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DS-13-2626 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-203364 Permit Number: DS-11-13-2626 Scheduled Inspection Date: December 09,2013 Permit Type: Driveways/Sidewalks/Slabs Inspector: Rodriguez,Jorge Inspection Type: Final Owner: LANE,CULLAN Work Classification: New Job Address:33 NW 93 Street Miami Shores, FL 33150- Phone Number (305)498-9822 Parcel Number 1131010340280 Project: <NONE> Contractor: HOME OWNER Building Department Comments INSTALL NEW PAVER/PATIO IN BACKYARD Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. December 09,2013 For Inspections please call: (305)762-4949 Page 17 of 29 PERMIT# CONTRACTOR: . SUBMITTAL DATE: - ADDRESS: NAME: (201 ev) LC-�{(�"�-` RESUBMITAL DATES: PROJECT TYPE: ZONING, FIRE STRUCTURAL IMPACT FEES ELECTRICAL HRSIDERM PLUMBING NOC MECHANICAL - Miami Shores Village Building Department NOV 2 0 2013 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 ` Y-- Tel:(305)795.2204 Fax:(305)756.8972 INSPECTION'S PHONE NUMBER:(305)762.4949 FBC 20 BUILDING Permit No. PERMIT APPLICATION Master Permit No.l S 1 , 2 b 16 Permit Type: BUILDING ROOFING JOB ADDRESS: 33 NW 93 Street City: Miami Shores County: Miami Dade gip; 33150 Folio/Parcel#: 11-3101-0340280 Is the Building Historically Designated:Yes NO X Flood Zone: No OWNER:Name(Fee Simple Titleholder):Cullen J Lane Phone#:305 498-9822 Address:33 NW 93 Street City: Miami Shores State. FL Zip. 33150 Tenant/l-essee Name: Phone#: Email: clane @cullenlanelaw.com CONTRACTOR:Company Name: Owner 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.$2000.00 Square/Linear Footage of Work: 576 Type of Work: DAddition DAlteration *ew ORepair/Replace ODemolition Description of work: Install new paver/patio in backyard. Color thru tile; Submittal Fee 5v. U Permit Fee$ 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 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 co co the issuance of a building permit with an estimated value exceeding$2500, the applicant must promise in good faith that copy the notice of commencement and construction lien law brochure will be delivered to the person j whose property is subjec nt Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspec on i c rs seven (7) days after the building permit is issued In the absence of such posted notice, the inspection will no d a reinspection fee will be charged. Signature Signature O r or Agent I Contractor The foregoing instrument was acknowledged before me this�0 The foregoing instrument was acknowledged before me this day of _,20/ 5,by CWA N ��-� day of ,J .20_,by who is personally known to me or who has produced 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: NOTARY PUBLIC: Sign: P a of Flow Sign: Print: Capon FF wets Print: a H�oiaes o n t My Commission Ex ' My Commission Expires: APPROVED BY Plans Examiner /3zomng Structural Review Clerk (Revised 3/12r2012)(Revised 07/lMr/)(Revisai 06110MM)(Revised 3/15/09) o! s 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 J NAME: (IJU FN L*) F DATE: JI 2® 113 ADDRESS: S5 WW 13 ST 1rtai7)t yAOYe,2 FK• 331CS`O Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida,FS 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 exerpption 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. I (4 nitial_ 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. 1 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 lieyumbers on permits and contracts. Initial -4. 1 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 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. 1 understand that as the owner-builder,I must provide direct,onsite supervision of the construction. Intial"°5 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 0 ensure that the persons whom I employ have the license required by law and by county or municipal ordinance. 7. 1 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. 01.17 Initial 8. 1 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. InitialL�!/ 9. 1 agree that as the party legally and financially responsible for this proposed construction activity,l 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 e/-6 10. 1 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://w ww.mygoddalicense.com/db r/ r/ilbfin ex.html - Initial 11. 1 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. 1 agree to notify Miami Shores Village immediately of any additions,deletions,or changes to any of the informatio at 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 world on our property,you may 1 working Y P PertY.Y Y 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 average. Before a building permit can be issued,this disclosure statement must be completed and signed by the property owner and retumed to the ICI 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 0� day of �J d ' 20 !