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DS-15-1044Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Parcel Number Applicant 790 NE 97 Street 1132060142190 Miami Shores, FL 33138- Block: Lot: ANN UENO ANN UENO 790 NE 97 Street MIAMI SHORES FL 33183- Contractor(s) Phone Cell Phone HOME OWNER In Review Approved:: In Review Denied: of Work: NEW DRIVEWAY PAVER ON SAND Additional Info: Return : Classification: Residential nina: 1 Fees Due Amount Bond Type - Owners Bond $500.00 CCF $3.60 DBPR Fee $2.25 DCA Fee $2.25 Education Surcharge $1.20 Permit Fee $150.00 Scanning Fee $3.00 Technology Fee $4,80 Total: $667.10 (312)305-0095 Valuation: $ 5,500.00 Total Sq Feet: 1025 Pay Date Pay Type Amt Paid Amt Due Invoice # DS -5-15-55405 05/01/2015 Credit Card $ 50.00 $ 617.10 05/12/2015 Credit Card $ 617.10 $ 0.00 t:. Bond #: 2713 � Avauaole Inspection Type: Final Review Review In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the pror er authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT I cert' th all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating ' construction and zong. Futhjrm„ I authorize the above-named contractor to do the work stated. /L / May 12, 2015 z Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy May 12, 2015 1 i � `Z��� Miami Shores Village Q00 Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (30S) 762-4949 BUILDING PERMIT APPLICATION FBC 20 0 Master Permit No. DS 15— 109, Sub Permit No. OBUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL [::]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS 7 JOB ADDRESS: 790 NE 97 St City: Miami Shores County: Miami Dade Zip: 33183 Folio/Parcel#:11-3206-014-2190 Is the Building Historically Designated: Yes NO X Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Ann Ueno Phone#: 3124305-0095 Address: 790 NE97 street City: Miami Shores State: FI Zip: 33183 Tenant/Lessee Name: Phone#: Email: e.ev®f CONTRACTOR: Company Name: N/A Phone#: Address: City: State: Zip: Qualifier Name: Phone#: State Certification or Registration #: Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ 5,500.00 Square/Linear Footage of Work: 1025 sqft Type of Work: ❑ Addition ❑ Alteration © New ❑ Repair/Replace ❑ Demolition Description of Work: New Driveway ( pavers on sand) Specify color of color thru tile: Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ (Revised02/24/2014) DBPR $ Notary $ Double Fee $ Bond $ 5po' M TOTAL FEE NOW DUE $ I I A. I O 61_�. (0 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, 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 gpproved and a reinspection fee will be charged. Signat Ue Signature OWNER or AGENT CONTRACTOR The foregoing instrume t was acknowledged before me this day of 20 B , by Lwho is personally known to me or who has produced (�5W2-Nft� as identification and who did take an oath\�,� NOTARY PUBLIC: `���` ��g V0r� _ p31061 Sign: Print: omo`�5S` 59 'oma seal: OE 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: as APPROVED BY jJ Pians Examiner bJ f Zoning Structural Review Clerk (Revised02/24/2014) NAME: ADDRE Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 1, 2,:�? I ---� I Do,hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, FS 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 id 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. 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 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 substantially improved it for sale or lease, which violates the exemption. Initial 5. I 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. 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 properly 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 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 h :/A-vww.m oddalicense.comidb or/pro/cilbfiinde .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 Te proposed construction activity at the following address: % 127 '9 Initial 12. 