DS-13-1534 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-194924 Permit Number: DS-7-13-1534
Scheduled Inspection Date:August 13,2013 Permit Type: Driveways/Sidewalks/Slabs
Inspector: Rodriguez,Jorge Inspection Type: Final
Owner: NOVAK, MYRON Work Classification: New
Job Address:71 NE 97 Street
Miami Shores, FL Phone Number
Parcel Number 1132060131010
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
INSTALLATION OF NEW PAVERS DRIVEWAY AND Infractto Passed Comments
SIDEWALK INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
August 12,2013 For Inspections please call: (305)762-4949 Page 14 of 51
Miami Shores Village
uL l o r01 N
Building Department
90050 N22W Avenue,Miami Shores,Flonda 33138 �v'�
Tel:(305)795.2204 Fax:(305)756.8972
INSPECTION'S PHONE NUMBER:(305)762.4949
C20
B DING Permit No.
PERMIT APPLICATION Permit No.
Permit Type: BUILDING ROOFING
JOB ADDRESS: �-1 NE
City: "ami Shores County. Miami Dade Zip;
Folio/Parcel#: kek 7-0 aZ.( , eloek
Is the Building Historl ally Designates:Yes NO Flood Zone:
OWNER:Name(Fee Simple Titleholder): &fd 0 /J,0 i Phone#:_�0�" �j�°�®(�
Address: , '�l � ;�
City: —State• /� / Zip:_.2313
Tenant/Lessee Nam: Phone#:
Email:
1
CONTRACTOR:Company Name:
Phone#:_
Address:
-A
City: _ State:. Zip;
Qualifier Name: Phone#:
State Certification,-D-` Certificate of Competency#:
Contact Phone#: Email Address:
DESIGNER:Architect/Engineer. Phone#:
Valve of Work for this Permit: SquardLinear Footage of Work: 600
Type of Work: OAddition OAheration G&W ORepak/Replace ODemoHdon
Description of Work: . o 'F d rte, tom IszJ ✓� � ®
-- Color dwu fik:
ed
Submittal Fee$ Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR ffi Bond$
Notary$ Training/Educadon Fee$ Teehnology Fee$
Double Fee$ Structural Review$
TOTAL FEE NOW DUE$_1 1(n,_10
s . v
400b 3
Bonding Company's Name(if applicable) i
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 Alit 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$25oo, 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 certl feed 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 Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this—a The foregoing instrument was acknowledged before we this
day of ,20 *3 by M`?2eYy t\I(2f 1�'K-- , day of .20_,by
who is personally known to me or who has produced ! t� who is personally known to me or who has produced
As identification andift,V take an oath. as identification and who did take an oath.
NOTARY PUBLIC: \�o` �'% NOTARY PUBLIC:
Sign: o:m_ o °'N -_ Sign:
Print: '-n cx+ a Print
My Commission Expires: My Commission Expires:
APPROVED BY �3 Plans Examiner �� Zoning
Structural Review Clerk
(Revised 3n2/2012xRevised 07/1OW"evised 06110aMXRevised 3/15/09)
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: kki L 011 DATE:
ADDRESS: 7f A;F C,
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
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
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 instod 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 fans outbuilding.I may also build or improve
a commercial building if the costs do not exceed$75,000.Th"uilding 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 WMI
5. 1 understand that as the owner-builder,I must provide direct,onsfte supervision of the construction.
Initial/
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.
J , t
7. 1 understand that it is frequent practices of unlicensed persons to have the properly 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.
Initi al
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.
[nital
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)/kfi
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 htti):/h m.mvfor dalicense.com/dbor/prolcilbrndex.htmlll
Initial /T JY
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 Shore 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 N 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 property 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
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 requir d when
the permit is issued.
Was acknowledged before me this q--Jay of ���`� 20
who.was personally known to me or who has
l� ��nunlcu,l,!
