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DS-16-201
Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number. INSP-251580 Permit Number: DS-1-16-201 Scheduled Inspection Date: March 10,2016 Permit Type: Driveways/SidewalksJSlabs Inspector: Rodriguez,Jorge Inspection Type: Final Owner: GOMEZ, RODOLFO AND SUSANA Work Classification: Addition/Alteration Job Address: 1156 NE 101 Street Miami Shores,FL Phone Number (305)898-8841 Parcel Number 1132050190250 Project <NONE> Contractor: HOME OWNER Building Department Comments CONCRETE DRIVEWAY Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed sw_ Failed Correction Needed Re-inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid March 10,2016 For Inspections please call: (305)762-4949 Page 9 of 28 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) hereinafter referred to as the owner of the following described pr erty(ad ss): A C-- 1 c) _ �5-�- :rn ?13 V2Legal Description t825?- feot ` Block Folio# o Requests permission to install (describe work): ZVL rt✓�i�rGwX Within the public right of way of(address) S' AAF /b/ S IY7( rn 313 IN CONSIDERATION of the approval of this permit by theillage, 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 Managgr of Miami Shores Village (or his fully authorized representative). Signature er o gent The foregoing instrument was acknowledged before me this day of .— , 2 by SU s}/1//t��ie Z• who is personally known to me or who has produced as identification and who did tak n oath. NOTAUBLIC: Sign•. Prin . o My Commission Expires: a, YP`a Notary Public State of Flora Joanna M Feliciano My Commission FF 082753 'of no Expiresol/12/2018 Miami Shores Village ° T` 10050 N.E.2nd Avenue NE ' y s, Miami Shores,FL 33138-0000 c" Phone: (305)795-2204 �, � � ``�� ,� 1 Expiration: 06/02/2016 Project Address Parcel Number Applicant 1156 NE 101 Street 1132050190250 RODOLFO AND SUSANA GOME1 Miami Shores, FL Block: Lot: Owner Information Address Phone Cell RODOLFO AND SUSANA GOMEZ (305)898-8841 Contractor(s) Phone Cell Phone Valuation: $ 3,000.00 HOME OWNER _........M..._.._..__._.____.R__.___.__._._ � �.�x .�_.. _. ___.____._.._.._.. Total Sq Feet: 960 Approved:In Review Available Inspections: Comments: Inspection Type: Date Approved::In Review Final Date Denied: Foundation Type of Work:CONCRETE DRIVEWAY Additional Info: Review Planning Bond Retum: Classification:Residential Review Building Scanning:3 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Bond Type-Owners Bond $500.00 Invoice# DS-146-58444 CCF $1.80 02/04/2016 Credit Card $647.80 $0.00 DBPR Fee $2.00 DCA Fee $2.00 Bond#:2979 Education Surcharge $0.60 Notary Fee $5.00 Permit Fee $125.00 Scanning Fee $9.00 Technology Fee $2.40 Total: $647.80 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVI • . that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and a ore,I authorize the above-named contractor to do the work stated. February 04,2016 Authorize nature: r / Applicant 1 Contractor I Agent ate Building Department Copy February 04,2016 1 r \� Miami Shores Village Building DepartmentJAN 2,6 2016 10050 N.E.2nd Avenue Miami Shores Florida 33138 � Tel:(305)795-2204 Fax:(305)756-8972 B�r: INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 201Y . BUILDING Master Permit No./.JS 16 — 20 PERMIT APPLICATION Sub Permit No. of"ILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL r-1 PLUMBING ❑ MECHANICAL F-]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: I I SCo PC I O ( ST City: Miami Shores County: Miami Dade