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Miami Shores Village Nrrtttt TY Residentiaj� C� ,
10050 N.E.2nd Avenue NE
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Miami Shores,FL 33138-0000
AP
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Phone: (305)795-2204
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it3l11 EXP iration: 0 09/2017
Project Address Parcel Number Applicant
9500 NE 6 Avenue 1132060140770
ANGEL W DIAZ
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
ANGEL W DIAZ 9500 NE 6 AVE (786)412-7310
MIAMI SHORES FL 33138-2739
Contractor(s) Phone Cell Phone Valuation: $ 3,500.00
HOME OWNER
_.... .... _. ., . Total Sq Feet: 56
Approved:In Review Available Inspections:
Comments:
Inspection Type:
Date Approved::In Review
Final PE Certification
Date Denied: Window Door Attachment
Type of Construction:BATHROOM RENOVATION Occupancy:Single Family Framing
Stories: Exterior: Insulation
Front Setback:
Rear Setback: Drywall Screw
Left Setback: Right Setback: Fill Cells Columns
Bedrooms: Bathrooms: Window and Door Buck
Plans Submitted: Certificate Status: Review Planning
Certificate Date: Additional Info: Review Building
Review Electrical
Bond Return: Classification:Residential Review Electrical
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Review Plumbing
CCF $2.40 Review Structural
DBPR Fee $2.00 Invoice# RC-9-16-61176 Review Mechanical
DCA Fee $2.00 09/01/2016 Credit Card $50.00 $79.40
Education Surcharge $0.80 10/11/2016 Credit Card $79.40 $0.00
Notary Fee $5.00
Permit Fee $105.00
Scanning Fee $9.00
Technology Fee $3.20
Total: $129.40
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 AIDAVIT: I erti hat all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction d zoning. rx:
orize the above-named contractor to do the work stated.
October 11, 2016
Au orized Signa ure:Owner / Applicant / Contractor / Agent Date
Building Department Copy
October 11,2016 1
STOBS BROS. CONSTRUCTION CO.
- 9
ANGEL W.DIAZ
Superintendent
S80 N.E.921 Street Mlaml Shores,Florida 33138
(30S)781-1692 Fax(308)787-6554 Cel (788)412-7310 E-AAaH:ang9 ww2®aol.com
C.C.C.011055
f Miami Shores Village '
Building Department s"P ° "M10050 N.E.2nd Avenue,Miami Shores, Florida 33138 BY: - '
Tel:(305)795-2204 Fax:(305)756-89721-p
INSPECTION LINE PHONE NUMBER:(305)762-4949 Imo`
FBC 20(°--1
BUILDING Master Permit No. �I
PE IT APPLICATION Sub Permit No.
BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: g5D0 VF
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder):4d/(,�;/ X11/4 Z Phone#: 766-!5 ��73/D
Address: Cf�� VF 1�; "
City: / _z4V_je&S State: li Zip:
Tenant/Lessee Name: Phone#:
Email: [tj ,� L .(DTlXJ
`CONTRACTORS Company Name: Phone#: 7A6-l4/7-7. 1
Address:
City: State: Zip:
Qualifier Name: Phone#:
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
\VValue-of-Work for this Permit:$� ,.�b0. D Square/Linear Footage of Work:J`�riv S`rf'/F
Type of Work: ❑ Addition ❑ Alteration ❑ New , Repair/Replace ❑ Demolition
-Description of Work:
Specify color of color thru tile: f
Submittal Fee$ SO' CO Permit Fee$( 0�) CCF$ ® CO/CC$
Scanning Fee$ X11 ' Radon Fee$ DBBPppR$ Notary$
) �� .
Technology Fee$ �0 Training/Education Fee$ �' 90 Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(Revised02/24/2014)
Bonding Company's Name(if applicable)
Bonding Company's Address
i
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 Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
d`ay�Iof 20 (C ,by day of 20 , by
who is personally known to who is personally known to
me or who has producedTA- � ( � Q Ck, as me or who has produced as
identification an ho did take an oath. identification and who did take an oath.
NOTARY PUBLI NOTARY PUBLIC:
Sign: Sign:
Print: �1 `� '� � `� Print:
�j 4
Seal: Seal:
o�ssrvad, plr�t�i} +„idi a�ytriR�Fl4ricj� �
� e � ti?li pid f4i�f�l� r 1L
F1='15673Q
rl
V
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
I
P
�St!0 y 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: '�� � �1��' DATE: �!�/s 6/6
ADDRESS:��®� '� 1--tel-Glo/ +S&dam
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. 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 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 he or she is responsible for the construction and
is not hiring a licensed contractor to assume responsibility.
Initial-
3.
nitial3. 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 /Ay_`
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.
InitialAZ?
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.html
Initial29�0
11. 1 am aware of,and consent to;an owner-builder building permit applied for in my name and understands that I am the parry
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 01 day of , 20 C7,
By �_+ who was personally known to me or who has
6
Produced there License or �- as identification.
o1PRY 11t,o Na.ary SPat�-of Ftonda
Zee
Snt'.ia Xv,Irez
4-dF hlVy Comm sOWNER Expreso9'o3ir_
NOTARY
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9500 NE 6 Ave Miami Shore
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.ADD SMOKE/CARBON MONOXIDE DETECTORS.
Get ANY AND ALL CLOTH AND RUBBER
QF6J INSULATED CONDUCTORS TO BE REPLACED.
818!2016 Custom Building Products RedGard 3-1/2 Gal.Waterproofing and Crack Prevention Membrane-LQWAF3-The Home DeW
Product Overview
RedGard 3.5 Gal.Waterproofing and Crack Prevention Membrane is a ready to use waterproofing and crack prevention membrane for tile and
stone installations.Just roll it on and let it dry.The membrane dries quickly.
• For the and stone installations
• Apply with a roller,trowel or sprayer(tools not included)
• Use 1 coat for crack prevention
• Use 2 coats for waterproofing
• Dries quickly
• Includes moisture control
• Covers 385 sq.ft.
Specifications
Dimensions
Product Width(in.) 12 Roll length(ft.) 0
Product thickness(mil) 30 Roll width(in.) 0
Recommended overlap(in.) 0
Details
Antimicrobial No Material Other
Commercial/Residential Commercial/Residential Moisture control included Yes
Cushioning No Package coverage(sq.ft.) 385
Flooring Product Type Underlayment Returnable 90-Day
Flooring type(s)used with Tile&Stone Subflooring type Any
Warranty/Certifications
Manufacturer Warranty 1 year product
•• ••• • • • • • ••
• •• • • • • ••• •
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• ••• ••• • •• •
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Review Rating:4&Up Prige:$ -!950 • • 0.090:Custom Building Products
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RedGard 3-1 /2 Gal. Waterproofing and Crack Prevention
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(36) Write a Review Gmestions&Answers{52)
$139.00 /each
Ready to use-Roll it on
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Vstea witp lgt�tYlo ran ase as a se.. ® Miami,FL 33135 Aisle 02,Bay 001
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