FW-11-1397Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 195569 Permit Number: FW -8 -11 -1397
Scheduled Inspection Date: July 22, 2013 Permit Type: Fence/Wall
Inspector: Rodriguez, Jorge Inspection Type: Final
Owner: NUTA, PABLO Work Classification: Wood Fence
Job Address: 9418 N MIAMI Avenue
Miami Shores, FL 33150 -
Phone Number
Parcel Number 1131010340020
Project: <NONE>
Contractor: HOME OWNER
I:5w
comments
FENCE WOOD AND CHAINLINK 5' HIGH
INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP- 184551. CREATED AS
REINSPECTION FOR INSP- 162732. Fence is not complete. post must be
embedded in a foundation. horizontal rails must be fastened at ends to post.
Fence must not exceed 5' high.
Failed ❑ Pickets must be attached with two fasteners at each connection. STOPPED
INSP
North side fence higher than 5
Correction ❑
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
July 22, 2013 For Inspections please call: (305)762 -4949 Page 29 of 36
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
,s ,D
SAN I
FBC 20
Permit No. I
Master Permit No.
ROOFING
C OB ADDRESS: 94 t s � M� Old 'Uc-
City: Miami Shores County: Miami Dade Zip: 3 3 C olio/Parcel #:
Is the Building Historically Designated: Yes
NO Flood Zone:
OWNER: Name (Fee Simple` Titleholder): h� hfy( a Phone #:
�l "l
Address: r? ty Moot Mt ,�iJ�
City: Mk Q N-1 L %L-0,0-, State:
Tenant/Lessee Name:
Email:
CONTRACTOR: Company Name: Phonek
Address:
City: State: Zip:
Qualifier Name: Phone #:
State Certification or Registration #: Certificate of Competency #:
Contact Phone #: Email Address:
DESIGNER: Architect/Engineer: Phone #:
.3s( r-0
Value of Work for this Permit: $ q(9D Square/Linear Footage of Work: L4)
Type of Work: ❑Addition DAlteration ONew ORepair/Replace ODemolition
Description of Work:
S�7,-� EFM
Color thru tile:
Submittal Fee ermit Fee $
Scanning Fee $ Radon Fee $
CCF $ CO /CC $ .
DBPR $ Bond $
Notary $ Z�)�.-) Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $ f 7—i A* j i KL,
TOTAL FEE NOW DUE $
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 not el j',yipproved and a reinspection fee will be charged.
Owner or Agent
The foregoing in ent was acknowledged before me this
day of �, 20 i, byq)rQ L0 QQ1 A-- >
who is personally known to me or who has produced —G,�- I Q
As identification and wlkMt/4i�,oath.
NOTARY PUBLIC
Sign:
Print:
Signature
Contractor
The foregoing instrument was acknowledged before me this
day of , 20 _, by ,
who is personally known to me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires: O R i D P `\`\`\�Rl`��` My Commission Expires:
APPROVED BY / �/ �% Plans Examiner Zoning
Structural Review
(Revised 3 /12 /2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Clerk
Miami Shores Village RECEIVED
Building Department AUG 0%
90050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY:
Tel: (305) 795.2204 Fag: (305) 756.8972 ---�°�
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING Permit No.
PERMIT APPLICATION Master Permit No.
FBC 20
Permit Type: BUILDING
OWNER: Name (Fee SimplleiTtllehold
Addrecc R14(9 �y
� °' �'L'am
'11
e
City: M cl ml S0 � State:
Email: TQ' DLD V)
JOB ADDRESS: 1� 4 19 a f n bry) t A j�
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #:
Is the Building Historically Designated: Yes
NO Flood Zone:
CONTRACTOR: Company Name: C' +c�,f-� �d Phone #:
Address:
City: State:
Qualifier Name: Phone #:
State Certification or Registration #: Certificate of Competency #: _
Contact Phone #:
Address:
DESIGNER: Architect/Engineer: Phone#:
WIN
Value of Work for this Permit: $ 7 co Square/Linear Footage of Work: '10 `r r
Type of Work:
Description of Work:
OAlteration ONew
Cwt► C(,\a
ODemolition
t,k_f.e
Submittal Fee Permit Fee $ 6 Q CCF $ CO /CC $
Scanning Fee $
Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE
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 insp ion which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will ie approved andoileinspection fee will be charged.
Owner or Agent
The fore o g i strument was acknowledged before m" -e this
day of , 20Q ' by'
who is personally known to me or who has produced
As identification and who did take an oath.
Signature
Contractor
The foregoing instrument was acknowledged before me this
day of , 20 _, by ,
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC•
0a0u�unnrtti,,,�
Sign:
a� ®' .
