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RC-09-1778 X131 NlE Miami Shores Village w Pext TXpe Rild:l�il I�tt[II# , 10050 N.E. 2nd Avenue WW" k "• Miami Shores, FL 33138-0000,. 4 ` Phone: (305)795 -2204 " f?X F � WKU �. n , Expiration: 5101 010 Project Address Parcel Number Applicant 169 110 Street 1121360030510 RUTH & ALFREDO MORALES i Miami Shores, FL 33161 Block: Lot: Owner Information Address Phone Cell RUTH & ALFREDO MORALES 169 110 Street MIAMI SHORES FL 33168 -4320 Contractor(s) Phone Cell Phone Valuation: $ 2, 000.00 ..,_.. Total Sq Feet: 135 Approved: In Review For Inspections please call: Comments: (305)762 -4949 Date Approved:: In Review Available Inspections: Date Denied: Inspection Type: Type of Construction: Occupancy: Final Stories: Exterior. Front Setback: Rear Setback: Left Setback: Right Setback: Bedrooms: Bathrooms: Plans Submitted: Certificate Status: Certificate Date: Additional Info: Bond Return: Classification: Residential Fees Due Amount Invoice # Total Amt Paid Amt Due CCF $1.20 RC -10 -09 -36253 $ 158.35 $ 158.35 Education Surcharge $0.40 $ �'�� Permit Fee - Additions/Alterations $150.00 Check #: 747 Permit Technology Fee $3.75 Scanning Fee $3.00 Total: $158.35 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. November 02, 2009 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy November 02, 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 RE u u, � Permit No. --�, — 7 78 PERMIT APPLICATIO 0 2 8 ' OQ9 aster Permit No. FBC 20 raror� s+ Permit Type BUILDING ROOFING- Owner's Name (Fee Simple Titleholder) Q hone., Owner's Address City 8 nn�� � �...� State Zip 5 6 Tenant/Lessee, Name r (4 • .Phone # Z Email Job Address (where the work is being done) C4 N \kf 110 41' ` City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES NO Flood Zone r i Contractor's Company Name t �P, yL G& 1 :1A A , Phone # 2—T Contractor's Address City State Zip Qualifier Name Phone # State Certificate or Registration No. Certificate of Competency No. - Contact Phone E -maff Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ U� Square / Linear Footage Of Work: ' Type of Work: ❑Addition []Alteration [)New air✓Repkace ❑ Demolition D scribe Work. a Submittal Fee $ Permit Fee $ �� CCF $ Notary $ Training/Education Fee $ Technology Fee $ J - Scanning $ Radon $ DPBR $ Bond $ Doable Fee $ Violation date: Structural Review. $ Total Fee Now Due $ 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 will not approved and a reinspection fee will be charged.. Signature Signature Owner or Agent Contractor lip The fore oing instrument was acknowledged before me thi The foregoing instrument was acknowledged before me this day of , 200 by IZ( 144/1 , �( day of , 20 _, by who, is personally known who has produced R who is personally known to me or "who has produced ' o d who did take an oath. as identification and who did take an oath NOTARY PUBLIC., NOTARY PUBLIC: I jq i A A Sign Sign: Print: Print: My Commission Expires: /► My Commission Expires: APPROVED BY �O •�� - Plans Examiner zoning Engineer Clerk checked (Revised 07 /10 /07)(Revised 06/10/2009) rn �F L L Ci cr L j A• 0 : 0 . rn �F L L Ci cr L j VILLAGE OF MIAM OWNER BUILDER DISCLOSURE TATEMENT NAME: C. .DATE: !/ Z 1i7 . ADDRESS: �(7 � IV t/lf � (/ 0 k- Do hereby petition the Village of Miami Shores to act as myown 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 pontractor. You have applied for a permit under an exoeption to the law. The exemption 4111 s you, as the owner of your property, your own eoi►traotor to act as 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 commeroial 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 for sale or lease, which is s violation bf this exemptimtt. You may not hire an unlicensed person as k contractor. It is your responsibility to make sure the people employed by you halve licensee required by state law•and. by county or mtudgipal licensing ordinances. Any person working on your building who is not licensed ttiyst' work under your supervision and must be employed by'you, which means that you must dedtict F.L•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 rogd and initial each paragraph. L I hold. title to the above property and I am planning on doing this construction Myself. Initial 2. I understand that as an oWnpr- 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) x and a new permit will be required. to be issued for reins permit, tatement of the Initial g WL 3. I 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 4. I understand that the building official and inspectors 'are not there to -des ign, alter or give advice on how to meet code — only if the structure meets' the minimum code. Initial S. I 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 M 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 required to live 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. Initial T. I under`staA& that if any person gets injured on my construction project they are ent[tl•ed to workman's compensation. And Ilk they do not posses a workmen's policy I could be held liable for all doctor and related cost which could include kiss of wages during recovery from injury. Initial • 8. I 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 C Was acknowledged