Zip: 3313�3 Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): /ajyo/4 A 6,b&t'C-a Phone#: A17.9T/ 6� Address: Il$to P6 /o f �* City: Pi;wtc SkoreS State: Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: ©u't/C- Au I Gtc ve— Phone#: Address: City: State Zip: Qualifier Name: Phone#: State Certification or Registration#: Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: a ue o or or this Per x O® O Alteration ^ StreIea; "age_of ork: 191 TypeofWork: F-1 Addition �I Alteration ❑ New ❑ Repair Replace ❑ Demolition Description of Work: CAD 1 V-C VU A-,/ Specify color of color thru tile: c Submittal Fee$ Permit Fee$ 25'coW CCF$ ` CO/CC$ Scanning Fee$ -6 Radon Fee$ 07-CJ �/DBPR$Q Notary$ �J ' Technology Fee$ oil y Training/Education Fee$ t) Double Fee$ Structural Reviews$ Bond$ � tt TOTAL FEE NOW DUE$ 1 (Revised02/24/2014) ro Bonding Company's Name(if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) Mortgage Lender's Address 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 approved and a reinspection fee will be charged. r Signature IZZx4 Signature N R or AGE CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of /' 20 16 ,by day of ,20 .by o is personally known to who is personally known to me or who has produced 75 ?C as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign rint Print: Seal: r Notary PublicS�n Fi a Seal: $ !Derma i FF 082753 ppy Com • Ex0fas 01J12rL018 �prp� APPROVED BY �l Plans Examiner ` Zoning Structural Review Clerk (Revised02/24/2014) L yt�°mss S ixa 1.93i Miami shores Village owes IT! Building Department 10050 N.E.2nd Avenue L�%,�Na�'� Miami Shores, Florida 33138 LORTel: (305) 795.2204 Fax: (305) 756.8972 SURVEY AFFIDAVIT STATE OF(FLORIDA) COUNTY OF(DADE) The undersigned Affiant, 0,00( � ,does hereby attest that IF (Property owner) The attached survey,performed by C7yti -ey (group 'Zo, uw"I' (Name of surveyor's company) For address: /41 Kityaq a Performed on (0-30—Z-00r(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. FGrth r,Affian eth nayght. Property Owner Signature Property Owner Print Name SWORN TO AND SUBSCRIBED before me this day of / 2-0,101 Affiant is personally known to me, ✓ produced as identification. �ppY ai:otaryoannPu��State Of Florida Y Comliciano o 12on I::082753 Notary18 xpires Revised(6/25/12)Rev1sed on 51221200 Revised on 6112/09 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: Rd) Do R • (00 K4_ ' DATE: I Zoo 20 ADDRESS: sr, M twm L -13131 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. 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 1 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 or substantially improved it for sale or lease,which violates the exemption. Initial S. i understand that,as the owner-builder,I must provide direct,onsite supervision of the construction.�/� Initial_/7 6. I 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 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 htt�://www.m�oridalicense.com/db�r/pro/Cilb/index.html//www.m�oridalicense.com/db�r/pro/Cilb/index.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: 9. (G ( 's T, aees� KC 33/34? 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 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 contractors 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 26 day of 20 J1, CO pN(� 60�1Q By�������P/n�who was personally known to me or who has u 2 ic 'i $ o �c�v Produced there License or as identification. Z 0 2 W WNER NOTARY 1100AWON DIE" 11K nip log V33T A top W � �,'"'`� h,.445 , • .,., ti•10 (L Uj co) • •••••• � ,^• , � �j_♦ 9999--- .....