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FW-14-901I Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-212400 Permit Number: FW -5-14-901 Scheduled Inspection Date: May 20, 2014 Permit Type: Fence/Wall Inspector: Rodriguez, Jorge Owner: GODINEZ, FELIPE ANDnLGA Job Address: 221 NE 104 Street Miami Shores, FL Project: <NONE> Contractor: HOME OWNER 13unama uepartment comments CHANGE SIDE GATES TO WOOD Inspection Type: Foundation Work Classification: Wood Fence ALL: 206- 2o5 - 4-7 i —1 Phone Number (305)751-1771 Parcel Number 1121360130560 INSPECTOR COMMENTS False Inspector Comments Passed 01 CREATED AS REINSPECTION FOR INSP-211762. Fence higher than 5' Failed Correction Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid May 19, 2014 For Inspections please call: (305)762-4949 Page 30 of 52 INSPECTION STRUCTURAL UK" INSPECTION DATE INSPI INSPECTION DATE INSP Foundation Zoning Final Sternwall ZONING COMMENTS Slab Columns 1 st Lift Columns 2nd Lift Tie Beam Truss/Rafters Roof Sheathing Bucks Windows/Doors ELECTRICAL Interior Framing INSPECTION DATE INSP Insulation Tem ora Pole Ceiling Grid 30 Day Temporary Drywall Pool Bonding Firewall Pool Deck Bonding Wire Lath Pool Wet Niche Pool Steel Underground Pool Deck Footer Ground Final Pool Slab Final Fence Wall Rough Screen Enclosure Ceiling Rough Driveway Rough Driveway Base Telephone Rough Tin Cap Telephone Final Roof in Progress TV Rough Mop in Progress TV Final Final Roof Cable Rough Shutters Attachment Cable Final Final Shutters Intercom Rough Rails and Guardrails Intercom Final ADA corn liance Alarm Rough Z� /e� Alarm Final DOCUMENTS Fire Alarm Rough Soil Bearing Cert Fire Alarm Final Soli Treatment Cert Service Work With Floor Elevation Survey Reinf Unit Mas Cert ELECTRICAL COMMENTS Insulation Certificate Spot Survey Final Survey_ Truss Certification STRUCTURAL COMMENTS Rough Water Service 2"d Rou h Top Out Fire Sprinklers Septic Tank Sewer Hook-up Roof Drains` uas LP Tank Well Lawn Sprinklers Main Drain Pool Pi in Backflow Preventor Interceptor Catch Basins Condensate Drains ' Miami Shores Village , b Building Department MAY n5 2014 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 BY: tJ INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20 BUILDING Master Perm � No. _aj /� PERMIT APPLICATION Sub Perm! No. PUP ILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLICWORKS [:]CHANGE CONTRACTOR CANCELLATION ❑ SHOP DRAWINGS JOB ADDRESS:, G AJ Ll City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO _ Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): C�— �� p Phone Address: � 1V� / 0'-1 (L, � , f `7 41-7 City: 1 )L� CA_t��State: f[ Zip: 1 3 2 Tenant/Lessee Name: Email Phone#: CONTRACTOR: Company Name: ��Phone#: Address: City: State: Qualifier Name: _ State Certification or Registration #: one#: ificate of Competency #: DESIGNER: Architect/Engineer: Phone#: p: Address: City: State: Zip: Value of Work for this Permit: $ r t36I Square/Linear Footage of Work: Type of Work: ❑ Addition Alteration ❑ New ' n ❑ Repair/Replace ❑ Demolition Description