FW-14-268Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 207137 Permit Number: FW -2 -14 -268
Inspection Date: March 24, 2014 Permit Type: Fence/Wall
Inspector: Rodriguez, Jorge Inspection Type: Final
Owner: MIRAMONTES, CARLOS & BARBARA
Job Address: 674 GRAND Concourse
Miami Shores, FL 33138-
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
Work Classification: IronlOrnamental
Phone Number
Parcel Number 1132060171950
NEW GATE IN BACK ALLEY & REPLACE FRONT FENCE
ALUMINUM.
infractio Passed Comments
INSPECTOR COMMENTS False
Passed
Inspector Comments
Failed El
Correction
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
For Inspections please call: (305)762 -4949
March 24, 2014 Page 1 of 1
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
Permit No.
Master Permit No
CFIVED
FEB 13 2014
BY:
FBC 2010
ROOFING
JOB ADDRESS: _674 G RA D C-oK)coi)(?sEr
City: Miami Shores County: Miami Dade Zip;
Folio/Parcel #:
Is the Building Historically Designated: Yes
OWNER: Name (Fee Simple
City:
Tenant
Email
NO _v/ Flood Zone:
os
CONTRACTOR: Company Name: f)V_Y 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: $ 35 Square/Linear Footage of Work:
Type of Work: ❑Addition DAlteration dNew Aepair/Rpplace
Description of Work: h" (A 1(x ba ,
ArAWJZAW - 5
/ f
Submittal Fee $'�;D• CV 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 $
DDemolition
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. I .
"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 NONCE 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 inspe which occurs seven (7) days after the building permit is issued. In the, absence of such posted notice, the
inspection will no be proved and a reinspection fee will be charged
Signature Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this � The foregoing instrument was acknowledged before me this
day of �, 20 .�, by ) kn r3ais nth �f day of , 20 _, by ,
who is personally known to me or who has produced who is personally known to me or who has produced
D %L/ 7/ x/1-6 As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign:
Notary Ubllc Stele cg rl" .
Joanna M Feliciano
My Comniisaion FF 052753
E%pitea 0111212018 iw.
APPROVED BY '�-1 4—' 4 Plans Examiner
Structural Review
(Revised 3 112/2012)(Revised 07 /10 /07)(Revised 06110/2009)(Revised 3115109)
Sign:
Print:
My Commission Expires:
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: �b&8&f�,A Iii CA U OA TC,\ DATE: a- l
ADDRESS: rn74ardAd CPaAAAk % MA 33)U'
Do hereby pefition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, RS 489.103(7).
And I have read and understood the following disclosure statement, which entities 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 bulk 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. 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 excel $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.
Initi al
5. l understand that, as the owner- builder, I must provide direct, onsite supervision of the construction.
Infial
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
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 wilfully acting as an
owner - builder and am aware of the limits of my insurance coverage for injuries to workers on my property.
Initial
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 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_
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 govem owner- builders as well as employers. I also understand that the
Construction must amply with all applicable laws, ordinances, building odes, 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 hftplhvww.mvfloddalicense.com/dbpr/i)ro/Cilbfindox.html
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
legally and financially responsible for the proposed construction activity at the following address:
marse Mtwixores
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.
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 ConstAuction 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 Z` day of tff
4
, 20
ByA r who was personally known to me or who has
License or 14 iS" -5--'- (j 7 q -- % / _X 9/c as identification.
-OWNER r u A, 0 , PblicS=1*04
M Feliciano
•
29C� FF 082753
Of . res 01/12/2018
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POOL REQUIREMENTS:
SELF-CLOSING/ SELF - LOCKING
GATES REQUIRED
FENC : 4' HCCz'(I�I "l1�.3
IF NEAND RS - CLIMBABLE
WALL, OWNER MSOT REPLACE/
WITH: q 4' FENCE ON
OWNER'S PROPERTY
A'001
Acc s G41
sate
dewk self, rO'h th tist 01*n ! S, ey
4
e locat c /nsi col and
a� ed 04 /se /f area
�lO�te4 �l � o th '
4ot s� e
4 42 Ott
Of J7 n s4 fte
pe
Fences GOpd
in e - rung me ids put 77ae
$nd o f the Plot hers °f a fen Kcal and horizontal
lot °rt$n finisher srd which the f Shall face
the
Y abutting right. w ce fhe ad o yin d
g)
AC =
AIR CONDITIONER
ASPH =
ASPHALT
BLDG. =
BUILDING
C.B. -
CATCH BASIN
C.B.S. =
CONCRETE BLOCK STRUCTURE
CONC -
CONCRETE
C
BLINK
L. =
CHAIN (FENCE)
�P =
EDGE OF PAVEMENT
FFDD =
FOUND
ILPB
IRON
=
AND SURVEYOR BUSINESS
MH =
MANHOLE
N &D -
NAIL & DISK
f -
PROPERTY LINE
RLS =
REGISTERED LAND SURVEYOR No.
