RC-09-2061Inspection Number: INSP - 143954
Scheduled Inspection Date: August 25, 2010
Inspector: Bruhn, Norman
Owner: ESCOTT, KEVIN
Job Address: 78 NW 99 Street
Miami Shores, FL 33150-
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
replace tile work in bathroom
Passed
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- 143705. No access NB
August 24, 2010
For Inspections please call: (305)762 -4949
Permit Number: RC -12 -09 -2061
Permit Type: Residential Construction
Inspection Type: Final
Work Classification: Alteration
Phone Number
Parcel Number 1131010330070
Page 5 of 26
Inspection Number: INSP - 146007
Scheduled Inspection Date: June 16, 2010
Inspector: Devaney, Michael
Owner: ESCOTT, KEVIN
Job Address: 78 NW 99 Street
Project: <NONE>
Miami Shores, FL 33150-
Contractor: HOME OWNER
Building Department Comments
June 15, 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
e �1
Phone Number
Permit Number: EL -12 -09 -2099
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Alteration
Parcel Number 1131010330070
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
/
Page 12 of 20
BUILDING
PERMIT APPLICATION
FBC20
Owner's Address , ,. j
City CN PFk D 51 CS
Tenant/Lessee Name
Email
Cc 5:
Job Address (where the work is being done)
Contractor's Company Name
Contractor's Address
City
Qualifier Name
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
Permit Type: BUILDING ROOFING.
Owner's Name (Fee Simple Titleholder) ye, ika Phone # 9. „St 23 t
State k Zip 1
'q$ 14.4 4s 51
City Miami Shores Villa • e County Miami -Dade Zip
FOLIO / PARCEL #
Is Building Historically Designated YES NO Flood Zone
State
State Certificate or Registration No. Certificate of Competency No.
'Contact Phone E -mail
Architect/Engineer's Name (if applicable) jeo, Phone #
Value of Work For this Permit $ ti Square / Linear Footage Of Work:
Type of Work: ❑Addition ['Alteration ['New ik Repair/Replace ❑ Demolition
Describe Work: t24ty \� �,r,r� ,II \jqANr
* * ** * ** ** *** * ** * * * * *** ** x * * * * *** * * * * * ** F * *,r** * * * * * * * **** * * *** * * * * * * * **
Submittal Fee $ Permit Fee $ leo Cr CCF $ 0 ' CO /CC $
Training/Education Fee $ 0'D-CO
Notary $
Scanning $ Radon $
0 Violation date:
DPBR $
Permit No.
Master Permit No.
Phone #
Phone #
Zip
Phone #
RECEIVED
DEC 1 4 2009
.......
Technology Fee $ 0
Bond $
Total Fee Now Due $ ( % 6y. (0°
See Reverse side -�
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable) l-3C 5
Mortgage Lender's Address fO Q o ) U ..3 3
City (C S State = A
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
COMIVIENCEMENT 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.
My Commission Expires:
APPROVED BY
Signature Signature
Owner oorlAgent Contractor
The f g g ttuument before me this f 9 The foregoing instrument was acknowledged before me this
day ofl/kali, 20tft by (ei) AJ FCol7 , day of , 20 _, by
who is personally known to me or who has produced CL .1D who is personally known to me or has produced
as identification and who did take an oath.
As identification and who did take an oath.
NOTARY PUBLIC: * * ` o +`'e tl � �� �� NOTARY PUBLIC:
Sign: `� w e,� ':O Sign:
Print: a -- • S • y' • ••••.J = Print:
% - *(0...0
My Commission Expires:
■
CZ °Al
(Revised 07 /I0 /07)(Revised 06/10/2009)
Zip SO 3 ®6
Plans Examiner Zoning
Engineer Clerk checked
OWNER BUILDER DISCLOSURE STATEMENT
NAME: CA.) DATE:a lq.°'S
ADDRESS: ".:)- % SI S 2`1+4r � vve Pc_ 3315U
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 disdosure 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, may act as my own
contractor with certain restrictions even though I do not have a license.
