PL-06-2742i
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING 111 )0G • •
WA -
PERMIT APPLICATION /odd
FBC 2004
Permit Type (circle): Building
Owner's Name (Fee Simple Titleholder)
Owner's Address 7, C / N�
City AmAtf De/el' State
Tenant/Lessee Name
Job Address (where the work is being done)
City Miami Shores Village
Permit No.
Master Permit No.
Nov 0 7 2006
Plumbing /) Mechanical Roofing
:lee_ Phone # 30.5 ' % 51-
Zip
33agf
Phone #
9SD/ AIL /?
County Miami -Dade
FOLIO / PARCEL # //- Sao 0o9 ^ Cy5YO
Is Building Historically Designated YES NO
Contractor's Company Name `
Contractor's Address 2( t[ Sn u }, to o n o
City �� �w��:5�.� State
Qualifier Name
State Certificate or Regis
Architect/Engineer's Name (if applicable)
t
49ee
Zip 33/ 32
Phone # 3 0 `a � a- � 19 4
iP 33 d 3S�
Phone # V 4.
Certificate of Competency No. cj n 00 ra 3
Value of.Work.For%;this Permit$ 3. tcd d.
S`.Ii.°i4OYe.'"
;
Type of Work:,,,x5 i.• Addition'-': 'QAlteration
A , ^as^-
Describe Work:'°•-•"• 4("$A`„'Q 11 474
N a1.N
Phone #
Sq pare!, Lin.ea r •Footage,Of Work:
Saticrt^uJt� .,. .tyre �,
❑News« ^cr e i,r,4•1 rj.aRepaii/Replace El Demolition •
• ., ,s s t..z a
*********************************
Submittal Fee $ Permit Fee $
Notary $ Training/Education Fee $
Scanning $ Radon $
********************************************
DPBR $
Bond $ Code Enforcement $
Structural Review. $
CCF $ CO/CC
Technology Fee $
Zoning $
Double Fee $
Total Fee Now Due $
See Reverse side -*
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 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 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 approvedynd'reinspection fee will be charged.
Signature
Owner or Agen
The foregoing instrument was acknowledged before me this
As identification and who did take an oath.
NOTARY PUBLIC:
1
Sign:
Print:
My Commission Expires:
Signature
Contractor
The foregoing instrument was acknowledge before m l!
! s
day of hiCVemilIl, 200 (7 , by Rm192,2:7— 40e,- , day of NoVQIyl , 200 , by 1CJ'ti -4 0 r 1 1JP,.Z
who is personally known to me or who has produced who is personally known to me or who has produced
as identification and who did take an oath.
MIRTA M. RODRIGUEZ
""O'"' Comm# 000378579
Expires 12/12/2008
Bonded thru (8 "' -4254
(3ReadiNoaery Assn.. Inc
NOTARY PUBLIC:
Sign:
Print:
MIRTA M. RODRIGUEZ
My Commission Expires:
**************************** ** ***********************************************************************
APPLICATION APPROVED BY:
(Revised 02/08/06)
Plans Examiner
Engineer
Zoning
ADDENDUM TO BUILDING PERMIT APPLICATION
AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN OBTAINED, THE
OWNERS NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.
PLEASE CIRCLE 0 DISCIPLINE APPLIED FOR:
PLUMBING
ELECTRICAL
PERMIT #
MECHANICAL
UNIT
FEE
ITEM
UNIT
FEE
-
ITEM
UNIT
FEE
t'61----___
BATH TUB
SWITCH OUTLETS
SPACE HEATERS
DISHWASHER
LIGHT OUTLETS
CENTRAL HEATING
DISPOSAL
RECEPTACLES
A/C (WIND)
FLOOR DRAIN
SERVICE TEMPORARY
NC (CENTRAL)
GREASE TRAP
SERVICE SIZE IN AMPS
DUCT WORK
INTERCEPTOR
SERVICE REPAIR/METER CHANGE
REFRIGERATION
LAVATORY
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
LAUNDRY TRAY
RANGE TOP
UNDERGROUND TANKS
CLOTHES WASHER
OVEN
ABOVE GROUND TANKS
SHOWER
WATER HEATER
U.F. PRESSURE VESSELS
. SINK. POT/3 COMP.
MOTORS 0-1 HP
STEAM BOILERS
SINK, RESIDENCE.
MOTORS OVER 1-3 HP
HOT WATER BOILERS
SINK, SLOP.
MOTORS OVER 3-5 HP
MECHANICAL VENTILATION
TEMPORARY WATER CLOSET
MOTORS OVER 5-8 HP
TRANSPORTING ASSEMBLIES
URINAL
MOTORS OVER 8-10 HP
ELEVATORS/ESCALATORS
WATER CLOSET
MOTORS OVER 10-25 HP
FIRE SPRINKLER SYSTEMS
INDIRECT WASTES
MOTORS OVER 25-100 HP
COOLING TOWERS
WATER SUPPLY TO:
MOTORS OVER 100 HP
VIOLATION
A/C UNIT
NC WINDOW
REINSPECTION
FIRE SPRINKLER
AIR CONDITIONERS
HEATER -NEW INST.
STRIP HEATER
•
HEATER -REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
GENERATORS TRANSFORMERS
SWIMMING POOL
GENERATORS TRANSFORMERS
WATER SERVICE
SPECIAL PURPOSE
SEWER CONNECTIONS
OUTLETS COMMERCIAL
UTILITY -SEWER
SIGN TUBES
UTILITY -WATER
SIGN TRANSFORMERS
SEPTIC TANK
SIGN TIME CLOCK
RELAY
FIXTURES
FAINFIELD, 4" TILE/RES.