of Work: C �t4CAO � Specify color of color thru tile: Submittal Fee $ Permit Fee $ Scanning Fee $ CCF $ CO/CC $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ Technology Fee $ TOTAL FEE NOW DUE S V 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. "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 an 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 thisQ day of 201 byaa 7 day of 20 by who is rsonally known to me or who has produced 63S-"-7who is personally known to me or who has produced L0L As identification and who did take an oath. NOTARY PUBLIC: as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: ********************************************************************************************* APPROVED BY �TT91� Plans Examiner ) l Zoning Structural Review Clerk (Revised02/24/2014)(Revised 5/2/2012)(Revised 3/12/2012) )(Revised 06/10/2009)(Revised 3/15/09)(Revised 7/10/2007) 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: NAME:7--yCcoum-z-/ DATE: -1 / 2-61 / V ADDRESS: Z- A) Z1- l 0 -1 S;� i r L j c,,%,t 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 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. 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 1, as the owner of the property listed, may act as m n 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 —Im 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 orlic 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 st iall 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. 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. It is my responsibility to ensure that the persons whom I employ have the license required by law and by county or municipal ordinance. Y Initial h 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. 1, 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. /A� 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 4e0Ar___ 9. 1 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. 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 hfp://www.myfloridalicense.com/dbprlpro/cilb/index.html Initial_`'W 11. 1 am aware of, and consent to; an owner -builder building permit applied for in my name and understands that I am the parry legally and financially responsible for the proposed construction activity at the following address: Initial 12. 1 agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the information th 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 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 day of 20 who was personally known to me or who has Produced there License or 6,3-5; ? 6�4 6 F as identification. OWNER - public State 0 1 F�aNrye► l -.vJoannaM Fe. 082753 •y, .4 ExP es 011 212018 �TIJ _ STATE OF (FLORIDA) COUNTY OF (DADE) Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 SURVEY AFFIDAVIT The undersigned Affiant,01 (YU does hereby attest that (Property owner) The attached survey, performed by MM TT ic,C) -S, �' O,, on ez (Name of surveyor's company) For address: "7:Z (A—) & f 0 Ci " 01' a 1/k.; f � - Performed oaiftO &L (date of survey) is an accurate