e S� The foregoing instrument was acknowledged before me this day o �_ 20 by fore _ , day of , 20 _, by who is pers•na11 known to me •r who has produced 1� - who is personally known to me or who has produced 1 (J7 " ' J x'fication and who did take an oath. as identification and who did take an oath. e NOTARY Sign: Print: My Commission Ex Commission # EE 128810 ,,;,;‘+*0 Bonded Through National Notary Assn. -r APPROVED BY 1ans Examiner (Revised 5 /2 /2012XRevised 3/12/2012) =7:ff)1. NOTARY PUBLIC: Sign: Print: My Commission Expires: XRevised 06 /10 /2009XRevised 3 /15 /09XRevised 7/10/2007) 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: t — Cft- DATE: --?,/ 5 A( 3 ADDRESS: Te N, C-D ® 5 i , M \A.34, S-v) eD 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 1 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 3. I understand that, as an owner builder, 1 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. 1 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 1� 4. I understand that 1 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 1 built or substantially improved it for sale or lease, which violates the exemption. Initial 5. 1 understand that, as the owner-builder, 1 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 1 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 - h 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 11 am willfully acting as an owner - builder and am aware of the limits of my insurance coverage for injuries to workers on my pro o :rty. Initial — 8. I understand that I may not delegate the responsibility for supervising work to be a licensed contract r who is not licenses to perform the work being done. Any person working on my building who is not licensed must work and ° r my direct supervision and must be employed by me, which means that I must comply with laws requiring the withholding o federal income tax and social security contributions under the Federal Insurance Contributions Act (FICA) and must provide orkers 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 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 regulatio 10. I understand that I may obtain more information regarding my obligations as an employer from the lnte United States Small Business Administration, and the Florida Department of Revenues. I also unders Florida Construction Industry Licensing Board at 850.487.1395 or h n : //www.m oridalicense.com/dbor/ 11. I am aware of, and consent to; an owner- builder building permit applied for in my name and understan legally and financially responsible for the proposed construction activity at the following address: Initial ill abide by all applicable Initial al Revenue Service, the nd that I may contact the ro /cilb/index.html Initial s that I am the party Initial 12. I agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of a information that I have provided on this disclosure. �nitial.� Licensed contractors are regulated by laws designed to protect the public. If you contract with a person ho does not have a license, the Constr4uction Industry Licensing Board and Department of Business and Professional Regu ation 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 i portant for you to understand that, if an unlicensed contractor or employee of an individual or firm is injured while working . n your property, you may be held liable for damages. If you obtain an owner - builder permit and wish to hire a licensed contractor, Ou 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 \1( day of JOirC , 201i who was personally known to me or ho has Produced there License or ident . tion -;.4 • Notary u - tats of Florida My Comm. . Expi es Sep 23.2015 ▪ Commissio. # E.E 128$1Assn. Bonded Through iatronai Notary STATE OF (FLORIDA) COUNTY OF (DADE) Miami Shores Village Building Department SURVEY AFFIDAVIT 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 The undersigned Affiant, N €it te. CR— t,1..; , does hereby attest that (Property owner) The attached survey, performed by Act L cot.).h1 '1 - LACA/ -yclZ-S (Name of surveyor's company) For address: Ms Ws ®® S j", M l.4 4\ S w'l Performed on 2IZ tA, L -(date of survey) is an accurate representation of the existing conditions and locations of all structures on the property as of this date. The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the property without first providing a survey less than seven (7) years old old. The Affiant, as property owner, further agrees to remove or obtain permits for any structures which now may exist on the property which are not permitted or which may violate zoning or building code regulations. The Affiant further understands that the existence of any such structures may affect final inspections as applicable to this or other permits. Further, Affiant say eth naught. Property Owner Signature SWORN TO AND SUBSCRIBED before me this d Affiant is personally known to me, producedT Revised on 5/22/2009/ Revised on 6/12/09 Property Owner Print Name as identification. Notary CLAUDIA V. CUBILLOS Notary Pubilc - State of Florida My Comm. Fxpues Sep 23, 2015 Commission # EE 128810 Bonded Thrn.gh National Notary Assn.