DS-16-814 v
Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-255617 Permit Number: DS-3-16-814
Scheduled Inspection Date:April 07,2016 Permit Type: Driveways/Sidewalks/Slabs
Inspector: Rodriguez,Jorge Inspection Type: Final
Owner. MARTINEZ-ARIZALA, B Work Classification: Addition/Alteration
Job Address:1238 NE 96 Street
Miami Shores,FL Phone Number
Parcel Number 1132060143920
Project <NONE>
Contractor: HOME OWNER
Building Department Comments
SEPARATE CONCRETE WALKWAY STEPS SET ON Infractio Passed Comments
SAND INSPECTOR COMMENTS False
EXPIRED PERMIT#DS 13-2537
Inspector Comments
Passed
� jC0
Failed
Correction C O, a-
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid
April 06,2016 For Inspections please call: (305)762.4949 Page 24 of 47
Ow
h Miami Shores Village
10050 N.E.2nd Avenue NE F,
Miami Shores,FL 33138-0000
` Phone: (305)795-2204 \s
Expiration: 09128/2016
Project Address Parcel Number Applicant
1238 NE 96 Street 1132060143920
B MARTINEZ-ARIZALA
Miami Shores, FL Block: Lot:
Owner information Address Phone Cell
B MARTINEZ ARIZALA 1238 NE 96 ST
MIAMI SHORES FL 33138-2554
Contractor(s) Phone Cell Phone Valuation: $ 700.00
HOME OWNER
Total Sq Feet: 124
Approved:In Review Available Inspections:
Comments:
Inspection Type:
Date Approved::In Review
Final
Date Denied: Foundation
Type of Work:SEPARATE CONCRETE WALKWAY STEP Additional Info: Review Planning
Bond Retum: Classification:Residential Review Building
Scanning:3
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60 Invoice# DS-3-16-59170
DBPR Fee $2.00 04/01/2016 Credit Card $69.60 $50.00
DCA Fee $2.00
Education Surcharge $0.20 03/25/2016 Credit Card $50.00 $0.00
Notary Fee $5.00
Permit Fee $100.00
Scanning Fee $9.00
Technology Fee $0.80
Total: $119.60
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore,I uthori{e the above-named contractor to do the work stated.
April 01,2016
Aub Si nature:Owner / App cant / Contractor / Agent Date
Building epartment opy
April 01,2016 1
Miami Shores Village
7MAR
1 �
S Building DepartmentS 2016
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
BY:
Tel:(305)795-2204 Fax:(305)756-8972
A INSPECTION LINE PHONE NUMBER:(305)762-4949
N` FBC 2014
BUILDING Master Permit No. ms S
PERMIT APPLICATION Sub Permit No.
BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION [—].SHOP
L /_ CONTRACTOR DRAWINGS
JOB ADDRESS: �( 1� �� �aree_+
City: Miami Shores County: Miami Dade Zip: 1313 13!9
Folio/Parcel#: is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
�e 309-907 3
OWNER:Name(Fee Simple Titleholder): fwrlq YyIaal- ne hone#:
Address 1
City: - State: Rn r Phil, zip: 33 13$'
Tenant/Lessee Name: Aj 14 Phone#: A)
Email
AOR:Company Name: nf?c 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:$ y p Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
YP
Description of Work: (2ZVjCf-e- IA)CL W'CLS4 M:32 as
Specify color of color thru tile: �My�
Submittal Fee$ W
rr"Q Permit Fee$ L -04 CCF$ 0° GO CO/CC$
Scanning Fee$ `W Radon Fee$ DBPR$ 0 ' c Notary$ �v®
Technology Fee$ d Training/Education Fee$ ' Double Fee$ /9?0
Structural Reviews$ Bond$ //�++
TOTAL FEE NOW DUE$ coc�I • 6�
(Revised02/24/2014)
Bonding Company's Name(if applicable) r
Bonding Company's Address
City State Zip
Mortgage Lender's Name(if applicable)
Mortgage Lenders 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.
Signature Jr DSignature
OWN4 or AGENT CONTRACTOR
The foregoing instrument was acknowledged
acc�ktnowledged before me this The foregoing instrument was acknowledged before me this
2-05 day of n P-4'4't`"'ti20 lj ,by day of 20 ,by
` � `" Lp t l who is personally known to ,who is personally known to
me or who has produced �L _D(Ltf— UUV; as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PU C: NOTARY PUBLIC:
Sign Sign
Print* �D N �--' �.0 — Print:
Seal: �W P Notary Public State of Florida Seal:
Sindia Alvarez
a My Commission FF 156750
q qP�� Expires 09103/2018
��'
APPROVED BY 7 Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
J ��AA
• yt� , s Miami Shores Village
o�. Building Department
10050 N.E.2nd Avenue
-- •► Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
OWNER BUILDER DISCLOSURE STATEMENT
NAME: c"T DATE: ��
Ari (,a
ADDRESS: e S�
1%
Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida,RS 489.103(7).
And I have read and understood the following disclosure statement,which entities 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 odes 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 ficensed contractor to assume responsibility.
Initial
4-
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 fist 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 lf 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--
5. 1 understand that,as the owner-builder,I must provide direct,onslte supervision of the construction.
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
• a
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. cam/
Initial Z V-1M
9. 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 govem owner-builders as well as employers.I also understand that the
Construction must comply with all applicable laws,ordinances,building lodes, and zoning regulations. ,n
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 htto:/Avww.mvfloridalicense.com/dbpr/pro/cilbtndex.html
Initial
11. 1 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:
e�QJ Qe/
<ct vn SG�v�s, FL 3�J(36 Initial aQ
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 Constr4uctlon 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
ve*rig whether the contractor is property 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
retuned 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 Q"5 day of 20
By 1 -`-t - Ulm CVV:�r—T( wh was personally known to me or who has
Produced there License or as identification.
�C
0 NER NOTARY
Notary Public State of Florida
Sindia Advarez
IF
My Commission FF 156750
x ofpoIExpires 09/03/2018
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• y ' Rick Scott
Mission: ' Governor
To protect,promote&Improve the health
of all people in Florida through Integrated John H.Armstrong,MD,FACS
state,county&community efforts. HEALTH State Surgeon General&Secretary
Vlslon:To be the Healthiest State in the Nation
September 24, 2013
Alberto Martinez-Arizala
1238 NE 96 Street
Miami, FL 33138
RE: Contingency Letter
Application Document No:AP1120095
Centrax Permit Number: 13-SC-1494663
OSTDS Number:
1238 NE 96 St
Miami, FL 33138
Lot: Block: Subdivision:Miami Shores Sec 3
Dear Applicant:
This will acknowledge receipt of an application dated 09/12/2013 for a permit to use an
existing onsite sewage treatment and disposal system located on the above referenced
property.
From a review of your completed application, it has been determined your existing system is
adequate for the proposed use.
This permit is granted for the construction of a new concrete walkway. There will be no
increase in sewage flow or characteristics and no impact on the unobstructed area.
****************.****APPROVED.********************
If you have any questions on this matter, please call our office at(305)623-3500.
Sincerely,
Betsy Lange, Engineering Specialist II
Enclosures
cc:
Florida Department of Health www.FlorldasHosith.com
in DADE COUNTY TWITTER:HealthyFLA
1725 NW 167 St,Opa Locka,FL 33056 FACEBOOK:FLDepartmentofHealth
PHONE:(305)623-3500.FAX:(305)623-3645 YOUTUBE:fidoh