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PL-7-715Scheduled Inspection Date: March 02, 2011 Inspector: Hernandez, Rafael Owner: PEREZ, ROHANMI Job Address: 28 NW 104 Street Miami Shores, FL 33138- Project: <NONE> Contractor: HOME OWNER Building Department Comments March 01, 2011 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 156412 Permit Number: PL -4 -07 -715 For Inspections please call: (305)762 -4949 Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Sprinkler System Phone Number Parcel Number 1121360131030 SPRINKLEDR SYSTEM INSTALLATION 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- 153954. not ready Page 33 of 44 BUILDING PERMIT APPLICATION FBC 20 Permit Type: PLUMBING OWNER: Name (Fee Simple Titlehol Address: ; W ( c City: E �.. ,r Tenant/Leessee Name: Email: / ` "1 d � t / JOB ADDRESS: • �� hCl Or 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 / State: I C Permit No. Master Permit No. „ Phone #: 2` (() Zip: / Phone #: City: Miami Shores County: Miami Dade Zip: 3 d � Folio/Parcel #: I I - ,2,13(r -. ! / _ IC l�.l Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: Phone #: Address: City: State: Zip: Qualifier Name: Phone #: State Certification or Registration #: Certificate of Competency #: Contact Phone #: Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: DAddress ❑Alteration New ❑Repair/Replace ❑Demolition Description of Work: Submittal Fee $ Permit Fee $ CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 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 sev ) days after the building permit is issued. In the absence of such posted notice, the inspection will not be appr and a reinspion fee will be charged. Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this L The foregoing instrument was acknowledged before me this day of -C 4::r_, b t , 20 ii IL' , by -1.),\ i.-Y t t f - day of , 20 _, by who is personally known to me or who has produced who who is personally known to me or who has produced 7 As identification and who did take an oath. as identification and who did take an oath. NO _ RY PUBLIC: ) NOTARY PUBLIC: Sign: . t-42 _ ®yC �T' � PUBLIC • STATE OF FLORIDA Sign: M Gomez Print: ,'T� 61 Print: My Co d missio /Expires: � ires: JAN. 16, 2011 My Commission Expires: BONDER TILED ATLANTIC BONDING CO., INC. APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Signature Scheduled Inspection Date: April 21, 2010 Inspector: Hernandez, Rafael Owner: ARTEAGA, KARLA Job Address: 28 NW 104 Street Miami Shores, FL 33138- Project: <NONE> Contractor: HOME OWNER Building Department Comments April 20, 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 -45954 Permit Number: PL -4 -07 -715 For Inspections please call: (305)762 -4949 Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Sprinkler System Phone Number Parcel Number 1121360131030 Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Page 30 of 30 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 N Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING . /CrlIA Permit No. PL 1- 115 PERMIT APPLICATION Master Permit No. FBC 2004 Permit Type: Plumbing Owner's Name (Fee Simple Titleholder) VIA A Owner sAddress ) (R) ' QL'1 � r (u / rn t 1 GY.J State Fi Ovi e 61 City City FOLIO / PARCEL # Miami Shores Village Is Building Historically Designated YES NO Contractor's Company Name Pis Cpriii1r Contractor's Address City State Qualifier Name rea Tenant /Lessee Name E -MAIL: l`. '.Q- cL CrNr1 Job Address (where the work is being done) Phone # Architect /Engineer's Name (if applicable) Phone # Zip J '1� / Phone # County Miami -Dade Zip State Certificate or Registration No. Certificate of Competency No. E -MAIL: 3pc c 2(P q Oq q Phone # 3 O 3L4 C 3 Zip Phone # Value of Work For this Permit $ 1 ( DO Square / Linear Footage Of Work: Type of Work: ❑Addition ❑Alteration ['New l[Of Repair/Replace I=1 Demolition Describe Work: Sp)/ r) tfe/i3 ************* WWWWW********************* Feesxx xxxrxrxx** X **W* *** * *** ***** *** ** **** * * * *** Submittal Fee $ Permit Fee $ J 6 0 CCF $ P O CO /CC Notary $ 'CO Training /Education Fee $ 0•750 Technology Fee $ 400 Scanning $ 3 Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ 17 19 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. 1 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: 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. "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 ith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is ubject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspec ion which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not e a and a reinspection fee will be charged. Signature Contractor The foregoing instrument was acknowledged before me this 12 The foregoing instrument was acknowledged before me this , 20 _, by day of 1 1 , 20 0 ' 7, by inlet rxrlrt4 !