RC-09-2088Inspection Number: INSP- 152106 Permit Number: RC -12 -09 -2088
Scheduled Inspection Date: November 09, 2010 Permit Type: Residential Construction
Inspection Type: Final
Owner: MENENDEZ, GUSTAVO Work Classification: Alteration
Job Address: 10166 NE 12 Avenue
Miami Shores, FL 33138-
Inspector: Bruhn, Norman
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
November 08, 2010
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
For Inspections please call: (305)762 -4949
Phone Number (305)772 -8358
Parcel Number 1132050190120
DEMOLISH EXISING WALL IN FOYER (A PARTITION
WALL- DOESN'T GO TO THE CEILING) PUT UP NEW
WALL TO GO 3" FORWARD IN FOYER, ALLOWING
SPACE ON OTHER SIDE OF WALL (IN KITCHEN AREA)
TO ADD CABINETS THERE. NEW WALL WILL ALSO BE A
PARTITION WALL.
Passed e �` :1
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
CREATED AS REINSPECTION FOR INSP- 131902. DRYWALL AND
FRAMING ARE REQUIRED FIRST. NB
Page 22 of 33
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: BUILDING ROOFING
Job Address (where the work is being done) Jf
Contractor's Company Name
Contractor's Address
City
Qualifier Name
'Contact Phone
Architect /Engineer's Name (if applicable)
Value of Work For this Permit $7" iJ O 9 ob
Submittal Fee $
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
Owner's Name (Fee Simple Titlehol
Owner's Address
,
ea
d r 01.44
loam
City e
State Zip
Tenant/Lesser ae
m p f � me " c oal
City Miami Shores Village County Miami -Dade Zip
FOLIO / PARCEL #
Is Building Historically Designated YES
State
E -mail
fly
NO
State Certificate or Registration No. Certificate of Competency No.
Type of Work: ❑Addition Q�Alteration ❑Ne ❑ Re , air /Re lace p e olition
D scribe/Vork: , r m e • 1 T) I f �o . 'y OAi oko
1
I . y�z .�i". ni 6 eV
1 • PIEIMINIMINITIMINEIMILMIRIEMEM .
1,01 M
1 _
******* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** *F * * * * **
Permit Fee $
e Ode 4
Permit No.
Master Permit No.
Phone #
■2-
Phone #
Phone #
L -NE 1L, ETiEN Z_
Phone 8 5(13
Flood Zone
Zip
Phone #
Square / Linear Footage Of Work: 1 e) S
* * * * * * * * * * * * * * * * * * * * * * * * * * * * **
CCF$ D •(00
CO /C C $
Notary $ Training /Education Fee $ 0. 2-0 Technology Fee $
Scanning $ C • 00 Radon $ 0 - DPBR $ -0 9 Bond $
Double Fee $ Violation date:
Structural Review. $ Total Fee Now Due $ 13 •*
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 i pection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection ill of be approved and a reinspection fee will be charged.
Signature
Owner or Agent
The fore oing instrument was ac
day of , 20Q",Fby
owle
who is p - rsonally known to me or who has produced
NOT Y PUBLIC:
4
Sign:
Print:.
My Commission Expires:
(Revised 07/10/07)(Revised 06/10/2009)
ignature
Contractor
ged bef• - me this , - foregoing instrument was acknowledged before me this
42/L /II W& 0ayof ,20,by
ntification and who did take an oath. as identification and who did take an oath.
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPROVED BY Q9� J .L ' 0' Cp Plans Examiner Zoning
Engineer Clerk checked
' 4 7 9 . 0
NOTARY PUBLIC:
41 1, 1 3 Sign:
le
-ate+
Print:
My Commission Expires:
NAME
ADDRESS:
5. I understand that, as the owner- builder, I must provide direct, onsite supervision of the construction.
M iami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
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 fora 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. I 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, a i act as my own
contractor with certain restrictions even though I do not have a license.
Initial
2. I understand that building permits are not required to be signed by a property owner unless he or she is r p. sible for the
construction and is not hiring a licensed contractor to assume responsibility.
initial
3. I 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 ins ear of my own
name. I also understand that the contractor is required by law to be licensed in Florida and to list his or lice
permits and contracts.
Initial
4. I 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 sub to ally improved
myself is sold or leased within 1 year after the construction is complete, the law will presume that I b It . s b a tially
improved it for sale or lease, which violates the exemption.
Initial
Initial
6. I 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 law n by county r
municipal ordinance.
By
7. I 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 wi ly acting as an
owner - builder and am aware of the limits of my insurance coverage for injuries to workers on my property.
Initial
8. I 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 co pensation for
the employee. I understand that my failure to follow these may subject to serious financial risk.
