FW-16-1307 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-258846 Permit Number: FW-5-16-1307
Scheduled Inspection Date:June 10,2016 Permit Type: Fence/Wall
Inspector: Porta Jr,Jose Inspection Type: Final
Owner: ROSSETTI,JOHN Work Classification: Wire Fence
Job Address:549 NE 95 Street
Miami Shores, FL
Phone Number
Parcel Number 1132060140740
Project: <NONE>
Contractor. HOME OWNER
Building Department Comments
ADDING FENCE ON EAST PROPERTY LINE 4'CHAIN Infractlo Passed comments
LINK TO MATCH EXISTING FENCE ON PROPERTY INSPECTOR COMMENTS f=alse
10to Inspector Comments
Passed 1E
Failed
Correction
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid
June 09,2016 For Inspections please call: (305)762-4949 Page 16 of 33
Miami Shores Village
10050 N.E.2nd Avenue NE
Miami Shores,FL 33138-0000
Phone: (305)795-2204 � 3
R 3 Expiration: 11/28/2016
Project Address Parcel Number Applicant
549 NE 95 Street 1132060140740
Miami Shores, FL Block: Lot: JOHN ROSSETTI
Owner information Address Phone Cell
JOHN ROSSETTI 549 NE 95 ST
MIAMI FL 33138-2731
Contractor(s) Phone Cell Phone Valuation: $ 500.00
HOME OWNER
.._ .....,. _ v. ... ...,.. _. Total Sq Feet: 100
Approved: Available Inspections:
Comments: Inspection Type:
Date Approved:
Final
Date Denied: Foundation
Type of Construction:Wire Fence Additional Info:ADDING FENCE ON EAST PROPER Review Building
Classification:Residential Scanning:1 Review Building
Review Planning
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60 Invoice# FW-5-16-59771
DBPR Fee $2.00 06/01/2016 Credit Card $58.60 $50.00
DCA Fee $2.00
Education Surcharge $0,20 05/162016 Credit Card $50.00 $0.00
Permit Fee-Wire&Wood $100.00
Scanning Fee $3.00
Technology Fee $0.80
Total: $108.60
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for§11 work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBI ,MECH,614CAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVI I rt' regoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and z F horize the above-named contractor to do the work stated.
June 01,2016
A rued S atu er / Applicant / Contractor / Agent Date
Buil ing Department Copy
Jun 01,2016 1
Miami Shores Village MAY 16 2016
�
BuildingDepartment p
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(30S)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20/e/
BUILDING Master Permit No..ar f if"
PERMIT APPLICATION Sub Permit No gli
❑BUILDING ❑ELECTRIC ❑ ROOFING REVISION ❑EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: '-4a9
City Miami Shores County: Miami Dade
Folio/Parcel#: is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
Zro
OWNER:Name(Fee Simple Titlpholder): Svc 16 i Phone#:,31�5'S��-� SS
Address:
City: State: �� Zip:
Tenant/Lessee Name: N/.� Phone#:
Email:
CONTRACTOR:Company Name: Phone#:
Address:
City: it e: Zip:
Qualifier Name: Phone#:
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ Jr� Square/Unear Footage of Work: & 441W—mk
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Of I
1
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$
(Revised02/24/2014)
� t
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
whvst-praperty4s-subject-totnachment.-Also,-arertdkdrWof the recorded nutibe of oommmcemenr=st-be paste-d-fffh6jd r
for the first inspection which occurs even (7) ays after the building permit is issued. In the absence of such posted notice, the
inspection will not be ap o d an reinsp !on fee will be charged.
Signature Signature
OWNER or AGENT CONTRACTOR
The for oIng instrument was acknowledged before me this The foregoing Instrument was acknowledged before me this
day of 20 by day of .20 by
O' who is personally known to who is personally known to
me or who has produced _ as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PU NOTARY PUBLIC:
Si Sign•
Print: Print:
Seal: Seal:
�- a� Notary Punic State Of Florida
Joanna M Feliciano
my commission FF 082753
Expires 01112
APPROVED BY / Plans Examiner C
�i Zoning
Structural Review Clerk
(Revised02/24/2014)
r
` , 1
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: -:rOkossa& DATE: '511-7-1110
ADDRESS: �2Y9 IUF•
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. 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.
Initial
2. 1 understand that building permits are not required to be signed by a property owner unless hefhelsnsible for the construction and
is not hiring a licensed contractor to assume responsibility.
Initial
3. I understand that,as an owner builder,I am the responsible party of record on a permit.I undefFanracts.
at I may protect myself from potential
financial risk by hiring a licensed contractor and having the permit filed in his or her name Insteown name.I also understand that the
contractor is required by law to be licensed in Florida and to list his or license numbers on perm
Initial
4. 1 understand that I may build or improve a one family or two-family residence or a farm outbuildbuild or improve a commercial
building if the costs do not exceed$75,000.The building or residence must be for my use or upancy.It may not be built or substantially
Improved for sale or lease.If a building or residence that I have built or substantially improved yself is d or leased within 1 year after the
construction is complete,the law will presume that I built or substantially improved it for sale or leas c v es the exemption.
Initial
5. 1 understand that,as the owner-builder,I must provide direct,onsite supervision of the constrynd;';'ujn
KA4
Initi
6. 1 understand that I may not hire an unlicensed person to act as my contractor or to superviseking on my building or residence.It
is my responsibility to ensure that the persons whom i employ have the license required by law or municipal ordinance.
Initi
p
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-buildtandcare a limits of my insurance
coverage for injuries to workers on my property.
Initia
8. 1 understand that I may not delegate the responsibility for supervising work to be a licensed cono is not licenses to perform the
work being done.Any person working on my building who is not licensed must work under my rvision and must be employed by
me,which means that I must comply with laws requiring the withholding of federal income tax ecurity contributions under the
Federal Insurance Contributions Act(FICA)and must provide workers compensation for the emdersta 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 actio I I 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 n
Initial
10. 1 understand that I may obtain more information regarding my obligations as an employer from tTay
nal Revenue Service,the United States
Small Business Administration,and the Florida Department of Revenues.I also understand that Intact the Florida Construction Industry
Licensing Board at 850.487.1395 or htto:Ih~.mvfloridalicense.com/dbor/aro/Cilbfindex.htmi
Initial
11. 1 am aware of,and consent to,an owner-builder building permit applied for in my name and undfndsat I am the party
legally and financially responsible for the proposed construction activity at the following address:
Initial
12. I agree to notify Miami Shores Village immediately of any additions,deletions,or changes to any the inf ation that I have provided on
this disclosure.
Initial
Licensed contractors are regulated by laws designed to protect the public.If you contract with a pers who does not have a license,the
Constr4uction Industry Licensing Board and Department of Business and Professional Regulation m 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 un erstand 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 20 '
'
MCC-2
By who was personally known to me or who has $.
'a
Produced there License or/, as identification.
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O NER ARY