FW-14-2687Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-224938 Permit Number: FW -12-14-2687
Scheduled Inspection Date: January 28, 2015 Permit Type: Fence/Wall
Inspector: Rodriguez, Jorge InspectionType: Final
Owner: BLEASDALE, DONALD & MAUREEN Work Classification: Iron/Ornamental
Job Address: 102 NE 106 Street
Miami Shores, FL 33138-2037
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
INSTALL S HIGH PICKET SLIDING GATE
,�T•7Ta>•[Ti170 M
Parcel Number 1121360050080
INSPECTOR COMMENTS False
January 27, 2015 For Inspections please call: (305)762-4949 Page 17 of 34
Inspector Comments
Passed
Failed
Correction
Needed ❑
Re -Inspection ❑
. Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
January 27, 2015 For Inspections please call: (305)762-4949 Page 17 of 34
BUILDING
PERMIT APPLICATION
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING ❑ ELECTRIC ❑ ROOFING
DEC 10 2014
FBC 2010
Master Permit No. rt u 1 Ll %off
Sub Permit No.
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
City: Miami Shores County: Miami Dade Zip: i
Folio/Parcel#: >/2.1 ala 00 f50 6 ? ® is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder):Phone#: Se 2 -ft? 757?
Address: lo:x No- t p& roq S j
City: At I AAA I e State: Zip: �t►�1 � �� q
Tenant/Lessee Name: N/A Phone#: g'ts
Email:
CONTRACTOR: Company Name: L" Phone#:
Address:
City: -State: Zip:
Qualifier Name: Phone#:
State Certification or Registration M
Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 0 Square/Linear Footage of Work: /S -'*r 66e -
Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: C44 Ar'4 C4a JV4 C V'tQaz^);r mow `V q M 127 i41 DID 4 $
gU b f +4 G 4% -IV .,AADS QI6N& A- -U AA s 4_--j J+,-,_
Specify color of color thru tile:
Submittal Fee $ za • QK) Permit Fee $ y 00 �`� CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $ E .(—
Technology Fee $ A ® Training/Education Fee $ q 0 Double Fee $
Structural Reviews $_y
(Revised02/24/2014)
Bond $ 0
TOTAL FEE NOW DUE $ � k it Q0
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 low 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
OWL4rAGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of ` c C� , 20 �, by day of . 20 . by
who is personally known to who is personally known to
me or who has produced 1 as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: ���tuiiiiiuiii,NOTARY PUBLIC:
Sign: Sign:
Print: = p ��r d _ Print:
Seal:Cly •• ��s�° Seal:
r� 1 //YZoning
APPROVED BY 1 1Plans Examiner f /
Structural Review Clerk
(Revised02/24/2014)
�<4
OWNER BUILDER DISCLOSURE STATEMENT
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
NAME: V E Pu L, DATE: t 7-1 IW Z'P I %
ADDRESS: / VZ Wt— I ►i� (--4g ' Ott t 0.04 rNfg/q�1� F[/ 33/3
Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, F.S 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 isnot 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 a is responsible for the construction and
Is not hiring a licensed contractor to assume responsibility.
Initial Y
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 lea hich violates the exemption.
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.
Is my responsibility to ensure that the persons whom I employ have the license required by law and by county or municipal ordinance.
Initial
a
7. 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 willfully acting as an owner -builder and am aware of the limits of my Insurance
coverage for injuries to workers on my property.
Initial
14
B. 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 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
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 http://www.mvfloridalicense.com/dbprlvro/cilb/`lndex.html
Initial
11. I 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:
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.
W`„I
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 I cN day of T)IfQ— , 20
who was personally known to me or who has
0%J1III
I�Iuppiii,,��.
Produced there License or Pt, `s id.enufi�
oo
OW ER NO�l�Q�
5582 N. W. th STREET SUITE 202 SURVEY No. 13-01161-2
MIAMI, FI.ORID,Q�33126 9� �yy�
TELEPHONE. (305) 2642660 ° 4b f✓ .oJ .
FAX. • (305) 2640229
DRAWN BY: AL LAND SURVEYORS SHEET No. 2 OF 2
BOUNDARY SUR
SCALE=1"=20' Miami Shores Village
APPROVED B DATE
SURVEYOR'S NOTE:
,ZONING DEPT �' �,
A) Asphalt Drive Encroaching onto Right-of-way on the West side o
B) Wood Fence Encroaching onto Subject Property on the East side R EPT
C) Overhead Utility Line Encroaching onto Subject Property on the f? v
• • • • SUBJECT TO COMPLIANCE WITH ALL FEDERAL
• I!