03 Q L
Print: - a : ° �' -s,*. Cn
My Commission Expires: TJ a e C
APPROVED BY fcF:J—lt.-- Plans Examiner
Structural Review
(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
Zoning
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
X NAME: �� O'
DATE: I 12011
KADDRESS: I in I
Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, FS 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. 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 f fj
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 �4
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. FK
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 � �substantially
improved it for sale or lease, which violates the exemption. f N
Initial
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 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.
Initial
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.myforidalicense.com /dbpr /pro /cilb /index.htm]
Initial �VJ
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 Shores Village immediately of any additions, deletions, or changes to any of the information that I
have provided on this disclosure.
Inifial
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. t I
Was acknowledged before me this °' day of NU-A. 20 l
Byl who was personally known to me or who has
odu there License or '� a�Aantvk
OWNER _ ® `
%, �vC�
IBIS
............... .........
Miami Shores Village
10050 N.E. 2nd Avenue
ua�
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Folio Number) 131010340020
Owner's Name: MARCELO BORDOWSKI Owner's Phone:
Job Address: 9418 MIAMI Avenue Total Square Feet: 80
Miami Shores, FL 33150- Total Job valuation: $ 400.00
Contractor(s) Phone Primary Contractor
HOME OWNER Yes
Planning and Zoning Criteria and Comments
Approved: Yes Date Approved: 813/2011 : Yes
Comments
IP 1
LEGEND OF SURVEY ABBREVIATIONS
A..... ARC DISTANCE AID ....
AIR CONDITIONING
C ..... CALCULATED C.B ...
. _CATCH BASIN
CL.... CLEAR Cl ....CENTER
LINE
ENC... ENCROACHMENT P,C .....
POINT OF CURVATURE
FIP .... FOUND IRON PIPE P.O-B...
POINT OF BEGINNING
DIM, ... OVER NANO W.M....
WATER METER
P.B.... PLAT BOOK M .....
MEASURED
PA. ... PROPERTY LINE CONC..CONCRETE
R.. _
UP ... U nLTY POLE FM.....
FOUND
CBS ...
CONCRETE BLOCK STRUCTURE
U.U.L
...OVERHEAD UTILITY LINE
P.C.C...
POINT OF COMPOUND CURVE
P.O-C...
POINT OF COMMENCEMENT
BLDG..
BUILDING
C.H.....
CHORD DISTANCE
D.E.....
DRAINAGE EASEMENT
F.H.....
FIRE HYDRANT
R.. _
RADIUS
CERTIFY TO:
Pablo A Nuta And Rebecca Parsons Schram
Biitmore Title Corp,
Chicago Title Insurance Company
(Mortgage Lenders of America, its successors and /or assigns, A.T,I.M.A.
NOVI)
... NATIONAL GEODETIC VERTICAL DATUM
PRC ...
POINT OF REVERSE CURVATURE
RAD...
RADIAL
RIW ...
RIGHT OF WAY
SEC...
SECTION
SCR...
SCREENED
S.LP....
9ET IRON PIPE
SWK ...
SIDEWALK
U.E.....
UTILITY BASEMENT
CHLF.....
CHAIN LINK FENCE
LEGAL DESCRIPTION:
Lot: 3 & S } OF LOT 2
Block: 167
Subdivision: plat of Section No. 6 -A Miami Shores
According to the Plot thereof as recorded in
Plat Book: 12 Page: 54
Public Records of MIAMI -DADE County, Florida.
ADDRESS:
9418 NORTH MIAMI AVE
MIAMI SHORES FL 33150
Encroachments Noted: NONE.
LOCATION SKETCH
scALE: N.T.S.
NOTES:
A) All Cleoremea a.Va -- iursnta ahem
hereon era of appasM =tare. Fees a shlp
by vt W moos. Legal ame.Mp of fakes net
datarmivd.
e) This awry is Intended fa mortgage a refhmnm PA"_
sly eeduslvely fw this Ins by thaa to when it is
a 11fhed. ThB awwy is rot To be used fw mwth Hon,
pmN"hV, dealgn, Lae other usa withal mitten mn-
sent of Th— Z. Kelly, Inc.
C) Code restNctien and title a h are n e fie d
re this a.—y.
D) The flood le fe—fl. vh— hereon does :rot haply
that the refere=ed Prop" all] w MII mt be free
from flowft a donwge and does mt meats 114111ty
ro the pert of the fume, ery efflux ar ee 0" thereef.
for say demage that remdh from nlioms an aWd
E) Tha lands depicted he— were na'voYed Per the
Iegal deee Wien and m elate. u to —hip or
matters of title are made or (mplhvd.
P) Vndaegrolmd 5...hmeela, If any. mt located.