Initi
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.
Initi
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 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.
Initi
4. I understand that I may build or improve a one family or two - family residence or a farm outbuilding. l 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 o cuparrcy. 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.
Initij
5. I understand that, as the owner- builder, I must provide direct, onsite supervision of the construction.
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Infi
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 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. 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.
8. I understand that 1 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. I understand that my failure to follow these may subject to serious financial risk.
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 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.
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 contact the
Florida Construction Industry Licensing Board at 850.487.1395 or http:/ hww. mvfloridalicense .comldbpr /pro/alb/iindex.html
Initi
11. I 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:
- 7 C^ i-s es
12. I agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the information that 1
have provided on this disclosure.
Initia�s )
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 WI 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 1 day of kif//lik 20 £J
By k 1 n/ ,6 G(T1 who was personally known to me or who has
Produced there License or /� as identification.
Initial
Initial, -�—
Initial
Initia
AL / -0era
Q; ia,� \' .4.1 ' Ir.
S. '... % 0 O,,\6y� 'N,
,,, AT �,,rr ilr����`.
Permit No: 09- (
Job Name:
407 , 2009
Norman Bruhn CBO
305 - 795 -2204
Building Critique Sheet
FA 30S -SSA -19
Cbryirrl '4 NR 1212(10C
M iami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 7952204
Fax: (305) 756.8972
Page 1 of 1
Plan review is not complete, when all items above are corrected, we will do a complete plan
review.
If any sheets are voided, remove them from the plans and replace with new revised sheets and
include one set of voided sheets in the re- submittal drawings.
12/21/2009 10:11 FAX 1 800 685 7530 DATA SCAN FIELD SERVICES IJ 002
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECt'ION'S PTIONE NUMBER: (305) 762.4949 r , n
BUILDING Permit No. �LY).0 2 O c 6
PERMIT APPLICATION Master Permit No. RC. - 12 — 09 2(
FBC 20
Permit Type: ELECTRICAL
Owner's Name (Fee Simple Titleholder) aCcI Phone it isolk. Sul_ °2.34
Owner's Address gh _''S' 51
City r _ Ane sWt'5 State >�C Zip WO
5O
Tenant /Lessee Name Phone it
Email
Job Address (where the work is being done) ,..c._
City Miami Shores Village County Miami -Dade Zip
FOLIO / PARCEL #
Is Building Historically Designated YES NO Flood Zone
Contractor's Company Name t..14 — 0 wwcA- o,,, \t,� Phone #
Contractor's Address
City State Zip
Qualifier Name
State Certificate or Registration No. Certificate of Competency No.
Contact Phone E -mail
Architect /E ngineer's Name (if applicable)
Value of Work For this Permit $ 444 Square / Linear Footage Of Work:
Type of Work: ❑Addition ['Alteration [New ❑ Repair /Replace ❑ Demolition
Describe Work: 2e_ure _.14 � me_. a..., c z` '' + ° ..� ciao -V.
VV: C c e t- y k L O i.le e - V 1 64 Lin. WANA " . e ' A,5 e..- 'r.-+Ces ,.
Submittal Fee $
NAt‘
Phone #
Phone
th3rat** ski:+k* tkdr?e* *oF+t*te74a * **ksFs4***dt****4t ** * **dadirk***Xd3r8rdr****** ** t45F3e *tc*dr***
Permit Fee $ 00' G C.CF $ (0'(0O CO /CC s
0°K)
Notary $ a Training/Education Fee $ O Technology Fee $
Scanning S 3 X 00 Radon $ DPER $ Bond $
Double Fee $ /60°° Violation date: �°
Structural Review. $ Total Fee Now Due $ , ``�
See Reverse side -+
12/21/2009 10:11 FAX 1 800 685 7530 DATA SCAN FIELD SERVICES Q003
Bonding 'r.:c3ntj iy's Nanic (if applicable)
Bonding Company's Address
City State
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. 1 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 than all the foregoing information is accurate and that all work wine done in compliance with all
applicable laws regulating constriction 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 ntttst
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
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this 2.2. The foregoing instrument was acknowledged before the this
day of I 20 Cri, by k -i .ii N 1SCCr7 , day of , 20 —, by
who is personally known to me or who has produced who is personally known to Inc or who has produced
as identification and who did take an oath.
