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DS-13-2425Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 201977 Permit Number: DS -10 -13 -2425 Scheduled Inspection Date: May 12, 2014 Permit Type: Driveways /Sidewalks /Slabs Inspector: Rodriguez, Jorge Inspection Type: Final Owner: EMERSON, EDITH TYLER Work Classification: Addition /Alteration Job Address: 284 NE 102 Street Miami Shores, FL 33138- Project: <NONE> Contractor: HOME OWNER t:unairng uepanment comments FLAGSTONE WALKWAY Phone Number (305)310 -9607 Parcel Number 1132060134710 INSPECTOR COMMENTS False May 09, 2014 For Inspections please call: (305)762 -4949 Page 1 of 22 Inspector Comments Passed Failed Correction Needed ❑ Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. May 09, 2014 For Inspections please call: (305)762 -4949 Page 1 of 22 q Miami Shores Village Bitilding 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 No. OCT 212013 FBC 20 l C2� Master Permit No. DS 13— � q25 Permit Type: BUILDING ROOFING JOB ADDRESS:._ /\/F— i /Y 4 "L_I ;�7 I City: Miami Shores County. n Miami Dade Zip: 39 13 g Folio/Parcel #: Is the Building Historically Designated: Yes 1061 Zone: OWNER: Name (Fee Simple Titleholder):& Gti &e.&SlYi Phone #: 3057 Z/ ® 96077- Address: X5 `�VL� City: yd 4kV4- State: Z Zip: 09 % 3e Tenant/Lessee Name: Phone #: Email: CONTRACTOR: Company Name: Phone #: Address: City: State Zip: Qualifier Name: Phone #: State Certification or Registration #: Contact Phone #: Email Address: Certificate of Competency #: DESIGNER: Architect/Engineer: .,'4 n -1W., Value of Work for this Permit: $ iquare %I.meaar F6o age dw k: 15L Type of Work: ❑Addition ❑Alteration .0f4ew ❑Repair/Replace ❑Demolition Description of Work: .( (' J/ IAL� Ui% fi➢c1 - �G r�,�{t �,L , Wt wilt d a B _ Ga / YCpi1 �J[�e�t a2 aa�� & - Color thru tile: ��x��, ��F��F��F��, x�F�, ��F��Fees�, r�F��F, u��u��F�F�F�� ,��F,x��•x��u�u Submittal Fee $ Permit Fee $ CCF CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ Technology Fee $ TOTAL FEE NOW DUE $ 1 I q. ± �4 ) 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 1 . 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 n Signature Owner or Agent lSt Contractor The fo o�ijn�g��inpsttrrument was acknowledged before me this The foregoing instrument was acknowledged before me this day oif ,►V W s , 20 �), bfAKI VK( day of , 20 _, by , who is personally known to me or who has produced F1 WICItJ - who is personally known to me or who has produced As identification and who di e a as identification and who did take an oath. NOTARY UBLIC: ` o s1Z#Ct 33 # o OTARY PUBLIC: saa `ea �s a •u� �w , .� l IPM W OMS - od >�N aT.r P 1C3U T'UI'C -1d l Print: My Commission Expire §!!jEV-WC-r-J0e rZ� ZG �- My Commission Expires: APPROVED BY `k J Plans Examiner CA6 q /(� Zoning Structural Review (Revised 5/2/2012)(Revised 3/12/2012) XRevised 06 /10 /2009)(Revised 3 /15 /09)(Revised 7/10/2007) Clerk Miami Stiores Village BuI d ng Department I0050,N.E.2nd.Avenue Miami Shows, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 RWNER BUILDER DISCLOSURE STATEMENT NAME: 6�'�I ATE ADDRESS: N e✓ 10 Z✓t d S�. M iU'm SVi® Ves &31 2�5 Do hereby peffliori the V1099,01 Miami Shores to act as my own cx rhtractor pursuant to the taws of the State of Florida, RS 489.1 MM. And I have read and undeQod ire, folloing clan statement, !!.e Rai to work as my own Contractor, I further understand that I as the owner must appear to person to complete all OPpOCations. State Law requires construction to be done by a licensed contractor. You have applied for a permit under an excaption 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 ors - family or two4arhOy 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 bulditg'mustbe fory0urown use and occupancy: ft may not bi built for sale orb. ff you sail or W a building yotf iaive built yourself with' owyaar after the c onstructon hffi COWOlefe; tfFSrtar *aPau" that you bilt for'sale of W W, which is 'a violation affhie'ekbifflption. You may not hire an unlicensed person as a contractor. it is your reW sibility to make sure the people employes 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 FICA and with-holdings tax and provide workers' compensation for rthat errpleyed alias pinta bylaw. Your bonstructon must' with ail appl(c8bls laws, "ordinances, buildings codes and zoning reg;I nis. Please read and InNW each paragraph. 