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RC-16-3405 INSPECTION RECORD POST ON SITE ' Permit NO. RC-12-16-3405 Miami Shores Village Permit Type:Residential Construction �!! 0 10050 N.E.2nd Avenue Miami Shores,FL 33138-0000 WorkC/aSSIfcado—&Abd 1 1 in/Alteration y� opo Phone: (305)795-2204 Fax. (305)756-8972 ORIDp` Issue Date:4/5/2017 Expires: 10/02/2017J INSPECTION REQUESTS: (305)762-4949 r Log on at https://bldg.miamishoresvillage.com/cap REQUESTS ARE ACCEPT URING 8:30 -3:30PM FOR THE FOLLOWING BUSINESS DAY. Requests must be received by pm r following day inspections. Residential Construction i Parcel #:1132060135510 IF Owner's Name:J HENRY VIDAL ., _ �w Owner's Phone: Job Address: 349 NE 99 Street0 Total Square Feet: 0 Miami Shores- FL 33138- }' Total Job Valuations $ 15,000.00 Bond Number: f .r• / 0}2 IS ALLOWED: MONDAY Contractor(s) Primary SATURDAY 8:00 MH 6 01 PM.B:OOAM-7:OOPM. Phone Prima Contractor HOME OWNER Yes NO WORK IS ALLOWED ON SUNDAY OR HOLIDAYS. BUILDING AND ROOFING INSPECTIONS ARE DONE MONDAY THROUGH FRIDAY. e a NO INSPECTION WILL BE MADE UNLESS THE PERMIT CARD IS DISPLAYED AND HAS BEEN APPROVED. PLANS ARE READLY AVAILABLE. IT IS THE PERMIT APPLICANT'S RESPONSIBILITY TO ENSURE THAT WORK IS ACCESSIBLE AND EXPOSED FOR INSPECTION PURPOSES. NEITHER THE BUILDING OFFICIAL NOR THE CITY SHALL BE LIABLE FOR EXPENSE ENTAILED IN THE REMOVAL OR REPLACEMENT OF ANY MATERIAL REQUIRED TO ALLOW INSPECTION. 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. INSPECTION RECORD STRUCTURAL ZONING PLUMBING INSPECTION DATE -'INSP INSPECTION DATE INSP INSPECTION DATE !,NSP Foundation Zoning Final Stemwall ZONING COMMENTS Rough Slab Water Service Columns(1st Lift) 2nd Rough Columns(2nd Lift) Top Out Tie Beam Fire Sprinklers Truss/Rafters Septic Tank Roof Sheathing Sewer Hook-up Bucks Roof Drains Windows/Doors Gas Interior Framing INSPECTION DATE INSP LP Tank Insulation Temporary Pole Well Ceiling Grid 30 Day Temporary Lawn Sprinklers Drywall Pool Bonding Main Drain Firewall Pool Deck Bonding Pool Piping Wire Lath Pool Wet Niche Backflow Preventor Pool Steel Underground Interceptor Pool Deck Footer Ground Catch.Basins Final Pool Slab Condensate Drains Final Fence Wall Rough HRS Final Screen Enclosure Ceiling Ro Driveway Rough ! PLUMBING COMMENTS Driveway Base Telephone Rough wh(o� yJ DeM,O o Tin Cap Telephone Final Roof in Progress TV Rough dL^ ►1c Mop in Progress TV Final Final Roof Cable Rough Shutters Attachment Cable Final Final Shutters Intercom Rough Rails and Guardrails Intercom Final MECHANICAL ADA compliance Alarm Rough INSPECTION DATE INSP ali 14 Alarm Final Underground Pipe DOCUMEN Fire Alarm Rough Soil Bearing Cert Fire Alarm Final Rough Soil Treatment Cert Service Work With Floor Elevation Survey Ventilation Rough Reinf Unit Mas Cert ELECTRICAL COM ENTS Z. Hood Rough Insulation Certificate Pressure Test Spot Survey Final Hood Final Survey Final Ventilation Truss Certification ei Final Pool Heater STRUCTURAL COMMENTS Final Vacuum MECHANICAL COMMENTS INSPECTION DATE INSP Final Sprinkler Final Alarm Permit NO. RC-12-16-3405 `SHORES`�` Miami Shores Village t Permit Type:Residential Construction 10050 N.E.2nd Avenue NE • `' ' Work Classification:Addition/Alteration Miami Shores,FL 33138-0000 P lea, r Permit Status:APPROVED Phone: (305)795-2204 FLORIOp' Issue Date:4/512017 r Expiration: 10/02/2017 Project Address Parcel Number Applicant 349 NE 99 Street 1132060135510 Miami Shores, FL 33138- Block: Lot: J HENRY VIDAL Owner Information Address Phone Cell J HENRY VIDAL 349 NE 99 Street MIAMI SHORES FL 33138-2436 LL�= Contractor(s) Phone Cell Phone Valuation: $ 15,000.00 HOME OWNER Total Sq Feet: 0 Approved:In Review Available Inspections: Comments: Inspection Type: Date Approved: : In Review Final PE Certification Date Denied: Drywall Type of Construction:REVERT CONVERTED GARAGE Occupancy:Single Family Miscellaneous Stories: Exterior: Window Door Attachment Front Setback: Rear Setback: Tie Beam Left Setback: Right Setback: Final Bedrooms: Bathrooms: Framing Plans Submitted:Yes Certificate Status: Insulation Certificate Date: Additional Info: REVERT CONVERTED GARAGE Truss Insp Foundation Bond Return: Classification: Residential Window and Door Buck Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Fill Cells Columns CCF $9.00 Wire Lathe DBPR FeeInvoice# RC-12-16-62398 Columns $6.75 04/05/2017 Credit Card $478.50 $50.00 DCA Fee $6.75 Review Mechanical Education Surcharge $3.00 12/19/2016 Credit Card $50.00 $0.00 Declaration of Use Notary Fee $5.00 Review Building Permit Fee $450.00 Review Plumbing Scanning Fee $36.00 Review Electrical Technology Fee $12.00 Review Electrical Total: $528.50 F.Termite Letter F.Elevation Certificate Review Planning Review Structural 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: certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and z ing. Futhermore,I thorize the above-named contractor to do the work stated. April 05, 2017 Aut zed Signat Owner / Applicant / Contractor / Agent Date Buildi g Dep rtment Copy April 05, 2017 1 Miami Shores Village REIE ci Yi g a. Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BYDEC 1 9 201fi ' Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 201(A BUILDING Master Permit No. PIC I ��J . PERMIT APPLICATION Sub Permit No. BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL r]PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION n SHOP CONTRACTOR DRAWINGS 10B ADDRESS: cel ry C 9 9 STS 6 C-V City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: At—52CQCD-D(J__5510 Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: >OWNER: Name(Fee Simple Titleholder): n P-y `V(d Q, Phone#: Address:_3 Ll q NE q q S�(,C�C City:Y`c1t CYY1\ 5Y)C),(e State: IF zip: `31 � Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: NOJl Phone#: Address: City: State: Zip: Qualifier Name: Phone#: State Certification or Registration#:_ Certificate of Competency#: .� w� -'DESIGNER:Architect/Engineer: i��-- (�5 LCM0k-klAsPhone#: aOS L%rZD SA--1) Address: ACS) N 1j 2VIn ST --#r Z�;:D-a7 City: State Zip: 33122 Value of Work for this Permit:$ )�5,000 • C-0 T Square/Linear Footage of Work: Type of Work: ❑ Addition ,® Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: PC V'e-� cony-42-4" Specify color of color thru tile: Submittal Fee$50 i9IN1 C) Permit Fee$ CCF$ CO/CC$ `— Scanning Fee$ Radon Fee$�� "-1 S DBPR$ J� Notary$ Technology Fee$ ( !i • Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ ,O TOTAL FEE NOW DUE$ (RPvisPdm/?4/?n141 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 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. I Si nature g Signature , OW R or AGENT CONTRACTOR The foregoing i strument was acknowledged before me this The foregoing instrument was acknowledged before me this day of YJ 20 , by day of 20 by 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 PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: vl Print: Seal: ;`�i ° ;,. PANIM A M OCHOA Seal: MY cOMMtSSION#FF900004 EXPIRES JUIy 14,2011) (4073984,53 FtorlAg0tary31nica•com APPROVED BY Plans Examiner Zoning Structural Review Clerk 10-4-4n')/In Mnl Al ° Miami Shores Village Building Department 10050 N.E.2nd Avenue Rip Miami Shores, Florida 33138 Tel:(305)795.2204 Fax: (305)756.8972 OWNER BUILDER DISCLOSURE STATEMENT NAME: �vr l RevvilDATE:JAI q 20 I fo ADDRESS: 3-1 / �r�, q'1 � PST 1r'NW! FU 3 31 3a 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 o he is responsible for the construction and is,not hiring a licensed contractor to assume responsibility. Initial 3. 1 understand that,as an owner builder,I am the responsible party of record on a permit.I understan 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 ntracts. 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, ch violates the exemption. Initial 5. I understand that,as the owner-builder,I must provide direct,onsite supervision of the constructio . Initial 6. 1 understand that I may not hire an unlicensed person to act as my contractor or to supervise persoWs 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 b 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 - AQ 8. 1 understand that I may not delegate the responsibility for supervising work to be a licensed contra r 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 1 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 —AR 9. 1 agree that,as the party legally and financially responsible for this proposed Construction activity,Iill 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 In rnal 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.myfloridalicense.com/dbpr/pro/cilb/index.htmi Initial 69 11. 1 am aware of,and consent to;an owner-builder building permit applied for in my name and understands that 1 am the party legally and financially responsible for the proposed construction activity at the following address: ,JAY) Initial 12. 1 agree to notify Miami Shores tillage immediately of any additions,deletions,or changes to any of th nformation 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 returned to the local permitting agency responsible for issuing the permit.A copy of the property owner's driver license,the notarized sign re a property owner,or othertype of verification acceptable to the local permitting agency is required when the permit is issued. ��;�QI$i•,1 Was acknowledged before me this �� day of G , 20 �i- �b By._'1chh ti V lid who was personally known to me or who has Produced ther License o V 2q 0-0 (o b +:!5�p Q 1'c entification. •tiiC►,;�•.,� MAHARAI K.GONZAI. ' 40— 'PS MY COMMISSION#GG OW R NOTARY ' EXPIRES:November: %'N'itq;`� Bonded Thru Notary Publi:, .�._y...�;•