RC-17-2850Inspection Number: INSP-296071
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Permit Number: RC -12-17-2850
Scheduled Inspection Date: January 26, 2018
Inspector: PV\Cl1n A4VCIY e Z
Owner: FUEIES, RUBEN
Job Address: 1185 NE 101 Street
Miami Shores, FL
Project <NONE>
Contractor: HOME OWNER
Permit Type: Residential Construction
Inspection Type: Final
Work Classification: Alteration
Phone Number
Parcel Number 1132050190110
Building Department Comments
REPLACE FLOOR KITCHEN TILES AND PANTRY
{nfreafio Passed Comments
INSPECTOR COMMENTS
False
Passed
d
Failed
Correction
Needed
Re -Inspection
Fee
No Additional Inspections can be scheduled until
re -inspection fee Is paid
Inspector Comments
January 25, 2018
For Inspections please call: (305)762-4949
Page 20 of 23
Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit
Permit NO. RC -12-17-2850
Permit Type: Residential Construction
Work Classification: Alteration
Permit Status: APPROVED
Issue Date: 1119/2018
Expiration: 07/18/2018
Parcel Number
Applicant
1185 NE 101 Street
Miami Shores, FL
1132050190110
Block: Lot:
RUBEN FUENTES
Owner Information
[RUBEN FUENTES
Address
600 GRAPETREE L-1
KEY BISCAYNE FL 33149
Contractor(s)
HOME OWNER
Phone
Cell Phone
Phone
Cell
Approved: In Review
Comments:
Date Approved: : In Review
Date Denied:
Type of Construction: REPLACE FLOOR KITCHEN TILES
Stories:
Front Setback:
Left Setback:
Bedrooms:
Plans Submitted: Yes
Certificate Date:
Bond Return :
Occupancy: Single Family
Exterior:
Rear Setback:
Right Setback:
Bathrooms:
Certificate Status:
Additional Info:
Classification: Residential
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Notary Fee
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$0.60
$2.00
$2.00
$0.20
$5.00
$100.00
$9.00
$0.80
$119.60
Pay Date Pay Type
Invoice # RC -12-17-65804
01/19/2018 Credit Card
12/04/2017 Credit Card
Amt Paid Amt Due
$ 69.60 $ 50.00
$ 50.00 $ 0.00
Available Inspections:
Inspection Type:
Window Door Attachment
Framing
Insulation
Drywall Screw
Final PE Certification
Window and Door Buck
Fill Cells Columns
Review Building
Review Building
Review Planning
Review Electrical
Review Plumbing
Review Structural
Review Mechanical
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 AF SAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction - . zoning.r.thermore I - .prize the above-named contractor to do the work stated.
ed Sign e: Owner / Applicant / Contractor / Agent
Building Department Copy
January 19, 2018
Date
January 19, 2018
1
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING
PERMIT APPLICATION
76BUILDING ❑ ELECTRIC ❑ ROOFING
❑PLUMBING ❑ MECHANICAL PUBLIC WORKS
JOB ADDRESS:
City:
REC -T\r1 ;
C 04 2017
BY: !• t111 •
FBC20I`i
Master Permit No. P C 1 -GeSD
Sub Permit No.
❑ REVISION
❑ CHANGE OF
CONTRACTOR
/7(cA't /0/ 57` QT
❑ EXTENSION RENEWAL
❑ CANCELLATION
❑ SHOP
DRAWINGS
Miami Shores County: Miami Dade
Zip: 33 (3dr'
Folio/Parcel#: //—c3.,�iD`J ^O / i _ 0// D Is the Building Historically Designated: Yes NO ix
Occupancy Type: Load: Construction Type:
OWNER: Name (Fee Simple Titleholder): L)./0 / 061..)�,� S
Address: //, ( ti 6 / 0 / S7)2,-,....el—
Flood
"`7j2 Q..el—
Flood Zone:
BFE: FFE:
Phone#: 7 o! O Z. -0/-60
City: /1/A L.Ch 6 /SPS State: F -L
Zip: /32c
Tenant/Lessee Name: Phone#:
f e/ x1417 j /0 2 to e A0 7`,ti A; L. cf b ,tn
CONTRACTOR: Company Name: -40NE Phone#:
Address:
City: State: Zip:
Qualifier Name: Phone#:
State Certification or Registration #: Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: a1 Zip:
Value of Work for this Permit: $_ _ Sf 0 a Square/Linear Footage of Work: oC a O sig
Type of Work: ❑ Addition ❑ Alteration ❑ New g Repair/Replace ❑ Demolition
Description of Work: :;ScLxfrAc c( f'002 !moi t.#.PN y
Email:
Specify color of color thru tile: /0 U/,&' ei4e#m (//C? -sae ko-hc(
Submittal Fee $03 Permit Fee $ (W • C5 CCF $
Scanning Fee $ Radon Fee $ DBPR $
Technology Fee $ Training/Education Fee $
Structural Reviews $
(Revised02/24/2014)
CO/CC $
Notary $ (5• co
Double Fee $
Bond $
TOTAL FEE NOW DUE $ 69 • 6`/
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.
