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PL-08-737 A ! Inspection Worksheet j .e, ,off Miami Shores Village ,' 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 [y.:::.�::ry�.:xy�.�::.::..::::••�.y+:.:. i:: :::::is;:{'ryyjyi::::i::::::::::::::::::i::::i::i::::i::i::'rj`::::::::::i::tt:::::Y::::i::::i::i}::::i::}::ti}:v;:ji::::::5;{:::::::i::::i::::::::::i::::::. :::..•::'.v..:•::.::'.v:..::.i'::i::i:' i::i'>:: Y::.: .::::: i' • ........................................ ... �. ...................................................................................................................tai:��'Int.��tT.�'i��:>::::P�»+� :�::.:'�'' '�`.;;:. Inspection Date: 10/15/2008 Permit Type: Plumbing - Residential Inspector: Levrock, James Inspection Type: Final Owner: DOS SANTOS, MALON Work Classification: Addition/Alteration Job Address: 801 91 Terrace NE Miami Shores Village, FL Qkmo� Phone Number Parcel Number 1132060050220 Project: <NONE> Block: Lot: Contractor: HOME OWNER Building Department Comments Plumbing work for bathroom Ins t Co ments Passed Failed Correction Needed Re-Inspection Fee ($75) No Additional Inspections can be scheduled until re-inspection fee is paid Tuesday, October 14, 2008 Page 1 of 2 C�g�r36 RE VILLAGE OF MIAMI SHORES _ 3 !2oog /OWNER BUILDER DISCLOSURE STATEMENT �( NAME: " )0;- 4- DATE: OU ADDRESS: �✓� �j �/G�� ./`l G��/� �� #%� 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 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 hold title to the above property and I am planning on doing this construc Myself. Initial 2. I understand that as an owner-builder I must abide by all zoning ordinances and building regulations in effect at the time of permit application. Inactive permits for a period of over 180 days will become null and void (expire and a new permit will be required to be issued for reinstatement permit. Initial 3. I have an understanding of the 2004 FBC & FRC and understand that this department and its inspectors are there to help enforce and interpret the c There is a copy of the code in this office for review. Initia 4. 1 understand that the building official and inspectors are not there to de , alter or give advice on how to meet code — only if the structure he minimum code. Initial 5. I understand that as an owner-builder, that any contractor disputes with s contractors and myself must be handled in a civil court with the advice attorney. The department will not mitigate any contract disputes. Initial 6. I understand that if I compensate any person or company for work performed they are required to have a business license in the county. If for any reason the do not posses a business license I will be responsible and liable for any g doing from this unlicensed company or person. Initial 7. I understand that if any person gets injured on my construction project—they are entitled to workmen's compensation. And if they do not posses a workmen' policy I could be held liable for all doctor and related cost which could in loss of wages during recovery from injury. Initia 8. I understand that under state and local laws I can not do any Electric Plumbing, Heating, Air & Roof work on my property with out first obt the proper permits by licensed contractors. Initial Was acknowledged before me this o day of Az>pl- , 20 By /IUI M 'bn r0 "D0-5 SGy-fi S who was personally known to me or who has Produced there License or fl —]�)',Va ii Z lc Gq 4-f o as identification. OWNER NO ARY qt's"'P c_ MONICALISSMDIAZ MY COMMISSION#DD 4M95 AQP.... SPIRES:October 2o,2pog Thru Notary Public UndenyMers Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 BUILDING ----� ., � ��, � Permit No. PERMIT APPLICATIO �E "� '�� Master Permit No. FBC 2004 APR 2 2008 Permit Type: Plumbing Owner's Name(Fee Simple Titlehdlder) ,ewoy �i�1Gf� � z;�✓S Phone# Owner's Address ,eG/elz Citz"y i �s State �� Zip 3-� ZS Tenant/Lessee Name Phone# E-MAIL: Job Address(where the work is being done) City Miami Shores Villaee County Miami-Dade Zip FOLIO/PARCEL# Is Building Historically Designated YES NO Contractor's Company Name 6�/ 7�®I�Y�G/� Phone# Contractor's Address City State Zip Qualifier Name Phone# State Certificate or Registration No. Certificate of Competency No. E-MAIL: Architect/Engineer's Name(if applicable) Phone# Value of Work For this Permit$ .�(�� G — Square/Linear Footage Of Work: Type of Work: ❑Addition ❑Alteration ❑New ❑ Repair/Replace ❑ Demolition Describe Work: 1 *iris**s4 it**x***r.*xxdo*xxY aF�:k F aY*****ie irxxxxx Fees*'�***'•'************************************** Submittal Fee$ Permit Fee$�6�� CCF$ CO/CC Notary$ Training/Education Fee$ Technology Fee$. Scanning$ Radon $ DPBR$ Zoning$ Bond$ Code Enforcement$ Double Fee$ Structural Review.$ Total Fee Now Due$ See Reverse side-a Bonding Company's Name(if applicable) Bonding Company's Address City State Zip Mora;e Lender's Nand(if applicable) Mortgagd-&$ft Vd4trr s . City State] 71. Zip Application is hereby made to obtain a permit to fro 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 661 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 constriction 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinwectio •fee l b c ged. Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this 194 The foregoing instrument was acknowledged before me this day of ,20 D(Y,by 4441 � 'Poj )OqfDJ • , day of ,20_,by who is personally known to me or who has produced-- yo/0 who is personally known to me or who has produced ' LiC 64 AfD 40 As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: 995 Sign: �pN �9�a� Sign: Print: e)ttt[k Print: My Commission Expires: t SC01 My Commission Expires: 9efrxxd:dexxrxxudr irxzxr9r Y aY de et 4e 9e drx x• :xaY dr 4:do �e a:xx KaYxxd:#xxrxxxxie 9c 4e ie 9:aYzxdxxxxxr.iexie d:tc 4ez4:xxae r'.aF ae*xx$:x%r.sY a:ie r.x>:r.*i:r.ac r.r. APPLICATION APPROVED BY. Plans Examiner Engineer Zoning (Revised 02/08/06)