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City of Miramar | Building Division (The City of Miramar)

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City of Miramar | Building Division
Community & Economic Development Department
2200 Civic Center Place | Miramar, Florida 33025
Tel: 954.602.3200 | Fax: 954.602.3635
www.miramarfl.gov
REV 01/2019
Who Can Apply (A or
B)
A. Licensed Contractors for Residential Permit can be issued to Licensed Contractors properly registered in the
Community Development - Building Division. Contractors shall provide all required applications properly signed and
notarized. Also, Contract signed by both parties (Contractor & Homeowner) shall be provided indicating contract
value per every applicable discipline.
ATTENTION HOMEOWNER – READ CAREFULLY
B. Homeowner/Builder for Residential Only. Permit can be issued to homeowner/builder if job address matches the
address on picture ID (Driver License, ID card) and Proof of ownership (Recorded warranty deed, tax statement,
settlement statement).
• If a contractor is hired, then the contractor must pull the permit.
Required D
o
c
u
m
ents
For Residential Application: (Conc. Slab on grade, Conc. Driveway & Pavers)
Permit application describing the proposed scope of work. For homeowner see the note (B) indicated above.
H.O.A. Affidavit of Awareness (Included in this package)
Owner-Builder Disclosure Statement (If application is by homeowner only)
For Residential a Full Scalable and Updated Boundary Survey (1 set). Reduced, faxed, enlarged surveys or any
altered surveys are not acceptable. The boundary survey submitted for application purpose shall be updated
with less than five (7) years, and it shall be original, signed and sealed by the Professional Land Surveyor.
On the boundary survey you shall provide dimensions and location of the proposed work.
Approval from South Broward Drainage District may be required if concrete slab or pavers are encroaching
drainage and/or lake easement.
SOUTH BROWARD DRAINAGE DISTRICT. 6591 S.W. 160
th
Ave. Southwest
Ranches. Florida 33331 Phone
(954) 680-3337 ⚫ Fax (954) 680-3339.
For Driveway, provide one (1) copy of the Residential Typical Driveway (See attached).
If Concrete Reinforcing Fiber is proposed as reinforcement, then provide one (1) set of manufacturer’s
specifications indicating dosage of fiber per cubic yard of concrete and compliance with ASTM C1116.
For Commercial Application (Concrete Slab on Grade):
Permit application describing the proposed scope of work
Four (4) full scalable site plans, indicating location and dimensions of the concrete slab
Four (4) Engineered details for concrete slab indicating dimensions and reinforcement. Engineered Details shall
be original signed & sealed by Prof. Engineer.
For Concrete Slab exceeding 250 square feet, approval from Broward Development & Environmental Regulation
Division (DERD). is required. Broward Development & Environmental Regulation Division (DERD). 1 North
University Drive, Suite A-102 Plantation, Florida 33324 Phone: (954) 357-6666.
Attention Applicant: As per Florida Statutes 713.13, a Recorded Notice of Commencement is required when construction,
renovation, alterations values exceed $2,500. This subsection does not apply to a direct contract to repair or replace an
existing heating or air-conditioning system in an amount less than $7,500. Construction cost (Including labor & material)
will be based on contract signed by both parties (owner & contractor) and/or as determined by the Building Official (FBC
109.3). Notice of commencement can be recorded at the office of Broward County Government Center / Records
Division 115 S. Andrews Ave. Fort Lauderdale, FL 33301
Concrete Slab,
Driveway & Pavers
Application Package
APPENDIX A
Broward County Board of Rules and Appeals
~Effective June 30, 2015
5
th
Edition (2014) FBC — Building
Broward County Administrative Provisions
BROWARD COUNTY UNIFORM BUILDING PERMIT APPLICATION
Select Trade: Building Electrical Plumbing Mechanical Other __
Application Number: Application Date:
Job Address: Unit: City:
Tax Folio No.: Flood Zone: BFE: Floor Area: Job Value:
Building Use: Construction Type: Occupancy Group:
1
Present Use: Proposed Used:
Description of Work:
New Addition Repair Alteration Demolition Revision Other:
Legal Description:
Attachment
Property Owner: Phone: Email:
2
Owner’s Address: City: State: Zip:
Contracting Co.: Phone:
Email:
3
Company Address: City: State: Zip:
Qualifier’s Name: Owner-Builder:
License Number:
Architect/Engineer’s Name: Phone: Email:
Architect/Engineer’s Address: City: State: Zip:
Bonding Company:
4
Bonding Company Address: City: State: Zip:
Fee Simple Titleholder’s name (if other than owner):
Fee Simple Titleholder’s Address (If other than owner): City: State: Zip:
Mortgage Lender’s Name:
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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and 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. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR
AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF
COMMENCEMENT.
