FW-14-1262Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-214241
Scheduled Inspection Date: July 15, 2014
Inspector: Rodriguez, Jorge
Owner: MORISSET, EDRIS
Job Address: 10691 NE 11 Court
Miami Shores, FL 33161-2122
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
REPLACE WOOD FENCE 5 FT HIGH
Permit Number: FW -6-14-1262
Permit Type: Fence/Wall
Inspection Type: Final
Work Classification: Wood Fence
Phone Number
Parcel Number 1122320280170
INSPECTOR COMMENTS False
July 15, 2014 For Inspections please call: (305)762-4949 Page 15 of 31
Inspector Comments
Passed✓
Failed
Correction
Needed a
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
July 15, 2014 For Inspections please call: (305)762-4949 Page 15 of 31
Miami Shores Village RECEIVE—Ti
JUN 16 014 1
BuildingDepartment
p artment
12- Y:-
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20
BUILDING Master Permit No. 4qj,-) 11-1 1_2'�
PERMIT APPLICATION Sub Permit No.
BU LDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑ RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
/n CONTRACTOR DRAWINGS
JOB ADDRESS:
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: / eI 2nd 70 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder):_ ' �r)/� IS A Ki S.SP .3ar 213
Address:
City: hit a vA C 1 State: f L Zip: J')/_ 22
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: M,lI S M/0r r l f. 0 /l Phone#: /�OJ% 2,73
Address: &."-%/ /V"C // L'k
City:
Qualifier Name:
State Certification or Registration #:
of Competency #:
DESIGNER: Architect/Engineer: Phone#:
) )t iep
Address: City: State: Zip:
to Value of Work for this Permit: $ zomp .r Square/Unear Footage of Work:
Zt-
Type of Work: ❑ Addition ❑ Alteration _ ❑ NewRepair/Replace ❑ Demolition
Description of Work: k'o ,/a/LL C
Specify color of color thru tile:
Submittal Fee
Scanning Fee $
Permit Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
(Revised02/24/2014)
CCF
DBPR $
bc�h
CO/cc $ .
Notary $
Double Fee $ _
Bond $
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 ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES, BOILERS, HEATERS, TANKS, 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.
I,
Signature
OWNER or AGENT
The foregoing instrument was acknowledged
asacknnowledged before me this
day of ���C . 20 . by
1 --s rw—q-133clho is personally known to
me or who has produced 45:L— d!4Q<a-A as
identification and who did take an oath.
NOTARY PUBLIC:
nui u�h�
I I S S+
Sign:
Print:
Seal:
�'°•. E ssion
,,y�, •. E173py9 �,.
N��kffi�k�k�kak*�k�k�k�k�k8��k�R�k�k4tl�*i+k*�k&�k
APPROVED BY
(Revised02/24/2014)
The foregoing instrument was acknowledged before me this
day of
me or who has produced
20 , by
who is personally known to
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
Plans Examiner
Structural Review
as
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:I�/f!S t4b1rr-r.r e 1*- DATE: i2
ADDRESS:./#1;p Ale- /( &"
Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, RS 489.103(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.
Infial
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 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.
Initial
5. 1 understand that, as the owner -builder, I must provide direct, onsite supervision of the construction.
InitialG�,
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 abid y 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 '44
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 h ://www.m loddalicense.com/db r/ ro/cilbfindex.htm
Initial
11. 1 am aware of, and consent to; an owner -builder building permit applied for in my name and understands at 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 changes to any of the information that
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�l qday of �uf , 20�-
By 2d 41 !-80 rz a_ who was personally known to me or who has
Produced there License or)—W-3 as identification.
i
0
Notary Public State of Florida
" Joanna M Feliciano
%9°� MY Commisalon FF 082753
11 'IV Ezpires01/12/2018
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
SURVEY AFFIDAVIT
STATE OF (FLORIDA)
COUNTY OF (DADE)
The undersigned Affiant, i p/10,Ft re , does hereby attest that
(Property owner) _
The attached survey, performed by �-
(Name of surveyor's company
For address:
Performed on (date of survey) is an accurate representation of the existing conditions and
locations of all st ct res on the property as of this date.
The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the property
without first providing a survey less than seven (7) years old old. The Affiant, as property owner, further agrees to
remove or obtain permits for any structures which now may exist on the property which are not permitted or which
may violate zoning or building code regulations. The Affiant further understands that the existence of any such
structures may affect final inspections as applicable to this or other permits.
Further, Affia saeth ght.
Property Owner Signature Property Owner Print Name .
SWORN TO AND SUBSCRIBED before me this day of
Affiant is personally known to me, produced as identification.
Notary
Revised on 5/22/2009/ Revised on 6/12(09
o Shadow Box
o Vertical Picket
YL Board on Board
Miami shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
WOOD FENCE DETAIL
4x4 Post Spacing
Fences <= 5` high posts spaced at Ton center maximum
Fences <= 4' high posts spaced at 6" on center maximum
Fence must not exceed Yin height
1 x pickets fastened
with two corrosion
resistant fasteners per
connection
-2x4 horizontal
+pressure treated
wood members
with two corrosion
resistant, fasteners
per connection
4x4 pressure treated ,
posts embedded Tinto
concrete footing 10"
diameterx 2'deep
ALL wood must be pressure treated I
All fasteners must be corrosion resistant L
No less than two fasteners in any connection
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NOTE: AL_ RIGHTS OF WAY, EASEMENTS,
SET BACK AND ZONING INFORMATION MUST
BE CONFIPMED BY ARCHITECT AND/OR
OWNER BSED UPON DESIGN USAGE.
)_LEVATION SHOWN THUSLY X 7 1
ARE REtATI711E TO THE NATIONAL
GEODETIC'ERTICAL DATUM OF 1929
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NOTE: AL_ RIGHTS OF WAY, EASEMENTS,
SET BACK AND ZONING INFORMATION MUST
BE CONFIPMED BY ARCHITECT AND/OR
OWNER BSED UPON DESIGN USAGE.
)_LEVATION SHOWN THUSLY X 7 1
ARE REtATI711E TO THE NATIONAL
GEODETIC'ERTICAL DATUM OF 1929
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SURVEYOR'S CERTIFICATION: We hereby
certify that the attached "Sketch of Sur-
vey" of the above described property is
true and correct to the best of 'our knowl-
edge and belief as recently surveyed under
our direction.
'dcfiTlm, Form. MAW. SKM, ><NC.
4�gu 9 State of Florida
N(NOT VALID dNLES32 SEALED
McNTOSH, FORTIN. I.BAVY. SK112S. INC..
9111 Pa tk Drive
Miami Shores, Florida 33138
eAl 8332q do�,le .-q,�-�, �qB3
�v x - 91-W � at/ 2'80 7T Feb. /G, `V7B �✓ 76'•