Initial
9. I 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
Initial
10. I understand that I may obtain more information regarding my obligations as an employer from the Intemal Revenue Service, the
United States Small Business Administration, and the Florida Department of Revenues. I also understand that I . y contact the
fit•
Florida Construction Industry Licensing Board at 850.487.1395 or http : / /www.mytloridalicense.com /dbor /pro /cilblin•
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. I agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the informa i , \.
have provided on this disclosure. \ \ \ \
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 g--( day of , 20c_
'at
roduced there License or t "} (Q+ 0 03 (Q' 204 identification.
who was personally known to me or who has
Initial
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Inspection Number: INSP- 131917 Permit Number: EL -12 -09 -2089
Scheduled Inspection Date: October 06, 2010 Permit Type: Electrical - Residential
Inspection Type: Final
Owner: MENENDEZ, GUSTAVO Work Classification: Addition /Alteration
Job Address: 10166 NE 12 Avenue
Miami Shores, FL 33138-
Inspector: Devaney, Michael
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
MOVE OUTLET 4' UP FOR TV INSTALLATION AND TO
PUT LIGHTS IN SHELVES /CABITES IN KITCHEN AREA
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
October 05, 2010
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
For Inspections please call: (305)762 -4949
-20-Kc-
Phone Number (305)772 -8358
Parcel Number 1132050190120
Page 2 of 25
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: ELECTRICAL
Owner's Name (Fee Simple Titleholder
Owner's Address , •
City
Tenant/Lessee Ntmt
Email
Job Address (where the work is being done)
City Miami Shores Village County Miami -Dade Zip
FOLIO / PARCEL #
Is Building Historically Designated YES NO V Flood Zone
Contractor's Company Name
Contractor's Address
City State Zip
Qualifier Name Phone #
State Certificate or Registration No. Certificate of Competency No.
Contact Phone
Notary $
Miami Shores Village
State
Building D epartment
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
F
YR MC.
Training /Education Fee $ ... Q 1
E -mail
Violation date:
Zip
Phone #
Phone #
Permit No.
Master Permit No. ecJ 0 -
D k . L NtN1
Phone # U
Architect/Engineer's Name (if applicable) Phone #
Type of Work: ❑Addition V Alteration , MAO( ❑ epair/Replace • l emolition
escribe Work: ' I�, V V \ L ' V f ' Q
mammirtmainwspailninnaminimminw. to
Value of Work For this Permit $ Square / Linear Footage Of Work:
******** * * * * * * * * * * * * * * * * * * * * * * * * * * ** * ** F * * *** * * * * * * * *** * * * * * * * * * * * * * * **
Submittal Fee $ Permit Fee $ CCF $ �' loo CO /CC $
Scanning $3 Radon $ DPBR $ Bond $
Double Fee $
Technology Fee $ 0
Structural Review. $ Total Fee Now Due $ t 04'(916
"
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 wil of be approved and a re- inspection fee will be charged.
Signature
NOTAR PUBLIC:
Sign:
Print:
My Commission Expires:
* * * * * * * * * * * * * * * * * * **
APPROVED BY
(Revised 07 /10 /07)(Revised 06/10/2009)
Owner or Agent Contractor
The fore oing instrument was ac owle ged befo e • "
day of 20021 .regoing instrument was acknowledged before me this
by day of 20
1 ,by
� �} � �
who is pers +nally known to me or who has produced l � who is personally known to me or who has produced
and who did take an oath. as identification and who did take an oath.
ti
dl
Plans Examiner Zoning
Engineer
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
Clerk checked
`OWNER BUILDER DISCLOSURE STATEMENT
M O IkkE\ TE
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
— %"
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 fora 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 $25,000.0 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.CA 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. I 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.
ADDRESS:
N
2. I understand that building permits are not required to be signed by a property owner unless he or she is res, .nsible for the
construction and is not hiring a licensed contractor to assume responsibility.
5. I understand that, as the owner- builder, I must provide direct, onsite supervision of the construction.
Initial
Initial
Initial
3. I understand that, as an owner builder, I am the responsible party of record on a permit I understand that 1 may protect myself
from potential financial risk by hiring a licensed contractor and having the permit filed in his or her name in tead of my own
name. I also understand that the contractor is required by law to be licensed in Florida and to list his or ce se
permits and contracts.
Initial
4. I 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 . 1 or • aIly
improved it for sale or lease, which violates the exemption.
Initial \
6. I 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 law -_d by county or
municipal ordinance.
7. I 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 willfu ly acting as an
owner- builder and am aware of the limits of my insurance coverage for injuries to workers on my property.
8. I 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 1 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 co I pensati. i or
the employee. I understand that my failure to follow these may subject to serious financial risk. s \, a
Initial VC
9. I agree that, as the party legally and financially responsible for this proposed Construction activity, I will abide by all applicable
laws and requirement that govem owner - builders as well as employers. I also understand that the
Construction must comply with all applicable laws, ordinances, building codes, and zoning regulations.
OWNER
OTARY
Initial
Initial
Was acknowledged before me this ' day of QQ,C Alt, / 20(fi
who was personally known to me or who has
Prod ced there License or 1 Q 5q 'O ' 0 as identification.
10. I 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 ►I ntact the
Florida Construction Industry Licensing Board at 850 .487.1395 or http:/ new. mvfloridalicense .com /dbpr /orolcilbfi ' :' .
t �
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:
) N� , i ZOO
12. I agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the inform
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 Toss 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
retumed 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.
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