RC-19-1035Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
1001 NE 96TH ST, Miami Shores, FL 33138
Contacts
Issue Date: 05/10/2019
Parcel Number
1132060143740
PermitNto.: RC-05-194M
Permit Type: Building (Residential)
WorkClassification: Alteration
Permit status: Approved;
Expiration: 11/06/2 019
KENNETH LUND Owner HOME OWNER Contractor
1001 NE 96 ST, MIAMI SHORES, FL 33138 HOME OWNER
Other:7147212270
Description:Ins ection Requests:
INTERIOR WORK IN LIVING ROM ADN MASTER Valuation: $ 36,000.00 305-762-4949
BEDROOM CLOSET. REPLACE EXISTING FIRE PLACE STRUCTURE
TO SUPPORT MARBLE. TO REPLACE RC-14-1300 Total Sq Feet: 800.00
Fees Amount
Payments
Date Paid Amt Paid
100% Permit Renewal Fee $1,080.00
Total Fees
$1,080.00
Total: $1,080.00
Check # 114
65/10/2019 $1,080.00
Amount Due:
$0.00
Building Department Copy
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 II the foregoing information is accurate and that all work will be done in compliance with all applicable laws
reguJBtlas cgdstru9tigr(and zoning.,40thermore, I authorize the above named contractor to do the work stated.
,_Z` 4 / `
Signature: Owner
/ Applicant / Contractor / Agent
Date
May 10, 2019 Page 2 of 2
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Miami Shores Village
Building Department
10050 NE 2 Ave
Miami Shores FL 33138
ftrml Na RC-Oa-'19
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issue Date 5/10/2019 Expires 11 /06/2019 '
T
INSPECTION REQUESTS: (305)7SZ4949 or log on at httpsaibldg.msvfl.govienergov_Prod/selfservice
Requests must be received by 3:30pm
WORK IS ALLOWED: MONDAY THROUGH FRIDAY, 8:00AM - 7:OOPM
SATURDAY 8:OOAM - 6:OOPM.
NO WORK IS ALLOWED ON SUNDAY OR HOLIDAYS
BUILDING AND ROOFING INSPECTIONS ARE DONE MONDAY THROUGH FRIDAY .
NO INSPECTION WILL BE MADE UNLESS THE PERMIT CARD IS DISPLAYED AND HAS BEEN APPROVED . PLANS ARE
READILY AVAILABLE. IT IS THE PERMIT APPLICANT'S RESPONSIBILITY TO ENSURE THAT WORK IS ACCESSIBLE AND
EXPOSED FOR INSPECTION PURPOSES. NEITHER THE BUILDING OFFICIAL NOR THE CITY SHALL BE LIABLE FOR
EXPENSE ENTAILED IN THE REMOVAL OR REPLACEMENT OF ANY MATERIAL REQUIRED TO ALLOW INSPECTION .
POST ON SITE
1132060143740
Owner's Name: ,KENNETH LUND Owner's Phone: (714)721-2270
Job Address: 1001 NE 96TH ST Total Square Feet: 800
Miami Shores, FL 33138 total Job Valuation: $ 36,000.00
Contractor(s) Phone Address
HOME OWNER
Description: INTERIOR WORK IN LIVING ROM ADN MASTER BEDROOIE4 CLOSET . REPLACE EXISTING FIRE PLACE
STRUCTURE TO SUPPORT MARBLE. TO REPLACE RC-14-1300
8 A
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED
AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU
INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF
COMMENCEMENT.
Page 1 of 1
INSPECTION
RECORD
WINDOWS & DOORS
PLUMBING
STRUCTURAL
INSPECTION
DATE
INSPPUBLIC
WORKS
INSPECTION DATE INSP
Final Sprinkler
Final Alarm
Stemwall
Slab.
Columns (1st Lift)
Columns (2nd Lift)
Tie Beam
IN
INSPECTION
DATE
BUILDING
PERMIT APPLICATION
Miami Shores Village
Rccp)
BUllding Department ✓Eu
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 MAY p 8101
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949 d k
FBC T200i- Master Permit No.(P—C- W ""/W �s�
Sub Permit No.