X
Signature of Property Owner or Agent
STATE OF FLORIDA
COUNTY OF
X
Signature of Qualifier
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me this
, 20_ by
day of
Sworn to (or affirmed) and subscribed before me this
, 20_ by
day of
(Type / Print Property Owner or Agent Name)
(Type / Print Qualifier’s Name)
NOTARY’S SIGNATURE as to Owner or Agent’s Signature
Notary Name
(Print, Type or Stamp Notary’s Name)
Personally Known or Produced Identification
Type of Identification Produced
NOTARY’S SIGNATURE as to Qualifier’s Signature
Notary Name
(Print, Type or Stamp Notary’s Name)
Personally Known or Produced Identification
Type of Identification Produced
APPROVED BY: Permit Officer Issue Date:
Code in Effect:
A jurisdiction may use a supplemental page requesting additional information and citing other conditions, please inquire.
Note: If any development work as described in FS 380.04 Sec. 2 a-g is to be performed, a development permit must be obtained prior to the issuance
of a
building permit.
City of Miramar | Building Division
Community & Economic Development Department
2200 Civic Center Place | Miramar, Florida 33025
Tel: 954.602.3200 | Fax: 954.602.3635
www.miramarfl.gov
Owner Name: ____________________________________________________________________________________
Address: Miramar, FL, Zip Code: ______________________
LOT: BLOCK: SUBDIVISION: ___________________________________________
I am submitting an application for a Building Permit as an Owner-Builder in accordance with the exemption set forth in
Florida Statute 489.103. Florida law requires construction to be done by a licensed contractor. It’s a requirement by law
you read and sign the following statements, and hence you can understand your responsibilities as an owner-builder. By
signing the following statements, you attest that:
DISCLOSURE STATEMENT
(Read and Initial to the left of each statement)
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.
2. I 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.
3. I 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 a contractor is required by law to be licensed in Florida and to
list his or her license numbers on permits and contracts.
4. I 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
own 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.
5. I understand that, as the owner-builder, I must provide direct, onsite supervision of the construction.
6. I 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 licenses
required by law and by county or municipal ordinance.
7. I understand that it is a frequent practice 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 her 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.
8. I understand that I may not delegate the responsibility for supervising work to a licensed contractor who is not
licensed 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 laws
may subject me to serious financial risk.
9. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by
all applicable laws and requirements 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.
Disclosure
Statement
City of Miramar | Building Division
Community & Economic Development Department
2200 Civic Center Place | Miramar, Florida 33025
Tel: 954.602.3200 | Fax: 954.602.3635
www.miramarfl.gov
10. I understand that I may obtain more information regarding my obligations as an employer from the Internal
Revenue Service, the United States Small Business Administration, the Florida Department of Financial Services, and
the Florida Department of Revenue. I also understand that I may contact the Florida Construction Industry Licensing
Board at (telephone number) or (Internet website address) for more information about licensed contractors.
11. I am aware of, and consent to, an owner-builder building permit applied for in my name and understand that I
am the party legally and financially responsible for the proposed construction activity at the address listed above.
12. I agree to notify (issuer of disclosure statements) immediately of any additions, deletions, or changes to any
of the information that I have provided on this disclosure.
Licensed contractors are regulated by laws designed to protect the public. If you contract with a person who does not
have a license, the Construction 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 a complaint. Your only remedy against an
unlicensed 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.
I have read the foregoing instructions and I am aware of my responsibilities.
___________________________________________ _____________________________
Owner Signature Date Signed
STATE OF FLORIDA, COUNTY OF BROWARD. Sworn to and subscribed before me this _day of _, 20 .
