RC-16-236 ti
Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone: (305)795-2204 Fax: (305)756.8972
Inspection Number: INSP-256977 Permit Number: RC-1-16-236
Scheduled Inspection Date:April 15,2016 Permit Type: Residential Construction
Inspector. Naranjo, Ismael Inspection Type: Final Building
Owner BOONE-SAENZ ORTA, ELIZABETH Work Classification: Alteration
SIvo A W
Job Address:61 NE 102 Street
Miami Shores,FL 33138- Phone Number
Parcel Number 1132060131670
Project <NONE>
Contractor: HOME OWNER
Building Department Comments
COVER EXISTING BROKEN TILES ON LANDING WITH Infractio Passed Comments
EXTERIOR TILE,CUT EXISTING WALKWAY(CONCRETE INSPECTOR COMMENTS False
SLAB)AND INSERT GRASS.
Inspector Comments
Passed
Failed 1
Correction
Needed
Re—inspection
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid
April 14,2016 For Inspections please call: (305)762-4949 Page 30 of 31
Miami Shores Village Y u,
. a
10050 N.E.2nd Avenue NE
Miami Shores,FL 331384000
(305)795-2204
Phone:
Expiration:07126/2016
Project Address Parcel Number Applicant
61 NE 102 Street 1132060131670 ELIZABETH&YRAK BOONE-SAE
Miami Shores, FL 33138- Block: Lot:
Owner Information Address Phone Cell
ELIZABETH&YRAK BOONE-SAENZ 61 NE 102 Street
---- MIAMI SHORES FL 33138-
61 NE 102 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 2,200.00
HOME OWNER
Total Sq Feet: 55
Approved:In Review Available Inspections:
Comments: Inspection Type:
Date Approved::In Review Window Door Attachment
Date Denied: Framing
Type of Construction:COVER EXISTING BROKEN TILES Occupancy: Insulation
Stories: Exterior: Drywall Screw
Front Setback: Rear Setback: Final PE Certification
Left Setback: Right Setback: Window and Door Buck
Bedrooms: Bathrooms: Fill Cells Columns
Plans Submitted:Yes Certificate Status: Review Planning
Certificate Date: Additional Info: Review Electrical
Bond Retum: Classification:Residential Review Plumbing
Review Structural
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Review Mechanical
CCF $1.80 Review Building
DBPR Fee $2.00 Invoice# RC-146-58481
DCA Fee $200 01/28/2016 Check#:6650 $122.80 $0.00
Education Surcharge $0.80
Notary Fee $5.00
Permit Fee $100.00
Scanning Fee $9.00
Technology Fee $2.40
Total: $122.80
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. in
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I ce ' hat all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and i n ore,I authoriz a above-named contractor to do the work stated.
January 28,2016
Autho Si re:Owner / Applicant / Contractor / Agent Uate
Building Department Copy
January 28,2016 1
A
r Miami Shores Village
r Building Department 4JA 81116
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 j
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20
BUILDING Master Permit No. MA&23,.G
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF [:]CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: f 1
City: Miami Shores County: Miami Dade Zi
31
Follo/Parcel#: J —'OI+ )&—!� s the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFEc
OWNER:Name(Fee Simple Titleholder): i Phone# LL.-y a �1
Address: 6 "
City: jn t i '7� State: EL Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: — Phone#:,
Address: t
City: _ State:_ Zip:
Qualifier Name: _ _ Phone#: >' _
State Certification or Registration#: Certificate of Competency#: _
DESIGNER:Architect/Engineer: Phone#:
Address: �7 �
/(O City: State: Zip:
6�
Value of Work for this Permit:$ . Square/Linear Footage of Work: o
Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition
Description of Work:
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$_ Q�j
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(Revised02/24/2014)
a
Bonding Company's Name(if applicable)
3
Bonding Company's Address
City State Zip
Mortgage Lender's Name(if applicable)
Mortgage Lender's Address lh
City Wt A State ZIP154%
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
---whoS !Tment. ' O;a certifledcopy of`therecorded not! —
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 Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of j 20 ( 1 ,by day of .20 ,by
� V1 k16S (o i �Jr onally known to .who is personally known to
me or who has produced T(.ID2 \ Li W(\W` me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUB NOTARY PUBLIC:
Sign: Sign:
Print:
-
Print• 'fir _1Q> Print:
Seal: OWN Notary Public State of Florida Seal:
Sindia Alvarez
" My Commission FF 158750
000 Expires 0914 !2018
APPROVED BY Plans Examiner ;j 7;Z*o*n*l n g
Structural Review Clerk
(Revised02/24/2014)
4
r e Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores,Florida 33138
Tel:(305)795.2204
Fax:(305)756.8972
y OWNER BUILDER DISCLOSURE STATEMENT
7 NAME: 16Z�"�QQA-e DATE: 1
ADDRESS: Al l T,�1"; 10 d '' -
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;l 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 1,as the owner of the property listed,may act as my own contractor with certain
restrictions even though I do not have a license.
