DS-13-1218Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 195253 Permit Number: DS -6 -13 -1218
Scheduled Inspection Date: July 17, 2013 Permit Type: Driveways /Sidewalks /Slabs
Inspector: Rodriguez, Jorge Inspection Type: Final
Owner: VIDAL, KAREN Work Classification: New
Job Address: 558 NE 94 Street
Miami Shores, FL 33138 -
Phone Number
Parcel Number 1132060140930
Project: <NONE>
Contractor: HOME OWNER
comments
INTALLATION OF NEW CONCRETE DRIVEWAY AND ' - - -`- 1 ......
WALKWAY INSPECTOR COMMENTS False
Passed IR6
Failed
Correction ❑
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
CREATED AS REINSPECTION FOR INSP- 192673. MUST SOD
DISTURBED AREAS 7/15/13
July 16, 2013 For Inspections please call: (305)762 -4949 Page 27 of 38
PRA
1r ��
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION
Permit Type: BUILDING
JOB ADDRESS: 661 1L)95-9VS1—
L �'-�.�
JUN 0 3 2013
Bea •
FBC 20
Permit No.
Master Permit No.
ROOFING
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #:
Is the Building Historically Designated: Yes NO iC
OWNER: Name (Fee Simple Titlehol(ter):
City: � �f � Q S State:
Tenant/Lessee Name:
Zone:
Email:
CONTRACTOR: Company Name: Phone #:
Address:
City: State:
Qualifier Name:
State Certification or Registration #:
Contact Phone #: Email Address:
DESIGNER: Architect/Engineer:
3m 3-33
Pho�ue #: '
' i � A
('Certificate of Competency #:
i , 4, ,t 'R
Phone#:
• s
Value of Work for this Permit: $ Sq re/Linear Foot;
s
Type of Work: ❑Addition ?Alteration ew , a ORc
Description of Work:
R
Color thru d1e: �• rd
e
de �
;e of Work:
dir/Repl ce ODemolition
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 $ 1 'W d V�-�
Bonding Company's Name (if applicable)
Bonding Company's Address
City State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State
g° a
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 inspect 'o which occurs en (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not l'e�pproXed and a r inspection fee will be charged.
Signature.
Signature,
I �Own�r or Agent Contractor
The fo oing instrum nt was owledged befo e e .s The foregoing instrument was acknowledged before me this
day of , 20LQ, by i day of .20 _, by ,
who: irs finally known �tme.or who has produced who is personally known to me or who has produced
j` • tfication and who did take an oath. as identification and who did take an oath.
NO
Sigi
Prin
My
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)
6l3 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: -51 bi CIO DATE: _
ADDRESS:
Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, KS 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 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 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 eiceed $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 o s bstantially
improved it for sale or lease, which violates the exemption. ,
Initial
5. 1 understand that as the owger-b4ilder, I must provide direct,,onsite supervision of the construction.
Initial Kul
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 Py county or
municipal ordinance. `
Initial
I 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.
Initial
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
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 htto:/Awww.myfloddalicense.com/dbpr/pro/cilbfindox.b#Tl1-
Initial r
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
Dally 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 Informati
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 V day of Y uC/ , 20 r�
By VA who was personally known to me or who has
Produced Pere License o J 10* as identification.
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OWNER NOTARY
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A minimum of two 12ft shade trees must be present
in the parkway /swale for each 75 feet of frontage
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in order to. pave any portion of the parkway /swale.
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The adjoining property owner proposing to pave a
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portion of the parkway /swale shall plant sufficient
shade trees approved by the public works director
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LOCATION MAP a,. w
PROPERTY ADDRESS: 558 NE 94 Street Miami Shores, Florida 33138.
LEGAL DESCRIPTION: The West 25 feet of Lot 4, and all of Lot 5, in Block 56, "MIAMI SHORES SECTION
2 ", according to the plat thereof, as recorded in Plat Book 10, Page 37, of the Public Records of Miami -Dade
County, Florida.
FOR: KAREN S. VIDAL.
CERTIFY TO: KAREN S. VIDAL.
SOVEREIGN TTI'LE & TRUST COMPANY.
OLD REPUBLIC NATIONAL TITLE INSURANCE COMPANY.
ASCENT HOME LOANS, its successors and/or assigns, as their interest may appear.
SILRVEYO WS NoTEB+
1) We survey was conducted for the purpese of a 'Boundary Surwyi only and Is not Intended to ddheate the regulatory
d
jrhrBawn any federal, state, regional or load atpncy, board, cansnhdah r attar entrap
Allom
R WAY
2) The -- y obtained by nwWw rnents and cdadatlam an this survey, meet and exceeds the Mk*mnm Technical Standards
( MEASUAW
nqui wnenb for o Suiwrban ores (1 foot In 7.300 teN) on epedfle0 h- Chapter 6i617 -4 RarNlo AdmWstrotM Code
( ) CAL01"191/
This Survey does not regent or determine awnwddp.
F1P. Fa" Rm PIPE
n
50
oasemants of record.
3) Examination of the Abstraat of Title wN have to be m�e to determine recorded hatrtsnants. if any ��g the property:
F FJL D OIIID BLOCK
,
io
54'8
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ate eteurwy has bow for the excluelve use of the entities named harem qtly and the .rtl attans hereon do not
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was far a Mortgage Transaction onlp Not to M used far design arnd /or construction purposes without
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9) Utility facilities within UdIty Easements not noted as violations.