representation of the existing conditions and locations of all structures 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, Affiant sa eth naught. Prope y Owner Signature Property Owner Print Name SWORN TO AND SUBSCRIBED before me this day of G� y. Affiant is personally known to me, produced e:33' identification. c State of Florida 10 l 0(� Jo a M Feliciano Revised on 5/22/2009/ Revised on 6/12/09 a °ih lesion FF 08253 ,ommes0111212018 o ca L N m t' ca as ro CU U .� U C U 01 w co x - to � ®� a E 4M d CL a E a) us O CT «- 25 c >, 0 _m v CL O a) C1 w -0 U_ � o'. BOUNDARY LOT -f2 BLOCK -120 .......... B U R V E Y ........... :.:o ................................15' ALLEY'::'::::'::::::: FIP 7/2"'.'.::•:::•:•:•:•::.......::.10 PAVEMENT :.:::::::.:::':::.::::: ::::::::::: :: NO /D.::':::'::'::':':'::' 75.00' (R&M )\,. .. ....... •'•''3 61'''" FEN C -..F/P 7/2" o '.•. . NO ID. 1 •::':'::.'.::':' PROPERTYADRESS: 4 CHAIN LINK � L J i LL..11. I in BLOCK -WO DATE: 04-26-2014 1 I (0 UPDATE: 1 19.6'to SUFFIX: L �i M •�� I I I. I '.'........'.' \ / ALUMINUM \ / I M I •'•'•' N y 1 STORY RESIDENCEI '•'•'•'•'• '•''' � x 4' CHAIN LINK FENCE I 1W 6.0ill :::...:: ' ' . S V_ � I • I' �� 'ti 4.' •','•, sU•: y : :� ' `•': �' : 0.51X0.5 I ':..�•': ' t 'ti:,"s s t TYPICAL I W 1/2 OF I PFpOV :ti I ; ,�jh ` ;. .Y'S.:y:' " �.I COLUMN I A . Lor-tsJLOT I Z® NTNG OK -10 OK -10U I LU • s••. � g�0 9.50' i ... . ;, : �y' 16.0' :' + .:. ' I 16.0' I w I 6' 1 • •. m 120 ss, ' •:i .y I Z S �g� LOT -0 I :':::':::::c � ..•FS..::t': "� ABOVE I I MOCK -120 I .'.'. '.'.'.'::.'. GATE U : ' GROUND I 2 I POOL ^ $iP I GATE.,. I 2 1 '.'.' ::. S.:.s::.?' ,'• ti • .. } I WALKING V 4-4 Cc STONES REMAAVER LOT -16 .... NORTH RIGHT OF WAY LINE ;;•;ASPHAL7..DR/VEWAY:;•'• 23' PARKWAY ........................................................ o O M EDGE OF PAVEMENS '.'.'.'..'....'.'.'....'.'.'......'.'.'.'....'.'.'..'.'.. '.'.'.':::.'.':.:':: .. /]: ..:.'.'.,j/(j.,'�J ',,�./�j' :': ' .,:/:,.}.1(j .. . _. ... -- .. - . - .'..................................... .......................:. "....... 70 TOTAL RIGHT OF WAY ..20' +/— ASPHALT PAVEMENT ::::.:.:.::.:.::::::::'::::'::: ::::::::'::::::::: MAY 0 5 2014 -1mob qQu(, Graphic Scale 0 4d 2d "rhe LOCATION MAP N (NOT TO SCALE) LEGAL DESCRIPTION: Lot 15 and the West 2 of Lot 16, in Block 120, of AMENDED PLAT OF SECTION No. 5 OF MIAMI SHORES, according to the plat thereof, as recorded in Plat Book 10, at Page 47, of the Public Records of Miami Dade County, Florida. Z � ZO W 7d' a zi a a LL N 'S W J U 3 u t7 W O li J li z 3 a o 0 a Z O a n J 3 0 J ¢W� V 3 V U O m U a ol1�1000 N F z a Z zQzo w Q pQ�o�6�ygJ� �7 Q > � i�Ewa �`Y3w W Q: K R' N (N N N x M iL O W �€€ >v z_ oK wZ LL J U' C h J W a OLL r Q x z u g a a a z¢ Q " c Z LU jm��„� U/ E z a IL ca z M J � IJ 0 F a J �Z�o -` t7 W Uj LL n n u u E M a xL2 r a o IL IL IL � J R_ _R L2 z 'z z J Z �W F aa W N j z w F z m w F a a a m U. U n n U U U U U J U "J O Q a OG V t7 Ci U FLOOD ZONE: WITHIN ZONE: X ORDER NO.: M-8441 PROPERTYADRESS: ELEV.: N/A L J i LL..11. 