PT-10-217Inspection Number: INSP - 135489 Permit Number: PT -2 -10 -217
Scheduled Inspection Date: July 02, 2010
Inspector: Bruhn, Norman
Owner: BRAZIS, LILLIAN & ALBERT
Job Address: 330 NE 97 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
Passed
Failed
July 01, 2010
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspector Comments
(7_
For Inspections please call: (305)762 -4949
Permit Type: Paint
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1132060135850
Page 4 of 14
Scheduled Inspection Date: July 02, 2010
Inspector: Bruhn, Norman
Owner: BRAZIS, LILLIAN & ALBERT
Job Address: 330 NE 97 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
July 01, 2010
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 135489 Permit Number: PT -2 -10 -217
For Inspections please call: (305)762 -4949
Permit Type: Paint
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1132060135850
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
Page 4 of 14
0,\
Tenant /Lessee Name
J
E -MAIL: r)°wick. QWIC$cllotoWl
Is Building Historically Designated YES
Contractor's Company Name
Contractor's Address
City_
Qualifier Name
State Certificate or Registration No.
OWNER BUILDER:
Value of Work For this Permit $ 300,00
Describe Work: exectRIo&Z„ ANTif44
Permit Fee $
NNE
Mi
Bu
10050
Tel:
BUILDING
PERMIT APPLICATION
FBC 2004
Permit Type: PAINT PERMIT
Owner's Name (Fee Simpl',e Titleholder) e3 - A0,,ES NovAcF- Phone # (9171 gel 144p+s5
Owner's Address 330 I,I(.1• c7 s-,
City MIAMI $140EAS ' State L. Zip 33138
330
Job Address (where the work is being done)
City • Miami Shores Village
•
FOLIO /PARCEL# t% - 320(9* - 0t3 -
State
Application is hereby made to obtain a permit to do the work and i
and that all work will he performed to meet the standards of all lav
EI.ECTRICAI. WORK. PLUMBING, SIGNS, WELLS. POOLS.
"WARNING TO OWNER: YOUR FAILURE TO RE
IMPROVEMENTS TO YOUR PROPERTY. IF YOU INT
RECORDING YOUR NOTICE pF COMMENCEMENT."
Notice to Applicant: .1s a condition to the issuance ofa building p
notice of commencement and construction lien law brochure will h
• of commencement must he posted al the job site for the, /rst inspec
inspection will not he approved and a reinspeclionfee will he char
Training /Education Fee $ N
Doable Fee $ Zoning $
mi Shores Village
lding Department
N.E.2nd Avenue. Miami Shores, Florida 33138
305) 795.2204 Fax: (305) 756.8972
NE q Tni Sr
County Miami -Dade Zip 33136
SO
NO X
islallations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit
s regulating construction in this jurisdiction. I understand that a separate permit must he secured liar
URNACE:S, BOILERS. HEATERS, TANKS and AIR CONDITIONERS, ETC
ORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR
ND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY KEFORI
CCF
Permit No. cl 1,0 - All
Master Permit No.
Phone #
Phone #
plErIalERwmil
fEd 4.11B
Certificate of Competency No.
3Y• ....
Zip
Phone #
Type of Work: ❑ Addition / ❑ Alteration / ❑New / RKepair /Replace
1101110th cm estimated value exceeding $ 2500. the applicant must promise in good jaith that a copy (Ole
delivered to the person whose properly is subject to attachment. Also, a certified copy of the recordd notice
on which occurs seven (7) days after the building permit is issued In the absence of such posted notice. the
ed.
* * * ** * * ** F * * * *dero4**dc**************** t
Technology Fee:
tary $ Code Enforcement $
Total Fee Now Due $ ( PY) - (
9
4_., 0000
21 10
See Reverse Side -
Directions: Please circle corresponding number to appropriate color sample.