Notary Public
F.S 489.103. 3(c). If any person violates the requirements of this subsection, the local permitting agency shall
withhold final approval, revoke the permit, or pursue any action or remedy for unlicensed activity against the
owner and any person performing work that requires licensure under the permit issued.
Disclosure
Statement
(Continuation)
City of
Miramar | Building Division
Community & Economic Development Department
2200 Civic Center Place | Miramar, Florida 33025
Tel: 954.602.3200 | Fax: 954.602.3635
www.miramarfl.gov
Affidavit
of
Aw
a
reness
of
H
o
me
o
wner’s
Association
Reg
ulation
s
The following “Affidavit” is required as per City’s ordinance. This is a mandatory affidavit which is required
even if your property is not located in a Homeowner’s Association.
ATTENTION APPLICANT. READ CAREFULLY
•
For homeowner/Builder applicants, this affidavit can be notarized by Permit Clerk at the Building
Division. Homeowner should appear in person with required picture I.D. (i.e. Driver License)
and proof of ownership (i.e. Recorded Warranty, County Tax Statement). The physical address on
I.D. shall match the address on the proof of ownership (i.e. Recorded Warranty Deed).
•
For Licensed Contractor applicants, this affidavit can be notarized outside the Building Division by any
Notary Public.
Homeowner or Condominium Association Affidavit requirement. Miramar - City Code Sec. 22-29.(c)(1) As
part of the application process for a building permit in accordance with this chapter and with Section 713.20
of the Land Development Code, each applicant shall sign an affidavit (the "affidavit of awareness")
indicating that the applicant is aware that, if the subject property is located in a Homeowners'
Association or Condominium Association, as defined in this section, the applicant's property may be
subject to additional regulations despite the issuance of a building permit by the city.
This serves to notify such homeowner that the issuance of a Building, Landscaping, or other permits by the
City of Miramar, Florida does not exempt he/she from any and all other regulations imposed by the
Homeowner’s Association (HOA) in which his/her property is located. Be aware that despite the issuance
of a building permit by the city, the applicant’s property may result in additional regulations or denial
to perform the work in your property located at HOA community.
Read and Initial to the left of the applicable statement
I acknowledge that I am the owner of property located in the following Homeowner’s Association:
Print Name of Homeowner’s Association
I acknowledge that my property is not located in a Homeowners’ Association.
Name:
Homeowner - Print
N
a
me
J
ob
A
ddr
ess:
Miramar, Flo
r
ida Zip Cod
e
:
Signa
ture:
Homeowner - Signature
STATE OF FLORIDA. Sworn to and subscribed before me this day of , 20
Notary Public
REV 1/2019
City of Miramar | Building Division
Community & Economic Development Department
2200 Civic Center Place | Miramar, Florida 33025
Tel: 954.602.3200 | Fax: 954.602.3635
www.miramarfl.gov
Footing Detail for
Residential Patio Slab
& Storage Shed Slab
• The area under proposed conc. slabs shall be free of debris and other deleterious materials.
ALTERNATE OPTION FOR SLAB REINFORCEMENT:
▪ Welded Wire Mesh: Applicant shall state clearly on plans and on the application (Description of work) the
use of Wire Mesh as reinforcement.
▪ Synthetic Reinforcing Fiber: Provide manufacturer’s specifications indicating fiber dosage per cubic yard of
concrete and compliance with ASTM C1116. Applicant shall state clearly on the application and plans the
use of reinforcing fiber as reinforcement.
NOTE:
▪ For Residential Concrete Driveway, a thickened edge is optional.
▪ For Commercial Conc. Slab: Engineered details signed & sealed by Prof. Engineer are required, indicating
reinforcement and dimensions.
REQUIRED PLANS REVIEW
RESIDENTIAL
COMMERCIAL
PLANNING & ZONING
PLANNING & ZONING
BUILDING/STRUCTURAL
FIRE DEPT.