1. t und®starhd that staffs law requires c pm% ton to be dons by; pcersed c antreft anus iave.applied for an caner - builder perm under an exemption from the law. The exemption spy that I, as the owner of the properly 110leCi, may act a my own conitractor with certain restrictions even trough I do not have a uterine. initial .CeJ 2. 1 urhderstend that buQdire pam is are not required to be signer by s property owner unless he Or she Is responsible for is corhatrutdtol and Is not hiring a Ooersed vonhtracor to assume respaMibi111y. 3. l uridersmnd that, an owner bugler, I am to raspbte► off record on a permit I understand that I may protect myseif from phiterdlitl tinarudai r�k ,by hiring a Ocersed oontrac6a' ami tnavirn9 to peml<t tied m h� ar thw rainier istead of my own rains. I. ado unhderstaruf � the contracar is ruled by law to be Ilerhsed b► Fk>rkfa artd t0 Oat h� o Ocer� numbers on permits acid corhtracts. initial �f"-c� 4. 1 understand that I may build or improve a one family or two -family reskle = or a farm outbyRding. l may also bdd.or Improve a winmemiai building 9 to c osls do not eacceed $75,000. The butktng or residence must be for my use or ncy. It may riot be built or Substantially improved for sale or Imo. ff a building or residence tat I have built or substantially it mmm myself is sold or leased within 1 year der the corstuclion Is complete, the law will presume that I built or substartally inproved it for sale or lease, which violates the exemptim iriOlal fir/ 5. t understand that, as the owner- builder, I mist provide direct, oske supervision of to corstiu*n. 1 6. 1 understand that I may not hire an unOcersed person to act as my conteco or to supervise persons wmWq on my building or residence. It Is my responsibility to ensure that is persons whom I employ have to Hoe= required by law and by county or mur"W ocOrei". ATP16-1 VIVO lie y6 1 V - .i... ^I I understand that It is frequent practices of unlicensed person to have the property owner obtain an ownes4)hrilder permit that ` errorredisty hod that the property owner is providing his or her own labor and materials. I, as an owner4mAderr be:f ld n gable and subjected to serious tinandal risk for any i *lies sustained by an unlicensed person or his or working on my property. r,liy homeowners Insurance may rrot provide coverage for those injurles. I am wigfuUy: oar owner4kler and am aware of the Umlts of my insurance coverage for injuries to workers on my property. InNuL -- 8. I understand that I may not delegate the responsibility for supervising work to be a licensed contractor who Is not Homes to dorm the work. don. working, on my building xrio rota must work under my direct supervision and must be emu 1 by me,wh that I mist comply jb bn regdrr% the withholding of federal Income tan and social semrriy contributions under the Federal Insurance Contribution Act (FICA) and must provide worker compensation for the employee. I understand that my failure to follow tie may subject lo serlone fuhetwid risk. Initial. 9. 1 agree that, as the party, IegaUy end financially responsible for this proposed Construction ach*, I will abide by all applicable laws and requirement that- govern suer- bupddrs as well 89 *r►�rers. I also understand that the Constructich must comply with all applib" laws, ordhhar ,'blift codes, and zoning regulates. tnitim -� 10. 1 understand that I may obtain mom Infomnation regarding my obligation as an employer from the Internal Revenue Service, the Urdmd Steles Smell Business ass Administration, and the Florlie Department of Revenues. I also understand that I may contact the Flnrlde Caeirucl on Industry Lkkensing Board at 650.487,1395 or fibAywrodorldeRcew. caNdbmlmo/cilb<hhden htmd 11. 