PFWJ
10) 0rlvirmys or portions thereof *Rhin Roadways not noted as vldations or encroachments.
11) Foundations and /or footings underneath the ground surface that may cross beyond the boundary Rtes of the herein descried
parcel are not shown.
LAW ambfm
12)) AN Iran Pipes ar Re -�Gard found and sham an the dwtah of survey have no caps urdest otherwise stated.
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13) Fen. owrnership determhe by visual meom only (R any); Legal ownership not determined
9350 S.VL L
14 No search of records was male by Of firm beside the record Oct therefore we do not irnPly or accept r*Wms ity for
on Easement. r1m 11 -tktn or Undtatlon for which information was not furnished.
1S) Caniact IM agproprkK* authorities Wlar to any deign work an the hrem- dawgad parcel for Building and Zoning
h
18 P-10-10" Land Surveyor and Mapper In reMmsibte charge: Rolando Oft LS 4312. State of Florida.
1 This survey b not valid without the signature and the mind fed of a Florida Licensed Land Surveyor and Mapper.
1 hereby certify to the above nand firm and /or parsons that the Sketch of Survey of the deeatbed property M true and correct te the best of my
leiowl and belief, w recently and platted under my direction: also that meets the Mi lrn Tedmiad Standards set in
Chapter 81017 -6. -
Flarldo Admktletrative Cade, pursuant te Ssotlon 472.027 Florida Statutes. _.
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PROPERTY ADDRESS: 558 NE 94 Street Miami Shores, Florida 33138.
LEGAL DESCRIPTION: The West 25 feet of Lot 4, and all of Lot 5, in Block 56, "MIAMI SHORES SECTION
2 ", according to the plat thereof, as recorded in Plat Book 10, Page 37, of the Public Records of Miami -Dade
County, Florida.
FOR: KAREN S. VIDAL.
CERTIFY TO: KAREN S. VIDAL.
SOVEREIGN TTI'LE & TRUST COMPANY.
OLD REPUBLIC NATIONAL TITLE INSURANCE COMPANY.
ASCENT HOME LOANS, its successors and/or assigns, as their interest may appear.
SILRVEYO WS NoTEB+
1) We survey was conducted for the purpese of a 'Boundary Surwyi only and Is not Intended to ddheate the regulatory
d
jrhrBawn any federal, state, regional or load atpncy, board, cansnhdah r attar entrap
Allom
R WAY
2) The -- y obtained by nwWw rnents and cdadatlam an this survey, meet and exceeds the Mk*mnm Technical Standards
( MEASUAW
nqui wnenb for o Suiwrban ores (1 foot In 7.300 teN) on epedfle0 h- Chapter 6i617 -4 RarNlo AdmWstrotM Code
( ) CAL01"191/
This Survey does not regent or determine awnwddp.
F1P. Fa" Rm PIPE
4 Legal dssaiptktn woe prodded by the client and is subject to my•dedeatlarm WnRatlarm restrictions reservations or
-BA
Fee FOUND RE RD
Foie FOLM DwoAtl�t "ME
oasemants of record.
3) Examination of the Abstraat of Title wN have to be m�e to determine recorded hatrtsnants. if any ��g the property:
F FJL D OIIID BLOCK
search of Public Records not performed by this office.
6) No effort was mafe by this office to locate any underground utilities and /or structures within or abutting the subject
AND
praprty.
CAM BASW
( )
ate eteurwy has bow for the excluelve use of the entities named harem qtly and the .rtl attans hereon do not
puPpiRpAUA�pTNttA/a"��eEAA��NfpI
elftNAlK;E "'ail
y
Aro
was far a Mortgage Transaction onlp Not to M used far design arnd /or construction purposes without
the t thised
CL
9) Utility facilities within UdIty Easements not noted as violations.
PFWJ
10) 0rlvirmys or portions thereof *Rhin Roadways not noted as vldations or encroachments.
11) Foundations and /or footings underneath the ground surface that may cross beyond the boundary Rtes of the herein descried
parcel are not shown.
LAW ambfm
12)) AN Iran Pipes ar Re -�Gard found and sham an the dwtah of survey have no caps urdest otherwise stated.
Rm" 1E a
13) Fen. owrnership determhe by visual meom only (R any); Legal ownership not determined
9350 S.VL L
14 No search of records was male by Of firm beside the record Oct therefore we do not irnPly or accept r*Wms ity for
on Easement. r1m 11 -tktn or Undtatlon for which information was not furnished.
1S) Caniact IM agproprkK* authorities Wlar to any deign work an the hrem- dawgad parcel for Building and Zoning
h
18 P-10-10" Land Surveyor and Mapper In reMmsibte charge: Rolando Oft LS 4312. State of Florida.
1 This survey b not valid without the signature and the mind fed of a Florida Licensed Land Surveyor and Mapper.
1 hereby certify to the above nand firm and /or parsons that the Sketch of Survey of the deeatbed property M true and correct te the best of my
leiowl and belief, w recently and platted under my direction: also that meets the Mi lrn Tedmiad Standards set in
Chapter 81017 -6. -
Flarldo Admktletrative Cade, pursuant te Ssotlon 472.027 Florida Statutes. _.
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