BUILDING/STRUCTURAL
REQUIRED INSPECTIONS
RESIDENTIAL
COMMERCIAL
Foundation B111 (Prior to Pour concrete)
Foundation B111 (Prior to Pour concrete)
Final Inspection B-999
Fire Marshal B-801. (When work is Completed)
Foundation – B111 (After Fire Marshal Approval)
FOR FINAL INSPECTION, THE WORK AREASHALL BE CLEAN OF DEBRIS AND/OR REMAINING CONSTRUCTION MATERIALS
01/2019
4” CONC. SLAB ON WELL
COMPACTED GROUND.
4” CONCRETE SLAB ON WELL
COMPACTED GROUND
ALTERNATE OPTION FOR SLAB REINFORCEMENT:
§ Welded Wire Mesh: Applicant shall state clearly on plans and on the application (Description of work) the use of Wire Mesh as reinforcement.
§ Synthetic Reinforcing Fiber: Provide manufacturer's specifications indicating fiber dosage per cubic yard of concrete and compliance with ASTM C1116.
Applicant shall state clearly on the application and plans the use of reinforcing fiber as reinforcement.
MARKED THE ALTERNATE OPTION FOR SLAB REINFORCEMENT:
o Welded Wire Mesh: Applicant shall state clearly on plans and
on the application (Description of work) the use of Wire Mesh as
reinforcement.
o Synthetic Reinforcing Fiber: Provide manufacturer's
specifications indicating fiber dosage per cubic yard of concrete and
compliance with ASTM C1116. Applicant shall state clearly on the
application and plans the use of reinforcing fiber as reinforcement.
AFTER RECORDING – RETURN TO:
PERMIT NUMBER:
NOTICE OF COMMENCEMENT
The undersigned hereby given notice that improvement will be made to certain
real property, and in accordance with Chapter 713,
Florida Statues the following information is provided in the Notice of Commencement.
1. DESCRIPTION OF PROPERTY (Legal description & street address, if available) TAX FOLIO NO.: _______________________________
SUBDIVISION
_______________________________BLOCK_________TRACT_________LOT________BLDG_______UNIT_______
__________________________________________________________________________________________________________
2. GENERAL DESCRIPTION OF IMPROVEMENT:
__________________________________________________________________________________________________________
3. OWNER INFORMATION: a. Name________________________________________________________________________________________________
b. Address________________________________________________________________________________ c. Interest in property____________________
_____
d. Name and address of fee simple titleholder (if other than Owner) __________________________________________________________________
____________
4. CONTRACTOR’S NAME, ADDRESS AND PHONE NUMBER:
____________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________
5. SURETY’S NAME, ADDRESS AND PHONE NUMBER AND BOND AMOUNT:
____________________________________________________________________________________________________________________________________
6. LENDER’S NAME, ADDRESS AND PHONE NUMBER:
____________________________________________________________________________________________________________________________________
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by
Section 713.13 (1) (a) 7., Florida Statutes:
NAME, ADDRESS AND PHONE NUMBER:
____________________________________________________________________________________________________________________________________
8. In addition to himself or herself, Owner designates the following to receive a copy of the Lienor’s Notice as provided in Section
713.13 (1) (b), Florida Statutes
:
NAME, ADDRESS AND PHONE NUMBER
:
____________________________________________________________________________________________________________________________________
9. Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a different date is
specified):________________ ______, 20____
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT
ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE
RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
________________________________________________ ____________________________________________________
Signature of Owner or Print Name and Provide Signatory’s Title/Office
Owner’s Authorized Officer/Director/Partner/Manager
State of Florida
County of Broward
The foregoing instrument was acknowledged before me this __________ day of _______________, 20________
By ___________________________________________________, as ________________________________________________
(name of person)
(type of authority,…e.g. officer, trustee, attorney in fact)
For __________________________________________________.
(name of party on behalf of whom instrument was executed)
_____ Personally known or _____ produced the following type of identification: __________________________________________
Notary ___________________________________________
(Signature of Notary Public)
Under Penalties of perjury, I declare that I have read the foregoing and that the facts
in it are true to the best of my knowledge and
belief (Section 92.525, Florida Statutes).
Signature(s) of Owner(s) or Owner(s)’ Authorized Officer/ Director / Partner/Manager who signed above:
By __________________________________________________ By _______________________________________________
Rev .08-09-07 (S.Recording)
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Completed 19 January 2021

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