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PT-17-995 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-280686 Permit Number: PT-4-17-995 Scheduled Inspection Date: July 28, 2017 Permit Type: Paint Inspector: Naranjo, Ismael Inspection Type: Final Owner: DIAZ,ANGEL W Work Classification: New Job Address:9500 NE 6 Avenue Miami Shores, FL Phone Number (786)412-7310 Parcel Number 1132060140770 Project: <NONE> Contractor: HOME OWNER Building Department Comments PAINT EXTERIOR Infractio Passed Comments INSPECTOR COMMENTS False r Inspector Comments Passed dl i Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. i July 27, 2017 For Inspections please call: (305)762-4949 Page 5 of 27 imann nonores v mage r p. 110 2017 nunaln tie artment �./� g p �1r• 10050 N.E.2nd Avenue,Miami Shores,Florida 33138` �� 6 Tel:(305)795.2204 Fax: (305)756.8972 INSPECTION'S PHONE NUMBER:(305)762A949 is U 1LOEN li Permit No. L rhKIVII I AYMIUA TUN Master Permit No. Vast: Lu i Permit Type:YAlA 1 1' I 1 NO 2_Q>07ZG N. 1-�1-1� S[A 7T� OWNER:Name(Fee Simple Titleholder): 'hi (i 'bI rt Z Phone#. 76-412 7�U Address: !R560 U G_ C &)E City:k is "k -,nIJ6 .ES State: 1=L zip: 33138 Tenant/Lessee Name: Phonet Email: Aw(� cn & JOB ADDRESS: '15Cn hJE 62 City: Miami Shores County: Miami Dade Zip: J31�� Folio/Parcel#: Is the Building Historically Designated:Yes NO Flood Zone: CONTRACTOR:Company Name: 0 w QE K Phone#: Address: �-f�O� � ) G /We City: U�a -I��S��rL�S State: �FL Zip: Qualifier Name: Phonet State Certification or Registration#: Certificate of Competency#: Contact Phone#: Email Address: II Value of Work for this Peerrmiit:$ 1i� Square/Linear Footage of Work: 1, Description of Work: i IA 07 ��l G ��-• 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..... "WARNING '1'0 OWNER: YOUR FAILURE '10 KLUORD A NU'11t;L UN` C:UMMENUEMENT MAY RESULT 1N YOUR PAYING TWIUE l+'UK IMPROVEMENTS '1'U YOUR FKUFEK'1'Y. It' YOU INTEND TO OKIA1N V'INANUI_Ntiq UUNJUL"1` Wfl'H YOUR LENDER UK AN A-1-1'UKNEY KEI+'UKE KEC;UKll1NG YOUR NOTICE OF UUMMENC;EMENT. Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding$2500,the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a cert&d copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven 1%)days after the building permit is issued In the absence of such posted notice,the inspection will not be approved and an inspection fee will be charged x**x**xxxxxxxx****xxxxxxxx********xx*xxFeesxx*********xxxxxx***xx****xxxx*xxxxxx*x***** Permit Fee$ CCF$ Notary$ Training/Education Fee$ � Technology Fee$ Double Fee$ TOTAL FEE NOW DUE$ PAINT COLOR APPROVAL AND AGREEMENT s y All elements on the site must be listed and indicate the color to be painted f ll1KlN U'HUlNN:Please circle corresponding number to appropriate color sample. Walls: 1 dC'//-53 2 3 4 &aL Fascia: 1 2 3 4 Attach color sample with name and`number Drip edge: 1 ./ 2 3 4 i Sort: 1(�dN 2 1 ZY � 4 1 1 ifs G!/�DUQh f IPS Roof: 1 2 3 4 Flower Bins: 1 2 3 4 f + Shutters: 1 2 3 4 ,, � Awnings: 1 . 2 3 4 2 ���c .. LW �17� 9 Chimney: 1 2 3 4 Doors&Jambs•1 2 3 4 41 Garage Doors: 1 2 3 4 down OC-131 Railings: 1 2 3 4 3 Fences: 1 2 3 4 Fwhiite All Brick: 1 2 3 4 ry� Stucco Bands: 1 2 3 4 (kl Other Stucco 4. Feature: 1 2 3 4 Accessory Bldg: 1 2 3 4 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. Signature. CAX� Signature: WDI 64911t Contractor The foregoing instrument was ac owle��dgpped��be��fore^me�this Q __, The�egoing instrument was acknowledged before me this day of �— ,20 t�"+✓��- l W��1`�, day ofLl ,20_,by who is personally known to me or who has produced who is personally known to me or who has produced L�Qk1� As identification and who did take an oath. as identification and who did take an oath. NOT rY PUBLIC: NOTARY PUBLIC: Sign: Sign. F Print: ►n�rr , Frint: dos "Po. Notary Public State of Flonda M Commission Expires: Mg Commission Expires: Sindia Alvarez dF�a My Commission FF 15G750 APPROVED BY: '" Code Official � Preservation Board i a t� r •� °i Wrought Iron 2124-10 t Herro ForIado t ! ' s r a e r e s � !�Y t t . ° s Miami Shores Village e,,, 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:A1A)0RPJQZ,F�,, ��15�7� DATE: —/`�� l ADDRESS:_950/ Al�i- k,�� V�i ,f M r�n� ► S-�� s�F L 330g 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 foryour own use.and occupancy:Ii-may not 6e 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.'Y,ou may not hire an unlicensed personas a contractor.It-is–your responsibility to make sure the people employ'e'd by'you`Fia"ve'licerises required by'3tate 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 1 do not have a license. Initial= t 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. i Initial M t 3. 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 orresidence 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–RA/,-?5_ 5. 1 understand that,as the owner'builder,I must provide direct,onsite supervision of the construction. Initial_ 6. 1 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 county or municipal ordinance. Initial-M 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. f Initial,!�'l/V� 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. Initial—,M AI 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 ,MAID i 30. 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.htmi Initial_ 11. 1 am aware of,and consent to;an owner-builder building permit applied for in my name and understands that I am the party 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 day of ���— , 20 01 N(IC RE 4)G�,u as By E (Xq -Q who was personally known to me or who has Produced there License or as identification. OWNER OTARY+olar,,0,t;;r.State of Florida 0Ay Commissior.FF 156150 '"�rEoao Expire' 09!0312018