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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 2C1 l ECO�St f iYx, ad>q r. /QZA{U. 3) tniv h+.'x'.,E3 f,Jyp yru%o6<, • >.:.... :;.sbrol'f `"'' •''' 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