DS-15-534 A_
Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-229940 Permit Number: DS-3-15-534
Scheduled Inspection Date:April 26,2016 Permit Type: Driveways/Sidewalks/Slabs
Inspector. Naranjo, Ismael
Inspection Type: Final
Owner: LAMOUR, MOISE AND MIKAELLE Work Classification: Addition/Alteration
Job Address:10516 NW 2 Avenue
Miami Shores, FL 33150-1227
Phone Number (305)754$925
Parcel Number 1121360020020
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
ASPHALT DRIVEWAY Infraction Passed Comments
INSPECTOR COMMENTS False
Inspector C mmen
Passed
Failed EJ
Correction
Needed
Re-Inspection
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
April 25,2016 For Inspections please call: (305)762-4949 Page 1 of 31
1 f 2
t Miami Shores Village
10050 N.E.2nd Avenue NW
•••• Miami Shores,FL 33138-0000 n3
331 11 c
Phone: (305)7952204
Expiration: 06116!2016
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Project Address Parcel Number Applicant
10516 NW 2 Avenue 1121360020020
MOISE AND MIKAELLE LAMOUP
Miami Shores, FL 33150-1227 Block: Lot:
Owner Information Address Phone Cell
MOISE AND MIKAELLE LAMOUR 10516 NW 2 Avenue (305)754-8925
MIAMI SHORES FL 33150
10516 NW 2 Avenue
MIAMI SHORES FL 33150
Contractor(s) Phone Cell Phone Valuation: $ 600.00
HOME OWNER
_._ __ _..._......._�_...........___ _ Total Sq Feet: 328
Approved:In Review Available Inspections:
Comments: Inspection Type:
Date Approved::In Review Final
Date Denied: Foundation
Type of Work: Additional Info: Review Building
Bond Retum: Classification:Residential Review Building
Scanning:3 Review Building
Review Building
Review Planning
Review Planning
Review Planning
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
Bond Type-Owners Bond $500.00 Invoice# DS-3-15-54756
CCF $0.60 03/11/2015 Check*1753 $50.00 $569.60
DBPR Fee $2.00
DCA Fee $2.00 12/21/2015 Check#:2035 $569.60 $0.00
Education Surcharge $0.20 Bond#:2932
Notary Fee $5.00
Permit Fee $100.00
Scanning Fee $9.00
Technology Fee $0.80
Total: $619.60
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 zo ' Fut ore,I authorize the above-named contractor to do the work stated.
December 21,2015
AutbdFimidSignature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
December 21,2015 1
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Miami Shores Village CEIVED
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Building Department MAR 11,2015
as 10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
5 FBC 20 10
BUILDING (waster Permit No. �C
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 5 LIle :0
City: Miami Shores County: Miami Dade Zig:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type:e: Load: Construction Type:e: Flood Zone: BFE: FFE:
P
tom► y� � r [tom [ 1
OWNER:Name(Fee Simple Titlehol er):►' �t )1� �I�fVY t f�uh- Phone#: J ' �
Address: G-
n
City: State: Zip:
Tenant/Lessee Name: Phone#:
Email:
an
� v
CONTRACTOR:Company Name: er / ej Phone#:
Address:
City: -State: Zip:
Qualifier Name: Phone#:
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: Ci State: Zip:
p:
Value of Work for this Permit:$ Square/Unear Footage of Work:_ Z5'Z
Type of Work: ❑ Additi n ❑ Iteration ❑ New ❑ Re air/Re lace ❑ Demolition
Yp P P
Qom-
Description of Work:_00- 2�
,fY color of
Specify color thru tile:
P
Submittal Fee$ 5D Permit Fee$ isQ 4' CCF$ CO/CC$
cJ—tio
Scanning Fee$ -1/� Radon Fee$ 2. DBPR$ iZ Notary$
D"20 U
TechnologyFee � Training/Education Education Fee Double Fee
� `�� g/
Structural Reviews$ Bond$ Q®
TOTAL FEE NOW DUE$ 67,
.