before me this ._ ;day of AJ , 20 By �(�,- L��a1C� who was personally known to me or who has Produced there License or 1 ' Q L as identification. Ank e OWNER Y . o I d Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 nspection Number: INSP- 128036 Permit Number: RC -10 -09 -1778 Inspection Date: November 19, 2009 Permit Type: Residential Construction Inspector: Bruhn, Norman Inspection Type: Final Owner: MORALES, RUTH & ALFREDO Work Classification: Repair Job Address: 169 NW 110 Street Miami Shores, FL 33161- Phone Number Parcel Number 1121360030510 Project: <NONE> Contractor: Building Department Comments Repair drywall and insulate bedroom. Inspector Comments Passed Failed Correction Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. For Inspections please call: (305)762 -4949 November 19, 2009 Page 1 of 1 O ®l Miami Shores Village P r y Etfttj 10050 N.E. 2nd Avenue �oCItGONAt#tl l ab , l";.; Miami Shores, FL 33138 -0000 r M Phone: (305)795 -2204 �R u Expiration: 04/1412010 Project Address Parcel Number Applicant 169 110 Street _ 1121360030510 RUTH 8 ALFREDO MORALES Mia Shores, FL 33161- Block: Lot: Owner Inform Address Phone Cell RUTH & ALFREDO MORALES 169 110 Street MIAMI SHORES FL 33168 -4320 Contractor(s) Phone Cell Phone Valuation: $ 1,500.00 HOME OWNER ; - Total Sq Feet: 100 Type of Work: ELECTRICAL For Inspections please call: Additional Info: RE -WIRE (305)762 -4949 Classification: Residential Available Inspections: Inspection Type: Underground Rough Final Meter Box Alteration Relocation Fire Alarm Service Change W. W. Fees Due Amount Invoice # Total Amt Paid Amt Due CCF $ EL -10-09 -36163 $ 168.60 $ 168.60 $ 0.00 Education Surcharge $0.40 Permit Fee - Additions/Alterations $160.00 Scanning Fee $3.00 Submittal Fee $0.00 Submittal Fee $0.00 Submittal Reversal Fee $0.00 Technology Fee $4.00 Total: $168.60 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 October 16, 2009 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Cop October 16, 2009 1 H P 6 Miami Shores Village 10050 N.E. 2nd Avenue �e��� 3 3HP IYfi W» J Miami Shores, FL 33138 -0000 AF F " AP Phone: (305)795 -2204 ,. xpir .� E ation: 04/18/201 Project Address Parcel Number Applicant 169 110 Street 1121360030510 Miami Shores, FL 33161 Block: Lot: RUTH & ALFREDO MORALES Owner Information Address Phone Cell RUTH & ALFREDO MORALES 169 110 Street MIAMI SHORES FL 33168 -4320 Contractor(s) Phone Cell Phone Valuation: $ 1,500.00 James Electric Inc. (954)652 -9532 HOMEOWNER Total Sq Feet: 100 Type of Work: ELECTRICAL For Inspections please call: Additional Info: RE -WIRE (305)762 -4949 Classification: Residential Available Inspections: Inspection Type: Final Meter Box Alteration Relocation Fire Alarm Service Change Underground Rough W. W. Fees Due' Amount Invoice # Total Amt Paid Amt Due CCF $1.20 EL -10-09 -36163 $ 168.60 $ 168.60 $ 0.00 Education Surcharge $0.40 Permit Fee - Additions/Alterations $160.00 Permit Technology Fee $4• EL - 11 - 09 - 36284 $ 100.00 $ 100.00 $ 0.00 Revision Fee $100.00 Scanning Fee $3.00 Check #: 747 Submittal Fee $0.00 Submittal Fee $0.00 Submittal Reversal Fee $0.00 Total: $268.60 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. November 02, 2009 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy November 02, 2009 1 ; CEI V _ Miami Shores Village C Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSP ,CTION'S PHONE NUMBER: .(305). 762.4949 t BUILDING;< Permit Ivor PERMIT APPLICAT ," T; - Permit No L— FBC 20 i Permit Type: ELECTRICAL Owner's Name (Fee Simple Titleholder) IA�" tAQ �cr 1 %Q Phone # - I.9 (o - 2- TS - Owner's Address (� q _N UJ I I ® jin � City (qAA6,4 State C, Zip 3 6 Sn Tenant/Lessee Name Phone # Email Job Address (where the work is being done) N \A ) - City Miami Shores Villaee County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES NO Flood Zone Contractor's Company Name 5 26 4 " . Phone r�� . f:��� Contractor's Address '" Ci State ��V Zip Qualifier Name �(' �-I Phone # State Certificate or Regisir n No. certificate of Competency No. 6 Contact Phone / E -mail Architect/Engineer's Name (if applicable) Phone # i Value of Work For this Permit $ Square / Linear Footage Of Work: 1 50b Type of Work: ❑Addition ❑Alteration ❑N--k ew ❑ Repair/Replace ❑ Demolition Describe Work: L4-- 2 -o ' C..5k C,a Submittal Fee $ Permit Fee $ ' v ® ®�'�® CCF $ j CO /CC $ Notary $ Training/Education Fee $ Technology Fee $ Scanning $ Radon $ DPBR $ Bond $ Double Fee $ Violation date: Structural Review. $ Total Fee Now Due $ 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 CONDITIOivERS, 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. � P M � Signature F ��'wl —��- // � / Signature Owner or Agent C The foregoing instrument was ac wledged�b me this 2 The foregoin trument edged before me this day of"". , 20 OR by � 11 1 Cf0 11P S , day of , 20 �9, by who is personally known to me or who has produced who is personally known to me or who has duced [, As identification and who did take an oath. — as identification and who did take th. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: A/)" Print: ` �' 9 Print: My Commission Expires: ' O, 6 C My Commission Expires: ° �O �p APPROVED BY d09-1'Plans Examiner Zoning Engineer Clerk checked (Revised 07 /10 /07)(Revised 06/10/2009)