FW-13-475 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-194246 Permit Number: FW-3-13475
Scheduled Inspection Date:August 27,2013 Permit Type: Fence/Wall
Inspector: Rodriguez,Jorge Inspection Type: Final
Owner: BYRNE,JOHN Work Classification: Wood Fence
Job Address:9413 N MIAMI Avenue
Miami Shores, FL 33150-
Phone Number
Parcel Number 1132060130520
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
INSTALLATION OF SIDE BY SIDE V HIGH WOODEN I Passed Comments
FENCE ON THE BACK PROPERTY LINE. INNSPECSPEC TOR COMMENTS False
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Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-191453. CREATED AS
4 REINSPECTION FOR INSP-189104. CREATED AS REINSPECTION FOR
INSP-187131. NO ONE HOME NO PERMIT POSTED. JR
Failed ❑ NO ONE HOME
NO PERMIT POSTED. JR
Work exceeds permit. NB
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
August 26,2013 For Inspections please call: (305)762-4949 Page 13 of 38
Miami Shores Village
6 qA tl
Building Department
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 •
Tel: (305)795.2204 Fax: (305)756.8972 ';
INSPECTION'S PHONE NUMBER:(3057 762.4949
►sl►3-- -1°� FBC 20
BUILDING Permit No. �
PERMIT APPLICATION Master Permit No.
Permit Type: BUILDING ROOFING
JOB ADDRESS: 1 4►tit A u e
City: Miami Shores County. Miami Dade Zip:
Folio/Parcel#:
Is the Building Historically Designated:Yes NO Flood Zone: CJ
OWNER:Name(Fee Simple Titleholder): aa`J`��-1n �rA.��yt Phone#: T(c►°-3 `�
Address: Q(� t -s 10 , m r9„n. �+' -..,--
City: R o & ons- State: FL Zip: -3 3lT Q
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: L O n.C- ®•z. n-e I- Phone#:
Address:
City: State: Zip:
Qualifier Name: Phone#:
State Certification or Registration#: Certificate of Competency#:
Contact Phone#: Email Address:
DESIGNER:Architect/Engineer: Phone#:
i
Value of Work for this Permit:$ G 0 0 Square/Linear Footage of Work:
Type of Work: ❑Addition ❑Alteration ❑New )<Repair/Replace ❑Demolition
Description of Work: Wood �n c e� '6 rC.c k c-e e so". in G c .n �,v
Color thru tile:
Submittal Fee$ Permit Fee$ O'CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$
TOTAL FEE NOW DUE$
I
Bonding Company's Name(if applicable)
b
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 co o the notice o commencement and construction lien law brochure will be delivered to the person
P g f PY f f P
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.
r
Signature Signature
Own or gent ) Contractor
The forego g' ent was le ed be re me this 1 The foregoing instrument was acknowledged before me this
day o �a, ,b � � day of 20 ,b
Y _ Y
who is a sonally known to me or who has produc who is personally known to me or who has produced
tification and who did take an oath. as identification and who did take an oath.
NOT AY PUBLIC: _ , �tJ os 1t621 NOTARY PUBLIC:
Vp\PV S ate°t23,2o��
• ,y P°bt�c pates 5
Sign: Qta c� # �2tacy ss Sign:
Print: _'. .�Ry G��m o�4�Na Print:
My Commission Expires: =.,� E My Commission Expires:
APPROVED BY J"/ � Plans Examiner ��� Zoning
Structural Review Clerk
(Revised 5/2/2012)(Revised 3/12/2012)XRevised 06/10/2009XRevised 3/15/09XRevised 7/10/2007)
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: Rti, r s« DATE: S it 113
ADDRESS: (4 (3 L),
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.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.
Initi el
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 3'
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 substantially
Improved it for sale or lease,which violates the exemption.
Initial
5. 1 understand that as the owner-builder,I must provide direct,oruite supervision of the construction.
Initi al
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. ((�--
Initi
I
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 lab6r 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
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.
Initi
9. 1 agree that,as the party legally and financially responsible for this proposed Construction activity,I will abide by all applicable
Ian 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 htta:/Avww.myfloddalicense.comtdbr)r/pro/dlbrndex.htmi
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:
Initialer
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 9 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 �� day of 20.�, ---
By who was personally known to me or who has
Produced there License or � Az)-4,2goidenflfication.
(2on,,----
1
OWNER
CLAUDIA V. CUBILLOS
z. Notary Public-State of Florida
My Comm. Expires Sep 23,2015
Commission# EE 128810
Bonded Through National Notary Assn.
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Miami Shores Village
Boom U1111111" Building Department
10050 N.E.2nd Avenue
ate` Miami Shores, Florida 33138
�OR1DA Tel: (305) 795.2204
Fax: (305) 756.8972
SURVEY AFFIDAVIT
STATE OF(FLORIDA)
COUNTY OF(DADE)
The undersigned Affiant, ,1v v, �IA e°does hereby attest that
(Property owner)
The attached survey, performed by L 6 vina s e �,n e_
(Name of surveyor's company)
For address: L( 3 k), YK t 4 �
Performed on Z6210 (date of survey)is an accurate representation of the existing conditions and
locations of all structures on the property as of this date.
The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the property
without first providing a survey less than seven (7) years old old. The Affiant, as property owner, further agrees to
remove or obtain permits for.any structures which now may exist on the property which are not permitted or which
may violate zoning or building code regulations. The Affiant further understands that the existence of any such
structures may affect final inspections as applicable to this or other permits.
jer ffia say eth naught.
roperty w ignature r Property /Owner Print Name
SWORN TO AND SUBSCRIBED before me this day of a�(JIv VV Affiant is_personally known to me, produced as identification.
w-Y Notary
• 46•, CLAUDIA V.CUBtLLOS
Revised on 5!22@009/Revised on 6!12109 `
Notary Public State of Florida
y9
`•r •=My Corgm Expires Sep 23.2015
'z Commission#EE.128810
Bonded Through National Notary Assn.
p
PERMIT#
CONTRACTOR:
SUBMITTAL DATE:
ADDRESS: hc
NAME:
RESUBMITAL DATES:
PROJECT TYPE:
NING FIRE
STRUCTURAL IMPACT FEES
ELECTRICAL HRSIDERM
PLUMBING N C
MECHANICAL BLDG.__)
t�,
Pspe I ot2
This property described as:
The South 36 feet of Lot 12, and the
North 36 feet of Lot 13, Block 4 ,
AN AMENDED PLAT OF MIAMI SHORES
SECTION NO. 1,
according to the Plat
thereof, as recorded in
Plat Book 10, Page 70
of the Public Records of-
Miami-Dade County, Florida.
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Miami Shores Village PROPERTY Off' Y �
• B Byrne, John J. 9413 North Miami Avenue, Miami Shores, Florida
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