fete
SignatureSignature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
d- day of DXN( , 20 14 , by day of , 20 , by
rlN11 , who is personally known to , who is personally known to
me or who has produced It 1;t1lk - NSA 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:
Print:
Seal:
Sign:
Print:
,t rr•; .i.i'V'.--wry -..•Y -,lY"'v Y 'r",.v.c Seal:
j, 1�Y °oe Notary Public State of Florida <
°'. Sindia Alvarez 4
P 'A c. ca My Commission FF 156750 '
******************f*Spon, **ee l991•&iiiQlse*********#**********************************************************
j/I�
APPROVED BY / -
Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
4
NAME:
- OWNERBUILDERDISCLOSURE STATEMENT
7?
il/� / (:Z./v7s
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
DATE: (2I 4 f2cY
ADDRESS: //RS— A)e- /0/ .57,._iJ7
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. 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 ow/ contractor with certain
restrictions even though I do not have a license.
Initial
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.
Initial
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 the
contractor is required by law to be licensed in Florida and to list his or license numbers on permits and con acts.
Initial
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 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 1 built or substantially improved it for sale or lease, which olates the exemption.
Initial
5. I understand that, as the owner -builder, I must provide direct, onsite supervision of the construction.
Initial
6. I understand that 1 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 o/ ty or municipal ordinance.
Ini
yr r
•
7. I 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. 1, as an owner-butIder, 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 aw_ e of the limits of my insurance
coverage for injuries to workers on my property.
Initial
8. I 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. 1 understand that my failure to follow
these may subject to serious financial risk.
Initial
9. I 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
NW;
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, 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.html
Initis
11. lam aware of, and consent to; an owner -builder building permit applied for In my name and underst ' ds that 1 am the party
legally and financially responsible for the proposed construction activity at the following address:
1/,S,A),,&r /67 -C/kaef
Initial
12. I agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the informa ion 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 Of day of DE EP1 ?—, 20 14
By Q-Ui? .t �►�� 5
who was personally known to me or who has
Produced there License or tL_ T2.LUi2__- La -1L. as identification.
rT rh61 P?' RYN,'YY 1r .r..„, 'r .x..., '.w' j
04SY V% Notary Public State of Florida K
1. Sindia Alvarez
'4c o`r My Commission FF 156750 1(
for A.e Expires 09/03/2018
Property Search Application - Miami -Dade County
Page 1 of 2
OFFICE G� TNS PROPERTY APPRIUSER
Summary Report
Property Information
Folio:
11-3205-019-0110
Property Address:
1185 NE 101 ST
Miami Shores, FL 33138-2676
Owner
RUBEN FUENTES
Mailing Address
1185 NE 101 ST
MIAMI SHORES, FL 33138-2676
PA Primary Zone
1400 SGL FAMILY - 3001-3250 SQ
Primary Land Use
0101 RESIDENTIAL - SINGLE
FAMILY : 1 UNIT
Beds / Baths / Half
3/2/0
Floors
1
Living Units
1
Actual Area
Sq.Ft
Living Area
Sq.Ft
Adjusted Area
2,127 Sq.Ft
Lot Size
12,220 Sq.Ft
Year Built
1949
Assessment Information
Year
2017
2016
2015
Land Value
$439,491
$409,050
$372,902
Building Value
$164,077
$165,310
$166,544
XF Value
$0
$0
$0
Market Value
$603,568
$574,360
$539,446
Assessed Value
$358,354
$350,984
$348,545
Benefits Information
Benefit
Type
2017
2016
2015
Save Our Homes
Cap
Assessment
Reduction
$245,214
$223,376
$190,901
Homestead
Exemption
$25,000
$25,000
$25,000
Second
Homestead
Exemption
$25,000
$25,000
$25,000
Note. Not all benefits are applicable to all Taxable Values (i.e. County,
School Board, City, Regional).
