The URL can be used to link to this page

DS-11-1658ta Ow Miami Shores Village g Building Department ?4 d, SEP 0 9 2011 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 Noa l)'. kgf BUILDING PERMIT APPLICATION FBC 20 t 7 Permit Type: BUILDING ROOFING 6e(1 _ , z9f* 0356 OWNER: Name (Fee Simple Titleholder): ect.,(10f 0f \ 0 Phone #: a) 7S6 — l F3-3 Z Address: /q/ ! / `V (n q %.- City: (6 041 v1 l am" ikd J`t° 5 State: F Zip: -3 3 / Tenant/Lessee Name: Phone #: Email: Master Permit No. JOB ADDRESS: / ("I/ / V l n q 571-- City: Miami Shores County: Miami Dade Zip: 3-5/6 6 Folio/Parcel #: Is the Building Historically Designated: Yes NO r/ Flood Zone: CONTRACTOR: Company Name: D 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: $ 5-1 6(6 b Square/Linear Footage of Work: Type of Work: ❑Addition ❑Alteration ❑New ORepair/Replace Description of Work: % / tV i v ❑Demolition ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees************* * * * * * * * * * * * * * * * * * * *** * * * * * * * * ** Submittal Fee $ Permit Fee $ /7J " CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ d " 6 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 absence of such posted notice, the inspection will not be approved and a reins, -ction fee 'ill be charged. Signature Signature Owner or Agent instrument was ackn• le red befo 1, - I , '_IL_� 20�� ,b� � _1 "T1 Wally known to me or who has produce /L. ZD " ,.1s)identification al did take an oath 1 NOT Y ' UBLIC: Sign: Print: My Commission Expires: Contractor The foregoing instrument was acknowledged before me this day of ,20_,by ho is personally known to me or who has produced as identification and who did take an oath. 1 *********** * * * * * * * * * * * * * * * * * * *** ** **** * * ** r ***** * *** ** *err * * * * * *** *** * * * * ** ors• * *** * * * ** * * ** r****** * *** * * * * * ** NOTARY PUBLIC: Sign: Print: My Commission Expires: APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 07 /10 /07)(Revised 06 /10 /2009XRevised 3/15/09) NOTICE OF COMMENCEMENT A RECORDED (COPY jMUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO.) � ? 1 t 1 Vs-�TAX FOLIO NO: STATE OF FLORIDA: COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713 Florida Statutes, the following information Is provided In this Notice of Commencement. 111111111111111111111111111 IIIII IIIIIUI111111 CFN 2012R0396788 OR Bk 28137 Ps 2790 (1ps) RECORDED 06/06/2012 09:05:32 HARVEY RUVIN. CLERK OF COURT MIAMI -DADE COUNTY. FLORIDA LAST PAGE Space above reserved for use of recording office 1. Legal description _of property and street/address: /1// A4 /p q SdLPr•rt'S r 33 tz 2. Description of improvement: 4,4 dn,,s16,,J sterfo,, d c t J et.,/ - 0,10 I fk t —C' ii -elid j 1,0.Ar. f� • 3. Owner(s) name add address [/ C / t I 1L kwrc 4.33/6 / Interest in property: Name and address of fee simple titleholder. 4. Contractor's name, address and phone number. / tdr. / 1 - l / a / G t D 9 4 - / . _ / v l , . /..annex , -i 3316 30 7c6- 'e32., 5. Surety: (Payment bond required by owner from contractor, if any) Name, address and phone number. Amount of bond $ 6. Lender's name and address: 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1Xa)7., Florida Statutes, Name, address and phone number: 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713..13(1)(b), Florida Statutes. Name, address and phone number. B. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a different date Is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNERAFTERTHE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713:13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Signatures) of Owner(s) or 9uner(sy' uthorized Officer/Director/Partner/Manager Prepared By ,L t'�I4 tf Prepared By Print Name jti(t r 1 C Ca y Print Name Title/Office Tide /Office STATE OF FLORIDA COUNTY OF MIAMI -DADE gig The fioreRoing I strum t wigged before me this of ,rday of E Individually, or O as for ersonally known, or CI produced the following type of !dentifi Signature of Notary Public: Print Name: (SEAL) c2 7 / VERIFICATION PURSUANT TO S CTION 92.525. FLORIDA STATUTES Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in H are true, to the best of my knowledge and belief. Signatures) of Owner(e) orrner(s)'s orized Officer/Director/Partner/Manager who signed above: By t/I 123.01-52 PAGES 3/10 EA By 'p 1 A 1 G FLORIDA, COUNTY i tN DADS 1 HEREBY CERTIFY that this is e hue copy of the o Mad in this office on day of JUN 0 6 2012 , A.D. 20 WITNESS y hand and Official Seal CLERK, of end County Courts i DA Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 OWNR BUILDER DISCLOSURE STATEMENT NAME: /V1tC/tt( C,/l DATE: ADDRESS: 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 t�� 2. 1 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, 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." l 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. Initlal_ 5. I understand that, as the owner - builder, I must provide direct, onsite supervision of the construction. Initial 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. 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 homeowners 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. 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 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 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.mvfloridalicense.com /dbpr /pro /cilbfindex../httml / Initial 4-' 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 01--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 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 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. qi Was acknowledged before me this day of , 20_1_ who was personally known to me or who has Produced there License or YOij 20 de tificati n. OWNER - NOTA coo' C1av v110 C,ot° lg 23 jai. : �. •+'•ea�,:� Kam"" 1 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 Permit NO DS -9 -11 -1658 Issue Date: Not Issued MOW Expires:Not Issued Folio Number:1121360040520 Owner's Name: MICHAEL & GENEVIEVE CLAY Job Address: 141 109 Street Miami Shores, FL 33161- Owner's Phone: 305 - 756 -9832 Total Square Feet: 0 Total Job Valuation: $ 5,400.00 Contractor(s) HOME OWNER Phone Primary Contractor Yes Planning and Zoning Criteria and Comments Approved: No Date Denied: 9/12/2011 Comments: PLEASE PROVIDE ACCURATE AND CONSISTENT SCALED AND DIMENTIONED DRAWINGS. DRIVAY MUST BE LOCATED COMPLETELY ON SWALE, NOT TO EXCEED 10 FEET IN WIDTH AT ANY POINT EXCEPT FOR 2 FOOT FLARSE. PROVIDE DIMENTION BETWEEN DRIVEWAY /FLARE AND EXTENSION OF SIDE PROPERTY LINE. IN PLANNING YOUR DRIVEWAY PLEASE CONSIDER THAT AT ANY TIME THE VILLAGE MAY CONSTRUCT A 5 FOOT WIDE SIDEWALK IN THE SWALE ALONG THE PROPERTY LINE AND THIS MAY AFFECT YOUR ABILITY TO USE THE CIRCULAR DRIVE IN THE SWALE. JI%c Q— i5c3�-- (c�JC>I Permit No: 11 -1658 Job Name: September 13, 2011 Miami Shores Village Building Department Building Critique Sheet 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 1) Provide approval from HRS /DOH/ 2) Provide zoning approval. 3) Provide details of the construction. Is this concrete, paver or asphalt? Page 1 of 1 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 - 795 -2204 09/13/2011 12:13 FAX 1 800 685 7530 DATA SCAN FIELD SERVICES Ij001 $$$ TX REPORT ass TRANSMISSION OK TX /RX NO 1781 RECIPIENT ADDRESS 919548356001 DESTINATION ID ST. TIME 09/13 12:12 TIME USE 00'48 PAGES SENT 3 RESULT OK Permit No: 11 -1658 Job Name: September 13, 2011 iami Shores Vivage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Building Critique Sheet 1) Provide approval from HRS/DOH/ 2) Provide zoning approval. 3) Provide details of the construction. Is this concrete, paver or asphalt? Page 1 of 1 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 -795 -2204 PERMIT #: �� 1 1, ❑ Contractor Owner ❑ Architect M lami S hores Viiiage Building Department RECEIPT DATE: S 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 4�i Picked up 2 sets of plans and (other) Address: 1 I N�� Oci From the building department on this date in order to have corrections done to plans And /or get County stamps. 