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EL-9-09-1596Inspection Number: INSP - 147446 Scheduled Inspection Date: March 16, 2011 Inspector: Devaney, Michael Owner: BLOCK BANK, H &R Job Address: 154 NW 111 Street Miami Shores, FL 33168 -4323 Project: <NONE> Contractor: HOME OWNER Building Department Comments March 15, 2011 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 Number: EL -9 -09 -1596 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1121360030450 Re- connect water Heater. Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Page 2 of 35 Scheduled Inspection Date: March 01, 2010 Inspector: Devaney, Michael Owner: BLOCK BANK, H&R Job Address: 154 NW 111 Street Project: <NONE> Miami Shores, FL 33168 -4323 Contractor: HOME OWNER Building Department Comments February 26, 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- 125742 Permit Number: EL -9 -09 -1596 For Inspections please call: (305)762 -4949 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1121360030450 Re- connect water Heater. Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments d�� G PG7'a 72-S 9 lad� 7i rt�/L �o Page 3 of 19 1015 Owner's Address / �` 9 4/L/', // / £7 City . A4 !Q fro / NO veS State Al-- Tenant/Lessee Name Email Contractor's Company Name 7 ', yt PV" Contractor's Address City Qualifier Name Submittal Fee Notary $5. 0 Scanning $J- 0 u Double Fee $ Structural Review. $ 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 ECEIVED SEP2 2009M BUILDING PERMIT APPLICATION ster Permit No. FBC 20 Permit Type: ELI+ CTRICAL / � ^ Owner's Name (Fee Simple Titleholder) (AM G14 G h ;fez Phone # //9'2 - 63 l — .57 Zip Phone # Job Address (where the I ' work is being done) City Miami Shores Village County Miami-Dade Zip 3 (( FOLIO / PARCEL # 11- Z(36 -6©3- o9s'Z Permit No. E L— q —Dq —159 Phone # 39/ 68 Is Building Historically Designated YES NO Flood Zone State Zip Phone # State Certificate or Registration No. Certificate of Competency No. Contact Phone E -mail Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ /00 .00 Square / Linear Footage Of Work: Type of Work: DAddition EAlteration ONew Er Repair/Replace ❑ Demolition Describe Work: !CO i'l lA e ci -f v Rea - ICY. ** s * * * ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** F * * * * * * * * ** *** * * * * * * *** * * * * * * ** Permit Fee $ /� er A CCF $ 6(1) f V CO /CC $ Training/E ation Fee $ :2-0 Technology Fee $ 1,6 v Radon $ DPBR $ V Bond $ , V ✓ iolation date: / .. / Total Fee Now Due $ LO l N V 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 $500, 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. Signature 7 Owner or Agent Contractor The foregoing instrument was acknowledged before me this 09 The foregoing instrument was acknowledged before me this day of e22.9 , 206, by \j % ( in CVO n 1f Z. day of , 20 _ , by C o is personally known to me or who has produced FLi Q ( . who is personally known to me or who has produced as identification and who did take an oath. 0080 As identificatio nd who did take an oath. NOTARY PUBLIC: ? , 004 Sign: Print: My Commission Expires: APPROVED BY (Revised 07 /10 /07)(Revised 06/10/2009) Signature NOTARY PUBLIC: Sign: Print: My Commission Expires: * * * * * * * * * * * * * * * * * * ** * * ** * *4 * * * * * * * A w e * * * * * * * * *** ********* ***** ****** * * * * * * * * * * *** ** * ** * * * * * * * * * * * * J '9 Plans Examiner Zoning Engineer Clerk checked s /t/,W i1I.c1 - Altiot ..(1-(oves ) g3 0 Son zi te z 7trz-631- 6Gre? • • • • • Shores Vii FY APPROVD I IoNVG DEPTI BLDG DEPT SUBJECT TO CC"; STATE A'..D C' • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • LANCE WITH ALL FEDERAL • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • DAIE 16 1/(-71-7 4zzeartg)-4P/1-47 we ; LO Me-4 ( L t/ ytto cioo4,.) OPPer. u, AU. lir) j S q ,t6 W. C`/ 7 ✓� i awl ( a -to v e. ) �j 33c O7 w Sho z jeZ ( ltrz- 63i- 666 r-a ZONING DEPT BLDG DEPT • • Miami Shores Villag: APPROVED BY DATE 3pspP SUBJECT TO COMPLIANCE WITH ALL FEDERAL •••• ... • • •• • • •• . • • • • • . .... . •••• • • • .. • • • .• •• .• ... .. ••• • .. ... •••• ... . • • • • •• •••• STATE AND COUNTY RULES AND REGULATIONS _L • • • • • •••• • ... • •• • • •• • • • • • .... • • •••• Copper A-lu m G�.0 iG1 o DeA4nu4.. L 64 eiLd c1 cj e i t. b Saes Tie-1-44&) wives a 3 k) me-4 („2 L to-el , / fA.0 u. NAME: ADDRESS: VILLAGE OF MIAMI SHORES OWNER BUILDER DISCLOSURE STATEMENT l�1 c*t G®f/1Zt�leZ DATE: 09° L c't W'i . l(I Sf iatetc CHerg �3 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 a permit under an exoeption to the law. The exemption 4llows 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 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 sate or lease, which is a violdtion Of this exemption. You ettay not hire an unlicensed person as it contractor. It is your responsibility to make sure the people employed by you havellccnses required by state law.and by county or municipal licensing ordinances. Any person working on your building who is not licensed tryst work under your supervision and must be employed by you, which means that you must deduct F.LC.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 construction Myself. Initial (� 2. I understand that as an owner- 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) and a new permit will be required. to be issued for reinstatement of the permit, 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 interpret the code. There is a copy of the code in this office for review. Initial ° e 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 structure meets the minimum code. 5. 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 all attorney. The department will not mitigate any contract disputes. Initial J; 6 6. I understand that if I compensate any person or company for work performed they are requited to have 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. 7. I understand that if any person gets injured on my construction project—they 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. 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. Was acknowledged before me this day of By V (C rn &Yre_ctle who was p Y ersonall known to me or who has Produced there License or - See 0 L (0o ? aeaa o � ssra� e �aee�` Initial v Initial U �O r) Initial V ' 20 Q ` as identification.