( e se 2/ /2014 R vi d0 24 �Oa
)
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.
Signature -.S Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day ofma& 20 �S by day of ,20 ,by
4241 sG zaa 'uc- who is personally known to ,who is personally known to
me or who has produced� rt�.S"�D , -® 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: Si n:
Print: Print:
Seal: o�q'eG Notary Public State of Florida
a Joanna M Feliciano Seal:
My Commission FF 082753 't
o Expires01H212018 —de1,� I
APPROVED BY fc-- Plans Examiner F-Y) vt� / L—Zoning
Structural Review Clerk
(Revised02/24/2014)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
R Tel: (305) 795.2204
Fax: (305)756.8972
OWNER BUILDER DISCLOSURE STATEMENT
NAME:1/, ( n�e L &Y4 DATE: 1.�
11 �
ADDRESS: 0� t ff C��✓ 5�
Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida,KS 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. I 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. P
Initial—A—lam-,
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.
WNW,
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
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���
i t`
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
�b�
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 http:/Avww.mvfloddalicarr*e.comidbr)r/i)ro/aibrindex.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:
raiz fA ,Vw 26kz-
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-144—"--
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 signet 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 MAM 20 Ir
BZa1rQU1• who was personally known to me or who has
Produced there License or Z6W.5q,0604Q2jr—C as identification.
OWNER
Note►Y Public Stete of FietWo
Joanna M Feliciano
RIA0ri0s 0827F 5230
XD" irr0i
a Roll
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BOUNDARY SUREY
A minimum Of two 12ft shade trees must be present
In the parkway/swale for each 75 feet of frontage
APR i7 2 5 in order to Pave any Portion of the parkway/swale.
The adjoining property owner proposing to pave a
]BY: portion of the parkway/swale shall plant sufficient
shade trees approved by the public works director
to meet the minimum requirement.
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NOT SWX-90EWALK CBS=CCNCWTE 3LOCK STRUCTURE CLF=CMN;,:NK FENCE.PL=IMPEPTY LINE. DUE-CRAINAGE UTIL'TY EASEVEY.
SURVEYOR'S SEAL IP PE. F-FOUND.AJC=AJR CONO(TICNER PAD.P/C=PROPEERTY CORNER DM= DRILLED HOLE.
W/F= WOOCEN FENCE.
'?E;1f%C;1ENCE.CL=CLEArL 128=REPA UE=UTILIrY EASEMENT.CONC-CONCRE,.9 SLAB.pjW=MGHT OF WAY.DE.DUNAGE EASjv5*q?
C/L=CE.'%'-Cq LINE. 0=0"ETER. TYP=TYPCAL M=&4EASL;qD. R=RECOMEO. ENCR=:NCMACH?.1ENT. COMP=COMPiTE.1 ASPI-=ASP.A.*
.VO-NAJL&DISC.S=SET. FFE=FINISH FLOOR-ELEVATION.OIS=OFFSEtP/P=POwF.7 POLE OMP-OVS714AD POWERT.NE. VE!ER
hOOO CE-
MASONFERY NWALL- ELEVATION BASE ON
CONCRETE= CBM# L-/(9 ELV. q.
MAINTMANcE & DRU4AGE EAS IUMNT
NOTES: UNLESS OTHERWISE SHOWN,THE FOLLOWING NOTES APPLY. . LOCATOR INDEX# 311 o
1) Record and measured calls are In substantial agreement. 2) Bearings. if shown are based on Plat date. 3
shown hereon were not abstracted for Easements or other recorded emcumbrances not shown on the plat in,,
IEVI 3 ary may not be shown on this sketch. 4) Underground portions of Footings. Foundations or Other improve:—,
located. 5) Elevations are based on National Geodetic Datum. 6) Fence Ties are to the Centerline of the fE.-..
Ties to the face of the Wall. 8 BEARINGS WHEN SHOWN ARE REFERRED TO AN ASSUMED VALUE SAID PB P/%---
7 7 ,