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EL-09-1532 Miami Shores Village 10050 N.E. 2nd Avenue F/ Miami Shores, FL 33138 -0000 Pj Phone: (305)795 -2204 IRR y Expiration: 1 010 Project Address Parcel Number Applicant 525 90 Street 1132060400030 Miami Shores, FL Block: Lot: MARIA LEANDER Owner Information Address Phone Cell MARIA LEANDER 525 NE 90 ST MIAMI SHORES FL 33138 -3148 Contractor(s) Phone Cell Phone Valuation: $ 1,000.00 HOME OWNER Total Sq Feet: 0 Type of Work: For Inspections please call: Additional Info: (305)762 -4949 Classification: Residential Available Inspections: Inspection Type: Fees Due Amount Invoice # Total Amt Paid Amt Due CCF $ EL -9-09 -35908 $ 50.00 $ 50.00 $ 0.00 Education Surcharge $0.20 Notary Fee $5.00 Check #: 5630 Permit Fee - AdditionstAlterations $100.00 EL -9-09 -35911 $ 58.30 $ 58.30 $ 0.00 Submittal Fee $50.00 Submittal Reversal Fee ($50 00) Check #: 5632 Technology Fee $2.50 Total: $108.30 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. September 17,. 2009 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy September 17, 2009 1 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 BUILDING Permit No. E L q — 0g — t5 ? J 2 PERMIT APPLICATION Master Permit No. FBC 20 Permit Type: ELECTRICAL Ceti., a>5 5 0 Owner's Name (Fee Simple Titleholder) C 1.1 +FF00 IJWIA V 1.qq 1 . hone # – O-r 73'1 lk3 e Owner's Address .sue f N• 1 9 . City & /Ht»11 5�� State PL Zip .43 / IF Tenant/Lessee Name Phone # Email Job Address (where the work is being done) 2 S Ad A. City Miami Shores Village County Miami =Dade 3 / 3 FOLIO / PARCEL # Is Building Historically Designated YES NO Flood Zone Contractor's Company Name Phone # Contractor's Address City State Zip Qualifier Name Phone # State Certificate or Registration No. Certificate of Competency No. Contact Phone E-mail Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ Square ! Linear Footage Of Work: Type of Work: ❑Addition ❑Alteration ❑New ❑ Repair/Replace ❑Demolition Describe Work: ��3Tr4 jTr -�{ /'L( I 'I Submittal Permit Fee $ Av'00 d'� Fee $ , � CCF $ —""" CO /CC $ Notary $ Q Training/Education Fee $ °-- ----- Technology Fee $ Scanning $ Radon $ DPBR $ Bond $ Double Fee $ Violation date: Structural Review. $ Total Fee Now Due $ _5, "s (D 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 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 re- inspection fee will be charged. Signature R� � _�� Signature Owner or Agent J- h Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day o 20 =/, by A y _ L C Cl�'j (, �eof 20 by , who is personally known to me or who has produced — / who is personally known to me or who has produced As identificatio d• a an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: q O f Sign: t Sign: Print: t r/r Print: 9 My Commission Expires: �,; 2� My Commission Expires: k�Y4ednY�Y> F •4rksY•k�F:4�traY4r�Y�Y��F9F•• 4r9c4r�ok4c • �Y�Y•& drBc�F9a4c�Y9e3e4c�Y�k�sY�F�Y4: �4oYoYoY4: sY�tr�ir4z& k4rde4avYArskvY�lr�Fat�YoY4e�• k�Y4e�F4e* 9r�YAs: keY9est�irkaY :Yzie9e4c:kk�e�tr•3t9zokoY•k APPROVED BY 1-5 ' P Plans Examiner Zoning Engineer Clerk checked (Revised 07 /10 /07)(Revised 06/10/2009) 4. b 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 minimum code. Initial �yy� - .--- 5. 1 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 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 requited to hfive 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. h,utial '�• 7. I understaud'that if any person gets iWured on my construction projsct they are entitled to workmen's compensation. - Ana if they do not posses a workmen's policy I could be held liable for all doctor and related cost which could include [dos of wages during recovery from injury. Initial 8. 1 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. Initial �h Was.acknowledged before me this _day of /--- , 20 By 2 C who was personally known to me or who has Produced there License or -t' �� as identification dentification Bit s OWNER ®C� 'ARY �56 e VILLAGE OF MIAMI Sjr0kHS OWNER BUILDER DISCLOSURE STATEMENT NAME: d L 9R 1 A V. 4 E40b 43? . DATE: ADDRESS: dS2S 00. L C. Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, RS 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 shows you, as the owner of your property, to act as your own cohtraetor even though you do not have a license. You must supervise the constrmtion yourself. You may build or improve a one- family or two- family redidbnee. 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 foe sale or lease, which is a violation bf this exemption. You gray not hire an unlicensed person as It contractor. It is your responsibility to make sure the people employed by you hive licenses ragnired by state law-and by county or municipal licensing ordinances. Any person working on your building who is not licensed rilyst work under your supervision and must be employed by you, which means that you must deduct F.LC.A and with - holdings tax and provide workers' compensation fbr that employee, all as prescribed bylaw. Your construction must comply with all applicable laws, ordinances, -buildings codes and zoning regulations. Please read and initial each paragraph. 1. I hold, fide to the above property and I am planning on doing this construction Myself. Initial 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. Inactive permits for a period of over 180 days -will become null and void (expired) and a new permit will be required. to be issued for reinstatement of the permit., Initial 3. 1 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. Initial Q2-,n,.- Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 135985 Permit Number: EL -9 -09 -1532 Scheduled Inspection Date: February 23, 2010 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: LEANDER, MARIA Work Classification: Alarm Job Address: 525 NE 90 Street Miami Shores, FL Phone Number Parcel Number 113206040003 Project: <NONE> Contractor: HOME OWNER Building Department Comments Install burglar alarm Inspector Comments Passed Failed Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. February 22, 2010 For Inspections please call: (305)762 -4949 Page 14 of 25