As identification and who did take an oath.
\ ��tt►t uutturt // �
ra g SI�V r d
r ,
@
I ites • �'��.
611 p1 •••
▪ C o D 16g90
NOTARY PUBLI
Sign:
Print:
My Commission Expires:
*** dc*** * * * * *** **** * * ***** * ** * ** ** *'fir* **** ** ** * *** *** ****• *** dt' ksl**** h*9:1: 4ts4t+ e*9t& 4r. 4dC********* Jedtvh3t+&tt ****drdrasledcakaYd ***
APPROVED 13Y
(Revised 07 /10 /07)(Revised 06/10/2009)
Ions Examiner
Signature
NOTARY PUBLIC:
Zip
Sign:
Print:
My Commission Expires:
Zoning
Engineer Clerk checked
Inspection Number: INSP- 146006 Permit Number: PL -12 -09 -2062
Scheduled Inspection Date: June 16, 2010
Inspector: Bruhn, Norman
Owner: ESCOTT, KEVIN
Job Address: 78 NW 99 Street
Miami Shores, FL 33150-
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
June 15, 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
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1131010330070
REPLACE PLUMBING FIXTURE/ TUB AND SOME OF THE
GALVANIZED PIPE.
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
Page 11 of 20
Owner's Address 73 {vv cis
City r" ("( SNU@.e_ State rc_.
Tenant/Lessee Name
Email
Job Address (where the work is being done) 'R$ NU 5
Contractor's Company Name
Contractor's Address
City
Contact Phone
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 APPLICATION Master Permit No.
FBC 20
Permit Type: PLUMBING
Owner's Name (Fee Simple Titleholder) Ker:a..3 ts� Phone # go+{...50.1
City Miami Shores Village County Miami -Dade
FOLIO / PARCEL #
Is Building Historically Designated YES
State
NO
E -mail
Zip 33 )SO
Phone #
Phone #
Permit No. I R' P-
Zip 3315
DEC 1 20
se WI X3
Flood Zone
Zip
Qualifier Name Phone #
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name (if applicable) NIA Phone #
_Ltoz, al- IJulg eeliis
r�
Value of Work For this Permit $ Oppy._ � qus are / Linear outage Of Work;
Type of Work: ['Addition ❑Alteration LINew p /Re
\ t� (J� Re p air p lace
❑Demolition
Describe Work: Qep \oee_ p Je• 11 �, k r " 3 °t s u,� cat A 14v0,,,i pee
* * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * ** F * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $ Permit Fee $ /O CCF $,p) CO /CC $
Notary $ Training/Ed cation Fee $ 0' DO Technology Fee $ 0
Scanning $ Radon $ DPBR $ Bond $
Double Fee $ /J 27 ate Violation date:
Structural Review. $
Total Fee Now Due $ 15 ` -lib
See Reverse side
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Na (if applicable) L XX 1�S
Mortgage Lender's Address R tO S3 S
City C
twte-P e5
State
Zip ' S'o3O
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 juridiction. 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 will not be aiproved and a reinspection fee will be charged.
E/2.. ®� p Owner or Agent Cjoi
The foregoing instrument was acknowledged before me this
day of (1t) , 20 (1, by kirlAii N (jL' (-6 11
who is personally known to me or who has produced P L, 11)
Signature
As identification and who did take an oath.
t uN ,1 11 11 i
o
********** **********:" :**" :**************************************************************
g Plu ls E miner
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
(Revised 07 /10 /07)(Revised 06/10/2009)
Engineer
Signature
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:
My Commission Expires:
Zoning
Clerk checked