• �. , . �TATF AND COI INTY RULES AND REGULATIONS !
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SURVEYOR'S N TE:
There may be Easements recorded in the Public Records not shown on this Survey.
The purpose of this Survey is for use in obtaining Title Insurance and Financing and should not be used for Construction purposes.
SM N.W. 7TH STREET, SUITE 202 :Nova Surveyors, Inc. 13-0001164-3
MIAMI, FL 33128 V Y SURVEY NO
TELEPHONE: (306) 2842880
FAX: (308) 284-0228
DRAWN BY: AA. LAND SURVEYORS SHEET NO 1 of 2
SURVEY OF LOT 8, BLOCK 201, OF DUNNING'S MIAMI SHORES EXTENSION NO.1, ACCORDING TO THE PLAT THEREOF AS RECORDED IN
PLAT BOOK 41, PAGE 51, OF THE PUBLIC RECORDS OF MIAMI-DADE COUNTY, FLORIDA.
PROPERTY ADDRESS: 102 NE 106 ST, MIAMI SHORES, FL 33138
FOR: BENNY L. NEWBY &. ADA M. NEWBY
LOCATION SKETCH Scale 1" = NT.S.
ABBREVIATION AND MEANING
A = ARC
FNIP. = FEDERAL NATIONAL INSURANCE
RAD. = RADIUS OF RADIAL
A/C = AIR CONDITIONER PAD
PROGRAM
RGE. = RANGE
A.E. = ANCHOR EASEMENT
IN.&EG. = INGRESS AND EGRESS
R.P. = RADIUS POINT
AR = ALUMINIUM ROOF
NE /0 C. rH su&rccT
PROPERTY
.57'REET
..
•�•
....
••••••
2011
L.M.E. = LAKE MAINTENANCE EASEMENT
6 70%6 —
� �
• • • • • .�
L.P. = LIGHT POLE
SEC. = SECTION
B.C.R. = BROWARD COUNTY RECORDS
M. = MEASURED DISTANCE
S.I.P. = SET IRON PIPE L.B. #6044
B.M. = BENCH MARK
MIH = MANHOLE
75 ..
., ..
NAP. = NOT APART OF
'
C =CALCULATED
NGVD = NATIONAL GEODETIC VERTICAL
TWP = TOWNSHIP
C.B. = CATCH BASIN
DATUM
U.E. = UTILITY EASEMENT
C.B.W. - CONCRETE BLOCK WALL
•• i•
••••••
1�3 •
••••
7.5 •M
••
•
W.M. = WATER METER
CH.B. = CHORD BEARING
O.R.B. = OFFICIAL RECORD BOOK
W.R. = WOOD ROOF
CL= CLEAR
O/S = OFFSET
W.S. = WOOD SHED
C.L.F. = CHAIN LINK FENCE
OVH. = OVERHANG
=ANGLE
C.M.E. = CANAL MAINTENANCE
P.B. = PLAT BOOK
17
EASEMENTS
P.C. = POINT OF CURVE
4
CONC. = CONCRETE
P.C.C. = POINT OF COMPOUND CURVE
S =CENTER LINE
C.P. = CONCRETE PORCH
PL. = PLANTER
C.S. = CONCRETE SLAB
P.L.S. = PROFESSIONAL LAND
=MONUMENT LINE
D.E. = DRAINAGE EASEMENT
SURVEYOR
.00
P.O.B.. = POINT OF BEGINNING
EASEMENTS
P.O.C.. = POINT OF COMMENCEMENT
DRIVE = DRIVEWAY
P.P. = POWER POLE
......
