DS-16-1155 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone: (305)795-2204 Fax:(305)756.8972
inspection Number: INSP-257796 Permit Number. DS-4-16-1155
Scheduled inspection Date: May 25,2016 Permit Type: Driveways/SidewalkslSlabs
Inspector: Mesa, Michael
Inspection Type: Final
Owner: EMERSON,EDITH TYLER Work Classification: Addition/Alteration
Job Address:284 NE 102 Street
Miami Shores,FL 33138- Phone Number .(305)310-9607
Parcel Number 1132060134710
Project <NONE>
Contractor. HOME OWNER
Building Department Comments
REPLACE EXISTING STONE WALKWAY WITH SOLID Infractio Passed Comments
AND THICK FL KEYSTONE WALKWAY. 36"X 58" INSPECTOR COMMENTS False
Inspector Comments
Passed r
v�2 0 C L SC; Pe t ukc L
Failed
Correction a
Needed
Re-Inspection
Fee
No Addiflonal Inspections can be scheduled until
re-inspection fee is paid
May 24,2016 For Inspections please call:(305)762-4949 Page 14 of 34
Miami Shores Village
10050 N.E.2nd Avenue NE
•'• Miami Shores,FL 33138-00003 p�
Phone: (305)795-2204 a € Y E E 3 Y1
$'" y Expiration: 10/30/201
Project Address Parcel Number Applicant
284 NE 102 Street 1132060134710
Miami Shores, FL 33138- Block: Lot: EDITH TYLER EMERSON
Owner Information Address Phone cell
EDITH TYLER EMERSON 284 NE 102 Street (305)310-9607
MIAMI FL 33138-2427
Contractor(s) Phone Cell Phone Valuation: $ 600.00
HOME OWNER
Total Sq Feet: 167
Approved:In Review Available Inspections:
Comments: Inspection Type:
Date Approved::In Review Final
Date Denied:
Foundation
Type of Work:REPLACE EXISTING STONE WALKWAY 0 Additional Info: Review Building
Bond Retum: Ciassfcation:Residential Review Planning
Scanning:3
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
Bond Type-Owners Bond $500.00 Invoice# DS-416-59585
CCF $0.60 04/29/2016 Credit Card $50.00 $569.60
DBPR Fee $2.00
DCA Fee $2.00 05/03/2016 Credit Card $569.60 $0.00
Education Surcharge $0.20 Bond#:3071
Notary Fee $5.00
Permit Fee $100.00
Scanning Fee $9.00
Technology Fee $0.80
Total: $619.60
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: rtify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and i hermore,I authorkfte above-named contractor to do the work stated.
May 03,2016
Auth-aftzed Signature:Owner ! 'Applicant / Contractor / Agent Date
Building Department Copy
May 03,2016 1
I.>\ Miami Shores Village APR 2 8 2010
Building Department ry:
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 201h
BUILDING Master Permit No.I)S' 155
PERMIT APPLICATION Sub Permit No.
;dBUILDING ❑ELECTRIC ❑ ROOFING ❑ REVISION ❑EXTENSION [-]RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 29HN F— 10:7—M 51
City Miami Shores County: Miami Dade Zip:
Follo/Parcel& ���►��q 32-0k-013- —11 10 1s the Building Historically Designated:Yes NO Lo"'
Occupancy Type:tit_ ► —Load: Construction Type: Flood Zone: X BFE: FFE: 10.
OWNER:Name(Fee Simple Titlpholder): 11 Ty �rP1?r✓ScS�- Phone#: 5o!; 310 ''beq
Address' W �jr-- loud �' p
City: Kiwi S�uyCCe$ State: 7L Zip: 'Sieg
Tenant/Lessee Name: `` Phone#:
Email: t i ewrL!/ ?1tMosm40Y & covin
CONTRACTOR:Company Name: Lb211j2'- 6u)etJeL _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:$ SOO ' QZ� Square/LinearFootage of Work: ���•�5�OF wA�l!GWAy \
Type of Work: ElAddition V Alteration Elo New Repair/Re lace (3& Wide-
Description
�J
Repair/Replace El
Description of Work: iZtplau eXIS11 -S—bone, wad, 5o I 'C a+HCl `
(Venin 64 f 1&0d� 4s*i rUe Ikwrm, ack-f itA is 3&jf W1cle X I x
2"Ato-p caved will a lard ft a 2" bed OF MovAIRAIJMNJ
Specify color of color t ru tile: NAhwAA�� V-rtcM
r�
Submittal Fee$ Permit Fee$ ( CCF GO CO/CC$ J
Scanning Fee$ Radon Fee$ DBPR$ Notary$ .
