DS-12-1061Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 174661
Permit Number: DS -6 -12 -1061
Scheduled Inspection Date: October 23, 2012
Inspector: Bruhn, Norman
Owner: DURU, CLEMENT
Job Address: 139 NW 102 Street
Miami Shores, FL 33150-
Project: <NONE>
Contractor: HOME OWNER
Permit Type: Driveways /Sidewalks /Slabs
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1131010220080
Building Department Comments
PATIO SLAB AND PLANTERS
Passed (J
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
IA) Ol -F.. r
October 23, 2012
For Inspections please call: (305)762 -4949
Page 2 of 18
7 /to/ 2_ - Me55ca9€
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Miami Shores Village c r I
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 APPLICATION
Permit Type: BUILDING
JOB ADDRESS: / 3 / Nw- (ts
B
JUN 1 1 2012
FBC 20 10
Permit No. D:512— '
Master Permit No.
ROOFING
City: Miami Shores County: Miami Dade Zip: r
Folio/Parcel #:
Is the Building Historically Designated: Yes
NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): C(_ Err Ep "44 Phone #: 3 �r 7 ( 7 (3S.
Address: (
City: (Y(C (3 IT t State: 1 " Zip: 33 (�'3
Tenant/Lessee Name: Phone #:
Email: C-4,D l�
CONTRACTOR: Company Name: C - Nf j ' -A/la Phone #:
Address:
City: 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: $ 5 m
Type of Work: OAddition OAlteration
Description of Work:
x (7'TY( irX -?=4",
8
Square/Linear Footage of Work: glr
ONew ORepair/Replace - ODemolition
a
°`Y /C. `" SY /3': X "` o2/' ' Gaze
,1v'; D 5'1459A, a) 7 '/ 4
v4, cl 7�p
* * * * * * * ** . ****************************F , , * *,r, **** **** * **F * *,r * *** * **** ** *,t, *,r *, ,rat** ***,t * **** *,t*******
Submittal Fee $ _., ® , t '' Permit Fee $ 45-6 CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Not Training/Education Fee $ Technology Fee $
Color thru tile: G2 r'"
Structural Review $
TOTAL FEE NOW DUE $ 2(01 °
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, CO ''^ SULT 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
Owner or Agent
it
The foregoing in�strum, it was acknowledged before me this %r
day of �,20L,by
who is personally known to me or who has producedP.-
As identification and ho did take an oath.
otiol tttitt���
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
APPROVED BY
p�;�� m a4m ?�J
•
GJ • .,
0\
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.
, 77491.,) -- Plans Examiner
Structural Review
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
(Revised 5/2/2012XRevised 3 /12/2012XRevised 07 /10 /07XRevised 06 /10/2009XRevised 3/15/09)
yfi•
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: `--U� ly(ZN i r ,C. DATE:
ADDRESS: /3% ac„! (o2-- Ark', Mu Pit i' eg, k33fez'
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 ( r&
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 C---MP
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 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 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
5. I understand that, as the owner- builder, I must provide direct, onsite supervision of the construction.
Initial9
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 C.,4)
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 C.1
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 G+" !
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 9
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 http : / /www.myfloridalicense.com /dbpr /pro /cilbfindex.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:
1 Meat
Initial C,1
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 Cie)
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 contractors 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 f I day of � e , 20 J —
By CLa -) who was personally known to me or who has
Produced there License or 1, rim
as identification.
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Permit No: 12 -1061
Job Name:
June 20, 2012 Page 1 of 1
i
L� AY
Provide corrections for zoning.
) Identify the flower bed wall height.
tt", v 3) The correct detail for the concrete slab is: 4' thick concrete with minimum 6'x6"- 10 x 10
61 Welded wire fabric.
4) NOTE: HRS APPROVAL PER ADDITION PLAN.
Building Critique Sheet
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
1
Permit NO. DS -6 -12 -1061
Issue Date: Not Issued
Planning and Zoning Criteria
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Expires:Not Issued
Folio Number:1131010220080
Owner's Name: CLEMENT DURU
Job Address: 139 102 Street
Miami Shores, FL 33150-
Owner's Phone:
Total Square Feet: 372
Total Job Valuation: $ 500.00
i
Contractor(s)
HOME OWNER
Phone
Primary Contractor
Yes
Planning and Zoning Criteria and Comments
Approved: No Date Denied: 6/18/2012
Comments: NOT MORE THAN 20% OF THE REAR YARD CAN BE COVERED. PLEASE PROVIDE CALUCLATOIN.
YOUR REAR YARD IS 75 FEET WIDE AND 17.5 FEET DEEP MEASURED FROM THE CLOSEST POINT ON THE HOUSE
TO THE REAR PLOT LINE.
PROVIDE DIMENSIONS ON PLAN.
7/2/12
PLEASE CLEARY IDENFIFY THE ARE OF WORK AND THE PERCENTAGE OF THE REAR YARD THAT IT COVERS.