Walls:
Fascia: 2 3 4
Drip Cap /Drip Edge: f 2 3 4
Soffit: l.i� 2 3 4
Roof: 1 3 3 4
Flower Bins: 1 C`/ 3 4
Shutters: 1 3 4
Awnings: 1 2 3 4
Chimney:
Doors and Door Jams:
3 4 cfowir UGE
�t�lW
Garage Doors: I 4
Railings: 1 2 3 4
Fences:
All brick (simulated or regular):
Stucco Banding:
Any other Stucco Features:
NOTARY PU
Sign:
Print:
My Commission Expires:
Owner or Agent
The for .oi instrument was a6`lanowltdt!ed befor
day off. 201 by
w io is er:onally kno‘. t{n or who has produced
PAINT COLOR APPROVAL AND AGREEMENT
All elements on the site must be listed and indicate the color to be painted
1 2
► e thi:
4
4
3 4
Accessory Buildings Other: SIvE A 8 &cr...
• kfc?(titication and wio did take s tiac�
r:•4 � � a . O.
0 S �� .woo a
; 4 4 �
Deep.
rL
At
0
o•
OWNER'S AFFIDAVIT: 1 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.
Signature
Contractor
The foregoing instrument was acknowledged before me this
day or : 20 .by
Oho is personally known to me or who hays produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
xxxxxxxWxxxxxxx*i**** xxxxxxxxxxxi ,$exxxxx xxwxxxxxxxxxxxxxxxx**** Yxxx
APPLICATION APPROVED BY:
cedar key
white opulence
1
ttelil■
xxx &xxw*****
Plans Examiner
Preservation Board
Code Enforcement
ame and
(Revised 04 /24/0;
\1107/12-(k OWNER BUILDER DISCLOSURE STATEMENT
NAME: l N o V - a. DATE: ! ' 12,
ADDRESS: iJ O) N cl 1 S
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 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.
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
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.
5. I understand that, as the owner - builder, I must provide direct onsite supervision of the construction.
Initial
Initial
Initial
2. I 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.
3. 1 understand that, as an owner builder, I am the responsible
po 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 li nse umbers on
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 built substantially
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 and b 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 willfully 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, whit means that I must comply with laws requiring the withholding of federal income tax and
social security contributions under the Federal Insurance Contributions Act (FICAyand must provide workers compensation for
the employee. I understand that my failure to follow these may subject to serious financial risk.
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.
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 1 ma contact the
Florida Construction Industry Licensing Board at 850.487.1395 or httpJ/ www. mvfloridalicense .com/dbor /oro/cilbfi : 1
Was acknowledged before me this 1 day of PE-5 , 20 0
By V I C . 021
Produced there License or
OWNER
t� f A-Cik_
YJ
Initial
Initial
who was personally known to me or who has
On 4 S5 \C frt � n.
•..
TA TE ........................ . ��o��•�
O \\`‘
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:
12. I agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the i ation at 1
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
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.
Project Address
330 97 Street
Miami Shores, FL 33138-
Owner Information
Type of Work: Exterior
Color:
Additional Info: PAINT
Classification: Residential
Color: _Approved
Color: _Approved_
February 17, 2010
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204
Fees Due Amount
CCF $0.60
Education Surcharge $0.20
Notary Fee $5.00
Permit Fee $60.00
Technology Fee $0.80
Total: $66.60
Building Department Copy
Address
Parcel Number
1132060135850
Block: Lot:
Phone
Code Comments: BEN MOORE - WALS, FASCI, SOF
Color. _Denied
i
Invoice # Invoice Total Amt Paid Amt Due
PT -2 -10 -37039
$66.60 $66.60 $0.00
Expiration: 08/15/2010
Applicant
LILLIAN & ALBERT BRAZIS
330 97 Street
MIAMI SHORES FL 33138 -2406
Valuation:
Total Sq Feet:
LILLIAN & ALBERT BRAZIS
CeII
$ 300.00
0
For Inspections please call:
(305)762 -4949
Available Inspections:
Inspection Type:
Final
1
2