(V1at« , day of who is personally known to me or who has produced_ y.iL/L who is personally known to me or who has produced 5/1 4 As identification and who did take an . as identification and who did take an oath. NOTARY PUBLIC: 9 ' NOTARY PUBLIC: p e �2.`Z� i ��ec5 Sign: r � � . �,�� "'• Sign: �\ ` . Print: ®�'(< Print: My Commission Expires: I My Commission Expires: * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ** * ** ** ******* ***** * ** * ***** ** ** * *rxxxx* *** ** ** * * * * **www* **ww *xxxxrx APPLICATION APPROVED BY: i"� 0 Plans Examiner ' ‘flir 11 • . Engineer Zoning (Revised 02/08/06) or Agent Signature • ITEM UNIT FEE ITEM UNIT FEE ITEM UNIT FEE BATH TUB SWITCH OUTLETS SPACE HEATERS DISHWASHER LIGHT OUTLETS CENTRAL HEATING DISPOSAL RECEPTACLES A/C (WIND) FLOOR DRAIN SERVICE TEMPORARY NC (CENTRAL) GREASE TRAP SERVICE SIZE IN AMPS DUCT WORK INTERCEPTOR SERVICE REPAIR/METER CHANGE REFRIGERATION LAVATORY APPLIANCE OUTLETS PROCESS AND PRESS PIPING LAUNDRY TRAY RANGE TOP UNDERGROUND TANKS CLOTHES WASHER OVEN ABOVE GROUND TANKS SHOWER WATER HEATER U.F. PRESSURE VESSELS SINK. POT /3 COMP. MOTORS 0 -1 HP STEAM BOILERS SINK, RESIDENCE. MOTORS OVER 1 -3 HP HOT WATER BOILERS SINK, SLOP. MOTORS OVER 3-5 HP MECHANICAL VENTILATION TEMPORARY WATER CLOSET MOTORS OVER 5-8 HP TRANSPORTING ASSEMBLIES URINAL MOTORS OVER 8 -10 HP ELEVATORS /ESCALATORS WATER CLOSET MOTORS OVER 10 -25 HP FIRE SPRINKLER SYSTEMS INDIRECT WASTES MOTORS OVER 25 -100 HP COOLING TOWERS WATER SUPPLY TO: MOTORS OVER 100 HP VIOLATION NC UNIT NC WINDOW REINSPECTION FIRE SPRINKLER AIR CONDITIONERS HEATER -NEW INST. STRIP HEATER HEATER - REPLACE GENERATORS TRANSFORMERS _- • LAWN SPRINKLER -WELL GENERATORS TRANSFORMERS .. SWIMMING POOL GENERATORS TRANSFORMERS WATER SERVICE SPECIAL PURPOSE SEWER CONNECTIONS OUTLETS COMMERCIAL UTILITY -SEWER SIGN TUBES • UTILITY -WATER SIGN TRANSFORMERS SEPTIC TANK SIGN TIME CLOCK RELAY FIXTURES FAINFIELD, 4" TILE/RES. ANTENNA PUMP & ABANDON SEPTIC TANK TELEVISION OUTLETS .■ SOAKAGE PIT CU. FT. VIOLATION CATCH BASIN REINSPECTION . DISCHARGE WELL DOMESTIC WELL DRAIN '. ROOF INLET ■ �� SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) • GAS PIPING . PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS. PLEASE CIRCLE 0 DISCIPLINE APPLIED FOR: ELECTRICAL PERMIT # MECHANICAL VILLAGE OF MIAMI SHORES OWNER BUILDER DISCLOSURE STATEMENT NAME: ? 1ict. R , kfea DATE: ADDRESS: ° 242 PV W ID u S aLaMt 33/S 6 D6 hereby petition the Village of Miami Shores toast 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 Orr 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 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 underyour supervision and must be employed by you, which means thatyou nnust 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 hold title to the above property and I am planning on doing this cons i tion Initial 2. I understand that as ati owner - builder I must abide by all zoning ord' ances and building regulations in effect at.the time of permit application Initial • 3. :I have an understanding of the 2004 FBC & FRC and understand that this department and its inspectors are there to help enforce and interpr t the code. There is a copy of the code in this office for review. Initial 4. I understand that the building official and inspectors are not there to design, alter or give advice on how to meet code - only if the struc e me=ts the minimum code. Initial Was acknowledged before me this day of %Y(Q 4,4 By 5. I understand that as an owner - builder, that any contractor dispute contractors and myself must be handled in a civil court with the attorney. The department will not mitigate any contract disputes. 6. I understand that if I compensate any person or company for work performed they are required to have a business license in the county. Iffor 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. 7. ' I. .understand that if any person gets injured on my construction project — y are entitled to workmen's compensation. And if they do not posses a workmen's policy I could be held liable for all doctor and related cost which could include loss of wages during recovery from injury. Initial Initial Initial with sub - vice of an 8. I understand that under state and local laws I can not do any Electrical, Plumbing, Heating, Air & Roof work on my with out first obtaining the proper permits by licensed contractors. who was personally known to me or who has as identification. `� MY COMMISSION # DD 09 2009 EXPIRE Notary Pbubr20n dermitem