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)