PERMIT #:
Contractor
Owner
J Architect
Pi
Miami Shores Viiiage
Building Department
RECEIPT
C C- r
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
DATE: 'for 2-
Address: / friA .1 (0 (,e fm t er m I 1 A ZC
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 ermitting process.
Acknowledged by:
PERMIT CLERK INITIAL:
RESUBMITTED DATE: O) f/oL
PERMIT CLERK INITIAL:
Planning and Zoning Criteria
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Folio Number:1131010220080
Owner's Name: CLEMENT DURU
Job Address: 139 102 Street
Miami Shores, FL 33150-
Owner's Phone:
Total Square Feet:
Total Job Valuation:
372
$ 500.00
1
Contractor(s)
HOME OWNER
Phone
Primary Contractor
Yes
1
Planning and Zoning Criteria and Comments
Approved: No Date Denied: 6/18/2012
Comments: NOT MORE THAN 20% OF THE REAR YARD CAN BE COVERED. PLEASE PROVIDE CALUCLATOIN.
YOUR REAR YARD IS 75 FEET WIDE AND 17.5 FEET DEEP MEASURED FROM THE CLOSEST POINT ON THE HOUSE
TO THE REAR PLOT LINE.
ISCVIS
0
gY:
PatinAtea
worm: WPLL
HeUrk ZPsttivr stab
Le gth: 8 -ff
Ydlac 4'
Miami Shores Village
APPROVED
ZONING DEPT
BLDG DEPT
BY
11
II
11
yu
Total yard square footage 75 x 15 = 1125 sq ft
20% Of construction area 225 aq ft
Actual construction area 224.16 sq ft
SUBJECT TO COMPLIANCE WITH ALL FEDERAL
STATE AND COI INTY RULES AND REGULATIONS
I _f
I
LJ
BACKYARDRGRA S
111 11 1111 0
LOT -1
BLOCK -I
FIP 1/2° rP
NO I.D.
— of
0.38' CL--- -
0 P
LOT -2
BLOCK -I
75.00'(R &M)
LOT -3 LOT-4
BLOCK -I ° BLOCK -I
FIP I /2"
�O NO I.D.
6' WOOD FENCE
LOT -17 1.9
BLOCK -1
THE WEST 1/2
25.00'
ACS X a
AC .xt z n
4.0' m.
•$<
.X
3
< LOT -17
BLOCK -I
re, al REMAINDER
0.53' CL
0.13' CL X
s<
*10.12'_
PORCH
FIP 1/2" 90e,fi 4°
NO I.D.
CL
FIP 1/2°
NO I.D.
;:�' coNc sJQ�bvaur
BLOCK
CORNER
NORTH RIGHT -OF -WAY LINE
II' PARKWAY
e
18.00'
►. th. ST.
16.30' ASPHALT PAVEMENT
50' PUBLIC RIGHT -OF -WAY : '1i
PROPERTY ADDRESS:
139 N.W. 102 ST.,
MIAMI SHORES, FL.. 33150
( FOLIO No. 11- 3101 -022 -0080 )
DESCRIPTION
The Westin of Lot 17 & all Lot 18, Block 1
of " GOLD CREST A SUBDIVISION "
according to the Plat thereof as
recorded In Plat Book 21 at Page 58 of
the Public Records of Mlaml -Dade
County, Florida.
There may be legal resMctions on the subject
property that are not shown on the Map of Survey
that may be found in the Public 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 jurisdictlon of any federal,
state, regional or local agency board, commission
or other entity.
Legal description was furnished by the client
The elevations of weMdentitled features as
depicted on this survey and map were measured
to an estUnated vertical posiflonal 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
Weil - Identified features as depicted on this survey
and map were measured to an estimated
horizontal positional accuracy 011/10 foot unless
otherwise shown.
Legal Description subject to any dedications,
(imitations, restrictions, reservations or recorded
easements.
LIST OF POSSIBLE ENCROACHMENT:
NIA
BENCH MARK USED
BM # N-567, Elev.= 10.54'
converted to NGVD 1929.
LOCATION MAP (NOr ro SCALE) A
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 Survey 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:
CLEMENT DURU & W BRENDA
SURVEYOR'S CERTIFICATION:
I 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.
AERIAL MAP (NOT TO SCALE)
FLOOD ZONE INFORMATION:
Community No. 120652
Panel No. 0090
Suffix: J
FIRM Date: 03-02-1994
Flood Zone: X
ARMANDO GARCIA
PROFESSIONAL LAND SURVEYOR No. 3109
STATE OF FLORIDA
Survey is not covered by
Proffesional Liability
Insurance.
ORIGINAL -08-07 -2009
FIELD DATE
REVISION: 03-03 -2011
UP-DATE: 07-05 -2011
JOB NO. 08- 234-09 -B
DRAWN J.V. & AVI
Land Surveyors & Mapper
8567 Coral Way, Miami, FLORIDA 33155
Telephone: 786- 290 -4184
SHEET
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