ANTENNA
PUMP & ABANDON SEPTIC TANK
TELEVISION OUTLETS
SOAKAGE PIT CU. FT.
VIOLATION
CATCH BASIN
REINSPECTION
DISCHARGE WELL
DOMESTIC WELL
AREA DRAIN
ROOF INLET
SOLAR WATER HEATER
FIRE STANDPIPE
POOL PIPING
LAWN SPRINKLER SYSTEM
GAS RANGE
(/
METER SET (GAS)
GAS PIPING y
Issue Date: 11/8/2006
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138-0000
Phone: (305)795-2204 Fax: (305)756-8972
Permit
Expires: 05/07/2007
Permit Status: APPROVED
Permit Number: PL-11-06-2742
Owner's Name: ROBERT ARDER
Permit Type: Plumbing - Residential
Work Classification: Gas
Job Address: 9701 13 Avenue NE
Miami Shores Village, FL
Contractor(s) Phone
SENTRY SEPTIC & PLUMBING (305)562-1194
Primary Contractor
Yes
Additional Information
Type of Work: GAS
Additional Info:
Classification: Residential
Type of Piping:
Bond Return :
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: 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. Futhermore, I authorize the above -named contractor to do the work
stated.
Parcel #:
Block:
Section:
Phone: 305-322-0063
1132050090540
Lot:
PB:
Total Square Feet: 0
Total Valuation: $ 1,500.00
Required Inspections
Press Test
ROW
Final
Fees Due Amount
CCF $1.20
Education Surcharge $0.40
Permit Fee - Additions/Alterations $180.00
Scanning Fee $3.00
Technology Fee $4.50
Total: $189.10
Building Department File Copy
Invoice Number
PL-11-06-26679
Total:
Amt Due
$189.10
11 13e—NOV
1 3 2006
Amt Paid
NOTICE: In addition to the requirements of this permit, there may be
additional restrictions applicable to this property that may be found in the .
public records of this county.
AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER
GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT
DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES.
Applicant Signature
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP- 1824
'permit Number: PL-11-06-2742
Inspection Date: 11/21/2006
Inspector: Levrack, James
Owner: ARDER, ROBERT
Job Address: 9701 13 Avenue NE
Miami Shores Village, FL
Project: <NONE>
Contractor: SENTRY SEPTIC & PLUMBING
Permit Type: Plumbing - Residential
Inspection Type: Press Test
Work Classification: Gas
NOV 2 2 2006
Block:
Phone Number 305-322-0063
Parcel Number 1132050090540
Lot:
Phone: (305)562-1194
Building Department Comments
A x-
(�06
Il��lab
ector Comments
Passed
Failed
Correction
Needed
Re -Inspection
Fee
($75)
No Additional Inspections can be scheduled until
re -inspection fee is paid.
Tuesday, November 21, 2006
Page 1 of 2
5. I understand that as an owner -builder, that any contractor disputes with sub-
contractors and myself must be handled in a civil court with the advice of an
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 they
do not posses a business license I will be responsible and liable for any wrong
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's
policy I could be held liable for all doctor and related cost which could include
loss of wages during recovery from injury.
Initial
8. I understand that under state and local laws I can not do any Electrical,
Plumbing, Heating, Air & Roof work on my property with out first obtaining
the proper permits by licensed contractors.
‘'
Was acknowledged before me this r1day of NOVOrnb-e1C, 20o 6
who was personally known to me or who has
Produced there License or as identification.
'.............................................
.......MIRTHM.RODRIGUEZ
1.444. Comm# 000378579
Expires 12/12/2008
Bonded u (800)432-4254
"� is moW
� Florida NOW/ Assn., Inc
VILLAGE OF MIAMI SHORES
OWNER BUILDER DISCLOSURE STATEMENT
NAME: '6p/ r / W DATE:
ADDRESS: 9 Ao < /1/4/?7<4-rke,
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.
M I hold title to the above property and I am planning on doing this construction
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
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 code. -
There is a copy of the code in this office for review.
r --- Initial
4. I understand that the building official and inspectors are not there to design,
alter or give advice on how to meet code —. only if the structure meets the
''' '••tJm nimum,code.`,
ATRM
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Initial
Miami Shores Village
Building Department
10050 NE 2 Ave, Miami Shores, FI 33138
Tel: (305)795-2204 • Fax; (305)756-8972
2/3/2016
Current Owner
9701 NE 13 Avenue
Miami Shores, FL 33138
Permit: PL-11-06-2742
Address: 9701 NE 13 Avenue, Miami Shores FL
Date Expired: 5/20/2007
Dear Sir or Madam,
Our records indicate that the above referenced permit has expired without obtaining the
proper final inspection. In order to serve you better, we need to keep our files up to date.
As per section 105.4.1 of the Florida Building Code, "Every permit issued shall become invalid
(expired) unless the work authorized by such permit is commenced within six months after its
issuance, or if the work authorized by such permit is suspended or abandoned for a period of
six months after the work is commenced, or completed without obtaining the final inspection
of the work performed."
Please be advised that open permits will hinder your ability to refinance or sell this property
Please contact the Building Department, within 15 days of receipt of this letter in order to take
care of this matter.
Sincerely,
Ismael Naranjo (C6O)
Building Director