-3 By IV (4/0- who was personally known to me or who has Produce 11-icense or as identification. C'�� PRb •� at Fbrida ZI 0 ER °►a0 14raoii FF 035esa JANOR logo nn." Miami Shores Village L� � Building Department LORIDA 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 RECEIPT PERMIT#: �;� DATE: I, CAL z Contractor ner o Architect Picked up 2 sets of plans and (other) Address: l,� ' �� ete- Fie, Z,> j--o From the building department on this date in order to have corrections done to plans And/or get County stamps. I understand the plans need to be brought back to Miami Shores Village Building Dep a continu rmitting process. Acknowledged by: PERMIT CLERK INITIAL: RESUBMITTED DATE: PERMIT CLERK INITIAL: i R Miami Shores Village Building Department KENN aM .�. 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 OR1DA Fax: (305) 756.8972 NOVEMBER 22, 2013 Permit No: DS13-2626 Building Critiaue Review 1. HRS APPROVAL REQUIRED. 2. PROVIDE DETAIL FOR THE PAVER SYSTEM. Ismael Naranjo Building Official Plan review is not complete,when all items above are corrected,we will do a complete plan review. If any sheets are voided, replace them with new revised sheets and place behind the most current page. o �� -�. 2," 1- l a«►G J c�1/✓ni 2- ��t,L �o +eqVD _ - LOT 21 BLi<163 LOCATION SKETCH � (BY �AT) �IQ z ., Q PL 127.50'(R&tVn SCALE: NTS 37.50' - v c$ o'�. 4'CLF" — JW _ _ a r 1� o °0 35.10' � 25' 30.05' o0 cn Conc.Driveway $ w '8 1.30' O D O Z _U M =O N > m G) z M-4 i 0 O m 5.00' z0 Ca _ ff 010 C I Zr o - - - I • r/1 /N ` - ---- -------------------a? II m 0 -- -- --t-- - -- ----- ------------------ .. rn `�. , \` CD �o S rT1 rn 15.00' (° spa a S v' I 0 m to 157 ALLEY o � C r i 38.75' ` r C7 25.15' a N 04 O 14 0 D -- w x z. IT 0.25' � A W Ln X 04 z 37.50' "; �' g — 4'CLF cy c Dj A d 0 3 - — - � 6) 92 Asphalt 15'ALLEY 0 N 0 R E V I E WSREPde I CERTIFIED TO: JOSEPH M. KAWALEK, A SINGLE MAN, 33 N.W. 93RD ST. , MIAMI SHORES, FLORIDA z z Florida Health Mia - CO�rt 33150. , SCOTT R. JAY, ESQ. , ATTORNEYS' TITLE INSURANCE FUND, INC. , CHASE MANHATTAN o v o0 500 O•$.T.D,$, & Well Program MORTGAGE CORPORATION, ITS SUCCESSORS AND/OR ASSIGNS, ATIM - APPIkation No.: )�qFl J Date: I I`��/ LEGAL DESCRIPTION: LOTS 22 AND 23 BLOCK 168 Signature OF PLAT OF SECTION NO 6—A MIAMI SHORES SUBDIVISION ABBREVIATIONS: ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 12 AT PAGE 54 SWK=SIDEW4LKCBS-CONCRETEBLOCKSTRUCTURE,CLF-CHAINLINKFENCE,PL=PROPERTY LINE,DUE=DRAINAGE UTILITY EASEMENT,,IP=IRONPIPE, OF THE PUBLIC RECORDS MIAMI—DADS COUNTY, FLORIDA F=FOUND,A/C-AIR CONDITIONER PAD,P/C=PROPERTY CORNER.D/H-DRILLED HOLE,WYF=VAODEN FENCE,RES=RESIDENCE,CL-C LEAR,RB=REBAR, UE=UTILITY EASEMENT. CONC-CONCRETE SLAB. RAN-RIGHT OF MY, DE-DRAINAGE EASEMENT, GL=CENTER LINE, 0=0WOMR,TYP=TYPICAL, M=MEASURED,R=RECORDED,ENCR=ENCROACHMENT,COMP=COMPUTER,ASH=ASPHALT,N/D=NAIL&DISC,S=SET,FEE-FINISH FLOOR ELEVATION, NOT VALID UNLESS EMBOSSED WITH 0/S=OFFSET,P/P=POWER POLE,OHP=OVERHEAD POWERLINE,Vw=WPI TER METER SINCE 1987 SURVEYOR'S SEAL v4DODFEN = i HEREBY CERTIFY That the survey represented MASONRYVw,L= ELEVATION BASED ON LOC.# thereon meets the minimum technical requirements BL.ANGO SURVEYORS INC. CONCRETE= .:• :..:• t••� •:.•� •:••� :••� •••••� •:••� CBM# ELV, adopted by the STATE OF FLORIDA Board of Land MAINTENANCE&DRAINAGE EASEMENT-M&D.E. TYPE OF SURVEY:BOUNDARY SURVEY Surveyors pursuant to Section 472.027 Florida Engineers•Land Surveyors•Planners•LB 1110007059 SURVEYOR'S NOTES: 1) OWNERSHIP SUBJECT TO OPINION OF TITLE. 2)NOT VALID WITHOUT THE SIGNATURE Statutes. 555 NORTH SHORE DRIVE AND RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER. 3) THE SURVEY DEPICTED HERE IS NOT There are no encroachments,overlaps,easements COVERED BY PROFESSIONAL LIABILITY INSURANCE. 4) LEGAL DESCRIPTION PROVIDED BY CLIENT. 5) appearing on the plat or visible easements otherthan MIAMI BEACH,FL 33141 UNDERGROUND ENCROACHMENTS NOT LOCATED. 6) ELEVATIONS ARE BASED ON NATIONAL GEODETIC as shown hereon. (305)865-1200 Fax: (305)865-7810 VERTICAL DATUM OF.1929. 7) OWNERSHIP OF FENCES ARE UNKNOWN. 8) THERE MAY BE ADDITIONAL REVISED: RESTRICTIONS NOT SHOWN ON THIS SURVEY THAT MAYBE FOUND IN THE PUBLIC RECORDS OF THIS COUNTY. 9) FLOOD ZONE: , X SUFFIX: 1: DATE:9/11/O9 BASE:N A 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 DETERMINE RECORDED ADISN.NUNEZ PANEL: 0302 COMMUNITY# 120652 INSTRUMENTS,IF ANY,AFFECTING THIS PROPERTY. REGISTERED LAND SURVEYOR DATE: SCALE: DWN.BY. JOB No. BEARINGS WHEN SHOWN ARE REFERRED TO AN ASSUMED VALUE OF SAID PB. PAGE STATE OF FLORIDA#5924 Il/14113 11"=20' IF,Blanco 13-898