• ••
P.P.S.. = POOL PUMP SLAB
••
E.T.P. = ELECTRIC TRANSFORMER PAD
P.R.C. = POINT OF REVERSE CURVE
F.F.E. = FINISHED FLOOR ELEVATION
PRM = PERMANENT REFERENCE
F.H. = FIRE HYDRANT
MONUMENT
F.I.P. = FOUND IRON PIPE
PT. = POINT OF TANGENCY
F.I.R. = FOUND IRON ROD
PVMT. = PAVEMENT
F.N. = FOUND NAIL
PWY = PARKWAY
F.N.D. = FOUND NAIL & DISK
R. = RECORD DISTANCE
N 9
/2
!3
/4�
N
ABBREVIATION AND MEANING
A = ARC
FNIP. = FEDERAL NATIONAL INSURANCE
RAD. = RADIUS OF RADIAL
A/C = AIR CONDITIONER PAD
PROGRAM
RGE. = RANGE
A.E. = ANCHOR EASEMENT
IN.&EG. = INGRESS AND EGRESS
R.P. = RADIUS POINT
AR = ALUMINIUM ROOF
EASEMENT
R.O.E. = ROOF OVERHANG
AIS = ALUMINIUM SHED
L.F.E. = LOWEST FLOOR ELEVATION
EASEMENT
ASPH. = ASPHALT
L.M.E. = LAKE MAINTENANCE EASEMENT
RNV = RIGHT—OF-WAY
B.C. = BLOCK CORNER
L.P. = LIGHT POLE
SEC. = SECTION
B.C.R. = BROWARD COUNTY RECORDS
M. = MEASURED DISTANCE
S.I.P. = SET IRON PIPE L.B. #6044
B.M. = BENCH MARK
MIH = MANHOLE
SWK = SIDEWALK
B.O.B. = BASIS OF BEARINGS
NAP. = NOT APART OF
T = TANGENT
C =CALCULATED
NGVD = NATIONAL GEODETIC VERTICAL
TWP = TOWNSHIP
C.B. = CATCH BASIN
DATUM
U.E. = UTILITY EASEMENT
C.B.W. - CONCRETE BLOCK WALL
N.T.S. = NOT TO SCALE
U.P. = UTILITY POLE
CH = CHORD
O.H.L. = OVERHEAD UTILITY LINES
W.M. = WATER METER
CH.B. = CHORD BEARING
O.R.B. = OFFICIAL RECORD BOOK
W.R. = WOOD ROOF
CL= CLEAR
O/S = OFFSET
W.S. = WOOD SHED
C.L.F. = CHAIN LINK FENCE
OVH. = OVERHANG
=ANGLE
C.M.E. = CANAL MAINTENANCE
P.B. = PLAT BOOK
EASEMENTS
P.C. = POINT OF CURVE
A =CENTRAL ANGLE
CONC. = CONCRETE
P.C.C. = POINT OF COMPOUND CURVE
S =CENTER LINE
C.P. = CONCRETE PORCH
PL. = PLANTER
C.S. = CONCRETE SLAB
P.L.S. = PROFESSIONAL LAND
=MONUMENT LINE
D.E. = DRAINAGE EASEMENT
SURVEYOR
D.M.E. = DRAINAGE MAINTENANCE
P.O.B.. = POINT OF BEGINNING
EASEMENTS
P.O.C.. = POINT OF COMMENCEMENT
DRIVE = DRIVEWAY
P.P. = POWER POLE
ENCR. = ENCROACHMENT
P.P.S.. = POOL PUMP SLAB
E.T.P. = ELECTRIC TRANSFORMER PAD
P.R.C. = POINT OF REVERSE CURVE
F.F.E. = FINISHED FLOOR ELEVATION
PRM = PERMANENT REFERENCE
F.H. = FIRE HYDRANT
MONUMENT
F.I.P. = FOUND IRON PIPE
PT. = POINT OF TANGENCY
F.I.R. = FOUND IRON ROD
PVMT. = PAVEMENT
F.N. = FOUND NAIL
PWY = PARKWAY
F.N.D. = FOUND NAIL & DISK
R. = RECORD DISTANCE
LEGAL NOTES TO ACCOMPANY SKETCH OF SURVEY ("SURVEY"1:
THERE MAY BE EASEMENTS RECORDED IN THE PUBLIC RECORDS NOT SHOWN ON THIS SURVEY.
THE PURPOSE OF THIS SURVEY IS FOR USE IN OBTAINING TITLE INSURANCE AND FINANCING, AND SHOULD NOT BE
USED FOR CONSTRUCTION PURPOSES.
EXAMINATIONS OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED INSTRUMENTS, IF ANY,
AFFECTING THE PROPERTY. THIS SURVEY IS SUBJECT TO DEDICATIONS, LIMITATIONS, RESTRICTIONS, RESERVATIONS
OR EASEMENTS OF RECORD, AND LEGAL DESCRIPTIONS PROVIDED BY CLIENT OR ATTESTING TITLE COMPANY.