0' in BLOCK -WO DATE: 04-26-2014 Miami Shores, FL. 33138 (0 UPDATE: 1 19.6'to SUFFIX: L I I. •.• ^- I I M I •'•'•' N 1 STORY RESIDENCEI I � x :::...:: ' ' . No. 221 I V_ � �� I I . 224' I LOT -14 tocK-120 I :.' :' 9.50' i ... . ;, : �y' 16.0' :' + .:. ' I 16.0' 11.10 6' METAL I METAL _ I GATE I GATE.,. 4-4 C) p I I'; .......'.'::: N ;.i I N F/P 1/21.::::':F/P 12S1 A I •'� NO ID. •.• • NO D. FIP 112„ �g-C• _ 130.01,. _ "; 15.00' NO ID. ..........:," y•14: `sh..'•;. 75.00' t (R&M) 5' SIDEWALK (M) �4.' S; ; �.tiT:4�•.a . : .... NORTH RIGHT OF WAY LINE ;;•;ASPHAL7..DR/VEWAY:;•'• 23' PARKWAY ........................................................ o O M EDGE OF PAVEMENS '.'.'.'..'....'.'.'....'.'.'......'.'.'.'....'.'.'..'.'.. '.'.'.':::.'.':.:':: .. /]: ..:.'.'.,j/(j.,'�J ',,�./�j' :': ' .,:/:,.}.1(j .. . _. ... -- .. - . - .'..................................... .......................:. "....... 70 TOTAL RIGHT OF WAY ..20' +/— ASPHALT PAVEMENT ::::.:.:.::.:.::::::::'::::'::: ::::::::'::::::::: MAY 0 5 2014 -1mob qQu(, Graphic Scale 0 4d 2d "rhe LOCATION MAP N (NOT TO SCALE) LEGAL DESCRIPTION: Lot 15 and the West 2 of Lot 16, in Block 120, of AMENDED PLAT OF SECTION No. 5 OF MIAMI SHORES, according to the plat thereof, as recorded in Plat Book 10, at Page 47, of the Public Records of Miami Dade County, Florida. Z � ZO W 7d' a zi a a LL N 'S W J U 3 u t7 W O li J li z 3 a o 0 a Z O a n J 3 0 J ¢W� V 3 V U O m U a ol1�1000 N F z a Z zQzo w Q pQ�o�6�ygJ� �7 Q > � i�Ewa �`Y3w W Q: K R' N (N N N x M iL O W �€€ >v z_ oK wZ LL J U' C h J W a OLL r Q x z u g a a a z¢ Q " c Z LU jm��„� U/ E z a IL ca z M J � IJ 0 F a J �Z�o -` t7 W Uj LL n n u u E M a xL2 r a o IL IL IL � J R_ _R L2 z 'z z J Z �W F aa W N j z w F z m w F a a a m U. U n n U U U U U J U "J O Q a OG V t7 Ci U FLOOD ZONE: WITHIN ZONE: X ORDER NO.: M-8441 PROPERTYADRESS: ELEV.: N/A FIELD BOOK : "FILE' 221 N.E. 104th Street COMMUNITY: 120652 DATE: 04-26-2014 Miami Shores, FL. 33138 PANEL No.: 0302 UPDATE: SUFFIX: L FOR. OLGA GODINEZ DATE: 09-11-2009 I HEREBY CERTIFY: THAT THIS DRAWING REPRESENTS THE RESULT OF A SURVEY OF THE THI SURVE�ISVALI WITHOUT THEWITHIN DESCRIBED PROPERTY AND THIS DRAWING AND SAID SURVEY WERE PREPAREDDJY ME OR UNDER MY DIRECTION.THERE SIG TUREL OF A FLORIDA LICEN SAPPER ARE NO ENCROACHMENTS UNLESS SHOWN THEREON. NOTES: • THIS SURVEY DOES NOT REFLECT OR DETERMINE OWNERSHIP. • EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO D RECORDED INSTRUMENTS, IF ANY, AFFECTING THE PROPERTY THIS SURVEY IS SUBJECT TO DEDICATIONS,LIMITATIONS, RESTRICTIONS, RESERVATIONS OR EASEMENTS OF RECORDS. • LEGAL DESCRIPTIONS PROVIDED BY CLIENT OR ATTESTING TITLE COMPANY. • UNLESS OTHERWISE NOTED, THIS FIRM HAS NOT AN ATTEMPED TO LOCATED FIX AND/OR FOUNDATIONS. • NOT VISIBLE ENCROACHMENTS WERE FOUND ON THE PROPERTY, UNLESS SHOWN. • IF SHOWN ELEVATIONS ARE REFERRED TO N.G.V.D. 1929 • BENCH MARK USED No. , LOCATOR , WITH ELEVATION: 1ROISO J. RAMIREZ PROFESSIONAL LAND SURVEYO & No. 2779 STATE OF FLORIDA 8341 SUNSET DRIVE MIAMI FL 33143 TEL: (305) 596-0888 & (305) 596-0990 E-MAIL: atlantl/weMce©bellsouth.net