DGT-13-0513Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 203476
Scheduled Inspection Date: November 25, 2013
Inspector: Rodriguez, Jorge
Owner: DARGHAM, GEORGE
Job Address: 972 NE 93 Street
Miami Shores, FL
Project: <NONE>
Contractor: HOME OWNER
comments
REPLACE EXISTING WOOD PATIO DECK
05/10/2013 - PENDING NOC
05/16/2013 - RECEIVED NOC
GEORGE 319.0245
Permit Number: DGT -3 -13 -513
Permit Type: Decks /Gazebos/Trellises
Inspection Type: Final
Work Classification: Deck - Wood
Phone Number
Parcel Number 1132060350070
INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP- 194565. CREATED AS
REINSPECTION FOR INSP- 194197. CREATED AS REINSPECTION FOR
INSP- 187486. Not ready. NB
Failed NO RECORD OF INSPECTIONS SUPPLY DOCUMENT FROM
ENG /ARCT. OF RECORD FOR ALL PHASES OF INSPECTION
Correction ❑
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
November 22, 2013 For Inspections please call: (305)762 -4949 Page 26 of 33
•
•
•
George Dargham R '- 1
972 NE 93`d Street 12013
Miami Shores, FL. 33138 BY®
Attention: Miami Shores Village
Ref: Permit # DGT -3 -13 -513
The purpose of this letter is to formally request an extension on the permit referenced above. The
reason for this request is that I, the homeowner, have come across new responsibilities within my
company that has required more days and hours of me. Since I am acting as my own contractor, I have
had very little time to work on this project.
I do expect that my work responsibilities will decrease over the next couple of months and free me up
once again to properly finish the wood deck project.
I would very much appreciate it if you can please extend my permit.
ThankyoA for your consideration,
Geo
J
pe0tm;�p4-erd4 n k1l1110/ y
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Miami Shores Village
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Building Department c�
10050 N.E.2nd Avenue, Mia ` Shores, Florida 33138 B Y.
° a ° ° ------------
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Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
cko,(, FBC 20 ING Permit No. 02fl)_450.
PERMIT APPLICATION Master Permit No.
Permit Type:
JOB ADDRESS:
BUILDING
S�reP
ROOFING
City: Miami Shores County: v Miami Dade
Folio/Parcel #: .✓'
Is the Building Historically Designated: Yes
NO 1, Flood Zone:
OWNER: Name (Fee Simple Titleholder):
�O e_ �1N r �1� Phone #: 3� '3 _g `7V `� /
Address: J \0 �. p ,5
City:
Tenar
Emai
State*
CONTRACTOR: Company Name: j4W- O o Phone #:
Address:
City:
Qualifier Name:
State Certification or Registration #:
Contact Phone #: Email Address:
DESIGNER: Architect/Engineer:
Certificate of Competency #:
30
Value of Work for this Permit: Square/Linear Foot of Work:
Type of Work: DAddition OAlteratio ONew � /Replace ODemolition
Description of Work: t (`j �� F- e t ,oC/ &A A✓o-�-1 G (t)®®P M_�
u
Color thru We: J. G
a9>
Submittal Fee $
Scanning Fee $
Permit Fee $
Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CCF $ CO /CC $
DBPR $ Bond $_
Technology Fee $
TOTAL FEE NOW DUE $ S,3!)=
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
zip
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 notA p a einspection fee will be charged.
Signature.
Owner or Agent Contractor
The foreg g instrument as acknowledged befor e this - The foregoing instrument was acknowledged before me this
day o 20 by day of 20 _, by ,
who isiners o/n�a11 T kno to me or who ha produced who is personally known to me or who has produced
s 1 /e
21 i
///��� s identification and who did take an oath. as identification and who did take an oath.
NOT
Sign:
Print: t a> ,�� �;� s C,6
My Commission Exp s:
r,R \,•e go�pe S��ou9h
APPROVED BY
Plans Examiner
Structural Review
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
(Revised 5 /2 /2012)(Revised 3/12/2012) )(Revised 06/10 /2009 )(Revised 3/15/09 )(Revised 7/10/2007)
,e,�`-3 zoning
Clerk
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: Georw. 0,0 � ,� DATE: I S I - qP
ADDRESS: T7,�- NF, 9-3 51, w m') S; orei, P6 5 31
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. 1 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 properly 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.
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 licen bets 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 ubstantia11
improved it for sale or lease, which violates the exemption.
In" I
5. 1 understand that, as the owner- builder, I must provide direct, onsite 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 county or
municipal ordinance.
I'
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 com nsation for
the employee. I understand that my failure to follow these may subject to serious financial risk.
Initi
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 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:/Avm.mvfloddalloonse.com/dbi)r/pro/cilbfindex.html
Initi al
11. 1 am aware of, and consent to; an owner- builder building permit applied for in my name and understands that I am the parry
legally and financially responsible for the proposed construction activity at the following address:
�� IJ
93 4hi-Il SA, C"'SF03 /"?�'
Initi
12. 1 agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the information that e'
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 15 day of dc�—, 20 1
By who was personally known to me or who has
Produced License or
l J I -! �� �s identification.
