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RC-19-1377Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 MIM Issue Date: 07/16/2019 Location Address Parcel Number 107 NW 96TH ST, Miami Shores, FL 33150 1131010250090 Contacts Permit NO.: RC-06-19-1377 Permit Type: Building (Residential) Work Classification: Alteration Permit Status: Approved Expiration: 01/13/2020 Ella Allen Owner HOME OWNER Contractor 10796 HOME OWNER Description: TUB TO SHOWER CONVERSION BATHFITTER Valuation: $ 5,600.00 Requests: Inspection 305-4949 Total Sq Feet: 0.00 Fees Amount Application Fee - Other $50.00 CCF $3.60 DBPR Fee $2.52 DCA Fee $2.00 Education Surcharge $1.20 Permit Fee $118.00 Scanning Fee $9.00 Technology Fee $4.20 Total: $190.52 Building Department Copy Payments Date Paid Amt Paid Total Fees $190.52 Credit Card 07/16/2019 $190.52 Amount Due: $0.00 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. rized Signature: Owner / Applicant / Contractor / Agent Date July 16, 2019 Page 2 of 2 4 Miami Shores Village Building Department artment 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 F' BC 201� � BUILDING Master Permit No. 'I'�r- —CL }C1 —I J PERMIT APPLICATION Sub Permit No. BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF [:]CANCELLATION [::]SHOP CONTRACTOR DRAWINGS JOB ADDRESS: I LJ i kz' q h 5-18 City: Miami Shores h 7 County: Miami Dade Zip: Folio/Parcel#: / `—.3� 0/— 6)2S-"y ETC Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee S / Address: l V City: Tenant/Lessee Name: Email: IMP14- ne#: CONTRACTOR: Company Name: r 1 d� F,��%��� Phone#: Address: City: State: Qualifier Name: Phone#: State Certification or Registration #: Certificate of Competency #: _ DESIGNER: Architect/Engineer: 13a+ /b 1�F^ Phone#: p: Address: City: State: Zip: / Value of Work for this Permit: $ 5! Square/Linear Footage of Work: 1 SQ,'T' If Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of ' /Work: / Jl.( _h i�— O s b d oZ ei' Cb M Ve NS i bh k/ 1' f h f�GhV i►rG 1 /h�!� Specify color of color thru tile: W A ) Submittal Fee $ Scanning Fee $ Technology Fee Structural Reviews $ Permit Fee $ Radon Fee $ Training/Education Fee $ CCF $ CO/CC $ DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ (�(� • �jZ (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 reinspection fee will be charged. Signature if �fJ� ,(Oita Signature OWNER or AGENT The foregoing instrument was acknowledged before me this day of EU NrL 20 by 1PLS.A PV%-�� who is personally known to me or who has produced y f�A— as identification and who did take an oath. NOTARY PPLENIS , Prir;Fz CONTRACTOR The foregoing instrument was acknowledged before me this day of 20 , by who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: SeaF9�z-,al-,-6. _54260 Seal: *************** ************ct/Ii/I APPROVED BY " %** Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) C1 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: �lla l'� �l ` )I DATE: 1 / DATE: ! ADDRESS: 107 1V A 1 91 :* ��, 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. 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 I do not have a license. Initial ,, G 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. Initial �r r 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--ef C? „ 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 lease, which violates the exemption. ` Initial r' a 9 5. 1 understand that, as the owner -builder, I must provide direct, onsite supervision of the construction. Initialer f 6. 1 understand that I 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 taw and by county or 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. 