DS-16-2608 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone: (306)795-2204 Fax:(305)756-8972
Inspection Number: I NSP-267742 Permit Number: DS-9-16-2608
Scheduled Inspection Date: November 02,2016 Permit Type: Driveways/Sidewalks/Slabs
Inspector: Mesa, Michel
Inspection Type: Final
Owner: RAMIREZ,LEONARDO Work Classification: Addition/Alteration
Job Address:25 NW 91 Street
Miami Shores,FL Phone Number (786)226-5901
Parcel Number 1131010140050
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
Us
6"CONCRETE DRIVEWAY AND PARK SPACE PODS n c o se ommen
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction
Needed
Re-Inspection
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
November 01,2016 For Inspections please call: (305)762-4949 Page 22 of 51
Pott26
Miami Shores Village 3 Pef1 €7y�18 �#ri4i SISlderl�alkst abs
10050 N.E.2nd Avenue NW �O/a� tt �t �t)tt8ltti
Miami Shores,FL 33138-0000 ,
y�l Phone: (305)795-2204a
ie 120-16 Expiration:
03/28/201
a
Project Address Parcel Number Applicant
25 NW 91 Street 1131010140050
LEONARDO RAMIREZ
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
LEONARDO RAMIREZ 25 NW 91 Street (786)226-5901
MIAMI SHORES FL 33150-
Contractor(s) Phone Cell Phone Valuation: $ 2,000.00
HOME OWNER Total Sq Feet: 1000
Approved:In Review Available Inspections:
Comments: Inspection Type:
Date Approved::In Review Final
Date Denied: Foundation
Type of Work:6"CONCRETE DRIVEWAY AND PARK SP Additional Info:6"CONCRETE DRIVEWAY AND PAF Review Building
Bond Retum: Classification:Residential Review Building
Scanning:3 Review Planning
Review Planning
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
Bond Type-Owners Bond $500.00 Invoice# DS-9-16-61422
CCF $1.20 09/29/2016 Credit Card $621.70 $50.00
DBPR Fee $2.25
DCA Fee $2.25 09/21/2016 Check#:2123 $50.00 $0.00
Education Surcharge $0.40 Bond#:3225
Notary Fee $5.00
Permit Fee $150.00
Scanning Fee $9.00
Technology Fee $1.60
Total: $671.70
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 zoning. Futhermore,I authorize the above-named contractor to do the work stated.
September 29,2016
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
September 29,2016 1
Miami Shores Village cEIVF�
S 1 2016
Building Department LBY:
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949 J -�--�
FBC 200
BUILDING Master Permit No, 16 -2(,®B
PERMIT APPLICATION Sub Permit No.
❑BUILDING F-1 ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ORENEWAL
❑PLUMBING F� MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF Ej CANCELLATION EJ SHOP
cc CONTRACTOR DRAWINGS
JOB ADDRESS: � � �w 1(S� S4t C-4
City: Miami Shores County: Miami Dade Zip: �J31j
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: CMM Flood Zone: `A� BFE: FIFE:
OWNER:Name(Fee Simple Titleholder): �e�C)Y\Ck%Ao lK�y�l`< Phone#: � J�;190l
Address: 215 %w 5A51✓tk—
City: WGWN-' cz:�Ceo State: — Zip: -L->'51CDo
Tenant/Lessee(,Name: tt Phone#:
Email: L1�-v'^+r eA- o XL �� t
VVA—
CONTRACTOR:Company Name: \gym-'( 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:$ Square/Linear Footage of Work: 8C)U SQF
Type of Work: ❑ Addition ❑ Alteration ® New ❑ Repair/Replace ❑ Demolition
11
Description of Work: Gyx� VCkd C --1P0j:ze—
�c:��v-
Specify color of color t�hy ru tile:
Submittal Fee$ � ►U Permit Fee$ ��r� CCF$ p . CO/CC$ af
Scanning Fee$ Radon Fee$ DBPR$ �' Notary$ ��*
Technology Fee$ G �G Training/Education Fee$ �' Double Fee$ !3
Structural Reviews$ Bond$ goo.
TOTAL FEE NOW DUE$ 121 ' l3
(Revised02/24/2014) Gal
l
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 c s seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approv 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,() ,C,'f -�'1--bf r ,20 ,by day of 20 by
�`QQY-\CAYCid hl vet who is personally known to ,who is personally known to
me or who has produced D r,V-ev UI Cyk3le- as me or who has produced as
identification and who did t an oath. identification and who did take an oath.
NOTARY P 1 NOTARY PUBLIC:
i
Sign: fix Sign:
Print: 1 Print:
Seal: �aYe..... YANADYPRIEM Seal:
MY COMMISSION#FF 214031
EXPIRES:March 25,2019
c °' Bonded Thru Notary Public Underw bra
APPROVED BY Plans Examiner ?I,-?191101 Zoning
Structural Review Clerk
(Revised02/24/2014)
a
7
3
OR,Es� Miami Shores Village
-,,. nmM Building Department
10050 N.E.2nd Avenue
^toRo Miami Shores, Florida 33138
Tel: (305)795.2204
Fax: (305)756.8972
OWNER BUILDER DISCLOSURE STATEMENT
I
NAME: _—_I.CAO DATE: CPQ t
ADDRESS: 7.6 IAW q%4 4zk- I%Au.,,rv%%S4wiea TL— ?j3I50
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 entities 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 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. ( (�
Initial L --
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—LL
L
5. 1 understand that,as the owner-builder,I must provide direct,onsite supervision of the construction.