Produced there License or as id tl lion.
p 4 r
OWNER
a
Miami Shores Village
logo Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
��OR1DA Tel: (305) 795.2204
Fax: (305) 756.8972
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
Whereas, (owner) dfG'i /.l v� hereinafter referred to as the owner of
the following described property(address):
Aek44k_ VY(f s
Legal Description Lot Block_ Subdivision
Folio#
Requests permission to install(describe work): .Y f U
ell
Within the public right of way of(address) % _S/4-
&zA4,,� /'-
IN CONSIDERATION of the approval of this permit by the Village,the owner agrees as follows:
1. To maintain and repair,when necessary,the above-mentioned item(s) installed within the dedicated right of
way. If it becomes necessary for Miami Shores Village or Dade County to make repairs or maintain said
items within public right of way including restoration of street by reason of the Owner's failure to do so,
such expense shall be paid by the Owner or shall constitute a lien against the above described property
until paid.
2. The owner does hereby agree to indemnify and hold Miami Shores Village or Dade County harmless from any
III
and all liability,which may rise by virtue of permitting the installation of these items within the public right of way.
1
3. The Owner does hereby agree to remove or relocate their facilities at their own expense,within 60 days
notice by the Village to do so. Failure to comply with this notice will result in the Village causing the item(s)
to be removed and a lien being placed on the property and/or assessed against the Owner for all costs
incurred in the removal and disposal of the item(s).
4. The undersigned further agrees that these conditions shall be deemed a covenant running with the land
and shall remain in full force and effect and be binding on the undersigned,their heirs and assigns, until
such time as this obligations has been canceled by an affidavit filed in the Public Records of Dade County,
Florida by the Village Manager of Miami Shores Village (or his fully authorized representative).
SIGNED, SEALED, EXECUTED AND ACKNOWLEDGE on this 10 day of ,2013
(Owner's Signature)
SI E L D LIV D' gyp\ goM&oaf 6"'5
Pub`c" eS S¢p 23��p
� �128 pssp.
a��,•" G°�r ou9��a
2
L
S11ORElip G,!
Miami Shores Village
Building Department ' l.u�s.,
M
10050 N.E.2nd Avenue
Miami Shores, Florida 33138 h� R 0
Tel: (305) 795.2204 lO
Fax: (305) 756.8972
Permit No: DS13-1534
P & Z Critique Sheet
1. Please draw plans to scale. Survey is 1 inch = 20 ft.
2. Mark distance from driveway to the extension of the side yards into the swale.
STOPPED REVIEW
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.
DAVID DACQUISTO
305-762-4264
i` L r� i�I i" U i< v Y
,y �� •+i,j dnfmum of two 12ft shade trees must be p rrt
in the parkway/swafe for each 75 feet of front
in order to pave an
T adjoining any Portion of the kway/swa e.
r (Lot 4, Block 7) n9 P�Qf?�ty dyvn�}I
P#on of the parkwa Jswate stela g t0 eve a
— — — .- e�,ap ro
. . . . . . .. e:minimum requirement.. or Found 5/8' .
. . . . .. . . . . . . . . . . . .
•.. t •
Found 5/B'. .. . . . . . io.5' A4phait Iran PIpe
Iron Pipe,. No Cap
1 No Cap �,' Edge of asphalt"• 100.00'(Rec.h Mess. I t5.eo• _ 4
� '�'a .5' � N 2t.t5' �►� ,`' •'oo �,c� x x:n � 9g4B4.
24.00' .. t 3ti•`�Fa� ;• 0,t0 O
0.20'
C.8.S a C 85'
anc. Area
23.
5 d' 24.00'
�°' I JUL 19 204
o.tr
0
- li �I [I T•= - OI
yl �
( Lot 20, I81 ock 7) w (Lot 21, Block 11
i� C
9.ow 2t.55'
o.20' 12 r ^ I am —29.25, ' U
ca
29. 70'
� — — _ — —t' 6.25 t-STOl -C.B.O.'' b a
Res. No.71 o a,�
g o
In
F.F. El. 13.26' 't. �u-
N "
m I
€39
t 2.64 x
�.,
-
r'J a 75'
1 t2.o• 11.85' phi ie g 16.60'
a
x
29. 70' alt$ an er "�29.25' _
I e:a• tit•
I � 4
m I I
Found 5/8
'
Found pipe 01, o iron Pipe , - N Ca
No Cap , o
` •a 3 100.00'f Rec.I: Mess. t. 5' Swk.
in to°
av
9704� - ��r
♦SNuRES D
' ... „�..� Miami Shores Village
,- �� Building Department
77!ii ► 10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
RECEIPT
PERMIT#: 3 -15 3 DATE:
I,
(NAME)
o Contractor
�p Owner
o Architect
Picked u 2 sets of plans and other d l/
P P (other)
Address: `ll Nt' S��
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 permitting process.