BOUNDARY SURVEY MEANS A DRAWING AND / OR A GRAPHIC REPRESENTATION OF THE SURVEY WORK PERFORMED IN
THE FIELD, COULD BE DRAWN AT A SHOWN SCALE AND / OR NOT TO SCALE.
EASEMENTS AS SHOWN ARE PER PLAT BOOK, UNLESS OTHERWISE SHOWN.
THE TERM "ENCROACHMENT" MEANS VISIBLE AND ABOVE GROUND ENCROACHMENTS.
- ARCHITECTS SHALL VERIFY ZONING REGULATIONS, RESTRICTIONS AND SETBACKS, AND THEY WILL BE RESPONSIBLE
- FOR SUBMITTING PLOT PLANS WITH THE CORRECT INFORMATION FOR THEIR APPROVAL FOR AUTHORIZATION TO
AUTHORITIES IN NEW CONSTRUCTIONS, UNLESS OTHERWISE NOTED. THIS FIRM HAS NOT ATTEMPTED TO LOCATE
FOOTING AND/OR FOUNDATIONS.
FENCE OWNERSHIP NOT DETERMINED.
- THIS PLAN OF SURVEY HAS BEEN PREPARED FOR THE EXCLUSIVE USE OF THE ENTRIES NAMED.
- HEREON, THE CERTIFICATE DOES NOT EXTEND TO ANY UNNAMED PARTY.
- THE SURVEYOR MAKES NO GUARANTEES AS TO THE ACCURACY OF THE INFORMATION BELOW. THE LOCAL F.E.M.A
- AGENT SHOULD BE CONTACTED FOR VERIFICATION. THE FNIP FLOOD MAPS HAVE DESIGNATED THE HEREIN DESCRIBED
LAND TO BE SITUATED IN ZONE: X COMMUNITYIPANEUSUFFIX: 120862 0302 L DATE OF FIRM: O811/2009
BASE FLOOD ELEVATION: WA.
CERTIFIED TO: BENNY L. NEWBY &. ADA M. NEWBY
CHRISTOPHER P. KELLEY, P.A.
OLD REPUBLIC NATIONAL TITLE INSURANCE COMPANY
4
LEGEND TYPICAL
--0H— OVERHEAD UTILITY LINES
Z= C.B.S. =WALL (COM
—*—* C.L.F. = CHAIN LINK FENCE
—0-0— I.F. = IRON FENCE
W.F. = WOOD FENCE
■ OM = EXISTING ELEVATIONS
SURVEYOR'S NOTES
1) IF SHOWN, BEARINGS ARE REFERRED TO AN ASSUMED
MERIDIAN, BY SAID PLAT IN THE DESCRIPTION OF THE
PROPERTY. IF NOT, THEN BEARINGS ARE REFERRED TO
COUNTY, TOWNSHIP MAPS.
2) THIS IS A SPECIFIC PURPOSE SURVEY.
3) THE CLOSURE IN THE BOUNDARY SURVEY IS ABOVE
1:75W FT.
4) IF SHOWN, ELEVATIONS ARE REFERRED TO
MIAhV-DADE COUNTY.
BMai ELEV. FEET OF N.G.V.D. OF 1928.
SURVEYOR'S CERTIFICATI
I HEREBY CERTIFY: THAT THIS "BOUNDARY SURVEY" OF
THE PROPERTY DESCRIBED HEREON, AS RECENTLY
SURVEYED AND DRAWN UNDER MY SUPERVISION,
COMPLIES WITH THE MINIMUM TECHNICAL STANDARDS
AS SET FORTH BY THE FLORIDA BOARD OF
PROFESSIONAL LAND SURVEYORS IN CHAPTER 61G17-6,
FLORIDA ADMINISTRATIVE CODE PURSUANT TO 472.027,
FLORIDA STATUTES.
BY:
E
PROFESSIONAL LAND SURVEYOR NO. 2534
STATE OF FLORIDA (VALID COPIES OF THIS SURVEY WILL
BEAR THE EMBOSSED SEAL OF THE ATTESTING LAND
SURVEYOR).
REVISED ON:
REVISED ON:
z
NO. 2634
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m STATE OF
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SURVEYOR'S SEAL
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