1 on aware of, and consent to; an owner - builder building permit applied for In my pm and tmdenttarhds that I am to party legally end ftnand* responsible for the proposed construcdon ecdivity at the toilowing a ddrnss: Initial 12 I pree to nd* Miami Shores Village imhmhedletelr of any edd( ton, deletions, or cdhar>ges to M01' the idormation that I have provided on this disclosure initlal Liceseed writ &*n are regulatad by taws designed to protest the public. If you contract with a person who does not have a tic use, the ConsNuction Industry Licensing Bard and Department of Business and Professional Regulation may be unable to mint you with any them W loss that you sustain as a result of wiitieactor may be In civil court. it Is also Irriporternt for you to understand that, y an unlicensed contactor or employee of'an Individual or filth Is *W while woddrig iln *our properly, you may be field liable for damages. ff you obtain an owner- builder permit and wish to hie a licensed contractor, you will be responsible for verffft Whether the contractor Is properly licensed and the status of the contractor's workers cofnpenatiori coverage. Before a but ft permit can be Issued, this ddisclosure sialdment sadist be completed aril signed by the properly owner and returned to the Imral pennitti V agency responsible for wing the permit A copy of the properly a'drlhaer Uaene, the notarket! stn We of the properly owner, or other type of verili aUon amble to the local penrdt M agency Is required when to penult Is Issued. p� was acknowledged before me this day of 20 j B P I�� CfyW �s personally � rsonall known to me or who has Y Produced there License CUM FOIM Notary ftft - Swe of F oft" °IV{,y COM- ixOM Sep 28.2015 Commission # EE 134275 idenfrfic;ation. NOTARY 4) IN .e/o"o seen goo s A \b % . 0. Y. 111 Lii-1 'p- ttw %� 4 w A, 5r. L —12 2 Miami Shores Village MIT r-1 E-1 mu APPROVED BY DATE OCT 212013 ZONING DEP T BLDG DEPT 'M3JECT 1"o CC MPUANCE *1 RH ALL FEDERAL STATE (,(,[-N Y �1,1 23 AND PEGULATIONS 1/0 7 kN lo .e/o"o seen goo s A \b % . 0. Y. 111 Lii-1 'p- ttw %� 4 w A, 5r. L —12 2 Miami Shores Village MIT r-1 E-1 mu APPROVED BY DATE OCT 212013 ZONING DEP T BLDG DEPT 'M3JECT 1"o CC MPUANCE *1 RH ALL FEDERAL STATE (,(,[-N Y �1,1 23 AND PEGULATIONS F A. s KILM RYRE ww Arzl/. xvm AM � •Re•uuva+fs-G -� •• �••y Survey of Lot: 1 -2 Block: 375':: •' ' • '•...' ••••• Subdivision: AN AMENDED PLAT OF MIAMI SHO. SECTION NO. 2•;••; •••� • ••:••' According to the Plat thereof-as recorded kn the Plat Boolt• 96. l0 ••••'� at Page No. 70 of the public records'of • MIXf DADE County "Ief ridq,,,% ....:. Property Address: 284 NE 102 ST •. • •••y For: VLADAMIR VUKOVIC MIAMI. • FL 33+138 .•� ••• • • Date:00d/111 /2003 .LOCATION SKETCH soei� t- a ,c!Tf L5011%. P O� Tt34 ��• 10 2 O STR ET x m O Fe �) 9 ''e- 11 U, -9 8 %b 3 4 i s 19 cc al .ga t"- 4 - tj g Itl 1j ZO 21 xe 23 sT SO w U 7.57 9 1.-3 . �i -T-WA PAA-FOWOPMOM CURVE PROF! CM.PCOPEIY PE- PLATOOOR PO. -PAWL POW- PARPOW PAM-PIRAWWREFOROMME MVOCOFED E7tCiDI6E31�i1A71O1�": Om � r •om.errm CP.:CC •PCrOL K -MORIK �7P�@I.L /6010 3IMMA Pl 8UM . CONCMI MAIL F 88 •• 0-mm- O.MA- SET1N48OMItL8O6011 �}TI@ wT1E 8YRYEY69 DALE. DAM -P AM MAM 09..O�T. gp. P�C10L A9O IOMOPT. M801${MNPROIANCE E'A4 M ORWE..Oes CIL.p11ERi¢+Aq LOiEB TRATTRU'OOIAiRORY OUMEY' T..TAMOEPR; p�Q� �_ - L.8m. C".-OY�ilMLOY1gFTY OA8- OFFOALREMMONK REC@M.Y Am I'm 06ta"wr Y.E.wtRRlfY II. CNVOW YR 0 R.LP.- ELECTAO PWW.. PAVE OM. YN.- 1111!lIY. TE LBfATA1AF�A8lF&TF�MIBY rFMI F PAM PLwPLAR76i UP.- UnMFO{6 IMD Eli.•Y..ZOEVATIOR. PA- .PROP�RYLIRB Vm.VAVM� b1OFNPIf3PFMF 8 MF..YAODF�E: EIi01t_84MICACHM ; P.iL.FOMMMU RL P.6.O.:PCOD'CPCCAO -C •ID CLIMB B.•i11COaBWE1). TQ CA F.LP:.FOUIDOOMIPO+E. P.O..POOWOFOURV@ A- CLMIRALANFItB P.LFL-FaMUMAM PT..POWOPTARAENCY. W-VR. •. P.M-PRODHEDFLOOR LNB PO61..P1ATITOP6Q3@Li..ANkiLL 2 8F O,3 o.....- ..- ..- .......�. -� Situated in Zone: X Community /Panel /Sfigfix: 120652 - 0093 -J Date of Firm: 07/17/1995 Base Flood Elev& ion: Certified to: VLADAMIR VUKOVIC AND JANET VUKOVIC ■ . PERMIT # W .5 13 — tai (01a> CONTRACTOR: -�1-2- SUBMITTAL DATE: Io ADDRESS: v� K_f__ I C.� NAME:�� -S�r' RESUBMITAL DATES: PROJECT TYPE: F'ILACVVQV... y FIRE STRUCTURAL IMPACT FEES ELECTRICAL HRSIDERM PLUMBING NOC Or MECHANICAL BLDG .__