I hereby -,Kfy tht the survey represented
hereon iha =tut=u= taehnknl stan-
dards forts by the Beard of Land Surveyors
le BJ -17.OW m 17.062 Pia. Admin. Cade pursuant
472.0 fl
OSE A. R A, P.S. & M. #4858
TATS O LORIDA
VALID IMPRINTED WITH AN
BOSS SURVEYORS'S SEAL
1, Ds SHOWN. BEARING ARE TO AN ASSUMED
MERIDIAN (BY PLAT).
2. IF SHOWN. ELEVATIONS ARE REFERRED N.G.V.D 1929.
3. THIS IS A SOWR ARY SURVEY.
~f
l
d'
07
Zl
Sheet 1 of 2
FLOOD ZONE: X
THIS I5 A FLOOD
HAZARD ZONE
✓ THIS I5 NOT A FLOOD
HAZARD ZONE
PANEL NO.% 302/L
COMMUNITY #: 120635
DATE OF FIRM: 09/11/2009
BASE FLOOD: N/A
FINISH FLOOR: NIA
LOWEST NIA
ADJ GRADE
I ,LO
17
i 40 �
,z
i-
LD
i0)
NORTH
THOMAS J. KELLY, INC.
L. B. #6486
SURVEYORS- MAPPERS -LAND PLANNERS
8128 SW 120 STREET PINECREST, FLORIDA 33156
(786) 242 -7692 DADE (954) 719 -3288 BRWO
(786) 242 -6494 DADE FAX (954) 779 -3260 BRWD FAX
DATE FIELD WORK SCALE SURVEY NO.
07/09/2011 1" = NT-5. 1 11 -0984
1
SHEET 2 OF 2
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AUG 0:t2011
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10 A5PH. PAV 15'ALLEY. cL• 1713. 1/2' e ® ®__ ®__
•� I.P• 4' CN •L..F.
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LOT' 3
NORTH _
`1 MIAMI AVE.
91lliar�^ �Fa ®ees Vel' ale
APPROVED BY � DATE THOMAS J. KELLY, INC.
L.B # 6486
ZONING DEPT 3 SURVEYORS— MAPPERS —LAND PLANNERS
1 125 SW 120 STREET PINECREST, FLORIDA 33156
(786) 242 -7692 DADE (954) 779 -3288 BRWD
BLDG DEP- 86) 242 -6494 DADE FAX (954)779 -3260 BRWD FAX
SUEiJECT T(? CnMPLIAW .! `.'JI7 H ALL FEDERAL D 07-09-11 WORK SCALE SURVEY 1SURR 84 0.
STATE Af !'� C(7UNTY fa''' '� S AND III- GUI- ATIONS
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APPROVED BY � DATE THOMAS J. KELLY, INC.
L.B # 6486
ZONING DEPT 3 SURVEYORS— MAPPERS —LAND PLANNERS
1 125 SW 120 STREET PINECREST, FLORIDA 33156
(786) 242 -7692 DADE (954) 779 -3288 BRWD
BLDG DEP- 86) 242 -6494 DADE FAX (954)779 -3260 BRWD FAX
SUEiJECT T(? CnMPLIAW .! `.'JI7 H ALL FEDERAL D 07-09-11 WORK SCALE SURVEY 1SURR 84 0.
STATE Af !'� C(7UNTY fa''' '� S AND III- GUI- ATIONS
�wii =ice
- RHS 3. E]Conv. Unins. 6. File Ni mb an Number 8. Mortgage Insurance *Case Number
CNOTE: This form is flunished to give you as �ment o�f aclual settlement costs. '
Amounts paid to and by the settlement agent are shown.
Item marked "(p.o.c.)" were paid outside the closing, they are shown here for informational purposes and am not included in the totals.
G.nRnpnonIfY ' 9418 N Miami A�e
| LomomzmN- ' . Miami Shores, rL 33150
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U.S. DEPARTMENT OF HOU&NO AND URBAN DEVEWPMENT
SETl'LEMENT STATEMENT PAGE 2
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CERTIFICATION DATE:
I have yreAcwed ft HUD -1 Settlement Statement and to the best ofmy knowledge and beHe� it Is a true and accurate statement of all 7 i p& 11d
disb is made on my account or by me in this transaction. I fwther certify that I have received a copy of the HUD -1 Settlement Statement.
AAM investri ,LLC
a
Borrower Seller
P Borrower Soller
The Settlement Statement which I have prepared is a true and accrotmt ofthis transaction. I have caused the fiords to be disbursed in accord -
ancewith this statement 13MMORE TITLE CORP.
Settlement Agent 7/28/2011
Date
WARNING: It is a to knowingly make false statements to the United States on this or any other similar form. Penalties upon conviction can include a
fore and imprisonment, r details see: Title 18 U.S. Code Section 1001 and Section 1010. Page 2 of3 114440