Technology Fee$_b Training/Education Fee$ C1-00 Double Fee$
Structural Reviews$ Bond$ G
TOTAL FEE NOW DUE$ 0T.
GO
(Revised02/24/2014) E r.9 a /'o
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. 1 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$2500,the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
- -whose IDPertY4subject-to-vttachment--,4lso;-o-cert#led copy of themcurded nuttce otcommerrcertreni mv3t p to th�jo
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature C Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of 20 by day of 20 by
VMFWk®IV—wP ker tAlly known to who is personally known to
me or who has produced �►�- ftL as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: N1111111UNq� NOTARY PUBLIC:
d0 /*
Sign:, '� %� Sign:
® •
Print: Print:
Seal: y� '�°ki ��o Seal:
spy W ,N 2.
i s •.;W001• •• ��
APPROVED BY
Plans Examiner � Zoning
Structural Review Clerk
(ReASW02/24/2014)
f
t
gs Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel:(305)795.2204
Fax:(305)756.8972
OWNER BUILDER DISCLOSURE STATEMENT
NAME: ZdI f h �i'��iV i PX$t11'1-WY�G�n DATE: 17'ell b
ADDRESS: 'I W /dr- 107w( G-t-1 A4f�t4mI S ho rtS Fi 3-5159
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 taw 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.
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. J
Initialw
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 1 built or substantially improved it for sale or lease,which violates the exemption.
Initial
S. I understand that,as the owner-builder,I must provide direct,onsite supervision of the construction.
InitialP _
6. 1 understand that 1 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
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.
Initia
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_
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/aro/CilbAndex.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,_
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
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 PPC&t L-- 20 I�
By 11+4 -k rl�'�la�" "* 'to was personally known to me or who has
Produced th re License or ` �tyi - as identi 'wall,
i
OWNER NOTARY
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MIAMI;FLORIDA 33172 . �• • • -• 000
TELEPHONE:(305)264-2660 X JQU U §11 r we' ,Bing: rlf'p r.
Fi�G(305)264-0229 LAND SUR;/E�O�i'4 ' ' •"
SHEET No. 2 OF 2
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SURVEYOR'S NOTE:
There may be Easements recorded in the Public Records not shown on this Survey.
1366 NW 97TH AVE,SUITE 200 ••• • • • ••• • •
TELEPHONE F"'+'2 �!� 0 0 0 yorS InC SURVEY No 3-0002831-5
TELEPHONE:(306)284-2880 • • i ••• • i • • '
FAX:(306)284-0228 ••• • • • • ••• • i
DRAWN BY:AA LAND SURVEYORS SHEET NO of 2
SURVEY OF LOT 1-2,BLOCK 35,OF AN AMEND`SSD PLAfQF,p &MI SHCPEOSECTION NO. 1,ACCORDING TO THE PLAT THEREOF AS
RECORDED IN PLAT BOOK 10,PAGE 706 b TFV_P13B`IC•RORDSV•PMj1Mi-DADS COUNTY,FLORIDA.
• ••• • ••• • •
PROPERTY ADDRESS: 284 NE 102 ST,MI/1},IAI,%I.•331. • • • ••
FOR: EDITH TYLER EMERSON.: : : : : :•: ••
LOCATION•SkEloCH : escsle 1"= NT.S.