Short Legal Description
5 53 42
MIAMI SHORES SEC 8 REV PB 43-67
LOT 1 BLK 176
LOT SIZE IRREGULAR
OR 19508-2223 01 2001 1
Generated On : 12/4/
Taxable Value Information
Exemption Value
Previous Sale
I
$50,000
$50,000
$50
Taxable Value
i ?
$308,354
$300,984
$298
School Board
Other disqualified
Exemption Value
t
$25,000
$25,000
$25.
Taxable Value
s
$333,354
$325,984
$323.
City
Exemption Value
$50,000
$50,000
$50.
Taxable Value
$308,354
$300,984
$298
Regional
Exemption Value
$50,000
$50,000
$50
Taxable Value
F
$308,354
$300,984
$298.
Sales Information
Previous Sale
Price
OR Book -Page
Qualification Descriptic
01/01/2001
$282,500
19508-2223
Sales which are qualified
08/01/2000
$183,000
19274-2527
Other disqualified
The Office of the Property Appraiser is continually editing and updating the tax roll. This website may not reflect the most current information on record. The Property Appra
http://www.miamidade.gov/propertysearch/
12/4/2017
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Revix United Group LLC
7175 NW 87th Ave
Miami, FL 33178
Bill To
Ruben Fuentes
786-202-0260
• • Sales Order
•
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Due Date
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AM
12/1/2017
12/1/2017
Item Code
Boxes/Pieces
Quantity
Description
UM
Price per -BO..
Amount
R094
-
11
T
201.3
-
Muira Caramello 10.5 x 42
Sales Tax Miami
sqft
41.17
7.00%
452.87T
31.70
-All materials are to be inspected on our premises. Please be cautious of what your are purchasing. Check merchandise
and quantities, for claims will not be accepted after it leaves our warehouse. In the event of a delivery, please inspect
material with driver as claims will not be accepted after material is accepted at site. Merchandise will not be stored in
warehouse beyond 15 days of purchase. After 15 days a non-refundable fee of $10.00 per day will be applied.
-Inspect before tile setting: Shade, caliber and class. Seller is not responsible for and does not warrant against: shades
variations, crazing, concave, and convex, abrasion, slipping, mishap, or other injured, scratching or wear on tile surface.
Installation constitutes acceptance. Absolutely no claims after installation. No returns on special orders, natural stones,
setting materials, sale items or open boxes. No claims or returns on discountinued or second quality materials. All
deposits are nonrefundable.
Total S484.57
-Revix does not install tile. In case previously agreed upon returns must be authorized by management and will be subject
to a 25% restocking fee, administrative charge.
-Returned checks will incur a $30.00 administrative fee, or a credit card fee when order is paid with credit card. In this
case no returns will be accepted after 5 days from date of invoice. Upon retum an inspection and verification will be
conducted by our warehouse personnel. Items must be returned in their original cartons with all original packing
materials. Delivery and shipping charges are not refundable.
-All delivery personell whether provided by Revix or Client must inspect merchandise before leaving warehouse. Revix
will not be financially or otherwise liable for damaged or lost merchandise during transportation which was inspected and
signed for by driver or client as in good condition and complete at the time of pick up at warehouse.
-Natural stone varies in color, tones, markings and texture due to its geological
porcelain) only serve as a basic rendition of actual material and its properties
mate, unpolished, semipolished. Grain, veins, texture may also vary from sample
inherent features and properties of all natural stone materials.
-Variations in shade and sizing are inherent in all kiln fired clay products like
according to these variations. In some instances the tonality (shading) and size
manufacturer on the packaging or through documents.
-As factories recommend, recitified tiles should be installed with a minimum joint
and installers' judgement and or opinions are not taken into consideration for issuing
Merchandise received in good condition:
Name: DL #
composition. Samples
whether natural, printed,
and any variations
ceramic tiles and they
(caliber) are clearly
of 1/16". Third
a refund or accepting
(natural stone or
glazed, polished,
must be accepted as
are classified
indicated by the
parties, subcontractors
exchanges.