1 understand that the plans need to be brought back to Miami Shores Village Building Department to continue permitting process. &-t 4-tte-t) Acknowledged by: PERMIT CLERK INITIAL: RESUBMITTED DATE: tt PERMIT CLERK INITIAL: Rick Scott Governor Steven L. Harris, M.D., M.Sc. Interim State Surgeon General April 23, 2012 Michael Clay 141 NE 109 St Miami, FL 33161 RE C EJVEDD j MAY 082012 s � T. RE: Contingency Letter Application Document No: AP 1069038 Centrax Permit Number: " 13 -SC- 1404653 OSTDS Number: 141 NE 109 St Miami, FL 33161 Lot:21 Block:2 Subdivision: College Heights Dear Applicant: This will acknowledge receipt of an application dated 04/16/2012 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, Jos ;:N� -�'�- pecialist 11 Miami -Dade County Health Department 1725 NW 167 St, Opa Locka, FL 33056 Phone: (305) 623 -3500 . Fax: (305) 623 -3645 . http: / /www.MyFloridaF:H.com 12.00' 0 C GGVd 19 3100 �?r 2.50' LOT 22 BLOCK 2 3.5' 122.91' (C &M) CONC. STAIRS 1.20' 20.90' QD law V 12.20' 35.10' 27.25' 123.01' (C &M) 1 LOT 20 BLOCK 2 0 rn NOT VALID UNLESS EMBOSSED WITH SURVEYOR'S SEAL REVISED: 4/12/12 FOR SEPTIC TANK ABBREVIATIONS: SWK= SIDEWALK, CBS = CONCRETE BLOCK STRUCTURE, CLF=CHAINLINKFENCE, PL=PROPERTY LINE, DUE = DRAINAGE UT nY EASEMENT, IP =1RONPIPE, F= FOUND, A/C =AIR CONDmONER PAD, P /C= PROPERTY CORNER, D/H= DRILLED HOLE, ' F= WOODEN FENCE, RES= RESIDENCE, CL- CLEAR, RB= REBPR, UE= UTILrrY EASEMENT. CONC= CONCRETE SLAB. RA WRIGHT OF MY, DE =DRAINAGE EASEMENT, C/L= CENTER LINE, O= DIAMTER, TYP= TYPICAL, M= MEASURED, R =RECORDED, ENCR =ENCROACHMENT, COMP = COMPUTER, ASH =ASPHALT. N/D =NAIL & DISC, S =SET, FEE = FINISH FLOOR ELEVATION, O/S =OFFSET, P/P =POWER POLE, OHP =OVERHEAD POWERLINE, WM =WATER METER WOOD FENCE= MASONRY WALL =1 I I I I I I I I I - ELEVATION .BASED ON LOC. #• CONCRETE= I •_;°•°••a :•+'••= : °:•1 CBM# ELV. MAINTENANCE & DRAINAGE EASEMENT= M & O.E. 1.20' z 0 A 77V • LOCATION SKETCH SCALE: NTS III -1(05_3 Miami APPROVED BY ZONING DEPT BLDG DEPT 5-4c4_ At SiSLIECT TOCOMPLIANCE WITH ALL FEDERAL AND COUNTY RULES AND REGULATIONS !r.Al , f44',// az'7 LZV ro • V, V N. A% 2 it i` • • N sn u �TTd'Q :Emf Y zseS,A•H SURVEY FOR: MICHAEL CLAY, 141 N.E. 109TH ST., MIAMI SHORES, FL. 33161 LEGAL DESCRIPTION: LOT 21 BLOCK 2 OF COLLEGE HEIGHTS ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK OF THE PUBLIC RECORDS MIAMI -DADE COUNTY, FLORIDA 42 TYPE OF SURVEY: BOUNDAR'•' SURVEY SURVEYORS NOTES: 1) OWNERSHIP SUBJECT TO OPINION OF TITLE. 2) NOT VALID WITHOUT THE SIGNATURE AND RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER. 3) THE SURVEY DEPICTED HERE IS NOT COVERED BY PROFESSIONAL LIABILITY INSURANCE. 4) LEGAL DESCRIPTION PROVIDED BY CLIENT. f) UNDERGROUND ENCROACHMENTS NOT LOCATED. 6) ELEVATIONS ARE BASED ON NATIONAL GEODETIC VERTICAL DATUM OF 1929. 7) OWNERSHIP OF FENCES ARE UNKNOWN. 8) THERE MAY BE ADDITIONAL RESTRICTIONS NOT SHOWN ON THIS SURVEY THAT MAY BE FOUND IN THE PUBLIC RECORDS OF THIS COUNTY. 9) CONTACT THE APPROPRIATE AUTHORITY PRIOR TO ANY DESIGN WORK FOR BUILDING AND ZONING INFORMATION. 10) EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO QETERMINE RECORDED INSTRUMENTS, IF ANY, AFFECTING THIS PROPERTY. BEARINGS WHEN SHOWN ARE REFERRED TO AN ASSUMED VALUE OF SAID PB 42 PAGE 8 1 HEREBY CERTIFY That the survey represented thereon meets the minimum technical requirements adopted by the STATE OF FLORIDA Board of Land Surveyors pursuant to Section 472.027 Florida Statutes. There are no encroachments, overlaps, easements appearing on the plat or visible easements other than as shown hereon. SI e G T98 BLrcO S Englneers • Land Surveyors • Planners • LB # 0007059 555 NORTH SHORE DRIVE MIAMI BEACH, FL 33141 (305) 865 -1200 Email: blancosurveyorsinc@yahoo.com Fax: (305) 865 -7810 ADIS N. NUNEZ - REGISTERED 17aND- SURVEYOR STATE OF FLORIDA #5924 FLOOD ZONE: X PANEL: 0139 DATE: 9211 SCALE: 1• =20' SUFFIX: j,' DATE: 9/11/09 BASE. N/A COMMUNITY# 120652 DWN. BY: F. Blanco JOB No - 1 -6 1