RC-13-379 (b�ef�6
Miami Shores Village _
Building Department i IT
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel: (305)795.2204 Fax: (305)756.8972
INSPECTION'S PHONE NUMBER:(305)762.4949
FBC 201
IL � Cr Permit No. rj 157!n9
PERMIT APPLICATION Master Permit No.
Permit Type: BUILDING ROOFING
JOB ADDRESS: 1O'kC$O A Wm�, Ao, �-ktml- 5665 V1 �U lS 0
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#:
Is the Building Historically Designated:Yes NO Flood Zone:
OWNER:Name(Fee Simple Titleholder): G �� y Phone_
Address: im ►uvW'v K1.141 !
City: W' re State
Tenant/Lessee Name: Phone#:
Email: V LA( f D 1/l 7-o®S y Q. C-ID M
CONTRACTOR: Company Name: nee yVe Phone#:
Address:
City: 10 4 State: Zip:
Qualifier Name: Phone#:
. t
State Certification or Registration#: Certificate of Competency#:
Contact Phone#: Email Address:
DESIGNER:Architect/Engineer: Phone#:
Value of Work for this Permit: Square/Linear Footage of Work:
Type of Work: OAddition OAlteration ONew ORepair/Replace ODemolition
Description of Work: rTAtiN,UA+Cy-
Color thru d1e:
Submittal Fee$ 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
9
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 informationds 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."
fY
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 occup.seven (7) (days after the building permit i� issued. In,the,,,absence•of sych;posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
® Owner or Agent Colatractor,
The fore instrument was a wledg be me this The foregoing instrument was acknowledged before me this
day of ,20) by �V� day of ,20_,by ,
r
who is pe ovally known to me or who has produced ho is personally known to me or who has produced
identification and who did take an oath. as identification and who did take an oath.
NOT Y UBLIC: .• NOTARY PUBLIC:
Sign: BI. LOS Sign:
Print' „9 % otary Public St e of Flon
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APPROVED BY NV740� Plans Examiner Zoning
Structural Review Clerk
(Revised 5/2/2012)(Revised 3/12/2012)XRevised 06/10/2009)(Revised 3/15/09)(Revised 7/10/2007)
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SUBJECT TO COMPLIANCE WITH ALL FEDERAL
STATE AND COUNTY RULES AND RFGULATIONS
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DATE FIELD WORK SCALE SURVEY No
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48.E PLANTER CONSTRUCTION
PLANTER CROSS ROBERTO ORREGON
SECTION 10400 N MIAMI AVE
MIAMI SHORES,FL 33150
1 (PLANS NOT TO SCALE)
12.0° o
16.0"
e.�
NEW PLANTERS FILL CELLS WITH
(SEE CROSS 1#5 AS SHOWN
SECTION FOR tt[.OR EVERY 4'
STRUCTURAL
DET/�1 L a}
10'0"
4'0"
�-12'0'
------w--�48.0" - -------�
PLANTER CROSS
SECTION
24.0"
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+ PLANTER CONSTRUCTION �- ; 5s
ROBERTO OBREOON
10400 N MIAMI AVE
MIAMI SHORES, FL 33150 t4l� �I l
(PLANS NOT TO SCALE)
Rick Scott
Mlsellon: Governor
To protect,promote&improve the health
of all people in Florida through integrated John H.Armstrong,MD,FACS
state,county&community efforts. HEALTH m. State Surgeon General&Secretary
Vision:To be the Healthiest State in the Nation ,
April 23, 2013
(Southern Septic)
1421 SW 153 Path
Miami, FL 33194
RE: Contingency Letter
Application Document No:AP1101341
Centrax Permit Number: 13-SC-1461954
OSTDS Number:
10400 N Miami Ave
Miami, FL 33150
Lot:4 5 Block:125 Subdivision:
Dear Applicant:
This will acknowledge receipt of an application dated 03/19/2013 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 your existing system is
adequate for the proposed use.
This permit is granted for the construction of new garden planters. There will be no increase in
sewage flow or characteristics and no impact on the unobstructed area.
*********************APPROVED*********************
If you have any questions on this matter, please call our office at(786) 315-4444.
i
Sincerely
Nic e G mbs, Engineering Specialist II
Enclosures
cc:
Florida Department of Health www.FloridasHealth.com
in DADE COUNTY TWITTER:HealthyFLA
1725 NW 167 St,Opa Locka,FL 33056 FACEBOOK:FLDepartmentofHealth
PHONE:(305)623-3500.FAX:(305)623-3645 YOUTUBE:fldoh
loss "oil" Miami Shores Village
Building Department
R�pp► 10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
RECEIPT
PERMIT#: 13 DATE: J
❑ Contractor
g Owner
❑Architect
Picked up 2 sets of plans and (other)
Address: l t gy� �.coWL 4o r�5 4 3-3 r
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 Build' department to continue permitting process.
Acknowledged by:
PERMIT CLERK INITIAL:
RESUBMITTED DATE: l
PERMIT CLERK INITIAL:
S ORES
Miami shores Village
Building Department M
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204 x20R�pA'
Fax: (305) 756.8972
February 26, 2013
Permit No: RC13-379
Building Critique
1. Provide plans from a licensed architect or engineer. The plans must meet all
provisions of the Florida Building Code. Stopped review.
2. Provide HRS/DOH approval.
Norman Bruhn CBO
305-762-4859
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.
i
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
NAME: rb oij 00 le.. DATE:
ADDRESS: 0 �� / 1°`�1��1r11 t�i1 IOLt �j�1��� 23(5 D
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 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.CA 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
permft 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.
Initia .C)
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 Iicedsed contractor to assume responsibility.
4
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 license numbers 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 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 bstantially
improved it for sale or lease,which violates the exemption. T-"a 7,\
Initial
5. 1 understand that as theowner-buildeF,I must provide direct,onsite supervision of the construction. •�y
Initial' v
6. 1 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,
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.
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.
Ini�k�
9. 1 agree that,as the party legally and financially responsible for this proposed Construction activity,I 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
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://www.mvBoddalicense.comtdbpr/pro%ilbrindex.html
Initial - , 0
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 A
12. 1 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.
Was acknowledged before me this �- 4 day of 20—A
�By�O who was personally known to me or who has
Produced there License or T1 44' 1�as identification.
OWNER CLAU ARYLOS
u` Notary Public-State of 3,2 Florida
X, My Co;im Expires Sep 23.2015
Commission#EE 128810
Bonded Through National Notary Assn.
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April 20,2013 D
® .- ®om�oe ®v�o.vam
TO: Permitting and Inspection Center
�s
IN RE: DAVID itOBERT OBREGON
10400 NORTH MIAMI AVENUE -
MIAMI, FL 33150 1
F6 -013
IS THERE ANY REASON WHY CONSTRUCTION AND ALTERATIONS
TO THE ABOVE PREMISES IS DONE BY LAYPERSONS WITHOUT
THE REQUIRED PERMITS AND/OR INSPECTIONS WHILE THE REST OF
THE NEIGHBORS ARE FORCED BY LAW TO GO THROUGH A
GENERAL CONTRACTOR OR ARCHITECT?
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Regulatory and Economic Resources 0 0 P 1 312 8 0®0.360
Building Code Support Division `® a�w 02 1 W
11805 SW 26th Street Room 230 - 000138 �5._o MAY OL 20.I 3
Miami Florida 33175-2474
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Miami Shores
10050 NE 2 Avenue
Miami, FL. 33138
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