-i- 00a'i----s ... y _ •o Cd O t f�� •L' %7� ',.Glruas ASO PROPERTY ADDRESS: 1156 NE 101. Street,. Miami Shores, Florida 33138. ZLL a l�• 1 :fit. LEGAL DESCRIPTION: Lot 2 , Block 177 , "REVISED PLAT OF TRACTS �J 175A, 175B, 175C, 176A, 176B, 176C, 177A, 177B & 178A, OF REVISED �� PLAT OF MIAMI SHORES SECTION 8" , according to the plat thereof, as recorded in Plat Book 43 , at Page 67, of the Public - Records ' of Dade County, Florida. JAN Z,� Z 6FOR: RODOLFO RUDY GOMEz & SUSANA FALERO GOMEZ. Cl)SCERTIFY TO: RODOLFOJUDY GOMEZ & 9VSANAFALERO GOMEZ. w "v; � • .STEVEN A. 'GREEXSPAN, P.A.. �A y»gA IPW11� /3.7tci 3 $Y. �, ti ATTORNEYS' TITLE -INSURANCE FUND} INC. �' w 'v��+�+ u� ; �:°t '""pj i-� - �i l�.4v' FREMONT INVEST'MEN'TS & tbAN, its successors anti/or a c gns � o l-�asdo�ellt� „c1 4� i�•7x' ,�� >� s their interest inay appear: - di• I ¢ p„g W-0061-"S ft 11z % 'hr GUN ITER GROUP,Inc. L s.45w I 0 a Land SuJ aveyaug�.an�Plannang 9350&W 221'D Timm= Mia,417.881155 U q r� mss` V P[i: 051 (3520-0073 FAX{805)220.8770 LU CSL. Z ABBRenAn. 0 _j , CALCULATEO I HEREBY COY TD THE Awn NAMED FBM Am=PERSONTHAT THE'S-am OF mummy suavET OF THE mm GESCRBED PROPERTY C 1- Q PV 0� � Ilk 6 TRUE ALAI CORRECT TO THE BEST OF OUR UNONLMSE AID BELIEF.AS RECEliI1.Y SURVEYED AN PLATED LEDER OUB OwAECTIMIL ALSO THAT CB:CACHH BASPI � a THERE ARE NO VISIBLE ENCROADOWITS OTHER THAN THOSE SHOWN AND THAT MEETS THE AIMMUM TEDWAI STAlDABOS SET FORTH BY THE CR:cam LINE a �f FLORIDA BOARD OF PROFESSVIAL LAND SURVEYORS 91 CHAPTER 616174L FLORIDA ADAINDSTRATNE CODE.PURSUANT To SECTIOIII 472.027 CLz_CLEAR t j/ I N FENCE FLORIDA STATUTES GEES CHANT 4. CONC:CONCRETE SURVEYOR'S NOTES CA'.CONCRETE POLE !PI TM 6 A BOIRIOARY SIBVEY. H�DRILL HOLE {OBS t OBSERVE AME AT FDD • BIC.ENROACH FHP- OMERSECNTBN=L PONT TMRMDDSNONRECTDADMBBF :FP�INTF LEGAL OSCRUrIlm WAS F BY CLW. FBI:FWHYDRANT ML PROPERTY 40 fAV s EXAM81AT1011 OF THE ABSTRACT TITLE WILL.HAVE TO BE MADE TO GETERMW RECORDED BSTRUMENTS.IF ANY AFFECTKG THE PROPERTY. L.P.:180111I n P.T.:PORT OF TANGENCY ti • ' LEGAL OESCRWTBN MART TO ANY CEDtCATDN$LIMITATDIIB.REMTLWiS.RESERYATDAS OR EASEMDITS OF RECORDS. Of MEAS ft RECORD SEARCH OF THE R”RECORDS NOT PERFORMED BY 7LRS OFFICE MRt MAL HOLE N.F.:WOOD FENCE s lfJ. �j04 • UTBtTY FACILITES WITHIN UTMITT EASEMENTS NOT'NOTED AS VIMATNRi3:ORNENAYS OR PORT)WIS THERE NITlIN ROADWAYS MOT MR MDRRAEMT LUE NAB NATER METER �lr �"` (I� 11 MOTS ASNOLATI@ISORENCROACiNi9RS. NO-NAIL 6DSC N9'.:wow FILE TLUS SIRLVEY HAS BEEN PREPARED FOR THE E%CLUSAIE USE OF THE flITLTES MAAND HEREDM. f:J • THE CERTIFDAT=HEREON 08 NOT E MNO TO ANY LAI&WED PARTIES. - A11-7• FOUNDATIONS FOOTINGSIOR FOOTS INERNEATH THE BROIAD SURFACE THAT MAY CRM BE 7W BOUNM 18ES OF THE PARCEL / _ �' �/ ♦ G MAN DESCRIBED ARE RIOT SHOWN HEREDL T .�ry?°i./�L+r- �✓� � • CONTACT THE APPROPBIIRE AUTHORITY PRHOB T8 ANY DEQ WORK OM THE HEREON! PANCEI IN AND 2TAV816 g Lj/r y,'_ ;4 /1 J�_ __-_� '/�+ J� i ALLI=TANL '�y12• �J '"A �jC/JVl� / (•7G i • All BOM PN'ES OR REBAB FOND AT PROP6iiT COlNERS PAVE ID CAPS UILESS OTHERWISE STATED. BY: R NOD ORJU- LS4312 NOT VALID WITHOUT THE SIGNATURE AND THE ORIGINAL RAISED SEAL Of A FLORIDA LICENSED SURVEYOR AND MAPPER On RICARDO ORTIZ LS-5629 ALt TO Tlx:Y�LF�tAI FU; 9 ai�E PRAM' P�11k.: � F Z BASE Ftp : FOLD VALID OATS JOB No. ND TH O F9.R ISg. DRAWN F ABy- RRIDA LIC PROFESSIONAL LAND SURVEYOR TALE S�IECT p TY FwS 0 zmv J?. "19 0".3 .? 7'�7'�l�� '' A 113.21 r0 l AND MAPPER. STATE OF FLORIDA