WM -
WATER METER _
/-
35'
� 35'
--C
_ spas' sao'
g, " 4 3 2 1
g3�8, 8 7 6 5
9
10 102 „ <t
11 �'
54.12' .4 .c
,+ ++ n
11ae. ,+ r 17 18 19 20 21 22 W
15 16
e2' 14 cI
SCALE: 1 INCH = 20 FEET
CONCOURSE ,
GRAND
ASPH Pvm
2' CURB & GUTTER
witwAffi i
SKETCH OF SURVEY
ORDER No. 13685
FB:. 272 PG. 1 & 2
DATE: MARCH 7 2005
SCALE: AS SHO{NN
A. R. TOUSSAINT do ASSOCIATES, INC.
LAND SURVEYORS
FLORIDA CERTIFICATE OF AUTHORIZATION NO. LB -273
620 N.E. 126 ST. NORTH MIAMI, FLORIDA 33161
LOTS 3, 4, AND THE EAST 5.0 FEET OF LOT
5, BLOCK 102, AMENDED PLAT OF MIAMI
SHORES, SECTION NO. 4, ACCORDING TO THE
Fo h7a-4
MEMBERi FLORIDA SOCIETY OF
PROFE4810NAL LAND SURVEYORS
AMERICAN CONGRESS ON
SURWVING AND MAPPING
TEL (305) 891 -7340
FAX: (305) 8930325
A. R. TOUSSAINT & ASSOCIATES, INC.
LAND SURVEYORS
HYDROGRAPHIC SURVEYORS
620 N.E. 126TH STREET Sheet I of 2
NORTH MIAMI, FLORIDA 33161
May 9, 2012
Ms. Barbara Miramontes
Keller Williams
1680 Meridian Avenue
Miami Beach, F133139
SURVEYORS AFFIDAVIT
This is to certify that on May 8, 2012, the under signed made a visual inspection
of the property represented on our Sketch of Survey, Order No. 13685 attached
herewith. Legal Description Lots 3, 4, and the East 5.0 Feet of Lot 5, Block 102,
Amended plat of Miami Shores, Section No. 4, Plat Book 15, Page 14. Address
674 Grand Concourse, Miami Shore, Florida
Village of Miami Shores, Planning and Zoning requirements
(1) Scale, l" 20
(2) Lot Lines, shown on sketch
(3) There are no recorded easements shown on the recorded record Plat, PB
15 -14.
(4) Visible utilities above the ground level are shown.
(5) The septic tank system location is unknown to the surveyor.
(6) Grand Concourse and alley right of ways are shown on the survey.
(7). Ground elevations were not requested, Boundary Survey only. This
property is located in FEMA X Zone for Point of Information.
(8) Structures as shown on attached survey. (9 &10) walls, fences, and
improvements as shown on attached survey.
MEMSERt FLORIDA SOWETY OF
PROF6SS10NAL LAND SURVEYORS
AMERICAN CONGRESS ON
SURVEYING AND MAPPING
Notary Public
A. R. TOUSSAINT & ASSOCIATES, INC.
LAND SURVEYORS
HYDROGRAPHIC SURVEYORS
620 N.E. 126TH STREET
NORTH MIAMI, FLORIDA 33161
CRYSTLE A. MCKENZIE
MY COMMISSION # EE087 B
EXPIRES Apra} 25, 2015
TEL. (908) 891 -7940
FAXt (308) H89.0325
Sheet 2 of 2
Albert R Toussaint, Pres
Professional Surveyor and
Mapper No.907
Professional Engineer No.8939
State of Florida.
P
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t/L✓ �--° �� arni Sho esf Village
APPROtiED".
BY ~DATE
ZONING DEFT
ClT-y
FEB 1 2014
BLDG DEPT
BY'
SUBJECT 10C(- Njpt.IpNCE W( (R All FEDERAL COP
STATE ANA L� -UN f �VL -S AND REGUtA O"S
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