1, 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. Initial``, 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 regulations. �) Initial 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.htmi Initial 6 �. 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: /07 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 b day of Vim( , 20 By Iyl I J n who was personally known to me or who has Produced the License o s identification NOTARY rA J 9 (0 S�orcs A Ac.-Y/.,c BATHROOM qCtPTACLE ON 20 AMP CKT e, A -4 ANDan PROTECTED - ADD SMOKUCARAON MONOXIDE QfTE&ORS. ANY AND ALL CLOTIIItAND kbiBER "r—r INSULATED ONDUCTOR4 T0,8E REPLACED,-,.'- :T AGE -�~�� f._ °, -� I zot"'ING S TR U LCT-UpA PLUMRM,PL t Approved T Disapproved C C L ELETR!CAA L Is kvscQj*vj r"LF- \j PLUMEIP'G 0 0 0 0 IN 1.4*54HA "CAL 0 01 10,0,0 !z( *JECT TO C� 177) Oqo 0 144'10E AAA Co,,j,,.,7 BAT H FITTERIV BATH FITTER® ACRYLIC WALL & FREE-STANDING SHOWER BASE SPECIFICATIONS A Bath Fitter® custom -formed one-piece acrylic shower wall system is manufactured from a co -extruded sheet that is approximately 1/8" thick and that consists of a pigmented acrylic surface reinforced with a blend of high - impact plastic material. Bath Fittef® acrylic shower walls are seamless and cover the existing walls of the shower stall. They are secured to the existing walls using a proprietary adhesive and installation technique. Exposed edges are capped with an extruded molding that is trimmed on site for an exact fit. Sample panels of the material used to form Bath Fitter' acrylic shower walls have been tested a0crfound to be in compliance with Standard CSA B-45.5-2011 / IAPMO Z124-2011, Clause 5,12. • • • • • • • • • • •. • .. . •••• A Bath Fittere free-standing acrylic shower base is manufactured from a co -extra *00:200" thick sheet that. consists of a pigmented acrylic surface reinforced with a blend of high -impact plastic material. Tiae support OAM i9: adhered to the floor. The ledges of the acrylic shower base are screwed to the wall•stLlls. The•support parq•is• pre -assembled and secured to the acrylic shower base using a proprietary adhesive MVt:stal1atio:rtmhnigt0•• .. .. .... •••••• Bath Fitter' free-standing acrylic shower bases are certified by C.S.A. to be in compZ NVE:with the•requiremenis of Standards CSA B45.0-02 General Requirements for Plumbing Fixtures and CSA,B45.�-201 -/-ARM0 21�4*-. 2011 Plastic Plumbing Fixtures. • • • • • • ACFLIC ` u a % i,`�Y.r3 Y �. •.�� .} 1. EASE E.y 1,-INO 'AA / I ADHES'•/E AC RvL4_ ;� .'�•rti 45 i � a A7HE2 YES SIJF'DF''i.r, f `4{r Detailed view « A » A"RY�-IC'� r?L! : i l,'.. IS IIG 4l'4LL v I � R � ACF.IUf .ti4.1 See Il e 1U4-B.'» I .�f r I I stall"« :A.. Bath Fitter04 Product Specifications SL�aCR- GD;H M _I. ''•`• • `��. 5'-..9EFESSE �ILIC�hiE �161 %.l=7LIL I • ;H;. dJFF 6r, -- SC?E',4' i i ACRr_Ic Detailed view « B » Rev. 03-19-12 BATH FBTTERc BATH FITTER® ACRYLIC SHOWER WALL SPECIFICATIONS A Bath Fittero custom -formed one-piece acrylic shower wall system is manufactured from a co -extruded sheet that is approximately 1/8" thick and that consists of a pigmented acrylic surface reinforced with a blend of high -impact plastic material. Bath Fitter acrylic shower walls are seamless and cover the existing walls of the shower stall. They are secured to the existing walls using a proprietary adhesive and installation, technique. Exposed edges are capped with an extruded molding that is trimmed on site for an exact fit. Sample pac"i of the material used to form Bath 