r7 ra ; r9 �ZO� �I re rs� aJ � I� _ 1s' 16I 17 Ib L 19 � to !tt It�� c,3! /q
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AIS s i s"01
ABBREVIATION AND MEANING LEGEND TYPICAL
A:ARC FNIP.:FEDERAL NATIONAL INSURANCE RAO.:RADIUS OF RADIAL —OH-OVERHEAD UTILITY LINES
AIC:AIR CONDITIONER PAD PROGRAM RGE.=RANGE
A.E.=ANCHOR EASEMENT IN.BEG.:INGRESS AND EGRESS R.P.-RADIUS POINT 2= C.B.S.-WALL fCBW1
AIR:ALUMINIUM ROOF EASEMENT R.O.E.=ROOF OVERHANG C.L.F.=CHAIN LINK FENCE
AIS:ALUMINIUM SHED L.F.E.:LOWEST FLOOR ELEVATION EASEMENT
ASPH.=ASPHALT L.M.E.=LAKE MAINTENANCE EASEMENT RNV-RIGHT-OF-WAY -mo- I.F.-IRON FENCE
B.C. BLOCK CORNER L.P.:LIGHT POLE SEC.-SECTION
B.C.R=BROWARO COUNTY RECORDS M.=MEASURED DISTANCE S.I.P.-SET IRON PIPE L.B.#6044 �.-.r W.F.=WOOD FENCE
B.M.=BENCH MARK MIH=MANHOLE SWK-SIDEWALK
B.O.B.=BASIS OF BEARINGS N.AP.-NOT APART OF T-TANGENT •0.00 -EXISTING ELEVATIONS
C=CALCULATED NGVD:NATIONAL GEODETIC VERTICAL TWP-TOWNSHIP
C.B. CATCH BASIN DATUM U.E.=UTILITY EASEMENT
C.B.W.:CONCRETE BLOCK WALL N.T.S.*NOT TO SCALE U.P.=UTILITY POLE SURVEYOR'S NOTES
CH:CHORD O.H.L.=OVERHEAD UTILITY LINES W.M.-WATER METER 1)IF SHOWN.BEARINGS ARE REFERRED TO AN ASSUMED
CH.B.:CHORD BEARING O.R.B.:OFFICIAL RECORD BOOK W.R.-WOOD ROOF MERIDIAN,BY SAID PLAT IN THE DESCRIPTION OF THE
CL:CLEAR OIS:OFFSET W.S.-WOOD SHED
C.L.F.:CHAIN LINK FENCE OVH.:OVERHANG PROPERTY.IF NOT,THEN BEARINGS ARE REFERRED TO
C.M.E.-CANAL MAINTENANCE P.B.:PLAT BOOK 'ANGLE COUNTY,TOWNSHIP MAPS.
EASEMENTS P.C.:POINT OF CURVE A -CENTRAL ANGLE 2)THIS IS A SPECIFIC PURPOSE SURVEY.
CONC.-CONCRETE P.C.C.-POINT OF COMPOUND CURVE 3)THE CLOSURE IN THE BOUNDARY SURVEY IS ABOVE
=CENTER LINE 1:7500 FT.
C.P.=CONCRETE PORCH PL.-PLANTER
C.S. CONCRETE SLAB P.L.S.:PROFESSIONAL LAND MONUMENT LINE 4)A SHOWN,ELEVATIONS ARE REFERRED TO
UI
� = MMFDADE COUNTY.
D.E.:DRAINAGE EASEMENT SURVEYOR
D.M.E.:DRAINAGE MAINTENANCE P.O.B..:POINT OF BEGINNING ALL ELEVATIONS SHOWN ARE REFERRED TO
EASEMENTS P.O.C..-POINT OF COMMENCEMENT NATIONAL GEOGRAPHIC VERTICAL DATUM OF 1929
DRIVE-DRIVEWAY P.P.:POWER POLE CITYOF MIAMI BENCH MARK#N-397-R
ENCR.:ENCROACHMENT P.P.S..:POOL PUMP SLAB LOCATOR#3100
E.T.P.:ELECTRIC TRANSFORMER PAD P.R.C.:.POINT OF REVERSE CURVE ELEVATION 10.12 FEET OF N.G.V.D.OF 1829
F.F.E.:FINISHED FLOOR ELEVATION PRM-PERMANENT REFERENCE
F.H.:FIRE HYDRANT MONUMENT
F.I.P.:FOUND IRON PIPE PT.:POINT OF TANGENCY SURVEYOR'S CERTIFICATION
F.1 R.-FOUND IRON ROD PVMT.-PAVEMENT
F.N.:FOUND NAIL PWY:PARKWAY I HEREBY CERTIFY:THAT THIS"BOUNDARY SURVEY"OF
F.N.O.:FOUND NAIL&DISK R.-RECORD DISTANCE THE PROPERTY DESCRIBED HEREON,AS RECENTLY
SURVEYED AND DRAWN UNDER MY SUPERVISION,
Pnet NOTES TO ACCOMPANY SKETCH OF SURVEY!"SURVEY"1 COMPLIES WITH THE MINIMUM TECHNICAL STANDARDS
AS SET FORTH BY THE FLORIDA BOARD OF
THERE MAY BE EASEMENTS RECORDED IN THE PUBLIC RECORDS NOT SHOWN ON THIS SURVEY. PROFESSIONAL LAND SURVEYORS IN CHAPTER 61G17.6,
THE PURPOSE OF THIS SURVEY IS FOR USE IN OBTAINING TITLE INSURANCE AND FINANCING,AND SHOULD NOT BE FLORIDA ADMINISTRATIVE CODE PURSUANT TO 472.027•
USED FOR CONSTRUCTION PURPOSES. FLORIDA STATUTES.
