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DS-13-0953• Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 190712 Permit Number. DS -5 -13 -953 Scheduled Inspection Date: January 31, 2014 Permit Type: Driveways /Sidewalks/Slabs Inspector: Rodriguez, Jorge Inspection Type: Final Owner: THOROGOOD, DANIEL Work Classification: Addition /Alteration Job Address: 635 NE 105 Street Miami Shores, FL Project: <NONE> Contractor: HOME OWNER Building Department Comments Phone Number Parcel Number 1122310120070 INSTALLATION OF KEYSTONE PATIO ON BACKYARD Intiractlo Passes commene: INSPECTOR COMMENTS False January 30, 2014 For Inspections please call: (305)762 -4949 Page 2 of 22 Inspector Comments Passed Failed Correction Needed ❑ Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. January 30, 2014 For Inspections please call: (305)762 -4949 Page 2 of 22 NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE J0B SITE AT 71*E F M, 0 p ff,#ISPECTION PERMIT NO -TAX FOLIO NO. STAtt OF FLORIDA: COUNTY OF MIAMI-DADE: THE UNDERSIGNED hei6by gives' rptic e ')[hqt , ; Inipr9yern" will be made to certain real property, and In accordance with Chgptee 11'3•, Florida Statutes, the following information Is provided In this Notice of Commencement CFH 2013RO447380 OR Bk 28665 Ps 2061; QP9) RECORDED 06/0612013 09:38,47 HARV.EY.RUVINY CLERK OF COURT HIMP.-DADE COUNTY? FLORIDA LAST 'AGE ' Space above reserved for use. of recording office description 1. Leal of property and street/address: _LeT 6 . F7D'.. I . . _...%.qVW _r *1 1 pkrf CIS df M cm I— D'AP'F C , F r-84 2. Description of Improvem k:n 0 - 0 F E- I M KAN 0-w Sl ze 3.Qwner(8) name and AddrbW IW1,64 N interest In property. _!aWhl.E9_ 4 Name and address of fee simple 'titleholdert 4 name, addr e*W and phone number: g 3Z4 5. SWety (Payment - bond required by owner from contractor, if any) NZ .. e, address and phone number. A mt of bond$ 6. Lendees name and address: 7. Persons within the State of Florida designated by Owner upon whom notices or other documents maybe served as provided by SecAl Florida Statutes.. Name, address and Phone number !I OF �FLORHtW COUNTY OF DADE I Pff-IfEMW LAMUM-T W= W_ AM "0- mmm 8. In addition to himself, Owners designates the following Goss d act a copy 713.1'S(1)(6), Florida Sta"O. Vf Name, address and phone number. 9. Expiration date of thliNotice of Commencement !C' #N exph—flon date is I yew ftm 1he date of recording wiless a different O. We Is SPecMeO WARNING TO OWNER: ANY PAMADE BY THE OWNER AFTER THE EXPIRATION . OF Tf.JE NOTICE OF COMMENCEMENT, ARE CONSIDERED M=MR 7 3, 713.13. -FLORIDA" WUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROPER PAYMENTS Ukbtllyd PART 1, SECTION IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND'POSTED,bN THE JOB SITE WORE THE FIRST 'INSPECTION, IF YOU. INTEND TO OBTAIN,FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK R RECOR YOUR NOTE E OF COMMENCEMENT. Signatu 5) of gro(s) wneg =)'Author#ed Officer/Director/Partner/Manager Prep ar, 0; Ely - , 7, - Prepared By Print Name Print Name Title/Office Title/Office Miami Shores e Villa g Building Department 90050 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 } „•V U g rh a V 1 N to v i..s .40 Y: t__ z - FBC 20 Permit No-03 �-953 Master Permit No. ROOFING JOB ADDRESS: _ � 35 14F 105^��L 5t City: Miami Shores County: Miami Dade Zip: Folio/Parcel #: 10f, t1feel &o if V l ev, fS S )?(Yt7. go-k- "-f i P;o< le-1 Is the Building Historically Designated: Yes NO X Flood Zone: IY® OWNER: Name (Fee Simple Titleholder):t�;n IJ `� -1®�ij Phone #:✓� 3Li2� Address V : 35" t4 Set �� 1'° City: MA;kk, ,drTeS -State: L Zip: _ 33 IS 19, Tenant/Lessee Name: Phone #. Email: CONTRACTOR: Company Name: tf _2 ,zjv e Phone #: Address: City: State Zip: Qualifier Name: Phone #: _ State Certification or Registration #: Certificate of Competency #: Contact Phone#: Email Address: DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ 800 Square/Linear Footage of Work: Type of Work: OAddition DAlteration UNew (Repair/Replace ODemolition Description of Work: Color thru tile: Submittal Fee $ Permit Fee $ ad CCF $ CO /CC $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ 1 S , Bonding Company's Name (if applicable) Bonding.Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address Zip 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 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 be approved and a reinspection fee will be charged. Signature - Signature qlmer or Agent Contractor The foreg n instrument was ac led 4ebefore m s CP foregoing instrument was acknowledged before me this day o , 20 L, by Y L Y of , 20 _, by , who is pens nal known to me or who has produced who is personally known to me or who has produced • +� .cation and who did take an oath. as identification and who did take an oath. NOTAR LIC: I LOS to of Florlds 9 23. f: 2045 Sign: _ Comm P nalNowll® Foul Print: se' P .._..A.e Tbfough!!t 14 My Commission Expire 4 APPROVED BY IX6 �� Plans Examiner Structural Review (Revised 3 /12/2012)(Revised 07 /10/07)(Revised 06 /10/2009)(Revised 3115/09) NOTARY PUBLIC: Sign: Print: My Commission Expires: 7 / 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 ADDRESS:. 696- N E7 tgs74% 5--r, lit [ $f *3:i 132 Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, RS 489.103M. 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 bunt 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. I 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 permft filed to 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 rime numbers on permits and contracts. lnitial, 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. if 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 prequme that I built or substantially improved it for sale or lease, which violates the exemption. Initial, 9f 5. 1 understand that, as the owner-builder, I, must provide direct, onbsite supervision of the construction. 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 CAUL 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, maybe held Gable 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 orr my property. : vl/gRA1 I 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 parson working on my building who is not lid must work under my direct supervision and must be employed by me, which means that I must comply with lams 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 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. inifial -. 10. I 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 httoJ/ www. mvfloridelicerse .com/dburlaro /dlb/index.html 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. I agree to notify Miami Shores Village immediately of any additions, deletions, or glandes to arty of the information that I have provided on the disclosure. 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 ver firing whether the contractor is property 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 hall perrnflting agency is required when the permit is issued. Was acknowledged before me this day of /K 20 !� I Produced there License or who was personally known to me or who has , y tote of Florida Notary Comm. Expires Sep 23. to 2015 1 Commission # EE 12BB�0 National Notary Assn. of of , Bonded Through POSIO&I To protect, promote & improve the health of all people in Florida through integrated state, county & community efforts. Cristin Thorogood 635 NE 105 Street Miami, FL 33138 I o—.n Vision: To be the Healthiest State in the Nation RE: Contingency Letter Application Document No: AP1107685 Centrax Permit Number: 13 -SC- 1472187 OSTDS Number: 635 NE 105 St Miami, FL 33138 Lot: Block: Dear Applicant: May 31, 2013 Subdivision: Golf View Estates Rick Scott Governor John H. Armstrong, MD, FACE State Surgeon General & Secretary This will acknowledge receipt of an application dated 05/13/2013 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 that your existing system is adequate for the proposed use. This permit is issued for construction of a patio. If you have any questions on this matter, please call our office at (305) 623 -3500. Enclosures cc: Florida Department of Health in DADE COUNTY 1725 NW 167 St, Opa Locka, FL 33056 PHONE: (305) 623 -3500. FAX: (305) 623 -3645 Sincerely, Joseph Piverger, Engineer Specialist II www.FloridasHealth.com TWITTER:HealthyFLA FACEBOOK:FLDepartmentofHealth YOUTUBE: fldoh J . �� tofting I • �� 'a � it 1' ' �� � •' � .� ��iiii iii I•• SuBjECT • compLtANCE STATE AND COL INTY RULES AND REGULATION' S .. ,,'�"" ter.. �,Mc.•..�- �»•._._ O f •t ! me MIAPA-DADE • I * 1' I . .., iit f � f _ �'! • r yl '• If ?�� • ' • Cam• -•Yi �.i! :'i � 1 ' •�C • •�� �� '.� x�'�` �� � • �t . , s>��>1 �� Vii,! `:M «�`tia' t Miami shores Village Building Department RECEIPT 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 PERMIT #: DATE: I, A( (NAME) ❑ Contractor 'Owner ❑ Architect Picked up 2 sets of plans and (other) Address: G 3 -- /V tF /0& r- st" 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: (Signature) PERMIT CLERK INITIAL: RESUBMITTED DATE: PERMIT CLERK INITIAL: Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 May 8, 2013 Permit No: DS13 -953 Building Critique 1. Provide HRS /DOH approval Norman Bruhn CBO 305 - 762 -4859 Norman Bruhn CBO 305 - 762 -4859 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.