1 agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the information t 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 owners 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. c Was acknowledged before me this day of , 20 who was personally known to me or who has Produce•there License or - — as — �`'• �XPir�s•. /� ,'moi 03106 2016 NO r in LIC mission # CP•.EE173059. Qt= F 1. ,,���IN1llilillO�\ Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY Whereas, (owner) Ann Ueno hereinafter referred to as the owner of the following described property (address): 790 NE 97 St. Miami Shores Legal Description Sec 3 Lot 1 & 2 Block 69 f=olio # 11-3206-014-2190 Requests permission to install (describe work): New Driveway Within the public right of way of (address) 97 th Street Subdivision Miami Shore Sect 2 IN CONSIDERATION of the approval of this permit by the Village, the owner agrees as follows: 1. To maintain and repair, when necessary, the above-mentioned item(s) installed within the dedicated right of way. If it becomes necessary for Miami Shores Village or Dade County to make repairs or maintain said items within public right of way including restoration of street by reason of the Owner's failure to do so, such expense shall be paid by the Owner or shall constitute a lien against the above described property until paid. 2. The owner does hereby agree to indemnify and hold Miami Shores Village or Dade County harmless from any and all liability, which may rise by virtue of permitting the installation of these items within the public right of way. 3. The Owner does hereby agree to remove or relocate their facilities at their own expense, within 60 days notice by the Village to do so. Failure to comply with this notice will result in the Village causing the item(s) to be removed and a lien being placed on the property and/or assessed against the Owner for all costs incurred in the removal and disposal of the item(s). 4. The undersigned further agrees that these conditions shall be deemed a covenant running with the land and shall remain in full force and effect and be binding on the undersigned, their heirs and assigns, until such time as this obligations has been canceled by an affidavit filed in the Public Records of Dade County, Florida by the Village Manager of Miami Shores Village (or his fully authorized representative). SIGNED, SEALED, EXECUTED AND ACKNOWLEDGE on this (Owner's Signature) SIGNED, SEAL D, AND DELIVERED in�h���'ff'%,� �QVes ' 06If �qT F 2 9x4 c, 'e�,n Lawn -5" 450 sgft Sidewalk 500 261.-611 sgft Zoning Detail : Lot Size : 1 1,500 5gft. Concrete paver GEM Pavers Grass ---\ I" bedding Sand Rebar #5 Area covered by House and Exl5ting slabs : 3,345 5gft Proposed Driveway * front patio : 1,050 5gf t Existing House t prop05Cd driveway and patio : 4,385 5gft Total Proposed green Area : 7,115 5gft Percentage of proposed green area : G2 % j4 o -OL— G° compacted aggregate base ------------------------------------ lryI P 10 +Existing Lawn Tree Septic tank. in the back Sidewalk ExistingGEM Pavers Path �. Lawn j Existing Porch I _ RE5 # 790 Y 00 790 NE 97 Strvet��,` Proposed DriveWAY. ��� •'� C M rn z z 0 r D z n ci m ® ® M 0 z D 03 3 e. Cn z = - r M < La CD > o -_t M > N.T.S ®1 ' F.I.P. 112' NO CAP 0.55' CL N OVEKHEAD WIRE - 0.40' CL as —� JOHN MARRA & ASSOC rofessional Land Surveyors & Mappers V1fiV1V 4.I®ARFIALANDSUAV EYORS. OM 777 N.W. 72rid AVENUE 1 2804 DEL PRADO BLVD SOUTH SUITE 30251 SUITE NO. 2023UNIT 9 MIAMI, FLORIDA :33926 � CAPE CORAL, tL 33SU04 PK (305) 26j2-44,00 � PIS: (239) 540-2G FAX: (305) 252-0-101 i�AX. (239) 340-2664 MAP OF BOUNDARY SURVEY 790 NE 97th STREET, MIAMI SHORES, FL 33138 Triangle of visibility area will be kept clear of obstructions between a height of 2 2 feet to 8 feet. 97th STREET I'NE TOTAL RIGHT -OF -WAS' 16,75" A5Pt1ALT PVMT. .� . IN 911 'Em"; /tank. in the back Sl A i l f 0 / y Path r r wn '40 CAP 31.33 — j I j -- s {j I �, I j i ONE O. 14.9 ,r11, 5T"15 I ti. CONC. i STAMP I DRIVEWAY F.I.P. f ld NO CAP _ — 1' W'F U.P. i- °, RETURN i 100.00 t�. A 1 � OVER.ME AD WIRE v 1 5' ALL1Y IN.A,P.) 6' 5PALT 0 ENCROACHMENT MOTES: LEGAL DESCRIPTION.• P9�qS 034�Q,P_ LOTS I AND 2, BLOCK69, OF MIAMI SHORE&SrCTVQ/1$'0.9.AfOORGING TO THE PLA 7- THEREOF AS RECORDED /N PLA T BGypm, r4 or.j7•QF �l N� �7�� THEPUBLIC RECORDS OFMIAM/-DADE COLW1 �Y,.dR�A' • O STATE OF cERrIFICA noN.- ANN UENO AND RICK UENO "' "' • �p 'rGCS�►�� g GREGORYR. FISHMAN FA LAW NORTH AMERICAN TITLE INSURANCE COM AAW SEAL BANK OF AMERICA. NA., /TS SUCCESSORS AND OR ASSIGNS, AS THEIR L.B.# 7806 /NTERESTMAYAPPEAR . : • ... . . 0,0 ... 0096: 4' W.F, 0.50' CL 0 U P. SV11K. 4 CL SAK 0. CL U 30.00' C A5 hALC _BURN SCALE: 1 IWOR FIELD DATE: 0811912014 SURVEY NO: 14-002847.1 SHEET: 12 OF 2