1"itter0acrylic shower wails have been tested and found *.to be in compliance with Standard CSA Standard B-45.5-2011 1 IAPMO Z124-2011, Clause 5.12. . . . •••• . .. •••••. •••••• • ..... . .... •••.. .... •••••• .:.... • • • EXIS I ING'NALL •••••• • • i ---- — ---'-- Rev.03-19-12 Bath Fitter* Product Specifications Technical Data Sheet FREE STANDING ACRYLIC SHOWER BASE SCREW - IN DRAIN & OFFSET DRAIN • Product name: Free standing Acrylic Shower Base Screw -in & Offset Drain • Trade name: Freestanding Acrylic Shower Base Screw -in & Offset Drain • Supplier/Manufacturer.Oatey Product description: These assemblies of drains are composed of ABS plastic, brass, stainless steel, rubber and of plated zincfor the superficial part (drain grate). Several plated finishes are available for the drain grate. The PVC glue is used in the fixing of the drain into the free-standing shower base. The drain top accommodates 4-1/4" strainers. Sealing and friction gaskets allow for positive seal to the shower base. BAT H FITTER® General use: The screw -in & the offset drains are designed to be installed on Free standing shower bases. The drains were manufactured to mechanically attach and water seal the acrylic FSSB to the plumbing. The screw -in & the offset drains allow quick and easy installation. Application overview: For quality assurance all Bath Fitter® drain assemblies must be installed exclusively by Bath Fitter® certified installers. Detailed installation instructions are tailored specifically for Bath Fitter® certified installers and are available in the Operations Man ual. Benefits: These long lasting components made of brass • • have a high resistance to drastic temperature changes i • • • • • • • Control Tests by Bath Fitter: • • • • • • • and to corrosion. Due to the offset design, the drain • • Y allows for a tolerance of +/-1.5" when roughing in the • • • • • • • • • Visual inspection tests • FSSB. •••••• • • Dimensional Tolerances • • • • • • Drain come in the following finishes; chrome, brushed nickel, and oil rubbed bronze. • • • • • •� • • • • grates •� •� ••• P FREESTANDING SCREW -IN DRAIN OFFSET DRAIN NP1 • • • FRE : ntr `•i ACRYLIC • A!RYLIC SHOWER BASE • • • • • SNOY:ER MKE ACRYLIC ACRYLIC •'•—•' SJPPORT PAN _ SUPPORT PAN • • • • arrsnac ES1VE MI RING DRA.I F'-ESTAND:,3 NP' a r ACRYLIC 3WnR EAM ACRYLIC �f A w EQIVE LuPPCRrrki GAWT FRICTION RING DRAM P-PE I Ci144 FREF STAND'\;, WI ACIMLIG SHX.T.R C: ZE ACr.UXC VAN IDFI ' X ,.�ZT [-ASK£T -so ;t_r%I VG r oRAea PPE 2' DRA,:I PEE ©2009 BATH FITTER ®Franchising Inc. - Technical Data Sheet Phone: 1 800 892-2847• Fax: 450-472-0027 www.bathfitter.com BAT H FITTER® FREE-STANDING ACRYLIC SHOWER BASE DRAIN SPECIFICATIONS NPI FREE -STAND NG ACRYLIC SHOWER BASE •••• ACRYLIC • • •••• •••••• SUPPORT PAN ADHESIVE • • • • • • • • 0 0 •••••• •• • r••••• GASKET • NUT •••••• • • • FRICTION RING •••••• ••••• ••••• •`', _ DRAIN •• •• •••• ••••:• • • • • • • •••••• • • • DRAIN PIPE • • • • • • • • • "t STRAINER GASKET GASKET __— EA "IN FREE-STANDING NP1 p ACRYLIC SHOWER BASE ACRYLIC ADHESIVE 0 SUPPORT PAtJ GASKET FRICTION RING NUT 2" DRAIN P PE Bath Fitter Rev 04-30-09 Product Specifications OAT H V ITT R ... . BATH FITTER® ACRYLIC WALL &•'•"••• •••••• FREE-STANDING SHOWER BASE SPECIFICATIONS. •..��; •..;;. A Bath Fitter`s custom -formed one-piece acrylic shower wall system is manufactured 0i *e a co -extruded s%%t..; that is approximately 1 /8" thick and that consists of a pigmented acrylic surface reinfdr" With ; bfgr*d of hk impact plastic material. Bath Fitter acrylic shower walls are seamless and cover the e"st rit walls.af the shoV�I,. .