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DEMO-15-2797 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 inspection Number: INSP-253443 Permit Number: DEMO-11-15-2797 Inspection Date:April 26,2016 Permit Type: Demolition Inspector: Naranjo, Ismael Inspection Type: Final Owner: GOSLIN,SIMON JAMES Work Classification: Building Job Address:1155 NE 100 Street Miami Shores, FL Phone Number (305)766-9635 Parcel Number 1132050190331 Project <NONE> Contractor: HOME OWNER Building Department Comments REMOVAL OF KITCHEN AND BATHROOM Infractio Passed Comments INSPECTOR COMMENTS False J.Uspector Comments Passed Ell-- CREATED AS REINSPECTI FOR INSP-247102. No access Failed ao J Correction ❑ Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid For Inspections please call: (305)762-4949 April 25,2016 Page 1 of 1 Miami Shores Village ' NOV Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 ;7z' Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20l/-/ BUILDING Master Permit No ` PERMIT APPLICATION Sub Permit No. ` 9BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING MECHANICAL PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: SV city: b Miami Shores• t County: Miami Dade zip: Folio/Parcel#: 2®J 3/ Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): &W V_A ( gl.� Phone#: .2 6:s b X635 Address: \k r3s N tL l CX7 ,51'- w.� � !� l� f`\'�1'� City: M�� �ncQ/� State: Zip: II Tenant/Lessee Name: Phone#: S 05 �4 g b 3 s Email: pnej'Dj csNs fj C�P" e CC)t-" CONTRACTOR:Company Name: Phone#: Address: City: State Zip: Qualifier Name: Phone#: State Certification or Registration I#: Certificate of Competency#: DESIGNER:Architect/Engineer: I'` SGT' o fA.QkeAp Phone#: Address: City: State: Zip: Value of Work for this Permit:$ t tr© Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Rep ace Demolition Description of Work: v C" Specify color of color thru tile: Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ bl. bo (Revised02/24/2014) 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 appom#and a reinspection fee will be charged. (,a/ Signature �GENT Signature OWNER or CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this A day of DC�.1`�L���— ,20 1 C2 .by j day of .20 ,by TL-D?,�ke, is personally known t ,who is personally known to me or who has produced N G®< as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLI NOTARY PUBLIC: Sign• Sign Print: Print: Seal: rpm a Notary Public State of Florida Seal: Sindia Alvarez say Commission FF 158750 a Expieea 08/0312018 APPROVED BY ' Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 lOR1lIUA Tei: 305 795.2204 Fax:(305)756.8972 OWNER BUILDER DISCLOSURE STATEMENT NAME: C < ("lam l—�b �'^ DATE: 42 Jt ADDRESS: 1 \ 5S S� 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 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 a contracts. Initial 4. 1 understand that I may build or improve a one family or two-family residence of a farm outbuilding.l may also build or improve a commercial building if the costs do not exceed$75,000.The bbilding"or residence must be for my use or occupancy.It may not be built or substantially improved for sale or tease.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,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 4 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 S. I 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 T 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://www.mvfloridalicense.com/dbor/nro/cilb/index.htmi 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: Initial — �q 12. 1 agree to notify Miami Shores Village immediately of any additions,deletions,or changes to any of th formation 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 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 ay of `° 0 l ► B6/� ( �'J• who was personally known to me or who has . I.Q 0 Z Produced re License or as identification. §� w OWNER 4RY u Miami Shores Village 10050 N.E.2nd Avenue NE Miami Shores,FL 33138-0000 Phone: (305)795-22047h 14h, Expiration: 5/17/2016 Project Address Parcel Number Applicant 1155 NE 100 Street 1132050190331 SIMON JAMES GOBLIN Miami Shores, FL Block: Lot: Owner Information Address Phone Cell SIMON JAMES GOSLIN 1155 NE 100 Street (305)766-9635 MIAMI SHORES FL 33138- 1155 NE 100 