Acknowledged by: 'PC&Wlt'�
0 (Signature)
PERMIT CLERK INITIAL:
RESUBMITTED DATE:
PERMIT CLERK INITIAL:
r� LHiv yr Z) ue< v c Y
�
� . f�a'� Scale: t ' _
t,1M o, 1 Q L ..�r ' r
�a (Lot d, Block 71 (Lot 3, Block 7)
Found 5!8'.. .:..... ....:':':::.:.:.:.::.:: :: :: :: :.:.:':x.:.15' Al l eY :;.'.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.'.'.'.'.:.' Found 5/8' ::
Iron Pipe- 10.5' Asphalt- ,.... '.....'.'. .....'.'..... .'.' -Iron Pipe...'.'
... No Cap
No Cap ..... Edge 406ASPMR•• l00.00'II�c.6 IIe88.) I6 ao' ...... .....
�- iv x x B9e
24.00' 21.i6' ��t• . • pd voce to,40e
C3 C.IL S. Conc. Area ,
5.4' 24.00'
m w,
a
.p
G J y
Y
® ` Q ~' J N
f\ J q (Lot 20, 1Block 7) (Lot 21, Black 7)
w G
Z 21.55'
vs � a N
w w 0.20' ad
® _ —29.25- — — :
f� U -j r.
s
°
W ¢ &L ?} _ cri ao m
a z �,
O z 29.70` ft N ® a 1° c c — — —� 6.25' !-ST Y-C.B.Res. No.71> ® O c F.F. EI. 13.25' .:t.® �Cr CL
® ILI '?-�
x
— 29.7Q' _ ! ; er Cd 29.25— —
Y_ I
Found 5/8'�'�° Iron Pipe.
iron Pipe . ��o. ;.: o No Gap
No Cap 50. A.it
Swk.
7.
k,at I � t.n
Pavem ` : ::': :.... ... I :....
0
:' ...'. ...... 97 t ........ ...5 -----... ��2 '.:.....:::....
L A 1\4 Ur- Z) U 1< V
Scale: 11
Lot 4, Block 7) (Lot 3, Block 7)
................. .......... .. ...... .. .... . . .
............... ............
................. ...... .. .. . ........ j5' mle
................ Found 5/81
Found5/ .. .................... .. .. ...... A59II .... .. .. .... ...
.... .... .... .. ... ...... alt ............ ..
....... Pipe
No Cap
Iran Pipe ... ........
...... Edge of 9 Neas.) ............
No cap 100.00,(Rec.
A
21.15'
0.to;,.9-
IL Ir
24.
fCon . Area
C, C
C3 C.8.S.
FL 4' 24.00' 0.is,
L 0' LIJ,
0.01
LL
CU
L (Lot 2t, Block 7)
5
(Lot 20, 18lock 7)
LLJ
0 C) 21.55'
z 7.
o.20' CD
29.25'
C3
22
LIJ LU
> 0 ni
29.70' C"U
0
Cr z -0 LU .25,
0 ST fit 6 C)
Res. 3.IV
cc F. R ij a *t. 4"
—1 F F. E . t3.26
o CO
1.2.611
iR r Q.7W
85' Ile 16.60. JAC-.14
29.LO C.IL Val 1 29.25'
Cs J
!AO
Found 5/W
:8#'RIO. Iran Pipe
Found 5�
Iron Pipe - 6 No Cap
� )�'e 50.00
No cap so.Co
Swk.
Swk.
100.00' Rec.&
A,
0
25,
0.7W
I E�q
v f
LO k,ay LO
ago
. . ...... .... . . ),. .. .. ... .......• ... ...... ........ ...............
...
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..
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.. . r .. . ........... . avemefV... .............
N. - :tT.
n.. .. . .............. . .. . . ..... . r....:.......
........ .. ............................................... ................. ...................... .. .. .............. .. .............