• stall. They are secured to the existing walls using a proprietary adhesive and inst@Watiool tech niqu%:Expo$g.. edges are capped with an extruded molding that is trimmed on site for an exact fit. . . . • 0000• Sample panels of the material used to form Bath Fitter' acrylic shower walls have bee: tested and found to t .i:.: compliance with Standard CSA B-45.5-2011 / IAPMO Z124-2011 Clause 5 12 " ' ••0 • .... A Bath Fitter"'' free-standing acrylic shower base is manufactured from a co -extruded .200" thick sheet that consists of a pigmented acrylic surface reinforced with a blend of high -impact plastic material. The support pan is adhered to the floor. The ledges of the acrylic shower base are screwed to the wall studs. The support pan is pre -assembled and secured to the acrylic shower base using a proprietary adhesive and installation technique Bath Fitter"' free-standing acrylic shower bases are certified by C.S.A. to be in compliance with the requirements of Standards CSA B45.0-02 General Requirements for Plumbing Fixtures and CSA B45.5-2011 / IAPMO Z_124- 2011 Plastic Plumbing Fixtures See 0 i <(B)3 SNC i. �-. B;•SE �i�Et15-I!J=_ I 11 h H°'- s'ES - :+ 3 Detailed view « A » � w SASE " r stail « A , M j, i Detailed view u G 11 Bath Fitter` Rev. 03-19-12 Product Spec.fcNtlons Technical Data Sheet FREE STANDING ACRYLIC SHOWER BASE SCREW - IN DRAIN & OFFSET DRAIN • Product name: Free standing Acrylic Shower Base Screw -in & Offset Drain • Trade name: Freestanding Acrylic Shower Base Screw -in & Offset Drain • Supplier/Manufacturer:Oatey Product description: These assemblies of drains ore composed of ABS plastic, brass, stainless steel, rubber and of plated zinc for the superficial part (drain grate). Several plated finishes are available for the drain grate. The PVC glue is used in the fixing of the drain into the free-standing shower base. The drain top accommodates 4-114" strainers. Sealing and friction gaskets allow for positive seal to the shower base. Benefits: These long lasting components made of brass have a high resistance to drastic temperature changes and to corrosion. Due to the offset design, the drain allows for a tolerance of +/- 1.S" when roughing in the FSSB. BAT H FITTER° General use: The screw -in & the offset drains are designed to be installed on Free standing shower bases. The drains were manufactured to mechanically attach and water seal the acrylic FSSB to the plumbirp. Thy++ screw -in & the offset drains allow quick and east • installation. • • • • • • • •••••• Application overview: For quality assurance olVpQ p, Fitter® drain assemblies must be installed exclu,1414YA Bath Fitter" certified installers. Detailed inst411G4V, • instructions are tailored specifically for Both F qA6 • • certified installers and are available in the ORF6a4ijr)j• Manual. • • • • • •• • Control Tests by Bath Fitter., • Visual inspection tests • Dimensional Tolerances Drain grates come in the following finishes; chrome, brushed nickel, and oil rubbed bronze. SCREW -IN DRAIN r a r r^' .F-7 t H �-,T-EZ c .. Phone: 1 800 892 2847• Fax: 1 - OFFSET DRAIN .� r www bathftter com y r BAT H "•• FITTER® ' FREE-STANDING ACRYLIC SHOWER BASE DRAIN SPECIFIC�7MONS:0•� • ...... ... . KP1 FREE-ST AND NG•••••• • ACRYLIC : • : 0 • °!MvCR RASE . • ••••• ACRYLIC '••• i • •• ^r0r',TF,"1: yEgl c • • • STRAINER GASKET - -►� GRAIN FREE-STANDING NP1 ACRYLIC iwu SHOI,%IFR BASE ACRYL IC _ �� ADLIESIVE 0 SUPPORT PAi� — CASKET FRICTION RING NUT_ 2' DP,AIN P PE - — Rev 04-30-09 Bath Fitter Product Specificatiors