Initial—U-
6.
nitialU-
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 LL
Y
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. 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. \ Q
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
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://www.mvfloridalicense.com/dbpr/pro/cilb/index.htmi 1 .n
Initial �G�.
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:
25 dW �lsk' S�fe�' M�arr+�Slr�ati,o'�-- 33t5o
Initial UL
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_ L12—
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
1 is required when the permit is issued.
Was acknowledged before me this Z1 day of 20
By L1-1'1,-'SQ1 &,,I el who was personally known to me or who has
Produced ere License or Dr;*u U CgYLS,2, -,P, 4 2-2b? as'identification.
Y^ie YANAD:PRl,,ETO MY COMMISSFF 214031EXPIRES:M25,2019W NOTARYBended Thru Notac Underwriters
R
LOT-J o LOCATION SKETCH
� F.LP. !1z �a NOT TO SCALE
EAST 75.00 (R&M) NO ID. h i W i i
2.40' 5'CHAIN LINK FENCE W E r
303' k 10.00' �- y
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LEGAL DESCRIPTION:
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LOT-4 LOT 5, "RECTOR SUBDIVISION", ACCORDING TO THE PLAT THEREOFAS
m cin c °J RECORDED IN PLAT BOOK 45,PAGE 1, OF THE PUBLIC RECORDS OF
m 0 TOY s do 1000 o �' m _j MIAMI-DADE COUNTY,FLORIDA. .0000
.
a N A N D RES/DENCE o v� 000 .... ......
0 o z m s ! �� o .,ti,°EE� SURVEYOR'S NOTES: •• •••• •
i 2 p M / N 90 �� t-4"f z Z ? 1)NOT VALID UNLESS SIGNATURE IS EMBOSSED WITH THE AVCrE12ED LAND SZ/hVEYOR S�tAL••
aCi / 36.90f� P I ; U �� 2)LEGAL DESCRIPTION PROVIDED BY OTHERS. •••••• • :90000
( L) 3)PROPERTIES SHOWN HEREON WERE NOT ABSTRACTED FOR"6EMENTSGR OTHER RECORDED
y m m /� I i C� LTJ - ] ENCUMBRANCES NOT SHOWN ON THE PROPERTY PLAT OF REQQgQ• 0 •••• 00:909
Z:-:E
T p O C •5 1 1.10' 180 A� l % r-'i Cj 4)MEASUREMENTS TO WOOD FENCES ARE TO OUTSIDE OF WOOD.
• •••
w C+� I w 5)UNDERGROUND UTILITIES,FOUNDATIONS,OR OTHER IMS NTS,Ih,4Nl(�RE NOf
wlj / f I '? 1 LOCATED. •• •• • ••••�•
�y 90 4' 1 5��dY ` , _; 6)ELEVATIONS,IF SHOWN ARE BASED ON NATIONAL GEODEWWA(aWICAL DATUM 1929. ••
i J `f
CERTIFIED TO: 4-� 7)FENCE OWNERSHIP NOT DETERMINED UNLESS OTHERWI'T NOTED. ••••••
m O 8)MEASUREMENTS TO WIRE FENCES ARE TO CENTER OF WIRE. • ••••• :00900•
UL It Q C/V�►'� � RAPID TITLE SERVICES COMPANY, 9)WALL MEASUREMENTS ARE TO/FROM FACE OF WALL • • • :••••0
S 42' 6 s 1 10)DRAWING DISTANCE BETWEEN WALLS AND/OR FENCES AND PROPERTY 100!, jY BE
y OLD REPUBLIC NATIONAL TITLE INSURANCE COMPANY, EXAGGERATED FOR CLARITY. •• •
F I P �z• F l P %Z, F L P /jjzJESSICA MERCEDES RAMIREZ AND LEONARD RAMIREZ, 11)FLOOD ZONE INFORMATION WAS DERIVED FROM FEDERAL EMERGENCY MANAGEMENT AGENCY
tU
NO ID. NO ID NO/D. PREFERRED MORTGAGE, ITS SUCCESSORS FLOOD INFORMATION RATE MAPS
95.00'R&�.1 AND,,0R ASSIGNS AS THEIR INTERESTS MAY APPEAR 12)BEARINGS IF ANY SHOWN ARE BASED ON ASSUMED PLAT MERIDIAN AT.'NORTH RIGHT OF WAY OF
