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FW-15-2710 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-253324 Permit Number: FW-10-15-2710 Scheduled Inspection Date: March 29,2016 Permit Type: FenceMall Inspector: Rodriguez,Jorge Inspection Type: Final Owner: SANTOS,AIMEE Work Classification: Wood Fence Job Address:135 NE 94 Street Miami Shores,FL 33138- Phone Number Parcel Number 1132060132881 Project <NONE> Contractor: ULTRA FENCE INC Phone: (305)592-4578 Building Department Comments WOOD FENCE& HIGH Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-252941 CREATED AS REINSPECTION FOR INSP-246460. Gates must be self closing No permit posted Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid March 28,2016 For Inspections please call: (305)762-4949 Page 11 of 27 jY ! x t Miami Shores Village 10050 N.E.2nd Avenue NE Miami Shores,FL 33138.0000 Phone: (305)795-2204 uExpiration: 09/2016 Project Address Parcel Number Applicant 135 NE 94 Street 1132060132881 AIMEE SANTOS Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Celt AIMEE SANTOS 45 NE 94 Street MIAMI SHORES FL 33138 Contractor(s) Phone Cell Phone Valuation: $ 1,200.00 ULTRA FENCE INC (305)592-4578 Total Sq Feet: 75 i Approved: Available Inspections: Comments: Inspection Type: Date Approved:: Final Date Denied: Foundation Type of Construction:Wood Fence Additional Info:WOOD FENCE 6'HIGH Review Planning Classification:Residential Scanning:3 Review Building Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 Invoice# FW-10-15-57540 DBPR Fee $2.00 02/11/2016 Check*3598 $66.20 $50.00 DCA Fee $2.00 Education Surcharge $0.40 10/23/2015 Check#:2172 $50.00 $0.00 Permit Fee-Wire&Wood $100.00 Scanning Fee $9.00 Technology Fee $1.60 Total: $116.20 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating constructiona onin . Futheomore,I authorize the above-named contractor to do the work stated. February 11,2016 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy February 11,2016 1 Miami Shores Village J� it 3( BuildingDepartment ocr 2 s 20� 5 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 BY- INSPECTION'S PHONE NUMBER:(305)762.4949 BUILDING Permit No. PERMIT APPLICATION Mister Permit No.:rGV FBC 20 Permit Type: BUILDING / OWNER:Name(Fee Simple Titleholder): Phone# ��✓'b l��1 Address: I -e( �y City: State: Tenant/Lessee Name: Phone#• Email: JOB ADDRESS: nc— 9q City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Flood Zone: CONTRACTOR:Company Na/me: C) Phone#: Address:'�LiI/ 61 I City: M1 State: ' Zip: Qualifier Name: ('a /^Ir�0 � Phone#:W-57�!�9 Z7YS ,gy,pp State Certification or Registration#: Certificate of Competency*: /a4!6 f DWC Contact Phone#• Email Address: �✓ ®� •,f / - DESIGNER Architect/Engineer. Phonek Value of Work for this Permit:$ Square/Linear Footage of Work: `75 Type of Work: OAddress'' SiAlteration ONew ORepair/Replace ODemolition Description of Work: ���` a ' -t�C 1(Q o G COLOR THROUGH ROOF TILE IS REQUIRED wAnawkdged by.- Submittal y.Submittal Fee$ 150 4^ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ r � ' re 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 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 cerci d co o the recorded notice commencement mast be P Perp' 1 .fie copy f of 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 appy d and a reinspection fee will be charged Si Si Owner or Agent Contractor The foregoing instrument was acknowledged before me this The f o' ent was acknowledged before me this day of . ne 1 20 J by A 1{1� f�_0'f 05 day of 20 by �4 aa4��—©Q� � who is personally known to me or who has produced who is who has produced As identification and who did take an oath. as identification and who did take an oath. NOTAR UBLIC: NOTARY PUBLIC: Sign: Sign: —67�— -- Printtk—iIINII M TSS print: d r4ft My Commission Expires: a 1 R NMI My Commission Expires: V. - C "*"INN9 Yr Com.Enprphl7.X14 Mp Cm n.Exm Jd 7.2011 . Bas>adttya�pUl�rmlpctarylbm APPROVED BY T01" t— Plans Examin C d1 Examiner "J--7 Zoning Structural Review Clerk {Revised 07/10/07XRevised 06/10=09XRevised 3/15/09xrcW4/10) 4 ���■ ate. Miami shores Village Building Department �R1fA� 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305)795.2204 Fax: (305)756.8972 Notice to Owner— Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla..Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers'Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees,including the owner,must obtain workers'compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if- 1. f1. The officer owns at least 10 percent of the stock of the corporation,or in the case of an LLC,a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State,Division of Corporations;and 3. The corporation is registered and listed as active with the Florida Department of State,Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers'compensation exemption and has acknowledge that he or she will not use day labor,part-time employees or subcontractors for your project.The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project.In these circumstances,Miami Shores Village does not require verification of workers'compensation insurance coverage from the contractor's company for day labor,part-time employees or subcontractors. BY SIGNING BELOW U ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature* lUner State of Florida County of Miami-Dade The foregoing was acknowledge before me this day of 9.J 4 ,20 By j_a4 who' ersonally known t or has produced as identification. Notary: SEAL: ANA M 70RI(ES A10 NO"F .$W dFlea 2=2L -f ___ __ - __ - bowld 1. '•Z MR-0FY SaadeOS N�Id A3 1 ULTRA FENCE 7941 NW 64 ST MIANH,FL 33166 305-5924578 Date: i D1 I "S State of i=i County of M%C4&y t% C CXA+^� Before me this day personally appeared L.Gt 7-a co—r'O fy4o,being duly sworn, deposes and says: That he or she will be the only person working on the project located at: Sworn to(or affirmed)and subscribed before me this lq day of 0 C. ,20 Nby L a z ci vu ersonally known OR uce I en cation Type of Identification Produced oi"►a'Y A ..,, ANA 0 Thi PWft-8tah of noufta Commission#►FF 249812 My Comm.Expires Jul 7.2919 Banded NsdaaalNotaryA=- arrie bf NoTary I FROM :Pdit FAX ND. :3057599257 SM36 18 2815 89:i2AM P2 -OFFICE miff ., a!**M II:011 fes- Mil P.m= f-M Boundary Survey pmw;afa Proper Addr�ees: go Rw4wn COPY "S N.E St GbW f4�mC 93198 erttftad,Jo: t3taro1o81�yta;AeTee l Imo;Wry t fc,�A 6jtdkr8BQM"#jdr,141 mill 'M'' awOCT`2 3 2015 Ma�eiet� i�ns�u�ransa Rete m (FIRMI information• Pand tom: 0m dll:C J t' od 1t X Paseo Rued OW 03MM Now. t.L•�10 6ymae�.7l�aowyuaoiaadoa icy . g mat�eme a7�maa�e8reme.a ee,aeo e d pm ,now. #& , aae ��n+69aa roe m Oem� m , g1e fts La, i m aeteaedoeeea0Y6A {�fa646MOl9 {enaVII. . 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Mouncdmry gaurvmy - Pfte2d2 1•- V Garay am 71d•suraw moss fid"i0 om ftmmw•ane to 300 admoa nat a►s Pbleir Fi�q I�pf ii�aeyorand tilsyOw. roam" BMW P. r•ewwrµraelor •girt ur t�wrw+ ' oart • jRn > uAlas tai �`' mus 90+0? nuc stt00P - �' � � • am lm%V.T ' � p N.L.A41ti BTI�ET OWM&Siv • • • •• • • • • • P.S.M. � '� '�'��. ••• 9 X5.98188 • •• • • • • • •• ••• • • • ••• • • Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 �ZOR ► Tel: (305) 795.2204 Fax: (305) 756.8972 WOOD FENCE DETAIL .a Shadow Box o Vertical Picket o Board on Board 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 Tin height pp 1x pickets fastened .,� with two corrosion resistant fasteners per connection 2x4 horizontal /pressure treated wood members with two corrosion resistant fasteners 00 per connection .. ... . . . . . .. 4x4 F;essA-;eatA ..posts e*r*d;�29n ... . . .. concrete footing 10" diameter x 2'deep . •.• . ... . ... ALL W800 m�Wt-b j prejstjrest ja jed; All fastVIters'lnustbVcof'rosiontesistant No less than two fasteners in any connection OV May 2009 .. .. ... . . . ... . . { OCT 232015 Miami shores Village logo Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 �tORI� Tel: (305) 795.2204 Fax: (305)756.8972 SURVEY AFFIDAVIT STATE OF(FLORIDA) COUNTY OF(DADE) The undersigned Affiant, i Mee�q VA 05 ,does hereby attest that (Property owner) The attached survey,performed by ?2.�j,'j (Name of surveyor's company) For address: 1-55 yr)t i �1 u Performed on (date of survey)is an accurate representation of the existing conditions and locations of all structu 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. Fu er,Affiant y eth naught AIME Property Owner Signature Property Owner Print Name SWORN TO AND SUBSCRI8915 f fo ehi this• .f • day of Perim IF. . . . . ft"Pdft 8"of ram \_ ANI►M TSS ,�ji . . . .. . . . . . ... ... . ... . . Revised on 5(2ZM Rolla!an 61120 ... . . . ... . . i t Ultra Fence Inc 7941 NW 64 ST llAA4T- F1..., 33166 CONTRACTOR COR 'O XCEMPT AFFIDAVIT . Sate of Fl County of Miami-Dade Before me this day personally appeared Lazaro Torres,who.being duty sworn,deposes and says: His workers compensation exempt form is attached for reference to pull out permit. Which expires.10/9/2016. That he will be the only person working on the project located at t 3S !u C Sworn to{or affirmed)and subscribed before me this t` day Of,-IX-► 2015 By �. `l Personally KnoAm Type of identification produced �d ANA M TORM ft"PWM-Oft aFbft I FF VMS IM Iia.ftow hl?.M" soPMa •• ••• •• • • • •• • ••• • ••• • ••• •• • • • • • • • • • • • • • • • • • • ••• • • • ••• • •