❑ BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [:]RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
ONTRACTOR DRAWINGS
JOB ADDRESS: /*100 / �97-z-"(2
City: Miami Shores County: Miami Dade Zip: 3&11� —
Folio/Parcel#: is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: _Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): `J ti Phone#:
Address: p 9 (
City: /f r am% State: % Zip: ��
Tenant/Lessee Name: // Phone#: ` ?/� % 22 %
Email: AllL✓N 7
CONTRACTOR: Company Name: Phone#:
Address:
City: State: Zip:
Qualifier Name: Phone#:
State Certification or Registration #: Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: 44 4 City: State: Zip:
Value of Work for this Permit: $ �Square/Linear Footage of Work: /'?-0 O
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description- of Work:
i �✓T�li d /' lv d t lC �� rr nh (�
[ 0 G el//,/( CC P — /AA - /"S-00
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Technology Fee $_
Structural Reviews $
Permit Fee $
Radon Fee $
Training/Education Fee $
0'`'1
CCF $ CO/CC $
DBPR $ Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ 1[ V w
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
Zip
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 reinspectionlege will be charged.
Signature Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this
day of /'20J by
V,(LN N-)r,-?H ho is rsonally no to
------------
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
*****************
APPROVED BY
(Revised02/24/2014)
20, �
%20T •.•Notary cV O�
6
The foregoing instrument was acknowledged before me this
day of
as me or who has produced
20 by
, who is personally known to
identification and who did take an oath.
NOTARY PUBLIC:
Sign:_
Print:
0
�- Seal:
Plans Examiner
Structural Review
as
*******************************************
Zoning
Clerk
t_—
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
OWNER BUILDER DISCLOSURE STATEMENT
NAME: " 4 --) VV D DATE:
ADDRESS: lO d / of E ���� S%�Pe IW, ,4,1,
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. tt 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. 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 1, as the owner of the property listed, may a y own contractor with certain
restrictions even though I do not have a license.
Initial
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.
Initia�2K
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 perm) cts.
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 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 I built or substantially improved it for sale or lea ch 'olates the exemption.
Initial
5. 1 understand that, as the owner -builder, 1 must provide direct, onsite supervision of the constructio
Initial
6. 1 understand that I may not hire an unlicensed person to act as my contractor or to supervise persons workipg on my building or residence. It
is my responsibility to ensure that the persons whom I employ have the license required by law and ty r municipal ordinance.
Initial
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.
Initia
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. 1 understand that my failure to follow
these may subject to serious financial risk.
Initial
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 regulatio
Initial 7Z
10. 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.myfloridalicense.com/dbpr/pro/cilb/index.html
Initial_�29
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: �j
Initial /, �/
12. 1 agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of th ation 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---,2016
By �N�-7�� #c�.�� who was peMm#TG&to me or who has
--------------
Produced there License or as identi
OWNER NOTARY
III111g111
S SILVER4 /��i���%
�� 60 0�'I',o�,9 •• /may
9,,160
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• •No80
Certificate of Completion
Description: Interior renovation.
Permit Type
Owner
Subdivision/Project
Construction Type V-B
Square Footage
Location
1001 NE 96TH ST
Miami Shores, FL 33138
Miami Shores Village
10050 N.E. 2nd Ave, Miami Shores, Florida 33138
Tel: 305-795-2204 Fax: 305-756-8972
Building Inspection Department
Building (Residential)
KENNETHLUND
4,192.00
Bldg. Permit No.
Contractor
Date Issued
Occupancy Single Family
Type
Flood Zone X
RC-05-19-1035
HOME OWNER
05/10/2019
If the building is located in a special flood hazard area documentation of the as -built lowest floor
elevation or lowest horizontal structural member has been provided and is retained in the records of
Miami Shores Village.
This certificate issued pursuant to the requirements of the Florida Building Code certifying that at the
time of issuance this structure was in compliance with the various ordinances of the jurisdiction
regulating building construction or use. ` If - i ,,.
Building Officials
Not Transferable
POST IN A CONSPICUOUS PLACE
Ismael Naranjo, CBO