Delivered By:
Sign:
Date:
• • • • • •
• • • • ••
• •• • •
•
•R • ••• •
4111
Structural Solutions
INSPECTION LETTER
To: Miami Shores Village
Building Department
10050 ne 2nd ave
Miami shores FL 33138
Owner: Ruben Fuentes
PERMIT NUMBER: 17-2850
PROPERTY ADDRESS: 1185 NE 101 ST
MIAMI SHORES FL 33138
JANUARY 10, 2018
•C••
•
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• • • • •
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•• • •• • • •
• • •
•. •
A&M Structural Solutions inspected the Ruben Fuentes residence located at 1185
NE 101 ST MIAMI SHORES FL 33138. The kitchen area was inspected to make sure
that existing floor is structurally sound and wood joists are in good condition.
Wood joists in kitchen area were inspected and found to be structurally sound
and in good condition for the new floor system. Size of the kitchen is 10'-11" by
12'-7".
If you have any question, please feel free to call me with 305-898-9995
0,0111111,11
%soPSOO D . i,ei
�,.•�\G•.
E NSA• �� iii
Masood Hajali
PE license # 82038
A&M Structural Solutions
No 82038
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47
0-.. STATE OF »Z/
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Revix United Group LLC
7175 NW 87th Ave
Miami, FL 33178
Bill To
Ruben Fuentes
786-202-0260
Sales Order
Date
Estimate #
12/1/2017
8118
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Item Code
Boxes/Pieces
Quantity
UM
Price per BO..
Amount
i tion
R094
11
201.3
/asTaxMiami
C. 46 IL
Muira Caramello 10.5 x 42
sqft
41.17
o
7.0O%
452.87T
53 i.70
A
S / 2-e
-All materials are to be inspected on our premises. Please be cautious of what your are purchasing. Check merchandise
and quantities, for claims will not be accepted after it leaves our warehouse. In the event ofa delivery, please inspect
material with driver as claims will not be accepted after material is accepted at site. Merchandise will not be stored in
warehouse beyond 15 days of purchase. After 15 days a non-refundable fee of $10.00 per day will be applied.
-Inspect before tile setting: Shade, caliber and class. Seller is not responsible for and does not warrant against: shades
variations, crazing, concave, and convex, abrasion, slipping, mishap, or other injured, scratching or wear on tile surface.
Installation constitutes acceptance. Absolutely no claims after installation. No returns on special orders, natural stones,
setting materials, sale items or open boxes. No claims or returns on discountinued or second quality materials. All
deposits are nonrefundable.
Total $484.57
-Revix does not install tile. In case previously agreed upon returns must be authorized by management and will be subject
to a 25% restocking fee, administrative charge.
-Returned checks will incur a $30.00 administrative fee, or a credit card fee when order is paid with credit card: In this
case no returns will be accepted after 5 days from date of invoice. Upon return an inspection and verification will be
conducted by our warehouse personnel. Items must be returned in their original cartons with all original packing
materials. Delivery and shipping charges are not refundable.
-All delivery personell whether provided by Revix or Client must inspect merchandise before leaving warehouse. Revix
will not be financially or otherwise liable for damaged or lost merchandise during transportation which was inspected and
signed for by driver or client as in good condition and complete at the time of pick up at warehouse.
-Natural stone varies in color, tones, markings and texture due to its geological composition. Samples (natural stone or
porcelain) only serve as a basic rendition of actual material and its properties whether natural, printed, glazed, polished,
mate, unpolished, semipolished. Grain, veins, texture may also vary from sample and any variations must be accepted as
inherent features and properties of all natural stone materials.
-Variations in shade and sizing are inherent in all kiln fired clay products like ceramic tiles and they are classified
according to these variations. In some instances the tonality (shading) and size (caliber) are clearly indicated by the
manufacturer on the packaging or through documents.
-As factories recommend, recitified tiles should be installed with a minimum joint of 1/16". Third parties, subcontractors
and installers' judgement and or opinions are not taken into consideration for issuing a refund or accepting exchanges.
Merchandise received in good condition:
Name: DL #
Delivered By: Sign: Date:
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