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 1,000.00 HOME OWNER - Total Sq Feet: 00 Type of Demo:Building Available Inspections: Additional Info: Inspection Type: Classification:Residential Final Scanning:4 Review Electrical Review Electrical Review Building Review Building Review Plumbing Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 Invoice# DEMO-1415-57644 DBPR Fee $2.00 11/19/2015 Credit Card $67.60 $50.00 DCA Fee $2.00 Education Surcharge $0.20 11/02/2015 Credit Card $50.00 $0.00 Permit Fee $100.00 Scanning Fee $12.00 Technology Fee $0.80 Total: $117.60 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 assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECT IC L,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDA 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 zoni Futhermor e,I authorize the above-named contractor to do the work stated. November 19,2015 Authorized SlpWureY Owner / Applicant / Contractor / Agent Date Building Department Copy November 19,2015 1 ENGINEERING AND CONSTRUCTION SERVICES, INC. "To provide quality engineering with integrity and commitment to the client." -5-2.11 November 10, 2015 Building Official NOV 19 2015 C/o: Miami Shores Building Department 10050 NE 2nd Ave, Miami Shores, FL 33138 x Re: 1155 NE 100 Street Temporary Shoring Inspection Inspection Date: 11/9/15 Permit No. Dear Building Official: We have inspected the temporay shoring installed at the above referenced property. The shoring was designed by our office to temporarily support the roof trusses while remodeling work was in progress. A load bearing wall between the kitchen and living room was removed as part of the remodeling. The temporary shoring was Properly installed per our plans and specifications. Should you have any questions, please do not hesitate to contact us. Res c Ily submitted, Bu g and Construction Services, Inc. 0. 5 3 Edgar n s, P..'L*#=57831 in 0"r Qzz 4� Z- $ N A Page 1 of 1 120 North Federal Highway I Suite 305 1 Lake Worth, FL 33460 Office(561)585-5696 1 Fax(561)585-5697 1 www.bunkerengineenng.com LEGEND: GOSLIN RESIDENCY BiJNKEM DENOTES WALLS REQUIRING SHORING (TEMPORARY SHORING) TRIBUTARY AREA Z WALL TO BE DEMOLISHED � � — AREA:200SF ROOF TRUSSES N " EXIST.PARTION WALL TO REMAIN (ABOVE) Z V - - - - - - - - NOTES: Lu W w — — — — — — — GENERAL: Z N , — — — — — — — I I 1.PROVIDE PROPER FOUNDATION BELOW BASE PLATES FOR THE Z WOOD DISTRIBUTION OF LEGS LOADS TO CONCRETE SLAB OR GROUND. W 0 SHORING 2.FASTEN ALL BRACES SECURELY. Lu 1-- 2��X4�� DOUBLE , I 3.CHECK TO SEE THAT THAT ALL CLAMPS,SCREWS,PINS AND ALL OTHER W () — — — — — — — COMPONENTS ARE IN THE CLOSED OR ENGAGED POSITION. T P I I 4.AVOID SHOCK OR IMPACT LOADS FOR WHICH SHORING WAS NOT Z L DESIGNED. co � nz P LATS I I USE LUMBER EQUIVALENT TO THE STRESS,SPECIES,GRADE,AND SIZE m Z Z SPECIFIED ON LAYOUT. USE ONLY LUMBER THAT IS IN GOOD CONDITION. O N DO NOT SPLICE TIMBER MEMBERS BETWEEN THEIR SUPPORTS. V 5.THE ERECTION OF SHORING SHALL BE UNDER THE RESPONSIBILITY OF _ _ r I IT —N AN EXPERIENCED AND COMPETENT PERSON. POST SHORING: O _ I 1.PLUMB ALL POST SHORE AS THE ERECTION PROCEEDS. CHECK PLUMB Z LL, cA u- 2"X4" BO OM I i OF POST SHORES JUST PRIOR TO POUR. O w P TE I 2•POST SHORE MAY REQUIRE ADDITIONAL STABILITY HORIZONTAL 2 0 E GARAGE — — — — — — — —Q I SHORING BEAMS SHOULD NOT BE SUPPORTED OTHER THAN AT THE co_w_(v I I BEARING PRONGS UNLESS RECOMMENDED BY YOUR SHORING SUPPLIER J QQ E IST. ORCH _ _-_ OR BEAM MANUFACTURER. U W Q — — — — — — — — — - — 3.DO NOT NAIL BEAM BEARING ENDS TO LEDGER. a — a. 4.ADJUSTABLE POST SHORE @ MAX SPACING OF 5'-0"O.C. = z 5.PROVIDE CONTINUOUS SHORING UNDER ENTIRE REPAIR AREA DOWN TO THE GROUND FLOOR. W m W =f ROOF TRUSSES 5 (D 24" O.C. o B TYPICAL SHORING DETAIL a o a z SCALE:3/8"=1'-0" DESIGN PARAMETERS: PLAN VIEW ROOF LOAD: V h SCALE:3/32"=1'-0" LIVE LOAD: 20 PSF z ROOF TRUSS (ABOVE) DEAD LOAD: 25 PSF w TRIBUTARY AREA: 200 SF z Z s' TOTAL LOAD: 9,000 LBS co 00 WOOD COLUMN CAPACITY: 716#/EA w TOTAL WOOD COLUMN CAPACITY: w 2"X4" 14,000(WOOD COLUMN) o --- --- I DOUBLE �jl z g TOP c!) ——— I PLATES !jj II' 0 10 911//f1�����t9/18/2015 2"X4" BOTTOM �'1 ;,��®• �, r— I PLATE = N0 L —— I I �' N S.P. = ROOF PLAN xv j O � SCALE:NTS ` n �1 TYPICAL SHORING DETAIL(SIDE VIEW) FE® ®ads ET SCALE:3/8"=1'-0" 1 OF 1