:' &
In a
2. 1 understand that building permits are not required to be signed by a properly owner unless he or she is responsible for the construction and
Is not hiring a licensed contractor to assume responsibility.
I
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 an tracts,
In
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 h violates the exemption.
I is
S. I understand that,as the owner-builder,I must provide direct,onsite supervision of the construction.
In
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 ty or municipal ordinance.
In a
• s
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.
In ial
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.
In al
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 regulati
Initi
aL
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 httK)://www.mvfloridalleense.comtdbor/prolcilb/index.htmi
In
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
legal[ and financially responsible for the proposed construction activity at the following address:
Initi
12. 1 agree to notify Miami Shores Village immediately of any additions,deletions,or changes to any of the ation that I have provided on
this disclosure.
Init1
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 3p�Nl)AQ 20 AQ
Bywho was personally known to me or who has
Produced there License or as identification.
LWN�
NotaryPubkic State of Florida
OWNE NOTARY : SindiaAlvareza MY Commission PF158750Expires 09103/2018
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Notes:
DRIVEWAY EXTENDS ONTO PARKWAY.
SURVEYOR'S CERTIFICATION:I HEREBY CERTIFY THAT THIS BOUNDARY SURVEY ISA TRUE
MAP OF BOUNDARY SURVEY AND CORRECT REPRESENTATWWORA$IIRVEYPREPARED UNDER MYDIRECTION.THIS
COMPLIES WITH THE MlNMPll�1}E f Aqq&S7iJNDARDS,AS SET FORTH BY THE STATE OF
Property Address: FLORIDA BOARD OFPRIO Y . RLL.ND(SURtVYORSINCHAPTER 61G17-6,FLORIDA
p ADMINISTRATIVE CQpE 4 ��Tpp•472.�1V_FkQRIDA STATUES.
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61 N.E. 102ND STREET
MIAMI SHORES, FL 33138 = 0 521 9��,,;;,.�+
'•, STATE OF :' Q
n l i n e La n d FLORIDA
SIGNED o '• •' � ; FOR THE FIRM
FERNANDO V. GO4fZIJR\/E P.S.M. No. 5259
q1 SURVEYORS,INC. STATE OF FLORIDA `" " '
15271 NW 60 AVE, Suite 208 NOT VALID WITHOUT AN AUTHENTIC ELECTRONIC SIGNATURE AND AUTHENTICATED
Miami Lakes, FL 33014 ELECTRONIC SEAL,AND/OR THE SIGNATURE AND/OR THE ORIGINAL.RAISED SEAL OF A
LICENSED SURVEYOR AND MAPPER.THE SEAL APPEARING ON THIS DOCUMENT WAS
www.OnlineLandSurveyors.Com AUTHORIZED BY FERNANDO V.GOMEZ,P.S.M.NO.5259 ON THE SURVEY DATE NOTED
I HEREON.
Survey Date:5/5/2015 Survey Code:0-16807 Page 1 of 2 Not valid without all pages.
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LOCATION MAP N.T.S. PROPERTY FRONT VIEW••
CERTIFIED TO: FLOOD INFORMATION:
ELIZABETH P. BOONE Community Number: VILLAGE OF MIAMI SHORES
HARK BURKHALTER YON, PL 120652
OLD REPUBLIC NATIONAL TITLE INSURANCE COMPANY Panel Number: 12086CO302L
ISSUED THROUGH ATTORNEY'S TITLE FUND SERVICES Suffix: L
PREFERRED MORTGAGE BANKERS, LLC Date of Firm Index: 9/11/2009
ITS'SUCCESSORS AND/OR ASSIGNS AS THEIR Flood Zone: X
INTEREST MAY APPEAR. Base Flood Elevation: N/A
Date of Survey: 5/5/2015
LEGAL DESCRIPTION: LOT 19 AND THE EAST 1/2 OF LOT 18, BLOCK 12, OF AMENDED PLAT OF MIAMI SHORES,
SECTION ONE, ACCORDING TO THE PLAT THEREOF, AS RECORDED IN PLAT BOOK 10, AT PAGE 70, OF THE
PUBLIC RECORDS OF MIAMI-DADE COUNTY, FLORIDA.
------- PROPERTY LINE Surveyor's Legend
I—:::' STRUCTURE cc��^+++
® CONC. BLOCK WALL 0- TREE L.M.E. LAKE or LANDSCAPE MAINT. ESMT. ESMT. EASEMENT
R.O.E. ROOF OVERHANG EASEMENT D.E. DRAINAGE EASEMENT
x CHAIN–LINK or WIRE FENCE P.P. POWER POLE P.P. POOL PUMP L.S.E. LANDSCAPE BUFFER ESMT.