OWNER
CLAUDIA V DFiods
Notary Public -
My Com;n Exp reCommission # °„ Bonded through Nat.
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
RECEIPT
PERMIT #: pG7- / 3 ^ J 13 DATE: —S/d-5/1 3
0
o Cr for
caner
❑ Architect
Picked up 2 sets of plans and (other)
Address: q
M
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
Acknowledged by:
PERMIT CLERK INITIAL:
RESUBMITTED DATE:
to continue permitting process.
PERMIT CLERK INITIAL: 0
Mlsslon:
To protect, prothote & improve the health
of all people in Florida through integrated
state, county & community efforts.
George Darglam
972 NE 93 Street
Miami, FL 33138
1 � ;
Rick Scott
Governor
John H. Armstrong, MD, FACE
State Surgeon General & Secretary
Vision: To be the Healthiest State in the Nation
RE: Contingency Letter
Application Document No: AP1102518
Centrax Permit Number: 13 -SC- 1463765
OSTDS Number:
972 NE 93 St
Miami, FL 33138
Lot:7 Block: na
Dear Applicant:
April 15, 2013
Subdivision:
This will acknowledge receipt of an application dated 03/28/2013 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 expansion of a wood deck. There will be no increase in sewage
flow or characteristics and no impact on the unofr'cted area.
*********************APPROVED*********************
If you have any questions on this matter, please call our office at (786) 315 -4444.
Sincerely,
Astrid Edwards, Engineer Supervisor III
Enclosures
cc:
Florida Department of Health www.FloridasHenith.com
in DADE COUNTY TWITTER:HealthyFLA
1725 NW 167 St, Opa Locks, FL 33056 FACEBOOK:FLDepartmentofHealth
PHONE: (305) 623 -3500. FAX: (305) 623 -3645 1 YOUTUBE: fldoh
* - tv I
CFH 2013R0386287
OR Bk 28632 Ps 2377; (1pq)
RECORDED 05/16/2013 09:51:09
NOTICE OF COMMENCEMENT HARVEY RUVINf CLERK OF COURT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE At TIME OfIfIRST WSPIECTION flIAMI-DADE COU M v FLORIDA
LAST PAGE
PERMIT NO.- � TAX FOUP NO.
STATE OF FLORIDA*
COUNTY OF MIAMI-DADE:
THE UNDERSIGNED hereby gives notle6 ft* Inipikov
propeftand In accordeppe with Chapter 713, Florldi
Is provided In this Notice of Commencements
1. Legil,description of property and strestladdress:
2. Description of Improvement: Re - bbi 11 Ni kP- (A=7 Aor—k-
A
3. Owner(p) name and address: rr-) S4,"-
-e- 4S,
interest fib pmpe►ty:
Name and dddresss . offee Simple Wholder
4. Qqnpraptoes name, 10dresp.and, phone nurnber. CZ-2 AS,
5. Syr .pty;j(Paynentbpnd*reqylre0 by contractor, ff. an y
)
Name, address and phone number.
Amount of bonq-$'
6. Lend "!'s and
7 Persons wifhin the State of Florida designated by Owner upon whom notices or other documents may be served as'providmd by
S 7 13N e, address
S. In add to hhhself, 6"ers detignatbi the following person(s) to receive a copy of the Llanors Notice as provided In. Section
713.13t1A), Florida 'Statutes.
9. EX014fiDif dite of this' Notice of Com M*e**ncdment'
#N eWralon date I yw from the date of recoOng unim a Oftrent di% Is
WAAMliQ 416 OWNEM AW OAYMEN TS MADE BY THE OWNr:A AFTER THE EXPi sp"
THE
DER CHAPTER 713i PART I, SECTION 713.13. FLORIDA '
IMPROPER- PAYMENTS UN S. AN
Q.,, CAN RESULT IN YOUR PAYING TWICE FOR
IMP YOUR PROPERTY. A!40TICE OF-00MMIENCEM 4, 1 " ' I
THE .30 WS E THE
FIRST U INTEND TO OBTAIN FINANCING, CONSUL GO RK
OR G NOTICE OF COMMENCEMENT.
019�ilf Sad
4 i
S eqs).or OWnor(6)lAuftrJz6d Officer/Dlfoctor/Partner/m A 0
Pre By
not Name GkQ-(\LqNf --a .
- T oft'e
STA. _f FLOFJDA
CWNW`OF'MIAMI -RAISE
The f6te§-6; - m - knoW- file eidbefoie me this day of J!JC
d .. ... . Y//,
I^ n.
for
82 11 dtked the 46116 g typ-66f -Identification:
Signatdit bf Nol.'v -Iwdbllc-
PrIM-Name:
Cf) -
vEPjFjcxnolm-Pu"%jAff To 8 22X&M FLORIDA UAUM
Under On-0-6s of p66ift, I deblati that fhkV6'r6ad thi foregoing and'
that the facts- t ` it are true, to the best of r► y knoWledge and bellef.
..........
/0
;6c F'O
Sign Owner(Ws A,uthotizod-Otficer/Dlrector/Paftw/Mma wh Jodi -\0
ages o W
BY