25P 102,
�t/� p O OUL `oW/jy 0W/M BLOCK N.W.91st STREET=WEST
w6�rCORNER LEGEND I.C.V. MIG4nONCONTROLVALVE P.C.P.PERMANENTCONTROLPOINT W/M WATERMETER
�i�� jo> �� A/C AIR CONDITIONER I.P. IRON PIPE
PLS PROFESSIONAL LAND SURVEYOR W.V. WATERVALVE
//��tt JV�JD I �T AVE AVENUE FPL FLORIDA POWER&LIGHT ISM PROFESSIONAL SURVEYORAND MAPPER W.U.P.WOODUTILITYPOLE
�� s�` GP BLVD. BOULEVARD F.I.P. FOUND IRON PIPE PL PROPERTYLINE
�� `X BM BENCHMARK F.I.R. FOUNDIRONROD P.O.B. POINTOFBEGINNING
C� r v`r ,. CATV CABLE TELEWSION BOX FND. FOUND P.O.C.POINTOFCOMMENCEMENT
y� D �r 25'PARKWAY O C.B. CATCH BASIN L ARCLEIVGTf! P.R.C. POINTOFREVERSECURVATURE SYMBOLS
CBS CONCRETE BLOCK STRUCTURE (L) LEGAL P.R.M.PERMANENTREFERENCEMONUMENT - v CONCRETE
CHB CHORDBEAR/NG L.P. LIGHTPOLE P.T. POINTOFTANGENCY yyi OVERHEAD UTILITYUNES
CH CHORD DISTANCE LB LICENSED BUSINESS R RADIUS WIRE FENCE
COR CORNER- LS LAND SURVEYOR (R) RECORD — WOOD FENCE
CT COURT (M) MEASURED RE. RIMELEVATION OPERTY CORNER
` yCENTERLINE NAVD NORTHAMERICAN VERTICAL DATUM RIW RIGHT-OF WAY �v�- WATER FLOW
d CL. CLEAR NGVD NATIONAL GEODETIC VERTICAL DATUM SAN. SANITARY 9.60 EXISTING GRADE ELEVATION
NOID.NOTIDENTIFIABLE CONC. CONCRETE S.I.P. SET IRON PIPE -•��PROPOSED GRADE ELEVATION
C.O. CLEANOUT NO. NUMBER SLR. SETIRONROD H WATER VALVE
3 NIS NOT TO SCALE ST. STREET SIGN
E.B. ELECTRIC BOX T TANGENT DRAINAGE MANHOLE
ELEV ELEVATION 0—RB OFFICIAL RECORD BOOK
mON/PL ONPROPERTYUNE
T.B.M TEMPORARYBENCHMARK SANITARYMANHOLEENCR. ENCROACHMENT�
� "E.R.P. ELEVATIONREFERENCEPOINT O.U.L OVERHEAD UTILITYUTEL. TELEPHONE FIREH?DRANTNES FINISH FLOOR P.C. POINTOFCURVATURE Typ TYPICAL LIGHTINGFIXTURE
F.F.
F.H. FIREHYDRANT P.C.C.POINTOFCOMPOUND CURVATURE U.E. UTILITYEASEMENT L7 FIRE DEPARMENT CONNECTION
FLOOD ZONE:X A BOUNDARY SURVEY
PROPERTY OF:JESSICA MERCEDES RAMIREZ
MAP&PANEL= 12086CO302 AND LEONARD RAMIREZI HEREBY CERTIFY THAT THIS SURVEY CONFORMS TO PROFESSIONAL SURVEYING AND MAPPING
COMMUNITY NO.: 120652 THE MINIMUM TECHNICAL,STANDARDS OF LAND
SURVEYING IN THE STATE AADMIFLORIDA, V OUTLINED LANNES & CSA RCIA INC.
SUFFIX.-L IN RULES 5J-17,(FLORIDA ADMINISTRATIVE CODE),AS � 7
25 N.W. 91st STREET, ADOPTED BY THE DEPARTMENT OF AGRICULTURE AND CONSUMER SERVICES,BOARD OF
MIAMI SHORES FLORIDA 33150 LB#2098
DATE OF FIRM: 09-11-2009 0
� ti
BASE ELEV.= N/A NOT VALID WITHOUT THE SIGNATUREAND THE PROFESSIONAL SURVEYORS AND MAPPERS IN ® FRANCISCO F. FAJARDO PSM#4767(QUALIFIER)
ORIGINAL RAISED SEAL OF A FLORIDA LICENSED SEPTEMBER,1981,AS AMENDED,PURSUANT TO 9nnee 385 ALHAMBRA CIRCLE-SUITE C,
SURVEYOR AND MAPPER. CHAPTER 472.027 OF THE FLORIDA STATUTES,AND IS
TRUE AND CORRECT TO THE BEST OF MY CORAL GABLES, FLORIDA 33134
KNOWLEDGEAND BELIEF. PH(305) 666-7909 FAX(305)442-2530
FRANCISCO F.FAJARDO
FLORIDA PROFESSIONAL SURVEYOR AND MAPPER FIELD DATE 09/09/2015 SCALE. 1"=20' IDRAWNBJONELLEY. DWG.No.:2580:21
REGISTRATION NO.4767.