EXAMINATIONS OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED INSTRUMENTS,IF ANY,
AFFECTING THE PROPERTY.THIS SURVEY IS SUBJECT TO DEDICATIONS,LIMITATIONS,RESTRICTIONS.RESERVATIONS y
OR EASEMENTS OF RECORD.AND LEGAL DESCRIPTIONS PROVIDED BY CLIENT OR ATTESTING TITLE COMPANY.
BOUNDARY SURVEY MEANS A DRAWING AND I OR A GRAPHIC REPRESENTATION OF THE SURVEY WORK PERFORMED IN
- THE FIELD,COULD BE DRAWN AT A SHOWN SCALE AND I OR NOT TO SCALE. BY. 16
EASEMENTS AS SHOWN ARE PER PLAT BOOK,UNLESS OTHERWISE SHOWN. (DATE OFFIELD WORK)
THE TERM"ENCROACHMENT"MEANS VISIBLE AND ABOVE GROUND ENCROACHMENTS.
ARCHITECTS$HALL VERIFY ZONING REGULATIONS,RESTRICTIONS AND SETBACKS,AND THEY WILL BE RESPONSIBLE
FOR SUBMITTING PLOT PLANS WITH THE CORRECT INFORMATION FOR THEIR APPROVAL FOR AUTHORIZATION TO
AUTHORITIES IN NEW CONSTRUCTIONS.UNLESS OTHERWISE NOTED.THIS FIRM HAS NOT ATTEMPTED TO LOCATE PROFESSIONAL LAND SURVEYOR NO. 2534
FOOTING AND10R FOUNDATIONS. STATE OF FLORIDA(VALID COPIES OF THIS SURVEY WILL
FENCE OWNERSHIP NOT DETERMINED. BEAR THE EMBOSSED SEAL OF THE ATTESTING LAND
THIS PLAN OF SURVEY HAS BEEN PREPARED FOR THE EXCLUSIVE USE OF THE ENTITIES NAMED. SURVEYOR).
HEREON,THE CERTIFICATE DOES NOT EXTEND TO ANY UNNAMED PARTY.
THE SURVEYOR MAKES NO GUARANTEES AS TO THE ACCURACY OF THE INFORMATION BELOW THE LOCAL F.E.M.A
AGENT SHOULD BE CONTACTED FOR VERIFICATION,THE FNIP FLOOD MAPS HAVE DESIGNATED THE HEREIN DESCRIBED REVISED ON:
LAND TO BE SITUATED IN ZONE:X COMMUNITYIPANELISUFFIX:120662 0302 L DATE OF FIRM:09/11/2009
BASE FLOOD ELEVATION:NIA
REVISED ON:
CERTIFIED TO:EDITH MER EMERSON N
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SURVEYOR'S SEAL 3
..,. p,..� Miami shores Village
Building Department
J�'jOR�p► 10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305)795.2204
Fax: (305)756.8972
RECEIPT
PERMIT#: DS 16—115 DATE: '412 8`/1(o
(Name)
❑ Contractor
downer
❑Architect
Picked up 2 sets of plans and (other)
Address: 2N lJle- (d7�
From the building department on this date in order to have corrections done to plans
And/or get County stamps. l understand that the plans need to be brought back to Miami
Shores Village Buildin artment to nue permitting process.
Signature.
(SIGNATURE)
PERMIT CLERK INITIAL: QA—,—
RESUBMITTED
DATE:
PERMIT CLERK INITIAL: ��'