C.B. CATCH BASIN
—�—,�— WOOD FENCE C.U.E. CO'JNTi UTILITY ESMT. PL PLANTER TI PROPERTY LINE L.A.E. LIMITED ACCESS EASEMENT
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— — — — EA=EMENT B.R. BEARING REFERENCE E.U.B. ELECTRIC UTILITY BOX
FND. OR F FOUND IRON PIPE/ p CENTRAL ANGLE or DELTA SEP. SEPTIC TANK
— CENTER LINE PIN AS NOTED ON PLAT D.F. DRAIN FIELD
LBM LIN– SURVEYOR CENSE IF– BUSINESS R RECORD OR RADIUS
RAD. RADIAL AC AIR CONDITIONER
WOOD DECK CALC CALCULATED POINT
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O BRICK TILE P.R.M. PERMANENT REFERENCE MONUMENT 0 WELL T O.B. TOP OF BANK
/ E.O.W. EDGE OF WATER
F77P.C.C. POINT OF COMPOUND CURVATURE T7 FIRE HYDRANT
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COVERED AREA D DEEDULATED C.M.E. CANAL MAINTENANCE EASEMENT
A.E. ANCHOR EASEMENT
GENERAL NOTES:
1) LEGAL DESCRIPTION PROVIDED BY OTHERS.
2) EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO
DETERMINE RECORDED INSTRUMENTS,IF ANY,AFFECTING PROPERTY, LTA
3) THE LANDS SHOWN HEREON WERE NOT ABSTRACTED FOR EASEMENT OR
OTHER RECORDED ENCUMBERANCES NOT SHOWN ON THE PLAT. Affiliate Member
4) THE PURPOSE OF THIS SURVEY IS FOR USE IN OBTAINING TITLE INSURANCE
AND FINANCING AND SHOULD NOT BE USED FOR CONSTRUCTION,PERMITTING Pow Kw,*v ----—
DESIGN,OR ANY OTHER PURPOSE WITHOUT THE WRITTEN CONSENT OF Printingto Scale: 6oves:
ONLINE LAND SURVEYORS INC. - �
5) UNDERGROUND PORTIONS OF FOOTINGS,FOUNDATIONS OR OTHER Raw karvv t:.!No_
IMPROVEMENTS WERE NOT LOCATED. 1. Select"None"from Page Scaling - -
2. Deselect"Auto-Rotate and Center"
6) ONLY VISIBLE AND ABOVE GROUND ENCROACHMENTS LOCATED. ® aao$oWte ad cmR
7 FENCE OWNERSHIP NOT DETERMINED. 3. Select"Choose paper source by
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6) WALL TIES ARE TO THE FACE OF THE WALL. PDF page size"
9) BEARINGS ARE BASE ON AN ASSUMED MERIDIAN.
10) BOUNDARY SURVEY MEANS A DRAWING AND/OR GRAPHIC REPRESENTATION
OF THE SURVEY WORK PERFORMED IN THE FIELD,COULD BE DRAWN ATA FR
LD WORK: 51412015
SHOWN SCALE AND/OR NOT TO SCALE. ;�' �`jE) I
11) NO IDENTIFICATION FOUND ON PROPERTY CORNERS UNLESS NOTED. RA WN BY.- C.S. C.
12) NOT VALID UNLESS SEALED WITH THE SIGNING SURVEYORS EMBOSSED OR
ELECTONIC SEAL.
13) DIMENSIONS SHOWN ARE PLAT AND MEASURED UNLESS OTHERWISE SHOWN. ECKED BY. F.V.G.
14) ELEVATIONS IF SHOWN ARE BASED UPON N.G.V.D. 1929 UNLESS OTHERWISE
NOTED. FINAL REVISION: 0510512015 -9TAXE
u15) THIS IS A BOUNDARY SURVEY UNLESS OTHERWISE NOTED.16) THIS BOUNDARY SURVEY HAS BEEN PREPARED FOR THE EXCLUSIVE USE OFOMPLETED: 5/5/2015 t F THE ENTITIES NAMED HEREON, THE CERTIFICATIONS DO NOT EXTEND TO ANY LOPIEJF;
UNNAMED PARTIES. r • a
SCALE: ill=20' ' �� ••••
URVEY CODE: 0-16807 'L9#49dd
15271 NW 60 AVE, Suite 208
Miami Lakes, FL 33014
/ n l i n e La n d Phone: (305)910-0123
SURVEYORS,iNC. Fax: (305)675-0999 {
www.OnlineLandSurveyors.Com
Survey Date:5/5/2015 Survey Code:0-16807 Page 2 of 2 Not valid without all pages.